To assess whether preoperative spinal angiography with endovascular embolization followed by microsurgical resection is technically feasible and safe for hypervascular spinal tumors, and to examine how cervical, thoracic, and lumbar vascular anatomy influences feasibility. We retrospectively reviewed 25 patients treated from 2017 to 2025 at two centers (14 men, 11 women; mean age 53 years) with hypervascular tumors involving the cervical (n = 3), thoracic (n = 15), lumbar and sacral (n = 7) spine. All underwent preoperative angiography (DSA)-embolization (within the same procedure if technically possible). We recorded whether embolization could be safely performed and any embolization-related complications; we also graded angiographic devascularization (devascularization grade, DG) and operative estimated blood loss (EBL). Selective or super-selective embolization was performed when arterial anatomy allowed safe catheterization, and surgery followed within 24–48 h. Embolization was feasible in 23/25 patients (92
The clinical translation of nanoparticles (NPs) for therapeutic applications is hindered significantly by unpredictable biodistribution in diseased patients, which results from the complex interplay between engineered physicochemical properties of NPs and specific changes in the function of biological barriers. This review delves into the multifaceted factors that govern NP biodistribution, highlighting the critical roles of intrinsic NP design, including size, shape, and surface chemistry, along with host-specific physiological and pathological conditions. We overview how these properties can change systemic circulation, organ-specific accumulation, and clearance pathways. The role of surface functionalization in targeted delivery is examined through the lens of altered serum composition, which affects protein corona formation. Particular attention is given to immune response, whether pathogen/antigen-primed, macrophage–monocyte-mediated clearance, compromised biological barriers, and host-specific factors such as sex, age, drug exposure, and gut microbiome. Disease contexts, including cancer and viral infections, are considered to evaluate translational challenges. NP biodistribution is shaped by the interplay between engineered physicochemical properties and disease-associated biological changes. Intrinsic NP characteristics influence systemic circulation, organ-specific accumulation, and clearance pathways. Altered serum composition affects protein corona formation and immune responses, including overactivated or suppressed immune states. Compromised biological barriers, including increased permeability of the blood–brain barrier, enhanced renal excretion, and reduced liver retention, further modify pharmacokinetic profiles. Host-specific variability and pathological conditions introduce additional complexity, creating unique barriers that passive targeting strategies often fail to overcome. Developing a comprehensive grasp of these interrelated mechanisms is crucial for engineering NPs that can translate preclinical results into expected clinical outcomes, ultimately closing the gap between research innovation and patient care.
Aim : to systematize current evidence and analyze the effectiveness of personalized approaches to correcting hemostatic disorders for preventing recurrent pregnancy loss and placenta-mediated complications. Materials and Methods . A systematic search for publications from 1999 to 2025 was conducted in PubMed/MEDLINE, eLibrary, CyberLeninka, DOAJ (for scientific articles) and FIPS (for patent documents) databases. Using combined MeSH queries, 412 records were initially identified. After removing duplicates and performing multi-stage screening, 63 full-text publications were included in the final analysis. Due to clinical and methodological heterogeneity across studies, a qualitative narrative synthesis of the data was performed. Results . Hemostatic dysregulation serves as a universal pathogenetic arm in pregnancy loss, manifesting through chorionic villi microthrombosis and placental dysfunction. The combination of acetylsalicylic acid (ASA) 100–150 mg and prophylactic doses of low-molecular-weight heparins (LMWHs) significantly increases live birth rates in antiphospholipid syndrome. It is emphasized that isolated carriage of thrombophilia gene polymorphisms is not an independent indication for LMWHs; their use is pathogenetically and clinically justified only when combined with additional risk factors, such as verified antiphospholipid syndrome (APS), a history of thrombosis, or multiple pregnancy losses. For primary preeclampsia prevention, ASA efficacy at 150 mg initiated at 11–14 weeks of gestational age is well established. The critical importance of preconception administration of active folates for hyperhomocysteinemia correction is confirmed. Integral monitoring via thrombodynamics enables tracking of trimester-specific coagulation changes and personalizing antithrombotic dosing. Sulodexide and dipyridamole demonstrate clinical potential in improving uteroplacental blood flow in fetoplacental insufficiency. Conclusion . The contemporary management paradigm for these patients requires a shift from empirical regimens to risk stratification and early preconception screening. Optimal clinical strategy is based on evidence-based ASA prescription, strictly differentiated use of LMWHs, folate metabolism correction, and dynamic therapy control using thrombodynamics. The presented data will help minimize iatrogenic complications and define the trajectory for future multicenter studies.
Background: Many probiotic strains have been studied in relation to irritable bowel syndrome (IBS). The aim of this study was to identify probiotic strains demonstrating efficacy in the management of IBS based on meta-analyses of randomized placebo-controlled trials (RPCTs). Methods: This systematic review was registered in the PROSPERO database (CRD420251047092). Searches were conducted in PubMed and Scopus on 8 April 2025. Additional completed studies with available results were identified through ClinicalTrials.gov. An additional search of the Cochrane Central Register of Controlled Trials (CENTRAL), including records indexed in EMBASE, was conducted in December 2025 and did not identify any additional studies. RPCTs were included if they evaluated single-strain probiotics without additional active components compared with a placebo in patients with IBS. Studies whose results could not be meta-analyzed were excluded. Results: A total of 2643 records were identified; 32 articles evaluating 10 probiotic strains were included in the meta-analyses. Meta-analyses demonstrated the efficacy of Bifidobacterium longum (formerly Bifidobacterium infantis) 35624, Lactobacillus rhamnosus GG, Lactiplantibacillus plantarum 299v (DSM 9843), Saccharomyces cerevisiae CNCM I-3856, and Bacillus coagulans Unique IS2 (MTCC 5260) in improving key IBS symptoms. Meta-analyses also demonstrated that Bacillus coagulans MTCC 5856 improved quality of life for those with IBS. Conflicting results were observed for Saccharomyces boulardii CNCM I-745. Meta-analyses did not demonstrate the efficacy of Escherichia coli Nissle 1917, Lactobacillus gasseri BNR17, or Lactobacillus casei Shirota. Conclusions: Several probiotic strains demonstrated efficacy in the treatment of IBS in meta-analyses of RPCTs.
Background: Neurovascular coupling (NVC) reflects the relationship between neuronal activity and cerebral blood flow and underpins the interpretation of functional neuroimaging. Disruption of NVC has been linked to aging, vascular pathology, and cognitive decline, and may precede structural brain changes. However, current evidence remains fragmented due to methodological heterogeneity, diverse NVC metrics, and small sample sizes. This systematic review and meta-analysis aim to synthesise available evidence and evaluate NVC as a potential biomarker of cognitive decline. Methods: This protocol follows PRISMA-P guidelines. A systematic search will be conducted in PubMed/MEDLINE, EMBASE, Scopus, Web of Science, and CINAHL. Eligible studies will include adults across the lifespan or individuals with vascular pathology and will report quantitative NVC measures alongside cognitive outcomes. Data extraction will include study characteristics, NVC metrics, cognitive assessments, and relevant physiological factors. A unified statistical approach will be applied to synthesise effect estimates describing associations between NVC, cognition, age, and vascular pathology. Analyses will be stratified by NVC modality, vascular condition, and cognitive domain. Heterogeneity will be assessed using the I² statistic and explored using meta-regression where appropriate. Longitudinal studies will be used to evaluate the predictive value of baseline NVC measures for future cognitive outcomes. Discussion: This study will provide a structured synthesis of current evidence on the role of NVC in cognitive decline across aging and vascular pathology. By integrating findings across diverse methodological approaches, it aims to clarify the strength and consistency of NVC–cognition associations and evaluate the potential of NVC as a sensitive biomarker. The results may inform future research directions and support the development of clinically relevant NVC-based predictive models. Systematic review registration: PROSPERO Registration number: CRD420261351976
