Wound healing is a complex and meticulously orchestrated process involving multiple phases and cellular interactions. This narrative review explores the intricate mechanisms behind wound healing, emphasizing the significance of cellular processes and molecular factors. The phases of wound healing are discussed, focusing on the roles of immune cells, growth factors, and extracellular matrix components. Cellular shape alterations driven by cytoskeletal modulation and the influence of the ‘Formin’ protein family are highlighted for their impact on wound healing processes. This review delves into the use of absorbable meshes in wound repair, discussing their categories and applications in different surgical scenarios. Interleukins (IL-2 and IL-6), CD31, CD34, platelet rich plasma (PRP), and adipose tissue-derived mesenchymal stem cells (ADSCs) are discussed in their respective roles in wound healing. The interactions between these factors and their potential synergies with absorbable meshes are explored, shedding light on how these combinations might enhance the healing process. Recent advances and challenges in the field are also presented, including insights into mesh integration, biocompatibility, infection prevention, and postoperative complications. This review underscores the importance of patient-specific factors and surgical techniques in optimizing mesh placement and healing outcomes. As wound healing remains a dynamic field, this narrative review provides a comprehensive overview of the current understanding and potential avenues for future research and clinical applications.
Wound healing and tissue regeneration are a field of clinical medicine presenting high research interest, since various local and systematic factors can inhibit these processes and lead to an inferior result. New methods of healing enhancement constantly arise, which, however, require experimental validation before their establishment in everyday practice. Platelet-rich plasma (PRP) is a well-known autologous factor that promotes tissue healing in various surgical defects. PRP derives from the centrifugation of peripheral blood and has a high concentration of growth factors that promote healing. Recently, the use of adipose-derived mesenchymal stem cells (ADMSCs) has been thoroughly investigated as a form of wound healing enhancement. ADMSCs are autologous stem cells deriving from fat tissue, with a capability of differentiation in specific cells, depending on the micro-environment that they are exposed to. The aim of the present comprehensive review is to record the experimental studies that have been published and investigate the synergistic use of PRP and ADMSC in animal models. The technical aspects of experimentations, as well as the major results of each study, are discussed. In addition, the limited clinical studies including humans are also reported. Future perspectives are discussed, along with the limitations of current studies on the long-term follow up needed on efficacy and safety.
Background: Late HIV diagnosis (CD4+ T-cell count < 350 cells/μL, or with an AIDS-defining event) remains a persistent challenge in Greece, indicating potential missed opportunities (MOs) for earlier testing. Aim: To determine the frequency of HIV indicator conditions (ICs) preceding diagnosis and to quantify MOs for earlier testing at a nationwide level in Greece. Methods: This multicentre retrospective study analysed data on 823 antiretroviral therapy-naive adults (≥ 18 years) diagnosed with HIV during 2019–21. Medical records were reviewed to identify pre-diagnosis healthcare contacts (HCCs) and ICs justifying HIV testing. Univariable and multivariable logistic regression identified factors associated with ≥ 1 MO. A Bayesian model estimated the time from seroconversion to diagnosis. Results: Among 517 participants with HCC data, 249 had ≥ 1 HCC. Of these, 59.0% (147/249) were late presenters. These cases had 365 HCCs, and 191 (52.3%) were MOs for testing. The most common ICs were sexually transmitted infections (39.8%; 76/191) and fever (11.0%; 21/191). Non-Greek origin was associated with lower odds of experiencing ≥ 1 MO (adjusted odds ratio: 0.48; 95% CI: 0.22─1.02), while higher education increased odds of MOs for early HIV diagnosis. Median time from seroconversion to diagnosis was 3.2 years for the full sample and 3.7 years for those with HCC, with about half of the latter reporting MOs post-estimated seroconversion. Recognising MOs would have potentially spared approximately 1 year of delay in diagnosis. Conclusion: MOs for earlier HIV diagnosis were prevalent in Greece. Leveraging IC-guided testing and addressing barriers could support earlier diagnosis and treatment, limiting adverse health outcomes and preventing transmission.
Background/Objectives: Opportunistic fungal infections are common among people living with HIV (PLHIV) and contribute substantially to morbidity, mortality, and hospitalization rates in this population. This study aimed to determine the prevalence of dermatological manifestations of fungal infections in HIV-positive patients and examine their association with demographic, clinical, and immunological characteristics. Methods: A retrospective review of medical records from 2500 PLHIV treated at the Infectious Diseases Unit of “Andreas Syggros” Hospital for Skin and Venereal Diseases between 1988 and 2017. Data from patients diagnosed with opportunistic fungal infections were analyzed. Participants were classified as either antiretroviral therapy (ART)-naïve or already receiving treatment. Recorded fungal infections were correlated with epidemiological variables and CD4+ T-cell counts. Results: Opportunistic fungal infections were identified in 859 patients (34.36%), with a marked male predominance. Candidiasis was the most frequently reported condition, with a higher prevalence among female patients. Lower CD4+ counts were significantly associated with an increased risk of cryptococcal meningitis, esophageal candidiasis, Pneumocystis jirovecii pneumonia (PJP), and oral candidiasis, whereas higher CD4+ counts were more common in patients with dermatophytosis, onychomycosis, and pityriasis/tinea versicolor. Conclusions: Opportunistic fungal infections remain highly prevalent in PLHIV, particularly among those with advanced immunosuppression. CD4+ T-cell counts are key diagnostic and prognostic markers, reinforcing their importance in monitoring disease progression and guiding clinical management.
Background/Objectives Opportunistic fungal infections are frequently observed in patients living with HIV and contribute significantly to morbidity, mortality, and hospitalization rates within this population. The aim of this study is to note the prevalence of dermatological manifestations related to fungal infections among HIV-positive patients and its correlation with demographic, other clinical characteristics and immune status of the participants. Methods A retrospective review was conducted on a cohort of 2,500 patients living with HIV that have been treated at the Infectious Diseases Unit of "Andreas Syggros" Hospital for Skin and Venereal Diseases from 1988 to 2017. Data from patients diagnosed with opportunistic fungal infections were analyzed. Patients were either antiretroviral therapy (ART)-naïve or already under treatment. Recorded fungal infections were correlated with epidemiological data and CD4+ cell counts. Results Opportunistic fungal infections were documented in 859 patients (34.36%), with a male predominance. Candidiasis was the most frequently reported condition, with higher prevalence among female patients. Lower CD4+ counts were significantly associated with increased risk of cryptococcal meningitis, esophageal candidiasis, Pneumocystis jirovecii pneumonia (PJP), and oral candidiasis, whereas higher CD4+ counts were observed in individuals with dermatophytosis, onychomycosis, and pityriasis/tinea versicolor. Conclusions Opportunistic fungal infections remain prevalent among HIV-positive individuals, particularly in immunocompromised patients. CD4+ cell counts serve as crucial diagnostic and prognostic markers for clinical outcomes in HIV patients, underscoring their role in disease monitoring and management.