Search Results (432)

Background: Childhood cancer is considered one of the main causes of mortality and morbidity worldwide. There is strong evidence of the oral toxic effects of oncologic treatments, but their incidence is difficult to determine. The novel therapeutic strategies in Pediatric Oncology have led to increased survival in this population, resulting in an increased incidence of long-term effects, which diminish the patient’s quality of life. Methods: The search for articles started on 5 November 2024 and ended on 5 December 2024. Following the PRISMA Statement, a total of 1266 articles were obtained, from which 13 were selected for review. All articles were considered to be of high quality. The antineoplastic treatments used in them were chemotherapy, radiotherapy, surgery and immune therapy. Results: Most articles were cohorts and case controls. Only one case report was obtained. The results revealed that the most prevalent sequelae in the pediatric population after antineoplastic treatment were enamel alterations, microdontia, dental caries, periodontal disease, gingivitis, hyposalivation, alteration of the oral microbiome, alteration of mandibular bone density and malocclusion. The lesions are different depending on the therapy used. Conclusions: Oncologic treatments in children with cancer cause multiple oral sequelae such as microdontia, dental caries, enamel alterations, salivary gland alterations, mucositis and root resorption. It cannot be concluded which therapy has the most detrimental effect as each has a different mechanism of action in the oral cavity. Full article

Chronic atrophic gastritis and intestinal metaplasia (IM) are gastric precancerous conditions (GPCs) associated with an increased risk of gastric cancer. Early detection and accurate characterization of GPC are therefore crucial for risk stratification and the implementation of preventive strategies. In the absence of clear mucosal changes observed through white-light imaging (WLI) or virtual chromoendoscopy, endocytoscopy can help unveil the presence of GPC by enabling in vivo assessment of nuclear and cellular structures at ultra-high magnification. Endocytoscopy is typically performed using WLI following dye-based staining of the mucosa. In this case, we demonstrate that combining endocytoscopy with the texture and color enhancement imaging (TXI) mode substantially improves the assessment of the gastric mucosa. In a 61-year-old man undergoing esophagogastroduodenoscopy, WLI showed multifocal erythema in the stomach, without clearly visible lesions on either WLI or narrow-band imaging. Conventional endocytoscopy revealed multiple small spots of IM with characteristic changes in glandular structures, which were even more evident when using the TXI mode. Histological analysis of targeted biopsies confirmed small foci of IM in both the antrum and corpus. The patient was enrolled in a surveillance program because of his clinical background. The combination of endocytoscopy with the TXI mode significantly enhances the delineation of mucosal and cellular architecture, supporting a more accurate optical diagnosis. Full article

Background and Objectives: this pilot study aimed to evaluate the diagnostic accuracy of ChatGPT-4o in analyzing oral mucosal lesions from clinical images. Materials and Methods: a total of 110 clinical images, including 100 pathological lesions and 10 healthy mucosal images, were retrieved from Google Images and analyzed by ChatGPT-4o using a standardized prompt. An expert panel of five clinicians established a reference diagnosis, categorizing lesions as benign or malignant. The AI-generated diagnoses were classified as correct or incorrect and further categorized as plausible or not plausible. The accuracy, sensitivity, specificity, and agreement with the expert panel were analyzed. The Artificial Intelligence Performance Instrument (AIPI) was used to assess the quality of AI-generated recommendations. Results: ChatGPT-4o correctly diagnosed 85% of cases. Among the 15 incorrect diagnoses, 10 were deemed plausible by the expert panel. The AI misclassified three malignant lesions as benign but did not categorize any benign lesions as malignant. Sensitivity and specificity were 91.7% and 100%, respectively. The AIPI score averaged 17.6 ± 1.73, indicating strong diagnostic reasoning. The McNemar test showed no significant differences between AI and expert diagnoses (p = 0.084). Conclusions: In this proof-of-concept pilot study, ChatGPT-4o demonstrated high diagnostic accuracy and strong descriptive capabilities in oral mucosal lesion analysis. A residual 8.3% false-negative rate for malignant lesions underscores the need for specialist oversight; however, the model shows promise as an AI-powered triage aid in settings with limited access to specialized care. Full article

Inflammatory bowel disease (IBD) is characterized by oxidative stress imbalance and intestinal barrier disruption. Reducing excessive ROS has become a promising therapeutic strategy. Compared with conventional polyphenols, nanomaterials offer greater stability and bioavailability for ROS scavenging. Here, ellagic acid (EA) was converted into uniform nanoparticles (EAs) with reactive oxygen scavenging capacity through horseradish peroxidase (HRP)-mediated oxidative polymerization and subsequently encapsulated in the anti-gastric acid hydrogel F-DP to obtain the hybrid system F-DP@EAs. EAs reduced ROS, MDA, NO, IL-1β, and TNF-α levels in vitro, while increasing IL-4 and IL-10 expression, thus alleviating inflammation. Herein, F-DP@EAs prolonged intestinal retention time and exerted superior protective effects in the DSS-induced colitis model. Oral F-DP@EAs lowered DAI, preserved colon length, increased glutathione (GSH) and superoxide dismutase (SOD), decreased NO and MDA, restored zonula occludens-1 (ZO-1), and reduced mucosal lesions. These findings demonstrate that combining nanoparticle and hydrogel technologies markedly enhances the preventive and protective efficacy of EA, highlighting F-DP@EAs as a promising candidate for future IBD therapy. Full article

Peste des petits ruminants is a highly contagious transboundary viral disease that poses a serious threat to small ruminant populations worldwide. In 2024, seven outbreaks of PPR were recorded in sheep flocks from Timiș County, marking the second confirmed incursions of peste des petits ruminants virus (PPRV) in Romania. This study aimed to document the clinical presentation, pathological findings, and diagnostic confirmation with these field outbreaks. Comprehensive field investigations were carried out between July and September 2024, including clinical examinations, post mortem analysis, serological screening, and molecular detection using reverse transcription polymerase chain reaction (RT-PCR). A total of 13,203 sheep were evaluated, with an overall mortality rate of 12.77%. Characteristic clinical signs included mucopurulent nasal discharge, oral erosions, respiratory distress, and diarrhea. Gross lesions observed during necropsy included hemorrhagic bronchopneumonia, bile-stained liver, catarrhal enteritis, and mucosal hemorrhages. Serological testing revealed flock-level seroprevalence rates ranging from 46.7% to 80.0%, with higher rates observed in older animals. RT-PCR confirmed PPRV infection in all affected flocks. Our findings provide strong evidence of virulent PPRV circulation in an area where the virus had not been reported before. The results highlight an urgent need to strengthen surveillance systems, enhance diagnostic capacity, and foster cross-border collaboration. These field-based insights can contribute to both national and international efforts aimed at controlling and ultimately eradicating the disease. Full article

Background/Objective: Oral lichen planus (OLP) is a chronic inflammatory disorder of the oral mucosa with unclear etiology. Increasing evidence implicates oral microbial dysbiosis in its pathogenesis, but little is known about supragingival plaque communities in relation to clinical subtypes. This cross-sectional case–control study aimed to characterize the supragingival plaque microbiota and microbial interaction networks in erosive OLP (E-OLP), non-erosive OLP (NE-OLP), and healthy controls (HCs), to elucidate microbial patterns associated with disease severity. Methods: Supragingival plaque samples were collected from 90 participants (30 per group) and analyzed using 16S rRNA gene sequencing. Alpha and beta diversity metrics, differential abundance, and co-occurrence network analyses were performed. Results: E-OLP exhibited pronounced dysbiosis, including the enrichment of pro-inflammatory taxa (e.g., Prevotella, Parvimonas) and depletion of health-associated commensals (e.g., Rothia, Capnocytophaga). Network analysis revealed the stepwise disintegration of microbial community structure from HC to NE-OLP to E-OLP, with reduced connectivity and increased dominance of pathogenic clusters in E-OLP. These microbial alterations aligned with clinical findings, as E-OLP patients showed significantly higher Reticulation/keratosis, Erythema, and Ulceration (REU) scores for erythema and ulceration compared to NE-OLP. Conclusions: Supragingival plaque dysbiosis and ecological disruption are strongly associated with OLP severity and subtype. This study highlights the utility of plaque-based microbial profiling in capturing lesion-proximal dysbiotic signals, which may complement mucosal and salivary analyses in future diagnostic frameworks. Multi-omics approaches incorporating fungal, viral, and metabolic profiling are warranted to fully elucidate host–microbe interactions in OLP. Full article

Background: PTEN is a tumor suppressor that controls many pathophysiological pathways, including cell proliferation, differentiation, apoptosis and invasiveness. Although PTEN down-modulation is a critical event in neoplastic progression, it becomes apparent that transient and local inhibition of PTEN activity might be beneficial for the healing process. Methods: In the present study, we investigated the impact of PTEN invalidation in mouse intestinal epithelium under a physiological condition and after dextran sulfate sodium (DSS) treatment to induce experimental colitis. PTEN conditional knockout was induced in intestinal epithelial cells after crossing villin-Cre and PTEN^flox/flox mice. Results: PTEN invalidation alleviates experimental colitis induced by DSS, as evidenced by decreased weight loss during the acute phase, the lower expression of inflammation markers, including the proinflammatory cytokines IFN-γ, CXCL1 and CXCL2, reduced mucosal lesions, and faster recovery after resolution of inflammation. This protective effect might result in part from the sustained proliferation of colonic epithelium, leading to hyperplasia and increased colonic crypt depth under physiological conditions, which was further exacerbated in the vicinity of mucosal injury induced by DSS treatment. Furthermore, PTEN knockout decreased paracellular permeability, thereby enhancing the intestinal barrier function. This process was associated with the reinforcement of claudin-3 immunostaining, especially on the surface epithelium of villin-Cre PTEN^flox/flox mice. Conclusions: PTEN inactivation exerts a protective effect on the onset of colitis, and the transient and local down-modulation of PTEN might constitute an approach to drive recovery following acute intestinal inflammation. Full article

Background/Objectives: Cutaneous leishmaniasis is an infectious disease that most frequently affects neglected populations. Besides its incidence, a high disease burden is associated with the possibility of mucosal sequelae. Clinical follow-up of these patients is difficult due to the limited access of the affected population to healthcare and the long lapse between the development of cutaneous and mucosal diseases. In this study, we evaluated the positivity of L. V. braziliensis DNA on the nasal mucosa of patients treated for leishmaniasis in an attempt to estimate the possible long-term risk of developing mucosal leishmaniasis and its association with important clinical characteristics. Methods: Samples were collected immediately after treatment completion using a nasal swab and specific DNA was amplified and detected using real-time PCR. Clinical and laboratorial data was systematically collected. Results: The positivity of L. V. braziliensis was 7% after treatment, and of this 60% had mucosal lesions before treatment, compared with only 13.4% in patients negative for L. V. braziliensis after treatment (p = 0.031). Conclusions: Molecular detection of L. V. braziliensis DNA on the nasal mucosa is a promising strategy to improve the follow-up and treatment of patients with American Tegumentary Leishmaniasis. Full article

Objectives: This study was designed to investigate the gastroprotective effects of Citrus reticulata ‘Chachi’ polysaccharide (CRP) against alcohol-induced gastric ulcers (GUs) and to elucidate its underlying mechanisms. Methods: CRP was extracted, purified, and structurally characterized. BALB/c mice (50/250 mg/kg CRP) and GES-1 cells (1 mg/mL CRP) were subjected to alcohol-induced injury. Oxidative stress (SOD, MDA, ROS), inflammation (TNF-α, IL-1β, NLRP3 inflammasome), mucosal barrier proteins (ZO-1, occludin, Claudin-5), and Nrf2/HO-1 signaling were analyzed via histopathology, Western blot, flow cytometry, and immunohistochemistry. Results: CRP pretreatment significantly alleviated gastric lesions, decreased oxidative stress, and suppressed inflammatory responses in alcohol-induced mice. Mechanistically, CRP induced the Nrf2/HO-1 antioxidant pathway while inhibiting the activation of the NLRP3 inflammasome. CRP also restored tight junction protein expression, enhanced mucosal repair, and reduced epithelial apoptosis. In vitro, CRP promoted cell proliferation, migration, and survival of GES-1 cells under alcohol stress. Conclusions: CRP mitigated alcohol-induced GU via dual antioxidant, anti-inflammatory, and barrier-protective mechanisms, positioning it as a considerable agent for GU. Full article

Background: Gastrointestinal endoscopy is crucial for diagnosing colorectal cancer and inflammatory bowel diseases, but its effectiveness can be impacted by peristalsis, poor bowel preparation, and inadequate withdrawal time. Conventional antispasmodics, though effective, may not be suitable for elderly patients or those with comorbidities. L-menthol, derived from peppermint oil, has emerged as a safer alternative. Through calcium channel blockade, L-menthol promotes GI smooth muscle relaxation. This study evaluated L-menthol’s efficacy and safety as a potential alternative to antispasmodic agents in endoscopy. Methods: Following PRISMA2020 guidelines and the Cochrane Handbook, we conducted a systematic review and meta-analysis of randomized controlled trials involving adults undergoing endoscopy, comparing L-menthol to placebo. The primary outcome was the adenoma detection rate, with secondary outcomes, including severity of peristalsis, safety, withdrawal time, and ease of examination. We searched five databases on 31 May 2023, with updates on 20 October 2024. Results: Fourteen studies were included. L-menthol reduced peristalsis during colonoscopy and upper endoscopy, achieving a suppression rate of 55.9% (560/1002 patients; odds ratio (OR) = 3.88, 95% confidence interval (95% CI): 2.13–7.07), which improved mucosal visualization. It improved ease of examination (OR = 2.53, 95% CI: 1.35–4.73), allowing endoscopists to perform procedures with less technical difficulty. However, L-menthol had no significant impact on the adenoma detection rate (OR = 1.06, 95% CI: 0.69–1.64), indicating no added benefit for lesion detection, and did not prolong withdrawal time (MD = 3.24 s, 95% CI: −101.05–107.53). Adverse event rates remained low and comparable to placebo (OR = 0.97, 95% CI: 0.74–1.27). Conclusions: L-menthol reduces peristalsis and enhances ease of examination without adverse events. Although its effect on the adenoma detection rate remains inconclusive, its antispasmodic properties make it a promising alternative for patients who cannot tolerate conventional agents. Full article

Artificial intelligence (AI) is rapidly transforming imaging modalities in inflammatory bowel disease (IBD), particularly in endoscopy and ultrasound. Despite their critical roles, both modalities are challenged by interobserver variability, subjectivity, and accessibility issues. AI offers significant potential to address these limitations by enhancing lesion detection, standardizing disease activity scoring, and supporting clinical decision-making. In endoscopy, deep convolutional neural networks have achieved high accuracy in detecting mucosal abnormalities and grading disease severity, reducing observer dependency and improving diagnostic consistency. AI-assisted colonoscopy systems have also demonstrated improvements in procedural quality metrics, including adenoma detection rates and withdrawal times. Similarly, AI applications in intestinal ultrasound show promise in automating measurements of bowel wall thickness, assessing vascularity, and distinguishing between inflammatory and fibrotic strictures, which are critical for tailored therapy decisions. Video capsule endoscopy has likewise benefited from AI, reducing interpretation times and enhancing the detection of subtle lesions. Despite these advancements, implementation challenges, including dataset quality, standardization, AI interpretability, clinician acceptance, and regulatory and ethical considerations, must be carefully addressed. The current review focuses on the most recent developments in the integration of AI into experimental designs, medical devices, and clinical workflows for optimizing diagnostic accuracy, treatment strategies, and patient outcomes in IBD management. Full article

Background: Oral ulceration with bone sequestration (OUBS) is an uncommon clinical lesion characterized by painful mucosal ulceration associated with exposed and necrotic bone in the oral cavity, often without known factors inducing osteonecrosis. Despite its potential for diagnostic confusion with more serious lesions, such as medication-related osteonecrosis, OUBS remains poorly understood and underreported. Objectives: To systematically review the literature on OUBS and identify its main clinical and radiographic characteristics to assist in early diagnosis and appropriate management. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted in the PubMed, Scopus, and Web of Science databases on 27 January 2024, to identify case reports, case series, and observational studies that described OUBS. Data extraction focused on demographic information, lesion location, clinical features, radiographic findings, possible etiological factors, management, and outcomes. The Joanna Briggs Institute (JBI) critical appraisal tools were utilized to assess the quality of the case reports and series. Data were synthesized narratively due to heterogeneity among studies. Results: Fifty-seven patients from 22 studies were included. The male-to-female ratio was 2.5:1, with most cases (71.9%) occurring in males. The mean age was 50.22 ± 11.49 years, with the highest incidence in patients aged 50–59 years (64.9%). Most cases were localized to the mandible (94.7%). Clinically, lesions were shallow ulcers (mean size: 0.75 ± 0.85 cm). Pain was the most common symptom (88.9%). Radiographs revealed no significant maxillary abnormalities, but some cases showed radiopaque areas in the mandible. Surgical interventions were most common (40.4%), with complete healing in 67.7% of cases within 4 weeks. Limitations include the predominance of case reports and series, which limits the strength of evidence. Conclusions: Recognizing OUBS can prevent misdiagnosis and unnecessary interventions. Further studies are needed to clarify its etiology and natural history. Registration: This review was registered on the PROSPERO database (registration number CRD42024541416). Full article

Background: Chronic atrophic gastritis precancerous lesions (PL-CAG) are characterized by the atrophy of gastric mucosal glands, often accompanied by intestinal metaplasia or dysplasia. Timely intervention and treatment can effectively reverse its malignant progression and prevent the onset of gastric cancer. Bombyx Batryticatus (BB) exhibits a range of pharmacological effects, including anticoagulation, antiepileptic properties, anticancer activity, and antibacterial effects. However, the pharmacological basis and mechanisms underlying BB’s efficacy in treating PL-CAG remain unclear. Methods: A three-factor modeling approach was implemented to develop a rat PL-CAG model, while the MNNG-induced PLGC (precancerous lesions of gastric cancer) cell model was served as a cell PL-CAG model. UPLC-QE-Orbitrap-MS/MS (Ultra performance liquid chromatography-quadrupole-electrostatic field orbital trap high-resolution mass spectrometry) was utilized to perform an in-depth analysis of the components in the plasma extract of BB. Leveraging network pharmacology, molecular docking analyses, and experimental validation, we initially elucidated the potential mechanisms through which BB mediates its therapeutic effects on PL-CAG at both in vivo and in vitro levels. Results: Prototype compounds of 42 blood-entering components were identified by UPLC-QE-Orbitrap-MS/MS analysis. Network pharmacology analysis and molecular docking studies indicate that the core targets are primarily enriched in the PI3K-Akt signaling pathway, and the key components, including Nepitrin, Quercetin 3-O-neohesperidoside, Rutin, and others, exhibited stable docking conformations with the first eleven pivotal targets. Both in vivo and in vitro experiments validated that BB may effectively treat PL-CAG via modulation of the PI3K-Akt signaling pathway. Conclusions: The therapeutic efficacy of BB in the management of PL-CAG may be achieved through the synergistic interaction of multiple components and targets, which may be more closely related to the inhibition of the PI3K/AKT signaling pathway. This approach will establish a solid experimental foundation and provide essential data for the clinical application of BB in treating PL-CAG, while also facilitating further research initiatives. Full article

Background: Colorectal cancer (CRC) is a term that refers to the combination of colon and rectal cancer as they are being treated as a single tumor. In CRC, 72% of tumors are colon cancer, while the other 28% represent rectal cancer. CRC is a multifactorial disease caused by both genetic and epigenetic changes in the colon mucosal cells, affecting the oncogenes, DNA repair genes, and tumor suppressor genes. Currently, two DNA methylation-based biomarkers for CRC have received FDA approval: SEPT9, used in blood-based screening tests, and a combination of NDRG4 and BMP3 for stool-based tests. Although DNA methylation biomarkers have been explored in colorectal cancer (CRC), the identification of robust and clinically valuable biomarkers remains a challenge, particularly for early-stage detection and precancerous lesions. Patients often receive diagnoses at the locally advanced stage, which limits the potential utility of current biomarkers in clinical settings. Methods: The datasets used in this study were retrieved from the GEO database, specifically GSE75548 and GSE75546 for rectal cancer and GSE50760 and GSE101764 for colon cancer, summing up to a total of 130 paired samples. These datasets represent expression profiling by array, methylation profiling by genome tiling array, and expression profiling by high-throughput sequencing and include rectal and colon cancer samples paired with adjacent normal tissue samples. Differential analysis was used to identify differentially methylated CPG sites (DMCs) and identify differentially expressed genes (DEGs). Results: From the integration of DMCs with DEGs in colorectal cancer, we identified 150 candidates for methylation-regulated genes (MRGs) with two genes common across all cohorts (GNG7 and PDX1) highlighted as candidate biomarkers in CRC. The functional enrichment analysis and protein–protein interactions (PPIs) identified relevant pathways involved in CRC, including the Wnt signaling pathway, extracellular matrix (ECM) organization, among other enriched pathways. Conclusions: Our findings show the strength of our in silco computational approach in jointly identifying methylation-regulated biomarkers for colon cancer and highlight several genes and pathways as biomarker candidates for further investigations. Full article

Autoimmune gastritis (AIG) has a strong correlation with gastric neuroendocrine tumors (NETs) and gastric cancer, making its timely and accurate diagnosis crucial for tumor prevention. The endoscopic manifestations of AIG differ from those of gastritis caused by Helicobacter pylori (H. pylori) infection in terms of the affected gastric anatomical regions and the pathological characteristics observed in biopsy samples. Therefore, when diagnosing AIG based on endoscopic images, it is essential not only to distinguish between normal and atrophic gastric mucosa but also to accurately identify the anatomical region in which the atrophic mucosa is located. In this study, we propose a patient-based multitask gastroscopy image classification network that analyzes all images obtained during the endoscopic procedure. First, we employ the Scale-Invariant Feature Transform (SIFT) algorithm for image registration, generating an image similarity matrix. Next, we use a hierarchical clustering algorithm to group images based on this matrix. Finally, we apply the RepLKNet model, which utilizes large-kernel convolution, to each image group to perform two tasks: anatomical region classification and lesion recognition. Our method achieves an accuracy of 93.4 ± 0.5% (95% CI) and a precision of 92.6 ± 0.4% (95% CI) in the anatomical region classification task, which categorizes images into the fundus, body, and antrum. Additionally, it attains an accuracy of 90.2 ± 1.0% (95% CI) and a precision of 90.5 ± 0.8% (95% CI) in the lesion recognition task, which identifies the presence of gastric mucosal atrophic lesions in gastroscopy images. These results demonstrate that the proposed multitask patient-based gastroscopy image analysis method holds significant practical value for advancing computer-aided diagnosis systems for atrophic gastritis and enhancing the diagnostic accuracy and efficiency of AIG. Full article