IntroductionSkin aging manifests as wrinkles, reduced elasticity, and roughness due to intrinsic and extrinsic factors. Peptide-based therapies enhance collagen synthesis and extracellular matrix integrity. This systematic review and meta-analysis (SRMA) evaluates the efficacy and safety of oral and topical peptides in improving hydration, elasticity, wrinkles, and brightness.MethodsA comprehensive search of MEDLINE, CENTRAL, and Web of Science was conducted following PRISMA guidelines. Randomized controlled trials (RCTs) assessing peptide effects on skin aging parameters were included. The Cochrane Risk of Bias Tool (RoB 2) assessed study quality. Data were synthesized using a random-effects model in RStudio (R version 4.1.1).ConclusionNineteen RCTs involving 1,341 participants were analyzed. Peptides, particularly oral formulations, significantly improved hydration and brightness, with a modest pooled effect on wrinkle reduction (MD = 0.27, p = 0.04). Subgroup analysis indicated that this benefit was largely driven by oral polypeptides (MD = 1.5, p = 0.01). While effects on elasticity and density were inconsistent, peptides were well tolerated, with minimal adverse events reported across trials. Overall, peptides appear to be safe, non-invasive anti-aging agents, though larger RCTs with standardized outcomes and histopathologic assessment are warranted.Systematic review registrationidentifier CRD420250652779.
Background: Abdominal wall endometriosis (AWE) is a rare form of endometriosis that often results in cyclic abdominal pain. The current treatment algorithm for AWE is not well established. Radiofrequency ablation (RFA) is an emerging technique that shows promise in treating AWE. Objective: This retrospective study aims to evaluate the safety and efficacy of ultrasound (US)-guided RFA for patients with AWE at the Security Forces Hospital in Riyadh, Saudi Arabia, between January 2020 and January 2024. Methods: Forty-two female patients with pathologically confirmed AWE who underwent US-guided RFA were included in the study. Lesions were assessed radiologically before the procedure using abdominal US, contrast-enhanced computed tomography (CT), and magnetic resonance imaging (MRI). All patients were followed for a minimum of 6 months after the intervention, with MRI used to evaluate lesion response. Treatment efficacy was assessed based on symptom relief, lesion volume reduction, and complication rates during the follow-up period. Results: Patient ages ranged from 28 to 52 years, with a median age of 42 years. All patients had a history of cesarean section and presented with cyclic pain. Preprocedure imaging revealed irregular hypoechoic lesions on US, solid soft-tissue masses on CT, and low signal intensity with heterogeneous enhancement on MRI. Histopathology confirmed the presence of endometrial cells in all cases, with most patients (40.48%) having lesions located below the scar. The majority of patients (95.2%) required only a single session of RFA. The complications included a minor scar wound, occurring in one case (2.4%). Complete radiological resolution was achieved in all patients (100%). Conclusion: This study demonstrates that RFA is a safe and effective treatment for AWE, offering significant symptom relief with minimal complications. Further research is warranted to validate these findings and optimize the treatment protocol.
Clostridioides difficile is an opportunistic pathogen of the gastrointestinal tract that can cause illnesses ranging from diarrhea to pseudomembranous colitis. Recurrent Clostridioides difficile infection remains a major clinical challenge, with substantial relapse rates after standard antibiotic therapy. Emerging evidence suggests that rifaximin can be used after the conventional therapy to reduce risk of the recurrence. However, rifaximin resistance in Clostridioides difficile remains the primary concern. The aim of this systematic review and meta-analysis is to estimate the risk of rifaximin resistance in Clostridioides difficile infection and among different ribotypes. The search included PubMed, Scopus, Web of Science, and Cochrane Library for studies reporting rifaximin resistance in Clostridioides difficile isolates. After systematically screening 731 records from all databases and excluding 664 studies, a total of 67 studies were included in the meta-analysis. The findings of the meta-analaysis indicated a resistance rate of 15.1% (95% CI, 12.0%-18.9%) for rifaximin and/or rifampicin and 12.8% (95% CI, 8.8%-18.2%) for rifaximin alone. Ribotype-specific analysis revealed high rifaximin resistance in RT017 (72.3%), RT027 (47.0%), and RT018 (20.9%), while RT012, RT002, RT112, and RT014/020 demonstrated low resistance. The study finding indicate that rifaximin/rifamycin resistance in Clostridioides difficile is concerning and not randomly distributed but is more frequently associated with certain ribotypes.
PURPOSE:Gene-disease relationship (GDR) is a key concept in monogenic disease diagnostics. Although functional analysis and disease modeling play important supporting roles, human genetics evidence remains key to supporting or challenging a proposed GDR. Such evidence typically comes from individual publications that address one GDR at a time. We hypothesized that a large cohort composed primarily of Mendelian phenotypes and enriched for consanguinity and founder effect can accelerate evidence generation by enabling high-throughput discovery of homozygous loss-of-function (LOF) variants as well as strong segregation data. METHODS:To test this hypothesis, we analyzed our Lifera Omics Database (LODB) for homozygous high-impact missense variants that are observed in 2 or more unrelated individuals to exploit the power of founder variants, as well as homozygous presumptive LOF variants. The search spanned 2904 genes with tentative GDRs in the literature. RESULTS:The analysis revealed 154 individuals with 119 homozygous LOF variants that support GDRs for 95 genes. Additionally, we identified 13 founder missense variants (33 homozygous individuals) that support GDR for 13 genes. Our data expand the mode of inheritance (MOI) of 19 genes for which the tentative GDRs were based on dominant variants. Phenotypic expansion was encountered in 18 of the supported GDRs, including those in which the full syndromic constellation has not been previously delineated. We also report four novel allelic disorders of reported GDRs. CONCLUSION:This work highlights the potential of diagnostic laboratories to accelerate GDR refinement through data sharing and working closely with referring physicians. It also showcases the added advantage concerning autosomal recessive GDR when the study population is enriched for consanguinity and founder effect.
Background High-risk biochemical recurrence (HR-BCR) of prostate cancer (PC) is a prostate-specific antigen (PSA)-only relapse state in which rapid PSA kinetics predict early metastatic progression. Variation in care pathways across Gulf Cooperation Council (GCC) systems supports the need for shared guidance. Methods The HR-BCR Expert Alignment Meeting (BEAM) convened 11 GCC-based senior clinicians with expertise in genitourinary oncology, including medical oncology, urologic oncology, and radiation oncology representation. A writing committee reviewed evidence up to December 2025 and drafted 19 statements. A modified two-round Delphi process used an anonymous online survey in Round 1 and live QR code–enabled voting in Round 2. Consensus was predefined as ≥80% Agree, with abstentions included in the denominator. Results Of 19 initial statements, 17 reached final consensus after two Delphi rounds. The panel standardized BCR definitions after radical prostatectomy (PSA ≥0.2 ng/mL confirmed) and radiotherapy (PSA rise ≥2 ng/mL above nadir), and defined HR-BCR primarily by PSA doubling time ≤9 months. Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) was endorsed as preferred restaging modality and considered sufficient for routine staging in EMBARK-aligned HR-BCR, where available. Management recommendations supported androgen receptor pathway inhibitors (ARPIs) plus androgen deprivation therapy (ADT) intensification for eligible patients, intermittent strategies with defined treatment-holiday and restart triggers, and proactive cardiovascular and bone protection. Enzalutamide plus ADT was endorsed as standard for eligible patients, with enzalutamide monotherapy as an evidence-based alternative for selected men. Conclusions This expert-based consensus provides an evidence-aligned, GCC-relevant pathway to harmonize definition, staging, and management of HR-BCR and to facilitate timely, equitable implementation of contemporary care.
