Illuminating Progress: A Comprehensive Review of the Evolution of Phototherapy for Neonatal Hyperbilirubinemia.

This comprehensive review thoroughly examines the historical evolution, physiological foundations, and contemporary advancements in the application of phototherapy for neonatal hyperbilirubinemia. Neonatal hyperbilirubinemia, a common condition resulting from the immature hepatic processes in newborns, poses potential risks, including neurotoxicity, if left untreated. The review traces the historical progression from early recognition of neonatal jaundice to the development of various phototherapy modalities, showcasing the dynamic landscape of neonatal care. Emphasizing the physiological intricacies of bilirubin metabolism in neonates, the study underscores the vulnerability of newborns to hyperbilirubinemia due to delayed hepatic maturation. Phototherapy is a cornerstone in managing hyperbilirubinemia, demonstrating consistent efficacy in reducing unconjugated bilirubin levels. The implications for clinical practice are significant, offering healthcare professionals insights into tailoring treatment strategies based on individual neonatal characteristics and the severity of jaundice. Integrating advanced monitoring and control systems enhances the precision and safety of phototherapy. Recommendations for future research emphasize the need to investigate long-term outcomes, explore adjunctive therapies, and address resource limitations to ensure global access to effective neonatal care. Overall, this review contributes to the ongoing refinement of neonatal care practices, offering a comprehensive understanding of neonatal hyperbilirubinemia and its evolving treatment landscape.

Revolutionizing Wound Healing: Unleashing Nanostructured Lipid Carriers Embodied with Herbal Medicinal Plant.

Wound healing is crucial for maintaining skin integrity and preventing complications from external threats. Various plants, such as Achillea millefolium, Aloe vera, Curcuma longa, Calendula officinalis, Camellia sinensis, Azadirachta indica, and Plantago, have demonstrated wound healing capabilities and have been used in herbal medicine for wound care. NLCs are second-generation lipid nanoparticles, blending solid and liquid lipids to improve medication loading and limit leakage. NLCs have been used in various applications, including cosmeceuticals, chemotherapy, gene therapy, and brain targeting. Wound healing is divided into four stages: hemostasis, inflammatory response, proliferation, and remodeling. Factors such as age, gender, chronic disorders, and local agents like infections can affect recovery. These plants' antiinflammatory, antioxidant, and antibacterial activities have demonstrated potential in wound healing. Combining herbal medicinal plants and nanostructured lipid carriers (NLCs) can revolutionise wound treatment and improve overall healthcare outcomes.

Current patterns of care for patients with extensive stage small cell lung cancer: Survey of US radiation oncologists on their recommendations regarding thoracic consolidation radiotherapy.

OBJECTIVES: Current National Comprehensive Cancer Network (NCCN) guidelines recommend thoracic consolidation radiation therapy (TCRT) for patients with Extensive Stage Small Cell Lung Cancer (ES-SCLC) with response to systemic chemotherapy, based on two randomized clinical trials, which varied in patient selection and radiation therapy doses administered. The current pattern of practice among US radiation oncologists is unknown. MATERIALS AND METHODS: We have surveyed practicing US radiation oncologist via a short online questionnaire. Respondents' characteristics and their self-rated knowledge base were analyzed for association with their treatment recommendations. RESULTS: We received 473 responses from practicing US radiation oncologists. Over half of respondents were practicing for over 10 years after completing residency training and 70% treated more than 10 lung cancer patients per year. 96% of respondents recommend TCRT for patients with ES-SCLC after systemic chemotherapy. Patient selection and radiation therapy doses vary greatly. High self-rated knowledge of individual clinical trials is associated with lower TCRT recommended doses. Patients treated at academic centers are less likely to receive TCRT than patients treated in private clinics (p=0.0101). CONCLUSION: Our analysis revealed that among the respondents, there was a very high adherence to current NCCN guidelines, which recommend TCRT for ES-SCLC patients with clinical response to systemic chemotherapy. The great variability in patient selection and radiation therapy doses is concerning and calls for future clinical trials to standardize treatment approaches and improve treatment outcomes among patients with ES-SCLC. Until such data exists and in light of poor long-term survival of patients with ES-SCLC, the shorter and less toxic regimen of 30Gy in 10 fractions should be used as the standard of care and the more aggressive regimens studied on clinical protocols.

Current Patterns of Care for Patients with Extensive-Stage SCLC: Survey of U.S. Radiation Oncologists on Their Recommendations Regarding Prophylactic Cranial Irradiation.

INTRODUCTION: Conflicting data from randomized clinical trials incite the debate over the appropriate use of prophylactic cranial irradiation (PCI) for patients with extensive-stage SCLC (ES-SCLC) who achieve clinical response to systemic chemotherapy. The current pattern of practice among U.S. radiation oncologists is unknown. METHODS: We surveyed practicing U.S. radiation oncologists through a short online questionnaire. Respondents' characteristics and their self-rated knowledge base were analyzed for association with their treatment recommendations. RESULTS: We received 473 responses from practicing U.S. radiation oncologists. More than half of the respondents had been practicing for more than 10 years after completing residency training, and 70% had treated more than 10 patients with lung cancer per year. Of the respondents, 90% recommended brain magnetic resonance imaging (MRI) before initiation of PCI and 98% recommended PCI for patients with ES-SCLC after systemic chemotherapy. Half of the respondents followed their patients with brain MRI after completion of PCI. One-third of the respondents prescribed memantine to patients undergoing PCI. Among the respondents, recent graduates (p = 0.004) and physicians practicing in academic centers (p = 0.005) were more likely to prescribe memantine. Self-rated knowledge base was not associated with any treatment recommendations. CONCLUSIONS: Our analysis revealed that among the respondents, there was a very high adherence to current National Comprehensive Cancer Network guidelines, which recommend providing universal PCI and obtaining brain MRI before initiation of PCI for patients with ES-SCLC with clinical response to systemic chemotherapy. These guidelines and practice patterns are not supported by clinical evidence because patients in the European Organization for Research and Treatment of Cancer trial did not undergo brain MRI before PCI and the Japanese randomized trial has shown a possible detrimental effect of PCI on overall survival when brain MRI was incorporated. A critical reevaluation of current guidelines is essential to determine the appropriate management of these patients.