Medical University of Lublin

Despite major advances in medicine, cancer treatment remains a considerable challenge. The rising incidence of new cases and the frequent resistance to cytostatics suggest that standard therapies may be insufficient. This highlights the need for novel compounds with potential anticancer activity and minimal side effects. Among natural molecules, soy isoflavones appear particularly promising. Soybeans and red clover are abundant in genistein and daidzein – isoflavones which are currently used as dietary supplements to alleviate menopausal symptoms, osteoporosis, and polycystic ovary syndrome. Reports also suggest potential benefits in neurodegenerative, cardiovascular, and metabolic diseases, including non-alcoholic fatty liver disease. Their mechanisms of action are diverse and extend beyond estrogenic activity, including anti-inflammatory, antioxidant, and immunomodulatory effects. In cancer, proposed mechanisms involve modulation of estrogen receptors, copper ion–dependent induction of cell death, promotion of apoptosis, inhibition of angiogenesis and metastasis, regulation of epigenetic processes, and effects on platelet function. Owing to their estrogen receptor interactions, isoflavones have been studied particularly in hormone-dependent cancers such as breast, ovarian, and prostate cancer. Moreover, in vitro and in vivo studies have reported promising results in other malignancies, including gliomas, neuroblastoma, hepatocellular carcinoma, lung and bladder cancers, osteosarcoma, and rhabdomyosarcoma. In summary, soy isoflavones require further investigation, particularly in combination with established chemotherapeutics, to evaluate their potential synergy with standard protocols. Their affordability, availability, and favorable safety profile strengthen their relevance as candidates for adjunctive cancer therapy.

This update and revision of the international guideline for urticaria was developed in accordance with the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. It is an initiative of the Global Allergy and Asthma Excellence Network (GA(2)LEN) and its Urticaria and Angioedema Centers of Reference and Excellence (UCAREs and ACAREs), with the participation of 210 delegates from 107 national and international societies, from 59 countries. The consensus conference was held on December 6th, 2024. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease, defined by a rapid appearance of wheals, angioedema, or both. The lifetime prevalence of acute urticaria is estimated to be approximately 20%. Chronic urticaria, categorized as either chronic spontaneous urticaria or chronic inducible urticaria, is disabling, impairs quality of life, and affects performance at work and school, however, novel therapies are available. This updated version of the international guideline for urticaria covers the definition and classification of urticaria and outlines expert-guided and evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria.

Intense efforts are employed to optimize neurosurgical resection of gliomas in different clinical scenarios. However, the level of evidence employed toward personalized treatment decisions is still moderate. Therefore, a joint task force was created by the European Association for Neurosurgical Societies (EANS) and the European Association of Neuro-Oncology (EANO) in order to provide interdisciplinary guidance on the extent of resection (EOR) in glioma surgery. This task force assessed the data on the EOR in gliomas, evaluated the level of evidence, and composed recommendations. The EOR is determined routinely by postoperative magnetic resonance imaging. Since EOR may be associated with survival and may have an impact on epilepsy, neurocognition, quality of life, neurological status, and also on planning of radiation and pharmacotherapy (evidence classes I-IV), recommendations of different levels can be made for the resection of newly diagnosed glioblastomas (level A), recurrent glioblastomas (level C), newly diagnosed (level B) and recurrent (good practice point) IDH mutant gliomas, ependymomas in children (level B) and adults (good practice point) as well as World Health Organization CNS grade 1 tumors (good practice point). We hereby report the outcome of this collaborative effort by the joint task force between EANS and EANO.

The increasing adoption of digital education, including mobile learning (mLearning), is transforming the training of future health professionals, offering advantages such as improved accessibility, timeliness, and affordability. While mLearning enhances clinical training by providing flexible access to information and supporting practical skills development, challenges such as inadequate resources and resistance from staff and patients need to be addressed for successful integration. This review aims to explore the factors for successful adoption of mLearning in clinical placements, providing valuable insights to inform best practices in its implementation. A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScR). Arksey and O’Malley and Joanna Briggs Institute (JBI) methodology was applied. Searching 6 electronic databases plus manual searching returned 5178 articles, with 76 articles included in analysis. All studies were published between 2008 and 2024, with a significant proportion originating from Canada (n = 12), the United States (n = 12), the United Kingdom (n = 11), and Australia (n = 11). The majority of the studies involved nursing (n = 47) and medical (n = 24) students. The analysis revealed 6 facilitators and 6 barriers. It identified positive attitudes toward mobile applications, highlighting their role in enhancing education in clinical environment, organizing training, and improving patient care. However, barriers such as the absence of regulations, ethical concerns, and technical issues were also noted, along with the need to address information literacy and skills. Mapping research regarding facilitators and barriers for introducing mobile learning technologies into undergraduate education in clinical environment has helped in creating a set of solutions which are capable to ensure the success and sustainability of mLearning. These solutions should be considered at the innovation’s design, implementation, and post-implementation stages to guarantee its effectiveness in education in clinical environments. This may help to enhance the learning experience, improve knowledge retention, and develop clinical skills, while providing a cost-effective solution for clinical training programs for healthcare professions. This, in turn, has positive implications for quality of care provided.

BACKGROUND:Chronic spontaneous urticaria (CSU) is characterized by wheals and/or angioedema without identifiable triggers. Mast cells play a pathogenic role in disease, but more evidence is needed to support their role in driving clinical manifestations. OBJECTIVE:We assessed the efficacy and safety of various dose regimens of barzolvolimab, a mast cell-depleting anti-KIT antibody, in patients with CSU. METHODS:Adults with antihistamine-refractory CSU (urticaria activity score over 7 days [UAS7] ≥ 16) in a phase 2 double-blind placebo-controlled trial were randomized 1:1:1:1 to receive barzolvolimab 75 mg every 4 weeks (n = 53); 150 mg every 4 weeks (n = 52); 300 mg every 8 weeks (n = 51); or placebo (n = 51). The primary end point was UAS7 change from baseline to week 12. RESULTS:There was significant improvement in mean (95% confidence interval) change from baseline to week 12 in UAS7 in barzolvolimab-treated patients compared to patients who received placebo (75 mg every 4 weeks: -6.60 [-10.71, -2.49] P = .0017; 150 mg every 4 weeks: -12.55 [-16.56, -8.55] P < .0001; 300 mg every 8 weeks: -13.41 [-17.47, -9.34] P < .0001). Clinical improvement was rapid and marked, with 22.9%, 51.1%, and 37.5% (75 mg, 150 mg, and 300 mg, respectively) of barzolvolimab-treated patients who experienced complete response (UAS7 = 0) versus 6.4% for placebo at 12 weeks. The disease of patients with and without prior omalizumab treatment responded similarly. All doses of barzolvolimab were well tolerated, with urticaria and hair color change as the most common adverse events in barzolvolimab-treated patients. CONCLUSION:This study provides evidence for the essential role of mast cells in the signs and symptoms of CSU. Barzolvolimab is a promising treatment for CSU. TRIAL REGISTRATION INFORMATION:ClinicalTrials.gov NCT05368285.