Search Results (4,845)

Background/Objectives: Acute pulmonary embolism (PE) and hospitalization-requiring community-acquired pneumonia (CAP) may present with overlapping clinical, laboratory, and radiological features. Soluble CD40 ligand (sCD40L) is a platelet-derived thrombo-inflammatory mediator that may be influenced by both thrombotic and inflammatory processes. This study retrospectively compared on-admission serum sCD40L concentrations between selected hospitalized patients with established acute PE and selected patients with hospitalization-requiring CAP. Methods: This single-center retrospective exploratory comparative biomarker study included 82 hospitalized adults: 48 with computed tomography pulmonary angiography (CTPA)-confirmed acute PE and 34 with hospitalization-requiring CAP defined using CURB-65-supported admission criteria. Stored admission serum samples were used for sCD40L measurement. Between-group comparison was the primary analysis; receiver operating characteristic (ROC) analysis was performed as a secondary exploratory description of the apparent within-sample discriminatory signal. Results: sCD40L was higher in acute PE than in hospitalization-requiring CAP (median 821.3 vs. 629.0 pg/mL; p < 0.001). ROC analysis demonstrated a strong exploratory within-sample discriminatory signal (AUC 0.951, 95% CI 0.905–0.997). After excluding five patients with recorded antiplatelet or rivaroxaban exposure, the apparent signal remained similar (AUC 0.945; bootstrap 95% CI 0.891–0.984), and sCD40L remained associated with PE in a Firth-penalized model adjusted for platelet count and COPD (OR 3.39 per 50 pg/mL, 95% CI 2.00–7.71; p < 0.001). Conclusions: In this retrospective selected two-group comparison, on-admission serum sCD40L concentrations were higher in established acute PE than in hospitalization-requiring CAP. ROC-derived estimates should be interpreted only as apparent within-sample discrimination and not as a replacement for D-dimer, clinical probability assessment, or imaging-based PE diagnosis. Prospective validation in unselected suspected-PE cohorts is required before any diagnostic or clinical use can be considered. Full article

Background: Polyendocrine Metabolic Ovarian Syndrome (PMOS) is recognized as the most prevalent endocrine disorder among women of reproductive age, with an estimated prevalence of approximately 18% according to current Rotterdam diagnostic criteria. Conditions such as dyslipidemia, insulin resistance, hyperandrogenism, central adiposity, and chronic inflammation are frequently observed in women diagnosed with PMOS. These conditions predispose such individuals to an increased risk of developing Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), which is the most prevalent chronic liver disease worldwide, affecting approximately 25% of the global population. PMOS and MASLD represent two interconnected metabolic disorders that share overlapping risk factors. Objective: The purpose of this narrative review is to investigate the underlying pathophysiological connections between PMOS and MASLD and to assess the efficacy of targeted nutritional interventions. Methods: An analysis of nearly 30 articles concerning nutritional strategies for PMOS and MASLD was conducted, including studies on dietary patterns, macronutrient-focused dietary strategies, and dietary supplement interventions. Results and Conclusions: The review concludes that a combined approach—comprising an anti-inflammatory dietary pattern, omega-3 supplementation, and myo-inositol—serves as a good evidence-based initial strategy for clinicians and dietitians managing women with coexisting PMOS and MASLD. It is noteworthy that most of the evidence for these recommendations comes from studies that focus solely on either PMOS or MASLD populations. Studies involving individuals with both conditions are currently lacking. Future research should prioritize long-term randomized controlled trials involving women from diverse backgrounds diagnosed with both PMOS and MASLD. These conditions, whether independently or concurrently, are imposing an increasing burden on women of reproductive age worldwide. As further research is conducted, nutritional interventions may serve as primary rather than supplementary therapeutic strategies for the management of PMOS and MASLD. Full article

The leaf miner Leucoptera coffeella Guérin-Méneville & Perrottet, 1842 (Lepidoptera: Lyonetiidae), is a major pest of coffee plants (Coffea spp.) worldwide. It is recognized for its widespread occurrence in coffee plantations and the quantitative and economic losses it causes to coffee production, especially in regions with higher temperatures and greater water deficits. We evaluated historical and current research approaches to leaf miner management, establishing current knowledge through a systematic review of research on biological control agents (BCAs), plant extracts and cover crops or intercropping for L. coffeella control, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted a systematic review of research findings from 1980 to 2025, developing a set of a priori criteria for subsequent replication of the review process. This review covers 130 publications, of which 28 met the inclusion criteria. The selected studies were conducted in five countries, although 75.00% of the studies were from Brazil. The BCAs accounted for 60.71%, followed by plant extracts (32.17%) and cover crops or intercropping (7.15%). Field studies were predominant, prioritizing diagnostic studies, surveys, studies on alternative control methods, and finally studies on BCAs, providing an effective solution. The limitations and prospects for their management were analyzed, and we highlighted recommendations that will improve future studies. Full article

Background/Objectives: Mouth breathing in childhood has been associated with alterations in craniofacial growth and the development of the maxillofacial complex. However, arguments persist regarding the scale of this relationship and its clinical consequences because of the diverse nature of the available evidence. This review aims to evaluate the evidence on the relationship between mouth breathing and maxillofacial development in children. Methods: A systematic narrative review with qualitative synthesis was conducted using databases such as PubMed/MEDLINE, SciELO, Cochrane Library, Google Scholar, and institutional academic repositories. Studies in English and Spanish that evaluated mouth breathing and its impact on craniofacial growth in children were included. The selection process involved reviewing titles, abstracts, and full texts against set inclusion and exclusion criteria. Results: The analyzed studies show a consistent association between mouth breathing and maxillofacial developmental abnormalities, including maxillary narrowing, high-arched palate, increased vertical growth pattern, and a higher prevalence of malocclusions. Likewise, considerable heterogeneity was observed in the diagnostic criteria used to define mouth breathing and to evaluate craniofacial development among the included studies. Furthermore, characteristic cephalometric changes were identified in patients with mouth breathing compared to nasal breathers. Conclusions: Evidence suggests a consistent association between mouth breathing and craniofacial alterations in children, including structural and dentofacial changes. Nonetheless, the variety in methods and the reliance on observational data restrict the ability to confirm definitive cause-and-effect links. Early identification and interdisciplinary management may help reduce the progression and severity of associated craniofacial alterations. Full article

Background and Objectives: Preoperative axillary ultrasound (PAUS) is a non-invasive method to assess nodal metastasis in breast cancer. Although sentinel lymph node biopsy (SLNB) is the gold standard, PAUS may help identify patients who can safely omit SLNB. This study evaluates PAUS’s diagnostic accuracy in predicting axillary nodal negativity (N0) in early-stage breast cancer. Methods: This retrospective study included 165 patients with confirmed early-stage breast cancer, excluding those with prior malignancies, neoadjuvant chemotherapy, or palpable axillary lymphadenopathy. PAUS classified nodes as positive or negative using stringent sonographic criteria, and findings were correlated with SLNB histopathology. Accuracy for detecting negative axillae, performance in patients meeting SOUND trial criteria, and overall diagnostic parameters were calculated. Results: Of the 165 patients, 86 were identified as node negative on PAUS, with a 90.69% accuracy for detecting negative nodes. For the full cohort, PAUS showed a sensitivity of 86.20%, specificity of 71.02%, positive predictive value of 61.72%, negative predictive value of 90.47%, and overall accuracy of 76.36% for identifying nodal status. Significant nodal features included shape, fatty hilum, and margins (p < 0.001), along with primary tumor size (p = 0.004). Histopathological findings such as extranodal extension (p < 0.001) and lymphovascular invasion (p < 0.001) were also significant. Conclusions: PAUS demonstrated high accuracy for identifying negative axillae and strong sensitivity and NPV, indicating it may identify node-negative patients who may forgo SLNB. These results support PAUS as a valuable tool for axillary surgery de-escalation, with further prospective validation recommended. Full article

Oropharyngeal dysphagia (OD) is traditionally managed as a mechanical swallowing impairment. This narrative review proposes a conceptual model that reframes chronic, severe OD as a high-risk clinical condition driving systemic malnutrition and progressive nutritional deterioration. We examine the epidemiological burden of OD-associated malnutrition across geriatric, neurological, and oncological populations, exploring how diagnostic heterogeneity influences reported prevalence ranges. The pathophysiological narrative synthesizes hypotheses regarding the potential disruption of the cephalic phase of digestion, the rheological limitations of texture-modified diets (TMDs), and the theoretical bioenergetic cost of impaired swallowing. Central to this review is the hypothetical sarcopenia–dysphagia vicious cycle, evaluating how molecular pathways—such as systemic inflammation, ubiquitin–proteasome-mediated proteolysis, and suppression of muscle protein synthesis—are inferred from broader cachexia models to affect oropharyngeal function. We discuss structured nutritional management strategies, including micro-volume fortification, application of the IDDSI framework with xanthan gum-based thickeners, and monitoring via GLIM criteria, bioelectrical impedance analysis, and routine laboratory parameters. Finally, we analyze the ethical challenges of transitioning to enteral nutrition and outline the translational limitations of emerging fields like 3D food printing. This model aims to encourage clinical focus on comprehensive nutritional restoration alongside airway safety. Full article

Background/Objectives: Canalicular adenoma (CaA) is a rare benign salivary gland neoplasm that primarily arises in minor salivary glands. Due to histological overlaps with other benign and malignant tumors, accurate diagnosis remains a challenge. This systematic review aims to comprehensively evaluate the clinical presentation, histopathological features, immunohistochemical (IHC) profiles, treatment modalities, and outcomes of CaA affecting the minor salivary glands. Methods: A systematic search of PubMed, Scopus, ScienceDirect, and Google Scholar was conducted for case reports and case series published in English between 2017 and 2025, following PRISMA guidelines. The review was registered in PROSPERO (CRD42023462417). Eligible studies described canalicular adenoma (CaA) of the minor salivary glands with clinical, histopathological, immunohistochemical, and treatment information. Risk of bias was assessed using the Joanna Briggs Institute tools, and data were synthesized descriptively due to heterogeneity in reporting. Results: Out of 1573 records identified, 23 studies met the inclusion criteria, comprising 44 cases. Canalicular adenoma most frequently affected the upper lip (63.6%), followed by the buccal mucosa and palate. Patients ranged from 29 to 84 years (mean 66 years), with a female predominance. Clinically, lesions presented as slow-growing, painless nodules measuring 2–40 mm. Histopathology consistently demonstrated branching canal-like structures lined by columnar or cuboidal epithelial cells, with immunohistochemistry showing positivity for AE1/AE3, CK7, S-100, and SOX10 and negativity for p63 and α-SMA. Surgical excision was the primary treatment, and recurrence was not reported in any of the 14 cases with documented post-treatment follow-up. Most studies showed moderate to high methodological quality. Conclusions: Canalicular adenoma is a rare benign neoplasm with a strong predilection for older women and for the upper lip. Accurate diagnosis requires correlation of clinical, histological, and immunohistochemical features due to its resemblance to other salivary gland tumors. Surgical management yields excellent outcomes, though multifocality may complicate interpretation of recurrence. Larger multi-institutional studies are needed to refine diagnostic criteria and clarify biological behavior. Full article

Background: Diabetic neuropathy (DN) is a common complication of diabetes mellitus that remains frequently undetected by conventional diagnostic methods. Sudomotor dysfunction, reflecting small-fiber impairment, has emerged as a potential early marker. SUDOSCAN, a rapid and non-invasive device measuring electrochemical skin conductance (ESC), has been proposed as a screening tool for early DN. The objective of this study was to systematically evaluate the diagnostic performance and clinical utility of SUDOSCAN in the early detection of DN. Methods: A systematic review was conducted in accordance with the PRISMA 2020 guidelines. Studies assessing SUDOSCAN-derived ESC in adults with diabetes were included. Data on diagnostic accuracy, correlations with established neuropathy measures, and clinical applicability were extracted. Where feasible, pooled sensitivity and specificity were estimated using a random-effects model. Results: Fifteen studies (n = 7343 participants) were included in the qualitative synthesis, with five of them contributing to the quantitative analysis. Reduced ESC values were consistently associated with DN, including early and asymptomatic cases. Pooled sensitivity and specificity for detecting DN were 0.81 (95% CI 0.73–0.87) and 0.73 (95% CI 0.57–0.85), respectively. ESC values correlated with neuropathy severity scores and autonomic dysfunction measures. However, substantial heterogeneity was observed due to variability in diagnostic criteria, ESC thresholds, and study populations. Conclusions: SUDOSCAN is a feasible, rapid, and non-invasive tool for detecting DN, particularly in the early-stage or small-fiber disease. It shows promise as a screening and adjunctive diagnostic modality, especially when combined with established clinical tools. Nevertheless, the lack of standardized thresholds limits its standalone use. Full article

Background and Objectives: Trauma-associated auditory dysfunction, encompassing tinnitus and hearing loss, represents a frequent yet underrecognized sequela of acoustic overexposure, blast injury, and head trauma. Despite increasing clinical awareness, the published literature exhibits substantial heterogeneity in reported prevalence estimates and recovery outcomes across different injury mechanisms. This narrative review aims to synthesize available evidence on the prevalence, clinical characteristics, recovery patterns, and prognostic factors of tinnitus and hearing loss following traumatic injury, with a particular focus on comparing outcomes across distinct trauma mechanisms and evaluating the impact of early intervention. Materials and Methods: A comprehensive literature search was conducted in PubMed, Embase, Scopus, and Web of Science for studies published between January 2010 and December 2025. The search strategy combined terms related to traumatic injury (e.g., “acoustic trauma,” “blast injury,” “traumatic brain injury,” “head trauma”) with terms related to auditory dysfunction (e.g., “tinnitus,” “hearing loss,” “auditory dysfunction”). Eligible studies included observational studies (cohort, cross-sectional, case–control) reporting original data on tinnitus and/or hearing loss prevalence, recovery outcomes, or prognostic factors in adult or mixed populations exposed to traumatic injury. A narrative synthesis was organized thematically around the key research questions. Results: The available evidence consistently indicates that tinnitus and hearing loss are frequent consequences of blast injury, acute acoustic trauma, and traumatic brain injury, although reported prevalence estimates vary considerably across studies due to differences in populations, injury mechanisms, and diagnostic criteria. Blast injury is associated with mixed hearing loss (conductive and sensorineural components), while acute acoustic trauma typically causes sensorineural hearing loss, often with a characteristic high-frequency notch. Traumatic brain injury can lead to central auditory processing deficits even when pure-tone thresholds are normal. Recovery is variable and often incomplete; tympanic membrane perforations frequently heal spontaneously, but sensorineural components often persist. Early treatment (within days to two weeks) is associated with better recovery outcomes. Conclusions: Trauma-associated tinnitus and hearing loss are highly prevalent and frequently result in persistent disability. The strong association between early treatment and improved recovery outcomes supports the implementation of prompt audiological evaluation and intervention following traumatic injury. These findings underscore the need for routine audiological screening in at-risk populations and for continued research into preventive strategies, standardised assessment protocols, and optimised treatment regimens. Full article

The rapid integration of artificial intelligence (AI) technologies into educational contexts has introduced innovative instructional approaches, particularly within Science, Technology, Engineering, and Mathematics (STEM) education. Although an increasing number of empirical studies have examined AI-supported instruction, existing findings remain heterogeneous, making it difficult to draw firm conclusions about its overall effectiveness. This study aims to systematically synthesize experimental and quasi-experimental research on AI-supported instructional interventions in STEM education, quantify their overall effects on student learning outcomes, and examine potential moderating factors, including educational level, STEM discipline, and intervention duration. A comprehensive systematic literature search was conducted across Web of Science, Scopus, ERIC, ScienceDirect, and Google Scholar, covering studies published between 2005 and 2025. A total of 35 studies meeting predefined inclusion criteria were included in the meta-analysis. Effect sizes were calculated using Hedges’ g, and a Random Effects Model (REM) was employed to account for heterogeneity among studies. Moderator analyses were conducted for educational level, STEM discipline, and intervention duration. Publication bias was assessed using multiple diagnostic methods. The meta-analysis revealed a statistically significant overall positive effect of AI-supported instruction on student learning outcomes in STEM education (g = 0.67, 95% CI [0.49, 0.85], p < 0.001). Moderator analyses indicated that AI interventions were most effective at the high school level. Although Science and Mathematics disciplines showed slightly higher effect sizes, the between-group difference was not statistically significant (Q = 4.85, df = 2, p = 0.088). Regarding intervention duration, the highest effect size was observed in interventions lasting more than one month and up to two months, though no consistent pattern of increasing effectiveness with longer durations was found. Publication bias analyses suggested minimal influence on the overall findings. AI-supported instructional interventions demonstrate a moderately to highly positive impact on student learning outcomes in STEM education. The effectiveness of these interventions varies according to educational level, disciplinary context, and intervention duration. These findings provide robust empirical evidence supporting the pedagogical value of AI in STEM education and offer guidance for educators and policymakers regarding effective implementation. Full article

This article examines the representation of mental illness, emergency treatment, and recovery, in Ned Vizzini’s 2006 Young Adult novel, It’s kind of a funny story. Existing criticism has predominantly pursued what we term “diagnostic realist” approaches, which evaluate fictional representations against clinical criteria. We both affirm what this work achieves and make the case for extending it. Drawing on work on disability representation in Young Adult Literature and perspectives from Mad Studies, we propose that a social model lens, which locates mental difference within social and structural contexts rather than within individual pathology, opens out further possibilities for understanding what this and related novels do. We then demonstrate how close attention to Vizzini’s artistry—including to his use of romance conventions, figurative language, intertextuality, and first-person focalisation—reveals a text that does not simply mirror mental illness realistically, but which actively dramatises how social environments, institutional structures, and modes of creative expression shape the experience of and recovery from mental ill health. Rather than displacing diagnostic approaches, we argue that these wider critical paradigms, inclusive of the social model and attendant attention to craft, can enhance understanding of the help such novels can provide for different kinds of readers. Full article

Background: Allergic contact dermatitis (ACD) is a common inflammatory skin disease and patch testing (PT) remains the gold standard for its diagnosis; however, PT interpretation is time-consuming and prone to inter-observer variability. Growing advances in digital imaging and artificial intelligence (AI) have encouraged the development of automated PT evaluation systems. This review aimed to summarize the use of deep learning networks (DNNs) and image-preprocessing techniques for PT classification. Methods: A literature review was conducted to identify original research published between 2020 and 2025 that applied deep learning algorithms to PT image analysis. Included studies were assessed with respect to model architecture, dataset characteristics, preprocessing strategies, and diagnostic performance. Results: Six original studies employing deep learning for PT image classification met the inclusion criteria. They employed a range of architectures, including YOLOv5x, EfficientNetB0, Xception, and custom CNN models. Reported diagnostic performance varied, with accuracy values ranging from 90% to 99.5%, F1-scores from 0.37 to 0.98, and AUROC values up to 0.94. Despite promising results, models remain unreliable for ICDRG grading, especially for severe reactions, and methodological variability in dataset composition, imaging conditions, preprocessing pipelines, and classification tasks limits comparability across studies. Conclusions: Deep learning shows promise for automated PT interpretation, but further standardized and multicenter studies with detailed preprocessing protocols and comprehensive ICDRG grading are required for clinical implementation. Full article

The maxillary second premolar, while frequently single rooted, exhibits a high degree of morphological diversity in its internal canal system. This unpredictability can lead to clinical oversights if a simple anatomy is assumed. The aim of this study was to review current knowledge regarding the number of roots and root canal configurations in permanent maxillary second premolars across different populations. A comprehensive literature search was conducted using the PubMed database for studies published between 2015 and December 2025, with the keyword “maxillary second premolar anatomy.” Out of 358 identified articles, 27 studies met the inclusion criteria and were analyzed. Only human-based studies on maxillary second premolars that used CBCT imaging and were written in English were included. The reviewed studies revealed that single-rooted maxillary second premolars are the most prevalent morphology, occurring in over 70% of cases, although significant variations exist among different ethnic groups. The presence of two roots was the second most common configuration, while three-rooted teeth were rare (<2%). Gender-related differences were also observed, with a higher prevalence of two-rooted teeth in males. Analysis of root canal configurations based on Vertucci’s classification demonstrated that all eight types can occur, with Type I being the most frequent in most populations with a result of more than 50% of all teeth. However, substantial variability was noted, with certain studies reporting a higher prevalence of more complex configurations such as Types IV and V. The findings emphasize the importance of thorough knowledge of root canal anatomy and its variations to ensure successful endodontic outcomes. Advanced imaging techniques, particularly cone beam computed tomography (CBCT), play a crucial role in improving diagnostic accuracy and proper endodontic treatment. Further research is needed to better understand anatomical differences across populations and enhance clinical decision-making in endodontics. Full article

Background: Sepsis remains a leading cause of morbidity, mortality, and healthcare expenditure worldwide. Despite international guidelines and diagnostic criteria, real-world variability in coding, treatment, and outcomes persist. This retrospective study analyzed 13,994 coded sepsis-related hospitalizations identified through administrative ICD-9-CM algorithms between 2016 and 2024 to evaluate the burden of sepsis, temporal trends, clinical outcomes, and healthcare costs within a regional health system. Methods: Hospitalization data across four local health authorities (ASL 201–204) over an 8-year period were analyzed. The coded sepsis cases were identified using validated ICD-9-CM-based algorithms and classified into four groups according to available microbiological coding: Gram-positive, Gram-negative, anaerobic and unspecified. Variables included patient demographics, length of stay, costs, outcomes (in-hospital and post-discharge mortality) and presence of septic shock. Comparative analyses were conducted using descriptive statistical methods and One-way ANOVA test and chi-squared tests were applied to evaluate the significance of differences. Multivariable logistic regression models were used to identify independent predictors of 6- and 12-month mortality. Results: The dataset included 13,994 coded sepsis-related hospitalizations, with the largest subgroup being ‘unspecified’ (48.0%). Among cases with specified etiology, coded anaerobic sepsis categories, though rare (0.7%), were associated with higher in-hospital mortality (45.5%) and economic burden (avg. € 8563). Mortality remained high at 6 and 12 months across all types, exceeding 50% post-discharge. Increasing age (OR ≈ 1.06 per year) and septic shock (OR ≈ 4.5–4.8) were the strongest independent predictors of mortality. Differences across microbiological groups should be interpreted cautiously given the high proportion of cases without organism-specific coding. Despite a modest reduction in mortality over time, sepsis was associated with persistently high 6- and 12-month mortality, highlighting a substantial long-term burden beyond the acute phase of illness. These findings suggest that sepsis-related hospitalizations are associated with substantial long-term mortality beyond the acute phase of illness. Discussion: These findings underscore the clinical and economic impact of sepsis in hospitalized patients, across microbiological coding categories. The high mortality rate at 6–12 months may support the need for further investigation into structured post-discharge follow-up strategies. Sepsis represents a substantial clinical and economic burden within the regional healthcare system, with persistently elevated short- and mid-term mortality. Incomplete organism-level documentation limits direct etiologic comparisons and highlights the need for improved integration between clinical, microbiological, and administrative data systems. Future research should integrate clinical variables and lab results to enable risk stratification and intervention planning. Full article

Background: Congenital anomalies of the kidney and urinary tract (CAKUT) comprise a heterogeneous spectrum of developmental disorders and represent the leading cause of chronic kidney disease and end-stage renal disease in the pediatric population. Although imaging remains the cornerstone of diagnosis, its limited ability to accurately assess disease severity and predict long-term outcomes has driven growing interest in urinary, serum, and tissue biomarkers as potential indicators of early renal injury. Objectives: To systematically summarize the current evidence on diagnostic and prognostic biomarkers in pediatric CAKUT, with particular focus on their potential clinical utility in early detection of renal injury and disease monitoring. Methods: A scoping review was conducted in accordance with PRISMA guidelines. PubMed, Embase, and Scopus were searched up to March 2026 using combinations of CAKUT-related terms and “biomarkers.” Studies involving human subjects with CAKUT that evaluated the diagnostic, prognostic, or therapeutic utility of biomarkers were included. Results: Out of 1130 records identified, 101 studies met the inclusion criteria. Urine was the most commonly analyzed biological sample. The principal biomarkers identified included NGAL, KIM-1, MCP-1, TGF-β1, CA19-9, β2-microglobulin, cystatin C, and microRNAs. Across various CAKUT subtypes—including posterior urethral valves, ureteropelvic junction obstruction, vesicoureteral reflux, and multicystic dysplastic kidney—these biomarkers showed significant associations with renal function, inflammatory activity, and fibrotic processes. Several biomarkers, particularly urinary NGAL, MCP-1, and CA19-9, demonstrated good diagnostic performance in differentiating obstructive from non-obstructive hydronephrosis and in predicting renal impairment. However, substantial heterogeneity in study design, along with the lack of standardized cutoff values, limits their translation into routine clinical practice. Conclusions: Current evidence underscores the potential of several biomarkers for the diagnosis and monitoring of CAKUT-related renal injury. Nevertheless, well-designed multicenter prospective studies are needed to validate their clinical utility and to support the integration of biomarker-based approaches with imaging in pediatric practice. Full article