Excessive UV radiation exposure is harmful to skin cells since sunburn is accompanied by oxidative burst, leading to a rapid increase in skin cancer. However, the insufficient UV photoprotection of approved sunscreens and the negative impact of their compositions on ecosystems and human health makes the utility of sunscreen a questionable recommendation. Therefore, discovering UV filters with significant antioxidant activity and improved topical performance and photostability is an urgent need. Recently, the use of nanosized natural molecules incorporated in sunscreens has been a scientific hot topic, as it has been suggested that they provide a synergistic effect with synthetic UV filters, improving overall SPF and antioxidant activity, higher retention on the epidermis, and less toxicity. The aim of this review was to verify the usefulness of sunscreens incorporating flavonoid-loaded nanoparticles. A literature review was performed, where original and review articles published in the last 6 years were analyzed. Formulations containing nanosized flavonoids with improved UVA photoprotection and safer toxicological profiles, associated or not with synthetic filters, are promising sunscreens and more clinical investigation must be performed to validate these findings.

Cutaneous melanoma is the deadliest type of skin cancer and current treatment is still inadequate, with low patient survival rates. The polyphenol xanthohumol has been shown to inhibit tumourigenesis and metastasization, however its physicochemical properties restrict its application. In this work, we developed PLGA nanoparticles encapsulating xanthohumol and tested its antiproliferative, antitumour, and migration effect on B16F10, malignant cutaneous melanoma, and RAW 264.7, macrophagic, mouse cell lines. PLGA nanoparticles had a size of 312 ± 41 nm and a PdI of 0.259, while achieving a xanthohumol loading of about 90%. The viability study showed similar cytoxicity between the xanthohumol and xanthohumol-loaded PLGA nanoparticles at 48 h with the IC50 established at 10 µM. Similar antimigration effects were observed for free and the encapsulated xanthohumol. It was also observed that the M1 antitumor phenotype was stimulated on macrophages. The ultimate anti-melanoma effect emerges from an association between the viability, migration and macrophagic phenotype modulation. These results display the remarkable antitumour effect of the xanthohumol-loaded PLGA nanoparticles and are the first advance towards the application of a nanoformulation to deliver xanthohumol to reduce adverse effects by currently employed chemotherapeutics.

Obesity is a risk factor for malignant melanoma. The lungs are main target organs for metastization and their immune response is a key modulator of this mechanism. The concept that the metastatic potential of some types of cancer is reduced or inhibited by obesity, known as the obesity paradox, drives major concerns on the prognosis of metastasized patients. The aim of this study was to investigate how high-fat diet (HFD)-induced obesity affects melanoma metastization. C57Bl6/J mice were fed with HFD or standard diet for 180 days and inoculated intravenously with B16F10 melanoma cells. Upon 21 days of inoculation, lung tissue of overweight and lean mice was assessed for histology and immunohistochemistry assays. Adipokine antibody arrays were performed in mice serum. In vitro RAW 264.7 macrophage cultures were established and incubated with FGF-21 and/or lipopolysaccharide (LPS). Conditioned media was added to B16F10 cells for viability quantification. HFD-fed mice presented a reduced number of metastases with lower proliferative rates. The high content of inflammatory foci observed in noninoculated obese mice was significantly decreased upon B16F10 inoculation, concurrent with a slight fibrosis reduction. Plasma levels of fibroblast growth factor-21 (FGF-21), an endocrine regulator, were elevated in noninoculated HFD mice and the expression of FGF receptor 1 (FGFR-1) was significantly upregulated after inoculation. FGF-21 reduced melanoma viability in LPS-stimulated macrophages. Altogether, these findings suggest that higher amounts of FGF-21 are able to counterbalance the proinflammatory effects associated with obesity, protecting the lungs from melanoma metastization.

Introduction: Early detection and referral of patients with mild cognitive impairment or early-stage dementia can contribute to improved outcomes for both patients and caregivers. Few studies explore the quality and underlying context of referral decision-making by Primary Care Clinicians. This study aimed to explore the perspectives of healthcare professionals from Northern Portugal regarding the facilitators, barriers, and solutions within the referral process to the Neurology service for patients suspected of having mild cognitive impairment.Methods: Two face-to-face focus groups were conducted with 11 primary and secondary care professionals from Northern Portugal, with experience in the field of dementia, selected and recruited through an email invitation. The discussion focused on the benefits of referrals, the strengths and challenges faced at different levels of care, and possible improvement strategies. Data were analyzed using inductive and deductive thematic analysis, with triangulation employed to ensure research rigor.Results: The study identified facilitators and barriers at the levels of patients and caregivers, healthcare professionals, and the healthcare system. This process is influenced by interconnected factors, including the sociodemographic and literacy context of patients and caregivers, clinical practice regarding the application of referral criteria, and the organizational and research context of the local healthcare system concerning dementia. Solutions were proposed to overcome the highlighted barriers, whose implementation is supported by many of the facilitators described.Conclusion: A deeper understanding of the interplay between sociodemographic, clinical, and organizational factors can lead to more objective and effective referral decisions, ultimately supporting timely diagnosis and enhancing quality of life. The findings of this study are valuable for optimizing local referral processes and may be useful in similar healthcare contexts. It is recommended that future research include the perspectives of patients and caregivers to enhance the approach to the national dementia strategy.

Background: To optimize the care of people with multiple sclerosis in Europe, the European Multiple Sclerosis Platform aimed to gather vital evidence from people with multiple sclerosis to understand prevalence, burden, and symptom management. Methods: An online survey was distributed by 24 European Multiple Sclerosis Platform–associated multiple sclerosis organizations across 22 countries. Descriptive statistics were applied. Results: Data from 17,151 people with multiple sclerosis revealed a mean of 13.7 symptoms. The five most prevalent symptoms included fatigue, sensory problems, sleep disturbances, cognitive impairment, and balance problems (range = 75%–93%). Respondents utilized a mean of 5.6 concurrent care modalities/strategies for symptom management, and 86% of them received disease-modifying drugs. They consulted a mean of 4.2 healthcare professionals for symptom management, with 50% experiencing coordination of care. Overall, 50% of respondents expressed satisfaction with their symptom management. However, satisfaction levels varied depending on the specific symptom: people with multiple sclerosis were twice as likely to report satisfaction with managing mobility, bladder control, and spasticity compared to managing sexual problems, fatigue, and cognitive impairment. Conclusion: This survey provides evidence of the high prevalence, burden, and impact of symptoms in people with multiple sclerosis, highlighting the need for multifaceted care strategies. The results call for a change in healthcare policies and practices.

Background: Dementia care involves ethically complex situations across diverse clinical, social care, and policy contexts, yet practice-oriented ethical guidance remains limited. Existing ethical frameworks rarely capture the full complexity of practice across European contexts. This article presents the development and pilot external validation of an Ethical Framework for Decision-Making in Dementia Care, designed for professional caregivers. Methods: Within COST Action CA21137 (Ethics in Dementia – EDEM), a multidisciplinary European consortium developed the framework through an iterative, deliberative, and consensus-seeking process involving workshops, online meetings, and adaptation of international bioethical norms. An exploratory and preliminary Content Validity Index (CVI) study with external experts assessed the framework’s relevance, clarity, simplicity, and applicability. Results: The resulting principle-based framework provides non-prescriptive ethical guidance across domains including dignity, autonomy, consent, justice, solidarity, privacy, and public responsibility. The CVI assessment indicated adequate overall content validity (S-CVI/Ave = 0.85), with highest agreement for relevance (0.96) and lowest for applicability (0.75). Conclusions: The EDEM-Framework offers a structured, exploratory, and practice-oriented contribution to clinical ethics in dementia care. It may strengthen ethical decision-making when supported by appropriate implementation strategies and ethics infrastructures.