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20 pages, 1115 KB  
Article
Inflammatory Insights: Analysis of a Fecal Biomarker in Neurodegenerative and Gastrointestinal Disorders
by Anca Chisoi, Nicolae Dobrin, Georgeta-Camelia Cozaru, Anita-Cristina Ionescu, Mariana Aschie, Lidia Kajanto, Sabina Elena Vlad, Manuela Enciu, Ion Alexandru Popovici and Bogdan Cîmpineanu
Biomedicines 2025, 13(10), 2411; https://doi.org/10.3390/biomedicines13102411 - 1 Oct 2025
Viewed by 296
Abstract
Background/Objectives: Inflammatory bowel disease (IBD) and Parkinson’s disease (PD) are chronic disorders affecting different organs, and evidence has proposed a bidirectional link between them. Fecal calprotectin, which reflects intestinal inflammation and gut barrier injury, is augmented in different neurodegenerative diseases, including PD. [...] Read more.
Background/Objectives: Inflammatory bowel disease (IBD) and Parkinson’s disease (PD) are chronic disorders affecting different organs, and evidence has proposed a bidirectional link between them. Fecal calprotectin, which reflects intestinal inflammation and gut barrier injury, is augmented in different neurodegenerative diseases, including PD. In this study, we aimed to investigate whether fecal calprotectin levels in PD increase independently of gastrointestinal inflammation and aging. Methods: Fecal calprotectin values were compared in two groups (PD and IBD) of 30 patients each, taking into consideration variables such as endoscopic aspects and age. Analyses of fecal calprotectin levels in PD patients show an increase with advancing age, which was not observed in the IBD cohort. Results: Most PD patients had fecal calprotectin values exceeding 200 μg/g (mean value 366.25 μg/g), and their levels were comparable to those of patients with inflammatory bowel disease (Ulcerative Colitis, Crohn’s Disease, mean value 537.70 μg/g). In the PD cohort, a weak positive association between calprotectin levels and inflammatory signs was observed, and in the IBD cohort, higher calprotectin levels were strongly associated with more severe endoscopic modifications. Conclusions: This weak but positive correlation with intestinal inflammation in PD patients suggests the involvement of complex mechanisms, other than those related to inflammaging or gut barrier injuries. Full article
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20 pages, 2814 KB  
Review
From Gut to Lungs: The Hidden Respiratory Impacts of IBD: A Systematic Review of the Literature
by Ionela Preotesoiu, Luana Alexandrescu, Bogdan Cimpineanu, Ioan Tiberiu Tofolean, Ionut Valentin Stanciu, Alexandra Herlo, Eugen Dumitru, Daria Maria Alexandrescu, Elena Dina, Cristina Daniela Aftenie, Andreea Nelson Twakor and Doina Ecaterina Tofolean
Int. J. Mol. Sci. 2025, 26(18), 8912; https://doi.org/10.3390/ijms26188912 - 12 Sep 2025
Viewed by 487
Abstract
Pulmonary complications are an important yet underappreciated aspect of inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC). These conditions often manifest with extraintestinal symptoms that can significantly influence the clinical trajectory of the disease. Pulmonary involvement in IBD [...] Read more.
Pulmonary complications are an important yet underappreciated aspect of inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC). These conditions often manifest with extraintestinal symptoms that can significantly influence the clinical trajectory of the disease. Pulmonary involvement in IBD can range from mild symptoms, such as a persistent cough, to severe conditions, including interstitial lung disease or pulmonary embolism. This systematic review aims to assess the prevalence, clinical presentations, and implications of pulmonary involvement in IBD patients. A comprehensive literature search was conducted using PubMed database up to the 1st of May 2024. Inclusion criteria focused on studies involving adult IBD patients with documented pulmonary symptoms, evaluated through clinical, radiological, and histopathological approaches. Of the 463 studies identified, 27 met the inclusion criteria, consisting of 36,264 patients. Pulmonary manifestations were classified into airway diseases and parenchymal involvement. Airway diseases, including bronchiectasis and chronic bronchitis, were the most common, followed by parenchymal conditions such as organizing pneumonia and interstitial lung disease (ILD). Smoking was identified as a significant risk factor for pulmonary involvement. Pulmonary involvement in IBD is diverse and often underdiagnosed. Early recognition and management are crucial to improving patient outcomes. Full article
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12 pages, 1831 KB  
Article
Serum Vitamin D Levels as Predictors of Response to Intravitreal Anti-VEGF Therapy in Diabetic Macular Edema: A Clinical Correlation Study
by Nejla Dervis, Sanda Jurja, Tatiana Chisnoiu, Cristina Maria Mihai and Ana Maria Stoica
Int. J. Mol. Sci. 2025, 26(17), 8481; https://doi.org/10.3390/ijms26178481 - 1 Sep 2025
Viewed by 526
Abstract
Our study explored the role of serum 25-hydroxyvitamin D [25(OH)D] levels as an indicator of response to intravitreal anti–vascular endothelial growth factor (anti-VEGF) therapy in patients with diabetic macular edema (DME), highlighting functional and anatomical outcomes linked to systemic biomarker profiles. In a [...] Read more.
Our study explored the role of serum 25-hydroxyvitamin D [25(OH)D] levels as an indicator of response to intravitreal anti–vascular endothelial growth factor (anti-VEGF) therapy in patients with diabetic macular edema (DME), highlighting functional and anatomical outcomes linked to systemic biomarker profiles. In a cohort of treatment-naive diabetic patients, vitamin D status was correlated with post-treatment changes in central macular thickness (CMT) and best-corrected visual acuity (BCVA), illustrating layered therapeutic responses among deficient, insufficient, and sufficient vitamin D groups. Functional gains, measured as improvements in decimal BCVA, and anatomical improvements, defined by CMT reduction via spectral-domain optical coherence tomography (SD-OCT), were primarily detected in patients with sufficient vitamin D levels. Remarkably, patients with serum 25(OH)D ≥ 30 ng/mL revealed complete dual-response rates, while those in the deficient group manifested partial therapeutic efficacy, supporting the immunoangiogenic modulatory role of vitamin D. Statistical associations exposed a tight linear connection between baseline and final visual acuity and a pronounced inverse relationship between CMT and final vision, suggesting that vitamin D may play a role in treatment-mediated structural recovery. These results may imply that low vitamin D levels lead to subclinical endothelial dysfunction and impaired retinal barrier repair, possibly through dysregulated anti–vascular endothelial growth factor (anti-VEGF) signaling, chronic inflammation, and oxidative stress. Our findings underscore the need for and importance of further research of vitamin D status as an adjunctive biomarker in the clinical approach of personalized DME and validates the potential of circulating vitamin D evaluation in therapeutic classification and predictive eye care. Full article
(This article belongs to the Special Issue Molecular Diagnosis and Treatments of Diabetes Mellitus: 2nd Edition)
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19 pages, 1324 KB  
Review
Smart Microbiomes: How AI Is Revolutionizing Personalized Medicine
by Luana Alexandrescu, Ionut Tiberiu Tofolean, Laura Maria Condur, Doina Ecaterina Tofolean, Alina Doina Nicoara, Lucian Serbanescu, Elena Rusu, Andreea Nelson Twakor, Eugen Dumitru, Andrei Dumitru, Cristina Tocia, Lucian Flavius Herlo, Daria Maria Alexandrescu and Alina Mihaela Stanigut
Bioengineering 2025, 12(9), 944; https://doi.org/10.3390/bioengineering12090944 - 31 Aug 2025
Viewed by 1227
Abstract
Background: Recent studies have shown that gut microbiota have important roles in different human diseases. There has been an ever-increasing application of high-throughput technologies for the characterization of microbial ecosystems. This led to an explosion of various molecular profiling data, and the analysis [...] Read more.
Background: Recent studies have shown that gut microbiota have important roles in different human diseases. There has been an ever-increasing application of high-throughput technologies for the characterization of microbial ecosystems. This led to an explosion of various molecular profiling data, and the analysis of such data has shown that machine-learning algorithms have been useful in identifying key molecular signatures. Results: In this review, we first analyze how dysbiosis of the intestinal microbiota relates to human disease and how possible modulation of the gut microbial ecosystem may be used for disease intervention. Further, we introduce categories and the workflows of different machine-learning approaches and how they perform integrative analysis of multi-omics data. Last, we review advances of machine learning in gut microbiome applications and discuss challenges it faces. Conclusions: We conclude that machine learning is indeed well suited for analyzing gut microbiome and that these approaches are beneficial for developing gut microbe-targeted therapies, helping in achieving personalized and precision medicine. Full article
(This article belongs to the Section Biosignal Processing)
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30 pages, 4082 KB  
Systematic Review
Ethanol-Induced Dysbiosis and Systemic Impact: A Meta-Analytical Synthesis of Human and Animal Research
by Luana Alexandrescu, Ionut Tiberiu Tofolean, Doina Ecaterina Tofolean, Alina Doina Nicoara, Andreea Nelson Twakor, Elena Rusu, Ionela Preotesoiu, Eugen Dumitru, Andrei Dumitru, Cristina Tocia, Alexandra Herlo, Daria Maria Alexandrescu, Ioana Popescu and Bogdan Cimpineanu
Microorganisms 2025, 13(9), 2000; https://doi.org/10.3390/microorganisms13092000 - 27 Aug 2025
Viewed by 762
Abstract
Background: Chronic ethanol consumption is a major global health concern traditionally associated with liver disease. Ethanol disrupts gut microbial communities, compromises intestinal barrier function, and contributes to hepatic, metabolic, and neurocognitive disorders. Methods: We conducted a systematic PubMed search and meta-analysis of 11 [...] Read more.
Background: Chronic ethanol consumption is a major global health concern traditionally associated with liver disease. Ethanol disrupts gut microbial communities, compromises intestinal barrier function, and contributes to hepatic, metabolic, and neurocognitive disorders. Methods: We conducted a systematic PubMed search and meta-analysis of 11 human and 19 animal studies evaluating ethanol-induced gut microbiota alterations. Studies were assessed for microbial diversity, taxonomic shifts, barrier integrity, and systemic effects. Effect sizes were calculated where possible, and interventional outcomes were examined. Results: Across species, ethanol exposure was consistently associated with reduced microbial diversity and depletion of beneficial commensals such as Faecalibacterium, Lactobacillus, Akkermansia, and Bifidobacterium, alongside an expansion of proinflammatory taxa (Proteobacteria, Enterococcus, Veillonella). Our analysis uniquely highlights discrepancies between human and animal studies, including opposite trends in specific genera (e.g., Akkermansia and Bifidobacterium) and the impact of confounders such as antibiotic exposure in human cohorts. We also demonstrate that microbiota-targeted interventions can partially restore diversity and improve clinical or behavioral outcomes. Conclusions: This meta-analysis highlights reproducible patterns of ethanol-induced gut dysbiosis across both human and animal studies. Full article
(This article belongs to the Special Issue Effects of Diet and Nutrition on Gut Microbiota)
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21 pages, 1307 KB  
Review
Spontaneous Coronary Artery Dissection Unveiled: Pathophysiology, Imaging, and Evolving Management Strategies
by Constantin Andrei Rusali, Ioana Caterina Lupu, Lavinia Maria Rusali and Lucia Cojocaru
J. Cardiovasc. Dev. Dis. 2025, 12(8), 286; https://doi.org/10.3390/jcdd12080286 - 28 Jul 2025
Viewed by 912
Abstract
Spontaneous coronary artery dissection (SCAD) is an increasingly recognized, non-atherosclerotic cause of acute coronary syndrome (ACS), particularly in younger women. This comprehensive review outlines SCAD’s unique pathophysiology, which is linked to underlying arteriopathies like fibromuscular dysplasia, and highlights the critical role of advanced [...] Read more.
Spontaneous coronary artery dissection (SCAD) is an increasingly recognized, non-atherosclerotic cause of acute coronary syndrome (ACS), particularly in younger women. This comprehensive review outlines SCAD’s unique pathophysiology, which is linked to underlying arteriopathies like fibromuscular dysplasia, and highlights the critical role of advanced intravascular imaging for accurate diagnosis. A fundamental shift in management is detailed, with evidence favoring a conservative strategy for stable patients due to high rates of spontaneous vessel healing, reserving technically challenging invasive interventions for high-risk cases. Importantly, this review also addresses long-term outcomes, noting significant rates of recurrence and Major Adverse Cardiac Events (MACE), a high prevalence of persistent chest pain, and the central role of beta-blocker therapy in secondary prevention. Ultimately, SCAD requires a departure from standard ACS protocols towards a personalized approach that emphasizes accurate diagnosis, cautious initial management, and vigilant long-term follow-up. Full article
(This article belongs to the Special Issue Coronary Arterial Anomalies)
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21 pages, 4061 KB  
Case Report
Hydatid Cyst in Pregnancy—A Diagnostic and Therapeutic Dilemma: Study Case Report
by Liliana Steriu, Ionut Eduard Iordache, Antonia Bisinicu, Bianca Andreea Steriu, Gabriela Baltatescu, Andreea Nelson Twakor, Eugen Dumitru and Vlad Tica
J. Clin. Med. 2025, 14(14), 5073; https://doi.org/10.3390/jcm14145073 - 17 Jul 2025
Cited by 1 | Viewed by 1142
Abstract
Background: Hydatid disease, caused by the larval form of Echinococcus granulosus, is a rare but potentially life-threatening condition during pregnancy, with an estimated incidence of 1 in 20,000 to 30,000 gestations. Physiological immunosuppression and increased placental steroid levels during pregnancy may promote cyst [...] Read more.
Background: Hydatid disease, caused by the larval form of Echinococcus granulosus, is a rare but potentially life-threatening condition during pregnancy, with an estimated incidence of 1 in 20,000 to 30,000 gestations. Physiological immunosuppression and increased placental steroid levels during pregnancy may promote cyst growth, elevating the risk of rupture, which can result in anaphylactic shock, sepsis, or widespread peritoneal dissemination. Diagnostic imaging, particularly ultrasonography, plays a central role in detection, while treatment decisions are complicated by the lack of standardized guidelines and the need to balance maternal–fetal safety. Methods: This case report describes a 29-year-old pregnant woman at 22 weeks’ gestation who was incidentally diagnosed with two large hepatic hydatid cysts during a routine ultrasound. Results: Given the high rupture risk, she underwent successful laparoscopic surgery in the second trimester, followed by careful monitoring and elective cesarean delivery at term. A third retroperitoneal cyst, initially managed conservatively, was excised postpartum. Conclusions: This case highlights the critical importance of individualized, multidisciplinary management in achieving favorable maternal and neonatal outcomes in complex presentations of hydatid disease during pregnancy. Full article
(This article belongs to the Section Obstetrics & Gynecology)
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30 pages, 1177 KB  
Review
Recent Preclinical Evidence on Phytocannabinoids in Neurodegenerative Disorders: A Focus on Parkinson’s and Alzheimer’s Disease
by Nicoleta-Mirela Blebea, Ciprian Pușcașu, Gabriel Hancu, Alina Mihaela Stăniguț and Cornel Chiriță
Pharmaceuticals 2025, 18(6), 890; https://doi.org/10.3390/ph18060890 - 13 Jun 2025
Viewed by 2427
Abstract
The endocannabinoid system (ECS) is a vital biological network essential for maintaining homeostasis and supporting various physiological functions. It comprises cannabinoid receptors, endogenous lipid-based ligands, known as endocannabinoids, as well as metabolic enzymes and associated proteins responsible for regulating their levels within tissues. [...] Read more.
The endocannabinoid system (ECS) is a vital biological network essential for maintaining homeostasis and supporting various physiological functions. It comprises cannabinoid receptors, endogenous lipid-based ligands, known as endocannabinoids, as well as metabolic enzymes and associated proteins responsible for regulating their levels within tissues. The ECS plays a central role in modulating processes involving the central nervous system (CNS). Recent studies have highlighted its antioxidant, anti-inflammatory, and neuroprotective properties. The therapeutic potential of cannabinoids, particularly phytocannabinoids derived from plants, has attracted significant attention in medical and pharmaceutical research. This interest has grown in parallel with the increasing availability of cannabinoid-based food supplements on the pharmaceutical market. Given the complexity of the ECS and its broad range of interactions, the discovery of this system has spurred extensive investigations into the use of cannabinoids for various health conditions. In this review, we examine recent preclinical evidence supporting the use of phytocannabinoids in the context of neurodegenerative diseases, particularly in Alzheimer’s disease and Parkinson’s disease. Targeting the ECS through phytocannabinoid-based pharmacological modulation offers a promising therapeutic strategy for these neurological disorders. Among these compounds, cannabidiol has emerged as a key focus of research due to its multifaceted effects and favorable safety profile. Nonetheless, continued investigation is necessary to clarify its mechanisms of action, and to develop effective, evidence-based clinical applications. Full article
(This article belongs to the Special Issue Medicinal Potential of Cannabidiol and New Structural Analogs)
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38 pages, 5968 KB  
Article
Marine Jellyfish Collagen and Other Bioactive Natural Compounds from the Sea, with Significant Potential for Wound Healing and Repair Materials
by Ana-Maria Pesterau, Antoanela Popescu, Rodica Sirbu, Emin Cadar, Florica Busuricu, Ana-Maria Laura Dragan, Carolina Pascale, Ana-Maria Ionescu, Claudia Florina Bogdan-Andreescu, Marius-Daniel Radu and Cezar Laurentiu Tomescu
Mar. Drugs 2025, 23(6), 252; https://doi.org/10.3390/md23060252 - 13 Jun 2025
Cited by 1 | Viewed by 2214
Abstract
Skin health must be ensured at all times in the case of wounds when the skin is subjected to traumatic actions that require multiple wound-healing measures. Wound healing is a complex, multi-phase biological process critical for restoring skin integrity after trauma. This study [...] Read more.
Skin health must be ensured at all times in the case of wounds when the skin is subjected to traumatic actions that require multiple wound-healing measures. Wound healing is a complex, multi-phase biological process critical for restoring skin integrity after trauma. This study investigates the development and evaluation of a novel composite hydrogel formulated from collagen peptides extracted from the jellyfish Rhizostoma pulmo and hydroethanolic extracts from the brown alga Cystoseira barbata, both sourced from the Romanian Black Sea coast. Throughout the work, the characteristics due to the biochemical compositions of the extracts from the brown alga C. barbata and from the jellyfish R. pulmo are highlighted as important, emphasizing the content of polysaccharides, proteins, and lipids. Total phenol content was analyzed for three extracts from natural products. The biochemical composition, antioxidant, antimicrobial, and in vitro wound-healing properties of the components and their composite (JPC-ALG) were assessed. The rheological behavior and optical microscopy studies of collagen hydrogels were prepared. The general mechanisms of wound healing with the involvement of polysaccharides and collagen peptides existing in all categories of extracts were highlighted. The study of the effects of JPC-ALG composites and individual extracts on fibroblast and keratocyte cell lines is also presented. Results demonstrated that the composite exhibited synergistic effects, enhancing fibroblast and keratinocyte migration and proliferation, key factors in wound closure. The findings support the potential application of this marine-derived bioactive composite as a promising biomaterial for wound-healing therapies. Full article
(This article belongs to the Special Issue Marine Bioactive Compounds for Skin Health)
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16 pages, 4159 KB  
Article
Therapeutic Efficacy of Silymarin, Vitamin E, and Essential Phospholipid Combination Therapy on Hepatic Steatosis, Fibrosis, and Metabolic Parameters in MASLD Patients: A Prospective Clinical Study
by Dan-Ionuț Gheonea, Cristina Tocia, Victor-Mihai Sacerdoțianu, Alexandra-Georgiana Bocioagă, Irina-Paula Doica, Nicolae Cătălin Manea, Adina Turcu-Știolică, Carmen-Nicoleta Oancea and Eugen Dumitru
Int. J. Mol. Sci. 2025, 26(12), 5427; https://doi.org/10.3390/ijms26125427 - 6 Jun 2025
Viewed by 3002
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease globally, and current estimates indicate an increase in incidence and prevalence in the general population. The design of the prospective study was to evaluate the response of patients with MASLD [...] Read more.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease globally, and current estimates indicate an increase in incidence and prevalence in the general population. The design of the prospective study was to evaluate the response of patients with MASLD to an original formula consisting of silymarin, vitamin E, and essential phospholipids. In total, 200 patients were initially enrolled in the study and a total of 190 who participated in all four visits were included in our analysis. During the visits, liver function tests, lipid profiles, blood glucose level, fibrosis, and steatosis values and grades were assessed. From baseline, visit 0, to month 6th, visit III, a statistically significant difference (p-value < 0.0001) was observed in the reduction in ALT, AST, GGT, ALP, TG, total cholesterol, and blood glucose levels. There was a significant decrease in the fibrosis value from the first visit to the last visit (p = 0.002). Even though administered separately, silymarin, essential phospholipids, and vitamin E have established their efficacy in MASLD, this study demonstrates that their combination produces an indubitable effect on liver steatosis, even in a short cure of 6 months, and it can be proposed due to it having no adverse effects on patients with MASLD. Full article
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14 pages, 1189 KB  
Article
The miR-21-5p, miR-30c-5p, and miR-182-5p as Biomarkers in Clear Cell Renal Cell Carcinoma: A Southeastern Romanian Cohort Study
by Ionuț Burlacu, Mariana Așchie, Georgeta Camelia Cozaru, Mariana Deacu, Gabriela Miruna Vizireanu, Adrian Nelutu Mitroi, Anca Florentina Mitroi and Costel Stelian Brînzan
Genes 2025, 16(6), 650; https://doi.org/10.3390/genes16060650 - 28 May 2025
Viewed by 779
Abstract
Background: This study aimed to evaluate the expression and clinical relevance of three mature miRNAs (miR-21-5p, miR-30c-5p, and miR-182-5p) in patients with clear cell renal cell carcinoma (ccRCC) from southeast Romania, and to explore their potential as non-invasive diagnostic and prognostic biomarkers. Methods: [...] Read more.
Background: This study aimed to evaluate the expression and clinical relevance of three mature miRNAs (miR-21-5p, miR-30c-5p, and miR-182-5p) in patients with clear cell renal cell carcinoma (ccRCC) from southeast Romania, and to explore their potential as non-invasive diagnostic and prognostic biomarkers. Methods: miRNA expression levels were measured using TaqMan® MGB and qRT-PCR in paired tumor and adjacent non-cancerous tissues, as well as in serum-derived exosomes, from 26 ccRCC patients. Statistical analysis included the Wilcoxon test for group comparisons and non-parametric tests for correlations with clinicopathological features. Receiver operating characteristic (ROC) curves were used to assess diagnostic performance, and miRNA panels were constructed for improved accuracy. Results: Significant dysregulation of the investigated miRNAs was observed. miR-21-5p was markedly overexpressed in both tumor tissues (3.46-fold, p < 0.001) and serum exosomes (3.26-fold, p < 0.001). miR-182-5p showed modest overexpression in tissues (0.56-fold, p < 0.001) and serum (0.85-fold, p < 0.001), whereas miR-30c-5p was significantly downregulated in both tissues (2.48-fold decrease, p < 0.001) and serum exosomes (2.29-fold decrease, p = 0.0003). Elevated miR-182-5p expression correlated with tumor localization in the right kidney (p = 0.02) and lymph node involvement (p = 0.04). Similarly, higher miR-21-5p levels in serum exosomes were associated with right-sided tumors (p = 0.01). ROC analysis revealed distinct expression profiles for all three miRNAs between ccRCC and normal tissue, both in tissue and exosomal samples (all p < 0.05). Combined biomarker panels yielded high diagnostic performance (AUC = 0.94 for tissue, AUC = 0.93 for exosomes). Conclusions: This study underscores the potential of miR-21-5p, miR-30c-5p, and miR-182-5p as non-invasive biomarkers for ccRCC diagnosis and prognosis. The use of serum exosomal miRNA panels offers a promising alternative to tissue-based diagnostics in Romanian ccRCC patients. Full article
(This article belongs to the Section Molecular Genetics and Genomics)
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23 pages, 1091 KB  
Review
Left Atrial Strain—Current Review of Clinical Applications
by Constantin Andrei Rusali, Ioana Caterina Lupu, Lavinia Maria Rusali and Lucia Cojocaru
Diagnostics 2025, 15(11), 1347; https://doi.org/10.3390/diagnostics15111347 - 27 May 2025
Cited by 1 | Viewed by 3345
Abstract
Left atrial strain has gained significant attention in recent years due to its potential to provide valuable insights into the function and mechanics of the left atrium. This review aims to evaluate the current applications of LA strain in clinical practice, particularly in [...] Read more.
Left atrial strain has gained significant attention in recent years due to its potential to provide valuable insights into the function and mechanics of the left atrium. This review aims to evaluate the current applications of LA strain in clinical practice, particularly in assessing various cardiac conditions, including heart failure, atrial fibrillation, valvular heart disease, and coronary artery disease. We summarize the latest evidence regarding the role of left atrial strain in assessing left atrial remodeling, predicting outcomes, and its potential use as a prognostic tool. Unlike previous reviews focusing on single disease states, this review synthesizes emerging data across multiple cardiac conditions, highlighting novel implications for clinical practice. Left atrial strain emerges as a promising non-invasive marker for evaluating atrial function and guiding clinical decision-making. However, further research must fully establish its role across diverse patient populations and clinical settings. Full article
(This article belongs to the Special Issue Advances in Echocardiography)
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16 pages, 1266 KB  
Review
Diuretic Therapy: Mechanisms, Clinical Applications, and Management
by Nicoleta-Mirela Blebea, Ciprian Pușcașu, Emil Ștefănescu and Alina Mihaela Stăniguț
J. Mind Med. Sci. 2025, 12(1), 26; https://doi.org/10.3390/jmms12010026 - 2 May 2025
Cited by 5 | Viewed by 9490
Abstract
Diuretics are a class of pharmacological agents that promote the renal excretion of water and electrolytes, increasing urine output and reducing fluid retention. They play a critical role in the management of edematous syndromes, irrespective of their etiology (cardiac, renal, or hepatic), as [...] Read more.
Diuretics are a class of pharmacological agents that promote the renal excretion of water and electrolytes, increasing urine output and reducing fluid retention. They play a critical role in the management of edematous syndromes, irrespective of their etiology (cardiac, renal, or hepatic), as well as in the treatment of hypertension (HTA). The mechanism of action of diuretics can be classified as either renal, as seen with saluretic diuretics that inhibit sodium and water reabsorption at various segments of the nephron, or extrarenal, involving alterations in the glomerular filtration pressure or osmotic mechanisms. Based on their site of action and mechanism, diuretics are categorized into multiple classes, including loop diuretics, thiazide and thiazide-like diuretics, potassium-sparing diuretics, carbonic anhydrase inhibitors, and osmotic diuretics. These agents are frequently used in combination with other antihypertensive or heart failure medications to optimize therapeutic efficacy. By reducing the blood volume and peripheral vascular resistance, diuretics improve cardiac function, lower blood pressure, and enhance exercise tolerance. Additionally, they are employed in managing chronic kidney disease (CKD), electrolyte imbalances, and specific metabolic disorders. Given the potential for adverse effects such as electrolyte disturbances and renal dysfunction, diuretic therapy should be individualized, with the careful monitoring of the dosage, patient response, and comorbid conditions. Patient education on adherence, lifestyle modifications, and the recognition of side effects is essential for optimizing the therapeutic outcomes and minimizing the risks associated with diuretic therapy. Full article
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26 pages, 2491 KB  
Article
Clinical and Epidemiological Characteristics of Pediatric Pertussis Cases: A Retrospective Study from Southeast Romania
by Cristina Maria Mihai, Ancuta Lupu, Tatiana Chisnoiu, Adriana Luminita Balasa, Ginel Baciu, Silvia Fotea, Vasile Valeriu Lupu, Violeta Popovici, Simona Claudia Cambrea, Mircea Grigorian, Felicia Suciu, Florin-Daniel Enache, Anna Sora and Ramona Mihaela Stoicescu
Antibiotics 2025, 14(5), 428; https://doi.org/10.3390/antibiotics14050428 - 23 Apr 2025
Cited by 3 | Viewed by 2791
Abstract
Background/Objectives: Pertussis remains a significant cause of respiratory illness in children, particularly in regions with suboptimal vaccination coverage. This retrospective study analyzes the clinical presentations, co-infections, treatment, and outcomes of pediatric patients diagnosed with Bordetella pertussis at the Constanța County Clinical Emergency Hospital [...] Read more.
Background/Objectives: Pertussis remains a significant cause of respiratory illness in children, particularly in regions with suboptimal vaccination coverage. This retrospective study analyzes the clinical presentations, co-infections, treatment, and outcomes of pediatric patients diagnosed with Bordetella pertussis at the Constanța County Clinical Emergency Hospital “St. Apostle Andrew” between 1 January and 30 September 2024. Methods: Thirty-eight children, predominantly under the age of 3 years (81.58%), were included. Demographic data, clinical features, coinfecting pathogens, antimicrobial regimens, and hospital outcomes were reviewed. Results: Only 7 out of 38 children (18.42%) had received pertussis vaccination, and none benefited from maternal immunization. The highest incidence occurred in infants under 1 year (44.74%). Intensive care was required in 18.42% of cases, and macrolides were the most frequently used antibiotics (68.42%). Co-detection of respiratory pathogens—particularly Streptococcus pneumoniae, enteroviruses, and human rhinoviruses—was common. Severe cases often exhibited hyperleukocytosis, which was associated with complications such as heart failure. Conclusions: These findings underscore the need for timely recognition and management of pertussis and its complications. Although macrolides remain the first-line therapy, adjunctive treatments like leukoreduction may be considered in critical cases. The persistence of pertussis despite vaccination efforts highlights the challenges posed by waning immunity and diagnostic limitations, reinforcing the need for strengthened public health strategies. Full article
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67 pages, 6303 KB  
Review
Bioactive Compounds of Marine Algae and Their Potential Health and Nutraceutical Applications: A Review
by Emin Cadar, Antoanela Popescu, Ana-Maria-Laura Dragan, Ana-Maria Pesterau, Carolina Pascale, Valentina Anuta, Irina Prasacu, Bruno Stefan Velescu, Cezar Laurentiu Tomescu, Claudia Florina Bogdan-Andreescu, Rodica Sirbu and Ana-Maria Ionescu
Mar. Drugs 2025, 23(4), 152; https://doi.org/10.3390/md23040152 - 31 Mar 2025
Cited by 10 | Viewed by 8504
Abstract
Currently, marine algae are still an under-exploited natural bioresource of bioactive compounds. Seaweeds represent a sustainable source for obtaining bioactive compounds that can be useful for the fabrication of new active products with biomedical benefits and applications as biomedicinals and nutraceuticals. The objective [...] Read more.
Currently, marine algae are still an under-exploited natural bioresource of bioactive compounds. Seaweeds represent a sustainable source for obtaining bioactive compounds that can be useful for the fabrication of new active products with biomedical benefits and applications as biomedicinals and nutraceuticals. The objective of this review is to highlight scientific papers that identify biocompounds from marine macroalgae and emphasize their benefits. The method used was data analysis to systematize information to identify biocompounds and their various benefits in pharmaceuticals, cosmetics, and nutraceuticals. The research results demonstrate the multiple uses of seaweeds. As pharmaceuticals, seaweeds are rich sources of bioactive compounds like polysaccharides, protein compounds, pigments, and polyphenols, which have demonstrated various pharmacological activities such as antioxidant, antibacterial, anti-inflammatory, antiviral, anticoagulant, and potentially anticarcinogenic effects. Seaweed has gained recognition as a functional food and offers a unique set of compounds that promote body health, including vitamins, minerals, and antioxidants. In conclusion, the importance of this review is to expand the possibilities for utilizing natural resources by broadening the areas of research for human health and marine nutraceuticals. Full article
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