Search Results (733)

Background/Objectives: Chemotherapy is an aggressive form of oncological treatment often accompanied by numerous adverse effects. A patient’s baseline status significantly influences the course of therapy, its efficacy, quality of life, and overall survival. This review aims to analyze the published peer-reviewed studies in this area and to assess whether they permit the formulation of preliminary recommendations for future prehabilitation protocols. Methods: An integrative review was conducted due to the limited number of relevant studies. Four databases—MEDLINE/PubMed (Medical Literature Analysis and Retrieval System Online/National Library of Medicine), Scopus, Cochrane, and Web of Science—were systematically searched for English-language articles published between 2010 and 13 January 2025, using the terms “prehabilitation,” “chemotherapy,” “drug therapy,” and “neoadjuvant.” A total of 162 records were retrieved. After duplicate removal, titles and abstracts were screened. The remaining papers were subjected to detailed analysis, resulting in ten studies with diverse methodologies being included. Results: We reviewed ten (n = 10) studies, most of which were reviews focused on breast cancer, indicating variation in the state of knowledge across different cancer types. A protein intake of 1.4 g/kg body mass helps preserve fat-free mass, with whey being more effective than casein. Omega-3 fatty acid supplementation at a dose of 2.2 g/kg may prevent chemotherapy-related neurotoxicity and support appetite and weight maintenance. Physical activity, especially when it includes strength training, improves VO₂max, preserves fat-free mass, and may reduce stress and anxiety. We identified one randomized controlled trial in which a single exercise session before the first dose of doxorubicin resulted in a smaller reduction in cardiac function. Continuous psychological support should be available. A combined behavioural and pharmacological approach appears to be the most effective strategy for smoking cessation. Conclusions: No official guidelines exist for prehabilitation before chemotherapy, and the availability of studies on this topic is very limited. The pre-treatment period represents a critical window for interventions. Further research is needed to evaluate the effectiveness and applicability of particularly single-component interventions. Full article

There is increasing use of modern medicine globally to manage cardiovascular diseases (CVDs). However, many people, especially in low-to-middle-income countries, still rely on traditional medicinal plants for their daily health needs. However, limited studies have explored the use of these remedies. Therefore, this narrative review aimed to evaluate the potential of Sclerocarya birrea (S. birrea) in managing diabetes, dyslipidemia, inflammation, and hypertension, including its effects on oxidative stress. This study reviewed evidence from PubMed, Web of Science, and ResearchGate, published in these databases up to 30 April 2025. The evidence showed that S. birrea had the potential to preserve cardiometabolic health and reduce CVD-associated risk factors. Notably, S. birrea improved glucose metabolism, inflammation, hypertension, and oxidative stress. This plant exhibits antihyperglycemic effects by activating adenosine monophosphate-activated protein kinase (AMPK) and inhibiting gluconeogenesis and the activities of carbohydrase. It also ameliorates dyslipidemia by modulating the activities of peroxisome proliferator-activated receptor alpha (PPARα) and increasing fatty acid oxidation. The anti-inflammatory potential of S. birrea is modulated by the activation of PPARα, which inhibits nuclear factor kappa beta (NF-κβ) and decreases the production of inflammatory cytokines. Its antioxidant property is attributed to its ability to increase antioxidant enzymes like catalase (CAT), superoxide dismutase (SOD), and glutathione (GSH), which are known to counteract oxidative damage. However, it is important to note that different parts of the plant had varying impacts on CVD risk factors, depending on whether the study was conducted preclinically or clinically. Therefore, its extract should be explored as a potential remedy for the management of CVD risk factors, especially in areas where access to healthcare is limited. Full article

Background: Inherent to the challenge of acute pulmonary embolism (APE), the breadth of presentation ranges from asymptomatic pulmonary emboli to sudden death. Risk stratification of patients with APE is mandatory for determining the appropriate therapeutic management approach. However, the optimal clinically most relevant combination of predictors of death remains to be determined. Radiomics is an emerging discipline in medicine that extracts and analyzes quantitative data from medical images using mathematical algorithms. In APE, these data can reveal thrombus characteristics that are not visible to the naked eye, which may help to more accurately identify patients at higher risk of early clinical deterioration or mortality. We conducted a scoping review to explore the current evidence on the prognostic performance of radiomic models in patients with APE. Methods: PubMed, Web of Science, EMBASE, and Scopus were searched for studies published between January 2010 and April 2025. Eligible studies evaluated the use of radiomics to predict adverse outcomes in patients with APE. The PROSPERO registration number is CRD420251083318. Results: Nine studies were included in this review. There was significant heterogeneity in the methodology for feature selection and model development. Radiomic models demonstrated variable performance across studies. Models that combined radiomic features with clinical data tended to show better predictive accuracy. Conclusions: This scoping review underscores the potential of radiomic models, particularly when combined with clinical data, to improve risk stratification in patients with APE. Full article

Skin aging is a complex biological process influenced by intrinsic factorssuch as genetic predispositions and hormonal changes as well as extrinsic factors including ultraviolet radiation, environmental pollution, and lifestyle habits. This process culminates in a progressive decline in the structural and functional integrity of the skin. This review delves into the protective roles of carotenoids, highlighting their significant anti-oxidative, anti-inflammatory, and photoprotective properties. We included studies that investigated the effects of dietary or topical carotenoids on skin aging markers in human and animal models. Eligible studies were identified through searches of PubMed, Scopus, Web of Science, Embase, Google Scholar, and the Cochrane Library from January 2000 to March 2025. Risk of bias was assessed using the Cochrane RoB tool for randomized trials and animal studies. A total of 176 studies were included, and data were synthesized narratively due to heterogeneity in study designs and outcomes. The findings indicate that carotenoids mitigate oxidative stress-induced cellular damage by scavenging reactive oxygen species (ROS) and Reactive Nitrogen Species (RNS), attenuating chronic inflammation, and enhancing dermal matrix integrity via collagen biosynthesis and modulation of matrix metalloproteinases. Additionally, they support skin hydration and elasticity by indirectly regulating aquaporins and promoting hyaluronic acid synthesis. This review further explores emerging strategies that incorporate carotenoid supplementation in lifestyle medicine and preventive dermatology. By elucidating the cellular pathways through which carotenoids exert their effects and modulate mitochondrial function, this review highlights their translational potential in anti-aging skincare. Ongoing research is essential to comprehend the complex connections between carotenoids, skin physiology, and overall health. This understanding will ultimately facilitate the creation of personalized nutritional and dermocosmetic strategies. Full article

Background/Objectives: Cellular senescence is characterised by irreversible cell cycle arrest and the secretion of a proinflammatory phenotype. In recent years, senescent cell accumulation and senescence-associated secretory phenotype (SASP) secretion have been linked to the onset of chronic degenerative diseases associated with ageing. In this context, the senotherapeutic compounds have emerged as promising drugs that specifically eliminate senescent cells (senolytics) or diminish the damage caused by SASP (senomorphics). On the other hand, computational approaches, such as network pharmacology and machine learning, have revolutionised the identification of novel drugs. These tools enable the analysis of large volumes of compounds and the optimisation of the search for the most promising ones as potential drugs. Therefore, we employed such approaches in the present study to identify potential senotherapeutic compounds. Methods: First, we constructed drug-protein interaction networks related to cellular senescence. Then, using three machine learning models (Random Forest, Support Vector Machine, and K-Nearest Neighbours), we classified these compounds based on their therapeutic potential against senescence. Results: Our results enabled us to identify 714 compounds with potential senescent therapeutic activity, of which 270 exhibited desirable medicinal chemistry properties, and we developed an interactive web tool freely accessible to the scientific community. Conclusions: we found that flavonoids were the most abundant compound class from which 18 have never been reported as senotherapeutics. Full article

Background/Objectives: Physical activity (PA) is widely recognized as a beneficial approach to improving the health-related quality of life (HRQoL) of breast cancer survivors. This study explored key research topics and emerging trends in studies related to PA and HRQoL among breast cancer survivors. Methods: Titles and abstracts of 3847 English-language research articles (2000–2024) were retrieved from PubMed, EMBASE, Web of Science, and Scopus using keywords related to ‘breast cancer’, ‘PA/exercise’, and ‘HRQoL’. A text-mining algorithm based on the Dirichlet-multinomial regression approach in Python was applied to identify the top 10 research topics and their trends over time. Results: In total, 10 key topics emerged: (1) Quality of Life and Well-being, (2) Cancer Treatment and Health-Related Fitness, (3) Supportive Care and Psychosocial Factors, (4) Survivorship, Palliative Care, and Integrative Medicine, (5) Physical Activity and Sedentary Behaviors, (6) Upper Limb-Related Side Effects, (7) Cancer-Related Fatigue and Symptoms, (8) Epidemiological and Clinical Factors, (9) Side Effects of Cancer Treatment, and (10) Weight Management. Among these, Topics 1, 2, 3, 8, and 9 followed upward trajectories, while others showed relatively stable trends. Conclusions: Findings highlight that PA research on breast cancer survivors’ HRQoL spans all stages of survivorship and considers both clinical outcomes and psychosocial and emotional well-being. Understanding how PA and HRQoL have been represented in research helps clarify which survivor needs have received attention and which remain underexplored. These thematic patterns underscore growing acknowledgement of survivors’ lived experiences and offer a roadmap for addressing future research and care gaps. Full article

Plant-derived pharmaceuticals represent a highly compelling area of research and continue to attract significant interest from countries, regions, scientific communities, and pharmaceutical companies worldwide. Among these, α- and β-amyrins have been identified as high-value triterpenoid compounds with a broad spectrum of potential therapeutic properties, including anti-inflammatory, antidiabetic, antiatherosclerotic, analgesic, antigout, neuroprotective, anti-Parkinsonian, anticancer, antibacterial, and anti-HIV activities. Relevant information and data were obtained through comprehensive searches of major scientific databases, including Web of Science, Elsevier, and the National Library of Medicine. This study highlighted the pharmaceutical potential of α- and β-amyrins, supported by specific evidence from in vivo, in vitro, and clinical trials. Various extraction methods for α- and β-amyrins are discussed, followed by recommendations for future directions in the development of these compounds as pharmaceutical agents and functional food ingredients. This review highlights the therapeutic of α- and β-amyrin compounds in the prevention and treatment of various serious diseases worldwide, potentially opening new opportunities and directions for the pharmaceutical industry. Full article

Objective—To identify effective data analytics and machine learning solutions that can help in the decision-making process in the medical domain and contribute to the understanding of COVID-19 disease. In this study, we analyze data from anonymized electronic medical records of 4711 patients with COVID-19 disease admitted to hospital in Atlanta. Methods—We used random forest, LightGBM, XGBoost, CatBoost, KNN, SVM, logistic regression, and MLP neural network models in this work. The models are evaluated depending on the type of prediction by relevant metrics, especially accuracy, F1-score, and ROC AUC score. Another aim of the work was to find out which factors most affected severity and mortality risk among the patients. To identify the important features, different statistical methods were used, as well as LASSO regression, and explainable artificial intelligence (XAI) method SHAP values for model explainability. The best models were implemented in a web application and tested by medical experts. The model for prediction of mortality risk was tested on a validation cohort of 45 patients from the Department of Infectiology and Travel Medicine, L. Pasteur University Hospital in Košice (UNLP). Results—Our study shows that the best model for predicting COVID-19 disease severity was the LightGBM model with accuracy of 88.4% using all features and 89.5% using the eight most important features. The best model for predicting mortality risk was also the LightGBM model, which achieved a ROC AUC score of 83.7% and a classification accuracy of 81.2% using all features. Using a simplified model trained on the 15 most important features, the ROC AUC score was 83.6% and the classification accuracy was 80.5%. We deployed the simplified models for predicting COVID-19 disease severity and for predicting the risk of COVID-19-related death in a web-based application and tested them with medical experts. This test resulted in a ROC AUC score of 83.6% and an overall prediction accuracy of 73.3%. Full article

Background/Objectives: Older adults (65+) are the fastest growing age group in Canada, comprising 18.8% of the country’s population. During the COVID-19 pandemic, use of virtual care, including telehealth and tele-medicine, increased dramatically among older adults in Canada who often face higher health risks, mobility limitations, and many barriers to accessing healthcare. Despite the rapid expansion in virtual care, no systematic review has focused specifically on virtual care among older adults in Canada. This review aims to explore the factors influencing virtual care adoption and the experiences of older Canadians during the pandemic through a systematic review. Methods: Conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, the review involved a comprehensive search of PubMed, Scopus, ESCBOHost, and Web of Science on 2 May 2025, yielding 281 unique citations. After screening and applying eligibility criteria, 15 studies employing quantitative, qualitative, or mixed-methods designs, with sample sizes ranging from 15 to 2,282,798, were included and appraised using the Mixed Methods Appraisal Tool (MMAT). Results: The review identified three domains of factors and the ways in which each factor shapes older adults’ virtual care experiences: (1) personal factors influencing virtual care use and demand (e.g., age, education, language, income, immigration status, community sizes), (2) resource factors impacting virtual care adoption (e.g., technology access, support), and (3) varying virtual care experiences among older adults (e.g., in assessment and communication efficacy, privacy, care quality, convenience, safety, and costs). Conclusions: This review highlights the complexities of virtual care engagement among older adults and underscores the need for inclusive, tailored strategies to improve the accessibility and effectiveness of virtual care delivery in both pandemic and post-pandemic contexts. Full article

Background and aim: Advanced Therapy Medicinal Products (ATMPs) are innovative drugs based on genes, tissues, or cells that target rare and severe diseases. ATMPs have shown promising clinical outcomes but are associated with high costs, raising questions about cost-effectiveness. Hence, this systematic review aims to analyze the cost-effectiveness and cost-utility profiles of the European Medicines Agency-authorized ATMPs for treating rare diseases. Methods: A systematic review was conducted following PRISMA guidelines. Studies were identified by searching PubMed, Embase, Web of Science, and ProQuest scientific databases. Economic evaluations reporting incremental cost-effectiveness/utility ratios (ICERs/ICURs) for ATMPs were included. Costs were standardized to 2023 Euros, and a cost-effectiveness plane was constructed to evaluate the results against willingness-to-pay (WTP) thresholds of EUR 50,000, EUR 100,000, and EUR 150,000 per QALY, as part of a sensitivity analysis. Results: A total of 61 studies met the inclusion criteria. ATMPs for rare blood diseases, such as tisagenlecleucel and axicabtagene ciloleucel, were found to be cost-effective in a majority of studies, with incremental QALYs ranging from 1.5 to 10 per patient over lifetime horizon. Tisagenlecleucel demonstrated a positive cost-effectiveness profile in the treatment of acute lymphoblastic leukemia (58%), while axicabtagene ciloleucel showed a positive profile in the treatment of diffuse large B-cell lymphoma (85%). Onasemnogene abeparvovec for spinal muscular atrophy (SMA) showed uncertain cost-effectiveness results, and voretigene neparvovec for retinal diseases was not cost-effective in 40% of studies, with incremental QALYs around 1.3 and high costs exceeding the WTP threshold set. Conclusions: ATMPs in treating rare diseases show promising economic potential, but cost-effectiveness varies across indications. Policymakers must balance innovation with system sustainability, using refined models and the long-term impact on patient outcomes. Full article

The genus Sonchus (Asteraceae) comprises 98 species, including 17 predominantly herbaceous taxa native to the Mediterranean region. These plants have long been utilized as traditional wild food sources due to their high nutritional value, as they are rich in vitamins A, C, and K, essential minerals, and bioactive compounds with antioxidant and anti-inflammatory properties. This review aims to provide a comprehensive synthesis of the taxonomy, geographic distribution, phytochemical composition, traditional uses, historical significance, and pharmacological properties of Sonchus species. A systematic literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar, focusing on studies from 1980 to 2024. Inclusion and exclusion criteria were applied, and methodological quality was assessed using standardized tools. A bibliometric analysis of 440 publications (from 1856 to 2025) reveals evolving research trends, with S. oleraceus, S. arvensis, and S. asper being the most extensively studied species. The review provides detailed taxonomic insights into 17 species and 14 subspecies, emphasizing their ecological adaptations and biogeographical patterns. Additionally, it highlights the cultural and medicinal relevance of Sonchus since antiquity while underscoring the threats posed by environmental degradation and changing dietary habits. Sonchus oleraceus and S. tenerrimus dominate the culinary applications of the genus, likely due to favorable taste, wide accessibility, and longstanding cultural importance. The comprehensive nutritional profile of Sonchus species positions these plants as valuable contributors to dietary diversity and food security. Finally, the study identifies current knowledge gaps and proposes future research directions to support the conservation and sustainable utilization of Sonchus species. Full article

Objectives: Digitalization has revolutionized dentistry, introducing advanced technological tools that improve diagnostic accuracy and access to healthcare. This study aims to examine the effects of integrating digital technologies into the dental field, analyzing the associated benefits and risks, with particular paid attention to the therapeutic relationship and decision-making autonomy. Materials and Methods: A literature search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library, complemented by Google Scholar for non-indexed studies. The selection criteria included peer-reviewed studies published in English between 2014 and 2024, focusing on digital dentistry, artificial intelligence, and medical ethics. This is a narrative review. Elements of PRISMA guidelines were applied to enhance transparency in reporting. Results: The analysis highlighted that although digital technologies and AI offer significant benefits, such as more accurate diagnoses and personalized treatments, there are associated risks, including the loss of empathy in the dentist–patient relationship, the risk of overdiagnosis, and the possibility of bias in the data. Conclusions: The balance between technological innovation and the centrality of the dentist is crucial. A human and ethical approach to digital medicine is essential to ensure that technologies improve patient care without compromising the therapeutic relationship. To preserve the quality of dental care, it is necessary to integrate digital technologies in a way that supports, rather than replaces, the therapeutic relationship. Full article

Cinnamic acid, an organic acid naturally occurring in plants of the Cinnamomum genus, has been highly valued for its medicinal properties in numerous ancient Chinese texts. This article reviews the chemical composition, pharmacological effects, and various applications of cinnamic acid and its derivatives reported in publications from 2016 to 2025, and anticipates their potential in medical and industrial fields. This review evaluates studies in major scientific databases, including Web of Science, PubMed, and ScienceDirect, to ensure a comprehensive analysis of the therapeutic potential of cinnamic acid. Through systematic integration of existing knowledge, it has been revealed that cinnamic acid has a wide range of pharmacological activities, including anti-tumor, antibacterial, anti-inflammatory, antidepressant and hypoglycemic effects. Additionally, it has been shown to be effective against a variety of pathogens such as Staphylococcus aureus, Pseudomonas aeruginosa, and foodborne Pseudomonas. Cinnamic acid acts by disrupting cell membranes, inhibiting ATPase activity, and preventing biofilm formation, thereby demonstrating its ability to act as a natural antimicrobial agent. Its anti-inflammatory properties are demonstrated by improving oxidative stress and reducing inflammatory cell infiltration. Furthermore, cinnamic acid enhances metabolic health by improving glucose uptake and insulin sensitivity, showing promising results in improving metabolic health in patients with diabetes and its complications. This systematic approach highlights the need for further investigation of the mechanisms and safety of cinnamic acid to substantiate its use as a basis for new drug development. Particularly in the context of increasing antibiotic resistance and the search for sustainable, effective medical treatments, the study of cinnamic acid is notably significant and innovative. Full article

Research results suggest the potential of topical adenosine as a hair-promoting agent. The aim of this study was to examine the available clinical evidence of the efficacy of topical adenosine products in hair loss. This systematic review was conducted in accordance with PRISMA and PICO guidelines and included articles indexed in PubMed, Scopus, and Web of Science. The strength of evidence was assessed according to the GRADE system. Wherever feasible, data were extracted for a meta-analysis. Among 8625 articles returned by the query, 7 clinical trials were identified of topical adenosine (lotion, shampoo) in hair loss. They unanimously reported on a reduction in hair loss and increase in hair density (strength of evidence very low to moderate). A meta-analysis of three eligible trials showed a tendency to increased hair density (OR = 1.03, 95% CI: 0.89–1.20, p = 0.68), an increase in thick hair (OR = 1.4, 95% CI: 0.82–2.38, p = 0.21) and a decrease in thin hairs (OR = 0.93, 95% CI: 0.61–1.43, p = 0.75) after 6 months of alopecia treatment with a 0.75% adenosine lotion. The results from clinical trials published until now suggest that topical adenosine increases hair thickness, reduces excessive hair loss, stimulates hair regrowth, and increases hair density. The overall strength of evidence remains low due to flawed design and small sample sizes in most trials. Nevertheless, topical adenosine products seem worth trying, especially in the case of contraindications or adverse effects to approved medicinal products for hair loss. Further, better designed trials of adenosine in hair loss are warranted. Full article

Introduction: Respiratory Syncytial Virus (RSV) is the leading cause of lower respiratory tract infections in infants and children, as well as hospitalizations for respiratory infections in the pediatric population, representing a significant public health concern. Nirsevimab, a long-acting anti-RSV monoclonal antibody, has recently been approved by the European Medicines Agency (EMA). The aim of this study is to assess the utility of certain parameters, such as the Number Needed to Immunize (NNI), in supporting decision-makers regarding the introduction of nirsevimab as a universal prophylactic measure. Methods: A literature review was conducted to identify the definition and application of the NNI in the context of infectious disease prevention. The following online databases were consulted: Scopus, MEDLINE, Google Scholar, Web of Science, and Cochrane Library. The search was restricted to English-language texts published between 1 January 2000 and 30 January 2025. Results: The NNI represents the number of individuals who need to be immunized to prevent clinical outcomes such as medical visits and hospitalizations caused by infectious diseases. Six studies were identified that utilized this parameter to outline the benefits of immunization and describe the advantages of using monoclonal antibodies for RSV disease. Finelli and colleagues report that to prevent one RSV-related hospitalization, 37–85 infants aged 0–5 months and 107–280 infants aged 6–11 months would need to be immunized with long-acting anti-RSV antibodies. A recent study by Mallah et al. on the efficacy of nirsevimab estimates that the NNI required to prevent one RSV-related hospitalization is 25 infants. Studies by Francisco and O’Leary report NNI values of 82 and 128 infants, respectively, to prevent one RSV-related hospitalization with nirsevimab. Mallah et al. describe NNI as a metric useful to quantify the immunization effort needed to prevent a single RSV hospitalization. A recent Italian study reports that 35 infants need to be immunized to prevent one hospitalization due to RSV-LRTI and 3 infants need to be immunized to prevent one primary care visit due to RSV-LRTI. The studies indicate that the NNI for anti-RSV monoclonal antibodies is lower than the corresponding Number Needed to Vaccinate (NNV) for vaccines already included in national immunization programs. The main limitations of using this parameter include the absence of a shared threshold for interpreting results and the lack of consideration for the indirect effects of immunization on the population. Conclusions: The NNI is an easily understandable tool that can be used to convey the value of an immunization intervention to a variety of stakeholders, thereby supporting public health decision-making processes when considered in association with the uptake of the preventative strategy. At the current status, the estimated NNI of monoclonal antibodies against RSV results favourable and confirms the use in the first year of life for the prevention of RSV disease. Full article