Search Results (371)

Background/Objectives: Pertussis has resurged worldwide despite long-standing vaccination programs. Whole-cell (wP) and acellular (aP) pertussis vaccines differ in immunobiology, durability, reactogenicity, and programmatic use. Poland is the only European Union/European Economic Area (EU/EEA) country that routinely primes infants with wP while using aP products for boosters, pregnancy, and selected indications, providing an informative programmatic context. This review compares both platforms across biological, clinical, safety, epidemiological, and supply domains. Methods: We conducted a narrative review of PubMed/MEDLINE literature and documents from the World Health Organization, European Centre for Disease Prevention and Control, national public health institutes, and regulatory authorities through July 2026. No protocol was registered and no quantitative synthesis was performed. Results: wP priming induces a persistent T-helper 1/T-helper 17-oriented response and an immunoglobulin G1-dominant profile, whereas aP vaccination produces higher, higher-avidity antibody concentrations, an increasing immunoglobulin G4 fraction, and substantially lower reactogenicity. Historical trials demonstrated marked product-level heterogeneity: efficacy ranged from 36–48% for poorly performing wP vaccines to 84–85% for multicomponent aP vaccines, while one United Kingdom wP product performed comparably to a five-component aP vaccine. Protection after aP schedules wanes within several years, no validated correlate of protection exists, and neither intramuscular platform reliably prevents colonization or transmission. In 2024, eight aP-using EU/EEA countries had higher pertussis notification rates than Poland despite stable Polish infant coverage. Conclusions: Neither platform is uniformly superior across products, schedules, and clinically relevant outcomes. Program performance depends primarily on timely infant vaccination, maternal vaccination, appropriate boosters, product-specific effectiveness evidence, and secure vaccine supply. Full article

Invasive candidiasis (IC) causes substantial mortality in critically ill children, yet pediatric data from Southeast Asia remain limited. We retrospectively studied 117 children aged ≤ 18 years with proven IC at a Thai tertiary center (2009–2023). Thirty-day mortality was 25.6%, rising to 47.1% in neonates; death occurred a median of 5.5 days after diagnosis. Firth penalized logistic regression identified septic shock (aOR, 4.89; 95% CI, 1.77–14.88) and thrombocytopenia (aOR, 3.74; 95% CI, 1.17–15.35) as independent mortality predictors, with septic shock remaining significant across all analytical frameworks, including Fine–Gray competing-risks analysis. Apparent mortality associated with absence of antifungal therapy reflected reverse causation: in all six untreated children who died, Candida was reported only 2–7 days after death. Candida albicans (43.6%), C. tropicalis (30.8%), and C. parapsilosis (24.8%) predominated; C. glabrata was absent. Non-albicans Candida was already common at the outset and showed no statistically detectable increase over 15 years. Among 45 consecutive pediatric bloodstream isolates (2021–2026), amphotericin B and echinocandins largely retained activity, whereas reduced azole susceptibility was concentrated in C. tropicalis (47.8% fluconazole-susceptible; 26.1% posaconazole wild-type). The reduced azole susceptibility of local C. tropicalis isolates argues for periodic reassessment of institutional susceptibility data rather than reliance on historical or external epidemiology; in comparable settings, an echinocandin or amphotericin B is a more reliable empiric choice than an azole, pending species identification and susceptibility results. Full article

Background: Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract disease and hospitalization in early infancy. The availability of maternal RSVpreF vaccination and long-acting infant monoclonal antibodies has created two effective but operationally distinct pathways for passive protection. Methods: This WAidid consensus document focuses on maternal RSV immunization within an integrated early infancy prevention strategy. A multidisciplinary Consensus Development Group reviewed evidence on infant RSV burden and seasonality, maternal vaccine efficacy and effectiveness, transplacental antibody transfer, long-acting monoclonal antibodies, implementation, equity, and economic considerations. Recommendations were developed using a modified Delphi process with a prespecified consensus threshold of at least 75% agreement. Results: Maternal vaccination can provide protection from birth when administered sufficiently before delivery, whereas direct infant monoclonal antibody prophylaxis provides rapid protection independent of maternal immune response and placental transfer. The relative value of the two approaches depends on gestational age, vaccination-to-delivery interval, infant risk, birth timing, local RSV circulation, antenatal care access, product availability, and cost. Post-pandemic disruption of RSV seasonality increases the importance of flexible strategies that protect infants born outside historically defined seasonal windows. Direct head-to-head evidence remains limited; therefore, policy decisions should integrate trial efficacy, emerging real-world effectiveness, implementation feasibility, and local epidemiology rather than assume universal superiority of one strategy. Conclusions: Maternal vaccination and infant monoclonal antibodies should be positioned within a coordinated prevention pathway. Maternal vaccination may serve as the principal strategy for appropriately timed pregnancies with reliable antenatal access, while infant monoclonal antibodies are particularly important when maternal vaccination is absent, too close to delivery, or potentially ineffective, or when the infant is preterm or otherwise at increased risk. Surveillance and locally adapted implementation are essential to maintain protection as RSV epidemiology evolves. Full article

Background/Objectives: Oral diseases are common, largely preventable and closely associated with social determinants, noncommunicable diseases and quality of life. Greece has historically had a high dentist-to-population ratio; however, oral health care remains highly dependent on private provision and out-of-pocket payment. This structured evidence synthesis and health-system mapping aims to summarize the current situation of oral health care in Greece, focusing on access, financing, workforce capacity, epidemiology, prevention, and quality measurement. Methods: A structured evidence synthesis and health-system mapping were conducted using publicly available and verifiable sources, including World Health Organization documents, OECD/European Observatory country health profiles, Eurostat data, official Greek government information, and peer-reviewed studies identified through PubMed, Google Scholar, publisher records, and reference-list searching. The final synthesis included 29 sources: 15 peer-reviewed articles and 14 official or institutional documents/data sources. A formal systematic review, with or without meta-analysis, was not methodologically feasible because the research question was not based on a single intervention, exposure, comparator, or outcome, and because key evidence on oral health-system organization, financing, and governance is contained in heterogeneous policy documents, administrative sources, official reports, and country profiles that are not consistently indexed in bibliographic databases. Evidence was organized across predefined health-system domains: governance, service delivery, financing, workforce, epidemiology, equity, information systems, and quality measurement. Results: Greece combines high dentist density with limited public dental coverage and major financial barriers. Current EOPYY rules list age-specific preventive and treatment benefits, and Dentist Pass provided a preventive dental-care voucher for children; however, no ring-fenced national dental-treatment allocation or nationwide uptake estimate was identified. Most routine adult dental care remains privately financed. Recent Eurostat data indicate that Greece has the highest reported unmet dental care needs in the European Union. Comparative WHO country-profile indicators suggest that Greece’s high dentist density does not, by itself, correspond to lower unmet dental care needs or stronger publicly reported coverage of routine and preventive oral health care. Epidemiological studies show persistent caries, periodontal disease and tooth loss, particularly among children, older adults and socioeconomically disadvantaged groups. Major system-level gaps include limited financial protection, weak integration with primary care, insufficient standardized referral pathways and limited routine measurement of oral health quality and outcomes. Conclusions: The findings suggest that strengthening oral health care in Greece would require a shift from fragmented, curative and privately financed care toward prevention-oriented, publicly accountable and measurable services integrated with universal health coverage and national quality-of-care reforms. Full article

Background: Heritable thoracic aortic disease (HTAD) accounts for approximately 20–25% of thoracic aortic aneurysm and dissection (TAAD) cases and is a major cause of premature death in young adults. Methods: This is a narrative, non-systematic review. We performed a selective synthesis of clinical practice guidelines (ACC/AHA 2022, EACTS/STS 2024), the revised Ghent nosology, large multicenter cohort studies (Montalcino Aortic Consortium), randomized pharmacotherapy trials, and molecular mechanism data published between 2010 and 2025; quantitative figures are reported as published in individual primary sources and were not pooled or re-analyzed. Results: The advent of next-generation sequencing (NGS) has driven a paradigm shift in HTAD management, from risk assessment based purely on phenotype (aortic diameter) to risk stratification based on genotype (molecular mutation). The 2022 ACC/AHA guideline identifies eleven genes with confirmed high-penetrance risk for HTAD; these, together with the established Loeys–Dietz gene TGFB3 (recognized through gene–disease validity assessment rather than the ACC/AHA list), can be grouped into three pathogenic mechanisms: extracellular matrix dysregulation, TGF-β signaling dysregulation, and vascular smooth muscle contractile dysfunction. Gene–disease association should be distinguished from guideline-defined classification and regarded as evolving, since additional candidate genes such as LTBP3 are already emerging in gene-negative families. Multigene panel testing identifies a pathogenic or likely pathogenic variant in roughly 8% of patients referred for suspected HTAD, a yield that rises substantially when applied to syndromic or strongly familial presentations. Prophylactic surgical thresholds are individualized by gene and are generally lower (around 4.0 cm) for high-risk TGFBR1/TGFBR2 and PRKG1 variants and higher (around 5.0 cm) for FBN1 and TGFB3, in contrast with the uniform 5.5 cm threshold historically applied to all patients. Randomized trials over the past decade—including the AIMS irbesartan trial, the Marfan Treatment Trialists’ individual patient data meta-analysis, and the celiprolol and irbesartan trials in vascular Ehlers–Danlos syndrome—now provide direct evidence that angiotensin receptor blockade slows the rate of aortic root dilation in Marfan syndrome, with more limited evidence in vascular Ehlers–Danlos syndrome and uncertain effects on dissection or mortality, while valve-sparing aortic root replacement provides durable long-term outcomes in reported single-center experience. These thresholds and pharmacotherapy recommendations rest predominantly on observational cohort, registry, and randomized trial data of varying maturity and should be interpreted as graded, evolving recommendations rather than fixed cut-points. Conclusions: This review synthesizes the molecular pathogenesis, diagnostic nosology, gene-specific epidemiologic and prognostic data, genetic testing yield, pharmacotherapy evidence, surgical outcomes, and updated prophylactic intervention algorithms per the ACC/AHA (2022) and EACTS/STS (2024) guidelines, providing a practical reference framework for individualizing surveillance and surgical decision-making in patients with HTAD. Full article

Caffeine is widely used in sport and exercise because of its established ergogenic effects, yet problematic use, dependence, and withdrawal in athletic populations remain poorly characterized. This structured narrative review used a systematic database search and prespecified selection process to identify studies directly addressing problematic caffeine use, dependence, use disorder, withdrawal, tolerance, habituation, or misuse in sport- and exercise-related populations. PubMed, Web of Science Core Collection, and Scopus were searched from inception to 15 June 2026. Four studies met the eligibility criteria: one cross-sectional study of caffeine dependence in university sport students, two experimental withdrawal studies, and one historical analysis of caffeine use and misuse in competitive cyclists. The evidence suggests that questionnaire-assessed dependence-related features, anxiety, self-reported withdrawal symptoms, withdrawal status, habitual intake, and performance may be interconnected; however, the studies were heterogeneous and generally did not use diagnostic assessments of caffeine use disorder. Athlete-specific prevalence and risk factors therefore remain unknown. Current evidence is insufficient for firm clinical or epidemiological conclusions, but it identifies an important gap between widespread ergogenic caffeine use and limited research on loss of control, continued use despite harm, withdrawal-driven use, and functional impairment. Standardized, athlete-specific research is urgently needed. Full article

Spatio-temporal epidemic forecasting aims to predict future outbreak trajectories across interconnected regions from historical epidemiological observations and meteorological covariates. However, existing approaches often fail to preserve historically salient epidemic states or to fully exploit delayed and region-varying meteorological associations, leading to unstable temporal representations and insufficient meteorological-context-aware spatio-temporal context for prediction at later forecast horizons. In this paper, we propose CASRL, a Climate-Aware Self-Retrospective Representation Learning network for stable and meteorological-context-aware spatio-temporal epidemic forecasting. CASRL first employs a Self-Retrospective Epidemic Encoder (SREE) to retrospectively aggregate historically salient epidemic states through query-guided weighting and adaptive gating, thereby preserving informative historical epidemic states within the look-back window. It then introduces a Climate-Adaptive Graph Message Passing (CAGMP) module that breaks away from traditional passive feature concatenation. Instead, it constructs a separate meteorological-view predictive graph conditioned on the static spatial prior and adaptively fuses it with the incidence-associated topology to model complex cross-regional predictive associations. By integrating self-retrospective epidemic representations with meteorological-view spatio-temporal interactions, CASRL produces forecasts with improved predictive stability at later forecast horizons. Extensive experiments on two public influenza benchmarks show that CASRL is competitive at shorter forecast horizons and provides clearer advantages at later forecast horizons, particularly in phase-alignment-related evaluation and 15-week-ahead forecasting. Full article

Background: Canine otitis externa caused by Pseudomonas aeruginosa is frequently chronic and treatment refractory, yet integrated historical phenotype–genotype data remain limited. We characterized an archival Hungarian collection obtained in 2010 and 2017. Methods: Broth microdilution minimum inhibitory concentrations (MICs) were determined for 67 isolates against 13 antimicrobial agents and chlorhexidine, and 59 isolates had matched long-read whole-genome assemblies. Resistance-associated determinants were identified using the Comprehensive Antibiotic Resistance Database, and their predicted proximity to mobile genetic elements and plasmid-like contigs was evaluated. Results: Current canine Clinical and Laboratory Standards Institute breakpoints classified 59/67 isolates (88.1%) as enrofloxacin resistant and 43/67 (64.2%) as marbofloxacin resistant. European Committee on Antimicrobial Susceptibility Testing epidemiological cut-off values identified non-wild-type subsets for ciprofloxacin (7/67), tobramycin (4/67), imipenem (1/67), and piperacillin–tazobactam (51/67), whereas all isolates remained within the available wild-type distributions for ceftazidime, gentamicin, and amikacin. No continuous MIC distribution changed significantly between sampling years after false-discovery-rate correction, although categorical marbofloxacin resistance decreased from 87.5% in 2010 to 42.9% in 2017. Resistance-gene screening identified 64 unique determinants, including near-universal efflux-system components, PDC and OXA-50-like β-lactamases, APH(3′)-IIb, arnA, and basS. The fluoroquinolone-associated determinant crpP occurred in 37/59 genomes and was located on plasmid-predicted contigs in six isolates. No determinant–MIC association remained significant after correction for multiple testing. Conclusions: The discordance between conserved resistance-gene repertoires and heterogeneous MICs demonstrates that sequence-based detection alone is insufficient for therapeutic inference. Integrated phenotypic and genomic surveillance is therefore required to support evidence-based antimicrobial stewardship in canine pseudomonal otitis. Full article

Moderate wine consumption has historically been associated with a J-shaped relationship between dose and total mortality, driven primarily by cardiovascular protection, enhanced endothelial function, improved glucose metabolism, and anti-inflammatory and antioxidant effects attributable to both ethanol and grape-derived phenolic constituents. Yet in recent years, international alcohol guidelines have shifted markedly towards the assertion that ‘no safe level’ of alcohol exists. This transition has occurred despite the continued consistency of mechanistic, clinical, and epidemiological evidence demonstrating hormetic (biphasic) responses to wine and its constituents and despite methodological controversies over the mathematical models used in several recent national guideline revisions. This narrative review synthesises mechanistic evidence on hormesis and wine-specific biological effects—including polyphenols, resveratrol, nitric oxide signalling, platelet modulation, and endothelial benefits—with epidemiological data on J-shaped associations with cardiovascular disease, diabetes, and total mortality. It further examines key methodological changes in recent guidelines, particularly the adoption of the ‘Sheffield model’ and the exclusion of or reduced emphasis on cardioprotective outcomes. The review argues that these methodological decisions, rather than new scientific evidence, largely explain the departure from earlier guideline thresholds that allowed moderate wine consumption. Understanding wine’s biological specificity, the differential health implications of drinking patterns and contexts, and the limitations of model-driven policy changes is essential to develop coherent, evidence-informed public health recommendations. Full article

Foodborne illnesses caused by Salmonella Typhimurium remain a major public health concern worldwide. Although ST19 has historically been a dominant lineage within this serotype, ST213 has become increasingly prevalent in Mexico. The biological factors underlying this epidemiological shift remain incompletely understood. In this study, we compared virulence-associated gene repertoires and stress-related phenotypes in representative S. Typhimurium ST19 and ST213 strains with distinct virulotypes (VTs). Comparative genomic analysis identified 119 virulence-associated genes distributed across 26 VTs, with most genes broadly conserved between genotypes. Representative strains were evaluated under simulated gastrointestinal tract (GIT) stress conditions, in post-stress recovery assays, and in a Caenorhabditis elegans infection model. Under the experimental conditions evaluated, the representative ST213 strains SAL109 (VT1), SAL115 (VT1), and SAL016 (VT12) tended to show higher persistence under host-associated stress conditions and greater intestinal colonization capacity in C. elegans than the ST19 strain SAL004 (VT23). However, strains sharing the same VT did not necessarily exhibit similar phenotypes, indicating that virulence-associated gene repertoires alone do not fully explain stress tolerance or host colonization behavior. Overall, these findings highlight phenotypic variability among strains with similar virulence gene content and support the importance of integrating genomic and phenotypic approaches to better understand the biology of emerging S. Typhimurium lineages. Full article

Endemic channels are widely used in dengue surveillance to detect unusual increases in case counts. However, conventional approaches that rely on historical averages with fixed standard deviation (SD)-based multipliers may produce unstable thresholds and false alerts. This study compared a conventional SD-based endemic channel with a log-scale SD-based endemic channel incorporating an enhanced alert rule to identify the optimal approach for routine dengue surveillance in Malaysia. Weekly national dengue case data from 2014 to 2024 were analyzed. A rolling validation approach was used to evaluate outbreak detection performance from 2017 to 2023 using three-year historical baselines. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and the Youden Index were calculated and pooled across the validation years. The optimal multiplier was selected based on the highest pooled Youden Index using the rolling validation period (2017–2023). The selected approach was then applied independently to the 2024 surveillance data as an operational demonstration of its potential use in routine dengue surveillance. A total of 260 epidemiological weeks were analyzed, of which 42 (16.2%) were classified as outbreak weeks. The log-scale SD-based endemic channel incorporating an enhanced alert rule achieved the highest pooled Youden Index of 0.43 at the optimal multiplier of 0.50. At this multiplier, sensitivity was 0.60, specificity 0.82, positive predictive value 0.35, negative predictive value 0.93, and overall accuracy 0.79. Compared with the conventional SD-based endemic channel at its optimal multiplier (1.00), the proposed approach demonstrated improved sensitivity (0.60 vs. 0.56), specificity (0.82 vs. 0.70), positive predictive value (0.35 vs. 0.23), negative predictive value (0.93 vs. 0.91), accuracy (0.79 vs. 0.68), and Youden Index (0.43 vs. 0.26). The log-scale SD-based endemic channel incorporating an enhanced alert rule demonstrated superior overall outbreak detection performance and was selected as the optimal approach for routine dengue surveillance. Full article

Background/Objectives: Type 2 diabetes mellitus (T2DM) is a global epidemic strongly associated with an increased risk of heart failure, independent of coronary artery disease or hypertension. This condition, historically termed diabetic cardiomyopathy (DCM) and recently redefined as “diabetic myocardial disorder,” remains frequently underdiagnosed in its subclinical stages. The objective of this non-systematic review is to synthesize current evidence on the pathophysiological mechanisms, diagnostic advancements, and evolving therapeutic strategies for diabetic myocardial involvement. Methods: A comprehensive review of contemporary literature was conducted, focusing on recent consensus statements from the ESC and AHA, large-scale epidemiological data (IDF/WHO), and pivotal clinical trials (EMPA-REG, DAPA-HF, and LEADER). We analyzed the role of multimodal imaging—specifically speckle-tracking echocardiography (STE) and multiparametric cardiac magnetic resonance (CMR)—and circulating biomarkers in early phenotyping. Results: Pathophysiological drivers include lipotoxicity, oxidative stress, and AGE-mediated fibrosis. Advanced imaging techniques, such as global longitudinal strain (GLS) and CMR T1-mapping/ECV quantification, demonstrate superior sensitivity over LVEF in detecting early subendocardial dysfunction and diffuse fibrosis. Furthermore, NT-proBNP serves as a robust prognostic marker for the HFpEF-like trajectory typical of diabetes. Clinically, the therapeutic landscape has shifted with SGLT2 inhibitors and GLP-1 receptor agonists, which provide significant cardioprotection and reduction in heart failure hospitalizations through mechanisms beyond glycemic control. Conclusions: Diabetic myocardial disorder represents a complex continuum within the cardiometabolic spectrum. Early detection through multimodal imaging and biomarkers is essential for risk stratification. Integrating novel glucose-lowering therapies with proven cardiovascular benefits is now mandatory to alter the natural history of the disease and prevent progression to overt heart failure. Full article

GPIV (CD36) is a multifunctional membrane protein expressed on various cells, including platelets, where it plays a role in adhesion and activation through the interaction with its ligands, including collagen types I and III and thrombospondin 1. Inherited GPIV deficiency, historically recognized in anti-Naka alloimmunized East Asian donors, is considered asymptomatic and associated with normal platelet aggregation, although impaired adhesion under high-flow conditions has been reported. Here, we reconsider the molecular basis, epidemiology and functional consequences of GPIV deficiency and report four unrelated patients in whom heterozygous CD36 variants are associated with markedly reduced platelet GPIV expression and a clinically relevant mucocutaneous bleeding diathesis. Patients suffered lifelong bleeding symptoms despite normal light-transmission aggregometry and platelet granule content and release and displayed decreased GPIV expression. Three of them showed slightly decreased VWF. Platelet adhesion to Type I collagen was reduced at high shear. These cases suggest for the first time an association between CD36 gene variants and bleeding and underscore the importance of including GPIV in the diagnostic workup of inherited platelet disorders, particularly when conventional assays do not reveal abnormalities. Full article

Historically, mpox was thought to be a geographically constrained ‘disease of poverty,’ leading to decades of neglect by global health actors. Waning population immunity from the cessation of smallpox vaccination and prolonged scientific neglect created conditions that enabled the monkeypox virus (MPXV) to adapt cryptically. This ultimately contributed to the emergence of unprecedented global public health crises. This review aims to systematically trace the history, epidemiology, genomic evolution, and reservoir ecology of mpox in West Africa from 1970 to 2025. Following PRISMA guidelines, 110 articles met the inclusion criteria and were synthesized to map the virus’s trajectory. For nearly four decades, an “Era of Silence” (1970–2016) masked the silent enzootic circulation of MPXV within West African wildlife, primarily rodents and small mammals. This epidemiological quiescence ended with the 2017 re-emergence in Nigeria, which signaled a fundamental paradigm shift. The disease profile transitioned from sporadic, rural paediatric infections to sustained, urban and secondary transmission among young adult males. This shift was often associated with sexual networks, especially among men who have sex with men, and was characterized by novel clinical presentations, including genital and perianal lesions. Genomic analyses revealed that clade II diverged from clade I approximately 3500 years ago and is uniquely defined by the deletion of virulence factors, such as the complement-binding protein. Importantly, the clade IIb lineage, which triggered the 2022 global outbreak, exhibits accelerated microevolution consistent with APOBEC3-mediated hypermutation. This host-driven mutational signature provides genomic evidence supporting the hypothesis that clade IIb circulated cryptically within human-to-human transmission chains in West Africa as early as 2014. Ecologically, while no definitive reservoir has yet been identified, evidence suggests diverse rodents and an expanding host range. The transformation of mpox from a rare zoonosis to a global threat underscores the severe consequences of delayed intervention, demanding robust, integrated “One Health” surveillance. Full article

Background/Objectives: Rhegmatogenous retinal detachment (RRD) is a vision-threatening condition characterized by the separation of the neurosensory retina from the retinal pigment epithelium due to retinal breaks, leading to subretinal fluid accumulation. This narrative review aims to provide a comprehensive overview of the epidemiology, risk factors, and historical evolution of RRD from a global perspective, highlighting trends, regional variations, and key advancements to inform clinical practice and future research. Methods: A targeted literature search was conducted using databases such as PubMed and Scopus to identify studies published from 1970 to 2025 on RRD epidemiology, risk factors, incidence rates and temporal trends. The inclusion criteria focused on population-based studies, meta-analyses, and reviews. The findings were synthesized narratively, with quantitative estimates reported where available from the included studies and meta-analyses. Results: The global annual incidence of RRD is estimated at 12.17 per 100,000 people, with significant regional variations: it is the highest in Europe (14.52 per 100,000) and lower in the Americas (8.95 per 100,000). The incidence of rhegmatogenous retinal detachment has risen by 5.4 cases per 100,000 people per decade, with projections suggesting that it could double over the next 20 years. The key risk factors include myopia (3–39-fold increased risk depending on severity), age (peak in 60–70s), male sex, cataract surgery, and trauma. Conclusions: The RRD incidence is rising globally, driven by aging populations and increasing myopia prevalence, with myopia as the strongest potentially modifiable risk factor. Historical advancements underscore the importance of early detection and surgical intervention. Future efforts should focus on applying preventive strategies in high-risk groups and addressing regional disparities in access to care. Full article