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Comprehensive Insights into Sarcopenia in Dialysis Patients: Mechanisms, Assessment, and Therapeutic Approaches
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The Role of Artificial Intelligence in Obesity Risk Prediction and Management: Approaches, Insights, and Recommendations
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Prognostic Differences Between Early-Onset and Late-Onset Colorectal Cancer
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Hypertension and Atrial Fibrillation: Bridging the Gap Between Mechanisms, Risk, and Therapy
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Next-Generation Cognitive-Behavioral Therapy for Depression: Integrating Digital Tools, Teletherapy, and Personalization for Enhanced Mental Health Outcomes
Journal Description
Medicina
Medicina
is an international, peer-reviewed, open access journal that covers all problems related to medicine. The journal is owned by the Lithuanian University of Health Sciences (LUHS) and is published monthly online by MDPI. Partner organizations are the Lithuanian Medical Association, Vilnius University, Rīga Stradiņš University, the University of Latvia, and the University of Tartu.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, MEDLINE, PMC, and other databases.
- Journal Rank: JCR - Q1 (Medicine, General and Internal) / CiteScore - Q1 (General Medicine)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 17.1 days after submission; acceptance to publication is undertaken in 2.5 days (median values for papers published in this journal in the second half of 2024).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
2.4 (2023);
5-Year Impact Factor:
2.7 (2023)
Latest Articles
Association Between HLA Class II Gene Polymorphisms and Cytokine Levels in PLWH with HIV-Related Dermatoses in Latvia
Medicina 2025, 61(6), 1091; https://doi.org/10.3390/medicina61061091 (registering DOI) - 15 Jun 2025
Abstract
Background and Objectives: This study explores the immunogenetic associations of human leukocyte antigens (HLAs) and cytokine levels in people living with HIV/AIDS (PLWH) who exhibit HIV-related skin disorders. HIV-related skin disorders, including inflammatory eruptions, atopic and seborrheic dermatitis, psoriasis, and pruritic papular eruption,
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Background and Objectives: This study explores the immunogenetic associations of human leukocyte antigens (HLAs) and cytokine levels in people living with HIV/AIDS (PLWH) who exhibit HIV-related skin disorders. HIV-related skin disorders, including inflammatory eruptions, atopic and seborrheic dermatitis, psoriasis, and pruritic papular eruption, are common among PLWH. These conditions may be influenced by genetic and immunological factors. This study aims to investigate the associations between HLA class II alleles, cytokine levels, and the presence of HIV-related dermatoses, providing insights into genetic susceptibility and immune mechanisms. Materials and Methods: This study included 115 PLWH with HIV-related skin disorders and a control group of 80 healthy individuals. HLA allele frequencies were analyzed, and cytokine levels (IL-1β, IL-10, IFN-y) were measured in blood samples. Statistical analyses were performed to identify significant differences in allele frequencies and cytokine responses between the groups. Results: Risk alleles (DQB1*0201:0301, OR = 19.4 and DQA1*0101:0501, OR = 4.2) and protective alleles (DRB1*07:13, OR = 0.19, DRB1*01:13, OR = 0.09, DRB1*04:11, OR = 0.07, and DQA1*0501:0501, OR = 0.24) showed statistically significant differences in frequency (p < 0.05) between PLWH and healthy controls. The protective DQA1*0501:0501 allele was associated with elevated levels of IL-1β (p < 0.001, r = 0.79) and IL-10 (p = 0.010, r = 0.63). Increased IL-1β levels may enhance immune responses, while higher IL-10 levels may exert anti-inflammatory effects, potentially reducing susceptibility to HIV-related dermatoses. Regression analysis revealed that IL-1β (Exp(B) = 0.76, p < 0.001) and IFN-γ (Exp(B) = 1.06, p = 0.043) are significant predictors for the likelihood of developing HIV-related dermatoses. An increase in IL-1β levels reduced this likelihood by 24%, while an increase in IFN-γ levels increased it by 6%. Conclusions: The findings emphasize the interaction between HLA class II alleles and cytokine profiles in determining genetic risk and clinical outcomes in PLWH with HIV-related skin disorders. Protective alleles, such as DQA1*0501:0501, may contribute to immune regulation, offering potential targets for therapeutic interventions in PLWH with dermatoses. Our results highlight the importance of IL-1β and IFN-γ as key modulators in the progression of HIV infection and the development of HIV-related dermatoses. Further research is needed to explore the mechanisms underlying these associations, particularly in the Latvian population, to inform targeted therapeutic strategies.
Full article
(This article belongs to the Section Dermatology)
Open AccessReview
Innovations in Chronic Pain Treatment: A Narrative Review on the Role of Cryoneurolysis
by
Andrea Tinnirello, Maurizio Marchesini, Silvia Mazzoleni, Carola Santi and Giuliano Lo Bianco
Medicina 2025, 61(6), 1090; https://doi.org/10.3390/medicina61061090 (registering DOI) - 15 Jun 2025
Abstract
Background and Objectives: Chronic pain is a significant global health issue, with conventional treatment strategies often proving insufficient or causing undesirable side effects. Interventional pain management techniques, including neuromodulation, have gained increasing interest as alternative therapeutic options. Cryoneurolysis, a technique leveraging extreme cold
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Background and Objectives: Chronic pain is a significant global health issue, with conventional treatment strategies often proving insufficient or causing undesirable side effects. Interventional pain management techniques, including neuromodulation, have gained increasing interest as alternative therapeutic options. Cryoneurolysis, a technique leveraging extreme cold to modulate pain pathways, has emerged as a promising tool in chronic pain management. However, its efficacy and role within current clinical practice remain under evaluation. Methods: A narrative review was conducted by searching PubMed, Scopus, Embase, and Web of Science databases for studies published between 2010 and 2024 using the keywords “Cryoneurolysis”, “Cryoanalgesia”, “Cryoablation”, and “Chronic pain.” Only English-language studies were included. Studies that examined intraoperative cryoablation or lacked statistical analyses (except case reports) were excluded. Results: A total of 55 studies were included: 4 randomized controlled trials (RCTs), 16 retrospective studies, 4 prospective observational studies, and 31 case reports or small case series. The studies displayed significant heterogeneity in patient selection, targeted nerves, procedural protocols, and follow-up durations. While two RCTs demonstrated a significant pain reduction compared to control groups, other RCTs reported no significant improvement. Observational studies and case reports frequently report positive outcomes, with some achieving complete pain relief. Cryoneurolysis appears to be most effective in treating neuropathic pain, particularly in patients with peripheral nerve involvement. Conclusions: Cryoneurolysis is a safe technique for chronic pain management, which has been successfully applied, particularly for selected neuropathic pain conditions. However, the current evidence is limited by study heterogeneity and a lack of high-quality comparative trials. Further well-designed randomized studies are necessary to define its long-term efficacy and its potential role relative to other interventional pain therapies, such as radiofrequency ablation.
Full article
(This article belongs to the Special Issue Treatment in Patients with Chronic Pain Syndrome)
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Open AccessArticle
A Retrospective Study on the Prevalence and Antimicrobial Susceptibility of Gram-Positive Cocci in a Pediatric Department: A Single-Center Report from Egypt
by
Mona Moheyeldin AbdelHalim, Shimaa A. Abdel Salam, Marwa O. Elgendy, Ahmed M. Abdel Hamied, Sultan M. Alshahrani, Ahmed R. N. Ibrahim and Heba Sherif Abdel Aziz
Medicina 2025, 61(6), 1089; https://doi.org/10.3390/medicina61061089 (registering DOI) - 14 Jun 2025
Abstract
Background and Objectives: The rising prevalence of drug-resistant organisms presents a significant challenge to healthcare, underscoring the importance of implementing effective antimicrobial stewardship programs. The success of these programs depends on access to accurate, evidence-based data reflecting local patterns of antibiotic resistance.
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Background and Objectives: The rising prevalence of drug-resistant organisms presents a significant challenge to healthcare, underscoring the importance of implementing effective antimicrobial stewardship programs. The success of these programs depends on access to accurate, evidence-based data reflecting local patterns of antibiotic resistance. This study aims to assess the antimicrobial susceptibility profiles of gram-positive bacteria isolated from pediatric patients in a tertiary care hospital in Egypt. Materials and Methods: We carried out a retrospective study over a five-year period, from January 2018 to December 2022, using microbiology laboratory records. Clinical samples included blood, urine, respiratory secretions, pus, wound, cerebrospinal fluid (CSF), and pleural fluid. The analysis focused on the resistance patterns of gram-positive pathogens identified through routine culture procedures. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disc diffusion method, and vancomycin MIC was confirmed using the VITEK 2 system. Results: A total of 3223 gram-positive bacterial isolates were identified. Staphylococcus aureus, including 82.5% methicillin-resistant strains (MRSA), exhibited high resistance to erythromycin (47.3%) and gentamicin (low potency) (32.1%). Coagulase-negative staphylococci (CoNS) showed the highest erythromycin resistance (up to 88.3%), while Enterococcus spp. demonstrated declining susceptibility to vancomycin, levofloxacin, and erythromycin. Across all isolates, vancomycin and gentamicin (high potency) showed the highest overall susceptibility. Resistance to cotrimoxazole and doxycycline declined over the five-year period. Conclusions: While a decline in resistance was noted for some agents, persistent resistance to key antibiotics (particularly erythromycin and gentamicin) among MRSA and CoNS remains concerning. These findings underscore the importance of targeted antimicrobial stewardship interventions and continuous surveillance to inform empirical therapy in pediatric settings.
Full article
(This article belongs to the Special Issue Emerging Trends in Infectious Disease Prevention and Control)
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Open AccessArticle
Impact of Early MPO-ANCA Positivity on Unique Clinical Features in Korean Patients with EGPA: A Single-Centre Cohort Study
by
Oh Chan Kwon, Jang Woo Ha, Min-Chan Park, Yong-Beom Park and Sang-Won Lee
Medicina 2025, 61(6), 1088; https://doi.org/10.3390/medicina61061088 (registering DOI) - 13 Jun 2025
Abstract
Objectives: Previous studies have suggested differences in vasculitic and eosinophilic phenotypes based on anti-neutrophil cytoplasmic antibody (ANCA) positivity in eosinophilic granulomatosis with polyangiitis (EGPA). However, their relevance under the 2022 American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) classification
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Objectives: Previous studies have suggested differences in vasculitic and eosinophilic phenotypes based on anti-neutrophil cytoplasmic antibody (ANCA) positivity in eosinophilic granulomatosis with polyangiitis (EGPA). However, their relevance under the 2022 American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) classification criteria remains unclear. We aimed to evaluate the clinical features and outcomes of EGPA according to myeloperoxidase (MPO)-ANCA status in a Korean cohort. Methods: We conducted a retrospective cohort study that included 57 patients with EGPA without proteinase 3-ANCA positivity who fulfilled the 2022 ACR/EULAR classification criteria. Patients were classified into MPO-ANCA-positive (n = 25) and MPO-ANCA-negative (n = 32) groups. Clinical manifestations, laboratory findings, and outcomes, including all-cause mortality, relapse, end-stage kidney disease (ESKD), cerebrovascular accident (CVA), and acute coronary syndrome (ACS), were compared between the two groups. Results: MPO-ANCA-positive patients exhibited higher Five-Factor Scores (1.0 [0.0–1.0] vs. 0.0 [0.0–1.0], p = 0.038), lower Short Form 36 Physical Component Summary scores (35.0 [19.7–56.3] vs. 52.5 [43.5–69.7], p = 0.048), and elevated systemic inflammation markers (higher erythrocyte sedimentation rate: 58.0 [16.0–97.5] mm/hr vs. 25.5 [7.0–63.8] mm/hr, p = 0.026). Constitutional symptoms were more frequent among MPO-ANCA-positive patients (n = 14 [56.0%] vs. n = 3 [9.4%], p < 0.001), whereas no significant differences were found in vasculitic or eosinophilic manifestations. Kaplan–Meier analysis revealed no differences in the overall (p = 0.36), relapse-free (p = 0.80), ESKD-free (p = 0.87), CVA-free (p = 0.26), or ACS-free (p = 0.94) survival rates between the two groups. Conclusions: In Korean patients with EGPA classified under the 2022 ACR/EULAR classification criteria, MPO-ANCA positivity, as compared to ANCA-negative status, was associated with a higher disease burden and poorer quality of life but not with distinct vasculitic or eosinophilic manifestations and adverse outcomes.
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(This article belongs to the Section Hematology and Immunology)
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Open AccessReview
Normal Haemostasis, Inherited Bleeding Disorders and Surgery: What Does the Anaesthesiologist Need to Know?
by
Mihai Ștefan, Daniela Filipescu, Cornelia Predoi, Liana Văleanu, Ștefan Andrei and Dana Tomescu
Medicina 2025, 61(6), 1087; https://doi.org/10.3390/medicina61061087 (registering DOI) - 13 Jun 2025
Abstract
Haemostasis is a critical physiological process that ensures blood loss is minimised following vascular injury. Understanding the mechanisms of normal haemostasis is essential for managing patients with inherited bleeding disorders, particularly in the surgical setting. Inherited bleeding disorders, such as haemophilia and von
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Haemostasis is a critical physiological process that ensures blood loss is minimised following vascular injury. Understanding the mechanisms of normal haemostasis is essential for managing patients with inherited bleeding disorders, particularly in the surgical setting. Inherited bleeding disorders, such as haemophilia and von Willebrand disease (vWD), pose unique challenges for anaesthesiologists and surgeons due to the increased risk of excessive bleeding during and after surgery. This state-of-the-art review outlines the essential knowledge for anaesthesiologists regarding normal haemostasis, the pathophysiology of inherited bleeding disorders, and the perioperative management strategies required for these patients. It draws on existing literature and current clinical guidelines to offer practical approaches for assessing and managing bleeding risks in surgical settings.
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(This article belongs to the Special Issue Recent Advances in Anesthesiology and Pain Medicine)
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Open AccessSystematic Review
Mind over Malignancy: A Systematic Review and Meta-Analysis of Psychological Distress, Coping, and Therapeutic Interventions in Oncology
by
Ana Maria Paslaru, Alina Plesea-Condratovici, Lavinia-Alexandra Moroianu, Oana-Maria Isailă, Laura Florentina Rebegea, Liliana Lacramioara Pavel and Anamaria Ciubară
Medicina 2025, 61(6), 1086; https://doi.org/10.3390/medicina61061086 (registering DOI) - 13 Jun 2025
Abstract
Background and Objectives: Psychological distress is a pervasive yet often undertreated aspect of the cancer experience, contributing to reduced quality of life, poorer treatment adherence, and worse health outcomes. This systematic review and meta-analysis evaluated the efficacy of non-pharmacological, evidence-based psychological interventions on
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Background and Objectives: Psychological distress is a pervasive yet often undertreated aspect of the cancer experience, contributing to reduced quality of life, poorer treatment adherence, and worse health outcomes. This systematic review and meta-analysis evaluated the efficacy of non-pharmacological, evidence-based psychological interventions on distress, depression, anxiety, coping capacity, and quality of life in adult cancer patients. Interventions were grouped into three domains: structured psychotherapeutic therapies (e.g., Cognitive Behavioral Therapy [CBT], Acceptance and Commitment Therapy [ACT], Meaning-Centered Psychotherapy [MCP]); mindfulness and stress reduction programs (e.g., Mindfulness-Based Stress Reduction [MBSR], Mindfulness-Based Cognitive Therapy [MBCT]); and coping and resilience-enhancing modalities (e.g., Promoting Resilience in Stress Management [PRISM], expressive writing). Materials and Methods: Following PRISMA guidelines, 42 randomized controlled trials published between 2015 and 2025 were included. A stratified meta-analytic approach calculated pooled standardized mean differences for each intervention class and outcome. Heterogeneity, subgroup, and moderator analyses explored drivers of effect variability. Results: Structured psychotherapeutic interventions yielded the largest effects, especially for depression. Mindfulness-based interventions produced moderate but significant improvements in distress and emotional regulation. Coping and resilience programs provided smaller yet statistically significant gains in adaptive coping. Between-study heterogeneity was moderate, partly explained by intervention type, delivery modality, and cancer subtype. Conclusions: These findings support integrating psychosocial care into standard oncology protocols and endorse its routine implementation as a core component of comprehensive cancer treatment.
Full article
(This article belongs to the Special Issue New Insights into the Diagnosis, Management, and Interventions of Mood Disorders)
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Open AccessArticle
Chronic Wound Management in Romania: A Survey on Practices, Protocols, and PRP Efficacy
by
Stefania-Mihaela Riza, Andrei-Ludovic Porosnicu, Cristian-Sorin Hariga and Ruxandra-Diana Sinescu
Medicina 2025, 61(6), 1085; https://doi.org/10.3390/medicina61061085 - 13 Jun 2025
Abstract
Background and Objectives: Chronic wounds pose a significant challenge to healthcare systems, requiring long-term management and multidisciplinary approaches. The absence of a standardized national therapeutic protocol in Romania has resulted in inconsistent clinical practices, which in turn affect treatment efficacy and patient outcomes.
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Background and Objectives: Chronic wounds pose a significant challenge to healthcare systems, requiring long-term management and multidisciplinary approaches. The absence of a standardized national therapeutic protocol in Romania has resulted in inconsistent clinical practices, which in turn affect treatment efficacy and patient outcomes. The implementation of structured guidelines and the integration of regenerative therapies could enhance the management of chronic wounds. Materials and Methods: This study employs a cross-sectional observational design to assess the current management strategies among physicians treating chronic wounds and to identify variations in treatment approaches. A 37-question questionnaire was distributed among plastic surgeons, general surgeons, vascular surgeons, and dermatologists via Google Forms. The data collection period spanned one month, resulting in a total of 240 responses from medical centers in Bucharest, Romania. Results: The study found that most physicians treated several cases per week (40.8%) of delayed healing wounds, with the most frequent types being bedsores (57.5%) and diabetic (58.3%) or venous ulcers (55%). Challenges in wound care included patient reluctance, financial constraints, and the psychological burden on caregivers. The most relevant decision factor for surgical treatment was wound stage (86.7%). Most physicians used an initial conservative approach in wound care (52.5%) or did not have a standard approach (44.2%). Around a quarter of respondents (25.8%) used PRP as a treatment method, considering it to have moderate effectiveness (51.6%). The most important factor for encouraging PRP usage was having the necessary equipment for the procedure (72.5%). The most frequently considered benefit in the case of implementing a treatment protocol was increased treatment efficacy (62.5%). Physicians were also highly interested in the use of a standardized treatment protocol (40%). Approximately 41.7% of the physicians expressed a very high interest in having a standardized diagnostic system for chronic wounds. Conclusions: This study highlights that wound care practices remain variable and that the decision-making process is often challenging. There is a moderate belief in the effectiveness of PRP, suggesting that logistical barriers need to be addressed to facilitate access to it. Therapeutic protocols were seen as key to improving care efficacy and consistency, therefore pressing the need for national strategies that support protocol development.
Full article
(This article belongs to the Special Issue Recent Advances in Plastic and Reconstructive Surgery)
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Open AccessArticle
Comparison of Quadratus Lumborum Block and Rectus Sheath Block for Postoperative Analgesia in Single-Port Laparoscopic Adnexal Surgery: A Randomized Controlled Trial
by
Dongju Kim, Seunguk Bang, Jihyun Chung, Youngin Lee, Hyun-Jung Shin and Yoonji Park
Medicina 2025, 61(6), 1084; https://doi.org/10.3390/medicina61061084 - 13 Jun 2025
Abstract
Background and Objectives: Regional anesthesia is a key component of multimodal analgesia following minimally invasive gynecologic surgery. However, single-port laparoscopic adnexal surgery differs anatomically and physiologically from multiport or open approaches, particularly in terms of incision site, tissue handling, and pain characteristics.
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Background and Objectives: Regional anesthesia is a key component of multimodal analgesia following minimally invasive gynecologic surgery. However, single-port laparoscopic adnexal surgery differs anatomically and physiologically from multiport or open approaches, particularly in terms of incision site, tissue handling, and pain characteristics. Despite its increasing use, evidence supporting procedure-specific regional analgesic protocols for this approach remains limited. This study aimed to compare the analgesic efficacy of quadratus lumborum block (QLB) and rectus sheath block (RSB) in this surgical context. Materials and Methods: In this randomized controlled trial, 68 patients undergoing single-port laparoscopic adnexal surgery were randomly assigned to receive either QLB or RSB at the end of surgery. Four patients were excluded due to missing patient-controlled analgesia (PCA) data, resulting in 64 patients analyzed (QLB group: n = 32; RSB group: n = 32). The primary outcome was cumulative opioid consumption over the first 24 postoperative hours. Secondary outcomes included interval-based opioid consumption, time to first PCA bolus, postoperative pain scores, and incidence of postoperative nausea and vomiting (PONV). Results: The RSB group demonstrated significantly lower cumulative opioid consumption at 24 h postoperatively (132.9 [61.3, 338.4] µg vs. 453.0 [253.1, 811.0] µg, p < 0.001). This trend persisted across most postoperative time points up to 48 h. Interval-based opioid consumption was also lower in the RSB group during 0–24 h and 32–48 h intervals (each comparison p < 0.05). The time to first PCA bolus was significantly longer in the RSB group (56.5 [41.0, 340.3] minutes vs. 40.5 [33.3, 68.8] minutes; p = 0.014), and Kaplan–Meier analysis confirmed a delayed first bolus request in the RSB group (log-rank p = 0.007). Pain scores and postoperative nausea and vomiting incidence were comparable between groups. Conclusions: Compared with QLB, RSB provided similar pain relief with significantly lower opioid consumption following single-port laparoscopic adnexal surgery. These findings highlight the potential advantages of RSB in enhancing analgesic efficiency and support the development of procedure-specific regional analgesia protocols tailored to this surgical approach.
Full article
(This article belongs to the Special Issue Regional and Local Anesthesia for Enhancing Recovery After Surgery)
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Open AccessArticle
Effects of Different Occlusal Splints on Joint Vibrations in Bruxers
by
Bora Akat, Ayşe Cavidan Akören and Evşen Tamam
Medicina 2025, 61(6), 1083; https://doi.org/10.3390/medicina61061083 - 12 Jun 2025
Abstract
Background and Objectives: This study aimed to evaluate the effects of hard, soft, and semi-soft splints on TMJ vibrations in bruxers with JVA and to compare them with data obtained from asymptomatic individuals. Materials and Methods: A total of 64 individuals
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Background and Objectives: This study aimed to evaluate the effects of hard, soft, and semi-soft splints on TMJ vibrations in bruxers with JVA and to compare them with data obtained from asymptomatic individuals. Materials and Methods: A total of 64 individuals were divided into four subgroups: control (n = 15); and hard (n = 17), soft (n = 16), and semi-soft (n = 16) splints. Electrovibratography records from all individuals included in the study before and after the 3-month splint treatment were obtained with the Biopak® System. Joint vibration analysis was used to evaluate TMJ sounds. Data normality was examined with the Kolmogorov–Smirnov and Levene tests. The significance of the differences was investigated by One-Way ANOVA and by the Kruskal–Wallis test. Conover’s multiple comparison test was used in post hoc tests. (ClinicalTrials.gov identifier: NCT06893744, on 24 March 2025, titled; Effects of Different Occlusal Splints). Results: After 3 months of treatment, for I < 300 Hz right opening, the control group was statistically lower than both semi-soft (p < 0.001) and hard (p < 0.001) splint groups. The difference between semi-soft and hard splints in post-treatment I < 300 Hz right opening is not statistically significant. After 3 months of treatment compared with the beginning, the increases in left-opening Ti (p = 0.004), I < 300 Hz (p = 0.004), and PA (p = 0.007) values in the soft splint group were statistically significant. Conclusions: All three kinds of splints improved clinical symptoms and complaints of bruxers. For joint vibrations in bruxers, hard and semi-soft splints are more beneficial than soft splints.
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(This article belongs to the Section Dentistry and Oral Health)
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The Role of Ultrasound as a Predictor of Malignancy in Indeterminate Thyroid Nodules—A Multicenter Study
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Reem J. Al Argan, Dania M. Alkhafaji, Feras M. Almajid, Njoud K. Alkhaldi, Zahra A. Al Ghareeb, Moutaz F. Osman, Manal A. Hasan, Safi G. Alqatari, Abrar J. Alwaheed, Fatima E. Ismaeel and Reem S. AlSulaiman
Medicina 2025, 61(6), 1082; https://doi.org/10.3390/medicina61061082 - 12 Jun 2025
Abstract
Background and Objectives: Indeterminate thyroid nodules (Bethesda III and IV) are a common clinical entity that present a diagnostic challenge due to their intermediate risk of malignancy. This study aimed to evaluate the role of ultrasound in risk stratification and malignancy prediction to
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Background and Objectives: Indeterminate thyroid nodules (Bethesda III and IV) are a common clinical entity that present a diagnostic challenge due to their intermediate risk of malignancy. This study aimed to evaluate the role of ultrasound in risk stratification and malignancy prediction to support clinical decision-making and reduce unnecessary surgical interventions. Materials and Methods: This retrospective multicenter cohort study included patients aged ≥18 years who underwent thyroid surgery between 2016 and 2022 at four centers in the Eastern Province of Saudi Arabia. Only nodules with indeterminate cytology (Bethesda III or IV) were included. Data collected included demographic characteristics, thyroid function, ultrasound features, cytology results, and histopathological findings. Results: A total of 679 patients with 733 nodules were reviewed. Of these, 206 patients with 223 indeterminate nodules were included (median age: 42 years; 88.3% female). The overall malignancy rate was 46.6%. Independent predictors of malignancy included solid hypoechoic composition (OR = 2.26, p = 0.012), microcalcifications (OR = 3.07, p = 0.002), lymph node involvement (OR = 2.43, p = 0.021), American Thyroid Association (ATA) intermediate to high suspicion category (OR = 1.9, p = 0.018), and Thyroid Imaging Reporting and Data Systems (TI-RADS) categories 4–5 (OR = 2.3, p = 0.003). Solid hypoechoic nodules showed 82.3% specificity and 63.0% positive predictive value (PPV); microcalcifications demonstrated 84.1% specificity and 68.4% PPV; lymph node involvement had 87.6% specificity and 68.9% PPV. The ATA and TI-RADS classifications showed higher sensitivity (63.5% and 68.0%, respectively), but lower specificity (53.1% and 52.8%, respectively). Conclusions: Ultrasound features, particularly solid hypoechoic composition, microcalcifications, and lymph node involvement, as well as ATA and TI-RADS classifications, were independent predictors of malignancy in indeterminate thyroid nodules. Although ATA and TI-RADS offered higher sensitivity, individual features demonstrated greater specificity and PPV. These findings support the use of ultrasound risk stratification to guide surgical decisions in high-risk cases and suggest that additional diagnostic evaluation may be appropriate for low-risk nodules.
Full article
(This article belongs to the Section Endocrinology)
Open AccessReview
Use of Robotic Surgery for the Management of Orbital Diseases: A Comprehensive Review
by
Riccardo Nocini, Lorenzo Marini, Luca Michelutti, Chiara Zilio, Stefania Troise, Salvatore Sembronio, Giovanni Dell’Aversana Orabona, Massimo Robiony and Alessandro Tel
Medicina 2025, 61(6), 1081; https://doi.org/10.3390/medicina61061081 - 12 Jun 2025
Abstract
Background and Objectives: Robotic surgery represents one of the most significant innovations in the field of surgery, offering new opportunities for the treatment of complex pathologies that require greater accuracy and precision. It is a technology that has become widely used in
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Background and Objectives: Robotic surgery represents one of the most significant innovations in the field of surgery, offering new opportunities for the treatment of complex pathologies that require greater accuracy and precision. It is a technology that has become widely used in general, urologic, gynecologic, and cardio-thoracic surgery, but has a limited evidence in the head and neck region. This review explores the use of robotic surgery in orbital pathology, focusing on its applications, benefits, and limitations. Materials and Methods: A cross-sectional search method was performed in multiple databases to answer the following question: “What are the applications of robotic surgery in the management of orbital pathologies?” Studies were carefully reviewed by two simultaneous researchers, and, in case of disagreement, a third researcher was engaged. Care was taken to identify the surgical hardware (robotic station) used to perform the surgical procedure. Results: Out of 491 records, eight studies met the inclusion criteria. These included cadaveric, preclinical, in vitro, and early clinical investigations assessing robotic approaches for fronto-orbital advancement, tumor resection, orbital decompression, and other surgical procedures such as lacrimal gland dissection and biopsy, medial and lateral orbital wall dissections, enucleation, and lid-sparing orbital exenteration. The robotic systems evaluated included the Da Vinci Xi, Da Vinci SP, Medineering Robotic Endoscope Guiding System, and a modular multi-arm concentric tube robot, each with specific advantages and limitations. Conclusions: Robotic surgery provides significant advantages for orbital pathologies such as improved precision, visualization, and tissue preservation, with reduced complications and faster recovery, although some limitations still exist. Future advancements, such as smaller instruments and AI integration, promise to improve outcomes, making robotic surgery more effective in treating orbital conditions.
Full article
(This article belongs to the Special Issue New Trends and Advances in Oral and Maxillofacial Surgery)
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Open AccessArticle
Early Phase I Cardiac Rehabilitation Integrated with Multidisciplinary Post-Acute Care in Decompensated Heart Failure: Insights from Serial Cardiopulmonary Exercise Testing
by
Ruei-Sian Ding, Ko-Long Lin, Wen-Hwa Wang, Ming-Hsuan Huang and I-Hsiu Liou
Medicina 2025, 61(6), 1080; https://doi.org/10.3390/medicina61061080 - 12 Jun 2025
Abstract
Background and Objectives: Acute decompensated heart failure (ADHF) leads to significant impairments in exercise capacity and functional outcomes. This study aimed to evaluate the feasibility and effectiveness of integrating early phase I cardiac rehabilitation with a multidisciplinary heart failure post-acute care (HF-PAC) program
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Background and Objectives: Acute decompensated heart failure (ADHF) leads to significant impairments in exercise capacity and functional outcomes. This study aimed to evaluate the feasibility and effectiveness of integrating early phase I cardiac rehabilitation with a multidisciplinary heart failure post-acute care (HF-PAC) program to improve functional capacity in patients hospitalized for ADHF, assessed by serial cardiopulmonary exercise testing (CPET). Materials and Methods: We conducted a prospective cohort study at a medical center in Taiwan. Patients hospitalized for ADHF between February 2017 and March 2023 who completed inpatient and six-month follow-up CPET were enrolled. The rehabilitation protocol included supervised aerobic and resistance training during hospitalization, followed by outpatient multidisciplinary care. The primary outcome was the change in peak oxygen uptake (peak VO2) over six months. Results: A total of 90 patients were included (74.4% male, mean age 58.4 ± 14.7 years). Peak VO2 significantly improved from 11.57 ± 3.33 to 13.99 ± 4.2 mL/kg/min (p < 0.001). Significant improvements were also observed in 6 min walk distance, anaerobic threshold, heart rate recovery, oxygen uptake efficiency slope, and left ventricular ejection fraction. Conclusions: Early integration of phase I cardiac rehabilitation with multidisciplinary HF-PAC is feasible and enhances exercise capacity in patients with ADHF. Serial CPET provides an objective evaluation of functional recovery and may guide rehabilitation strategies in this high-risk population.
Full article
(This article belongs to the Section Cardiology)
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Open AccessArticle
Impact of Para-Aortic Lymphadenectomy on Clinically FIGO Stage IIIC1 High-Grade Endometrial Cancer: A Retrospective Cohort Study from Two Tertiary Centers in Korea and Taiwan
by
Yen-Ling Lai, Jun-Hyeong Seo, Koping Chang, Hyun-Soo Kim, Jung Chen, Tyan-Shin Yang, Yu-Li Chen and Yoo-Young Lee
Medicina 2025, 61(6), 1079; https://doi.org/10.3390/medicina61061079 - 12 Jun 2025
Abstract
Background and Objectives: The therapeutic effect of para-aortic lymphadenectomy in patients with clinically para-aortic node-negative diseases remains controversial. In this study, we investigated whether combined pelvic and para-aortic lymphadenectomy has a survival benefit compared with pelvic lymphadenectomy alone in patients with clinically
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Background and Objectives: The therapeutic effect of para-aortic lymphadenectomy in patients with clinically para-aortic node-negative diseases remains controversial. In this study, we investigated whether combined pelvic and para-aortic lymphadenectomy has a survival benefit compared with pelvic lymphadenectomy alone in patients with clinically FIGO stage IIIC1 high-grade endometrial cancer. Materials and Methods: We retrospectively reviewed patients with clinically FIGO stage IIIC1 high-grade endometrial cancer in the period between January 2000 and December 2020 at two tertiary centers. The patients were stratified according to type of lymphadenectomy and subgroup analyses performed. Kaplan–Meier analysis and a Cox proportional-hazards model were used to evaluate survival outcomes. Results: A total of 56 patients were identified. Of these patients, 18 underwent pelvic lymphadenectomy alone and 38 underwent combined pelvic and para-aortic lymphadenectomy. After staging surgery, 34 (60.7%) patients had pathologically confirmed lymph node metastases. Within a median follow-up of 57.5 months, there were no significant differences in recurrence-free survival (RFS) and overall survival (OS) between the two groups. In subgroup analyses, the node- and lymphovascular space invasion (LVSI)-positive patients characterized by grade 3 endometrioid histologic type (p = 0.010) or negative peritoneal washing cytology (p = 0.035) had an RFS benefit from combined pelvic and para-aortic lymphadenectomy. Conclusions: The addition of para-aortic lymphadenectomy to pelvic lymphadenectomy did not improve survival in patients with clinically FIGO IIIC1 endometrial cancer. However, para-aortic lymphadenectomy may have RFS benefit for patients with grade 3 endometrioid histologic type and positive LVSI.
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(This article belongs to the Special Issue Endometrial Cancer: Biomarkers and Management)
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Role of Inflammatory Markers as a Risk Factor for Community-Acquired Pneumonia Management
by
Ruta Nutautiene, Irmantas Aleksa, Ieva Janulaityte, Erika Skrodeniene, Kristina Bieksiene, Diana Zaliaduonyte, Darius Batulevicius and Astra Vitkauskiene
Medicina 2025, 61(6), 1078; https://doi.org/10.3390/medicina61061078 - 11 Jun 2025
Abstract
Background and Objectives: Community-acquired pneumonia (CAP) remains a major health burden worldwide, with high morbidity and mortality, particularly among older adults and those with comorbidities. This study aimed to evaluate the etiological factors of CAP and to investigate systemic inflammatory markers (IL-6,
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Background and Objectives: Community-acquired pneumonia (CAP) remains a major health burden worldwide, with high morbidity and mortality, particularly among older adults and those with comorbidities. This study aimed to evaluate the etiological factors of CAP and to investigate systemic inflammatory markers (IL-6, IL-8, IFN-γ, and G-CSF) in blood samples collected from CAP patients to identify which markers could be targets for potential etiological, clinical, and therapeutic interventions. Materials and Methods: A prospective study was conducted in 41 patients with confirmed CAP hospitalised during the winter season of 2024–2025. Clinical, demographic, and laboratory data were collected at admission and seven days later. Serum IL-6, IL-8, IFN-γ, and G-CSF concentrations were measured using a multiplex assay. Results: Aetiology was identified in 87.8% of cases, with typical bacterial pathogens being more prevalent among older, smoking patients, while atypical pathogens were more common among younger, non-smoking patients. Hospitalisation and increased inflammatory markers were associated with older age. After seven days of treatment, significant decreases in IL-6, IFN-γ, and G-CSF concentrations were observed. IFN-γ levels were significantly higher in patients with atypical aetiology. Higher concentrations of IL-8 and G-CSF were associated with hospitalisation. IL-6 levels were positively correlated with age, C-reactive protein (CRP), and pneumonia severity index (PSI) scores. Conclusions: Systemic inflammatory markers, especially IL-6, IL-8, IFN-γ, and G-CSF, may be valuable tools in managing generalised pneumonia. They can help to differentiate etiologically, assess disease severity, and make treatment decisions.
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(This article belongs to the Special Issue Infection, Inflammation and Immunity in Health and Disease)
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Open AccessReview
Neonates at Risk: Understanding the Impact of High-Risk Pregnancies on Neonatal Health
by
Rozeta Sokou, Alexandra Lianou, Maria Lampridou, Polytimi Panagiotounakou, Georgios Kafalidis, Styliani Paliatsiou, Paraskevi Volaki, Andreas G. Tsantes, Theodora Boutsikou, Zoi Iliodromiti and Nicoletta Iacovidou
Medicina 2025, 61(6), 1077; https://doi.org/10.3390/medicina61061077 - 11 Jun 2025
Abstract
High-risk pregnancies (HRPs) constitute a significant global health issue due to their strong association with increased maternal and neonatal morbidity and mortality. Although pregnancy is generally characterized by positive expectations, the presence of maternal comorbidities, gestational complications, or adverse socioeconomic and environmental conditions
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High-risk pregnancies (HRPs) constitute a significant global health issue due to their strong association with increased maternal and neonatal morbidity and mortality. Although pregnancy is generally characterized by positive expectations, the presence of maternal comorbidities, gestational complications, or adverse socioeconomic and environmental conditions can markedly elevate the probability of unfavorable outcomes. HRPs contribute disproportionately to complications such as preterm birth, fetal growth restriction, low birth weight, and congenital anomalies, which are key determinants of neonatal mortality and long-term developmental and health challenges. A broad spectrum of risk factors as well as insufficient prenatal care, underscores the complex nature of HRPs. These conditions necessitate a multidisciplinary management approach encompassing early risk identification, continuous monitoring, and individualized interventions. The neonatal prognosis in such contexts is strongly influenced by gestational age at delivery, birth weight, the standard of neonatal care, and the underlying etiological factors driving preterm or complicated deliveries. Preventive strategies including comprehensive prenatal screening, systematic antenatal follow-up, and timely referral to specialized perinatal care centers are essential for reducing the burden of HRPs. Furthermore, addressing social determinants of health—such as low socioeconomic status and limited access to healthcare—is critical for optimizing maternal and neonatal outcomes. This review consolidates current evidence on the epidemiology, etiological factors, and clinical implications of high-risk pregnancies, emphasizing the necessity of an integrative, preventive, and multidisciplinary framework to mitigate adverse neonatal outcomes and improve long-term health trajectories.
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(This article belongs to the Special Issue From Conception to Birth: Embryonic Development and Disease)
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Open AccessSystematic Review
Improving Outcomes in Pancreatic Adenocarcinoma: A Systematic Review of Immunotherapy in Multimodal Treatment
by
Paul-Cristian Borz, Mihnea Bogdan Borz, Oliviu-Cristian Borz, Toader Zaharie, Claudia Hagiu, Lidia Munteanu and Simona Gurzu
Medicina 2025, 61(6), 1076; https://doi.org/10.3390/medicina61061076 - 11 Jun 2025
Abstract
Background: Despite advances in chemotherapy and supportive care, pancreatic ductal adenocarcinoma (PDAC) continues to carry a dismal prognosis, with a five-year survival rate of approximately 13%. While immunotherapy has revolutionized treatment for several malignancies, its efficacy in PDAC remains limited. Recent research
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Background: Despite advances in chemotherapy and supportive care, pancreatic ductal adenocarcinoma (PDAC) continues to carry a dismal prognosis, with a five-year survival rate of approximately 13%. While immunotherapy has revolutionized treatment for several malignancies, its efficacy in PDAC remains limited. Recent research has shifted focus toward integrating immunotherapy with chemotherapy, radiation, and targeted therapies in an effort to overcome therapeutic resistance and improve outcomes. Ongoing clinical trials are actively investigating these multimodal strategies. Materials and Methods: A systematic search was conducted using PubMed and ScienceDirect to identify relevant studies published in the past six years. Search terms included “pancreatic adenocarcinoma immunotherapy,” “pancreatic cancer treatments,” and “combination treatments for pancreatic adenocarcinoma.” Only English-language articles were included. Results: A total of 126 articles were initially identified through the database search. After a full-text screening, 48 articles were deemed potentially relevant. Following a rigorous review, 11 studies met the inclusion criteria and were selected for analysis. These studies included randomized controlled trials, non-randomized controlled trials, and retrospective studies. Meta-analyses and case reports were excluded. Articles that failed to meet the inclusion criteria were excluded, primarily due to the absence of relevant data addressing the main objective of this review. Conclusions: Combination strategies with immunotherapy and chemotherapy offer modest survival gains in metastatic settings, yet efforts in resectable and borderline resectable disease have fallen short. These outcomes reflect the profound immunosuppressive forces of the PDAC microenvironment. A new era of treatment must move beyond broad immunotherapeutic applications toward a precision-driven model. Molecular markers, such as KRAS mutations and circulating tumor DNA (ctDNA) profiles, are beginning to illuminate paths for personalized therapy selection. Future progress will depend on biomarker-guided clinical trials, a deeper understanding of immune resistance mechanisms, and bold innovation at the intersection of immunology and tumor biology.
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(This article belongs to the Special Issue Pancreatic Cancer: Advances in Treatment and Future Prospects)
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The Association of Khorana Risk Score with Venous Thromboembolism and Overall Survival in Patients with Metastatic Gastric Cancer
by
Ezgi Turkoglu, Goncagul Akdag Topal, Sedat Yıldırım, Oguzcan Kınıkoglu, Nisanur Sarıyar Busery, Tugba Kaya, Hacer Sahika Yıldız, Furkan Turkoglu, Cihad Tatar, Abdullah Sakin, Deniz Isık, Seval Ay Ersoy, Tugba Basoglu, Hatice Odabas and Nedim Turan
Medicina 2025, 61(6), 1075; https://doi.org/10.3390/medicina61061075 - 11 Jun 2025
Abstract
Background and Objectives: Venous thromboembolism (VTE) is a serious complication frequently encountered in cancer patients and is associated with high morbidity. In patients undergoing cancer treatment—particularly those receiving chemotherapy—VTE increases treatment-related complications and has a direct impact on mortality. The development of VTE
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Background and Objectives: Venous thromboembolism (VTE) is a serious complication frequently encountered in cancer patients and is associated with high morbidity. In patients undergoing cancer treatment—particularly those receiving chemotherapy—VTE increases treatment-related complications and has a direct impact on mortality. The development of VTE in oncology patients varies depending on cancer type, treatment protocols, and individual patient characteristics. The Khorana Risk Score (KRS) is a validated risk assessment tool used to estimate the risk of VTE development in patients receiving chemotherapy. KRS provides risk estimations based on the patient’s clinical features, cancer type, and treatment process. This study aims to investigate the prognostic value of the Khorana Risk Score in predicting VTE development and overall survival in patients with metastatic gastric cancer. Materials and Methods: This retrospective study used data from 337 metastatic gastric cancer patients who presented to Kartal Dr. Lütfi Kırdar City Hospital between January 2012 and June 2024. Patients were categorized into intermediate- and high-risk groups according to the Khorana Risk Score. The study’s primary endpoints were the development of VTE and overall survival. Results: There was no statistically significant difference in VTE incidence (p = 0.27) or overall survival (11.9 months vs. 11.5 months, p = 0.23) between patients in the intermediate- and high-risk groups. Conclusions: These results indicate that the Khorana Risk Score is insufficient in predicting VTE development in patients with metastatic gastric cancer and has a weak association with overall survival outcomes. In conclusion, this study demonstrates the KRS’s inadequacy in predicting VTE and survival outcomes in patients with metastatic gastric cancer, highlighting the need for more tailored approaches.
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(This article belongs to the Section Oncology)
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Clinical Significance of Peripheral Arterial Disease Evaluation in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis
by
Jeong Yeop Whang, Lucy Eunju Lee, Jang Woo Ha, Oh Chan Kwon, Yong-Beom Park and Sang-Won Lee
Medicina 2025, 61(6), 1074; https://doi.org/10.3390/medicina61061074 - 11 Jun 2025
Abstract
Background and Objectives: This study investigated the frequency and clinical significance of subclinical but substantial peripheral arterial disease (PAD), identified using PAD evaluation, including pulse volume recording/ankle–brachial index (PVR/ABI), transcutaneous oxygen pressure (TcpO2), and skin perfusion pressure (SPP) tests in patients with
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Background and Objectives: This study investigated the frequency and clinical significance of subclinical but substantial peripheral arterial disease (PAD), identified using PAD evaluation, including pulse volume recording/ankle–brachial index (PVR/ABI), transcutaneous oxygen pressure (TcpO2), and skin perfusion pressure (SPP) tests in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Materials and Methods: This study included 54 patients with PAD evaluation results at or after AAV diagnosis. PVR/ABI and/or TcpO2 and/or SPP were performed on the same day. Abnormal PVR/ABI, TcpO2, and SPP were defined as PVR/ABI < 0.97, TcpO2 < 40 mmHg, and SPP < 50 mmHg, respectively. Poor outcomes included all-cause mortality, end-stage kidney disease (ESKD), cerebrovascular accidents, and acute coronary syndrome after PAD evaluation. Results: The median age of the 54 patients was 67 years, and 48.1% were male. In total, 3 of 54 patients (5.6%), 6 of 16 (37.5%), and 6 of 23 (26.1%) had abnormal PVR/ABI, TcpO2, and SPP, respectively. The concordance rate between abnormal PVR/ABI and abnormal TcpO2 or SPP was very low. Among the 54 patients, 5 (9.3%) died, and 2 (3.7%) progressed to ESKD. Abnormal SPP was significantly associated with cutaneous and renal manifestations at the time of PAD evaluation and had the potential to predict progression to ESKD during follow-up in patients with AAV. Conclusions: This study is the first to reveal the clinical usefulness of PAD evaluation: abnormal SPP may have the potential to identify subclinical but substantial PAD and can predict simultaneous kidney involvement as well as future progression to ESKD in patients with AAV.
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(This article belongs to the Section Hematology and Immunology)
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Open AccessArticle
Molecular Crosstalk Between SIRT1, Wnt/β-Catenin Signaling, and Inflammatory Pathways in Renal Transplant Rejection: Role of miRNAs, lncRNAs, IL-1, IL-6, and Tubulointerstitial Inflammation
by
Nurhak Aksungur, Murat Kizilkaya, Necip Altundaş, Eda Balkan, Salih Kara, Elif Demirci and Abdullah Uyanik
Medicina 2025, 61(6), 1073; https://doi.org/10.3390/medicina61061073 - 11 Jun 2025
Abstract
Background/Objectives: This study aimed to evaluate the relationship between sirtuin family members (SIRT1, SIRT3, and SIRT6) and Wnt/β-catenin pathways with inflammation during the rejection process following kidney transplantation, as well as to explore their potential roles as candidate biomarkers. Materials and Methods
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Background/Objectives: This study aimed to evaluate the relationship between sirtuin family members (SIRT1, SIRT3, and SIRT6) and Wnt/β-catenin pathways with inflammation during the rejection process following kidney transplantation, as well as to explore their potential roles as candidate biomarkers. Materials and Methods: Blood samples were collected from 35 kidney transplant rejection patients and 30 healthy controls. The gene expression levels of SIRT1, SIRT3, SIRT6, and Wnt/β-catenin pathway components were measured using real-time PCR, and miRNA and lncRNA expression levels were analyzed. Statistical analyses were performed using SPSS version 23. Results: Significant alterations in SIRT1, SIRT3, and SIRT6 expression levels were observed in rejection patients, suggesting their potential role in disease pathogenesis and as therapeutic biomarkers. Key altered genes included hsa-miR-34c-1, hsa-miR-122b-5b, MALAT1, HOTAIR, LINC00473, TUG, PVT1, SIRT1, SIRT3, SIRT6, WNT1, TCF-LEF, LRP, AXIN1, IL1B, IL6, and IFNB1, all showing significant changes. However, no significant differences were found for miRNAs such as hsa-miR-21-2, hsa-miR-155-5p, and hsa-miR-200b-3p. SIRT1 expression was significantly decreased in the cellular rejection group, with a more pronounced reduction in these patients. Significant differences in SIRT1 expression were observed with interstitial inflammation and glomerulitis. Increased inflammation severity correlated with decreased SIRT1 and increased TCF-LEF, TUG, and miR-21 levels, while tubulitis severity was associated with elevated TCF-LEF and miR-155 expression. Conclusions: Along with the activation of Wnt/β-catenin pathways and increased levels of certain miRNAs and long non-coding RNAs (lncRNAs) associated with TCF-LEF transcription factors, the observed decrease in SIRT1 expression may be related to the severity of inflammation and tubulitis. These findings suggest that SIRT1, Wnt/β-catenin pathways, and non-coding RNAs play a role in the rejection process following kidney transplantation and could be considered as potential biomarkers or therapeutic target candidates for future research.
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(This article belongs to the Section Surgery)
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Open AccessArticle
Rapid Tests for Viral Upper Airway Respiratory Infections in the Workplace: A Pilot Study on a Professional Football Team
by
Dimitrios Papagiannis, George D. Vavougios, Kyriakos Yiangou, Evangelos Latzourakis, Foteini Malli, Konstantinos I. Gourgoulianis and Georgios M. Hadjigeorgiou
Medicina 2025, 61(6), 1072; https://doi.org/10.3390/medicina61061072 - 11 Jun 2025
Abstract
Background and Objectives: Acute infections among elite athletes are predominantly attributed to upper respiratory tract pathogens. From a practical standpoint, medical personnel responsible for the healthcare of professional football players should be aware of this and develop infection prevention strategies. This pilot study
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Background and Objectives: Acute infections among elite athletes are predominantly attributed to upper respiratory tract pathogens. From a practical standpoint, medical personnel responsible for the healthcare of professional football players should be aware of this and develop infection prevention strategies. This pilot study aimed to investigate the prevalence of respiratory infections in football players using multiplex rapid diagnostic tests targeting four respiratory pathogens. Materials and Methods: The mean age of the participants was 32.76 ± 10.96 years. Among the participants, 32 were professional football players, with a mean age of 26.5 years, SD + 5.3, and 18 were members of staff, with a mean age of 44.3 years, SD + 8.6. In the present study, participants were followed up over a period of 6 months (from October 2024 to March 2025). Results: Among the participants and among a total of 1078 tests, 10 tests were found to be positive. We recorded a proportion of 0.46% for Flu-A, 0.27% for Flu-B, 0.18% for SARS-CoV-2, and 0 positive tests for RSV and adenovirus. There were six days of absence for players and staff and the proportion of total absenteeism was calculated as 3.7%. Univariate analysis revealed no statistically significant difference in infection risk between staff and players (odds ratio: 0.3795; 95% confidence interval: 0.07843–1.735). Conclusions: The multiplex rapid diagnostic test platform has a demonstrated ease of use and appears to be a reliable and safe method for distinguishing contagious symptomatic individuals from non-contagious individuals in occupational settings. Early identification of respiratory infections facilitates improved clinical management, thereby enhancing the quality of care for both athletes and supporting staff.
Full article
(This article belongs to the Section Pulmonology)

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