Dry eye disease(DED)is a multifactorial disorder that disturbs ocular surface equilibrium,considerably diminishing quality of life.Present therapies only offer symptomatic alleviation.Stem cell treatment,especially me...Dry eye disease(DED)is a multifactorial disorder that disturbs ocular surface equilibrium,considerably diminishing quality of life.Present therapies only offer symptomatic alleviation.Stem cell treatment,especially mesenchymal stem cells(MSCs),has surfaced as a viable approach for tissue regeneration and immunological regulation in DED.Preclinical and early clinical investigations indicate that MSCs can improve lacrimal gland functionality,diminish inflammation,and facilitate corneal regeneration.Nonetheless,obstacles persist in enhancing MSC viability,determining the optimal MSC source,and guaranteeing sustained therapeutic effectiveness.Additional extensive randomized clinical trials are required to confirm the efficacy of MSC-based therapies for severe DED.展开更多
BACKGROUND Precision medicine is an emerging field that includes tumor-targeted delivery and tumor microenvironment.This review explores the synergistic potential of combining nano-drug delivery systems with low radia...BACKGROUND Precision medicine is an emerging field that includes tumor-targeted delivery and tumor microenvironment.This review explores the synergistic potential of combining nano-drug delivery systems with low radiation doses to achieve optimized therapeutic outcomes,particularly in the context of cancer treatment.Nanoparticle-based drug carriers offer precise and targeted delivery,enhancing the therapeutic index of anticancer agents.The use of lower radiation doses has become a focus in radiation oncology to minimize off-target effects on healthy tissues in palliation treatment with high-target volume lesions.AIM To conduct a bibliometric review of nanomedicine and glioblastoma(GBM),all relevant studies from the last two decades were included.METHODS The search strategy comprised the keywords“nanomedicine”and“glioblastoma”in the title and/or abstract.All English-language documents from 1 January 2000 to 31 December 2023 were considered for the analysis.R code(version 4.2.0)with R Studio(version 2022.12.0-353)and the Bibliometrix package(version 4.0.1)were used for the analysis.A total of 680 documents were collected.RESULTS We analyzed the bibliometric features of nanomedicine in glioma.With the limitations of the research,our analysis aims to highlight the increasing interest of researchers in the precision medicine field in GBM treatment and lead us to suggest further studies focusing on the association between nanomedicine and radiotherapy.CONCLUSION Due to the poor prognosis associated with GBM,new therapeutic approaches are necessary.There is an increasing interest in precision medicine,which includes nanomedicine and radiotherapy,for GBM treatment.This integration enhances the efficacy of targeted treatments and provides a promising avenue for reducing adverse effects,signifying a notable advancement in precision oncology.展开更多
BACKGROUND Cytomegalovirus(CMV)is a ubiquitous herpesvirus that can cause significant ocular morbidity,particularly in immunocompromised individuals.AIM To summarize the current understanding of the ophthalmic impact ...BACKGROUND Cytomegalovirus(CMV)is a ubiquitous herpesvirus that can cause significant ocular morbidity,particularly in immunocompromised individuals.AIM To summarize the current understanding of the ophthalmic impact of CMV,with a focus on its epidemiology,clinical manifestations,diagnosis,and management,ocular symptoms of CMV floaters,blurred vision,and loss of peripheral vision,eventually progressing to retinal necrosis and detachment.CMV retinitis(CMVR)is a sight-threatening condition that can lead to retinal detachment,blindness,and even death.METHODS We discuss the pathophysiology of CMVR,including the role of immune suppression and viral reactivation.We also examine the clinical features of CMVR,including its characteristic retinal lesions and associated ocular complications.Diagnostic approaches are reviewed,including polymerase chain reaction and fundus photography.RESULTS We discuss treatment options,including antiviral medications,intravitreal injections,and surgical interventions.Finally,we highlight areas of ongoing research and future directions in managing CMV-related ocular disease.CONCLUSION CMV poses a significant threat to ocular health,particularly in immunocompromised populations such as those with human immunodeficiency virus/acquired immune deficiency syndrome.展开更多
BACKGROUND High-resolution optical coherence tomography(HR-OCT)has become an essential instrument in the screening and diagnosis of ocular surface neoplasms.Research demonstrates that HR-OCT possesses a diagnostic sen...BACKGROUND High-resolution optical coherence tomography(HR-OCT)has become an essential instrument in the screening and diagnosis of ocular surface neoplasms.Research demonstrates that HR-OCT possesses a diagnostic sensitivity ranging from 85%to 90%for ocular surface squamous neoplasia(OSSN).The connections between HR-OCT features and histological findings have consistently shown robustness,hence increasing the reliability of clinical diagnosis.AIM To examine the existing HR-OCT indicators employed in the identification of common non-benign ocular surface tumors,namely,basal cell carcinoma,OSSN,and melanocytic conjunctival lesions,and to assess their diagnostic efficacy,benefits,and prospective developments.METHODS A thorough literature review was performed to assess the published research on HR-OCT in the diagnosis of ocular surface cancers.Significant attention was given to research that compares HR-OCT characteristics with histopath-ologic validation,as well as on publications addressing the integration of emerging technologies and artificial intelligence in ocular oncology imaging.RESULTS HR-OCT exhibits elevated diagnostic sensitivity(85%-90%)for identifying OSSN and presents distinct imaging patterns that align closely with histology results.This approach has substantial clinical advantages due to its non-invasive characteristics,improved axial resolution,and real-time imaging capabilities.HR-OCT has demonstrated potential in assessing various lesions,including basal cell carcinoma and melanocytic conjunctival malignancies.CONCLUSION HR-OCT assumes an increasingly vital role in the early identification and clinical management of ocular surface malignancies.With advancements in imaging technology and the integration of artificial intelligence,HR-OCT is anticipated to enhance individualized diagnosis and treatment planning in ocular oncology,hence improving patient outcomes.展开更多
BACKGROUND Eyelid reconstruction is an intricate process,addressing both aesthetic and functional aspects post-trauma or oncological surgery.Aesthetic concerns and oncological radicality guide personalized approaches....BACKGROUND Eyelid reconstruction is an intricate process,addressing both aesthetic and functional aspects post-trauma or oncological surgery.Aesthetic concerns and oncological radicality guide personalized approaches.The complex anatomy,involving anterior and posterior lamellae,requires tailored reconstruction for optimal functionality.AIM To formulate an eyelid reconstruction algorithm through an extensive literature review and to validate it by juxtaposing surgical outcomes from Cattinara Hos-in dry eye and tears,which may lead to long-term consequences such as chronic conjunctivitis,discomfort,or photo-phobia.To prevent this issue,scars should be oriented vertically or perpendicularly to the free eyelid margin when the size of the tumor allows.In employing a malar flap to repair a lower eyelid defect,the malar incision must ascend diagonally;this facilitates enhanced flap advancement and mitigates ectropion by restricting vertical traction.Conse-quently,it is imperative to maintain that the generated tension remains consistently horizontal and never vertical[9].Lagophthalmos is a disorder characterized by the inability to completely close the eyelids,leading to corneal exposure and an increased risk of keratitis or ulceration;it may arise following upper eyelid surgery.To avert this issue,it is essential to preserve a minimum of 1 cm of skin between the superior edge of the excision and the inferior boundary of the eyebrow.Epiphora may occur in cancers involving the lacrimal puncta,requiring their removal.As previously stated,when employing a glabellar flap to rectify medial canthal abnormalities,it is essential to prevent a trapdoor effect or thickening of the flap relative to the eyelid skin to which it is affixed.Constraints about our proposed algorithm enco-mpass limited sample sizes and possible publication biases in existing studies.Subsequent investigations ought to examine long-term results to further refine the algorithm.Future research should evaluate the algorithm across varied populations and examine the impact of novel graft materials on enhancing reconstructive outcomes.CONCLUSION Eyelid reconstruction remains one of the most intriguing challenges for a plastic surgeon today.The most fascinating aspect of this discipline is the need to restore the functionality of such an essential structure while maintaining its aesthetics.In our opinion,creating decision-making algorithms can facilitate reaching this goal by allowing for the individualization of the reconstructive path while minimizing the incidence of complications.The fact that we have decreased the incidence of severe complications is a sign that the work is moving in the right direction.The fact that there has been no need for reintervention,neither for reconstructive issues nor for inadequate oncological radicality,overall signifies greater patient satisfaction as they do not have to undergo the stress of new surgeries.Even the minor complic-ations recorded are in line with those reported in the literature,and,even more importantly for patients,they are of limited duration.In our experience,after a year of application,we can say that the objective has been achieved,but much more can still be done.Behind every work,a scientific basis must be continually renewed and refreshed to maintain high-quality standards.Therefore,searching for possible alternative solutions to be included in one’s surgical armamentarium is fundamental to providing the patient with a fully personalized option.展开更多
BACKGROUND Simultanagnosia is a neurological disorder that impairs an individual's ability to perceive more than one object at a time visually.While the individual may acknowledge the presence of multiple objects ...BACKGROUND Simultanagnosia is a neurological disorder that impairs an individual's ability to perceive more than one object at a time visually.While the individual may acknowledge the presence of multiple objects in his field of view,he cannot generally summarize the overall percept.CASE SUMMARY We describe a case of simultanagnosia in Posterior Cortical Atrophy,evidenced by the Ishihara color test.A 54-year-old woman complained of reading problems despite normal visual acuity and a structural eye exam.The patient failed to identify any of the Ishihara color plates in either eye despite adequate naming of colors.Automated visual field testing showed a homonymous hemianopia.Structural and functional neuroimaging and cerebrospinal fluid analysis were consistent with posterior cortical atrophy.CONCLUSION Simultanagnosia can be tested with the Ishihara pseudoisochromatic plates because the recognition of embedded number patterns in the test requires appreciation of a collection of individual stimuli.展开更多
BACKGROUND The surgical management of corneal lesions resulting from eyelid pathologies requires a comprehensive approach to ensure optimal patient outcomes.Eyelid lesions,ranging from benign to malignant,can lead to ...BACKGROUND The surgical management of corneal lesions resulting from eyelid pathologies requires a comprehensive approach to ensure optimal patient outcomes.Eyelid lesions,ranging from benign to malignant,can lead to corneal damage through mechanisms such as mechanical abrasion,secondary infection,or inflammatory responses.AIM To assess the surgical methodologies utilized in the treatment of corneal lesions resulting from eyelid disorders and evaluate their effects on patient outcomes,recurrence rates,and postoperative complications.The incorporation of advanced imaging techniques,including optical coherence tomography and ultrasound biomicroscopy,in conjunction with histopathological analysis,is addressed to improve surgical accuracy and patient outcomes.METHODS The authors searched online databases(PubMed and Cochrane)for publications on the surgical management of lid lesions.Records received from the two databases were checked for duplicates and relevance.Only records with full texts and in English language were included.RESULTS A total of 28 records were obtained following the screening for relevancy and duplication.The review underscores essential surgical approaches employed in the treatment of corneal lesions resulting from common eyelid diseases,focusing on operative efficacy,complication rates,and long-term results.CONCLUSION This systematic review emphasizes the significance of choosing suitable surgical techniques tailored to individual patient characteristics and stresses the need for interdisciplinary collaboration in ophthalmic care.The results indicate that sophisticated imaging techniques and careful preoperative preparation markedly improve surgical accuracy and long-term results.展开更多
Retinal degenerative diseases,such as age-related macular degeneration,retinitis pigmentosa,and Stargardt disease,are primary contributors to irreversible vision loss globally.Due to the scarcity of effective curative...Retinal degenerative diseases,such as age-related macular degeneration,retinitis pigmentosa,and Stargardt disease,are primary contributors to irreversible vision loss globally.Due to the scarcity of effective curative treatments,stem cell therapy has emerged as a revolutionary advancement in ophthalmology.In the last ten years,significant advancements have been achieved in the derivation of retinal pigment epithelium and photoreceptor precursors from human embryonic stem cells and induced pluripotent stem cells,with initial clinical trials indicating safety and potential efficacy.Innovative delivery platforms,such as biodegradable scaffolds,microcarrier suspensions,and minimally invasive subretinal devices,are tackling prior challenges related to cell survival and integration.Simultaneously,gene-edited and patient-specific induced pluripotent stem cells are positioned to surmount immunological and ethical constraints.Future combinatorial strategies that incorporate stem cells with gene therapy,CRISPR-mediated editing,and bioengineered retinal organoids offer potential for personalized and regenerative methodologies.Nonetheless,enduring functional integration,immune tolerance,and oncogenic safety continue to pose significant challenges.To effectively transition from laboratory research to clinical application,collaborative frameworks among academic institutions,biotechnology companies,and regulatory agencies will be crucial for unlocking the complete therapeutic potential of stem cell-based treatments for retinal diseases.Stem cell therapy has transitioned from a distant promise to an advancing reality set to transform retinal care.展开更多
Usher syndrome(USH)should no longer be considered a fixed diagnosis limited to syndromic early-onset sensorineural hearing loss and progressive vision decline due to rod-cone retinal dystrophy.Patients increasingly pr...Usher syndrome(USH)should no longer be considered a fixed diagnosis limited to syndromic early-onset sensorineural hearing loss and progressive vision decline due to rod-cone retinal dystrophy.Patients increasingly present with partial or delayed retinal manifestations,often lacking a clinically relevant audiological history.Concurrently,genomic testing uncovers variants that challenge the practical relevance of the traditional definition of type I,II,and III subclassifications.This review argues for a paradigm shift toward genotype-first diagnosis led by ophthalmologists,integrating retinal findings and audiological evaluations with comprehensive genetic information.The rise of gene-specific molecular therapies,including antisense oligonucleotides and CRISPR-mediated gene editing for USH2A and MYO7A,demands timely and accurate molecular categorization for each patient.Delays in precise molecular diagnosis may risk excluding patients from potentially vision-saving trials.Diagnostic gaps persist,including limited variant interpretation tools,underrepresentation of non-Caucasian populations in reference databases,and a lack of standardized retinal imaging protocols.The establishment of centralized,real-time Usher registries and interdisciplinary diagnostic models is essential.The future of USH management lies in anticipatory,individualized care that begins in the retina clinic.展开更多
BACKGROUND Pituitary neuroendocrine tumors(PitNETs),formerly referred to as pituitary adenomas,are prevalent intracranial neoplasms that,although often benign histologically,can demonstrate invasive growth,therapeutic...BACKGROUND Pituitary neuroendocrine tumors(PitNETs),formerly referred to as pituitary adenomas,are prevalent intracranial neoplasms that,although often benign histologically,can demonstrate invasive growth,therapeutic resistance,and recurrence.Emerging evidence supports the presence of a subpopulation of tumorinitiating cells with stem-like properties-pituitary adenoma stem cells(PASCs)-that may drive these aggressive features.This systematic review aims to critically examine the evidence on PASCs,their phenotypic and functional characteristics,and their role in PitNET pathophysiology.AIM To study the molecular markers,signaling pathways,research models,and phenotypic traits of PASCs,and to assess their potential significance for future translational and clinical applications.METHODS A comprehensive literature search was conducted in PubMed,Scopus,and Ovid MEDLINE in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Thirty-four studies were included based on predefined eligibility criteria.Data were extracted regarding PASC isolation methods(e.g.,neurosphere formation,side population sorting),marker expression[e.g.,SRY-related HMG-box transcription factor(SOX)2,octamer-binding transcription factor 4,CD133,Nestin],pathway involvement(e.g.,Wnt/betacatenin,Notch,Sonic hedgehog),and functional behaviors such as self-renewal,differentiation,tumorigenicity,and therapy resistance.RESULTS Following duplicate removal,315 unique articles were screened,with 47 full texts assessed for eligibility.Ultimately,34 studies published between 2007 and 2025 met the inclusion criteria.The majority utilized human PitNET samples(83%),with a subset employing rat-derived cell lines(28%)or murine models(15%).PASCs were identified and characterized using various in vitro and in vivo approaches.Commonly reported stemness markers included SOX2(59%),CD133(38%),Nestin(35%),and octamer-binding transcription factor 4(26%),with others such as SOX9,paired-like homeobox 1,and C-X-C chemokine receptor type 4 also frequently cited.Wnt/betacatenin(18%)and phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin(9%)signaling pathways were most implicated,followed by Notch,Sonic hedgehog,and janus kinase/signal transducer and activator of transcription cascades.Functional assays revealed consistent findings of tumor initiation(44%),selfrenewal(35%),and tumor progression or invasion(35%).Notably,a minority of studies explored therapeutic interventions targeting PASCs,including gamma-secretase inhibitors and possible novel combinations of molecular agents.CONCLUSION The accumulating evidence on PASCs highlights their pivotal role in PitNET tumorigenesis,progression,and therapy resistance.Their molecular and functional overlap with normal pituitary stem cells underscores the need for further lineage-tracing and in vivo validation.展开更多
To maintain care during the coronavirus disease 2019 outbreak,telemedicine was implemented quickly.Jowell et al's pandemic study on telehealth integration and liver transplant evaluation is examined in this editor...To maintain care during the coronavirus disease 2019 outbreak,telemedicine was implemented quickly.Jowell et al's pandemic study on telehealth integration and liver transplant evaluation is examined in this editorial.The study showed that telehealth did not affect clinical outcomes including time to evaluation,listing rates,or pre-transplant death.The study found that telehealth did not increase sociodemographic inequalities,suggesting a fair care framework.The editorial discusses how telemedicine in hepatology might help patients receive expert treatment while reducing logistical and financial burdens.Telehealth can democratize liver transplantation by delivering equivalent clinical results as inperson examinations.However,the editorial highlights technological barriers,difficulties in remotely assessing mental and physical health,and the need for specialized outreach to underserved communities.After the pandemic,telemedicine is essential to a more flexible,patient-centered healthcare system.The editorial encourages creativity and research to overcome challenges,improve hybrid care models,and ensure telehealth's egalitarian and successful potential.Pandemic insights can improve liver transplantation treatment and outcomes for diverse patient populations.展开更多
Viral infections of the ocular surface significantly contribute to morbidity and visual impairment globally.The herpes simplex virus(HSV),adenovirus,cytomegalovirus(CMV),and human papillomavirus(HPV)are predominant pa...Viral infections of the ocular surface significantly contribute to morbidity and visual impairment globally.The herpes simplex virus(HSV),adenovirus,cytomegalovirus(CMV),and human papillomavirus(HPV)are predominant pathogens impacting the cornea and conjunctiva,resulting in recurrent illness,epidemic outbreaks,and virus-associated neoplasia.Progress in virology,immunology,and molecular diagnostics has enhanced comprehension of host–virus interactions and introduced novel therapeutic opportunities.A narrative literature review was performed utilizing PubMed,Scopus,and Web of Science,encompassing papers published from 2000 to 2025,with a specific focus on research from 2020 onwards.Eligible publications were peer-reviewed clinical and experimental investigations,together with reviews that focused on epidemiology,etiology,diagnostic methodologies,and therapeutic alternatives.Research indicates that HSV keratitis is the predominant infectious cause of corneal blindness in high-income nations,although adenovirus persists in instigating epidemics of keratoconjunctivitis in the absence of licensed antiviral treatments.CMV keratitis,previously confined to immunocompromised persons,is now acknowledged in immunocompetent patients as a causative agent of corneal endotheliitis.HPV is associated with ocular surface squamous neoplasia,especially in areas with elevated ultraviolet exposure and high human immunodeficiency virus prevalence.Innovative molecular diagnostics,innovative antiviral agents,immunomodulatory approaches,and immunization initiatives signify significant progress that could enhance preventative and therapeutic results.展开更多
BACKGROUND Dry eye disease(DED)represents a multifactorial condition characterized by ocular discomfort and visual disturbances.The management of DED relies heavily on accurate diagnosis to tailor effective treatments...BACKGROUND Dry eye disease(DED)represents a multifactorial condition characterized by ocular discomfort and visual disturbances.The management of DED relies heavily on accurate diagnosis to tailor effective treatments.Diagnostic approaches encompass both subjective and objective assessments.AIM To review the diagnostic methods used in the process of dry eye disease management.METHODS A comprehensive review of diagnostic approaches for dry eye was performed using scientific databases.Studies published within the last four years were considered.Studies were excluded if a full text was absent or the article was not written in English.Articles were assessed for relevancy,and a total of 107 studies were selected.The selection method used a systematic methodology,which guaranteed an exhaustive assessment of the diagnostic techniques reported in current literature.The study adheres to principles for systematic reviews ensuring dependability and accuracy.The studies were assessed for emphasize on both novel traditional and diagnostic methods for dry eye disease management.RESULTS Key objective tests include tear break-up time,which evaluates tear film stability;fluorescein and lissamine green staining,which assess ocular surface damage and inflammation;tear osmolarity measurement,indicative of tear film quality;and tear volume assessment via Schirmer's test,which evaluates tear production.Advanced imaging techniques such as optical coherence tomography and meibography offer detailed anatomical insights into the ocular surface and meibomian glands,aiding in the diagnosis of underlying structural abnormalities.Moreover,emerging technologies such as matrix metalloproteinase-9 testing and inflammatory biomarkers provide additional diagnostic precision,particularly in identifying inflammatory components of DED.CONCLUSION Integrating a combination of subjective and objective diagnostic tools allows clinicians to comprehensively assess the condition,tailor treatment plans,and monitor therapeutic efficacy.Continued advancements in diagnostic technologies promise to enhance our understanding and management of this prevalent ocular condition.展开更多
BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the tr...BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the treatment rates of eye emergencies in Africa.Ocular emergencies are particularly delicate due to the eye’s intricate structure and the necessity for its refractive components to remain transparent.METHODS This review examines the low treatment rates of eye emergencies in Africa,drawing on 96 records extracted from the PubMed database using predetermined search criteria.RESULTS The epidemiology of ocular injuries,as detailed in the studies,reveals significant relationships between the incidence and prevalence of eye injuries and factors such as age,gender,and occupation.The causes of eye emergencies range from accidents to gender-based violence and insect or animal attacks.Management approaches reported in the review include both surgical and non-surgical interventions,from medication to evisceration or enucleation of the eye.Preventive measures emphasize eye health education and the use of protective eyewear and facial protection.However,inadequate healthcare infrastructure and personnel,cultural and geographical barriers,and socioeconomic and behavioral factors hinder the effective prevention,service uptake,and management of eye emergencies.CONCLUSION The authors recommend developing eye health policies,enhancing community engagement,improving healthcare personnel training and retention,and increasing funding for eye care programs as solutions to address the low treatment rate of eye emergencies in Africa.展开更多
Optic neuritis(ON)is a focal inflammatory demyelinating disorder of the optic nerve.Although classically regarded as a sentinel event for multiple sclerosis(MS),ON also occurs in antibody-mediated entities such as aqu...Optic neuritis(ON)is a focal inflammatory demyelinating disorder of the optic nerve.Although classically regarded as a sentinel event for multiple sclerosis(MS),ON also occurs in antibody-mediated entities such as aquaporin-4-IgGpositive neuromyelitis optica spectrum disorder(AQP4-NMOSD)and myelinoligodendrocyte-glycoprotein-antibody disease.In all these settings biological sex is a pivotal determinant of susceptibility,clinical expression,treatment response and long-term outcome.Data synthesized from an extensive literature analysis utilizing PubMed,Scopus,and Web of Science in this review shows that women experience ON far more frequently–with female-to-male ratios ranging from 3:1 in MS to almost 9:1 in AQP4-NMOSD–yet men,when affected,tend to accumulate irreversible neuro-axonal loss more rapidly.Sex-specific patterns arise at every biological stratum:X-linked gene dosage,epigenetic regulation,hormonal cycles from puberty through menopause,metabolic co-modifiers such as obesity and vitamin-D status,and psychosocial forces that influence healthcare utilization.By weaving these elements into an expanded narrative,the present review provides a detailed resource for clinicians and investigators aiming at gender-tailored management of ON.展开更多
Graft failure is the worst complication of organ transplantation.Considering liver transplantation,aminotransferase levels have been demonstrated to be a precursor of severe graft failure,in particular when they excee...Graft failure is the worst complication of organ transplantation.Considering liver transplantation,aminotransferase levels have been demonstrated to be a precursor of severe graft failure,in particular when they exceed 5000 U/L in the immediate post-operation.However,some studies show that the outcome of the transplanted liver is not determinable by biochemistry alone.One of the most relevant studies is the one published by Lazzarotto-da-Silva et al.In this retrospective study,341 transplanted livers are considered.In 25 cases,this severe biochemical insult has been reported.But despite this event,more than half had significant long-term survival.One of the most valuable elements that emerge from this work is the identification of two easily measurable markers-serum factor V and arterial lactate,which independently can indicate the graft's 90-day outcome.This finding provides a key clinical picture to distinguish patients who are most likely to recover from those destined for irreversible graft loss.In a time where organs are increasingly scarce,these discoveries could facilitate more prudent use of retransplantation,improving both individual outcomes and the overall distribution of resources.This study contributes significantly to a deeper understanding of early graft injury,although larger prospective studies are needed.It highlights the need to move beyond singular value thresholds and toward integrated,evidence-based decision making during the crucial early posttransplant period.This study not only captures risk but also provides a tool for intervention.展开更多
Retinal pigment epithelium(RPE)dysfunction is involved in the advancement of numerous degenerative retinal illnesses,such as age-related macular degeneration and hereditary retinal abnormalities.Transplantation of RPE...Retinal pigment epithelium(RPE)dysfunction is involved in the advancement of numerous degenerative retinal illnesses,such as age-related macular degeneration and hereditary retinal abnormalities.Transplantation of RPE produced from stem cells has emerged as a promising therapeutic strategy to restore retinal function and prevent vision loss.However,other obstacles impede its clinical application,including immunological rejection,cell viability,functional integration,and the necessity for consistent differentiation techniques.This review offers a thorough examination of the molecular processes regulating RPE integrity,investigates recent progress in stem cell-derived RPE therapeutics,and addresses significant challenges to their broad implementation.Furthermore,we emphasize prospective avenues intended to enhance the safety,efficacy,and enduring success of RPE transplantation in clinical environments.展开更多
BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations.This manuscript explores the multidisciplinary appro...BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations.This manuscript explores the multidisciplinary approach to understanding and managing pituitary macroadenomas,integrating neurosurgery,endocrinology,radiology,and pathology perspectives.AIM To summarize the literature on pituitary macroadenoma and outline the possible multidisciplinary approach in the diagnosis,management,and rehabilitation of individuals with pituitary adenomas,to add to already preexisting knowledge,in managing these cases enhancing better ocular and systemic outcomes.METHODS A search was conducted on an online publication database(PubMed)using the term“pituitary adenoma”including all results published over twenty years(2004-2024).Results were sorted for relevance,language,and completeness.RESULTS A total of 176 records were returned.The guidelines of the PRISMA 2020 statement were followed in this study.A total of 23 records were excluded due to being out of scope while a further 13 records were duplicates.Another 17 records were not available as full-length articles and were also excluded.The references of each included record was further searched for relevant publications.A total of 141 records were therefore used in this minireview.CONCLUSION Pituitary macroadenomas pose substantial clinical challenges due to their size and potential for significant hormonal and neurological impact,modern therapeutic strategies offer effective management options.Early detection and comprehensive treatment are essential for optimizing patient outcomes and maintaining quality of life.Continued research and advancements in medical technology are likely to further enhance the management and prognosis of this condition in the future.展开更多
Stem cell therapies are successfully used in various fields of medicine.This new approach of research is also expanding in ophthalmology.Huge investments,resources and important clinical trials have been performed in ...Stem cell therapies are successfully used in various fields of medicine.This new approach of research is also expanding in ophthalmology.Huge investments,resources and important clinical trials have been performed in stem cell research and in potential therapies.In recent years,great strides have been made in genetic research,which permitted and enhanced the differentiation of stem cells.Moreover,the possibility of exploiting stem cells from other districts(such as adipose,dental pulp,bone marrow stem cells,etc.)for the treatment of ophthalmic diseases,renders this topic fascinating.Furthermore,great strides have been made in biomedical engineering,which have proposed new materials and threedimensional structures useful for cell therapy of the eye.The encouraging results obtained on clinical trials conducted on animals have given a significant boost in the creation of study protocols also in humans.Results are limited to date,but clinical trials continue to evolve.Our attention is centered on the literature reported over the past 20 years,considering animal(the most represented in literature)and human clinical trials,which are limiting.The aim of our review is to present a brief overview of the main types of treatments based on stem cells in the field of ophthalmic pathologies.展开更多
The demand for procedures aiming to rejuvenate the upper third part of the face and the periocular region has increased in the past several years.Blepharoplasty is one of the most frequently performed procedures world...The demand for procedures aiming to rejuvenate the upper third part of the face and the periocular region has increased in the past several years.Blepharoplasty is one of the most frequently performed procedures worldwide to date.Surgery is currently the first choice in order to achieve permanent and effective results;however,it is burdened by potential surgical complications feared by patients.There is an increasing trend in individuals to request less invasive,non-surgical,effective,and safe procedures for eyelid treatment.The aim of this minireview is to present a brief overview of non-surgical blepharoplasty techniques that have been reported in the literature in the past 10 years.Numerous modern techniques that provide a rejuvenation of the entire area have been described.Numerous less invasive methods have been proposed in the current literature and in modern-day routine clinical settings.Dermal fillers are a commonly chosen option for providing enhanced aesthetic results,especially considering that volume loss can be one of the main underlying causes of facial and periorbital aging.Deoxycholic acid use may be considered when the problem is represented by periorbital excess fat deposits.The simultaneous excess and loss of elasticity of the skin can be assessed with techniques such as lasers and plasma exeresis.Furthermore,techniques such as platelet-rich plasma injections and the insertion of twisted polydioxanone threads are emerging as viable methods to rejuvenate the periorbital region.展开更多
文摘Dry eye disease(DED)is a multifactorial disorder that disturbs ocular surface equilibrium,considerably diminishing quality of life.Present therapies only offer symptomatic alleviation.Stem cell treatment,especially mesenchymal stem cells(MSCs),has surfaced as a viable approach for tissue regeneration and immunological regulation in DED.Preclinical and early clinical investigations indicate that MSCs can improve lacrimal gland functionality,diminish inflammation,and facilitate corneal regeneration.Nonetheless,obstacles persist in enhancing MSC viability,determining the optimal MSC source,and guaranteeing sustained therapeutic effectiveness.Additional extensive randomized clinical trials are required to confirm the efficacy of MSC-based therapies for severe DED.
文摘BACKGROUND Precision medicine is an emerging field that includes tumor-targeted delivery and tumor microenvironment.This review explores the synergistic potential of combining nano-drug delivery systems with low radiation doses to achieve optimized therapeutic outcomes,particularly in the context of cancer treatment.Nanoparticle-based drug carriers offer precise and targeted delivery,enhancing the therapeutic index of anticancer agents.The use of lower radiation doses has become a focus in radiation oncology to minimize off-target effects on healthy tissues in palliation treatment with high-target volume lesions.AIM To conduct a bibliometric review of nanomedicine and glioblastoma(GBM),all relevant studies from the last two decades were included.METHODS The search strategy comprised the keywords“nanomedicine”and“glioblastoma”in the title and/or abstract.All English-language documents from 1 January 2000 to 31 December 2023 were considered for the analysis.R code(version 4.2.0)with R Studio(version 2022.12.0-353)and the Bibliometrix package(version 4.0.1)were used for the analysis.A total of 680 documents were collected.RESULTS We analyzed the bibliometric features of nanomedicine in glioma.With the limitations of the research,our analysis aims to highlight the increasing interest of researchers in the precision medicine field in GBM treatment and lead us to suggest further studies focusing on the association between nanomedicine and radiotherapy.CONCLUSION Due to the poor prognosis associated with GBM,new therapeutic approaches are necessary.There is an increasing interest in precision medicine,which includes nanomedicine and radiotherapy,for GBM treatment.This integration enhances the efficacy of targeted treatments and provides a promising avenue for reducing adverse effects,signifying a notable advancement in precision oncology.
文摘BACKGROUND Cytomegalovirus(CMV)is a ubiquitous herpesvirus that can cause significant ocular morbidity,particularly in immunocompromised individuals.AIM To summarize the current understanding of the ophthalmic impact of CMV,with a focus on its epidemiology,clinical manifestations,diagnosis,and management,ocular symptoms of CMV floaters,blurred vision,and loss of peripheral vision,eventually progressing to retinal necrosis and detachment.CMV retinitis(CMVR)is a sight-threatening condition that can lead to retinal detachment,blindness,and even death.METHODS We discuss the pathophysiology of CMVR,including the role of immune suppression and viral reactivation.We also examine the clinical features of CMVR,including its characteristic retinal lesions and associated ocular complications.Diagnostic approaches are reviewed,including polymerase chain reaction and fundus photography.RESULTS We discuss treatment options,including antiviral medications,intravitreal injections,and surgical interventions.Finally,we highlight areas of ongoing research and future directions in managing CMV-related ocular disease.CONCLUSION CMV poses a significant threat to ocular health,particularly in immunocompromised populations such as those with human immunodeficiency virus/acquired immune deficiency syndrome.
文摘BACKGROUND High-resolution optical coherence tomography(HR-OCT)has become an essential instrument in the screening and diagnosis of ocular surface neoplasms.Research demonstrates that HR-OCT possesses a diagnostic sensitivity ranging from 85%to 90%for ocular surface squamous neoplasia(OSSN).The connections between HR-OCT features and histological findings have consistently shown robustness,hence increasing the reliability of clinical diagnosis.AIM To examine the existing HR-OCT indicators employed in the identification of common non-benign ocular surface tumors,namely,basal cell carcinoma,OSSN,and melanocytic conjunctival lesions,and to assess their diagnostic efficacy,benefits,and prospective developments.METHODS A thorough literature review was performed to assess the published research on HR-OCT in the diagnosis of ocular surface cancers.Significant attention was given to research that compares HR-OCT characteristics with histopath-ologic validation,as well as on publications addressing the integration of emerging technologies and artificial intelligence in ocular oncology imaging.RESULTS HR-OCT exhibits elevated diagnostic sensitivity(85%-90%)for identifying OSSN and presents distinct imaging patterns that align closely with histology results.This approach has substantial clinical advantages due to its non-invasive characteristics,improved axial resolution,and real-time imaging capabilities.HR-OCT has demonstrated potential in assessing various lesions,including basal cell carcinoma and melanocytic conjunctival malignancies.CONCLUSION HR-OCT assumes an increasingly vital role in the early identification and clinical management of ocular surface malignancies.With advancements in imaging technology and the integration of artificial intelligence,HR-OCT is anticipated to enhance individualized diagnosis and treatment planning in ocular oncology,hence improving patient outcomes.
文摘BACKGROUND Eyelid reconstruction is an intricate process,addressing both aesthetic and functional aspects post-trauma or oncological surgery.Aesthetic concerns and oncological radicality guide personalized approaches.The complex anatomy,involving anterior and posterior lamellae,requires tailored reconstruction for optimal functionality.AIM To formulate an eyelid reconstruction algorithm through an extensive literature review and to validate it by juxtaposing surgical outcomes from Cattinara Hos-in dry eye and tears,which may lead to long-term consequences such as chronic conjunctivitis,discomfort,or photo-phobia.To prevent this issue,scars should be oriented vertically or perpendicularly to the free eyelid margin when the size of the tumor allows.In employing a malar flap to repair a lower eyelid defect,the malar incision must ascend diagonally;this facilitates enhanced flap advancement and mitigates ectropion by restricting vertical traction.Conse-quently,it is imperative to maintain that the generated tension remains consistently horizontal and never vertical[9].Lagophthalmos is a disorder characterized by the inability to completely close the eyelids,leading to corneal exposure and an increased risk of keratitis or ulceration;it may arise following upper eyelid surgery.To avert this issue,it is essential to preserve a minimum of 1 cm of skin between the superior edge of the excision and the inferior boundary of the eyebrow.Epiphora may occur in cancers involving the lacrimal puncta,requiring their removal.As previously stated,when employing a glabellar flap to rectify medial canthal abnormalities,it is essential to prevent a trapdoor effect or thickening of the flap relative to the eyelid skin to which it is affixed.Constraints about our proposed algorithm enco-mpass limited sample sizes and possible publication biases in existing studies.Subsequent investigations ought to examine long-term results to further refine the algorithm.Future research should evaluate the algorithm across varied populations and examine the impact of novel graft materials on enhancing reconstructive outcomes.CONCLUSION Eyelid reconstruction remains one of the most intriguing challenges for a plastic surgeon today.The most fascinating aspect of this discipline is the need to restore the functionality of such an essential structure while maintaining its aesthetics.In our opinion,creating decision-making algorithms can facilitate reaching this goal by allowing for the individualization of the reconstructive path while minimizing the incidence of complications.The fact that we have decreased the incidence of severe complications is a sign that the work is moving in the right direction.The fact that there has been no need for reintervention,neither for reconstructive issues nor for inadequate oncological radicality,overall signifies greater patient satisfaction as they do not have to undergo the stress of new surgeries.Even the minor complic-ations recorded are in line with those reported in the literature,and,even more importantly for patients,they are of limited duration.In our experience,after a year of application,we can say that the objective has been achieved,but much more can still be done.Behind every work,a scientific basis must be continually renewed and refreshed to maintain high-quality standards.Therefore,searching for possible alternative solutions to be included in one’s surgical armamentarium is fundamental to providing the patient with a fully personalized option.
文摘BACKGROUND Simultanagnosia is a neurological disorder that impairs an individual's ability to perceive more than one object at a time visually.While the individual may acknowledge the presence of multiple objects in his field of view,he cannot generally summarize the overall percept.CASE SUMMARY We describe a case of simultanagnosia in Posterior Cortical Atrophy,evidenced by the Ishihara color test.A 54-year-old woman complained of reading problems despite normal visual acuity and a structural eye exam.The patient failed to identify any of the Ishihara color plates in either eye despite adequate naming of colors.Automated visual field testing showed a homonymous hemianopia.Structural and functional neuroimaging and cerebrospinal fluid analysis were consistent with posterior cortical atrophy.CONCLUSION Simultanagnosia can be tested with the Ishihara pseudoisochromatic plates because the recognition of embedded number patterns in the test requires appreciation of a collection of individual stimuli.
文摘BACKGROUND The surgical management of corneal lesions resulting from eyelid pathologies requires a comprehensive approach to ensure optimal patient outcomes.Eyelid lesions,ranging from benign to malignant,can lead to corneal damage through mechanisms such as mechanical abrasion,secondary infection,or inflammatory responses.AIM To assess the surgical methodologies utilized in the treatment of corneal lesions resulting from eyelid disorders and evaluate their effects on patient outcomes,recurrence rates,and postoperative complications.The incorporation of advanced imaging techniques,including optical coherence tomography and ultrasound biomicroscopy,in conjunction with histopathological analysis,is addressed to improve surgical accuracy and patient outcomes.METHODS The authors searched online databases(PubMed and Cochrane)for publications on the surgical management of lid lesions.Records received from the two databases were checked for duplicates and relevance.Only records with full texts and in English language were included.RESULTS A total of 28 records were obtained following the screening for relevancy and duplication.The review underscores essential surgical approaches employed in the treatment of corneal lesions resulting from common eyelid diseases,focusing on operative efficacy,complication rates,and long-term results.CONCLUSION This systematic review emphasizes the significance of choosing suitable surgical techniques tailored to individual patient characteristics and stresses the need for interdisciplinary collaboration in ophthalmic care.The results indicate that sophisticated imaging techniques and careful preoperative preparation markedly improve surgical accuracy and long-term results.
文摘Retinal degenerative diseases,such as age-related macular degeneration,retinitis pigmentosa,and Stargardt disease,are primary contributors to irreversible vision loss globally.Due to the scarcity of effective curative treatments,stem cell therapy has emerged as a revolutionary advancement in ophthalmology.In the last ten years,significant advancements have been achieved in the derivation of retinal pigment epithelium and photoreceptor precursors from human embryonic stem cells and induced pluripotent stem cells,with initial clinical trials indicating safety and potential efficacy.Innovative delivery platforms,such as biodegradable scaffolds,microcarrier suspensions,and minimally invasive subretinal devices,are tackling prior challenges related to cell survival and integration.Simultaneously,gene-edited and patient-specific induced pluripotent stem cells are positioned to surmount immunological and ethical constraints.Future combinatorial strategies that incorporate stem cells with gene therapy,CRISPR-mediated editing,and bioengineered retinal organoids offer potential for personalized and regenerative methodologies.Nonetheless,enduring functional integration,immune tolerance,and oncogenic safety continue to pose significant challenges.To effectively transition from laboratory research to clinical application,collaborative frameworks among academic institutions,biotechnology companies,and regulatory agencies will be crucial for unlocking the complete therapeutic potential of stem cell-based treatments for retinal diseases.Stem cell therapy has transitioned from a distant promise to an advancing reality set to transform retinal care.
文摘Usher syndrome(USH)should no longer be considered a fixed diagnosis limited to syndromic early-onset sensorineural hearing loss and progressive vision decline due to rod-cone retinal dystrophy.Patients increasingly present with partial or delayed retinal manifestations,often lacking a clinically relevant audiological history.Concurrently,genomic testing uncovers variants that challenge the practical relevance of the traditional definition of type I,II,and III subclassifications.This review argues for a paradigm shift toward genotype-first diagnosis led by ophthalmologists,integrating retinal findings and audiological evaluations with comprehensive genetic information.The rise of gene-specific molecular therapies,including antisense oligonucleotides and CRISPR-mediated gene editing for USH2A and MYO7A,demands timely and accurate molecular categorization for each patient.Delays in precise molecular diagnosis may risk excluding patients from potentially vision-saving trials.Diagnostic gaps persist,including limited variant interpretation tools,underrepresentation of non-Caucasian populations in reference databases,and a lack of standardized retinal imaging protocols.The establishment of centralized,real-time Usher registries and interdisciplinary diagnostic models is essential.The future of USH management lies in anticipatory,individualized care that begins in the retina clinic.
文摘BACKGROUND Pituitary neuroendocrine tumors(PitNETs),formerly referred to as pituitary adenomas,are prevalent intracranial neoplasms that,although often benign histologically,can demonstrate invasive growth,therapeutic resistance,and recurrence.Emerging evidence supports the presence of a subpopulation of tumorinitiating cells with stem-like properties-pituitary adenoma stem cells(PASCs)-that may drive these aggressive features.This systematic review aims to critically examine the evidence on PASCs,their phenotypic and functional characteristics,and their role in PitNET pathophysiology.AIM To study the molecular markers,signaling pathways,research models,and phenotypic traits of PASCs,and to assess their potential significance for future translational and clinical applications.METHODS A comprehensive literature search was conducted in PubMed,Scopus,and Ovid MEDLINE in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Thirty-four studies were included based on predefined eligibility criteria.Data were extracted regarding PASC isolation methods(e.g.,neurosphere formation,side population sorting),marker expression[e.g.,SRY-related HMG-box transcription factor(SOX)2,octamer-binding transcription factor 4,CD133,Nestin],pathway involvement(e.g.,Wnt/betacatenin,Notch,Sonic hedgehog),and functional behaviors such as self-renewal,differentiation,tumorigenicity,and therapy resistance.RESULTS Following duplicate removal,315 unique articles were screened,with 47 full texts assessed for eligibility.Ultimately,34 studies published between 2007 and 2025 met the inclusion criteria.The majority utilized human PitNET samples(83%),with a subset employing rat-derived cell lines(28%)or murine models(15%).PASCs were identified and characterized using various in vitro and in vivo approaches.Commonly reported stemness markers included SOX2(59%),CD133(38%),Nestin(35%),and octamer-binding transcription factor 4(26%),with others such as SOX9,paired-like homeobox 1,and C-X-C chemokine receptor type 4 also frequently cited.Wnt/betacatenin(18%)and phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin(9%)signaling pathways were most implicated,followed by Notch,Sonic hedgehog,and janus kinase/signal transducer and activator of transcription cascades.Functional assays revealed consistent findings of tumor initiation(44%),selfrenewal(35%),and tumor progression or invasion(35%).Notably,a minority of studies explored therapeutic interventions targeting PASCs,including gamma-secretase inhibitors and possible novel combinations of molecular agents.CONCLUSION The accumulating evidence on PASCs highlights their pivotal role in PitNET tumorigenesis,progression,and therapy resistance.Their molecular and functional overlap with normal pituitary stem cells underscores the need for further lineage-tracing and in vivo validation.
文摘To maintain care during the coronavirus disease 2019 outbreak,telemedicine was implemented quickly.Jowell et al's pandemic study on telehealth integration and liver transplant evaluation is examined in this editorial.The study showed that telehealth did not affect clinical outcomes including time to evaluation,listing rates,or pre-transplant death.The study found that telehealth did not increase sociodemographic inequalities,suggesting a fair care framework.The editorial discusses how telemedicine in hepatology might help patients receive expert treatment while reducing logistical and financial burdens.Telehealth can democratize liver transplantation by delivering equivalent clinical results as inperson examinations.However,the editorial highlights technological barriers,difficulties in remotely assessing mental and physical health,and the need for specialized outreach to underserved communities.After the pandemic,telemedicine is essential to a more flexible,patient-centered healthcare system.The editorial encourages creativity and research to overcome challenges,improve hybrid care models,and ensure telehealth's egalitarian and successful potential.Pandemic insights can improve liver transplantation treatment and outcomes for diverse patient populations.
文摘Viral infections of the ocular surface significantly contribute to morbidity and visual impairment globally.The herpes simplex virus(HSV),adenovirus,cytomegalovirus(CMV),and human papillomavirus(HPV)are predominant pathogens impacting the cornea and conjunctiva,resulting in recurrent illness,epidemic outbreaks,and virus-associated neoplasia.Progress in virology,immunology,and molecular diagnostics has enhanced comprehension of host–virus interactions and introduced novel therapeutic opportunities.A narrative literature review was performed utilizing PubMed,Scopus,and Web of Science,encompassing papers published from 2000 to 2025,with a specific focus on research from 2020 onwards.Eligible publications were peer-reviewed clinical and experimental investigations,together with reviews that focused on epidemiology,etiology,diagnostic methodologies,and therapeutic alternatives.Research indicates that HSV keratitis is the predominant infectious cause of corneal blindness in high-income nations,although adenovirus persists in instigating epidemics of keratoconjunctivitis in the absence of licensed antiviral treatments.CMV keratitis,previously confined to immunocompromised persons,is now acknowledged in immunocompetent patients as a causative agent of corneal endotheliitis.HPV is associated with ocular surface squamous neoplasia,especially in areas with elevated ultraviolet exposure and high human immunodeficiency virus prevalence.Innovative molecular diagnostics,innovative antiviral agents,immunomodulatory approaches,and immunization initiatives signify significant progress that could enhance preventative and therapeutic results.
文摘BACKGROUND Dry eye disease(DED)represents a multifactorial condition characterized by ocular discomfort and visual disturbances.The management of DED relies heavily on accurate diagnosis to tailor effective treatments.Diagnostic approaches encompass both subjective and objective assessments.AIM To review the diagnostic methods used in the process of dry eye disease management.METHODS A comprehensive review of diagnostic approaches for dry eye was performed using scientific databases.Studies published within the last four years were considered.Studies were excluded if a full text was absent or the article was not written in English.Articles were assessed for relevancy,and a total of 107 studies were selected.The selection method used a systematic methodology,which guaranteed an exhaustive assessment of the diagnostic techniques reported in current literature.The study adheres to principles for systematic reviews ensuring dependability and accuracy.The studies were assessed for emphasize on both novel traditional and diagnostic methods for dry eye disease management.RESULTS Key objective tests include tear break-up time,which evaluates tear film stability;fluorescein and lissamine green staining,which assess ocular surface damage and inflammation;tear osmolarity measurement,indicative of tear film quality;and tear volume assessment via Schirmer's test,which evaluates tear production.Advanced imaging techniques such as optical coherence tomography and meibography offer detailed anatomical insights into the ocular surface and meibomian glands,aiding in the diagnosis of underlying structural abnormalities.Moreover,emerging technologies such as matrix metalloproteinase-9 testing and inflammatory biomarkers provide additional diagnostic precision,particularly in identifying inflammatory components of DED.CONCLUSION Integrating a combination of subjective and objective diagnostic tools allows clinicians to comprehensively assess the condition,tailor treatment plans,and monitor therapeutic efficacy.Continued advancements in diagnostic technologies promise to enhance our understanding and management of this prevalent ocular condition.
文摘BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the treatment rates of eye emergencies in Africa.Ocular emergencies are particularly delicate due to the eye’s intricate structure and the necessity for its refractive components to remain transparent.METHODS This review examines the low treatment rates of eye emergencies in Africa,drawing on 96 records extracted from the PubMed database using predetermined search criteria.RESULTS The epidemiology of ocular injuries,as detailed in the studies,reveals significant relationships between the incidence and prevalence of eye injuries and factors such as age,gender,and occupation.The causes of eye emergencies range from accidents to gender-based violence and insect or animal attacks.Management approaches reported in the review include both surgical and non-surgical interventions,from medication to evisceration or enucleation of the eye.Preventive measures emphasize eye health education and the use of protective eyewear and facial protection.However,inadequate healthcare infrastructure and personnel,cultural and geographical barriers,and socioeconomic and behavioral factors hinder the effective prevention,service uptake,and management of eye emergencies.CONCLUSION The authors recommend developing eye health policies,enhancing community engagement,improving healthcare personnel training and retention,and increasing funding for eye care programs as solutions to address the low treatment rate of eye emergencies in Africa.
文摘Optic neuritis(ON)is a focal inflammatory demyelinating disorder of the optic nerve.Although classically regarded as a sentinel event for multiple sclerosis(MS),ON also occurs in antibody-mediated entities such as aquaporin-4-IgGpositive neuromyelitis optica spectrum disorder(AQP4-NMOSD)and myelinoligodendrocyte-glycoprotein-antibody disease.In all these settings biological sex is a pivotal determinant of susceptibility,clinical expression,treatment response and long-term outcome.Data synthesized from an extensive literature analysis utilizing PubMed,Scopus,and Web of Science in this review shows that women experience ON far more frequently–with female-to-male ratios ranging from 3:1 in MS to almost 9:1 in AQP4-NMOSD–yet men,when affected,tend to accumulate irreversible neuro-axonal loss more rapidly.Sex-specific patterns arise at every biological stratum:X-linked gene dosage,epigenetic regulation,hormonal cycles from puberty through menopause,metabolic co-modifiers such as obesity and vitamin-D status,and psychosocial forces that influence healthcare utilization.By weaving these elements into an expanded narrative,the present review provides a detailed resource for clinicians and investigators aiming at gender-tailored management of ON.
文摘Graft failure is the worst complication of organ transplantation.Considering liver transplantation,aminotransferase levels have been demonstrated to be a precursor of severe graft failure,in particular when they exceed 5000 U/L in the immediate post-operation.However,some studies show that the outcome of the transplanted liver is not determinable by biochemistry alone.One of the most relevant studies is the one published by Lazzarotto-da-Silva et al.In this retrospective study,341 transplanted livers are considered.In 25 cases,this severe biochemical insult has been reported.But despite this event,more than half had significant long-term survival.One of the most valuable elements that emerge from this work is the identification of two easily measurable markers-serum factor V and arterial lactate,which independently can indicate the graft's 90-day outcome.This finding provides a key clinical picture to distinguish patients who are most likely to recover from those destined for irreversible graft loss.In a time where organs are increasingly scarce,these discoveries could facilitate more prudent use of retransplantation,improving both individual outcomes and the overall distribution of resources.This study contributes significantly to a deeper understanding of early graft injury,although larger prospective studies are needed.It highlights the need to move beyond singular value thresholds and toward integrated,evidence-based decision making during the crucial early posttransplant period.This study not only captures risk but also provides a tool for intervention.
文摘Retinal pigment epithelium(RPE)dysfunction is involved in the advancement of numerous degenerative retinal illnesses,such as age-related macular degeneration and hereditary retinal abnormalities.Transplantation of RPE produced from stem cells has emerged as a promising therapeutic strategy to restore retinal function and prevent vision loss.However,other obstacles impede its clinical application,including immunological rejection,cell viability,functional integration,and the necessity for consistent differentiation techniques.This review offers a thorough examination of the molecular processes regulating RPE integrity,investigates recent progress in stem cell-derived RPE therapeutics,and addresses significant challenges to their broad implementation.Furthermore,we emphasize prospective avenues intended to enhance the safety,efficacy,and enduring success of RPE transplantation in clinical environments.
文摘BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations.This manuscript explores the multidisciplinary approach to understanding and managing pituitary macroadenomas,integrating neurosurgery,endocrinology,radiology,and pathology perspectives.AIM To summarize the literature on pituitary macroadenoma and outline the possible multidisciplinary approach in the diagnosis,management,and rehabilitation of individuals with pituitary adenomas,to add to already preexisting knowledge,in managing these cases enhancing better ocular and systemic outcomes.METHODS A search was conducted on an online publication database(PubMed)using the term“pituitary adenoma”including all results published over twenty years(2004-2024).Results were sorted for relevance,language,and completeness.RESULTS A total of 176 records were returned.The guidelines of the PRISMA 2020 statement were followed in this study.A total of 23 records were excluded due to being out of scope while a further 13 records were duplicates.Another 17 records were not available as full-length articles and were also excluded.The references of each included record was further searched for relevant publications.A total of 141 records were therefore used in this minireview.CONCLUSION Pituitary macroadenomas pose substantial clinical challenges due to their size and potential for significant hormonal and neurological impact,modern therapeutic strategies offer effective management options.Early detection and comprehensive treatment are essential for optimizing patient outcomes and maintaining quality of life.Continued research and advancements in medical technology are likely to further enhance the management and prognosis of this condition in the future.
文摘Stem cell therapies are successfully used in various fields of medicine.This new approach of research is also expanding in ophthalmology.Huge investments,resources and important clinical trials have been performed in stem cell research and in potential therapies.In recent years,great strides have been made in genetic research,which permitted and enhanced the differentiation of stem cells.Moreover,the possibility of exploiting stem cells from other districts(such as adipose,dental pulp,bone marrow stem cells,etc.)for the treatment of ophthalmic diseases,renders this topic fascinating.Furthermore,great strides have been made in biomedical engineering,which have proposed new materials and threedimensional structures useful for cell therapy of the eye.The encouraging results obtained on clinical trials conducted on animals have given a significant boost in the creation of study protocols also in humans.Results are limited to date,but clinical trials continue to evolve.Our attention is centered on the literature reported over the past 20 years,considering animal(the most represented in literature)and human clinical trials,which are limiting.The aim of our review is to present a brief overview of the main types of treatments based on stem cells in the field of ophthalmic pathologies.
文摘The demand for procedures aiming to rejuvenate the upper third part of the face and the periocular region has increased in the past several years.Blepharoplasty is one of the most frequently performed procedures worldwide to date.Surgery is currently the first choice in order to achieve permanent and effective results;however,it is burdened by potential surgical complications feared by patients.There is an increasing trend in individuals to request less invasive,non-surgical,effective,and safe procedures for eyelid treatment.The aim of this minireview is to present a brief overview of non-surgical blepharoplasty techniques that have been reported in the literature in the past 10 years.Numerous modern techniques that provide a rejuvenation of the entire area have been described.Numerous less invasive methods have been proposed in the current literature and in modern-day routine clinical settings.Dermal fillers are a commonly chosen option for providing enhanced aesthetic results,especially considering that volume loss can be one of the main underlying causes of facial and periorbital aging.Deoxycholic acid use may be considered when the problem is represented by periorbital excess fat deposits.The simultaneous excess and loss of elasticity of the skin can be assessed with techniques such as lasers and plasma exeresis.Furthermore,techniques such as platelet-rich plasma injections and the insertion of twisted polydioxanone threads are emerging as viable methods to rejuvenate the periorbital region.
