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The field of dental prosthetics has undergone significant evolution due to advances in materials, technology, and patient-specific customization. Practical interferences, such as technological limitations, material constraints, and clinical challenges, continue to influence the trajectory of this field. This paper aims to analyze these interferences, highlighting their impact on the design, production, and clinical application of dental prostheses. By reviewing existing literature and case studies, this work identifies key obstacles and proposes strategies for overcoming them. The findings underscore the need for interdisciplinary collaboration, continuous research, and technological investment to address these interferences effectively.

Key Clinical Massage: Tubo‐ovarian abscess (TOA) is a serious health hazard for women, causing severe sepsis. Antimicrobial treatment is effective, but one‐third of patients experience unfavorable outcomes. ITP, an autoimmune condition, can lead to bruising and bleeding. Diagnosing TOA in women of childbearing age is crucial, and combining emergency surgery with ITP patients can increase treatment costs and reduce quality of life. ITP can lead to severe complications, including postoperative hemorrhage, and may require platelet transfusions, glucocorticosteroids, and immunoglobulin. These treatments increase costs, decrease quality of life, and impact prognosis. Preventing ITP is crucial. Patients should be administered blood products based on platelet count and anemia or spontaneous bleeding tendencies. Perioperative blood management should aim for a target platelet level of 30 × 109/L and a hemoglobin concentration of 80 g/L before surgery. Post‐surgery, perioperative care is crucial and vigilant for secondary bleeding. A tubo‐ovarian abscess (TOA) is a frequently encountered inflammatory mass in therapeutic settings. TOA is a serious consequence of pelvic inflammatory disease (PID) that can lead to severe sepsis. In recent years, the incidence of TOA has increased, presenting a significant health hazard for women. To effectively target the diverse range of bacteria responsible for TOA, it is essential to use antimicrobial medicines that have a wide spectrum of activity. Nevertheless, the efficacy of antibiotic treatment stands at approximately 70%, while a significant proportion of patients, around one‐third, experience unfavorable clinical outcomes necessitating drainage or surgical intervention. Immune thrombocytopenia (ITP) is an autoimmune condition characterized by a marked decrease in the quantity of platelets present in the bloodstream. ITP is characterized by thrombocytopenia, which leads to a heightened susceptibility to bruising and bleeding. The diagnosis of ITP and the prediction of treatment response continue to pose important and persistent issues in the field of hematology. The platelet count is commonly employed as a surrogate indicator of disease severity in patients with ITP and thus plays a crucial role in determining the necessity of treatment. A 25‐year‐old woman with a history of sexual activity underwent open abdominal exploration due to the sudden onset of lower abdominal pain. During the operation, a left TOA was discovered, and an incision and drainage were performed. Symptomatic treatments, such as anti‐infectives and abdominal drainage, were administered. The culture of pus in the abdominal cavity suggested the presence of Escherichia coli. However, the patient presented with ITP and had a platelet count of less than 50 × 109/L before the operation. After the operation, the patient developed incisional and pelvic hematomas with signs of infection. As a result, the patient was discharged from the hospital after undergoing another laparotomy and receiving platelet transfusions and immunotherapy. Clinicians should be vigilant when diagnosing TOA in women of childbearing age, even in the absence of high‐risk factors. A timely antibiotic or surgical intervention is necessary to preserve fertility and ensure quality of life. Combining emergency surgery with ITP patients poses a significant challenge for clinicians in terms of treatment. ITP can lead to serious complications, such as postoperative bleeding, which may require platelet transfusions, glucocorticoids, and immunoglobulin. This can increase the cost of treatment, reduce the quality of life, and seriously affect the prognosis. Therefore, preventing ITP is crucial. It is important to pay attention to the perioperative care of patients after surgery and be alert to the possibility of secondary hemorrhage. [ABSTRACT FROM AUTHOR]

Key Clinical Message: This case report explores the clinical journey of a patient initially diagnosed with botryomycosis, only to later reveal the underlying and rare condition of actinomycosis. The report highlights the challenges in getting to an accurate diagnosis, emphasizing the importance of considering uncommon pathologies, the utility of multi‐disciplinary teams and clinico‐pathologic correlation in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: Direct oral anticoagulants (DOACs) have been approved, for over a decade, by both European and American medicine agencies, for treatment and prevention of several cardiovascular conditions. Since then, an increasing amount of data has been added to the medical literature day by day, resulting in a dichotomy in selection of the appropriate agent, dosage, and duration of treatment for special populations with multiple comorbidities. Considering these issues, we have prepared a comprehensive review for the clinical practitioner, to optimize the DOAC utilization in clinical practice. Methods: A thorough literature search and review was conducted, concerning mainly the last decade. Our review focused on the current guidelines and the most recently published studies in PubMed, Science Direct Scopus, and Google Scholar to date. Conclusion: The purpose of this study is to provide guidance for healthcare professionals for making proper decisions when confronted with clinical challenges. Nevertheless, further research is required to establish DOAC superiority in complicated cases, where there is clinical uncertainty. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) has been used in healthcare for decades and has the potential to revolutionize dentistry by solving multiple clinical problems and making the work of clinicians easier. In particular, the study of AI applications in periodontal disease and cariology is important because these are two major areas of concern in dental health. Periodontal disease, which affects the gums and bone surrounding the teeth, is a major cause of tooth loss in adults. Cariology, the study of dental decay, is also an important area of focus for AI research. AI algorithms can be used to analyze dental images and detect early signs of decay that may be missed by human dentists. The review first discusses the history of AI in healthcare and then highlights some of the ways technology has improved dentistry and then describe some basic AI models such as artificial neural networks (ANNs), convolutional neural networks (CNNs), and random forest. The article then delves into how AI is involved in periodontal disease, cariology, endodontics, prosthodontics, and orthodontics including classifying different types of periodontal disease, identifying areas of bone loss, determining the severity of the disease, analyzing dental images, and detecting early signs of diseases. On the other hand, the application of AI in dentistry is relatively uncommon because implementing AI technologies in dentistry presents several challenges that need to be addressed for successful implementation of AI technologies in dentistry.

The study aimed to assess the prevalence of the frailty syndrome in older patients hospitalized in the geriatric ward depending on the diagnostic criteria used, the feasibility of particular diagnostic scales in hospitalized patients, and their compatibility; 416 patients (81.2 ± 6.91 years) admitted to the Department of Geriatrics of Hospital of the Ministry of the Interior and Administration in Bialystok within eight months were included in the study. Four diagnostic scales were used to identify the frailty syndrome: Fried criteria, 7-point Clinical Frailty Scale (CFS), 40-item Frailty Index (FI), and FRAIL Scale. Depending on the scale, the prevalence of frailty syndrome varied from 26.8% (FRAIL Scale), 52.3% (Clinical Frailty Scale), and 58.1% (Fried criteria) up to 62.9% (Frailty Index). We observed the highest feasibility for CFS (100%) and the lowest for the Fried scale (79.8%). The highest level of agreement was found between the CFS and Frailty Index, with 80.3% consistent ratings (Cohen Kappa 0.6). Patients in the geriatric ward are characterized by a high prevalence of frailty, although it differs depending on the criteria. The most difficult to use in daily practice was the Fried scale, while the Clinical Frailty Scale was determined feasible in all patients. [ABSTRACT FROM AUTHOR]

Abstract Extracellular vesicles (EVs) are nano-sized, natural, cell-derived vesicles that contain the same nucleic acids, proteins, and lipids as their source cells. Thus, they can serve as natural carriers for therapeutic agents and drugs, and have many advantages over conventional nanocarriers, including their low immunogenicity, good biocompatibility, natural blood–brain barrier penetration, and capacity for gene delivery. This review first introduces the classification of EVs and then discusses several currently popular methods for isolating and purifying EVs, EVs-mediated drug delivery, and the functionalization of EVs as carriers. Thereby, it provides new avenues for the development of EVs-based therapeutic strategies in different fields of medicine. Finally, it highlights some challenges and future perspectives with regard to the clinical application of EVs. Graphical Abstract

Computed tomography (CT) is a powerful and widely used imaging technique in modern medicine. However, it often requires the use of contrast agents to visualize structures with similar radiographic density. Unfortunately, current clinical contrast agents (CAs) for CT have remained largely unchanged for decades and come with several significant drawbacks, including serious nephrotoxicity and short circulation half-lives. The next generation of CT radiocontrast agents should strive to be long-circulating, non-toxic, and non-immunogenic. Nanoparticle contrast agents have shown promise in recent years and are likely to comprise the majority of next-generation CT contrast agents. This review highlights the fundamental mechanism and background of X-ray and contrast agents. It also focuses on the challenges associated with current clinical contrast agents and provides a brief overview of potential future agents that are based on various materials such as lipids, polymers, dendrimers, metallic, and non-metallic inorganic nanoparticles (NPs). We realized a need for clarification on a number of concerns related to the use of iodinated contrast material as debates regarding the safety of these agents with patients with kidney disease, shellfish allergies, and thyroid dysfunction remain ongoing in medical practice. This review was partially inspired by debates witnessed in medical practice regarding outdated misconceptions of contrast material that warrant clarification in translational and clinical arenas. Given that conversation around currently available agents is at somewhat of a high water mark, and nanoparticle research has now reached an unprecedented number of readers, we find that this review is timely and unique in the context of recent discussions in the field. [Display omitted] [ABSTRACT FROM AUTHOR]

Extracellular vesicles (EVs) are nano-sized, natural, cell-derived vesicles that contain the same nucleic acids, proteins, and lipids as their source cells. Thus, they can serve as natural carriers for therapeutic agents and drugs, and have many advantages over conventional nanocarriers, including their low immunogenicity, good biocompatibility, natural blood–brain barrier penetration, and capacity for gene delivery. This review first introduces the classification of EVs and then discusses several currently popular methods for isolating and purifying EVs, EVs-mediated drug delivery, and the functionalization of EVs as carriers. Thereby, it provides new avenues for the development of EVs-based therapeutic strategies in different fields of medicine. Finally, it highlights some challenges and future perspectives with regard to the clinical application of EVs. Highlights: Various current techniques for isolating extracellular vesicles are reviewed, and their advantages and disadvantages are compared. An overview of the strategies used for the modification of extracellular vesicles and their application as delivery systems or therapeutic agents in different diseases is provided. Several challenges in the clinical application of extracellular vesicles-based nanoplatforms are discussed, along with solutions for their implementation as a promising therapeutic tool. [ABSTRACT FROM AUTHOR]

Idiopathic inflammatory myopathies (IIMs) represent a diverse group of systemic autoimmune disorders with variable clinical manifestations and disease course. Currently, the challenges of IIMs are multifold, including difficulties in timely diagnosis owing to clinical heterogeneity, limited insights into disease pathogenesis, as well as a restricted number of available therapies. However, advances utilizing myositis-specific autoantibodies have facilitated the definition of subgroups as well as the prediction of clinical phenotypes, disease course, and response to treatment. Herein we provide an overview of the clinical presentations of dermatomyositis, anti-synthetase syndrome, immune-mediated necrotizing myopathy, and inclusion body myositis. We then provide an updated review of available and promising therapies for each of these disease groups. We synthesize current treatment recommendations in the context of case-based construct to facilitate application to patient care. Finally, we provide high-yield, clinical pearls relevant to each of the subgroups that can be incorporated into clinical reasoning. There are many exciting developments on the horizon for IIM. As insights into pathogenesis evolve, the therapeutic armamentarium is expanding with many novel therapies in development, holding promise for more targeted treatment approaches. [ABSTRACT FROM AUTHOR]

The growing number of migrant patients in western countries calls for better cross-cultural competence among health providers. As workplaces, hospitals have become increasingly multicultural, and many doctors are themselves of foreign origin, including psychiatrists. The aims of this study were to explore what clinical challenges International Medical Graduates (IMGs) and native-born Norwegian doctors training in psychiatry perceived when treating patients from other cultures, and what factors might be associated with such cross-cultural challenges. We developed a six-item inventory of perceived cross-cultural clinical challenges (PCC), to assess what cross-cultural problems trainees in psychiatry found most challenging. The PCC was completed by 216 trainees who also reported on individual- and work-related background factors. Comparisons of PCC between the two groups were done by one-way analysis of variance, and associations between PCC and background factors were analyzed by linear multiple regression. The overall response rate was 93%. Native -born Norwegian doctors reported higher levels of PCC than did IMGs. Both native-born Norwegian doctors and IMGs rated "assessing psychosis," "assessing suicide risk," and "lacking tools in cross-cultural consultations" as the most demanding challenges in cross-cultural consultations. Independent factors associated with higher PCC included being a native-born Norwegian doctor and experiencing high levels of work-home conflict. The findings suggest that trainees in psychiatry may need more training and better tools in cross-cultural assessment of mental disorders. Possible differences in PCC between native-born doctors and IMGs should be taken into consideration when developing mentoring programs, as should the doctors' work-home conflict level, which might impact the PCC., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Herein, the recent advances in the development of resorbable polymeric-based biomaterials, their geometrical forms, resorption mechanisms, and their capabilities in various biomedical applications are critically reviewed. A comprehensive discussion of the engineering approaches for the fabrication of polymeric resorbable scaffolds for tissue engineering, drug delivery, surgical, cardiological, aesthetical, dental and cardiovascular applications, are also explained. Furthermore, to understand the internal structures of resorbable scaffolds, representative studies of their evaluation by medical imaging techniques, e.g., cardiac computer tomography, are succinctly highlighted. This approach provides crucial clinical insights which help to improve the materials' suitable and viable characteristics for them to meet the highly restrictive medical requirements. Finally, the aspects of the legal regulations and the associated challenges in translating research into desirable clinical and marketable materials of polymeric-based formulations, are presented., (© 2024 The Author(s). Advanced Healthcare Materials published by Wiley‐VCH GmbH.)

Parkinson's disease (PD) is taking a staggering toll on healthcare systems worldwide, with the bulk of the expenditures invested in the late stages of the disease. Considering the rising life expectancy and the increasing prevalence of PD across the globe, a clear understanding of the early signs and treatment options available for advanced PD (APD), will facilitate tailoring management programs and support services. This task is complicated by the lack of both global consensus in defining APD and standardized care guidelines. This perspective prepared by a panel of movement disorder specialists, proposes to extend and optimize currently accepted PD coding to better reflect the diverse disease manifestations, with emphasis on non-motor features. The panel seeks to promote timely diagnosis by adjustment of evaluation tools for use by community neurologists and suggests modification of eligibility criteria for advanced therapy. Moreover, it advocatesmultidisciplinary assessments of APD patients to drive personalized, patient-centered and holistic management. Overall, earlier and more targeted intervention is expected to markedly improve patient quality of life. [ABSTRACT FROM AUTHOR]

Parkinson’s disease (PD) is taking a staggering toll on healthcare systems worldwide, with the bulk of the expenditures invested in the late stages of the disease. Considering the rising life expectancy and the increasing prevalence of PD across the globe, a clear understanding of the early signs and treatment options available for advanced PD (APD), will facilitate tailoring management programs and support services. This task is complicated by the lack of both global consensus in defining APD and standardized care guidelines. This perspective prepared by a panel of movement disorder specialists, proposes to extend and optimize currently accepted PD coding to better reflect the diverse disease manifestations, with emphasis on non-motor features. The panel seeks to promote timely diagnosis by adjustment of evaluation tools for use by community neurologists and suggests modification of eligibility criteria for advanced therapy. Moreover, it advocates multidisciplinary assessments of APD patients to drive personalized, patient-centered and holistic management. Overall, earlier and more targeted intervention is expected to markedly improve patient quality of life.

In recent years, the incidence of different types of cancer and patient survival have been rising, as well as their prevalence. The increase in survival in recent years exposes the patients to a set of stressful factors such as more rigorous follow-up and more aggressive therapeutic regimens that, added to the diagnosis of the disease itself, cause an increase in the incidence of depressive disorders. These alterations have important consequences for the patients, reducing their average survival and quality of life, and for these reasons, special emphasis has been placed on developing numerous screening tests and early recognition of depressive symptoms. Despite that cancer and major depressive disorder are complex and heterogeneous entities, they also share many critical pathophysiological mechanisms, aiding to explain this complex relationship from a biological perspective. Moreover, a growing body of evidence is supporting the relevant role of lifestyle habits in the prevention and management of both depression and cancer. Therefore, the present study aims to perform a thorough review of the intricate relationship between depression and cancer, with a special focus on its biological links, clinical management, challenges, and the central role of lifestyle medicine as adjunctive and preventive approaches to improve the quality of life of these patients.

Modern methods of molecular diagnostics and therapy have revolutionized the field of medicine in recent years by providing more precise and effective tools for detecting and treating diseases. This progress includes a growing exploration of the body's secreted vesicles, known as extracellular vesicles (EVs), for both diagnostic and therapeutic purposes. EVs are a heterogeneous population of lipid bilayer vesicles secreted by almost every cell type studied so far. They are detected in body fluids and conditioned culture media from living cells. EVs play a crucial role in communication between cells and organs, both locally and over long distances. They are recognized for their ability to transport endogenous RNA and proteins between cells, including messenger RNA (mRNA), microRNA (miRNA), misfolded neurodegenerative proteins, and several other biomolecules. This review explores the dual utilization of EVs, serving not only for diagnostic purposes but also as a platform for delivering therapeutic molecules to cells and tissues. Through an exploration of their composition, biogenesis, and selective cargo packaging, we elucidate the intricate mechanisms behind RNA transport between cells via EVs, highlighting their potential use for both diagnostic and therapeutic applications. Finally, it addresses challenges and outlines prospective directions for the clinical utilization of EVs. [ABSTRACT FROM AUTHOR]

Background: Worldwide, diabetic kidney disease (DKD) remains the leading cause of chronic kidney disease (CKD) and its successor, the end stage renal disease, both of which constitute major morbidity and mortality concerns. Content: The residual risk of disease progression remains despite the advert of newer therapeutic modalities and current biomarkers. Meanwhile, microRNAs (miRNAs) are small non-coding RNAs, which regulate gene expression post-translationally by binding to specific mRNAs. Circulating miRNAs are increasingly recognised as novel biomarker or therapeutic targets, owing to their unique characteristics, such as their resilience to degradation by endogenous RNases, multiple downstream targets, involvement in biological processes, some degree of tissue specificity, relatively easy access and quantification. Unlike proteins, there are far less miRNAs and mature miRNAs are highly stable, structurally less complex without post-translational modification with high degree of conservation across species. Aberrant expression of miRNAs has been established in both in vitro and in vivo models of DKD. An up-to-date compilation of previous studies involving selected circulating miRNAs in blood and urine samples of DKD patients is discussed herein. Summary: This review highlights the unmet clinical challenges and dysregulation of miRNAs in the pathogenesis of DKD. [ABSTRACT FROM AUTHOR]

Eating disorders (EDs) are disabling, deadly, and costly mental disorders that considerably impair physical health and disrupt psychosocial functioning. Disturbed attitudes toward weight, body shape, and eating play a key role in the origin and maintenance of EDs. As EDs are under-researched, there is a great deal of uncertainty as to their pathophysiology, treatment, and management. Future challenges, emerging treatments, and outstanding research questions are addressed in this review.

Fateme Mohammadi,1 Mojtaba Farjam,2 Yousef Gholampour,2 Banafsheh Tehranineshat,3 Khodayar Oshvandi,4 Mostafa Bijani5 1Chronic Diseases (Home Care) Research Center and Autism Spectrum Disorders Research Center, School of Nursing and Midwifery, Department of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran; 2Noncommunicable Diseases Research Center (NCDRC), Fasa University of Medical Sciences, Fasa, Iran; 3Community-Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran; 4Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran; 5Department of Medical Surgical Nursing, Fasa University of Medical Sciences, Fasa, IranCorrespondence: Mostafa BijaniDepartment of Medical Surgical Nursing, Fasa University of Medical Sciences, Fasa 81936-13119, IranTel +98 9173308451Email bizhani_mostafa@yahoo.comBackground: Medical personnel act as the protectors of people’s health by preventing, controlling, and treating emerging diseases, including the coronavirus infection. COVID-19 is a highly infectious and contagious disease which has presented the Iranian healthcare system with a variety of clinical challenges. There is a lack of research on clinical challenges in health crises especially those caused by emerging diseases, hence a need for more exploration of these clinical challenges and dilemmas. The present study aims to determine the different aspects of health professionals’ perception of the psychological safety of patients infected with the coronavirus (COVID-19).Methods: The present study is a qualitative work which uses conventional content analysis. The participants were 17 health professionals who were responsible for COVID-19 patients and met the inclusion criteria. They were selected via purposeful sampling. The study lasted from February to March 2020. Data were collected through semi-structured, individual interviews which were conducted via video call. The collection of data was kept up to the point of saturation. The collected data were analyzed using the conventional content analysis method.Results: Three themes such as “respect for dignity”, “comprehensive support” and “peaceful environment” with 11 categories were extracted from the findings of the study.Conclusion: According to the results of the present study, patients infected with the coronavirus should be given care in a peaceful environment where they receive comprehensive support and have their dignity respected. Such conditions can guarantee the psychological safety of these patients and produce positive behavioral results on their part. Thus, it is essential that the cultural, professional, and organizational prerequisites of protecting all the dimensions of the psychological safety of these patients be provided.Keywords: Patient Safety, Safety Management, medical personnel, emerging diseases, coronavirus, qualitative research

Nanotherapeutics utilize the properties of nanomaterials to alter the pharmacology of the drugs and therapies being transported, leading to changes in their biological disposition (absorption, distribution, cellular uptake, metabolism and elimination) and ultimately, their pharmacological effect. This provides an opportunity to optimize the pharmacology of drugs, particularly for those that are dependent on hepatic action. Old age is associated with changes in many pharmacokinetic processes which tend to impair drug efficacy and increase risk of toxicity. While these age-related changes are drug-specific they could be directly addressed using nanotechnology and precision targeting. The benefits of nanotherapeutics needs to be balanced against toxicity, with future use in humans dependent upon the gathering of information about the clearance and long-term safety of nanomaterials.

• Vital signaling pathways for pancreatic cancer (PC) growth, metastasis, and resistance are reviewed. • Interplay of selected signaling pathways in PC progression is discussed. • Small molecular inhibitors, including their advantages and challenges are explored. • Diverse small molecular inhibitors in current PC clinical trials are assessed. Pancreatic cancer (PC), a disease with high heterogeneity and a dense stromal microenvironment, presents significant challenges and a bleak prognosis. Recent breakthroughs have illuminated the crucial interplay among RAS, epidermal growth factor receptor (EGFR), and hedgehog pathways in PC progression. Small molecular inhibitors have emerged as a potential solution with their advantages of oral administration and the ability to target intracellular and extracellular sites effectively. However, despite the US FDA approving over 100 small-molecule targeted antitumor drugs, challenges such as low response rates and drug resistance persist. This review delves into the possibility of using small molecules to treat persistent or spreading PC, highlighting the challenges and the urgent need for a diverse selection of inhibitors to develop more effective treatment strategies. This review unveils groundbreaking strategies for using small molecules to treat pancreatic cancer (PC). It explores innovative approaches to overcome the challenges posed by the dense stroma, offering the potential for enhanced drug delivery and improved patient outcomes. [ABSTRACT FROM AUTHOR]

In this work, we reported a young man complaining of asthenia and intermittent fever for 10 days, and an ultrasound showed an undefined lesion on his liver. Facing the patient's situation with severe agranulocytosis, anemia, and thrombocytopenia, we passed through a tough diagnostic process for choosing an appropriate treatment for him with an ambiguous result of pathological biopsy. The undefined liver lesion was successfully solved by withdrawing the androgen for observation, without lobectomy. The lesion gradually diminished over 2 years of follow-up.

Abstract Background Although several aspects of asthma care have been identified as being sub-optimal in Canada, such as patient education, practice guideline adoption, and access to care, there remains a need to determine the extent to which these gaps remain, so as to investigate their underlying causes, and potential solutions. Methods An ethics-approved mixed methods educational needs assessment was conducted in four Canadian provinces (Alberta, British Columbia, Ontario, and Quebec), combining a qualitative phase (45-min semi-structured interviews with community-based healthcare providers and key stakeholders) and a quantitative phase (15-min survey, healthcare providers only). Results A total of 234 participants were included in the study, 44 in semi-structured interviews and 190 in the online survey. Five clinical areas were reported to be suboptimal by multiple categories of participants, and specific causes were identified for each. These areas included: Integration of guidelines into clinical practice, use of spirometry, individualisation of asthma devices to patient needs, emphasis on patient adherence and self-management, and clarity regarding roles and responsibilities of different members of the asthma healthcare team. Common causes for gaps in all these areas included suboptimal knowledge amongst healthcare providers, differing perceptions on the importance of certain interventions, and inadequate communication between healthcare providers. Conclusions This study provides a better understanding of the specific causes underlying common gaps and challenges in asthma care in Canada. This information can inform future continuing medical education, and help providers in community settings obtain access to adequate materials, resources, and training to support optimal care of adult patients with asthma.

The COVID-19 pandemic has caused a global health threat. This disease has brought about huge changes in the priorities of medical and surgical procedures. This short review article summarizes several test methods for COVID-19 that are currently being used or under development. This paper also introduces the corresponding changes in the diagnosis and treatment of urological diseases during the COVID-19 pandemic. We further discuss the potential impacts of the pandemic on urology, including the outpatient setting, clinical work, teaching, and research. [ABSTRACT FROM AUTHOR]

Eating disorders (EDs) are disabling, deadly, and costly mental disorders that considerably impair physical health and disrupt psychosocial functioning. Disturbed attitudes toward weight, body shape, and eating play a key role in the origin and maintenance of EDs. As EDs are under-researched, there is a great deal of uncertainty as to their pathophysiology, treatment, and management. Future challenges, emerging treatments, and outstanding research questions are addressed in this review. [ABSTRACT FROM AUTHOR]

The field of precision oncology is rapidly progressing toward integrated "multiomics" analysis of multiple molecular species (such as DNA, RNA, or proteins) to provide a more complete profile of tumor heterogeneity. Micro/nanomaterial‐based systems, which leverage the unique properties of miniature materials, are currently well positioned to expand beyond rudimentary biomarker detection toward multiomics signature analysis. To enable clinical translation, the rational design and implementation of miniaturized systems should be driven by the unique clinical challenges present at various crucial cancer stages. This review features micro/nanomaterial‐based systems that are robustly tested on real patient samples for molecular biomarker detection at i) initial cancer screening and/or diagnosis, ii) cancer prognosis and risk stratification, and iii) longitudinal treatment/recurrence monitoring. Furthermore, this review discusses the use of micro/nanomaterials to facilitate sample preparation for different molecular biomarker species. Finally, this review deliberates on the recent paradigm shift of micro/nanomaterial‐based system innovation toward integrated multiomics cancer signature analysis and puts forth insights and perspectives on existing challenges. It is anticipated that this review could stimulate the propagation of new concepts and approaches to kick‐start a new generation of clinically translational technologies that capitalize on multiomics cancer signatures. [ABSTRACT FROM AUTHOR]

Curcumin is a bioactive compound that is extracted from Curcuma longa and that is known for its antimicrobial properties. Curcuminoids are the main constituents of curcumin that exhibit antioxidant properties. It has a broad spectrum of antibacterial actions against a wide range of bacteria, even those resistant to antibiotics. Curcumin has been shown to be effective against the microorganisms that are responsible for surgical infections and implant-related bone infections, primarily Staphylococcus aureus and Escherichia coli. The efficacy of curcumin against Helicobacter pylori and Mycobacterium tuberculosis, alone or in combination with other classic antibiotics, is one of its most promising antibacterial effects. Curcumin is known to have antifungal action against numerous fungi that are responsible for a variety of infections, including dermatophytosis. Candidemia and candidiasis caused by Candida species have also been reported to be treated using curcumin. Life-threatening diseases and infections caused by viruses can be counteracted by curcumin, recognizing its antiviral potential. In combination therapy with other phytochemicals, curcumin shows synergistic effects, and this approach appears to be suitable for the eradication of antibiotic-resistant microbes and promising for achieving co-loaded antimicrobial pro-regenerative coatings for orthopedic implant biomaterials. Poor water solubility, low bioavailability, and rapid degradation are the main disadvantages of curcumin. The use of nanotechnologies for the delivery of curcumin could increase the prospects for its clinical application, mainly in orthopedics and other surgical scenarios. Curcumin-loaded nanoparticles revealed antimicrobial properties against S. aureus in periprosthetic joint infections.

Judgement, as one of the core tenets of medicine, relies upon the integration of multilayered data with nuanced decision making. Cancer offers a unique context for medical decisions given not only its variegated forms with evolution of disease but also the need to take into account the individual condition of patients, their ability to receive treatment, and their responses to treatment. Challenges remain in the accurate detection, characterization, and monitoring of cancers despite improved technologies. Radiographic assessment of disease most commonly relies upon visual evaluations, the interpretations of which may be augmented by advanced computational analyses. In particular, artificial intelligence (AI) promises to make great strides in the qualitative interpretation of cancer imaging by expert clinicians, including volumetric delineation of tumors over time, extrapolation of the tumor genotype and biological course from its radiographic phenotype, prediction of clinical outcome, and assessment of the impact of disease and treatment on adjacent organs. AI may automate processes in the initial interpretation of images and shift the clinical workflow of radiographic detection, management decisions on whether or not to administer an intervention, and subsequent observation to a yet to be envisioned paradigm. Here, the authors review the current state of AI as applied to medical imaging of cancer and describe advances in 4 tumor types (lung, brain, breast, and prostate) to illustrate how common clinical problems are being addressed. Although most studies evaluating AI applications in oncology to date have not been vigorously validated for reproducibility and generalizability, the results do highlight increasingly concerted efforts in pushing AI technology to clinical use and to impact future directions in cancer care. [ABSTRACT FROM AUTHOR]

Lung cancer has a high mortality rate among cancers in both women and men. Currently, lung cáncer diagnosis is made with clinical examination, low-dose CT scan and molecular-based methods and its treatment options include chemotherapy, surgery, radiotherapy or immunotherapy. However, the life expectancy of lung cancer is not very high, and still it is usually diagnosed very lately, which leads to poorer prognosis. MicroRNAs [miRNAs] are small noncoding RNAs that regulate many diverse activities in the cell that can affect tumorigenesis by regulating many cell functions related to cancer, such as cell cycle, metastasis, angiogenesis, metabolism, and apoptosis. Also, it can have a potential diagnostic, therapeutic, and prognostic value for lung cancer. MiR320a is a promising microRNA that may help us in the diagnosis, treatment and prognosis of lung cancer, but some aspects of its clinical application are still vague, especially its effect on heavy smokers, delivery mechanism, toxicity and lack of reliable critical value. In this paper, we examined its comprehensive molecular interactions that lead to its tumor suppressor effect, and we reviewed its clinical application until now., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Résumé La prévalence de la maltraitance infantile serait plus importante lorsque l’un des parents a lui-même vécu des abus ou de la négligence durant l’enfance. Si les programmes les plus largement diffusés au Canada mettent de l’avant des résultats mitigés à endiguer la maltraitance, des approches cliniques centrées sur les phénomènes de répétition générationnelle seraient-elles des avenues fertiles pour le développement des pratiques ? Cet article poursuit quatre objectifs, lesquels seront soutenus par une recension narrative : (1) documenter les facteurs de risque de la maltraitance ; (2) identifier les défis cliniques posés par l’intervention auprès des parents en difficultés ; (3) formuler une analyse critique des modèles d’intervention les plus largement diffusés au Canada ; (4) ouvrir sur des perspectives d’intervention innovantes incluant les multiples facettes des vulnérabilités parentales. The prevalence of child abuse is higher in families with psychosocial vulnerabilities or when one or both parents experienced abuse or neglect during childhood. While the most widespread intervention approaches in Canada (e.g. material support or parenting skills programs) show mixed results in providing changes in mistreatment cycles, we examine clinical practice focused on generational repetition of trauma. In order to explore this topic, this paper has 4 objectives and will be supported by a narrative review of the literature: (1) to document the causalities of child maltreatment; (2) to identify the clinical challenges of struggling parents; (3) to develop a critical analysis of the intervention programs commonly spread in Canada; (4) to take into account multifaceted vulnerabilities of these families through innovative practice perspectives. [ABSTRACT FROM AUTHOR]

Background: Immune checkpoint-inhibitors (ICIs) are changing outcomes in different cancer settings, notably for patients with non-small-cell lung cancer (NSCLC). There are, however, still important gaps of evidence for clinical practice when using these novel treatments. In this study, we assessed physicians' opinion and experience on challenges for clinical practice with ICIs monotherapy in NSCLC., Methods: A survey was conducted on experienced physicians treating patients with NSCLC with ICIs. Two rounds of pilot tests were carried out for validation among a group of experts. Topics under analysis were in relation to treatment of elderly populations, performance status, brain metastases, use of steroids or antibiotics, the effects of gut microbiome, autoimmune diseases, human immunodeficiency virus infection, solid organ transplants, use of anti-programmed cell death protein 1 versus anti-programmed death-ligand 1 drugs, atypical tumour responses, predictors of response, duration of treatment and a final open question on additional relevant challenges., Results: Two hundred and twenty-one answers were collected, including 106 (48%) valid answers from experts for final analysis (physicians who have treated at least 20 patients with NSCLC with ICIs). The vast majority agreed that the selected topics in this study are important challenges ahead and more evidence is needed. Moreover, predictors of response, treating brain metastasis, shorter duration of treatment, the effects of gut microbiome and concomitant use of steroids were voted the most important topics to be further addressed in prospective clinical research., Conclusions: This survey contributed to understanding which are the main challenges for clinical practice with ICIs monotherapy in NSCLC. It can also contribute to guide further clinical research, considering the opinions and experience of those who regularly treat NSCLC patients with ICIs., Competing Interests: Disclosure GM reports support for advisory board/consultation positions for AstraZeneca, Roche, Novartis, Lilly and Pfizer. AP reports honoraria and/or advisory fees from: AstraZeneca, Bristol Myers Squibb (BMS), Roche/Italfarma. MS reports honoraria and/or advisory fees from: Amgen, AstraZeneca, BMS, Boehringer Ingelheim, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi Avemtis, Siemens Healthineers, Takeda. He also declares research support (institutional) from: Amgen, BMS, Dracen Pharmaceuticals, Janssen, Novartis, Pfizer, Siemens Healthineers. AA took part in advisory boards for Amgen, AstraZeneca, Bayer, Daiichi, EISAI, Genomic Health, Hengrui, Innate, Ipsen, Leo Pharma, Lilly, Merck, Merck Sharp & Dohme (MSD), Novartis, Pfizer, Seattle Genetics. He received speaker fees from Amgen, AstraZeneca, Bayer, Daiichi, Eisai, Genomic Health, Ipsen, Leo Pharma, Lilly, Merck, MSD, Novartis, Pfizer, Seattle Genetics. He received research grants from BMS, Roche. All other authors have declared no conflicts of interests., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background Thirty years after the origin of the field of psycho-oncology, limited data exist about the work practices of professionals providing psychosocial care to children with cancer and their families. Method A survey was designed to assess training, work environment, theoretical orientation, services provided, subspecialty areas or areas of special interest, satisfactions, challenges, and continuing education needs of pediatric psycho-oncologists. Members of national and international psycho-oncology organizations were invited to participate in the web-based survey. Results Seven hundred eighty-six professionals from 63 countries responded. The sample consisted mostly of psychologists (41%), physicians (20%), and social workers (14%). Approximately half of the participants worked in a designated psycho-oncology unit. Psychologists and social workers provided the majority of psychosocial services. Individual sessions with parents were most common (42%), followed by sessions with children (41%), survivors (36%), families (31%), and siblings (25%). Therapies provided include cognitive behavioral therapy (50%), relaxation (43%), psychodynamic psychotherapy (27%), play therapy (26%), and imagery (23%). Two-thirds reported having appropriate supervision, 37% were conducting research, and only half felt their salary was appropriate. Differences in therapeutic modalities were found by country. Clinicians desire training on clinical interventions, improving communication with medical staff, research, and ethics. Conclusions An international cohort of clinicians providing pediatric psycho-oncology services perform a wide variety of tasks, use a range of therapeutic approaches, and report considerable work satisfaction. Problem areas include professional inter-relations, inadequate supervision, and need for additional specialized training. Opportunity exists for global collaboration in pediatric psycho-oncology research and practices to enhance clinical effectiveness and reduce professional isolation. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Curcumin is a bioactive compound that is extracted from Curcuma longa and that is known for its antimicrobial properties. Curcuminoids are the main constituents of curcumin that exhibit antioxidant properties. It has a broad spectrum of antibacterial actions against a wide range of bacteria, even those resistant to antibiotics. Curcumin has been shown to be effective against the microorganisms that are responsible for surgical infections and implant-related bone infections, primarily Staphylococcus aureus and Escherichia coli. The efficacy of curcumin against Helicobacter pylori and Mycobacterium tuberculosis, alone or in combination with other classic antibiotics, is one of its most promising antibacterial effects. Curcumin is known to have antifungal action against numerous fungi that are responsible for a variety of infections, including dermatophytosis. Candidemia and candidiasis caused by Candida species have also been reported to be treated using curcumin. Life-threatening diseases and infections caused by viruses can be counteracted by curcumin, recognizing its antiviral potential. In combination therapy with other phytochemicals, curcumin shows synergistic effects, and this approach appears to be suitable for the eradication of antibiotic-resistant microbes and promising for achieving co-loaded antimicrobial pro-regenerative coatings for orthopedic implant biomaterials. Poor water solubility, low bioavailability, and rapid degradation are the main disadvantages of curcumin. The use of nanotechnologies for the delivery of curcumin could increase the prospects for its clinical application, mainly in orthopedics and other surgical scenarios. Curcumin-loaded nanoparticles revealed antimicrobial properties against S. aureus in periprosthetic joint infections. [ABSTRACT FROM AUTHOR]

In an era characterized by high-tech medicine, high-tech diseases, lack of resources, pervasive audit, and enhanced consumer awareness, there are many challenges and controversies confronting child mental health clinicians. In outlining some of these, I take the opportunity to tilt at a few windmills, question some dogma, and stroke a few sacred cows. The only apology I offer is for my selectivity. If the occasional blood pressure is raised, a soap-box or two is mounted, or some letters of rage (or approval) are penned (or e-mailed) this paper will have served its purpose. [ABSTRACT FROM PUBLISHER]