Life

10 pages, 240 KiB

Open AccessArticle

Which Classes of Antibiotics Are Associated with the Acquisition of Carbapenemase-Producing Enterobacterales?

by Lisa Sadou, Benoît Pilmis, Rasha Eid, Pierre Moenne Locoz, Sophie Lefèvre, Françoise Jauréguy, Vanessa Rathouin, Jean-Ralph Zahar and Laura Foucault-Fruchard

Life 2025, 15(7), 1072; https://doi.org/10.3390/life15071072 - 4 Jul 2025

Abstract

Background: Enterobacterales are among the most frequent causes of healthcare-associated infections and are increasingly affected by antimicrobial resistance. Antibiotic use disrupts the gut microbiota, facilitating colonization by multidrug-resistant organisms, including carbapenemase-producing Enterobacterales (CPE). While animal studies have suggested that certain antibiotic classes may [...] Read more.

Background: Enterobacterales are among the most frequent causes of healthcare-associated infections and are increasingly affected by antimicrobial resistance. Antibiotic use disrupts the gut microbiota, facilitating colonization by multidrug-resistant organisms, including carbapenemase-producing Enterobacterales (CPE). While animal studies have suggested that certain antibiotic classes may increase the risk of CPE acquisition, clinical data identifying which classes are most implicated remain limited. Methods: We conducted a single-center, retrospective case-control study (2021–2024) comparing antibiotic prescriptions in patients who acquired CPE with those in controls hospitalized in the same unit and during the same risk period but who did not acquire CPE. The objective of this study was to identify which antibiotic classes or pharmacological properties are associated with the acquisition of carbapenemase-producing Enterobacterales (CPE) in hospitalized patients. Results: During the study period, 35 cases and 70 controls were included. Most cases acquired NDM-type metalloenzymes. Before the risk period, 55 patients had received antibiotic therapy. Univariate analysis identified an association between CPE acquisition and the prescription of fluoroquinolones and antibiotics excreted in bile. During the risk period, only metronidazole prescription was significantly associated with CPE acquisition. Our study has several limitations, including the small sample size, the single-center retrospective design, and the lack of molecular typing (e.g., WGS) to confirm potential clonal transmission. Conclusions: In this preliminary study, metronidazole use was associated with an increased risk of CPE acquisition during risk periods. However, these results should be interpreted cautiously and need to be confirmed in larger, multicenter studies. The high exposure of patients to multiple antibiotic classes highlights the importance of strict antibiotic stewardship policies in the current era of global CPE dissemination. Full article

(This article belongs to the Collection Feature Papers in Microbiology)

20 pages, 727 KiB

Open AccessArticle

Gastrointestinal Cancers with Consideration of DPD and UGT1A1 Plasma Levels: Chemotherapy-Related Toxicity

by Velko Minchev, Hristo Tsankov, Bozil Robev, Martin Takov, Stefan Federchev, Kalina Kamenova, Lozan Todorov, Liliya Atanasova, Nadya Hristova-Avakumova, Rumen Nikolov, Pavlina Gateva and Vanyo Mitev

Life 2025, 15(7), 1071; https://doi.org/10.3390/life15071071 - 4 Jul 2025

Abstract

Unpredictable, dose-limiting toxicity remains a challenge in cancer treatment. We evaluated dihydropyrimidine dehydrogenase (DPD) and UDP-glucuronosyltransferase 1A1 (UGT1A1) plasma levels in the context of chemotherapy-induced toxicity and disease progression. Seventy gastrointestinal cancer patients (30 FOLFOX; 40 FOLFIRI) were enrolled. DPD and UGT1A1 plasma [...] Read more.

Unpredictable, dose-limiting toxicity remains a challenge in cancer treatment. We evaluated dihydropyrimidine dehydrogenase (DPD) and UDP-glucuronosyltransferase 1A1 (UGT1A1) plasma levels in the context of chemotherapy-induced toxicity and disease progression. Seventy gastrointestinal cancer patients (30 FOLFOX; 40 FOLFIRI) were enrolled. DPD and UGT1A1 plasma levels were determined using ELISA. Univariable and bivariable analyses and a general linear model (GLM) framework were used. Post-infusional reductions in white blood cell and granulocyte counts were observed. For FOLFOX, the granulocyte counts decreased by 17% (r = 0.54; p = 0.0030), while FOLFIRI caused a 41% reduction (r = 0.43; p = 0.0063). DPD levels were lower in FOLFOX than in FOLFIRI (2.543 vs. 3.579; p = 0.0363; Cohen’s d = 0.52). The multiple linear regression models associated DPD levels with cancer progression (b* = 0.258, p = 0.034). The bivariate analysis and multiple linear regression indicated some trends of association between UGT1A1 levels and reduction in white blood cell (b* = 0.359, p = 0.042) and granulocyte counts (b* = 0.383, p = 0.030) among FOLFIRI-treated patients. These preliminary observations suggest that DPD and UGT1A1 might contribute to evaluating response assessment. Full article

(This article belongs to the Section Medical Research)

16 pages, 570 KiB

Open AccessArticle

Comparison of Guided Exercise and Self-Paced Exercise After Lumbar Spine Surgery: A Randomized Controlled Trial

by Seong Son, Han Byeol Park, Kyeong Sik Kong, Byung Rhae Yoo, Woo Kyung Kim and Jae Ang Sim

Life 2025, 15(7), 1070; https://doi.org/10.3390/life15071070 - 4 Jul 2025

Abstract

Background: The efficacy of postoperative exercise rehabilitation after spine surgery is controversial, and a protocol for exercise treatment and detailed outcomes based on functional activity have not yet been established. This study aimed to determine the efficacy of exercise rehabilitation after lumbar spine [...] Read more.

Background: The efficacy of postoperative exercise rehabilitation after spine surgery is controversial, and a protocol for exercise treatment and detailed outcomes based on functional activity have not yet been established. This study aimed to determine the efficacy of exercise rehabilitation after lumbar spine surgery. Methods: A prospective, randomized controlled trial was conducted in 40 patients who underwent lumbar spine surgery (20 patients each in the exercise and control groups) for 12 weeks. Clinical outcomes were assessed using the visual analog scale (VAS) for pain and EuroQol-5 Dimensions 5-Level version (EQ-5D-5L). Body proportions, including body mass index, total muscle mass, and body fat percentage were analyzed. Functional activity was evaluated based on the range of motion of the lumbar spine, strength and endurance of lumbar flexion/extension, flexibility, 6 min walking test, single-leg stance, coordination, and gait pattern analysis. Results: The exercise group showed significantly greater improvement in VAS for pain (66.67% versus 20.00%, p < 0.001) and EQ-5D-5L (45.56% versus 20.00, p = 0.039) compared to the control group. Serial assessment revealed significant improvement in strength of lumbar flexion/extension, 6 min walking test, single-leg stance, coordination, and gait patterns in the exercise group compared to the control group. In particular, the single-leg stance time for the affected leg improved more markedly in the exercise group (280.9% versus 48.7%, p < 0.001). Conclusion: Tailored postoperative exercise after lumbar spine surgery is effective in reducing pain and enhancing functional recovery, including strength and balance. Full article

(This article belongs to the Special Issue Innovative Perspectives in Physical Therapy and Health)

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13 pages, 680 KiB

Open AccessReview

Microbiome Against the Background of the Complex Aetiology in Sarcoidosis—What Do We Already Know?

by Maciej Szymański, Katarzyna Góralska and Ewa Brzeziańska-Lasota

Life 2025, 15(7), 1069; https://doi.org/10.3390/life15071069 - 4 Jul 2025

Abstract

Sarcoidosis is a multi-organ, systemic disease of immunological origin. While its aetiology is unknown, it is believed to be influenced by genetic susceptibility, environmental factors, and autoimmunity. Recent research on the development and progression of sarcoidosis has focused increasingly on the role of [...] Read more.

Sarcoidosis is a multi-organ, systemic disease of immunological origin. While its aetiology is unknown, it is believed to be influenced by genetic susceptibility, environmental factors, and autoimmunity. Recent research on the development and progression of sarcoidosis has focused increasingly on the role of microorganisms. Changes in the respiratory tract microbiome, and hence the physiology of the respiratory tract, are believed to influence the course of sarcoidosis; this is not unlikely, as research indicates that the state of the microbiota inhabiting individual ontocenoses, such as the intestines or blood, may be related to the health of the entire body. This review therefore discusses the microbiological factors that are believed to be involved in the development of the disease; however, as the aetiological factors of sarcoidosis are diverse and are based on highly complex mechanisms, our analysis is restricted to only the most likely factors. Full article

(This article belongs to the Special Issue The Emerging Role of Microbiota in Health and Diseases)

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11 pages, 6109 KiB

Open AccessCase Report

Severe ARDS Complicated by Active Pulmonary Tuberculosis and Recurrent Nosocomial Infections: Therapeutic Challenges and Clinical Outcomes

by Wei-Hung Chang, Yi-Ting Wang, Ting-Yu Hu and Li-Kuo Kuo

Life 2025, 15(7), 1068; https://doi.org/10.3390/life15071068 - 4 Jul 2025

Abstract

Background: Acute respiratory distress syndrome (ARDS) secondary to tuberculosis (TB) is rare and associated with high mortality. Management is further complicated by comorbidities and ICU-related complications. Methods: We report a 43-year-old woman with post-polio sequelae and uncontrolled diabetes who developed ARDS due to [...] Read more.

Background: Acute respiratory distress syndrome (ARDS) secondary to tuberculosis (TB) is rare and associated with high mortality. Management is further complicated by comorbidities and ICU-related complications. Methods: We report a 43-year-old woman with post-polio sequelae and uncontrolled diabetes who developed ARDS due to pulmonary TB, complicated by recurrent nosocomial infections and gastrointestinal bleeding. Early bronchoscopy and GeneXpert MTB/RIF PCR were performed on ICU Day 2, enabling anti-TB therapy initiation by ICU Day 3. The patient received lung-protective ventilation, prone positioning, tailored antibiotics, and multidisciplinary care. Results: The patient’s clinical course was complicated by two episodes of ventilator-associated pneumonia and gastrointestinal bleeding, but with individualized management, she achieved ventilator weaning and functional recovery. Conclusions: Early TB recognition in ARDS is crucial. Multidisciplinary ICU management, including prudent steroid use, improves outcomes. Full article

(This article belongs to the Special Issue Advances in Intensive Care Medicine)

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19 pages, 719 KiB

Open AccessArticle

Redefining Systemic Sclerosis Classification: Anti-Topoisomerase Antibody as a Superior Predictor of Interstitial Lung Disease and Skin Progression Compared to Limited Cutaneous Systemic Sclerosis Subset

by Chana Chaovanitkul, Tippawan Onchan, Patnarin Pongkulkiat, Ajanee Mahakkanukrauh, Siraphop Suwannaroj and Chingching Foocharoen

Life 2025, 15(7), 1067; https://doi.org/10.3390/life15071067 - 4 Jul 2025

Abstract

Background: Currently, no information exists on the clinical course of anti-topoisomerase I antibody (ATA)-positive limited cutaneous systemic sclerosis (lcSSc). We aimed to evaluate the incidence of and time to the development of interstitial lung disease (ILD), pulmonary hypertension (PHT), scleroderma renal crisis (SRC), [...] Read more.

Background: Currently, no information exists on the clinical course of anti-topoisomerase I antibody (ATA)-positive limited cutaneous systemic sclerosis (lcSSc). We aimed to evaluate the incidence of and time to the development of interstitial lung disease (ILD), pulmonary hypertension (PHT), scleroderma renal crisis (SRC), and maximal modified Rodnan skin score (max-mRSS) in patients with lcSSc and dcSSc, with and without ATA. Methods: This cohort study included 522 patients with systemic sclerosis (SSc). The incidence of and time to the development of ILD, PHT, SRC, and max-mRSS were assessed. Results: ATA-positive dcSSc (dcSSc-posATA) was the most common presentation among Thai patients (321 cases; 61.5%). The median time to the development of ILD was shorter than that in lcSSc-posATA, comparable to that in dcSSc-posATA (1.0 vs. 1.8 years, p = 0.21), and shorter than that in ATA-negative dcSSc (dcSSc-negATA) (1.0 vs. 4.8 years, p = 0.001). The time to max-mRSS in lcSSc-posATA was comparable to that in dcSSc-posATA (p = 0.17) but shorter than that in dcSSc-negATA (p < 0.001). Conclusions: Patients with lcSSc-posATA had a similar risk of ILD development and time to reach max-mRSS as those with dcSSc, regardless of the presence of ATA, but had earlier ILD development and max-mRSS compared to those with dcSSc-negATA. Their prognosis appeared to be better than that of dcSSc-posATA. Full article

(This article belongs to the Special Issue Clinical Manifestations and Treatment of Autoimmune Diseases: 2nd Edition)

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14 pages, 731 KiB

Open AccessArticle

Enhancing Bone–Cartilage Interface Healing in Osteochondral Autograft Transplantation: Effects of BMAC Augmentation and Rehabilitation Protocols

by Robert Gherghel, Ilie Onu, Ana Onu, Ioana-Irina Rezus, Ovidiu Alexa, Daniel Andrei Iordan, Luana Andreea Macovei and Elena Rezus

Life 2025, 15(7), 1066; https://doi.org/10.3390/life15071066 - 3 Jul 2025

Abstract

This study aimed to evaluate the effectiveness of different rehabilitation protocols following osteochondral autograft transplantation (OAT) in patients with focal osteochondral defects of the femoral condyle, using the MOCART 2.0 knee score as a primary imaging outcome. Twenty-nine patients were divided into three [...] Read more.

This study aimed to evaluate the effectiveness of different rehabilitation protocols following osteochondral autograft transplantation (OAT) in patients with focal osteochondral defects of the femoral condyle, using the MOCART 2.0 knee score as a primary imaging outcome. Twenty-nine patients were divided into three groups: Group 1 (n = 9) received OAT with bone marrow aspirate concentrate (BMAC) and a 12-week two-phase rehabilitation program; Group 2 (n = 11) received OAT with a 12-week program without BMAC; and Group 3 (n = 9) received OAT with a shortened 6-week program. At the 12-month follow-up, Group 1 demonstrated a superior cartilage repair quality, with the highest mean MOCART 2.0 score (96.1), compared to Group 2 (80.2) and Group 3 (71.7). Notably, complete defect filling was observed in five patients in Group 1 versus four in Group 2 and only one in Group 3. The integration and surface integrity were also better preserved in Group 1. The addition of BMAC and an extended, progressive rehabilitation protocol significantly enhanced the morphological cartilage repair parameters. These results suggest that a biologically enhanced and prolonged recovery plan may offer a greater structural restoration of cartilage after OAT than conventional or accelerated protocols. Full article

(This article belongs to the Special Issue Recent Advances in Physiotherapy for Musculoskeletal)

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9 pages, 447 KiB

Open AccessArticle

Potential Clinical Use of CytoSorb^® for Ticagrelor and Rivaroxaban Elimination Prior to Emergency Orthopedic Surgery in Trauma Patients

by Gabriele Melegari, Fabio Gazzotti, Federica Arturi, Elisabetta Bertellini, Andrea Tognù, Domenico Pietro Santonastaso, Matteo Villani, Francesca Coppi, Fabrizio Fattorini, Fabio Catani and Alberto Barbieri

Life 2025, 15(7), 1065; https://doi.org/10.3390/life15071065 - 3 Jul 2025

Abstract

Background: Major orthopedic trauma in patients receiving anticoagulants such as ticagrelor or rivaroxaban poses a significant perioperative challenge, particularly in emergency contexts where bleeding risks are heightened and specific reversal agents may be unavailable. CytoSorb^®, a hemoadsorption device, has demonstrated efficacy [...] Read more.

Background: Major orthopedic trauma in patients receiving anticoagulants such as ticagrelor or rivaroxaban poses a significant perioperative challenge, particularly in emergency contexts where bleeding risks are heightened and specific reversal agents may be unavailable. CytoSorb^®, a hemoadsorption device, has demonstrated efficacy in cardiac surgery for drug removal. Its potential application in trauma surgery remains unexplored. Objective: This protocol describes a prospective clinical investigation assessing the feasibility and safety of CytoSorb^® hemoadsorption for the preoperative removal of ticagrelor and rivaroxaban in trauma patients requiring urgent orthopedic surgery. Methods: The proposed intervention involves integrating CytoSorb^® into a dedicated extracorporeal circuit under normothermic conditions (37 °C) with a blood flow of 150–200 mL/min for 300 min. Serial plasma samples will be collected at predefined intervals (0, 30, 60, 120, 240, 300 min) and drug concentrations. The primary outcome is the pharmacokinetic profile of drug clearance. Secondary endpoints include procedural safety, bleeding complications, and the feasibility of timely surgery. Expected Impact: The study aims to provide real-world data on the practical integration of CytoSorb^® for anticoagulant removal in orthopedic trauma care, potentially facilitating earlier surgery and improving perioperative safety. Findings may inform future randomized trials and protocol standardization. Full article

(This article belongs to the Special Issue Advances in Anesthesia and Critical Care)

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14 pages, 5332 KiB

Open AccessCase Report

Extramammary Paget’s Disease of the Scalp with an Underlying Atypical Meningioma—A Case Report and Review of the Literature

by Carolina Solomon, Adina Patricia Apostu, Ioana Irina Trufin, Salomea Ruth Halmagyi, Liliana Rogojan, Simona Corina Șenilă and Loredana Ungureanu

Life 2025, 15(7), 1064; https://doi.org/10.3390/life15071064 - 3 Jul 2025

Abstract

Extramammary Paget’s disease (EMPD) is a rare adenocarcinoma originating from apocrine glands, primarily affecting the anogenital and axillary regions. Ectopic EMPD, occurring in non-apocrine sites such as the scalp, is exceptionally uncommon. We report a case of ectopic EMPD of the scalp distinguished [...] Read more.

Extramammary Paget’s disease (EMPD) is a rare adenocarcinoma originating from apocrine glands, primarily affecting the anogenital and axillary regions. Ectopic EMPD, occurring in non-apocrine sites such as the scalp, is exceptionally uncommon. We report a case of ectopic EMPD of the scalp distinguished by its association with an intraosseous atypical meningioma, a previously unreported finding. A 70-year-old female presented with a persistent 15 cm erythematous, alopecic scalp lesion that had been misdiagnosed for a decade. Histopathological analysis confirmed ectopic EMPD, while imaging identified an adjacent intraosseous meningioma. Surgical resection was performed for the meningioma, and radiotherapy was selected as the treatment modality for EMPD. Due to its clinical resemblance to inflammatory dermatoses, ectopic EMPD is often underrecognized, underscoring the critical role of histopathology and immunohistochemical markers in diagnosis. Given its potential association with malignancies, comprehensive systemic evaluation is warranted. The high recurrence rate following surgical excision necessitates consideration of alternative therapeutic approaches, including radiotherapy, Mohs micrographic surgery, or photodynamic therapy. This case highlights the necessity for heightened clinical awareness of atypical scalp lesions and underscores the importance of thorough diagnostic assessment. Further research is needed to clarify the relationship between EMPD and other neoplasms and to optimize management strategies. Full article

(This article belongs to the Special Issue Skin Cancer: From Molecular Basis to Therapy: 2nd Edition)

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31 pages, 683 KiB

Open AccessReview

Risk Factors Associated with the Development of Immune-Checkpoint Inhibitor Diabetes Mellitus: An Integrative Review

by Vivian Crowder and Veronica Brady

Life 2025, 15(7), 1063; https://doi.org/10.3390/life15071063 - 3 Jul 2025

Abstract

Immune checkpoint inhibitor diabetes mellitus (ICI-DM) is an emerging phenomenon in the adult oncology population, with an increased incidence reflecting the increased use of immunotherapy; however, risk factors for ICI-DM have not been fully identified. The aim of this integrated literature review was [...] Read more.

Immune checkpoint inhibitor diabetes mellitus (ICI-DM) is an emerging phenomenon in the adult oncology population, with an increased incidence reflecting the increased use of immunotherapy; however, risk factors for ICI-DM have not been fully identified. The aim of this integrated literature review was to synthesize the published literature on ICI-DM and the factors associated with an increased risk for its development. The review was guided by Sanieszko’s Epidemiology Triad theoretical framework. We conducted a literature search using the Cumulative Index to Nursing and Allied Health Literature, Web of Science, and PubMed databases. The analysis included 2030 studies that met the search criteria, 23 of which were peer-reviewed articles that met the inclusion criteria. The results demonstrated a positive relationship between older age, medical history of diabetes, the presence of susceptible alleles, and exposure to immunotherapy, with an increased risk for ICI-DM. Future studies should include larger samples, more diverse populations, and a broad range of institutions to confirm the risk factors associated with ICI-DM. Full article

(This article belongs to the Special Issue Management of Patients with Diabetes)

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21 pages, 1475 KiB

Open AccessReview

The Role of Predictive Biomarkers in Modern Prostate Cancer Radiotherapy: A Literature Review on Personalised Treatment Strategies and the Prediction of Adverse Effects

by Jelena Stanić, Ivana Šović, Luka Jovanovic, Ivana Z. Matić, Predrag Nikić and Marina Nikitović

Life 2025, 15(7), 1062; https://doi.org/10.3390/life15071062 - 2 Jul 2025

Abstract

Prostate cancer is one of the most prevalent malignancies in men, posing a significant public health challenge due to its high incidence and long-term treatment-related toxicities. Long-lived patients often experience prolonged side effects that can severely diminish their quality of life. Despite advancements [...] Read more.

Prostate cancer is one of the most prevalent malignancies in men, posing a significant public health challenge due to its high incidence and long-term treatment-related toxicities. Long-lived patients often experience prolonged side effects that can severely diminish their quality of life. Despite advancements in radiotherapy techniques like IMRT and VMAT, some patients still experience acute and late side effects. Current treatment protocols do not account for individual variability in normal-tissue radiosensitivity, highlighting the need for predictive tools and a personalised treatment approach. Genetic factors and molecular regulators like microRNAs (miRNAs) contribute to these variations by influencing DNA repair, inflammation, and apoptosis. This review explores potential biomarkers of radiotoxicity, focusing on immune-related factors such as IL-6 and TGF-β1, SNPs influencing radiosensitivity, miRNAs involved in radiation responses, and functional assays including the radiation-induced lymphocyte apoptosis (RILA) test. These approaches offer promising tools for identifying radiosensitive patients and enabling risk-adapted radiotherapy. Full article

(This article belongs to the Section Radiobiology and Nuclear Medicine)

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17 pages, 1304 KiB

Open AccessSystematic Review

Cardiovascular Diseases and Type D Personality: Systematic Review and Meta-Analysis of the Literature of the Last 10 Years

by Omar Anwar Saleh Al Nakhebi, Raluka Albu-Kalinovic, Adela Bosun, Oana Neda-Stepan, Marius Gliga, Cătălina-Angela Crișan, Ileana Marinescu, Cristian Mornoș and Virgil-Radu Enatescu

Life 2025, 15(7), 1061; https://doi.org/10.3390/life15071061 - 2 Jul 2025

Abstract

Background: Cardiovascular diseases (CVDs) are a leading cause of death globally, with a significant impact on public health and quality of life. In addition to traditional risk factors such as hypertension, diabetes, smoking, and hypercholesterolemia, a growing body of scientific evidence suggests [...] Read more.

Background: Cardiovascular diseases (CVDs) are a leading cause of death globally, with a significant impact on public health and quality of life. In addition to traditional risk factors such as hypertension, diabetes, smoking, and hypercholesterolemia, a growing body of scientific evidence suggests the crucial role of psychosocial factors, including personality, in the development and prognosis of CVDs. In recent decades, researchers have focused on the so-called “type D personality.” Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search was conducted using the PubMed/Medline, Scopus, and Cochrane databases. Fifteen studies were included in the final quantitative analysis, involving 5687 people. The qualitative assessment of the studies included in this meta-analysis was conducted adopting the Quality System Tool. Results: Several studies have shown a significant correlation between type D personality and an increased risk of CVDs, as well as a worse prognosis in patients with established CVDs. The overall quality of the studies included in this synthesis ranged from 0.70 to 0.96, indicating the general good quality levels of the studies (69%). The association between type D personality and CVDs in terms of prevalence underlined a raw proportion of 0.36. Conclusions: This study reinforces the significance of type D personality as a psychological risk factor for CVD, with implications for both disease prevalence and severity. Full article

(This article belongs to the Section Medical Research)

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16 pages, 996 KiB

Open AccessArticle

MMP-2—Potential Predictor of Epithelial–Mesenchymal Transition in Squamous Cell Carcinogenesis

by Doinița Temelie-Olinici, Bild Walther, Laura Gheucă-Solovăstru, Mihaela Perțea, Daniela-Anicuța Leca, Bogdan-Vasile Grecu, Ioana-Alina Halip, Mădălina Mocanu, Ioana-Adriana Popescu, Adriana-Ionela Pătrașcu and Dan Vâță

Life 2025, 15(7), 1060; https://doi.org/10.3390/life15071060 - 2 Jul 2025

Abstract

Epithelial–mesenchymal transition (EMT) is one of the key steps in cutaneous carcinogenesis. At the molecular level, this cellular dedifferentiation is modulated by the interaction of signalling pathways that favour basement membrane degradation under the influence of proinflammatory cytokines and matrix metalloproteinases (MMPs). Given [...] Read more.

Epithelial–mesenchymal transition (EMT) is one of the key steps in cutaneous carcinogenesis. At the molecular level, this cellular dedifferentiation is modulated by the interaction of signalling pathways that favour basement membrane degradation under the influence of proinflammatory cytokines and matrix metalloproteinases (MMPs). Given the intricate role of these endopeptidases in modulating extracellular matrix turnover, the present study aimed primarily to identify the MMP-2 expression profile during the early stages of cutaneous malignant transformation. Forty-eight lesions with malignant transformation potential were excised in healthy tissue. Following the histopathological diagnosis of keratoacanthoma, Bowen’s disease and actinic keratosis, the biological preparations were deparaffinised and homogenised in order to perform the FRET technique using the “MMP-2 Assay Kit Fluorometric”. The results of the previous part of this research indicate that MMP-2 expression is more intense in lesions of actinic keratosis compared to normal tissues and to keratoacanthoma or Bowen’s disease lesions, inversely proportional to the histopathological degree of dysplasia. Monitoring metalloproteinase activity in dysplastic epithelium may improve the detection of malignant transformation and guide treatment decisions. Full article

(This article belongs to the Special Issue Current Research on Dermatology: Pathology, Clinical Manifestation, Investigation and Therapy—Third Edition)

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21 pages, 565 KiB

Open AccessArticle

Efficacy of Manual Therapy and Electrophysical Modalities for Treatment of Cubital Tunnel Syndrome: A Randomized Interventional Trial

by Michał Wieczorek and Tomasz Wolny

Life 2025, 15(7), 1059; https://doi.org/10.3390/life15071059 - 2 Jul 2025

Abstract

The aim of this study was to evaluate the efficacy of manual therapy based on neurodynamic techniques and electrophysical modalities in the conservative treatment of cubital tunnel syndrome (CuTS). A total of 128 upper limbs affected by CuTS were initially enrolled in this [...] Read more.

The aim of this study was to evaluate the efficacy of manual therapy based on neurodynamic techniques and electrophysical modalities in the conservative treatment of cubital tunnel syndrome (CuTS). A total of 128 upper limbs affected by CuTS were initially enrolled in this study, with 82 completing the full treatment protocol. The participants were divided into the following two intervention arms: the first arm (MT) (42 arms) received therapy based on sliding and tensioning neurodynamic techniques, while the second arm (EM) (40 arms) underwent physiotherapy based on electrophysical modalities, specifically low-level laser therapy (LLLT) and ultrasound therapy (US). Chi² and Student’s t-test were used to compare the intervention arms, and no statistically significant differences were found. The evaluated outcomes included nerve conduction testing, ultrasound assessments (measuring cross-sectional area and shear modulus), pain levels, two-point discrimination, thresholds for cutaneous sensory perception, symptom severity, functional ability in specific tasks, and overall post-treatment improvement. Baseline comparisons indicated no statistically significant differences in any measured variables between the intervention groups (p > 0.05). Following treatment, each group exhibited significant improvements in their respective parameters (p < 0.01). Comparisons between groups post-intervention revealed statistically significant differences in nerve conduction results, ultrasound measurements (cross-sectional area and shear modulus), two-point discrimination, and sensory perception thresholds. These parameters improved more in the MT intervention arm. The use of neurodynamic techniques, ultrasound, and low-level laser therapy in the conservative treatment of mild to moderate forms of CuTS has a beneficial therapeutic effect. Full article

(This article belongs to the Special Issue Physical Rehabilitation for Musculoskeletal Disorders)

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12 pages, 481 KiB

Open AccessArticle

Prenatal Valproic Acid Exposure Affects Song Learning in Zebra Finches: A Potential Model for Vocal Development in Autism

by Estifanos Ghebrihiwet Tewelde, Boglárka Morvai, Gergely Zachar and Ákos Pogány

Life 2025, 15(7), 1058; https://doi.org/10.3390/life15071058 - 1 Jul 2025

Abstract

Autism spectrum disorder (ASD) encompasses a range of neurodevelopmental conditions characterized by impairments in social abilities and communication. Studying appropriate animal models can enhance our understanding of the neural mechanisms underlying these conditions, potentially leading to improved treatment and intervention strategies. Modeling impairments [...] Read more.

Autism spectrum disorder (ASD) encompasses a range of neurodevelopmental conditions characterized by impairments in social abilities and communication. Studying appropriate animal models can enhance our understanding of the neural mechanisms underlying these conditions, potentially leading to improved treatment and intervention strategies. Modeling impairments in linguistic development and vocal communication caused by autism had been a challenging goal for a long time. Prenatal valproic acid (VPA) treatment has been successfully used to induce ASD-like behavioral symptoms in several vertebrate species including birds. Applying VPA-treatment on songbirds, therefore, offers a promising research paradigm to model ASD. In this study, we investigated the effect of embryonic VPA treatment on song learning in the highly social zebra finch (Taeniopygia guttata). Fertilized eggs were injected with either 0.45 µmol VPA or a saline solution on day 9 of incubation, and hatchlings were allowed to stay with their parents until day 35 post-hatching to facilitate song learning from the father. Once male offsprings reached adulthood, their songs were recorded and compared to those of their fathers. VPA-exposed males exhibited significantly greater similarity to their fathers’ songs compared to control males (74% vs. 31%, respectively), suggesting a reduced ability to modify and develop their own vocal patterns as subadults. Additionally, they showed higher entropy in their songs compared to controls (−1.4 vs. −1.7), indicating more disorganized vocalizations. These findings suggest that prenatal VPA exposure disrupts typical song learning and vocal development in zebra finches, likely by affecting neural mechanisms involved in vocal learning and crystallization of the songs. Our study suggests VPA treatment in songbirds provides a useful tool to model and investigate linguistic developmental disorders related to ASD in humans. Full article

(This article belongs to the Section Animal Science)

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26 pages, 3455 KiB

Open AccessReview

Exposure to Per- and Polyfluoroalkyl Substances (PFASs) in Healthcare: Environmental and Clinical Insights

by George Briassoulis, Stavroula Ilia and Efrossini Briassouli

Life 2025, 15(7), 1057; https://doi.org/10.3390/life15071057 - 1 Jul 2025

Abstract

Per- and polyfluoroalkyl substances (PFASs) are synthetic chemicals extensively used in various industries due to their unique physicochemical properties. Their persistence in the environment and potential for bioaccumulation have raised significant health concerns. This review aims to elucidate the sources, exposure pathways, toxicological [...] Read more.

Per- and polyfluoroalkyl substances (PFASs) are synthetic chemicals extensively used in various industries due to their unique physicochemical properties. Their persistence in the environment and potential for bioaccumulation have raised significant health concerns. This review aims to elucidate the sources, exposure pathways, toxicological effects, and regulatory measures related to PFASs, with a particular focus on pediatric populations and medical applications. A comprehensive narrative review was conducted using PubMed, Scopus, and Web of Science to identify peer-reviewed literature published between 2000 and 2025. The search focused on PFAS use in healthcare, environmental contamination, exposure pathways, health effects, and regulatory actions. Relevant studies, reports, and policy documents were screened and thematically synthesized by the authors to evaluate clinical and environmental risks, particularly in pediatric populations. PFAS exposure is linked to various adverse health effects, including immunotoxicity, endocrine disruption, metabolic disorders, and carcinogenicity. Children are particularly vulnerable due to developmental susceptibilities and exposure through medical devices and environmental sources. Regulatory measures are evolving, but gaps remain, especially concerning medical device applications. There is an urgent need for comprehensive strategies to monitor and mitigate PFAS exposure, particularly in vulnerable populations. Enhanced regulatory frameworks, safer alternatives in medical devices, and public health interventions are essential to address the challenges posed by PFASs. Full article

(This article belongs to the Section Medical Research)

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2 pages, 139 KiB

Open AccessReply

Reply to Saher, L. Outcomes of Microvascular Decompression Surgery: A Study on Cerebrospinal Fluid Leakage and Surgical Techniques. Comment on “Lee, H.S.; Park, K. Dura Closure Tactics to Prevent CSF Leakage in Microvascular Decompression Surgery. Life 2025, 15, 574”

by Hyun Seok Lee and Kwan Park

Life 2025, 15(7), 1056; https://doi.org/10.3390/life15071056 - 1 Jul 2025

Abstract

Thank you for your valuable comments and thoughtful suggestions [...] Full article

(This article belongs to the Section Physiology and Pathology)

2 pages, 123 KiB

Open AccessComment

Outcomes of Microvascular Decompression Surgery: A Study on Cerebrospinal Fluid Leakage and Surgical Techniques. Comment on Lee, H.S.; Park, K. Dura Closure Tactics to Prevent CSF Leakage in Microvascular Decompression Surgery. Life 2025, 15, 574

by Laiba Saher

Life 2025, 15(7), 1055; https://doi.org/10.3390/life15071055 - 1 Jul 2025

Abstract

I have critically appraised the article “Dura Closure Tactics to Prevent CSF Leakage in Microvascular Decompression Surgery” by Hyun Seok Lee and Kwan Park [...] Full article

(This article belongs to the Section Medical Research)

15 pages, 762 KiB

Open AccessArticle

Evaluating the Linkage Between Resistin and Viral Seropositivity in Psoriasis: Evidence from a Tertiary Centre

by Habeeb Ali Baig, Waseema Sultana, Mohamed Soliman, Dhaifallah Alenizi, Awwad Alenezy, Srinath Mote, Ahmed M. S. Hegazy, Bader Khalid Alanazi, Mansour Srhan Alanazi, Yousef Albedaiwi and Nawal Salama Gouda

Life 2025, 15(7), 1054; https://doi.org/10.3390/life15071054 - 30 Jun 2025

Abstract

Psoriasis, a chronic immune-mediated inflammatory skin disorder, presents complex pathogenetic mechanisms potentially influenced by viral infections. This comprehensive study explored the possible interplay of resistance and viral infections among psoriasis patients using serological screening techniques. The investigation involved 90 patients aged 23–45 years, [...] Read more.

Psoriasis, a chronic immune-mediated inflammatory skin disorder, presents complex pathogenetic mechanisms potentially influenced by viral infections. This comprehensive study explored the possible interplay of resistance and viral infections among psoriasis patients using serological screening techniques. The investigation involved 90 patients aged 23–45 years, systematically examining viral seropositivity for HSV (herpes simplex virus), HZ (herpes zoster), HBV (hepatitis B virus), HIV (human immunodeficiency virus), and HCV (hepatitis C virus) through ELISA testing. The findings revealed notable active or recent viral infection rates: 8.9% HSV positivity, 2.2% HZ antibody detection, 4.4% HCV positivity, and 4.4% HIV positivity. The research can contribute to current knowledge gaps, broaden the knowledge regarding the relationship between psoriasis and viral infection, and assess resistance, as it can mediate the interaction. The results can lead to improved diagnosis, treatment, and patient care options. This study emphasizes the importance of thorough viral testing for psoriasis patients, as well as focused therapeutic regimens that take into account viral co-infections. It elucidates the complex networks of biological relationships between immune factors, contributes information that is critical to our understanding of the multifactorial etiology of psoriasis, and concludes with a strong argument for investigating the mechanisms of viral involvement in this chronic-relapsing inflammatory disease. Full article

(This article belongs to the Special Issue Innovative Approaches in Dermatological Therapies and Diagnostics)

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