The interaction between cancer and coronavirus disease 2019 (COVID-19) poses significant challenges, particularly for immunocompromised individuals who are at heightened risk for acute infections and long-term complications. The pandemic has exacerbated existing vulnerabilities in cancer care by disrupting treatment protocols and delaying diagnoses, leading to worsened health outcomes. This article emphasizes the importance of investigating the potential impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on cancer progression and highlights the need for effective strategies to protect this high-risk population. Long-term health consequences, including the emergence of long COVID, further emphasize the need for ongoing surveillance and comprehensive healthcare planning for cancer patients during and after pandemics. A multifaceted approach is essential, incorporating vaccination, timely therapeutic interventions, and sustained support for patients with lingering symptoms. This article also discusses and urges continued research into the oncogenic risks associated with SARS-CoV-2, which is crucial for enhancing our understanding of the broader health implications of COVID-19 and for informing public health strategies aimed at safeguarding cancer patients in future pandemics. Moreover, effective data collection and the development of refined clinical guidelines are vital for improving patient outcomes and preparing healthcare systems to support cancer patients during crises. Additionally, this article discusses the importance of investigating the mechanisms by which SARS-CoV-2 may increase cancer susceptibility, including chronic inflammation, cellular senescence, and immune dysregulation. Understanding these mechanisms is crucial for elucidating the virus’s long-term oncogenic potential, particularly among cancer survivors and individuals with chronic infections. Ensuring continuity and resilience in cancer care during global crises requires strategies to mitigate healthcare disruptions, enhance access to screenings and treatments, and address the specific challenges faced by cancer patients experiencing long COVID.

We report a rare case of a female patient with multiple rheumatological conditions. The patient initially presented with periodic, diffuse abdominal pain. This complaint was not fully investigated because polyarthritic symptoms became the predominant ones. This led to the diagnosis of rheumatoid arthritis. Afterward, the patient complained of xerostomia, xerophthalmia, and diffuse rash. After investigations, she was diagnosed with Sjögren’s syndrome. Suspecting a case of methotrexate-induced vasculitis, her initial prescription was changed to azathioprine and then to etanercept. Eventually, her persistent abdominal pain, combined with her Armenian origin, prompted her physician to order a genetic analysis of the MEFV gene, which revealed the V726A/P369S mutation, giving rise to the diagnosis of Familial Mediterranean Fever. In her routine follow-up, the patient was in a stable condition, adherent to the medications, and showed improvement in her symptoms. Therefore, this case shows the importance of early genetic testing in similar cases, which in turn will allow timely diagnosis and treatment.

Breath analysis is a relatively new topic of study that has a lot of potential for both therapeutic and scientific applications. The volatile organic compounds (VOCs) found in breath are created internally by the body due to environmental interactions, gut and air passage bacteria, and metabolites of ingested precursors. Breath analysis may help diagnose disorders linked to changes in breath composition, according to several recent research. An analytical technique that shows promise for the metabolic examination of breath is infrared spectroscopy. Chemical substances found in exhaled human breath can be used to diagnose illnesses, determine physiological states, or evaluate environmental exposure. Exhaled breath (EB) is the perfect biological fluid because it is nearly limitless and causes little to no discomfort for the patient, which promotes collaboration. Furthermore, EB can be sampled without requiring medical professionals or privacy, and it usually doesn’t produce infectious waste (despite airborne infections), which makes breath analysis a desirable method for a variety of applications. Breath analysis is a non-invasive method that solely uses the volatile composition of the EB to characterize the bloodstream and airways’ volatile content, which indicates the state and condition of the entire body’s metabolism. The absorption strength of the metabolites is still very modest, though, because EB contains minimal amounts of them. Several of the most recent uses of infrared spectroscopy for breath analysis, published between 2020 and 2024, are presented in this study.

Vanishing bile duct syndrome (VBDS) is a rare condition, representing approximately 0.5% of small bile duct diseases, characterized by progressive destruction of intrahepatic bile ducts, leading to ductopenia. This condition encompasses various etiologies, with drug-induced VBDS (D-VBDS) accounting for 7% of VBDS cases. D-VBDS arises from liver injury due to chemical drugs, traditional medicines, and dietary supplements, often resulting in inflammatory responses and necrosis of bile duct epithelium. Recent years have seen a rise in reported cases, making drug-related injuries a leading cause of acute liver failure in Western countries. This review provides a comprehensive analysis of VBDS, focusing on the histopathological features of acute and chronic D-VBDS, alongside exploring its clinical presentation, prognostic implications, and future research directions. Understanding the diverse etiologies, clinical manifestations, and biochemical parameters associated with D-VBDS is essential for improving diagnosis, treatment strategies, and patient outcomes.

The global epidemic of hypertension remains largely uncontrolled and is a leading contributor to noncommunicable disease deaths worldwide. Failure to detect and to adequately treat hypertension is the largest contributor to uncontrolled hypertension. Yet, suboptimal adherence, which includes failure to initiate a prescription for antihypertensive pharmacotherapy, to take medications as often as prescribed, and to persist on pharmacotherapy long-term, is a well-recognized factor contributing to uncontrolled hypertension. A large body of research has identified several variables including patient, sociodemographic, comorbid medical and behavioral conditions, therapy-related, healthcare team, and are associated with nonadherence. Unfortunately, these factors individually and even in combination are typically only weakly related to adherence of individual patients. A two-fold strategy can be efficiently applied in the clinical setting to improve adherence. First, address major categories of adherence throughout the therapeutic journey for all patients from initiation of pharmacotherapy to titration, and maintenance. Efficient, scalable strategies in this category include teach back, clarity on treatment goals including the blood pressure range required to attain consistent control, initiation, and titration of single-pill antihypertensive combinations, limiting out-of-pocket expense, and refill consolidation. Second, objectively assess adherence when treatment goals are not attained with effective pharmacotherapy. Then, identify and address patient-specific barriers for individuals with suboptimal adherence. Given the multiple competing priorities and resultant time demands on clinicians and healthcare teams, effective, replicable, and scalable strategies to optimize adherence are important in attaining the evidence-based benefits of antihypertensive pharmacotherapy.

The advent of immunotherapy has revolutionized the therapeutic landscape of breast cancer. The immune checkpoint inhibitor drug, pembrolizumab, a monoclonal antibody targeting programmed cell death protein 1 (PD-1), was recently approved by the Food and Drug Administration (FDA) as a neoadjuvant treatment in combination with traditional chemotherapy in locally advanced triple-negative breast cancer (LA-TNBC). This manuscript aims to highlight an uncommon adverse event of immune checkpoint inhibitors (ICIs): hypereosinophilia (HE). Herein, we report the case of AW, a 49-year-old female patient, who was treated for triple-negative breast cancer (TNBC) with pembrolizumab, achieving a complete response. After undergoing surgery, pembrolizumab was reintroduced as adjuvant therapy, at which point an abnormal increase in eosinophil count was observed. Hence, treatment was interrupted, and after glucocorticoid administration, the eosinophil count reverted to normality. Our findings underscore the necessity for vigilant monitoring of blood eosinophil levels during pembrolizumab therapy and provide insights into the management of such immunotherapy-related adverse events.

Esketamine, the S-enantiomer of ketamine, has gained prominence as an adjunct in pain management during general anesthesia due to its higher potency and ability to achieve therapeutic effects at lower doses than ketamine. While its benefits for pain relief and mental health are well-established, the specific effects of esketamine on cardiac function during anesthesia remain under investigation. Anesthesia itself induces physiological changes in the cardiovascular system, and esketamine can exacerbate these effects by increasing sympathetic activity, heart rate, blood pressure, and cardiac output. Additionally, it can induce peripheral vasoconstriction, raising systemic vascular resistance. These cardiovascular effects are particularly concerning in patients with pre-existing heart conditions, underscoring the importance of preoperative assessment, continuous monitoring, and potential dose adjustments. This review examined the hemodynamic effects of esketamine, the associated cardiovascular risks, and the clinical implications for patients with cardiac conditions, offering recommendations for its safe use in anesthesia.

Cervical cancer is the fourth leading cause of cancer-related deaths among women worldwide, causing over 660,000 new cases and 350,000 deaths in 2022, with a disproportionately high burden in low-resource countries where access to treatment is limited. Human papillomavirus (HPV) is a common sexually transmitted infection that accounts for approximately 95% of cervical cancer cases. Persistent HPV infection can progress to cervical dysplasia, categorized into varying severities (CIN1, CIN2, and CIN3), which significantly increases cancer risk. The mechanism of HPV-induced malignancy involves the disruption of cellular apoptosis by integrating viral genetic material into cervical cells, particularly within the transformation zone. The viral proteins E6 and E7 play pivotal roles in cervical carcinogenesis by inhibiting tumor suppressor proteins, promoting uncontrolled cell proliferation, and evading immune responses, ultimately driving progression toward malignancy. Timely detection and intervention are essential for managing HPV-related cervical cancers. Preventative measures such as HPV vaccination have demonstrated substantial efficacy. Six vaccines targeting high-risk (HR) HPV strains are recommended before sexual activity or exposure. Despite these advancements, barriers, such as misinformation, logistical challenges, and limited healthcare infrastructure, persist, particularly in underserved regions. Advances in diagnostic and therapeutic technologies have offered new avenues for addressing these challenges. Next-generation sequencing and CRISPR gene editing are emerging as promising tools for HPV-related cancer treatment that enable precise and targeted interventions. Furthermore, artificial intelligence (AI) and imaging innovations have significantly enhanced diagnostic accuracy and personalized care. Pap smears and HPV DNA testing are indispensable tools for early detection. To tackle HPV-related cervical cancer globally, a multifaceted approach is required. Public health education, vaccination programs, research, and international collaboration are crucial. Public health campaigns should combat misinformation, strengthen vaccination programs, and focus on novel therapies, screening technologies, and next-generation sequencing.

This review explored the physiological mechanisms underlying arginine vasopressin deficiency (AVP-D, formerly central diabetes insipidus) and AVP resistance (AVP-R, formerly nephrogenic diabetes insipidus), with a focus on water balance regulation. Vital components include the hypothalamic-pituitary-AVP axis, renal AVP responsiveness, and neural mechanisms of thirst regulation. Recent insights on thirst generation within circumventricular brain nuclei (subfornical organ, median preoptic nucleus, and organum vasculosum of the lamina terminalis) are discussed, along with the diagnostic utility of copeptin in polyuric states. This review highlighted the critical role of hypothalamic-pituitary integrity and renal AVP responsiveness in maintaining water-electrolyte homeostasis. Understanding these mechanisms provided the foundation for optimizing therapeutic strategies and advancing research on AVP-related disorders.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is an emerging and rapidly growing health problem that currently affects more than one-third of the world general population and more than two-thirds of patients with obesity or type 2 diabetes. MASLD is associated with one or more cardio-metabolic risk factors (CMRFs) that determine the complexity of its natural history and management. Although the term MASLD encompasses a single disease, each CMRF has a different impact on MASLD, and the number of overlapping CMRFs results in a different rate of progression and outcomes of both liver and systemic disease. Its pathogenesis is characterized by insulin resistance, lipotoxicity and a complex cross-talk between liver, adipose tissue, muscle, intestine through the release of hepatokines, cytokines, myokines and inflammatory products. The stage of liver fibrosis is the best predictor of liver outcomes, such as liver failure and mortality, and also predicts the high risk of all-cause mortality associated with the disease. In many cases, the development of hepatocellular carcinoma (HCC) is associated with advanced fibrosis or cirrhosis, although it can occur at all stages of the disease, making prevention difficult. MASLD is characterized by increasing very low-density lipoprotein (VLDL) secretion and chronic low-grade systemic inflammation, which increase the risk of cardio-vascular, renal, and endocrine diseases and extrahepatic cancer. Thus, the management of MASLD requires a holistic approach and treatment of CMRFs through multispecialty collaboration. Currently, diet and physical activity are the effective first-line approaches. There are no approved drugs for the treatment of MASLD, apart from resmetirom, which in a percentage of cases improves metabolic dysfunction-associated steatohepatitis (MASH) and fibrosis. We summarize the wide and varied recent literature on the complex etiopathogenetic, clinical and therapeutic aspects of MASLD, connecting and interpreting it to facilitate clinical and management approaches.

Chronic pain, affecting approximately 30.3% of adults worldwide, presents a significant global health issue, severely impacting individuals’ quality of life and creating substantial socioeconomic challenges. Traditional pain management methods, such as physical therapy and pharmacological treatments, primarily focus on the biological aspects of pain while often neglecting the psychological and social factors. However, recent advancements in neuroscience have revealed that chronic pain is influenced by changes in the central nervous system, including mechanisms like central sensitization and neuroplasticity. This paper examines contemporary neuroscience-informed interventions, including Pain Neuroscience Education (PNE), mindfulness practices, and cognitive functional therapy (CFT), which target these neurobiological changes to improve pain perception and behaviors. These interventions help rewire the brain’s pain pathways, promoting long-term pain relief and functional recovery. Additionally, combining neuroscience-based approaches with conventional therapies has been shown to enhance treatment outcomes. This work emphasizes the need for personalized approaches and the integration of emerging technologies to enhance the accessibility and effectiveness of chronic pain management.

Team-based care is a patient management strategy involving a team of at least two healthcare professionals working collaboratively toward a shared clinical goal. This approach is now increasingly recommended by international hypertension guidelines mainly to improve medication adherence and hence, blood pressure control. The goal of this paper was to review the most recent evidence on the benefits of a team-based care approach in the management of hypertension. The results show that in recent years, numerous controlled clinical trials have demonstrated the efficacy of this strategy to lower blood pressure, achieve blood pressure targets more rapidly, and obtain more hypertensive patients under control. These improvements are due essentially to two factors: improved drug adherence/persistence and a reduction of therapeutic inertia. Best results are obtained when physicians collaborate with pharmacists and/or nurses, but other healthcare professionals may be involved successfully as well. Recent data have also demonstrated that the team-based care approach is cost-effective. These observations should be a strong incentive for hypertension centers to engage in the development of a team-based care strategy.

The International Agency for Research on Cancer (IARC) Monographs Programme plays an important role in cancer prevention by identifying potential carcinogenic hazards. However, the terminology used in IARC’s classifications and Monographs can confuse the public, health professionals, and policymakers. Terms like “carcinogenic to humans” imply causation, although classifications only indicate increased risk under certain conditions. For example, the lifetime incidence of mesothelioma among firefighters is approximately 14 in 10,000, compared to 7 in 10,000 in the general population. Despite doubling the risk, occupational exposure as a firefighter does not cause this type of cancer in 9,986 out of 10,000 firefighters. However, the IARC concludes that “occupational exposure as a firefighter causes mesothelioma” (IARC Working Group on the Identification of Carcinogenic Hazards to Humans. Occupational Exposure as a Firefighter. Lyon: IARC; 2023. pp. 1–730. PMID: 37963216). In addition, the lack of essential information about dosage and context in the IARC carcinogen lists can lead to agents with health benefits under certain conditions (e.g., solar radiation, red meat consumption, approved drugs) being perceived as universally harmful, discouraging beneficial exposures, behaviors, or treatments. Here, I propose renaming the groups of agents classified by the IARC and adding basic labels to specific agents to improve the accuracy and interpretability of the IARC classification lists. These adjustments do not interfere with the IARC’s objective of identifying potential hazards, are easy to implement, and enhance accuracy and clarity, providing stronger support to guide cancer prevention strategies.

Regenerating gene (Reg) was first isolated in 1988 and proposed to be specifically expressed in rat regenerating pancreatic islets. Since then, many genes homologous to Reg have been discovered in other species, including humans, mice, hamsters, rabbits, sheep, dogs, cats, pigs, giant pandas, chickens, and frogs. Moreover, Reg and its related genes (Reg family genes) have been classified as types I, II, III, and IV. They are closely associated with cell and tissue regeneration, cell proliferation, and anti-apoptosis in various tissues and cells including pancreatic β cells. In particular, focusing on the digestive organs and tissues, there have been reports that they play important roles not only in stomach, colon, liver, and pancreatic duct cancer, but also in intestinal epithelial cells, especially inflammatory bowel diseases (IBD), such as Crohn’s disease (CD) and ulcerative colitis (UC). This review describes and discusses the expression of Reg family genes in intestinal epithelial cells of those affected by IBD and the molecular mechanisms underlying this expression.

Systemic hypertension, a significant global health issue and a leading risk factor for cardiovascular mortality affects half of the adult population, with increasing prevalence notably in low- and middle-income countries. Despite advancements in diagnosis and treatment, only one in four individuals with hypertension achieve satisfactory control over their condition. Medication adherence, critical for effective hypertension management, is complex and multifaceted. Non-adherence, encompassing late or non-initiation, sub-optimal implementation, and early discontinuation of treatment, is prevalent worldwide, with reported rates of anti-hypertensive medication non-adherence ranging from 30% to 40%. Adherence is influenced by various factors including drug regimen complexity, patient education, and socioeconomic status. Poor adherence is linked to increased cardiovascular risks and is compounded by clinical inertia among physicians. Addressing barriers to adherence and implementing evidence-based interventions can significantly reduce the global burden of hypertension and its associated complications. This review highlighted the critical need for improved adherence strategies to enhance hypertension management. It focused on novel tools such as mobile health interventions and regimen-simplification through single-pill combinations, which can improve treatment persistence and blood pressure control.

The Age-Friendly Health System movement has been a unifying factor in caring for older adults at the University of Utah Health. Despite progress, challenges to efficient healthcare collaboration exist, particularly between geriatric primary care and oral health. This manuscript presents four of those challenges (lack of communication between medical and dental providers, the distance between medical and dental services, patient discomfort with the inclusion of oral health in primary health care, and provider discomfort in requesting oral health information in medical encounters) with the solutions derived at the University of Utah Health. Leaders at University of Utah Health developed five interventions to address these challenges (participation in the development of EPIC Wisdom^©, a fully integrated oral health record in the electronic health record (EHR), co-location in new centers and oral health consultation in existing centers, implementing a geriatric health assessment that included oral health, widespread adoption of the 4 Ms framework). Applying the lessons learned from these challenges can benefit all older adults and may help prevent the conditions associated with periodontal disease.

The gut microbiota, a complex ecosystem of microorganisms, plays an essential role in maintaining immune and metabolic homeostasis. Disruption of this microbial balance, known as dysbiosis, has been increasingly implicated in the pathogenesis of chronic inflammatory conditions, including cardiovascular, gastrointestinal, and autoimmune diseases, as well as metabolic disorders such as diabetes and obesity. A crucial mechanism through which the gut microbiota exerts its effects on host physiology is via the production of bioactive metabolites. These metabolites, including short-chain fatty acids, bile acids, and tryptophan derivatives, are key in modulating immune responses and regulating metabolic functions. Dysbiosis disrupts the production and function of these metabolites, thereby contributing to immune dysregulation, chronic inflammation, and disease progression. This review examines the role of gut microbiota-derived metabolites in chronic inflammatory diseases, with a focus on their immunomodulatory and metabolic effects. A deeper understanding of these mechanisms may open the way for novel therapeutic strategies aimed at restoring immune homeostasis and mitigating the global burden of chronic inflammatory diseases.

Alcohol is a well-known toxic etiologic factor for liver injury. Metabolic substrates of alcohol (especially acetaldehyde) have a major responsibility and genetic susceptibility, alterations in microbiota and immune system are important co-factors for this injury. Major injury in liver is hepatocellular lipid accumulation. Therefore the relationship between non-alcoholic and alcoholic fatty liver diseases should have been defined clearly. Recently two major liver committees adopted new terminologies such as metabolic-associated fatty liver disease (MAFLD), metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-related liver disease (MetALD), and alcoholic liver disease (ALD) instead of non-alcoholic fatty liver disease (NAFLD). These terminologies were based on the effects of metabolic syndrome on liver. Alcohol consumption was defined differently according to these nomenclatures. MAFLD defined alcohol intake (regardless of amount) as “dual etiology fatty liver disease” and the Delphi consensus defined MASLD, MetALD, or ALD according to daily consumption of alcohol amount.

According to research, hepatocellular carcinoma (HCC), ranks third globally in terms of cause of death and is the fifth most common type of cancer overall. Finding novel means of diagnosis and treatment is therefore crucial. The use of nanotechnology as a cancer treatment has drawn a lot of interest recently. Despite significant advancements in detection and treatment, there is still a long way to go before this disease is completely eradicated. Therefore, it’s critical to find innovative ways to diagnose and cure conditions. In particular, the substantial inertness of metallic nanoparticles (NPs) and their nanoscale structures, which have sizes comparable to many biological molecules, attract a great deal of interest in the biomedical field. Due to their exceptional optical qualities, chemically modified surface through the attachment of various ligands, biocompatibility (bio-inertness and low cytotoxicity), and superior optical properties, gold NPs (AuNPs) have garnered significant interest. The current review discusses the efficiency of AuNPs in various fields, including imaging, immunotherapy, and photothermal therapy for treating liver cancer. Finally, this review summarized the limitations of the prospects of the AuNPs.

Oral cancer is rare in Western nations but widespread in high-risk regions around the globe. Risk factors, such as tobacco usage, alcohol intake, and betel nut chewing, enhance the chance of the illness, making it mostly avoidable. Due to its high mortality, early detection is crucial. Prevention and diagnosis begin with oral mucosa lesions that may be malignant and local diseases that cause persistent inflammation. Clinical therapies for oral cancer mostly include surgery, radiation, and chemotherapy. Unsatisfactory therapeutic impact and harmful side effects remain clinical treatment’s key issues. Future research should examine the cancer microenvironment and treatment. This review examined oral cancer risk factors, preventative strategies, and early diagnostic approaches. This review also discusses immunotherapy methods for countering this fatal disease. Immunotherapy targeting the cancer microenvironment may provide a novel oral cancer treatment.

Ventilator-associated pneumonia (VAP) is a common and serious complication in critically ill patients, particularly those requiring prolonged mechanical ventilation. Extensively drug-resistant (XDR) Acinetobacter baumannii has emerged as a significant threat in VAP cases, complicating treatment due to its exceptionally high level of antibiotic resistance. We present a case of a 62-year-old male patient with severe acute ischemic stroke, who developed VAP during his stay in the intensive care unit (ICU). Cultures confirmed XDR Acinetobacter baumannii as the causative organism. The infection was further complicated by the development of a lung abscess, a rare but severe consequence of VAP. The patient was treated with a targeted antimicrobial regimen consisting of colistin, vancomycin, and tigecycline. Despite the pathogen’s resistance profile, the patient’s infection showed gradual improvement with sustained treatment. However, the recovery process was significantly prolonged due to the complexity of the infection, necessitating extended supportive care during hospitalization. This case highlights the challenges posed by XDR infections in critically ill patients and the importance of a tailored antimicrobial approach to effectively manage severe complications such as lung abscess.

Metastasis causes a majority of deaths in breast cancer patients. Metastasis is the spread of cancer to distant sites in the body away from the primary tumor, creating secondary tumors, or metastases. A tumor metastasizes when cancer cells strategically regulate genes that play a role in angiogenesis, epithelial-mesenchymal transition (EMT), migration, invasion, and regulation of the cell cycle to bypass apoptosis and increase proliferation and stemness. Several transcription factors have also been identified to play a role in metastatic breast cancer, as they enable invasion, intravasation, transport, extravasation, and colonization of metastasis through other processes such as angiogenesis and EMT, making them a prime target for cancer treatment. Understanding how transcription factors play a role in breast cancer metastasis will enable the development of targeted therapeutics for breast cancer. This paper reviews the roles of E2Fs, hypoxia-inducible factors (HIFs), EMT master regulators, sex determining region Y (SRY)-related high-mobility group (HMG) box (SOX), E26 transformation-specific (ETS), Yin Yang 1 (YY1), forkhead box M1 (FoxM1), BTB domain and CNC homology 1 (Bach1), sineoculis homeobox homolog (SIX), runt-related transcription factor 2 (RUNX2), myelocytomatosis (MYC), Kruppel-like factors (KLFs), and c-Jun in breast cancer metastasis.

Molluscum contagiosum (MC) is a common skin infection caused by a poxvirus, primarily affecting children and immunocompromised adults. It manifests as single or multiple raised, pearl-like papules and is highly contagious, spreading through skin contact or contaminated objects. Traditional treatments include cryosurgery, curettage, and pulsed dye laser ablation. However, in early 2024, berdazimer topical gel, 10.3% (ZELSUVMI^TM), was approved as the first topical treatment for MC. This review explores the potential of Zelsuvmi gel as a significant advancement in treatment due to its nitric oxide (NO)-producing properties. NO is a naturally occurring molecule in the body with multiple roles, including immune defense, antimicrobial activity, and modulation of apoptosis, inflammation, and cytokine production. The novel mechanism of action of Zelsuvmi, utilizing NO’s antiviral properties, has demonstrated compelling efficacy in clinical settings. The article also considers the broader implications of this treatment, not only for current dermatological practice but also for future research into innovative therapies for viral skin infections. Through an evaluation of clinical data, this review highlights Zelsuvmi’s potential to transform treatment approaches for MC, offering a non-invasive, effective option that may influence both clinical management and future prevention strategies.

Immediate implant-supported rehabilitation of atrophic maxillae with a fixed screw-retained prosthesis has to deal with the fixtures’ disparallelism and a high risk of fracture of the fixture-abutment connecting screw. After the flapless placement of six implants, with the distal ones inclined at more than 30° to bypass the sinus cavities and reduce the cantilever effects, the provisional prosthesis was immediately connected. The low-profile OT Equator attachment system enabled a trustworthy anchorage of the superstructure without the connection-screws allocation on the rear fixtures. Three months later, all implants were definitively loaded. The patient was monitored for two years follow-up. No problem arose during the whole treatment. The prosthesis maintained its stability and anchorage with complete functional and aesthetic results. No signs of periimplantitis or radiographically evident bone loss were noted. The OT Bridge system successfully simplified the immediate loading of all implants regardless of the inclination of the rear fixtures, avoiding a provisional mobile denture.

Hypertension (HTN) is connected to many complications such as stroke, heart attack, heart failure, and kidney damage. Aging, lifestyle modifications, and obesity are risk factors associated with arterial HTN. On the other hand, chronic kidney disease (CKD) is a gradually progressive disease that is associated with cardiovascular disease (CVD), HTN, anemia, electrolyte imbalance, acid-base abnormalities, and bone disease. Blood pressure (BP) in hemodialysis patients shows a dynamic nature during dialysis procedures, including intradialytic hypotension and/or intradialytic HTN. Even though hypotensive events are common in hemodialysis sessions, intradialytic HTN, in which the BP increases during and/or immediately after hemodialysis, was associated with a higher mortality risk. The prevalence of intradialytic HTN has been described in 5–20% of hemodialysis treatments. The coexisting comorbidities in CKD patients need adequate pharmacological treatment. As a result, CKD patients are at a high risk for polypharmacy, which causes an elevated risk for adverse drug effects and influences non-adherence to medication. In addition, it is required individualization of medication doses adapted to the decreased renal function according to the progression of CKD. The improvement of health literacy through suitable interventions can facilitate the perception of illness, resulting in high therapy adherence in such a group of patients. This review considers the aspects of HTN management and adherence to the treatment in patients in permanent hemodialysis therapy, contributing to the determination of more effective strategies for improved treatment compliance, aiming at the prevention of CVD in this patient population.

Combined treatment of photobiomodulation therapy and pilocarpine hydrochloride (Salagen) helped a patient suffering from severe oral mucositis and malnutrition resulting from radiochemotherapy for head and neck cancers. This treatment sped up the patient’s healing process and improved his quality of life by stimulating cells and increasing saliva secretion. The severity of oral mucositis was measured according to the World Health Organization (WHO) scale and the oral mucositis assessment scale. This case report highlighted a new combination treatment that may be the key to successfully managing severe oral mucositis during radiochemotherapy without the need to stop or modify cancer therapy.

Age-related changes in the brain cause cognitive decline and dementia. In recent year’s researchers’ extensively studied the relationship between age related changes in functional connectivity (FC) in dementia. Those studies explore the alterations in FC patterns observed in aging and neurodegenerative disorders using techniques such as resting-state functional magnetic resonance imaging (rs-fMRI), electroencephalography (EEG) coherence analysis, and graph theory approaches. The current review summarizes the findings, which highlight the impact of FC changes on cognitive decline and neurodegenerative disease progression using these techniques and emphasize the importance of understanding neural alterations for early detection and intervention. The findings underscore the complexity of cognitive aging and the need for further research to differentiate normal aging from pathological conditions. rs-fMRI is essential for studying brain changes associated with aging and pathology by capturing coherent fluctuations in brain activity during rest, providing insights into FC without task-related confounds. Key networks such as the default mode network and front parietal control network are crucial in revealing age-related connectivity changes. Despite challenges like neurovascular uncoupling and data complexity, ongoing advancements promise improved clinical applications of rs-fMRI in understanding cognitive decline across the lifespan. EEG and magnetoencephalography (MEG) are cost-effective techniques with high temporal resolution, allowing detailed study of brain rhythms and FC. Recent studies highlight EEG/MEG’s potential in early Alzheimer’s disease detection by identifying changes in brain connectivity patterns. Integration of machine learning techniques enhances diagnostic accuracy, although further validation and research are necessary. Graph theory offers a quantitative framework to analyze cognitive networks, identifying distinct topological differences between healthy aging and pathological conditions. Future research should expand exploration into diverse neurodegenerative disorders beyond mild cognitive impairment, integrating neuroimaging techniques to refine diagnostic precision and deepen insights into brain function and connectivity.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are integral to diabetes treatment, facilitating renal glucose excretion and offering benefits in cardiovascular risk reduction, kidney function preservation, and weight management. However, their integration into diabetes care presents challenges due to associated adverse effects. This review assesses the efficacy of SGLT2 inhibitors in diabetes management. A comprehensive literature search using PubMed and Google Scholar yielded pertinent studies. Clinical evidence demonstrates the effectiveness of SGLT2 inhibitors in glycemic control and in reducing cardiovascular risks in diabetes patients. Moreover, these agents exhibit positive effects on cardiovascular and renal functions. Despite their therapeutic promise, careful consideration is warranted when integrating SGLT2 inhibitors into diabetes care. Common adverse effects such as genitourinary infections, hypoglycemia, and sporadic diabetic ketoacidosis necessitate rigorous patient monitoring and education. Nonetheless, SGLT2 inhibitors offer a comprehensive approach to diabetes management, showing efficacy across multiple domains. In summary, SGLT2 inhibitors play a crucial role in diabetes care, offering benefits beyond glycemic control. However, their use requires careful patient selection, education, and monitoring to manage associated risks effectively. Awareness of potential adverse effects is essential for optimizing the therapeutic benefits of SGLT2 inhibitors in T2DM (type 2 diabetes mellitus) management.

Hyperuricemia (HUA), defined by elevated serum uric acid levels, is well-established in its association with systemic conditions like gout and cardiovascular diseases. Recently, however, emerging research has revealed a potential connection between HUA and ocular disorders, particularly epiretinal pathologies. This review investigates the pathophysiological mechanisms linking HUA to epiretinal conditions, including epiretinal membrane formation, macular edema, and retinal vascular diseases. By thoroughly analyzing current literature, this review seeks to deepen the understanding of the relationship between HUA and epiretinal disorders, with the aim of informing new therapeutic strategies and enhancing patient outcomes.

Diabetic vascular disease, as one of the common complications in diabetic patients, threatens the quality of life and health of patients. Autophagy maintains cellular homeostasis and survival as an important intracellular self-repair mechanism. In recent years, with the gradual deepening of autophagy research, more and more studies have found that vascular cells such as endothelial cells, smooth muscle cells, and inflammatory cells are closely associated with various autophagy disorders. Different autophagy regulatory mechanisms can lead to different or similar cellular outcomes, and there are complex crosstalk mechanisms in the process. Therefore, we will summarize the latest research progresses with regards to the role of autophagy in diabetic vascular disease, focusing on the complex regulatory mechanisms of mitophagy, epigenetic modifications, apoptosis, inflammation, and autophagy in the development of diabetic vascular disease, aiming to provide effective therapeutic targets for diabetic vascular injury.

Streptococcus pneumoniae (S. pneumoniae), which is a Gram-positive diplococcus, has emerged as a significant human pathogen. It is a primary cause of bacterial pneumonia, otitis media, meningitis, and septicemia, leading to a considerable impact on global morbidity and mortality. The investigation of S. pneumoniae and its virulence factors has resulted in the identification of surface endonuclease A (EndA). EndA functions in DNA uptake during natural transformation and plays a significant role in gene transfer. The ability of S. pneumoniae to degrade neutrophil extracellular traps (NETs) enhances its virulence and invasive potential in pneumococcal infections. NETosis occurs when neutrophils release chromatin into the extracellular space to form NETs, capturing and neutralizing pathogens. Currently, NETosis can be induced by several microbes, particulate matter, and sterile stimuli through distinct cellular mechanisms, and this includes the involvement of EndA in S. pneumoniae. Here, we reviewed the cellular functions of EndA, its role in S. pneumoniae as a virulence factor in relation to NETosis, its relationship to immunogenicity, and its involvement in several diseases. The discovery of this relationship would significantly impact therapeutic technology in reducing disease burden, especially pneumococcal infections.

Autologous fat grafting is a common technique in cosmetic and reconstructive surgery, addressing facial rejuvenation, breast contouring, scar mitigation, and soft tissue corrections. However, clinical outcomes can be inconsistent and unpredictable. While extensive research has explored the mechanisms of harvesting, purifying, and transplanting adipose tissue, there is a notable gap in understanding the impact of donor-related factors on fat grafting success. This review aims to fill this gap by examining how variables like donor age, sex, health status, and anatomical site of fat harvest influence the biological efficacy of adipose-derived stem cells (ASCs). Younger donors often exhibit higher ASC proliferation rates and regenerative potential, while older donors may have reduced cell viability. Hormonal differences between sexes and donor health conditions, such as obesity or diabetes, can also impact ASC functionality and graft outcomes. The anatomical source of the fat further affects its cellular composition and regenerative potential. Understanding these donor-related factors is vital for optimizing fat grafting techniques. The review also explores innovative strategies, such as adipose tissue cryopreservation and acellular fat matrices, to mitigate donor variability. These approaches offer promising avenues for enhancing the predictability and effectiveness of fat grafting. By synthesizing current knowledge and highlighting novel strategies, this review aims to improve clinical outcomes and advance the field of aesthetic and reconstructive surgery.

Harmattan is a season characterized by dust, cold, and sub-humid trade winds in Sub-Saharan countries. It’s similar to meteorological phenomena like Asian dust storms, Santa Ana winds, Australian bushfires, and Saharan dust in the Caribbean. It causes profound changes in the cardiorespiratory system in apparently healthy individuals and increases the risk of hospitalization in susceptible individuals. Exposure to these extreme conditions has been associated with alterations in autonomic function and baroreceptor sensitivity thus resulting in dysregulation of blood pressure control mechanisms. Baroreceptors are critical regulators of hemodynamics and cardiovascular function. They play a vital role in the short-term responses to blood pressure perturbation and are essential for acute restoration of blood pressure following cold exposure. Harmattan wind contains a barrage of chemicals, dust, and particulate matters depending on industrialization, natural and human activities. Particulate matter from Harmattan dust can trigger systemic inflammation and oxidative stress, exacerbating endothelial dysfunction and impairing vascular reactivity thus contributing to the pathogenesis of alterations in baroreceptor insensitivity, and cardiovascular diseases, including hypertension and atherosclerosis. Furthermore, fine particulate matter from dust may penetrate deep into the respiratory tract, activating pulmonary sensory receptors and eliciting reflex responses that influence autonomic tone. The presence of rich acrolein smokes and non-essential heavy metals such as cadmium, lead, and mercury in Harmattan wind also reduces baroreflex sensitivity, culminating in a sustained increase in diastolic and systolic blood pressure. This integrated review aims to provide valuable insights into how changes in each of these environmental constituents alter vital pathophysiologic and immunologic mechanisms of the body leading to baroreceptor instability and ultimately hemodynamic imbalance using available primary studies. Understanding this intricate interplay is crucial for implementing targeted interventions and informed public health strategies to mitigate the adverse effects of extreme environmental exposure and ultimately reduce poor health outcomes in the affected regions.

Diabetic ketoalkalosis (DKALK) is a rare but significant variant of diabetic emergencies, characterized by metabolic alkalosis rather than the typical acidosis seen in diabetic ketoacidosis (DKA). Despite its clinical importance, DKALK often goes unrecognized due to limited literature on its presentation and biochemical variables. This work examines the pathophysiology, clinical presentation, diagnostic challenges, management strategies, and implications for clinical practice of DKALK, drawing insights from case studies and research gaps in the field. Notable case studies underscore the diagnostic challenges and emphasize the importance of tailored management strategies for DKALK. Risk assessment involves recognizing predisposing factors such as severe vomiting, alcohol abuse, or concomitant diuretic use. Timely recognition and intervention are essential to prevent potentially life-threatening complications associated with DKALK. Continued research efforts are warranted to refine diagnostic criteria, optimize therapeutic approaches, and enhance early recognition of DKALK, ultimately improving patient outcomes in this challenging clinical scenario.

The emergence and subsequent advancement of nanotechnology in recent years have greatly benefited the healthcare sector, particularly in the treatment of cancer. As per study, major fatalities are related to the lung cancer. For many years, oral tyrosine kinase inhibitors (TKIs) against the epidermal growth factor receptor (EGFR) family of receptors have been used in the clinic to treat human malignancies, although they observed some very serious adverse effects in the treatment of lung cancer, especially in non-small cell lung cancer (NSCLC). Despite EGFR-TKIs’ exceptional qualities as small-molecule targeted medications, their applicability is nevertheless limited by their poor solubility, inconsistent oral bioavailability, high daily dose needs, high plasma albumin binding propensity, and initial/acquired drug resistance. Article’s purpose is to investigate EGFR-TKI’s effects on lung cancer and get around some of its drawbacks, nanotechnology will be an innovative strategy. An effective tool to increase the effectiveness of these pharmaceuticals is nanotechnology by methods other than oral. This article signifies that a range of nanomedicine delivery systems have been developed to effectively distribute EGFR-TKIs with improved drug release kinetics and tissue-targeting capacity. This review article intends to present information regarding lung cancer and EGFR relation, mechanism of recently approved EGFR-TKI’s targeted therapy, an updated landscape of EGFR-TKIs and their clinical status over lung cancer, advantages and disadvantages of nanotechnology, and new breakthroughs in nano-delivery which mentioned as a significantly better over traditional drug chemotherapy and delivery.

Postbiotics, representing the newest member of the family of biotics, are metabolites produced as a result of fermentation of lactic acid bacteria (LAB) in the De Man, Rogosa, and Sharpe (MRS) medium which includes proteins, sugars and minerals. The components of postbiotics includes exopolysaccharides (EPS), short-chain fatty acids (SCFAs), bacteriocins, antioxidants, and metabolizing enzymes. Several studies indicate that postbiotics have multiple properties such as antimicrobial, immunomodulatory, antioxidant, anti-inflammatory, anti-obesity, anti-diabetic, and anti-tumoral properties. Natural polysaccharides refer to the polysaccharides obtained from biological organisms including algae, plants, animals, and microorganisms. Polysaccharides are either branched or linear macromolecules and are composed of a few major and some minor monosaccharides, including glucose, fructose, mannose, arabinose, galactose, fucose, galacturonic acid, glucosamine, galactosamine or their derivatives. Similar to postbiotics, polysaccharides also exhibit anti-inflammatory, antibacterial, antitumor, antiviral, immunomodulatory, and antioxidant properties. Although polysaccharides cannot be directly digested by the human body due to the lack of specific enzymes, they can be digested by gut-residing bacteria including but not limited to LAB. Recent studies indicate that large non-starch polysaccharides such as alginate, fucoidan, chitosan, carrageenan, and guar gum can be degraded into low molecular weight oligosaccharides which in turn can provide health benefits to the human health. These new findings inspired us to propose a polysaccharides-based postbiotics, also called glycanbiotics, and their potential applications. We propose that polysaccharides can be fermented by probiotics, and subsequent removal of bacteria will increase the safety of their produced metabolites, including oligosaccharides, disaccharides, monosaccharides and their derivatives. These polysaccharides-based postbiotics may mimic metabolization of polysaccharides in vitro and consequently broaden the applications of postbiotics. Non-probiotics such as Akkermansia muciniphila and other bacteria can also be used for glycanbiotics production, thus providing novel applications for human health.

The integration of digital technologies like CAD/CAM systems and intraoral scanners is transforming the field of dentistry, providing numerous benefits for both patients and dental professionals. This case study explores the significance and benefits of dental CAD/CAM technology in revolutionizing the dental industry, focusing on the creation of personalized dental restorations with precision and speed. The study emphasizes the applications of CAD/CAM technology and showcases the state-of-the-art Medit i700 intraoral scanner for detailed dental impression scanning. By adopting these advanced technologies, dental practices can save time, enhance patient satisfaction, and reduce costs in the long run. The methodology involved systematic digital assessments, planning, and execution to address cosmetic concerns, resulting in a successful transformation of a patient’s smile using e.max^® CAD/CAM technology and Medit i700 scanner. The case study highlights the importance of patient preference, efficiency, and accuracy in digital dentistry, demonstrating the potential for providing personalized and effective solutions for aesthetic dental concerns. Embracing digital advancements and patient-centered care is crucial for delivering high-quality and innovative solutions in modern aesthetic dentistry.

This article provides an informative overview of the current situation and future trends in cervical cancer prevention. Cervical cancer remains a significant public health concern worldwide and is characterized by notable variations in both incidence and mortality rates between developed and developing countries. This underscores the importance of understanding the pathophysiology of cervical cancer, stressing the involvement of high-risk HPV types. The presence of supplementary risk factors facilitates the transition from infection to cancer. This review examines current preventive methods, including the success of HPV vaccines such as Gardasil and Cervarix, and the effectiveness of screening techniques, from cytology to HPV DNA testing. It noted the limitations faced by primary and secondary preventive measures, particularly in low-resource settings, which include access to vaccines and effective screening procedures. Emerging technologies in cervical cancer prevention, such as liquid-based cytology, molecular testing, and AI, promise to improve early detection and diagnosis accuracy and efficiency. The potential of precision medicine to customize treatment based on individual risk factors was discussed. It explores the innovation in genetic editing techniques, such as CRISPR/Cas9, in targeting HPV oncoproteins, the advent of immunotherapy, the role of tumor-infiltrating lymphocytes, and the prospects of biomarkers in improving early detection. Research and technological advancements are leading to transformative changes in cervical cancer prevention. These developments suggest a path toward improved screening, diagnosis, and treatment that could significantly reduce the global burden of the disease. However, realizing the full potential of these advances requires inclusive research and international collaboration to overcome access disparities, particularly in resource-limited settings.

Excessive exposure to ultraviolet (UV) radiation causes premature aging of the skin, known as photoaging. UV radiation induces DNA damage, oxidative stress, inflammatory reactions, and degradation of extracellular matrix (ECM) proteins, contributing to the aged skin phenotype. The skin synthesizes vitamin D upon UVB exposure, which plays a pivotal role in the proper function of multiple body systems. Vitamin D protects skin from photo-damage by repairing cyclobutane pyrimidine dimers, reversing oxidative stress, and reducing chronic inflammation. Moreover, various epidemiological studies have identified vitamin D deficiency as a marker for common dermatological disorders. Improvement of clinical outcomes with vitamin D supplementation further suggests its protective role against skin pathologies. This review comprehensively covers the involvement of vitamin D in combating UV-induced photoaging and various skin disorders, highlighting the significance of maintaining vitamin D adequacy for healthy skin.

Therapy of malignant tumors still represents a huge problem for healthcare, since these diseases lead to a high rate of disability and premature death of the population. The main problems of adoptive cell therapy for malignant tumors are a low rate of migration of effector lymphocytes into tumors, as well as their low activity in tumors due to suppressive tumor microenvironment. In addition, it should be noted that systemic intravenous administration of a large number of activated lymphocytes may be accompanied by a pronounced cytokine release syndrome, which leads to significant negative side effects, including high temperature, blood clotting disorders, aggression of immune cells against their own tissues, even neurotoxicity. Functional nanomaterials, such as magnetic nanoparticles with various surface modifications (PEG, PEI, DMSA, citrate, etc.) are highly promising agents for targeted delivery of different anti-tumor substances. Magnet-driven enrichment of effector anti-tumor lymphocytes in tumors would highly increase the effectiveness and enhance safety of adoptive lymphocyte therapy. However, different research groups obtained opposing data about the feasibility and efficiency of such approach. Thus, this review is focused on experimental details of the contradicting studies and aims to elucidate the possible reasons of these controversies and the best practices to efficiently target lymphocytes into tumors.

During cellular stress, the master regulators of intrinsic self-death (apoptosis) are BCL-2 family proteins. The BCL-2 family proteins play a key role in apoptosis and are tightly regulated via other BCL-2 family proteins, non-BCL-2 protein suppressors, and epigenetic modifications. As the name implies, these proteins possess one or two of the four BCL-2 homology domains (BH1–BH4). According to their roles, they are classified as pro-apoptotic or pro-survival proteins. BH-3-only proteins possess a single BH3 domain and are specific/key effector proteins for intracellular death commitment, particularly in the context of cell survival and programmed cell death. This delicate interplay among the BCL-2 family members is essential for maintaining the primary hemostasis, or balance, of cell fate. The anti-apoptotic proteins, such as BCL-2 and BCL-XL, promote cell survival by inhibiting apoptosis. On the other hand, the pro-apoptotic proteins, such as BAX and BAK, drive apoptosis. It ensures that cells are able to respond appropriately to various internal and external signals, ultimately determining whether a cell survives or undergoes programmed cell death. Understanding and targeting this delicate balance is a promising avenue for developing therapeutic strategies to modulate cell fate and treat various diseases. The molecular pathogenesis of BCL-2 family proteins in blood disorders involves differential expression of these components resulting in the dysregulation of the pathway contributing to cell survival and resistance to apoptosis as observed in follicular lymphoma, diffuse large B-cell lymphoma, acute lymphoblastic leukemia, and acute myeloid leukemia. Such dysregulation is a major impediment to standard therapies and aids in chemo resistance. Studies show some promising clinical outcomes with antineoplastic agent venetoclax either as a monotherapy or in combination with other agents. This review discusses recent studies on the regulation of BCL-2 family proteins which might provide a molecular landscape for their clinical implications in blood disorders.

Mushrooms, due to their many medical, preventive, and nutraceutical purposes, as well as their reputation as a folk remedy, have long been an integral part of traditional cuisines. The therapeutic advantages of mushrooms may be attributed to their bioactive components, including polysaccharides (both low and high molecular weight), terpenoids, phenolic compounds, fatty acids, lectins, and glucans. The bioactive components have been discovered to possess various health advantages, including antibacterial, antifungal, anticancer, radical scavenging, cardiovascular, anti-hypercholesterolemia, and anti-diabetic effects. These effects have gained worldwide attention and stimulated interest in further investigating their potential applications. Functional foods have the dual purpose of serving as both nourishment and medication. They may assist in the management and prevention of health disorders that are not functioning optimally, as well as mitigate some adverse effects of life-threatening diseases. Further evaluation is necessary to fully understand the mechanisms via which mushrooms operate and improve their therapeutic properties. This review delves into the possible medicinal potential of mushrooms and the advantages they may provide to human health.

Lung cancer remains a leading cause of cancer-related deaths globally, and a significant number of patients are ineligible for surgery, while chemoradiotherapy often shows limited efficacy, a systemic distribution, a low drug concentration at tumor sites, severe side effects, and the emergence of drug resistance. In this context, a nanodrug delivery system (NDDS) has emerged as a promising approach for lung cancer treatment, offering distinct advantages such as targeted delivery, responsiveness to the tumor microenvironment, site-specific release, and enhanced induction of apoptosis in cancer cells, ultimately leading to tumor growth inhibition or even elimination. This review aims to provide an overview of the physiological characteristics of lung cancer, highlight the limitations of conventional treatment methods, and extensively examine recent significant advancements in NDDS utilized for lung cancer therapy. The findings from this review lay the foundation for further development and optimization of NDDSs in the treatment of lung cancer.

In this review, we present the main luminal fuels that are responsible for energy production in colonocytes, namely the bacterial metabolites short-chain fatty acids and lactate, which are produced from undigestible polysaccharides and proteins, and hydrogen sulfide that is mainly produced from undigested proteins. In addition to these luminal fuels, colonocytes can use glutamine, and to a lower extent glucose, as energy substrates provided by arterial capillaries. The effects of excessive concentrations of bacterial metabolites within the colonic luminal fluid (including butyrate, hydrogen sulfide, p-cresol, indole derivatives, ammonia, 4-hydroxyphenylacetic acid, and acetaldehyde) on the mitochondrial energy metabolism in colonic epithelial cells and the consequences of altered ATP production on the colonic epithelium renewal and barrier function are detailed, as well as consequences for water and electrolyte absorption. The relationships between modifications of these latter processes and development of colitis are then discussed. Finally, several mechanisms that are considered as adaptive against deleterious effects of bacterial metabolites on colonic epithelial cell energy metabolism are presented.

Bacteriophages are viruses that infect bacterial cells and use their machinery to reproduce. This unique characteristic holds immense promise for combating antibiotic-resistant bacterial infections, a growing global threat. There are two types: one of them is named temperate phages, which inject their genomic material into bacteria and integrate into the host’s genome, while the second one is entitled as lytic phages that subdue the entire metabolism of the bacterium for the synthesis of its genome and proteins, including lytic proteins involved in breaking bacterial cell membrane and release of novel phages. In addition, phage therapy can be expressed through anti-biofilm activity and by triggering innate and adaptive immune cells responses. Moreover, no adverse effects of phage therapy have been reported. However, phage therapy is still grim for many and could influence some interpretations related to immune response, bacteriophage selections, and phage resistance in the future.

The dynamic of the virus-host interaction is subject to constant evolution, which makes it difficult to predict when the SARS-CoV-2 pandemic will become endemic. Vaccines in conjunction with efforts around masking and social distancing have reduced SARS-CoV-2 infection rates, however, there are still significant challenges to contend with before the pandemic shifts to endemic, such as the coronavirus acquiring mutations that allow the virus to dodge the immunity acquired by hosts. SARS-CoV-2 variants deploy convergent evolutionary mechanisms to sharpen their ability to impede the host’s innate immune response. The continued emergence of variants and sub-variants poses a significant hurdle to reaching endemicity. This underscores the importance of continued public health measures to control SARS-CoV-2 transmission and the need to develop better second-generation vaccines and effective treatments that would tackle current and future variants. We hypothesize that the hosts’ immunity to the virus is also evolving, which is likely to abet the process of reaching endemicity.

Over the past few decades, it has become clear that an excessive activity of matrix metalloproteinases (MMPs) can accelerate the progression and fatal outcomes of several serious age-related diseases, including atherosclerotic coronary heart disorders and various types of malignancies. These proteolytic enzymes mediate the degradation and remodeling of the extracellular matrix through cleaving its various components, thereby affecting many critical functions of surrounding cells and intercellular communication. Consequently, the low expression levels of MMPs can be important in the prevention and treatment of such chronic life-threatening pathologies, contributing to the better quality of life and longer life expectancy. In this review article, the pathogenic proteolytic roles of MMPs are examined in more detail, especially in the cases of heart attack and stroke as well as cancer invasion and metastasis, showing that these enzymes can be considered not only as diagnostic and prognostic biomarkers but also as important therapeutic targets in the fight against many age- and lifestyle-related serious disorders. The identification and development of suppressing agents with a selective activity towards specific MMPs have, however, still remained a complex and complicated challenge, in which natural plant-derived compounds are increasingly recognized as promising leads for the new-generation inhibitors.

Nerve cell death is the central aspect of human neurodegenerative disorders. Neuronal death in results leads to the onset of various human neurological disorders such as Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, amyotrophic lateral sclerosis, and stroke. In developing neurons, apoptosis is assumed to provide a counterbalance to overexuberant cell replication. Numerous signals may induce apoptosis in neurons, such as the absence of neurotrophic factor support, increased levels of metabolic and oxidative stress, and overstimulation of glutamate receptors (leading to the calcium influx). Cell death and neurological disorders have been related to oxidative stress, which creates an imbalance between antioxidant defenses and free radical production. In this paper, a summary of the engrossment of oxidative stress, neuronal apoptosis, and mitochondrial dysfunction in neurodegenerative disorders has been discussed. Antioxidant therapy’s potential assistance for neurodegenerative illnesses in human beings is still up for dispute, despite encouraging pre-clinical research findings. One elucidation for this disparity could be the non-existence of an accurate way to assess oxidative stress in the brain. The explosion in research on apoptosis in neurodegeneration has stemmed from the conception that persuading neuronal apoptotic death may be crucial to the progression of a disease and that anti-apoptotic approaches may be useful in the prevention of neurodegenerative processes. A deeper understanding of the role that apoptosis plays in neurodegenerative processes will serve as the foundation for future research into the development of focused, effective treatment modalities.

Dry eye disease (DED) is a complex and multifactorial ocular surface disease affecting a large proportion of the population. There is emerging evidence of the impact of the microbiomes of the ocular surface and gut on the symptoms of DED, with many parallels being drawn to inflammatory diseases of other organ systems. A key factor involved in the promotion of healthy microbiomes, and which has been associated with ocular surface disease, is micro- and macronutrient deficiency. A comprehensive review of how these deficiencies can contribute to DED is absent from the literature. This review reports the composition of healthy ocular and gut microbiomes, and how nutrient deficiencies may impact these floral populations, with linkage to the subsequent impact on ocular health. The review highlights that vitamin B1 and iron are linked to reduced levels of butyrate, a fatty acid implicated in inflammatory conditions such as ulcerative colitis which itself is a condition known to be associated with ocular surface diseases. Vitamin B12 has been shown to have a role in maintaining gut microbial eubiosis and has been linked to the severity of dry eye symptoms. Similar beneficial effects of gut microbial eubiosis were noted with vitamin A and omega-3 polyunsaturated fatty acids. Selenium and calcium have complex interactions with the gut microbiome and have both been implicated in the development of thyroid orbitopathy. Further, diabetes mellitus is associated with ocular surface diseases and changes in the ocular microbiome. A better understanding of how changes in both the gut and eye microbiome impact DED could allow for an improved understanding of DED pathophysiology and the development of new, effective treatment strategies.

Acquired or hereditary epilepsy affects millions of people. Today, the disease is pharmacoresistant in about 30 percent of cases, meaning that the seizures do not come under acceptable control in response to medication. Therefore, there is a great need for the development of novel methods for epilepsy research and treatment. Although in vivo animal models best mimic the clinical features of epilepsy, in vitro models have clear advantages in elucidating the fine details and cellular mechanisms of neurological disorders. In contrast to short-lived experiments in acute brain slices, cell cultures are often chosen as chronic models for antiseizure medication screening and epilepsy research under reduced, well-controlled in vitro conditions that still include all major cell types susceptible to epileptic seizures. Organotypic brain slices or dissociated cells produce spontaneous synchronized epileptiform discharges classified as interictal and ictal-like. In addition, pharmacologically or electrically induced seizures and status epilepticus can be obtained for electrophysiological and imaging experiments. Relatively simple cell cultures of primary rodent neurons provide entry-level models for the initial screening of antiseizure medications and basic epilepsy research. However, more sophisticated human cultures of stem cell-derived neurons offer the possibility of medical studies using the human genotype without the need to obtain brain tissue from patients. As an evolution of this method, programmed differentiation of brain cells is now being used in stem cell therapy for neurological disorders. Overall, cell culture greatly expands the repertoire of methods available to study epileptic disorders and potential cures.

Three-dimensional (3D) and four-dimensional (4D) printing have emerged as the next-generation fabrication technologies, covering a broad spectrum of areas, including construction, medicine, transportation, and textiles. 3D printing, also known as additive manufacturing (AM), allows the fabrication of complex structures with high precision via a layer-by-layer addition of various materials. On the other hand, 4D printing technology enables printing smart materials that can alter their shape, properties, and functions upon a stimulus, such as solvent, radiation, heat, pH, magnetism, current, pressure, and relative humidity (RH). Myriad of biomedical materials (BMMs) currently serve in many biomedical engineering fields aiding patients’ needs and expanding their life-span. 3D printing of BMMs provides geometries that are impossible via conventional processing techniques, while 4D printing yields dynamic BMMs, which are intended to be in long-term contact with biological systems owing to their time-dependent stimuli responsiveness. This review comprehensively covers the most recent technological advances in 3D and 4D printing towards fabricating BMMs for tissue engineering, drug delivery, surgical and diagnostic tools, and implants and prosthetics. In addition, the challenges and gaps of 3D and 4D printed BMMs, along with their future outlook, are also extensively discussed. The current review also addresses the scarcity in the literature on the composition, properties, and performances of 3D and 4D printed BMMs in medical applications and their pros and cons. Moreover, the content presented would be immensely beneficial for material scientists, chemists, and engineers engaged in AM manufacturing and clinicians in the biomedical field.

Schizophrenia is a serious mental disorder affecting about 1% of the population. It is characterised by multiple symptoms which are mostly responsive to treatment with antipsychotic medications. Cognitive impairment is regarded as a core feature of illness which is mostly poorly responsive to treatment with the current antipsychotic medications. Improving cognitive function is an important treatment goal as it is associated with better outcomes in employment and quality of life. Adjunctive pharmacological treatments have been examined to improve measures of cognition but with limited success. Cannabidiol (CBD), has shown promise in preclinical models of cognitive deficits of schizophrenia. On the other hand, limited studies in small groups of patients with schizophrenia have shown no significant clinical benefits for cognitive function as an adjunct to ongoing treatment with antipsychotics. A single trial, in which CBD as a standalone treatment was compared to the antipsychotic medication amisulpride, showed significant changes in cognitive measures for both agents, with no statistically significant difference between them. It might therefore be concluded that the preclinical findings have failed to translate to the clinic. However, the preclinical findings themselves are based on a circumscribed set of studies in multiple cognitive models and have used varying doses and routes of drug administration. The same general methodological issues are present in the suite of clinical studies. Issues such as patient heterogeneity in terms of illness duration, formulation and dose of CBD employed, and length of cannabinoid treatment might militate positive findings. The limited clinical database available makes the benefits (or lack thereof) of CBD for the cognitive effects of schizophrenia uncertain. Continued research in much larger patient populations than have so far been investigated as well as a consideration of dose ranging studies are required to fully assess the potential risks against the benefits of CBD treatment for cognitive deficits in schizophrenia.

Atypical ductal hyperplasia (ADH) is a benign lesion of the breast that is associated with an increased risk of invasive breast cancer. This review explores the pathophysiology, risk factors for progression to breast cancer, and lifetime management for patients diagnosed with ADH on core needle biopsy (CNB). The management plan for patients diagnosed with ADH includes regular clinical surveillance, diagnostic mammography, along with risk-reduction strategies such as lifestyle modifications or the use of adjuvant endocrine therapies. This review aims to delve into the complexities of ADH from diagnosis to management to aid clinicians in finding the best way to approach this high-risk breast lesion.

Within group A Streptococcus (GAS), only Streptococcus pyogenes exhibits clinical significance. GAS is typed serologically based on unique surface proteins and critical virulence factors, such as a hyaluronic acid capsule that shields GAS from phagocytosis. The burden of GAS was estimated in the last five years as 14,000 to 25,000 cases of the invasive group A streptococcal disease in the USA with an estimated death from 1,500 to 2,300 cases per year. Early in the summer of 2022 in England, there was more scarlet fever than was anticipated. Early in the current season, the number of notifications rose to unusual heights. The analysis of invasive GAS (iGAS) isolate typing data shows that this season has seen a wide variety of encoding mature M protein (emm) gene sequence types found. Therefore, public health authorities should think about initiatives to increase clinicians’ and the general public’s awareness of GAS infections and to promote their quick diagnosis, molecular testing and antibiotic susceptibility testing, and standard treatment.

Artificial intelligence (AI) studies are increasingly reporting successful results in the diagnosis and prognosis prediction of ophthalmological diseases as well as systemic disorders. The goal of this review is to detail how AI can be utilized in making diagnostic predictions to enhance the clinical setting. It is crucial to keep improving methods that emphasize clarity in AI models. This makes it possible to evaluate the information obtained from ocular imaging and easily incorporate it into therapeutic decision-making procedures. This will contribute to the wider acceptance and adoption of AI-based ocular imaging in healthcare settings combining advanced machine learning and deep learning techniques with new developments. Multiple studies were reviewed and evaluated, including AI-based algorithms, retinal images, fundus and optic nerve head (ONH) photographs, and extensive expert reviews. In these studies, carried out in various countries and laboratories of the world, it is seen those complex diagnoses, which can be detected systemic diseases from ophthalmological images, can be made much faster and with higher predictability, accuracy, sensitivity, and specificity, in addition to ophthalmological diseases, by comparing large numbers of images and teaching them to the computer. It is now clear that it can be taken advantage of AI to achieve diagnostic certainty. Collaboration between the fields of medicine and engineering foresees promising advances in improving the predictive accuracy and precision of future medical diagnoses achieved by training machines with this information. However, it is important to keep in mind that each new development requires new additions or updates to various social, psychological, ethical, and legal regulations.

Cancer cure with immunotherapy is an innovative step towards cancer treatment with better survivability, but it is mostly dependent on the response of the patient’s immune system to the immunotherapeutic approach. This descriptive review article emphasizes the conventional and advanced treatment modalities currently available for breast cancer management. This review also highlights the clinical management of breast cancer concerning immune response especially to unravel the prospects for manipulation of immune cells: such as lymphocytes, including T-cells, T-regulatory cells and natural killer cells, and others like macrophages, dendritic cells, and the panel of interleukins or interferons released by them which has made a significant impact on breast cancer research. In addition, an effort was made to emphasize the different clinical trials and their future implication for the reduction of breast cancer cases. Overall, an attempt has been made to shed light on the possibilities of immunotherapeutics in breast cancer care, as well as the role of immune response in the incidence, aggressiveness, and survival of breast cancer.

Gelotology (the study of laughter) has it seems mainly evaded the attention of longevity scientists, positive biologists, and geroscientists. However, the potential of laughter to result in immediate improved affect, increase overall well-being, reduce cortisol levels, benefit the immune system, and support cardiovascular health, to name only a few of its possible effects, renders it of high interest as an anti-aging strategy. As an intervention, laughter has, at least theoretically, the potential to slow the process of aging, and to ameliorate its lived experience. What makes laughter particularly attractive is that it is accessible to all, is very low risk, and is inherently, for most people, enjoyable. Ten years ago, lifestyle medics first proposed that laughter be prescribed in primary care. They pointed to its efficacy in general patient care, geriatrics, rheumatology, critical care, oncology, rehabilitation, psychiatry, home care, palliative care, terminal care, and hospice care. Nevertheless, laughter prescription has been slow to take off. It is therefore of interest to contemplate why, how, and to what effect, laughter can be harnessed to improve people’s lives. Quality research is recommended to uncover the secrets of laughter, its dynamic effects on the body, if, and how, it may impact longevity, and how it can best be used to promote successful and active aging.

Chronic obstructive pulmonary disease (COPD) is an inflammatory lung pathology characterized by persistent airflow limitation and is the third leading cause of death globally. COPD pathophysiology includes both environmental and host risk factors and the presence of comorbidities contributes to its harmful outcome. Cardiovascular disease (CVD) is closely related to COPD and their coexistence is associated with worse outcomes than either condition alone. COPD impairs the cardiovascular system favoring mostly endothelial dysfunction that is a significant COPD prognostic factor at different stages of the disease. The mechanisms promoting endothelial dysfunction in the systemic and/or pulmonary circulation of COPD patients are different and include systemic inflammation, alteration of adhesion and pro-inflammatory molecules, oxidative stress, cellular senescence, and apoptosis. Nevertheless, the role of endothelium in the onset and progression of COPD and CVD is not yet fully understood. Hence, the purpose of this narrative review is to analyze the literature and provide evidence supporting the importance of endothelial dysfunction in COPD.

The integration of three-dimensional (3D) printing techniques into the domains of biomedical research and personalized medicine highlights the evolving paradigm shifts within contemporary healthcare. This technological advancement signifies potential breakthroughs in patient-specific therapeutic interventions and innovations. This systematic review offers a critical assessment of the existing literature, elucidating the present status, inherent challenges, and prospective avenues of 3D printing in augmenting biomedical applications and formulating tailored medical strategies. Based on an exhaustive literature analysis comprising empirical studies, case studies, and extensive reviews from the past decade, pivotal sectors including tissue engineering, prosthetic development, drug delivery systems, and customized medical apparatuses are delineated. The advent of 3D printing provides precision in the fabrication of patient-centric implants, bio-structures, and devices, thereby mitigating associated risks. Concurrently, it facilitates the ideation of individualized drug delivery paradigms to optimize therapeutic outcomes. Notwithstanding these advancements, issues concerning material biocompatibility, regulatory compliance, and the economic implications of avant-garde printing techniques persist. To fully harness the transformative potential of 3D printing in healthcare, collaborative endeavors amongst academicians, clinicians, industrial entities, and regulatory bodies are paramount. With continued research and innovation, 3D printing is poised to redefine the trajectories of biomedical science and patient-centric care. The paper aims to justify the research objective of whether to what extent the integration of 3D printing technology in biomedicine enhances patient-specific treatment and contributes to improved healthcare outcomes.

According to recent data reported, it is noted that lung cancer is the leading cause of cancer death internationally followed by cardiovascular diseases and diabetes. This disease is observed in both women and men and is related to lifestyle habits. Several causes are reported to be at the origin of lung cancer, especially smoking. It is important to note that the majority of lung cancers develop in the bronchi, that is to say at the level of the upper airways which lead to the lungs, which does not however make it possible to rule out the risk factors that come under environmental pollution since man breathes the air quality of the environment every day for his breathing. This review of the literature has made it possible to draw up a state of knowledge in order to understand the risk factors that increase lung cancer. More specifically, this work will make it possible to raise awareness in the field of the fight against cancer, in particular lung cancer.

Effective clinical management of women with schizophrenia is therapeutically challenging. While there have been recent advances in the understanding of neurobiological, hormonal, and female reproductive cycle factors that play a decisive role in the development and progression of schizophrenia in women, this knowledge has not yet been fully translated into treatment practice. The aim was to apply the best evidence available to optimally treat women with schizophrenia at various periods of the lifespan. A narrative review was conducted of recent advances (2018–2023) in aspects of schizophrenia in women that demand sex-specific treatment. Sex steroids impact antipsychotic absorption, distribution, metabolism, elimination, passage through the blood-brain barrier, and blood flow rate to the brain. For these reasons, premenopausal women with schizophrenia, as compared to male age peers, require lower doses of most antipsychotic drugs and suffer comparatively more adverse events (metabolic, sexual, and cardiovascular) at similar doses. Apart from pharmacologic treatment, women have specific reproductive planning needs and need protection from sexual exploitation and domestic abuse. In addition, when pregnant, schizophrenia women show a high risk of gestational diabetes and pre-eclampsia/eclampsia that requires prevention. Prevention is also needed against long-term health hazards for their offspring. Another period of therapeutic challenge specific to women is menopause. The collected evidence points to women-specific recommendations for both biological and psychosocial treatment strategies for schizophrenia.

The gut microbiota comprises a complex bacterial community that resides in the intestine. Imbalances in the gut microbiota can disrupt immune homeostasis, triggering autoimmune diseases including non-infectious uveitis. Despite recent advances, the underlying mechanisms linking the microbiome and uveitis are not fully understood. This review offers a comprehensive analysis of the literature addressing microbiome’s relationship with ocular inflammation. Additionally, it explores the potential of modulating the gut microbiota as a novel therapeutic target. A literature search of published articles related to the role of ocular microbiome in non-infectious uveitis in PubMed and Scopus databases was conducted. The following keywords were used: microbiome, uveitis, and immune-mediate diseases.

Nocturnal heartburn (NHB) is a symptom that affects up to 25% of the general population and has been shown to cause sleep disruption that adversely affects quality of life and psychomotor performance. Few studies have evaluated the association between occasional NHB and sleep disturbances; therefore, this connection may be underappreciated and left untreated by the primary care provider and patient, with potentially significant negative clinical consequences and effects on quality of life. This review sought to describe what is currently known about the interplay between occasional NHB and sleep disruption, and identify whether acid suppression therapy can improve symptoms of occasional NHB and associated sleep disruptions. The pathophysiology of heartburn-induced sleep disruption appears to follow a bidirectional cycle due to the normal physiologic changes that occur in the upper gastrointestinal tract during sleep and due to the potential for heartburn symptoms to cause sleep arousal. The majority of the identified studies suggested that pharmacologic interventions for acid reduction, including proton pump inhibitors or histamine type-2 receptor antagonists (H2RAs), improved objective and/or subjective sleep outcomes among individuals with gastroesophageal reflux disease (GERD) and NHB. Several studies specific to famotidine demonstrated that treatment with 10 mg or 20 mg reduced nighttime awakenings due to NHB. In conclusion, NHB symptoms can cause sleep dysfunction that can have a profound adverse downstream effect on quality of life, next-day functioning, and health-related outcomes. The current approach to managing occasional NHB is similar to that associated with GERD, highlighting the need for studies specific to the occasional heartburn population. Health care providers should investigate NHB as one of the potential causes of sleep complaints, and patients with heartburn should be questioned about sleep quality, recalled arousals, next-day vitality, early fatigue, and next-day functioning.

Lung tuberculosis (TB) remains a heavy burden on public health worldwide. This review discusses mainly the mechanisms of the development of pulmonary fibrosis in an experimental TB model in mice. The involvement of individual components of the extracellular matrix, the activity of matrix metalloproteinases, and the role of their tissue inhibitors in the fibrosis development. The current TB therapy activates fibrosis along with anti-mycobacterial action. The paper describes the authors’ results of experimental use of the liposome-encapsulated dextrazid (LЕDZ) combined with isoniazid (INH) which has both antifibrotic and anti-mycobacterial effects to be considered for future treatment.

Protein kinases, a family of enzymes responsible for regulating various cellular processes, have been implicated in the development and progression of various heart diseases, making them attractive therapeutic targets. This review focuses on the role of protein kinases induced phosphorylation and protein phosphatase-induced dephosphorylation in cardiovascular disorders, including heart failure, ischemic heart disease, arrhythmias, hypertension, and diabetic cardiomyopathy. This paper explores the potential of novel kinase-targeted therapies and emerging technologies for the prevention and treatment of these conditions. It also discusses the involvement of protein kinase A (PKA), protein kinase C (PKC), phosphoinositide 3-kinases (PI3Ks), mitogen-activated protein kinases (MAPKs), and Ca²⁺/calmodulin-dependent protein kinase II (CaMKII) in heart dysfunction and alterations in their function that contribute to their respective cardiac disorders. Furthermore, this article presents a comprehensive overview of protein kinases in cardiac disorders and the potential of innovative kinase-targeted therapies, advanced technologies, and multidisciplinary approaches for the effective prevention and treatment of cardiovascular diseases, ultimately aiming to improve patient outcomes and quality of life.

Type 1 diabetes is a chronic condition that results from the destruction of insulin-producing β-cells in the pancreas. Current treatments for type 1 diabetes, such as insulin therapy and pancreatic islet transplantation, have several limitations and, hence not quite effective in the long run. As current therapy methods fail to slow disease development, novel strategies such as the development of a bioartificial pancreas are being seriously considered. Over the last decade, research has focused on tissue engineering, which aids in the design of biological alternatives for the repair and replacement of non-functional or damaged organs. Three dimensional (3D) bioprinting technology which employs 3D printing technology to generate 3D tissue-like structures from biomaterials and cells, offers a promising solution for the treatment of type 1 diabetes by providing the ability to generate functional endocrine pancreatic tissue. Bioprinted structures are therefore an important aspect of tissue engineering because they have been found to replicate the native extracellular matrix, promoting cell survival and proliferation. In this review, recent developments in 3D bioprinting of endocrine pancreas for the treatment of type 1 diabetes particularly focussing on the choice of cells, biomaterials, growth factors, and essential considerations have been discussed in detail. Additionally, the key challenges and perspectives towards recapitulation of the pancreatic function of the pancreatic organ engineering technologies have also been discussed.

Amazingly, almost 50 years after the first demonstration of anticancer effects of cannabinoids in vitro and in vivo, well-designed clinical trials that definitively prove tumour-inhibiting effects in man are still missing. Whereas a large number of preclinical studies exist that describe tumour-inhibiting effects of cannabinoids, alone or in combination, but also in the form of medical cannabis or natural extracts in vitro, the number of in vivo studies is still limited. Even more limited are well-documented experiences in man. Most animal studies and experience with cannabinoids in man concern brain tumours. This review summarises the effects of phytocannabinoids in brain, breast, colorectal, head and neck, haematological, liver, lung, pancreatic, ovarian, prostate, and skin cancers in animal models and, if available, in patients. The large majority of animal studies demonstrate tumour-inhibiting effects of cannabinoids, thus confirming in vitro data. Experiences in cancer patients are almost exclusively limited to individual case reports and case series without a control group. Many questions are currently unanswered such as the role of pure cannabinoids compared to combinations, cannabinoids as the eventual sole cancer therapy, optimal dosages, or duration of treatment. Pure cannabidiol (CBD) seems to be superior to pure delta-9-tetrahydrocannabinol (THC) in experimental settings. The role of medical cannabis or extracts is less clear as they vary in their phytochemical composition. In conclusion, cannabis/cannabinoids may slow the progression of tumours. However, the hope that cannabinoids could eventually cure cancer as often spread in social media, is, at present, wishful thinking. Above all, well-designed clinical trials paired with long-term follow-up of cancer patients are needed.

The prevalence of skin cancer has increased hastily in the recent decade for both kinds of melanoma and non-melanoma skin cancer. Skin cancers mostly encompass keratinocyte cancers: cutaneous squamous cell carcinoma, basal cell carcinoma, and melanoma. This review discusses the recent advancements in the treatment of skin cancer. In addition to chemotherapy, immunotherapy, targeted therapy, and photodynamic therapy (PDT), there are several other therapies for skin cancer. Additionally, PDT use in combination with chemotherapy, radiation, immunotherapy, and surgery is being actively investigated. This review will specifically address the pathophysiology of skin cancer, diagnostic approaches, and current therapies used in the topical treatment of skin cancers and introduce emerging treatment using nanotechnology that may be beneficial for these indications.

Since the early 1970s, the U.S. Food and Drug Administration (FDA) has received over 800 investigational new drug applications (INDs) for, and pre-INDs pertaining to, research of cannabis or cannabis-derived products. The current data show that applications for research of these products submitted by both academic researchers and commercial developers focus on four major clinical areas: addiction and pain medicine (53%), neurology (19%), immunology and inflammation (14%), and psychiatry (9%). The product types studied have expanded greatly in recent years and include a wide variety of topical, inhalable, injectable, and oral products. In this article, the authors present a breakdown of cannabis and cannabis-derived applications received by the FDA over the past 50 years. The authors also provide a summary of their experience and challenges in reviewing applications for research of cannabis and cannabis-derived products, as well as recommendations for those interested in studying cannabis and cannabis-derived products in human clinical trials. This perspective article includes a discussion on important IND criteria, the pre-IND consultation program, drug master files (DMFs), and various guidance documents and resources. Lastly, the authors provide their perspective for the future of cannabis drug development.

Progeroid syndromes are characterized by clinical signs of premature ageing, which may contain several diseases such as Werner syndrome, Bloom syndrome, Rothmund-Thomson syndrome, Hutchinson-Gilford progeria syndrome, and Cockayne syndrome. These disorders may also exhibit some pathological involvements reminiscent of primary mitochondrial diseases. Emerging evidence has linked mitochondria even to physiological ageing. In addition, alterations in the maintenance pathway of mitochondria have been also deliberated as relevant in age-related diseases. In particular, mitophagy and its regulatory pathway might be key process for the homeostasis of mitochondria. Therefore, chronic DNA damage and/or the activation of poly[adenosine diphosphate (ADP)-ribose] polymerase 1 (PARP1) could be a threat to the mitochondrial alterations. The PARP1 is an enzyme responding to the DNA damage, which might be also involved in the mitophagy. Interestingly, the PARP1 has been reported to play an important role in the longevity of lifespan, which has attracted growing attention with the social development. This review may provide a rationalized overview of the involvement of mitochondrial oxidative stresses in genetically defined accelerated ageing, progeroid syndromes, physiological ageing, and/or age-related diseases for the innovative therapeutic approaches.

The paper aims to review the possibilities of a complex transdisciplinary approach to forming health and longevity. Determinants of productive longevity (DPL) and health culture are reviewed; definitions of health, stress, and eustress, and their roles in active and productive longevity are given. DPL making a decisive contribution to the phenomenon of active longevity are stated and analyzed from the point of view of evidence-based medicine. They are as follows: 1) environmental factors including geographical location, “Blue zones”, and mountain areas, as well as level of the environmental pollution; 2) dietary regimen to support active longevity, including vegetarianism, calorie restriction, fasting, the role of vitamins, biological antioxidants, geroprotectors, and micronutrients; 3) importance of activity and eustress phenomenon, by other words, lifestyle: physical activity, sexual relationship, Qigong and Yoga practices, cognitive activity, sense of humor, and acceptance of age in activities of daily living and survival; 4) genetic and epigenetic particularities as a condition for long-living; 5) level of health care and early diagnostics to prevent age-associated diseases; 6) the role of the state of mind and meditation as well, how it is used for forming health due to Qigong and Yoga natural systems, in religion, and medical practice; 7) motivation for active longevity that significantly increases chances to productive longevity.

Radiation is a primary therapy in the treatment of thoracic malignancies with clear survival benefits. Consequently, patients with cancer are living longer but may be subject to a wide array of cardiotoxic effects from collateral radiation damage. Ensuing fibrosis can affect any portion of the cardiac parenchyma, increasing the risk for accelerated coronary artery disease, pericardial sequelae such as constrictive pericarditis, valvulopathy, restrictive cardiomyopathy, and a myriad of conduction system abnormalities. Unfortunately, the effects of cardiotoxicity can be subclinical or delayed and there remains an unmet need to standardize management strategies for these patients. Based on current data, it is prudent to consider percutaneous approaches first for coronary and valvular disease and traditional, supportive measures for the remaining sequelae. Every attempt should be made to undergo a complete operative haul due to the increased risks of re-operation if surgery is to be performed. Surrounding the patient with a multidisciplinary heart team is critical.

Oral cancer is the most common carcinoma of head and neck cancers. The majority of oral cancers are oral squamous cell carcinoma (OSCC). Among the various etiological factors, oral microbes—bacteria are also associated with pathogenesis of OSCC. But only few studies have been done associating the presence of oral bacteriome with OSCC. The main aim of this review is to focus on association of microbes with OSCC, the pathogenesis, variation in bacteriome profiling in different geographic conditions, their role in pathogenesis of OSCC, and different samples and methods that are used to study their association with habits and tumour node metastasis (TNM) staging. To conclude, the imbalance in the oral bacteriome could be considered an etiological factor for OSCC. Since the bacteriome profiling varies greatly with geographic location and even in an individual in different locations of the oral cavity, it advocates more research. The study on identifying bacteria associated with OSCC will also enable their use as diagnostic markers and preventive management of OSCC.

This case report demonstrates the successful induction of apexogenesis in an extensively carious lower right first molar with immature roots through the use of stepwise excavation and calcium-enriched mixture (CEM) cement as an indirect pulp capping material. The patient, an 8-year-old boy, presented with pain and carious pulp exposure. The initial treatment involved removing soft dentin and applying CEM cement as an indirect pulp cap. The patient experienced pain relief after 24 h, and subsequent follow-up appointments showed complete healing and maturation of the tooth. The case highlights the potential of indirect pulp treatment with CEM cement and emphasizes the importance of regenerative biomaterials in promoting healing and dentin bridge formation. Further clinical work and research are recommended to explore the efficacy of this treatment approach.

The patient is a 58-year-old male who presented with chief complaints of right-sided numbness, tingling, and loss of temperature sensation in the upper and lower extremities. The patient’s symptoms began around the face and right corner of the mouth [maxillary/mandibular (V2/V3) distribution] before descending to the arm, trunk, and followed by the lower leg and foot. His home medication regimen included lisinopril, atorvastatin, long and short-acting insulin, and amlodipine. During the interview, the patient admitted to abstinence from his medications. Upon examination, the patient was found to have a loss of hot and cold touch on the right side and expressed 2+ reflexes (brisk response; normal) on both upper and lower extremities. In the initial work-up of the patient, he received a computed tomography (CT) scan which demonstrated an area of potential ischemic infarct of one of the left sided pontine perforator arteries. Immediately at that time he was given a loading dose of 325 mg aspirin and started on 81 mg daily. Because of the patient’s symptoms and risk factors, he was hospitalized for further additional work-up and eventually discharged on dual antiplatelet therapy. This case is intriguing as both neuroradiological reading and neurological examination helped with localization of the lesion and changing the treatment strategy of the patient. With a pontine perforator ischemic event, the harms of treatment with thrombolytics would have outweighed the benefits. This interprofessional work between neuroradiology, internal medicine, and neurology ensured that the patient received the best care for his specific ailments.

Infection and suppuration of chronic wounds reduce the effectiveness of their treatment with a course of antibiotics and antiseptics combined with frequently renewed dressings. Therefore, daily short-term procedures of cleaning wounds from purulent-necrotic masses by mechanical methods, including the use of cleansing solutions and necrophage fly larvae, are also part of the general practice of chronic wound treatment. But even they do not always provide rapid healing of chronic wounds. In this connection, it is suggested to supplement the treatment of chronic wounds with preparations dissolving dense pus and wound dressings made in the form of warm moist compresses creating a local greenhouse effect in the wounds. Solutions of 3% hydrogen peroxide and 2–10% sodium bicarbonate heated to a temperature of 37°–45°С, possessing alkaline activity at рН 8.4–8.5 and enriched with dissolved carbon dioxide or oxygen gas (due to overpressure of 0.2 atm were suggested as pyolytic drugs. The first results of the use of pyolytics and warm moist dressings-compresses in the treatment of chronic wounds demonstrate a wound-healing effect. It is suggested to consider sanitizing therapy with pyolytics and warm moist wound dressings-compresses as an alternative to the use of modern cleansing solutions and artificial introduction of larvae of the necrophage fly into the purulent masses of chronic wounds to dissolve dense pus and accelerate the healing process.

Bell’s palsy is a rapid unilateral peripheral paralysis of cranial nerve VII whose etiology is varied, most commonly associated with an acute infectious or inflammatory demyelinating process. Nerve injury can result in edema because of increased permeability of vascular structures, which can sometimes be seen as a locus of enhancement of magnetic resonance imaging (MRI). Bell’s palsy is typically considered a clinical diagnosis and the specificity and sensitivity of imaging have been poorly studied. Herein is describe a case of a 73-year-old male who presented to the emergency department with left-sided facial droop and no other focal neurological abnormalities. With a history of a Janus kinase 2 (JAK2) mutation and the new initial facial drooping, acute cerebrovascular insult was high on the differential. Initial labs and computerized tomography (CT) head were inconclusive, but MRI showed pronounced enhancement of the left distal internal carotid artery (ICA) with contiguous enhancement of the labyrinthine, geniculate, and tympanic segments of the left facial nerve. Diagnosing Bell’s palsy can be a challenge as there are numerous postulated etiologies stemming from trauma, infection, and neoplasm; with infection (particularly viral) postulated to be the most likely source. Though MRI is currently not validated as a tool in expediting Bell’s palsy diagnosis, findings such as the enhancement seen here provide some insight into the benefit of MRI as a diagnostic modality in some cases. This case is unique both for the diagnostic dilemma between stroke and Bell’s palsy and the potential for MRI imaging to help guide clinical decision-making into treatment.

Self-replicating RNA viruses such as alphaviruses, flaviviruses, paramyxoviruses, and rhabdoviruses have been engineered as expression vectors for vaccine development. The prominent feature of self-replicating RNA viruses is their RNA-dependent RNA polymerase activity, which generates massive self-amplification of RNA in the cytoplasm of infected host cells leading to extreme levels of transgene expression. Infectious diseases have been targeted by overexpression of surface proteins of pathogens as antigens for vaccine development. Moreover, overexpression of tumor-associated antigens and immunostimulatory genes has been the basis for cancer vaccines. Proof-of-concept of robust antigen-specific immune responses and protection against challenges with lethal doses of infectious agents have been demonstrated. Likewise, vaccine development against various cancers has elicited strong immune responses and resulted in tumor regression and eradication, cure, and prolonged survival in animal tumor models. Good safety and immune responses have been achieved in clinical trials. The ERVEBO® vaccine, based on the vesicular stomatitis virus, has been approved for immunization against the Ebola virus disease.

Diabetes mellitus has become increasingly more common and diagnosed within the global population. Coupled with the continued prevalence of substance use, there are some distinct considerations for users suffering (knowingly or unknowingly) from type 1 or type 2 diabetes. The various different types of drugs of abuse including central nervous system stimulants, depressants, and hallucinogens present varying direct and indirect complications for diabetes based on their physiological and psychological effects ranging from non-compliance with medication to an increased risk of hypoglycaemia, hyperglycaemia, and/or ketoacidosis. This perspective highlights these issues supported by the drug history and toxicological findings in patients undergoing drug rehabilitation in the United Arab Emirates (UAE) demonstrating the use of alcohol, amphetamines, benzodiazepines, cannabis, opiates/opioids (especially tramadol), pregabalin, and synthetic cannabinoids. Physicians and drug clinic professionals should be aware of the contraindications of substance use and diabetes with a view to educating patients and healthcare professionals within such clinical settings.

Complex enzyme interactions play a role in the spread of cancer, a process fueled by unregulated cell proliferation. DNA topoisomerases, which are important for fixing DNA topological problems, have drawn a lot of interest as potential targets for anti-cancer medications. Cancer treatment, which includes radiation, surgery, and chemotherapy, tries to control cell survival, demise, and mobility, which are mediated by ion transportation across cell membranes via channels and carriers. The malignant transition is characterised by altered channels and carriers. Chemoresistance, which commonly develops after chemotherapy, denotes decreased therapeutic effectiveness against cancer progression. Chemosensitizers are used in combination with anti-cancer medications to overcome this resistance, particularly against adenosine triphosphate (ATP)-binding cassette (ABC) transporters including P-glycoprotein, multidrug resistance-associated protein 1 (MRP1), breast cancer resistance protein (BCRP). Effective targets for treatment are transcription factors, which play a key role in the development of cancer. With the use of interactions with receptors, enzymes, ion channels, transporters, and TFs, nanotechnology improves the safety of tumour localization, treatment, and diagnostics. As a result of mutations or altered signalling, rat sarcoma (RAS) proteins regulate signalling, which is essential for both healthy growth and the development of cancer. Rational treatments that target RAS pathways have the potential to inhibit the growth and spread of tumours. New treatments are still being developed, and they are showing promise in clinical settings. The roles of receptors on tumour cells, their significance for cancer therapy, and recent advancements in preclinical and clinical research are all included in this overview.

The development of patient-specific prosthetics, medication administration, the manufacture of tissues and organs, and surgical planning have all benefited significantly from the use of three-dimensional (3D) printing during the past few decades. The enthusiasm for customized healthcare has increased because the United States of America launched its Precision Medicine Initiative in 2015. In a nutshell, the phrase “personalized medicine” refers to medical care that is tailored to the patient. Nevertheless, the biomedical materials utilized in 3D printing are often stable and can’t react or be adaptive and intelligent in the body’s interior environment. Ex-situ fabrication of these substances, which includes printing on a flat substrate before releasing it onto the target surface, may cause a discrepancy between the printed portion and the target areas. The 3D printing is one method that might be used to provide customized treatment. The four-dimensional (4D) printing is developed while employing components that can be tweaked with stimulation. Several researchers have been looking at a new area recently that blends medicines with 3D and 4D printing. The development of 4D printing overcomes a number of these issues and creates a promising future for the biomedical industry. Smart materials that have been pre-programmed can be used in 4D printing to create structures that react interactively to outside stimuli. Despite these benefits, dynamic materials created using 4D technology remain in their development. As a result, several ideas for pharmaceutical products and formulas that may be customized and printed have emerged. Furthermore, Spritam®, the first medicine produced by 3D printing, has indeed reached a medical facility. This paper offers a summary of several 3D and 4D printing technologies and how they are used in the pharmaceutical industry for customized medicine and drug delivery systems.

The current literature findings on autophagy’s beneficial and detrimental roles in diabetes mellitus (DM) and diabetes-related comorbidities were reviewed. The effects of oral hypoglycaemic medicines and autophagy in DM. Autophagy plays an important function in cellular homeostasis by promoting cell survival or initiating cell death in physiological settings was also assessed. Although autophagy protects insulin-target tissues, organelle failure caused by autophagy malfunction influences DM and other metabolic diseases. Endoplasmic reticulum and oxidative stress enhance autophagy levels, making it easier to regulate stress-induced intracellular changes. Evidence suggests that autophagy-caused cell death can occur when autophagy is overstimulated and constitutively activated, which might prevent or develop DM. Even though the precise role of autophagy in DM complications is uncertain, deregulation of the autophagic machinery is strongly linked to beta cell destruction and the aetiology of DM. Thus, improving autophagy dysfunction is a possible therapeutic objective in treating DM and other metabolic disorders.

Wound healing is a very dynamic and complex process as it involves the patient, wound-level parameters, as well as biological, environmental, and socioeconomic factors. Its process includes hemostasis, inflammation, proliferation, and remodeling. Evaluation of wound components such as angiogenesis, inflammation, restoration of connective tissue matrix, wound contraction, remodeling, and re-epithelization would detail the healing process. Understanding key mechanisms in the healing process is critical to wound research. Elucidating its healing complexity would enable control and optimize the processes for achieving faster healing, preventing wound complications, and undesired outcomes such as infection, periwound dermatitis and edema, hematomas, dehiscence, maceration, or scarring. Wound assessment is an essential step for selecting an appropriate treatment and evaluating the wound healing process. The use of artificial intelligence (AI) as advanced computer-assisted methods is promising for gaining insights into wound assessment and healing. As AI-based approaches have been explored for various applications in wound care and research, this paper provides an overview of recent studies exploring the application of AI and its technical developments and suitability for accurate wound assessment and prediction of wound healing. Several studies have been done across the globe, especially in North America, Europe, Oceania, and Asia. The results of these studies have shown that AI-based approaches are promising for wound assessment and prediction of wound healing. However, there are still some limitations and challenges that need to be addressed. This paper also discusses the challenges and limitations of AI-based approaches for wound assessment and prediction of wound healing. The paper concludes with a discussion of future research directions and recommendations for the use of AI-based approaches for wound assessment and prediction of wound healing.

The idea that proteins are the main determining factors in the functioning of cells and organisms, and their dysfunctions are the first cause of pathologies, has been predominant in biology and biomedicine until recently. This protein-centered view was too simplistic and failed to explain the physiological and pathological complexity of the cell. About 80% of the human genome is dynamically and pervasively transcribed, mostly as non-protein-coding RNAs (ncRNAs), which competitively interact with each other and with coding RNAs generating a complex RNA network regulating RNA processing, stability, and translation and, accordingly, fine-tuning the gene expression of the cells. Qualitative and quantitative dysregulations of RNA-RNA interaction networks are strongly involved in the onset and progression of many pathologies, including cancers and degenerative diseases. This review will summarize the RNA species involved in the competitive endogenous RNA network, their mechanisms of action, and involvement in pathological phenotypes. Moreover, it will give an overview of the most advanced experimental and computational methods to dissect and rebuild RNA networks.

Abnormal energy metabolism is one of the ten hallmarks of tumors, and tumor cell metabolism provides energy and a suitable microenvironment for tumorigenesis and metastasis. Tumor cells can consume large amounts of glucose and produce large amounts of lactate through glycolysis even in the presence of oxygen, a process called aerobic glycolysis, also known as the Warburg effect. Lactate is the end product of the aerobic glycolysis. Lactate dehydrogenase A (LDHA), which is highly expressed in cancer cells, promotes lactate production and transports lactate to the tumor microenvironment and is taken up by surrounding stromal cells under the action of monocarboxylate transporter 1/4 (MCT1/4), which in turn influences the immune response and enhances the invasion and metastasis of cancer cells. Therapeutic strategies targeting lactate metabolism have been intensively investigated, focusing on its metastasis-promoting properties and various target inhibitors; AZD3965, an MCT1 inhibitor, has entered phase I clinical trials, and the LDHA inhibitor N-hydroxyindole (NHI) has shown cancer therapeutic activity in pre-clinical studies. Interventions targeting lactate metabolism are emerging as a promising option for cancer therapy, with chemotherapy or radiotherapy combined with lactate-metabolism-targeted drugs adding to the effectiveness of cancer treatment. Based on current research, this article outlines the role of lactate metabolism in tumor metastasis and the potential value of inhibitors targeting lactate metabolism in cancer therapy.

Stroke, a central nervous system (CNS) injury, is responsible for the second leading cause of death in the world, bringing a great burden on the world. Stroke is normally divided into ischemic and hemorrhagic stroke, among which ischemic stroke takes up 87% proportion. Accumulating evidence has denoted a rather pivotal role for autophagy in the pathogenesis of ischemic stroke, which is activated in neuronal cells, glial cells, and endothelial cells. Besides, circular RNAs (circRNAs), a novel type of epigenetic regulation, are highly expressed in the CNS and are involved in the process of CNS diseases, which is regarded as an important molecular mechanism in ischemic stroke. Meanwhile, circRNA and autophagy have a significant correlation. The intracellular signaling pathways regulating autophagy can either restrain or activate autophagy. However, under the circumstances of ischemic stroke, the precise communication between circRNA and stroke is largely unknown. This review aims to provide a summary of the relationship between circRNA, autophagy, and ischemic stroke, as well as the current research advancements in understanding how circRNA regulates autophagy in the context of stroke.

Broncho-alveolar lavage (BAL) represents a safe tool for the differential diagnosis of various pulmonary fibrotic diseases. Idiopathic pulmonary fibrosis (IPF) belongs to a heterogeneous group of diseases, interstitial lung disease (ILD), presenting a progressive impairment of pulmonary functions. IPF is characterized by the excessive accumulation of extracellular matrix (ECM) in the alveolar parenchyma that may lead to irreversible pulmonary remodeling. Although the exact pathogenetic mechanisms leading to IPF development are still unclear it has been demonstrated that fibroblasts differentiating toward myofibroblasts are the major actors involved in this process. The possibility of obtaining and expanding fibroblasts from the BAL of ILD patients for research purposes has been recently explored. This approach is discussed here as a reliable chance, helpful to advance the scientific community knowledge and to devise two- and three-dimensional (2D/3D) pre-clinical in vitro models of these diseases, further overcoming technical and ethical concerns related to the use of fibroblasts derived from tissue biopsy.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can result in a range of persistent symptoms impacting everyday functioning for a considerable proportion of patients, a condition termed Long coronavirus disease (COVID) or post COVID-19 syndrome. The severity and set of symptoms vary between patients, and include fatigue, cognitive dysfunction, sleep disturbances, palpitations, tachycardia, pain, depression, and anxiety. The high prevalence of Long COVID combined with the lack of treatment approaches has resulted in considerable unmet clinical needs. There is a growing body of evidence that cannabis-based medicinal products (CBMPs) can be used to treat symptoms including pain, anxiety, depression, fatigue, sleep, headaches, and cognitive dysfunction, which are commonly reported in Long COVID. This article provides an overview of the pathophysiology of Long COVID and discusses preliminary pre-clinical, clinical trials, and real-world evidence (RWE) for CBMPs in the context of Long COVID. This review summarises current clinical trials and studies exploring CBMPs in Long COVID. The current evidence provides a rationale to further explore CBMPs as a treatment for Long COVID symptoms. In addition to further randomised controlled trials (RCTs), the increasing availability of CBMPs globally, coupled with the continued prevalence of Long COVID in the population, also highlights the value of real-world data in the research of CBMPs in Long COVID. Critically, there is an evident need for multidisciplinary approaches of CBMPs and Long COVID in real-world clinical practice settings.

Bochdalek hernia (BH) is a congenital diaphragmatic defect primarily diagnosed in neonates and is usually left-sided. Adult diagnosis, especially of right-sided BH is exceedingly rare and usually presents with symptoms. Till now, only 31 cases have been diagnosed to be right-sided BH along with intrathoracic kidney. This report presents a 26-year-old asymptomatic male who was incidentally diagnosed with a massive right congenital diaphragmatic hernia. Imaging revealed severe abdominal herniation, a right intrathoracic ectopic kidney, and a right liver lobe hypoplasty along with hypertrophied left liver lobe extending down to the pelvic cavity. Several surgeons were consulted, with controversial opinions on whether elective surgery should be performed or withheld. Due to the high risk associated with surgery and the patient’s choice, the surgery was deferred. For almost 18 months, the patient did not report any symptoms or complications. This case highlights the rarity of asymptomatic right-sided BH in adults and the challenges in determining a management approach. Also, it proposes a conservative approach for such patients as a management modality. Most extensive diagrammatic defect reported is estimated to have a neck defect of 10 cm. Most BH cases have been treated surgically and reports on the outcome of a conservative approach are exceedingly rare. In such cases, patient preferences and a thorough risk assessment play vital roles in decision-making regarding conservative versus surgical approaches.

Enhanced recovery after surgery (ERAS) is a recommended surgical strategy at present, the core content is to reduce perioperative stress response and postoperative complications through perioperative multi-mode analgesia and intensive surgery. Electroacupuncture (EA) has been widely used in various clinical applications, and its efficacy and safety have been fully proven. The application of acupuncture in ERAS will have an important impact on rehabilitation research and development. In this review, the molecular mechanism of EA in ERAS are summed up from promoting perioperative efficacy to improving postoperative immune status. The combination of EA and ERAS may better promote the recovery of patients and the development of rehabilitation.

Gastrointestinal (GI) cancer is one of the leading causes of death that affect many patients around the world. The coronavirus disease 2019 (COVID-19) pandemic significantly impacted our healthcare system in large that diagnosis and management of GI cancer have suffered with a reduction in cancer screening. This review will describe the current practices of cancer screening during COVID-19 pandemic and summarize how each GI cancer (esophageal, gastric, colorectal, and hepatocellular cancers) has been affected by COVID-19. World widely there has been a decreasing trend in screening, diagnosis, and management of GI cancers during the COVID-19 pandemic. Many healthcare institutions are now observing the effect of this change and implementing practice variations to adapt to the pandemic.

In the context of in-hospital care management, the need for infusion therapies involves the choice of appropriate devices. Historically, there is no consensus about the preference for vascular accesses, although the data present in the literature would seem to favor peripheral ones due to fearful complications and a non-negligible rate of bloodstream infections. It is also true the decision for central routes is sometimes dictated by the patient’s general clinical conditions (especially as a result of surgery) or by the need to establish continuous short or long-term support therapies. Therefore, it would seem anachronistic to favor one strategy rather than another. Probably data should be reviewed, considering and evaluating the correct application of indications and guidelines for both positioning and management of venous accesses, without facing methodological biases that could lead to scarcy and inconclusive results; although it is undeniable that some conditions promote the onset of complications.

The gastrointestinal (GI) microbiome remains an emerging topic of study and the characterization and impact on human health and disease continue to be an area of great interest. Similarly, the coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the healthcare system with active disease, lasting effects, and complications with the full impact yet to be determined. The most current evidence of the interaction between COVID-19 and the GI microbiome is reviewed, with a focus on key mediators and the microbiome changes associated with acute disease and post-acute COVID-19 syndrome (PACS).