Advances in Clinical and Experimental Medicine最新文献

{"title":"Associations of propofol and midazolam with the 30-day mortality in patients with sepsis-associated encephalopathy: A study of the MIMIC database.","authors":"Lanfen Zhan, Xinyao Xiang, Yu Zhang, Lingmin Zhou","doi":"10.17219/acem/196102","DOIUrl":"10.17219/acem/196102","url":null,"abstract":"<p><strong>Background: </strong>Propofol and midazolam have been widely used in patients with sepsis. However, the effectiveness of these drugs in reducing the duration of mechanical ventilation and the risk of mortality remains controversial.</p><p><strong>Objectives: </strong>To investigate and compare effects of propofol and midazolam on 30-day mortality in patients with sepsis-associated encephalopathy (SAE).</p><p><strong>Material and methods: </strong>A retrospective cohort study was conducted on data from 952 adult patients with SAE extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Univariable and multivariable Cox proportional hazard models were utilized to investigate the associations of propofol and midazolam with 30-day mortality; and univariable and multivariable logistic regression analyses were used to explore the relationships of propofol and midazolam with ventilation duration. The outcome measures were hazard ratios (HRs), odds ratios (ORs), and 95% confidence intervals (95% CIs). In addition, subgroup analyses of age, simplified acute physiological score (SAPS)-II, Charlson Comorbidity Index (CCI), and ventilation duration were also performed to further assess the associations of propofol and midazolam with 30-day mortality.</p><p><strong>Results: </strong>Among eligible patients, 265 (27.84%) died within 30 days. After adjusting for covariates, treatment with propofol was associated with both lower risk of 30-day mortality (HR = 0.67, 95% CI: 0.51-0.88) and lower odds of prolonged ventilation duration (OR = 0.71, 95% CI: 0.53-0.96) compared to treatment with midazolam. Moreover, the negative association between treatment with propofol and 30-day mortality was also significant in subgroups of age ≥65 years, SAPS-II score ≥47, CCI score ≥3, and ventilation duration ≥5 days (all p < 0.05).</p><p><strong>Conclusions: </strong>Among patients with SAE, treatment with propofol was relatively more effective than treatment with midazolam in reducing the risk of 30-day mortality and the duration of mechanical ventilation. However, the causal relationships of propofol and midazolam with prognosis in patients with SAE need further clarification.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"1467-1474"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956860","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":"Patient's characteristic included for treatment with individualized allogenic 3D bone block before or during/after orthodontic treatment: A 6-year observational study.","authors":"Sebastian Dominiak, Marzena Dominiak, Paweł Kubasiewicz-Ross, Tomasz Gedrange","doi":"10.17219/acem/199994","DOIUrl":"10.17219/acem/199994","url":null,"abstract":"<p><strong>Background: </strong>The most important part of orthodontic treatment (OT) is the pre-orthodontic examination (PE). Only a precise evaluation of clinical and radiological features can reduce the risk of complications.</p><p><strong>Objectives: </strong>To develop practical guidelines for advanced clinical-radiological pre-orthodontic examinations and for qualifying patients for alveolar bone reconstructions.</p><p><strong>Material and methods: </strong>A retrospective assessment was performed on 49 out of 145 patients (aged 22-55) referred for alveolar bone reconstructions over a 6-year observation period, with 77.6% of the patients being women. Patient examinations were conducted using the following parameters: clinical (e.g., gingival recession (GR), Miller and Angle classifications), radiological (using cone beam computed tomography (CBCT) to evaluate bone dehiscence, occlusal plane (OccP), atlanto-occipital joint position (O-C1), width of mentalis muscle (B:D), bone marrow steatosis (BMS), and various cephalometric parameters such as the position of the alveolar ridge (AR) relative to the mandible, labial width angle, and volumetry of AR, as well as vitamin D level. Statistical analyses were performed using Student's t-test, Shapiro-Wilk test and Pearson's χ2 test.</p><p><strong>Results: </strong>In the group of patients before orthodontic treatment (OT), the average bone marrow steatosis (BMS) was significantly lower compared to that in patients after treatment (-12 HU vs -137 Hounsfield units (HU)). In patients with class C dehiscence, the B:D measurement was significantly greater than in those with class A dehiscence (15.0 mm vs 12.5 mm). Additionally, a lateral shift of the atlanto-occipital joint (Oc-1) had a significant negative impact on the angles describing lower teeth inclination. Overall, the odds of gingival recession (GR) were 6.5 times higher in women (OR = 6.55); GR odds increased by more than 3.5 times when B:D exceeded 14.1 mm, by 4 times when the occlusal plane (OccP) was flat, and by 8 times when bone density was 24.9 ng/mL.</p><p><strong>Conclusions: </strong>Insufficient bone volume was observed in a similar proportion both before and during/after orthodontic treatment. The described pre-orthodontic examination allows for an accurate assessment of soft tissue and bone condition, thereby reducing the risk of further complications. CBCT should become a standard component of the pre-orthodontic examination.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"1501-1520"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603367","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":"Preoperative hemoglobin A1c as a predictor of lymph node metastasis in diabetic women with endometrial cancer.","authors":"Busra Korpe, Caner Kose, Kadriye Erdogan, Yaprak Engin-Ustun, Vakkas Korkmaz","doi":"10.17219/acem/198152","DOIUrl":"10.17219/acem/198152","url":null,"abstract":"<p><strong>Background: </strong>Glycated hemoglobin A1c (HbA1c) is a well-established marker for glycemic control; recent studies suggest its potential role in cancer prognosis. Understanding the relationship between preoperative HbA1c levels and lymph node metastasis (LNM) in diabetic women with endometrial cancer (EC) can enhance prognostic assessments and treatment strategies.</p><p><strong>Objectives: </strong>This study aimed to evaluate the predictive value of preoperative HbA1c levels for LNM in diabetic women with EC.</p><p><strong>Material and methods: </strong>A retrospective analysis was conducted on 233 diabetic women who underwent surgery for endometrioid-type EC at a tertiary referral hospital between 2010 and 2021. Data collected included demographic information, fasting plasma glucose, HbA1c levels, ultrasound findings, and tumor characteristics. Receiver operating characteristic (ROC) analysis was used to assess the predictive power of HbA1c levels for LNM. Univariate and multivariate regression analyses were performed to identify independent risk factors for LNM.</p><p><strong>Results: </strong>The mean preoperative HbA1c level was 7.03 ±1.37%. A cutoff HbA1c level ≥7.26% demonstrated a sensitivity of 73.7%, a specificity of 72.3% and an area under the curve (AUC) of 0.781 for predicting LNM (p < 0.001). Significant correlations were found between HbA1c levels and endometrial thickness (r = 0.231, p < 0.001), primary tumor diameter (PTD) (r = 0.173, p = 0.008) and duration of diabetes (r = 0.203, p = 0.002). Multivariate analysis identified HbA1c level (odds ratio (OR) = 2.621, 95% confidence interval (95% CI): 1.722-3.987, p < 0.001), lymphovascular space involvement (LVSI) (OR = 19.193, 95% CI: 5.805-63.458, p < 0.001), body mass index (BMI) (OR = 1.095, 95% CI: 1.010-1.188, p = 0.029), and duration of diabetes (OR = 1.019, 95% CI: 1.001-1.301, p = 0.039) as independent risk factors for LNM.</p><p><strong>Conclusions: </strong>Preoperative HbA1c levels serve as a significant predictor for LNM in diabetic women with EC. A cutoff HbA1c level ≥7.26% indicates higher risk of LNM. These findings underscore the importance of glycemic control in reducing cancer progression risks and improving the prognosis of diabetic patients with EC. Integrating HbA1c monitoring into preoperative assessments can help tailor personalized treatment strategies for better outcomes.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"1451-1457"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603368","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 p16 gene and P16INK4a protein in hematologic malignancies and therapeutic implications: A systematic review.","authors":"Paula Jabłonowska-Babij, Maciej Majcherek, Anna Kłopot, Agnieszka Szeremet, Tomasz Wróbel, Anna Czyż","doi":"10.17219/acem/192903","DOIUrl":"10.17219/acem/192903","url":null,"abstract":"<p><p>Hematological malignancies encompass a diverse group of cancers affecting the blood, bone marrow and lymph nodes. The p16 gene, encoding the P16INK4A protein, plays a pivotal role in cell cycle regulation and tumor suppression. Understanding the involvement of p16 in the development and progression of hematological malignancies is crucial for advancing therapeutic strategies. This systematic review aims to elucidate the multifaceted roles of the p16 gene and P16INK4A protein in hematological malignancies, focusing on their impact on disease pathogenesis, prognostic significance and therapeutic implications. A comprehensive search was conducted across electronic databases, including PubMed, Scopus and Google Scholar, using predefined search terms related to p16, P16INK4A, hematological malignancies, and therapy. Studies published up to 2023 were included, encompassing clinical trials, observational studies, meta-analyses, and preclinical research. The review synthesizes evidence highlighting the dysregulation of the p16 pathway in various hematological cancers. Alterations in p16 expression levels, genetic mutations and epigenetic modifications contribute to disease initiation and progression. Moreover, the prognostic significance of p16 status in predicting therapeutic outcomes and patient survival is explored. The p16 gene and P16INK4A protein emerge as promising biomarkers and therapeutic targets in hematological malignancies. Integrating knowledge of p16 dysregulation into clinical practice holds the potential to optimize treatment strategies, enhance patient outcomes and pave the way for personalized medicine approaches in the management of these challenging diseases.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"1575-1587"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142764985","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":"Association between stress-induced hyperglycemia ratio and sepsis risk in patients admitted to ICU.","authors":"Yanjun Xu, Jing Yang, Zexing Jiang, Peng Liu, Xudong Wang","doi":"10.17219/acem/194503","DOIUrl":"10.17219/acem/194503","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is a life-threatening condition characterized by a dysregulated host immune response to infection. Currently, stress hyperglycemia is frequently associated with an unfavorable prognosis in cardiovascular and cerebrovascular disease. During sepsis, the progression of the immune response and inflammation often leads to aberrant metabolic indicators. However, the association between the stress-induced hyperglycemia ratio (SHR) and sepsis in patients admitted to the intensive care unit (ICU) remains uncertain.</p><p><strong>Objectives: </strong>This study aimed to explore the potential correlation between SHR and sepsis.</p><p><strong>Material and methods: </strong>In this retrospective cohort study, data were obtained from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Patients with recorded glucose and glycosylated HbA1c levels within 24-h ICU admission were identified. The endpoints of the follow-up period were the occurrence of sepsis during ICU stay or ICU discharge. After adjustment for factors including demographics, vital signs and biochemical indicators, the univariate and multivariate logistic regression model was employed to examine the relationship between SHR, baseline blood glucose levels and the risk of sepsis. The associations were further explored in subgroups based on age, gender and presence/absence of type 2 diabetes.</p><p><strong>Results: </strong>Of the total 2,161 patients, with the average age of 64.96 ±16.84 years, 205 (9.49%) had sepsis. After adjustment or confounders, high SHR levels were associated with the risk of sepsis odds ratio (OR) = 1.53, 95% confidence interval (95% CI): 1.07-2.17). Similar results were found in patients aged ≥65 years (OR = 1.91, 95% CI: 1.16-3.17), in men (OR = 1.64, 95% CI: 1.02-2.63) and patients without type 2 diabetes history (OR = 1.58, 95% CI: 1.01-2.48). The baseline blood glucose level did not exhibit a significant association with the risk of sepsis.</p><p><strong>Conclusions: </strong>Elevated SHR levels were correlated with sepsis. Bedside monitoring of SHR may be a valuable tool for clinicians to identify patients at high risk of sepsis, and be beneficial to promptly implement clinical interventions.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"1475-1483"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969289","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":"Anticancer potential of nerolidol on acute lymphoblastic leukemia cells through the interactions with the NF-κB/STAT-3 and PI3K/Akt signaling pathways.","authors":"Xuejiao Wang, Ke Wang, Hengfei Du","doi":"10.17219/acem/192695","DOIUrl":"10.17219/acem/192695","url":null,"abstract":"<p><strong>Background: </strong>Leukemia may form at any age, from newborns to the elderly, and accounts for considerable mortality worldwide.</p><p><strong>Objectives: </strong>Nerolidol (NRD) is isolated from the aromatic florae oils and was found to have anticancer activities. However, the role of NRD in antiproliferative and apoptosis actions in acute lymphoblastic leukemia (ALL) is unclear.</p><p><strong>Material and methods: </strong>Human ALL cell lines, MOLT-4, were used to examine the potential anticancer mechanisms of NRD on cellular proliferation, reactive oxygen species (ROS)-mediated apoptosis, oxidative stress markers, caspases, PI3K/AKT, nuclear factor kappa B (NF-κB), and STAT-3/VEGF/Bcl-2 signaling pathways.</p><p><strong>Results: </strong>The MTT (3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide) assay demonstrated that NRD inhibited MOLT-4 cell proliferation in a concentration-dependent manner, with an IC50 value of 30 μM. It was found that NRD (20 and 30 μM/mL) resulted in accumulated intracellular ROS, reduced oxidative stress and loss of mitochondrial membrane potential (MMP) in MOLT-4 cells in a concentration-related way. Nerolidol was able to induce apoptosis, as evidenced by dual acridine orange/ethidium bromide (AO/EB) staining. The levels of antioxidants, caspases-3, -8 and -9 were enhanced by NRD. This research proves that NRD instantaneously triggers ROS-mediated pro-apoptotic signaling and caspases and attenuates PI3K/Akt/NF-κB and STAT3/VEGF/Bcl-2 anti-apoptotic signaling.</p><p><strong>Conclusions: </strong>Our results suggest that NRD treatment stimulates apoptosis in MOLT-4 cells by causing the accumulation of intracellular ROS through PI3K/AKT/STAT-3 signaling pathways.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"1553-1564"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998350","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":"ERAS protocols for oral cancer free tissue transfer reconstruction: Critical review and clinical checklist.","authors":"Andrzej Marek Jaxa-Kwiatkowski, Anna Leszczyszyn, Hanna Gerber","doi":"10.17219/acem/207741","DOIUrl":"10.17219/acem/207741","url":null,"abstract":"<p><p>The Enhanced Recovery After Surgery (ERAS) consensus offers a robust framework but must be tailored to the unique challenges of free-tissue transfer reconstructions in oral cancer. Factors such as clinical heterogeneity, institutional variability, inconsistent monitoring, and the absence of internal compliance audits can undermine postoperative recovery. By fostering multidisciplinary collaboration, ERAS can evolve from a theoretical guideline into a reproducible clinical pathway that enhances survival, functional outcomes and quality of life for oral cancer patients undergoing free-tissue reconstruction. Our proposed checklist merges evidence-based recommendations with practical adaptations to establish a more consistent, auditable and outcome-driven approach to perioperative care.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"1425-1431"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752073","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":"Best practice approaches to social prescribing in European Primary Care: A Delphi protocol focused on link workers.","authors":"Ferdinando Petrazzuoli, Josep Vidal-Alaball, Joyce Kenkre, Thomas Kloppe, Sinah Evers, Hendrik Napierala, Jean-Pierre Jacquet, Wolfram J Herrmann, Natasa Mrduljaš-Đujić, Andrea Neculau, Katerina Javorska, David Halata, Miriam Dolan, Joanne Robins, Patrick Ouvrard, Juan Manuel Mendive, Carmen López Fando, Jane Randall-Smith, Erwin Rebhandl, Sara Paternoster, Hans Thulesius, Sian Brand, Gindrovel Dumitra, Donata Kurpas","doi":"10.17219/acem/208216","DOIUrl":"10.17219/acem/208216","url":null,"abstract":"<p><strong>Introduction: </strong>Social prescribing (SP) is an innovative model that connects individuals to non-clinical community resources. However, its uptake and evaluation have been hindered by inconsistent role definitions for key stakeholders. Although recent studies have refined SP definitions, outside the UK, the responsibilities, educational backgrounds and training requirements of social prescribing link workers (SPLWs) remain poorly defined. Additionally, it is essential to identify which patient populations will benefit most from SP, establish specific methodologies, and standardize assessment tools and referral pathways.</p><p><strong>Material and methods: </strong>We will employ a 3-round Delphi protocol with an international expert panel to establish consensus on SP definitions. Approximately 60 participants from diverse disciplines and regions will be recruited to complete multiple survey rounds, providing insights into the roles of SPLWs, beneficiary populations, methodologies, and assessment tools. Consensus will be defined as at least 80% agreement on a 5-point Likert scale. Data collection and analysis will follow rigorous protocols to ensure validity, reliability and transparency, in accordance with the Guidance on Conducting and REporting DElphi Studies (CREDES) guidelines.</p><p><strong>Objectives: </strong>The aim of this research is to unify the fragmented understanding of SP and the role of SPLWs, thereby establishing a foundation for integrating SPLWs into healthcare systems where appropriate. The Delphi technique offers key strengths - namely, participant anonymity and structured iterative feedback - to enable robust consensus building. While we acknowledge limitations such as potential participant attrition and the resource-intensive nature of the methodology, these will be mitigated through targeted engagement strategies and strict adherence to established best practices.</p><p><strong>Conclusion: </strong>This study addresses critical gaps in SP engagement, conceptual understanding and implementation. The anticipated outcomes will reinforce SP's role in community-based, integrated care to reduce health inequalities and foster social cohesion across Europe and beyond. Ultimately, this work aims to enhance the uptake and adoption of SP in primary care.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"1589-1595"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764293","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":"Experience with sodium glucose cotransporter-2 inhibitors in adult patients with Fontan circulation.","authors":"Paweł Skorek, Magdalena M Frączek-Jucha, Agnieszka Sarnecka, Maciej Skubera, Natasza Libiszewska, Lidia Tomkiewicz-Pająk","doi":"10.17219/acem/194617","DOIUrl":"10.17219/acem/194617","url":null,"abstract":"<p><strong>Background: </strong>We still know little about the effective pharmacological treatment of heart failure (HF) associated with the Fontan circulation. One of the new options may be sodium glucose cotransporter-2 inhibitors (SGLT2i), which have been proven effective in classic forms of left ventricular HF.</p><p><strong>Objectives: </strong>To evaluate the effect and safety of SGLT2i inclusion in adults with Fontan circulation. To this end, we conducted observation and complex diagnostics of adult Fontan patients in whom we started treatment with flozins.</p><p><strong>Material and methods: </strong>The study population consisted of 17 adult Fontan patients with average age 30.5 (9.7) years, 59% in II New York Heart Association (NYHA) class, among whom 53% received dapagliflozin and rest empagliflozin.</p><p><strong>Results: </strong>The average observation time was 11.0 (3.7) months. None of the patients have reported side effects or complications related to treatment. We observed a significant increase (20.1 mL/kg/min vs 24.2 mL/kg/min, p = 0.008) in the median of maximum oxygen uptake (VO2 max) among participants (9) who completed at least 2 reliable cardiopulmonary exercise tests. We did not notice any significant differences in N-terminal prohormone of brain natriuretic peptide concentration (641.35 (923.7) vs 741.47 (1,139.02), p = 0.12) after the inclusion. Interestingly, we observed a significant increase in erythrocytes (+6%, p = 0.003), hemoglobin (+7%, p = 0.03) and hematocrit (+7%, p = 0.02).</p><p><strong>Conclusions: </strong>To the best of our knowledge, this is the first study to demonstrate that the implementation of SGLT2i may have a positive effect on exercise capacity among adults with Fontan circulation. Our experience confirms the high safety of using these drugs in Fontan adults.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"1493-1499"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977120","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":"Nutrition & exercise for brain health: Enhancing cognitive function and neuroplasticity.","authors":"Mahdi Esmaeilzadeh, Nasrollah Moradikor","doi":"10.17219/acem/208533","DOIUrl":"10.17219/acem/208533","url":null,"abstract":"<p><p>This editorial examines the relationship between nutrition, physical activity, and brain health, emphasizing their effects on cognitive function and mental well-being. Evidence supports a balanced diet - rich in antioxidants, omega-3 fatty acids, polyphenols, and patterned after the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet - as crucial for sustaining neural structure, function, and plasticity. Similarly, regular exercise has been shown to enhance mood, attention, memory, and overall cognitive performance. However, despite these demonstrated benefits, the precise neurobiological mechanisms through which diet and exercise influence brain health remain unclear. This article explores both the efficacy of these interventions and the challenges involved in optimizing them for long-term cognitive resilience.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"1419-1423"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144990926","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}