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Volume 13, September
 
 

Med. Sci., Volume 13, Issue 4 (December 2025) – 5 articles

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40 pages, 5440 KB  
Review
Right Heart Failure in Critical and Chronic Care: Current Concepts, Challenges and Mechanical Support Strategies
by Debora Emanuela Torre and Carmelo Pirri
Med. Sci. 2025, 13(4), 210; https://doi.org/10.3390/medsci13040210 (registering DOI) - 28 Sep 2025
Abstract
Right heart failure (RHF) remains an under-recognized yet devastating condition in critically ill and chronic patients, frequently complicating cardiac surgery, pulmonary embolism, advanced heart failure, sepsis and left ventricular assist device (LVAD) implantation. Despite growing awareness, clinical decision making is still hampered by [...] Read more.
Right heart failure (RHF) remains an under-recognized yet devastating condition in critically ill and chronic patients, frequently complicating cardiac surgery, pulmonary embolism, advanced heart failure, sepsis and left ventricular assist device (LVAD) implantation. Despite growing awareness, clinical decision making is still hampered by the complex pathophysiology, limitations in diagnosis and a fragmented therapeutic landscape. In recent years, progress in hemodynamic phenotyping, advanced echocardiographic and biomarker-based assessment, and the development of mechanical circulatory support (MCS) systems, including percutaneous and surgical right ventricle assist devices (RVAD), veno-arterial extracorporeal membrane oxygenation (V-A ECMO), Impella RP (right percutaneous) or BiPella (Impella CP/5.0/5.5 + Impella RP) has expanded the armamentarium for managing RHF. This review synthetizes current evidences on the anatomical, physiological and molecular underpinnings of RHF, delineates the distinction and continuum between acute and chronic forms and provides a comparative analysis of diagnostic tools and MCS strategies. By integrating mechanistic insights with emerging clinical frameworks, the review aims to support earlier recognition, tailored management and innovative therapeutic approaches for this high-risk population. Full article
(This article belongs to the Section Cardiovascular Disease)
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10 pages, 1366 KB  
Article
Immunotropic Effects of Steroid Hormone Medicines in Combination with Plasma-Treated Solution in Women of a Reproductive Age and Postmenopausal Women
by Tatyana Ivanovna Pavlik, Nadejda Maximovna Kostukova, Darya Andreevna Razvolyaeva, Evgeny Mikhaylovich Konchekov, Leonid Viktorovich Kolik, Namik Guseinaga-ogly Gusein-zade and Nikolai L’vovich Shimanovskii
Med. Sci. 2025, 13(4), 209; https://doi.org/10.3390/medsci13040209 - 24 Sep 2025
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Abstract
Background: Steroidal glucocorticoid and gestagenic drugs and cold plasma-treated solutions (PTSs) are known to exert anti-inflammatory effects by influencing the production of a number of cytokines. The aim of this work was to test their independent and combined effects exerted on the production [...] Read more.
Background: Steroidal glucocorticoid and gestagenic drugs and cold plasma-treated solutions (PTSs) are known to exert anti-inflammatory effects by influencing the production of a number of cytokines. The aim of this work was to test their independent and combined effects exerted on the production of cytokines IL-1, IL-6, TNF-α, TGF-β, and IL-10 and reactive oxygen and nitrogen species (RONS) by leukocytes in women of a reproductive age and postmenopausal women. Methods: ELISA and chemiluminescence methods were used for this purpose. Results: PTS reduced IL-6 and RONS production by 50% and increased IL-10 production 2-fold in postmenopausal women, and it reduced IL-6 production by 80% and RONS production by 50% in women of reproductive age. When PTS and steroid hormonal drugs are used together, there is a general suppression of cytokine and oxidant activity. Conclusions: PTS reduces the production of inflammatory factors by leukocytes and stimulates the production of anti-inflammatory factors, more so in postmenopausal women. Progestins showed greater suppression of pro-inflammatory cytokine and RONS formation and stimulation of anti-inflammatory cytokines for women of reproductive age and dexamethasone showed such results for postmenopausal women. Full article
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12 pages, 1635 KB  
Article
Penile Scintigraphy—A Diagnostic Method for Vasculogenic Erectile Dysfunction
by Nina Kulchenko, Daniil Yuferov, Farid Mangutov, Dmitri Kruglov, Elina Korovyakova, Petr Shegai, Andrei Kaprin and Grigory Demyashkin
Med. Sci. 2025, 13(4), 208; https://doi.org/10.3390/medsci13040208 - 24 Sep 2025
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Abstract
Background: Erectile dysfunction (ED) is a disease whose occurrence is steadily increasing worldwide. This pathology is multifactorial and often combined with other diseases. ED of organic genesis in 50–80% of men is vasculogenic. Methods: A survey was conducted of 88 men (aged [...] Read more.
Background: Erectile dysfunction (ED) is a disease whose occurrence is steadily increasing worldwide. This pathology is multifactorial and often combined with other diseases. ED of organic genesis in 50–80% of men is vasculogenic. Methods: A survey was conducted of 88 men (aged 44 to 62) who complained of erectile dysfunction. It consisted of a questionnaire administered according to the protocols “International Index of Erectile Function” and “Aging Male Screening”, and was followed by a color Doppler ultrasound (Logiq 9 ExpertGE with a 7 MHz linear transducer using B mode) and penile scintigraphy (single-photon emission computed tomography). The procedures were initially performed at rest, then during pharmacologically induced erection, which was achieved through the intake of phosphodiesterase-5 (PDE5) inhibitors. Patients who did not respond to pharmacological stimulation and had IIEF scores below 5–7 were offered surgical treatment—penile prosthesis followed by histological examination of the tissue of the corpus cavernosum. Statistical analysis was carried out using Microsoft Excel and STATISTICA 10.0 software. The Mann–Whitney U test was used to assess differences between quantitative variables, with the significance level set at p ≤ 0.05. Results: Penile scintigraphy shows high sensitivity (85.2%) and specificity (83.3%), outperforming color Doppler ultrasonography in detecting vasculogenic ED. Conclusion: Penile scintigraphy is demonstrated to be a highly informative method, allowing us to analyze the condition of the magistral and organ blood flow, as well as the microcirculatory bed of the cavernous bodies of the penis. This improves the effectiveness of this method in diagnosing various types of vasculogenic erectile dysfunction (ED), which opens opportunities for its use together with ultrasound examination when the latter is less informative. Full article
(This article belongs to the Section Nephrology and Urology)
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18 pages, 4077 KB  
Systematic Review
Prevalence and Epidemiological Patterns of Enterobius vermicularis Infection in Thailand: A Systematic Review and Meta-Analysis
by Jurairat Jongthawin, Aongart Mahittikorn, Apiporn Thinkhamrop Suwannatrai, Chutima Rattanawan, Kinley Wangdi, Frederick Ramirez Masangkay and Manas Kotepui
Med. Sci. 2025, 13(4), 207; https://doi.org/10.3390/medsci13040207 - 24 Sep 2025
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Abstract
Background: Enterobiasis, caused by Enterobius vermicularis, is recognized as a common intestinal helminthiasis worldwide. Despite multiple surveys in Thailand, no pooled synthesis at the country level has been carried out to evaluate prevalence patterns, temporal trends, or vulnerable groups. Therefore, this systematic [...] Read more.
Background: Enterobiasis, caused by Enterobius vermicularis, is recognized as a common intestinal helminthiasis worldwide. Despite multiple surveys in Thailand, no pooled synthesis at the country level has been carried out to evaluate prevalence patterns, temporal trends, or vulnerable groups. Therefore, this systematic review and meta-analysis were undertaken to provide an updated and comprehensive estimate of the prevalence of E. vermicularis in Thailand and to identify high-risk populations for targeted interventions. Methods: The systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO: CRD420251053217). Studies reporting E. vermicularis infection in Thailand were systematically searched in international and Thai databases. Pooled prevalence and odds ratios (ORs) were calculated using random-effects models. Subgroup analyses and meta-regression were performed according to year, region, age, population type, and diagnostic method. Results: A total of 56 studies, including 52,765 participants, were analyzed. The overall pooled prevalence was estimated at 3.6% (95% confidence interval [CI]: 2.1–5.9%), with a decline observed in the subgroup analysis by publication year, from 4.75% in 2000–2009 to 1.15% in 2020–2023. The highest prevalence was reported in Central Thailand (7.93%). High infection rates were found among immigrant children (25.2%), hilltribe children (19.9%), Karen students (15.5%), and children in orphanages (11.4%). A markedly higher prevalence was detected by the Scotch tape method compared with direct smear/concentration (12.9% vs. 0.33%). No significant difference in infection risk was observed between males and females (OR = 1.03, p = 0.65). Conclusions: The pooled prevalence of E. vermicularis in Thailand was estimated at 3.6%, but this figure should be interpreted with caution due to high heterogeneity across studies. More meaningful insights were identified in subgroup analyses, which revealed a temporal decline in prevalence, geographic clustering in Central Thailand, and disproportionately high infection rates among socioeconomically disadvantaged child populations. No statistically significant association was found between gender and risk of infection. These patterns underscore the need for targeted screening, deworming, and hygiene interventions, along with the standardized use of the Scotch tape technique for accurate surveillance and comparability of future studies. Full article
(This article belongs to the Section Immunology and Infectious Diseases)
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23 pages, 1440 KB  
Systematic Review
Diagnostic and Prognostic Potential of Tetranectin in Heart Failure and Cardiovascular Disease: A Systematic Review
by Paula Alexandra Vulciu, Luminita Pilat, Maria-Daniela Mot, Paula Irina Barata, Imola Donath Mikos, Mos Raluca Stefana Ioana, Alexandru Alexandru, Cristiana-Smaranda Ivan, Norberth-Istvan Varga, Narcisa Carmen Mladin and Maria Puschita
Med. Sci. 2025, 13(4), 206; https://doi.org/10.3390/medsci13040206 - 24 Sep 2025
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Abstract
Background: Tetranectin (CLEC3B), a plasminogen-binding protein involved in fibrinolysis and tissue remodeling, has been increasingly studied as a potential diagnostic and prognostic biomarker in cardiovascular disease (CVD). This review synthesizes current evidence on its clinical utility across heart failure (HF), coronary artery disease [...] Read more.
Background: Tetranectin (CLEC3B), a plasminogen-binding protein involved in fibrinolysis and tissue remodeling, has been increasingly studied as a potential diagnostic and prognostic biomarker in cardiovascular disease (CVD). This review synthesizes current evidence on its clinical utility across heart failure (HF), coronary artery disease (CAD), and related conditions. Objectives: To systematically evaluate and synthesize published clinical evidence on the diagnostic and prognostic value of tetranectin in cardiovascular diseases. Methods: A systematic search of PubMed, Google Scholar, and Scopus (January 2010–June 2025) identified original human studies examining associations between tetranectin (CLEC3B) and cardiovascular diseases, including heart failure, coronary artery disease, myocardial infarction, and cardiometabolic conditions. Eligible studies included adult cohorts with observational designs; experimental, in vitro, and pediatric studies were excluded. Two reviewers independently extracted data on study design, population characteristics, biomarker assessment, and outcomes, resolving discrepancies by consensus. Results: Twelve studies were included. Tetranectin levels were consistently lower in patients with CAD, MI, and advanced HF compared to controls. Higher circulating TN levels were associated with reduced risk of HF onset, cardiovascular death, and hospitalization. In two studies, combining tetranectin with NT-proBNP improved diagnostic accuracy over NT-proBNP alone. Mechanistic studies revealed correlations between TN expression and fibrosis-related gene pathways, supporting its biological relevance. Conclusions: Tetranectin shows consistent promise as a diagnostic and prognostic biomarker in cardiovascular disease, particularly in heart failure and coronary artery disease. Its involvement in fibrotic remodeling, plasminogen activation, and vascular homeostasis underlines biological pathways relevance. Combining tetranectin with established biomarkers may improve cardiovascular risk stratification and guide more personalized therapeutic strategies. Further large-scale and longitudinal studies are needed to validate its clinical utility across diverse settings. Full article
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