Search Results (3,291)

Objective: The aim of this systematic review was to compare the impact of various dietary patterns on cancer mortality, recurrence, remission, quality of life, and prostate-specific antigen (PSA) in non-metastatic prostate cancer patients. Methods: Ovid Medline, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus databaseswere searched from inception to March 2024. Dietary interventions or observational studies investigating dietary patterns in men with non-metastatic prostate cancer with at least one primary outcome related to mortality, recurrence, remission, quality of life or PSA/PSA doubling time were included. Two independent reviewers conducted article selection, data extraction, and quality assessment. Results: Sixteen eligible articles were included. Adherence to a Mediterranean dietary pattern was linked to lower overall mortality and increased quality of life and adherence to a Prudent diet was associated with both lower overall and cancer-specific mortality risk. A plant-based dietary pattern is associated with increased quality of life. Contrastingly, a Western diet was associated with a higher cancer-specific mortality and overall mortality and high-inflammatory, hyperinsulinaemic, and insulin-resistant diets with increased recurrence. Conclusions: Despite the heterogeneity and inconsistencies of PCa literature, there is fair evidence that suggests unprocessed foods with healthier dietary patterns of Mediterranean and prudent diets confer a beneficial effect on overall and cancer-specific mortality, recurrence, and quality of life whereas, a more Western and unhealthier diet generates the opposite. The increased risk of bias prevents conclusive interpretation of these results and, hence, detracts from its clinical implementation. Future research should focus on increasing sample sizes and robustness and standardisation in study design. Full article

Background: Meniere’s disease (MD) is a chronic inner ear disorder affecting approximately 0.2% of the population, with 30% of patients remaining refractory to conventional treatments. The pathophysiology involves endolymphatic hydrops, suggesting that agents affecting fluid homeostasis might provide therapeutic benefit. Sodium-glucose cotransporter 2 (SGLT-2) inhibitors, originally developed for diabetes, offer unique mechanisms including natriuresis and osmotic diuresis that may address the underlying fluid imbalance in MD. Methods: We conducted a retrospective observational study at the Korea University Anam Hospital, analyzing the medical records of patients with definite MD (Bárány Society criteria) who received off-label empagliflozin 10 mg daily between January 2023 and December 2023. Six patients (3 men, 3 women; mean age 55.8 years) with treatment-resistant MD were identified who had failed conventional therapy for at least 3 months. Primary outcomes included changes in pure tone threshold average (PTA), low-frequency threshold average (LFA), vertigo episode frequency, and vertigo severity using visual analog scale (VAS) scores, assessed at baseline and after 3 months of treatment. Results: All patients demonstrated clinically significant improvements in both auditory and vestibular symptoms. Mean PTA improved from 31.4 dB to 20.8 dB (improvement of 10.6 dB, p < 0.05). Low-frequency hearing showed more substantial recovery, with LFA improving from 37.2 dB to 15.6 dB (improvement of 21.6 dB, p < 0.01). Vertigo frequency decreased dramatically from 1.6 episodes per month to 0.1 episodes per month, with four patients experiencing a complete resolution of vertigo episodes. VAS scores for vertigo severity decreased from 5.2 to 0.5. Treatment was well-tolerated, with only minor adverse effects reported in two patients: transient polyuria in one patient and 5 kg weight loss in another, both consistent with the known pharmacological profile of SGLT-2 inhibitors. Conclusions: This preliminary study suggests a potential clinical benefit of repurposing SGLT-2 inhibitors for treatment-resistant MD. However, the retrospective design and inherent limitations prevent definitive conclusions about causality. The significant improvements observed in both hearing thresholds and vestibular symptoms warrant further investigation through randomized controlled trials with objective outcome measures to establish the true efficacy of this therapeutic approach. Full article

Background: Bovine bone-derived xenografts are widely used in regenerative dental procedures due to their osteoconductive properties and volumetric stability. However, their long-term behavior and biological integration remain a subject of debate. This systematic review aims to critically assess the histological and clinical outcomes associated with bovine xenografts over extended follow-up periods. Methods: An electronic search was performed in PubMed, Scopus, and Web of Science, including studies published in the English language from 2005 to 2025 for a total of 217 records, which were initially identified from PubMed, Scopus, and Wos. Results: After duplicate removal, following title/abstract screening and full-text evaluation, 11 studies met the inclusion criteria. These studies reported on the use of bovine-derived xenografts in clinical contexts, assessing parameters such as graft integration, histological remodeling, complication incidence (e.g., chronic inflammation or foreign body reactions), and implant success rates over time. Conclusions: The current evidence suggests that bovine-derived xenografts, particularly Bio-Oss^®, are associated with favorable long-term outcomes in bone regenerative procedures, demonstrating satisfactory graft integration and implant survival rates. However, variations in study design, follow-up duration, and outcome measures warrant further high-quality, long-term randomized clinical trials to confirm these findings and guide clinical decision-making. Full article

Background/Objectives: Functional abilities are fundamental for social participation. However, functional abilities assessment tools validated for children/and adolescents undergoing cancer treatment are lacking. A preliminary validation of the Gross Motor Function Measure-88 (GMFM-88) scale for children with cancer found that some items are unable to discriminate or distinguish between different gross motor function levels. This study aims to develop and validate the Functional Abilities Assessment in Paediatric Oncology (FAAP-O), starting with GMFM-88. Methods: This multicentre study (ClinicalTrials.gov Identifier: NCT04862130) involved children and adolescents (6 months–18 years old) diagnosed with cancer, in any phase of treatment or less than 1 year of therapy. A multiphase mixed-methods design was employed. The content validity of each item of GMFM-88 for the paediatric oncology population was calculated with the Content Validity Ratio (CVR). Items with a CVR score > 0.70 were included in the FAAP-O scale. Other items with a score between 0 and 0.70 were selected for their relevance by consensus with five focus groups and a plenary meeting. The FAAP-O items set was organised in five dimensions by exploratory factor analyses. The calculation of FAAP-O internal consistency was made using Cronbach’s α while and inter/intra-rater reliability was assessed by intraclass correlation coefficients (ICCs). Results: The study involved 217 subjects. The FAAP-O included 36 items; its internal consistency was good in each dimension (0.90 ≤ α ≤ 0.96) and its inter/intra-rater reliability was excellent (ICC > 0.90). Conclusions: A new specifically validated scale to assess functional abilities in children and adolescents with cancer is provided. Validated tools are necessary for specific, objective rehabilitation assessments, which are fundamental in clinical practice and research. Full article

Background and Objectives: Metformin, a staple in diabetes care, has recently emerged as a candidate chemotherapeutic agent. In vitro studies suggest that metformin inhibits cancer growth by altering cellular metabolism and enhancing immune responses. Clinical observations further indicate that it suppresses key tumor-promoting pathways such as mTOR and STAT3. This review critically evaluates the therapeutic potential of metformin in oncology through the lens of precision medicine. This review integrates evidence from molecular mechanisms, clinical studies, biomarker-driven trial designs, and the regulatory challenges that continue to delay its approval for oncologic use. Methods: A structured literature search (2015–2025) identified 63 relevant studies, including preclinical, clinical, and translational research. Conclusions: Although metformin shows consistent anticancer effects in laboratory and animal models, its clinical benefits in patients are variable. This inconsistency is likely due to tumor heterogeneity and a lack of biomarker-based patient selection in trials. Targeting these shortcomings through biomarker-enriched, tumor-specific clinical trials is essential to define metformin’s role as a repurposed agent in precision oncology. Full article

Objectives: Connective tissue diseases (CTDs) include a diverse group of systemic autoimmune conditions, among which interstitial lung disease (ILD) is acknowledged as a major determinant of prognosis. High-resolution computed tomography (HRCT) is the gold standard for ILD assessment. The distribution of HRCT patterns across CTDs remain incompletely defined. The objective of this systematic review is to synthesize available evidence regarding the prevalence of specific radiological patterns within CTD-ILDs and to assess whether specific patterns occur at different frequencies among individual CTDs. Methods: The inclusion criteria encompassed original human studies published in English between 2015 and 2024, involving adult participants (≥18 years) with CTD-ILDs assessed primarily by HRCT and designed as retrospective, prospective, or cross-sectional trials with extractable data. We systematically searched PubMed, Scopus, and Web of Science (January 2025). Risk of bias was evaluated using the Newcastle–Ottawa Scale (NOS) for cohort and case–control studies, and the JBI Critical Appraisal Checklist for cross-sectional studies. Data were extracted and categorized by HRCT pattern for each CTD, and then summarized descriptively and statistically. Results: We analyzed 23 studies published between 2015 and 2024, which included 2020 patients with CTD-ILDs. The analysis revealed non-specific interstitial pneumonia (NSIP) as the most prevalent pattern overall (36.5%), followed by definite usual interstitial pneumonia (UIP) (24.8%), organizing pneumonia (OP) (9.8%) and lymphoid interstitial pneumonia (LIP) (1.25%). HRCT distribution varied by CTD: NSIP predominated in systemic sclerosis, idiopathic inflammatory myopathies, and mixed connective tissue disease; UIP was most frequent in rheumatoid arthritis; LIP was more common in Sjögren’s syndrome. While global differences were statistically significant, pairwise comparisons often lacked significance, likely due to sample size constraints. Discussion: Limitations include varying risk of bias across study designs, heterogeneity in HRCT reporting, small sample sizes, and inconsistent follow-up, which may reduce precision and generalizability. In addition to the quantitative synthesis, this review offers a detailed description of each radiologic pattern mentioned above, illustrated by representative examples to support the recognition in clinical settings. Furthermore, it includes a brief overview of the major CTDs associated with ILD, summarizing their epidemiological data, risk factors for ILD and clinical presentation and diagnostic recommendations. Conclusions: NSIP emerged as the most common HRCT pattern across CTD-ILDs, with UIP predominating in RA. Although inter-disease differences were observed, statistical significance was limited, likely reflecting sample size constraints. These findings emphasize the diagnostic and prognostic relevance of HRCT pattern recognition and highlight the need for larger, standardized studies. Full article

Micronutrients and nutraceuticals play crucial roles in wound healing and tissue regeneration, supporting various physiological processes. This review aims to synthesize and evaluate the functions of various micronutrients and nutraceuticals, emphasizing the synergistic interactions among different nutrients that facilitate wound healing processes. A thorough literature review was performed using electronic databases, including PubMed, Scopus, Web of Science, Embase, Google Scholar, and Cochrane Library, to identify molecular studies, animal models, randomized controlled trials, and observational human studies published up to January 2000. Two independent reviewers screened the articles, extracted data, and evaluated the Risk of Bias using the Risk of Bias 2 (RoB 2) tool for the 190 studies that met the inclusion criteria. Evidence suggests that bioactive compounds found in functional foods and dietary supplements can help prevent chronic conditions and promote wellness beyond basic nutrition. Vitamins A, C, and E, as well as minerals such as zinc, selenium, and iron, are essential for cell proliferation and the formation of new tissues. Additionally, nutraceuticals, including omega-3 fatty acids, glutamine, arginine, and polyphenols, exhibit anti-inflammatory and antioxidant properties, which promote healing and reduce the risk of infection. Probiotics and other bioactive compounds in nutraceuticals contribute to maintaining the balance of microbiota, reducing inflammation, and stimulating cell regeneration. Significant variability was noted in study design, sample size, intervention dosage, and outcome measures. This evidence underscores the necessity for further well-designed clinical trials to determine the optimal dosages and combinations for specific wound types across diverse patient populations. This systematic review was prospectively registered in PROSPERO (ID: 1072091). Full article

The global fight against HIV/AIDS has been significantly bolstered by the development and implementation of pre-exposure prophylaxis (PrEP), yet innovation in PrEP interventions, improved adherence and greater access are still needed to maximize its benefit. Nonhuman primate (NHP) infection with simian immunodeficiency virus (SIV) has served as an instrumental animal model in advancing HIV PrEP research. This review comprehensively examines the utility of NHP models in evaluating the efficacy, pharmacokinetics, and safety of diverse PrEP strategies, including oral, injectable, implantable, and topical formulations. It discusses the development of diverse challenge models that simulate human transmission routes and the advantages of NHPs in enabling controlled and mechanistically informative studies. It also highlights the successful translation of pivotal NHP studies evaluating tenofovir-based regimens as well the long-acting agents, cabotegravir and lenacapavir, into the clinical settings, emphasizing the consistently high predictive power of the NHP models for the HIV PrEP clinical efficacy. Finally, it underscores the importance of species-specific pharmacologic considerations and the value of NHP data in informing clinical trial design. As the global community strives to end the HIV epidemic as a public health threat in the absence of an efficacious prophylactic vaccine, NHP models make a critical contribution in the development of next-generation HIV prevention tools. Full article

Background: Glaucoma is a progressive optic neuropathy marked by retinal ganglion cells (RGCs), apoptosis, vascular insufficiency, oxidative stress, mitochondrial dysfunction, excitotoxicity, and neuroinflammation. While intraocular pressure (IOP) reduction remains the primary intervention, many patients continue to lose vision despite adequate pressure control. Emerging neuroprotective agents—citicoline, coenzyme Q10 (CoQ10), pyruvate, nicotinamide, pyrroloquinoline quinone (PQQ), homotaurine, berberine, and gamma-aminobutyric acid (GABA)—target complementary pathogenic pathways in experimental and clinical settings. Methods: This literature review synthesizes current evidence on glaucoma neuroprotection, specifically drawing on the most relevant and recent studies identified via PubMed. Results: Citicoline enhances phospholipid synthesis, stabilizes mitochondrial membranes, modulates neurotransmitters, and improves electrophysiological and visual field outcomes. CoQ10 preserves mitochondrial bioenergetics, scavenges reactive oxygen species, and mitigates glutamate-induced excitotoxicity. Pyruvate supports energy metabolism, scavenges reactive oxygen species, and restores metabolic transporter expression. Nicotinamide and its precursor nicotinamide riboside boost NAD⁺ levels, protect against early mitochondrial dysfunction, and enhance photopic negative response amplitudes. PQQ reduces systemic inflammation and enhances mitochondrial metabolites, while homotaurine modulates GABAergic signaling and inhibits β-amyloid aggregation. Berberine attenuates excitotoxicity, inflammation, and apoptosis via the P2X7 and GABA-PKC-α pathways. Preclinical models demonstrate synergy when agents are combined to address multiple targets. Clinical trials of fixed-dose combinations—such as citicoline + CoQ10 ± vitamin B3, citicoline + homotaurine ± vitamin E or PQQ, and nicotinamide + pyruvate—show additive improvements in RGCs’ electrophysiology, visual function, contrast sensitivity, and quality of life without altering IOP. Conclusions: A multi-targeted approach is suitable for glaucoma’s complex neurobiology and may slow progression more effectively than monotherapies. Ongoing randomized controlled trials are essential to establish optimal compound ratios, dosages, long-term safety, and structural outcomes. However, current evidence remains limited by small sample sizes, heterogeneous study designs, and a lack of long-term real-world data. Integrating combination neuroprotection into standard care holds promise for preserving vision and reducing the global burden of irreversible glaucoma-related blindness. Full article

Background and Objectives: Endocrowns have emerged as a minimally invasive restorative option in dentistry, aiming to preserve as much of the original tooth structure as possible. This scoping review investigates the success rates, biomechanical performance, and material efficacy of endocrowns for restoring molars, in comparison to conventional post-and-core crowns. Materials and Methods: A comprehensive literature review was conducted to identify relevant studies using PubMed and Scopus databases. The search covered publications up to March 2025. All study types focusing on molar restorations were included, except for case reports. Data extraction and screening were performed independently by two reviewers. Results: A total of 37 studies fulfilled the eligibility criteria. Eleven systematic reviews examined comparisons between endocrowns and post-and-core crowns, as well as differences in material selection, survival and success rates, and outcomes between molars and premolars. The remaining 26 studies addressed the clinical performance and longevity of endocrowns, with an emphasis on preparation design, adhesive protocols, and mechanical behavior related to material selection. Conclusions: Endocrown restorations present a conservative and predictable alternative to post-and-core crowns for molars with extensive coronal damage. However, due to variability in reported outcomes, high-quality randomized clinical trials are crucial for confirming their clinical effectiveness. The development of novel, standardized treatment guidelines would provide clinicians with adequate information to effectively restore endodontically treated teeth (ETT). Full article

Background: After ischemic heart disease, stroke is globally the second leading cause of death and the second most common cause of disability. The rehabilitation of patients with chronic stroke increasingly uses advanced technologies, such as treadmill perturbation-based training (TPBT). While the results of studies with TPBT are promising, they are inconclusive due to the limited number of works and inconsistent research methodologies. Therefore, more randomized clinical trials (RCTs) are needed to evaluate TPBT’s efficacy and applicability in post-stroke rehabilitation. This prospective RCT was designed to assess whether and to what extent TPBT can improve postural balance and gait quality and reduce fear of falling in patients with chronic stroke. Methods: Fifty individuals who were at least six months post-stroke were enrolled in the trial and randomly assigned to the experimental group (EG; n = 25) to receive the TPBT or the control group (CG; n = 25) to receive overground gait and balance training. Both groups exercised six times per day for three weeks. Results: The Berg Balance Scale showed post-intervention that the postural balance improved significantly in both groups (EG, p = 0.001 and CG, p = 0.009), but the change did not statistically significantly differentiate the EG from the CG (p = 0.256). The significant improvements in walking speed over the distance of 10 m (p = 0.015) and fear of falling (p = 0.002) in the CG were not significantly different from those in the EG (p = 0.543). Conclusions: TPBT applied to patients with chronic stroke improves their postural control comparably to conventional gait and balance training but does not enhance their gait quality. Full article

Background/Objectives: This review aimed to evaluate whether patients undergoing dental extractions while taking antidepressants experience increased intra-operative or post-operative bleeding compared to patients not taking these medications. Methods: A comprehensive literature search was conducted across PubMed, EMBASE, Web of Science, Scopus, and ClinicalTrials.gov for randomized controlled trials (RCTs) published before 17 August 2025. Studies were included if they compared bleeding outcomes between antidepressant users and non-users undergoing dental extraction procedures. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with the International Prospective Register of Systematic Reviews (PROSPERO, CRD42025645035). Results: Of 689 studies screened, no RCTs met the eligibility criteria. Only one retrospective study, which did not match the inclusion criteria, identified a 1% incidence of bleeding complications in users of selective serotonin reuptake inhibitors (SSRIs) undergoing invasive dental procedures. However, it lacked a control group and standardized methodology, so this study was included in the discussion section. Conclusions: The lack of high-quality evidence, especially studies examining dynamic coagulation parameters like bleeding time and prothrombin time before and after antidepressant use, highlights a significant gap in the research. These findings emphasize the urgent need for well-designed clinical trials to determine the potential effect of antidepressants on bleeding risk. Full article

Cancer care has become increasingly complex, expensive, and inaccessible, with patients often exposed to increased treatment-related harms for marginal benefits. Pragmatic clinical trials offer a solution by conducting real-world studies that evaluate dose optimization, toxicity, quality of life, and resource utilization. Pragmatic trials can also address the efficacy–effectiveness gap: the poorer outcomes and greater toxicity observed in everyday practice compared to those reported in many clinical trials. The Rethinking Clinical Trials (REaCT) program was designed to conduct patient-centered practice-changing research by involving patients, their families, and healthcare providers in the design of inclusive, real-world clinical trials. The REaCT process starts with surveys and systematic reviews to identify knowledge gaps and uses this information to design pragmatic clinical trials that address these deficits. Since 2014, the program has conducted 17 patient and 17 healthcare provider surveys with 2298 and 1033 responses, respectively. With these results, the program has performed 22 systematic reviews. These surveys and systematic reviews have resulted in 19 completed and 8 ongoing REaCT clinical trials that have recruited over 5000 patients from across Canada. Here, we present some of the practice-changing research conducted by the REaCT program and address challenges facing the growth of pragmatic research.  Full article

A novel skin test for an in vivo assessment of SARS-CoV-2-specific T-cell immunity was developed using CoronaDermPS, a multiepitope recombinant polypeptide encompassing MHC II–binding CD4+ T-cell epitopes of the SARS-CoV-2 structural proteins (S, E, M) and full length nucleocapsid (N). In silico epitope prediction and modeling guided antigen design, which was expressed in Escherichia coli, was purified (>95% purity) and formulated for intradermal administration. Preclinical evaluation in guinea pigs, mice, and rhesus macaques demonstrated a robust delayed type hypersensitivity (DTH) response at optimal doses (10–75 µg), with no acute or chronic toxicity, mutagenicity, or adverse effects on reproductive organs. An integrated clinical analysis included 374 volunteers stratified by vaccination status (EpiVacCorona, Gam-COVID-Vac, CoviVac) prior to COVID-19 infection (Wuhan/Alpha, Delta, Omicron variants), and SARS-CoV-2–naïve controls. Safety assessments across phase I–II trials recorded 477 adverse events, of which >88% were mild and self-limiting; no severe or anaphylactic reactions occurred. DTH responses were measured at 24 h, 72 h, and 144 h post-injection by papule and hyperemia measurements. Overall, 282/374 participants (75.4%) exhibited a positive skin test. Receiver operating characteristic analysis yielded an overall AUC of 0.825 (95% CI: 0.726–0.924), sensitivity 79.5% (95% CI: 75.1–83.3%), and specificity 85.5% (95% CI: 81.8–88.7%), with comparable diagnostic accuracy across vaccine, and variant subgroups (AUC range 0.782–0.870). CoronaDerm-PS–based skin testing offers a simple, reproducible, and low-cost method for qualitative evaluation of T-cell–mediated immunity to SARS-CoV-2, independent of specialized laboratory equipment (Eurasian Patent No. 047119). Its high safety profile and consistent performance across diverse cohorts support its utility for mass screening and monitoring of cellular immune protection following infection or vaccination. Full article

Functional foods enriched with bioactive compounds—including vitamins, minerals, polyphenols, probiotics, fatty acids, and amino acids—have gained growing attention due to their ability to modulate immune responses. This review aims to summarize and critically evaluate evidence from both preclinical and clinical studies on the immunomodulatory effects of these compounds. A structured literature search was performed across major scientific databases in accordance with PRISMA 2020 guidelines. Seventy studies met the predefined eligibility criteria and were included. Evidence indicates that functional ingredients support immune function via antioxidant, anti-inflammatory, and microbiome-mediated pathways. Clinical trials further report benefits including a reduced risk of respiratory infections and enhanced vaccine responses. Nonetheless, important challenges remain regarding bioavailability, inter-individual variability, and the long-term safety of supplementation. Emerging research on precision nutrition and innovative delivery systems may further enhance the efficacy of these bioactive compounds. Overall, functional foods and nutraceuticals show strong potential as adjunct strategies for maintaining immune health; however, further well-designed clinical studies are required to confirm their translational applicability. Full article