The microbiome has been described as the last human “organ” and is currently the topic of great research interest worldwide. The application of culture-independent methods, like 16S ribosomal next-generation sequencing, has offered researchers the opportunity to identify bacterial populations that were impossible to detect previously using conventional culture methods. Further standardization of these new approaches to characterizing the microbiome is desirable. The present review discusses the mounting evidence suggesting that alterations in the microbiome and microbial metabolites, such as short-chain fatty acids in the gut, mouth, and ocular surface, may play a key role in the pathogenesis of ocular pathologies such as ocular surface disease, glaucoma, uveitis, age-related macular degeneration, and diabetic retinopathy. Clarifying the probable role of the microbiome in ocular diseases would not only offer valuable insights into pathogenesis but could also enable the development of novel therapeutic approaches. As yet, microbial-based therapeutic applications in ophthalmology are limited. Nevertheless, recently emerging strategies utilizing probiotics and prebiotics, or even fecal transplantation to regulate microbiome composition, offer promising research avenues for developing future innovative therapies for ocular diseases. Further studies employing standardized methodological protocols are needed to ensure the reproducibility of results and to eventually unlock the precise links between the microbiome and the eye.
Esophagogastric junction adenocarcinoma (EGJAC) is a distinct and increasingly prevalent malignancy associated with a poor survival. Among EGJACs, Siewert type II tumors pose particular challenges because of their heterogeneous origins, molecular diversity, and the absence of consensus regarding classification and management. Although anatomical classifications remain clinically useful, they inadequately reflect the biological complexity of these tumors. Recent molecular and omics advances have clarified esophagogastric junction tumorigenesis by revealing the interactions between reflux-related conditions and intrinsic and environmental risk factors. Accumulating evidence suggests that Siewert II tumors may originate from multiple cellular populations within the junctional zone, including Barrett’s metaplasia, cardiac-type epithelium, and gastric mucosa, each associated with distinct pathogenetic pathways. Genomic and transcriptomic studies have identified key oncogenic drivers and pathways, supporting biologically driven subclassification and potentially explaining variability in the therapeutic response. Currently, surgical and systemic treatment strategies for Siewert II tumors are largely extrapolated from esophageal and gastric cancer paradigms. Integrating molecular profiling with anatomical classification may improve clinical trial stratification and enable more personalized therapeutic approaches. This review summarizes the current evidence on the epidemiology, risk factors, histopathology, and molecular landscape of Siewert II adenocarcinomas, emphasizing the need for integrative classification frameworks to advance precision oncology and improve the patient outcomes.
Oxidative stress (OS) and endothelial dysfunction are major drivers of cardiovascular disease (CVD) in peritoneal dialysis (PD). MOTS-c, a mitochondria-derived peptide, is emerging as a key regulator of skeletal muscle health, metabolic homeostasis, and vascular function, yet its role in the uremic environment remains unexplored. We investigated the relationship between MOTS-c levels, OS markers, and vascular stiffness in PD patients. This pilot, clinical study included 32 stable PD patients (mean age 60.7 ± 1.2 years, 62.5
Background: Family caregivers of intensive care unit (ICU) patients face a double burden: the psychological toll of critical illness and the economic and occupational disruptions that often accompany prolonged caregiving. While prior research has examined caregiver distress, few studies have systematically integrated economic, psychological and spiritual domains over long-term follow-up. Methods: This study presents a cross-sectional analysis conducted at long-term follow-up examining economic, occupational, psychological, and spiritual correlates among family caregivers of former ICU patients. From an initial cohort of 189 caregivers, 92 participated in a five-year follow-up, completing validated psychometric instruments (SCL-90-R, SpREUK, CD-RISC-10, Heartland Forgiveness, F-COPES). Multivariate regression models were used to identify predictors of psychological and spiritual outcomes, while cluster analysis explored heterogeneity in caregiver profiles. Results: Job loss emerged as a strong predictor of anxiety and hostility, while reduced working hours showed a protective association against depression and anxiety. Financial burden was less consistently associated with psychopathology. Spirituality demonstrated an ambivalent pattern of correlational associations: while dimensions such as trust and reflection were linked to adaptive coping, higher levels of spiritual engagement were also associated with elevated depressive symptoms, suggesting a reactive rather than purely protective role. Resilience and coping resources (e.g., reframing, forgiveness, personal competence) mitigated distress, whereas neuroticism amplified vulnerability. Cluster analysis revealed three distinct caregiver subgroups: a high-burden cluster (severe psychopathology and economic strain), a moderate cluster with mixed spiritual and psychological engagement and a resilient cluster with minimal burden. Conclusions: This study highlights that economic stressors are not peripheral but central drivers of caregiver distress and that spirituality, although valued, may operate in both adaptive and maladaptive ways. Tailored interventions must integrate financial protection, psychological support and sensitive spiritual care to address the multidimensional reality of ICU caregiving.
Chronic lymphocytic leukemia (CLL) is a frequent type of adult leukemia. Bruton Tyrosine Kinase inhibitors (BTKi) are first-line treatments for CLL. Despite being efficient, BTKi have also been associated with significant side effects, including arrhythmias, hemorrhagic complications, and opportunistic infections. Zanubrutinib is a second-generation BTKi that recently received FDA approval for CLL and is associated with improved outcomes and a better safety profile compared to first-generation BTKi. In the present study, we report a case of a patient with CLL, with an in-range absolute neutrophil count and an isolated Aspergillus fumigatus brain abscess mimicking a brain tumor. The lesion was excised "en bloc", and lesion cultures revealed Aspergillus fumigatus sensitive to amphotericin and voriconazole. The patient received postoperative treatment with voriconazole. While invasive fungal infections with brain involvement have been previously reported, to our knowledge, this is the first documented case of an isolated Aspergillus fumigatus brain abscess in a patient receiving zanubrutinib.
