Search Results (7,985)

Background/Objectives: Migraine is a common neurological disease with a high disability burden. Despite this, many people with migraine do not take medication to prevent attacks, even when this is indicated. Many non-pharmacological approaches to migraine treatment exist, but little is known about how people with migraine use these options. Methods: The online Migraine in Aotearoa New Zealand (NZ) Survey collected responses from 530 people with migraine from August to October 2022. Questions included current and previous use of preventive medications, supplements (e.g., magnesium, riboflavin, coenzyme Q10) and complementary therapies (e.g., meditation, biofeedback, yoga, acupuncture). Results: Around half of the respondents were currently using a supplement, 58% were currently using complementary therapy and half were taking preventive medication. One in five were using all three approaches for migraine prevention. Of those not taking preventive medication, 44% were taking a supplement, and 53% were using complementary therapy. For commonly used non-pharmacological approaches, 20–30% of people had tried them in the past but stopped due to lack of efficacy or other reasons. A high proportion of people would like to try approaches that are not readily available or expensive in NZ (e.g., neurostimulation devices and biofeedback). Conclusions: The use of supplements and complementary therapies for migraine prevention is common, often in combination with medication. There are high levels of discontinuation due to ineffectiveness and cost prohibits use for many. Improved access to non-pharmacological therapies, particularly as an adjunct, has the potential to improve outcomes for people with migraine, but more and better migraine treatment options are also needed. Full article

Background and Objective: Alcoholic liver disease (ALD) is a major health burden caused by chronic alcohol consumption, leading to oxidative stress, inflammation, and fibrosis. Current treatments are limited, highlighting the need for novel therapeutic agents. This study investigated the hepatoprotective effects of ‘Terpinen-4-ol (T4OL)’, a natural monoterpene from tea tree oil, against ethanol-induced liver injury, focusing on its molecular and cellular mechanisms. Materials and Methods: Network pharmacology and molecular docking were employed to predict T4OL’s interaction with ALD-associated targets. Human HepG2 cells were used to validate the in silico findings. Cells were exposed to ethanol (8%) prior to treatment with T4OL or silymarin (SIL), and cytotoxicity was assessed through MTT, crystal violet, and trypan blue assays. Moreover, ELISA and qPCR were conducted to evaluate antioxidant, inflammatory, and fibrotic markers. Results: Network pharmacology analysis suggested that T4OL exerts its hepatoprotective effects by suppressing inflammatory and fibrotic mediators (HIF-1α, TGF-β1, and TNF-α). Docking studies also exhibited a strong binding affinity of T4OL to key ALD targets, with docking scores comparable to SIL. In addition, T4OL (13–1300 µM) dose-dependently protected HepG2 cells from ethanol-induced damage, restoring viability by up to 80% at 650 µM. It significantly elevated antioxidant levels (GSH by 2.5-fold, SOD by 1.8-fold) and suppressed pro-inflammatory and fibrotic markers (IL-6, COL1A1, TIMP-1) by 40–60%. At higher concentrations (650–1300 µM), T4OL outperformed SIL in cytoprotection and anti-fibrotic effects. Conclusions: T4OL mitigates ethanol-induced liver injury by targeting oxidative stress, inflammation, and fibrosis pathways, demonstrating superior efficacy to SIL at optimal doses. Its multi-target action supports its potential as a therapeutic candidate for ALD. Full article

Background/Objectives: Patients with inflammatory bowel disease (IBD) are at an increased risk of various cancers; such as colorectal cancer; skin cancer; bile duct cancer; or lymphoma; with IBD itself not being the sole cause. Inappropriate or ineffective IBD therapy with a continuous inflammatory burden within the gut leads to an increased risk of malignancy. Our study aimed to investigate the risk of malignancy in our patient cohort; focusing on concomitant therapy; disease duration; and inflammatory burden. Methods: A total of 333 consecutive adult patients with IBD (Crohn’s disease; ulcerative colitis; and IBD unclassified) were included in this study. Data from patients were collected retrospectively using patient charts. The patients were treated in the gastroenterological outpatient clinic of the University Hospital of Augsburg; Germany; between 1 January 2014 and 31 December 2018. Results: The study group included 333 patients; 32 (9.61%) of whom suffered from malignancy (any form). Men (n = 21; 65.62%) tended to develop malignancy more often than women (n = 11; 34.38%, p = 0.051). It was also observed that the probability of developing cancer was 2.40 times higher in male patients than in female patients in our cohort. However, this trend was non-significant (HR = 2.412; p = 0.075). Furthermore; the probability of developing cancer increased with the increasing age at the time of the first diagnosis of IBD (HR = 1.088; p < 0.025). A total of 20 patients (6.00%) received their cancer diagnosis after being diagnosed with IBD. The majority of those patients had skin (n = 6; 30.00%) or colon cancer (n = 5; 25.00%). Other diseases such as CML; NHL; HL; HCC; liver sarcoma; prostate cancer; breast cancer; seminoma; thyroid cancer (a second cancer in one of the patients); or CUP syndrome/lung cancer were diagnosed in single patients. Patients with IBD and colon cancer (n = 5; 25.00%) shared some of the known risk factors for tumour development; such as a long-lasting IBD (n = 5; 100.00%), diagnosis at a young age (under 30; n = 3; 60.00%), and the coexistence of PSC (n = 1; 20.00%). The cancer prevalence rate was relatively low in our cohort despite the use of diverse biologics and immunosuppressive drugs. Faecal calprotectin was confirmed as a relevant tool for inflammation monitoring in this cohort. Conclusions: In our study cohort; we could show a low prevalence rate of malignancy in IBD. There were more malignancies in men and in patients who were diagnosed with IBD at later ages. It can be observed that the prevalence rate of cancer was relatively low despite the use of diverse biologics and immunosuppressive drugs; which is the major conclusion of this study. Additionally; the known correlation between elevated levels of faecal calprotectin and gut inflammation was confirmed through our statistical analysis. The use of calprotectin as a non-invasive screening tool for gut inflammation is advised. Full article

Climate change is among the most significant challenges of the 21st century, with global warming, heat stress, floods, and drought occurring in various parts of the globe, including Africa. The impact of climate change on health is becoming increasingly substantial on the African continent due to weaknesses in economies, infrastructure, and healthcare systems. This review explores the relationship between climate change and emerging and re-emerging infectious diseases in Africa and highlights possible solutions. It was conducted by summarizing and synthesizing related information from relevant scientific publications. This review reveals that climate change significantly contributes to Africa’s emerging and re-emerging infectious diseases, including Ebola, Marburg, Lassa fever, dengue fever, malaria, and cholera. The impact of climate change on infectious diseases is variable across the continent, with countries in West and Central Africa experiencing more significant climate change-instigated disease burdens. Multisectoral cooperation between climate change actors, environmental health researchers, policy makers, and political leaders centered in the One Health approach is necessary to develop and implement resilient interventions for climate change-induced emerging and re-emerging infections and related health hazards. Full article

We primarily focus on the formulation, theoretical, and numerical analyses of a non-autonomous model for tuberculosis (TB) prevention and control programs in a population where individuals suffering from the double trouble of tuberculosis and diabetes are present. The model incorporates four time-dependent control functions, saturated treatment of non-infectious individuals harboring tuberculosis, and saturated incidence rate. Furthermore, the basic reproduction number of the autonomous form of the proposed optimal control mathematical model is calculated. Sensitivity indexes regarding the constant control parameters reveal that the proposed control and preventive measures will reduce the tuberculosis burden in the population. This study establishes that the combination of campaigns that teach people how the development of tuberculosis and diabetes can be prevented, a treatment strategy that provides saturated treatment to non-infectious individuals exposed to tuberculosis infections, and prompt effective treatment of individuals infected with tuberculosis disease is the optimal strategy to achieve zero TB by 2035. Full article

(1) Background: Geospatial associations for COVID-19 mortality were estimated using a cohort of 28,128 hospitalized Medicaid patients identified from the 2020–2021 Kentucky Health Facility and Services administrative claims data. (2) Methods: County-level patient information (age, sex, chronic obstructive pulmonary disease [COPD], and mechanical ventilation use [96 hrs. plus]); social deprivation index (SDI) scores; physician and nurse rates per 100,000; and annual average particulate matter 2.5 (PM_2.5) were used as the predictors. Ordinary least-squares (OLS) regression and multiscale geographically weighted regression (MGWR) with the dependent variable, COVID-19 mortality per 100,000, were performed to compute global and local effects, respectively. (3) Results: MGWR (adjusted R²: 0.52; corrected Akaike information criterion [AICc]: 292.51) performed better at explaining the association between the dependent variable and predictors than the OLS regression (adjusted R²: 0.36; AICc: 301.20). The percentages of patients with COPD and who were mechanically ventilated (96 hrs. plus) were significantly associated with COVID-19 mortality, respectively (OLS standardized βCOPD: 0.22; βventilation: 0.53; MGWR mean βCOPD: 0.38; βventilation: 0.57). Other predictors were not statistically significant in both models. (4) Conclusions: A risk of COVID-19 mortality was observed among patients with COPD and prolonged mechanical ventilation use, after controlling for social determinants, the healthcare workforce, and PM_2.5 in rural and Appalachian counties of Kentucky. These counties are characterized by persistent poverty, healthcare workforce shortages, economic distress, and poor population health outcomes. Improving population health protection through multisector collaborations in rural and Appalachian counties may help reduce future health burdens. Full article

Air pollution is a major environmental risk factor that contributes significantly to the global burden of disease, particularly through its impact on respiratory and cardiovascular health. The aim of this study is to investigate the temporal variations of ambient air pollutants and the influence of MPs (MPs) on their concentrations in the metropolitan area of Tehran from 2017 to 2021. Hourly data for PM_2.5, PM₁₀, O₃, NO₂, SO₂, and CO from all air quality monitoring stations were obtained. Effects of MPs for the same period were assessed. The results revealed that Tehran’s residents are continuously exposed to harmful levels of PM_2.5 (5.7 to 6.3 times), PM₁₀ (4.5–5.6 times), and NO₂ (8.7–10.0 times) that are significantly higher than the updated World Health Organization (WHO) air quality guidelines. All other air pollutants (except for O₃) showed the lowest and highest concentrations during summer and winter, respectively. The highest concentration of O₃ was found on weekends (weekend effect), while other ambient air pollutants had higher levels on weekdays (holiday effect). Although other air pollutants exhibited two peaks, in the morning and late evening, the hourly concentration of O₃ reached its maximum level at 3:00 pm. Approximately 51% to 65% of the Air Quality Index (AQI) values were classified as unhealthy for sensitive groups. Throughout the study period, PM_2.5 was identified as the primary pollutant affecting air quality in Tehran. Among MPs, temperature was the most important factor in increasing the concentration of O₃, while the other ambient pollutants decreased under the influence of wind speed. Given the current situation, effective and evidence-based air quality management strategies, like those that have been successfully applied elsewhere, are now a necessity to avoid the public health impact and economic losses from air pollution. Although this research focuses on Tehran as a model case of rapidly developing cities facing severe air quality challenges, the findings and recommendations have broader applicability to similar urban environments worldwide. Full article

Coronary artery disease (CAD) remains a leading cause of global morbidity and mortality despite advances in medical and interventional therapies. Mesenchymal stem cell (MSC) therapy has emerged as a promising regenerative approach for patients with refractory or non-revascularizable CAD. MSCs exhibit unique immunomodulatory, pro-angiogenic, and anti-fibrotic properties, primarily through paracrine mechanisms involving the secretion of cytokines, growth factors, and exosomal microRNAs. Clinical and preclinical studies have demonstrated improvements in myocardial perfusion, left ventricular ejection fraction (LVEF), and functional capacity following MSC-based interventions, particularly in patients with low baseline LVEF and heightened inflammation. Various MSC sources—including bone marrow, adipose tissue, and umbilical cord—offer distinct advantages, while delivery strategies such as intracoronary, intramyocardial, intravenous, and subcutaneous administration impact cell retention and efficacy. Advances in genetic modification, hypoxic preconditioning, and exosome-based therapies aim to enhance MSC survival and therapeutic potency. However, challenges persist regarding cell engraftment, cryopreservation effects, and inter-patient variability. Moving toward precision cell therapy, future approaches may involve stratifying patients by inflammatory status, ischemic burden, and comorbidities to optimize treatment outcomes. MSCs may not yet replace conventional therapies but are increasingly positioned to complement them within a personalized, regenerative framework for CAD management. Full article

Background and Objectives: Oral cancer remains a critical global health burden. Oral potentially malignant disorders (OMPDs) such as leukoplakia and oral lichen planus can precede oral squamous cell carcinoma (OSCC). Inflammation, tissue remodeling, and dysregulated signaling pathways are central to malignant transformation. This observational study aimed to evaluate the expression patterns of Maspin, β-catenin, and MMP-14 by immunohistochemistry (IHC) in oral leukoplakia, oral lichen planus, OSCC, and normal mucosa, exploring associations with lesion type, with no prognostic inferences drawn from a single timepoint. Materials and Methods: Biopsy specimens from 67 patients presenting with oral lesions (27 leukoplakia, 22 lichen planus, 18 OSCC), and 10 healthy controls were collected between January 2015 and January 2023. Inclusion criteria were age over 18 years and no other chronic illness, and a histopathologic diagnosis of oral leukoplakia, oral lichen planus or OSCC. Exclusion criteria were smokers, alcohol abuse, and prior head and neck radiotherapy, prior immunosuppressive therapy, systemic inflammatory diseases, absence of histopathological confirmation of the clinical diagnosis, and squamous cell carcinoma of the vermilion. Two pathologists independently scored staining in 10 high-power fields. Normal mucosa served as baseline. Immunohistochemical analysis was conducted using specific antibodies targeting Maspin, β-catenin, and MMP-14. Marker expression was assessed using a semi-quantitative scoring system based on staining intensity and classified into four categories: negative (−), weakly positive (+) for 1–10%, moderately positive (++) for 11–50%, and highly positive (+++) for more than 50%. Results: Maspin showed moderate (++) cytoplasmic/nuclear staining in leukoplakia and lichen planus in 78% of cases and high (+++) in OSCC and stroma in all cases. β-catenin shifted from membranous moderate positivity in 100% of OPMD cases to cytoplasmic/nuclear high positivity in all cases of OSCC. MMP-14 showed positivity (+) in 89% of OPMDs and high positivity (+++) in 100% of OSCC. Conclusions: Maspin, β-catenin, and MMP-14 exhibit distinct expression patterns across lesion types. While Maspin may reflect early tissue remodeling, β-catenin and MMP-14 changes suggest Wnt signaling activation and matrix remodeling in OSCC. Longitudinal studies are needed to establish their predictive value. This observational study refrains from prognostic claims and instead highlights biomarkers for future validation. Full article

Background: This study aimed to evaluate whether low-concentration iodine contrast-enhanced multiphase low-monoenergetic computed tomography (LCLM CT; 270 mg I/mL, 40 keV) is non-inferior to standard-dose computed tomography (SDCT; 350 mg I/mL) in image quality and lesion detectability for chronic liver disease patients. Methods: Sixty-seven patients underwent both protocols. Image quality was assessed using a 5-point scale with a non-inferiority margin of –0.5. Quantitative metrics included signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Lesion detectability was evaluated using jackknife free-response receiver operating characteristic (JAFROC) analysis with a –0.1 margin. Results: LCLM CT reduced iodine dose per kilogram by 21.9%. Despite higher image noise, it achieved higher CNR for the aorta and hepatic lesions, as well as superior hepatic artery clarity. Image quality was non-inferior (difference: –0.119; 95% CI: –0.192 to –0.047), and lesion detectability (FOM: 0.744 vs. 0.721; difference: 0.023; 95% CI: –0.170 to 0.218) also showed non-inferiority. Conclusions: LCLM CT maintains diagnostic performance and improves vascular contrast while reducing iodine burden, supporting its clinical utility in longitudinal HCC surveillance. Full article

Background Psoriasis (PsO): is an immune-mediated inflammatory disease that imposes a significant burden on patients. Many patients experience relapse or inadequate responses, and PsO subtypes also lack effective therapies, highlighting the need for new therapeutic targets. Methods: We performed a proteome-wide Mendelian randomization (MR) to explore potential therapeutic targets for PsO. Protein quantitative trait loci (pQTLs) data were obtained from the Pharma Proteomics Project (54,219 UK Biobank participants, 2923 proteins), and PsO phenotype and subtype data were sourced from FinnGen (10,312 cases; 397,564 controls) for discovery. Replication MR utilized integrated protein data (Iceland and Norfolk) and phenotype data from multiple databases (UK Biobank and GWAS Catalog). Reverse MR and colocalization were used to support causal relationships. Single-cell RNA-seq analysis revealed distinct expression patterns of protein-coding genes across different cell types in PsO biopsy samples and normal skin tissues. Protein-protein interactions (PPI) and molecular docking were used to evaluate druggability. Results: MR analysis identified 13 proteins significantly associated with PsO risk (p < ), including 10 proteins associated with PsO subtypes. Decreased levels of eight proteins (IFNLR1, APOF, TDRKH, DDR1, HLA-E, LTA, MOG, and ICAM3) and increased levels of five proteins (IFNGR2, HCG22, IL12B, BTN3A2, and TRIM40) showed protective effects against PsO progression. Robust colocalization (PPH₄ > 0.9) identified IFNLR1, IFNGR2, APOF, and TDRKH as top candidates. Single-cell RNA sequencing analysis revealed that IFNLR1, IFNGR2, LTA, TDRKH, and DDR1 were specifically expressed in T cells of psoriatic biopsy specimens compared to healthy controls. Molecular docking indicated the druggability of IFNLR1 and IFNGR2. Conclusions: We identified several potential therapeutic targets for PsO, with IFNLR1, IFNGR2, APOF, and TDRKH emerging as promising candidates, particularly IFNLR1 and IFNGR2, which are associated with the IFN family. These findings may provide new perspectives on PsO therapy and pathogenesis. Full article

Human papillomavirus (HPV) is one of the most common sexually transmitted infections, affecting both men and women. However, in Serbia, the previous epidemiological and clinical research on HPV has primarily focused on women due to its established role in cervical cancer, while the data on HPV prevalence in men remain scarce. This study analyzed 634 samples from men (mean age: 30 years, SD = 9.98; range: 18–79) from between 2012 and 2024. Overall, 30.76% of the tested men were HPV–positive, with the highest percentage of cases being observed in those aged 25–29 years (32.82%). The most common genotypes were HPV 16 and HPV 31 (22.05% each), followed by HPV6 (20.51%), HPV 56, and HPV 52 (9.23% each). The prevalence of HPV was the highest in the samples from men with genital warts (40.77%). Among the available vaccines, the nonavalent Gardasil 9 provides the broadest protection, covering genotypes found in 82% of the HPV–positive cases identified in this study. Our findings underscore the importance of comprehensive HPV prevention and control measures for the male population, contributing to ongoing research efforts aimed at reducing the burden of HPV–associated diseases in our region. Increasing the vaccination coverage among Serbian men could substantially reduce the overall burden of HPV–related diseases in both sexes. Full article

Chronic kidney disease (CKD) is a global health burden that affects close to one billion individuals. As many healthcare systems struggle to accommodate existing patients, CKD incidence and related costs are projected to continue rising. Based on a systematic search, this narrative review offers an in-depth assessment of advances in CKD pharmacotherapy published between 2020 and 2025, with a specific emphasis on drug combinations. Various treatment approaches for CKD exist, many of them targeting different mechanisms. Therefore, combining multiple medications could provide patients with better outcomes, though this comes with the risk of increased adverse effects and unnecessary costs. Alternatively, using biomarkers presents an opportunity to ascertain the most appropriate treatments specifically tailored to an individual’s molecular profile, thus personalizing CKD management. The second part of this review presents the current state-of-the-art methods to guide CKD therapy based on markers predicting treatment response. Collectively, this review presents possible pathways toward more effective CKD treatment. Full article

Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that leads to severe functional decline and death, imposing significant physical, emotional, and ethical burdens on patients and healthcare providers. With no curative treatment, ALS care depends on the early and sustained integration of palliative care to address complex and evolving needs. Nurses play a pivotal role in this process, yet their lived experiences remain underexplored. This study aimed to synthesize qualitative evidence on nurses’ experiences in ALS care, with a focus on emotional, ethical, and palliative dimensions. Methods: A meta-synthesis of qualitative studies was conducted using Sandelowski and Barroso’s four-step method. A systematic search across five databases identified eight studies exploring nurses’ experiences with ALS care. Thematic synthesis was applied to extract overarching patterns. Results: Three core themes emerged: (1) Relational Dimension: From challenges to empathy and Trust and mistrust—emphasizing communication barriers and the value of relational trust; (2) Care Dimension: Competence, Palliative care needs, and Rewarding complexity—highlighting the emotional demands of care, the need for timely palliative integration, and the professional meaning derived from ALS care; (3) Ethical Dimension: Medical interventionism and Patient-centered values—exploring dilemmas around life-sustaining treatments, patient autonomy, and end-of-life decisions. Conclusion: Nurses in ALS care face complex emotional and ethical challenges that call for strong institutional support and palliative training. Enhancing palliative care integration from diagnosis, alongside targeted education and psychological support, is crucial to improving care quality and sustaining the well-being of both patients and nurses. Full article

Obesity is reaching global epidemic proportions worldwide, posing a significant burden on individual health and society. Altered gut microbiota is considered a key factor in the pathogenesis of many diseases, producing metabolites that contribute to the health-beneficial properties of postbiotics. Postbiotics, bioactive microbial components derived from probiotics, are emerging as a valuable strategy in modern medicine and a promising alternative for managing obesity without the need for live bacteria. This work provides a comprehensive overview of the potential health benefits of postbiotics, particularly in relation to obesity, which represents an important health challenge. Despite the encouraging insights into the health benefits of postbiotics, we highlight the need for further research to clarify the mechanisms and the specific roles of different postbiotic components. Integrating postbiotics into health interventions has the potential to enhance preventive care and significantly improve health outcomes in at-risk populations. Full article