With the increase of the medium lifespan in developing countries, skin aging rise attention more and more. In 2007, Kaya and Saurat rebranded the extreme expression of skin fragility under the name of ‘‘dermatoporosis’’ or chronic cutaneous insufficiency/fragility syndrome. Dermatoporosis is still underused in medical literature and nurses and wound specialists know also about this condition, but they call it “skin tears”. There is obvious confusion cause the nursing literature talks about skin tears while dermatologists write about dermatoporosis. Clinical aspects comprise atrophy, purpura, and pseudo-stellate scars. Firstly, the British dermatologist Thomas Bateman described senile purpura in 1818 as purpuric patches arising in elderly people after minimal trauma, especially on the dorsum of the hands. Furthermore, between 1970 and the full documentation of Kaya and Saurat in 2007, we found medical papers about senile purpura, pseudoscars, skin tears, and so on. Starting from this historical data, they bring valuable information according to clinical aspects, histopathology, ultrasonographic aspects, pathophysiology, and therapeutics. This paper aims to analyze published data for improving the diagnosis and management of dermatoporosis.
Clinical research is the cornerstone of the progress recorded in psychiatry in the last six decades, or of what is called the psychopharmacological revolution. Regardless of the stage of clinical research, there are sensitive ethical and legal aspects that may appear during this process, and such challenges have to be acknowledged in order to preserve its scientific value, integrity, and centered-on-the-patient-wellbeing core principles. Also, adequate strategies focused on preventing the risk of ethical misconduct and litigation have to be found to avoid a loss of trust in the results of clinical research, to protect vulnerable populations from abuse, and to ensure a legally stable environment for investigators. In order to explore these practical problems, a narrative review was performed through a search in PubMed and Google Scholar databases. The main ethical risks detected in clinical research were related to errors in the methodology of obtaining informed consent, monitoring the participant's safety during the clinical trial, and falsifying collected data. Several famous cases of ethical misconduct were found and analyzed, and methods to decrease the risk of the re-appearance of such problems have been listed. In conclusion, this review is an invitation to explore the complexity of the methodology of clinical research and its ethical and legal risks, as well as to find new ways to mitigate the possibility of such risks related to the research process.
A significant number of neurological diseases are pathogenetically related to oxidative stress, including but not limited to cerebrovascular afflictions such as ischemic and hemorrhagic stroke, Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, amyotrophic lateral sclerosis, and so on. Natural nutrients may help limit the impact of oxidative stress and, therefore, delay or prevent the impairment of these diseases. Although these natural components have not entered routine use, many have been studied in preclinical or even clinical settings with promising results. Therefore, the need to find the stage of the research in the field of validating the properties and clinical usefulness of such nutrients represents the main reason this narrative review was conducted. This analysis explored the PubMed database for papers related to the influence of natural nutrients on the onset and evolution of some of the most severe neurological disorders. The results of the review provide an overview of the pathways oxidative stress may undertake and how the use of nutrients may counteract these pathways. In conclusion, natural nutrients may have beneficial effects that can be impactful on clinical outcomes, but more good quality research in this field is needed before formulating any clear recommendation.
The assessment of suicide risk is a highly debated topic in the literature due to the complex interplay between social, psychological, cultural, and biological factors that contribute to the pathogenesis of self-harm. There is no unanimously accepted predictive model of suicide and no widely recognized evidence-based algorithm for psychiatric and psychological evaluation in clinical and non-clinical populations for early detection of self-harm. Therefore, this narrative review is focused on identifying the validated clinical instruments that may contribute to the construction of a possible screening and monitoring plan for suicide risk in military and civilian populations. Four electronic databases were searched (PubMed, CINAHL, Google Scholar, and Clarivate/Web of Science) for relevant reports on psychometric tools for detecting suicide risk published between the inception of each archive and January 2025. Seventeen instruments dedicated to the measurement of suicide and suicide-related aspects were reviewed, as well as three tools for the evaluation of depression severity that include specific items for assessing self-harm. The advantages and vulnerabilities of each instrument were assessed, and the particular features of using these tools in the military population were also explored. In conclusion, although a large number of validated instruments for the assessment of suicide risk exist, it is not possible to recommend the use of a single tool, either for clinical and nonclinical populations or for military and civilian personnel. The endeavor of finding an algorithm for the assessment of suicide risk is still far from reaching its end, as new psychometric instruments and possibly a new paradigm for the phenomenon of self-harm are sorely needed.
Asymptomatic bacteriuria (ABU) is a common finding in everyday clinical practice. Many patients, many of them with significant comorbidities, will present, when tested, with bacterial colonization of the urine even if they have no lower urinary tract symptoms at all. Therefore, the clinician is having a dilemma: Should I prescribe antibiotics to sterilize the urine or not? This article aims to update and eventually support physicians in the difficult decision of whether to treat or not to treat patients with ABS and when.
Background and aim: Influenza, commonly referred to as "the flu," is an infectious illness caused by influenza viruses (IV). Despite the availability of efficient antiviral drugs, the IV still significantly increases mortality. Antiviral drugs swiftly remove these viruses from pulmonary secretions, suggesting that a prolonged inflammatory response may be to blame for the poor result. Therefore, using immunomodulatory medications looks advantageous. Numerous anti-inflammatory effects are produced by statins. Numerous retrospective studies recommended that statins be considered for IV therapy. This study set out to comprehensively examine the immunomodulatory potential of statins in IV prophylaxis and therapy. Methods: From the beginning until 25 March 2022, a number of electronic databases (Scopus, EMBASE, PubMed, Web of Science, ProQuest, OVID, EBSCO, and CINAHL) were searched for cohort studies and randomized trials assessing the association between outcomes or risk of infections and statin therapy. Data were gathered on the investigated characteristics, measuring statin usage, quality evaluation, and results (set for potential confounders). Results: Finding additional therapeutic agents for influenza prevention and management is crucial since there are uncertain public health issues regarding the clinical efficacy of conventional medications. Pro-inflammatory cytokines are released as a result of influenza. According to the results, by using antiinflammatory medications, severe influenza infections can be prevented along with pleiotropic effects. As a result, statins, which are cardioprotective medications with immunomodulatory and anti-inflammatory properties, may be beneficial for individuals with IV. Conclusion: Based on the positive immunomodulatory effects of statin administration, our systematic review's findings suggested that IVs may be prevented and treated.
Gestational diabetes (GDM) is characterized by the initial onset of elevated glucose levels while pregnant throughout the 24th week up until the 28th week of gestation affecting around 2
Burn injuries are among the most severe forms of trauma, often leading to multiple organ dysfunction syndrome (MODS), a major contributor to morbidity and mortality in burn patients. This review examines the pathophysiological mechanisms, clinical manifestations, and management strategies associated with MODS in burn patients. Following a severe burn injury, the systemic inflammatory response and subsequent release of pro-inflammatory cytokines precipitate dysfunction across various organ systems. Early recognition and aggressive management of MODS, including fluid resuscitation, infection control, and organ support, are crucial for improving survival outcomes. A comprehensive understanding of the multifactorial etiology and interrelated nature of organ dysfunction in burn patients is essential for developing targeted therapies and optimizing patient care. This review provides a current overview of the topic. In the coming years, new insights into the pathophysiological mechanisms are expected to enhance our comprehension of the subject further.
More and more research in recent years has focused on neurogenesis and neuroplasticity. The hippocampus is a key location of adult neurogenesis. Because this part of the brain is regulated by environmental variables, it must be mentioned the therapeutic potential for neurodegenerative illnesses and brain injuries. Furthermore, this information challenges the historical concept of a static brain and tries to demonstrate its flexibility, adaptability, and possibility for regeneration. Those mechanisms which are found in a variety of mammalian species, including humans, are important when it comes to adaptive learning and memory, thus providing insights into cognitive well-being and mental health. The discovery of the brain's dynamic nature represented by new neurons, marks a shift in the field of neurology with far-reaching potentials. This paper highlights the significant potential of adult neurogenesis when it comes to clinical applications such as Alz-heimer’s disease.
Delirium is associated with lower quality of life, increased healthcare costs, longer hospitalizations, and worse prognosis when detected in patients who are already confronted with a severe and invalidating disease, like the major neurocognitive disorder (MND). In order to identify the most evidence-based interventions that could be included in case management for patients with both delirium and MND, this narrative review explored three electronic databases (Pubmed, Cochrane, and Web of Science/Clarivate) for primary and secondary sources dedicated to this topic. All papers published in English between the inception of each database and September 2024 were screened for relevant data on pharmacological and non-pharmacological therapies targeting delirium. The results supported the use of a multicomponent approach as the first line of treatment, mitigating the precipitating factors, and only as a second line, the use of pharmacological instruments. There is a lack of validated therapies targeting specifically the delirium superimposed on MND, most of the recommendations being extrapolated from studies with delirium in the general population or in elderly patients with different organic diseases. Further studies are required to investigate the specifics of delirium in patients with MND and potential strategies focused on neurobiological mechanisms instead of just clinical manifestations.
