Adv Clin Exp Med [JOURNAL]
Sun
200 papers
Precision management of atorvastatin: Cross-sectional analysis of genetic polymorphisms.
Ibrahim R, Odeh M, Mallah E … +8 more , Abu-Qatouseh L, Awaad AA, Mansoor K, Ahmad MIA, Shdifat A, Hyari MA, Omari KW, Arafat T
Adv Clin Exp Med · 2026 Jan · PMID 41489862 · Publisher ↗
BACKGROUND: Hyperlipidemia is a major risk factor for cardiovascular diseases and is associated with complications such as atherosclerosis and tendon injury. Though atorvastatin reduces cholesterol, genetic variants (CYP...
BACKGROUND: Hyperlipidemia is a major risk factor for cardiovascular diseases and is associated with complications such as atherosclerosis and tendon injury. Though atorvastatin reduces cholesterol, genetic variants (CYP2D6-4, SULT1A1, CYP2C192) affect its response. These genetic variations influence atorvastatin metabolism, thereby affecting its therapeutic effectiveness. OBJECTIVES: To advance personalized therapeutic drug monitoring and improve lipid profile management, this study aims to develop a robust and LC-MS/MS method for quantifying atorvastatin levels in human plasma. Additionally, to investigate the influence of genetic polymorphisms - particularly CYP2D6-4-on plasma concentrations of atorvastatin in patients with hyperlipidemia. MATERIAL AND METHODS: Ethical approval for the study was obtained from the appropriate institutional review boards, and written informed consent was obtained from all participants. Atorvastatin was measured using LC-MS/MS. PCR-based methods were used for genotyping. Statistical analyses were performed to evaluate relationships between plasma atorvastatin levels and genetic variants. RESULTS: The LC-MS/MS method demonstrated excellent linearity, accuracy, precision, and stability, for the quantification of atorvastatin in human plasma. Higher atorvastatin concentrations were tied to CYP2D6-4. Furthermore, the study validated the analytical method for consistent and reliable measurement of atorvastatin levels in clinical samples. CONCLUSIONS: This study successfully developed and validated a straightforward and reliable LC-MS/MS method for quantifying atorvastatin levels in human plasma. Significant CYP2D64 - atorvastatin links highlight the value of pharmacogenetic dosing. Integrating pharmacogenetics - especially in the Jordanian population - may enhance the safety, efficacy, and individualization of atorvastatin therapy.
Insights into brain oscillations and connectivity in neuropsychiatric disorders.
Gregorio FD, Battaglia S
Adv Clin Exp Med · 2026 Feb · PMID 41267473 · Publisher ↗
Electroencephalography has advanced from spectral analyses to integrate functional-connectivity and oscillatory metrics, offering mechanistic insights into network dysfunction across neurological and psychiatric disorder...
Electroencephalography has advanced from spectral analyses to integrate functional-connectivity and oscillatory metrics, offering mechanistic insights into network dysfunction across neurological and psychiatric disorders. Methodological advances, such as source reconstruction and brain modelling, enhance spatial precision and mitigate volume conduction. Empirical studies show that oscillatory brain activity and functional connectivity serve human cognition and their disruptions underlie symptoms in a variety of neuropsychiatric disorders. The study of the relation between brain oscillations and connectivity is pivotal for the advances in cognitive and clinical neuroscience. Crucially, integrating these biomarkers into machine-learning frameworks and closed-loop neuromodulation holds promise for personalized diagnostics and interventions.
From consensus to action: Implementing cardiovascular prevention guidelines in primary healthcare.
Kurpas D, Petrazzuoli F, Shantsila E … +11 more , Antonopoulou M, Christodorescu R, Korzh O, Kümler T, Kyriakou M, Neubeck L, Papakonstantinou PE, Richter D, Semb AG, Vargas MF, Ferrini M
Adv Clin Exp Med · 2026 Jan · PMID 41267470 · Publisher ↗
Cardiovascular prevention guidelines are based on robust evidence, yet their implementation in primary healthcare remains inconsistent due to systemic barriers, workload pressures and insufficiently adapted tools. The 20...
Cardiovascular prevention guidelines are based on robust evidence, yet their implementation in primary healthcare remains inconsistent due to systemic barriers, workload pressures and insufficiently adapted tools. The 2025 European consensus emphasizes the need for multidisciplinary teamwork, digital innovation and equity-focused strategies to strengthen prevention across diverse healthcare systems. Translating these recommendations into actionable, context-specific approaches is essential to close the evidence-practice gap and improve population cardiovascular outcomes.
Personalized medicine for patients with chronic diseases in Europe: From concept to clinical practice.
Stefanicka-Wojtas D, Kurpas D
Adv Clin Exp Med · 2026 Jan · PMID 41231106 · Publisher ↗
The rising prevalence of chronic diseases presents a major challenge to healthcare systems worldwide, particularly within primary care. While advances in diagnostics and therapeutics have improved disease management, tra...
The rising prevalence of chronic diseases presents a major challenge to healthcare systems worldwide, particularly within primary care. While advances in diagnostics and therapeutics have improved disease management, traditional care models often neglect the individual contexts and lived experiences of patients. Personalized medicine (PM) offers a paradigm shift from standardized treatment approaches toward patient-specific care, integrating biological, behavioral and psychosocial dimensions to optimize outcomes. This editorial synthesizes findings from the Regions4PerMed (Horizon 2020) project, encompassing focus groups, stakeholder surveys and best practice analyses across 20 European countries. Stakeholders from government, academia, patient organizations and healthcare practice, identified key barriers to PM implementation, including fragmented data systems, insufficient clinician training and limited patient engagement. Cross-border data exchange standards, integration of real-world evidence (RWE) and sustainable funding mechanisms emerged as critical enablers of progress. The transition from concept to practice requires aligning policy, technology and human factors. Personalized care extends beyond genomics and precision therapies to encompass communication, motivation and shared decision-making. Training healthcare professionals in holistic competencies, enhancing digital literacy and promoting trust in data-driven systems are essential for successful adoption. By reframing personalization as both a scientific and relational endeavor, PM can strengthen chronic disease care through more adaptive, patient-centered models. Coordinated action across policy, education and technology domains is vital to embed personalization into everyday clinical practice and ensure sustainable, equitable healthcare delivery across Europe.
Immune reprogramming of cold tumors using TGF-β/PD-L1 bispecific antibody and armed oncolytic virus therapy.
Sun Y, Hu S, Yi M … +1 more , Dai Z
Adv Clin Exp Med · 2025 Nov · PMID 41231105 · Publisher ↗
Immunotherapy has revolutionized oncology; however, its efficacy remains limited by the immunosuppressive tumor microenvironment (TME). This editorial synthesizes recent advances demonstrating how rationally designed com...
Immunotherapy has revolutionized oncology; however, its efficacy remains limited by the immunosuppressive tumor microenvironment (TME). This editorial synthesizes recent advances demonstrating how rationally designed combination strategies - particularly those incorporating the transforming growth factor beta/programmed death-ligand 1 (TGF-β/PD-L1) bispecific antibody platform (YM101/BiTP) and the multi-cytokine-armed oncolytic virus VG161 - can overcome resistance mechanisms. By concurrently dismantling immunosuppressive networks, activating innate immunity and remodeling the TME, these approaches show superior preclinical activity across challenging tumor phenotypes. The integration of mechanistic insights with evolving biomarker-driven strategies heralds a new era of personalized combination immunotherapy.
Recent advances in the study of perinatal mental health: Epidemiology, psychopathology and intervention.
Chen C, Nakagawa S
Adv Clin Exp Med · 2025 Dec · PMID 41194706 · Publisher ↗
Perinatal mental health has been increasingly recognized as one of the most prevalent and consequential complications of pregnancy and childbirth. Approximately 1 in 5 women experience depression during or after pregnanc...
Perinatal mental health has been increasingly recognized as one of the most prevalent and consequential complications of pregnancy and childbirth. Approximately 1 in 5 women experience depression during or after pregnancy, and up to 1 in 4 encounter difficulties in establishing an emotional bond with their infants - a condition known as mother-to-infant bonding difficulties (MIBD). Pooled global estimates from meta-analyses indicate that these conditions are more prevalent than major obstetric complications such as gestational diabetes and preeclampsia. They also represent the leading cause of maternal mortality, particularly in high-income countries. For example, suicidal ideation (SI) is approx. 16 times more common among women with postpartum depression (PPD) than among those without. Moreover, SI occurring alongside PPD is often associated with prior depressive episodes and a lack of social support, whereas SI in the absence of depression tends to be linked to first-time motherhood, infection during pregnancy, or loneliness. Postpartum depression and MIBD are also closely interconnected, exhibiting a bidirectional relationship and sharing major risk factors such as prenatal depression, limited family support, and adverse childhood experiences. When left untreated, perinatal depression and MIBD can impair maternal functioning and delay infants' emotional, cognitive and social development. Emerging integrative approaches that combine psychotherapy with bonding-focused, lifestyle and psychosocial components show promise in improving outcomes. Future research should focus on developing comprehensive, multimodal interventions that integrate psychotherapy with lifestyle and psychosocial elements within a preventive, family-centered framework, promoting sustained recovery beyond active treatment.
YOLO algorithm improves diagnostic performance of mammography: More than eyes.
Zhang H, Yang X, Yuan L … +3 more , Zhao H, Jiang P, Yu QQ
Adv Clin Exp Med · 2025 Dec · PMID 41194705 · Publisher ↗
BACKGROUND: Breast cancer (BC) is now the most common malignancy in women. Early detection and precise diagnosis are essential for improving survival. OBJECTIVES: To develop an integrated computer-aided diagnosis (CAD) s...
BACKGROUND: Breast cancer (BC) is now the most common malignancy in women. Early detection and precise diagnosis are essential for improving survival. OBJECTIVES: To develop an integrated computer-aided diagnosis (CAD) system that automatically detects, segments and classifies lesions in mammographic images, thereby aiding BC diagnosis. MATERIAL AND METHODS: We adopted YOLOv5 as the object-detection backbone and used the Curated Breast Imaging Subset of the Digital Database for Screening Mammography (CBIS-DDSM). Data augmentation (random rotations, crops and flips) increased the dataset to 5,801 images, which were randomly split into training, validation and test sets (7 : 2 : 1). Lesion-classification performance was evaluated with the area under the receiver operating characteristic (ROC) curve (AUC), precision, recall, and mean average precision at a 0.5 confidence threshold (mAP@0.5). RESULTS: The CAD system yielded an mAP@0.5 of 0.417 and an F1-score of 0.46 for lesion detection, achieved an AUC of 0.90 for distinguishing benign from malignant lesions, and processed images at 65 fps. CONCLUSIONS: The integrated CAD system combines rapid detection and classification with high accuracy, underscoring its strong clinical value.
Stromal cells as a part of tumor microenvironment of melanoma: Their role in cancer progression and drug resistance.
Matkowski R, Simiczyjew A, Ziętek M … +1 more , Nowak D
Adv Clin Exp Med · 2025 Dec · PMID 41194437 · Publisher ↗
Today, it is well established that the tumor microenvironment (TME), the tumor niche, along with melanoma cells, plays a crucial role in cancer dissemination and influences the effectiveness of anticancer therapies. Ther...
Today, it is well established that the tumor microenvironment (TME), the tumor niche, along with melanoma cells, plays a crucial role in cancer dissemination and influences the effectiveness of anticancer therapies. Therefore, it may serve as a potential therapeutic target in melanoma treatment. In our research, we focused on the effects exerted by cells within the melanoma microenvironment on cancer progression and the development of therapy resistance. Specifically, we examined stromal cells accompanying melanoma cells in the tumor - cancer-associated fibroblasts (CAFs), cancer-associated keratinocytes (CAKs), and cancer-associated adipocytes (CAAs). Particular attention was given to keratinocytes, as their role in the melanoma microenvironment remains the least understood.
Blood biomarkers of Alzheimer's disease: Balancing clinical relevance with improved accessibility and sustainability.
Daly T
Adv Clin Exp Med · 2025 Nov · PMID 41194436 · Publisher ↗
The U.S. Food and Drug Administration (FDA) recently approved a blood-based biomarker to confirm diagnosis of Alzheimer's disease (AD-BBMs). When used in conjunction with human expertise in the diagnosis of neurocognitiv...
The U.S. Food and Drug Administration (FDA) recently approved a blood-based biomarker to confirm diagnosis of Alzheimer's disease (AD-BBMs). When used in conjunction with human expertise in the diagnosis of neurocognitive disorder due to Alzheimer's disease (AD), blood-based biomarkers could increase both the accessibility and sustainability of medical practice and research. Indeed, AD-BBMs are likely to be more cost-effective in the long term and conservative calculations performed here suggest that they would have an approx. 10-fold and 36-fold lower carbon footprint compared to cerebrospinal fluid (CSF) lumbar punctures and amyloid positron emission tomography (PET) scans, respectively. Their use will require a careful balance of trade-offs to maximize benefits and minimize harms for current patients, while ensuring the sustainable integration of these tools into healthcare systems so that diagnostic precision remains accessible to present and future generations in an aging global population amid anthropogenic climate change.
Access to services. Mental health in catastrophes and emergencies: Aspects.
Bährer-Kohler S
Adv Clin Exp Med · 2025 Dec · PMID 41171619 · Publisher ↗
Disasters, wars and health emergencies profoundly affect mental health, with nearly 1/3 of affected populations developing conditions such as posttraumatic stress disorder (PTSD), depression or anxiety, particularly amon...
Disasters, wars and health emergencies profoundly affect mental health, with nearly 1/3 of affected populations developing conditions such as posttraumatic stress disorder (PTSD), depression or anxiety, particularly among vulnerable groups like children, the elderly and the chronically ill. Access to mental health and psychosocial support (MHPSS) is often limited by conflict-related disruptions, stigma or resource shortages, while healthcare workers themselves face immense psychological strain and inadequate protection. Long-term strategies integrating disaster preparedness, mental health services and professional support are essential to safeguard both affected populations and frontline workers during emergencies.
Community-acquired pneumonia in HIV-infected patients: Updated insights on epidemiology and etiology.
Biała M, Knysz B
Adv Clin Exp Med · 2025 Dec · PMID 41159483 · Publisher ↗
Bacterial pneumonia is a cause of HIV-associated morbidity and mortality. Recurrent pneumonia, defined as 2 or more episodes within a 12-month period, is an AIDS-defining illness. The prevalence of bacterial pulmonary in...
Bacterial pneumonia is a cause of HIV-associated morbidity and mortality. Recurrent pneumonia, defined as 2 or more episodes within a 12-month period, is an AIDS-defining illness. The prevalence of bacterial pulmonary infections in HIV-infected patients has been decreasing with the introduction and widespread use of antiretroviral therapy. In well-developed settings, the frequency of bacterial pneumonia in people living with HIV is comparable to that in the general population. Studies have shown that the cumulative incidence of pneumonia is higher in HIV-infected patients with advanced immunosuppression, airflow limitation, smoking, intravenous drug use, or in those from underdeveloped countries and urban areas. In HIV-infected patients with community-acquired bacterial pneumonia, Streptococcus pneumoniae and Haemophilus species are the most frequently isolated pathogens. However, in untreated or poorly adherent HIV-infected individuals, opportunistic infections may occur. Although the incidence of opportunistic infections among HIV-infected patients has declined in well-developed settings due to the widespread use of antiretroviral therapy, tuberculosis remains a serious threat and a major cause of morbidity and mortality among HIV-infected individuals worldwide. Early diagnosis of HIV infection, timely initiation of antiretroviral therapy with good adherence, and promotion of vaccination remain priorities. This editorial provides an overview of community-acquired pneumonia in HIV-infected patients and discusses recent changes in its epidemiology and etiology.
Neurobiological effects of childhood maltreatment: Health consequences, recovery pathways and clinical implications for holistic care.
Hakamata Y, Hori H
Adv Clin Exp Med · 2025 Nov · PMID 41159482 · Publisher ↗
Adverse childhood experiences (ACEs), such as childhood abuse and neglect, have a profound impact on our bodies, affecting the brain, autonomic nervous system, endocrine system, immune and inflammatory systems, as well a...
Adverse childhood experiences (ACEs), such as childhood abuse and neglect, have a profound impact on our bodies, affecting the brain, autonomic nervous system, endocrine system, immune and inflammatory systems, as well as genetic expressions. Childhood maltreatment can leave long-lasting neurobiological scars, significantly increasing the risk of developing both physical and mental disorders, including depression and posttraumatic stress disorder (PTSD). The ICD-11, an international disease classification system, has recently introduced new diagnostic criteria for what is known as complex PTSD. In this context, we will briefly overview the neurobiological effects of ACEs, the associated health conditions they can lead to, and potential pathways to recovery. These pathways include promoting the reinstatement of emotional and interpersonal skills that may have been impaired during early development. Approaching ACEs from a holistic perspective may open new avenues for more effective clinical practices for individuals suffering both physically and mentally.
The efficacy of carfilzomib and dexamethason (Kd-70) as once-weekly two-drug regimen: The analysis of real-world data from Poland.
Olszewska-Szopa M, Czyż A, Węgrzyn M … +1 more , Wróbel T
Adv Clin Exp Med · 2026 Jan · PMID 41159481 · Publisher ↗
BACKGROUND: The two-drug regimen Kd-70 (carfilzomib at a dose of 70 mg/m2 with dexamethasone) is a recommended treatment option for patients with relapsed or refractory multiple myeloma, according to both American and Eu...
BACKGROUND: The two-drug regimen Kd-70 (carfilzomib at a dose of 70 mg/m2 with dexamethasone) is a recommended treatment option for patients with relapsed or refractory multiple myeloma, according to both American and European guidelines. However, aside from the A.R.R.O.W. trial, real-world data on its effectiveness remain limited. OBJECTIVES: We aimed to assess the effectiveness of the two-drug regimen Kd-70 in real-world practice. MATERIAL AND METHODS: We analyzed data from the Polish Ministry of Health registry, which included 412 patients treated with the Kd-70 regimen in Poland. RESULTS: The overall response rate (ORR) was 67.15%, comparable to the A.R.R.O.W. trial. However, the complete response (CR) rate (5.3%) and very good partial response (VGPR) rate (9.59%) were lower than those reported in the A.R.R.O.W. study. Notably, Kd-70 showed significantly lower efficacy in patients who required treatment for primary resistance or disease progression within the 1st year after diagnosis. In contrast, the number of prior treatment lines did not impact the regimen's effectiveness. CONCLUSIONS: In real-world clinical practice, the Kd-70 regimen demonstrated an ORR comparable to that observed in the A.R.R.O.W. trial. However, the CR and VGPR rates were lower. These findings underscore the need for further investigation into factors influencing treatment outcomes in this patient population.
Transcranial direct current stimulation (tDCS): A new, (still) legal form of "neurodoping" in sports?
Chmiel J
Adv Clin Exp Med · 2025 Oct · PMID 41078301 · Publisher ↗
Transcranial direct current stimulation (tDCS) has emerged as a widely accessible, noninvasive technique capable of modulating cortical excitability. A rapidly expanding body of sports-science literature suggests that it...
Transcranial direct current stimulation (tDCS) has emerged as a widely accessible, noninvasive technique capable of modulating cortical excitability. A rapidly expanding body of sports-science literature suggests that it can produce modest but measurable gains in endurance, strength, skill acquisition, and perceived exertion. This editorial reviews the physiological mechanisms underlying tDCS, evaluates the evidence for its ergogenic effects, and situates the technology within the broader framework of "neurodoping". Applying the 2021 World Anti-Doping Agency (WADA) Code, I argue that tDCS already satisfies 2 of the 3 criteria for prohibition - namely, potential performance enhancement and violation of the spirit of sport - while failing the 3rd criterion, as standard protocols pose minimal health risk. This editorial also considers practical and ethical counterarguments to a ban, including tDCS's low cost, relative safety, requirement for continued training effort, and the near-impossibility of detection or enforcement. Drawing parallels with accepted performance aids such as mindfulness, nutrition and altitude tents, this editorial concludes that outright prohibition could drive use underground and impede open scientific scrutiny. Instead, it advocates rigorous long-term safety monitoring, transparent research, and nuanced policy development that distinguishes therapeutic from performance applications. Ultimately, it frames tDCS as a "still-legal" yet ethically contested innovation at the frontier of sports technology, urging stakeholders to balance principles of fair play with scientific evidence as the debate over neurodoping continues to evolve.
HCV infection: Extrahepatic manifestations of infection and treatment options.
Simon K, Pazgan-Simon M
Adv Clin Exp Med · 2025 Nov · PMID 40999736 · Publisher ↗
Currently, there is no doubt that hepatitis C virus (HCV) infection is a systemic disease affecting not only the liver but also a range of other organs - extrahepatic manifestations (EHMs). Extrahepatic manifestations us...
Currently, there is no doubt that hepatitis C virus (HCV) infection is a systemic disease affecting not only the liver but also a range of other organs - extrahepatic manifestations (EHMs). Extrahepatic manifestations usually occur concurrently with liver disease, primarily have an immunological basis, and/or are a consequence of the direct impact of HCV on virtually all organs. The scope of the problem is significant; it has been shown that 30-40% of HCV-infected individuals are affected, which aligns with our own observations. Viral elimination (either spontaneous HCV clearance or as a result of pharmacotherapy) is crucial for the patient's prognosis, both in terms of liver disease and EHM. Achieving a sustained virological response (SVR) only in many cases of EHMs is associated with remission of clinical symptoms of EHMs.
The correlation between nailfold capillaroscopic findings and adaptive optics imaging of retinal microvasculature in patients with systemic sclerosis.
Paczwa K, Szeretucha M, Romanowska-Próchnicka K … +4 more , Ornowska S, Olesińska M, Różycki R, Gołębiewska J
Adv Clin Exp Med · 2026 Jan · PMID 40959997 · Publisher ↗
BACKGROUND: Vascular injury is a central and early feature of systemic sclerosis (SSc) pathogenesis. Although nailfold capillaroscopy (NC) effectively visualizes characteristic peripheral arteriolar and capillary changes...
BACKGROUND: Vascular injury is a central and early feature of systemic sclerosis (SSc) pathogenesis. Although nailfold capillaroscopy (NC) effectively visualizes characteristic peripheral arteriolar and capillary changes, the retinal microcirculation provides a noninvasive, high-resolution view into subtler vascular dysfunction. Consequently, retinal vascular imaging may offer an ideal modality for monitoring microvascular injury and detecting early manifestations of SSc. OBJECTIVES: To compare retinal microvascular parameters between SSc patients and healthy controls using adaptive optics (AO) imaging, and to evaluate the correlation between adaptive optics-derived retinal measurements and NC findings in SSc. MATERIAL AND METHODS: The study included 31 patients with SSc and 41 healthy controls. The AO images of the retinal arteries were obtained in both groups and the measurements were compared. Nailfold capillaroscopy was also performed in the SSc cohort, and its findings were directly compared with the AO imaging results. RESULTS: Retinal arterial wall thickness was significantly lower in SSc patients than in healthy controls (p = 0.016), and the wall-to-lumen ratio was similarly reduced in the SSc group (p = 0.048). Within the SSc cohort, hypertensive patients exhibited a significantly greater wall cross-sectional area compared to those without hypertension (p = 0.026). CONCLUSIONS: Adaptive optics retinal imaging demonstrated a significant reduction in mean arterial wall thickness in SSc patients compared with healthy controls. However, no correlation was identified between the AO findings and the NC parameters or the disease stage. Our analysis revealed that alterations in retinal vascular parameters were confined to SSc patients with comorbid hypertension or those receiving sildenafil therapy. To fully establish the clinical utility of adaptive optics imaging in SSc, and to elucidate its relationship with NC findings, larger, multicenter studies with more diverse patient cohorts are warranted.
Outcomes of the toe PIP joint transfer for IIIB hypoplastic thumb: Is it justified when pollicization is denied?
Górecki M, Czarnecki P, Bręborowicz E … +1 more , Romanowski L
Adv Clin Exp Med · 2026 Feb · PMID 40959996 · Publisher ↗
BACKGROUND: Amputation followed by index finger pollicization is the gold-standard treatment for type III B thumb hypoplasia. However, despite its high success rate, some parents decline this procedure because it results...
BACKGROUND: Amputation followed by index finger pollicization is the gold-standard treatment for type III B thumb hypoplasia. However, despite its high success rate, some parents decline this procedure because it results in a four-finger hand. OBJECTIVES: To evaluate the outcomes of reconstructive surgery in eight patients with type III B thumb hypoplasia, stabilized using a non-vascularized proximal interphalangeal (PIP) joint harvested from the foot when parental consent for pollicization was not granted. MATERIAL AND METHODS: The study cohort comprised 8 postoperative patients (mean follow-up: 7 years) who underwent reconstructive stabilization of a hypoplastic thumb using a PIP joint from the foot. Hand function was evaluated by measuring range of motion (ROM), thumb stability and length, grip strength, and performance on a manual manipulation test. Donor-site morbidity was assessed via foot examination following PIP joint harvest. Functional outcomes were further analyzed using specialized patient-reported questionnaires. RESULTS: Most patients achieved good thumb stability and a functional passive range of motion. Reconstructed thumbs averaged approx. 75% of the length of a normal thumb, and grip strength measured about 50% of that in the contralateral hand. Donor-site assessment revealed toe shortening in the majority of cases but no deficits in ambulation or weight-bearing. The overall complication rate was 25%, and most patients and their parents reported satisfaction with the treatment. CONCLUSIONS: Thumb reconstruction with a non-vascularized PIP joint yields enhanced stability and reduced hypermobility, with outcomes comparable to those reported for similar techniques. This approach represents a viable alternative for patients whose parents decline pollicization.
Polish validation of the LGBTQ+ Healthcare Experiences Scale (LGBTQ+ HCES).
Czapla M, Stańczykiewicz B, Kurpas D … +4 more , Uchmanowicz I, Uchmanowicz B, Juárez-Vela R, Karniej P
Adv Clin Exp Med · 2025 Sep · PMID 40948467 · Publisher ↗
BACKGROUND: The Lesbian, Gay, Bisexual, Transgender, and Queer individuals frequently encounter disparities in healthcare access, quality and inclusivity. Despite growing awareness of these challenges, Poland has lacked...
BACKGROUND: The Lesbian, Gay, Bisexual, Transgender, and Queer individuals frequently encounter disparities in healthcare access, quality and inclusivity. Despite growing awareness of these challenges, Poland has lacked a psychometrically validated tool to assess the experiences of sexual and gender minorities in clinical settings. OBJECTIVES: This study aimed to develop and validate the LGBTQ+ Healthcare Experiences Scale (LGBTQ+ HCES) tailored to the Polish context. MATERIAL AND METHODS: A multi-phase cross-sectional study was conducted in 2025. The initial pool of items was developed through a narrative literature review and refined by 4 researchers with clinical and academic experience in LGBTQ+ health. Content validity was assessed using a 2-round Delphi process involving a multidisciplinary panel of experts (n = 12), who rated item clarity and relevance using Aiken's V. A pilot test with 30 LGBTQ+ participants confirmed comprehension and technical usability. The final 15-item instrument, comprising 3 subscales (Respect and Inclusivity, Discrimination and Microaggressions, Trust and Comfort), was administered to 172 LGBTQ+ individuals recruited via social media. Psychometric evaluation included descriptive analysis, confirmatory factor analysis (CFA) and reliability testing (Cronbach's á, McDonald's ů). RESULTS: Confirmatory factor analysis supported a 3-factor model comprising Respect and Inclusivity, Discrimination and Microaggressions, and Trust and Comfort. Model fit indices met recommended thresholds (root mean square error of approximation = 0.041, standardized root mean square residual = 0.057, comparative fit index = 0.998). All subscales demonstrated acceptable to strong internal consistency (á = 0.745-0.778; ů = 0.92). No significant floor or ceiling effects were found to compromise the scale's performance. All items showed positive item-total correlations and contributed meaningfully to their respective subscales. CONCLUSIONS: The LGBTQ+ HCES is a valid, reliable and culturally grounded instrument for assessing healthcare experiences among LGBTQ+ populations in Poland. It holds promise for research, public health surveillance and health system quality improvement efforts to promote inclusive and equitable care.
Basket trial designs in oncology: A comprehensive systematic review.
Bartoszkiewicz M, Kufel-Grabowska J, Burchardt P
Adv Clin Exp Med · 2026 Feb · PMID 40905058 · Publisher ↗
BACKGROUND: Basket trials are an innovative type of clinical trial primarily used in oncology. A distinctive feature of these studies is the grouping of patients based on specific molecular characteristics, such as genet...
BACKGROUND: Basket trials are an innovative type of clinical trial primarily used in oncology. A distinctive feature of these studies is the grouping of patients based on specific molecular characteristics, such as genetic mutations or immunological subtypes, rather than traditional criteria like the type of cancer. MATERIAL AND METHODS: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Medical databases were searched for studies published between 2014 and 2024. The inclusion criteria focused on basket trials as a clinical trial model in oncology. OBJECTIVES: This work aims to outline the principles of conducting basket trials in oncology, analyze basket trials from the past decade, and highlight the emerging trends in this type of trial. RESULTS: The analysis of 76 articles meeting the inclusion criteria revealed that most of these studies are conducted as phase II clinical trials. The average duration of the basket trials in the analysis was 5.9 years (mean = 5.05), with an average recruitment target of 326 patients (mean = 123.5). Most of these studies were conducted in the USA, and the majority of basket trials focused on patients with solid tumors. CONCLUSION: The systematic review confirms that basket trials have significant potential as a clinical trial model, as evidenced by the increasing number of basket trial projects being conducted.
Psychological distress in Chinese women with benign breast disease and breast cancer during diagnosis: A cross-sectional study.
Gao Y, Wang J, Guo J … +1 more , Gao J
Adv Clin Exp Med · 2026 Feb · PMID 40905057 · Publisher ↗
BACKGROUND: Research on the psychological distress experienced by women with benign breast disease (BBD) remains limited, though some evidence suggests it may resemble that of women with breast cancer (BC). OBJECTIVES: T...
BACKGROUND: Research on the psychological distress experienced by women with benign breast disease (BBD) remains limited, though some evidence suggests it may resemble that of women with breast cancer (BC). OBJECTIVES: This study aimed to use the Distress Thermometer (DT) to assess the levels of psychological distress and identify influencing factors during the diagnostic phase in patients with BC and BBD. MATERIAL AND METHODS: From October 2022 to May 2023, a questionnaire survey incorporating the DT and Problem List (PL) was conducted among inpatients in the diagnostic phase for BC or BBD at the Breast Surgery Department of Shanxi Bethune Hospital (Taiyuan, China). Statistical analysis, including descriptive and inferential methods, was performed to examine factors affecting psychological distress in patients with BBD and BC. RESULTS: In this study, 373 participants were evaluated for psychological distress during the diagnostic phase. Among 255 patients diagnosed with BBD, the median distress score was 4, with a distress prevalence of 52%. The primary sources of distress included anxiety (43.5%), fear (21.2%), pain (7.1%), sleep disturbances (6.7%), and childcare responsibilities (5.1%). Among 118 BC patients, the median distress score was slightly higher at 4.5, with a distress prevalence of 63.6%. Key distress factors were anxiety (47.5%), fear (33.1%), financial worries (21.2%), depression (18.6%), and sadness (15.3%). Key predictors of distress varied between the 2 groups. For patients diagnosed with BBD, younger age, lower education levels, unemployment, and a higher Breast Imaging Reporting and Data System (BI-RADS®) classification significantly contributed to higher distress levels. In patients diagnosed with BC, younger age, lower education levels, and unemployment were the primary risk factors. CONCLUSIONS: These findings underscore the psychological burden faced by both patient groups during diagnosis, highlighting the need for early identification and management of distress in this population.
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