Adv Clin Exp Med [JOURNAL]
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200 papers
Impact of patient-physician communication and disease knowledge on treatment adherence in glaucoma patients.
Malewicz K, Chabowski M, Staś J … +3 more , Cybulska AM, Szymańska-Chabowska A, Jankowska-Polańska B
Adv Clin Exp Med · 2026 May · PMID 41744375 · Publisher ↗
BACKGROUND: Glaucoma is a chronic, progressive optic neuropathy that can lead to irreversible blindness if left untreated. It is the leading cause of irreversible blindness globally. Effective management relies heavily o...
BACKGROUND: Glaucoma is a chronic, progressive optic neuropathy that can lead to irreversible blindness if left untreated. It is the leading cause of irreversible blindness globally. Effective management relies heavily on the control of intraocular pressure (IOP), typically through lifelong pharmacological treatment, but adherence to therapy is often a challenge due to the asymptomatic nature of the disease. OBJECTIVES: The primary aim of this study was to evaluate the predictive influence of the doctor-patient relationship, the quality of communication between doctor and patient, patient knowledge about glaucoma, and quality of life when adhering to therapeutic recommendations among a group of Polish glaucoma patients. MATERIAL AND METHODS: This study was conducted at the Ophthalmology Outpatient Clinic of the University Clinical Hospital in Wrocław, Poland. A total of 190 patients were enrolled, and adherence to treatment was assessed using the Adherence to Refills and Medications Scale (ARMS). Additional variables included patient-physician communication (CAT-14), relationship quality (PDRQ-9), visual function (NEI VFQ-25), and glaucoma knowledge (GKQ-10). RESULTS: The results indicated that 58.9% of patients showed low adherence to their prescribed treatment. Satisfaction with doctor-patient communication, higher levels of knowledge about glaucoma, and better visual function were significantly associated with better adherence. The quality of the patient-physician relationship, while not statistically significant, also showed potential positive effects on adherence. CONCLUSIONS: Improving patient education and enhancing the quality of communication between healthcare providers and patients are critical to increasing adherence to glaucoma treatment. Importantly, the study provides a valuable evidence base for developing adherence-enhancing strategies within the Polish healthcare system. Given the scarcity of such data in Central and Eastern Europe, our results may also inform similar efforts in the region. Designing culturally sensitive and system-specific interventions, such as brief communication training for ophthalmologists or structured patient education programs, could help address persistent adherence challenges in chronic ophthalmic care.
Transcriptomic profiling of human corneal epithelial cells exposed to PM2.5: Identification of differentially expressed genes and pathways.
Li Y, Liu W, Bao H … +2 more , Ma Y, Zhang H
Adv Clin Exp Med · 2026 Apr · PMID 41733015 · Publisher ↗
BACKGROUND: High levels of PM2.5 air pollution pose serious health risks, especially in rapidly urbanizing areas. While its effects on organs such as the heart and lungs are well documented, its effects on the cornea rem...
BACKGROUND: High levels of PM2.5 air pollution pose serious health risks, especially in rapidly urbanizing areas. While its effects on organs such as the heart and lungs are well documented, its effects on the cornea remain less well understood. Emerging evidence links PM2.5 exposure to corneal damage through processes such as autophagy, inflammation, and oxidative stress; however, the precise molecular pathways remain largely unknown. OBJECTIVES: This study aimed to identify key genes and signaling pathways in PM2.5-exposed human corneal epithelial cells (HCECs) using RNA sequencing and bioinformatics analysis. MATERIAL AND METHODS: Human corneal epithelial cells were cultured and exposed to 25 μg/mL PM2.5 for 24 h. High-throughput sequencing was performed after total RNA extraction and library construction for mRNA and microRNA (miRNA). Clean reads were mapped to the reference genome after filtering out low-quality reads. The Differential Expression Sequencing 2 (DESeq2) R package was used to identify differentially expressed (DE) mRNAs and miRNAs with a fold change ≥2 or ≤0.5 and a false discovery rate (FDR) ≤ 0.001.. Bioinformatics analyses included hierarchical clustering, protein-protein interaction network construction, target gene prediction, and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. RESULTS: The analysis identified 45 DE mRNAs, including 14 upregulated and 31 downregulated transcripts, along with 16 upregulated miRNAs. A gene interaction network was constructed comprising nine mRNAs (6 upregulated and 3 downregulated), while a combined miRNA-mRNA network included 14 miRNAs and 21 mRNAs, forming 73 interaction pairs. Functional enrichment analysis of these genes revealed 30 significantly enriched GO terms, as well as 27 KEGG signaling pathways. CONCLUSIONS: This study constructed regulatory networks and identified genes DE in the corneal response to PM2.5 exposure, particularly those involved in autophagy, inflammatory responses, and oxidative stress-related pathways. These results lay the groundwork for further research into the effects of PM2.5 on ocular surface health and provide insights into the molecular mechanisms underlying PM2.5-induced damage to human corneal epithelial cells, potentially guiding the development of targeted diagnostics or therapies to mitigate ocular surface injury caused by PM2.5.
Regulatory T cells and plasmacytoid dendritic cells in drug rash with eosinophilia and systemic symptoms VS maculopapular drug eruption: A serological pilot study.
Julanon N, Chaowattanapanit S, Choonhakarn C … +4 more , Wongjirattikarn R, Chakrit T, Salao K, Sawanyawisuth K
Adv Clin Exp Med · 2026 Apr · PMID 41733014 · Publisher ↗
BACKGROUND: Regulatory T (Treg) cells and plasmacytoid dendritic cells (pDCs) are involved in the pathogenesis of drug rash with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome (DRESS/DIHS). OBJ...
BACKGROUND: Regulatory T (Treg) cells and plasmacytoid dendritic cells (pDCs) are involved in the pathogenesis of drug rash with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome (DRESS/DIHS). OBJECTIVES: To compare circulating Treg cells and pDCs at different stages among patients with DRESS/DIHS, patients with maculopapular drug eruption (MPE), and healthy subjects, and to assess circulating Treg cells and pDCs at post-steroid cessation in DRESS/DIHS. MATERIAL AND METHODS: This was a cross-sectional study that enrolled adult patients diagnosed with DRESS/DIHS and MPE. Blood samples were obtained from the patients at the initial presentation (acute phase), 1 week later (subacute phase), during the 3rd week (resolution phase), and post-steroid cessation for DRESS/DIHS. Healthy subjects' blood samples were also taken. Peripheral blood mononuclear cells were isolated for flow cytometry analysis. RESULTS: A total of 22 patients participated in this study: patients with DRESS/DIHS (n = 9), patients with MPE (n = 8), and healthy subjects (n = 5). During the acute stage of DRESS/DIHS and MPE, the mean percentage of Treg cells and pDCs significantly decreased compared to healthy subjects. However, Treg cells showed a progressive increase towards the resolution phase in both conditions, while pDCs continued to decrease towards the resolution phase. Following steroid discontinuation in DRESS/DIHS, both Treg cells and pDCs showed a progressive increase in number. CONCLUSIONS: Treg cells and pDCs play a role in DRESS/DIHS and MPE pathogenesis, evidenced by the fluctuation in their percentages at each stage of both conditions. However, increased circulating Treg cells may crucially mitigate inflammation in both conditions.
Expanded clinical target volume and survival in non-operative ESCC: Prognostic benefits and inflammatory risks.
Jiang D, Huang C, Guo K … +6 more , Zhang X, Ma X, Mao H, Li Z, Cheng W, Cheng Y
Adv Clin Exp Med · 2026 Mar · PMID 41733013 · Publisher ↗
BACKGROUND: Concurrent chemoradiotherapy (CRT) is the standard treatment for locally advanced esophageal squamous cell carcinoma (ESCC). However, out-of-field locoregional relapse remains common. The optimal longitudinal...
BACKGROUND: Concurrent chemoradiotherapy (CRT) is the standard treatment for locally advanced esophageal squamous cell carcinoma (ESCC). However, out-of-field locoregional relapse remains common. The optimal longitudinal expansion from gross tumor volume (GTV) to clinical target volume (CTV) varies across practice, and its impact on local control is not fully defined. OBJECTIVES: To explore the relationship between GTV-CTV margin expansion and inflammatory biomarkers and their combined impact on prognosis to determine a more optimal target volume range for esophageal cancer (EC). MATERIAL AND METHODS: A retrospective analysis of 209 ESCC patients undergoing radical CRT was conducted. Patients were categorized into small (SM), medium (MM) and large (LM) margin groups based on GTV-CTV expansion. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and their respective fold changes were calculated and analyzed for correlations with CTV margin expansion and patient prognosis. RESULTS: Larger radiation fields led to higher post-treatment inflammatory markers with significant fold changes. Kaplan-Meier (KM) curves and receiver operating characteristic (ROC) curves indicated that the LM group, low pre-treatment NLR, low post-treatment NLR, PLR and SII, and fold changes in NLR, PLR and SII before and after treatment could predict local recurrence-free survival (LRFS). However, Cox analysis identified pre-treatment NLR, the change in SII from preto post-treatment, and GTV-CTV margin expansion as independent predictors. CONCLUSIONS: Although inflammatory biomarkers offer prognostic value, primary GTV-CTV margin expansion has a stronger influence on LRFS in ESCC patients undergoing CRT. Further multi-institutional studies are needed to validate these findings and address current study limitations, including single-center design, small sample size and exclusion of in-field recurrences.
Evaluation of nurse-led sedation protocols on clinical outcomes in mechanically ventilated adults within intensive care units: A meta-analysis of randomized controlled trials.
Li J, Li H, Hou X … +2 more , Shi Y, Zhao J
Adv Clin Exp Med · 2026 Mar · PMID 41733012 · Publisher ↗
BACKGROUND: Many hospitals worldwide implement nurse-led sedation protocols to prevent both underand over-sedation and to enhance comfort and safety for mechanically ventilated patients in intensive care units (ICUs); ho...
BACKGROUND: Many hospitals worldwide implement nurse-led sedation protocols to prevent both underand over-sedation and to enhance comfort and safety for mechanically ventilated patients in intensive care units (ICUs); however, definitive conclusions regarding their effectiveness remain limited. OBJECTIVES: To assess the efficacy of nurse-led sedation protocols on clinical outcomes in mechanically ventilated adults within ICUs. MATERIAL AND METHODS: A systematic search was conducted across 4 electronic databases - PubMed, Embase, Scopus, and the Cochrane Library - to identify relevant studies published in peer-reviewed journals. The standard mean difference (SMD) and risk ratio (RR), along with their corresponding 95% confidence intervals (95% CIs), were calculated. Heterogeneity among studies was assessed using the Cochran's Q test and I2 statistic, with significance determined by the appropriate p-value. All statistical analyses were performed using Review Manager (RevMan) v. 5.4. RESULTS: This meta-analysis of 10 randomized controlled trials (RCTs; n = 1,151 patients) indicates that a nurse-led sedation protocol is significantly more effective than usual care in reducing ICU mortality (RR = 0.34 (95% CI: 0.25 to 0.45); I2 = 38%, p < 0.001), duration of mechanical ventilation (SMD = -1.94 (95% CI: -2.16 to -1.72); I2 = 73%, p < 0.001), length of hospital stay (SMD = -1.70 (95% CI: -1.80 to -1.59); I2 = 79%, p < 0.001), length of ICU stay (SMD = -1.58 (95% CI: -1.76 to -1.40); I2 = 66%, p < 0.001), and incidence of delirium (RR = 0.47 (95% CI: 0.39 to 0.57); I2 = 15%, p < 0.87). CONCLUSION: Compared to usual care, nurse-led sedation protocol can improve ICU mortality and other clinical outcomes in mechanically ventilated ICU patients safely and effectively.
Chromosomal and gene mapping of uterine fibroids: A systematic review.
Tanos V, Papailiou V, Tanos P
Adv Clin Exp Med · 2026 Mar · PMID 41733011 · Publisher ↗
Genetic mutations and their phenotypic manifestation have been recognized as critical factors in tumorigenesis. However, the relationship between these mutations and the pathogenesis of uterine leiomyomas (UL) remains in...
Genetic mutations and their phenotypic manifestation have been recognized as critical factors in tumorigenesis. However, the relationship between these mutations and the pathogenesis of uterine leiomyomas (UL) remains inadequately characterized. There is compelling evidence to suggest a genetic underpinning in UL development, alongside influences from epigenetics, environmental stimuli, growth hormones, and growth factors. A plethora of studies have tried to elucidate the genetic and epigenetic etiologies associated with UL, but the definitive implications of these findings remain unclear. An extensive systematic review was conducted to investigate the genetic etiologies of UL. This systematic review aimed to consolidate current knowledge on genetic and epigenetic causes of UL, offering a comprehensive perspective on the evidence and its relevance in other solid tumors. A secondary focus was to identify the most significant genetic association with the genesis of UL. A total of 60 articles were identified, and 10 chromosomes and 51 genes were found to be implicated in the development of UL. The main trend in fibroid research focuses on genetic abnormalities and aberrations as the etiology of UL development. It has been estimated that 40% of UL can be associated with chromosome-specific aberrations. Chromosomal gain, loss, rearrangement, single nucleotide polymorphism (SNP), and translocation are the most common aberrations associated with UL development. The most recurrent ones include chromosome X and 7q deletions, and rearrangements of 12q15, 6p21 and 10q22. MED12 has been identified as a gene of particular importance in the development of UL.
Effectiveness of modified ultrasound-guided ilioinguinal and iliohypogastric nerve blocks for postoperative pain control in transinguinal inguinal hernia repair.
Zhang Y, Zhang N, Li G
Adv Clin Exp Med · 2026 Mar · PMID 41698175 · Publisher ↗
BACKGROUND: Inguinal hernia repair ranks among the most prevalent surgical interventions worldwide. Effective postoperative pain management is paramount for enhancing patient comfort, facilitating early mobilization and...
BACKGROUND: Inguinal hernia repair ranks among the most prevalent surgical interventions worldwide. Effective postoperative pain management is paramount for enhancing patient comfort, facilitating early mobilization and optimizing recovery outcomes. OBJECTIVES: This study aimed to rigorously evaluate the efficacy of a modified ultrasound-guided (USG) lower abdominal nerve block in conjunction with local anesthetic (LA) injection during inguinal hernia surgery in elderly patients. MATERIAL AND METHODS: This prospective cohort study included 50 elderly male patients (mean age 71.84 ±5.56 years) who underwent ultrasound-guided transinguinal hernia surgery from May 2022 to June 2023. Patients were divided into the intervention group (n = 28) and the control group (n = 22). Pain scores were assessed using the visual analogue scale (VAS) multiple times as initial, during and within the first 24 h post-surgery. Secondary outcomes, encompassing vital signs, analgesic consumption and overall patient satisfaction, were also monitored. RESULTS: The mean age of the cohort was 71.84 ±5.56 years, with a mean body mass index (BMI) of 24.96 ±1.59 kg/m2. A substantial proportion of patients (82%) presented with comorbidities, including hypertension and cerebral infarction. The post-surgery VAS score was significantly decreased in both groups in comparison to the pre-group (in the control group: pre vs post Z = -3.494 p = 0.005, in the intervention group: pre vs post Z = -4.373 p ≤ 0.001). The primary VAS scores were at the highest level at admission time in both groups; however, duringand post-VAS scores were significantly lower in the intervention group than in the control group at time points during and after surgery (p < 0.001, U = 610; and p < 0.001, U = 471, respectively). CONCLUSIONS: The implementation of a modified ultrasound-guided lower abdominal nerve block markedly enhances postoperative analgesia, reduces opioid requirements and improves patient satisfaction in elderly patients undergoing transinguinal hernia repair. These findings underscore the importance of effective pain management strategies in this vulnerable population.
Procedural sedation in emergency departments: Efficacy and adverse outcomes from a systematic review and meta-analysis.
Qu Z, Xu C, Qu Z … +1 more , Liang H
Adv Clin Exp Med · 2026 Mar · PMID 41698174 · Publisher ↗
BACKGROUND: Procedural sedation reduces pain, anxiety, and discomfort during emergency department (ED) procedures. Analgesics, sedatives and anxiolytics ensure patient comfort but can cause respiratory, cardiovascular, n...
BACKGROUND: Procedural sedation reduces pain, anxiety, and discomfort during emergency department (ED) procedures. Analgesics, sedatives and anxiolytics ensure patient comfort but can cause respiratory, cardiovascular, neurological, and gastrointestinal (GI) side effects. OBJECTIVES: To synthesize data on adverse events and procedural efficacy from randomized controlled trials (RCTs) involving the use of different drugs/drug combinations used for procedural sedation. MATERIAL AND METHODS: A systematic literature review was conducted using MEDLINE and CENTRAL databases for RCTs that involved adult patients who were administered drugs for procedural sedation in the ED. Outcomes such as hypoxia, hypotension, apnea, agitation, GI disturbances (nausea, vomiting), and bradycardia/dysrhythmia were extracted from the trials. A meta-analysis was performed using OpenMeta (Analyst) software to determine the pooled incidence of each adverse outcome and procedural success for the different drugs and drug combinations. RESULTS: A total of 50 RCTs were included in the meta-analysis with information from 5,398 patients. Meta-analysis of the data showed a pooled incidence of 136 events/1,000 sedations (95% confidence interval (95% CI): 112-160) for hypoxia, 23 events/1,000 sedations (95% CI: 15-31) for hypotension, 143 events/1,000 sedations (95% CI: 110-177) for agitation, 51 events/1,000 sedations (95% CI: 38-64) for apnea, 45 events/1,000 sedations (95% CI: 30-60) for GI disturbances, and 30 events/1,000 sedations (95% CI: 19-41) for bradycardia/dysrhythmia. The procedural success rate was 921 events/1,000 sedations (95% CI: 896-946). CONCLUSION: The results of this meta-analysis shed light on the adverse effects of various procedural sedation agents used for different procedures in the ED. Ketamine-propofol combinations were associated with less hemodynamic instability, whereas propofol caused hypotension and respiratory events and GI disturbances were associated with the administration of fentanyl and ketamine. Thus, individual patient factors such as age and comorbidities and the risk profile of different agents should be considered during procedural sedation protocols. This meta-analysis summarizes the side effects of several drugs to help physicians administer them safely.
Potential salivary protein biomarkers for the identification of mild traumatic brain injury: A systematic review.
Fabiyi O, Kalinina D, Kontos AP … +3 more , Zynda AJ, Ali S, Abidi SH
Adv Clin Exp Med · 2026 Mar · PMID 41698173 · Publisher ↗
Uncovering objective biomarkers of mild traumatic brain injury (mTBI) may lead to earlier and more accurate identification of this injury, improved prognostic assessment and earlier targeted treatments. Emerging evidence...
Uncovering objective biomarkers of mild traumatic brain injury (mTBI) may lead to earlier and more accurate identification of this injury, improved prognostic assessment and earlier targeted treatments. Emerging evidence highlights the potential of salivary biomarkers, particularly proteins, as a noninvasive, inexpensive and objective method for diagnosing mTBI, due to their presence in saliva following blood-brain barrier disruption; however, consensus on their utility remains limited. Our aim was to explore the diagnostic potential of salivary protein biomarkers in the identification of mTBI. A comprehensive search was conducted from April to September 2024 across the PubMed, Embase and Google Scholar databases. Original observational studies examining the diagnostic utility of salivary protein biomarkers for mTBI in human populations were included. Seven (1.7%) studies out of 411 identified reports met the inclusion criteria. A total of 49 salivary proteins demonstrated significant differential expression. Subgroup analysis based on the mechanism of injury (sports-related and non-sports-related) identified 4 overlapping proteins: ALOX5, ITGB2, ADRB2, and HRH1. ALOX5 and ITGB2 were significantly upregulated in both subgroups, while ADRB2 and HRH1 were downregulated in sports-related cases and upregulated in non-sports-related cases, which may reflect differential expression related to the region of impact and progression of injury pathophysiology. These findings suggest that salivary proteins such as ALOX5, ITGB2, ADRB2, and HRH1 may serve as promising noninvasive biomarkers for the diagnosis of mTBI. Their involvement in key processes in mTBI pathology supports further investigation in larger, rigorously designed clinical studies to validate their diagnostic utility.
Mendelian randomization study of diabetes, blood lipids, and the risk of knee and hip osteoarthritis.
Dong P, Zhu B, Li Z … +1 more , Tang X
Adv Clin Exp Med · 2026 Mar · PMID 41686128 · Publisher ↗
BACKGROUND: Osteoarthritis (OA), particularly knee and hip osteoarthritis (KOA and HOA), is a leading cause of disability. Although diabetes-related factors and lipid abnormalities have been implicated in OA development,...
BACKGROUND: Osteoarthritis (OA), particularly knee and hip osteoarthritis (KOA and HOA), is a leading cause of disability. Although diabetes-related factors and lipid abnormalities have been implicated in OA development, the causal nature of these associations remains unclear. OBJECTIVES: This study investigates the relationships between diabetes-related factors (type 2 diabetes (T2D), fasting insulin and glycated hemoglobin (HbA1c)), blood lipid risk factors (high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides), and OA using Mendelian randomization (MR) analysis. MATERIAL AND METHODS: A bidirectional MR design was applied, using genetic data from publicly available genome-wide association studies (GWAS) that included 403,124 KOA cases and 393,873 HOA cases, along with datasets on diabetes-related and blood lipid risk factors. Genetic variants were used as instrumental variables, and causal relationships were assessed using the TwoSampleMR (v. 0.5.7) package in R. The primary analytical methods included inverse-variance weighted (IVW) analysis, weighted median (WM) analysis, and MR-Egger regression. RESULTS: The forward MR analysis did not identify a causal relationship between diabetes-related factors or blood lipid markers and OA. However, this does not exclude the possibility of indirect pathways or small effects that may not have been detected. In the reverse MR analysis, fasting insulin demonstrated a potential causal relationship with HOA (odds ratio (OR) = 2.568, 95% confidence interval (95% CI): 1.192-5.536, p = 0.016). Additionally, HbA1c (OR = 1.675, 95% CI: 1.254-2.238, p < 0.01), T2D (OR = 1.082, 95% CI: 1.008-1.162, p = 0.03), and LDL-C (OR = 0.799, 95% CI: 0.688-0.928, p < 0.01) were associated with KOA. Glycated hemoglobin and T2D appeared to be potential risk factors for KOA, whereas LDL-C showed a protective association. CONCLUSIONS: This study provides evidence supporting causal associations between diabetes-related factors, blood lipid levels, and the risk of KOA and HOA. These findings suggest that effective blood glucose control and lipid management may help prevent or slow the progression of OA.
Reliability and educational value of YouTube videos on penile prosthesis information.
Doğan AE, Özenç G, Üntan İ … +6 more , Altan M, Yığman M, Akpınar Ç, Çimen S, Ekenci BY, Sarı H
Adv Clin Exp Med · 2026 Mar · PMID 41686127 · Publisher ↗
BACKGROUND: In the contemporary era, acquiring online information has become a prevalent practice. As with any affliction, individuals are inclined to investigate the potential therapeutic avenues for erectile dysfunctio...
BACKGROUND: In the contemporary era, acquiring online information has become a prevalent practice. As with any affliction, individuals are inclined to investigate the potential therapeutic avenues for erectile dysfunction (ED) on the internet. OBJECTIVES: To evaluate the quality, comprehensibility and informative content of YouTube videos on penile prosthesis implantation, with a focus on videos produced by healthcare professionals, and to address the videos according to the class of physician producing the video. MATERIAL AND METHODS: A search for "penile prosthesis" was conducted on YouTube using a censored network to ensure privacy and prevent bias. The first 100 relevant videos uploaded in the last decade were analyzed. They were categorized by source (academicians, government or private hospital physicians, and non-physicians) and assessed for quality using the modified Quality Criteria for Consumer Health Information (DISCERN) scale, Global Quality Scale (GQS) and a newly developed Total Informative Score based on the European Association of Urology Patient Information Forms. The Kruskal-Wallis H test, Kendall's tau correlation test and Spearman's test were used for statistical analysis. RESULTS: Of the videos analyzed, 87% provided informative content, with the majority (51%) uploaded by academic sources. The median duration time was 185 s (111-397). The average modified DISCERN score was low (median: 2, Q1-Q3: 2-3), indicating generally inadequate quality, with 54% rated as poor. No statistical significance occurred between GQS scores for the videos published by the upload source. Videos by government hospital physicians scored the highest in quality measures, while non-physician videos garnered more views and likes. The Patient Education Materials Assessment Tool (PEMAT) understandability and actionability scores showed that videos from healthcare professionals had higher understandability (70%) than those from other sources. CONCLUSIONS: The overall quality of YouTube videos on penile prostheses is low, despite most being informative. Videos created by physicians are more reliable and easier to understand. Implementing stricter guidelines for content creators and promoting public awareness initiatives are recommended to improve patient access to high-quality information.
Osteoarthritis and chondrosarcoma: Bioinformatics analysis based on single-cell RNA sequencing and molecular docking.
Hao Z, Qu R, He W
Adv Clin Exp Med · 2026 Mar · PMID 41669898 · Publisher ↗
BACKGROUND: Osteoarthritis (OA) and chondrosarcoma (CHS) are joint-disabling diseases that differ in their clinical manifestations, pathobiological mechanisms and management strategies. OBJECTIVES: This study aims to inv...
BACKGROUND: Osteoarthritis (OA) and chondrosarcoma (CHS) are joint-disabling diseases that differ in their clinical manifestations, pathobiological mechanisms and management strategies. OBJECTIVES: This study aims to investigate the cellular heterogeneity and molecular mechanisms underlying osteoarthritis and CHS using single-cell RNA sequencing and molecular docking approaches, with the goal of identifying potential therapeutic targets. MATERIAL AND METHODS: Publicly available single-cell RNA sequencing datasets for osteoarthritis and CHS were retrieved for detailed analysis. The t-distributed stochastic neighbor embedding method (t-SNE) and the uniform manifold approximation and projection (UMAP) method were used to visualize cellular clustering, and differential expression analyses were performed to evaluate key genes across distinct cell populations. Additionally, we conducted a computational study, including molecular docking of the DAP3 protein with the natural compounds curcumin and resveratrol, to assess their potential as therapeutic agents. RESULTS: We identified significant differences in the distribution of cell subpopulations and gene expression profiles between OA and CHS. Only selected cell subgroups - including neurons, chondrocytes and immune cells - exhibited tissue-specific expression differences in disease-associated genes. In silico molecular docking demonstrated that curcumin and resveratrol can bind to the DAP3 protein suggesting a potential molecular basis for developing novel therapeutic strategies. CONCLUSIONS: This study provides detailed single-cell insights into OA and CHS and identifies potential therapeutic targets. These findings not only deepen our understanding of the cellular and molecular features of these diseases but also highlight promising avenues for future therapeutic development.
Hemodynamic impact of remimazolam versus propofol during painless colonoscopy in older adults: A multicenter, single-blind, randomized controlled trial.
Yuan Q, Dai M, Han L … +8 more , Li C, Jiang X, Ruan Q, Chen Y, Deng C, Chen T, Liu T, Wang X
Adv Clin Exp Med · 2026 Mar · PMID 41669897 · Publisher ↗
BACKGROUND: Since older patients are at high risk of hypotension and hypoxia during anesthesia, it is crucial to choose safe sedatives. OBJECTIVES: To compare the efficacy and safety of remimazolam with propofol in elder...
BACKGROUND: Since older patients are at high risk of hypotension and hypoxia during anesthesia, it is crucial to choose safe sedatives. OBJECTIVES: To compare the efficacy and safety of remimazolam with propofol in elderly patients undergoing endoscopic procedures. MATERIAL AND METHODS: This multicenter, single-blind, randomized study included patients aged ≥65 years (American Society of Anesthesiologists (ASA) physical status I-III) who were randomized in a 1:1 ratio to receive either remimazolam (0.1-0.2 mg/kg) or propofol (0.3-0.5 mg/kg). The primary endpoint was the rate of occurrence of hypotensive events. Secondary endpoints included time to patient unresponsiveness and time to awakening (defined as a Modified Observer's Assessment of Alertness/Sedation (MOAA/S) score ≤3 and ≥4), time to leaving the operating room, cognitive function assessment (using the Mini-Cog test), and additional parameters. RESULTS: A total of 300 patients aged ≥65 years were enrolled. Patients who received remimazolam (n = 132) experienced a significantly lower incidence of intraoperative hypotension compared with those treated with propofol (n = 138) (56.8% vs 82.6%, p < 0.001). The median time to reach a MOAA/S score of 3 was shorter in the remimazolam group than in the propofol group (1.17 min [interquartile range (IQR): 0.85-1.44] vs 1.33 min [IQR: 0.88-2.00], p = 0.041). At 10 min post-awakening, the median Ramsay sedation score was lower in the remimazolam group (2.03 ±0.17 vs 2.14 ±0.35, p = 0.001). Tukey's post hoc analysis showed a significant decline in cognitive scores before and after anesthesia in the propofol group (p = 0.002), whereas no significant change was observed in the remimazolam group (p = 0.658). There was no significant difference in treatment-related adverse events (AEs) between the 2 groups. CONCLUSIONS: Remimazolam significantly reduced the incidence of intraoperative hypotension during colonoscopy, providing a safer sedative option for elderly patients and supporting its use as a preferred agent in this population.
Expression profile of circular RNA in angiotensin II-mediated abdominal aortic aneurysm in mice: A microarray analysis.
Lou J, Wu S, Lin T … +1 more , Zeng G
Adv Clin Exp Med · 2026 Feb · PMID 41662509 · Publisher ↗
BACKGROUND: Abdominal aortic aneurysm (AAA) is a cardiovascular condition characterized by the abnormal dilation of the abdominal aorta. OBJECTIVES: A circular RNA (circRNA) microarray was utilized to identify differenti...
BACKGROUND: Abdominal aortic aneurysm (AAA) is a cardiovascular condition characterized by the abnormal dilation of the abdominal aorta. OBJECTIVES: A circular RNA (circRNA) microarray was utilized to identify differentially expressed circRNAs in angiotensin II (Ang II)-stimulated AAA mice. MATERIAL AND METHODS: Male apolipoprotein E-deficient (apoE-/-) mice were randomly assigned to 2 groups and subjected to 28 days of infusion with either Ang II or saline. At the end of the experiment, the mice were euthanized via exsanguination under anesthesia. The periadventitial tissues were carefully removed from the aortic wall to measure the maximal external diameter of the suprarenal aorta, and then stored for further analysis. Samples from both the control and AAA groups were used for circRNA expression profiling. The R package Bioconductor was employed to perform Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Arraystar's proprietary miRNA target prediction software, integrating miRanda and TargetScan, was used to predict the circRNA/miRNA interactions. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was employed to confirm the reliability of the microarray results. RESULTS: A total of 13,103 circRNAs were detected. Compared to the control group, 90 circRNAs were upregulated and 234 were downregulated in the Ang II-induced AAA group. Gene Ontology analysis indicated that the target genes associated with the differentially expressed circRNAs were involved in a variety of biological processes. The KEGG pathway analysis revealed that the differentially expressed circRNAs influenced several critical pathways, including the MAPK signaling pathway, insulin signaling pathway, Ras signaling pathway, and autophagy. The results of RT-qPCR showed that the expression levels of circRNA_30395, circRNA_30398 and circRNA_012594 were significantly increased in AAA, while circRNA_006097 and circRNA_009932 were notably decreased. The top 5 miRNAs related to each validated circRNA were identified through bioinformatic analysis. Among these differentially expressed circRNAs, miR-136-5p was predicted to be the target gene of circRNA_30398 with high probability. CONCLUSIONS: The differential expression of various circRNAs identified in AAA suggests that the circRNA-miRNA-mRNA axis may serve as a potential molecular regulatory mechanism for AAA.
Single-cell pseudotime and cell communication analysis of pancreatic cancer.
Ni C, Wang X, Cai Z … +8 more , Chen Y, Wang H, Wang Q, Lin H, Zhou Y, Yuan Y, Sun B, Sun Z
Adv Clin Exp Med · 2026 Feb · PMID 41662508 · Publisher ↗
BACKGROUND: Pancreatic cancer (PC) is among the most aggressive and lethal malignancies, characterized by development within a complex tumor microenvironment (TME) that includes a desmoplastic stroma composed of extracel...
BACKGROUND: Pancreatic cancer (PC) is among the most aggressive and lethal malignancies, characterized by development within a complex tumor microenvironment (TME) that includes a desmoplastic stroma composed of extracellular matrix (ECM) and various cellular components. OBJECTIVES: This study aims to elucidate the cellular and molecular mechanisms regulating PC progression through an integrated analysis of single-cell pseudotime trajectories and intercellular communication. MATERIAL AND METHODS: We constructed pseudotime trajectories using single-cell RNA sequencing (scRNA-seq) data from PC tissues to trace the developmental progression of cancer cells. Transitional cell states and critical genes involved in the shift from early-to-advanced disease stages were identified. Through a comprehensive analysis, we pinpointed key transcription factors and signaling pathways implicated in tumor progression. Expression of stemness-associated genes in pancreatic stellate cells (PSC) was validated using immunofluorescence and transmission electron microscopy (TEM). Additionally, cell-cell communication analysis was performed to examine interactions within the TME, with particular emphasis on ligand-receptor pairings. RESULTS: Our analysis identified key transcription factors and signaling pathways that drive the cellular transitions associated with cancer progression. The findings revealed extensive intercellular crosstalk between cancer cells, stromal fibroblasts, and diverse immune cell subpopulations. Notably, the study underscored the distinct functional contributions of these cell populations to tumor development, immune evasion and metastatic dissemination. CONCLUSIONS: The study uncovers the complex cellular diversity and intercellular crosstalk in PC, providing novel avenues for therapeutic interventions and early predictive markers in diagnosis. These findings support the potential for more targeted, personalized treatment strategies in combating PC.
Enhancing professional outcome in nursing and midwifery: A systematic review of competency-based education's impact on performance, self-confidence and anxiety reduction.
Jiang G, Hou L
Adv Clin Exp Med · 2026 Feb · PMID 41662507 · Publisher ↗
Clinical skills refresher courses focusing on competence are essential for enhancing the clinical performance of healthcare providers. These courses play a pivotal role in nursing and midwifery education, offering studen...
Clinical skills refresher courses focusing on competence are essential for enhancing the clinical performance of healthcare providers. These courses play a pivotal role in nursing and midwifery education, offering students initial exposure to clinical environments and preparing them for subsequent internships. This systematic review aimed to assess the effectiveness of clinical skills refresher courses on clinical performance, particularly focusing on competency-based supplementary clinical skills courses. A comprehensive literature search was conducted across articles published in the last 15 years, utilizing PubMed, Embase, Cochrane Library, Web of Science, and Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases with specific keywords. This extensive search yielded 1,751 records, of which 13 were selected based on strict inclusion and exclusion criteria. Of these, 5 studies examined the effect of competency-based education (CBE) on the quality of clinical skills, 5 studies assessed clinical skills in detail, and 3 studies discussed other variables related to nursing skills, such as anxiety. The results indicate that CBE significantly enhances clinical skills and self-efficacy among nursing students, addressing gaps in practical training and psychological readiness for clinical internships. This review recommends the implementation of well-organized competency-based training courses in nursing and midwifery education. By bridging the gap between theoretical knowledge and practical experience, this approach equips nurses and midwives to effectively address contemporary healthcare challenges, ultimately improving patient outcomes, enhancing professional confidence and ensuring adherence to healthcare standards.
Alzheimer's disease: Time to reassess research and clinical priorities.
Wiatrak B, Szeląg A
Adv Clin Exp Med · 2026 Mar · PMID 41635245 · Publisher ↗
Alzheimer's disease (AD) remains one of the most pressing challenges in contemporary neurology, with growing evidence highlighting the limitations of the amyloid hypothesis and monomodal therapies. This editorial advocat...
Alzheimer's disease (AD) remains one of the most pressing challenges in contemporary neurology, with growing evidence highlighting the limitations of the amyloid hypothesis and monomodal therapies. This editorial advocates for a shift toward multidimensional research and therapeutic frameworks that integrate molecular, electrophysiological, neuroimaging, and behavioral data. Emphasis is placed on the potential of microRNA-based biomarkers, electroencephalography (EEG) analysis, and non-invasive methods to improve early diagnosis. Emerging multimodal treatment strategies - including immunotherapy, neurostimulation, and nutraceuticals - are discussed alongside ethical and regulatory challenges in implementing novel interventions. The authors propose an integrated, patient-centered model that combines precision medicine with preventive approaches rooted in lifestyle, digital biomarkers, and AI-powered personalization. A paradigm shift toward systemic, translational, and ethically grounded strategies is urgently needed to meet the growing burden of AD.
The stage of laryngeal cancer before and after the COVID-19 pandemic: A retrospective study.
Cieślik J, Tomik J
Adv Clin Exp Med · 2026 Mar · PMID 41607198 · Publisher ↗
BACKGROUND: The COVID-19 pandemic severely restricted global access to healthcare, including for patients with laryngeal cancer (LC). OBJECTIVES: To compare laryngeal cancer stage distribution (TNM classification), surgi...
BACKGROUND: The COVID-19 pandemic severely restricted global access to healthcare, including for patients with laryngeal cancer (LC). OBJECTIVES: To compare laryngeal cancer stage distribution (TNM classification), surgical treatment patterns (types of surgery and perioperative complications), and timelines before vs 1 year after the COVID-19 pandemic declaration. MATERIAL AND METHODS: We conducted a retrospective, single-center, cross-sectional study at a tertiary care center in Poland. The analysis included 110 patients hospitalized for laryngeal cancer during 2 six-month intervals: October 2019-March 2020 (prepandemic, group 1) and October 2021-March 2022 (post-pandemic, group 2). RESULTS: Group 1 included 49 patients, and group 2 included 61. Baseline characteristics were similar between groups, with males comprising 96.9% of group 1 and 83.6% of group 2. Admissions via the fast-track cancer pathway increased from 33.3% in group 1 to 52.5% in group 2. Although a higher proportion of patients in group 2 were classified as stage IVB by TNM, the difference was not statistically significant. Surgical treatment patterns were largely consistent across groups, except for a decrease in total laryngectomy from 18.4% in group 1 to 3.3% in group 2. Moderately differentiated tumors (G2) were more common in group 1 (66.7%) than in group 2 (35%). High concordance was observed between clinical and pathological staging for tumor size (79.1%) and regional lymph node metastasis (87.5%). CONCLUSIONS: Future research should extend the post-COVID-19 observation period, as pandemic-related adverse effects on cancer diagnosis and outcomes may not fully manifest until several years later.
Heart failure in Poland: Epidemiology, hospitalizations, and trends from 2014 to 2021.
Lelonek M, Nessler JM, Bohdan M … +8 more , Hryniewiecki T, Władysiuk M, Niesyczyński G, Cegłowska U, Hałgas K, Śmiglewska A, Wiśniewska A, Siniarski A
Adv Clin Exp Med · 2026 Apr · PMID 41574898 · Publisher ↗
BACKGROUND: Heart failure (HF) is marked by a poor prognosis, heightened mortality risk, and recurrent hospitalizations. Poland consistently ranks among the highest of all Organization for Economic Co-operation and Devel...
BACKGROUND: Heart failure (HF) is marked by a poor prognosis, heightened mortality risk, and recurrent hospitalizations. Poland consistently ranks among the highest of all Organization for Economic Co-operation and Development (OECD) countries, with a hospitalization rate of 616 per 100,000 citizens in 2019 - nearly 3 times the 34-country average. OBJECTIVES: This study aims to provide essential insights into the management of HF patients in Poland, with a particular focus on individuals experiencing recurrent hospitalizations, over the period 2014-2021. MATERIAL AND METHODS: This observational study analyzes long-term registry data from the Polish Ministry of Health and the Health Needs Map. It includes more than 1,000,000 patients diagnosed with HF (ICD-10: I50) or pulmonary edema (ICD-10: J81), treated across all medical facilities operating under a uniform national healthcare system. This study inherently employs a population-based approach, encompassing all medical facilities that treat patients with these ICD-10 codes. RESULTS: Here, we present data on HF prevalence, incidence, and the healthcare pathway. The number of diagnosed HF cases in Poland increased to 1.02 million by December 31, 2019. In 2021, the standardized HF prevalence rate reached 2,626 per 100,000 population, with the highest prevalence observed in individuals aged 80-89 years (32%). Heart failure hospitalizations (HFH) in 2019 were 1022 per 100,000, decreasing to 205,000 in 2021. Notably, the number of hospitalizations exceeded the number of patients receiving treatment by 18-25%. Between 2014 and 2021, more than 9.2 million healthcare services were recorded, accounting for 48% of all HF-related encounters. CONCLUSIONS: This study, relevant to both Polish and international cardiologists, provides a comprehensive overview of HF trends and associated risks, offering insights that may help refine diagnosis and treatment strategies in Central and Eastern European populations.
Internal peacekeepers and external mediators: A new model of peripheral immune tolerance involving regulatory T cells and mesenchymal stem cells.
Pham PV
Adv Clin Exp Med · 2026 Feb · PMID 41574897 · Publisher ↗
The 2025 Nobel Prize in Physiology or Medicine honored the seminal discovery that regulatory T cells (Tregs) restrain immune responses and prevent autoimmunity through peripheral immune tolerance. However, to obtain a ho...
The 2025 Nobel Prize in Physiology or Medicine honored the seminal discovery that regulatory T cells (Tregs) restrain immune responses and prevent autoimmunity through peripheral immune tolerance. However, to obtain a holistic view of peripheral immune tolerance, it is also necessary to consider the role of mesenchymal stem/stromal cells (MSCs) in this process. Therefore, I propose a two-tier model that incorporates both Tregs and MSCs, with Tregs acting within the immune system as an "internal checkpoint" to temper effector cell activity, and tissue-resident MSCs - or "master signaling cells" - serving as an "external checkpoint." Injuryor pathogen-induced inflammation activates MSCs, which in turn secrete a broad repertoire of immunomodulatory molecules, create a local anti-inflammatory milieu, promote tissue repair, and directly dampen excessive immune activity at the site of damage. The concerted actions of Tregs and MSCs are essential for effective peripheral immune tolerance, shielding the host from pathogens and collateral tissue injury. This model helps explain the pathophysiology of autoimmunity and tumor immune evasion, as well as the therapeutic potential of MSC-based interventions.
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