Brain-derived neurotrophic factor (BDNF) is a key regulator of neuronal survival, synaptic plasticity, and neurogenesis and has emerged as a potential biomarker and therapeutic target in neurodegenerative diseases. This narrative review critically summarizes current evidence on BDNF dysregulation in Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, and amyotrophic lateral sclerosis, with emphasis on biomarker potential, therapeutic modulation, and translational challenges. Relevant literature was identified through targeted PubMed searches and reference-list screening, prioritizing original experimental and clinical studies, meta-analyses, and recent reviews. Altered BDNF expression and impaired signaling through tropomyosin receptor kinase B (TrkB) and the p75 neurotrophin receptor (p75NTR) are implicated in synaptic dysfunction, disrupted axonal transport, abnormal protein-related pathology, and neuronal vulnerability. Peripheral and central BDNF alterations have been associated with disease severity, but methodological heterogeneity and inconsistent findings for variants such as Val66Met limit biomarker application. TrkB-targeting approaches, gene delivery, pharmacological modulation of BDNF-related pathways, and physical activity show neuroprotective potential, predominantly in experimental studies. BDNF therefore represents a promising translational link between neurodegenerative mechanisms, biomarker development, and therapeutic innovation, but clinical translation requires standardized assessment, improved delivery strategies, biomarker-guided patient selection, and selective modulation of disease- and receptor-specific signaling.
Introduction. Renal angiomyolipoma (AML) is an uncommon benign renal neoplasm with a diverse body of literature spanning diagnosis, pathology, molecular biology, surveillance, and treatment. This study aimed to identify and characterize the 50 most-cited publications on renal AML and to examine the bibliometric, methodological, authorship, and thematic features associated with their citation performance. Methods. A retrospective bibliometric analysis was performed using the Web of Science Core Collection. The database was searched on July 22, 2026, for publications indexed from 1975 to 2026 using terms related to renal AML. Citation counts were recorded as of August 5, 2026. Of 1,414 retrieved records, the 100 most-cited were screened for eligibility, and the 50 highest-ranked eligible publications were included. Citation performance, source journals, geographic and institutional contributions, study designs, levels of evidence, authorship characteristics, and research themes were analyzed. Keyword co-occurrence, reference co-citation, and bibliographic coupling analyses were also performed. Exploratory associations with citation rate within the selected corpus were assessed using negative binomial regression. Results. The 50 articles were published between 1986 and 2020 and accumulated 7,764 citations, with a median of 122.5 citations per article (IQR 103.2–194.8). The Journal of Urology contributed the largest number of publications (n = 8), while the United States was the leading country of first-author affiliation (n = 28, 56.0%). Retrospective observational studies were the most common design (28.0%), and Level IV evidence predominated (66.0%). Multi-country authorship was present in 23 of 48 articles with available address data (47.9%). In exploratory adjusted analysis within the selected corpus, review articles had a higher citation rate than primary clinical studies (IRR 1.83, 95% CI 1.37–2.46), while multi-country publications had a higher citation rate than single-country publications (IRR 1.66, 95% CI 1.29–2.14). Major research themes included tuberous sclerosis complex pathology and molecular biology, diagnosis and imaging, embolization, surgery and follow-up, epithelioid and atypical variants, and mTOR inhibition and lymphangioleiomyomatosis. Conclusions. The most-cited literature on renal AML is multidisciplinary and reflects the evolution of the field across diagnosis, pathology, surveillance, and treatment. Review articles and multi-country authorship were associated with higher citation rates within the selected corpus. Future bibliometric studies could include newer and less-cited publications to assess patterns beyond this citation-selected corpus.
Introduction. This retrospective cohort study aimed to estimate the return‑to‑work (RTW) proportion among stroke survivors in metropolitan Shanghai, China, who were employed pre-stroke and to explore factors associated with RTW. Methods. A retrospective cohort study included stroke patients admitted to a tertiary rehabilitation center in Shanghai, China, between 2018 and 2023, with telephone follow-up conducted in 2024. Data were collected from electronic medical records and structured interviews. The primary outcome was RTW status. Eligibility required pre-stroke employment. The primary model included age group and social dysfunction, selected based on clinical plausibility and prior literature. Results. Of 79 eligible patients, 20 had returned to paid work at follow‑up (median: 12 months; IQR, 9–18 months), yielding an RTW proportion of 25.32% (20/79). In the primary Firth regression model, absence of social dysfunction was associated with higher odds of RTW (adjusted OR 10.57, 95% CI 2.38–100.76; p < 0.001), whereas age < 60 years did not reach statistical significance (adjusted OR 3.09, 95% CI 0.96–11.59; p = 0.058). In the sensitivity analysis restricted to participants aged < 60 years, absence of social dysfunction remained associated with RTW (OR = 8.66, 95% CI: 1.81–85.07; p = 0.005). Conclusions. Only a minority of participants had returned to paid work at follow-up. Absence of social dysfunction showed a notable association with RTW in this exploratory analysis. These findings suggest that vocational rehabilitation programs addressing social dysfunction merit further investigation in larger prospective studies.
Introduction. Night-shift work may affect neuroendocrine regulation and eating behavior, but data on the combined assessment of these changes among healthcare professionals remain limited. This cross-sectional study compared six outcomes (serum nesfatin-1, melatonin, and cortisol concentrations and the emotional, external, and restrained eating subscale scores) between daytime and night-shift healthcare professionals. Methods. Eighty healthcare professionals (nurses and other healthcare professionals [physicians/technicians]) were recruited by convenience sampling at a tertiary university hospital and classified into daytime (n = 40) or night-shift (n = 40) groups according to work schedule. Fasting venous blood was collected between 08:00 and 09:00 AM: immediately after the night shift for night-shift workers and after usual nocturnal sleep for daytime workers. Serum nesfatin-1 and melatonin were measured by ELISA; cortisol, insulin, and thyroid hormones were measured by ECLIA. Eating behavior was assessed with the Dutch Eating Behavior Questionnaire (DEBQ). Group comparisons and separate multivariable linear regression models adjusted for age, sex, and body mass index were performed for the six outcomes. Results. The groups were comparable in age, height, body weight, and body mass index (all p > 0.05). Night-shift workers had significantly lower nesfatin-1 and melatonin levels and significantly higher cortisol levels than daytime workers (p < 0.001). DEBQ assessment showed higher emotional and external eating scores among night-shift workers (p < 0.001), while restrained eating scores were lower (p = 0.005). In multivariable regression analysis, night-shift work remained associated with hormonal and eating behavior outcomes after adjustment for age, sex, and body mass index. Conclusions. Night-shift workers had lower morning nesfatin-1 and melatonin concentrations, higher morning cortisol concentrations, higher emotional and external eating scores, and lower restrained eating scores than daytime workers. These cross-sectional, single-time-point findings show group differences but do not establish altered circadian rhythms or causal links between hormone concentrations and eating behavior.
Introduction. Clostridioides difficile infection (CDI) remains the leading cause of healthcare-associated diarrhea in developed countries and poses a major public health challenge due to its associated morbidity and mortality. This study aimed to describe the frequency of classical CDI risk factors and to characterize the clinical and epidemiological features of hospitalized CDI patients in a tertiary hospital in Madrid. A secondary exploratory objective was to examine associations between these factors and clinical outcomes. Methods. A retrospective observational cohort study was conducted, including all adults admitted to Alcorcón Foundation University Hospital between May 2020 and January 2024 with a first microbiologically confirmed CDI episode. Demographic, epidemiological, and clinical variables were analyzed. Associations between potential risk factors and outcomes (severe disease, intensive care unit [ICU] admission, prolonged length of stay, recurrence, and all-cause one-year mortality) were assessed using multivariable logistic regression models. Results. A total of 237 patients were included (45.1% female, median age 80.1 years). Prior hospitalization (70.0%), antibiotic exposure (73.4%), and proton pump inhibitor (PPI) therapy (69.6%) were frequent. Severe episodes occurred in 16.0% of patients, recurrence in 17.3%, and one-year mortality reached 33.3%. In multivariable analysis, antibiotic exposure, prior hospitalization, and PPI use were not independently associated with the studied outcomes. Age ≥ 80 years was associated with lower odds of ICU admission (adjusted odds ratio [aOR] 0.09, 95% confidence interval [CI] 0.02–0.42). Institutionalization was associated with increased one-year mortality (aOR 2.59, 95% CI 1.18–5.65), and a Charlson Comorbidity Index ≥ 3 was associated with prolonged length of stay (aOR 1.94, 95% CI 1.02–3.66) and higher one-year mortality (aOR 3.10, 95% CI 1.67–5.73). Conclusions. Classical CDI risk factors were highly prevalent, but most were not independently associated with adverse clinical outcomes after adjustment. Institutionalization and higher comorbidity burden were associated with worse prognosis, likely reflecting underlying frailty and multimorbidity rather than direct causal effects. These findings support further evaluation of measures of clinical vulnerability in CDI prognostic assessment.
