Search Results (437)

With the growing interest in personalized medicine, alternative biological matrices to blood are increasingly explored as sources of diagnostic information. Saliva has emerged as a promising diagnostic matrix due to its non-invasive collection, suitability for home sampling, and minimal requirements for personnel training. Numerous studies have demonstrated the presence of metabolites in saliva that enable disease diagnosis and monitoring. However, the influence of pre-analytical and analytical factors on salivary metabolomics outcomes remains insufficiently characterized. In this study, we investigated factors potentially affecting the number and abundance of detected metabolites in untargeted salivary metabolomics using liquid chromatography coupled with mass spectrometry (LC–MS). The impact of chromatographic column type, extraction protocol, and saliva type (stimulated versus resting) was evaluated. Additionally, the effect of swab type on analyte recovery was assessed. The use of a synthetic swab for saliva collection yielded results most comparable to those obtained without swabs, for both resting and stimulated saliva samples, indicating minimal pre-analytical interference. The greatest metabolite coverage was obtained using ACN:MeOH (1:1, v/v), with a ZIC-HILIC column for polar metabolites and a C18 column for non-polar metabolite separation. These findings demonstrate that swab type, chromatographic column, extraction solvent, and saliva type critically shape metabolite coverage in untargeted salivary metabolomics. Importantly, the distinct metabolic profiles of resting and stimulated saliva suggest that these matrices may provide complementary clinical insights, underscoring the need for saliva type selection tailored to specific diagnostic and biomarker discovery objectives. Full article

Freezing cold injury (FCI) is a localized injury caused by prolonged exposure to sub-zero temperatures, posing a significant health risk to military personnel operating in extreme climates. This study aimed to explore how FCI affects the health and lives of soldiers in the Norwegian Armed Forces (NAF), addressing the broader context of its impact on military readiness and the personnel’s well-being. Sixteen participants with a history of grade 2 FCI were recruited through the Norwegian Armed Forces Health Registry and interviewed. Systematic content analysis was used to identify key themes related to the causes and consequences of FCI, as well as the influence of military culture. The findings indicate that FCI results from interacting environmental, behavioural, and systemic factors. Environmental contributors included cold exposure and limited opportunities to eat or drink. Behavioural and individual contributors included reduced awareness of bodily cues in cold conditions and the need to remove gloves for weapon handling under time pressure. Systemic contributors, particularly military cultural norms emphasizing strict discipline and toughness, were perceived to discourage early symptom reporting and the use of preventive measures. Most participants (11/16) reported long-term consequences, including chronic physical discomfort, functional limitations, and negative impacts on their careers and daily lives. This study highlights the significant short- and long-term consequences of FCI, which extend beyond physical harm to affect soldiers’ overall health, functioning, and career progression. The findings emphasize the need for targeted preventive measures to mitigate the risks of FCI and protect military personnel in extreme climates. Full article

Cancer ranks as one of the top causes of death worldwide, and the World Health Organisation (WHO) estimates an increase of up to 55% in cases over the next 15 years, reaching 300 million cases worldwide. Current approaches to the treatment of cancer, such as chemotherapy and radiation therapy, have been used with continuous significant advancements. However, these conventional methods have harmful side effects that can last a lifetime. Today, there is growing interest in developing alternative cancer therapies from natural products or complementary medicine. One of the natural sources that has shown promise as an anticancer agent is honey, which has long been applied as a complementary medicine, and its beneficial health effects on various diseases in both animal and human models have been widely studied. Malaysian honey, such as Tualang, pineapple, Gelam, Kelulut, and Acacia, possesses a rich composition of phytochemicals, including polyphenols and flavonoids, which are reported to have promising anticancer properties. Examples of the phytochemicals highlighted in this review are phenolic acid, syringic acid, salicylic acid, p-coumaric acid, gallic acid, benzoic acid, caffeic acid, chrysin and its derivatives, kaempferol, fisetin, catechin, apigenin, quercetin, acacetin, pinocembrin, pinobanksin, hesperetin, naringenin, vitexin, isoorientin, xanthohumol, and galangin. This review highlights the anticancer mechanisms and molecular pathways of the phytochemicals found in Malaysian honey, focusing on their antioxidant effects, induction of mitochondrial-mediated apoptosis, inhibition of angiogenesis and metastasis, and suppression of cancer cell proliferation. The findings of various studies published in the past five years are collated to understand their mechanisms of action. Full article

Thoracoabdominal aortic aneurysms (TAAAs) are uncommon and usually silent until rupture, causing a substantial burden to the health care system. Aneurysm growth and rupture prediction is mainly based on aneurysm diameter measurement by imaging modalities, meaning that the biology of aneurysm growth is not part of a potentially more adequate surveillance of aortic aneurysm patients. Alternatives or complementary options for aortic aneurysm surveillance are an ongoing, non-addressed open issue of vascular medicine. The application of different biomarkers has been discussed, yet so far, an adequate candidate for aortic aneurysm surveillance, if it comes to the thoracic or thoracoabdominal aorta, preferably without radiation exposure, has not been named. Elastin breakdown, as a component of aortic wall degeneration primarily driven by matrix metalloproteinases (MMPs), is a core element of aneurysm development. Desmosine is an elastin-specific cross-link increasingly studied as a circulating or urinary biomarker of compromised aortic wall integrity and disease activity. Accordingly, this review investigated whether plasma desmosine (pDES), a highly specific marker of elastin degradation, could be used as a non-invasive biomarker for detecting aortic aneurysms and assessing their risk profile. The existing literature of desmosine in fields of aortic pathologies in the acute and chronic setting will be assessed based on the current literature; furthermore, future perspectives of desmosine as a biomarker of aortic pathologies, such as aortic aneurysm dynamics, will be discussed. Full article

Preclinical imaging has recently been expanded through the use of ostrich embryos as an alternative in vivo model. In ovo experiments represent a promising substitute for conventional rodent-based animal testing. For artifact-free dynamic nuclear medicine imaging, reliable immobilization of embryos is essential. Although previous studies have demonstrated the feasibility of isoflurane anesthesia, the kinetics and uptake mechanisms of isoflurane in ostrich embryos remain insufficiently characterized. The aim of this study was to characterize gas exchange dynamics in ostrich eggs and to quantify isoflurane uptake using two complementary approaches: indirect consumption measurements in a closed system and direct quantification by serial blood sampling. Fourteen ostrich eggs, including seven fertilized and seven unfertilized specimens, were analyzed at developmental stages up to day 37 of incubation. Gas exchange was assessed in a sealed container using a clinical anesthesia gas monitoring system to measure oxygen consumption and carbon dioxide excretion. Isoflurane uptake was evaluated during exposure to concentrations of 2%, 4%, or 6%. In a separate experimental series, serial blood samples were collected during and after exposure to the same concentrations to determine systemic uptake. Fertilized embryos showed progressive increases in metabolic activity, with a maximal oxygen consumption and carbon dioxide excretion of 116 mL/h/kg and 93 mL/h/kg on day 37. Indirect measurements demonstrated isoflurane uptake rates of up to 1.1 mL/min at 6%, with proportionally lower values at 4% and 2%. Blood analyses confirmed systemic absorption, peak concentrations of 160 µg/mL, and detectable residual levels for up to 120 min after exposure. These findings refine in ovo imaging. Full article

Moyamoya disease (MMD) is a chronic, progressive cerebrovascular disorder characterized by steno-occlusive changes in the intracranial internal carotid arteries and the development of fragile collateral networks. Imaging plays a pivotal role in diagnosis, disease staging, and management, yet the expanding range of available imaging modalities has resulted in heterogeneous evidence that remains difficult to synthesize. This scoping review aimed to systematically map and critically appraise imaging-based diagnostic approaches used in MMD, summarizing their diagnostic performance, clinical utility, and limitations. A comprehensive literature search was conducted across major databases, and original studies evaluating imaging modalities in human MMD were included. Thirty-three studies published between 1995 and 2023 were analyzed, encompassing digital subtraction angiography, magnetic resonance imaging and angiography, perfusion and functional MRI, computed tomography-based techniques, nuclear medicine, ultrasound, neurophysiological methods, and emerging artificial intelligence applications. Digital subtraction angiography remains the diagnostic reference standard, particularly for disease confirmation and surgical planning. However, noninvasive modalities provide critical complementary information. Magnetic resonance-based techniques offer multiparametric assessment of vascular morphology, hemodynamics, vessel wall pathology, and parenchymal injury. Computed tomography angiography and perfusion imaging provide accessible alternatives with high sensitivity for vascular changes, while functional and neurophysiological methods contribute additional hemodynamic and regional assessments. Artificial intelligence applications show promising diagnostic performance but remain in early validation stages. The evidence base is limited by methodological heterogeneity, inconsistent reference standards, incomplete reporting of diagnostic accuracy metrics, and a scarcity of longitudinal and multimodal studies. Collectively, the findings support a multimodal imaging strategy in MMD, integrating structural and functional information to inform diagnosis and management. Future research should prioritize standardized protocols, longitudinal designs, and clinically validated imaging biomarkers to enable evidence-based diagnostic pathways. Full article

Infectious diseases continue to represent one of the most persistent challenges in human health and agricultural productivity. These diseases are caused by a wide range of pathogenic microorganisms, including bacteria, fungi, viruses, and parasites. Antimicrobial resistance, or AMR, is the gradual evolution of pathogenic microbes to evade the action of commonly used antimicrobial agents (antibiotics, antifungals, antivirals, and antiparasitics) and is a problem that continues to be exacerbated by the inappropriate use of antimicrobials across multiple global industries. AMR poses a major threat to our society, and without mitigation, will lead to devastating consequences with broad implications beyond human health. The search for alternative or complementary therapies to conventional antimicrobials is, therefore, of the utmost priority. In this review, we first outline the prevalence of AMR and the circumstances driving the proliferation of AMR, which is widely recognised as a One Health issue—through interconnected factors within human and veterinary medicine, agricultural practice, and the environment. We next summarise the various classes of pathogens, common antimicrobial agents, and the mechanisms which pathogens have evolved to evade antimicrobial action. Within this context, we discuss the therapeutic potential of bacteriophages, virophages, and mycoviruses against antimicrobial-resistant infections, and consider the future perspectives of virus-based formulations. Full article

In this narrative review, we address the prevention and therapy of iron deficiency anemia (IDA) with oral iron products in pediatric patients. Fortification of complementary foods with iron-containing micronutrient powders is the preferred method for the prevention of IDA in resource-limited settings. In developed countries, the prevention of sideropenia is through the consumption of iron-rich foods of animal origin. Regarding oral iron therapy, ferrous sulfate is the most widely used and cheapest product, but it is less well tolerated due to gastrointestinal side effects compared to complexes of ferric iron with polysaccharides, and complexes of iron with amino acids in casein, such as iron protein succinylate and iron acetyl aspartylate. These latter products are expensive and available only as single-dose vials with a fixed amount of elemental iron. Intermittent administration of ferrous sulfate, once or twice a week, is equally effective to daily therapy, with fewer side effects, and can be used in selected patients. Oral carbonyl iron has excellent bioavailability and the additional advantage of a high safety margin in cases of accidental overdose compared to iron salts, an important consideration given the potentially lethal consequences of iron overdose. Newer liposomal and sucrosomial iron products appear to have better intestinal tolerance and similar efficacy in the treatment of IDA, but limited pediatric data exist. In conclusion, all oral medicinal iron products are effective when prescribed for the treatment of IDA, if well-absorbed and taken consistently for 3 to 6 months. Physicians should be prepared to use alternative oral agents with better tolerance in case of gastrointestinal side effects. Full article

Recently, complementary and alternative medicine (CAM) has been actively employed for patients experiencing symptoms unresponsive to Western medical treatments like drug therapy. The natural compounds carotenoids and astaxanthin (AST) have demonstrated various beneficial biological actions for human health in several studies. Given their broad pharmacological activities and reduced toxicity, ASTs possess significant potential as resources for the development of natural analgesic drugs. Given recent studies showing that AST can modulate neuronal excitability, including nociceptive sensory transmission through voltage-gated Ca²⁺ channels and the n-methyl-D-aspartate (NMDA) glutamate receptor, and inhibit the cyclooxygenase-2 cascade, AST holds promise as a CAM, particularly as a therapeutic agent for nociceptive and pathological pain. Based on the in vivo research findings from our laboratory presented in this review, we have confirmed that carotenoid ASTs possess: (i) an intravenous anesthetic effect on both nociceptive and inflammatory pain comparable to existing analgesics such as ketamine; and (ii) an anti-inflammatory effect on chronic pain with an efficacy almost equivalent to that of the commonly used non-steroidal anti-inflammatory drug (NSAID) celecoxib. Therefore, these findings suggest that, as natural compounds, ASTs contribute to the relief of nociceptive and inflammatory pain, implying their potential for clinical application. Full article

Background/Objectives: Gastric ulcer is a prevalent global gastrointestinal disorder influenced by multiple factors, including excessive alcohol consumption, poor dietary habits, psychological stress, smoking, and the chronic use of non-steroidal anti-inflammatory drugs. Among these, alcohol plays a critical role in gastric mucosal injury by enhancing gastric acid secretion, triggering inflammatory responses, inducing oxidative stress, and promoting epithelial cell apoptosis while simultaneously depleting key protective mediators such as nitric oxide and prostaglandin E₂. Growing interest has focused on medicinal plants as promising sources of novel therapeutic agents for the management of peptic ulcer disease. Methods: This review summarizes commonly used medicinal plants documented in both Ayurvedic and modern medical systems that exhibit ulcer-healing potential. Experimental and preclinical studies indicate that various herbal drugs and plant extracts derived from different plant parts exert significant anti-ulcer effects through multiple mechanisms, including antioxidant activity, modulation of inflammatory pathways, enhancement of mucosal defense, and inhibition of gastric acid secretion. Results: The review further highlights the gastroprotective effects of these herbal remedies as demonstrated in established experimental ulcer models. Conclusions: Exploring plant-based therapies for gastric ulcers offers valuable insights into alternative and complementary treatment strategies. Continued research aimed at identifying bioactive compounds, elucidating their molecular mechanisms, and developing improved formulations may contribute to safer, more effective, and patient-friendly therapeutic options for peptic ulcer management. Full article

Background/Objectives: Aromatherapy is widely used in midwifery, with pain relief during labour being a common objective. This umbrella review consolidates evidence from systematic reviews and meta-analyses on its efficacy for this purpose. Methods: Following PRISMA guidelines, nine systematic reviews and meta-analyses published between 2011 and 2023 were included, encompassing 127 primary studies. Populations, interventions, comparators, and outcomes were systematically extracted, and methodological quality was assessed using AMSTAR 2. Results: Lavender and rose were the most commonly used essential oils. Application methods included inhalation, massage, and bathing. Across reviews, aromatherapy showed statistically significant effects on labour pain reduction, particularly during the early stages of labour. However, high heterogeneity, low methodological quality of many reviews, and inconsistent reporting limit the overall strength of the evidence. No adverse effects were reported. Conclusions: The study results suggest that aromatherapy could be an effective, non-invasive intervention for labour pain. However, due to the low methodological quality of the studies and the correspondingly low strength of evidence, these results cannot yet be applied to the general population. This means that no general recommendation for use can be made at this time. Available reviews did not identify an increase in adverse maternal or neonatal outcomes, but safety monitoring and reporting were often limited by low review quality and inconsistent methods. Future high-quality randomized trials and evidence-based clinical guidelines are needed. Full article

Background: The growing interest in developing new bioactive agents from natural sources led to medicinal and aromatic plants. These plants provide valuable phytochemicals that can serve as natural preservatives, food additives, and flavorings, with various applications. The aim of this study is to evaluate the potential of Juniperus oxycedrus berries’ supercritical extract through preliminary screenings related to in vitro antibacterial activity, as well as bioinformatics assessments of absorption and toxicity. Methods: Supercritical carbon dioxide (CO₂) was used to extract the bioactive phytochemical compounds from the berries. The extract was characterized using spectrophotometric methods and reverse-phase high-performance liquid chromatography (RP-HPLC). The antibacterial potential was tested against Staphylococcus aureus ATCC 25923, where the Minimal Inhibitory Concentration and the Minimal Bactericidal Concentration were determined. Additionally, the influence of the extract on the growth curve kinetics of S. aureus was assessed. For the bioinformatics analyses, SwissADME and ProTox-3.0 prediction software were utilized, focusing on the identified phenolic compounds as fingerprint molecules. Results: The results demonstrated that exposure to the juniper extract inhibited bacterial growth, resulting in a prolonged lag phase of 6 to 8 h, depending on the concentration of the extract. The software predictions revealed that the investigated phenolic compounds might exhibit high gastrointestinal absorption, along with potential interactions with metabolic mediators and pathways. Conclusions: The in vitro and in silico findings support the application of J. oxycedrus berries extract as an alternative or complementary strategy for pharmacological treatment and food applications aimed at targeting S. aureus. Full article

Trigeminal neuralgia and orofacial pain often require effective local anesthesia with minimal side effects. Puerarin (PUE), a major bioactive flavonoid derived from Pueraria lobata, has shown potential analgesic properties. This study aimed to investigate the inhibitory effects of local PUE administration on the excitability of wide-dynamic-range (WDR) neurons in the spinal trigeminal nucleus caudalis (SpVc) and to compare its potency with the conventional local anesthetic lidocaine. Extracellular single-unit recordings were performed on SpVc WDR neurons in anesthetized rats. PUE (1 and 10 mM) or lidocaine (37 mM; 1%) was administered subcutaneously into the peripheral receptive field. Neuronal responses to graded non-noxious and noxious mechanical stimuli were quantified before and after drug application. Local administration of PUE significantly suppressed the mean firing frequency of SpVc WDR neurons in a dose-dependent and reversible manner. The inhibitory effect peaked at 10 min post-injection and recovered within 30 min. Notably, 10 mM PUE exerted an inhibitory magnitude (68.7 ± 6.4%) comparable to that of 37 mM lidocaine (58.1 ± 4.3%), indicating that PUE possesses approximately four-fold the inhibitory potency of lidocaine on a molar basis. The suppressive effect was consistent across both non-noxious and noxious stimulus intensities. These findings provide the first in vivo evidence that PUE effectively attenuates trigeminal nociceptive transmission, likely via the modulation of voltage-gated sodium channels and acid-sensing ionic channels at peripheral nerve terminals. As a natural dietary constituent with high potency and a low risk of systemic side effects, PUR represents a promising candidate for complementary and alternative medicine in the management of orofacial pain, such as temporomandibular disorders and trigeminal neuralgia. Full article

Background: Traditional, complementary, and alternative medicine (TCAM) is a promising and increasingly popular approach in managing chronic neck and shoulder pain. Despite recognized benefits for pain relief and well-being, how TCAM facilitates self-care practices is poorly understood. This scoping review maps the existing evidence on TCAM-based self-care strategies for adults with chronic neck and shoulder pain to identify which domains of self-care are addressed and which are overlooked. Methods: We searched five academic databases, including PubMed, Scopus, Embase, Cinahl Complete (EBSCOhost), and Public Health Database (ProQuest). Articles published over a 20-year period that examined the use of TCAM for adults with chronic neck and shoulder pain were included. An analytical framework based on Riegel’s three core components of self-care (maintenance, monitoring, and management) was used to structure and synthesize the findings from included studies. Results: Thirty-three studies met the inclusion criteria. Most research focused on just one or two self-care components, primarily self-care maintenance (e.g., physical activities and treatment adherence) and self-care management (e.g., pain control). However, critical dimensions, such as psychological well-being, social support, work–life balance, and cultural context, were frequently overlooked. Conclusions: To enhance the quality of life for adults with chronic neck and shoulder pain, future TCAM research must adopt a more holistic self-care approach that extends beyond physical symptoms. Our findings highlight the need for integrated research, policy, and clinical services that address the full spectrum of self-care in chronic pain management. Full article

Previous in vivo studies have clearly demonstrated that the intravenous administration of the carotenoid astaxanthin (AST) suppresses the excitability of rat trigeminal spinal nucleus caudalis (SpVc) neurons. This action is hypothesized to be mediated through the inhibition of both voltage-gated Ca²⁺ (Cav) channels and excitatory glutamate receptor transmission. The objective of this study was to determine whether acute intravenous administration of AST alleviates the hyperexcitability of SpVc wide dynamic range (WDR) neurons in a rat model of inflammation. Neuronal responses to both nociceptive and non-nociceptive mechanical stimulation were evaluated using an in vivo electrophysiological model. One day following inflammation induced by Complete Freund’s Adjuvant (CFA), the mechanical escape threshold was significantly reduced compared to pre-injection baseline values. Subsequently, extracellular single-unit recordings were performed on SpVc WDR neurons in anesthetized, inflamed rats. The neuronal responses to both non-noxious and noxious orofacial mechanical stimuli were then analyzed. Acute intravenous administration of AST at 1 and 5 mM elicited a dose-dependent reduction in the mean firing frequency of SpVc WDR neurons in response to noxious mechanical stimuli. This inhibition peaked within 10 min and was fully reversed after approximately 25 min. Importantly, AST preferentially inhibited the discharge frequency of SpVc WDR neurons in response to noxious stimulation, exhibiting a significantly greater effect than on the response evoked by non-noxious stimulation (41.5 ± 3.0% vs. 20.7 ± 4.2%, p < 0.05). Collectively, these findings demonstrate that acute intravenous administration of AST effectively suppresses noxious synaptic transmission within the SpVc during inflammation. We propose that this suppressive effect is mediated by the inhibition of upregulated Cav channels and glutamate receptors. Consequently, AST is implicated as a promising therapeutic candidate for the management of trigeminal inflammatory pain, given its potential for a favorable safety profile compared to conventional treatments. Full article