Recent studies have suggested an evolving understanding of the association be-tween vaping,specifically electronic cigarette(e-cigarette)use,and the progre-ssion of atherosclerosis,a significant contributor to cardiov...Recent studies have suggested an evolving understanding of the association be-tween vaping,specifically electronic cigarette(e-cigarette)use,and the progre-ssion of atherosclerosis,a significant contributor to cardiovascular disease.Des-pite the prevailing perception of vaping as a safer alternative to traditional toba-cco smoking,accumulating evidence suggests that the aerosols emitted by e-cigarettes contain harmful constituents that may promote endothelial dysfunction,oxidative stress,inflammation,and dyslipidemia—key mechanisms implicated in atherosclerosis pathogenesis.While past research,including experimental studies and clinical investigations,has shed light on the potential cardiovascular risks associated with vaping,gaps in knowledge persist.Future research endeavors should focus on interpreting the long-term effects of vaping on atherosclerosis development and progression,exploring the impact of different e-cigarette formu-lations and user demographics,and identifying effective strategies for mitigating the cardiovascular consequences of vaping.By identifying and addressing these research gaps,we can enhance our understanding of the cardiovascular implica-tions of vaping and inform evidence-based interventions and policies to safe-guard public health.Core Tip:E-cigarette use has been linked to various cardiovascular risks,including the progression of atherosclerosis.Despite the perception of vaping as a safer alternative to smoking,evidence suggests that e-cigarette aerosols contain harmful substances that contribute to endothelial dysfunction,oxidative stress,inflammation,and dyslipidemia.These mechanisms are crucial in the development and progression of atherosclerosis.This review explores multiple facets of e-cigarettes and arterial health,focusing on the connection between vaping and atherosclerosis progression.It presents up-to-date evidence on pathophysiology and significant clinical implications,the impact of various constituents,and discusses contemporary public health strategies.展开更多
Gallbladder cancer is a rare,aggressive malignancy that has a poor overall prognosis.Effective treatment consists of early detection and surgical treatment.With the wide spread treatment of gallbladder disease with mi...Gallbladder cancer is a rare,aggressive malignancy that has a poor overall prognosis.Effective treatment consists of early detection and surgical treatment.With the wide spread treatment of gallbladder disease with minimally invasive techniques,the rate of incidental gallbladder cancer has seen an equitable rise along with stage migration towards earlier disease.Although the treatment remains mostly surgical,newer modalities such as regional therapy as well as directed therapy based on molecular medicine has led to improved outcomes in patients with advanced disease.We aim to summarize the management of gallbladder cancer along with the newer developments in this formidable disease process.展开更多
BACKGROUND Gallbladder cancer is the most common malignancy of the biliary tract.Neo-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 resection.Currently,there is no consensus of guidelines for ...BACKGROUND Gallbladder cancer is the most common malignancy of the biliary tract.Neo-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 resection.Currently,there is no consensus of guidelines for neoadjuvant therapy in gallbladder cancer.As investigations continue to analyze the regimen and benefit of NACT for ongoing care of gallbladder cancer patients,we examined American College of Surgeons National Surgical Quality Improvement Program(NSQIP)database to determine if there was higher morbidity among the neo-adjuvant group within the 30-day post-operative period.We hypothesized patients who underwent NACT were more likely to have higher post-operative morbidity.AIM To investigate the 30-day post-operative morbidity outcomes between patients who received NACT and underwent surgery and patients who only had surgery.METHODS A retrospective analysis of the targeted hepatectomy NSQIP data between 2015 and 2019 was performed to determine if NACT in gallbladder cancer increased the risk for post-operative morbidity(bile leak,infection rate,rate of converting to open surgery,etc.)compared to the group who only had surgery.To calculate the odds ratio for the primary and secondary outcomes,a crude logistic regression was performed.RESULTS Of the 452 patients,52 patients received NACT prior to surgery.There were no statistically significant differences in the odds of morbidity between the two groups,including bile leak[odds ratio(OR),0.69;95%confidence interval(95%CI):0.16-2.10;P=0.55],superficial wound infection(OR,0.58;95%CI:0.03-3.02;P=0.61),and organ space wound infection(OR,0.63;95%CI:0.18-1.63;P=0.61).CONCLUSION There was no significant difference in the risk of 30-day post-operative morbidity between the NACT and surgery group and the surgery only group.展开更多
BACKGROUND Resection of hepatic metastasis from neuroendocrine tumors(NETs)improves quality of life and prolongs 5-year survival.Ablation can be utilized with surgery to achieve complete resection.Although several stu...BACKGROUND Resection of hepatic metastasis from neuroendocrine tumors(NETs)improves quality of life and prolongs 5-year survival.Ablation can be utilized with surgery to achieve complete resection.Although several studies report long-term out-comes for patients undergoing ablation,none have explored perioperative effects of ablation in patients with metastatic NETs.AIM To determine if intra-operative ablation during hepatectomy increases risk of ad-verse outcomes such as surgical site infections(SSIs),bleeding,and bile leak.METHODS A retrospective analysis of the hepatectomy National Surgical Quality Impro-vement Program database from 2015-2019 was performed to determine the odds of SSIs,bile leaks,or bleeding in patients undergoing intraoperative ablation when compared to hepatectomy alone.RESULTS Of the 966 patients included in the study,298(30.9%)underwent ablation during hepatectomy.There were 78(11.7%)patients with SSIs in the hepatectomy alone group and 39(13.1%)patients with a SSIs in the hepatectomy with ablation group.Bile leak occurred in 41(6.2%)and 14(4.8%)patients in the two groups,respec-tively;bleeding occurred in 117(17.5%)and 33(11.1%),respectively.After con-trolling for confounding variables,ablation did not increase risk of SSI(P=0.63),bile leak(P=0.34)or bleeding(P=0.07)when compared to patients undergoing resection alone on multivariate analysis.CONCLUSION Intraoperative ablation with hepatic resection for NETs is safe in the perioperative period without significant increased risk of infection,bleeding,or bile leak.Surgeons should utilize this modality when appropriate to a-chieve optimal disease control and outcomes.展开更多
BACKGROUND Pancreatic adenocarcinoma is currently the fourth leading cause of cancer-related deaths in the United States.In patients with“borderline resectable”disease,current National Comprehensive Cancer Center gu...BACKGROUND Pancreatic adenocarcinoma is currently the fourth leading cause of cancer-related deaths in the United States.In patients with“borderline resectable”disease,current National Comprehensive Cancer Center guidelines recommend the use of neoadjuvant chemoradiation prior to a pancreaticoduodenectomy.Although neoadjuvant radiotherapy may improve negative margin resection rate,it is theorized that its administration increases operative times and complexity.AIM To investigate the association between neoadjuvant radiotherapy and 30-d morbidity and mortality outcomes among patients receiving a pancreaticoduodenectomy for pancreatic adenocarcinoma.METHODS Patients listed in the 2015-2019 National Surgery Quality Improvement Program data set,who received a pancreaticoduodenectomy for pancreatic adenocarcinoma,were divided into two groups based off neoadjuvant radiotherapy status.Multivariable regression was used to determine if there is a significant correlation between neoadjuvant radiotherapy,perioperative blood transfusion status,total operative time,and other perioperative outcomes.RESULTS Of the 11458 patients included in the study,1470(12.8%)underwent neoadjuvant radiotherapy.Patients who received neoadjuvant radiotherapy were significantly more likely to require a perioperative blood transfusion[adjusted odds ratio(aOR)=1.58,95%confidence interval(CI):1.37-1.82;P<0.001]and have longer surgeries(insulin receptor-related receptor=1.14,95%CI:1.11-1.16;P<0.001),while simultaneously having lower rates of organ space infections(aOR=0.80,95%CI:0.66-0.97;P=0.02)and pancreatic fistula formation(aOR=0.50,95%CI:0.40-0.63;P<0.001)compared to those who underwent surgery alone.CONCLUSION Neoadjuvant radiotherapy,while not associated with increased mortality,will impact the complexity of surgical resection in patients with pancreatic adenocarcinoma.展开更多
This comprehensive review investigates the significant psychological impact and profound psychological comorbidities found in individuals suffering from chronic pruritic dermatoses, including atopic dermatitis, chroni...This comprehensive review investigates the significant psychological impact and profound psychological comorbidities found in individuals suffering from chronic pruritic dermatoses, including atopic dermatitis, chronic urticaria, and prurigo nodularis. Highlighting the complex, reciprocal relationship between pruritus and psychiatric conditions such as depression, anxiety, and sleep disturbances, this paper elucidates the comprehensive impact of dermatological disorders on the skin in addition to the far-reaching effects on an individual’s psychological well-being. By evaluating the efficacy of integrated psychodermatological interventions, including cognitive behavioral therapy, mindfulness practices, pharmacological treatments, and innovative telepsychiatry and digital health solutions, this review aims to lay the foundation for a more holistic approach to treatment of concurrent dermatological and psychiatric conditions. Future research endeavors should delve deeper into the mechanistic foundation of the pruritus-psychiatry interface, the refinement of tailored treatment strategies, and the evaluation of long-term patient outcomes. In doing so, this review seeks to contribute to the optimization of patient care and well-being, underscoring the pivotal role of addressing both dermatological and psychological needs in achieving comprehensive health outcomes.展开更多
This comprehensive review explores the intricate dynamics between psychosocial factors and chronic wound healing processes, specifically focusing on prevalent conditions such as pressure ulcers, diabetic foot ulcers, ...This comprehensive review explores the intricate dynamics between psychosocial factors and chronic wound healing processes, specifically focusing on prevalent conditions such as pressure ulcers, diabetic foot ulcers, and venous leg ulcers. By examining the roles of psychiatric conditions, including depression, anxiety, and post-traumatic stress disorder (PTSD), this paper illuminates how these factors intricately influence wound healing dynamics, including mechanisms of pain perception and inflammatory responses. Furthermore, we evaluate the effectiveness of integrated biopsychosocial interventions, which encompass a holistic approach to wound care, thereby enhancing healing outcomes for dermatology patients. Future studies should focus on investigating the specific psychosocial determinants that significantly influence wound healing, exploring novel therapeutic strategies, and implementing personalized interventions to meet the unique needs of each patient. Such endeavors hold promise in advancing the fields of psychodermatology and wound management, fostering a deeper understanding and application of psychosocial considerations in dermatological care.展开更多
Background: Cutaneous oncology encompasses a broad range of skin malignancies, including melanoma, cutaneous squamous cell carcinoma (SCC), and basal cell carcinoma (BCC), all of which pose significant global health c...Background: Cutaneous oncology encompasses a broad range of skin malignancies, including melanoma, cutaneous squamous cell carcinoma (SCC), and basal cell carcinoma (BCC), all of which pose significant global health challenges. The World Health Organization (WHO) estimates that melanoma incidence has increased by approximately 50% over the past three decades. While SCC and BCC are generally less aggressive than melanoma, they contribute significantly to the overall burden of skin cancer due to their high prevalence. Traditional treatment modalities for these malignancies, such as surgery, radiation, and chemotherapy, have shown limitations in achieving durable responses and minimizing systemic toxicity. As a result, there is an increasing need for more effective and less toxic treatment options. Immunotherapeutic strategies have emerged as a promising avenue in oncology, with the potential to revolutionize treatment approaches for cutaneous malignancies. Objectives: This literature review aims to undertake an in-depth examination of immunotherapeutic strategies for melanoma, SCC, and BCC. Specifically, the review focuses on the role of immune checkpoint inhibitors, adoptive cell therapies, and emerging immunotherapies, assessing their impact on treatment outcomes, survival rates, and patient quality of life. Methods: A literature search was conducted using databases such as PubMed, Google Scholar, and Scopus. The search terms included “cutaneous oncology”, “immunotherapy”, “immune checkpoint inhibitors”, “adoptive cell therapy”, “melanoma”, “cutaneous squamous cell carcinoma”, and “basal cell carcinoma”. Peer-reviewed articles published in the last 10 years that reported clinical outcomes from immunotherapy-based treatments for cutaneous malignancies were included. The studies were reviewed and analyzed based on their reported clinical outcomes, including survival rates, adverse events, and quality of life metrics. Results: Our review identified significant advancements in immunotherapeutic strategies for cutaneous oncology. Immune checkpoint inhibitors, such as pembrolizumab and nivolumab, demonstrated improved overall survival rates, particularly in melanoma patients. In addition, adoptive cell therapies, including tumor-infiltrating lymphocyte (TIL) therapies, showed promise in managing both cutaneous SCC and BCC, with reported reductions in tumor burden and durable responses. Emerging immunotherapies, such as cancer vaccines and oncolytic viruses, are in early clinical trials but exhibit potential in enhancing antitumor immunity and expanding treatment options. Conclusions: Immunotherapeutic strategies represent a critical advancement in the management of cutaneous malignancies, offering improved outcomes compared to traditional therapies. Immune checkpoint inhibitors and adoptive cell therapies are already reshaping clinical practice, while emerging immunotherapies provide exciting avenues for future research. These therapies not only enhance survival rates but also reduce systemic toxicities, representing a transformative approach to treating skin cancer. Further research and clinical trials are needed to refine these strategies and expand their applicability to a broader patient population.展开更多
Skin diseases such as psoriasis, atopic dermatitis, burns, and other barrier insults pose ongoing therapeutic challenges, often requiring treatments that address both inflammation and skin barrier repair. The primary ...Skin diseases such as psoriasis, atopic dermatitis, burns, and other barrier insults pose ongoing therapeutic challenges, often requiring treatments that address both inflammation and skin barrier repair. The primary aim of this review is to provide a comprehensive overview of the potential benefits of sea buckthorn oil, derived from Hippophae rhamnoides, as a treatment for various skin diseases, detailing its anti-inflammatory properties, reporting benefits across several skin conditions, and highlighting challenges in formulation as well as preservation of the oil’s nutritional benefits. Drawing from a wide array of existing literature, this review investigates sea buckthorn oil’s rich composition of omega fatty acids, vitamins, and antioxidants, which may contribute to its therapeutic effects by modulating inflammatory pathways and enhancing skin barrier function. Clinical trials and patient case studies indicate that sea buckthorn oil shows promise in reducing erythema, inflammation, and improving skin sensitivity. However, challenges such as formulation stability, sourcing of quality oil, and variability in response to treatment across conditions need to be addressed. Future research should focus on optimizing formulations and conducting large-scale clinical trials to validate the therapeutic efficacy of sea buckthorn oil in the management of skin diseases. Additionally, further exploration of the regulatory mechanisms underlying its ability to modulate inflammation and repair the skin barrier is needed to fully elucidate its clinical potential. Sea buckthorn oil offers a novel and promising adjunctive treatment for psoriasis, atopic dermatitis, and wound-healing with significant potential to enhance therapeutic options for additional skin diseases.展开更多
Tracheal stenosis represents a significant challenge.Surgeons continue to search for appropriate reconstructive techniques and grafting materials for long tracheal segment reconstruction.Grafts can be classified as sy...Tracheal stenosis represents a significant challenge.Surgeons continue to search for appropriate reconstructive techniques and grafting materials for long tracheal segment reconstruction.Grafts can be classified as synthetic,allogenic,autogenic,transplant,and engineered.Although none of these grafts have provided overwhelming success,acellular composite engineered grafts have shown early promise and can be applied in benign and malignant tracheal diseases.Intraluminal granulation tissue causing re-stenosis is the biggest challenge in tracheal reconstruction.Tracheal wound healing and tissue regeneration pathways must be deeply explored and better characterized to advance the field of tracheal reconstruction.展开更多
文摘Recent studies have suggested an evolving understanding of the association be-tween vaping,specifically electronic cigarette(e-cigarette)use,and the progre-ssion of atherosclerosis,a significant contributor to cardiovascular disease.Des-pite the prevailing perception of vaping as a safer alternative to traditional toba-cco smoking,accumulating evidence suggests that the aerosols emitted by e-cigarettes contain harmful constituents that may promote endothelial dysfunction,oxidative stress,inflammation,and dyslipidemia—key mechanisms implicated in atherosclerosis pathogenesis.While past research,including experimental studies and clinical investigations,has shed light on the potential cardiovascular risks associated with vaping,gaps in knowledge persist.Future research endeavors should focus on interpreting the long-term effects of vaping on atherosclerosis development and progression,exploring the impact of different e-cigarette formu-lations and user demographics,and identifying effective strategies for mitigating the cardiovascular consequences of vaping.By identifying and addressing these research gaps,we can enhance our understanding of the cardiovascular implica-tions of vaping and inform evidence-based interventions and policies to safe-guard public health.Core Tip:E-cigarette use has been linked to various cardiovascular risks,including the progression of atherosclerosis.Despite the perception of vaping as a safer alternative to smoking,evidence suggests that e-cigarette aerosols contain harmful substances that contribute to endothelial dysfunction,oxidative stress,inflammation,and dyslipidemia.These mechanisms are crucial in the development and progression of atherosclerosis.This review explores multiple facets of e-cigarettes and arterial health,focusing on the connection between vaping and atherosclerosis progression.It presents up-to-date evidence on pathophysiology and significant clinical implications,the impact of various constituents,and discusses contemporary public health strategies.
文摘Gallbladder cancer is a rare,aggressive malignancy that has a poor overall prognosis.Effective treatment consists of early detection and surgical treatment.With the wide spread treatment of gallbladder disease with minimally invasive techniques,the rate of incidental gallbladder cancer has seen an equitable rise along with stage migration towards earlier disease.Although the treatment remains mostly surgical,newer modalities such as regional therapy as well as directed therapy based on molecular medicine has led to improved outcomes in patients with advanced disease.We aim to summarize the management of gallbladder cancer along with the newer developments in this formidable disease process.
文摘BACKGROUND Gallbladder cancer is the most common malignancy of the biliary tract.Neo-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 resection.Currently,there is no consensus of guidelines for neoadjuvant therapy in gallbladder cancer.As investigations continue to analyze the regimen and benefit of NACT for ongoing care of gallbladder cancer patients,we examined American College of Surgeons National Surgical Quality Improvement Program(NSQIP)database to determine if there was higher morbidity among the neo-adjuvant group within the 30-day post-operative period.We hypothesized patients who underwent NACT were more likely to have higher post-operative morbidity.AIM To investigate the 30-day post-operative morbidity outcomes between patients who received NACT and underwent surgery and patients who only had surgery.METHODS A retrospective analysis of the targeted hepatectomy NSQIP data between 2015 and 2019 was performed to determine if NACT in gallbladder cancer increased the risk for post-operative morbidity(bile leak,infection rate,rate of converting to open surgery,etc.)compared to the group who only had surgery.To calculate the odds ratio for the primary and secondary outcomes,a crude logistic regression was performed.RESULTS Of the 452 patients,52 patients received NACT prior to surgery.There were no statistically significant differences in the odds of morbidity between the two groups,including bile leak[odds ratio(OR),0.69;95%confidence interval(95%CI):0.16-2.10;P=0.55],superficial wound infection(OR,0.58;95%CI:0.03-3.02;P=0.61),and organ space wound infection(OR,0.63;95%CI:0.18-1.63;P=0.61).CONCLUSION There was no significant difference in the risk of 30-day post-operative morbidity between the NACT and surgery group and the surgery only group.
文摘BACKGROUND Resection of hepatic metastasis from neuroendocrine tumors(NETs)improves quality of life and prolongs 5-year survival.Ablation can be utilized with surgery to achieve complete resection.Although several studies report long-term out-comes for patients undergoing ablation,none have explored perioperative effects of ablation in patients with metastatic NETs.AIM To determine if intra-operative ablation during hepatectomy increases risk of ad-verse outcomes such as surgical site infections(SSIs),bleeding,and bile leak.METHODS A retrospective analysis of the hepatectomy National Surgical Quality Impro-vement Program database from 2015-2019 was performed to determine the odds of SSIs,bile leaks,or bleeding in patients undergoing intraoperative ablation when compared to hepatectomy alone.RESULTS Of the 966 patients included in the study,298(30.9%)underwent ablation during hepatectomy.There were 78(11.7%)patients with SSIs in the hepatectomy alone group and 39(13.1%)patients with a SSIs in the hepatectomy with ablation group.Bile leak occurred in 41(6.2%)and 14(4.8%)patients in the two groups,respec-tively;bleeding occurred in 117(17.5%)and 33(11.1%),respectively.After con-trolling for confounding variables,ablation did not increase risk of SSI(P=0.63),bile leak(P=0.34)or bleeding(P=0.07)when compared to patients undergoing resection alone on multivariate analysis.CONCLUSION Intraoperative ablation with hepatic resection for NETs is safe in the perioperative period without significant increased risk of infection,bleeding,or bile leak.Surgeons should utilize this modality when appropriate to a-chieve optimal disease control and outcomes.
文摘BACKGROUND Pancreatic adenocarcinoma is currently the fourth leading cause of cancer-related deaths in the United States.In patients with“borderline resectable”disease,current National Comprehensive Cancer Center guidelines recommend the use of neoadjuvant chemoradiation prior to a pancreaticoduodenectomy.Although neoadjuvant radiotherapy may improve negative margin resection rate,it is theorized that its administration increases operative times and complexity.AIM To investigate the association between neoadjuvant radiotherapy and 30-d morbidity and mortality outcomes among patients receiving a pancreaticoduodenectomy for pancreatic adenocarcinoma.METHODS Patients listed in the 2015-2019 National Surgery Quality Improvement Program data set,who received a pancreaticoduodenectomy for pancreatic adenocarcinoma,were divided into two groups based off neoadjuvant radiotherapy status.Multivariable regression was used to determine if there is a significant correlation between neoadjuvant radiotherapy,perioperative blood transfusion status,total operative time,and other perioperative outcomes.RESULTS Of the 11458 patients included in the study,1470(12.8%)underwent neoadjuvant radiotherapy.Patients who received neoadjuvant radiotherapy were significantly more likely to require a perioperative blood transfusion[adjusted odds ratio(aOR)=1.58,95%confidence interval(CI):1.37-1.82;P<0.001]and have longer surgeries(insulin receptor-related receptor=1.14,95%CI:1.11-1.16;P<0.001),while simultaneously having lower rates of organ space infections(aOR=0.80,95%CI:0.66-0.97;P=0.02)and pancreatic fistula formation(aOR=0.50,95%CI:0.40-0.63;P<0.001)compared to those who underwent surgery alone.CONCLUSION Neoadjuvant radiotherapy,while not associated with increased mortality,will impact the complexity of surgical resection in patients with pancreatic adenocarcinoma.
文摘This comprehensive review investigates the significant psychological impact and profound psychological comorbidities found in individuals suffering from chronic pruritic dermatoses, including atopic dermatitis, chronic urticaria, and prurigo nodularis. Highlighting the complex, reciprocal relationship between pruritus and psychiatric conditions such as depression, anxiety, and sleep disturbances, this paper elucidates the comprehensive impact of dermatological disorders on the skin in addition to the far-reaching effects on an individual’s psychological well-being. By evaluating the efficacy of integrated psychodermatological interventions, including cognitive behavioral therapy, mindfulness practices, pharmacological treatments, and innovative telepsychiatry and digital health solutions, this review aims to lay the foundation for a more holistic approach to treatment of concurrent dermatological and psychiatric conditions. Future research endeavors should delve deeper into the mechanistic foundation of the pruritus-psychiatry interface, the refinement of tailored treatment strategies, and the evaluation of long-term patient outcomes. In doing so, this review seeks to contribute to the optimization of patient care and well-being, underscoring the pivotal role of addressing both dermatological and psychological needs in achieving comprehensive health outcomes.
文摘This comprehensive review explores the intricate dynamics between psychosocial factors and chronic wound healing processes, specifically focusing on prevalent conditions such as pressure ulcers, diabetic foot ulcers, and venous leg ulcers. By examining the roles of psychiatric conditions, including depression, anxiety, and post-traumatic stress disorder (PTSD), this paper illuminates how these factors intricately influence wound healing dynamics, including mechanisms of pain perception and inflammatory responses. Furthermore, we evaluate the effectiveness of integrated biopsychosocial interventions, which encompass a holistic approach to wound care, thereby enhancing healing outcomes for dermatology patients. Future studies should focus on investigating the specific psychosocial determinants that significantly influence wound healing, exploring novel therapeutic strategies, and implementing personalized interventions to meet the unique needs of each patient. Such endeavors hold promise in advancing the fields of psychodermatology and wound management, fostering a deeper understanding and application of psychosocial considerations in dermatological care.
文摘Background: Cutaneous oncology encompasses a broad range of skin malignancies, including melanoma, cutaneous squamous cell carcinoma (SCC), and basal cell carcinoma (BCC), all of which pose significant global health challenges. The World Health Organization (WHO) estimates that melanoma incidence has increased by approximately 50% over the past three decades. While SCC and BCC are generally less aggressive than melanoma, they contribute significantly to the overall burden of skin cancer due to their high prevalence. Traditional treatment modalities for these malignancies, such as surgery, radiation, and chemotherapy, have shown limitations in achieving durable responses and minimizing systemic toxicity. As a result, there is an increasing need for more effective and less toxic treatment options. Immunotherapeutic strategies have emerged as a promising avenue in oncology, with the potential to revolutionize treatment approaches for cutaneous malignancies. Objectives: This literature review aims to undertake an in-depth examination of immunotherapeutic strategies for melanoma, SCC, and BCC. Specifically, the review focuses on the role of immune checkpoint inhibitors, adoptive cell therapies, and emerging immunotherapies, assessing their impact on treatment outcomes, survival rates, and patient quality of life. Methods: A literature search was conducted using databases such as PubMed, Google Scholar, and Scopus. The search terms included “cutaneous oncology”, “immunotherapy”, “immune checkpoint inhibitors”, “adoptive cell therapy”, “melanoma”, “cutaneous squamous cell carcinoma”, and “basal cell carcinoma”. Peer-reviewed articles published in the last 10 years that reported clinical outcomes from immunotherapy-based treatments for cutaneous malignancies were included. The studies were reviewed and analyzed based on their reported clinical outcomes, including survival rates, adverse events, and quality of life metrics. Results: Our review identified significant advancements in immunotherapeutic strategies for cutaneous oncology. Immune checkpoint inhibitors, such as pembrolizumab and nivolumab, demonstrated improved overall survival rates, particularly in melanoma patients. In addition, adoptive cell therapies, including tumor-infiltrating lymphocyte (TIL) therapies, showed promise in managing both cutaneous SCC and BCC, with reported reductions in tumor burden and durable responses. Emerging immunotherapies, such as cancer vaccines and oncolytic viruses, are in early clinical trials but exhibit potential in enhancing antitumor immunity and expanding treatment options. Conclusions: Immunotherapeutic strategies represent a critical advancement in the management of cutaneous malignancies, offering improved outcomes compared to traditional therapies. Immune checkpoint inhibitors and adoptive cell therapies are already reshaping clinical practice, while emerging immunotherapies provide exciting avenues for future research. These therapies not only enhance survival rates but also reduce systemic toxicities, representing a transformative approach to treating skin cancer. Further research and clinical trials are needed to refine these strategies and expand their applicability to a broader patient population.
文摘Skin diseases such as psoriasis, atopic dermatitis, burns, and other barrier insults pose ongoing therapeutic challenges, often requiring treatments that address both inflammation and skin barrier repair. The primary aim of this review is to provide a comprehensive overview of the potential benefits of sea buckthorn oil, derived from Hippophae rhamnoides, as a treatment for various skin diseases, detailing its anti-inflammatory properties, reporting benefits across several skin conditions, and highlighting challenges in formulation as well as preservation of the oil’s nutritional benefits. Drawing from a wide array of existing literature, this review investigates sea buckthorn oil’s rich composition of omega fatty acids, vitamins, and antioxidants, which may contribute to its therapeutic effects by modulating inflammatory pathways and enhancing skin barrier function. Clinical trials and patient case studies indicate that sea buckthorn oil shows promise in reducing erythema, inflammation, and improving skin sensitivity. However, challenges such as formulation stability, sourcing of quality oil, and variability in response to treatment across conditions need to be addressed. Future research should focus on optimizing formulations and conducting large-scale clinical trials to validate the therapeutic efficacy of sea buckthorn oil in the management of skin diseases. Additionally, further exploration of the regulatory mechanisms underlying its ability to modulate inflammation and repair the skin barrier is needed to fully elucidate its clinical potential. Sea buckthorn oil offers a novel and promising adjunctive treatment for psoriasis, atopic dermatitis, and wound-healing with significant potential to enhance therapeutic options for additional skin diseases.
文摘Tracheal stenosis represents a significant challenge.Surgeons continue to search for appropriate reconstructive techniques and grafting materials for long tracheal segment reconstruction.Grafts can be classified as synthetic,allogenic,autogenic,transplant,and engineered.Although none of these grafts have provided overwhelming success,acellular composite engineered grafts have shown early promise and can be applied in benign and malignant tracheal diseases.Intraluminal granulation tissue causing re-stenosis is the biggest challenge in tracheal reconstruction.Tracheal wound healing and tissue regeneration pathways must be deeply explored and better characterized to advance the field of tracheal reconstruction.
