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Frontiers in Medicine 2023
PubMed: 38020110
DOI: 10.3389/fmed.2023.1322157 -
Revista Brasileira de Medicina Do... 2023Fibromyalgia is a chronic pain syndrome with a complex multifactorial etiopathogenesis that more frequently affects women. Although widespread pain is the dominant...
Fibromyalgia is a chronic pain syndrome with a complex multifactorial etiopathogenesis that more frequently affects women. Although widespread pain is the dominant feature, fibromyalgia incorporates a wide variety of symptoms, such as fatigue, unrefreshed sleep, and cognitive and mood disorders. Central sensitization to pain is a key element in the pathophysiology of this syndrome. Due to its prevalence and repercussions on quality of life and work productivity, fibromyalgia is a common condition in occupational medicine outpatient clinics. Thus, physicians must be attentive to its symptoms to facilitate diagnosis and management. This article will address basic topics about fibromyalgia, including: epidemiology, predisposing factors, pathophysiological considerations, clinical manifestations, classification criteria, differential diagnosis, basic principles of treatment, and the contribution of occupational physicians.
PubMed: 38313087
DOI: 10.47626/1679-4435-2022-870 -
Frontiers in Public Health 2023
Topics: Occupational Health
PubMed: 37736082
DOI: 10.3389/fpubh.2023.1257402 -
IScience Nov 2023Extracellular vesicles (EVs) represent pivotal mediators in cell-to-cell communication. They are lipid-membranous carriers of several biomolecules, which can be produced... (Review)
Review
Extracellular vesicles (EVs) represent pivotal mediators in cell-to-cell communication. They are lipid-membranous carriers of several biomolecules, which can be produced by almost all cells. In the current of precision medicine, EVs gained growing attention thanks to their potential in both biomarker discovery and nanotherapeutics applications. However, current technical limitations in isolating and/or detecting EVs restrain their standard use in clinics. This review explores all the state-of-the-art analytical technologies which are currently overcoming these issues. On one end, several innovative optical-, electrical-, and spectroscopy-based detection methods represent advantageous label-free methodologies for faster EV detection. On the other end, microfluidics-based lab-on-a-chip tools support EV purification from low-concentrated samples. Altogether, these technologies will strengthen the routine application of EVs in clinics.
PubMed: 37867957
DOI: 10.1016/j.isci.2023.108105 -
La Clinica Terapeutica 2023Diabetes mellitus is an ever-increasing disease and is defined as a "social disease" due to the significant economic damage it causes to the affected individuals and the... (Review)
Review
Diabetes mellitus is an ever-increasing disease and is defined as a "social disease" due to the significant economic damage it causes to the affected individuals and the community involved in its care. This paper presents the process of certification of diabetic disease and the application for invalidity in order to obtain welfare and economic benefits provided by law; it, also, describes the prescription process and the appropriateness of therapeutic prescription for the diabetic patient in terms of clinical-prescriptive appropriateness and economic-prescriptive appropriateness. Finally, it reports on the side effects of the most common antidi-abetics, the off-label use of metformin and the physician's responsibili-ties in the light of the Gelli-Bianco law.
Topics: Humans; Certification; Diabetes Mellitus; Hypoglycemic Agents; Off-Label Use
PubMed: 37378509
DOI: 10.7417/CT.2023.2539 -
Annals of Occupational and... 2023ChatGPT has the potential to revolutionize occupational medicine by providing a powerful tool for analyzing data, improving communication, and increasing efficiency. It...
ChatGPT has the potential to revolutionize occupational medicine by providing a powerful tool for analyzing data, improving communication, and increasing efficiency. It can help identify patterns and trends in workplace health and safety, act as a virtual assistant for workers, employers, and occupational health professionals, and automate certain tasks. However, caution is required due to ethical concerns, the need to maintain confidentiality, and the risk of inconsistent or inaccurate results. ChatGPT cannot replace the crucial role of the occupational health professional in the medical surveillance of workers and the analysis of data on workers' health.
PubMed: 38029273
DOI: 10.35371/aoem.2023.35.e42 -
Information and Communication Technology Medicine: Integrative Specialty for the Future of Medicine.Interactive Journal of Medical Research Jul 2023The impact of information and communication technology (ICT) on medicine is unprecedented and ever-increasing. This has made it more and more difficult for doctors to...
The impact of information and communication technology (ICT) on medicine is unprecedented and ever-increasing. This has made it more and more difficult for doctors to keep pace with ICT developments and to adequately match the input of ICT experts. As a result, medical disciplines may not be able to take full advantage of growing possibilities. In this personal viewpoint paper, I argue for the establishment of a novel medical specialty, ICT medicine. ICT medicine is needed to optimally face the challenges of ICT-based developments, including artificial intelligence (AI), and to ensure their efficient and beneficial use. ICT medicine is rooted in both medicine and ICT, and in contrast to existing medical specialties it is integrative in nature, as long-standing structural collaborations with ICT and other stakeholders cross the boundaries between disciplines. Thus, new concepts and theories may evolve that are better suited to addressing ICT-related issues in medicine. ICT doctors will be instrumental in the conception, development, implementation, and evaluation of digital tools, systems, and services. They provide a bridge between ICT professionals and clinical users and educate doctors in digital applications and services. Notably, ICT doctors may have a pivotal role in the validation, verification, and evaluation of AI models. ICT medicine institutes offer a home to these new professionals, enhancing their independence within health care organizations and in relation to ICT companies. Importantly, in an era of growing technicalization and use of AI algorithms, ICT doctors may safeguard the human factor in medicine. And, from a societal perspective, they may promote digital inclusion and the continuing high quality of digital services and provide leadership in the future digitalization of medicine.
PubMed: 37440294
DOI: 10.2196/42831 -
Mycopathologia Dec 2023Mucosal and invasive candidiasis can be challenging to treat in the setting of drug intolerance, antifungal resistance, drug-drug interactions, or host immune status.... (Review)
Review
Mucosal and invasive candidiasis can be challenging to treat in the setting of drug intolerance, antifungal resistance, drug-drug interactions, or host immune status. Antifungals with novel mechanisms of action and distinct pharmacokinetic/pharmacodynamic properties have been developed in recent years. Rezafungin is an echinocandin with high-tissue penetration and an extended half-life that allows for once-weekly administration, making it a convenient treatment option for invasive candidiasis while obviating the need for central catheter placement. Ibrexafungerp is an oral glucan synthase inhibitor that is active against most echinocandin-resistant Candida species. At present, it is approved for the treatment of acute vulvovaginal candidiasis and is under investigation as an oral step-down therapy following initial treatment with an echinocandin for cases of invasive candidiasis. Oteseconazole is a long-acting tetrazole that exhibits a higher affinity for the fungal enzyme CYP51, resulting in a potentially lower risk of drug-drug interactions and side effects compared to other azoles. It is currently approved for the treatment of recurrent vulvovaginal candidiasis. Fosmanogepix has a novel mechanism of action and potent activity against several Candida strains resistant to other antifungals. Due to its considerable bioavailability and tissue penetration, it holds promise as a potential treatment option in patients with invasive candidiasis, including those with chorioretinitis or meningitis. Results from clinical trials and observational studies will further delineate the role of these agents in the management of candidiasis. As the usage of these novel antifungals becomes widespread, we expect to acquire a greater understanding of their efficacy and potential benefits.
Topics: Female; Humans; Antifungal Agents; Candidiasis, Vulvovaginal; Echinocandins; Candida; Candidiasis, Invasive
PubMed: 37470902
DOI: 10.1007/s11046-023-00759-5 -
Pharmacological Reports : PR Oct 2023Melanoma is a highly aggressive and life-threatening form of skin cancer that accounts for a significant proportion of cancer-related deaths worldwide. Although... (Review)
Review
Melanoma is a highly aggressive and life-threatening form of skin cancer that accounts for a significant proportion of cancer-related deaths worldwide. Although conventional cancer therapies, such as surgical excision, chemotherapy, and radiation, have been used to treat malignant melanoma, their efficacy is often limited due to the development of resistance and adverse side effects. Therefore, there is a growing interest in developing alternative treatment options for melanoma that are more effective and less toxic. Terpenes, a diverse group of naturally occurring compounds of plant origin, have emerged as potential anticancer agents due to their ability to inhibit tumor growth and induce apoptosis in cancer cells. In this review, the current understanding of the anticancer effects of terpenes (including, thymoquinone, β-elemene, carvacrol, limonene, α-pinene, β-caryophyllene, perillyl alcohol, taxol, betulinic acid, α-bisabolol, ursolic acid, linalool, lupeol, and artesunate) was summarized, with a special focus on their potential as therapeutic agents for malignant melanoma.
Topics: Humans; Terpenes; Limonene; Antineoplastic Agents; Melanoma; Skin Neoplasms; Melanoma, Cutaneous Malignant
PubMed: 37515699
DOI: 10.1007/s43440-023-00512-1 -
Nutrients Jul 2023(1) Objective: To review the scientific literature on the impact of interventions to enhance the occupational health of health-care workers with overnutrition. (2)... (Meta-Analysis)
Meta-Analysis Review
(1) Objective: To review the scientific literature on the impact of interventions to enhance the occupational health of health-care workers with overnutrition. (2) Methods: Scoping review with meta-analysis. Data were obtained by consulting the following bibliographic databases: MEDLINE (via PubMed), Embase, Cochrane Library, Scopus, Web of Science, Latin American and Caribbean Literature on Health Sciences (LILACS), and Medicina en Español (MEDES). The terms used as descriptors and as text in the title and abstract fields of the records were "health workers", "overnutrition", and "occupational health", using the filters "human", "adult": 19+ years", and "clinical trial". The search update date was January 2023. The documentary quality of the articles was evaluated using the CONSORT questionnaire and the presence of bias was assessed using the Rob 2.0 tool. (3) Results: From the 611 digitally retrieved references, 17 clinical trials were selected after applying the inclusion and exclusion criteria. CONSORT scores ranged from a minimum of 14.6% to a maximum of 91.7%, with a median of 68.8%. According to the SIGN criteria, this review provided "1" evidence with a grade B recommendation. Six different types of intervention were tested, grouped into strategies ranging from a single intervention to a combination of four interventions. The summary effect of the meta-analysis showed significant weight loss, but no association with reduced body mass index. (4) Conclusions: While workplace interventions have been shown to be potentially effective, and strategies using different types of interventions have been proven to be useful in tackling overnutrition, an effective and sustainable solution for changing the behavior of health professionals to tackle overweight and obesity has yet to be identified.
Topics: Humans; Obesity; Overweight; Health Personnel; Body Mass Index; Occupational Health
PubMed: 37571353
DOI: 10.3390/nu15153416