Search Results (130)

Background/Objectives: Inflammatory bowel disease (IBD) is characterized by chronic relapsing and remitting inflammation of the gastrointestinal tract. Fecal microbiota transplantation (FMT) has emerged as an FDA-approved treatment for recurrent Clostridioides difficile infections (CDIs), with promising potential in patients with IBD. This manuscript aimed to provide a comprehensive and updated review of the available literature on fecal microbiota transplantation, its clinical use in IBD in general, as well as in patients with IBD and CDI. Methods: An extensive literature search was performed from October 2024 to March 2025. All publications available within PubMed, Medline, Embase, Google Scholar, and Cochrane databases were reviewed. All original articles, case reports, review articles, systematic reviews, and meta-analyses were included. Qualitative and quantitative data were both extracted. Discussion: Intestinal microbiota is an integral part of the human body, and dysbiosis (an imbalance in the gut’s microbial community) has been linked with several pathologies. Dysbiosis in IBD is marked by reduced beneficial bacteria and increased pro-inflammatory pathogens, contributing to mucosal damage and immune dysregulation. FMT has emerged as a solution to dysbiosis, with the first case recorded in 1917. FMT has been successful in treating patients with CDI. The diagnostic value of the gut microbiome is currently being explored as a possible therapeutic approach to IBD. Several studies have assessed FMT in patients with IBD and CDI with promising results in both ulcerative colitis (UC) and Crohn’s disease (CD) but varying efficacy based on administration routes, donor selection, and processing methods. In the context of recurrent CDI in patients with IBD, FMT demonstrates a high cure rate and potential benefit in concurrently improving IBD activity. However, risks such as IBD flare-ups post-FMT remain a concern. Conclusions: FMT holds promising potential in the management of CDI in patients with IBD. By restoring microbial diversity and correcting dysbiosis, FMT offers a novel, microbiota-targeted alternative to conventional therapies. While data support its efficacy in improving disease remission, variability in outcomes underscores the need for standardized protocols and additional large-scale, controlled studies. Continued research efforts into donor selection, treatment regimens, and long-term safety will be critical to optimizing FMT’s role in IBD and CDI care as well as improving patient outcomes. Full article

The gut microbiota has emerged as a key area of biomedical research due to its integral role in maintaining host health and its involvement in the pathogenesis of many systemic diseases. Growing evidence supports the notion that gut dysbiosis contributes significantly to diseases and their progression. An example would be inflammatory bowel disease (IBD), a group of conditions that cause inflammation and swelling of the digestive tract, with the principal types being ulcerative colitis (UC) and Crohn’s disease (CD). Another notable disease with significant association to gut dysbiosis would be colorectal cancer (CRC), a malignancy which typically begins as polyps in the colon or rectum, but has the potential to metastasise to other parts of the body, including the liver and lungs, among others. Concurrently, advances in nanomedicine, an evolving field that applies nanotechnology for disease prevention, diagnosis, and treatment, have opened new avenues for targeted and efficient therapeutic strategies. In this paper, we provide an overview of the gut microbiota and the implications of its dysregulation in human disease. We then review the emerging nanotechnology-based approaches for both therapeutic and diagnostic purposes, with a particular focus on their applications in IBD and CRC. Full article

Objectives: Unlike other body parts, unclarified lesions at the end of extremities have unique challenges due to their small size and interference. Traditional imaging methods struggle with low resolution. HFUS enhances resolution, offering a potential diagnostic value. Methods: From January 2019 to October 2023, the clinical and HFUS data of patients with unclarified lesions at the end of extremities were retrospectively analyzed. Independently, the diagnosis was made using two diagnostic modes (Mode A: only clinical information; Mode B: clinical and HFUS information). The diagnostic performance of the two modes was evaluated across different classification methods. Results: For all lesions, the correct rate of Mode B was higher than that of Mode A (52.8% vs. 18.4%, p < 0.001), and the indeterminate rate decreased by 43.0%. For benign lesions (51.0% vs. 18.2%), subungual lesions (40.8% vs. 21.1%), non-subungual lesions (55.6% vs. 17.8%), and common cases (60.9% vs. 20.3%), the diagnostic correct rate of Mode B was also higher than that of Mode A (all p < 0.05). However, there was no significant difference in rare lesions (9.8% vs. 4.9%) and malignant lesions (62.9% vs. 19.4%) between the two modes (both p > 0.05). Moreover, the indeterminate rate for all categories of lesions significantly diminished. Otherwise, Mode B demonstrated strong performance for malignant lesions (85.7% vs. 42.9%, p < 0.001). Conclusions: Adding HFUS can significantly improve the accuracy of diagnosing unclarified lesions at the end of extremities and reduce uncertainty, especially for benign and common lesions. HFUS has also demonstrated better performance in screening for malignant lesions. Full article

This study aimed to assess the incidence and distribution of dermatomycetes in patients at the Medical Military Academy (MMA) with suspected superficial skin infections over a five-year period (October 2017 to October 2022) and to analyze variations in fungal infections based on factors such as gender, body part, and time, particularly influenced by the COVID-19 pandemic. A total of 3993 samples were analyzed. Collected data were statistically analyzed with two tests. A total of 1048 samples were positive for fungal infections. Over the study period, Trichophyton mentagrophytes and Trichophyton rubrum were the predominant taxa, while Microsporum canis and Candida albicans were frequently observed. Statistical analysis indicated significant annual variations for T. mentagrophytes, T. rubrum, and M. canis, with monthly differences for T. mentagrophytes in June and August and M. canis in October and December. Gender-based analysis showed that T. rubrum and T. mentagrophytes were more common in males, while M. canis, C. albicans, Candida spp., and Geotrichum candidum were more prevalent in females. Analysis by body part revealed that Trichophyton rubrum and Microsporum canis showed significant differences between surface types. These findings can help improve diagnostic, therapeutic, and preventative strategies. Full article

Tumor diseases are characterized by high interindividual and intratumoral heterogeneity (ITH). The development and progression of neoplasms outline complex networks of extracellular and cellular signals that have yet to be fully elucidated. This narrative review provides a comprehensive overview of the literature related to the cellular and molecular mechanisms underlying the heterogeneity of the tumor mass. Furthermore, it examines the possible role of the tumor microenvironment in the development and support of the neoplasm, in order to highlight its potential in the construction of a diagnostic–therapeutic approach to precision medicine. Many authors underline the importance of the tumor microenvironment (TME) as it actively takes part in the growth of the neoplastic mass and in the formation of metastases and in the acquisition of resistance to anticancer drugs. In specific body districts, the ideal conditions occur for the TME establishment, particularly the inflammatory state, the recruitment of cell types, the release of specific cytokines and growth factors, hypoxic conditions. These components actively intervene by enabling tumor progression and construction of physical barriers shaped by the extracellular matrix that contribute to forming peripheral tolerance by intervention of myeloid precursors and the polarization of M2 macrophages. In recent years, ITH and the TME have assumed an important position in cancer research and pharmacology as they enable understanding the dense network of communication existing between the neoplasm and the surrounding environment, and to monitor and deepen the effects of drugs with a view to develop increasingly precise and effective therapies. In the last decade, knowledge of TME has been exploited to produce targeted molecular agents (inhibitory small molecules, monoclonal antibodies, gene therapy). Nonetheless, the bibliography shows the need to study ITH through new prognostic and predictive biomarkers (e.g., ctDNA and CTCs) and to increase its basic biology knowledge. Precision medicine is a new opportunity in the treatment of oncological diseases that is transforming the development of new drug approaches and their clinical use. Biology and biotechnologies are providing the bases for this revolution. Full article

Herein, we present scanning electron microscopy imagery of Demodex folliculorum on the eyelashes of a patient with a two-year history of dry, burning, and watery eyes. Demodex mites are part of the normal human skin flora, inhabiting hair follicles and sebaceous glands. However, in some individuals, they may contribute to ocular surface diseases, including blepharitis and dry eye disease. Symptoms often include itching, photophobia, and a foreign body sensation. The pathogenic role of Demodex is not fully understood but may involve microabrasions, gland obstruction, hypersensitivity reactions, and bacterial dysbiosis. The presence of collarettes at the base of eyelashes is a diagnostic hallmark. Although optimal treatment remains debated, options include topical tea tree oil, ivermectin, and a recently FDA-approved drug lotilaner. Our patient responded favorably to a two-month regimen of tea tree oil-based eyelid wipes. This case underscores the clinical relevance of Demodex infestation in chronic ocular discomfort and highlights the importance of diagnostics. Full article

Aiming at the problem that the existing auxiliary diagnosis methods for fractures are mostly limited to specific body parts and lack generality and robustness when applied to multi-part diagnoses, this study proposes a two-stage upper limb fracture auxiliary diagnosis method based on deep learning and develops a corresponding auxiliary diagnosis system. In the first stage, this study employs an improved ResNet-50 model combined with transfer learning and a Squeeze-and-Excitation (SE) attention mechanism for fracture image localization. In the second stage, an improved You Only Look Once (YOLO) model based on Scale Sequence Feature Fusion (SSFF) and Triple Feature Encoder (TFE) modules is used for fracture diagnoses in different body parts. Contrary to the traditional methods that are tailored to specific body parts, the integrated design approach presented in this paper is better suited to meeting the diagnostic needs of multiple body parts, demonstrating better generality and clinical application potential. Full article

As a significant zoonotic disease, rabies poses substantial economic challenges for the livestock sector, highlighting the need for effective wildlife monitoring as part of a One Health approach. This study documents the first case of paralytic rabies in a lowland tapir (Tapirus terrestris) at the Guaycolec Wildlife Station in Formosa, Argentina. The 12-year-old male tapir exhibited neurological symptoms, including limb paralysis and dysphagia, leading to its death. The rabies virus was confirmed through direct immunofluorescence, virus isolation in BHK-21 cells, and molecular diagnostics via real-time RT-PCR and conventional PCR. Antigenic variant 3, associated with Desmodus rotundus, was identified. Histopathological examination revealed non-suppurative encephalitis with lymphocytic perivascular cuffs, neuronal vacuolization, and acidophilic intracytoplasmic inclusion bodies in the grey matter. This case underscores the importance of expanded surveillance for non-traditional hosts, as it demonstrates the potential for rabies transmission in changing environments. The findings highlight the need to maintain epidemiological surveillance systems at the wildlife–livestock–human interface and to develop targeted control strategies to mitigate the spread of rabies, particularly in areas where vampire bat populations are subject to anthropogenic pressures. Comprehensive monitoring and early detection are essential for effective rabies management in both wildlife and urban contexts. Full article

Mitochondria are considered as “the plant of power” with cells for a long time. However, recent researches suggest that mitochondria also take part in innate immune response to a great extent. Remarkably, mtDNA was reported to have immunnostimulatory potential in 2004. Since then, there has been rapid growth in understanding the role of mtDNA in innate immune. The mtDNA is released into cytosol, extracellular environment, or circulating blood through BAK/BAX pore, mPTP, and GSDMD pore upon mitochondrial damage, where it is recognized by PRRs including TLR9, cGAS, and NLRP3, thereby triggering innate immune response. On the other hand, regular exercise has been recognized as an effective intervention strategy for innate immune response. Some studies show that chronic moderate-intensity endurance exercise, resistance training, HIIT, and moderate-intensity acute exercise enhance mitochondrial function by promoting mtDNA transcription and replication, thus blunting the abnormal release of mtDNA and excessive innate immune response. On the contrary, high-intensity acute exercise elicits the opposite effect. Nevertheless, only a very small body of research by far has been performed to illustrate the impact of exercise on mtDNA-driven innate immune response, and an overall review is lacking. In light of these, we summarize the current knowledge on the mechanism mediating the release of mtDNA, the role of mtDNA in innate immune response and the influence of exercise on mtDNA leakage, hoping to pave the way to investigate new diagnostic and therapeutic approaches for immunopathies. Full article

Introduction: Basal cell carcinoma (BCC) is the most frequently diagnosed skin cancer globally. Despite the well-established dermoscopic features of BCC, overlapping characteristics with other benign and malignant skin conditions cause challenges in differential diagnosis. Part III of this review highlights the role of dermoscopy in differential diagnosis, treatment planning, therapy monitoring and the integration of novel technologies including ultraviolet-induced fluorescence dermoscopy (UVFD) and optical super-high magnification dermoscopy (OSHMD). Methods: A search of the PubMed database was conducted for studies reporting on advances in the dermoscopic assessment of BCC, including differential diagnosis, treatment, monitoring and novel diagnostic technologies. Results: Even entities with well-defined dermoscopic features distinguishing them from BCC can sometimes mimic BCC. Additionally, rare lesions such as neurothekeoma, reticulohistiocytoma, solitary circumscribed neuroma, dermal leiomyosarcoma and various adnexal tumors often remain dermoscopically indistinguishable from BCC, which underscores the importance of histopathology as the diagnostic gold standard. Dermoscopy aids in delineating the tumor margins, optimizing Mohs micrographic surgery (MMS) and traditional excision. It may also help to monitor therapeutic effects by detecting the disappearance of BCC patterns, the presence of residual tumor or recurrences. Dermoscopy may aid in the prediction of therapeutic responses to imiquimod, photodynamic therapy or vismodegib. UVFD and OSHMD appear to be valuable complementary diagnostic techniques for detecting BCC. UVFD seems to be particularly valuable for the detection of small tumors (<5 mm), facial lesions and nodular or non-pigmented BCC subtypes, while OSHMD is useful for the assessment of superficial and non-pigmented BCCs. Three-dimensional total-body photography enhances diagnostic precision but, so far, only when used in combination with traditional dermoscopy. Conclusions: Dermoscopy is valuable for margin delineation, therapy monitoring and differential diagnosis but can be inconclusive, which highlights the role of histopathology as the gold standard. Modifications in dermoscopy technique may further enhance its accuracy. Full article

Corpectomy is the surgical procedure of resecting a vertebral body or a part of it in order to decompress neural structures. Corpectomy is performed in patients with degenerative disease or cancer and following injury to the spine. We present a case of multilevel corpectomy in a female patient with massive degenerative disease associated with rheumatoid arthritis, combined with cervical myelopathy and osteoporosis. We present the case of a female patient who underwent C4-C5-C6 corpectomy and spinal stabilisation with a Cervical 3D Expandable cage and a cervical plate attached to the C3-C7 bodies. The rheumatoid arthritis caused degenerative changes, which, combined with the impact of environmental conditions and the patient’s postural defects, led to a pathological profile of the spine along the vertical and transverse axis, manifesting clinically as a cervical myelopathy with its characteristic neurological symptoms. Pre-operative imaging studies revealed a critical stenosis of the spinal canal. This report showcases an effective surgical technique for severe degenerative disease bearing an increased risk of tetraplegia that could be brought on by even a minor injury to the cervical spine in the presence of this kind of pathology. Multilevel cervical corpectomy can be an effective method for treating spinal canal stenosis to prevent the onset of neurological deficits. This procedure requires careful diagnostic work-up, surgical planning and an interdisciplinary approach, especially in patients with co-morbidities. Full article

Background: Frontal fibrosing alopecia (FFA) is a primary cicatricial alopecia, initially described in postmenopausal women but increasingly reported in men. The male form remains under-recognized, often misdiagnosed as androgenetic alopecia (AGA) or alopecia areata (AA), particularly in the beard. Objective: This review aims to summarize the current literature on the epidemiology, clinical presentation, etiopathogenesis, diagnosis, and treatment of FFA in men. Epidemiology and Clinical Features: FFA in men typically presents at a younger age compared to women. Key features include frontal and temporal hairline recession, early involvement of the beard and sideburns, and a high prevalence of eyebrow alopecia (43–94.9%). Facial papules and body hair loss are more common in men than women. Occipital involvement varies widely across studies (8–45%). Clinical features like beard alopecia, often presenting as plaque or diffuse patterns, are highly suggestive of FFA in men but are not part of current diagnostic criteria. Etiopathogenesis: FFA is postulated to have an autoimmune basis influenced by genetic, hormonal, and environmental factors. Genetic studies have identified associations with HLA-B*07:02 and CYP1B1 loci. Environmental triggers include prolonged use of facial sunscreens and moisturizers, as demonstrated in case-control studies and meta-analyses. Diagnosis: Diagnosis is predominantly clinical, supported by trichoscopy and biopsy when needed, particularly in cases overlapping with AGA or AA. Unique presentations, such as beard alopecia and the “watch sign”, highlight the importance of considering FFA in atypical male cases. Treatment: Current treatment protocols in men mirror those for women and focus on disease stabilization. Oral 5-ARi (dutasteride) combined with topical corticosteroids and calcineurin inhibitors form the first line. Additional treatments include intralesional corticosteroids, oral isotretinoin for facial papules, and minoxidil for associated AGA. Surgical hair transplantation remains controversial, requiring disease control and careful patient counselling. Conclusions: FFA in men presents with distinct clinical features and challenges in diagnosis, often overlapping with other alopecia. Further studies are needed to validate diagnostic criteria and evaluate treatment efficacy in this underrepresented population. Full article

Introduction: The significant impact of nonalcoholic fatty liver disease (NAFLD) on public health, combined with the limitations of current diagnostic approaches, demands a more comprehensive and accurate method to identify NAFLD cases in large general populations. Methods: In this cross-sectional study, we recruited 3733 individuals (average age 51.8 years) who underwent health check-ups between October 2015 and October 2016. NAFLD was diagnosed using ultrasound; 114 serum metabolites were measured using gas chromatography–mass spectrometry. We adopted the least absolute shrinkage and selection operator (LASSO) method to build a metabolomic-based diagnostic model. Results: NAFLD was diagnosed in 826 participants. While each metabolite exhibited a limited diagnostic ability for NAFLD when used individually, compared with BMI, the model constructed using the LASSO demonstrated adequate diagnostic power (area under the curve [AUC] 0.866, 95% confidence interval 0.847–0.885 in test set) and even for lean (BMI < 23) populations (AUC for LASSO 0.828, for BMI 0.78). Moreover, the LASSO model-derived ‘pre-NAFLD’ condition showed a potential association with insulin resistance and elevated triglycerides. Conclusions: Our metabolomic-based approach provides a comprehensive evaluation of NAFLD or ‘pre-NAFLD’, both considered parts of a hypothetical ‘NAFLD spectrum’, independent of body type. Metabolomics could offer additional diagnostic benefits and potentially expand the disease concept. Full article

Deep neck infection is a pathology at the border of two specialties, otorhinolaryngology and maxillofacial surgery, and represents a medico-surgical emergency. In terms of its evolution, it can extend to the level of the thorax and result in mediastinitis, with difficult evolution and poor prognosis. The aims of this scoping review are to present the etiology, bacteriology, clinical manifestations, and diagnostics, as well as treatment, in light of the research published in the last 5 years on deep neck infection associated with descending necrotizing mediastinitis. The most common primary sources of deep neck infection are odontogenic and tonsillar. The other sources that are involved in deep neck infection are salivary glands, foreign bodies, malignancies, and iatrogenic causes after endoscopic maneuvers. The bacteriologic aspect is polymorphic, including both aerobic and anaerobic species. Complications that may appear include jugular vein thrombosis, airway obstruction, acute respiratory distress syndrome, sepsis, and disseminated intravascular coagulation. Timely diagnosis is important for ensuring the positive evolution of a deep neck infection. A CT scan is important for characterizing the nature of a deep neck lesion and identifying the spaces involved, and this method represents the gold standard for diagnosis of these lesions. Following the establishment of a definitive diagnosis, antibiotic therapy is initiated empirically, and is modified according to bacteriological exam results. The administration of antibiotics is an essential part of the treatment strategy for patients with a deep neck infection. Based on CT results, different surgical methods are applied under general anesthesia. The surgical strategy involves opening and draining the cervical spaces and debriding the necrotic tissue. In the cases of odontogenic causes, drainage and extraction of the infected teeth are performed. It is especially important to follow up on the dynamic progression of the patient. In the management of a deep neck infection associated with descending necrotizing mediastinitis, a multidisciplinary team is necessary. Full article

Background/Objectives: Biomaterials are an essential part of healthcare for both diagnostic and therapeutic procedures. Although some biomaterials possess antimicrobial properties, introducing biomaterial into the body may lead to infections due to bacterial adhesion on their surfaces and still poses a major clinical problem. Peptides derived from the human cartilage-specific C-type lectin domain family 3 member A (CLEC3A) show a potent antimicrobial effect. In addition, coating titanium, a commonly used prosthetic material, with the CLEC3A-derived AMPs HT-47 and WRK-30 greatly reduces the number of adherent bacteria in vitro. The aim of this study was to evaluate the effectiveness of CLEC3A-derived peptides HT-47 and WRK-30 in reducing bacterial adhesion and mitigating infection in vivo in a murine biomaterial-associated infection model. Methods: To do so, an in vivo mouse infection model was used, where titanium plates—either uncoated or coated with chimeric CLEC3A-derived peptides TiBP-HT-47 and TiBP-WRK-30—were implanted subcutaneously into mice. This was followed by the introduction of Staphylococcus aureus bacterial cultures to induce a biomaterial-associated infection. After 24 h, the titanium plates, surrounding tissue, and mice blood samples were investigated. Results: CLEC3A-coated titanium plates lead to a significantly lower bacterial count than uncoated ones. Additionally, they prevent the infection from spreading to the surrounding tissue. Moreover, mice with CLEC3A-coated implants display lower IL-6 serum levels and therefore decreased systemic inflammation. Conclusions: In conclusion, in this biomaterial-associated infection mouse-model, CLEC3A-derived peptides show in vivo antimicrobial activity by reducing bacterial burden on biomaterial and wound tissue and decreasing systemic inflammation, making them promising candidates for clinical applications. Full article