Search Results (11,862)

The burden of cancer is growing in almost every country. Bone metastases significantly affect the prognosis and lead to an increase in mortality and morbidity. The management of cancer-induced bone pain (CIBP) still shows various unmet needs. Opioid use is burdened by a number of possible side effects. Moreover, recent progresses in cancer treatment significantly increased the life expectancy of cancer patients, even those with metastatic disease. In this narrative review, we reported the main findings regarding TRP channel function in cancer pain models. TRP cation channels play a key role in different functions of cancer cells, including the regulation of their potential for metastasization, and are the main channels involved in the pathways of pain perception, through peripheral and central effects. Genetic deletion decreased pain sensitivity following tumour cell inoculation. Preclinical data suggest a potential role for modulators of some TRP channels, such as TRPV1, TRPA1, TRPM7 and TRPM8. Clinical results are still scarce; however, the physiological role in modulating bone remodelling and the involvement of TRP channels in preclinical models of bone cancer pain have garnered interest as areas of research in the last few years, as innovative analgesic strategies that may overcome the long-term side effects of opioids. Full article

Alzheimer’s disease (AD) is one of the most common and severe forms of dementia and neurodegenerative disease. As life expectancy increases in line with developments in medicine, the elderly population is projected to increase in the next few decades; therefore, an increase in the prevalence of some diseases, such as AD, is also expected. As a result, until a radical treatment becomes available, AD is expected to be more frequently recorded as one of the top causes of death worldwide. Given the current lack of a cure for AD, and the only treatments available being ones that alleviate major symptoms, the identification of contributing factors that influence disease incidence is crucial. In this context, genetic and/or epigenetic factors, mainly environmental, disease-related, dietary, or combinations/interactions of these factors, are assessed. In this review, we conducted a literature search focusing on environmental factors such as air pollution, toxic elements, pesticides, and infectious agents, as well as dietary factors including various diets, vitamin D deficiency, social factors (e.g., tobacco and alcohol use), and variables that are affected by both environmental and genetic factors, such as dietary behavior and gut microbiota. We also evaluated studies on the beneficial effects of antibiotics and diets, such as the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) and Mediterranean diets. Full article

Background/Objectives: Frailty syndrome significantly impacts the health and quality of life of institutionalised older adults, increasing the risk of adverse outcomes such as disability and mortality. This systematic review aimed to evaluate the effectiveness of physical activity interventions in preventing and mitigating frailty syndrome among institutionalised older adults and to identify key intervention characteristics influencing their effectiveness. Methods: A systematic search following PRISMA guidelines was conducted in the Web of Science, PubMed, and Cochrane databases to identify randomised controlled trials published from 2001 to June 2024. Studies involving institutionalised adults aged 60 or older, assessing the impact of physical activity interventions on frailty using validated measures, were included. A narrative synthesis approach was employed to analyse the findings due to the heterogeneity of interventions and settings. Results: Twelve randomised controlled trials comprising 1223 participants were included. Multicomponent exercise programmes—combining resistance exercises, balance, and aerobic training—consistently improved frailty indicators, including muscle strength, gait speed, and balance, among others parameters. Frailty reversal occurred in 36% of participants, with interventions showing a reduction in frailty criteria and improved functional autonomy. Programmes integrating physical activity with cognitive or nutritional components demonstrated high efficacy. The control groups showed minimal improvement, highlighting the unique impact of tailored interventions. Despite variability in intervention design, frailty was consistently shown to be reversible in pre-frail and frail individuals, where the benefits were evident including for individuals over 85 years old. Conclusions: Physical activity interventions, particularly multicomponent exercise programmes, are effective in reducing frailty and improving health outcomes in institutionalised older adults. Future research should focus on optimising intervention characteristics and exploring the long-term sustainability of benefits in diverse populations. These findings reinforce the importance of exercise as a cornerstone in frailty management. Full article

Saliva has emerged as a powerful diagnostic tool due to its non-invasive collection, straightforward storage, and ability to mirror systemic health. This narrative review explores the diagnostic potential of salivary biomarkers in detecting systemic diseases, supported by examples such as salivary proteomics’ role in monitoring endocrine disorders, cancer, and viral infections. Advances in technologies like microfluidics, biosensors, and next-generation sequencing have enhanced the sensitivity and specificity of salivary diagnostics, making it a viable alternative to blood-based diagnostics. The review also evaluates challenges such as the need for standardized collection protocols, variability in salivary composition, and the integration of these technologies into clinical workflows. The findings emphasize the transformative potential of saliva in personalized medicine, especially for early disease detection and real-time health monitoring. Practical applications include its use in mass screenings and public health crises, highlighting saliva as a cornerstone for future advancements in non-invasive diagnostics. Full article

Introduction: Breastfeeding plays a fundamental role in newborns’ and infants’ health. Breast milk’s protective power against malnutrition and its positive effect on neurological and physical development are well established and are reflected in the policy statements of all major pediatric health entities. However, breastfeeding also plays an important role in the prevention of so-called non-communicable diseases, such as obesity, hypertension, dyslipidemia, and autoimmune diseases. Methods: This narrative review aims to analyze the effect of breastfeeding and breast milk on the development of non-communicable diseases, with a special focus on weight excess, dyslipidemia, allergy, and gastrointestinal diseases. This narrative review was carried out through three steps: executing the search, examining abstracts and full texts, and analyzing results. To achieve this, the databases PubMed, EMBASE, Scopus, ScienceDirect, Web of Science, and Google Scholar were explored to collect and select publications from 1990 to 2024 to find pertinent studies in line with this review’s development. The search included randomized placebo-controlled trials, controlled clinical trials, double-blind, randomized controlled studies, and systematic reviews. A total of 104 manuscripts were ultimately included in the analysis. Results: Breastfeeding is associated with a decreased vulnerability to early viral infections or chronic inflammatory conditions during preschool years, a reduced incidence of weight excess, and likely lower cholesterol concentration, besides having a small protective effect against systolic blood hypertension. Conclusions: Pediatricians must promote breastfeeding, support the mother–infant dyad, and consider breast milk as a real “health voucher” that can last lifelong. However, further studies are needed to better define the extent and duration of breastfeeding’s protective power in this context. Full article

Background: To minimize systematic bias, long-term follow-up is essential to assess the effect of resilience-building interventions. However, research focuses on the short-term period immediately following these interventions. Objectives: We investigated the long-term impact of resilience-building interventions on nurses, as measured via RCTs. Methods: A narrative review based on a systematic literature search (September–15 November 2024) using the keywords “Resilience/Psychological, Adaptation/Psychological, nurses, randomized controlled trial, follow-up” in the EBSCOhost, MEDLINE, ProQuest, Google Scholar, PubMed, and Scopus databases was applied. Results: A total of 38 studies were identified. Of these, only six encompassed long-term follow-up assessment after resilience-building interventions, also meeting the inclusion criteria for this review. Two of them focused on critical care nurses. Intervention durations ranged from 8 to 12 weeks, with shorter interventions also included (90 min lecture on stress, 3 h sensory awareness class). These data suggest that resilience improvements may become apparent 3 months post intervention, even when no immediate improvement is observed upon program completion, highlighting the importance of timing in the assessment process. Conclusions: These findings provide valuable insights for researchers designing resilience programs in critical care environments. Selecting appropriate assessment tools and conducting measurements at multiple time points may be as crucial as the interventions themselves in determining their effectiveness. This is clinically meaningful since it may inform providers of resilience programs for the time frame during which they need to be applied. Potentially, future research can explore what characteristics these interventions need to have in order to be effective longitudinally. Full article

The maintenance of the integrity of the entire endothelium, glycocalyx included, and, therefore, of tissue aorta’s homeostasis, depends on the expressions of several molecular pathways and their interactions, such as syndecan molecules. Alterations in syndecans, i.e., quantitative alterations or linking to their shedding, contributes to invoking endothelium dysfunction, which causes damage to the vessel wall due to the increased production of growth-stimulating and pro-inflammatory gene products. Inflammatory processes negatively affect the integrity of the endothelial glycocalyx, a dynamic layer of the luminal portion of endothelial cells composed of proteoglycans, glycoproteins, and glycosaminoglycans, i.e., syndecans. In turn, structural alterations in the endothelial glycocalyx influence the coagulative state, increasing pro-thrombotic processes. The family of syndecans constitutes a major component of glycocalyx or, more accurately, the major source of cell surface heparan sulfate. It encompasses four components: syndecan-1, syndecan-2, and syndecan-4 (with syndecan-3 only expressed in neural tissue), which have a fundamental role in regulating the events of acute and chronic aorta damage subsequently correlated with the formation of aneurysms. As such, the aim of our review is to highlight the current knowledge on the roles of syndecans and to analyze their relationship with the pathological processes of the aortic wall based on the most recent literature. Full article

Dengue is a growing global public health challenge, with rising incidence and case fatality rates fueled by urbanization and climate change. The substantial mortality, morbidity, and economic burden associated with the disease underscore the need for effective prevention strategies, including vector control, personal protective measures, and vaccination. This narrative review provides a practical guide for clinicians to ensure the appropriate administration of dengue vaccines to at-risk groups, such as individuals in endemic regions and travelers to these areas. Live-attenuated tetravalent dengue vaccines, including Dengvaxia^®, Qdenga^®, and Butantan-DV, have demonstrated efficacy in clinical trials but require careful use due to the risk of antibody-dependent enhancement (ADE). To mitigate this risk, guidelines recommend vaccination primarily for individuals with prior confirmed dengue infection, emphasizing the importance of accessible and affordable point-of-care rapid testing. Co-administration of dengue vaccines with other live-attenuated or inactivated vaccines has been shown to be safe and immunogenic, broadening their potential application. However, live-attenuated vaccines are contraindicated for immunocompromised individuals and pregnant women. Enhancing clinician awareness, expanding diagnostic capabilities, and prioritizing high-risk populations are critical steps to optimize vaccination strategies. Combined with robust prevention programs, these efforts are essential to reducing the global burden of dengue and mitigating its impact. Full article

This article explores the veneration of Hatixhe, an 18th-century Sufi saint from Tirana, Albania, whose legacy continues to resonate across religious and cultural boundaries. Despite limited historical records, Hatixhe’s sainthood is venerated through hagiographic narratives that portray her as a compassionate healer, spiritual protector, and symbol of resilience. This study investigates the visual, ritual, and sensory dimensions of her shrine, which has become one of the focal points for interfaith devotion in post-socialist Albania. Embodied rituals—such as touching her tomb and lighting candles—allow devotees to connect with her shenjtëri (“sainthood”). Through these acts, Hatixhe’s legacy as a grua e shenjt (“holy woman”) or grua e mirë (“good woman”) is anchored in both religious and cultural contexts, as her shenjtëri integrates local and national values, partly transcending Islamic frameworks. Hatixhe’s teqe, preserved through the efforts of her female heirs during the communist era, serves as a unique testament to a female lineage in Albanian Sufism. By examining the spatial, material, and symbolic aspects of her veneration, this study underscores the significance of Hatixhe’s shenjtëri as a site of blessing and communal solidarity for women, enriching the understanding of their roles in Albanian spiritual and social life. Full article

Background: A growing body of research has documented persistent wage gaps between women and men in the healthcare workforce, a pattern widely observed across cadres and countries. Less well known is whether various intersecting characteristics often associated with social discrimination may exacerbate or attenuate gendered disparities. This review scopes contemporary research from diverse settings focusing on how race, ethnicity, and sexual and gender minority status may intersect in shaping earnings differentials among healthcare practitioners to help inform policy and management decisions. Methods: Studies quantifying the intersecting axes of gender and other postulated social drivers of differed practitioner earnings were identified by systematically searching five bibliographic databases (Embase, CINAHL, EconLit, SocIndex, and PsychInfo) and scanning the reference lists of review articles and other forms of the global health literature. A total of 2123 reports were retrieved; after screening, 21 articles were retained for narrative synthesis. Results: The studies covered data from four countries (Brazil, Norway, the United Kingdom, and the United States). Physicians were researched most often (43% of the synthesized articles) followed by nurses (38%). No uniform patterns were found in gendered earnings variations stratified by race, ethnicity, and/or ancestry; however, wide variations were seen in the way the relationships were operationalized across studies and contexts. One investigation included sexual orientation as a factor in earnings gaps, but presented results combined with other personal characteristics. None of the studies examined wage data by gender minority status. Conclusions: This review highlighted notable limitations in the available research in relation to disaggregated measures of ethnocultural heterogeneity, robust methodologies and transparent reporting, and the underlying health workforce information systems for incorporating more diversity elements and enhancing cross-national comparability in assessments of structural wage gaps among healthcare practitioners. Full article

Cancer cells utilize larger amounts of glucose than their normal counterparts, and the expression of GLUT transporters is a known diagnostic target and a prognostic factor for many cancers. Recent evidence has shown that sodium-glucose transporters are also expressed in different types of cancer, and SGLT2 has raised particular interest because of the current availability of anti-diabetic drugs that block SGLT2 in the kidney, which could be readily re-purposed for the treatment of cancer. The aim of this article is to perform a narrative review of the existing literature and a critical appraisal of the evidence for a role of SGLT2 inhibitors for the treatment and prevention of cancer. SGLT2 inhibitors block Na-dependent glucose uptake in the proximal kidney tubules, leading to glycosuria and the improvement of blood glucose levels and insulin sensitivity in diabetic patients. They also have a series of systemic effects, including reduced blood pressure, weight loss, and reduced inflammation, which also make them effective for heart failure and kidney disease. Epidemiological evidence in diabetic patients suggests that individuals treated with SGLT2 inhibitors may have a lower incidence and better outcomes of cancer. These studies are confirmed by pre-clinical evidence of an effect of SGLT2 inhibitors against cancer in xenograft and genetically engineered models, as well as by in vitro mechanistic studies. The action of SGLT2 inhibitors in cancer can be mediated by the direct inhibition of glucose uptake in cancer cells, as well as by systemic effects. In conclusion, there is evidence suggesting a potential role of SGLT2 inhibitors against different types of cancer. The most convincing evidence exists for lung and breast adenocarcinomas, hepatocellular carcinoma, and pancreatic cancer. Several ongoing clinical trials will provide more information on the efficacy of SGLT2 inhibitors against cancer. Full article

Antimicrobial resistance (AMR) poses a critical global health threat, necessitating innovative approaches in antimicrobial stewardship (AMS). Artificial intelligence (AI) and machine learning (ML) have emerged as transformative tools in this domain, enabling data-driven interventions to optimize antibiotic use and combat resistance. This comprehensive review explores the multifaceted role of AI and ML models in enhancing antimicrobial stewardship efforts across healthcare systems. AI-powered predictive analytics can identify patterns of resistance, forecast outbreaks, and guide personalized antibiotic therapies by leveraging large-scale clinical and epidemiological data. ML algorithms facilitate rapid pathogen identification, resistance profiling, and real-time monitoring, enabling precise decision making. These technologies also support the development of advanced diagnostic tools, reducing the reliance on broad-spectrum antibiotics and fostering timely, targeted treatments. In public health, AI-driven surveillance systems improve the detection of AMR trends and enhance global monitoring capabilities. By integrating diverse data sources—such as electronic health records, laboratory results, and environmental data—ML models provide actionable insights to policymakers, healthcare providers, and public health officials. Additionally, AI applications in antimicrobial stewardship programs (ASPs) promote adherence to prescribing guidelines, evaluate intervention outcomes, and optimize resource allocation. Despite these advancements, challenges such as data quality, algorithm transparency, and ethical considerations must be addressed to maximize the potential of AI and ML in this field. Future research should focus on developing interpretable models and fostering interdisciplinary collaborations to ensure the equitable and sustainable integration of AI into antimicrobial stewardship initiatives. Full article

Background: Artificial intelligence (AI) is revolutionizing occupational health and safety (OHS) by addressing workplace hazards and enhancing employee well-being. This review explores the broader context of increasing automation and digitalization, focusing on the role of human–AI interaction in improving workplace health, safety, and productivity while considering associated challenges. Methods: A narrative review methodology was employed, involving a comprehensive literature search in PubMed, Embase, and Scopus for studies published within the last 25 years. After screening for relevance and eligibility, a total of 52 articles were included in the final analysis. These publications examined various AI applications in OHS, such as wearable technologies, predictive analytics, and ergonomic tools, with a focus on their contributions and limitations. Results: Key findings demonstrate that AI enhances hazard detection, enables real-time monitoring, and improves training through immersive simulations, significantly contributing to safer and more efficient workplaces. However, challenges such as data privacy concerns, algorithmic biases, and reduced worker autonomy were identified as significant barriers to broader AI adoption in OHS. Conclusions: AI holds great promise in transforming OHS practices, but its integration requires ethical frameworks and human-centric collaboration models to ensure transparency, equity, and worker empowerment. Addressing these challenges will allow workplaces to harness the full potential of AI in creating safer, healthier, and more sustainable environments. Full article

Traumatic experiences are significant life events that are thought to impact one’s personal life narrative and narrative identity. Individuals who have experienced trauma may display fragmented memories and decreased narrative cohesion, resulting in trauma narratives that are disjointed and poorly integrated into the larger picture of their lives. Metacognition, defined as the ability to form increasingly complex and integrated ideas about the self, others, and the wider world, offers a framework to better understand life narratives and has been proposed as a construct that allows personal narratives to evolve in response to new experiences. In this paper, we will review the alterations commonly observed in trauma narratives. We will utilize the integrated model of metacognition as a framework to understand these deviations with an eye toward clinical implications. Although treatments that focus on trauma narratives exist, we argue that the study of metacognition provides unique insights into the process of integration of traumatic experience into an evolving personal narrative and may allow for more complete treatment of trauma-related disorders. Full article