Abstract Gastric cancer (GC) remains a leading cause of morbidity and mortality within the global digestive system. Early screening is critical to improve patient prognosis and reduce mortality. In recent years, advances in big data and artificial intelligence have underpinned the creation and application of innovative scoring systems for GC screening. These tools are designed to enable accurate risk stratification, highlighting their specific value in facilitating early detection among low-risk groups. However, such systems still carry a non-negligible risk of missed diagnoses, delaying detection and impacting screening efficacy and safety. This review systematically examines the foundational principles and current applications of newly developed scoring systems for GC screening. It further delves into mechanisms contributing to missed diagnoses in low-risk groups, including limitations in model design – such as feature selection and threshold setting – and the complexity of tumor biological behavior, such as heterogeneity and progression variability in low-risk GCs. Additional factors, including insufficient clinical samples and data, as well as constrained sensitivity and specificity of current screening technologies, are explored in depth. By synthesizing recent literature and research advances, this review identifies the principal mechanisms behind screening omissions in low-risk individuals. It also provides theoretical foundations and clinical recommendations aimed at optimizing screening tools and refining early detection strategies, thereby promoting precision and personalization in GC screening.
Abstract Diabetic retinopathy (DR) is a leading cause of visual impairment among adults with diabetes and represents a growing burden for healthcare systems worldwide. Although traditionally regarded as a microvascular complication, increasing evidence indicates that functional impairment of retinal neurons and the neurovascular unit occurs at early preclinical stages of the disease. Objective assessment of these changes may improve early detection and risk stratification. Electroretinography (ERG) provides a direct measure of retinal function, but its routine use has historically been limited by technical complexity. The introduction of portable, non-mydriatic devices has renewed interest in functional retinal testing in both clinical and screening settings. The RETeval™ handheld system enables rapid acquisition of flicker ERG responses combined with automated pupillometry, generating an integrated risk score for DR. The present narrative review summarizes and critically appraises current evidence on the use of the RETeval™ device for the detection, staging, and risk assessment of DR. Particular attention is given to its performance in early disease, prognostic value, practical limitations, and potential role as a complementary tool in diabetes-related eye care.
Introduction. Multiple sclerosis (MS) is a chronic, inflammatory, and demyelinating neurological disease with a multifactorial etiology. Genetic, environmental, and infectious factors play a role in its pathogenesis. Periodontitis is a chronic inflammatory disease of tooth-supporting tissues that involves infection by microorganisms and the host-mediated loss of periodontal attachment. The existence of a definitive link between MS and periodontitis has not been established conclusively to date. Materials and Methods. The study group included 170 patients with relapsing-remitting MS: 123 women and 47 men aged 26-66 years. The control group consisted of 150 patients-99 women and 51 men aged 21-72 years. The periodontal probing depth (PPD), modified sulcus bleeding index (mSBI), approximal plaque index (API), and community periodontal index of treatment needs (CPITN) were assessed in all patients. Results. A total of 104(61%) patients in the study group had healthy periodontal tissues, 50(30%) had gingivitis, 16(9%) had periodontitis (based on the presence of PPD >4 mm). In the control group, periodontitis was significantly more common (p = 0.027). Almost half of the MS patients (83 subjects, 48.8%) reported dry mouth, whereas in the control group only 16% (p <0.0001) reported dry mouth. Patients with higher expanded disability status scale scores had higher API and mSBI scores and fewer teeth. Conclusion. In this study, no association was found between MS and periodontitis. Xerostomia, on the other hand, was significantly more common in patients with MS.
Objective. To understand the latent molecular interactions between aspartame and hepatocellular carcinoma (HCC), this study analyzes the critical functions of genes involved in redox imbalance that may facilitate malignancy. Materials and Methods. We employed a hybrid computational strategy - combining transcriptomic differential expression, weighted gene co-expression network analysis, and an ensemble of 12 machine learning techniques - to isolate central oxidative stress (OS) genes involved in the aspartame-HCC axis. The binding capacities of aspartame toward identified target molecules were subsequently authenticated through network toxicology and molecular docking analyses. Results. In total, 42 shared targets were discovered within the aspartame-HCC axis. Utilizing machine learning, four pivotal OS-related genes - specifically rho family guanosine triphosphatase (GTPase) 3 (RND3), glutathione S-transferase zeta 1 (GSTZ1), aurora kinase A (AURKA), and ADP-ribosylation factor 1 (ARF1) - were prioritized. Among these, ARF1 and AURKA showed significant overexpression, whereas GSTZ1 and RND3 exhibited substantial downregulation in hepatic malignancy (P < 0.001). Furthermore, the structural interactions between aspartame and these central proteins were validated via docking, revealing strong affinities with energies between -7.1 and -5.0 kcal/mol. Conclusion. This study highlights that aspartame may be associated with HCC progression via potential interactions with specific OS genes and the associated signaling pathways.
Introduction. This study aimed to observe the changes in periapical radiograph signs before and after root canal-based management chronic periapical periodontitis and their relationships with treatment prognosis. Materials and Methods. One hundred patients (100 teeth) with chronic periapical periodontitis receiving root canal therapy were enrolled. Periapical radiograph signs before and after treatment were assessed. On the basis of the healing status of the periapical lesions at 12 months, patients were allocated into a healed group (n = 74) and an unhealed group (n = 26). The maximum horizontal diameter (X) and maximum vertical diameter (Y) of periapical shadows, as well as the maximum horizontal length (L) and maximum vertical height (H) of alveolar bone resorption were recorded. Potential risk and protective factors for nonhealing were analyzed. Results. The values of X, Y, L, and H decreased progressively at 3, 6, and 12 months following treatment, and all were significantly smaller than before treatment (p < 0.05). Coronal restoration materials of inlay, root filling >2 mm and overfilling, coronal microleakage, instrument fracture, and increases in X, Y, L, and H at 3 months after treatment became risk factors for nonhealing at 12 months after root canal treatment, while retreatment after surgery was a protective factor (p < 0.05). X, Y, L, and H at 3 months after treatment were positively correlated with the nonhealing risk of tooth apexes (p < 0.05). Conclusions. Periapical radiograph indicators were reduced after root canal treatment, which are closely related to the poor healing of tooth apexes and conducive to early diagnosis and intervention.
Objective We explore the clinical and prognostic significance of RUNX1 in ovarian serous cystadenocarcinoma (OSC) and report its previously unreported role in regulating ferroptosis.Methods RUNX1 expression and prognosis were tested using TCGA-OV and GTEx data. Functional roles were assessed in vitro via RUNX1 knockdown in OSC cell lines, while measuring proliferation (3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) and colony formation) and ferroptosis sensitivity (erastin treatment and glutathione/malondialdehyde (GSH/MDA) assays). Mechanisms were explored via western blotting and bioinformatic analysis.Results RUNX1 was significantly higher in OSC patients and correlated to poor overall survival, thereby indicating its prognostic value. RUNX1 knockdown suppressed proliferation and increased erastin-induced ferroptosis sensitivity. Silencing RUNX1 reduced GSH, elevated MDA, and inhibited Nrf2 signaling, thus, suggesting ferroptosis regulation via this pathway.Conclusion RUNX1 is an independent prognostic biomarker for OSC. Crucially, we provide novel evidence that RUNX1 promotes OSC progression by conferring resistance to ferroptosis likely through the Nrf2 pathway. Thus, targeting the RUNX1-ferroptosis axis represents a promising therapeutic strategy.
Obesity stigma is a pervasive social issue with substantial psychological, social, and economic consequences. This paper reviews the impact of weight-based discrimination across five key demographic factors: income, age, education, sex, and race. The findings indicate that individuals with lower socioeconomic status face heightened levels of stigma, particularly within healthcare settings. Age-related differences show that younger individuals often experience more intense social pressure than adults. Lower educational attainment is associated with greater internalized stigma and increased psychological distress. Sex-based disparities reveal that women and men experience obesity stigma in different contexts, while racial differences shape distinct experiences of stigma, with Black, Hispanic, and other racial groups facing unique challenges. Addressing obesity stigma requires a multifaceted approach, including education for healthcare providers and targeted public health campaigns. A deeper understanding of these determinants can guide policy development, reduce bias, and promote equitable healthcare for individuals living with obesity.
Sulfur is present in human and animal tissues, in organic compounds (such as sulfur amino acids), and inorganic compounds (such as hydrogen sulfide). Hydrogen sulfide can be sourced from a pool of compounds containing sulfane sulfur. The presence of sulfane sulfur has been observed, over the years in human and animal tissues, as well as cell cultures. The cold cyanolysis method (Wood's method), determined sulfane sulfur contents ranged from 60 to 400 nmol per mg of protein. In amphibians, the level of sulfane sulfur changes seasonally. No gender differences relating to sulfane sulfur levels were found in mice. External factors such as cyanide, menadione (induces oxidative stress), heavy metal ions, or changes in the level of L-cysteine and other sulfur compounds which result from mutations of genes for enzymes involved in the transformation of these compounds, temporarily affect the level of sulfane sulfur, which, however, returns to the control level, which illustrates the adaptation to changed conditions and the tendency to maintain the level of sulfane sulfur. This points to the essential importance of sulfane sulfur for living organisms.
The environment in which cancer cells can be functionally shaped is called the tumor microenvironment (TME). TME plays a complex role in cancer biology and treatment resistance. During the initiation and progression of cancer, not only is the single transformed cell growing and multiplying, but its environment is also developing. TME promotes the growth and expansion of cancer cells and the metastasis process. Many cell types, such as inflammation-associated cells, fibroblasts, nerve cells, and vascular endothelial cells, are involved in TME. Molecules such as cytokines and chemokines are released by these cells. Utilizing these molecules, the growth signals in cancer cells are directly activated, leading to tumor growth. This results in the reprogramming of cells surrounding the tumor. Continuous interactions between tumor cells and TME play a decisive role in tumor induction, growth, metastasis, and reply to treatments. Understanding the dynamics of the tumor microenvironment is crucial for developing targeted therapies and improving cancer treatment outcomes. This review aims to review the available information on different aspects of TME in different types of cancer. Understanding of the TME has underscored its complex role in cancer biology and therapy resistance. Targeting components of TME holds promise for developing more effective cancer treatments in the future.
Glaucoma, a leading cause of irreversible blindness, often necessitates intervention beyond conventional therapies when intraocular pressure (IOP) cannot be adequately controlled. Endoscopic cyclophotocoagulation (ECP), a targeted cyclo-destructive procedure, has emerged as a valuable surgical option due to its ability to precisely coagulate the ciliary processes under direct visualization. This literature review explores ECP's role in contemporary glaucoma management. It examines its efficacy, safety, and integration with phacoemulsification, novel hybrid procedures, such as ECP with Kahook Dual Blade or iStent insertion and vitrectomy pars plana. Clinical studies consistently demonstrate a significant reduction in IOP and medication burden, particularly when ECP is combined with cataract surgery. While complications such as inflammation and transient IOP spikes are noted, severe adverse outcomes remain uncommon. Pediatric and refractory glaucoma cases show variable responses, emphasizing the need for individualized patient selection. Comparative studies suggest that ECP provides outcomes that are on par with or superior to traditional surgical options, with a lower complication rate and preservation of conjunctival integrity, which is advantageous for future interventions. However, the predominance of retrospective studies and limited long-term data warrant further randomized, controlled trials to establish definitive guidelines. ECP represents a promising, minimally invasive strategy in glaucoma care, particularly as part of combination procedures. Growing evidence supports its clinical utility across a wide range of patient populations.
Blood vessels play a fundamental and unique role in brain tumor pathogenesis, including by mediating interactions with the peripheral immune system. Despite this intimate connection, endogenous immune surveillance and multiple modalities of immunotherapy have thus far exerted relatively little impact on disease progression and patient survival in high-grade brain tumors, such as glioblastoma (GBM). This applies to both adults and children, where complex vascular processes have emerged as possible actionable targets beyond anti-angiogenesis. Indeed, vascular responses in GBM include angiogenic, non-angiogenic (cooption, vasectasia), and angiocrine interactions mediated by soluble factors and extracellular vesicles (EVs). It is still poorly understood why immune cells are excluded from the GBM tumor microenvironment and what barriers may operate at the immune-vascular interface which could be modified to improve immunotherapy outcomes. The emerging research directions include efforts to overcome the immune cell exclusion, defining molecular hallmarks of treatment susceptibility in subsets of patients, assessing different immune effectors, and rational temporal scheduling of immunotherapy administration relative to the effects of cytoreductive treatments. It is suggested that experimental insights into the interplay between vascular and immune cell compartments may serve as hypothesis-generating material for future clinical studies in GBM.
Fish oils, such as cod liver oil or shark liver oil, are a valuable source of essential omega-3 unsaturated fatty acids (EFAs) (mainly DHA and EPA) and vitamins A and D, which are crucial for the proper functioning of the body, including neurological development, vision and the cardiovascular system. Due to the low consumption of fish in Poland, dietary supplements containing these oils have gained popularity. However, a significant problem is the potential contamination of fish and fish products with heavy metals, especially mercury. Mercury, mainly in the form of methylmercury, accumulates in aquatic organisms, especially in predatory and long-lived fish, due to environmental pollution. Methylmercury is highly toxic. It penetrates the blood-brain and blood-placenta barriers, posing a risk of neurotoxicity, developmental problems and a negative impact on the circulatory, immune, urinary and hormonal systems. The applicable regulations (e.g. Commission Regulation (EC) No. 629/2008, ICH Q3D guidelines) specify permissible levels of mercury in food, dietary supplements and medicinal products, with the standards for supplements being more stringent than for fish meat. Studies have shown that commercially available fish oil supplements usually contain mercury in amounts below the established limits, making them safe for consumption. Nevertheless, due to the dynamic development of the market and the lack of mandatory control before placing on the market, the need for constant quality monitoring and possible tightening of legal requirements for dietary supplements is postulated.
Tuberculosis (TB) remains a global public health challenge, particularly in resource-limited settings, where centralized diagnostic systems may be constrained by logistical delays, infrastructure gaps, and limited workforce capacity. In recent years, decentralized diagnostic approaches have emerged as promising alternatives to improve access, timeliness, and patient-centered care. This narrative review examines the evolving landscape of decentralized TB diagnostics in primary laboratories, especially in the post-COVID-19 era, where pandemic-related investments in health infrastructure and digital systems have created new opportunities for diagnostic reform. We identify and synthesize five persistent implementation challenges — quality assurance, human resource limitations, infrastructural deficits, financial sustainability, and community engagement — as well as several key enablers, including portable molecular technologies, digital health platforms, and policy-linked diagnostic networks. This review highlights the importance of embedding decentralized models into national TB programs, supported by regulatory frameworks, sustainable financing, and cross-sector collaboration. Accelerating the institutionalization of decentralized diagnostics is essential to achieving diagnostic equity and advancing TB elimination goals in high-burden countries.
Acne vulgaris is a common skin disorder. Minor acne lesions that do not require dermatological intervention can be treated in a cosmetologist's salon. Standard cosmetic-based anti-acne procedures can be enhanced by specialized devices that facilitate the delivery of cosmetic active ingredients into the skin. The action of these devices may involve lasers, LEDs, and hydrogen purification. To date, these methods have not been compared in light of the available literature. Therefore, the purpose of this article was to present devices that assist in alleviating acne, along with a comparison of their practical applicability in dermatologists' and cosmetologists' salons.
Introduction. This study aims to compare the effects of platelet-rich plasma (PRP) alone versus PRP combined with hyaluronic acid and collagen supplements in promoting healing after anterior cruciate ligament (ACL) reconstruction surgery. Materials and Methods. Data from 140 patients undergoing arthroscopic ACL reconstruction (January 2022-January 2024) were analyzed. Participants were divided into a PRP group (n=70) and a combination group (PRP + hyaluronic acid + collagen, n=70). Both groups received their respective treatments during surgery and followed a standardized rehabilitation regimen. Outpatient follow-ups occurred at 1, 2, 3, 6, and 12 months post-surgery. Objective assessments included Visual Analog Scale (VAS), Lysholm, and International Knee Documentation Committee (IKDC) scores. Thigh and calf circumferences were measured preoperatively and on postoperative day 3. MRI scans at 12 months assessed tendon-to-bone healing. Results. At the 12-month follow-up, the combination group showed significantly greater improvements in Lysholm and IKDC scores, and lower VAS scores compared to the PRP group at all postoperative time points (p < 0.05). The combination group also exhibited significantly smaller increases in thigh and calf circumference postoperatively (p < 0.05), indicating less swelling. MRI results revealed significantly better tendon-bone healing grades in the combination group (p < 0.05). No complications were reported in either group. Conclusions. PRP combined with hyaluronic acid and collagen significantly enhances knee function recovery, reduces pain and swelling, and promotes tendon-bone healing after ACL reconstruction compared to PRP alone.
Introduction Non-vitamin K antagonist oral anticoagulants (NOACs) such as rivaroxaban offer potential advantages over warfarin in patients with non-valvular atrial fibrillation (NVAF). However, long-term real-world data evaluating their efficacy and safety, particularly in high-risk subgroups, remain limited.Materials and Methods This prospective observational cohort study enrolled 140 patients with newly diagnosed NVAF receiving rivaroxaban (20 mg daily or 15 mg daily in cases of renal impairment) for stroke prevention. Clinical, biochemical, and echocardiographic parameters were collected at baseline and monitored over 12 months. Primary efficacy and safety endpoints included stroke/systemic embolism and major bleeding (ISTH criteria), respectively. Secondary endpoints included TIA, cardiovascular hospitalization/mortality, non-major bleeding, renal/hepatic dysfunction, and treatment discontinuation. Kaplan-Meier survival analysis and multivariate logistic regression were used to evaluate outcomes and predictors.Results Stroke and systemic embolism occurred in 3.57% and 0.71% of patients, respectively. Major bleeding occurred in 5.71%, including gastrointestinal (2.86%) and intracranial (1.43%) events. Clinically relevant non-major bleeding and minor bleeding were reported in 8.57% and 12.86% of patients, respectively. Treatment was discontinued in 10% due to adverse events, primarily bleeding and renal function deterioration. Regression analysis identified age, CHA2DS2-VASc, HAS-BLED score, renal impairment, low hemoglobin, and prior stroke/TIA as independent predictors of adverse outcomes.Conclusions Rivaroxaban demonstrated favorable efficacy and acceptable safety in NVAF patients, including elderly and comorbid populations. Bleeding and renal dysfunction were notable risks. Close monitoring and individualized risk stratification remain essential for optimizing anticoagulation outcomes in real-world clinical practice.
Introduction. Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a prevalent sleep and respiratory disorder with links to cardiovascular and cerebrovascular conditions. The proprotein convertase subtilisin kexin 9 (PCSK9) is closely associated with these conditions. This study aims to assess serum PCSK9 levels in OSAHS patients and their correlation with disease severity. It aims to establish the significance of serum PCSK9 levels as a predictive indicator for OSAHS onset, progression, and severity. Materials and Methods. 182 participants without regular OSAHS medication were enrolled from a local hospital sleep clinic. Based on polysomnography and the apnea-hypopnea index (AHI), participants were categorized into mild, moderate, and severe OSAHS groups. Serum PCSK9 concentrations were measured using an enzyme-linked immunosorbent assay. Comparative analyses were conducted using OSAHS severity, and multivariate logistic regression evaluated the relationship between serum PCSK9 levels and OSAHS severity. Results. A significant positive association was found between serum PCSK9 levels and OSAHS severity (p < 0.001). Individuals with more severe OSAHS had higher serum PCSK9 levels, with this association remaining statistically significant after adjusting for confounders (p < 0.001). ROC curve analysis showed a good predictive value for OSAHS onset, progression, and severity, with an area under the curve of 0.81 (p < 0.001). Conclusions. This study demonstrates that OSAHS affects serum PCSK9 levels, with severity positively linked to PCSK9 levels. Serum PCSK9 levels could be a reliable biomarker for OSAHS clinical evaluation and treatment.
Introduction Toxoplasmosis, caused by the protozoan Toxoplasma gondii, is a widespread zoonotic disease, with an estimated 50% of the global population exposed to the pathogen. While the majority of infections remain asymptomatic, individuals with compromised immune systems, such as transplant recipients, pregnant women, and neonates, are particularly vulnerable to severe manifestations. One of the most serious complications in such populations is ocular toxoplasmosis, which can lead to inflammatory eye conditions such as retinitis and choroiditis, collectively known as chorioretinitis.Materials and Methods This case study presents a 53-year-old female patient who experienced a reactivation of ocular toxoplasmosis following hematopoietic stem cell transplantation for multiple myeloma. The patient developed inflammatory retinal changes that significantly affected her vision. Prompt diagnosis and targeted treatment markedly improved visual acuity and reduced the limitation of inflammatory lesions.Results In preventing toxoplasmosis, it may be beneficial to consider ophthalmologic examinations for patients before scheduled hematopoietic stem cell transplantation, both for recipients and donors.Conclusions The case underscores the importance of early detection and intervention in immunosuppressed patients to prevent long-term complications such as vision loss. It also highlights the value of preventive measures, including serological testing and ophthalmologic evaluation before stem cell transplantation. Such strategies are essential for identifying latent infections and mitigating the risk of reactivation in high-risk individuals.
Introduction Inflammatory bowel disease (IBD) is a chronic condition that significantly impacts the gastrointestinal system. Using an AMO/DSS-induced IBD mouse model, we evaluated the therapeutic potential of epidermal growth factor (EGF) enema and epidermal growth factor receptor (EGFR) monoclonal antibody (mAb) injection as a treatment for IBD. Materials and Methods Twelve male C57BL/6 mice were divided into 4 groups (n=3 in each group), including a control group, model group, model group treated with EGF, and model group treated with EGF and EGFR mAb. Mice were sacrificed 9 weeks after disease symptoms first appeared. Colon tissues were then analyzed for histological changes, and protein expression levels of EGFR, Ki-67, p-AKT, and p-ERK were evaluated using immunohistochemistry and Western blotting. Results The AOM/DSS model exhibited significant weight loss and inflammation-driven colon damage compared to baseline at week 2; however, by the end of the study, body weight showed a trend toward recovery, with no significant differences observed between the groups. Histological analysis indicated partial improvement in the EGF group, and the combination treatment reduced inflammation compared to the model group. Both treatments significantly reduced Ki67 expression, with no significant difference between the EGF and combination treatments. Additionally, both treatments led to a decrease in p-Akt and p-ERK1/2 Conclusion EGF enema and EGFR mAb injection exhibited significant therapeutic effects against AOM/DSS-induced IBD in vivo . Hence, EGFR-targeted therapy represents a promising approach for treating IBD-related complications.
Introduction Vitreomacular traction (VMT) syndrome occurs when posterior vitreous detachment (PVD) induces traction on the macula. This traction can lead to the development of intraretinal pseudocysts and detachment of the fovea from the retinal pigment epithelium (RPE). VMT could be isolated or associated with other macular abnormalities such as age-related macular degeneration (AMD), retinal vein occlusion (RVO), and diabetic retinopathy (DR). Materials and Methods A 69-year-old patient reported to the Ophthalmology Clinic due to a decline in his vision in the left eye. His medical history included a 30-year duration of diabetes, managed with insulin therapy for the past 5 years, as well as an episode of branch retinal vein occlusion (BRVO). At admission, the left eye’s visual acuity (VA) was 0.02, with an intraocular pressure (IOP) of 20 mmHg. After evaluation and diagnostic tests, the patient was qualified for pars plana vitrectomy (PPV). The procedure involved applying a dye, peeling the epiretinal membrane (ERM), internal limiting membrane (ILM), and endotamponade with SF6 gas. Results The surgery went without any complications. Optical coherence tomography (OCT) revealed the release of macular traction and the restoration of normal morphology of the macula. Ten days after the procedure, a follow-up examination showed an improvement in VA in the left eye to 0.3, with an IOP of 16 mmHg. Conclusions PPV with removal of the ERM and ILM, combined with SF6 gas tamponade, is an effective treatment for patients with vitreomacular traction syndrome complicated by diabetic retinopathy and BRVO.
