Advances in Clinical and Experimental Medicine最新文献

{"title":"Gender identity stories: Experiences and perspectives of transgender people about healthcare system in Spain.","authors":"Antonio Martinez-Sabater, Elena Chover-Sierra, Pablo Del Pozo-Herce, Alberto Tovar-Reinoso, Natalia Cano-Ruiz, Marta Araujo-Blesa, Javier Curto-Ramos, Gustavo Mora-Navarro, Raquel Martínez-Pascual, Raúl Juárez-Vela, Eva Garcia Carpintero-Blas","doi":"10.17219/acem/208133","DOIUrl":"10.17219/acem/208133","url":null,"abstract":"<p><strong>Background: </strong>Despite legal advances and the depathologization of transgender identities, transgender individuals still face significant barriers and discrimination within healthcare systems. A pervasive lack of training in gender diversity among healthcare professionals often results in uncomfortable, even hostile, clinical encounters, exacerbating physical and mental health vulnerabilities. Consequently, fear of stigma and discrimination leads many transgender people to avoid seeking care, placing their wellbeing at further risk due to delayed or foregone medical attention.</p><p><strong>Objectives: </strong>To explore transgender individuals' perceptions of healthcare professionals' awareness and responsiveness to their care and support needs in the Valencian Community (Spain).</p><p><strong>Material and methods: </strong>We conducted a descriptive qualitative study with a phenomenological approach in the Valencian Community. Using convenience sampling, we recruited 14 participants. Data were collected between April and June 2022 via in-depth, semi-structured, open-ended interviews. The study comprised 2 sequential phases: An initial focus group session, followed by individual interviews conducted using a snowball sampling technique.</p><p><strong>Results: </strong>We identified 3 thematic domains: T1: Experiences of professional care among transgender individuals; T2: Impact of cisgender-centric regulations within the healthcare system; T3: Gender diversity education needs for healthcare professionals.</p><p><strong>Conclusions: </strong>The transformation of the health system is urgent to ensure inclusive and equitable care for transgender people. According to the interviews, they consider that better training of professionals will improve their care. In addition, they highlight the need to reduce bureaucratic barriers, create specific protocols, and improve access to specialized treatment. Implementing inclusive public policies will contribute to a fairer and more accessible system.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870817","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 evolution of transanal approaches in rectal cancer surgery.","authors":"Sara Lauricella, Francesco Brucchi, Roberto Cirocchi","doi":"10.17219/acem/203579","DOIUrl":"10.17219/acem/203579","url":null,"abstract":"<p><p>Minimally invasive techniques are progressively transforming colorectal (CRC) surgery. Given the high mortality and morbidity rates associated with conventional surgical treatments for CRC, the development of less invasive alternatives is crucial. The long-established use of transanal platforms for local excision of early-stage rectal cancers paved the way for the development of a transanal approach to total mesorectal excision (TME). Transanal total mesorectal excision (taTME) has emerged as a novel technique for treating low CRC, offering superior and more accurate visualization of the presacral mesorectal plane compared to the abdominal approach, and providing particular advantages in the narrow male pelvis. The current data on oncological and functional outcomes are promising. The transanal transection and single-stapled anastomosis (TTSS) approach represents the latest advancement in transanal techniques for treating low CRC. Evolving from taTME, it provides a more controlled and potentially safer anastomotic technique. However, the data are still preliminary, and larger studies are needed to validate its effectiveness. This review explores the evolution of minimally invasive and transanal surgical techniques for low CRC treatment, comparing outcomes across various approaches with a focus on patient selection criteria and oncological results.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870820","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":"Family medicine: Discovering new fields for research and clinical care in the current world.","authors":"Christos Lionis","doi":"10.17219/acem/208659","DOIUrl":"https://doi.org/10.17219/acem/208659","url":null,"abstract":"<p><p>Strengthening primary healthcare (PHC) research is vital to address the demands of a rapidly changing health landscape. Leadership, infrastructure, and sufficient funding have been discussed as key factors in expanding PHC research capacity. This editorial aims to highlight emerging research priorities in a world increasingly affected by crises such as war, conflict, and climate change. Research on suffering, meaning, hope, and compassion represents a promising and necessary new frontier in PHC. This field urgently needs the attention of academic institutions and funding bodies committed to strengthening primary care and family medicine.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815551","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":"Comparison of phonemic awareness in children with auditory processing disorder and children without auditory processing disorder using an objective test for assessing phonemic hearing: A preliminary study.","authors":"Andrzej K Konopka, Julia Pyttel, Anna Kasprzyk, Grażyna Mielnik-Niedzielska, Artur Niedzielski","doi":"10.17219/acem/204557","DOIUrl":"https://doi.org/10.17219/acem/204557","url":null,"abstract":"<p><strong>Background: </strong>Phonemic awareness is defined as the ability to break down a word into smaller units called phonemes or described as the ability to synthesize words from segments of one's own speech. Impaired phonemic hearing, depending on the degree of severity, hinders or prevents speech reception, disrupts the proper development of a child's pronunciation, may cause disorders in already developed speech, and complicates the acquisition of writing skills or disturbs the skill that has already been acquired.</p><p><strong>Objectives: </strong>To create an objectified tool for phonemic hearing diagnostics to ensure that verbal material is always presented at the same intensity, from the same distance, and in the same direction. Another aim was to compare children with and without auditory processing disorder (APD) if they have disrupted phonemic hearing.</p><p><strong>Material and methods: </strong>A study involving 20 individuals was conducted using a sound level meter to determine the level of the auditory stimulus (therapist's voice) provided to patients during the diagnosis. Each participant in the study was tasked with repeating, in the most natural way for them, 2 pairs of words containing opposing sounds.</p><p><strong>Results: </strong>The analysis revealed significant discrepancies both in the articulation of verbal material by different examiners and in the presentation of the same material by a single examiner using different methods. When the same phonemic opposition was presented in an identical manner by different diagnosticians, amplitude differences of up to 10.8 dB were observed, with a standard deviation (SD) of 2.5 dB. These findings underscored the need to develop an objectified tool for phonemic hearing diagnostics to ensure consistency and reliability in assessment.</p><p><strong>Conclusions: </strong>In the research group encompassing children with APD, disorders within phonemic hearing occur more frequently and have a deeper nature. Phonemic hearing disorders in children are associated with significant difficulties in learning and daily functioning.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815549","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":"Establishing new boundaries for medical liability: The role of AI as a decision-maker.","authors":"Claudia Giorgetti, Arianna Giorgetti, Rafael Boscolo-Berto","doi":"10.17219/acem/208596","DOIUrl":"https://doi.org/10.17219/acem/208596","url":null,"abstract":"<p><p>The introduction of artificial intelligence (AI) in healthcare has created novel challenges for the field of medical malpractice. As healthcare professionals increasingly rely on AI in their decision-making processes, traditional medicolegal assessments may struggle to adapt. It is essential to examine AI's role in clinical care - both its current applications and future advancements - to clarify accountability for diagnostic and therapeutic errors. Clinical decision support systems (CDSSs), in particular, unlike other traditional medical technologies, work as co-decision makers alongside physicians. They function through the elaboration of patient information, medical knowledge, learnt patterns, etc., to generate a decision output (e.g., the suggested diagnosis), which should then be evaluated by the physician. In light of the AI Act, CDSSs cannot function fully autonomously, but instead physicians are to be assigned an oversight role. It is questionable, however, whether it would always be appropriate to assign full responsibility, and consequently liability, to the physician. This would be especially true if oversight is limited to reviewing outputs generated by the CDSS in a manner that leaves no real control in the hands of the physician. Future research should aim to define clear liability allocation frameworks and design workflows that ensure effective oversight, thereby preventing unfair liability burdens.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815550","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":"Risk assessment of human monkeypox infections: A systematic review and meta-analysis.","authors":"Yue Wang, Jianlei Wang","doi":"10.17219/acem/203099","DOIUrl":"https://doi.org/10.17219/acem/203099","url":null,"abstract":"<p><strong>Background: </strong>Human monkeypox is a zoonotic disease with increasing global prevalence. Although several studies have identified its potential risk factors, findings remain inconsistent, highlighting the need for a systematic evaluation.</p><p><strong>Objectives: </strong>To systematically investigate risk factors associated with human monkeypox infections using meta-analysis.</p><p><strong>Material and methods: </strong>A comprehensive search of PubMed, Scopus, Web of Science, Embase, and The Cochrane Library databases was conducted on all records up to February 19, 2024. Eligible studies assessing risk factors for monkeypox were included. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated, and heterogeneity was evaluated using I2 statistics.</p><p><strong>Results: </strong>Of the 1,844 articles identified, 9 studies met the inclusion criteria after screening, no publication bias was identified, and the meta-analysis results showed strong robustness. Human immunodeficiency virus (HIV) infection significantly increased monkeypox risk (OR = 2.21, 95% CI: 1.13-4.34, p = 0.02, I2 = 93%). Concurrent sexually transmitted infections (STIs) were also a significant risk factor (OR = 1.84, 95% CI: 1.46-2.33), as was body mass index (BMI) higher than 30 kg/m2 (OR = 1.18, 95% CI: 0.19-7.53, p = 0.86), lower economic status (OR = 0.33, 95% CI: 0.01-9.36, p = 0.52), education level (OR = 0.74, 95% CI: 0.30-1.79, p = 0.50), or men who have sex with men (MSM) status (OR = 1.22, 95% CI: 0.84-1.75, p = 0.29).</p><p><strong>Conclusion: </strong>HIV infection and concurrent STIs significantly increase monkeypox risk, underscoring the need for targeted prevention, including screening and risk reduction strategies in vulnerable populations, particularly MSM.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764297","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 urinary biomarkers in the diagnosis, prognosis and pathophysiology of heart failure with preserved ejection fraction.","authors":"Aleksandra A Nasiadka, Alicja Rydzewska-Rosołowska, Katarzyna Kakareko, Irena Głowińska, Tomasz Hryszko","doi":"10.17219/acem/200268","DOIUrl":"https://doi.org/10.17219/acem/200268","url":null,"abstract":"<p><p>Heart failure with preserved ejection fraction (HFpEF) poses a significant clinical challenge due to its increasing incidence, diagnostic complexities and pathophysiological heterogeneity. This study offers valuable insights into the role of urinary biomarkers in patients with HFpEF. Our research focused on profiling alterations in urinary biomarkers, encompassing albumin, indicators of tubular injury, oxidative stress markers, and proteomic changes in individuals with this condition. These findings may provide a potential tool for addressing the diagnostic challenges associated with HFpEF, particularly given the absence of specific cutoff points in the diagnosis of this disease. Furthermore, we explored the potential pathophysiological relationships of these biomarkers, which, in a broader context, facilitate a deeper understanding of this complex disease and may identify potential pharmacotherapeutic targets. We also examined the prognostic value of the identified biomarkers, which could serve as useful instruments for predicting disease risk and forecasting clinical outcomes. Additionally, we emphasized the existing knowledge surrounding potential biomarkers, suggesting that a better understanding of these markers may contribute to the development of clinically relevant tools and enhance our comprehension of HFpEF. The findings from this study align with the current literature, which underscores the complexity of HFpEF and the need for innovative diagnostic, prognostic and therapeutic strategies.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764299","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":"Systematic review and meta-analysis of randomized controlled trials comparing the clinical outcomes of SARS-CoV-2 and influenza in pediatric patients.","authors":"Chiqiong Liu, Fengying He","doi":"10.17219/acem/192224","DOIUrl":"10.17219/acem/192224","url":null,"abstract":"<p><p>Only a few studies have examined the effects of coronavirus disease 2019 (COVID-19) and influenza on clinical outcomes in pediatric patients. Furthermore, no meta-analysis has assessed the impact of these diseases on adverse outcomes. This study aims to compare the clinical outcomes of COVID-19 and influenza in pediatric patients. Searches were conducted from December 2019 to February 2022 in databases including Embase, Scopus, PubMed Central (PMC), MEDLINE, Google Scholar, Cochrane Library, and ScienceDirect. Our meta-analysis used a random-effects model, reporting pooled odds ratios (ORs) or standardized mean differences with 95% confidence intervals (95% CIs). Thirteen studies meeting the inclusion criteria were analyzed. Most studies had poor quality. The pooled OR was 0.13 for oxygen requirement (95% CI: 0.04-0.45; I2 = 74%) and 0.03 for steroid requirement (95% CI: 0.01-0.19; I2 = 60.8%). No significant differences were found in outcomes such as intensive care unit (ICU) admission, duration of inpatient stay, invasive/non-invasive ventilation, death, acute respiratory distress syndrome (ARDS), and acute kidney injury (AKI). SARS-CoV-2 infection was comparable to influenza regarding mortality, pediatric intensive care unit (PICU) admissions, mechanical ventilation, and AKI incidence, but with notable differences in oxygen supplementation.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"1267-1276"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142919061","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":"Renal protection by acacetin in streptozotocin-induced diabetic nephropathy via TLR4/NF-κB pathway modulation in rats.","authors":"Hangying Yu, Min Guo","doi":"10.17219/acem/192225","DOIUrl":"10.17219/acem/192225","url":null,"abstract":"<p><strong>Background: </strong>Diabetic nephropathy (DN), the most severe microvascular consequence of diabetes mellitus (DM), is the precursor to end-stage renal disease (ESRD). The development of problems linked to DN involves both oxidative damage and inflammation. Natural flavone acacetin (AC) has anti-inflammatory, antioxidant and anti-cancer properties. However, the effect of AC on DN is not clear.</p><p><strong>Objectives: </strong>To investigate potential nephroprotective effects of AC caused by reducing inflammation and oxidative stress via the TLR4/NF-κB pathway in rats with streptozotocin (STZ)-induced DN.</p><p><strong>Material and methods: </strong>In this study, we investigated the nephroprotective effect of AC compared to that of a positive control therapy of irbesartan (IRB) in DN induced with STZ. In this model, rats were given an intraperitoneal injection of STZ (180 mg/kg body weight (BW)), along with daily doses of AC (10 mg/kg BW) or IRB (180 mg/kg BW) to induce DN. Histopathology, albumin, blood glucose (Bg), BW, oxidative stress indicators, and western blot of inflammatory signaling pathways in the kidney were examined.</p><p><strong>Results: </strong>Reduction of blood glucose, proteinuria, serum malondialdehyde (MDA), serum creatinine, and blood urea nitrogen (BUN), as well as the inhibition of toll-like receptor 4 (TLR4), high mobility group box 1 (HMGB1) and nuclear factor kappa B (NF-κB) protein expression were observed. These data demonstrated that AC could improve BW, antioxidant enzyme and renal histopathology in rats with STZ-induced DN.</p><p><strong>Conclusions: </strong>Results from the rat model highlight how AC-suppressed inflammation and oxidative stress can attenuate STZ-induced DN by downregulating the TLR4/NF-κB pathway in rats.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"1353-1363"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142919060","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":"Umbelliferone inhibits proliferation and metastasis via modulating cadherin/β-catenin complex-aided cell-cell adhesion in glioblastoma cells.","authors":"Wei Ma, Hangyu Shi, Xinya Dong, Yongqiang Shi, Luyi Zhang, Bin Jiang","doi":"10.17219/acem/192547","DOIUrl":"10.17219/acem/192547","url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma multiforme (GBM) is the most aggressive brain tumor malignancy in adults, accounting for nearly 50% of all gliomas. Current medications for GBM frequently lead to drug resistance.</p><p><strong>Objectives: </strong>Umbelliferone (UMB) is found extensively in many plants and shows numerous pharmacological actions against inflammation, degenerative diseases and cancers. However, its anticancer effects on GBM cells have not yet been explored.</p><p><strong>Material and methods: </strong>This research intended to assess the antitumor efficacy of UMB and the molecular mechanism of cell-cell adhesion proteins in human U-87 GBM cells. The cytotoxicity assay, intracellular reactive oxygen species (ROS), cell adhesion proteins, and cell apoptosis actions of UMB were assessed using 3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyl tetrazolium bromide (MTT), dichlorodihydrofluorescein diacetate (DCFH-DA), 4',6-diamidino-2-phenylindole (DAPI), acridine orange/ethidium bromide (AO/EB), and western blot.</p><p><strong>Results: </strong>The findings revealed that UMB reduced the proliferation of GBM cells and cell adhesion proteins, while augmenting apoptosis through the elevation of cellular ROS. Bcl-2 family protein levels of Bcl-2 and Bcl-XL were mitigated; conversely, the pro-apoptotic proteins Bad and Bim were elevated upon treatment with UMB in a quantity-dependent way. Furthermore, UMB-treated GBM cells suppressed N-cadherin, β-catenin, Slug, and matrix metalloproteinase 2 (MMP-2) expression, whereas they showed enhanced TIMP protein and E-cadherin levels.</p><p><strong>Conclusions: </strong>Our findings suggest that UMB can prevent proliferation and metastasis and stimulate apoptosis in GBM cells.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"1383-1392"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969297","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}