RESUMO
Alzheimer's disease (AD), a neurodegenerative disorder characterized by cognitive decline, poses a significant healthcare challenge worldwide. The accumulation of amyloid-beta (Aß) plaques and hyperphosphorylated tau protein drives neuronal degeneration and neuroinflammation, perpetuating disease progression. Despite advancements in understanding the cellular and molecular mechanisms, treatment hurdles persist, emphasizing the need for innovative intervention strategies. Quantum dots (QDs) emerge as promising nanotechnological tools with unique photo-physical properties, offering advantages over conventional imaging modalities. This systematic review endeavors to elucidate the theranostic potential of QDs in AD by synthesizing preclinical and clinical evidence. A comprehensive search across electronic databases yielded 20 eligible studies investigating the diagnostic, therapeutic, or combined theranostic applications of various QDs in AD. The findings unveil the diverse roles of QDs, including inhibiting Aß and tau aggregation, modulating amyloidogenesis pathways, restoring membrane fluidity, and enabling simultaneous detection of AD biomarkers. The review highlights the potential of QDs in targeting multiple pathological hallmarks, delivering therapeutic payloads across the blood-brain barrier, and facilitating real-time imaging and high-throughput screening. While promising, challenges such as biocompatibility, surface modifications, and clinical translation warrant further investigation. This systematic review provides a comprehensive synthesis of the theranostic potential of QDs in AD, paving the way for translational research and clinical implementation.
RESUMO
Inflammatory bowel disease (IBD) presents a complex interplay of chronic inflammation in the gastrointestinal tract and is associated with various extraintestinal manifestations, including cardiovascular complications (CVCs). IBD patients face an elevated risk of CVCs, including coronary artery disease, heart failure, arrhythmias, stroke, peripheral artery disease, venous thromboembolism, and mesenteric ischemia, necessitating comprehensive cardiovascular risk assessment and management. The intricate interplay between chronic inflammation, genetic predisposition, environmental factors, and immune dysregulation likely contributes to the development of CVCs in IBD patients. While the exact mechanisms linking IBD and CVCs remain speculative, potential pathways may involve shared inflammatory pathways, endothelial dysfunction, dysbiosis of the gut microbiome, and traditional cardiovascular risk factors exacerbated by the chronic inflammatory state. Moreover, IBD medications, particularly corticosteroids, may impact cardiovascular health by inducing hypertension, insulin resistance, and dyslipidemia, further amplifying the overall CVC risk. Lifestyle factors such as smoking, obesity, and dietary habits may also exacerbate cardiovascular risks in individuals with IBD. Lifestyle modifications, including smoking cessation, adoption of a heart-healthy diet, regular exercise, and optimization of traditional cardiovascular risk factors, play a fundamental role in mitigating CVC risk. Emerging preventive strategies targeting inflammation modulation and gut microbiome interventions hold promise for future interventions, although further research is warranted to elucidate their efficacy and safety profiles in the context of IBD. Continued interdisciplinary collaboration, advanced research methodologies, and innovative interventions are essential to address the growing burden of CVCs in individuals living with IBD and to improve their long-term cardiovascular outcomes.
RESUMO
Enhanced recovery after surgery (ERAS) protocols have transformed perioperative care by implementing evidence-based strategies to hasten patient recovery, decrease complications, and shorten hospital stays. However, challenges such as inconsistent adherence and the need for personalized adjustments persist, prompting exploration into innovative solutions. The emergence of artificial intelligence (AI) and machine learning (ML) offers a promising avenue for optimizing ERAS protocols. While ERAS emphasizes preoperative optimization, minimally invasive surgery (MIS), and standardized postoperative care, challenges such as adherence variability and resource constraints impede its effectiveness. AI/ML technologies offer opportunities to overcome these challenges by enabling real-time risk prediction, personalized interventions, and efficient resource allocation. AI/ML applications in ERAS extend to patient risk stratification, personalized care plans, and outcome prediction. By analyzing extensive patient datasets, AI/ML algorithms can predict individual patient risks and tailor interventions accordingly. Moreover, AI/ML facilitates proactive interventions through predictive modeling of postoperative outcomes, optimizing resource allocation, and enhancing patient care. Despite the potential benefits, integrating AI and ML into ERAS protocols faces obstacles such as data access, ethical considerations, and healthcare professional training. Overcoming these challenges requires a human-centered approach, fostering collaboration among clinicians, data scientists, and patients. Transparent communication, robust cybersecurity measures, and ethical model validation are crucial for successful integration. It is essential to ensure that AI and ML complement rather than replace human expertise, with clinicians maintaining oversight and accountability.
RESUMO
Single-incision laparoscopic cholecystectomy (SILC) is a minimally invasive surgical technique introduced as an advancement to laparoscopic cholecystectomy (LC). This narrative review delves into the emergence of SILC, emphasizing its distinct advantages such as improved cosmesis, reduced postoperative pain, and potentially faster recovery compared to traditional LC. The study meticulously examines current trends and challenges in SILC, including variations in techniques and their impact on patient outcomes. Furthermore, the article sheds light on the technical intricacies and longer operative times associated with SILC. It aims to contribute valuable insights to the medical community by synthesizing existing literature and recent research findings, fostering a deeper understanding of SILC, and guiding future advancements in minimally invasive surgical approaches. The discussion extends to the learning curve, complications, and a comparative analysis between SILC and traditional LC, offering a nuanced understanding of their respective strengths and limitations. The article concludes with a forward-looking perspective, exploring future directions and innovations in SILC, including advancements in surgical techniques and the integration of innovative technologies, such as robotic assistance and in vivo robots, to enhance precision and efficacy. The call for continued research into the long-term outcomes, safety, and refined patient selection criteria emphasizes the evolving landscape of SILC and its potential to shape the future of minimally invasive abdominal surgeries.
RESUMO
Hashimoto's thyroiditis (HT) poses diagnostic challenges due to its diverse clinical presentation and the intricacies of autoimmune thyroid diseases. This comprehensive narrative review explores the evolving landscape of diagnostic challenges in HT, aiming to provide a thorough understanding of the complexities involved in its diagnosis. The diagnostic criteria for HT involve a multifaceted approach, including clinical features, laboratory findings, and imaging studies. Serum antibodies against thyroid antigens, primarily thyroperoxidase (TPO) and thyroglobulin, play a crucial role in confirming the autoimmune nature of the disease. However, seronegative HT adds complexity by presenting without detectable antibodies. The significance of addressing diagnostic challenges lies in potential delays and misdiagnoses, emphasizing the need for accurate and timely intervention. The review explores future directions, emphasizing molecular and cellular aspects, genetic factors, and the emerging field of thyroid regeneration. Standardized diagnostic criteria are essential, considering the subjective nature of the current process. The heterogeneity of disease manifestations complicates targeted treatments, necessitating a deeper understanding of clinical presentations and underlying pathophysiology. Future research directions and challenges outlined in this review contribute to advancing our understanding and improving diagnostic precision in HT.
