Polygenic risk scores (PRS) have emerged as important tools for quantifying inherited susceptibility to cancer, and are increasingly combined with environmental and lifestyle factors into composite risk scores (CRS). In this context, environmental inputs should be understood not as isolated covariates, but as components of the human exposome, encompassing cumulative, time-varying, and interacting exposures across the life course, which fundamentally shape cancer risk alongside inherited susceptibility. These approaches are often discussed as candidates for precision prevention and screening, yet their evidentiary basis spans heterogeneous study designs, outcomes, and methodological assumptions. Here, we provide an integrated review of genetic, environmental, and composite cancer risk models, explicitly distinguishing etiologic association from predictive performance and clinical translation. We synthesize evidence from large genome-wide association studies, cohort and case–control analyses, and recent CRS evaluations using both narrative assessment and structured quantitative summaries. Across cancer sites, PRS and CRS consistently stratify relative risk, with monotonic increases in odds ratios across score percentiles. However, gains in discrimination metrics such as the area under the curve or C-index are generally modest and heterogeneous, and calibration performance varies substantially across populations and settings. External validation and multi-ancestry evaluations remain limited, and methodological challenges, including overfitting, population stratification, and model transportability, are frequently under-reported. We argue that current evidence supports the use of PRS and CRS primarily as tools for risk stratification, prioritization, and risk-enriched research designs, rather than as stand-alone clinical decision systems. The most near-term translational value lies in targeted screening strategies, prevention trials, and population-level risk assessment, provided that calibration, governance, and equity considerations are explicitly addressed. We conclude by outlining key methodological and data requirements needed to advance CRS from exploratory models toward robust, population-appropriate tools in cancer prevention. Cancer risk prediction is evolving from static PRS to dynamic, exposome-aware CRS. Integrating genome and exposome reframes cancer risk as a life-course system. CRS redefine precision prevention beyond age-based screening paradigms. AI-driven models enable causal, multimodal, and continuously learning risk systems. Equitable multi-ancestry validation is essential for responsible genomic medicine.

To identify ethnic differences among women with gestational diabetes mellitus (GDM) in a multiethnic cohort. This observational study included pregnant women with GDM (IADPSG criteria) attending a tertiary centre between January 2020-December 2023, classified according to their ethnic group as White, Black, Asian, or Other. Multivariable logistic and linear regression analyses were performed. A total of 633 women (513 White, 64 Black, 32 Asian, and 24 Other/Middle Eastern) were considered eligible for inclusion. Asian women had higher HbA1c than White, Black, and Other (5.5

Childhood cancers are rare, but incidence has risen modestly in countries with robust registration, partly reflecting improved diagnosis. In high-income countries, cancer is the leading cause of disease-related death in children. Marked inequities in incidence, survival, and research capacity underscore the need for large-scale collaboration to identify environmental, genetic, and contextual determinants of risk. The Childhood Cancer and Leukemia International Consortium (CLIC) was established in 2007 to study the etiology of childhood leukemia and later expanded in 2019 to include other childhood cancers, principally solid tumors. CLIC pools harmonized, individual-level data from case-control and cohort studies, obtained through interviews, record linkage (insurance claims, registries), or geographic information systems, and integrates germline genomic data where available. Membership has grown from 13 studies in 9 countries to 57 studies in 21 countries; recruitment spans the early 1960s to the present and encompasses approximately 150,000 cases across all tumor types and 300,000 controls with clinical, demographic, and exposure data, centralized via harmonized data dictionaries at the Data Coordination Center, established in 2014 at the International Agency for Research on Cancer, and supported by a secure analysis platform. Pooled analyses across diverse populations have implicated parental age, prenatal vitamin or folic acid use, mode of delivery, fetal growth, selected congenital anomalies, occupational or household exposures (e.g., pesticides), paternal smoking, and markers of early-life immune modulation (e.g., breastfeeding, daycare attendance) in leukemia risk, informing carcinogen evaluation and prevention. The integration of genetic ancestry and germline susceptibility data is clarifying ancestry-related differences in leukemia biology and outcomes, while confirming risk loci with population-specific effects. CLIC is now adding polygenic risk scores and exposomic data to refine etiologic subtyping and identify modifiable pathways, while broadening representation from underserved regions through partnership-building and capacity-strengthening.

BACKGROUND:Metabolic dysfunction-associated steatotic liver disease (MASLD) commonly affects patients with Type 2 diabetes mellitus (T2DM). Fibrosis-4 (FIB-4) has been linked to chronic kidney disease (CKD) in patients with MASLD; however, its association with CKD in broader, not preselected for MASLD, T2DM populations remains unclear. AIM:To investigate the association of FIB-4 with CKD in unselected patients with T2DM and compare its discriminatory ability with that of HellenicSCORE II and aspartate aminotransferase-to-platelet ratio index (APRI). METHODS:We retrospectively analyzed data from consecutive patients with T2DM. Characteristics and baseline laboratory results were recorded. RESULTS:A total of 214 patients (mean age 67.6 ± 10.3 years) were enrolled, including 158 (73.8%) males and 56 (26.2%) females. Ninety-six (44.8%) had normal kidney function, and 54 (25.2%) had CKD at enrollment. Those with CKD were significantly older (p = 0.002) and had higher scores on the HellenicSCORE II (p = 0.004), APRI (p = 0.001), and FIB-4 (p < 0.001). Additionally, hypertension and cardiovascular disease were more common in the CKD than in the non-CKD group (p < 0.001 for both). In the multivariate analysis, sex (OR: 0.13, 95% CI: 0.03-0.6; p = 0.008) and FIB-4 (OR: 10.4, 95% CI: 2-54.1; p = 0.005) were independently associated with CKD. Among the evaluated scores, FIB-4 demonstrated the highest numerical AUROC for identifying CKD (0.769; 95% CI: 0.668-0.869), compared with APRI (0.668; 95% CI: 0.558-0.778) and HellenicSCORE II (0.651; 95% CI: 0.544-0.757). CONCLUSIONS:FIB-4 was independently associated with the presence of CKD in patients with T2DM and demonstrated the highest numerical AUROC among the evaluated scores.

Metabolic dysfunction–associated steatotic liver disease (MASLD) is a systemic disorder associated with cardiovascular, renal, and metabolic comorbidities. We evaluated cardiovascular disease (CVD), four-domain cardiovascular–renal–hepatic–metabolic (CRHM) involvement, and their associations with non-invasive liver-related scores in patients with type 2 diabetes mellitus (T2DM) and MASLD. We retrospectively analyzed 216 patients with T2DM and MASLD. A study-specific four-domain CRHM phenotype was defined as the coexistence of T2DM, MASLD, chronic kidney disease (CKD), and atherosclerotic CVD. FIB-4, AST-to-ALT ratio (AAR), APRI, Hellenic Score II, Fibrotic NASH Index (FNI), and CORE model were evaluated. CVD was present in 75/216 participants (34.7

Hexavalent chromium (Cr(VI)) is a highly toxic and carcinogenic trace element. While carcinogenicity through inhalation is well-established, gastrointestinal (GI) carcinogenicity via oral ingestion remains contentious. This study aimed to measure GI cancer mortality at Oinofyta, Greece, where the toxic waste of industries was discarded in the village's water source for a long time. An ecological study was carried out at the Oinofyta municipal unit, where the primary water supply had been contaminated with Cr(VI) for approximately three decades. Mortality data of all residents of Oinofyta for the period 2000-2021 were obtained from the Hellenic Statistical Authority, and causes of death were classified according to the ICD-10. Standardized Mortality Ratios (SMRs) were computed, stratified by five-year age groups, biological sex, and calendar year, using the population of the entire Voiotia regional unit as the reference population. A higher all GI cancer SMR was observed during the second decade (SMR = 1.44; 95%CI = 1.03, 1.95), but not the first (SMR = 0.98; 95%CI = 0.64, 1.44). Overall, the SMR was evidently higher for males (SMR = 1.35; 95%CI = 1.0, 1.8), but not for females (SMR = 0.97; 95%CI = 0.6, 1.49). A borderline higher SMR was also observed for colorectal cancer in males (SMR = 1.63; 95%CI = 0.93, 2.65; p = 0.08). Additionally, the SMR for all GI cancers demonstrated a significant increasing trend from 2000-2009 to 2010-2021 (0.98;95%CI = 0.64,1.44 to 1.44;95%CI = 1.03, 1.95). This ecological study presents a population-level association between Cr(VI)-contaminated drinking water with certain GI cancers, suggesting further research for etiological associations.

OBJECTIVE:The EGKARDIA study screened socioeconomically vulnerable populations for cardiometabolic diseases during the Greek economic crisis and assessed its impact on their health. STUDY DESIGN:EGKARDIA was a cross-sectional primary healthcare study conducted between 2013 and 2015 at health centers in the metropolitan region of Athens, Greece. The study included individuals aged 30 and above recruited from Open Care Centers for the Elderly, social and municipal clinics, and those voluntarily seeking screening. MAIN OUTCOME MEASURES:The primary outcome was the prevalence of cardiometabolic diseases (hypertension, obesity, dyslipidemia, diabetes mellitus); factors associated with hypertension were also studied (sociodemographic and lifestyle data, dietary and physical activity patterns, mental health and health-related quality of life, self-perception of being affected by the economic crisis). RESULTS:Among 5609 participants (65 % female at birth, 31 % aged 65 years or more, 39 % with only compulsory education, and 24 % unemployed), 89 % were physically inactive or minimally active, 56 % were ever-smokers, 27 % were obese, 55 % had hypertension (28 % undiagnosed), 84 % had dyslipidemia (49 % undiagnosed), and 15 % had diabetes mellitus (9 % undiagnosed). Additionally, 20 % showed moderate or severe depression. Hypertension was independently associated with male sex at birth, older age, low education, physical inactivity, retirement, unemployment, depression, overweight and obesity, diabetes mellitus and dyslipidemia. A similar set of associations was noted regarding undiagnosed hypertension. CONCLUSIONS:The EGKARDIA study revealed a particularly high prevalence of cardiometabolic diseases among socioeconomically vulnerable individuals, emphasizing the need for targeted public health interventions to support those populations.

This review highlights the role of Anti-Müllerian Hormone (AMH) in ovarian insufficiency and as a predictor of menopause. AMH, produced by granulosa cells in growing follicles, is a key marker of ovarian reserve, reflecting the remaining pool of viable follicles. In cases of primary ovarian insufficiency (POI), AMH levels are significantly reduced, aiding in diagnosis and distinguishing POI from other causes of amenorrhea. AMH levels below 8 pmol/L have shown high sensitivity (85

To determine whether the abnormal glucose concentrations at various oral glucose tolerance test (OGTT) time points are associated with adverse perinatal outcomes in pregnancies complicated by gestational diabetes mellitus (GDM). A retrospective study included 257 pregnant women with GDM (IADPSG criteria) who delivered between 2020–2023 at a tertiary hospital. Women were classified based on their OGTT results: isolated fasting hyperglycemia (group A), isolated post-load hyperglycemia (group B), and combined hyperglycemia (group C). Multivariable linear and logistic regression analyses were performed. Most women had fasting hyperglycemia (54.1

To evaluate interventions designed to improve transition to adult-oriented care for youth with chronic physical health problems. Methods: Electronic searches were conducted in PubMed, Google Scholar, EMBASE, and PsycINFO focusing on patient education and preparation, and their effect on the course and the follow-up of diseases, as well as on the quality of life of young people. Results: Seventeen studies met inclusion criteria. Educational programs, either hospital-based or Internet-based, and also workshops with a cognitive–behavioral approach seem to reflect positively on transition outcomes. Conclusions: This systematic review illustrates a map of interventions that enhance a successful transition of young chronic patients to adult health care. The findings suggest that educational programs, behavioral workshops, common medical appointments with pediatric and adult healthcare providers, training of the latter, and patient families are useful to transition experience. Transition programs should be developed with a long-term perspective preparing and empowering youth for the future.

Glucagon-like peptide 1 receptor agonists (GLP-1RA) are commonly used as treatment for type 2 diabetes mellitus and obesity. GLP-1RA have been found to be valuable therapeutic approaches not only for glucose control, but also for weight loss and cardiovascular risk reduction. It has also been established that GLP-1RA have immunological and anti-inflammatory effects. The aim of this article was to comprehensively review the literature and to collect, analyse and quantitatively resynthesize evidence on the possible effects of GLP-1RA on inflammatory skin diseases. Through body weight reduction and subsequent systemic inflammation reduction, but mainly through their direct interaction with signalling pathways of inflammation and immune cells, GLP-1RA can improve psoriasis and hidradenitis suppurativa (HS). Clinical data of the positive effects of GLP-1RA in patients with psoriasis and HS are presented. Moreover, the immune cells and inflammatory pathways affected by GLP-1RA are discussed.

Giant parathyroid adenoma (GPA) is an extremely rare cause of primary hyperparathyroidism (PHPT) and may sometimes mimic parathyroid carcinoma (PC). Parathyroid carcinoma is also a very rare entity. Both preoperative and postoperative diagnosis of the two conditions remains a challenge. The purpose of this article is to present the diagnostic and therapeutic approach used for a 76-year-old female patient with a GPA measuring 5.4 × 2.3 cm, mimicking PC. The patient was referred to our clinic for the management of severe hypercalcemia revealed during the neurological evaluation of psychiatric and cognitive symptoms, confusion, weakness, and bone pain. PHPT was confirmed based on the patient’s biochemical profile, which showed extremely high levels of serum calcium and parathyroid hormone (PTH). Wholebody computed tomography revealed a large nodule below the inferior pole of the right lobe of the thyroid gland and no further pathology in other organs. En bloc resection of the tumor with removal of the ipsilateral hemithyroid and other involved tissues was performed. Histopathological evaluation was diagnostic for a GPA. Post-surgery hungry bone syndrome (HBS) developed and was treated. However, the patient succumbed 3 weeks later due to septic shock. GPA is an exceptionally rare endocrine tumor that should be suspected along with PC in patients with significantly elevated levels of PTH and calcium, and/or palpable neck mass. In our case, diagnosis was based principally on histopathological examination together with clinical presentation, biochemical profile, and imaging studies. Resection of the tumor remains the treatment of choice.

Objective: To investigate the clinical characteristics associated with the presence of LSV at birth. Design: Prospective 1:1 case–control study. Setting: Two tertiary neonatal units in Athens, Greece. Patients: Premature neonates (≤36 weeks gestational age) who underwent cerebral ultrasound within the first 3 weeks of life, where LSV was detected. Main outcome measure: Associations between LSV and clinical characteristics at birth. Both unmatched and matched analyses stratifying the study population by gestational week were conducted. Two-sided p-values were computed using the likelihood ratio test. Results: This study included 166 participants (83 cases and 83 controls). Neonates with LSV exhibited more concurrent cerebral findings, notably periventricular echogenicity. LSV was correlated with higher z-scores for head circumference and body length. LSV was not associated with congenital CMV. Conclusions: This study indicated a relationship between LSV and increased head circumference and body length. Further research is warranted to explore LSV’s pathophysiological mechanisms.

Background/Objectives: Survival rates for ovarian cancer remain distressingly low. Despite established prognostic factors, the need to identify modifiable parameters to influence survival outcomes is imperative. Overweight and obesity, both prevalent conditions, have been implicated in cancer development and potentially poor survival. However, conflicting data on the associations of body mass index (BMI) with progression-free survival (PFS) and overall survival (OS) in ovarian cancer patients necessitate further exploration. This study aims to investigate the prognostic role of BMI before chemotherapy in women with ovarian cancer, specifically focusing on PFS and OS. Methods: A retrospective analysis encompassed 1,136 patients diagnosed with ovarian carcinomas between 1995 and 2018. Patients were categorized based on BMI at presentation, and a comprehensive examination of clinicopathological, treatment, and survival data was conducted. Results: In the patient population, normal weight patients (BMI < 25 kg/m2) demonstrated a median PFS of 12.8 months (95% CI 11.7–13.9 months), while overweight/obese patients (BMI ≥ 25 kg/m2) exhibited a significantly longer median PFS of 14.9 months (95% CI 13.6–16.4 months, P = 0.006). No statistically significant difference was noted in median OS between the two BMI groups. Subgroup analysis for different histological subtypes revealed a statistically significant benefit for overweight and obese patients with serous and endometrioid histology (mPFS 12.9 months, 95% CI 11.7–14.0 vs. 15.6 months, 95% CI 13.9–17.3, P = 0.012 and 14.6 months 95% CI 13.7–15.5 vs. 25.6 months, 95% CI 9.5–41.7, P = 0.031, respectively). Additionally, BMI ≥ 25 kg/m2 demonstrated a significant advantage in advanced-stage disease. Conclusions: The study underscores the intricate association between BMI and ovarian cancer prognosis. While a statistically significant difference in progression-free survival was noted between normal weight and overweight/obese patients, with the latter group experiencing a survival benefit, no such difference was observed in overall survival.

Background: Inflammatory bowel diseases (IBDs), consisting mainly of Crohn’s disease (CD) and ulcerative colitis (UC), are chronic illnesses mainly affecting the gastrointestinal tract, but not only. The role of the human gut microbiome in IBD has been established as findings suggest that in CD and UC, certain phyla, though different in each disease, are affected in count and diversity, with dominance of pathogenic bacteria and loss of protective ones. The commonly used pro- and prebiotics are under investigation for their role in the induction and maintenance of remission of IBD, with promising results. Considering the above, the aim of this systematic review is to further investigate the role of probiotics in the maintenance of remission in adult-onset CD. Materials and Methods: The systematic review was conducted according to the recommendations of the Cochrane Handbook for Systematic Reviews , and the results were reported following the rules of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Eligible studies were identified in the Cochrane database and PubMed; the end of the search date was December 31, 2023. Results: The search identified a total of 2015 items, of which 11 were included in this systematic review. The findings concerning the use of probiotics, either as monotherapy or as adjunctive therapy to traditional treatments, in the maintenance of remission of CD were inconclusive, with four trials indicating a not statistically significant trend favoring their administration for relapse prevention. Conclusions: Although the role of probiotics in CD is doubted, this systematic review highlights the need for further research on the effect of probiotics on the microbiome profiles of IBD patients as well as large-scale, randomized controlled trials with standardized probiotic formulations, aiming at personalized probiotic therapies with valuable results in CD.

Background/Objectives: Low levels of vitamins and minerals are linked to increased frailty, but the effectiveness of micronutrient supplementation remains debated. Methods: A systematic search of PubMed and Embase (end of search 10 June 2025) identified 21 randomized controlled trials from 33 articles assessing supplementation in frail individuals. Results: Regarding vitamin D supplementation, seven studies (2600 participants) reported all-cause mortality (pooled RR: 1.04, 95% CI: 0.83 to 1.31, I2 = 35%) with moderate certainty of evidence, whereas only one study reported on the change in frailty levels. For multicomponent supplementation, four studies (180 participants) were identified on all-cause mortality, and two studies on change in frailty levels (pooled MD = −0.28, 95% CI: −0.71 to 0.16, I2 = 0%) with very low certainty of evidence for both outcomes. Only one study investigated nicotinamide supplementation. Conclusions: Further research is needed to justify the prescription of micronutrient supplementation in this population. Future research in frailty should focus on longitudinal change in frailty levels, cognitive function, and functional measures.

Glucagon-like peptide 1 receptor agonists (GLP-1RA) are commonly used as treatment for type 2 diabetes mellitus and obesity. GLP-1RA have been found to be valuable therapeutic approaches not only for glucose control, but also for weight loss and cardiovascular risk reduction. It has also been established that GLP-1RA have immunological and anti-inflammatory effects. The aim of this article was to comprehensively review the literature and to collect, analyse and quantitatively resynthesize evidence on the possible effects of GLP-1RA on inflammatory skin diseases. Through body weight reduction and subsequent systemic inflammation reduction, but mainly through their direct interaction with signalling pathways of inflammation and immune cells, GLP-1RA can improve psoriasis and hidradenitis suppurativa (HS). Clinical data of the positive effects of GLP-1RA in patients with psoriasis and HS are presented. Moreover, the immune cells and inflammatory pathways affected by GLP-1RA are discussed.

"Ozempic face" and facial aging have been observed as side effects in many patients after glucagon like peptide 1 receptor agonists (GLP-1RA) therapy for type 2 diabetes mellitus (T2DM) and obesity. However, those medications can reduce systemic inflammation and possibly promote skin health. The rapid weight loss observed with GLP-1RA has been implicated in facial aging. However, recent evidence suggests further pathophysiological mechanisms for this side effect. The aim of this article is to review the literature and present available data on the possible mechanisms of GLP-1RA on skin aging. Indeed, GLP-1RA may affect other types of skin cells, which may accelerate the process of skin aging itself. More specifically, GLP-1RA can act on adipose-derived stem cells (ADSC) and fibroblasts, that present GLP-1R on their surface. Stimulation of the receptor reduces the ability of ADSC to produce protective cytokines. The absence of those cytokines promotes the production of reactive oxygen species (ROS) and causes oxidative damage on fibroblasts. GLP-1RA also reduce the glucose intake of the ADSC, leading to reduced production of ATP and apoptosis. Finally, the stimulation of GLP-1R on ADSCs reduces indirectly the production of estrogens from dermal white adipose tissues (DWAT), which reduces stimulation of fibroblasts to produce collagen. GLP-1RA can also affect the process of skin aging through interaction with advanced glycation end products (AGEs) and RAGE (receptors of AGEs) activation. In conclusion, many patients receiving GLP-1RA suffer from "Ozempic face" and facial aging. It seems that this complication is not exclusively related to decreased facial fat, but there are more aging mechanisms that have to be elucidated.

Until the Othonian University (later known as the National and Kapodistrian University of Athens) began operating, only the Military Hospital and the Maternity Hospital were in operation in Athens. In the mid-18th century, the Elpis General Hospital of Athens was founded as a Civil Hospital, originally situated on Akadimias Street in the building where the Cultural Center of Athens is now located. The Hospital's current complex in the Ampelokipi area of Athens was initially entrusted to the Hellenic Red Cross to care for war casualties. It functioned as a military hospital until the military decided to vacate the premises and relocate in that area the Municipal Hospital of Athens "Elpis". Today, the Elpis General Hospital of Athens is equipped with modern facilities and staffed by highly skilled medical and support personnel, continuing to serve the health needs of the public.​.