Search Results (129)

Background: Fragility fractures of the pelvis (FFP) are increasingly encountered in older adults, yet early deterioration is difficult to anticipate because fracture instability interacts with frailty and systemic vulnerability. We developed and validated an admission-based multimodal framework to predict 90-day treatment failure (TF90) before definitive management. Methods: This multicentre retrospective prediction study included 1684 consecutive patients aged ≥65 years with FFP treated at five tertiary hospitals. TF90 was defined as persistent fracture-related pain or immobility, delayed conversion to operative stabilisation, secondary displacement, FFP-related unplanned readmission, revision or unplanned reoperation, or all-cause mortality within 90 days. Only predictors available within 24 h of admission and before the definitive treatment decision were eligible, including CT-defined fracture morphology, frailty, clinical characteristics and routine laboratory biomarkers; DXA and specialised bone metabolism measurements were evaluated separately in an extended model. Four prespecified models were developed in 985 patients, temporally validated in 520 patients and evaluated in a completely held-out Centre E internal–external validation cohort of 179 patients, with additional leave-one-centre-out internal–external cross-validation. Results: TF90 occurred in 307 patients (18.2%) and increased from 8.1% in FFP I to 37.1% in FFP IV. Higher risk was associated with advanced age, greater frailty, impaired prefracture mobility, bilateral posterior ring injury, greater displacement, systemic inflammation, hypoalbuminaemia and renal dysfunction. In temporal validation, AUROCs were 0.732 for the simple logistic model, 0.763 for the core logistic model, 0.759 for the core random forest and 0.755 for the extended random forest. Neither greater algorithmic complexity nor specialised skeletal measurements provided reproducible incremental value. A development-derived high-risk stratum had a TF90 incidence of 32.2% and contained 70.0% of all events. At the fixed threshold of 0.209, sensitivity was 71.3%, specificity 70.0% and negative predictive value 93.1%. Conclusions: Pretreatment integration of pelvic ring mechanics, frailty and routinely available systemic biomarkers enables clinically relevant enrichment of older patients at risk of TF90. The model is best positioned to support intensified surveillance and structured reassessment rather than determine operative treatment. Independent prospective external validation, recalibration and clinical impact evaluation are required before routine implementation. Full article

Background and Objectives: Facial nerve palsy (FNP) remains a clinically relevant complication after vestibular schwannoma (VS) resection. Recovery trajectories vary according to the severity of neural injury and early postoperative facial function. This study aimed to characterize the temporal pattern of facial nerve recovery during the first postoperative year and to explore factors associated with favorable long-term function. Materials and Methods: We retrospectively analyzed 51 adult patients who developed FNP after VS surgery between 2020 and 2023. Facial nerve function was assessed using the House–Brackmann (HB) grading system and the Sunnybrook Facial Grading System (SBFGS) at discharge and at 1, 3, 6, and 12 months postoperatively. Longitudinal changes were analyzed using non-parametric repeated-measures methods with effect-size estimation. Favorable 12-month facial nerve function was defined as HB grade I–II. Given the limited number of unfavorable outcomes, associations with 12-month recovery were explored using parsimonious Firth-penalized logistic regression models. Results: At discharge, 45.1% of patients had HB II, 29.4% HB III–IV, and 25.5% HB V–VI. Facial function improved significantly during follow-up. Median SBFGS total score increased from 58.0 at discharge to 99.0 at 12 months (Friedman χ² = 118.78, df = 4, p < 0.001; Kendall’s W = 0.58), while HB grade also improved significantly (χ² = 107.48, df = 4, p < 0.001; W = 0.53). At 12 months, 37/51 patients (72.5%) achieved HB I–II and none remained in the HB V–VI category. Synkinesis, defined as an SBFGS synkinesis subscore > 0, was observed in 10/51 patients (19.6%) at 6 months and 19/51 (37.3%) at 12 months. HB grade and SBFGS score at discharge were strongly inversely correlated (Spearman ρ = −0.943, p < 0.001) and were therefore evaluated in separate models. After adjustment for age and tumor size, each one-grade increase in discharge HB was associated with lower odds of favorable 12-month function (OR 0.30, 95% CI 0.11–0.58; p < 0.001), whereas each 10-point increase in discharge SBFGS was associated with higher odds of favorable function (OR 1.90, 95% CI 1.32–3.53; p < 0.001). Conclusions: Facial nerve function showed substantial longitudinal improvement during the first year after VS surgery. Early postoperative facial function was independently associated with 12-month outcome in exploratory penalized regression analyses. Recovery may continue over several months, supporting prolonged functional surveillance, while the independent contribution of rehabilitation and the effect of nerve grafting require evaluation in larger prospective cohorts. Full article

Chimeric antigen receptor T-cell therapy and bispecific T-cell engagers have transformed treatment of relapsed and refractory hematologic malignancies, achieving unprecedented response rates. However, their clinical adoption has revealed a complex spectrum of cardiovascular toxicities, differing in frequency and pattern between the two technologies. Manifestations range from common hemodynamic perturbations—hypotension and tachycardia—to severe events, including malignant arrhythmias, left ventricular dysfunction, myocardial infarction, and cardiogenic shock. These complications seem to have different pathophysiological pathways that are yet to be completely understood: on the one hand, they are frequently intertwined with cytokine release syndrome, the hallmark immune complication of T-cell-redirecting therapies, as seen with chimeric antigen receptor T-cell therapy; on the other, a substantial proportion of cardiovascular events—particularly with bispecific T-cell engagers—occur independently of cytokine release syndrome. Proposed cardiotoxic mechanisms include on-target, off-tumor antigen recognition and consequent damage; interleukin-6-driven systemic inflammation; and off-target, off-tumor antigen cross-reactivity. Effective management requires proactive baseline risk stratification, serial cardiac biomarker monitoring, and timely immunosuppressive intervention—primarily tocilizumab—to mitigate cytokine release syndrome-driven injury. Despite rapid clinical expansion, critical gaps remain: long-term cardiovascular outcomes are poorly characterized, validated surveillance protocols are lacking, and cardiovascular endpoints are rarely included in pivotal trials. This narrative review appraises the pathophysiology, clinical spectrum, and management of cardiovascular toxicities associated with these therapies, aiming to define this emerging cardio-oncology frontier, inform multidisciplinary care frameworks and propose a clinical management algorithm. Full article

Aortitis—inflammation of the aortic wall—presents at the interface of vasculitis, infection, structural aortic disease, and cardiovascular risk. It may occur in giant cell arteritis (GCA), Takayasu arteritis, immunoglobulin G4 (IgG4)-related disease, drug-induced injury, infection, or as an isolated finding after aortic surgery. Modern imaging detects aortic inflammation more frequently, but the main challenge is classification rather than detection: determining whether disease is infectious or immune-mediated, active or dominated by fixed structural damage, systemic or isolated, and whether the dominant threat is aneurysm, dissection, undertreated infection, or avoidable immunosuppression. This review considers aortitis as a high-risk vascular syndrome requiring aetiology-first classification rather than descriptive labelling. Before escalating immunosuppression, infection must be actively excluded and inflammatory activity distinguished from fixed vascular damage. Treatment should be individualised according to phenotype, age, vascular territory, comorbidity, and toxicity risk, with surveillance continuing even after symptoms and inflammatory markers improve. Optimal care depends on multidisciplinary assessment integrating rheumatology, infectious diseases, vascular surgery, radiology, and cardiology expertise. Progress will require standardised imaging definitions, registries linking inflammatory control with structural vascular outcomes, and validation of artificial intelligence (AI) tools before clinical adoption. Full article

Breast cancer is associated with systemic inflammation and increased cardiovascular risk, and anthracycline chemotherapy may contribute to persistent myocardial injury. This study aimed to evaluate acute changes in inflammatory cytokines and plasma redox status after the first anthracycline cycle and to assess long-term ventricular function after 10 years in women with breast cancer. We conducted a prospective study of 17 patients with breast cancer treated with anthracycline-based chemotherapy at Salvador Hospital, Santiago, Chile. Plasma cytokines were measured at baseline (day −7) and on day +3 after the first cycle using a MILLIPLEX Luminex^® assay. Echocardiographic assessment of left ventricular systolic and diastolic function, together with oxidative stress parameters, was performed at baseline and after 10 years of follow-up. Anthracycline exposure was associated with an acute increase in several cytokines related to inflammatory and vascular remodeling, including EGF, eotaxin, MCP-1, and VEGF. In addition, markers of redox imbalance suggested an acute pro-oxidant response after treatment. At long-term follow-up (10 years), left ventricular ejection fraction (LVEF) remained within the normal range in all patients. However, integrative echocardiographic assessment revealed impaired left ventricular relaxation, evidenced by significant reductions in the mitral inflow E/A ratio, and septal and lateral e′ velocities with respect to baseline, despite preserved estimated filling pressures. These alterations were accompanied by persistent oxidative stress, reflected by persistently elevated levels of lipid peroxidation markers, such as in vivo 8-isoprostanes. In this pilot cohort, anthracycline chemotherapy induced an early inflammatory and oxidative response that was not associated with overt long-term systolic dysfunction but was accompanied by persistent biochemical and diastolic alterations. These findings support the concept of a long-term subclinical cardiotoxic phenotype and highlight the potential value of combining echocardiographic assessment with circulating redox and inflammatory biomarkers to improve long-term cardiovascular surveillance in breast cancer survivors. Full article

Previous analyses of substance-involved craniofacial trauma have often combined alcohol and drug/medication involvement. We conducted a cross-sectional analysis comparing alcohol-only and drug/medication-only facial injury encounters in the public Consumer Product Safety Commission National Electronic Injury Surveillance System (NEISS), 2019–2023. Primary facial injuries (Body_Part = 76) were classified using the released Alcohol_Involved and Drug_Involved fields. Survey-weighted estimates and Taylor-linearized 95% confidence intervals incorporated the released PSU, stratum, and weight variables; design-based logistic regression evaluated code-4 hospitalization. Among 146,857 observed facial injury encounters, 4117 were alcohol-only and 2302 were drug/medication-only. Weighted annual alcohol-only proportions were stable (trend odds ratio [OR] per year, 0.99; 95% CI, 0.96–1.03; p = 0.716), whereas drug/medication-only proportions increased (OR, 1.15; 95% CI, 1.04–1.27; p = 0.009). Compared with alcohol-only encounters, drug/medication-only encounters involved older patients (weighted mean age, 63.1 vs. 47.6 years) and a lower weighted male proportion (55.6% vs. 67.5%). Weighted code-4 hospitalization was 23.1% versus 11.8%; the adjusted OR was 1.91 (95% CI, 1.45–2.53; p < 0.001). Adult-only and alternative-period sensitivity analyses supported the main conclusions. Separate classification of alcohol and drug/medication involvement revealed distinct demographic, temporal, and disposition patterns among NEISS-captured product-associated ED encounters. Full article

Background: Drug-induced liver injury (DILI) is a leading cause of acute liver failure worldwide, yet epidemiological data from Central Asia remain scarce. Infodemiology—the study of online health information-seeking behavior—offers a novel approach to population-level health surveillance. Objective: Our aim was to investigate online information-seeking behavior related to DILI, hepatotoxic medications, and dietary supplements among the population of Kazakhstan using Google Trends data over a five-year period. Methods: A quantitative, retrospective, observational infodemiology study was conducted using Google Trends data from Kazakhstan (May 2021–May 2026). A total of 21 search terms were organized into five thematic sets: DILI symptoms, hepatotoxic medications, self-treatment and detoxification, liver-related symptoms, and general medication queries. Sets 1–4 were searched in Russian and Set 5 in Kazakh. Descriptive statistics, the Mann–Kendall trend test, and Spearman’s rank correlation analysis were performed using PAST software version 5. Results: A statistically significant trend was identified for 20 out of 21 search terms (p < 0.05). The majority of terms showed decreasing trends over the study period. In contrast, dietary supplements (BAD) demonstrated the strongest increasing trend (S = +1275, Z = +7.93, p < 0.001). Search interest for the general term “liver” was the highest of all 21 terms (mean RSV 84.30), while specific DILI symptoms such as dark urine (mean 1.28) and skin itching (mean 0.07) showed minimal search activity. Strong positive correlations were found between paracetamol and antibiotic searches (rs = 0.812, p < 0.001), consistent with self-medication patterns. Dietary supplements showed significant negative correlations with all detox-related terms (rs = −0.650, p < 0.001). Conclusions: This is the first infodemiology study on DILI in Central Asia. The significant increase in dietary supplement searches, combined with the low public awareness of specific DILI symptoms, highlights a critical public health concern. These findings underscore the need for enhanced regulation of dietary supplements, targeted public health education, and the integration of digital surveillance tools into pharmacovigilance systems in Kazakhstan. Full article

Background/Objectives: Infective endocarditis (IE) is a life-threatening cardiovascular infection with in-hospital mortality of 15–30% despite modern therapy. Contemporary IE demonstrates non-random valve involvement: aortic and mitral 35–45%, tricuspid 5–10% (30–50% in intravenous drug users [IVDU]), and pulmonary < 1%. These patterns implicate valve-specific anatomy and hemodynamics as central determinants of susceptibility. This narrative review examines the reported distribution of IE across the aortic, mitral, tricuspid and pulmonary valves and summarises the anatomical, haemodynamic, structural, microbial and patient-related factors associated with valve-specific susceptibility. Methods: A structured narrative review of English-language literature was conducted using PubMed/MEDLINE, Embase, Scopus, and Google Scholar (January 1990–March 2026). Search terms included “infective endocarditis,” “valve anatomy,” “hemodynamics,” “bicuspid aortic valve,” “prosthetic valve endocarditis,” and “transcatheter aortic valve replacement (TAVR) endocarditis.” We included anatomical studies, clinical cohorts, surgical series, imaging research, and international guidelines. Evidence was synthesized narratively using Oxford Centre for Evidence-Based Medicine (CEBM) levels. Results: IE susceptibility follows a biologically coherent gradient determined by the interaction between valve anatomy, hemodynamic stress, endothelial injury, and structural substrate. The aortic valve is most vulnerable because of high shear stress, congenital abnormalities such as bicuspid aortic valve, and direct continuity with the cardiac fibrous skeleton, predisposing to peri-annular extension. Mitral valve IE is largely conditional upon pre-existing structural disease, particularly mitral valve prolapse, rheumatic heart disease, and mitral annular calcification, and is characterized by a high risk of systemic embolization. Tricuspid valve IE reflects the interaction between low-pressure hemodynamics and acquired patient-specific modifiers, including intravenous drug use, cardiovascular implantable electronic devices, and congenital heart disease. Pulmonary valve IE remains uncommon because of favorable native hemodynamics but occurs predominantly in repaired congenital heart disease, right ventricular outflow tract reconstruction, and prosthetic pulmonary valves. Across all valve types, multimodality imaging and anatomical assessment consistently influence complication detection, surgical planning, and long-term surveillance. Conclusions: IE involvement is unevenly distributed among the cardiac valves. Aortic and mitral involvement predominate, tricuspid involvement is strongly influenced by injection drug use and intracardiac devices, and pulmonary-valve IE remains rare and is principally associated with congenital abnormalities or prosthetic material. These patterns highlight the possible contributions of haemodynamic stress, pre-existing structural abnormalities, and age-related valvular changes to the greater susceptibility of left-sided valves. Full article

Background/Objectives: School-age athletes occupy a paradoxical position in the adolescent opioid crisis, combining health-oriented activity with elevated risk of sports-related injury and prescription opioid exposure. In response to the opioid epidemic, states enacted opioid prescribing limit laws (OPLLs) beginning in 2016–2017, yet whether these supply-side policies reached high-risk youth subgroups remains unclear. This study evaluated national temporal trends in prescription opioid misuse among U.S. high school students during the period of OPLL implementation and examined differences across athletic participation, concussion history, sex, grade, race/ethnicity, and substance-use profiles. Methods: Using four biennial waves of the Youth Risk Behavior Surveillance System with a consistent prescription pain-medicine measure (2017, 2019, 2021, and 2023; total N = 44,501), we conducted survey-weighted multivariable logistic regression models producing adjusted odds ratios (aORs) for lifetime prescription opioid misuse, controlling for survey year, sports participation, sex, grade, race/ethnicity, alcohol use, and other illicit drug use. Interaction and stratified models examined differences associated with sports participation, concussion history, demographic characteristics, and substance use. Results: Weighted prescription opioid misuse declined from 13.9% in 2017 to 12.0% in 2023, with a significant unadjusted linear decline per two-year survey wave (OR = 0.936; 95% CI: 0.879–0.997; p = 0.040). This overall trend was attenuated after adjustment (aOR = 0.967; 95% CI: 0.914–1.024; p = 0.248). Temporal patterns differed significantly across race/ethnicity, sex, grade, and selected substance-use groups. White and male students demonstrated significant adjusted linear declines, whereas Hispanic/Latino and female students remained flat. Black/African American students showed significant year-to-year variation, with elevated adjusted odds in 2019 and 2021 relative to 2017. Concussion history was independently associated with misuse among athletes (aOR = 1.645; 95% CI: 1.417–1.909; p < 0.001), with significant associations observed among White, Asian, Black/African American, and Hispanic/Latino athletes. The pooled concussion-by-race/ethnicity interaction, however, was not significant (p = 0.295). Conclusions: Although prescription opioid misuse declined descriptively between 2017 and 2023, adjusted analyses did not identify a significant overall national temporal change. Since subgroup patterns diverged, prevention planning and surveillance should be disaggregated by race/ethnicity and sex rather than guided by national totals, and groups whose misuse did not decline may require strategies extending beyond clinical prescribing controls. Full article

Background and Clinical Significance: Endoscopic ureterocele incision is the preferred initial treatment for ureteroceles associated with duplex collecting systems due to its capability for rapid decompression via a minimally invasive technique with generally favorable outcomes among pediatric patients. However, the postoperative trajectory in children with solitary functioning renal units remains inadequately characterized. We present a severe, yet reversible, case of postrenal acute kidney injury (AKI) following endoscopic ureterocele incision in an infant with a contralateral multicystic dysplastic kidney (MCDK). This case emphasizes the pathophysiological implications of failed ureterocele decompression and the vital importance of rigorous postoperative monitoring. Case Presentation: A female infant with a right MCDK and a left duplex collecting system featuring an upper pole ureterocele underwent transurethral endoscopic incision due to progressive hydronephrosis. Within 24 h following surgery, the patient exhibited oliguria, oedema, worsening hydronephrosis, hyponatremia (125 mmol/L), metabolic acidosis, and increasing serum creatinine levels, indicative of postrenal AKI. Arterial blood gas analyses indicated severe renal-driven metabolic acidosis with bicarbonate levels of 13.9 mmol/L, accompanied by respiratory compensation and normal lactate levels. Imaging studies revealed deteriorating hydronephrosis of the upper and lower poles of the left kidney. Emergency open nephrostomy placement in the lower pole, after failed jj insertion in the lower pole ureteral orifice, resulted in the immediate restoration of urinary drainage and progressive biochemical recovery. The patient required a brief period of intensive care monitoring, followed by hospitalization in pediatric and urological departments. Longitudinal imaging demonstrated persistent but stable upper pole dilatation with preserved parenchyma. Definitive management was later achieved through right nephrectomy of the non-functioning MCDK. Conclusions: In patients with solitary functioning renal units, the endoscopic ureterocele incision may result in postoperative local oedema, potentially leading to clinically significant obstructive AKI. This case underscores the necessity for intensified surveillance and individualized postoperative management strategies in anatomically complex pediatric patients. Full article

Agriculture remains one of the most hazardous industries in the United States, yet nonfatal surveillance remains incomplete. Prior studies have shown that trauma registries can support agricultural injury surveillance, but many approaches rely on text review, state-specific indicators, or coding frameworks that are not easily transferable across systems. In this study, Florida Trauma Registry records from 2016 to 2021 were screened using a reproducible case definition based on International Classification of Diseases, Tenth Revision (ICD-10) external cause of injury codes, registry occupation and industry fields, and the work-related indicator. Agricultural injuries were summarized descriptively and mapped to Occupational Injury and Illness Classification System (OIICS) categories. Injury severity scores (ISS) were modeled using generalized additive models (GAMs). The case definition identified 963 agricultural injuries requiring trauma care, including 17 fatalities. Most injuries were minor, and the leading event categories were contact incidents, falls, slips, and trips, and transportation incidents. Body region was the strongest correlate of severity, with head and abdomen/pelvic contents injuries showing the highest adjusted ISS. These findings suggest that the National Trauma Data Standard (NTDS)-aligned trauma registry fields may support reproducible agricultural injury surveillance when narrative text is unavailable. Full article

Background: Climate change is increasingly recognised not only as an environmental emergency but also as a structural determinant of health and health-system performance. Its clinical consequences will not be distributed evenly: high-income countries face rising heat mortality, infrastructure fragility, ageing-related vulnerability, and the need to decarbonise technologically intensive care; middle- and low-income countries face heterogeneous but often more compressed combinations of heat, infectious disease, food insecurity, water stress, displacement, conflict-related fragility, and limited fiscal capacity. Objective: This structured narrative review proposes a comparative framework for understanding how climate change will transform health care across high-, middle-, and low-income settings and identifies adaptation priorities that are resilient, equitable, and low-carbon. Methods: We synthesised major climate-health assessments, peer-reviewed epidemiological studies, modelling papers, systematic and scoping reviews, and health-system decarbonisation literature identified through targeted searches and reference chaining. Five climate-health pathways, specified a priori from established direct, indirect, and socially mediated pathway frameworks, were used to organise the review. Findings: Climate change will reshape health care through five interacting pathways: direct thermal injury and extreme-weather mortality; altered infectious disease ecology; food, water, and nutritional insecurity; mental, maternal-child, and occupational impacts; and damage to the infrastructure, workforce, supply chains, finances, and emissions profile of health systems. In high-income countries, climate stress exposes the limits of hospital-centred, carbon-intensive, just-in-time care. In middle-income countries, expanding coverage and technology coexist with uneven insurance, large informal workforces, and rapidly growing emissions. In low-income and fragile settings, the same hazards interact with undernutrition, weak surveillance, under-resourced primary care, and constrained finance to produce larger marginal health losses. Conclusions: The central contribution is the concept of the climate-health divide: the unequal conversion of shared climate hazards into clinical demand, service disruption, financial stress, and emissions-intensive responses. Climate resilience and healthcare decarbonisation should therefore be designed together rather than treated as separate agendas. Full article

Weapon carrying and violent behaviors during adolescence are associated with increased risk of injuries and have been linked to suicidal ideation. However, little is known about these associations among Puerto Rican high school students. This cross-sectional study analyzed 2019 Puerto Rico Youth Risk Behavior Surveillance System (YRBSS) data from students in grades 9–12. Survey-weighted descriptive statistics summarized prevalence, and multivariable logistic regression examined associations between suicidal ideation and sociodemographic, violent behavior, and psychosocial variables. Among Puerto Rican high school students, 52% were female, and 12% reported suicidal ideation. Bivariate analyses showed significant associations between suicidal ideation and sex, age, weapon carrying, bullying victimization, persistent sadness/hopelessness, and cigarette use (p < 0.05). In the fully adjusted model, persistent sadness/hopelessness was the strongest factor associated with suicidal ideation (AOR = 8.88, 95% CI: 4.91–16.03). Bullying victimization and cigarette use also remained independently associated with higher odds of suicidal ideation. Weapon carrying was not independently associated with suicidal ideation after adjustment for psychosocial factors. Persistent sadness/hopelessness, bullying victimization, and cigarette use were independently associated with suicidal ideation, highlighting the multifactorial nature of adolescent suicide risk. These findings underscore the importance of comprehensive mental health screening and interventions that address emotional distress, social stressors, and behavioral risk factors among Puerto Rican adolescents. Full article

Over time, our understanding of the central nervous system (CNS) as an immunologically privileged site where immune-cell infiltration takes place has changed; research has transformed the dominant view, showing that the CNS is an immunologically specialized tissue featuring complex interactions between the immune system and CNS processes, where the choroid plexus (CP) has an essential role in regulating neuronal tissue homeostasis and immune-cell trafficking. Although immune-cell entry into the CNS is tightly controlled, small numbers of antigen-experienced lymphocytes can access cerebrospinal fluid (CSF) compartments for immune surveillance under normal conditions. During an injury, such as cerebral ischemia or spinal cord damage, dendritic cell precursors infiltrate the CNS, suggesting their involvement in modulating lymphocyte activity. However, the immunoregulatory function of the CP alone is insufficient to prevent damage. Injury can trigger a cascade of events including activation of microglia toward a pro-inflammatory M1 phenotype, infiltration of peripheral immune cells across the blood–brain barrier (BBB), and uncontrolled neuroinflammation. T cells play a critical role in this process. Th1 cells exacerbate inflammation upon recognizing neural antigens, whereas Th2 cells promote recovery by releasing neurotrophic factors. This highlights the dual role of inflammation in CNS injury and repair. Full article

The safety of non-food products is embedded in the United Nations 2030 Agenda for Sustainable Development and the European Union (EU) framework, supporting health protection, responsible production and consumption, and market surveillance. The EU Rapid Alert System for dangerous non-food products, known as Safety Gate (formerly RAPEX), was established in 2005 to facilitate the exchange of information on products posing risks within the internal market. The aim of this study was to present the interdependencies reported in the Safety Gate system/RAPEX in 2005–2025, considering: product category, type of risk, country of origin, notifying country and year, as well as measures taken. The VOSviewer 1.6.20 and Statistica 13.3 were used. The results highlighted the following problems: toys from China with chemical, choking and injury risks; electrical appliances also from China with electric shock hazards; motor vehicles from Germany with injury risks; cosmetics from Italy with chemical and microbiological risks; and clothing from Turkey with suffocation risks. Reporting is expected to continue under existing regulatory frameworks, although changing the name of the system from RAPEX to “Safety Gate” may reduce its recognition. The findings highlight the need for targeted enforcement, improved risk profiling by product category and origin, and ongoing monitoring of emerging safety risks. Full article