Search Results (17,875)

Peste des Petits Ruminants (PPR), a highly contagious disease of domestic and wild small ruminants, is characterized by severe morbidity and mortality. PPRV, the causative agent, is a morbillivirus in the family Paramyxoviridae. The virus poses a significant barrier to sustainable agricultural development in the developing world. Currently, no effective therapeutics agent for PPRV infection is available. Ginsenoside Rb3, the major bioactive constituent in the plants of ginseng, was reported to exert a wide range of pharmacologic and immunologic effects. However, it is unclear whether Ginsenoside Rb3 can act as an antiviral against PPRV infection. Here, we show that Ginsenoside Rb3 exhibits significant antiviral activity against PPRV in cell culture models. The mechanism of action of Ginsenoside Rb3 against PPRV is mainly attributed to its ability to inhibit PPRV-mediated autophagy, thus leading to promotion of interferon responses. In summary, our study establishes Ginsenoside Rb3 as a novel antiviral agent effective against PPRV, sheds light on its mode of action, and reveals a novel immunomodulatory strategy that may prove essential for combating both current and future viral outbreaks. Full article

Drug-induced kidney injury remains a major clinical challenge associated with diverse therapeutic agents and is an important cause of acute kidney injury, chronic renal dysfunction, and treatment-related morbidity. Growing evidence indicates that nephrotoxicity caused by anticancer, immunosuppressive, and anti-infective drugs is strongly driven by oxidative stress and redox homeostasis disruption. Excessive production of reactive oxygen species (ROS) in renal tubular cells overwhelms endogenous antioxidant defenses and triggers mitochondrial dysfunction, inflammatory signaling, and activation of stress-responsive pathways that culminate in tubular injury and renal functional decline. These processes promote apoptosis, necrosis, microvascular injury, and a reduction in the glomerular filtration rate, while dysregulation of redox-sensitive pathways involved in cell survival and repair further heightens renal vulnerability. This review summarizes current mechanistic insights into oxidative stress-mediated pathways of drug-induced nephrotoxicity, with emphasis on their translational relevance. In addition, it discusses emerging biomarkers for early detection and highlights recent advances in antioxidant-based and redox-modulating strategies that may help prevent renal injury and preserve kidney function. Full article

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by immune dysregulation and systemic inflammation, with the cardiovascular (CV) system representing a major yet frequently under-recognized target. Cardiac involvement spans from subclinical myocardial inflammation to overt pericardial disease, myocarditis, valvular abnormalities, coronary microvascular dysfunction, and accelerated atherosclerosis. Given that CV disease remains a leading cause of morbidity and mortality in SLE, early detection of silent cardiac injury is crucial. Aim: This review aims to provide a comprehensive and clinically oriented overview of CV involvement in SLE, focusing on the role of multimodal cardiac imaging in the detection, characterization, and risk stratification of cardiac abnormalities, as well as its potential implications for clinical management and preventive strategies. Methods: This narrative review is based on a structured, non-systematic search of PubMed (2013–2026), combining the term “systemic lupus erythematosus” with imaging-related keywords including “transthoracic echocardiography,” “cardiac magnetic resonance,” and “cardiac computed tomography.” English-language studies in adult populations were screened and selected according to clinical relevance, methodological robustness, and contribution to understanding SLE-related cardiac involvement. Discussion: Multimodal cardiac imaging plays a central role in the evaluation of SLE-related cardiac disease. Transthoracic echocardiography (TTE) represents the first-line modality for the assessment of ventricular function, pericardial disease, and valvular abnormalities, while deformation imaging enables the detection of subtle myocardial dysfunction. Cardiac magnetic resonance (CMR) provides comprehensive tissue characterization, allowing differentiation between active inflammation and chronic fibrosis. Cardiac computed tomography (cCT) identifies subclinical coronary atherosclerosis and high-risk plaque features, whereas nuclear imaging techniques offer insight into inflammatory activity and microvascular dysfunction. Conclusions: An integrated, imaging-based approach enables early diagnosis, refined CV risk stratification, longitudinal monitoring, and personalized therapeutic strategies. Multimodal imaging thus represents a key pillar of precision medicine in lupus-associated CV disease. Full article

Therapeutic termination of pregnancy (TToP) represents an intervention that is performed for medical reasons, such as risks to maternal health or severe fetal anomalies. Advances in prenatal screening and diagnostic tools—including serum markers, ultrasound, cell-free fetal DNA, chorionic villus sampling and amniocentesis—have significantly improved early detection and clinical decision-making. This narrative review synthesizes current knowledge on the genetic, environmental and psychosocial determinants that influence the decision of the patients to pursue TToP. The literature search was performed primarily using PubMed database, while Scopus and Google Scholar were used to identify additional relevant studies. Some of the selected studies, as well as certain sections of this review, address both therapeutic and voluntary termination of pregnancy, whereas others focus exclusively on TToP. Moreover, this review describes the types of abortion (medical or surgical/aspiration) along with their management strategies to prevent or address potential complications. It is well known that demographic, cultural and socio-economic factors continue to influence the access to TToP, as well as the perceptions of it. Psychiatric comorbidities (such as anxiety, affective and psychotic disorders) are observed with a higher prevalence among women undergoing TToP and may influence both the decision and psychological outcomes post-procedure. While most women report emotional relief after TToP, some of them experience depression, post-traumatic stress disorder or substance misuse. Legal and ethical considerations further complicate access to safe abortion, leading to situations where patients may resort to unsafe procedures, which result in higher rates of morbidity and mortality. Data from the EUROCAT network show rising trends in congenital anomalies like trisomy 13, trisomy 18 and caudal regression syndrome (conditions commonly associated with TToP). Therefore, it is mandatory to form a multidisciplinary team in these cases, integrating medical, psychological and ethical dimensions. Ensuring safe, evidence-based and compassionate access to TToP remains a critical component of reproductive healthcare. Full article

Background/Objectives: Cardiorenal syndrome type 2 (CRS-2) is characterized by progressive renal dysfunction caused by chronic heart failure (HF) and is associated with increased morbidity and mortality. However, the prognostic value of renal biomarkers in patients with CRS-2 hospitalized for decompensated HF remains unclear. Methods: This prospective observational cohort study included 200 consecutive patients hospitalized for decompensated HF in the Intensive Care Unit of the Clinic for Internal Medicine at the University Clinical Centre Tuzla between April and October 2025. CRS-2 was defined as chronic HF with chronic kidney disease persisting for ≥3 months before admission according to KDIGO criteria. Patients were followed for three months. The primary composite outcome was all-cause mortality or initiation of renal replacement therapy. Results: CRS-2 was identified in 130 patients (65.0%) and was associated with higher in-hospital mortality (32.3% vs. 11.4%, p = 0.002) and three-month mortality (44.6% vs. 21.4%, p = 0.002). Within the CRS-2 subgroup, patients who experienced the primary composite outcome had higher admission levels of cystatin C and urinary albumin-to-creatinine ratio (UACR) and lower estimated glomerular filtration rate (eGFR). ROC analysis demonstrated moderate discriminative ability of cystatin C (AUC 0.739) and UACR (AUC 0.733). In Cox regression analysis, cystatin C (HR 1.534, 95% CI 1.263–1.863, p < 0.001) and UACR (HR 1.003, 95% CI 1.001–1.006, p = 0.001) were significantly associated with the primary composite outcome. Conclusions: Renal dysfunction markers, particularly cystatin C and albuminuria, are associated with early adverse outcomes in CRS-2 patients hospitalized for decompensated HF. Routine assessment of these biomarkers may provide additional prognostic information and support risk assessment in this high-risk population. Full article

Cardiovascular diseases (CVDs) remain the primary cause of human morbidity and mortality in the world. Inflammation, oxidative stress, and vascular remodeling are the key factors that make CVDs worse. The nuclear factor κB (NF-κB) signaling pathway is a major regulator in the progression of CVDs. NF-κB activates wrongly, induces the secretion of pro-inflammatory cytokines (including TNF-α, IL-6, and IL-1β), and enhances reactive oxygen species (ROS) generation. These accelerate endothelial dysfunction, myocardial damage, and atherosclerotic plaque development. Natural products are structurally diverse, multi-targeted, and low toxicity. They offer a promising way to prevent and treat cardiovascular disease by modulating the NF-κB signaling pathway. This review summarizes the recent studies about using natural products (including flavonoids, terpenoids, alkaloids, polyphenols, and polysaccharides) to treat CVDs through the NF-κB pathway, with a critical analysis of evidence strength according to CVDs indication (atherosclerosis, myocardial ischemia/reperfusion injury, pulmonary arterial hypertension, etc.) and study type (in vitro, in vivo animal, and human clinical research). We detail their molecular mechanisms, such as inhibiting the nuclear translocation of NF-κB p65, downregulating IκB phosphorylation, blocking upstream signaling (e.g., TLR4/MyD88, PI3K/Akt, MAPK), and affecting with other pathways (e.g., Nrf2/HO-1, SIRT1) to reduce inflammation and oxidative stress together. We also detail the effects of these natural products in various CVDs models, including atherosclerosis, hypertension, myocardial ischemia/reperfusion injury, diabetic cardiomyopathy, and pulmonary arterial hypertension, highlighting the characteristics of their treatments. Finally, we discuss the challenges of bringing natural products into the clinic and share some ideas to solve difficulties, with an in-depth critical analysis of the translational bottlenecks (poor bioavailability, unclear structure–activity relationships, incomplete mechanistic elucidation, and lack of large-scale clinical trials) and their underlying causes across different natural product classes. In summary, this review offers new perspectives on developing natural product-based therapies targeting the NF-κB signaling pathway for CVDs. It offers useful references for both preclinical studies and clinical applications. Full article

Posttraumatic stress disorder (PTSD) has been linked to impaired physical function, which in turn predicts falls, morbidity, and mortality. However, few studies have used objective measures such as handgrip strength to assess physical function. In this cross-sectional study, we investigated associations of average PTSD symptom severity and symptom domain severity with measures of maximum handgrip strength and handgrip asymmetry from 11/2021–12/2023, among 381 male firefighters and emergency medical responders who responded to the World Trade Center disaster, using covariate-adjusted linear regression models. PTSD was diagnosed using the Structured Clinical Interview for the DSM-5 in 17% of responders. Greater overall PTSD average symptom severity was associated with weaker maximum handgrip strength (β = −4.43 lbs; 95%; CI: −8.77, −0.09; p = 0.045). Higher re-experiencing symptom severity was associated with weaker maximum handgrip strength (β = −4.17 lbs; 95% CI: −8.13, −0.22; p = 0.039). Avoidance symptoms were associated with weaker handgrip strength in adjusted models (β = −4.14 lbs; 95% CI: −7.56, −0.73; p = 0.018), and associated with a larger negative difference assessing for hand asymmetry (β = −2.20 lbs; 95% CI: −4.18, −0.22; p = 0.029). Findings suggest that PTSD may contribute to long-term physical decline, even in populations with high baseline fitness. Full article

The remarkable evolution of oncological therapies has dramatically improved cancer survival rates but has simultaneously introduced a significant burden of cardiovascular complications. Cardio-oncology has emerged as a critical multidisciplinary field focused on mitigating the “collateral damage” of life-saving anticancer treatments, ranging from traditional chemotherapeutics to novel immunotherapies. This review provides a comprehensive analysis of the pathophysiological mechanisms, clinical phenotypes, and evolving management strategies for cancer therapy-related cardiac dysfunction (CTRCD). An extensive synthesis of the current literature was conducted, focusing on the molecular pathways of cardiotoxicity, including Topoisomerase IIβ inhibition by anthracyclines, HER2 signaling disruption by targeted agents, and immune-mediated myocarditis triggered by checkpoint inhibitors (ICIs). Cardiotoxicity is increasingly recognized as a spectrum of phenotypes. Heart failure with reduced ejection fraction (HFrEF) remains a primary concern with cytotoxic agents, while heart failure with preserved ejection fraction (HFpEF) is emerging as a critical complication of radiation therapy and tyrosine kinase inhibitors (TKIs). The integration of advanced diagnostic tools—specifically Global Longitudinal Strain (GLS) and Cardiac Magnetic Resonance (CMR) mapping—has shifted the clinical focus toward subclinical detection. Furthermore, pivotal clinical trials such as PRADA and SUCCOUR have validated early pharmacological prophylaxis and strain-guided interventions. Emerging challenges, including the management of CAR-T cell-induced cytokine release syndrome and the specific cardiovascular needs of pediatric and geriatric populations, are also explored. The future of cardio-oncology lies in precision medicine, leveraging genomic profiling and artificial intelligence to identify high-risk individuals. A proactive, multidisciplinary approach is essential to ensure that the success of modern oncology is not compromised by irreversible cardiovascular morbidity. Full article

Wild mushroom consumption is widespread worldwide and remains an important cause of foodborne intoxication. This concise review analyzes recent literature on the geographic distribution of poisonous wild mushrooms and the epidemiological patterns of intoxication reported in Asia, Europe, and the Americas. Most poisoning incidents occur as a result of the misidentification of toxic species as edible during mushroom foraging. Alongside well-known poisonous mushrooms, several newly identified toxic species have been reported in recent years. The available epidemiological evidence demonstrates clear regional clustering of poisoning incidents, pronounced seasonal peaks associated with mushroom growth, and a predominance of cases in populations where wild mushroom foraging is a traditional practice. Amatoxin-containing species of the genus Amanita remain the leading cause of severe and fatal intoxications worldwide. Overall, the analyzed studies indicate that wild mushroom poisoning continues to represent a significant food safety and public health concern, particularly in Asia and parts of Europe. Improved toxicological surveillance, public awareness, and timely clinical management are essential for reducing morbidity and mortality associated with these intoxications. Full article

Stroke remains a major cause of morbidity and mortality worldwide. Although reperfusion therapies and secondary prevention have advanced, the global stroke burden continues to rise, driven by increasing rates of hypertension and diabetes mellitus. Type 2 diabetes (T2DM) increases the risk of acute ischemic stroke (AIS) through mechanisms involving chronic hyperglycemia, endothelial dysfunction, inflammation, and accelerated atherogenesis. In recent years, glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as promising agents for cardiovascular and cerebrovascular risk reduction in patients with T2DM. Beyond their glucose-lowering properties, GLP-1RAs improve blood pressure regulation and lipid metabolism, as mentioned in the 2025 AHA Journal guidelines for the prevention, detection, evaluation, and management of high blood pressure in adults. Emerging preclinical and clinical evidence indicates that GLP-1RAs also provide direct neurovascular protection by stabilizing the blood–brain barrier, modulating neuroinflammation, and promoting neuronal survival. These mechanisms may reduce ischemic injury, improve recovery after stroke, and protect against cognitive decline. Major cardiovascular outcome trials have demonstrated significant reductions in major adverse cardiovascular events and, to a lesser degree, non-fatal stroke among patients receiving GLP-1RAs. This narrative review evaluates current evidence on the neurovascular, cardiometabolic, and anti-inflammatory actions of GLP-1RAs and their potential role in mitigating stroke risk and promoting cerebrovascular health. Additionally, it highlights gaps in the literature, explores clinical and guideline implications, and outlines future directions for integrating GLP-1RA therapy into comprehensive stroke prevention and recovery strategies. Full article

Malaria remains a major global health challenge. While treatments targeting parasite replication exist, effective interventions for neurological manifestations are scarce, necessitating new strategies for cerebral malaria. In this study, we investigated the effect of a single-chain variable fragment (scFv) against glycosylphosphatidylinositol (GPI) as an intervention tool to mitigate the effects of Plasmodium in a preclinical model. We used C57BL/6J mice infected with Plasmodium berghei-ANKA (PbA) and treated them with anti-GPI scFv or phosphate-buffered saline (PBS) on days 0, 3, and 6 post-infection. Uninfected controls were treated on the same days with scFv or PBS. The animals were evaluated for morbidity and mortality, body weight, parasitemia, blood count, cytokines, and histopathology. Results show that anti-GPI scFv prevented lethality in 71.4% of infected animals and promoted recovery from weight loss. Furthermore, the intervention inhibited neurological and systemic signs, reduced parasitemia, and improved hematological and histopathological parameters in the brain, lungs, and kidneys. In conclusion, anti-GPI scFv exerts a significant systemic effect on experimental cerebral malaria (ECM) pathology, representing a promising tool for severe manifestations of the disease. Full article

Reconstruction of craniomaxillofacial (CMF) bony defects requires individualized strategies based on defect characteristics and graft bed biology, with traditional approaches relying on autogenous non-vascularized bone grafts or vascularized free flaps that, while reliable, are associated with donor-site morbidity and operative complexity. Biologically driven reconstructive strategies, including tissue engineering, cellular bone matrix allografts (CBMs), and growth factor adjuncts, have emerged as alternatives or complements to autograft-based reconstruction. This review introduces and details these new innovations with emphasis on the current literature, thus empowering surgeons to enhance their clinical armamentarium. Full article

Respiratory Syncytial Virus infection is a significant cause of morbidity and mortality in infants. Maternal vaccination with the bivalent vaccine Abrysvo^® in the third trimester (24–36 weeks) is an effective strategy to prevent severe respiratory illnesses in newborns. However, the introduction of this new technology faces structural obstacles that amplify inequalities. This rapid literature review sought to map and synthesize evidence on inequalities and inequities in adherence and accessibility to maternal vaccination among Black pregnant women. A rapid literature review was conducted using a mixed-methods approach (narrative synthesis and thematic analysis), following guidelines adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Cochrane Handbook. The research question was structured using the acronym Population/Problem, Exposure, Comparison, and Outcome, focusing on Black pregnant women, maternal vaccination, comparison with other groups, and barriers/determinants. The search was conducted in databases such as PubMed (via Medical Literature Analysis and Retrieval System Online), Scopus and Literatura Latino-Americana e do Caribe em Ciências da Saúde, covering studies published between 2022 and 2025 that presented disaggregated analysis by race. The analysis and interpretation of the findings were guided by Critical Race Theory. The analysis of the twelve included studies (mainly from the United States, the United Kingdom, and Brazil) revealed systematic and robust disparities. Black pregnant women had lower vaccination coverage and were less likely to receive timely recommendations compared to White pregnant women. The barriers identified include: institutional distrust (resulting from structural racism), poor access to prenatal care, inadequate communication, and socioeconomic factors. Inequities are structural and multifactorial phenomena. To ensure that the benefits of the vaccine are distributed equitably, strategies such as anti-racist training for healthcare teams, active vaccination outreach, and continuous monitoring of data disaggregated by race are essential. Full article

Introduction: Interpregnancy interval (IPI) plays a critical role in neonatal health, yet optimal spacing remains controversial. This study assessed neonatal outcomes across short and long IPI using three complementary classification approaches to identify consistent patterns of risk. Materials and Methods: In this retrospective cohort study, medical records of 1194 women with a prior live birth who delivered singleton pregnancies in 2024 at a tertiary referral center were analyzed. IPI was calculated as the delivery-to-conception interval (LMP + 14 days). Three IPI classification systems were applied: (1) classical cut-offs (<6, 6–11, 12–23, 24–59, and ≥60 months), (2) quartiles, and (3) tertiles. Primary outcomes included preterm birth, low birth weight (LBW), and NICU admission. Multivariable logistic regression models adjusted for maternal age, gravidity, and previous cesarean delivery. Results: Short IPI (6–11 months) demonstrated the highest NICU admission rates (29.4%). Very long IPI (≥60 months) showed the highest prevalence of LBW (16.6%). Multivariable regression analysis revealed that intervals ≥ 24 months were independently protective against preterm birth (24–59 months: aOR 0.48, p = 0.002; ≥60 months: aOR 0.58, p = 0.042), while maternal age increased preterm birth risk by 7% per year. Short IPI (6–11 months) and very long IPI (≥60 months) independently increased NICU admission risk (aOR 2.29, p = 0.002 and aOR 1.61, p = 0.036, respectively). Previous cesarean delivery was an independent predictor of NICU admission (aOR 1.35; p = 0.048). Conclusions: Short and very long IPIs are associated with increased neonatal morbidity, particularly NICU admission, while the apparent preterm risk in long intervals is largely mediated by maternal age. Once adjusted, IPIs exceeding 24 months demonstrate protective effects against preterm birth. However, the rising trend toward LBW and NICU admission in intervals beyond 5 years suggests that birth-spacing counseling targeting an optimal window of 18–24 months provides the best balance in minimizing competing neonatal risks. Full article

Background: Tuberculosis (TB) remains a major global health challenge, with Mycobacterium tuberculosis (M. tuberculosis) causing significant morbidity and mortality mainly in high-burden countries. Following exposure to M. tuberculosis, individuals may become infected, developing TB infection (TBI) through inhalation of the bacillus: this affects approximately one-fourth of the global population and serves as a critical reservoir for potential disease reactivation and transmission. The risk of being infected with M. tuberculosis is shaped by bacterial load of people with TB, contact patterns, environmental factors, and host susceptibility, particularly in high-risk congregate settings. Elucidating these determinants is instrumental for optimising TB prevention and control strategies. Methods: A preliminary PubMed search was conducted on 25 August 2024, using the keywords “latent tuberculosis infection,” “risk factors,” and “systematic review.” Targeted reviews were then performed in November 2024 to examine factors influencing progression from exposure to M. tuberculosis to TBI. Systematic reviews published between January 2000 and November 2024 were included. Results: The scoping review analysed eight systematic reviews, grouping findings into three key themes: (1) proximity and behavioural risk factors; (2) environmental risk factors; and (3) host immune vulnerabilities. Close contact with people with TB in crowded settings, such as dormitories, healthcare facilities, and prisons, was strongly associated with an elevated risk of TBI. Healthcare workers travelling from low- to high-incidence regions faced the highest risk due to frequent exposure to M. tuberculosis, while military personnel and general travellers had lower risks. Environmental exposures, including second-hand smoke and inadequate ventilation, further heightened susceptibility among children and adults. Host immune risk factors, such as advanced age, low body mass index, lack of BCG vaccination, and metabolic disorders such as diabetes, markedly increase susceptibility to TBI. The interplay between proximity, behavioural and environmental risk factors, and host immune vulnerabilities highlights the multifactorial nature of TBI risk. Conclusion: Effective TBI control demands a multifaceted approach, combining robust infection prevention and control measures, comorbidity management, and mitigation of behavioural risk factors like smoking. Tailored strategies are crucial for high-risk settings such as healthcare facilities and prisons. Multisectoral collaboration is essential to address key risk factors and protect vulnerable populations from progressing to TBI. Full article