RESUMO
BACKGROUND: Platelet-rich plasma (PRP) and its combined therapeutic modalities have catalyzed new possibilities in dermatology; however, limitations in evidence and lack of consensus remain among clinicians regarding optimal composition, protocol, technique, and application. OBJECTIVE: To provide an update and analysis of the evidence for PRP in hair restoration and skin rejuvenation through review of recent available data, highlighting controversies and expert insights to guide future studies, and stimulate discourse and innovations benefitting patients. METHODS: A structured review and expert analysis of PubMed publications before October 2023, with a focus on recent literature from January 2020 through October 2023. RESULTS AND CONCLUSION: Growing literature supports the utility and benefits of PRP and related autologous products for applications for skin and hair, with strongest evidence for androgenetic alopecia and skin rejuvenation. However, this is limited by lack of consensus regarding best practices and protocols. Randomized, controlled trials with uniform metrics comparing outcomes of various compositions of autologous blood products, preparation methods, dosimetry, and frequency of treatments are still required. This will allow the medical discourse to grow beyond the realm of expert opinion into consensus, standardization, and more wide spread adoption of best practices that will benefit patients.
Assuntos
Alopecia , Plasma Rico em Plaquetas , Rejuvenescimento , Humanos , Alopecia/terapia , Técnicas Cosméticas , Envelhecimento da Pele , Cabelo/crescimento & desenvolvimento , Cabelo/transplanteRESUMO
Cardiovascular disease (CVD) and cancer are leading causes of mortality worldwide, traditionally linked through adverse effects of cancer therapies on cardiovascular health. However, reverse cardio-oncology, a burgeoning field, shifts this perspective to examine how cardiovascular diseases influence the onset and progression of cancer. This novel approach has revealed a higher likelihood of cancer development in patients with pre-existing cardiovascular conditions, attributed to shared risk factors such as obesity, a sedentary lifestyle, and smoking. Underlying mechanisms like chronic inflammation and clonal hematopoiesis further illuminate the connections between cardiovascular ailments and cancer. This comprehensive narrative review, spanning a broad spectrum of studies, outlines the syndromic classification of cardio-oncology, the intersection of cardiovascular risk factors and oncogenesis, and the bidirectional dynamics between CVD and cancer. Additionally, the review also discusses the pathophysiological mechanisms underpinning this interconnection, examining the roles of cardiokines, genetic factors, and the effects of cardiovascular therapies and biomarkers in cancer diagnostics. Lastly, it aims to underline future directives, emphasising the need for integrated healthcare strategies, interdisciplinary research, and comprehensive treatment protocols.
Assuntos
Doenças Cardiovasculares , Neoplasias , Humanos , Cardio-Oncologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/terapia , Neoplasias/terapia , Fatores de Risco , InflamaçãoRESUMO
Post-inflammatory hypopigmentation is a common acquired pigmentary disorder that is more prominent in skin of color, leading to great cosmetic and psychosocial implications. Often, a diagnosis with a pigmentary disorder can negatively impact an individual's health-related quality of life and may result in stigma. Although most cases of post-inflammatory hypopigmentation resolve spontaneously over time, a systematic diagnostic approach can help with identifying the underlying etiology and informing treatment strategies. It can be due to cutaneous inflammation, sequelae of inflammatory or infectious dermatoses, or dermatologic procedures. Therefore, a thorough understanding of the epidemiology, patient history, physical exam findings, and clinical features of post-inflammatory hypopigmentation phenomenon can explain the primary cause to providers and allow for patient education. It is also important to understand the various therapeutic approaches available and the efficacy of these options, which will inform providers to choose the appropriate therapy for patients. Although algorithms exist for classifying acquired disorders of hypopigmentation, there are no established algorithms for the diagnosis and treatment of post-inflammatory hypopigmentation, which warrants further exploration and discourse.
RESUMO
The conventional synthesis of hematite nanoparticles (HNPs) is expensive and creates secondary contaminants. Therefore, to combat these issues, there is a requirement for a cheap, effective, and eco-friendly technique. Herein, HNPs were prepared using the fruit extract of Spondias pinnata - an abundant source available in Western-coastal India. The polyphenolic compounds aided the synthesis process and the entire procedure was very rapid. The obtained HNPs had needle-like morphology with agglomerations due to the magnetic interactions as seen in FESEM and HRTEM images. Fe and O elements were noticed in EDS results. The crystalline nature and crystal phase were confirmed from XRD and SAED patterns. The lattice parameters of HNPs were in tandem with the literature. Fe-O crystalline vibrations were noticed in FTIR studies. VSM results portrayed the superparamagnetic nature of HNPs with a high magnetic saturation value of 8.949 emu/g and a negligible hysteresis loop. Thermal stability was ascertained using TGA results with 32% overall weight loss. XPS studies revealed the existence of pure HNPs with signature peaks. Raman spectrum showed the bands specific for HNPs, comparable to the commercial one. In addition, the HNPs were mesoporous with a high surface area (72.04 m2/g) - higher than the commercial one. The anticancer potential of the HNPs was successfully demonstrated against two mammalian cancer cell lines. Therefore, the HNPs synthesized in this study could be applied in various biomedical fields, especially for anticancer formulations.
Assuntos
Nanopartículas , Animais , Índia , Nanopartículas Magnéticas de Óxido de Ferro , Magnetismo , Mamíferos , Microscopia Eletrônica de Transmissão , Nanopartículas/químicaRESUMO
Anemia is a common concern in older people and can have significant morbidity and mortality. Because anemia is a sign, not a diagnosis, an evaluation is almost always warranted to identify the underlying cause. The purpose of this study was to study the clinical profile of elderly patients with anemia and to study characteristics of hematological types of anemia in such patients as well as the closest possible etiological profile. Hundred patients above the age of 60 years were included in the study. Clinical profile with laboratory studies of Hemoglobin and diagnostic tests to fix the etiology. Majority of patients had normocytic blood picture. Renal failure was the most common underlying chronic disease. Significant number of patients were on non steroidal anti-inflammatory drugs which could contribute to the anaemia. 14% of the patients had an underlying malignancy. 73.3% of the patients in the microcytic group had an underlying GI lesion on endoscopy. Identifying anemia as an important aspect of a comprehensive geriatric assessment is absolutely essential further to clinical detection. Confirming the type of anemia is critical to direct the investigation for profiling the etiology since it is well known that the treatment of anemia goes a long way in improving the overall outcome and quality of life.
RESUMO
CONTEXT: Sepsis is a serious health problem in the elderly with a high degree of mortality. There is very limited data available in elderly subjects regarding the markers for sepsis. Development of good markers will help in overall management and prediction of sepsis. OBJECTIVES: Serial estimation of Interleukin-6 (IL-6) and Tumor Necrosis Factor-Alpha (TNF-alpha) and their correlation with mortality in sepsis in elderly patients and to determine the influence of gender on cytokine production and mortality in elderly patients with sepsis. SETTINGS AND DESIGN: The prospective study was conducted at our tertiary care center from April 2007 to September 2008. Elderly Patients satisfying the Systemic Inflammatory Response Syndrome (SIRS) criteria were included. METHODS AND MATERIAL: TNF-alpha and IL-6 were estimated in 30 elderly patients admitted to our intensive care unit with SIRS and sepsis. The estimations were done on day 1, 3 and 7 of admission. STATISTICAL ANALYSIS USED: Student and paired 't' tests, and ANOVA, which were further followed up by post-hoc 't' tests with Bonferroni correction using SPSS. RESULTS: Reducing levels of IL-6 levels from day 1 to 7 was found in the survivor group. TNF-alpha level was significantly low on day 1 in the nonsurvivor female group. CONCLUSIONS: Serial estimation of cytokines in elderly patients with sepsis will help in prediction of mortality. Female gender was an independent predictor of increased morality in critically ill patients with sepsis.