Medicina (Kaunas, Lithuania)最新文献

{"title":"Superior Mesenteric Artery Syndrome Across Adulthood: A Retrospective Clinicoradiological Case Series.","authors":"Alina Cristiana Venter, Gineta Andreescu, Oana Alexandra Isac, Timea Claudia Ghitea, Lavinia Florica Marcut, Corina Suteu, Cristian Marius Daina","doi":"10.3390/medicina62091812","DOIUrl":"10.3390/medicina62091812","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Superior mesenteric artery syndrome (SMAS) is an uncommon cause of proximal duodenal obstruction that requires clinicoradiological correlation. <i>Materials and Methods</i>: We retrospectively reviewed 13 patients with SMAS identified at the Clinical County Emergency Hospital Bihor, Romania, during 2019-2024. Clinical records and contrast-enhanced computer tomography (CT) examinations were reviewed descriptively. <i>Results</i>: The cohort included 13 adults aged 19-85 years (mean 45.5 ± 17.8; median 43 years). Abdominal pain was reported in 12/13 patients (92.3%), vomiting or emetic symptoms in 6/13 (46.2%), feeding difficulty or appetite disturbance in 5/13 (38.5%), and documented weight loss in 3/13 (23.1%). CT measurements were available for the aortomesenteric angle in 7/13 patients (range, 10-25°) and for the aortomesenteric distance in 8/13 (range, 3-8 mm); direct third-part duodenal compression and proximal dilatation were interpreted together with compatible symptoms. Imaging showed Nutcracker-type left renal vein compression in 3/13 patients (23.1%) and possible May-Thurner anatomy in 1/13 (7.7%); these findings were not adjudicated as clinical syndromes without corresponding manifestations. Based on the management labels, 9/13 patients (69.2%) underwent surgery at some point and 4/13 (30.8%) received medical therapy only. Standardized follow-up and procedure-level outcome data were not available for all patients. <i>Conclusions</i>: This small, retrospective series is descriptive and cannot estimate prevalence, diagnostic delay, or comparative treatment effectiveness. It illustrates heterogeneous adult presentations and supports interpreting aortomesenteric measurements together with compatible symptoms and evidence of duodenal obstruction.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cerebroplacental-Renal Ratio as a Novel Doppler-Based Marker of Adverse Perinatal Outcome in Pregnancy-Induced Hypertension.","authors":"Yücel Kaya, Kübra Kurt Bilirer, Aybekcan Batman, Burcu Çiçek, İlteriş Yaman, Ali Selçuk Yeniocak, Can Tercan, Karolin Ohanoglu Cetinel, Damla Yasemin Yenliç Kaya, Gülseren Polat","doi":"10.3390/medicina62091806","DOIUrl":"10.3390/medicina62091806","url":null,"abstract":"<p><p><i>Background and Objectives:</i> To evaluate the association between the newly defined cerebroplacental-renal ratio (CPRR) and adverse perinatal outcome (APO) in pregnancy-induced hypertension (PIH), and to compare its discriminative performance with the cerebroplacental ratio (CPR) and cerebroplacental-uterine ratio (CPUR). <i>Materials and Methods:</i> This prospective, single-center cohort study included 105 women with PIH (preeclampsia, <i>n</i> = 63; gestational hypertension, <i>n</i> = 42). Doppler assessment was performed at ≥34 + 0 weeks and within 7 days before delivery. CPR was calculated as middle cerebral artery pulsatility index (PI)/umbilical artery PI, CPUR as CPR/mean uterine artery PI, and CPRR as CPR/right renal artery PI. APO was defined by the presence of any of the following: non-reassuring fetal status, a 5 min Apgar score <7, neonatal intensive care unit admission, or neonatal death. Receiver operating characteristic analysis and multivariable logistic regression adjusted for gestational age at ultrasound assessment and diagnosis group were performed. <i>Results:</i> APO occurred in 37 pregnancies (35.2%). CPUR and CPRR were significantly lower in the APO group, whereas CPR did not differ significantly. CPRR showed a higher apparent AUC for APO than CPR and CPUR (AUC 0.786, 95% CI 0.698-0.875), with significantly higher AUCs on pairwise DeLong comparisons. After adjustment, CPRR was the only Doppler index independently associated with APO (adjusted OR 1.423 per 0.1-unit decrease; 95% CI 1.162-1.743; <i>p</i> = 0.001). <i>Conclusions:</i> CPRR was independently associated with APO in PIH and showed higher discriminative performance than CPR and CPUR; however, these findings require validation in independent, multicenter studies before clinical application.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preclinical Evaluation of Labetalol for Cutaneous Melanoma Drug Repurposing: Cytotoxic Activity in A375 Cells and Mitochondria-Associated Apoptotic Signaling.","authors":"Richard Dahma, Elena-Alina Moacă, Iasmina-Alexandra Predescu, Ana-Cristiane Dragomir, Oana-Andrada Iftode, Stela Iurciuc, Diana Haj Ali, Ioana Macaşoi, Maria Sala-Cîrtog, Iulia-Najette Crintea, Alina-Doina Tănase, Marilena Dinuţi","doi":"10.3390/medicina62091802","DOIUrl":"10.3390/medicina62091802","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Drug repurposing provides an opportunity to identify anticancer activities among established pharmacological agents. Labetalol (LB), an α₁- and non-selective β-adrenergic receptor antagonist, has been insufficiently investigated in melanoma. This study evaluated the potential anti-melanoma activity of LB in A375 human melanoma cells, compared its effects with those observed in HaCaT immortalized non-tumoral keratinocytes, and investigated the cellular mechanisms associated with LB-induced cytotoxicity. <i>Materials and Methods</i>: A375 and HaCaT cells were exposed to 75-500 μM LB for 24 h. Cell viability and lysosomal dye retention were assessed using MTT and NRU assays. A DMSO-only concentration series (0.075-0.50% <i>v</i>/<i>v</i>) was additionally evaluated by MTT in both cell lines. Mitochondrial membrane potential, mitochondrial staining patterns, nuclear morphology, cytoskeletal organization, caspase-3/7 and caspase-9 activities, and plasma membrane integrity were evaluated using JC-1, MitoTracker Red CMXRos, immunofluorescence, luminescence-based caspase assays, and AO/PI staining. The acute irritation potential of 500 μM LB was assessed using the HET-CAM assay. <i>Results</i>: DMSO alone did not significantly reduce viability over the investigated concentration range in either cell line. LB reduced A375 cell viability in a concentration-dependent manner, with a 24 h IC₅₀ of 422.5 μM and a viability of 33.61% at 500 μM. Under the same experimental conditions, HaCaT viability remained at 89.01% at 500 μM, and an IC₅₀ was not reached within the investigated concentration range. At the highest concentration, neutral red uptake and the JC-1 aggregate/monomer ratio decreased to approximately 33% and 24% of the corresponding control values, respectively. The apoptotic index increased from approximately 3% in control cells to 31%, while caspase-3/7 and caspase-9 activities increased to approximately 482% and 324% of the control. Qualitative imaging demonstrated mitochondrial staining redistribution, cytoskeletal disorganization, apoptosis-associated morphology, and loss of plasma membrane integrity at higher concentrations. In the HET-CAM assay, 500 μM LB produced a mean irritation score of 0.71 ± 0.27, within the non-irritant range. <i>Conclusions</i>: LB displayed concentration-dependent in vitro cytotoxicity in A375 melanoma cells, whereas HaCaT keratinocytes showed limited changes under the investigated conditions. LB treatment was also associated with mitochondria-associated apoptotic signaling in A375 cells. These findings provide preliminary evidence supporting further investigation of LB within a melanoma-directed drug-repurposing strategy. Additional studies are required to establish receptor dependence, achievable local exposure, safety, and translational relevance.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated First-Trimester Assessment of Placental Biomarkers, Metabolic Indices, and IGF-1/IGFBP-5 in Relation to Subsequent Gestational Diabetes Mellitus: A Prospective Cohort Study.","authors":"Soner Gök, Berfin Can Gök, Esin Avcı Çiçek, Hande Senol","doi":"10.3390/medicina62091804","DOIUrl":"10.3390/medicina62091804","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Gestational diabetes mellitus (GDM) is usually diagnosed at 24-28 gestational weeks, although metabolic and placental alterations may emerge considerably earlier. This study evaluated whether routinely available first-trimester placental biomarkers, metabolic indices, and insulin-like growth factor (IGF)-axis components are associated with GDM diagnosed later in pregnancy and whether these markers provide complementary information across distinct biological domains. <i>Materials and Methods</i>: Of 200 women completing the 75-g OGTT (34 with GDM and 166 normoglycemic), deferred IGF-1 and IGFBP-5 assays were performed in a complete-biomarker analytic cohort of 90 participants with complete clinical follow-up and available stored specimens (30 GDM and 60 controls). At 11+0-13+6 weeks, pregnancy-associated plasma protein-A (PAPP-A), free β-human chorionic gonadotropin (free β-hCG), IGF-1, IGF-binding protein-5 (IGFBP-5), fasting glucose, insulin, and lipid parameters were assessed. HOMA-IR, the triglyceride-glucose (TyG) index, TG/HDL-C, and LDL/HDL-C were calculated. GDM was diagnosed using a 75-g oral glucose tolerance test at 24-28 weeks. Group comparisons, correlation analyses, and logistic regression were performed. <i>Results</i>: Compared with controls, women who later developed GDM had higher first-trimester insulin, HOMA-IR, triglycerides, VLDL-C, TyG, and TG/HDL-C and lower HDL-C, free β-hCG, PAPP-A, PAPP-A MoM, and IGF-1 (all <i>p</i> < 0.05). Birth weight was also higher in the GDM group. Correlation patterns differed between groups, suggesting distinct relationships among placental, metabolic, and IGF-related markers. In the four-variable adjusted model, higher HOMA-IR (OR 2.123, 95% CI 1.089-4.137; <i>p</i> = 0.027) and TyG (OR 3.747, 95% CI 1.010-13.894; <i>p</i> = 0.048) were associated with increased GDM odds, whereas free β-hCG MoM (OR 0.325, 95% CI 0.115-0.920; <i>p</i> = 0.034) and IGF-1 (OR 0.856, 95% CI 0.748-0.980; <i>p</i> = 0.024) showed inverse associations. <i>Conclusions</i>: Pregnancies that subsequently developed GDM showed detectable first-trimester differences across metabolic, placental, and IGF-related pathways. The combined pattern supports further evaluation of multidomain early-risk assessment, although clinical predictive utility requires validation in larger independent cohorts.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Hospital Admission and Cardiac Diagnosis in Children Presenting with Chest Pain: The Role of Recurrent Presentation and Inflammatory Markers.","authors":"Şule Demir, Murat Ayar, Ayşe Nilsu Doğan, Aykut Çağlar","doi":"10.3390/medicina62091809","DOIUrl":"10.3390/medicina62091809","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Pediatric chest pain is usually benign, but identifying children who require admission or have a cardiac diagnosis remains challenging. We aimed to identify factors associated with these outcomes, with a focus on recurrent presentation and the combined value of C-reactive protein (CRP) and predefined red-flag findings. <i>Materials and Methods</i>: This retrospective cohort included children aged 0-18 years presenting with chest pain to a tertiary pediatric emergency department between January 2021 and January 2026; visits with insufficient documentation were excluded. Red-flag findings were predefined as effort-related chest pain, syncope, palpitations, dyspnea, fever, or a family history of sudden cardiac death. Independent predictors were assessed using multivariable Firth logistic regression, and cluster-robust standard errors were used in a sensitivity analysis to account for recurrent visits. <i>Results</i>: Of 1703 visits (1435 patients), 452 (26.5%) were recurrent presentations. Admission occurred in 64 visits (3.8%), and 91 (5.3%) had a cardiac diagnosis. Red-flag findings (OR, 5.15), abnormal ECG (OR, 4.00), CRP > 5 mg/L (OR, 3.71), male sex (OR, 2.13), and recurrent presentation (OR, 2.51) were independently associated with admission (all <i>p</i> ≤ 0.009). Recurrent presentation was not associated with a cardiac or psychogenic diagnosis. Admission and cardiac diagnosis rates increased from 1.4%/2.2% in children with neither elevated CRP nor red-flag findings to 22.2%/24.8% in those with both. Routine ECG, troponin, and chest radiography had low diagnostic yields (2.1-6.0%), whereas echocardiography performed selectively yielded abnormal findings in 79.7%. <i>Conclusions</i>: Red-flag findings, abnormal ECG, elevated CRP, and recurrence were associated with admission, whereas recurrence was not associated with diagnosis. Combining CRP with red flags may improve risk stratification, though prospective validation is needed.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DAMPs and PAMPs in the Perioperative Period: Danger Signaling, Immune Dysfunction, and Oncologic Implications.","authors":"Hector Katifelis, Theofania Lappa, Sofia Poulopoulou, Maria Gazouli","doi":"10.3390/medicina62091807","DOIUrl":"10.3390/medicina62091807","url":null,"abstract":"<p><p><i>Background and Objectives</i>: The perioperative period is characterized by marked biological stress responses that extend beyond direct tissue injury. Innate immune activation during surgery is largely driven by molecular danger signals. Surgical trauma, ischemia-reperfusion injury, blood transfusions, mechanical ventilation, and perioperative infections are critical events that result in the release of danger signals: damage-associated molecular patterns (DAMPs) and pathogen-associated molecular patterns (PAMPs). This narrative review examines perioperative DAMP and PAMP sources, their molecular recognition pathways, and their clinical and oncological significance. <i>Materials and Methods</i>: A literature search was conducted across PubMed/MEDLINE, Scopus, and Web of Science databases for English-language articles published up to July 2026. Search terms included DAMPs, PAMPs, perioperative, surgical stress, cancer surgery, innate immunity, PRRs, TLRs, inflammasome, HMGB1, mtDNA, perioperative immunosuppression, and anesthesia. <i>Results:</i> Danger signals interact with pattern-recognition receptors, including Toll-like receptors and inflammasome pathways, driving sterile inflammation, immune dysregulation, and postoperative organ injury. Rather than initiating these cascades, anesthetics and opioids act as modulators. In cancer surgery, heightened danger signaling and temporary immunosuppression may compromise host defenses during a vulnerable window. <i>Conclusions</i>: Circulating DAMPs and potentially selected PAMP-related markers warrant further investigation as biomarkers for perioperative risk stratification. Overcoming translational barriers will require standardized assays, validation of biomarker signatures, and integration of artificial intelligence-driven molecular profiling to advance personalized onco-anesthesia strategies.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Eleven-Point Ultrasound-Guided Fascia Hydrorelease Protocol for Non-Odontogenic Toothache and Orofacial Pain: A Clinical Protocol.","authors":"Hiroaki Kimura, Tadashi Kobayashi, Ryoya Asaka, Hideaki Obata","doi":"10.3390/medicina62091808","DOIUrl":"10.3390/medicina62091808","url":null,"abstract":"<p><p><i>Background and Objectives:</i> Non-odontogenic toothache often persists without an identifiable dental cause and may lead to unnecessary pulpectomy or tooth extraction. It may also result in long-term combined use of psychotropic medications, forming a recurrent clinical pattern. Ultrasound-guided fascia hydrorelease (US-FHR) targeting fascia-derived pathology has been applied to non-odontogenic toothache; however, treatment regions have not been systematically described. This article presents a proposed eleven-point US-FHR protocol for non-odontogenic toothache and related orofacial pain. <i>Materials and Methods:</i> This is an experience-based clinical protocol; it is not an efficacy study and does not include a new prospective study on human participants. The protocol was organized on the basis of long-term clinical experience at Kimura Pain Clinic and a focused literature search. <i>Results:</i> The protocol comprises 11 POINTs distributed across six anatomical regions: (1) three POINTs in the masticatory muscle region, (2) three POINTs in the medial pterygoid and capsular region, (3) one POINT in the parotid region, (4) two POINTs in the cervical region, (5) one POINT in the facial-artery region, and (6) one POINT in the upper posterior cervical region. For each POINT, the anatomical rationale, referred-pain pattern, procedural concept, and safety considerations are described. <i>Conclusions:</i> The proposed eleven-point protocol represents an expanded and structured development of the earlier four-region approach. Prospective, ideally controlled, studies are needed to evaluate its clinical effectiveness.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of the Richmond Agitation-Sedation Scale for Mortality and Admission in Older Emergency Department Patients.","authors":"Secdegül Coşkun Yaş, Mehmet Ali Aslaner","doi":"10.3390/medicina62091803","DOIUrl":"10.3390/medicina62091803","url":null,"abstract":"<p><p><i>Background and Objectives:</i> Altered arousal may provide rapid prognostic information in older emergency department (ED) patients. Originally developed to monitor agitation and sedation in critically ill patients, the Richmond Agitation-Sedation Scale (RASS) provides a rapid measure of arousal. However, its prognostic value relative to the Glasgow Coma Scale (GCS) in older ED patients remains uncertain. We evaluated whether RASS was associated with clinical outcomes and provided information beyond GCS. <i>Materials and Methods:</i> This study was a single-center retrospective cohort study of nontraumatic ED patients aged ≥ 65 years from January 2024 through October 2025. Only the first ED visit per patient was included. The primary outcome was in-hospital mortality; secondary outcomes were hospital and intensive care unit (ICU) admission. RASS was modeled categorically to preserve deviations in both directions from 0. Multivariable logistic regression and DeLong AUC comparisons were performed. <i>Results:</i> Among 10,208 patients, 352 (3.4%) died, 2301 (22.5%) were hospitalized, and 856 (8.4%) were admitted to the ICU. Mortality increased from 2.2% at RASS 0 to 59.4% at -5 and 45.5% at +3. Hospital and ICU admission rates also increased in both directions from RASS 0 (all trend <i>p</i> < 0.001). After adjustment for age, sex, vital signs, and GCS, both reduced arousal (RASS ≤ -4: aOR, 4.93; 95% CI, 2.10-11.61) and agitation (RASS ≥ +2: aOR, 5.16; 95% CI, 2.46-10.85) remained associated with mortality. RASS and GCS had similar discrimination for mortality (AUC, 0.683 vs. 0.679; <i>p</i> = 0.72), whereas their combination improved discrimination (AUC, 0.712; both comparisons <i>p</i> < 0.001). Among patients with GCS 15, mortality was 9.9% with abnormal RASS versus 1.9% with RASS 0. <i>Conclusions:</i> RASS demonstrated a bidirectional association with adverse outcomes and provided prognostic information comparable to and complementary to GCS. Its rapid assessment may help identify high-risk older ED patients, including those with GCS 15.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Exercise-Based Interventions on Depressive Symptoms in Adults with Lung Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Mesut Süleymanoğulları, Zarife Pancar","doi":"10.3390/medicina62091805","DOIUrl":"10.3390/medicina62091805","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Exercise is increasingly used in supportive care for lung cancer, but its effects on depressive symptoms remain uncertain. This systematic review and meta-analysis synthesized randomized evidence. <i>Materials and Methods</i>: Four electronic databases were searched for reports published from January 2000 to July 2026. Eligible studies enrolled adults with lung cancer and compared a structured exercise-based intervention with usual care or an eligible active rehabilitation comparator. One depression result per independent trial was selected using documented rules for assessment time, outcome format, and multiple intervention arms. A random-effects model used REML with Hartung-Knapp inference. <i>Results</i>: Seventeen studies met the eligibility criteria; 15 independent trials (1041 participants) contributed to the primary synthesis. The pooled effect favored exercise (Hedges' g = -0.75, 95% CI -1.18 to -0.32; <i>p</i> = 0.002), but heterogeneity was considerable (τ² = 0.4582; τ = 0.6769; I² = 87.1%; H² = 7.76; Q(14) = 74.11, <i>p</i> < 0.001) and the 95% prediction interval crossed the null (-2.27 to 0.76). The direction remained favorable in all sensitivity analyses, although exclusion of two influential studies attenuated the pooled effect to -0.49 and reduced I² to approximately 0%. Exploratory subgroup and study-level moderator analyses did not identify a stable explanation for heterogeneity. Certainty was very low after downgrading for risk of bias, inconsistency, and indirectness. <i>Conclusions</i>: Exercise-based interventions may reduce depressive symptom scores in some adults with lung cancer, but confidence in the magnitude and transferability of the average effect is limited. The evidence does not establish efficacy for major depressive disorder or identify an optimal modality, dose, or delivery format.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translation and Assessment of Structural Validity and Internal Consistency of the Polish Health Literacy Questionnaire (HLQ) in Health Professions Students.","authors":"Agnieszka Lipiak, Monika Karasiewicz, Barbara Gawłowska, Rafał Staszewski, Sylwia Wiśniewska-Leśków, Melanie Hawkins, Richard H Osborne, Ewelina Chawłowska","doi":"10.3390/medicina62091801","DOIUrl":"10.3390/medicina62091801","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Assessing health literacy requires valid measurement tools that capture its multidimensional nature. The nine-scale Health Literacy Questionnaire (HLQ) is globally used for this purpose. This study reports on the initial psychometric assessment of the Polish version of the HLQ. <i>Materials and Methods</i>: The HLQ was translated using the developers' Translation Integrity Procedure and administered to 918 health professions students in a cross-sectional survey. Confirmatory factor analyses (CFA) and reliability tests were conducted. <i>Results</i>: One-factor CFAs generally supported the intended structure of the individual HLQ scales, although some variation in model fit was observed across scales. A full, restrictive nine-factor CFA supported the original nine-factor model, with good fit indices: χ²_WLSMV (866 df) = 1752.08, <i>p</i> < 0.0001, CFI = 0.973, TLI = 0.970, SRMR = 0.045, RMSEA = 0.035. Factor loadings were generally acceptable (≥0.50), with only two items below the threshold. Internal consistency of scales was good to acceptable in all but one domain marginally lower than desired: \"Appraisal of health information\" (Cronbach's α = 0.69, composite reliability 0.68). <i>Conclusions</i>: The findings provide initial evidence supporting structural validity and internal consistency of the Polish HLQ in this sample. Further testing in other Polish populations is recommended.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}