Adv Clin Exp Med [JOURNAL]
Sun
200 papers
Cisplatin-induced WWP1-eccDNA expression contributes to ovarian cancer resistance.
Lu C, Han L, Guo X … +5 more , Du R, Zhang H, Guo K, Tu Y, Li R
Adv Clin Exp Med · 2026 Feb · PMID 40905056 · Publisher ↗
BACKGROUND: Multidrug resistance remains a major obstacle in the treatment of ovarian cancer (OC) patients. Recent research has underscored the critical role of extrachromosomal circular DNA (eccDNA) in tumor initiation...
BACKGROUND: Multidrug resistance remains a major obstacle in the treatment of ovarian cancer (OC) patients. Recent research has underscored the critical role of extrachromosomal circular DNA (eccDNA) in tumor initiation and progression. However, there is limited comprehensive understanding of the role eccDNA plays in tumor resistance. OBJECTIVES: This study investigates the involvement of WWP1-eccDNA in the resistance mechanisms of OC. MATERIAL AND METHODS: Human OC cells (SKOV3 and cisplatin-resistant SKOV3/DDP) were cultured and high-throughput sequencing was performed, leading to the identification of eccDNA in SKOV3/DDP cells. Female BALB/cA-nu nude mice with SKOV3 and SKOV3/DDP xenografts received cisplatin (5.5 mg/kg), hydroxyurea (50 mg/kg) or saline for 14 days, followed by tumor weight assessment. Digital droplet polymerase chain reaction (ddPCR) and real-time quantitative polymerase chain reaction (qPCR) were used to quantify WWP1-eccDNA, evaluating their sensitivity and accuracy. Linear DNA removal and BsmI digestion were tested to improve eccDNA detection. RESULTS: WWP1-eccDNA was among the top upregulated eccDNA in SKOV3/DDP cells. Both cisplatin and hydroxyurea reduced tumor growth in mice, with cisplatin showing limited efficacy in resistant tumors. The ddPCR outperformed RT-qPCR in sensitivity, and linear DNA removal improved WWP1-eccDNA detection. WWP1-eccDNA levels were significantly elevated in SKOV3/DDP tumors. Treatment with cisplatin further increased its expression, whereas hydroxyurea led to a reduction in WWP1-eccDNA levels. CONCLUSIONS: WWP1-eccDNA is critical in OC resistance, with cisplatin treatment increasing WWP1-eccDNA levels, contributing to resistance. The ddPCR proves to be a superior method for eccDNA detection.
Bioinformatics analysis identified TCP1 and NOTCH1 as potential target molecules to overcome 5-fluorouracil resistance in cholangiocarcinoma.
Kidoikhammouan S, Kanchanangkul N, Lert-Itthiporn W … +5 more , Deenonpoe R, Saengboonmee C, Obchoei S, Wongkham S, Seubwai W
Adv Clin Exp Med · 2026 Jan · PMID 40905055 · Publisher ↗
BACKGROUND: Late diagnosis and chemotherapy resistance, particularly to 5-fluorouracil (5-FU), contribute to the low survival rate in cholangiocarcinoma (CCA) patients. Identifying relevant genes and pathways, as well as...
BACKGROUND: Late diagnosis and chemotherapy resistance, particularly to 5-fluorouracil (5-FU), contribute to the low survival rate in cholangiocarcinoma (CCA) patients. Identifying relevant genes and pathways, as well as novel targeted molecules, is crucial to overcoming 5-FU resistance and improving treatment outcomes for CCA patients. OBJECTIVES: This study aimed to determine the potential molecules associated with 5-FU resistance in CCA cells. MATERIAL AND METHODS: Transcriptomic datasets from 4 stable 5-FU-resistant cell lines and their corresponding parental lines were retrieved from the Gene Expression Omnibus. A series of bioinformatics analyses were conducted to identify key genes upregulated in 5-FU-resistant cells compared to their parental counterparts. The expression levels of candidate genes identified through bioinformatics analysis were validated in CCA tissues and cell lines. RESULTS: Differential gene expression, protein-protein interaction, and Hub genes analysis revealed 8 genes that were significantly upregulated in 5-FU resistance cells compared to their parental cells. Six of the 8 genes, including TCP1, RPS6, RPS29, HSPA5, RPS15A, and NOTCH1, were upregulated in patient CCA tissues. Using real-time PCR, only the expression levels of NOTCH1 and TCP1 were significantly higher in the 5-FU insensitive CCA cell lines, KKU-213A and KKU-213B, than that of the 5-FU sensitive CCA cell line, KKU-055. A similar result was observed in stable 5-FU-resistant cell lines (KKU-213A-FR and KKU-213B-FR) compared to their parental cells. CONCLUSIONS: The bioinformatic analysis and PCR results revealed that NOTCH1 and TCP1 might be associated with 5-FU resistance and serve as potential molecular targets to enhance 5-FU sensitivity in CCA cells.
Nutrition & exercise for brain health: Enhancing cognitive function and neuroplasticity.
Esmaeilzadeh M, Moradikor N
Adv Clin Exp Med · 2025 Sep · PMID 40905054 · Publisher ↗
This editorial examines the relationship between nutrition, physical activity, and brain health, emphasizing their effects on cognitive function and mental well-being. Evidence supports a balanced diet - rich in antioxid...
This editorial examines the relationship between nutrition, physical activity, and brain health, emphasizing their effects on cognitive function and mental well-being. Evidence supports a balanced diet - rich in antioxidants, omega-3 fatty acids, polyphenols, and patterned after the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet - as crucial for sustaining neural structure, function, and plasticity. Similarly, regular exercise has been shown to enhance mood, attention, memory, and overall cognitive performance. However, despite these demonstrated benefits, the precise neurobiological mechanisms through which diet and exercise influence brain health remain unclear. This article explores both the efficacy of these interventions and the challenges involved in optimizing them for long-term cognitive resilience.
Diagnosis and management of traumatic injuries in pediatric patients secondary to dental local anesthesia: A systematic review.
Olszewska A, Kensy J, Czajka-Jakubowska A … +4 more , Pergolini D, Bossù M, Romeo U, Matys J
Adv Clin Exp Med · 2026 Jan · PMID 40856087 · Publisher ↗
This study examines soft tissue injuries secondary to the prevalence of local anesthesia, differential diagnosis and therapeutic approaches. In October 2024, a comprehensive search was performed in PubMed, Web of Science...
This study examines soft tissue injuries secondary to the prevalence of local anesthesia, differential diagnosis and therapeutic approaches. In October 2024, a comprehensive search was performed in PubMed, Web of Science and Scopus along with gray literature sources, adhering to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, using the following keywords: "bite", "traumatic injuries", "soft tissue injuries", "self-inflicted injuries", "topical anesthesia", "local anesthesia", "pediatric", or "children". The search was limited to English-language publications. Additional manual screening of reference lists was performed. The risk of bias was assessed using the checklist developed by the Joanna Briggs Institute (JBI). Out of 574 identified studies, 21 were included in the qualitative analysis (9 randomized controlled trials (RCTs), 6 case reports and 6 cohort studies), mainly focusing on children aged 6-12. Anesthesia methods included traditional techniques (12 studies) and computer-controlled injection (5 studies). The role of articaine (9) and lidocaine (10) was analyzed. Suggested interventions to mitigate injury risks and improve recovery included the use of phentolamine mesylate (2 studies) and non-pharmacological strategies: intraoral appliances (2 studies) and photobiomodulation (2 studies). The included studies varied in design, sample size and duration, limiting direct comparisons. Effect sizes and confidence intervals were inconsistently reported, and the risk of bias assessment using the Cohen's kappa test highlighted methodological heterogeneity and potential reporting bias. Soft tissue injuries from local anesthesia in children can cause significant pain and cooperation issues. Effective strategies include early intervention with pharmacological and non-pharmacological approaches. Increased awareness and patient-specific management are essential for reducing risks and improving outcomes.
Effectiveness of sorafenib in combination with physical thermal ablation for hepatocellular carcinoma: A meta-analysis.
Wen X, Qi F, Qian H … +3 more , Tao R, Li J, Wang L
Adv Clin Exp Med · 2025 Dec · PMID 40856086 · Publisher ↗
BACKGROUND: Hepatocellular carcinoma (HCC) is the 6th most common cancer worldwide and claims roughly 700,000 lives each year; nearly 50% of global HCC fatalities occur in China. OBJECTIVES: To conduct a comprehensive me...
BACKGROUND: Hepatocellular carcinoma (HCC) is the 6th most common cancer worldwide and claims roughly 700,000 lives each year; nearly 50% of global HCC fatalities occur in China. OBJECTIVES: To conduct a comprehensive meta-analysis identifying predictors of sorafenib efficacy in combination with thermal ablation for HCC treatment. MATERIAL AND METHODS: A comprehensive literature search was conducted up to October 2024, reviewing 720 identified studies. From these, 19 studies were selected that included a total of 3,341 participants with HCC at baseline. The meta-analysis examined the effects of sorafenib in combination with physical thermal ablation, using odds ratios (ORs) and 95% confidence intervals (95% CIs). Analyses were performed using two-sided methods and either fixed-effect or random-effects models, depending on the level of heterogeneity. RESULTS: The meta-analysis revealed that combining physical thermal ablation with sorafenib significantly improved outcomes in HCC patients: Overall survival (OS) was more than doubled (OR = 2.03; 95% CI: 1.55-2.67; p < 0.001), recurrence rates were significantly reduced (OR = 0.62; 95% CI: 0.39-0.98; p = 0.04), and overall treatment efficacy was markedly higher (OR = 2.53; 95% CI: 1.61-3.96; p < 0.001) compared with thermal ablation alone. CONCLUSION: In individuals with HCC, physical thermal ablation and sorafenib had significantly higher OS, lower recurrence rates, and high overall efficacy compared to physical thermal ablation. To validate this discovery, more research is needed, and caution must be implemented when interacting with its values.
Relative qualities of telerehabilitation compared to traditional in-person speech and language treatment for individuals with aphasia: A meta-analysis.
Zhang L
Adv Clin Exp Med · 2025 Dec · PMID 40856085 · Publisher ↗
BACKGROUND: Stroke is a leading cause of disability and one of the primary causes of death worldwide. Stroke survivors often experience a range of symptoms, including impaired motor function, speech and language abnormal...
BACKGROUND: Stroke is a leading cause of disability and one of the primary causes of death worldwide. Stroke survivors often experience a range of symptoms, including impaired motor function, speech and language abnormalities, swallowing difficulties, cognitive deficits, visual disturbances, and sensory impairments. OBJECTIVES: This meta-analysis was conducted to assess and compare the relative effectiveness of telerehabilitation compared to traditional in-person speech and language therapy for individuals with aphasia. MATERIAL AND METHODS: A comprehensive literature search was conducted up to October 2024, reviewing 1,185 identified studies. Ultimately, 6 studies were selected that included a total of 168 participants with aphasia at baseline. The meta-analysis examined the relative effectiveness of telerehabilitation compared to traditional in-person speech and language therapy using continuous outcomes, with mean differences (MD) and 95% confidence intervals (95% CIs) calculated. Analyses were performed using either fixed-effect or random-effects models, depending on heterogeneity. RESULTS: In individuals with aphasia, telerehabilitation demonstrated significantly greater improvements in generalization post-intervention compared to face-to-face treatment (MD = 11.53; 95% CI: 3.64-19.43; p = 0.004). However, no significant differences were found between telerehabilitation and face-to-face treatment in naming accuracy post-intervention (MD = 3.09; 95% CI: 1.98-8.16; p = 0.23), Western Aphasia Battery (WAB) aphasia quotient (MD = -0.54; 95% CI: -9.96-8.88; p = 0.91), auditory comprehension post-intervention (MD = 0.66; 95% CI: -8.83-10.14; p = 0.89), or functional communication post-intervention (MD = -0.95; 95% CI: -10.19-8.29; p = 0.84). CONCLUSION: In individuals with aphasia, telerehabilitation showed significantly greater improvements in generalization post-intervention compared to face-to-face treatment. However, no significant differences were observed between the 2 approaches in naming accuracy, WAB aphasia quotient, auditory comprehension, or functional communication post-intervention. To validate these findings, further research is needed, and caution should be exercised when interpreting the current results due to the limited number of included studies.
The evolution of transanal approaches in rectal cancer surgery.
Lauricella S, Brucchi F, Cirocchi R
Adv Clin Exp Med · 2025 Dec · PMID 40827934 · Publisher ↗
Minimally invasive techniques are progressively transforming colorectal (CRC) surgery. Given the high mortality and morbidity rates associated with conventional surgical treatments for CRC, the development of less invasi...
Minimally invasive techniques are progressively transforming colorectal (CRC) surgery. Given the high mortality and morbidity rates associated with conventional surgical treatments for CRC, the development of less invasive alternatives is crucial. The long-established use of transanal platforms for local excision of early-stage rectal cancers paved the way for the development of a transanal approach to total mesorectal excision (TME). Transanal total mesorectal excision (taTME) has emerged as a novel technique for treating low CRC, offering superior and more accurate visualization of the presacral mesorectal plane compared to the abdominal approach, and providing particular advantages in the narrow male pelvis. The current data on oncological and functional outcomes are promising. The transanal transection and single-stapled anastomosis (TTSS) approach represents the latest advancement in transanal techniques for treating low CRC. Evolving from taTME, it provides a more controlled and potentially safer anastomotic technique. However, the data are still preliminary, and larger studies are needed to validate its effectiveness. This review explores the evolution of minimally invasive and transanal surgical techniques for low CRC treatment, comparing outcomes across various approaches with a focus on patient selection criteria and oncological results.
Gender identity stories: Experiences and perspectives of transgender people about healthcare system in Spain.
Martinez-Sabater A, Chover-Sierra E, Pozo-Herce PD … +8 more , Tovar-Reinoso A, Cano-Ruiz N, Araujo-Blesa M, Curto-Ramos J, Mora-Navarro G, Martínez-Pascual R, Juárez-Vela R, Carpintero-Blas EG
Adv Clin Exp Med · 2025 Dec · PMID 40827933 · Publisher ↗
BACKGROUND: Despite legal advances and the depathologization of transgender identities, transgender individuals still face significant barriers and discrimination within healthcare systems. A pervasive lack of training i...
BACKGROUND: Despite legal advances and the depathologization of transgender identities, transgender individuals still face significant barriers and discrimination within healthcare systems. A pervasive lack of training in gender diversity among healthcare professionals often results in uncomfortable, even hostile, clinical encounters, exacerbating physical and mental health vulnerabilities. Consequently, fear of stigma and discrimination leads many transgender people to avoid seeking care, placing their wellbeing at further risk due to delayed or foregone medical attention. OBJECTIVES: To explore transgender individuals' perceptions of healthcare professionals' awareness and responsiveness to their care and support needs in the Valencian Community (Spain). MATERIAL AND METHODS: We conducted a descriptive qualitative study with a phenomenological approach in the Valencian Community. Using convenience sampling, we recruited 14 participants. Data were collected between April and June 2022 via in-depth, semi-structured, open-ended interviews. The study comprised 2 sequential phases: An initial focus group session, followed by individual interviews conducted using a snowball sampling technique. RESULTS: We identified 3 thematic domains: T1: Experiences of professional care among transgender individuals; T2: Impact of cisgender-centric regulations within the healthcare system; T3: Gender diversity education needs for healthcare professionals. CONCLUSIONS: The transformation of the health system is urgent to ensure inclusive and equitable care for transgender people. According to the interviews, they consider that better training of professionals will improve their care. In addition, they highlight the need to reduce bureaucratic barriers, create specific protocols, and improve access to specialized treatment. Implementing inclusive public policies will contribute to a fairer and more accessible system.
Revealing the causal relationship between HBV and HCV infection and liver cirrhosis by Mendelian randomization.
Huang JC, Feng YW, Zhao K … +1 more , Dai D
Adv Clin Exp Med · 2025 Dec · PMID 40827932 · Publisher ↗
BACKGROUND: The chronic progression of viral hepatitis and the terminal stage of cirrhosis impose a long-term disease burden on patients. The assessment of liver damage can be facilitated through the measurement of liver...
BACKGROUND: The chronic progression of viral hepatitis and the terminal stage of cirrhosis impose a long-term disease burden on patients. The assessment of liver damage can be facilitated through the measurement of liver biomarkers. OBJECTIVES: To conduct a comprehensive analysis of the relationship between hepatitis B virus (HBV), hepatitis C virus (HCV), liver biomarkers, and cirrhosis via Mendelian randomization (MR). MATERIAL AND METHODS: A bidirectional multi-sample MR approach was used to extract data from publicly available genome-wide association studies (GWAS) databases. Information on liver biomarkers and cirrhosis, along with data from 351,885 HBV samples containing 19,079,722 single nucleotide polymorphisms (SNPs) and 176,698 HCV samples comprising 12,454,320 SNPs, were aggregated. The TwoSampleMR 0.5.7 package in R language facilitated the bidirectional MR analysis, utilizing methods such as inverse-variance weighting, weighted median and MR-Egger to investigate the causal relationships between HBV, HCV, liver biomarkers, and cirrhosis. RESULTS: The MR analysis revealed potential causal relationships between cirrhosis and HBV infection, indicating an increased probability of HBV as cirrhosis escalates (odds ratio (OR) = 1.253; 95% confidence interval (95% CI): 1.037-1.514; p = 0.019). Additionally, a potential causal link was observed between HBV and the level of aspartate aminotransferase (AST), with an increase in HBV leading to a gradual decrease in AST levels (OR = 0.972; 95% CI: 0.958-0.986; p < 0.01). A similar causal relationship was identified between HCV infection and cirrhosis, where the probability of cirrhosis significantly increases with rising HCV levels (OR = 2.213; 95% CI: 1.752-2.796; p < 0.01). The results demonstrated no pleiotropy or heterogeneity within the analysis. CONCLUSIONS: This research highlights a causal relationship between HBV and AST levels, suggesting that monitoring AST levels can indicate the extent of liver damage caused by chronic HBV infection. Additionally, causal connections were established between HBV, HCV and cirrhosis, emphasizing that cirrhosis represents the terminal stage of chronic HBV and HCV infections. By managing the progression of the disease, the risk of cirrhosis can be reduced.
Comparative study of the protective effects of adenosine triphosphate and resveratrol against amiodarone-induced potential liver damage and dysfunction in rats.
Karadogan MT, Yavuzer B, Gursul C … +6 more , Huseynova G, Yazici GN, Gulaboglu M, Yilmaz F, Mendil AS, Suleyman H
Adv Clin Exp Med · 2025 Dec · PMID 40827931 · Publisher ↗
BACKGROUND: Amiodarone is the most commonly used class III antiarrhytmic drug with antiarrhytmic and vasodilator properties. Adenosine triphosphate (ATP) serves as a crucial source of intracellular energy, while resverat...
BACKGROUND: Amiodarone is the most commonly used class III antiarrhytmic drug with antiarrhytmic and vasodilator properties. Adenosine triphosphate (ATP) serves as a crucial source of intracellular energy, while resveratrol is known for its potent antioxidant activity. OBJECTIVES: This study aimed to biochemically, histopathologically and immunohistochemically evaluate the effects of ATP, resveratrol and their combination on potential liver damage and dysfunction induced by amiodarone in rats. MATERIAL AND METHODS: The rats were divided into 6 groups: healthy control (HG), amiodarone alone (ADG), amiodarone + ATP at 2 mg/kg (AAG-2), amiodarone + ATP at 5 mg/kg (AAG-5), resveratrol + amiodarone (RAG), and resveratrol + amiodarone + ATP at 2 mg/kg (RAA-2). Amiodarone (50 mg/kg, orally), ATP (2 mg/kg and 5 mg/kg, intraperitoneally) and resveratrol (25 mg/kg, orally) were administered once daily for 14 days. Following treatment, liver tissues were excised for biochemical analysis. Oxidative stress was assessed by measuring malondialdehyde (MDA) levels, while antioxidant status was evaluated through total glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) levels. To assess liver function, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities were measured in serum samples collected from the animals' tail veins. In addition, liver tissues were subjected to histopathological and immunohistochemical examination to evaluate structural and molecular changes associated with treatment. RESULTS: Amiodarone administration led to a significant increase in oxidative stress markers and a reduction in antioxidant levels in rat liver tissue. Additionally, serum levels of ALT and AST were elevated, indicating liver dysfunction. Histopathological and immunohistochemical analyses revealed severe (grade 3) oxidative damage in the liver tissue. All biochemical parameters in the 5 mg/kg ATP and resveratrol + 2 mg/kg ATP treatment groups were comparable to those observed in the HG group. Histopathological and immunohistochemical evaluations showed a reduction in liver damage severity to grade 2 in the groups treated with ATP (2 mg/kg) and resveratrol alone, and to grade 1 in the groups receiving ATP (5 mg/kg) or the combination of resveratrol + ATP (2 mg/kg). CONCLUSIONS: The results of the present study suggest that adjusting the ATP dosage or using a combination of ATP and resveratrol may be effective strategies for minimizing amiodarone-induced liver damage.
Progress in stem cells mitochondrial proteomics research: A review.
Yao W, Yu X, Wang Y … +1 more , Xia L
Adv Clin Exp Med · 2025 Dec · PMID 40827930 · Publisher ↗
This review summarizes the latest advancements in stem cell (SC) mitochondrial proteomics. With the rapid development of biotechnology, mitochondrial proteomics has emerged as a pivotal area in SC research. The research...
This review summarizes the latest advancements in stem cell (SC) mitochondrial proteomics. With the rapid development of biotechnology, mitochondrial proteomics has emerged as a pivotal area in SC research. The research methods used in mitochondrial proteomics include mass spectrometry (MS), with pre-MS sample processing, MS data acquisition employing both qualitative and quantitative approaches, and bioinformatics analysis to annotate and explore protein functions. In recent years, mitochondrial proteomics research has contributed to the establishment and expansion of our understanding of the roles of various mitochondrial proteins involved in regulating SC differentiation, metabolism and aging, including Drp1, Mfn1/2, OPA1, SIRT3, Bcl-2, YME1L, and PGC-1α. This multidisciplinary approach, combining qualitative and quantitative proteomics with bioinformatics, sheds light on the intricate regulatory mechanisms of mitochondrial proteins in SC. These findings provide a scientific basis for developing novel therapeutic targets and strategies, thereby advancing the field of regenerative medicine and personalized treatment paradigms.
Establishing new boundaries for medical liability: The role of AI as a decision-maker.
Giorgetti C, Giorgetti A, Boscolo-Berto R
Adv Clin Exp Med · 2025 Oct · PMID 40788001 · Publisher ↗
The introduction of artificial intelligence (AI) in healthcare has created novel challenges for the field of medical malpractice. As healthcare professionals increasingly rely on AI in their decision-making processes, tr...
The introduction of artificial intelligence (AI) in healthcare has created novel challenges for the field of medical malpractice. As healthcare professionals increasingly rely on AI in their decision-making processes, traditional medicolegal assessments may struggle to adapt. It is essential to examine AI's role in clinical care - both its current applications and future advancements - to clarify accountability for diagnostic and therapeutic errors. Clinical decision support systems (CDSSs), in particular, unlike other traditional medical technologies, work as co-decision makers alongside physicians. They function through the elaboration of patient information, medical knowledge, learnt patterns, etc., to generate a decision output (e.g., the suggested diagnosis), which should then be evaluated by the physician. In light of the AI Act, CDSSs cannot function fully autonomously, but instead physicians are to be assigned an oversight role. It is questionable, however, whether it would always be appropriate to assign full responsibility, and consequently liability, to the physician. This would be especially true if oversight is limited to reviewing outputs generated by the CDSS in a manner that leaves no real control in the hands of the physician. Future research should aim to define clear liability allocation frameworks and design workflows that ensure effective oversight, thereby preventing unfair liability burdens.
Family medicine: Discovering new fields for research and clinical care in the current world.
Lionis C
Adv Clin Exp Med · 2025 Oct · PMID 40788000 · Publisher ↗
Strengthening primary healthcare (PHC) research is vital to address the demands of a rapidly changing health landscape. Leadership, infrastructure, and sufficient funding have been discussed as key factors in expanding P...
Strengthening primary healthcare (PHC) research is vital to address the demands of a rapidly changing health landscape. Leadership, infrastructure, and sufficient funding have been discussed as key factors in expanding PHC research capacity. This editorial aims to highlight emerging research priorities in a world increasingly affected by crises such as war, conflict, and climate change. Research on suffering, meaning, hope, and compassion represents a promising and necessary new frontier in PHC. This field urgently needs the attention of academic institutions and funding bodies committed to strengthening primary care and family medicine.
Comparison of phonemic awareness in children with auditory processing disorder and children without auditory processing disorder using an objective test for assessing phonemic hearing: A preliminary study.
Konopka AK, Pyttel J, Kasprzyk A … +2 more , Mielnik-Niedzielska G, Niedzielski A
Adv Clin Exp Med · 2026 Feb · PMID 40787999 · Publisher ↗
BACKGROUND: Phonemic awareness is defined as the ability to break down a word into smaller units called phonemes or described as the ability to synthesize words from segments of one's own speech. Impaired phonemic hearin...
BACKGROUND: Phonemic awareness is defined as the ability to break down a word into smaller units called phonemes or described as the ability to synthesize words from segments of one's own speech. Impaired phonemic hearing, depending on the degree of severity, hinders or prevents speech reception, disrupts the proper development of a child's pronunciation, may cause disorders in already developed speech, and complicates the acquisition of writing skills or disturbs the skill that has already been acquired. OBJECTIVES: To create an objectified tool for phonemic hearing diagnostics to ensure that verbal material is always presented at the same intensity, from the same distance, and in the same direction. Another aim was to compare children with and without auditory processing disorder (APD) if they have disrupted phonemic hearing. MATERIAL AND METHODS: A study involving 20 individuals was conducted using a sound level meter to determine the level of the auditory stimulus (therapist's voice) provided to patients during the diagnosis. Each participant in the study was tasked with repeating, in the most natural way for them, 2 pairs of words containing opposing sounds. RESULTS: The analysis revealed significant discrepancies both in the articulation of verbal material by different examiners and in the presentation of the same material by a single examiner using different methods. When the same phonemic opposition was presented in an identical manner by different diagnosticians, amplitude differences of up to 10.8 dB were observed, with a standard deviation (SD) of 2.5 dB. These findings underscored the need to develop an objectified tool for phonemic hearing diagnostics to ensure consistency and reliability in assessment. CONCLUSIONS: In the research group encompassing children with APD, disorders within phonemic hearing occur more frequently and have a deeper nature. Phonemic hearing disorders in children are associated with significant difficulties in learning and daily functioning.
Matrix metalloproteinases and tissue inhibitors of metalloproteinases as potential biomarkers for pulmonary arterial hypertension: A review.
Kozłowska WU, Łomzik J, Kamiński K … +1 more , Kazimierczyk R
Adv Clin Exp Med · 2026 Feb · PMID 40748774 · Publisher ↗
Pulmonary arterial hypertension (PAH) is a rare and progressive syndrome that is frequently diagnosed at an advanced stage due to the nonspecific nature of its symptoms. Current research aims to identify novel diagnostic...
Pulmonary arterial hypertension (PAH) is a rare and progressive syndrome that is frequently diagnosed at an advanced stage due to the nonspecific nature of its symptoms. Current research aims to identify novel diagnostic tools, including biomarkers, to facilitate earlier detection and differentiation of pulmonary hypertension (PH) subtypes. Matrix metalloproteinases (MMPs) play a critical role in the pathogenesis of PAH through extracellular matrix (ECM) remodeling, with their activity tightly regulated by tissue inhibitors of metalloproteinases (TIMPs). This review summarizes existing studies on the potential of MMPs and TIMPs as biomarkers for PAH. Our analysis highlights significant differences in MMP concentrations between PAH patients and healthy controls. In particular, MMP-2, MMP-7 and MMP-9 exhibit promising prognostic value, which could contribute to risk stratification and support clinical decision-making in the future. However, large-scale, randomized prospective studies involving well-characterized patient cohorts are necessary to confirm their clinical utility and clarify their mechanistic roles in PAH pathogenesis.
Immunogenic mutanome of breast cancer: Advances, challenges and future directions in neoantigen-based immunotherapy.
Alkayyal AA, Saeedi NH, Moawadh MS
Adv Clin Exp Med · 2026 Feb · PMID 40748773 · Publisher ↗
Breast cancer (BC) remains a leading cause of cancer-related mortality worldwide, underscoring the need for novel, more effective therapies. Neoantigen-based immunotherapy - which harnesses tumor-specific somatic mutatio...
Breast cancer (BC) remains a leading cause of cancer-related mortality worldwide, underscoring the need for novel, more effective therapies. Neoantigen-based immunotherapy - which harnesses tumor-specific somatic mutations to boost immune recognition - has emerged as a particularly promising strategy. Advances in next-generation sequencing and computational immunopeptidomics now allow systematic mapping of the tumor mutanome and rapid identification of immunogenic neoantigens, enabling personalized vaccine design and more precise deployment of immune-checkpoint blockade. However, intratumor heterogeneity, immune-escape mechanisms and the often-limited intrinsic immunogenicity of individual neoepitopes continue to constrain clinical efficacy. This review synthesizes the current landscape of neoantigen-targeted immunotherapies in BC, outlines the principal obstacles to their broader impact and highlights emerging solutions - including improved epitope-prediction algorithms, multi-epitope vaccine constructs and synergistic combination regimens. A deeper understanding of the immunogenic mutanome is expected to translate into more durable and widely applicable treatments for patients with breast cancer.
The diagnostic performance of shear-wave elastography combined with ultrasound and magnetic resonance imaging in breast lesions: A single center retrospective study.
Zhou WY, Zhang LL, Zhou X … +2 more , Pan XB, Qi LX
Adv Clin Exp Med · 2026 Jan · PMID 40748772 · Publisher ↗
BACKGROUND: Breast cancer remains a major healthcare challenge, highlighting the need for early and accurate diagnosis. Shear-wave elastography (SWE), an ultrasound-based imaging technique that quantifies tissue elastici...
BACKGROUND: Breast cancer remains a major healthcare challenge, highlighting the need for early and accurate diagnosis. Shear-wave elastography (SWE), an ultrasound-based imaging technique that quantifies tissue elasticity, has emerged as a promising tool. Recent studies suggest that SWE may provide additional diagnostic value when used alongside conventional imaging methods. OBJECTIVES: This study aimed to assess the diagnostic performance of SWE when combined with conventional ultrasound and magnetic resonance imaging (MRI) in the evaluation of breast lesions. MATERIAL AND METHODS: This retrospective study included patients with breast lesions who underwent SWE, conventional ultrasound and MRI. The diagnostic performance of each modality was evaluated individually and in combination. Histopathological results served as the gold standard for diagnosis. Key performance metrics - sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy - were calculated for each imaging approach. RESULTS: A total of 99 patients were included in the study, comprising 64 with benign lesions and 35 with malignant lesions. Malignant lesions were generally larger and exhibited distinct imaging characteristics across ultrasound, SWE and MRI. When assessed individually, SWE, ultrasound and MRI showed comparable diagnostic accuracy (64.6%, 62.6% and 62.6%, respectively). However, combining all 3 modalities significantly improved diagnostic performance, yielding sensitivity, specificity, PPV, NPV, and overall accuracy of 94.3%, 89.1%, 82.5%, 96.6%, and 90.9%, respectively (p < 0.001). The area under the curve (AUC) for the combined approach was significantly higher than for any single modality (0.917 vs 0.642, 0.627 and 0.633; p < 0.001). CONCLUSIONS: While SWE alone offers diagnostic performance comparable to that of ultrasound and MRI individually, its greatest value lies in combination with these imaging modalities. Integrating ultrasound, SWE and MRI significantly enhances diagnostic accuracy, sensitivity and specificity, offering a promising multimodal approach for more reliable differentiation between benign and malignant breast lesions.
Risk assessment of human monkeypox infections: A systematic review and meta-analysis.
Wang Y, Wang J
Adv Clin Exp Med · 2026 Jan · PMID 40748771 · Publisher ↗
BACKGROUND: Human monkeypox is a zoonotic disease with increasing global prevalence. Although several studies have identified its potential risk factors, findings remain inconsistent, highlighting the need for a systemat...
BACKGROUND: Human monkeypox is a zoonotic disease with increasing global prevalence. Although several studies have identified its potential risk factors, findings remain inconsistent, highlighting the need for a systematic evaluation. OBJECTIVES: To systematically investigate risk factors associated with human monkeypox infections using meta-analysis. MATERIAL AND METHODS: A comprehensive search of PubMed, Scopus, Web of Science, Embase, and The Cochrane Library databases was conducted on all records up to February 19, 2024. Eligible studies assessing risk factors for monkeypox were included. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated, and heterogeneity was evaluated using I2 statistics. RESULTS: Of the 1,844 articles identified, 9 studies met the inclusion criteria after screening, no publication bias was identified, and the meta-analysis results showed strong robustness. Human immunodeficiency virus (HIV) infection significantly increased monkeypox risk (OR = 2.21, 95% CI: 1.13-4.34, p = 0.02, I2 = 93%). Concurrent sexually transmitted infections (STIs) were also a significant risk factor (OR = 1.84, 95% CI: 1.46-2.33), as was body mass index (BMI) higher than 30 kg/m2 (OR = 1.18, 95% CI: 0.19-7.53, p = 0.86), lower economic status (OR = 0.33, 95% CI: 0.01-9.36, p = 0.52), education level (OR = 0.74, 95% CI: 0.30-1.79, p = 0.50), or men who have sex with men (MSM) status (OR = 1.22, 95% CI: 0.84-1.75, p = 0.29). CONCLUSION: HIV infection and concurrent STIs significantly increase monkeypox risk, underscoring the need for targeted prevention, including screening and risk reduction strategies in vulnerable populations, particularly MSM.
Best practice approaches to social prescribing in European Primary Care: A Delphi protocol focused on link workers.
Petrazzuoli F, Vidal-Alaball J, Kenkre J … +21 more , Kloppe T, Evers S, Napierala H, Jacquet JP, Herrmann WJ, Mrduljaš-Đujić N, Neculau A, Javorska K, Halata D, Dolan M, Robins J, Ouvrard P, Mendive JM, Fando CL, Randall-Smith J, Rebhandl E, Paternoster S, Thulesius H, Brand S, Dumitra G, Kurpas D
Adv Clin Exp Med · 2025 Sep · PMID 40748770 · Publisher ↗
INTRODUCTION: Social prescribing (SP) is an innovative model that connects individuals to non-clinical community resources. However, its uptake and evaluation have been hindered by inconsistent role definitions for key s...
INTRODUCTION: Social prescribing (SP) is an innovative model that connects individuals to non-clinical community resources. However, its uptake and evaluation have been hindered by inconsistent role definitions for key stakeholders. Although recent studies have refined SP definitions, outside the UK, the responsibilities, educational backgrounds and training requirements of social prescribing link workers (SPLWs) remain poorly defined. Additionally, it is essential to identify which patient populations will benefit most from SP, establish specific methodologies, and standardize assessment tools and referral pathways. MATERIAL AND METHODS: We will employ a 3-round Delphi protocol with an international expert panel to establish consensus on SP definitions. Approximately 60 participants from diverse disciplines and regions will be recruited to complete multiple survey rounds, providing insights into the roles of SPLWs, beneficiary populations, methodologies, and assessment tools. Consensus will be defined as at least 80% agreement on a 5-point Likert scale. Data collection and analysis will follow rigorous protocols to ensure validity, reliability and transparency, in accordance with the Guidance on Conducting and REporting DElphi Studies (CREDES) guidelines. OBJECTIVES: The aim of this research is to unify the fragmented understanding of SP and the role of SPLWs, thereby establishing a foundation for integrating SPLWs into healthcare systems where appropriate. The Delphi technique offers key strengths - namely, participant anonymity and structured iterative feedback - to enable robust consensus building. While we acknowledge limitations such as potential participant attrition and the resource-intensive nature of the methodology, these will be mitigated through targeted engagement strategies and strict adherence to established best practices. CONCLUSION: This study addresses critical gaps in SP engagement, conceptual understanding and implementation. The anticipated outcomes will reinforce SP's role in community-based, integrated care to reduce health inequalities and foster social cohesion across Europe and beyond. Ultimately, this work aims to enhance the uptake and adoption of SP in primary care.
Caregivers' perspectives on long-term cognitive, psychiatric, psychological, and social outcomes in NMDAR encephalitis: Initial findings from the multi-center prospective SAPIENCE study.
Duda-Sikuła M, Boeken OJ, Patricio V … +8 more , Buttard C, Benaiteau M, Mendes A, Honnorat J, Easton A, Dalmau J, Finke C, Kurpas D
Adv Clin Exp Med · 2025 Aug · PMID 40748769 · Publisher ↗
The SAPIENCE study explores the long-term psychological, social, and systemic challenges faced by caregivers of individuals with NMDAR encephalitis. It aims to inform patientand caregiver-centered strategies that support...
The SAPIENCE study explores the long-term psychological, social, and systemic challenges faced by caregivers of individuals with NMDAR encephalitis. It aims to inform patientand caregiver-centered strategies that support recovery and wellbeing.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe