Search Results (328)

Background: Complementary and alternative medicine (CAM) is increasingly used to supplement evidence-based medicine (EBM), especially in the treatment of cancer patients. Objective: The study aimed to analyze the beliefs, attitudes, and expectations of healthcare professionals and cancer patients regarding the integration of CAM into the Western medical system, and to examine differences between these groups in their expectations for CAM effectiveness. The hypotheses were that there are no statistically significant differences in attitudes between healthcare professionals (nurses and physicians) and cancer patients regarding CAM integration into EBM and the effectiveness of CAM. Methods: The study was conducted on a stratified sample of 832 respondents: 411 cancer patients and 421 health professionals (100 physicians and 321 nurses). Validated questionnaires based on CHBQ and IMAQ instruments were used. Descriptive and inferential statistics were applied in the analysis. Results: Patients showed a significantly more positive attitude toward CAM methods than healthcare professionals. A total of 70% of respondents believed that CAM should be integrated into EBM. Most respondents supported formally noting CAM therapies in medical records and including them in medical history. Healthcare professionals, especially physicians, expressed greater concerns about the effectiveness of CAM, while patients had more positive expectations about its benefits. Conclusions: The findings suggest that healthcare professionals require better education on CAM therapies and that greater openness is necessary to integrate these methods into medical practice. Although patients have high expectations for CAM, its inclusion in the formal medical system requires further research on safety and efficacy. Full article

Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility, with ovulation induction remaining the first-line treatment approach. Although letrozole has emerged as the most effective monotherapy, treatment resistance, side effects, and patient preferences have led to increasing interest in adjunctive or alternative approaches. This narrative review summarizes the current evidence for ovulation induction in patients with PCOS, including conventional pharmacologic agents, such as clomiphene citrate, letrozole, gonadotropins, and insulin-sensitizing agents, as well as complementary therapies, such as acupuncture and Chinese herbal medicine. We also examine emerging adjuvants, such as vitamin D, omega-3 fatty acids, sildenafil, and antioxidants that may enhance clinical pregnancy rates or improve endometrial receptivity. While robust evidence supports the use of letrozole as a first-line agent, complementary and integrative therapies may offer additional benefits, particularly in treatment-resistant or preference-driven contexts. Further high-quality studies are needed to clarify the role of combined therapeutic strategies in optimizing fertility outcomes for women with PCOS. Full article

Malignant hilar biliary obstruction (MHBO) is a complex clinical condition commonly observed in individuals with advanced cholangiocarcinoma and other hepatobiliary malignancies. Endoscopic stenting remains the primary palliative intervention for unresectable cases; however, the optimal strategy has not been clearly defined owing to the anatomical intricacies of the hilar region and the heterogeneity of disease presentation. This narrative review summarizes current evidence and ongoing debates on functional liver volume-based drainage, unilateral versus bilateral stenting, stent type selection, and above-the-papilla approaches. In addition, we highlight recent progress in endoscopic ultrasound-guided biliary drainage as a promising alternative or complementary approach when conventional transpapillary drainage proves inadequate. With recent advances in systemic therapies, including immunotherapy, patient survival has improved, underscoring the need for durable, reintervention-friendly stent strategies. Although uncovered metal stents have long been regarded as the standard for unresectable cases, their limitations in reintervention have prompted renewed consideration of both stent type and drainage technique. Robust prospective studies remain essential to establish standardized, evidence-based guidelines that optimize patient benefit and improve long-term outcomes in unresectable MHBO. Full article

Nigella sativa L. is a species of the Ranunculaceae family and belongs to the genus Nigella, which comprises 14 species native to the regions of the Eastern Mediterranean, North Africa, and subcontinental India. Several significant groups of bioactive compounds, with pharmacological activities, have been isolated from the Nigella sativa L. species. Numerous beneficial effects have been demonstrated for these compounds. This review provides a comprehensive summary of the chemical constituents, bioactive compounds, modern administration methods, studies on the antidiabetic potential, evidence in commonly associated type 2 diabetes mellitus (T2DM) conditions, and evidence of T2DM complications. Research shows that Nigella sativa L. can be successfully included in complementary and alternative therapy for T2DM pathology, having multiple benefits both in diseases associated with and in complications of T2DM. Full article

Prostate-specific membrane antigen (PSMA) targeting agents have been the cornerstone of advanced prostate cancer (PCa) management in theranostics due to their high sensitivity for detecting and treating metastatic disease. However, approximately one-third of metastatic castration-resistant PCa (mCRPC) lesions may exhibit low or absent PSMA expression due to tumor heterogeneity, prior androgen deprivation therapy, or loss of androgen receptor expression, subsequently altering their response to PSMA-targeted therapy. The molecular and biological mechanisms underlying PSMA downregulation remain elusive but may include neuroendocrine differentiation or epithelial-to-mesenchymal transition (EMT). This review addresses this knowledge gap by examining recent preclinical and clinical evidence on novel radiotracers with the potential to provide alternative strategies beyond PSMA for imaging and treating PCa. The diagnostic performance and therapeutic potential of three emerging radiotracer classes are discussed, including gastrin-releasing peptide receptor (GRPR) ligands, androgen receptor (AR) ligands, and amino acid analogs. This article further highlights the complementary roles of these radiotracers along with their utility in specific patient populations, such as those with low prostate-specific antigen (PSA), biochemical recurrence (BCR), or confirmed PSMA-negative disease. For instance, GRPR-targeted radiotracers have achieved sensitivity of up to 88% and specificity of up to 90% for detecting primary tumors in PCa. The radiolabeled androgen agonist, fluorine-18 (¹⁸F)-fluoro-5α-dihydrotestosterone (FDHT), has demonstrated 98% true-positive rate in predicting lesions on positron emission tomography (PET) scans of mCRPC patients. On the other hand, the synthetic amino acid analog ¹⁸F-fluciclovine demonstrated a lesion detection rate of 84% for PSA levels at or above 5, and 62.5% for PSA levels ranging from 0.7 to less than 1. This review concludes with future directions on the paradigm of multi-tracer and dual-targeting strategies, which can effectively address challenges associated with PCa tumor heterogeneity and facilitate personalized approaches in theranostics. Full article

Background: Adjuvant endocrine therapy (AET) enhances survival outcomes in hormone receptor–positive (HR+) breast cancer. However, this treatment is associated with toxicities that may adversely affect the quality of life (QoL) and impact patient–physician communication. A thorough understanding of symptom-reporting behaviors is essential for optimizing survivorship care. Methods: This cross-sectional study surveyed 191 female patients with HR+ breast cancer undergoing adjuvant AET (tamoxifen or aromatase inhibitors ± ovarian function suppression [OFS]) at Antalya Training and Research Hospital between July and August 2025. QoL, symptom burden, and adverse event (AE) reporting behaviors were assessed using validated instruments (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 [EORTC QLQ-C30], adapted Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events [PRO-CTCAE]). Categorical variables were compared using chi-square tests, and multivariate analyses were performed using logistic regression. Results: The median age was 54 years (interquartile range [IQR]: 46–61 years). The following independent variables were identified as predictors of a higher symptom burden: prior chemotherapy (odds ratio [OR]: 3.75; 95% confidence interval [CI]: 1.46–9.69; p = 0.006), OFS use (OR: 3.29; 95% CI: 1.51–7.15; p = 0.003), AE reporting to physicians (OR: 3.52; 95% CI: 1.80–6.88; p < 0.001), and complementary and alternative medicine (CAM) use (OR: 7.27; 95% CI: 1.57–33.63; p = 0.011). Independent predictors of poor QoL included receiving psychological support (OR: 0.36; 95% CI: 0.19–0.67; p = 0.002) and AE reporting (OR: 0.28; 95% CI: 0.13–0.64; p = 0.001). Conclusions: Symptom burden and QoL in patients with HR+ breast cancer receiving AET are influenced by clinical history, including chemotherapy and OFS; behavioral factors, such as reporting behaviors; and supportive care, including CAM and psychological support. The routine integration of patient-reported outcomes and proactive symptom monitoring is crucial for delivering personalized and effective survivorship care. Full article

Background: Inhaled medications are central in managing pediatric respiratory diseases, yet device complexity and nebulizer use often challenge caregivers and affect adherence. This study assessed current usage patterns and parental perceptions of inhaled therapies in Romania, aiming to identify modifiable factors for targeted education. Methods: A cross-sectional observational survey was distributed via SVC^® (Spitalul Virtual pentru Copii—Virtual Children’s Hospital), a widely accessed social media platform for Romanian parents. Data included demographics, inhaled medication use, prescribing sources, adherence, and treatment perceptions. Results: A total of 1825 parents participated, mostly urban residents (87.6%). Chronic respiratory disease, mainly asthma, was reported in 7.3% of children. Inhaled therapy was used in 71.9% of cases, predominantly saline solutions, bronchodilators, and corticosteroids, marking a decline compared with the past decade. Nebulizers (74.1%) were the main devices used. Prescriptions were largely pediatrician-based, though self-medication occurred, particularly with saline solutions, often influenced by non-medical sources (p = 0.003). Parents of children with chronic disease were less likely to self-medicate (p = 0.042), especially with β₂-agonists and corticosteroids (p < 0.001). Additionally, 31.3% reported use of complementary remedies, including homeopathy. Overall, 73.5% perceived inhaled therapy as effective, with adverse events reported by only 8.3%. Conclusions: Inhaled therapy remains prevalent in Romanian children, though self-medication and alternative treatments persist, shaped by cultural factors and limited medical education. Parents of children with chronic disease show better adherence and reliance on prescribed therapy. Enhancing parental education via accessible digital platforms may reduce inappropriate practices and improve outcomes in low-resource settings. Full article

The BCR-ABL fusion oncoprotein, a constitutively active tyrosine kinase, plays a central role in the pathogenesis of chronic myeloid leukemia (CML). While tyrosine kinase inhibitors (TKIs) have transformed CML treatment, issues such as drug resistance, particularly involving mutations like T315I, and adverse effects underscore the need for alternative or complementary therapeutic strategies. Natural products derived from plants have long served as a reservoir for anticancer agents, offering structural diversity and multi-targeted bioactivity. Notably, many plant-based compounds exhibit anticancer effects with comparatively lower toxicity and fewer side effects than synthetic TKIs, making them attractive candidates for safer long-term use. This review explores the recent advances in plant-based natural compounds that directly or indirectly inhibit BCR-ABL kinase activity and its downstream signaling pathways. Key compounds are discussed with respect to their mechanisms of action, structure–activity relationships, and potential to overcome TKI resistance. Several of these compounds directly target BCR-ABL or promote its degradation, while others inhibit downstream effectors such as STAT5 and PI3K/Akt, leading to apoptosis and growth inhibition of leukemic cells. The synergistic potential of these natural products with existing TKIs and their promise to target drug-resistant CML cells further highlight their translational value. By integrating insights from molecular pharmacology, medicinal chemistry, and leukemia biology, this review supports the continued investigation of plant-derived agents as novel or adjunctive therapies against BCR-ABL-driven leukemias. Full article

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation that leads to tissue damage and disability. RA affects approximately 0.5–1% of the global population and is driven by a complex interplay of genetic susceptibility, environmental factors, and immune dysregulation. While biologic and targeted synthetic DMARDs improved RA treatment, they have limitations in efficacy, safety, and accessibility. B-cell-targeting therapies, such as anti-CD20, have shown effectiveness, but only with broad immunosuppression, which can increase infection risk and compromise humoral immunity. Therefore, there is an unmet need for more selective therapeutic strategies that modulate pathogenic immune pathways while preserving protective immune functions. It has been suggested that targeting the BAFF pathway may offer a more favorable therapeutic approach compared to targeting CD20. Objectives: In this study, we evaluated the therapeutic potential of V3-46s mIgG2a, an anti-BAFF-R (BR3) antibody in a mouse RA model, hypothesizing that it would offer a more selective and effective strategy. Methods: We expressed and purified four antibody variants and assessed their binding and neutralizing activity in vitro. V3-46s mIgG2a was selected for in vivo evaluation in a collagen-induced arthritis (CIA) model. Results: Treatment with this antibody delayed disease onset and reduced arthritis severity, spleen index, and B-cell populations. Conclusions: These findings highlight the potential of BAFF-R-targeting antibodies as a therapeutic approach for RA treatment. This preclinical work lays the groundwork for future development of BAFF-R blockade as a complementary or alternative strategy to current biologic treatments. Full article

The global rise in obesity continues to outpace advances in pharmacologic treatment. While incretin-based therapies have demonstrated significant efficacy in promoting weight loss, their widespread use remains limited by gastrointestinal side effects, long-term tolerability concerns, and access issues. Additionally, sustaining weight loss over time poses an ongoing clinical challenge. These limitations highlight the need for alternative or complementary pharmacologic strategies. One such approach involves stimulating thermogenesis, particularly through the activation of brown and beige adipose tissue. This narrative review focuses on β3 adrenergic receptors as key mediators of browning and thermogenic energy expenditure. We review preclinical and clinical data, address pharmacokinetic and delivery challenges, and assess the translational potential of targeting thermogenesis in the management of obesity. Future directions are proposed to guide the development of safe and effective therapies that utilize this underexplored pharmacologic pathway. Full article

Telerehabilitation is an effective, accessible addition or alternative to conventional rehabilitation for fracture management, especially in older adults after hip fractures, leveraging video visits, mHealth apps, virtual reality (VR), and wearable sensors to deliver exercise, education, and monitoring at home with high satisfaction and adherence. Across non-surgical and surgical contexts, telemedicine shows feasibility and cost benefits, with mixed superiority but consistent non-inferiority for functional outcomes versus in-person care. In hip fracture populations, randomized and non-randomized studies indicate improvements in functional independence measure (FIM), Timed Up and Go test (TUG), Activities of Daily Living/Instrumental Activities of Daily Living (ADLs/IADLs), and quality of life, with some evidence for reduced anxiety and depression, while effects on mobility, pain, and adverse events remain uncertain overall. In patients with upper-limb fractures, telerehabilitation appears to improve function and pain, though strength gains may lag compared with in-person therapy in some trials; adjuncts like motor imagery and virtual reality may enhance outcomes and motivation. Application is facilitated by user-friendly platforms, caregiver involvement, and simple modalities such as structured phone follow-up. Limitations include small samples, heterogeneous protocols, scarce long-term data, and a predominance of non-inferiority or complementary designs, warranting larger, definitive trials. This technology can lead to improved patient management at home, effortlessly verifying treatment compliance, efficacy, and safety, while simultaneously reducing the need for hospitalization, promoting a more peaceful recovery. Here, we have undertaken a narrative review of the medical–scientific literature in this field. Full article

Modern lifestyle factors—such as dietary changes, reduced microbial exposure, and genetic susceptibility—profoundly influence the composition and function of the commensal microbiota. Additionally, dysregulation of the gut microbiota has been linked to impaired immune responses and an increased prevalence of skin disorders, including allergies and inflammatory conditions, thereby underscoring the importance of the gut–skin axis. Chronic gastrointestinal and dermatological manifestations frequently lead to excessive antimicrobial use, which in turn fosters the selection and colonization of multidrug-resistant organisms, most notably methicillin-resistant Staphylococcus pseudintermedius (MRSP) in companion animals. Furthermore, the growing threat of antimicrobial resistance (AMR) to both human and animal health reinforces the urgent need for alternative strategies like modulating the gut microbiota, which also contributes to the prevention and management of skin conditions. Against this backdrop, the present review aims to evaluate microbiota modulation as an alternative and complementary approach to antimicrobial therapy, focusing on its ability to restore microbial balance, strengthen epithelial barrier integrity, and improve overall health outcomes in dogs affected by atopic dermatitis (cAD). Promising interventions—including probiotics, prebiotics, postbiotics, and fecal microbiota transplantation—are highlighted for their potential role in mitigating AMR and warrant further investigation as sustainable therapeutic strategies. Full article

Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), remains one of the most devastating infectious diseases worldwide, with rising multidrug resistance limiting the effectiveness of conventional treatments. Novel therapeutic approaches are urgently needed to complement or replace existing regimens. Among emerging candidates, antimicrobial peptides (AMPs) stand out as versatile molecules capable of exerting direct antimycobacterial effects while also modulating the host immune response. This review explores peptide-based strategies against TB, with a focus on four major axes of innovation. First, we examine host-directed pathways, including the vitamin D–cathelicidin axis and other immunomodulatory mechanisms and their regulatory role in the induction of endogenous AMPs such as cathelicidin LL-37, which contributes to host-directed defense. Second, we discuss peptide-based vaccines designed to elicit robust and durable protective immunity, representing a complementary alternative to classical vaccine approaches. Third, we highlight the synergistic potential of AMPs in combination with first-line and second-line anti-TB drugs, aiming to restore or enhance bactericidal activity against resistant strains. Finally, we analyze technological platforms, including nanocarriers and inhalable formulations, that enable targeted pulmonary delivery, improve peptide stability, and enhance bioavailability. By integrating molecular design, immune modulation, and advanced delivery systems, peptide-based strategies provide a multifaceted approach to overcoming the limitations of current TB therapy. Collectively, these advances position AMPs not only as promising standalone agents but also as key components in combination and host-directed therapies, with strong potential to reshape the future clinical management of tuberculosis. Full article

Background /Objectives: The rising prevalence of metabolic disorders, such as obesity, is linked to increased consumption of high-calorie foods and sedentary lifestyles. While conventional treatments rely on lifestyle modifications and pharmaceuticals, these often have limitations and adverse effects. As an alternative, natural compounds like β-caryophyllene (BCP), found in spices such as black pepper and cloves, have gained interest due to their anti-inflammatory and metabolic properties. This study investigated the effects of BCP on the gut–brain axis in obese C57BL/6J mice. Methods: Quantitative real-time PCR (RT-qPCR) was performed using a Rotor-GeneQ thermocycler (Qiagen). Relative gene expression levels were normalized to the reference gene’s transcript levels (2^−∆∆Ct method). Results: BCP was found to modulate key receptors, including FFAR3, LEPR, and GHSR, which are involved in appetite regulation and insulin sensitivity. Its action on the CNR2 (CB2 receptor) suggests additional benefits in energy balance and anorexigenic activity. Conclusions: These findings support BCP’s potential as a complementary therapy for obesity, though further studies are needed to confirm its efficacy in humans. Its safety profile and multifactorial effects make it a promising alternative to conventional treatments. Full article

This review summarizes recent advances in photoactive nanomaterials containing metals and their biomedical applications, particularly in cancer diagnosis and therapy. Conventional approaches such as chemotherapy and radiotherapy suffer from low specificity, systemic toxicity, and resistance, while light-based therapies, including photothermal therapy (PTT) and photodynamic therapy (PDT), offer minimally invasive and localized alternatives. Metal nanomaterials, especially gold and silver, exhibit unique localized surface plasmon resonance (LSPR) effects that enable efficient light-to-heat or light-to-reactive oxygen conversion, supporting precise tumor ablation, drug delivery, and imaging. We discuss strategies for structural design, surface functionalization, and encapsulation to enhance stability, targeting, and therapeutic efficiency. Emerging hybrid systems, such as carbon-based nanostructures and metal–organic frameworks, are also considered for their complementary properties. Computational modeling tools, including finite element and discrete dipole approximations, are highlighted for predicting nanomaterial performance and guiding rational design. Finally, we critically assess challenges such as toxicity, long-term biocompatibility, and clinical translation, and provide perspectives for future development. By integrating materials design, simulation, and preclinical findings, this review aims to inform the advancement of safer and more effective nanotechnology-based platforms for personalized cancer treatment and diagnosis. Full article