Main Pathology Research Articles

Psychiatric comorbidity in hospitalized patients evaluated by psychiatric consultation in a Brazilian tertiary hospital: A study protocol

Introduction: The prevalence of mental disorders in the general population has been increasing in recent years, with the incidence of these diseases being even higher in hospitalized populations. The rates of depression in these patients are four to five times higher than in the general population. In this regard, it is important to understand the incidence of psychiatric disorders in different sectors of tertiary hospitals to recognize, locate, and treat the main pathologies and provide better medical care to hospitalized patients. Objective: To assess the prevalence of psychiatric disorders and the demographic profile of patients hospitalized in a tertiary hospital in Brazil who underwent psychiatric consultation. Method: This is an observational, descriptive, analytical, and retrospective study that will be conducted through the collection of patient records via psychiatric consultation, gathering demographic data and hospitalization-related data such as the origin of admission, primary diagnosis, psychiatric diagnosis, proposed treatment, among others. Conclusion: The identified challenges include the underutilization of psychiatric consultations and variability in the protocols adopted. Improving services requires data uniformity and proper diagnosis to optimize hospital care quality and reduce costs.

Assessment of serum soluble transferrin receptor in adult Egyptian aplastic anemia patients

Aplastic Anemia (AA) is one of the life-threatening bone marrow failure syndromes. One of the main pathologies of AA is reduced erythropoietic activity evidenced by decreased soluble transferrin receptor (sTfR) levels which results in minimal iron utilization and accumulation of iron in tissues in the form of ferritin. This study aimed to measure serum level of sTfR in adult AA patients and correlate it with the severity of the disease and the response to treatment. The study included 35 randomly selected AA patients recruited from the Hematology Department, aged from 17 to 66 years and 27 normal controls of matched age and sex. The level of sTfR was measured by using an enzyme linked immunoassay. The median level of sTfR was significantly lower in AA cases than in controls (17.9 nmol/l, ranged 9.87–30.42 nmol/l vs. 52.2 nmol/l; ranged 29.74–86.84 nmol/l, (p<0.001). The concentration of sTfR was significantly lower in the Very Severe Aplastic Anemia (VSAA) patients in comparison to Severe Aplastic Anemia (SAA) 34.27 nmol/l (ranged 31.05 – 45.41 nmol/l) vs. 55.15 nmol/l (ranged 48.78–63.88 nmol/l), respectively, p= 0.004). The level of sTfR in responders to immunosuppressive treatment did not show any difference in comparison to non-responders [55.15 nmol/l (ranged 47.36 – 65.35 nmol/l) vs. 48.26 nmol/l (ranged 34.62 – 60.39 nmol/l), (p=0.808). In conclusion, sTfR level was significantly lower in AA cases than controls. The sTfR concentration expresses the erythropoietic activity in AA patients and can be an indicator of severity of bone marrow failure.

Recent Molecular Targets and their Ligands for the Treatment of Alzheimer Disease.

Alzheimer's disease is a multifaceted neurodegenerative disease. Cholinergic dysfunction, amyloid β toxicity, tauopathies, oxidative stress, neuroinflammation are among the main pathologies of the disease. Ligands targeting more than one pathology, multi-target directed ligands, attract attention in the recent years to tackle Alzheimer's disease. In this review, we aimed to cover different biochemical pathways, that are revealed in recent years for the pathology of the disease, as druggable targets such as cannabinoid receptors, matrix metalloproteinases, histone deacetylase and various kinases including, glycogen synthase kinase-3, mitogen-activated protein kinase and c-Jun N-terminal kinase, and their ligands for the treatment of Alzheimer's disease in the hope of providing more realistic insights into the field.

Management of Strangulated Inguinal Hernias in People Aged 60 Years and Over at the Prefectural Hospital of Kissidougou, Republic of Guinea-Conakry

Introduction: Strangulated inguinal hernias in the elderly remain a real public health problem due to their risk of intestinal necrosis leading to a high rate of morbidity and mortality. The objective of our study was to evaluate the management of strangulated inguinal hernias in people aged 60 and over at the prefectural hospital of Kissidougou. Methods: This was a retrospective descriptive study over a 3-year period from January 1, 2018 to December 31, 2020. The material consisted of all the files of patients operated on for a strangulated inguinal hernia in the elderly during the study period. Results: During this study period, we recorded 76 files of patients operated on for HIE in the elderly, i.e. a frequency of 3.34% compared to the types of hernias. The average age of our patients was 70.46 years with extremes of 60 years and 83 years. 88% of patients were male with a sex ratio of 7.4. Farmers were the most affected, i.e. 32.89%. HBP and diabetes were the main associated pathologies with 51.32% and 34.21% respectively. General anesthesia was used in all our patients. The BASSINI technique was performed in 100% of cases. The evolution was favorable in 80.26%. The case fatality rate was 3.95%. The average length of hospitalization of our patients was 8.38 days. Conclusion: Improving the prognosis of these patients would require early diagnosis and especially early management of all cases of simple inguinal hernias.

A review of endoscopic findings in upper gastrointestinal bleeding in Calabar, South-South Nigeria: A two-center study

Objectives: Upper gastrointestinal bleeding (UGIB) is a leading cause of mortality and morbidity in Nigeria. Endoscopy is vital for the diagnosis of UGIB. At present, there are no published data on UGIB in Cross River State, Nigeria. This study aims to report the endoscopic findings in our patients with UGIB in Calabar, Cross River State (CRS). Material and Methods: This was a retrospective study of patients with UGIB who had esophagogastroduodenoscopy (EGD) performed at two health facilities in Calabar, CRS, from November 2012 to May 2024. Patients’ demographics and endoscopic findings were obtained from the endoscopy registers into a spreadsheet and analyzed statistically (using the Statistical Package for Social Sciences version 20 software). Summary statistics (means ± standard deviation [SD]) for continuous variables and frequencies and percentages for categorical variables were analyzed. Categorical variables were compared for differences using the chi-square test or Fisher’s exact test. Results: A total of 923 EGDs were performed during the study period. 151 (16.4%) of these cases had UGIB as an indication for the procedure. There were 105 males (69.5%) and 46 females (30.5%) with a mean age of 47.5 (SD ± 17.9) years. Peptic ulcer disease (PUD) (gastritis and benign gastric ulcer – 68, 45%) was the main pathology found in patients, followed by bleeding esophageal varices (33, 21.9%). Conclusion: Endoscopy is important in the diagnosis of UGIB. PUD and bleeding esophageal varices are the leading causes of UGIB in our environment, respectively.

Knee pain in primary care medicine : diagnostic and therapeutic approach

Knee pain is one of the most common musculoskeletal complaints in primary care medicine. The leading causes of knee pain are osteoarthritis and musculoskeletal disorders. A careful history and a rigorous clinical examination usually enable a diagnosis to be made without the need for further investigations. A systematic search for red flags helps identify patients requiring urgent and specialized care. When necessary, X-rays and ultrasound are the first-line imaging tests to perform. The latter can be used to guide a joint puncture for diagnostic and therapeutic purposes. This article reviews the diagnostic approach and summarizes the management of the main pathologies encountered in the general practitioner's office.

MANUTENÇÃO PREDIAL: ANÁLISE DAS PRINCIPAIS PATOLOGIAS

This paper addresses the main pathologies in civil construction, focusing on the analysis of causes, effects and solutions for defects that compromise the durability and safety of buildings. The objective of the study is to highlight the importance of preparing detailed projects, executing construction processes in accordance with Brazilian technical standards and using preventive maintenance as essential factors to avoid the emergence of the most recurrent pathologies identified, such as: cracks, fissures, splits, infiltrations, carbonation of concrete and corrosion of reinforcements. As a result, it was observed that the inadequate choice of materials and the lack of qualified labor are indicated as the most significant factors for the emergence of the pathologies listed above. Thus, building maintenance is essential to ensure that structures achieve the planned durability, avoiding high costs with future repairs and ensuring the safety and functionality of buildings.

Living with a chronic disease: tertiary prevention tools in asbestos-exposed patients

Abstract Background The main asbestos-related pathology is asbestosis, frequently associated with pleural plaques. The spirometric pattern is mainly restrictive, with reduction in all lung volumes (FEV1, FVC, TLC). Also a reduction in alveolus-capillary diffusion of carbon monoxide (DLCO) may be added, related to the fibrotic process. The aim of the study is to analyze the health surveillance data, correlating the spirometric finding and its variation over time with the clinical and radiological picture. Methods The study is conducted on 372 patients with asbestosis from occupational exposure diagnosed in the period 2017-2023, as part of the Tuscany Region’s program for former asbestos exposures (DGR 396/2016). The investigation is at the second level of surveillance, which includes chest CT and Respiratory Functionality Testing (RFT). Data are obtained from patients’ medical records and processed through a database. Results Out of 372 patients with asbestosis, 213 had pleural plaques (57.25%). Out of those, there is a progressive worsening of RFTs in a restrictive direction (TLC <80%, FEV1/FVC >70%) in 71 patients (33.3%), with a mean TLC loss of 8.7 ± 5.9 mL over subsequent follow-ups on a yearly basis. The FEV1/FVC ratio also declines, with a mean reduction of 5 ± 2.4%. Out of those 71 patients, 14 (19.7%) also show a mean reduction in DLCO of 6.7 ± 5 mL/min/mmHg. The negative trend in RFTs correlates with the worsening clinical and radiological picture attributable to the occurrence of plaques on a fibrotic framework. Conclusions The health surveillance protocol that we adopted has as objective the ascertainment of pulmonary pleura-parenchymal alterations correlated with occupational exposure, investigating their evolution over time through the analysis of spirometric data, and to optimize the management of the functional disability, with a view to the tertiary prevention of patients with asbestos-related disease. Key messages • The negative trend in asbestosis PFRs correlates with the worsening of the clinical and radiological picture attributable to the appearance of pleural plaques on an interstitial fibrosis. • Health surveillance is essential in order to optimize the management of functional disability, with a view to tertiary prevention of patients with asbestos-related disease.

Use of neonatal lung ultrasound in European neonatal units: a survey by the European Society of Paediatric Research

ObjectiveRegarding the use of lung ultrasound (LU) in neonatal intensive care units (NICUs) across Europe, to assess how widely it is used, for what indications and how its implementation might...

Oxygen, the Paradox of Life and the Eye

Oxidative stress, caused by the formation of free radicals, such as reactive oxygen species (ROS), leads to cell and tissue degradation, contributing to various diseases and aging. While oxygen is essential for aerobic organisms, it inevitably causes oxidative stress. Antioxidants protect against damage from free radicals, and oxidative stress arises when an imbalance occurs between free radical production and antioxidant defenses. However, when investigating whether an excess of antioxidants, almost eliminating oxidative stress, could benefit aging and disease susceptibility, it was observed that a basic level of oxidative stress appears necessary to maintain the correct homeostasis of tissues and organs and life in general. Therefore, this review aimed to compile the most significant and recent papers characterizing and describing the dual role of oxygen as a molecule essential for life and as a precursor of oxidative stress, which can be detrimental to life. We conducted targeted searches in PubMed and Google browsers to gather all relevant papers. We then focused on the eye, an organ particularly vulnerable due to its high metabolic activity combined with direct exposure to light and environmental pollutants, which produces a substantial number of free radicals (mainly ROS). We present a curated selection of relevant literature describing the main ocular pathologies of the posterior and anterior segments of the eye, highlighting oxidative stress as a significant contributing factor. Additionally, we report how endogenous and exogenous antioxidants can mitigate the development and progression of these diseases. Finally, we consider a frequently overlooked aspect: the balance between oxidants and antioxidants in maintaining the homeostatic equilibrium of tissues and organs. It is widely recognized that when oxidants overwhelm antioxidants, oxidative stress occurs, leading to negative consequences for the organism's homeostasis. However, we emphasize that a similarly dangerous situation can arise when the presence of antioxidants overwhelms the production of free radicals, drastically reducing their amount and adversely affecting aging and longevity. Unfortunately, no specific studies have addressed this particular situation in the eye.

Maternal Pathologies Associated with Admission to the Intensive Care Unit

Introduction: Maternal health is a global concern due to its significant impact on mothers and newborns. In developing countries, obstetric complications often lead to ICU admissions.Objective: To determine the prevalence of maternal pathologies associated with admission to the Intensive Care Unit (ICU) at the Instituto Ecuatoriano de Seguridad Social (IESS) in Manta, during the period from August 2022 to August 2023.Methods: A descriptive cross-sectional study was conducted with 13 patients admitted to the ICU for maternal pathologies. Variables analyzed included age, type of delivery, maternal pathology, and length of hospital stay.Results: Women aged 25 to 30 years represented 30.77% of ICU admissions. 76.92% of deliveries were by cesarean section. The main pathologies identified were severe preeclampsia (31.03%) and sepsis (20.69%). The duration of hospital stay ranged from three to five days in most cases.Conclusions: Adolescent women and those aged 25 to 30 are most likely to require intensive care. Severe preeclampsia and sepsis are the primary causes of ICU admission.

Assessing the economic burden of vision loss and irreversible legal blindness in Spain (2021–2030): a societal perspective

ObjectiveTo estimate the economic impact for the society, generated as a consequence of the onset of loss of vision and irreversible legal blindness, for the main ophthalmologic diseases in Spain: glaucoma, diabetic retinopathy (DR), diabetic macular edema (DME), age-related macular degeneration (AMD) and high myopia (HM).MethodsA cost analysis model was developed to estimate the economic burden of glaucoma, DR, DME, AMD and HM over a 10-year time horizon (2021-2030), from a societal perspective in Spain.The epidemiological and economic parameters used in the model were obtained through a literature review. Prevalence, incidence, and progression stages were used to establish the epidemiological flows. Annual costs per patient from publications were included and classified into direct healthcare, direct non-healthcare and indirect costs. Costs from other countries were converted based on purchasing-power-parity (€EUR, PPP). Epidemiological parameters about population and cost results were validated by a panel of experts.All costs were adjusted to euros, 2021 (€, 2021), and using the Consumer Price Index (CPI) of the last 10 years, extrapolated to 2030 euros (€, 2030).ResultsIt was estimated that the total population of patients with the main diseases pathologies (glaucoma, DR, DME, AMD and HM) will increase to 7.99 million patients by 2030, representing an increase of 103%.The total cost by 2030 of all pathologies would amount to 99.8 billion euros. Direct non-healthcare costs account for the largest item (44%), followed by loss of productivity costs (38%), and direct healthcare costs (18%). The pathologies with the highest cumulative costs will be glaucoma (€33.6 billion) and DME (€19.8 billion).The greatest increment costs compared to 2021 will likely be generated by pathologies related to diabetes mellitus, such as DR (703%) and DME (317%).ConclusionsKnowing the costs associated with the pathologies that generate loss of vision and irreversible legal blindness is essential to understand the socioeconomic impact associated with these pathologies. Furthermore, the high cost of treating these diseases makes necessary to coordinate efforts between administrations, together with the support of patient associations, to meet their needs.

Pain in non-communicative older adults beyond dementia: a narrative review.

Aging is associated with an increased risk of developing pain, especially in the presence of concurrent chronic clinical conditions. Similarly, multimorbidity can affect the perception and ability of older adults to appropriately respond to and communicate pain, and there is a clinical heterogeneity in the processing of painful sensations in different neurological conditions. The present narrative review is aimed at assessing the prevalent diseases associated with poor communication and pain in older adults, together with the available diagnostic instruments for the clinical assessment of pain in such a vulnerable population. Dementia was the most described pathology identified in the current literature associated with poor communication in older adults affected by pain, along with Parkinson's disease and stroke. Notably, a common pattern of pain behaviors in these neurological disorders also emerged, indicating potential similarities in the clinical presentation and appropriate diagnostic workout. At the same time, there are many differences in the way patients express their pain according to their main neurological pathology. In addition to this, although a plethora of observation-based tools for pain in patients with dementia have been developed, there is no gold standard, and the clinical utility of such measurements is still largely unaddressed. Meanwhile, there is substantially no standardized observation-based tool for pain in non-communicative patients with Parkinson's disease, and only a few for stroke. Overall, the present narrative review provides an update on the prevalent diseases beyond dementia associated with a communicative disability and a painful condition in older adults.

Tau-Targeted Immunotherapy for Alzheimer's Disease: Insight into Clinical Trials

The use of immunotherapy as a therapeutic approach to Alzheimer's Disease (AD) is gaining rapid interest, with the primary goal of targeting abnormalities that impact neuronal viability through specific antibodies. Currently, clinical strategies focus intensively on targeting the two main pathologies associated with AD, beta-amyloid (Ab) and tau. This review examines ongoing research in the realm of tau immunotherapy, including clinical trials that demonstrate promising potential for halting AD progression. Several trials are underway, focusing on improving tau-targeted immunotherapy tools based on passive and active immunization protocols. Tau-targeted therapies have proven relevant and demonstrated safety and efficacy in both animal models and human clinical trials. Some studies have demonstrated a reduction in tau protein aggregation in animal models, highlighting a potential mechanism by which these antibodies inhibit the spread of tau protein in the extracellular space. Recent discoveries have highlighted the potential role of tau-targeting therapy with antibodies and have revealed significant promise in treating pathological tau in AD.

Postoperative Pancreatic Fistula Following Duct To Mucosa Pancreaticojejunostomy After 100 Consecutive Whipple’s Surgery

Background: Postoperative pancreatic fistula (POPF) remains a concerning complication following pancreaticojejunostomy (PJ). Its incidence can be as high as 20%, with identified risk factors including soft gland texture, small main pancreatic duct (MPD) diameter, pancreatic pathology, and significant intraoperative blood loss. Our primary objective is to determine the incidence of POPF and assess its associated risk factors by consistently applying a uniform surgical technique and utilizing uniform suturing materials. Methods: Our study included patients who underwent PJ following pancreaticoduodenectomy at our center using a consistent duct-to-mucosa technique and the same suturing material, PDS 5-0. Data from 100 consecutive patients were collected and entered into the Statistical Package for the Social Sciences (SPSS 26) for analysis of postoperative pancreatic fistula (POPF). Results: Among the 100 patients, the incidence of clinically relevant POPF was 5%. Factors such as gland texture and main pancreatic duct (MPD) diameter did not demonstrate any statistically significant correlation with POPF, however the frequency of POPF was notably high in cases with an MPD diameter of less than 3 mm. Mortality following clinically relevant POPF was substantial, reaching 4%, and this association was statistically significant (p < 0.001). Conclusion: POPF represents a severe complication associated with statistically significant mortality. Employing a uniform standard duct-to-mucosa anastomotic technique along with consistent use of suturing material is imperative to mitigate bias and minimize the risk of POPF.

Obstructions of prosthetic heart valves: diagnosis and treatment considerations

Objectives: Since the first years of native heart valve replacement by - prosthetic valves; prosthesis thrombogenicity has kept its importance as a serious problem causing post-operative morbidities and mortality. This study aims to evaluate early postoperative morbidity and mortality of patients diagnosed with prosthetic valve thrombosis and treated surgically or non-surgically. Methods: Thirty-one patients diagnosed with and treated for prosthetic valve thrombosis were evaluated retrospectively. The patients were followed up for 58 months. Results: There were 24 females and 7 males. The mean patient age at the time of prosthetic valve thrombosis diagnosis was 40.7±11 (range, 10-57) years. The mean duration between prosthetic valve replacement and the first signs of prosthetic valve thrombosis was 67.67±66 (range, 1 to 300) months. All patients presented with a functional capacity of NYHA Class III or IV. A total of 32 interventions; 27 surgical and 5 thrombolytic treatments due to elevated aortic prosthetic valve pressure gradient which did not improve with thrombolysis. Of 27 surgical interventions for thrombosed prosthetic valves, 21 involved mitral, 2 aortic, and 4 tricuspid positions. A total of 9 patients died during follow-up. The overall mortality rate was 29.03%. The mortality rate was 29.62% after surgical interventions and 20% after thrombolytic treatment. Conclusion: Currently prosthetic valve replacement is the basic palliation method in the management of patients with diseased native heart valves. In the majority of mechanical prosthetic valve obstructions, the main pathology is fibrous tissue proliferation-related to irregular warfarin usage, which in turn causes the development of acute symptoms secondary to acute valve thrombosis. The necessary treatment method for prosthetic valve obstructions should be either the use of thrombolytic agents or the replacement of the obstructed prosthetic valve with a new one.

Preoperative visualization of the greater occipital nerve with magnetic resonance imaging in candidates for occipital nerve decompression for headaches

Occipital nerve decompression is effective in reducing headache symptoms in select patients with migraine and occipital neuralgia. Eligibility for surgery relies on subjective symptoms and responses to nerve blocks and Onabotulinum toxin A (Botox) injections. No validated objective method exists for detecting occipital headache pathologies. The purpose of the study is to explore the potential of high-resolution Magnetic Resolution Imaging (MRI) in identifying greater occipital nerve (GON) pathologies in chronic headache patients. The MRI protocol included three sequences targeting fat-suppressed fluid-sensitive T2-weighted signals. Visualization of the GON involved generating 2-D image slices with sequential rotation to track the nerve course. Twelve patients underwent pre-surgical MRI assessment. MRI identified four main pathologies that were validated against intra-operative examination: GON entanglement by the occipital artery, increased nerve thickness and hyperintensity suggesting inflammation compared to the non-symptomatic contralateral side, early GON branching with rejoining at a distal point, and a connection between the GON and the lesser occipital nerve. MRI possesses the ability to visualize the GON and identify suspected trigger points associated with headache symptoms. This case series highlights MRI's potential to provide objective evidence of nerve pathology. Further research is warranted to establish MRI as a gold standard for diagnosing extracranial contributors in headaches.

Examining characteristics of those who receive pedorthic services: A clinical audit.

Diabetes-related foot complications, including neuropathic plantar forefoot ulcers, are a significant contributor to morbidity and increased healthcare costs. This retrospective clinical audit examines the characteristics of people accessing pedorthics services who are at risk of neuropathic plantar forefoot ulcer (re)occurrence and the pathways and funding models used to access these services. A clinical record audit was conducted on all patients accessing a pedorthics service who had diabetes and neuropathy with a history of plantar forefoot ulceration. The data included demographics, diabetes and neuropathy duration, main forefoot pathology and other comorbidity, footwear and insole interventions, and health fund access status. A total of 70 patient records were accessed, and relevant data was extracted. The mean age of participants was 64.69 (standard deviation (SD) 11.78) years; 61% were male and 39% female. Duration of diabetes ranged from one to 35 years, with a mean of 14.09 years (SD 6.58). The mean duration of neuropathy was 8.56 (SD 4.16) years. The most common forefoot conditions were bony prominences at 71% (n = 50), rigid flat foot and limited joint mobility (53%, n = 37), and hallux abductovalgus at 47% (n = 33). All participants had hyperkeratosis; 34% (n = 24) had forefoot amputation, and around 34% (n = 24) had a history of digital amputation. Various publicly funded packages and private health insurance were accessed. This study investigates the sociodemographic and medical profiles of individuals with diabetes-related foot complexities prone to neuropathic plantar forefoot ulcers. It is the first to examine patients receiving pedorthic services, informing practitioner surveys and preventive care strategies. Understanding patient characteristics aids in optimising multidisciplinary care and reducing ulcer incidence. Further studies are warranted to explore the field to establish an effective multidisciplinary care approach between medical professionals, podiatrists and pedorthists to optimise patient outcomes.

Steroid-induced dermatoses: a challenge for modern dermatology

The aim of this work is to determine the variability and significance of motivating and provoking factors associated with the uncontrolled use of topical glucocorticosteroids, psychological features of this condition. Materials and methods. 50 patients with exacerbation of inflammatory dermatoses after long-term topical application of drugs with glucocorticosteroids as an active substance were examined. The key diagnostic measures were a clinical examination, an anamnesis collection with clarification of the activity class of the used agent, duration and potential reason for its systematic or periodic use. Assessment of the psycho-emotional state in relation to self-perception of one’s own body was carried out using the dermatological version of the dysmorphic disorder questionnaire – BDDQ-DV. Results. The main pathology for which patients of both sexes used this group of drugs were rosacea, perioral dermatitis, and seborrheic dermatitis. Taking into account anamnestic data, the mean duration of application of topical corticosteroids in creams, ointments or lotions was 10.25 ± 3.50 months for women and 8.3 ± 1.6 months for the male cohort. Most patients received information about the need to use a topical steroid from acquaintances / friends and pharmacists. The most frequent pharmacological agent was betamethasone dipropionate. Analyzing the psychopathological aspect of the studied group, dysmorphic manifestations are prevalent and the most well argued. 32 individuals (64 %) from the cohort met the criteria for concern about the body or its parts. Conclusions. Regional clinical features of steroid-induced dermatoses, which are mostly represented by chronic inflammatory conditions located in aesthetically significant areas, have been determined. 64 % of patients with steroid-induced dermatoses develop a psychopathological profile. An important aspect remains the necessity to raise the awareness of medical, pharmaceutical workers, and the public about the need and correct use of topical corticosteroids.

New insights into the pathogenesis of SARS-CoV-2 during and after the COVID-19 pandemic.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the respiratory distress condition known as COVID-19. This disease broadly affects several physiological systems, including the gastrointestinal, renal, and central nervous (CNS) systems, significantly influencing the patient's overall quality of life. Additionally, numerous risk factors have been suggested, including gender, body weight, age, metabolic status, renal health, preexisting cardiomyopathies, and inflammatory conditions. Despite advances in understanding the genome and pathophysiological ramifications of COVID-19, its precise origins remain elusive. SARS-CoV-2 interacts with a receptor-binding domain within angiotensin-converting enzyme 2 (ACE2). This receptor is expressed in various organs of different species, including humans, with different abundance. Although COVID-19 has multiorgan manifestations, the main pathologies occur in the lung, including pulmonary fibrosis, respiratory failure, pulmonary embolism, and secondary bacterial pneumonia. In the post-COVID-19 period, different sequelae may occur, which may have various causes, including the direct action of the virus, alteration of the immune response, and metabolic alterations during infection, among others. Recognizing the serious adverse health effects associated with COVID-19, it becomes imperative to comprehensively elucidate and discuss the existing evidence surrounding this viral infection, including those related to the pathophysiological effects of the disease and the subsequent consequences. This review aims to contribute to a comprehensive understanding of the impact of COVID-19 and its long-term effects on human health.