Search Results (10)

Background: Vernal keratoconjunctivitis (VKC) is a chronic, recurrent, and frequently severe allergic ocular condition predominantly impacting children and adolescents in tropical and subtropical areas. It profoundly affects patients’ quality of life owing to its chronic symptoms and possible vision-threatening effects. Notwithstanding progress in comprehending VKC, its ocular symptoms and therapeutic approaches necessitate ongoing assessment. Aims: This review summarizes the main factors to consider when diagnosing, treating, and managing patients with VKC based on the current literature in this field. Methods: This comprehensive review examined peer-reviewed literature from 2010 to 2024 obtained from PubMed. The selection criteria encompassed research addressing the clinical presentation, diagnostic difficulties, and therapy of visual symptoms in pediatric patients with VKC. The publications chosen were those focusing on those that elucidate the pathophysiology, consequences, and innovations in treatment methodologies. Results: The ocular manifestations of VKC are varied and characterized by prominent symptoms such as severe itching, photophobia, lacrimation, and a viscous mucoid discharge. Clinical manifestations range from conjunctival hyperemia and limbal thickening to severe consequences that jeopardize vision, including shield ulcers and keratoconus. Improvements in imaging techniques such as anterior segment optical coherence tomography (AS-OCT) and in vivo confocal microscopy have enhanced diagnostic accuracy. The pharmacological approach has transitioned to steroid-sparing techniques, prioritizing mast cell stabilizers, antihistamines, and immunomodulators such as cyclosporine. Novel therapies, including biologics that target interleukin pathways, demonstrate potential in refractory instances. Nonetheless, access to modern medicines is restricted in resource-limited environments. Conclusions: VKC poses considerable diagnostic and treatment difficulties due to its chronic nature and possible consequences. This review emphasizes the necessity for prompt diagnosis and customized management approaches to avert vision impairment. Despite considerable advancements in comprehending VKC’s etiology and therapy, inequalities in access to sophisticated care highlight the necessity for global activities to guarantee equitable treatment alternatives. Full article

Diabetic foot ulcers (DFUs) are a multifactorial pathophysiologic condition that occurs in patients with diabetes mellitus (DM). Approximately 9.1 to 26.1 million people are affected by DFUs annually. This condition can lead to progressive foot infections and, ultimately, foot amputation. Various microbes contribute to DFUs, including methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli can form biofilms composed of complex matrices that create a protective shield around the microorganisms, enhancing their survival and resistance to treatment. Biofilm formation is a critical virulence factor directly associated with the onset and persistence of DFUs. It not only complicates the clinical management of these ulcers but also facilitates antibiotic resistance, necessitating a comprehensive approach to treatment. Effective management strategies must therefore target biofilm formation, and the virulence factors associated with these pathogens. By addressing these elements, conventional antibiotics can be rendered more effective in treating diabetic foot ulcers. This approach aims not only to promote wound healing but also to address underlying causes and prevent further complications. This article seeks to highlight the significance of biofilm formation in DFUs, explore methodologies for studying this condition, as well as discuss demographic considerations and treatment options. Full article

Background: The incidence of melanoma is increasing globally. The estimated worldwide incidence is projected to increase from 324,635 cases in 2020 to 510,000 in 2040. In the UK, melanoma accounts for 4% of all new cases of cancer. Melanomas occurring in the skin of the head and neck represent 13% and 23% of cases in women and men, respectively. Prognostic indicators include presence of nodal or distant metastasis, ulceration, and Breslow thickness, where >4 mm thickness predicts poorest overall survival rates. Giant melanomas, a term generally applied to melanomas larger than 5–10 cm, are rare and often have a very poor prognosis. Clinical case: An 82-year-old female presented acutely with a 2–3-day history of delirium and urinary retention in February 2022. In addition, she was noted to have a large fungating growth on her forehead that obscured the bridge of the nose and had been slowly increasing in size for the past year prior to admission. She had initially presented in primary care with a small growth on her forehead but declined further investigations for fear of contracting COVID-19. She consented to having further assessment and management of the forehead mass. A shave biopsy revealed giant nodular melanoma, specifically, the largest melanoma of the face reported in the literature. Remarkably, our patient underwent a successful complete excision and skin grafting, with no evidence of recurrence or distal metastasis after 2 years of follow up. Conclusions: This case highlights the anxieties people felt about contracting COVID-19 when national guidelines recommended shielding that had resulted in further morbidity. Despite poor prognostic factors, clinically and histologically, our patient did not need any systemic anticancer therapy nor radiotherapy. She was well after 2 years follow up without any signs of recurrence. Full article

Intestinal mucus serves as the first line barrier within the mucosa to protect against microbiota attack due to its water-repellent properties, which are the result of the high abundance of phosphatidylcholine bound to mucins. A deficiency of mucus phosphatidylcholine predisposes it to mucosal inflammation by the attack of commensal microbiota, as it is intrinsically low in ulcerative colitis. However, for precipitation of an acute inflammatory episode, mucus phosphatidylcholine has to fall below the critical level required for mucosal protection. Bacterial ectophospholipase could be a candidate for further thinning of the mucus phosphatidylcholine shield as shown, for example, with the ectophospholipase containing Helicobacter pylori bacterium. Despite supporting evidence for this mechanism in the intestine, the responsible ectophospholipase-carrying bacteria species are still to be defined. Applying phosphatidylcholine to the lumen can serve to fill up empty mucin-binding sites in ulcerative colitis as well as provide a substrate for the ectophospholipase-carrying bacteria preventing their attacks on the mucus phosphatidylcholine layer. Evidence supporting this concept comes from clinical trials in humans with ulcerative colitis as well as from colitis mouse models where phosphatidylcholine was substituted in the lumen. An alternative strategy could involve adding non-absorbable phospholipase inhibitors to the intestinal lumen, which has been shown to be effective in a mouse model of ulcerative colitis. Bacterial phospholipase should be considered a pathogenetic factor of the intestinal microbiota and therapeutic strategies should be developed to prevent their hyperactivity for clinical improvement of intestinal inflammation. Full article

Vernal keratoconjunctivitis (VKC) is a complex and multifactorial disease process that employs Th2 cell-mediated immunologic processes, which involves the overexpression of interleukin 4 (IL-4), IL-5, IL-9, IL-13, and IL-31, and the activation of mast cells that release IL-5 and CCL-11, recruiting eosinophils to the site of inflammation. The disease primarily affects young males and is more common in regions with warm climates. VKC is characterized by persistent and recurrent conjunctival inflammation that can adversely affect the patient’s quality of life, and, when inadequately treated, may lead to a host of ocular complications, such as corneal shield ulcers and scarring. The major distinct forms of VKC include limbal or palpebral, which may occur in combination. The clinicopathological features of VKC include the presence of pseudogerontoxon, limbal gelatinous hyperplasia, and perilimbal hyperpigmentation. Topical immunomodulators are effective anti-steroidal options for controlling severe and chronic cases of VKC. This review will provide a brief overview of topical immunomodulators, including cyclosporin and tacrolimus, and will highlight the clinical manifestations, pathological mechanisms, and fibroproliferative changes in the conjunctiva that can result from recurrent disease. Full article

The purpose of this paper is to review the specialized literature to highlight the effects produced by energy drinks in terms of skin health. To carry out this review, we consulted previous articles with descriptive cross-sectional designs, case series, and individual case reports published between 2000 and 2023. Therefore, while caffeine acute consumption among adults can have beneficial effects, in children, it can cause health problems like overnight breaks, headaches, and dulled cognition since their organs are still developing and their endocrine system is not yet stable. Despite the antioxidant and neuroprotective effects of caffeine from energy drinks, their excessive consumption among adolescents can cause disorders like high systolic blood pressure, agitation, nausea, anxiety, osteoporosis, heart palpitations, poor sleep quality, and stomach ulcers. Among athletes, taurine supplementation has been proven to improve exercise capacity in cold weather conditions. Also, vigilance, attention, and reaction time were all improved by caffeine consumption. Caffeine administration in low doses caused a risk of cardiovascular disease. It was effective in treating migraines in children, but raised systolic blood pressure, and contributed to skin healing in adolescents. On the other side, taurine prevents obesity among children, causes positive effects on oxidative stress and inflammation in adolescents, helps shield the skin from damaging oxidative stress among students, and impacts exercise capacity in athletes. Significant increases in serum levels of uric acid, creatinine, BUN, ALT, and ALP caused by chronic intake of EDs indicated different degrees of injury to the kidneys and liver. Furthermore, the effects on the cardiovascular system could be worse if taurine and caffeine are combined. Caffeine alone does not significantly decrease sleep as much as a taurine/high caffeine ratio. On the other hand, a low ratio does. Full article

Background: Vernal keratoconjunctivitis (VKC) severely affects the quality of life of affected patients. The development of a shield ulcer is considered one of the most severe late-stage complications, which when untreated leads to irreversible vision loss. In this systematic review, we outlined the results of surgical treatments of corneal shield ulcers in VKC. Methods: We searched 12 literature databases on 3 April 2023 for studies of patients with VKC in which shield ulcers were treated by any surgical treatment. Treatment results were reviewed qualitatively. Assessments of the risk of bias of individual studies were made using the Clinical Appraisal Skills Programme. Results: Ten studies with 398 patients with VKC were eligible for the qualitative review. Two categories of surgical approaches were described: supratarsal corticosteroid injection and debridement with or without amniotic membrane transplantation. Almost all patients experienced resolution or improvement of their shield ulcers, regardless of treatment modality. Time to healing was faster with surgical debridement. A small proportion experienced recurrence and side effects. Conclusions: Surgical treatment for shield ulcers in VKC seems highly effective, but careful post-operative treatment and follow-ups are necessary due to the risk of recurrence and potential side effects. Full article

New endoscopic approaches for the prevention of delayed bleeding (DB) after gastric endoscopic submucosal dissection (ESD) have been reported in recent years, and endoscopic delivery of biodegradable polymers for iatrogenic ulcer hemostasis and coverage has emerged as one of the most promising techniques for post-ESD management. However, the comparative efficacy of these techniques remains uncertain. We performed a systematic search of multiple databases up to May 2022 to identify studies reporting DB rates as outcomes in patients undergoing gastric ESD who were treated with subsequent endoscopic management, including endoscopic closure (clip-based methods and suturing), PGA sheet tissue shielding, and hemostatic powder/gel spray (including polymeric sealants and other adhesives). The risk ratios (RRs) of delayed bleeding in treatment groups and control groups were pooled, and the Bayesian framework was used to perform a network meta-analysis (NMA). Among these studies, 16 head-to-head comparisons that covered 2742 lesions were included in the NMA. Tissue shielding using PGA sheets significantly reduced the risk of DB by nearly two thirds in high-risk patients, while hemostatic spray systems, primarily polymer-based, reduced DB in low-risk patients nine-fold. Researchers should recognize the essential role of polymers in the management of ESD-induced ulcers, and develop and validate clinical application strategies for promising materials. Full article

Background and Objectives: To report the long-term outcomes of patients with refractory Vernal Keratoconjunctivitis (VKC) who underwent surgical excision of giant papillae (GP) with mitomycin C (MMC) 0.02% and amniotic membrane transplantation (AMT). Materials and Methods: This is a retrospective interventional single-center case series including five eyes of four patients who had refractory, symptomatic VKC with GP, along with corneal shield ulcers and/or punctate epithelial erosions. They underwent surgical excision of GP with MMC 0.02% alone (1 eye) or with MMC 0.02% and AMT (4 eyes). Their long-term visual and surgical outcomes were studied. Results: All subjects were male with bilateral involvement and mean age of presentation 9.8 years. The surgery was uneventful in all cases. Amongst the four eyes which underwent MMC with AMT, only one eye demonstrated papillary regrowth requiring repeat surgery. Postoperative follow-up ranged from 59 to 77 months (median 66 months). Four patients had the best corrected visual acuity (BCVA) >/= 6/9.5. One patient had BCVA 6/15 at the final follow-up due to the presence of anterior corneal stromal scar and poor ocular surface. Conclusions: Surgical excision of GP in combination with MMC and AMT, in refractory VKC, is a good treatment option with better clinical outcomes over a longer follow-up. Full article

This paper presents a cost-effective sensor system for mattresses that can classify the sleeping posture of an individual and prevent pressure ulcers. This system applies projected capacitive sensing to the field of health care. The charge time (CT) method was used to sensitively and accurately measure the capacitance of the projected electrodes. The required characteristics of the projected capacitor were identified to develop large-area applications for sensory mattresses. The area of the electrodes, the use of shielding, and the increased length of the transmission line were calibrated to more accurately measure the capacitance of the electrodes in large-size applications. To offer the users comfort in the prone position, a flexible substrate was selected and covered with 16 × 20 electrodes. Compared with the static charge sensitive bed (SCSB), our proposed system-flexible projected capacitive-sensing mattress (FPCSM) comes with more electrodes to increase the resolution of posture identification. As for the body pressure system (BPS), the FPCSM has advantages such as lower cost, higher aging-resistance capability, and the ability to sense the capacitance of the covered regions without physical contact. The proposed guard ring design effectively absorbs the noise and interrupts leakage paths. The projected capacitive electrode is suitable for proximity-sensing applications and succeeds at quickly recognizing the sleeping pattern of the user. Full article