BACKGROUND:Research in exercise oncology has consistently provided evidence supporting the integration of exercise into all phases of cancer care. However, less is known about how this can be implemented across different patient populations and healthcare settings. This study aims to generate knowledge about the equitable implementation of digitally supported physical rehabilitation during and after systemic cancer treatment through feasibility testing in 5 South Baltic countries. Methodology. This study is part of the gAMBeRh project (Advanced Modeling of Baltic E-cancer caRe) and is an international, multicenter, prospective study with a hybrid implementation-effectiveness design. It includes 2 single-arm feasibility trials, each aiming to enroll 30 patients undergoing systemic treatment and 30 patients who have completed systemic treatment or are receiving long-term or life-prolonging treatment at each participating site, for a total of 300 adult cancer patients. All tumor groups are eligible, and participants must be .18 years of age. We will use the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to structure data collection and reporting. Additionally, Group Concept Mapping will be used to evaluate determinants of participation among patients and determinants of intervention delivery among healthcare professionals (HCPs). Enrollment began in September 2024 and is expected to be completed by December 2026. Discussion. While digital solutions have the potential to overcome barriers to integrating exercise into oncology care, inequitable implementation may inadvertently exacerbate disparities in cancer rehabilitation if these innovations remain inaccessible to patients with fewer resources. By evaluating reach, effectiveness, adoption, implementation, and maintenance, as well as the determinants of participation among patients and HCPs, this study will contribute to the evidence base on the implementation of digitally supported physical rehabilitation in cancer care. CONCLUSIONS:Findings from the AMBeR eRehab study will inform future efforts to digitize cancer rehabilitation while ensuring that inequities are not reproduced.
BACKGROUND:Primary healthcare (PHC) facilities are fundamental components of health systems across Europe, serving as the first point of contact and ensuring continuity of care. However, the COVID-19 pandemic exposed significant gaps in their preparedness for large-scale health crises. Although emergency preparedness frameworks developed by the World Health Organization (WHO) and the European Union existed, they often lacked adequate integration of PHC into comprehensive public health (PH) emergency preparedness and response plans (EPRPs). OBJECTIVES:To identify regulatory and operational gaps in the integration of PHC into existing European health EPRPs; to evaluate challenges related to governance and health information system (HIS) interoperability between PHC and PH authorities; and to develop a multilevel governance model to harmonize the role of PHC across the continuum of health crisis management in future PH emergencies. MATERIAL AND METHODS:The EURODATA research group conducted a comprehensive analysis of the role of primary care during the COVID-19 pandemic. The study included a review of international and European health policies and emergency preparedness frameworks. The analysis followed the health EPRP framework and focused on regulations, governance structures, HIS interoperability, and the role of PHC. Based on these findings, recommendations were developed to strengthen EPRPs for European PHC systems. RESULTS:The analysis identified limited regulatory guidance on coordination between PHC and PH authorities, insufficient interoperability of HIS, and gaps in local coordination. The proposed EPRP framework addresses these shortcomings by promoting improved governance, integration of information systems, and harmonization of the role of PHC within coordinated health crisis management. CONCLUSIONS:Strengthening the role of PHC in health emergency preparedness is essential for building resilient health systems. The proposed EPRP provides actionable strategies to address the identified gaps and improve the integration of PHC into health crisis management. Implementation of these recommendations may enhance the capacity of European PHC systems to respond effectively to both acute and chronic health needs during future crises.
BACKGROUND:Rural general practitioners (GPs) encounter unique challenges in accessing continuing professional development (CPD). E-learning offers a potential solution by overcoming geographic and time constraints, particularly when the content is relevant to the rural primary care context. OBJECTIVES:To identify rural GPs' preferences regarding the format, duration, and content of e-learning and to assess their current engagement with and awareness of CPD specific to rural primary care. MATERIAL AND METHODS:A single cross-sectional online survey was distributed through 2 recruitment channels: the Royal College of General Practitioners (RCGP) in the UK and the European Rural and Isolated Practitioners Association (EURIPA), a pan-European network of the World Organization of Family Doctors (WONCA). A total of 157 RCGP members responded to the survey, with an unknown response rate; 30 of 94 active EURIPA members responded after the survey was distributed through its newsletter and Google Group. The survey assessed e-learning engagement, preferred formats and durations, and priority topics. Descriptive statistics were used to summarize the responses. RESULTS:Five of the 67 survey participants who answered the question on whether they used any rural primary care-relevant e-learning responded positively (8%). Preferred formats for rural primary care-relevant e-learning included interactive e-modules, webinars, online lectures, and podcasts; the preferred duration was 30-40 min. Priority topics included emergency care, mental health and addiction, multimorbidity and complexity, managing risk and uncertainty, frailty, and telemedicine. CONCLUSIONS:Rural GPs favor short, interactive, context-specific e-learning. These findings can guide the design of pan-European rural primary care modules. Future studies should evaluate educational effectiveness and implementation feasibility.
BACKGROUND:The adenoma detection rate (ADR) is a key quality metric in colonoscopy. However, it may not accurately reflect the true number of adenomas and requires pathological evaluation of all detected polyps. The adenoma miss rate (AMR), which quantifies adenomas missed during colonoscopy, may provide a more comprehensive measure of colonoscopy quality. OBJECTIVES:To evaluate the effectiveness of ADR and selected surrogate quality indicators (SQIs) in reflecting AMR. MATERIAL AND METHODS:In this prospective, cross-sectional, multicenter study, we analyzed asymptomatic individuals aged 50-72 years who underwent tandem colonoscopies using a split-dose bowel preparation regimen. Colonoscopies were performed by 7 endoscopists (experts with >10 years of experience from different institutions) over the last 5 years. Consecutive colonoscopies were performed by the same endoscopist under identical conditions. During the 2nd colonoscopy, polyps missed during the 1st colonoscopy were documented. All removed polyps were subsequently evaluated by a pathologist. RESULTS:We analyzed colonoscopy data from 356 patients (182 (51.12%) males and 174 (48.88%) females), representing a total of 712 colonoscopies. Adenomas were confirmed in 221 participants (62%). The number of adenomas missed during the 1st colonoscopy was 88, whereas 60 participants had at least 1 missed adenoma. No statistically significant variation among endoscopists was observed in the polyp detection rate (range: 48.000-64.000%, p = 0.658) or the adenoma detection rate (range: 54.000-74.000%, p = 0.151). Adenomas per positive participant ranged from 1.05 to 1.89, and adenomas per colonoscopy ranged from 0.70 to 1.44 (p = 0.063). The overall pooled lesion-level AMR was 20.046%. None of the SQIs showed a significant association with AMR (p > 0.050 for all comparisons). Although SQIs and ADR varied among endoscopists, no statistically significant variation in AMR was observed among the 7 endoscopists (p > 0.050). CONCLUSIONS:A high ADR alone does not ensure a lower AMR in tandem colonoscopy for colorectal cancer screening. In this limited provider-level sample, no statistically significant association was observed between SQIs and AMR.
Dyslipidemia has been identified as an important modifiable risk factor for ischemic stroke (IS); however, inconsistent findings have limited its translational application. This study aimed to integrate scientometric and meta-analytic approaches to provide a comprehensive understanding of lipid abnormalities in IS. A scientometric analysis of 1,962 publications published between 2005 and 2024 revealed evolving research trends, ranging from traditional studies of lipid metabolism to investigations of molecular mechanisms involving high-density lipoprotein (HDL) dysfunction, lipidomics, and precision prevention. A meta-analysis of 13 eligible studies demonstrated that patients with IS had significantly higher levels of total cholesterol (TC; mean difference (MD) = 0.94 mmol/L, 95% confidence interval (95% CI): 0.36-1.52), triglycerides (TG; MD = 0.37 mmol/L, 95% CI: 0.19-0.55), and low-density lipoprotein cholesterol (LDL-C; MD = 0.66 mmol/L, 95% CI: 0.33-0.99), as well as lower levels of high-density lipoprotein cholesterol (HDL-C; MD = -0.30 mmol/L, 95% CI: -0.41 to -0.18), with all comparisons reaching statistical significance (p < 0.001). These findings indicate a strong association between dyslipidemia and the risk of IS. The integration of bibliometric and quantitative evidence underscores the importance of comprehensive lipid screening and management in stroke prevention and provides a dual-framework model linking academic research trends with clinical decision-making.
BACKGROUND:In recent years, advancements in artificial intelligence (AI) have led to the creation of numerous large language models, including Chat Generative Pre-trained Transformer (ChatGPT), a natural language processing model developed by OpenAI. There has been increasing interest in exploring the potential of this tool, as evidenced by several studies in the healthcare domain that have investigated the performance of ChatGPT in responding to specific questions on relevant topics. However, its application in forensic contexts remains largely unexplored. OBJECTIVES:This study aims to evaluate the performance of ChatGPT in estimating the post-mortem interval (PMI) by considering thanatochronological changes as well as through the application of the Henssge nomogram. MATERIAL AND METHODS:Fifteen questions concerning PMI estimation were presented to ChatGPT. These questions were categorized into 3 domains, each addressing different aspects: 1) theoretical notions, 2) practical application of theoretical notions, and 3) utilization of the Henssge nomogram. The evaluation of responses included 3 sub-criteria: focus, accuracy, and completeness. RESULTS:The results showed a high level of accuracy and completeness in addressing theoretical issues. However, the AI failed when responding to practical case scenarios and when calculating PMI using the Henssge nomogram. CONCLUSIONS:Although AI may be attractive for application to forensic science questions, uncertain source documents and incomplete access to the scientific literature may affect accuracy. The study concluded that AI should be investigated for use in forensic science; however, it is currently not suitable for practical PMI estimation.
BACKGROUND:Owing to medical advances and improved living conditions, life expectancy continues to increase. Consequently, population aging poses growing challenges for healthcare systems. OBJECTIVES:The aim of this study was to assess whether men's perceptions of aging have changed between 2013 and 2023. MATERIAL AND METHODS:A cross-sectional comparative study was conducted in 2013 and 2023 using identical research tools and inclusion criteria. Participants were randomly selected from hospitalized patients in the Podlaskie Province, Poland. The following instruments were used: an original questionnaire, the Satisfaction with Life Scale (SWLS), the Generalised Self-Efficacy Scale (GSES), the Beck Depression Inventory (BDI), the Inventory of Health Behaviour (IHB), the Androgen Deficiency in Aging Male questionnaire (ADAM), and the Aging Males' Symptoms Scale (AMS). RESULTS:Most respondents in both 2013 and 2023 associated old age with declining testosterone levels and considered it to begin after the age of 75. Men generally rated their health as good and regarded andropause as a natural process. Psychological symptoms of aging were reported by 80.5% of respondents in 2013 and 75.9% in 2023, while sexual dysfunction was reported by 65.8% and 63.3%, respectively. More than half of the respondents had no depressive symptoms according to the BDI. Men with high self-efficacy predominated in both study periods. CONCLUSIONS:Respondents' knowledge of the aging process remains incomplete and often inaccurate. Despite this, men generally rated their health positively and perceived andropause as a natural process. Psychological symptoms of aging and sexual dysfunction were reported by a substantial proportion of participants.
BACKGROUND:Osteoarthritis (OA) is a degenerative joint disease characterized by synovial inflammation, cartilage degradation, and subchondral bone remodeling. Currently, no universally accepted or clinically validated biomarkers exist for OA diagnosis and treatment, highlighting the need to identify potential genetic biomarkers to support early detection and therapeutic research. OBJECTIVES:This study aimed to identify and preliminarily validate potential diagnostic biomarkers for OA using integrated bioinformatics and machine learning (ML) approaches to provide molecular insights supporting early diagnosis and therapeutic strategies. MATERIAL AND METHODS:Gene expression data from OA patients and normal controls were obtained from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were identified using R. Protein-protein interaction (PPI) network analysis and functional module analysis were performed to screen for hub genes. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were conducted to determine the biological roles and pathways of DEGs, along with transcription factor prediction. Three ML models (least absolute shrinkage and selection operator (LASSO), support vector machine recursive feature elimination (SVM-RFE), and Random Forest) were used to identify OA-specific characteristic genes. Key diagnostic genes were identified from the intersection of the ML results and validated using external datasets of cartilage, synovium, and blood. IRS2 expression was further validated via in vivo (animal model) and in vitro (cell culture) experiments. RESULTS:Fifteen OA-related characteristic genes were identified, including IRS2, ADM, SIK1, PTN, CX3CR1, WNT5A, IL21R, APOD, CRLF1, FKBP5, PNMAL1, NPR3, RARRES1, ASPN, and POSTN. Functional enrichment analysis suggested involvement in extracellular matrix (ECM) organization, interleukin-17 (IL-17) and relaxin signaling, and the AGE-RAGE pathway in diabetic complications. Three genes showed strong diagnostic potential. IRS2 was downregulated, while WNT5A and PTN were upregulated in OA samples. Immunohistochemistry (IHC), real-time quantitative polymerase chain reaction (qPCR), and western blotting (WB) confirmed the downregulation of IRS2 in OA samples, consistent with bioinformatics predictions, in both chondrocytes and mouse joint tissues. CONCLUSIONS:IRS2, WNT5A, and PTN may serve as potential diagnostic biomarkers for osteoarthritis, supporting early or tissue-specific diagnosis and offering insights for future clinical and therapeutic applications.
Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening cerebrovascular event associated with profound neurological and systemic disturbances. Among these, alterations in hypothalamic-pituitary function, water-electrolyte balance, and glucose metabolism are frequently observed but remain difficult to interpret, particularly in the setting of critical illness. Many endocrine abnormalities detected during the acute phase reflect adaptive neuroendocrine stress responses rather than true hormonal failure, whereas persistent deficiencies may emerge during recovery and contribute to long-term morbidity. This narrative review summarizes current evidence on endocrine disturbances after aSAH, emphasizing the distinction between acute neurocritical care physiology and chronic endocrine sequelae. We discuss the hypothalamic-pituitary-adrenal (HPA), thyroid, somatotropic, and gonadal axes, as well as dysnatremia and stress hyperglycemia, addressing their prevalence, pathophysiological background, diagnostic challenges, and therapeutic considerations in both intensive care unit (ICU) and post-acute settings. Available data remain heterogeneous and largely observational. Current evidence does not support routine hormonal intervention during the acute phase except in clearly defined endocrine emergencies. Careful interpretation of biochemical findings and structured endocrine follow-up after neurological stabilization appear essential for identifying clinically meaningful long-term dysfunction.
Cryotherapy is a commonly used physiotherapeutic modality in rehabilitation following anterior cruciate ligament reconstruction (ACLR). Previous systematic reviews (published in 2005 and 2014) concluded that the available evidence was insufficient to determine its effectiveness in postoperative recovery. This systematic review aimed to update and synthesize current evidence on cryotherapy after ACLR, including all randomized controlled trials (RCTs) investigating any form of postoperative cryotherapy (e.g., ice packs, continuous-flow devices, and compression-cooling devices). A comprehensive search of MEDLINE (PubMed), Embase, Web of Science, PEDro (Physiotherapy Evidence Database), and PROSPERO was conducted in April 2024 and updated in October 2025. Eligible studies included RCTs involving adults (≥18 years) undergoing ACLR. A total of 273 RCTs were identified, of which 9 studies (n = 509 participants) met the inclusion criteria. Outcomes included pain, range of motion (ROM), postoperative blood loss, and functional measures. Cryotherapy showed potential benefits in reducing pain and improving ROM in the early postoperative phase. However, results were inconsistent across studies, with substantial heterogeneity in intervention protocols, outcome measures, and follow-up time points. Overall, the current evidence remains limited and methodologically heterogeneous, with no clear consensus regarding the effectiveness of cryotherapy after ACLR. Further high-quality, standardized RCTs are needed to clarify its clinical value and determine which cryotherapy modalities may be most effective.
BACKGROUND:Endoscopic retrograde cholangiopancreatography (ERCP) induces substantial psychological distress and physiological stress responses that may adversely affect clinical outcomes. Although psychological nursing interventions have demonstrated efficacy in attenuating perioperative stress across various surgical settings, robust evidence regarding their application in ERCP remains limited. OBJECTIVES:To evaluate the effectiveness of a structured preoperative psychological nursing intervention on psychophysiological stress responses and clinical outcomes in patients undergoing ERCP. MATERIAL AND METHODS:This prospective cohort study enrolled 297 consecutive patients undergoing ERCP at a tertiary care center between June 2022 and June 2025. Participants were allocated to either a control group (n = 148) receiving standard care or an intervention group (n = 149) receiving standard care plus a psychological nursing protocol comprising trust-building communication, procedural education, and relaxation training. The primary outcome was psychological stress measured using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). Secondary outcomes included intraoperative hemodynamic parameters, behavioral stress-response grades, and postoperative complication rates. Outcome assessors were blinded to group allocation. RESULTS:Post-intervention, the intervention group demonstrated significantly lower anxiety (SAS: 28.92 ±4.78 vs 41.85 ±8.97; t-test: degrees of freedom (df) = 295; p < 0.001; Cohen's d = 1.79, 95% confidence interval (95% CI): 1.52-2.06) and depression (SDS: 27.89 ±5.14 vs 42.67 ±9.83; t-test: df = 295; p < 0.001; Cohen's d = 1.88, 95% CI: 1.61-2.15) scores compared with controls. Patients receiving the intervention exhibited superior intraoperative hemodynamic stability, including reduced heart rate variability (coefficient of variation: 0.07 ±0.03 vs 0.14 ±0.06; t-test: df = 295; p < 0.001) and fewer severe behavioral stress responses (grade III: 0% vs 7.4%; ÷2 test: df = 2; p < 0.001). The intervention group experienced significantly fewer overall postoperative complications (12.1% vs 27.7%; ÷2 test: df = 1; p = 0.001; risk ratio (RR) = 0.44, 95% CI: 0.26-0.73; number needed to treat (NNT) = 6.4). CONCLUSIONS:Structured preoperative psychological nursing intervention significantly attenuates psychophysiological stress responses and reduces postoperative complications in patients undergoing ERCP. These findings support integration of psychological support protocols into perioperative care pathways, although confirmation through multicenter randomized controlled trials is warranted.
BACKGROUND:Nonalcoholic fatty liver disease (NAFLD) is increasingly recognized as a multisystem disorder with potential cardiovascular consequences. Its role in patients with unstable angina (UA), a high-risk manifestation of coronary artery disease (CAD), remains underexplored. OBJECTIVES:To evaluate the impact of NAFLD on long-term cardiovascular outcomes in patients with UA. MATERIAL AND METHODS:This prospective cohort study enrolled 150 patients diagnosed with UA, who were categorized into NAFLD and non-NAFLD groups based on imaging and clinical criteria. Baseline metabolic and liver function parameters were recorded. Patients were followed for 3 years to document major adverse cardiovascular events (MACE). Kaplan-Meier analysis was used to assess event-free survival, and multivariate logistic regression was performed to identify independent predictors of MACE. RESULTS:Patients with NAFLD exhibited worse metabolic and liver function profiles than those without NAFLD. During the 3-year follow-up period, the incidence of MACE was significantly higher in the NAFLD group. Kaplan-Meier analysis revealed shorter MACE-free survival time among patients with NAFLD (p < 0.05). However, in multivariate logistic regression analysis, diabetes mellitus, but not NAFLD, remained an independent predictor of MACE after adjustment for potential confounding factors. CONCLUSIONS:Nonalcoholic fatty liver disease is associated with metabolic dysfunction and an increased risk of cardiovascular events in patients with UA. Although it is not an independent predictor of MACE, its presence may indicate a higher long-term cardiovascular risk and should be considered in clinical risk stratification.
Obesity is a chronic disease that is widespread worldwide. Its diagnosis is based on specific criteria, including a body mass index (BMI) ≥30 kg/m2 or waist circumference measurement. The consequences of obesity include type 2 diabetes mellitus, hypercholesterolemia, hypertension, an increased risk of infectious complications, cancer, and even death. Patients living with obesity are subjected to constant negative evaluation by society through the process of stigmatization. Available data suggest that people with obesity experience stigma in the workplace, at school, on the Internet, and in healthcare settings. Stigmatization is largely driven by a lack of understanding and knowledge about obesity and its underlying causes. People living with obesity are often judged as lazy and accused of having excessive body weight as a consequence of an inappropriate lifestyle. In Poland, the high level of stigmatization of patients with obesity is accompanied by a low level of knowledge about the disease. However, the willingness to help patients, as declared by medical professionals in Poland, offers hope that appropriate education may improve access to effective treatment. Well-designed educational interventions, social campaigns, and the activities of medical societies in developing guidelines, recommendations, and communication manuals for healthcare professionals working with patients living with obesity should constitute essential elements in the fight against stigma. In addition, cooperation with decision-makers to prevent the exclusion of patients with obesity from the healthcare system is necessary.
Agricultural sciences and medicine are converging toward a shared mechanistic framework that links plant biology to human health. This editorial proposes Translational Agricultural Medicine (TAM) as a conceptual and hypothesis-generating framework. Translational Agricultural Medicine positions plant molecular responses, particularly stress-induced redox regulation and phytochemical biosynthesis, as biologically relevant factors that may inform preventive nutrition and translational health research. Evidence from plant stress biology, including redox networks, parallels key biochemical processes underlying metabolic disorders and cancer in humans. Plant-derived bioactives, such as glucosinolates and phenolics, as well as legume proteins, further illustrate how agricultural variables influence the nutritional and biochemical properties of diets relevant to health outcomes. Climate-driven changes in crop physiology reinforce the need to align breeding and agroecological management with public health priorities. Collectively, this perspective reframes plants not as passive dietary components but as upstream contributors to the nutritional modulation of human metabolism, positioning climate-resilient crops and targeted dietary strategies as important components of future preventive health approaches.
Heart failure (HF) is a complex, multifactorial, and difficult-to-treat syndrome. Over the past years, a concerning increase in its global prevalence, mortality, costs, and burden on the healthcare system has been observed. The recent development of machine learning (ML), especially unsupervised and deep learning (DL) algorithms, offers a potential way to facilitate diagnosis, enable more precise treatment, and reduce both mortality and costs of HF patients. Especially unsupervised ML and DL present new opportunities for increased efficiency in clinical practice in cardiology. Unsupervised ML, e.g., enables novel phenogrouping of HF patients into high-risk groups and disease outcome prediction. Deep learning algorithms can enhance echocardiographic analysis by improving image quality and ECG interpretation, and by providing assistance and guidance to inexperienced cardiologists. However, substantial challenges related to generalizability, external validation, overfitting, model explainability, and ethical considerations currently severely limit the implementation of AI-based tools in real-world clinical practice. This review critically evaluates current AI models in HF, focusing on their roles in diagnosis, risk stratification, and treatment personalization, as well as the major challenges that restrict their application in clinical practice.
This article presents selected recommendations included in the 6th Edition of European Glaucoma Society (EGS) guidelines and highlights key differences compared to the previous (5th) and the latest revisions of Polish Ophthalmology Society (PTO) guidelines. The current edition is primarily an update to the earlier guidelines, incorporating the context of new technologies, the results of recent scientific research, and responses to important clinical questions-including those informed by input from the Experts by Experience (EbE-EGS) patient panel. These guidelines constitute a comprehensive, coherent, and evidence-based set of information and recommendations, useful both for making complex therapeutic decisions and in everyday clinical practice.
BACKGROUND:In cases of alveolar bone atrophy prior to implant treatment, sinus floor elevation remains the treatment of choice. During a sinus lift procedure, a stabilizing grafting material is required. Among the many available options, xenografts and allografts are widely used. Owing to their different properties, they can be applied in various clinical settings. Low-level laser therapy (LLLT) is an increasingly popular adjunctive tool in regenerative dentistry. Its beneficial effects on the healing process are well established. However, its ability to influence bone healing following sinus floor elevation remains insufficiently investigated. OBJECTIVES:The primary objective was to compare 2 bone grafts of different origins (allograft and xenograft) used in sinus lift procedures. The secondary objective was to evaluate the influence of LLLT on postoperative recovery in terms of pain, trismus, and soft tissue response. MATERIAL AND METHODS:Twenty patients were randomly allocated to 2 groups. A xenograft was used in half of the patients, whereas an allograft was used in the remaining patients. In each group, 5 patients were randomly selected to receive adjunctive LLLT using a diode laser with a wavelength of 635 nm and an energy density of 6 J/cm2. All patients underwent clinical and radiological examinations before surgery. Subsequently, a standard lateral sinus lift procedure was performed. Follow-up visits were conducted on postoperative days 3 and 7, during which pain, trismus, and swelling were assessed. After 135 days, cone-beam computed tomography (CBCT) and clinical examinations were performed to evaluate bone gain, density, and homogeneity. RESULTS:Low-level laser therapy significantly reduced trismus. Trismus was also less pronounced in male patients. Low-level laser therapy was associated with increased facial swelling. Pain levels were low, with no significant differences between the study groups. After 135 days, allografts demonstrated greater homogeneity, whereas xenografts exhibited higher radiographic density. CONCLUSIONS:Low-level laser therapy may improve recovery following sinus lift surgery by reducing postoperative trismus. No significant differences were observed between the grafting materials in terms of bone gain. However, differences in radiodensity suggest distinct resorption patterns, with xenografts exhibiting higher density values after 135 days.
BACKGROUND:Transcriptional repressor 1 of the Snail family (SNAI1) and miR-145 play crucial roles in the development of colon cancer. Tumor invasiveness and epithelial-mesenchymal transition (EMT) are associated with SNAI1, whereas miR-145 is considered a tumor suppressor. Although cAMP/PKA signaling is critical for regulating cell survival and invasiveness, the precise mechanisms through which SNAI1 and miR-145 influence tumor cell behavior via this pathway remain unclear. OBJECTIVES:To examine the mechanisms by which SNAI1 and miR-145 regulate colon cancer cell invasion and survival through the cAMP/PKA signaling pathway and to assess their functional relationship. MATERIAL AND METHODS:SNAI1 and miR-145 were overexpressed in the colon cancer cell lines DLD1 and HCT116, respectively, and cAMP and PKA activity was assessed using quantitative real-time PCR (qPCR) and western blot analysis. In addition, a luciferase reporter assay and application of the PKA inhibitor H89 were used to further investigate the roles of SNAI1 and miR-145 in regulating cell invasion and survival. RESULTS:Overexpression of SNAI1 significantly increased cAMP and PKA activity and promoted cell survival and invasion. However, overexpression of miR-145 decreased cell invasion and survival by blocking the cAMP/PKA signaling pathway. When both were overexpressed, miR-145 further decreased cAMP/PKA activity and inhibited the tumor-promoting effects of SNAI1. Use of the PKA inhibitor H89 also reduced the tumor-promoting effect of SNAI1. CONCLUSIONS:By activating the cAMP/PKA signaling pathway, SNAI1 promotes colon cancer cell survival and invasion, whereas miR-145 suppresses tumor progression by inhibiting this pathway. These findings suggest that SNAI1 and miR-145 may represent viable therapeutic targets for colon cancer treatment and that targeting the cAMP/PKA pathway may provide a novel therapeutic strategy.
Metabolic dysfunction-associated steatohepatitis (MASH) represents a progressive form of metabolic dysfunction-associated steatotic liver disease (MASLD) and contributes significantly to morbidity and mortality in developed countries. Current clinical practice primarily relies on dietary and lifestyle modifications, while specialized obesity management is used less frequently. However, the long-term efficacy of these approaches remains unsatisfactory. Among pharmacological options, gliflozins have emerged as a promising class of agents with potential benefits in reducing histological activity and improving the prognosis of MASLD/MASH. The beneficial effects of gliflozins in diabetes, cardiology, and nephrology have already been demonstrated, and their use is becoming increasingly common across various clinical indications. However, their role in the treatment of MASLD/MASH has not yet been fully clarified. Preliminary studies suggest that gliflozins may positively influence disease progression in these conditions. This article provides a comprehensive overview of MASLD/MASH and reviews current evidence regarding the therapeutic effects of gliflozins on these liver diseases.
BACKGROUND:Gastrointestinal (GI) cancers remain among the most lethal malignancies worldwide, highlighting the need for novel insights into modifiable risk factors. Blood-based metabolic biomarkers - routinely measured in clinical settings - may play a role in cancer etiology, but their causal impact remains unclear. OBJECTIVES:This study aimed to explore the causal relationship between metabolic blood biomarkers and the risk of GI cancers using Mendelian randomization (MR). MATERIAL AND METHODS:We conducted an MR analysis using large-scale genome-wide association study (GWAS) data to evaluate the causal effects of metabolic blood traits (e.g., low-density lipoprotein (LDL) cholesterol, creatinine, uric acid, total protein, and total cholesterol) on the risk of 4 major GI cancers: gastric, colorectal, pancreatic, and gallbladder cancer. Statistical robustness was evaluated using the MR-PRESSO test and Cochran's Q test. RESULTS:Mendelian randomization analysis revealed several significant associations. Low-density lipoprotein cholesterol was inversely associated with gastric cancer risk (odds ratio (OR) = 0.815, 95% confidence interval (95% CI): 0.703-0.946, p < 0.01), while total cholesterol also showed a protective effect (OR = 0.790, 95% CI: 0.693-0.900, p < 0.01). Serum creatinine levels were strongly associated with a reduced risk of gallbladder cancer (OR = 0.037, 95% CI: 0.005-0.287, p < 0.01). Higher serum total protein (OR = 0.855, 95% CI: 0.777-0.940, p < 0.01) and uric acid levels (OR = 0.855, 95% CI: 0.769-0.951, p < 0.01) were associated with a reduced risk of colorectal cancer (CRC). Serum uric acid levels were also associated with a reduced risk of gastric cancer (OR = 0.822, 95% CI: 0.719-0.941, p < 0.01), but with an increased risk of pancreatic cancer (OR = 1.246, 95% CI: 1.01-1.539, p = 0.040). CONCLUSIONS:Our findings provide causal evidence linking common metabolic blood biomarkers to site-specific GI cancer risks. These results may inform biomarker-based risk stratification and preventive strategies in oncology and public health.
