Adv Clin Exp Med [JOURNAL]
Sun
200 papers
Epidemiology of tuberculosis, scabies, and enteric infections in Polish prisons (2002-2023): A nationwide data analysis and systematic review.
Korkosz R, Trzcionka A, Deręgowski R … +4 more , Kiełbratowski M, Kuśka-Kiełbratowska A, Rahnama-Hezavah M, Tanasiewicz M
Adv Clin Exp Med · 2026 Jun · PMID 42335388 · Publisher ↗
The specific conditions prevailing in prisons increase the risk of disease transmission among inmates. Several factors influence the risk of infectious disease transmission in prisons, including overcrowding, limited acc...
The specific conditions prevailing in prisons increase the risk of disease transmission among inmates. Several factors influence the risk of infectious disease transmission in prisons, including overcrowding, limited access to water, delayed diagnosis, and poor ventilation. The aim of this study was to assess the burden of selected infectious diseases among Polish prisoners between 2002 and 2023 and to analyze the literature addressing these diseases published between 2015 and 2025. In the 1st part, a systematic review was conducted. In the 2nd part, the results of the authors' own research were presented. The source material was obtained from Statistics Poland. An increase in tuberculosis (TB) cases was observed from the early to mid-2010s, peaking in 2012. Subsequently, a decrease in TB cases was noted after 2012, reaching a nadir in 2021, followed by a resurgence in 2023. A decrease in scabies cases was also observed. However, from 2009 onward, this trend reversed, with cases increasing and peaking in 2014. Subsequently, the number of cases reached a new low in 2022, before increasing again in 2023. For Salmonella/Shigella, the number of tests remained around 5,000 in the early years, reaching a peak of 8,876 in 2020. This was followed by a decline, with 5,204 tests recorded in 2023. To minimize the risk of infectious disease transmission in prisons, several preventive measures should be implemented, including screening of newly admitted prisoners, introduction of prophylactic programs, and development of standardized procedures to follow in cases of infection.
Global, regional, and national burden of gastroesophageal reflux disease (GERD), 1990-2021, with projections to 2050.
Li K, Li H, An Z … +6 more , Xu X, Zuo J, Li J, Qian X, Liu L, Cui J
Adv Clin Exp Med · 2026 Jun · PMID 42335387 · Publisher ↗
Gastroesophageal reflux disease (GERD) is a common digestive system disorder encountered in clinical practice. In recent years, the prevalence of GERD has increased, substantially affecting patients' daily lives. This st...
Gastroesophageal reflux disease (GERD) is a common digestive system disorder encountered in clinical practice. In recent years, the prevalence of GERD has increased, substantially affecting patients' daily lives. This study aimed to address this issue by leveraging data from the Global Burden of Disease (GBD) 2021 database to systematically evaluate the burden and epidemiological characteristics of GERD and to predict trends in GERD burden from 2022 to 2050. We comprehensively analyzed the burden of GERD from 1990 to 2021, evaluated years lived with disability (YLDs), prevalence and incidence rates, and conducted stratified analyses according to geographical region, Sociodemographic Index (SDI), sex, and age groups ranging from 0 to 95 years. Globally, in 2021, there were 324 million (95% uncertainty interval (95% UI): 287.7-358.9 million) incident cases, 826 million (95% UI: 733-926 million) prevalent cases, and 6.34 million (95% UI: 3.19-11.24 million) YLDs attributable to GERD. Among individuals aged 0-95 years, women aged 35-39 years had the highest prevalence, estimated at 45.32 million (95% UI: 32.92-61.05 million). The burden was highest in middle-SDI regions and lowest in high-SDI regions. Predictions using autoregressive integrated moving average (ARIMA) modeling indicated that the global burden of GERD will continue to increase from 2022 to 2050, posing increasingly severe challenges to global healthcare systems, particularly among women. It is projected that by 2050, women will account for 54% of new cases.
Prediction model for postoperative urinary tract infection after unilateral pyeloplasty in children.
Wang H, Hao C, Li L … +4 more , Sun Q, Cui X, Bai D, Song J
Adv Clin Exp Med · 2026 Jun · PMID 42335386 · Publisher ↗
BACKGROUND: Postoperative urinary tract infection (UTI) following pyeloplasty remains a significant complication and continues to pose challenges in pediatric urological care. OBJECTIVES: This study aimed to develop a si...
BACKGROUND: Postoperative urinary tract infection (UTI) following pyeloplasty remains a significant complication and continues to pose challenges in pediatric urological care. OBJECTIVES: This study aimed to develop a simplified predictive model to identify risk factors for postoperative UTI after unilateral pyeloplasty and to support clinicians in implementing preventive strategies targeting modifiable risk factors. MATERIAL AND METHODS: Clinical data from children who underwent unilateral pyeloplasty at the Children's Hospital of Capital Institute of Pediatrics (Beijing, China) between January 2012 and January 2022 were retrospectively analyzed. Variables including sex, age, body mass index (BMI), surgical modality, drainage tube type, and parameters from blood and urine tests were evaluated. Statistical analyses, including least absolute shrinkage and selection operator (LASSO) regression, logistic regression, and random forest modeling, were performed to identify significant predictive factors. Variables with the greatest predictive importance were used to develop a nomogram, and its clinical utility was evaluated using decision curve analysis (DCA). RESULTS: Among 764 patients, 265 (35%) developed postoperative UTI. Key risk factors included surgical modality, laterality of ureteropelvic junction obstruction (UPJO), drainage tube type, blood urea nitrogen (BUN) level, and patient height. LASSO regression identified 14 predictive variables, while logistic regression determined independent risk and protective factors. Ultimately, 8 variables (e.g., sex, operative time, drainage tube type, history of infection, history of fistula, age, BUN level, and renal cortical thickness) were selected for development of the nomogram predicting postoperative UTI risk after unilateral pyeloplasty. CONCLUSIONS: This study identified 8 factors associated with postoperative UTI following unilateral pyeloplasty in children. The developed predictive model may assist clinicians in identifying high-risk patients, thereby supporting improved perioperative planning and postoperative management.
Association between rivaroxaban use and acute kidney injury in patients over 65 years: A large-scale analysis of spontaneous reporting system data.
Peng P, Guo Y, Zhu Y
Adv Clin Exp Med · 2026 Jun · PMID 42335385 · Publisher ↗
BACKGROUND: Given that long-term anticoagulant therapy is required in many clinical scenarios, continuous safety monitoring of direct factor Xa inhibitors is of great importance. To date, the renal safety of these agents...
BACKGROUND: Given that long-term anticoagulant therapy is required in many clinical scenarios, continuous safety monitoring of direct factor Xa inhibitors is of great importance. To date, the renal safety of these agents remains a subject of debate. OBJECTIVES: The aim of this study was to assess the association between direct factor Xa inhibitors and acute kidney injury (AKI) using data from the U.S. Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS). MATERIAL AND METHODS: The study period extended from the first quarter of 2014 to the last quarter of 2024, and reports of adverse events (AEs) related to rivaroxaban and apixaban were extracted separately from FAERS. The association between direct factor Xa inhibitors and AKI was evaluated using disproportionality analysis methods. RESULTS: Rivaroxaban-associated AKI was more common in men, and the risk was higher among patients older than 65 years. Rivaroxaban showed a significant positive signal for AKI in patients older than 65 years, with a reported reporting odds ratio (ROR) of 3.82 (95% confidence interval (95% CI): 3.65-4.01), proportional reporting ratio (PRR) of 3.78, EBGM05 of 3.68, and IC025 of 1.88. In comparison, apixaban showed no significant risk signal, with an ROR of 0.86 (95% CI: 0.79-0.94), PRR of 0.86, EBGM05 of 0.86, and IC025 of -0.34. Acute kidney injury typically occurred at a median of 109 days after treatment initiation, with approx. 50% of cases occurring within the first 3 months. The main outcomes of AKI were hospitalization (56.06%) and death (37.67%). CONCLUSIONS: Our findings suggest a significant association between rivaroxaban use and AKI in elderly patients. Clinical monitoring of renal function should be intensified in elderly patients receiving rivaroxaban. However, it should be emphasized that this study presents only disproportionality analysis results and cannot establish a causal relationship between rivaroxaban and AKI. Therefore, the findings should be interpreted with caution.
Gut microbiome in type 2 diabetes mellitus: A literature review.
Wojakowicz K, Pielech AK, Kowalińska JE … +2 more , Stypka R, Rabczyński M
Adv Clin Exp Med · 2026 Jun · PMID 42267869 · Publisher ↗
Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder influenced by genetic, environmental, and lifestyle factors. Emerging evidence highlights the crucial role of the gut microbiota (GM) in the pathophysiology...
Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder influenced by genetic, environmental, and lifestyle factors. Emerging evidence highlights the crucial role of the gut microbiota (GM) in the pathophysiology of T2DM, with alterations in microbial diversity and composition contributing to insulin resistance, systemic inflammation, and metabolic dysregulation. This review explores the current literature on the role of the GM, its metabolites, including short-chain fatty acids (SCFAs), bile acids (BAs), and branched-chain amino acids (BCAAs), as well as the impact of diet and body mass index (BMI) on the progression of T2DM. We examine how dietary patterns, including fiber intake, fat composition, and the use of prebiotics and probiotics, modulate the GM. Furthermore, we analyze evidence regarding the influence of the microbiome on host metabolism, gut permeability, and the pathophysiology of T2DM. Understanding the dynamic interactions among the GM, microbial metabolites, diet, and BMI may provide promising avenues for the development of personalized therapeutic strategies targeting microbiome-mediated mechanisms in the prevention and management of T2DM. Such approaches may facilitate more effective patient-centered interventions.
Complex mosaic form of trisomy chromosome 18 and monosomy chromosome X in a girl with esophageal atresia and mild developmental delay: Diagnostic and therapeutic challenge and a review of literature.
Chrzanowska J, Oparska A, Wróblewska A … +4 more , Ciucias K, Luboińska-Cebula M, Śmigiel RS, Wikiera B
Adv Clin Exp Med · 2026 Jun · PMID 42267868 · Publisher ↗
The coexistence of mosaic trisomy 18 and Turner syndrome represents an extremely rare genetic constellation, with only a few cases reported in the literature to date. We present the case of a 7-year-old girl with esophag...
The coexistence of mosaic trisomy 18 and Turner syndrome represents an extremely rare genetic constellation, with only a few cases reported in the literature to date. We present the case of a 7-year-old girl with esophageal atresia, full trisomy 18 in lymphocytes, and mosaic copy number changes involving trisomy 18 with coexisting monosomy X in fibroblasts, suggesting the presence of additional cell populations lacking trisomy 18. In addition, we provide a review of the relevant literature. This case is of particular clinical significance, as it describes long-term survival in a child with Edwards syndrome and illustrates the diagnostic challenges associated with tissue-limited mosaicism. Furthermore, it underscores that an established diagnosis of one genetic disorder does not preclude the coexistence of another, particularly when the clinical phenotype deviates from the classical presentation of the primary syndrome. Adequate analysis of a sufficient number of metaphases in karyotyping is essential to reliably detect or exclude mosaicism in Edwards syndrome, as the distinction between full and mosaic trisomy 18 carries important prognostic implications.
Retrospective analysis of guideline-based massage therapy in primary care for musculoskeletal disorders.
Kassolik K, Piwecki M, Nowak B … +4 more , Nowak Z, Wilk I, Gielecki J, Kurpas D
Adv Clin Exp Med · 2026 Jun · PMID 42267867 · Publisher ↗
BACKGROUND: Musculoskeletal disorders (MSDs) impose a significant burden on primary healthcare systems and the economy. Massage therapy (MT) may represent a useful tool for addressing these issues. However, the lack of r...
BACKGROUND: Musculoskeletal disorders (MSDs) impose a significant burden on primary healthcare systems and the economy. Massage therapy (MT) may represent a useful tool for addressing these issues. However, the lack of robust evidence confirming its effectiveness makes this therapy controversial. OBJECTIVES: This study aimed to assess the feasibility of implementing guideline-based MT into routine primary care practice. MATERIAL AND METHODS: In this retrospective study, records of 258 primary care patients (median (Me) = 51.5 years; 1st and 3rd quartiles (Q1-Q3) = 42-66) were analyzed. These patients had previously received MT according to guidelines recommended by the Polish Society of Physiotherapy, the Polish Society of Family Medicine, the College of Family Physicians in Poland, and the European Rural and Isolated Practitioners Association (EURIPA). The effectiveness of therapy was evaluated using the visual analogue scale (VAS) and the number of general practitioner (GP) appointments booked by patients (NA). RESULTS: The majority of patients who received MT suffered from low back pain (M54.5) (39.1%); soft tissue disorders related to use, overuse, and pressure (M70) (27.5%); unspecified spondylosis (M47.9) (9.3%); and osteoarthritis of the knee (M17.5 and M17.9) (4.3%). A Wilcoxon test revealed a significant reduction in NA for M54.5 (p < 0.001), M70 (p < 0.001), others (p < 0.001), M17 (p = 0.004), and M47.9 (p < 0.001), as well as in VAS scores for M54.5 (p < 0.001), M70 (p < 0.001), others (p < 0.001), M47.9 (p < 0.001), and M17 (p = 0.003) after MT. CONCLUSIONS: This study supports the potential benefits of integrating physiotherapy-led massage into routine primary care practice for the management of selected musculoskeletal disorders. When implemented in cooperation with family physicians, MT may reduce pain and decrease the need for additional GP visits.
Association of lipid layer patterns with tear evaporation in smokers, refractive errors, and high body mass index.
Almutairi MS, Alghamdi SA, Altoaimi BH … +2 more , Rickert M, El-Hiti GA
Adv Clin Exp Med · 2026 Jun · PMID 42267866 · Publisher ↗
BACKGROUND: The stability of the tear film is essential for ocular health. Smoking, refractive errors (RE), and a high body mass index (BMI) are key risk factors for dry eye disease. Dry eye symptoms may be caused by a h...
BACKGROUND: The stability of the tear film is essential for ocular health. Smoking, refractive errors (RE), and a high body mass index (BMI) are key risk factors for dry eye disease. Dry eye symptoms may be caused by a high tear evaporation rate (TER) and/or a thin lipid layer. OBJECTIVES: To assess the correlation between TER and lipid layer patterns (LLP) within 4 distinct groups: healthy controls, smokers, subjects with RE, and individuals with high BMI. MATERIAL AND METHODS: The study included 120 subjects aged 18-30 years divided into 4 groups (30 per group; 15 women and 15 men). The ocular surface disease index (OSDI) was assessed, followed by evaluation of LLP using EASYTEAR View+ and TER using the Delfin VapoMeter. RESULTS: Kruskal-Wallis tests revealed significant between-group differences in OSDI (χ2 = 62.91, n = 120, p < 0.001) and LLP (χ2 = 26.59, n = 120, p < 0.001), but not in TER (χ2 = 7.20, n = 120, p = 0.066). Within-group Kendall tau-b correlations between TER and LLP revealed strong negative associations in the high-BMI (τb = -0.563, n = 30, p < 0.001) and smoker groups (τb = -0.457, n = 30, p = 0.002). A moderate negative correlation was found in the RE group (τb = -0.287, n = 30, p = 0.043), but not in healthy controls (τb = -0.199, n = 30, p = 0.189). CONCLUSIONS: The association between TER and LLP was strongly negative in smokers and the high-BMI group, moderate in the RE group, and absent in healthy controls. The inverse relationship between TER and LLP may indicate compromised tear film stability in populations at risk of dry eye disease.
Novel method for 3D volume evaluation of the intracardiac leads using iterative metal artifact reduction technique in computed tomography.
Młynarski R, Sosna M, Młynarska A … +6 more , Zalewska A, Kempa K, Rozmus M, Badon M, Dudkowska M, Golba KS
Adv Clin Exp Med · 2026 Jun · PMID 42247616 · Publisher ↗
BACKGROUND: Intracardiac leads commonly produce metal artifacts on computed tomography (CT) images. These artifacts may be reduced using dedicated metal artifact reduction algorithms, such as metal artifact reduction (MA...
BACKGROUND: Intracardiac leads commonly produce metal artifacts on computed tomography (CT) images. These artifacts may be reduced using dedicated metal artifact reduction algorithms, such as metal artifact reduction (MAR). OBJECTIVES: The aim of this study was to develop a method for measuring lead-related artifacts in CT and to assess the suitability of various reconstruction presets for lead visualization. MATERIAL AND METHODS: Fifty-four patients (mean age: 73.9 ±11.32 years) with implanted cardiac implantable electronic devices (CIEDs) who underwent cardiac CT, chest CT, or pulmonary angio-CT were included in the study. Images were reconstructed using at least 2 kernels (soft tissue and lung) with slice thicknesses of 0.6 mm or 1.0 mm. A tissue density volume >1,000 HU, corresponding to the presumed volume of hyperdense artifacts, was isolated within a manually drawn spherical region of interest (ROI), and the values were recorded. The obtained values for each iterative metal artifact reduction (iMAR) reconstruction preset were compared with native images (without iMAR) to calculate the percentage reduction in hyperdense artifacts. RESULTS: All tested algorithm variants reduced artifact volume; however, only 2 presets achieved statistically significant reductions: "dental fillings" (p = 0.001) and "neuro coils" (p = 0.000). Pacemaker-dedicated presets reduced metal artifacts in all cases, although the reductions were not statistically significant (p = 0.667), which may limit their reliability in routine clinical practice. CONCLUSIONS: We proposed a method for evaluating intracardiac leads that enables precise three-dimensional (3D) assessment of hyperdense artifacts. The metal artifact reduction technique demonstrated promising results, particularly for the "dental fillings" and "neuro coils" presets.
Health literacy, media literacy, and the digital divide: A conceptual framework for public health.
Navas-Echazarreta N, Satústegui-Dordá PJ, Chover-Sierra E … +5 more , Juárez-Vela R, Czapla M, Pozo-Herce PD, Martínez-Pascual RM, Martinez-Sabater A
Adv Clin Exp Med · 2026 Jun · PMID 42247615 · Publisher ↗
The increasing digitalization of health systems has transformed the ways in which individuals and communities interact with information, health services, and decisions related to their wellbeing. In this context, health...
The increasing digitalization of health systems has transformed the ways in which individuals and communities interact with information, health services, and decisions related to their wellbeing. In this context, health literacy, media health literacy, and the digital divide in health have emerged as critical determinants of informed and equitable participation in digital environments. The aim of this conceptual review is to examine the interconnections between health literacy, media health literacy, and the digital divide, and to propose an integrated conceptual framework to inform equitable public health practice, policy, and research in the digital era. The article provides a critical and integrated analysis of these constructs, highlighting their conceptual relationships, key methodological challenges, and implications for clinical practice, health policy development, and public health research. The findings indicate that approaches focused exclusively on individual skill development are insufficient to address digital health inequities. Without attention to structural and organizational determinants, the expansion of health technologies may reproduce or exacerbate pre-existing social and health inequalities. Accordingly, the review underscores the need for multilevel approaches that align literacy development, digital inclusion, and health system design to strengthen equity in the digital era.
Impact of the COVID-19 pandemic on pediatric hemolytic uremic syndrome: Epidemiology, complications, and outcomes.
Jarosz-Wójcik E, Zajączkowski MA, Drożdż D … +6 more , Warmachowska P, Brzeźniak M, Molek AM, Andrasz O, Szczerbak O, Miklaszewska M
Adv Clin Exp Med · 2026 Jun · PMID 42247614 · Publisher ↗
BACKGROUND: Hemolytic-uremic syndrome (HUS) is a thrombotic microangiopathy that is most commonly caused by infection with Shiga toxin-producing Escherichia coli (STEC-HUS). Atypical HUS (aHUS) is associated with inappro...
BACKGROUND: Hemolytic-uremic syndrome (HUS) is a thrombotic microangiopathy that is most commonly caused by infection with Shiga toxin-producing Escherichia coli (STEC-HUS). Atypical HUS (aHUS) is associated with inappropriate activation of the alternative complement pathway caused by infections, including SARS-CoV-2, malignancies, medications, or other triggering factors in genetically predisposed individuals. OBJECTIVES: Assessment of the impact of the COVID-19 pandemic on epidemiology, course, complications, and outcome of HUS in children in a single tertiary nephrological center in Poland. MATERIAL AND METHODS: It is a retrospective study, in which a total number of 74 pediatric patients with HUS were analyzed, including 16 cases in 5-year period before the outbreak of the COVID-19 pandemic (HUS-5) and 58 cases in 5-year period after the outbreak of the pandemic (HUS+5). RESULTS: A more than 3.6-fold increase in HUS cases and a 7-fold higher incidence of STEC-HUS were reported in the HUS+5 population. Strokes and persistent neurological complications were observed only in this group. 91.9% of patients presented with abnormal renal ultrasound (USG) findings at admission, and these findings improved significantly more frequently in the HUS-5 (68.75% vs 25.9%, p = 0.002) group. Mortality did not differ significantly between the 2 analyzed groups and was 6.8% for the entire population. CONCLUSIONS: The COVID-19 pandemic has had a significant impact on the incidence of HUS in the pediatric population. SARS-CoV-2 infection most markedly increases the risk of neurological complications but does not affect overall mortality.
Oncogenic impact of PIK3CA, KRAS, and PTEN mutations in cervical cancer among South Indian women.
Rasheed AHRS, Sekar PKC, Sreevalsan A … +2 more , Veerabathiran R, Anand V
Adv Clin Exp Med · 2026 Jun · PMID 42247613 · Publisher ↗
BACKGROUND: Cervical cancer (CC) affects millions of women worldwide. This condition is strongly associated with human papillomavirus (HPV) infection. Oncogenic alterations are known to contribute to the development and...
BACKGROUND: Cervical cancer (CC) affects millions of women worldwide. This condition is strongly associated with human papillomavirus (HPV) infection. Oncogenic alterations are known to contribute to the development and progression of CC. OBJECTIVES: This study aimed to screen for variations in selected genes associated with CC, including PIK3CA, KRAS, and PTEN, and to detect high-risk HPV genotypes 16, 18, 31, 45, 52, and 58 using gene-specific polymerase chain reaction (PCR), followed by single-strand conformation polymorphism (SSCP) analysis and confirmation using bidirectional DNA sequencing. MATERIAL AND METHODS: The study included 414 participants, comprising 204 cases and 210 controls. Healthy controls were disease-free individuals participating in regular health checkups. Selected gene mutations were analyzed using PCR-based assays, SSCP, and sequence analysis. HPV genotyping was also performed. RESULTS: All study participants were analyzed for mutations in the PIK3CA, KRAS, and PTEN genes. The analysis revealed mutation frequencies of 6.37% for KRAS, 2.45% for PTEN, and 16.66% for PIK3CA in CC cases. These findings suggest that PIK3CA and KRAS mutations are more frequent in patients with CC than PTEN mutations. HPV infection was detected in 87.10% of patients with CC, 79.24% of participants with high-grade squamous intraepithelial lesions (HSIL), and 60.34% of participants with low-grade squamous intraepithelial lesions (LSIL). This study contributes to understanding the genetic basis of CC in South India and may facilitate the development of future targeted therapies. CONCLUSIONS: The high prevalence of HPV underscores its etiological significance in CC. These findings contribute to a deeper understanding of the molecular mechanisms underlying CC in this population and may support the development of targeted therapeutic strategies for high-risk individuals. Future prospective studies and functional analyses are warranted to validate the clinical significance of these mutations and clarify their role in disease progression.
Advances in immune checkpoint inhibitor therapy for microsatellite instability-high (MSI-H) and mismatch repair-deficient (dMMR) colorectal cancer: Insights from the tumor immune microenvironment.
Zhao Y, Li L, Zhang B … +2 more , Li B, Zhou W
Adv Clin Exp Med · 2026 May · PMID 42204793 · Publisher ↗
This review systematically analyzes the relationship between the immune microenvironment characteristics of microsatellite instability-high (MSI-H) or deficient mismatch repair (dMMR) colorectal cancer (CRC) and the effi...
This review systematically analyzes the relationship between the immune microenvironment characteristics of microsatellite instability-high (MSI-H) or deficient mismatch repair (dMMR) colorectal cancer (CRC) and the efficacy of immune checkpoint inhibitors (ICIs). The article emphasizes that this tumor subtype has a high mutation burden, abundant neoantigens, and significant immune cell infiltration, explaining its high sensitivity to immunotherapy, while also pointing out that some patients exhibit primary non-response or subsequent resistance. Based on single-cell and spatial omics, as well as multi-omics integration analyses, the authors reveal the complexity and heterogeneity of key immune cell subpopulations, spatial distribution, and resistance mechanisms (such as abnormal Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathways, human leukocyte antigen (HLA) loss, and metabolic reprogramming, and propose the necessity of multi-time-point dynamic monitoring and multimodal combination therapy. The study underscores that, in the future, standardized data integration and the establishment of artificial intelligence (AI) prediction models will be required to facilitate the implementation of precise, individualized immunotherapy strategies, thereby further improving clinical efficacy.
Inflammatory cytokines and metabolic pathways in osteomyelitis: Mendelian randomization insights and experimental validation.
Chen X, Mo R, Yang S … +2 more , Zhou P, Qikai H
Adv Clin Exp Med · 2026 May · PMID 42200571 · Publisher ↗
BACKGROUND: Osteomyelitis is a challenging orthopedic condition characterized by bone inflammation, often resulting from infection. The roles of inflammatory cytokines (ICs) and metabolites in its pathogenesis are not fu...
BACKGROUND: Osteomyelitis is a challenging orthopedic condition characterized by bone inflammation, often resulting from infection. The roles of inflammatory cytokines (ICs) and metabolites in its pathogenesis are not fully understood. OBJECTIVES: This study aimed to explore the potential causal relationships among ICs, metabolites, and osteomyelitis using Mendelian randomization (MR) analysis and in vitro experiments. MATERIAL AND METHODS: A 2-sample MR analysis (FinnGen: 1,881 cases and 391,037 controls) was performed to screen 91 cytokines and more than 1,400 metabolites. In vitro experiments using MC3T3-E1 cells treated with staphylococcal protein A (SPA) were conducted to evaluate the effects of p-cresol sulfate (PCS), a circulating metabolite identified through MR analysis, on cell proliferation, osteogenic differentiation, and inflammation. RESULTS: Mendelian randomization analysis identified significant associations between several ICs and osteomyelitis risk. Elevated levels of CUB domain-containing protein 1 (CDCP1; odds ratio (OR) = 1.19, 95% confidence interval (95% CI): 1.03-1.38) and thymic stromal lymphopoietin (TSLP; OR = 1.26, 95% CI: 1.05-1.51) were associated with increased risk, whereas higher levels of adenosine deaminase (ADA; OR = 0.85, 95% CI: 0.74-0.98) and interleukin-5 (IL-5; OR = 0.79, 95% CI: 0.65-0.96) were associated with reduced risk. Metabolites such as PCS (OR = 0.74, 95% CI: 0.59-0.93) were identified as protective, whereas others, such as beta-cryptoxanthin (β-CX; OR = 1.33, 95% CI: 1.07-1.66), were associated with increased risk. Mediation analysis further suggested that several metabolites significantly mediated the indirect effects of cytokines on osteomyelitis risk. In vitro experiments demonstrated that PCS enhanced osteogenic potential, reduced intracellular reactive oxygen species (ROS) production, and lowered IC levels. CONCLUSIONS: These findings provide insight into the associations among ICs, metabolites, and osteomyelitis, suggesting potential therapeutic targets for reducing disease severity. They also highlight the complex interplay among these factors in osteomyelitis pathogenesis. Further studies are needed to clarify the mechanisms through which ICs and metabolites influence osteomyelitis, particularly through regulation of inflammatory responses and oxidative stress.
Prognostic model of endoplasmic reticulum stress-related lncRNAs in lung adenocarcinoma: Construction and validation using WGCNA.
Li H, Zhao Z, Li J … +3 more , Rong Y, Zheng A, Hao M
Adv Clin Exp Med · 2026 May · PMID 42186940 · Publisher ↗
BACKGROUND: Lung adenocarcinoma (LUAD) ranks among the deadliest malignancies worldwide. The endoplasmic reticulum (ER) stress response plays a critical role in the pathogenesis of various cancers, and long non-coding RN...
BACKGROUND: Lung adenocarcinoma (LUAD) ranks among the deadliest malignancies worldwide. The endoplasmic reticulum (ER) stress response plays a critical role in the pathogenesis of various cancers, and long non-coding RNAs (lncRNAs) are known for their regulatory roles in gene expression and disease progression. OBJECTIVES: To construct and validate a prognostic model based on ER stress-related lncRNAs in LUAD. MATERIAL AND METHODS: The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) databases were used. Utilizing the Molecular Signatures Database (MSigDB), we identified ER stress-related mRNAs and lncRNAs. Weighted gene co-expression network analysis (WGCNA) was employed to identify genes associated with LUAD prognosis. An lncRNA-based prognostic risk scoring model was constructed using univariate and least absolute shrinkage and selection operator (LASSO) regression analyses and independently validated. Consensus clustering analysis was applied to define risk subgroups, optimizing the risk scoring system. The model's performance was evaluated using receiver operating characteristic (ROC) curves and nomograms. Differentially expressed gene (DEG) and enrichment analyses were performed to investigate the biological relevance of the risk score. Additionally, the relationships between risk scores, immune infiltration, and the tumor microenvironment (TME) were explored. RESULTS: Using WGCNA, we successfully identified genes strongly associated with ER stress in LUAD prognosis. A prognostic model comprising 13 signature genes was developed, demonstrating robust discrimination between highand low-risk patients, with the high-risk group exhibiting reduced overall survival (OS). The model's predictive accuracy was confirmed through Kaplan-Meier and ROC analyses. Correlation analysis between risk scores and immune infiltration indicated that the model reflects the immune landscape of LUAD. Subgroup analysis using consensus clustering (C1 and C2) revealed more pronounced differences in immune cell dynamics than the binary risk score classification alone. CONCLUSIONS: This study introduces a novel prognostic model based on the co-expression of ER stress-related lncRNAs in LUAD.
Balancing osteogenesis and adipogenesis in osteogenesis imperfecta: PLIN2 and E2F2 as key targets for mesenchymal stem cell therapy.
Wang X, Liu Z, Hu X … +1 more , Cui Y
Adv Clin Exp Med · 2026 May · PMID 42186939 · Publisher ↗
BACKGROUND: Osteogenesis imperfecta (OI) necessitates innovative mesenchymal stem cell (MSC) therapies targeting key molecular pathways to enhance targeted and combination treatments and improve bone health. OBJECTIVES:...
BACKGROUND: Osteogenesis imperfecta (OI) necessitates innovative mesenchymal stem cell (MSC) therapies targeting key molecular pathways to enhance targeted and combination treatments and improve bone health. OBJECTIVES: To investigate the therapeutic mechanisms of various interventions for OI by analyzing relevant datasets, with a focus on lipid metabolism-related genes, particularly PLIN2, in order to determine whether they influence the balance between osteoblast and adipocyte differentiation. MATERIAL AND METHODS: This study analyzed datasets from the Gene Expression Omnibus (GEO; GSE157587, GSE214064, GSE186141) and UK Biobank genome-wide association study (GWAS) summary statistics (UKB-b-4657, UKB-b-1096, UKB-b-8875, UKB-b-20124) using bioinformatics tools, including GEO2R, DESeq2, TwoSampleMR, MR-Egger, MR-PRESSO, gwasrapidd, and summary data-based Mendelian randomization (MR), to identify differentially expressed genes (DEGs) and assess causal relationships with heel bone mineral density (BMD). RESULTS: Differentially expressed genes analysis of GSE157587 identified PLIN2 as the most significant gene influenced by MSC therapy in OI (log2 fold change = 0.428, adjusted p = 3.29 × 10-6), whereas GSE186141 revealed 770 DEGs in OI patients, with 7 overlapping with PLIN2-related genes. Notably, TNFRSF19 (log2 fold change = -2.7454, adjusted p = 3.930 × 10-7 in OI; 1.5001, adjusted p = 3.482 × 10-3 in PLIN2 knockdown) and E2F2 (log2 fold change = -2.1428, adjusted p = 8.830 × 10-5 in OI; 1.7207, adjusted p = 1.244 × 10-2 in PLIN2 knockdown) were identified as key genes. Mendelian randomization analysis confirmed a negative association between E2F2 and heel BMD (p = 1.116 × 10-7 to 6.073 × 10-5; effect size -0.0461 to -0.0277). CONCLUSIONS: PLIN2 and E2F2 emerge as critical targets for refining MSC therapy in OI, with the potential to improve bone formation and reduce fat accumulation by restoring the osteogenesis-adipogenesis balance. These findings may support the development of combination therapies or engineered MSCs, ultimately improving clinical outcomes for patients with OI.
Genetic biomarker screening for drug-resistant epilepsy in low- and middle-income countries (LMICs).
Kalinina D, Muxunov A, Utebekov Z … +5 more , Kyrgyzbay G, Kimadiev D, Zhumabaeva G, Almazan J, Sarria-Santamera A
Adv Clin Exp Med · 2026 May · PMID 42160116 · Publisher ↗
Drug-resistant epilepsy (DRE) presents a major clinical and economic challenge, particularly in lowand middle-income countries (LMICs), where healthcare resources are limited and treatment gaps remain significant. Althou...
Drug-resistant epilepsy (DRE) presents a major clinical and economic challenge, particularly in lowand middle-income countries (LMICs), where healthcare resources are limited and treatment gaps remain significant. Although epilepsy surgery remains the most effective intervention for eligible DRE patients, outcomes are variable, with success rates ranging from 30% to 70%. Emerging evidence suggests that genetic biomarkers can inform patient selection, predict surgical outcomes, and guide treatment planning. This review explores the potential of integrating genetic testing into presurgical evaluation protocols in LMICs. It examines the role of specific gene mutations in pharmacoresistance, seizure localization, and structural brain abnormalities, with a focus on improving surgical success rates and reducing unnecessary interventions. Incorporating genetic stratification into clinical decision-making could enhance cost-effectiveness, minimize the burden on healthcare systems, and support the development of personalized treatment pathways. Advancing genetic research and building capacity in precision neurology are essential steps toward improving DRE management in resource-constrained settings.
Gastrointestinal manifestations of systemic lupus erythematosus (SLE): A comprehensive literature review.
Bajurny W, Grabowska J, Pielech A … +3 more , Struzik N, Mastalerz JA, Szmyrka M
Adv Clin Exp Med · 2026 May · PMID 42160115 · Publisher ↗
Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by a broad spectrum of clinical manifestations, including gastrointestinal (GI) involvement. Although the joints, skin, and kidneys are mos...
Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by a broad spectrum of clinical manifestations, including gastrointestinal (GI) involvement. Although the joints, skin, and kidneys are most commonly affected, GI manifestations are frequently underrecognized despite their potential to significantly influence patient outcomes. Eleven major GI manifestations have been identified and described: oral ulcers, lupus enteritis (LE), lupus peritonitis (LP), mesenteric vasculitis, mesenteric thrombosis, protein-losing enteropathy (PLE), intestinal pseudo-obstruction (IPO), lupus pancreatitis, lupus hepatitis (LH), gastroesophageal reflux disease (GERD), and medication-related adverse effects. These manifestations may present with nonspecific symptoms, such as abdominal pain, diarrhea, vomiting, and weight loss, which often complicate timely diagnosis. Imaging modalities, particularly contrast-enhanced computed tomography, together with serological markers, including antinuclear antibodies (ANA) and complement levels, play a central role in diagnosis. Corticosteroids remain the cornerstone of treatment, whereas immunosuppressive agents and biologic therapies are reserved for refractory cases. Medication-induced GI adverse effects, particularly those associated with glucocorticoids, nonsteroidal anti-inflammatory drugs (NSAIDs), and immunosuppressive agents such as azathioprine (AZA) and cyclophosphamide (CPA), also represent important contributors to GI pathology in patients with SLE. Gastrointestinal involvement in SLE is heterogeneous and may be severe. Increased awareness, early recognition, and individualized treatment strategies are essential for improving patient outcomes. Further research is required to establish standardized diagnostic criteria and therapeutic guidelines for GI manifestations in SLE.
Clinicopathological and prognostic value of DLL4 expression in gastric cancer: A systematic review and meta-analysis.
Du Q, Zhao C, Sun C … +2 more , Zu G, Du S
Adv Clin Exp Med · 2026 May · PMID 42160114 · Publisher ↗
BACKGROUND: The clinicopathological significance and prognostic value of Delta-like ligand 4 (DLL4) expression in gastric cancer (GC) remain controversial. Therefore, we conducted a meta-analysis to ascertain the correla...
BACKGROUND: The clinicopathological significance and prognostic value of Delta-like ligand 4 (DLL4) expression in gastric cancer (GC) remain controversial. Therefore, we conducted a meta-analysis to ascertain the correlation between DLL4 expression and the clinicopathological features and prognosis of GC patients. OBJECTIVES: To clarify the association between DLL4 expression, clinicopathological parameters, and the prognosis of GC patients, as well as to resolve the existing controversies. MATERIAL AND METHODS: A systematic retrieval was performed according to the selection criteria. The hazard ratio (HR) or odds ratio (OR) and 95% confidence interval (95% CI) were applied to assess the clinicopathological and prognostic value of DLL4 expression in patients with GC. RESULTS: A total of 1,535 patients with GC were included across 7 articles. DLL4 expression was correlated with lymph node metastasis (OR = 5.612, 95% CI: 1.332-23.644; p = 0.019), venous invasion (OR = 3.807, 95% CI: 1.557-9.310, p = 0.003), and TNM stage (OR = 4.183, 95% CI: 1.270-13.775, p = 0.003). However, DLL4 expression was not related to sex (OR = 0.976, 95% CI: 0.767-1.242, p = 0.845), age (OR = 0.765, 95% CI: 0.389-1.506, p = 0.438), T stage (OR = 1.306, 95% CI: 0.717-2.380, p = 0.384), tumor differentiation (OR = 0.952, 95% CI: 0.687-1.318, p = 0.072), or Lauren classification (OR = 1.224, 95% CI: 0.620-2.417, p = 0.560). Furthermore, high DLL4 expression was associated with poorer overall survival (OS) (HR = 1.530, 95% CI: 1.272-1.841, p = 0.000) in patients with GC. The Kaplan-Meier Plotter database confirmed that patients with high DLL4 expression in GC had a poorer prognosis (HR = 1.35, 95% CI: 1.08-1.68, p = 0.009). CONCLUSION: DLL4 expression was associated with venous invasion, lymph node metastasis, TNM stage, and poor OS in GC patients, but was not associated with age, sex, T stage, Lauren classification, or tumor differentiation.
Platelet-rich plasma plus hyaluronic acid vs platelet-rich plasma intra-articular injections for knee osteoarthritis: A systematic review and meta-analysis.
Tomaszewski M, Smereka J, Al-Jeabory M … +5 more , Fudalej P, Pruc M, Krupowies MW, Gaca Z, Szarpak Ł
Adv Clin Exp Med · 2026 May · PMID 42109003 · Publisher ↗
BACKGROUND: Knee osteoarthritis (KOA) is a common condition characterized by pain, stiffness, and reduced function, significantly impacting quality of life. OBJECTIVES: This study aimed to evaluate the combined use of pl...
BACKGROUND: Knee osteoarthritis (KOA) is a common condition characterized by pain, stiffness, and reduced function, significantly impacting quality of life. OBJECTIVES: This study aimed to evaluate the combined use of platelet-rich plasma (PRP) and hyaluronic acid (HA) compared to PRP alone in treating KOA. The hypothesis was that PRP + HA would provide superior outcomes in pain relief and functional improvement due to their complementary biological effects. MATERIAL AND METHODS: A systematic review and meta-analysis were conducted according to PRISMA guidelines. The analysis included 11 trials with a total of 892 participants. The studies compared the efficacy of PRP + HA compared to PRP alone. Key outcomes evaluated were changes in the visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Inter-national Knee Documentation Committee (IKDC) scores at 1, 3, 6, 12, and 24 months post-treatment. RESULTS: At baseline, no significant differences in VAS scores were observed between the 2 groups (5.82 ±2.71 for PRP + HA vs 5.66 ±2.96 for PRP). By the 6-month follow-up, PRP + HA showed a more substantial reduction in VAS scores (-2.83 ±1.60 vs -2.56 ±1.66; standardized mean difference (SMD) = -1.08, 95% confidence interval (95% CI): -2.22 to 0.05; p < 0.001), with the largest improvement seen at 24 months (-2.7 ±0.2 for PRP + HA vs 0.4 ±0.23 for PRP; SMD = -14.10, 95% CI: -17.41 to -10.79; p < 0.001). WOMAC scores at 12 months also favored the PRP + HA group (-25.26 ±15.24 vs -19.6 ±14.20; SMD = -0.95; p = 0.01). IKDC scores showed no significant differences between groups. CONCLUSION: The combination of PRP and HA provides superior pain relief and functional improvement compared to PRP alone, particularly at 6 and 24 months. These findings support the inclusion of PRP + HA in KOA treatment protocols and warrant further investigation into its long-term benefits.
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