Search Results (23,021)

Dental caries is a biofilm-mediated, non-communicable, multifactorial disease in which the balance between demineralization and remineralization determines whether an initial enamel lesion remains stable, arrests, or progresses toward cavitation. Contemporary caries management prioritizes preservation of tooth structure and emphasizes individualized decisions based on lesion activity, cavitation status, cleansability, radiographic depth, and patient’s caries risk. Resin infiltration has emerged as a microinvasive approach positioned between noninvasive preventive strategies and conventional restorative treatment. This evidence-based narrative review summarizes the current literature on resin infiltration for incipient, non-cavitated proximal carious lesions in permanent teeth, with emphasis on diagnosis, case selection, clinical protocol, and current evidence. A structured search of three databases (PubMed, Embase, and the Cochrane Central Register of Controlled Trials) identified randomized clinical trials, observational clinical studies, systematic reviews, narrative reviews, and relevant in vitro investigations. The strongest clinical evidence supports resin infiltration for non-cavitated proximal lesions in permanent teeth, particularly enamel and selected outer dentin lesions, where long-term studies demonstrate reduced radiographic progression. In vitro studies indicate that lesion penetration, enamel hardness, and surface roughness depend on lesion characteristics, pretreatment, and technique, and help explain the caries-arresting effect. Current evidence shows that resin infiltration should be considered a selective microinvasive option for incipient proximal caries, guided by lesion assessment and patient’s caries risk rather than a universal substitute for prevention or restoration. Full article

Epithelioid sarcoma (EPS) is an ultra-rare malignant mesenchymal neoplasm of uncertain differentiation that comprises two distinct clinicopathological subtypes: classic and proximal. Classic EPS most commonly occurs in the distal upper extremity of adolescents and young adults, whereas proximal-type EPS most often affects the truncal regions of young to middle-aged adults. Both classic and proximal-type EPSs exhibit aggressive clinical behavior, including a higher risk of local recurrence and regional lymph node or distant metastasis. Histologically, classic EPS is characterized by irregular nodules composed of epithelioid and spindled cells, while proximal-type EPS consists of multinodular distributions and sheets of large polygonal cells. EPS has a distinctive immunoprofile with characteristic expression of cytokeratins and epithelial membrane antigen. Loss of nuclear expression of SMARCB1 protein occurs in the vast majority of cases. Moreover, SMARCB1 homozygous deletions have also been observed in both subtypes. Surgery is the mainstay treatment approach for localized EPS. Systemic treatment options for metastatic or unresectable locally advanced disease are very limited. The withdrawal of tazemetostat has created a significant gap in available treatment options. In this review, we provide an overview of the current knowledge on the clinical and radiological features, histopathology, immunohistochemistry, pathogenesis, and management of EPS. Full article

Background/Objectives: Patients with prolonged disorder of consciousness (PDOC) who regained consciousness in intensive care for consciousness rehabilitation (ICCR) were referred to further brain rehabilitation (FBR). The current retrospective cohort study evaluated the functional and cognitive outcomes of FBR. Methods: We assessed outcomes in 258 PDOC patients during FBR and used multivariate regression analyses to examine the influence of demographic and clinical characteristics on outcomes. Results: During FBR, Functional Independence Measure (FIM) motor, cognitive, and total scores improved from 21 ± 11, 11 ± 10, and 32 ± 15 to 43 ± 26, 18 ± 7, and 61 ± 32, respectively (p < 0.001). Dynamic Lowenstein Occupational Therapy Cognitive Assessment (DLOTCA) total scores increased from 57 ± 29 to 82 ± 36, and the average 6-min-walk (6MW) distances improved from 295 to 374 m (p < 0.001). Higher discharge FIM and DLOTCA scores were associated with younger age, traumatic etiology of the brain injury, shorter time to regaining consciousness, and higher FIM and DLOTCA scores at admission to FBR (p < 0.05). Conclusions: We observed functional and cognitive improvement in the examined patients. The improvement was associated with factors that may mainly reflect the severity of brain damage. The findings support continuing rehabilitation before and after emerging from PDOC. Full article

Background/Objectives: Kidney transplantation is the most effective treatment for pediatric patients with end-stage renal disease (ESRD), offering superior survival rates and quality of life compared to dialysis. However, long-term graft survival remains a complex clinical and surgical challenge. This systematic review aims to evaluate short- and long-term graft outcomes and comprehensively analyze the primary clinical, immunological, and procedural risk factors driving pediatric graft failure. Methods: A comprehensive search was conducted across the PubMed database, yielding 289 initial records. Following duplicate removal and systematic title and abstract screening, 108 full-text articles were evaluated for eligibility. Ultimately, 35 high-quality studies met the full inclusion criteria and were selected for final data synthesis and analysis. Results: Synthesized data revealed high short-term outcomes, with a 1-year graft survival rate of 94.60%. However, survival experienced a steady decline over time, dropping to 59.50% at the 10-year mark. Acute rejection episodes and delayed graft function (DGF) were identified as the primary immunological primary risk factors. Furthermore, specific donor characteristics, early surgical complications (such as vascular thrombosis), post-transplant infections affecting nearly 45% of patients, and adolescent non-adherence to immunosuppressive regimens were heavily associated with accelerated graft failure. Conclusions: While short-term success in pediatric kidney transplantation is highly encouraging, long-term graft longevity requires targeted clinical interventions. Optimizing outcomes necessitates precise, lifelong management strategies specifically focused on mitigating chronic rejection, preventing post-operative infections, and implementing multidisciplinary support systems to enhance patient adherence to immunosuppressive therapy. Full article

Background/Objectives: Nutritional status and adipose tissue-derived mediators have been implicated in the development and clinical characteristics of epithelial ovarian carcinoma; however, studies integrating circulating adipokines, adipokine receptor expression, and nutritional status remain limited. This study aimed to evaluate circulating adipokine concentrations, adipokine receptor expression, nutritional status parameters, and their associations with clinically relevant features and disease stage in women with epithelial ovarian carcinoma. Methods: A total of 151 women were included, comprising 43 patients with epithelial ovarian carcinoma, 89 with benign ovarian tumors, and 19 healthy controls. The nutritional status parameters included body composition, dietary intake, and serum glucose concentration. Circulating adipokines were quantified by ELISA, whereas adipokine receptor expression was evaluated by automated immunohistochemistry in patients with available tumor tissue. Associations with clinicopathological variables were assessed using correlation analyses and multivariable regression models. Results: Compared with women with benign ovarian tumors, women with epithelial ovarian carcinoma had significantly lower circulating leptin concentrations, whereas their circulating resistin concentrations were significantly higher than in healthy controls. In multivariable analysis, lower leptin and higher resistin concentrations were associated with clinical disease classification, while lower leptin was also associated with advanced-stage disease. Visceral fat was associated with clinical disease classification. In addition, AdipoR1 expression was significantly more frequent in malignant than in benign ovarian tumors. Conclusions: Circulating leptin and resistin, visceral fat, and AdipoR1 expression were associated with clinically relevant characteristics across the study groups. Together, these findings provide a more comprehensive characterization of the metabolic and inflammatory alterations associated with epithelial ovarian carcinoma and may contribute to the identification of potential clinically relevant markers. Full article

Background/Objectives: The molecular mechanisms underlying susceptibility to severe COVID-19 remain incompletely understood. We aimed to identify the signaling pathways associated with disease severity by integrating transcriptomic data and characterizing ligand–receptor interactions involved in the host response to SARS-CoV-2 infection. Methods: We integrated publicly available bulk RNA-sequencing data from nasopharyngeal (NP) swabs (GSE152075) and single-cell RNA-sequencing data from bronchoalveolar lavage fluid samples (GSE145926). Analyses focused on secreted ligands and their cognate receptors and were performed in relation to demographic and clinical characteristics associated with susceptibility to severe COVID-19, including sex, age, and viral load. Results: Patients with characteristics associated with increased susceptibility to severe disease, including male sex, advanced age, and high viral load, exhibited transcriptional programs enriched for inflammatory and immune-response pathways. In contrast, individuals with lower susceptibility displayed reduced expression of 43 ligand genes compared with matched negative controls, suggesting distinct secretory programs associated with the host response to infection. We identified an association between the expression of lactoferrin (LTF) and its receptor, LDL receptor-related protein 11 (LRP11), and susceptibility to severe COVID-19. LRP11 was predominantly expressed in human pulmonary epithelial cells, and its expression increased during SARS-CoV-2 infection in monkeys. Conclusions: Our findings provide insight into the molecular mechanisms associated with susceptibility to severe COVID-19 through the analysis of ligand and receptor expression in nasopharyngeal swabs and bronchoalveolar lavage fluid samples. The association between LTF and LRP11 highlights a potentially relevant signaling axis in disease pathogenesis and provides a rationale for future functional studies aimed at clarifying its role in COVID-19 severity. Full article

Background: Sacubitril/valsartan is a cornerstone of guideline-directed medical therapy for heart failure with reduced ejection fraction (HFrEF), yet data regarding reverse remodeling after ARNI initiation in patients previously treated with cardiac resynchronization therapy (CRT) remain limited. This study evaluated echocardiographic reverse remodeling following sacubitril/valsartan initiation in a real-world cohort of CRT-treated patients and explored the association between treatment timing and remodeling response. Methods: This single-center retrospective pilot study included 188 patients with HFrEF treated with CRT who subsequently initiated sacubitril/valsartan. Patients were categorized into early (≤12 months after CRT, n = 112) and late (>12 months, n = 76) initiation groups. Echocardiographic parameters and functional status were assessed at baseline and at approximately 12 months. Reverse remodeling was evaluated using changes in left ventricular ejection fraction (LVEF), ventricular volumes, and clinical status. Multivariable logistic regression was used to explore factors associated with reverse remodeling (ΔLVEF ≥ 10%). Results: Sacubitril/valsartan therapy was associated with significant improvements in LVEF, left ventricular end-diastolic volume, left atrial volume, and NYHA functional class in both groups. The magnitude of improvement in echocardiographic parameters was similar between early and late initiation groups. In exploratory multivariable analyses, earlier ARNI initiation was associated with clinically meaningful reverse remodeling (ΔLVEF ≥ 10%) (OR 6.36, 95% CI 1.59–25.50, p = 0.009). SGLT2 inhibitor therapy was also associated with reverse remodeling (OR 5.76, 95% CI 1.86–17.87, p = 0.002), while a longer CRT-to-ARNI interval was associated with lower odds of response (OR 0.77 per year, 95% CI 0.62–0.96, p = 0.018). Analysis of CRT-to-ARNI interval as a continuous variable showed only a weak association with reverse remodeling, while receiver operating characteristic analysis did not identify a meaningful temporal threshold (AUC 0.497). Conclusions: Sacubitril/valsartan initiation after CRT was associated with significant reverse remodeling, including in patients who initiated therapy several years after CRT implantation, although the late-initiation subgroup was of limited size, and treatment intervals beyond the interquartile range (4.0–7.0 years) were sparsely represented. Absolute echocardiographic improvements were broadly similar between groups, and receiver operating characteristic analysis did not identify a discriminative temporal threshold (AUC 0.497), indicating no discriminative ability beyond chance. Exploratory multivariable analysis identified an association between earlier initiation and clinically meaningful reverse remodeling, but this finding was not supported by a clinically meaningful temporal threshold. Full article

Objective: To describe the clinical and sociodemographic profile of patients treated in a public assisted reproduction unit and to analyze the association between these characteristics and the type of assisted reproductive technique used. Materials and Methods: A retrospective, observational, descriptive-analytical study was conducted including patients who initiated or underwent assisted reproductive techniques at a tertiary public hospital in Andalusia between January and June 2025. Sociodemographic and clinical variables were collected from electronic medical records and analyzed using bivariate and multivariate models. The main outcome was the type of assisted reproductive technique used. Results: A total of 222 patients were included. The mean age was 34.70 years (SD 3.99), and most were employed, nonsmokers, and of normal weight. Heterosexual couples were the most frequent family model, although single mothers by choice and female couples also represented a substantial proportion of the cohort. In the adjusted multivariable model, older maternal age (aOR = 1.19, p = 0.004), male factor infertility (aOR = 5.07, p = 0.026), and mixed factor infertility (aOR = 5.43, p = 0.017) were significantly associated with higher odds of undergoing high-complexity techniques. Conversely, urban residence (aOR = 0.24, p = 0.003) and single motherhood by choice (aOR = 0.12, p = 0.010) were significantly associated with lower odds of high-complexity techniques (and higher reliance on low-complexity procedures). Educational level, BMI, smoking status, and structural uterine pathology showed no independent association with technique complexity. Structural uterine pathology was among the most frequent gynecological findings, but no independent association with high-complexity techniques was demonstrated in the adjusted analysis. New family models accounted for 23.6% of the cohort, including 16.67% single mothers by choice and 6.94% female couples. Conclusions: In this cohort, the type of assisted reproductive technique used was mainly associated with clinical factors and family model rather than with the sociodemographic variables analyzed. These findings describe patterns of technique selection in a public assisted reproduction unit, but do not directly assess access to care. Full article

Background: Ovarian torsion is a pediatric surgical emergency in which timely diagnosis and preservation of ovarian tissue are important considerations for future reproductive and endocrine function. This study aimed to describe the clinical characteristics, diagnostic evaluation, surgical management, and outcomes of pediatric ovarian torsion and explore factors associated with ovarian preservation and oophorectomy. Methods: A retrospective, single-center cohort study was conducted including 56 girls with surgically confirmed ovarian torsion treated at a tertiary pediatric center between January 2010 and December 2025. Secondary analyses of factors associated with oophorectomy were considered exploratory. Demographic, clinical, imaging, operative, and outcome data were extracted from medical records. Variables included symptom duration, degree of torsion, laterality, diagnostic assessment, gynecologist consultation, associated pathology, intraoperative macroscopic color change following detorsion, oophoropexy, oophorectomy, postoperative complications, and recurrence. Univariable comparisons were performed using the Mann–Whitney U test, chi-square test, Fisher’s exact test, or Monte Carlo exact test, as appropriate. Exploratory multivariable logistic regression, supplemented by Firth penalized logistic regression, was performed in the postnatal cohort to assess factors associated with oophorectomy. Results: The median age at diagnosis was 10 years (range 0–17) and the median duration of symptoms before admission was 18 h (IQR 8–72). Ovarian preservation was achieved in 35 patients (62.5%), whereas complete oophorectomy or adnexectomy was performed in 21 (37.5%). Complete macroscopic color change following detorsion was observed in 19 patients (33.9%), partial color change in 13 (23.2%), and no macroscopic color change in 24 (42.9%). Prenatal ovarian torsion represented a clinically distinct subgroup and was associated with a high oophorectomy rate (8/8, 100%), compared with 13/48 (27.1%) among patients with postnatal torsion (p < 0.001). In the postnatal cohort, complete oophorectomy or adnexectomy occurred in 19.4% of patients with preoperative gynecologist consultation and 41.2% of those without consultation (unadjusted OR 0.34, 95% CI 0.09–1.28; p = 0.173). In exploratory multivariable analysis adjusting for age and calendar period, preoperative gynecologist consultation was not independently associated with oophorectomy (adjusted OR 0.41, 95% CI 0.09–1.78; p = 0.234); Firth penalized regression yielded similar results. Associated pathology was identified in 66.1% of patients. Documented recurrence occurred in three patients (5.4%), and postoperative complications were uncommon (3.6%). Conclusions: Ovarian preservation was achieved in more than half of pediatric patients with ovarian torsion, whereas prenatal torsion was associated with a high oophorectomy rate. Preoperative gynecologist consultation was associated with a numerically lower unadjusted oophorectomy rate; however, this association was not statistically significant in either unadjusted or adjusted analyses, and residual confounding and changes in clinical practice over the 15-year study period cannot be excluded. Full article

Background and Objectives: Wearable health technologies have become increasingly important in the remote management of cardiovascular diseases (CVDs); however, their successful implementation depends not only on technical performance but also on patient usability and technology acceptance. This study aimed to evaluate the perceived usability and technology acceptance of a wearable monitoring system among patients with CVDs and to investigate whether demographic and clinical characteristics influenced these outcomes. Materials and Methods: A cross-sectional observational study was conducted among 60 patients with CVDs enrolled in a six-month wearable monitoring program at the Medical Rehabilitation Outpatient Clinic of the Avram Iancu Clinical Hospital, Oradea, Romania. Participants used a Garmin vívosmart^® 5 fitness tracker to continuously monitor physiological and behavioral parameters. At the end of the monitoring period, perceived ease of use (PEU) was assessed using the System Usability Scale (SUS), while technology acceptance was evaluated using a Technology Acceptance Model (TAM)-based questionnaire. Descriptive statistics, reliability analysis, Spearman’s rank correlation, and multiple linear regression analyses were performed. Results: The wearable monitoring system demonstrated high PEU, with a median SUS score of 82.5 (IQR = 23.1) and a mean score of 75.5 ± 17.6. Overall, 75.0% of participants rated the system as having good or excellent usability. The SUS questionnaire demonstrated acceptable internal consistency (Cronbach’s α = 0.730; McDonald’s ω = 0.741). Technology acceptance was generally favorable, with an overall median TAM-based score of 1.33 (IQR = 0.78). Age and comorbidity burden were not associated with PEU, and no participant characteristics independently predicted SUS scores. Although the overall regression model was not statistically significant, age showed a statistically significant association with the overall TAM-based score (β = 0.328, p = 0.037). Significant positive correlations were observed between PU, self-efficacy (SE), and reverse-scored technology anxiety (TA) measure (p < 0.001). Conclusions: Patients with CVDs reported high PEU and favorable acceptance of wearable monitoring technology. While usability appeared independent of demographic and clinical characteristics, technology acceptance showed an exploratory association with age, although the overall regression model was not statistically significant. These findings support the integration of wearable monitoring systems into routine cardiovascular care and highlight the importance of patient-centered implementation strategies to promote long-term engagement. Full article

Background: Breast cancer continues to be a major contributor to illness among women in Jordan, particularly in underserved regions. Despite the establishment of mammography services in southern Jordan, no formal quality assurance audit has evaluated diagnostic performance or geographic equity of access. This study aimed to evaluate the diagnostic performance of mammography services using established quality assurance indicators and to investigate geographic variation in mammographic findings and diagnostic pathways among women attending a regional referral center in southern Jordan. Methods: This study employed a retrospective hospital-based clinical audit that was conducted using mammography records from Ma’an Hospital between 2016 and 2024. A total of 592 women aged 20 years and older who underwent mammography were included. Data extracted from electronic and paper-based medical records included demographic characteristics, mammography indication, BI-RADS^® classifications, follow-up procedures, reporting timelines, and histopathological outcomes. Histopathological confirmation served as the reference standard for diagnostic accuracy analyses. Diagnostic performance was evaluated using Cancer Detection Rate (CDR), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Geographic variation was evaluated according to place of residence, while multivariable logistic regression was used to determine whether associations remained independent of age and mammography indication. Results: Of the 592 mammography examinations, 354 (59.8%) were performed for screening purposes and 238 (40.2%) for diagnostic evaluation. BI-RADS^® 1 and BI-RADS^® 2 were the most frequently assigned categories, accounting for 38.3% and 28.7% of examinations, respectively, whereas BI-RADS^® 4 and 5 findings accounted for 6.3% and 1.0%. The overall CDR was 52.4 per 1000 examinations with sensitivity (93.9% (95% CI 80.4–98.3%)) and specificity (97.4% (95% CI 95.3–98.5%)), positive predictive value (PPV) (73.8% (95% CI 58.0–86.1%)), and negative predictive value (NPV) (99.5% (95% CI 98.2–99.9%)). Suspicious findings (BI-RADS^® 4–5) were significantly more frequent among urban than rural women (9.4% vs. 3.7%; adjusted OR 3.05, 95% CI 1.37–6.78), whereas reporting delay, ultrasound use, biopsy rate, and further follow-up did not differ significantly by residence. Conclusions: Mammography services at Ma’an Hospital exhibit high diagnostic accuracy and strong clinical performance in breast cancer detection over the nine-year study period. Women in rural areas were less likely to have suspicious mammographic findings detected than those in urban areas, regardless of age and mammography type. No significant differences were observed in reporting timelines or follow-up procedures by place of residence. These findings underscore the value of regional quality assurance audits in identifying service disparities and guiding improvements in breast cancer screening and diagnostic services, especially in underserved communities. Full article

Cardiac amyloidosis (CA) is an infiltrative cardiomyopathy caused by extracellular deposition of misfolded proteins, most commonly immunoglobulin light chains (AL) or transthyretin (ATTR). Once considered a rare disease, CA is increasingly recognised due to improved diagnostic strategies and the availability of disease-modifying therapies. Early diagnosis is crucial, as treatment efficacy and clinical outcomes are strongly influenced by the stage of cardiac involvement. Multimodality cardiac imaging plays a central role in the diagnostic pathway, risk stratification, and evaluation of therapeutic response in CA. Echocardiography represents the first-line imaging modality and is essential for raising clinical suspicion through the identification of characteristic structural and functional abnormalities, including ventricular wall thickening, diastolic dysfunction, and distinctive strain patterns. Bone scintigraphy has revolutionised the non-invasive diagnosis of ATTR-CA, allowing accurate identification of transthyretin-related disease in the absence of monoclonal gammopathy, which needs to be excluded via serum and urinary immunofixation. Cardiovascular magnetic resonance provides advanced tissue characterisation through late gadolinium enhancement and quantitative mapping techniques, enabling detection of early myocardial involvement and robust prognostic stratification. Emerging imaging modalities, including dual-energy (spectral) computed tomography and positron emission tomography tracers, show promise in myocardial amyloid quantification and subtype differentiation, although their role is still evolving. Integration of imaging findings with clinical and laboratory parameters allows comprehensive disease assessment, facilitating early diagnosis, guiding therapeutic decisions, and improving risk stratification. This review summarises the current role of multimodality imaging in CA, highlighting its contribution from early detection to prognostic evaluation and monitoring of treatment efficacy, with particular emphasis on the emerging role of quantitative imaging in monitoring treatment response. Full article

Background/Objectives: Preterm birth remains the leading cause of neonatal morbidity and mortality, with cervical insufficiency being a major risk factor. Quantitative fetal fibronectin (qfFN) and the QUiPP App version 2.0 are established tools for preterm birth prediction; however, the value of repeated assessments remains unclear. This study aimed to evaluate the prognostic accuracy of longitudinal qfFN measurements and QUiPP risk assessment in women with progressive cervical insufficiency and to evaluate the prognostic performance of repeated assessments. Methods: In this retrospective cohort study, 88 women with progressive cervical insufficiency who underwent repeated qfFN measurements were included. Cervical length, qfFN, and QUiPP risk were assessed at diagnosis and at subsequent time points. Prognostic performance for delivery within one week and before 34 and 37 gestational weeks was evaluated. Results: The prognostic performance represented by the area under the curve increased from 0.71 to 0.75 for qfFN and from 0.74 to 0.82 for QUiPP from the first to the final assessment, although neither difference reached statistical significance (qfFN p = 0.522; QUiPP risk p = 0.135). For imminent preterm birth, qfFN demonstrated excellent rule-out performance, with a negative predictive value of 100% at <10 ng/mL. QUiPP risk provided superior risk stratification and achieved excellent prognostic accuracy for delivery before 34 weeks at the final assessment (area under the curve = 0.82). Receiver operating characteristic analysis identified optimal cutoffs of approximately 40 ng/mL for qfFN and 23% for QUiPP risk in predicting delivery before 34 weeks. Conclusions: Repeated qfFN assessment combined with QUiPP risk estimation was associated with numerically higher discriminatory performance at the final assessment. While the identified optimal cutoff values need to be validated in prospective trials, they might have the potential to safely reduce unnecessary interventions in the future. qfFN functioned as an effective rule-out test, whereas QUiPP enhanced risk stratification, supporting their combined repeated use to guide clinical management before 34 + 0 weeks of gestation. Full article

The surgical management of rectal cancer has evolved from open resection to laparoscopic and, more recently, robotic minimally invasive approaches. Laparoscopy established the short-term benefits of minimally invasive rectal surgery but is limited within the confines of the bony pelvis, prompting adoption of the robotic platform with its three-dimensional visualization, wristed instruments, and tremor filtration. Whether these refinements translate into measurable clinical benefit remains debated. This narrative review compares the two approaches across oncologic, perioperative, functional, and economic domains. Pathologic outcomes are broadly equivalent, though contemporary evidence—most notably the REAL trial—suggests a possible emerging robotic advantage, although further study is necessary in this regard. Robotic surgery offers potential advantages in conversion rates, blood loss, and postoperative urinary and sexual function, while laparoscopy retains advantages in operative time and cost. At present, platform choice should be guided by patient anatomy, tumor characteristics, and surgical expertise, with robotic surgery likely most valuable in anatomically challenging cases where laparoscopy is most limited. Full article

Galium odoratum (L.) Scop., commonly known as sweet woodruff, is a perennial European woodland herb traditionally used as a medicinal and aromatic plant. Its characteristic sweet, hay-like scent is mainly linked to coumarin, which is formed from glycosidically bound melilotoside precursors during wilting and drying. However, the phytochemistry of G. odoratum extends beyond coumarin. The species also contains iridoid glycosides, coumarin-related melilotosides, caffeoylquinic acids, flavonoids, and volatile constituents. This review summarizes current knowledge on traditional use, phytochemical constituents, metabolite dynamics, biological and ecological relevance, toxicology, and potential applications. Seasonal variation, organ-specific differences, post-harvest metabolism, and differences in analytical methodology affect analytical interpretation of the available data. Reported biological activities are mainly based on isolated constituents, in vitro studies, animal models, or non-standardized extracts, and no convincing clinical evidence is available for defined G. odoratum preparations. Potential applications require standardized plant material, controlled processing, sustainable sourcing, and safety assessment, while the valorization of processing residues may provide an additional route toward more resource-efficient utilization of the species. Overall, G. odoratum should be regarded as a chemically diverse species rather than merely as a source of coumarin aroma. Full article