Advances in Clinical and Experimental Medicine最新文献

{"title":"Honey-based dressing vs gelatin sponge for palatal wound healing after free gingival graft harvest: A randomized clinical trial.","authors":"Nela Molga-Chlipała, Bartłomiej Górski","doi":"10.17219/acem/213515","DOIUrl":"https://doi.org/10.17219/acem/213515","url":null,"abstract":"<p><strong>Background: </strong>Subepithelial connective tissue graft (SCTG) is commonly used in dental procedures and is associated with postoperative discomfort at the palatal donor site. The question is whether the use of a honey-based dressing may improve patients' postoperative experience and promote wound healing.</p><p><strong>Objectives: </strong>The aim of this study was to compare the effects of a non-adherent viscose net dressing coated with 99% Manuka honey and 1% Manuka oil (Actilite; Advancis Medical, Kirkby-in-Ashfield, UK) and an absorbable hemostatic porcine gelatin sponge (Aegis Lifesciences, Sanand, India) on the healing of the palatal donor site and patient morbidity after free gingival graft (FGG) preparation.</p><p><strong>Material and methods: </strong>A total of 21 patients (16 females and 5 males) with multiple gingival recessions (GR) were treated using the modified coronally advanced tunnel technique (MCAT) and subepithelial connective tissue graft (SCTG) following FGG de-epithelialization. Two grafts were harvested from both sides of the palate in each patient. Using a split-mouth design, donor sites were randomly assigned to the test group (honey dressing) or the control group (gelatin sponge). The palatal donor sites were evaluated at 1, 2, 4, 7, and 14 days postoperatively for pain, patient discomfort, changes in dietary habits, and burning sensation. Wound healing and delayed bleeding were assessed 2 weeks after surgery.</p><p><strong>Results: </strong>In both the honey group and the gelatin sponge group, no significant differences were observed in postoperative pain, patient discomfort, burning sensation, or changes in dietary habits at 14 days postoperatively (p > 0.05). No prolonged bleeding was observed during the 2-week follow-up, and wound healing was assessed as \"very good\" after 14 days.</p><p><strong>Conclusions: </strong>Both dressing materials can be successfully used at the palatal donor site after periodontal surgery and result in comparable outcomes in wound healing. Honey dressing may be considered an alternative to traditional dressing methods.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TRPC3 induces intervertebral disc degeneration by mediating the Ca2+/NF-κB pathway to inhibit autophagy.","authors":"Yingchao Gao, Ning Zhang, Jun-Fei Zhang, Zhengqi Fei","doi":"10.17219/acem/207572","DOIUrl":"https://doi.org/10.17219/acem/207572","url":null,"abstract":"<p><strong>Background: </strong>Intervertebral disc degeneration (IDD) is the primary cause of lower back pain. Transient receptor potential canonical 3 (TRPC3) is a nonselective cation channel permeable to Ca2+.</p><p><strong>Objectives: </strong>This study explores the mechanisms by which the TRPC3-mediated Ca2+/nuclear factor kappa B (NF-κB) pathway regulates autophagy in IDD.</p><p><strong>Material and methods: </strong>An IDD rat model was established using the annulus fibrosus puncture method and was treated with local intraspinal injection of adeno-associated virus (AAV)-shRNA targeting TRPC3. Primary human nucleus pulposus cells (NPCs) were transfected with TRPC3 siRNA and subsequently treated with pyrrolidine dithiocarbamate (PDTC; an NF-κB inhibitor), rapamycin (RAPA), or 3-methyladenine (3-MA), respectively. Micro-computed tomography (micro-CT), hematoxylin and eosin (H&E) staining, immunohistochemistry, western blotting, transmission electron microscopy (TEM), and flow cytometry were performed.</p><p><strong>Results: </strong>TRPC3 expression was significantly increased in IDD rats (p < 0.05). TRPC3 shRNA ameliorated histopathological damage in IDD rats and promoted the expression of autophagy-related protein 5 (ATG5), Beclin-1, and LC3-II (all p < 0.05). In vitro, interleukin-1 beta (IL-1β) increased Ca2+ levels, siRNA TRPC3 reduced them, and PDTC further decreased them (p < 0.05). In addition, siRNA TRPC3 increased the expression of ATG5, Beclin-1, and the LC3-II/LC3-I ratio and inhibited phosphorylation of p-NF-κB p65 in NPCs (p < 0.05). Transmission electron microscopy and flow cytometry showed that siRNA TRPC3-induced autophagy promoted apoptosis in NPCs (p < 0.05). Furthermore, siRNA TRPC3 increased the levels of aggrecan and collagen II and decreased matrix metalloproteinase-13 (MMP-13) expression (p < 0.05).</p><p><strong>Conclusions: </strong>TRPC3 exacerbates IDD by inhibiting protective autophagy via activation of the Ca2+/NF-κB signaling pathway. Knockdown of TRPC3 promotes autophagy, which in turn influences NPC apoptosis and extracellular matrix (ECM) metabolism. This study offers potential novel strategies for IDD prevention and treatment.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of static and dynamic evaluation of sarcopenia in liver transplant candidates.","authors":"Maciej Miarka, Wiktor Smyk, Aleksandra Bodys-Pełka, Krzysztof Gibiński, Renata Główczyńska, Wojciech Figiel, Joanna Raszeja-Wyszomirska","doi":"10.17219/acem/212528","DOIUrl":"https://doi.org/10.17219/acem/212528","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia, characterized by the loss of skeletal muscle mass, strength, and function, is a prevalent and severe complication of liver cirrhosis, irrespective of its etiology. Despite its early onset in cirrhosis, the impact of sarcopenia on liver transplantation (LT) outcomes is often underestimated.</p><p><strong>Objectives: </strong>This study evaluates the role of both static and dynamic assessments of sarcopenia in LT recipients, focusing on cardiopulmonary performance and the likelihood of prolonged ICU stays.</p><p><strong>Material and methods: </strong>We studied 54 LT recipients (median age: 53.5 years, 59% female patients) at a single center. The L3 skeletal muscle index (L3SMI) was measured using computed tomography (CT) scans, while exercise tolerance was evaluated with the 6-minute walk test (6MWT). Cardiac output (CO) was recorded in liters per minute.</p><p><strong>Results: </strong>The median Model for End-Stage Liver Disease (MELD) score was 14.4, with 37% of patients classified as Child-Pugh class C. Major LT indications included autoimmune liver diseases (46.3%) and alcohol-related liver disease (ALD; 31.5%). Sarcopenia was present in 60.4% of patients. No significant differences in L3SMI were found related to underlying liver disease, gender, body mass index (BMI), or ammonia levels. However, patients with ALD covered significantly shorter distances in the 6MWT (p = 0.02). Sarcopenic patients had significantly higher CO than non-sarcopenic patients (p < 0.01). Intensive care unit (ICU) stay ≥3 days was observed in 77.8% of recipients, with no clear risk factors identified.</p><p><strong>Conclusions: </strong>Sarcopenia linked to end-stage liver disease (ESLD) correlates with cirrhotic cardiomyopathy, as evidenced by increased CO. Further studies are required to clarify the role of 6MWT and CO in post-LT risk stratification.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author guidelines in the AI era: Writing for readers, search engines, and reproducibility. Insights from editorial practice.","authors":"Marek Misiak, Donata Kurpas","doi":"10.17219/acem/218743","DOIUrl":"https://doi.org/10.17219/acem/218743","url":null,"abstract":"<p><p>Scientific journals establish author guidelines to ensure manuscript consistency, enhance readability, and maintain editorial standards. However, the rationale behind specific requirements is not always apparent to submitting authors, leading to misunderstandings and noncompliance. This editorial examines the instructions for authors currently applied at Advances in Clinical and Experimental Medicine, explaining the purpose behind selected regulations that may initially seem arbitrary or overly prescriptive. We analyze requirements concerning manuscript titles (sentence case, study design specification, avoidance of nonstandard abbreviations), author affiliations (institutional hierarchy, geographic formatting), ORCID (Open Researcher and Contributor ID) usage, highlights preparation, taxonomic nomenclature (italicization of genus and species, distinction between genes and proteins), laboratory equipment reporting (manufacturer details, catalog numbers, software versions), abbreviation protocols, and supplementary file management. We demonstrate that these requirements serve essential practical functions: improving search engine optimization and discoverability, ensuring experimental reproducibility, preventing taxonomic and nomenclatural confusion, facilitating rigorous peer review, and enhancing reader comprehension across different formats and access points. The editorial also addresses the evolving nature of author guidelines in the era of artificial intelligence (AI) and digital publishing, emphasizing that editorial policies should function as adaptable documents that respond to technological advances and changing scholarly communication practices. By fostering open dialogue between editors and authors regarding the rationale behind publication requirements, journals can maintain high standards while remaining responsive to the legitimate concerns of the research community. We conclude that transparent communication about editorial policies not only improves compliance but also strengthens the collaborative relationship between journals and the researchers they serve.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statin therapy improves long-term survival in patients with myocardial infarction and non-obstructive coronary arteries (MINOCA).","authors":"Konrad Stępień, Grzegorz Horosin, Natalia Kachnic, Alicia Del Carmen Yika, Aleksandra Karcińska, Piotr Walczak, Karol Nowak, Mateusz Podolec, Jadwiga Nessler, Jarosław Zalewski","doi":"10.17219/acem/211628","DOIUrl":"https://doi.org/10.17219/acem/211628","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines suggest that statins may be beneficial in patients with myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA). However, the available data are ambiguous.</p><p><strong>Objectives: </strong>We sought to investigate the effect of statin therapy on long-term mortality among MINOCA patients.</p><p><strong>Material and methods: </strong>Between 2012 and 2019, coronary angiography was performed in 1,011 patients hospitalized with a diagnosis of MI. Patients with lesions narrowing coronary arteries by less than 50% were classified as MINOCA. Baseline clinical characteristics, laboratory and echocardiographic parameters, statin type prescribed at discharge, as well as long-term all-cause mortality were collected in the MINOCA group.</p><p><strong>Results: </strong>MINOCA was diagnosed in 77 (7.6%) patients, while statins were prescribed in 57 (74%) of them at discharge. Subjects treated with statins had a higher prevalence of hypertension (94.7 vs 70%, p = 0.008) and dyslipidemia (77.2 vs 45%, p = 0.008), had a higher body mass index (BMI; p = 0.028), and were less likely to suffer from active cancer (17.5 vs 55.0%, p = 0.001). In multivariable logistic regression, active cancer independently reduced (odds ratio (OR) = 0.143, 95% confidence interval (95% CI): 0.027-0.748), whereas higher baseline low-density lipoorotein cholesterol (LDL-C) (OR = 3.216, 95% CI: 1.192-8.686) independently increased the likelihood of statin prescription at discharge. In the median follow-up of 69.2 [interquartile range (IQR): 37.8-79.9] months, all-cause mortality was significantly higher in MINOCA patients not treated with statins (p = 0.025).</p><p><strong>Conclusions: </strong>Roughly 75% of MINOCA patients were treated with statins at discharge. This decision was independently influenced by clinical characteristics and lipid profile. Statin prescription was associated with lower long-term all-cause mortality.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autoimmune mechanisms in drug-resistant focal epilepsy: Pathophysiology, biomarkers, and therapeutic implications.","authors":"Kamil Aleksander Kunecki, Edyta Dziadkowiak","doi":"10.17219/acem/218006","DOIUrl":"https://doi.org/10.17219/acem/218006","url":null,"abstract":"<p><p>This review explores the role of autoimmune mechanisms in drug-resistant epilepsy (DRE), with emphasis on etiology, mechanisms of drug resistance, and potential immunomodulatory interventions. A structured review of clinical and experimental studies was conducted to assess current knowledge on the interplay between molecular mechanisms and immune responses in DRE. Particular attention was given to the involvement of the mTOR pathway, blood-brain barrier (BBB) dysfunction, astrocyte activation, and overexpression of efflux transporters, as well as the presence of neuronal autoantibodies such as N-methyl-D-aspartate receptor (NMDAR) and GluR3. The available evidence suggests that, although conventional pharmacologic approaches fail in a subset of patients, immunologic diagnostics and targeted therapies - including intravenous immunoglobulin, corticosteroids, rituximab, and plasmapheresis - may provide clinical benefit. Seizure reduction has been reported in selected patients; however, therapeutic response remains heterogeneous and is limited by small study populations. In conclusion, early identification of autoimmune mechanisms in DRE may help optimize treatment strategies, improve patient outcomes, and reduce the long-term clinical and societal burden of the disease.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing ageism in healthcare: A systematic review of educational interventions and methodological insights.","authors":"Alexis Caballero-Bonafé, Raquel Valera-Lloris, Laura Fernández-Puerta, Juan-Ramón De-Moya-Romero, Elena Chover-Sierra, Antonio Martínez-Sabater","doi":"10.17219/acem/220419","DOIUrl":"https://doi.org/10.17219/acem/220419","url":null,"abstract":"<p><p>Ageism, defined as stereotypes, prejudice, and discrimination toward older adults, represents a global challenge with negative consequences for health, wellbeing, and quality of care. This review aimed to analyze the characteristics and effectiveness of educational interventions designed to reduce ageism in healthcare settings. A systematic review was conducted using PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus. Eleven primary studies met the inclusion criteria: 1) educational or training interventions targeting healthcare professionals or students; 2) primary studies; 3) quantitative or mixed-methods designs with extractable quantitative outcomes; 4) published between 2020 and 2025; and 5) articles in English or Spanish. Three main types of interventions were identified. First, gerontological education has shown promising effects, particularly when explicitly addressing ageism, although the evidence remains limited. Second, clinical simulation-based interventions yielded mixed results, especially when not supported by structured educational components. Third, empathy-focused interventions were insufficient to reduce ageist attitudes. Only 1 randomized trial was conducted among healthcare professionals. Educational multicomponent interventions, particularly those incorporating gerontological content, may help reduce ageism in healthcare settings. However, the available evidence is limited and heterogeneous, and remains largely restricted to student populations. Further methodologically robust studies, particularly among practicing healthcare professionals and in real clinical settings, are needed to determine whether improvements in attitudes translate into sustained changes in clinical practice.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Academic mediator-driven research translation: The concept for making possible implementation.","authors":"Sajee Sattayut, Patcharawan Srisilapanan, Piyachat Patcharanuchat","doi":"10.17219/acem/220569","DOIUrl":"https://doi.org/10.17219/acem/220569","url":null,"abstract":"<p><p>Translation research into practice remains one of the critical yet underdeveloped aspects of scientific progress. This editorial explores how academic mediation can transform fragmented research activities into sustainable translational ecosystems. Drawing from Thailand's experience in laser dentistry, the paper illustrates a progression from individual projects to collective research networks and the institutionalization of the Hub of Knowledge in Orofacial Laserology (HKOL). The model demonstrates how innovation can move beyond diffusion and normalization to achieve implementation grounded in education and community relevance through structured collaboration, standardized protocols, and academic stewardship. By addressing theoretical gaps and aligning practice with governance, the academic mediator-driven model offers an adaptable framework for integrating research, clinical service, and policy. It underscores that effective translation is not a spontaneous outcome of evidence but the result of deliberate structure, shared accountability, and long-term academic continuity.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical competence of Polish paramedics in caring for LGBT patients: A national cross-sectional study.","authors":"Michał Czapla, Piotr Karniej, Raúl Juárez-Vela, Kamil Kędzierski, Anthony Dissen, Krzysztof Griesmann, Jakub Wojciechowski, Aleksander Mickiewicz, Jacek Smereka, Jan Świtała, Łukasz Lewandowski","doi":"10.17219/acem/216536","DOIUrl":"https://doi.org/10.17219/acem/216536","url":null,"abstract":"<p><strong>Background: </strong>Systemic preparation for the care of lesbian, gay, bisexual, and transgender (LGBT) patients in Poland remains limited, despite the increasing visibility of sexual and gender minorities in clinical settings. Emergency medical services, often the first and sometimes the only point of contact with healthcare, operate without structured guidance on inclusive practice. For paramedics, this gap translates into uncertainty at the bedside and inconsistent quality of care. However, the clinical competence of Polish paramedics in responding to the needs of LGBT patients has never been empirically examined.</p><p><strong>Objectives: </strong>This study aimed to assess the clinical preparedness, attitudinal awareness, and basic knowledge of Polish paramedics regarding LGBT patients.</p><p><strong>Material and methods: </strong>In a national cross-sectional survey (n = 465), 289 participants completed the LGBT-Development of Clinical Skills Scale (LGBT-DOCSS) scale. Data were analyzed using beta-inflated generalized additive model for location, scale, and shape (GAMLSS) regression with least absolute shrinkage and selection operator (LASSO)-based predictor selection.</p><p><strong>Results: </strong>Clinical preparedness was low (predicted μ = 2.32/7), particularly among those without prior LGBT-specific training or exposure. Attitudinal awareness was high (μ = 5.82), while basic knowledge scores were moderate (μ = 4.06). Recent LGBT-related training was associated with higher clinical preparedness (β = 0.779, p < 0.001), and prior informal experience also showed a positive association (β = 0.553, p < 0.001). Male sex (β = 0.369, p < 0.001) was associated with higher clinical preparedness, while homosexual orientation (β = 0.349, p = 0.001) was associated with higher overall clinical competence. Lower attitudinal awareness was observed among men (β = -0.545, p < 0.001) and those without LGBT contact (β = -0.688, p < 0.001). Recent training had no significant effect on basic knowledge (β = 0.280, p = 0.295).</p><p><strong>Conclusions: </strong>Polish paramedics express attitudinal awareness but lack clinical readiness, with a low baseline clinical preparedness score (μ = 2.32/7). Given the frontline role of emergency medical services, these findings highlight an urgent need for structured, practice-oriented LGBT training within paramedic education and continuing professional development.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits and adverse effects of ketogenic diet treatment in pediatric patients with inborn errors of metabolism.","authors":"Dorota Wesół-Kucharska, Magdalena Alicja Kaczor, Ewa Ehmke Vel Emczyńska-Seliga","doi":"10.17219/acem/219994","DOIUrl":"https://doi.org/10.17219/acem/219994","url":null,"abstract":"<p><strong>Background: </strong>The ketogenic diet (KD) is an established therapeutic option for epilepsy and selected inborn errors of metabolism (IEMs), particularly glucose transporter type 1 deficiency (GLUT1D) and pyruvate dehydrogenase complex deficiency (PDCD). Increasing evidence suggests broader applications of KD in pediatric metabolic disorders; however, data on its safety and efficacy in heterogeneous IEM populations remain limited.</p><p><strong>Objectives: </strong>To evaluate the efficacy, clinical benefits, and adverse effects (AEs) of KD in pediatric patients with various IEMs.</p><p><strong>Material and methods: </strong>A retrospective analysis was conducted in pediatric patients with IEMs receiving KD treatment. Patients were categorized into 3 groups: 1) other IEMs (n = 7), 2) mitochondrial diseases (MD) (n = 17), and 3) GLUT1D and PDCD (n = 20). The median age at initiation of KD was 37, 53, and 53 months, respectively, and the median duration of KD treatment was 5, 11, and 55 months in groups 1, 2, and 3.</p><p><strong>Results: </strong>The KD was associated with clinical benefits in 84% of patients. Among children with epilepsy (n = 23), a seizure reduction of >50% was observed in 73.9% of patients, including complete seizure freedom in 4 individuals. Improvements were also noted in muscle tone (27.6%), exercise tolerance (51.2%), ataxia (83.3%), and involuntary movements (60%). Lactate levels decreased in 84.6% of patients with mitochondrial disease and in all patients with PDCD. The KD was discontinued in 12 patients due to insufficient efficacy (n = 5) or AEs (AEs; n = 7). The most common AEs included gastrointestinal (GI) symptoms, dyslipidemia, hyperuricemia, metabolic acidosis, and decreased free carnitine; most were transient. No significant association was found between median β-hydroxybutyrate (BHB) levels and clinical outcomes.</p><p><strong>Conclusions: </strong>The KD is an effective and generally well-tolerated therapeutic option in pediatric IEMs, with benefits extending beyond seizure control. Adverse effects are typically manageable, although GI intolerance may limit long-term use. Ketogenic diet should be considered not only for refractory epilepsy but also for selected metabolic indications.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}