Mpox: epidemiology, clinical manifestations and recent developments in treatment and prevention.

INTRODUCTION: The 2022 Mpox outbreak is the largest viral outbreak recorded outside of Africa. The recent rise in human outbreaks has led to the perception that Mpox, an emerging zoonotic disease, has potential for epidemic spread. Healthcare practitioners are familiarizing themselves with the varied clinical manifestations and therapeutic approaches for this virus while public health organizations seek to limit the outbreak and treat those affected. In light of the worldwide upsurge, we have assembled a review on Mpox to streamline information access for healthcare professionals. AREAS COVERED: Within this article, you will find an overview outlining the virology, epidemiology, symptoms, diagnosis, and management of Mpox. Furthermore, we provide an analysis of Mpox infective mechanisms and management strategies for children and adolescents in the current literature. EXPERT OPINION: The spread of Mpox to non-endemic regions has elicited public alarm due to the lack of easily available information regarding the virus. While we continue to understand Mpox and its possible evolution increased education and knowledge among the public and healthcare providers is crucial. Through the creation of reviews that compile crucial information into a centralized location, we can assist in lessening the harmful effects of the virus through caution and education.

Pharmacotherapies to prevent epidural fibrosis after laminectomy: a systematic review of in vitro and in vivo animal models.

BACKGROUND CONTEXT: Excessive production of epidural fibrosis in the nerve root can be a pain source after laminectomy. Pharmacotherapy is a minimally invasive treatment option to attenuate epidural fibrosis by suppressing proliferation and activation of fibroblasts, inflammation, and angiogenesis, and inducing apoptosis. PURPOSE: We reviewed and tabulated pharmaceuticals with their respective signaling axes implicated in reducing epidural fibrosis. Additionally, we summarized current literature for the feasibility of novel biologics and microRNA to lessen epidural fibrosis. STUDY DESIGN/SETTING: Systematic Review. METHODS: According to the PRISMA guidelines, we systematically reviewed the literature in October 2022. The exclusion criteria included duplicates, nonrelevant articles, and insufficient detail of drug mechanism. RESULTS: We obtained a total of 2,499 articles from PubMed and Embase databases. After screening the articles, 74 articles were finally selected for the systematic review and classified based on the functions of drugs and microRNAs which included inhibition of fibroblast proliferation and activation, pro-apoptosis, anti-inflammation, and antiangiogenesis. In addition, we summarized various pathways to prevent epidural fibrosis. CONCLUSION: This study allows a comprehensive review of pharmacotherapies to prevent epidural fibrosis during laminectomy. CLINICAL SIGNIFICANCE: We expect that our review would enable researchers and clinicians to better understand the mechanism of anti-fibrosis drugs for the clinical application of epidural fibrosis therapies.

Human photoreceptors switch from autonomous axon extension to cell-mediated process pulling during synaptic marker redistribution.

Photoreceptors (PRs) are the primary visual sensory cells, and their loss leads to blindness that is currently incurable. Although cell replacement therapy holds promise, success is hindered by our limited understanding of PR axon growth during development and regeneration. Here, we generate retinal organoids from human pluripotent stem cells to study the mechanisms of PR process extension. We find that early-born PRs exhibit autonomous axon extension from dynamic terminals. However, as PRs age from 40 to 80 days of differentiation, they lose dynamic terminals on 2D substrata and in 3D retinal organoids. Interestingly, PRs without motile terminals are still capable of extending axons but only by process stretching via attachment to motile non-PR cells. Immobile PR terminals of late-born PRs have fewer and less organized actin filaments but more synaptic proteins compared with early-born PR terminals. These findings may help inform the development of PR transplantation therapies.