Search Results (572)

Background: The UGT1A1 gene is associated with the toxicity caused by SN38, the cytotoxic component of Sacituzumab govitecan (SG) used in the treatment of metastatic triple-negative breast cancer (mTNBC), among other approved indications. In this study, we aimed to analyze the effect of UGT1A1*28 allele on the safety and, secondarily, the effectiveness of SG in mTNBC. Methods: This was a multicenter, ambispective study that included patients treated with SG for mTNBC. Genotyping for UGT1A1*28 was performed using real-time polymerase chain reaction (PCR). Adverse events (AEs) of grade ≥ 2 during the first three cycles were compared between patients who were homozygous mutant (UGT1A1*28/*28) and those with wild-type (WT) or heterozygous genotypes. Effectiveness between the two groups was also compared using progression-free survival (PFS) and overall survival (OS) assessed with the Kaplan–Meier method. Results: A total of 81 patients were included: 37.0% were WT, 55.6% heterozygous, and 7.4% homozygous mutant. All UGT1A1 *28/*28 patients experienced grade ≥ 2 AEs (100% vs. 69.3%; p = 0.109), with a statistically significant association in the case of febrile neutropenia (33.3% vs. 6.7%; p = 0.025), and a trend towards higher rates of anemia and diarrhea (50.0% vs. 17.3%; p = 0.053). Genotype did not influence PFS or OS; however, dose reductions were associated with better survival outcomes. Conclusions: This real-world study shows a correlation between toxicity and the presence of the UGT1A1*28 mutation in patients treated with SG for mTNBC. Improving treatment tolerability through dose reductions may enhance SG effectiveness. These findings support the implementation of UGT1A1 genotyping in routine clinical practice. Full article

Background/Objectives: Patients with rheumatic immune-mediated inflammatory diseases (R-IMID) require latent tuberculosis infection screening and, in case of positivity, chemoprophylaxis. Isoniazid INH remains the standard regimen, but hepatotoxicity is an underrecognized concern. To describe the characteristics of R-IMID patients developing hepatotoxicity during INH therapy and identify potential risk factors through clinical analysis and literature review. Methods: Retrospective study of 64 R-IMID who developed hepatotoxicity with INH. Mean age was 53.4 ± 10.5 years; 70.3% female. Diagnoses included spondyloarthritis/psoriatic arthritis (56.3%), rheumatoid arthritis (32.8%), systemic sclerosis (4.7%), connective tissue diseases (4.7%), and other IMIDs (3.2%). All patients showed ≥ 2 × upper limit of normality (ULN) liver enzyme elevation, 34.4% ≥ 3 ULN, 20.3% ≥ 4 ULN. Literature review (19 studies) revealed INH-related hepatotoxicity rates of 1–41%, exacerbated by concurrent methotrexate, sulfasalazine, TNF inhibitors, and prior drug-induced liver injury. Results: Hepatotoxicity was frequent when INH was combined with other hepatotoxic drugs, especially methotrexate. Conclusions: INH prophylaxis in R-IMID patients carries substantial hepatotoxic risk. Careful hepatic monitoring and individualized risk stratification are essential to prevent liver injury in immunosuppressed populations. Full article

Natural bodybuilders optimize their body composition by combining training and nutrition strategies. This study compared the resistance training practices of amateur and professional natural bodybuilders, during the pre-contest phase and in general. Fifty-six drug-tested Spanish bodybuilders (27 amateurs, 29 professionals) completed a 34-item survey assessing training and competing experience, training frequency, exercise selection, weekly sets per muscle group, repetition ranges, and contest-preparation characteristics. Participants trained ≈5 days·week⁻¹ (Amateur: 4.74 ± 0.45; Professional: 4.83 ± 0.47) and most muscle groups were trained >1 and <3 times·week⁻¹. Weekly direct sets per muscle group averaged ~8–17, with the highest volumes for back (Amateur: mean 15.3; Professional: mean 17.0 sets·week⁻¹) and chest (Amateur: 11.8; Professional: 12.7) and the lowest for hamstrings (Amateur: 8.56; Professional: 8.10). The dominant repetition range was 6–10 reps (Amateur: 74.1%; Professional: 89.7%), with 11–15 reps commonly selected as the secondary range. No statistically significant differences were detected between amateurs and professionals for the main training variables, although professionals showed a trend toward more years competing (p = 0.078, d = 0.49). In conclusion, high-level natural bodybuilders adhere to practices that are generally in line with current scientific recommendations. However, interindividual variability highlights the need for individualized programming. Full article

Introduction: Stroke is a severe neurological condition associated with high rates of mortality and disability. Objective: This systematic review aimed to analyze the efficacy of early mobilization (EM) on the quality of life and the dependency levels in stroke patients. Additionally, the impact on anxiety and depression, the occurrence of adverse effects, and length of hospital stay were assessed. Methods: A systematic search was conducted in PubMed, Web of Science, and Scopus databases. The search was restricted to randomized controlled trials published within the last 10 years that included EM as an intervention in the experimental group. The Cochrane tools were used to assess risk of bias, and the PEDro scale was applied to evaluate the methodological quality of the included studies. Results: Nine studies were included in this review. Findings indicated that EM performed within 24–48 h post-stroke reduces dependency levels; however, no significant improvement in quality of life was observed. Evidence regarding anxiety and depression was inconclusive, and no significant differences were reported between groups concerning adverse events or reduction in hospital stay duration. Conclusions: This review demonstrates that EM is beneficial for reducing dependency after stroke, but there is no evidence of a significant improvement in quality of life. Further research is needed to establish clear protocols and appropriate intervention doses. Full article

Alginate [ALG] and chitosan [CS] are biomaterials of importance in drug-delivery because of their ability to form ionically-crosslinked nanosystems and polyelectrolyte-complexes under mild conditions. Here, a modified ionic-polyelectrolyte-pre-gelation method, with a controlled addition of reagents and sonication throughout the process, is reported to produce ALG¬¬-CS-based NPs. A mathematical study of the effects of the factors with influence in the process on the properties of NPs has been performed using a two-phase-design-of-experiment-based procedure, something never done to our knowledge. The concentration of ALG, CS and CaCl₂ and the ratio ALG:CS have significant influence on polydispersity (PDI), surface-charge (ZP) and encapsulation efficiency (EE%) of NPs. Moreover, CS flow rate has a significant effect over PDI and EE%. Thus, the values of ALG, CS and CaCl₂ concentration (mg/mL), ALG:CS (mL:mL) and CS flow rate (mL/min) to obtain the minimum-expected PDI (0.168) or the optimized EE% (86.7) are {0.30, 0.79, 1.00, 2.50:1.00, 0.86} or {0.30, 1.00, 1.00, 2.50:1.00, 2.00}, with ALG:CaCl₂ (mL:mL) and CaCl₂ flow rate (mL/min) fixed at 2.50:0.31 and 1.25. Although most of the conditions yielded highly-negative particles (minimum-expected of −67.8 mV using 0.69, 0.30 and 0.13 mg/mL of ALG, CS and CaCl₂ and ALG:CS of 2.50:0.59 mL:mL), varying the mass ratio of ALG:CS allowed for the generation of positively-charged particles (up to +21.1 mV with 0.30, 1.00 and 0.61 mg/mL of ALG, CS and CaCl₂ and ALG:CS of 2.50:1.00 mL:mL). In both cases, ALG:CaCl₂ (mL:mL), CaCl₂ and CS flow rates (mL/min) were fixed at 2.50:0.31, 1.25 and 1.25. The model for the NPs size depends only on CS and CaCl₂ concentrations, with the minimum- or maximum-expected (160 or 635 nm) at 0.30 and 1.00 or 1.00 and 0.30 of CS and CaCl₂, although the method allows a wide range of sizes (144.0–1965.0 nm). Full article

This study investigated the bioaccumulation of ciguatoxins (CTXs) in dusky grouper (Epinephelus marginatus) following dietary exposure to toxic fish flesh. Two feeding groups were established: group A (amberjack (Seriola spp.) and dusky grouper flesh) and group B (moray eel (Muraena spp. and Gymnothorax spp.) flesh). CTX-like toxicity was detected in muscle and liver of group A. Flesh toxicity progressively increased from the first sampling. In contrast, CTX activity was only detected in livers in group B. Liquid chromatography–mass spectrometry analysis revealed the presence of C-CTX1 in both groups, and the 17-OH-C-CTX1 analogue was exclusively observed in group A. Toxicity in the liver peaked at 10 weeks in experimental group A, but it showed a decline by the end of the experiment while increasing the storage of the toxin in muscle tissue. These findings demonstrate the differential bioaccumulation of CTXs in grouper flesh and liver, highlighting the potential role of the liver in metabolizing and/or detoxifying ciguatoxins. The efficacy of a combination of different techniques, including the cell-based assay (CBA) and liquid chromatography—low- and high-resolution mass spectrometry (LC-MS/MS and LC-HRMS), was demonstrated to confirm the presence of CTX analogues at very low levels. The results provide insights into CTX transfer and accumulation in marine food webs, underlining the need for further studies on toxin metabolism in predatory fish species. Full article

(1) Background: Female homelessness is one of the most invisible forms of social exclusion, aggravated by structural and gender factors and by experiences of violence. This research analyzes the multifaceted barriers hindering women experiencing homelessness from accessing healthcare services, from the perspective of social intervention professionals. (2) Methods: A qualitative study was conducted using three focus groups with 21 professionals from Santa Cruz de Tenerife, Lleida and Barcelona. An interpretative phenomenological approach guided data collection and analysis, and transcripts were examined through thematic analysis to identify common patterns in professionals’ meaning-making regarding healthcare barriers. (3) Results: Gender-based violence cuts across the life trajectories of most women experiencing homelessness, hindering their access to healthcare services. Barriers identified include lack of documentation, stigma and discriminatory treatment, limited access to specialized services, the absence of a gender perspective in healthcare, and a lack of coordination between social and health services. In addition, the study highlights the lack of preventive programs and health education tailored to this population. (4) Conclusions: It is essential to adopt a comprehensive, intersectional and gender-sensitive approach to safeguard the right to health for these women. Measures such as training for healthcare personnel, simplifying bureaucratic procedures, creating specialized resources, and improving inter-institutional coordination are proposed. Full article

Background: Musculoskeletal pain syndromes (MPSs) represent a major cause of disability and reduced quality of life, and conventional therapeutic approaches often provide only partial or temporary relief. Hyperbaric oxygen therapy (HBOT) delivered as 100% oxygen at 1.3–2.5 ATA, has been proposed to modulate inflammatory processes and enhance tissue repair. This review evaluated the effectiveness of HBOT on pain, function, quality of life, and physiological outcomes in individuals with MPS. Methods: This systematic review was conducted in different databases between June 30 and 30 September 2025, following PRISMA guidelines and was previously registered in PROSPERO (CRD420251073730). Studies published in English, Spanish, or Portuguese evaluating HBOT as a standalone or adjunctive intervention were included. Methodological quality and risk of bias were assessed using PEDro, NIH, and RoB 2.0 tools, and certainty of evidence was graded with GRADE. Results: Eighteen studies (17 RCTs and 1 case series; n = 671) were included. HBOT protocols ranged from 3 to 60 sessions, lasting 60–90 min, at approximately 1.3–2.5 ATA. Consistent reductions in pain and modest functional improvements were observed in fibromyalgia and postoperative conditions such as knee arthroplasty and peripheral nerve repair, with associated improvements in quality of life and inflammatory markers. Results for delayed-onset muscle soreness and acute ligament injuries were inconsistent. Conclusions: HBOT may provide adjunctive benefits in musculoskeletal pain syndromes, yet the current evidence remains limited. Standardized treatment protocols and high-quality trials are needed to better define its clinical applicability. Full article

Introduction: During pharmaceutical care, community pharmacists play a crucial role by carrying out interventions aimed at preventing, detecting, and resolving drug-related problems (DRPs) and negative outcomes associated with medication (NOM), simultaneously enhancing patients’ knowledge about their treatments. The chronic use of Benzodiazepines (BZDs) is known to be associated with risks such as tolerance, dependence, and cognitive impairment. Furthermore, the combined use of BZDs with other medications or alcohol may expose patients to significant drug interactions. Objectives: This study aimed to characterize and describe the clinical profile of patients using BZDs, to evaluate the extent of polypharmacy and potential drug interactions, to investigate their level of knowledge regarding BZD treatment, and ultimately, to propose evidence-based interventions from the community pharmacy to contribute to improving patient safety and minimizing risks associated with BZD use. Method: A cross-sectional, descriptive study was conducted in a single community pharmacy in Gran Canaria (Canary Islands, Spain). The study population comprised 125 adult patients with active BZD prescriptions. Data collection was performed through pharmacist–patient structured interviews using a questionnaire that included sociodemographic, clinical, and BZD knowledge variables. Results: Lormetazepam and alprazolam were the BZDs most frequently prescribed and dispensed. Potential drug interactions with other medications were detected in 38.4% of BZD users. Notably, 61.5% of patients using BZDs also reported the concurrent use of opioid analgesics, with tramadol being the most common opioid (48.1% of BZD users were also treated with tramadol). Statistically significant differences were observed between patients with and without BZD and other drug interactions in several adverse outcome variables, including the risk of falls (p = 0.003), cognitive impairment (p = 0.047), and urinary incontinence (p = 0.016). Existing BZD dependence is detected in 25% and 22.1% of cases, respectively. Patients’ knowledge of their BZD treatment revealed critical gaps, which are identified as a challenge and a clear opportunity for intervention through pharmaceutical care services. Conclusions: The findings underscore the essential and proactive role of community pharmacists in identifying and managing drug interactions, as well as in supporting deprescribing strategies through collaborative and interprofessional care models. Full article

Background/Objectives: Subjective tinnitus, defined as the perception of sound without an external source, is a common and often debilitating condition. In the absence of pharmacotherapy, disease management guidelines recommend counseling interventions to alleviate tinnitus-related distress and improve patient outcome. This study evaluated the benefit of guideline-compliant counseling provided by “Meine Tinnitus App”, a smartphone-based application, for the treatment of subjective tinnitus. Methods: A randomized controlled study was conducted in 204 patients with confirmed chronic subjective tinnitus enrolled at 33 ear, nose and throat (ENT) practices in Germany. Tinnitus improvement was evaluated after 10 weeks of intervention (digital counseling in addition to standard care vs. standard care only). The primary endpoint was the change in tinnitus-related distress (measured by the Mini-TQ-12 validated questionnaire). The secondary endpoint was the change in tinnitus-associated daily burden and coping difficulties (measured by the validated BVB-2000 questionnaire). Treatment effects for the primary and secondary endpoints were represented by the estimated marginal means (EMMs). Results: Patients of the intervention group showed a significant reduction in tinnitus-related distress (EMM [95% CI]: 4.5 [3.3–5.8]; p < 0.001) and a significant improvement in tinnitus-associated daily burden and coping difficulties (EMM [95% CI]: 0.5 [0.2–0.7]; p < 0.001) compared to patients of the control group, with large to moderate effect sizes (Hedges’ g between 1.1. and 0.5). These positive treatment effects were confirmed by responder and sensitivity analyses. Additionally, patients with high vs. low app usage showed a greater improvement in treatment effect for both endpoints (p < 0.05), further supporting the health benefits of digital counseling. Conclusions: This study demonstrated the efficacy of tinnitus counseling provided by “Meine Tinnitus App” to alleviate tinnitus-related distress, daily burden, and coping difficulties in patients with subjective tinnitus (German Clinical Trials Register DRKS00025379). Full article

The pond slider (Trachemys scripta) is native to the southeastern United States but has been introduced all around the world, including to the Canary Islands (Spain), along with other less-common exotic freshwater turtles such as Graptemys pseudogeographica, Mauremys spp., and Pseudemys peninsularis. The aim of this study was to determine the presence of pathogenic bacteria in these animals and to evaluate the associated health risks for humans and local fauna. For this purpose, cloacal samples from 42 specimens collected on the islands of Tenerife and Gran Canaria (Canary Islands) were analyzed for potentially zoonotic bacteria using selective culture media and PCR. Non-tuberculous mycobacteria were the most isolated pathogen (57.9%), followed by Yersinia enterocolitica (42.1%) and Escherichia coli carrying stx and/or eae genes (33.3%). Salmonella spp. was detected in 31.0% of the chelonians, identifying Salmonella Typhi and Salmonella Typhimurium serotypes. Staphylococcus spp. showed a prevalence of 21%, mainly Staphylococcus aureus along with one antibiotic-resistant Staphylococcus hominis isolate. Pseudomonas spp. were found in 10.1% of samples, although only one isolate corresponded to Pseudomonas aeruginosa. Campylobacter spp. and Vibrio spp. were detected at low frequencies (<10%), and Listeria monocytogenes was not identified. Overall, the results indicate that aquatic turtle populations in the Canary Islands pose notable health risks, especially for animal handlers and people with compromised immune systems. Full article

Objective: The aim was to evaluate the effects of two high-resistance training (RT) protocols combined with curcumin supplementation on antioxidant capacity, systemic inflammation, bone and muscle health, and body composition. Methods: Eighty-one apparently healthy older adults [(68.2 ± 4.6 years (57% women); BMI 26.4 ± 4.8 kg/m²; minimally active according to IPAQ] were randomly allocated to accentuated eccentric (Aecc), maximal strength (Max), or a non-training control (C). Additionally, participants received either a bio-optimized curcumin formulation (Cur) or a placebo (Pla), resulting in six study groups: Aecc-Cur, Aecc-Pla, Max-Cur, Max-Pla, C-Cur, and C-Pla. Participants underwent pre- and post-intervention assessments of oxidative stress, inflammation, and bone health parameters, whole-body composition, and muscle function. Aecc and Max performed six familiarization sessions and a 16-week intervention. Participants in the curcumin groups received 500 mg/day of a bio-optimized curcumin formulation (Cursol^TM; 2 × 250 mg capsules per day, corresponding to 10.50 mg/day of curcumin) throughout the intervention. Data were analyzed using three-way repeated-measures ANOVA/ANCOVA with time (pre–post) as the within-subject factor and training group and supplementation as between-subject factors, with Least Significant Difference post hoc comparisons and effect sizes (Hedges’ g, ηp²) reported, and the significance level set at p < 0.05. Results: Aecc was the most effective in improving antioxidant capacity (glutathione; F = 25.57, p ≤ 0.001, ηp² = 0.262) and bone biomarkers (serum-procollagen type I N-propeptide—P1NP, p ≤ 0.001, ηp² = 0.504; serum beta C-terminal cross-linked telopeptide of type I collagen—β-CTX—p = 0.022, ηp² = 0.074, and their ratio—P1NP/β-CTX—p ≤ 0.001, ηp² = 0.605). Interleukin-6 (IL-6) decreased more in Aecc (p ≤ 0.001, ηp² = 0.584) and tumor necrosis factor-alpha (TNF-α) in Max (p ≤ 0.001, ηp² = 0.471). Both groups similarly improved body composition and muscle function. Bone mineral density was generally unchanged. Overall, curcumin supplementation enhanced the benefits of high-RT programs (further glutathione increase in Aecc [Hedge’s g: 0.49]; IL-6 decrease in both modalities [Hedge’s g: 0.48–1.27]; decrease in TNF-α in controls [Hedge’s g: 0.47]; better outcomes in P1NP/β-CTX in all groups [Hedge’s g: 0.46–1.46]; among others). Conclusions: Aecc is recommended for supporting antioxidant capacity and bone health, while the choice between Aecc and Max may depend on the individual’s inflammatory profile. Curcumin supplementation further amplifies the benefits of both RT protocols across most outcome variables. Full article

The electrochemical capture and transformation of carbon dioxide (CO₂) (ECC) has recently emerged as a transformative alternative to conventional sorbent-based processes, enabling fully reversible operation under mild conditions and direct compatibility with renewable energy sources. This review focuses on redox-active metal–organic frameworks (MOFs) as electrosorbent materials for the electrochemical capture of CO₂. Rather than encompassing all electrochemical CO₂ capture technologies, we use molecular, polymeric, and COF-based systems as a framework to define what makes a MOF truly “redox-active” for CO₂ electrosorption and how its performance can be assessed. This includes capacitive versus faradic electrosorption mechanisms and design strategies based on the redox chemistry associated with metal nodes, π-conjugated ligands, and strongly redox-active units such as tetrathiafulvalene, viologen, and ferrocene. The way in which defects affect hybrid MOF composites was highlighted, and in situ and operando spectroscopic techniques have improved the understanding of the reaction mechanism in carbon dioxide capture and release under controlled potential. Research comparing carbonaceous materials, redox polymers, and hybrid structures has highlighted both the opportunities and limitations of MOFs, particularly in terms of energy efficiency, scalability, structural robustness, and reproducibility. From a broader perspective, redox-active MOFs occupy a unique position at the intersection of coordination chemistry, electrochemistry, and materials engineering for large-scale applications. In this review, we analyze how redox activity in MOFs—at the metal nodes, ligands, and extended structures—can be harnessed to design energy-efficient, cyclic electrochemical CO₂ capture systems. Furthermore, we propose cross-cutting metrics and design rules that enable meaningful comparisons between materials and device architecture. Full article

Objectives: To examine three elastic band resistance training (EB-RT) modalities—high-velocity (HVRT), accentuated eccentric (Aecc), and maximal strength (Max)—on bone health, strength, redox-inflammatory profile, and neuroplasticity in sedentary older adults. Methods: Sixty-one participants (69.41 ± 4.61 years) were randomly assigned to HVRT (n = 21), Aecc (n = 13), Max (n = 10), or passive controls (n = 17). Training was conducted three times a week for 16 weeks. Sessions included four sets of alternating upper- and lower-limb EB exercises, with intensity guided by the OMNI–RES EB scale. HVRT emphasized explosive concentric actions [~70% one-repetition maximum (1RM); 3–4 rating of perceived exertion in the first repetition (RPE-1)]. Aecc performed 5 s eccentric overload [>100% 1RM; 7–8 RPE-1]. Max employed controlled 2 s concentric/eccentric actions [~80–85% 1RM; 7–8 RPE-1]. Results: All training groups improved isokinetic strength (p < 0.01, g = 0.91–2.40). HVRT increased brain-derived neurotrophic factor (BDNF) (p = 0.019, g = 0.42) and glutathione peroxidase (GPx) (p < 0.001, g = 0.31). Aecc elicited the strongest osteoanabolic and antioxidant effects (P1NP, p = 0.001, g = 1.21; β-CTX, p < 0.001, g = 1.82; F2-isoprostanes, p = 0.007, g = 0.94). Max induced moderate bone turnover benefits (P1NP, p = 0.005, g = 1.08; β-CTX, p < 0.001, g = 1.12), but no GPx or BDNF gains. Controls maintained or declined all variables. Conclusions: EB-RT over 16 weeks improved most outcomes overall, showing modality-specific trends: HVRT favored neuroplasticity, Aecc enhanced redox-inflammatory and bone remodeling responses, and Max improved strength and bone health. These findings support elastic band resistance training as a safe and individualized strategy for healthy aging. Full article

Background: Triple therapy with cystic fibrosis transmembrane conductance regulator (CFTR) modulators in patients with cystic fibrosis (CF) has led to a shift in the nutritional management of the disease. Correct assessment of nutritional status is crucial due to its significant impact in pulmonary function and overall patient survival. This study aims to provide mid-term data on anthropometric and body composition changes in pediatric patients treated with elexacaftor–tezacaftor–ivacaftor (ETI). Methods: A prospective, longitudinal, multicenter study was conducted involving pediatric CF patients receiving ETI therapy. Anthropometric measurements and bioelectrical impedance analysis (BIA) data were collected at baseline and after 24 months of treatment. Results: A group of 66 pediatric patients, median age of 11.11 years (IQR: 8.2–12.5), was studied. The BMI z-score increased from −0.63 at baseline to −0.38 (p < 0.001) after 2 years of ETI treatment. Somatometric parameters were compared with a retrospective cohort showing no significant results. Significant changes comparing body composition were also observed over the 24 months period: fat mass (FM) increased from 6.2 kg to 7.4 kg (p < 0.001) free fat mass (FFM), increased from 28.2 kg to 34.2 kg (p < 0.001) and body cellular mass (BCM), increased from 7.8 kg to 8.7 kg (p = 0.02). Conclusions: Pediatric patients undergoing ETI treatment showed mid-term improvements in anthropometric parameters, alongside notable changes in body composition. Long-term studies are needed to confirm these findings and to better understand the implications for pediatric CF care. Full article