Search Results (41,008)

Spirulina-derived protein hydrolysates (SPPHs) have attracted considerable attention as bioactive agents due to their potential metabolic and physiological benefits. This study evaluated the therapeutic efficacy of different enzyme-specific SPPHs—Pepsin (SPPH-P), Trypsin (SPPH-T), Chymotrypsin (SPPH-C), and a combined hydrolysate (SPPH-PTC)—in high-fat diet (HFD)-induced male Wister rats, compared with Spirulina platensis protein extract (SPPE, formulated using freeze–thaw cycles and ultrasonication followed by centrifugation) and atorvastatin as a Positive Control. The animals were randomly allocated into seven groups (n = 6 per group) and received their respective treatments orally for 4 weeks. Across treatment groups, significant improvements in obesity-related anthropometric indices were observed, including reductions in BMI, Lee Index, and abdominal circumference to thoracic circumference ratio (AC:TC), with the strongest effects noted in the atorvastatin and SPPH-PTC groups. Protein metabolism markers showed enhanced hepatic and serum protein status, reflected by increased albumin and total protein concentrations. Lipid profile analysis revealed marked decreases in total cholesterol, triglycerides, and LDL in both serum and liver homogenates, while HDL exhibited non-significant but favorable elevations. Liver function markers (bilirubin, ALT, AST) and renal parameters (uric acid, BUN) demonstrated notable improvements, particularly in enzyme-derived hydrolysate groups and Positive Control. Antioxidant assessments indicated substantial reductions in MDA levels and significant increases in SOD, CAT, and GSH activities in serum and liver tissues, confirming enhanced oxidative stress resistance. Among all treatments, SPPH-PTC consistently produced the most robust therapeutic outcomes. Overall, Spirulina protein hydrolysates, especially the combined PTC formulation, exert comprehensive beneficial effects on metabolic regulation, hepatic and renal function, and oxidative balance. These findings support their potential application as functional bioactive agents for managing obesity-associated metabolic disturbances. Full article

Leptomeningeal metastasis (LM) is a severe and increasingly recognized complication of advanced non-small-cell lung cancer (NSCLC), particularly in patients with actionable genomic alterations. Although LM has historically been associated with poor outcomes, molecularly targeted systemic therapies with improved central nervous system (CNS) activity are reshaping its therapeutic landscape. This review summarizes current concepts in the pathogenesis, diagnosis, and risk stratification of LM, focusing on systemic treatment strategies for NSCLC harboring actionable driver alterations. We highlight the rationale and emerging evidence for next-generation tyrosine kinase inhibitors targeting EGFR, ALK, and other oncogenic drivers, and discuss their role as the cornerstone of LM management. Intrathecal chemotherapy, immunotherapy, and radiotherapy are also reviewed within a risk-adapted treatment framework. An individualized approach integrating molecular profiling, neurological status, and disease distribution is essential to optimize outcomes. Prospective studies are needed to refine systemic treatment strategies and establish evidence-based algorithms for this high-risk population. Full article

Background: Nutritional deterioration and systemic inflammation frequently accompany gastrointestinal cancers and may negatively affect treatment tolerance, quality of life, and clinical outcomes. This study aimed to evaluate nutritional status, dietary behaviors, inflammatory biomarkers, and multidimensional nutritional–inflammatory profiles in patients with gastrointestinal cancers within the context of tertiary prevention. Methods: A cross-sectional study was conducted among 150 patients with gastrointestinal cancers. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), while dietary behaviors were evaluated using an original questionnaire. Biochemical markers, including albumin, hemoglobin, C-reactive protein (CRP), fibrinogen, and neutrophil-to-lymphocyte ratio (NLR), were evaluated in participants with available laboratory data. Exploratory hierarchical clustering analysis was performed to identify multidimensional nutritional–inflammatory profiles. Results: According to the MNA classification, 79.3% of participants were at risk of malnutrition and 2.0% were malnourished despite predominantly normal or excessive body weight. Nutritional risk was identified in 91.4% of patients with normal BMI and in 79.5% of overweight patients. Only 32.0% of patients reported receiving dietary counseling during treatment, while oral nutritional supplements and therapeutic diets were used by 40.7% and 41.3% of participants, respectively. Biochemical analyses revealed elevated inflammatory markers accompanied by reduced albumin concentration and anemia-related abnormalities. Exploratory clustering analysis suggested three distinct nutritional–inflammatory profiles (Stable/Supported, Hidden Malnutrition, and Inflammatory Deterioration), highlighting metabolic heterogeneity within the study population. Conclusions: Patients with gastrointestinal cancers frequently present nutritional risk accompanied by inflammatory activation despite preserved or excessive body weight. A multidimensional assessment integrating nutritional screening, dietary evaluation, inflammatory biomarkers, and exploratory profile-based clustering may improve understanding of nutritional heterogeneity in gastrointestinal cancer patients and may support future research on individualized nutritional assessment and supportive care. Full article

Background/Objectives: Adult degenerative lumbar deformity is a heterogeneous condition in which outcome depends on radiographic correction, patient-related risk factors, and surgical burden. This study evaluated spinopelvic realignment, clinical outcomes, complications, and predictors of unfavorable postoperative course after surgical treatment of adult degenerative lumbar deformity. Methods: This three-center retrospective cohort study included adult patients who underwent posterior decompression and instrumented fusion, with or without interbody fusion, for adult degenerative lumbar deformity between January 2021 and December 2024. Of 136 screened patients, 113 completed final follow-up and were included in the analysis. The mean follow-up duration was 31.0 ± 12.9 months. Radiographic parameters were assessed preoperatively, immediately postoperatively, and at final follow-up. Patient-reported outcome measures were analyzed using available paired data. Unfavorable postoperative course was defined as persistent or worsened pain with functional limitation, symptomatic mechanical complication, deep infection requiring surgical treatment, or revision/reoperation. Results: Surgery produced significant immediate improvement in coronal and sagittal alignment. Cobb angle improved from 29.8 ± 13.1° to 13.7 ± 6.7°, lumbar lordosis increased from 28.8 ± 15.5° to 40.3 ± 16.0°, PI–LL mismatch decreased from 21.7 ± 10.0° to 10.1 ± 11.5°, and SVA decreased from 58.8 ± 31.4 mm to 32.5 ± 36.0 mm. Partial loss of correction was observed at final follow-up, although alignment generally remained improved compared with baseline. ODI improved from 57.8 ± 12.6 to 34.7 ± 8.7 in patients with available paired data. Any postoperative complication occurred in 42.5% (n = 48) of patients, revision/reoperation in 23.9% (n = 27), and unfavorable postoperative course in 35.4% (n = 40). In multivariable analysis, osteoporosis, greater fusion length, and residual immediate postoperative PI–LL mismatch were independently associated with unfavorable postoperative course. Conclusions: In this three-center retrospective cohort, surgery for adult degenerative lumbar deformity was associated with significant radiographic correction and meaningful clinical improvement in patients with available paired outcome data. However, the substantial complication and revision/reoperation burden highlights the morbidity of adult degenerative lumbar deformity surgery. Osteoporosis, fusion length, and residual immediate postoperative PI–LL mismatch may help identify patients at higher risk for unfavorable postoperative course. Full article

Background/Objective: The psychosexual burden of human papillomavirus (HPV)-induced genital warts (GWs) in men remains underexplored. This study aimed to determine the prevalence of sexual dysfunction in men with GWs and to evaluate the effects of disease duration and condom use on the sexual cycle using the International Index of Erectile Function (IIEF-15). Methods: This single-center, cross-sectional study was conducted in the dermatology outpatient clinic of Kayseri City Education and Research Hospital between May and June 2026 and enrolled 150 sexually active male patients with clinically diagnosed, currently present genital wart lesions. To minimize reading comprehension and social desirability biases, a two-stage protocol was implemented. First, a clinician explained each IIEF-15 item face-to-face. Patients then completed the questionnaire independently and submitted it in a sealed envelope. Associations were analyzed using Spearman’s rank correlation, and group comparisons used the Mann–Whitney U and Kruskal–Wallis tests. Results: The median age was 30.0 years (IQR 25.0–36.0) and the median disease duration was 18.0 months (IQR 8.0–35.8). Erectile dysfunction (ED) of varying severity was detected in 84.7% (n = 127) of patients. In unadjusted analysis, longer disease duration was associated with lower sexual function scores; however, these associations did not remain significant after adjustment for age. As ED severity increased, all other sexual function domains declined concurrently and strongly (Spearman rho ranging from −0.679 to −0.821; p < 0.0001). Condom users exhibited higher total sexual function scores than non-users (median 55.5, IQR 43.2–61.0 vs. median 49.5, IQR 37.0–60.0); however, this difference did not reach statistical significance (p = 0.076). Conclusions: Genital warts in men constitute a major psychosexual condition that disrupts multiple phases of the sexual response cycle, not merely a dermatological lesion. Our cross-sectional findings suggest that lesion-directed treatment alone may not fully address this psychosexual burden: whether the proactive integration of multidisciplinary sexual counseling improves outcomes should be tested in controlled, longitudinal studies. Full article

Background: Postural problems such as head forward posture, thoracic hyperkyphosis, and lumbar hyperlordosis, when seen together, further complicate postural control, increasing the importance of comprehensive approaches in treatment. This study aims to examine the effect of 6 weeks of telerehabilitation with web-based exercises and compare the home-based exercises in individuals with postural problems. Trial Design: A Randomized Controlled Study. Methods: A total of 34 volunteers with postural deformity among young adults were randomly divided into telerehabilitation (n = 17) and control (n = 17) groups. Craniovertebral, thoracic kyphosis, and lumbar lordosis angles of all individuals were evaluated with a smartphone application (Clinometer+ Bubble), hamstring and pectoral muscle shortness with a goniometer, and trunk muscle endurance with endurance tests created by McGill and Sorenson. Whilst the tele-rehabilitation group was provided with a video-based exercise program, the control group was advised to follow the same exercise program at home. Exercises were performed 3 days a week for 6 weeks, as 1-h sessions. Participants in the telerehabilitation group were followed up with a synchronized video conference. Results: A significant difference was observed in the telerehabilitation group in muscle shortness and the endurance tests (p < 0.05). Only a significant difference in left (p = 0.03) and right (p = 0.04) muscle shortness was observed in the home exercise group. Significant differences were observed in Craniovertebral and lumbar lordosis angles between groups (p < 0.05), with the telerehabilitation group showing better outcomes. The kyphosis angle, muscle shortness, and endurance test results between groups were found to be similar (p > 0.05). Conclusions: Six weeks of telerehabilitation can improve muscle shortness and trunk endurance in young adults with postural deformities. Both the exercise program using telerehabilitation and the home exercise program were beneficial for individuals with postural problems, with more favorable effects observed in the telerehabilitation group. Full article

Tuberculosis (TB) remains a leading cause of death from a single infectious agent, and its outcome is shaped not only by Mycobacterium tuberculosis (Mtb) itself, but also by the host’s metabolic state. This review synthesises current understanding of how Mtb reprograms macrophage immunometabolism and how this reprogramming propagates to a systemic level, culminating in skeletal muscle dysregulation and TB-associated cachexia. We describe the molecular mechanisms by which Mtb subverts phagosomal maturation, the glycolytic (Warburg-like) switch governed by HIF-1α and accumulation of immunomodulatory tricarboxylic acid cycle intermediates, and the M1/M2 polarisation balance that dictates bacterial containment versus persistence. We then trace the cytokine- and metabolite-mediated circuits (TNF-α, IL-6, IL-1β, lactate, ketone bodies, free fatty acids) that link infected macrophages to ubiquitin–proteasome and autophagy–lysosome-driven muscle proteolysis, mitochondrial dysfunction and oxidative stress. Building on these mechanisms, we propose an immunometabolic and muscle-derived biomarker framework that, although still requiring clinical validation, may offer value for diagnosis, host-response stratification and treatment monitoring, and we discuss host-directed therapeutic strategies that target macrophage metabolism and muscle preservation. By integrating immunity, metabolism and systemic pathology at the molecular level, this work highlights translational opportunities relevant to the host immunity, diagnosis and treatment of tuberculosis. Full article

Global population aging has emerged as a major driver of the growing burden of neurological diseases, highlighting the urgent demand for advances in early diagnosis, prevention, and rehabilitation. These conditions are typically characterized by insidious onset and irreversible progression, yet their clinical management remains critically compromised by substantial diagnostic delays, representing an intractable bottleneck for existing detection technologies. Therefore, the development of precise, early-stage detection technologies is crucial for expanding the therapeutic window and improving long-term clinical outcomes, addressing a critical unmet clinical need. Herein, we review and compare precision detection strategies for neurological diseases, focusing on the types and mechanisms of mainstream biosensing platforms. Based on the classification of detection substrates and signal transduction mechanisms, four major bio-detection branches are analyzed, including liquid, exosomal, imaging, and digital biomarker detection, with representative studies demonstrating detection limits reaching femtomolar concentrations, clinical diagnostic sensitivities exceeding 90%, and classification accuracies comparable to or surpassing conventional imaging modalities. The inherent advantages and limitations of each biosensing technology are also comprehensively discussed. This review underscores that future research on neurological biomarker sensing is trending toward multimodal integration, which enables the construction of more robust early warning and prognostic assessment systems. This work aims to provide valuable theoretical insights for clinical translation of relevant sensing technologies and integrated diagnostic and treatment strategies, thereby facilitating the progress of early intervention and rehabilitation for common neurological diseases. Full article

Background: Immune checkpoint inhibitors (ICIs) have transformed cancer treatment but are associated with immune-related adverse events (irAEs) and variable clinical outcomes. Clinical predictors of organ-specific irAEs remain indeterminate, particularly in real-world populations. Methods: We conducted a retrospective single-center cohort study including 751 adult patients with solid tumors treated with ICIs between 2018 and 2025. Clinical, demographic, and treatment-related variables were analyzed. Multivariable logistic regression identified predictors of irAEs, while associations with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were assessed using logistic and Cox regression models. Results: The most frequent irAEs were endocrine (9.9%), dermatologic (9.1%), gastrointestinal (7.6%), and pulmonary (4.7%). Female sex independently predicted endocrine (aOR 1.98, p = 0.007) and rheumatologic irAEs (aOR 4.06, p = 0.007). Combination immunotherapy was associated with increased dermatologic (aOR 2.66, p = 0.013) and gastrointestinal irAEs (aOR 2.65, p = 0.016), while concurrent radiotherapy predicted gastrointestinal toxicity (aOR 1.82, p = 0.044). Atezolizumab was associated with higher pulmonary irAE risk (aOR 2.97, p = 0.048). Endocrine, dermatologic, gastrointestinal, and pulmonary irAEs were independently associated with improved ORR (OR range: 2.53–4.30, all p < 0.01). Conclusions: Organ-specific irAEs exhibit distinct clinical predictors and differential prognostic implications in patients receiving ICIs. Select irAEs are associated with improved treatment response and disease control, yet our results should be regarded as hypothesis-generating requiring further investigation. Full article

Peritoneal metastasis (PM) is the most frequent and lethal pattern of dissemination in gastrointestinal malignancies. Despite advances in systemic chemotherapy, outcomes remain poor because the unique biology of PM, characterized by poor vascularization and the peritoneal–plasma barrier (PPB), limits drug penetration and contributes to treatment resistance. To address these challenges, several locoregional treatment strategies have been developed, including cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) and pressurized intraperitoneal aerosol chemotherapy (PIPAC). However, their widespread adoption is constrained by invasiveness, strict patient selection, and inconsistent survival benefits. Normothermic intraperitoneal and systemic treatment (NIPS) has emerged as a practical and less invasive alternative, particularly in East Asia. Through an implanted intraperitoneal port, NIPS enables repeated drug administration, providing sustained regional exposure while imposing minimal procedural burden. Importantly, it can be readily integrated with systemic chemotherapy, making it suitable for long-term multimodal treatment. Among available agents, paclitaxel (PTX) is particularly well suited for intraperitoneal administration because of its prolonged retention within the peritoneal cavity and limited systemic absorption. These pharmacokinetic properties allow high local drug concentrations with relatively low systemic toxicity. Consequently, PTX-based NIPS represents a biologically rational and clinically feasible treatment strategy for PM. This review summarizes the pharmacological rationale, clinical evidence, and emerging innovations in drug formulation and delivery that may further enhance the efficacy of PTX-based intraperitoneal chemotherapy for this challenging disease. Full article

Background and Objectives: Faricimab, the first bispecific antibody targeting VEGF-A and angiopoietin-2, has demonstrated durable efficacy in pivotal phase 3 trials for neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). Real-world data on treatment-naïve patients managed with fixed-interval maintenance protocols, particularly from South-Eastern Europe, remain limited. This pilot study evaluated 24-month outcomes of intravitreal faricimab in treatment-naïve nAMD and DME, using a standardized four-injection loading phase followed by fixed every-16-week (Q16W) maintenance. Materials and Methods: This study conducted a retrospective, observational, single-center pilot cohort study of 20 consecutive treatment-naïve eyes (9 nAMD, 11 DME). All patients received four monthly loading injections followed by a fixed every-16-week (Q16W) maintenance schedule, supplemented by discretionary additional injections for residual or recurrent disease activity (215 injections total; mean 10.75 ± 0.79 per patient; range 9–12). Primary outcomes were changes in central foveal thickness (CFT) and best-corrected visual acuity (BCVA; Snellen lines with ETDRS letter equivalents) at months 4 and 24. Prespecified secondary analyses included bootstrap 95% confidence intervals, a linear mixed-effects model with a time × disease-group interaction, Bayesian credible intervals with weakly informative priors, false-discovery-rate (FDR) correction, and a minimum detectable effect-size analysis. Results: All 20 eyes completed 24-month follow-up. In nAMD, mean CFT decreased by 186.9 ± 71.9 µm (35.9%; bootstrap 95% CI 148.1–236.0; p < 0.001; d = 2.60), and BCVA improved by 3.89 ± 0.78 Snellen lines (~19 ETDRS letters; 95% CI 3.44–4.33; p < 0.001; d = 4.97). In DME, CFT decreased by 197.7 ± 65.7 µm (39.3%; 95% CI 162.5–237.3; p < 0.001; d = 3.01), and BCVA improved by 4.55 ± 1.04 lines (~23 ETDRS letters; 95% CI 4.00–5.09; p < 0.001; d = 4.39). All 20 eyes (100%) achieved ≥ 3 Snellen lines gain and ≥20% CFT reduction; 80% reached final BCVA ≥ 7 lines. A linear mixed-effects model showed a significant time effect (p < 0.001) but no time × group interaction (CFT p = 0.84; BCVA p = 0.51), indicating concordant trajectories across diseases. Bayesian analysis with weakly informative priors yielded posterior P(|d| > 0.8) ≥ 0.99 for all primary outcomes. After FDR correction, all pre-specified primary comparisons remained significant. The minimum detectable effect size with the realized sample sizes (Cohen’s d ≈ 0.66 combined, 1.07 nAMD, 0.94 DME at 80% power) was substantially below all observed effect sizes. No ocular or systemic adverse events were recorded. Conclusions: In this small, single-center, treatment-naïve pilot cohort, a fixed Q16W faricimab maintenance schedule with discretionary additional injections was associated with durable anatomical and functional improvements over 24 months in both nAMD and DME, with no adverse events recorded across 215 injections. Given the limited sample, these findings should be regarded as hypothesis-generating. The high responder rates likely reflect the cohort’s substantial baseline visual impairment (mean baseline BCVA ~20/120–20/200), which provides greater absolute capacity for measurable gain than in higher-acuity registration trial populations. These pilot data support fixed-interval faricimab as a logistically feasible candidate strategy in resource-constrained settings and should be confirmed in larger multicenter cohorts using standardized ETDRS acuity assessment. Full article

Background/Objectives: Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy characterized by limited treatment options and poor prognosis. Gemcitabine is a commonly used chemotherapy; however, gemcitabine resistance in PDAC poses a critical barrier to effective treatment, as the underlying mechanisms are not yet fully understood. Methods: This study employs an exploratory untargeted metabolomics approach to investigate metabolic differences in PDAC cells in the presence and absence of gemcitabine treatment. HPAF-II, MIA PaCa-2, and BxPC-3 cell lines were used as models for gemcitabine-resistant, moderately responsive, and permissive PDAC cells, respectively. Results: MTT assay results revealed that BxPC-3 cells are highly sensitive to gemcitabine treatment, HPAF-II cells are the most resistant, and MIA PaCa-2 cells exhibit moderate sensitivity. Orthogonal Partial Least Squares Discriminant Analysis (OPLS-DA) of the metabolomics data demonstrated clear differentiation of gemcitabine-treated and untreated (control) cells. When comparing the treated vs. control conditions, 170 metabolites matched to an in-house library of standards were significant (p < 0.05 or fold change ≥ 2 or VIP ≥ 1) differentiators in HPAF-II cells, whereas MIA PaCa-2 and BxPC-3 cells had 178 and 218 differentiating metabolites, respectively. HPAF-II cells treated with gemcitabine had significantly higher levels of N-acetylneuraminic acid and 7-dehydrocholesterol compared with the control group. In contrast, these metabolites were significantly lower or non-significant in BxPC-3 treated cells. Pathway analysis revealed that the steroid biosynthesis pathway was significantly perturbed in HPAF-II cells, whereas amino sugar and nucleotide sugar metabolism was predominantly altered in BxPC-3 cells. Conclusions: Overall, this exploratory study reveals metabolic differences between treated and untreated cells to derive targeted therapeutic strategies that could be used in the future to improve treatment outcomes for PDAC patients. Full article

Psychological stress can affect female reproductive function through behavioral, endocrine, ovarian, and oxidative mechanisms. Antioxidant supplements have therefore attracted attention for their potential to mitigate stress-related reproductive alterations. Coenzyme Q10 (CoQ10) is a lipid-soluble quinone involved in mitochondrial energy metabolism and is widely used as a dietary supplement. However, whether CoQ10 modulates female reproductive responses to repeated psychological stress remains unclear. Although water avoidance stress (WAS) is a well-established psychogenic stress model, its effects on female reproductive outcomes are still not fully defined. In this study, we examined how repeated WAS affects female reproductive outcomes and whether CoQ10 modifies these effects. Twenty-eight regularly cycling female rats were assigned to sham control, WAS, CoQ10, or WAS + CoQ10 groups. WAS was applied for 1 h/day for 10 days, and CoQ10 was administered orally at 100 mg/kg/day. Repeated WAS did not significantly alter sexual incentive motivation parameters, reproductive hormones, corticosterone, total antioxidant capacity (T-AOC), 8-hydroxy-deoxyguanosine (8-OHdG), or mast cell count under the present experimental conditions (all p > 0.05). However, WAS reduced male-directed active investigation time (p = 0.008) and male investigation preference ratio (p = 0.024), increased absolute ovarian and adrenal gland weights (p = 0.035 and p = 0.016, respectively), reduced primordial follicle number (p = 0.030), decreased germinative epithelium thickness (p = 0.017), lowered VEGF histoscore (p = 0.033) regardless of CoQ10 treatment, and reduced corpus luteum angiogenesis in animals not receiving CoQ10 (p = 0.030). CoQ10 reduced total investigation time toward the male (p = 0.032), male investigation preference ratio (p = 0.037), 17-β estradiol (E2) (p = 0.003), testosterone (p = 0.021), and germinative epithelium thickness (p < 0.001) regardless of WAS exposure. CoQ10 also decreased kisspeptin-1 levels under non-stressed conditions (p = 0.010), while increasing corpus luteum angiogenesis under stress conditions (p = 0.003). Overall, repeated WAS produced selective behavioral and ovarian alterations rather than broad reproductive dysfunction. CoQ10 was not associated with a broadly protective or uniformly beneficial profile in this model, and its endocrine, behavioral, and ovarian effects should be interpreted with caution. Full article

Candida auris has emerged as a multidrug-resistant, healthcare-associated pathogen worldwide; however, outcome data on C. auris candidaemia in East Asia remain limited. We conducted a retrospective cohort study of adult patients with candidaemia who received antifungal therapy at a tertiary hospital in Seoul, Republic of Korea, from January 2023 to December 2024, comparing C. auris with other Candida species. Confounding was addressed by inverse probability of treatment weighting (IPTW) using a five-covariate propensity score (age, Charlson Comorbidity Index, septic shock, ICU admission at antifungal initiation, and concomitant Gram-negative infection). Among 423 patients, C. auris accounted for 6.9% of cases and was uniformly fluconazole non-susceptible, with frequent high-level caspofungin resistance but preserved micafungin and anidulafungin susceptibility. Patients with C. auris were older, with greater comorbidity and more frequent ICU admission at antifungal initiation. After IPTW adjustment, C. auris was not associated with higher 30-day mortality, the primary outcome (adjusted hazard ratio 0.59, 95% CI 0.26–1.32); the wide confidence interval indicates limited precision rather than equivalence, and results were directionally consistent for 90-day and in-hospital mortality and across sensitivity analyses that varied both the comparison cohort and the analytic method. Residual confounding by unmeasured illness severity and limited precision preclude concluding equivalence. Continued surveillance, molecular characterisation, and infection control remain essential. Full article

Background/Objectives: Psilocibin (PSY), a serotonergic hallucinogen, has attracted increasing scientific interest due to its therapeutic potential, particularly in treatment-resistant depression. In parallel with its growing clinical and research relevance, important questions have emerged regarding its safety profile, including potential effects on the liver, kidneys, cardiovascular system, and immune function. The aim of this narrative review was to systematically collect, critically appraise, and organize the dispersed evidence regarding potential multi-organ safety signals associated with PSY exposure. Methods: A narrative review was conducted including preclinical studies, pharmacological investigations, available clinical data, and published case reports, including reports of mushroom-related intoxications involving PSY-containing species. All available sources addressing potential toxicological outcomes associated with PSY were considered, regardless of exposure context, in order to reflect the current state of evidence. Results: The available evidence base is limited and heterogeneous, consisting primarily of case reports, observational data, and mechanistic preclinical studies. Reported adverse events are rare and frequently confounded by polysubstance use, uncertainty of dose, co-ingestion of other compounds, and lack of exposure standardization. Despite these limitations, biologically plausible mechanisms related to serotonergic receptor activation provide a rationale for further investigation of potential organ-specific effects. However, current controlled clinical data do not provide consistent evidence supporting intrinsic multi-organ toxicity of PSY. Conclusions: Current evidence does not confirm clinically meaningful intrinsic multi-organ toxicity of PSY under controlled conditions. Nevertheless, the available literature suggests the presence of potential safety signals that warrant further systematic evaluation. In the context of growing clinical interest in PSY, this review provides a structured synthesis of current knowledge and highlights critical gaps in understanding its organ-specific safety profile. Full article