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Topic Review
Butterflies and Ribbons in Multiple Gestation
In neonatology, multiple pregnancies are common. Unfortunately, it is not rare for one baby to die. Communication with parents in these circumstances has been demonstrated to be sub-optimal. Formal training programs for clinicians in NICUs, using either the Butterfly or Ribbon approaches, should be routinely offered. 
  • 251
  • 04 Sep 2023
Topic Review
Alopecia Associated with Antiseizure Medication
The mainstay of treatment for epilepsy is antiseizure medications (ASMs). Approximately 70% of individuals with epilepsy obtain seizure freedom with adequate ASMs therapy. Adverse effects of antiseizure medications (ASMs) remain one of the major causes of non-adherence. Cosmetic side effects (CSEs) are among the most commonly reported side effects of ASMs. Alopecia is one of the CSEs that has a high intolerance rate leading to poor therapeutical compliance. 
  • 342
  • 04 Sep 2023
Topic Review
Hyperbaric Oxygen in Restoring Host Homeostasis
Sepsis and septic shock continue to be a leading cause of death worldwide. Sepsis was previously thought to be an overwhelming, systemic, proinflammatory response to infection, which was followed by a phase of immunosuppression. New paradigms suggest that the proinflammatory and immunosuppression phases occurs simultaneously, and the pathophysiology begind the disease complex is not only explained by the pathogen’s type, load and virulence, but to a large extend also by host’s dysregulated response to infection. Many of these dysregulated host immune responses that occurs in sepsis are also targets of hyperbaric oxygen (HBO2) treatment. HBO2 treatment has been shown to improve survival in clinical studies on patients with necrotizing soft tissue infections as well as experimental sepsis models. Inflammation and oxygen-sensing pathways are connected on the cellular level in a self-reinforcing and detrimental manner in inflammatory conditions, which may be interrupted when intervening with HBO2 treatment. HBO2 treatment acts to maintain homeostasis by protecting the host from collateral tissue damage during resistance to infection by reducing neutrophil extracellular traps, inhibiting neutrophil adhesion to vascular endothelium, reducing proinflammatory cytokines, and halting the Warburg effect, while also aiding the host in tolerance to infection by reducing iron-mediated injury and upregulating anti-inflammatory measures.
  • 331
  • 01 Sep 2023
Topic Review
Ocular Manifestations of COVID-19
Since its emergence in early 2020, the SARS-CoV-2 infection has had a significant impact on the entire eye care system. Ophthalmologists have been categorized as a high-risk group for contracting the virus due to the belief that the eye may be a site of inoculation and transmission of the SARS-CoV-2 infection. 
  • 215
  • 01 Sep 2023
Topic Review
Pancreatic Ductal Adenocarcinoma Stroma in Photodynamic Therapy
Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest solid malignancies, with a five-year survival of less than 10%. The resistance of the disease and the associated lack of therapeutic response is attributed primarily to its dense, fibrotic stroma, which acts as a barrier to drug perfusion and permits tumour survival and invasion. As clinical trials of chemotherapy (CT), radiotherapy (RT), and targeted agents have not been successful, improving the survival rate in unresectable PDAC remains an urgent clinical need. Photodynamic stromal depletion (PSD) is a recent approach that uses visible or near-infrared light to destroy the desmoplastic tissue. Preclinical evidence suggests this can resensitise tumour cells to subsequent therapies whilst averting the tumorigenic effects of tumour–stromal cell interactions. So far, the pre-clinical studies have suggested that photodynamic therapy (PDT) can successfully mediate the destruction of various stromal elements without increasing the aggressiveness of the tumour. 
  • 230
  • 01 Sep 2023
Topic Review
Interdisciplinary Therapeutic Approaches to Atypical and Malignant Meningiomas
Meningiomas have the highest incidence among brain tumors. In contrast to benign tumors that constitute the majority of this tumor entity, the treatment of aggressive meningiomas (WHO Grade 2 and 3) is more challenging, requiring gross total removal of the tumor and the affected dura and adjuvant radiotherapy. Not every diagnosed meningioma has to or can be resected. The age and physical condition of patients play major roles in treatment decisions
  • 168
  • 01 Sep 2023
Topic Review
Teeth Damage during General Anesthesia
Dental injuries during anesthesia, especially when advanced airway management is required, represent a legal problem. Factors such as poor dental condition and excessive pressure during intubation contribute to dental damage. The maxillary central incisors are commonly affected.
  • 456
  • 01 Sep 2023
Topic Review
Nerve Injury and Photobiomodulation
The available therapeutic options for restoring function and sensitivity in long-term nervous injuries pose challenges. Microsurgery interventions for direct nerve repair often lead to serious complications and limited success. Non-surgical methods, although somewhat effective, have limited benefits. These methods involve drug administration, such as with analgesics or corticosteroids. Photobiomodulation therapy (PBMT) has emerged as a promising approach based on clinical and laboratory studies. PBMT stimulates the migration and proliferation of neuronal fiber cellular aggregates. Experimental studies on animal models with peripheral nerve compression injuries have shown that PBMT can enhance the functionality of damaged nerves, preserving their activity and preventing scar tissue formation. The mechanism of action depends on the wavelength, which can positively or negatively affect photo acceptor resonances, influencing their conformation and activities. These findings suggest that photobiomodulation may accelerate and improve nerve regeneration.
  • 225
  • 01 Sep 2023
Topic Review
Orexin in REM Sleep
Orexin plays a significant role in the modulation of REM sleep, as well as in the regulation of appetite and feeding. There is evidence on the role of orexin in the modulation of sleep and wakefulness and highlights that orexin should be considered essentially as a neurotransmitter inhibiting REM sleep and, to a lesser extent, a wake promoting agent. Subsequently, the relationship between orexin, REM sleep, and appetite regulation is examined in detail, shedding light on their interconnected nature in both physiological conditions and diseases (such as narcolepsy, sleep-related eating disorder, idiopathic hypersomnia, and night eating syndrome).
  • 315
  • 01 Sep 2023
Topic Review
Types of Retinal Cell Death in Diabetic Retinopathy
Diabetic retinopathy (DR) is a major complication of diabetes and a leading cause of blindness worldwide. DR was recently defined as a neurovascular disease associated with tissue-specific neurovascular impairment of the retina in patients with diabetes. Neurovascular cell death is the main cause of neurovascular impairment in DR.
  • 140
  • 01 Sep 2023
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