Advances in medical sciences最新文献

{"title":"The effects of electronic nicotine delivery systems on metabolic markers - a systematic review.","authors":"Katarzyna Pawłowicz, Aleksandra Kozdraś, Szymon Nowakowski, Klaudia Szczesna, Anna Wiącek, Kamilla Klama, Damian Skrypnik","doi":"10.1016/j.advms.2026.10.006","DOIUrl":"https://doi.org/10.1016/j.advms.2026.10.006","url":null,"abstract":"<p><p>The increasing popularity of electronic cigarettes (e-cigarettes) has become a significant public health concern. Recent data show not only a growing number of users, especially among young adults, but also a notable expansion of the global e-cigarette market. E-cigarettes are often perceived as a less harmful alternative to traditional smoking, and although they do contain fewer toxic substances, their long-term health effects are still not fully understood. At the same time, obesity rates are rising worldwide and have become one of the leading preventable causes of chronic diseases. Nicotine, the main active substance in both conventional cigarettes and e-cigarettes, may play a role in body weight regulation. Its known effects include appetite suppression and an increase in the resting metabolic rate. Consequently, some individuals may use e-cigarettes as a tool to manage weight, particularly after quitting smoking. However, combustible cigarettes, nicotine itself, and e-cigarettes are not recommended for the treatment or prevention of obesity, and they should not be used as a strategy for intentional weight reduction. This review aims to summarise the current state of knowledge on the relationship between e-cigarette use and body mass. We discuss both physiological mechanisms related to nicotine as well as behavioural aspects that might influence food intake and weight control. Given the increasing prevalence of both vaping and obesity, understanding the potential links between the two is important from both a clinical and public health perspective.</p>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206475","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":"Tirzepatide persistence, adherence, and dose escalation in a real-world setting with high out-of-pocket costs: a Polish cohort study.","authors":"Artur Dziewierz, Agata Krawczyk-Ożóg, Łukasz Szarpak, Iwona Kowalska-Bobko, Zbigniew Siudak","doi":"10.1016/j.advms.2026.10.005","DOIUrl":"https://doi.org/10.1016/j.advms.2026.10.005","url":null,"abstract":"<p><strong>Purpose: </strong>Tirzepatide is effective in clinical trials, but its real-world use where obesity pharmacotherapy is self-funded remains poorly characterized. We aimed to characterize tirzepatide persistence, adherence, and dose escalation in a high out-of-pocket-cost setting.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed nationwide electronic health records from a large Polish private healthcare provider. We included 3,030 adults with a first recorded tirzepatide prescription between November 2023 and February 2025. The primary endpoint was time to observed treatment discontinuation. Multivariable Cox regression identified persistence predictors, while adherence was assessed using proportion of days covered (PDC). Successful titration was escalation from 2.5 or 5 mg to ≥10 mg.</p><p><strong>Results: </strong>The cohort included 69.0% women; 83.3% had obesity and 20.0% had type 2 diabetes. Higher first recorded dose was associated with earlier loss of observed treatment. Compared with 2.5 mg initiators, the hazard ratio for discontinuation was 1.44 (95%CI 1.26-1.64, p<0.001) for 15 mg and 1.24 (95%CI 1.12-1.39, p<0.001) for 10 mg doses. Traditional comorbidities did not independently predict persistence (all p>0.10). Among385 patients persistent for ≥180 days, median PDC was 0.86 (IQR 0.73-0.95), with 68% classified as adherent (PDC ≥80%). Of 2,194 eligible low-dose patients, 565 (25.8%) escalated to ≥10 mg, corresponding to 18.6% of the full cohort.</p><p><strong>Conclusions: </strong>Real-world tirzepatide persistence was suboptimal and associated with recorded starting dose. Traditional clinical comorbidities had limited impact on discontinuation timing. Nonclinical factors, including affordability, tolerability, and patient expectations, may contribute to early loss of observed treatment; although these were not directly measured.</p>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147092","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":"Transplantation of undifferentiated and differentiated neural precursors towards Schwann-like phenotype in a model of acute spinal cord injury.","authors":"Marcela María José Rodríguez-Baeza, Hermelinda Salgado-Ceballos, Nidia Jannette Carrillo-González, Tania Campos-Ordoñez, Laura Alvarez-Mejía, Gabriela Escobar-Camberos, Graciela Gudiño-Cabrera","doi":"10.1016/j.advms.2026.10.002","DOIUrl":"https://doi.org/10.1016/j.advms.2026.10.002","url":null,"abstract":"<p><strong>Purpose: </strong>Traumatic spinal cord injury (TSCI) is a severe condition that profoundly affects individuals and places a substantial burden on healthcare systems. This study assesses functional recovery in TSCI under three conditions: a sham group without transplants, neural progenitor cells (NPCs) transplants, and NPCs differentiated into a Schwann-like phenotype (dNPCs) using an olfactory ensheathing cells-conditioned medium.</p><p><strong>Materials/methods: </strong>An experimental model of TSCI was used, using complete transection in rats. Transplants were performed in the acute phase of TSCI using NPCs exposed to a conditioned medium.</p><p><strong>Results: </strong>The NPCs formed neurospheres and acquired a Schwann-like morphology, confirmed via GFAP and p75 immunolabeling. NPCs-transplanted rats exhibited superior motor recovery compared to dNPCs and sham groups based on the Basso, Beattie, and Bresnahan (BBB) functional test. NPCs transplants promoted axonal regeneration and reduced lesion size. Both NPCs and dNPCs transplants reduced edema and inflammatory cell infiltration compared with the sham group. Immunohistochemistry revealed enhanced sensory neuron fiber regeneration (CGRP) and neuronal presence (NeuN) near the injury site in transplanted rats, with greater expression of p75 in NPCs-treated groups. Thus, the NPCs contributed to reduced lesion expansion, probably by releasing neurotrophic factors and forming a protective barrier.</p><p><strong>Conclusions: </strong>These findings suggest that NPCs transplants may favorably modify the pathophysiological response to TSCI in the acute phase and improve functional outcomes, offering a potential therapeutic strategy for further investigation in chronic TSCI or its application in combined treatments.</p>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102727","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":"Exploratory assessment of catestatin and thrombospondin-1 as potential biomarkers of disease severity and treatment response in pulmonary arterial hypertension","authors":"Mirosława Kowalkowska,&nbsp;Łukasz Wołowiec,&nbsp;Grzegorz Grześk","doi":"10.1016/j.advms.2026.09.005","DOIUrl":"10.1016/j.advms.2026.09.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Pulmonary arterial hypertension (PAH) is a rare disease associated with high morbidity and mortality. This exploratory study evaluated the effects of treatment escalation on cardiac function and circulating biomarkers, including N-terminal pro-B-type natriuretic peptide (NT-proBNP), catestatin, and thrombospondin-1 (TSP-1), as potential markers of disease severity and treatment response.</div></div><div><h3>Methods</h3><div>Twenty-six patients with PAH were prospectively followed. Echocardiographic and biochemical parameters were assessed at baseline and after 3, 6, and 18 months. Five patients died during follow-up; longitudinal analyses included 21 patients with complete data. Patients received dual or triple combination therapy according to clinical indications. Owing to the observational design and limited sample size, all analyses were considered exploratory and hypothesis-generating.</div></div><div><h3>Results</h3><div>Patients receiving triple therapy showed a greater decline in left ventricular ejection fraction, larger increases in NT-proBNP, and higher rehospitalization rates than those receiving dual therapy. Catestatin and TSP-1 were associated with clinical stability and survival. However, treatment escalation was preferentially applied to patients with more severe disease; therefore, observed differences between treatment groups likely reflect baseline disease severity and confounding by indication rather than treatment efficacy. Observed differences between treatment groups should be interpreted cautiously because treatment escalation was preferentially applied to patients with more severe disease.</div></div><div><h3>Conclusions</h3><div>In this exploratory single-centre study, catestatin and TSP-1 demonstrated potential associations with disease severity and clinical outcomes in PAH. These findings are preliminary and hypothesis-generating. Larger multicentre studies are required to validate their prognostic value before clinical application.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 2","pages":"Pages 322-329"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001108","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":"Predictive factors of functional recovery in older inpatients: AIRCOT Study","authors":"Sergio Martinez-Zujeros,&nbsp;Pedro J. Zufiria,&nbsp;Ángel Sánchez-Cabeza,&nbsp;María Luisa Delgado-Losada","doi":"10.1016/j.advms.2026.09.006","DOIUrl":"10.1016/j.advms.2026.09.006","url":null,"abstract":"<div><h3>Purpose</h3><div>Geriatric functional recovery units need improved prognostic tools to anticipate rehabilitation outcomes. Although machine learning offers promising possibilities, thorough exploratory analyses are essential before clinical use. This study examines determinants of functional recovery and develops predictive models for the Modified Barthel Index (MBI) at discharge, aiming to identify key variables, determine the most relevant predictors, and generate initial models of MBI at discharge.</div></div><div><h3>Materials and methods</h3><div>A retrospective longitudinal study was conducted with 957 patients admitted in a Functional Recovery Unit. Sociodemographic, clinical, functional and psychosocial variables were analyzed. Functional assessments included MBI, muscle strength, and ambulation capacity. Descriptive analyses, association tests, and linear models - including multiple regression and Least Absolute Shrinkage and Selection Operator (LASSO) regularization, were applied to predict MBI at discharge.</div></div><div><h3>Results</h3><div>Participants had a mean age of 82.4 years, with a predominance of women and high rates of acquired brain injury and hip fracture. Functional recovery was primarily associated with pre-admission and admission MBI scores, trunk muscle tone, cognitive impairment, and time since injury. Complex models outperformed simpler ones, with the LASSO model achieving R² = 0.849. The strongest predictors were previous MBI, MBI at admission, trunk muscle tone, motor aphasia, and muscle strength.</div></div><div><h3>Conclusions</h3><div>Functional status before and at admission is the most reliable predictor of autonomy at discharge. While some comorbidities and biomarkers showed inconsistent associations, multivariable models improved predictive accuracy and may support individualized clinical decision-making. Further research should incorporate advanced machine learning techniques and evaluate their clinical applicability.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 2","pages":"Pages 349-359"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149056847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of selected fibrosis markers and echocardiography parameters in patients with atrial fibrillation treating cryoablation - perspectives of clinical use","authors":"Klaudia Katarzyna Mickiewicz,&nbsp;Anna Lisowska,&nbsp;Monika Oleksiuk- Bójko,&nbsp;Kacper Orzeł,&nbsp;Robert Sawicki,&nbsp;Ewa Tarasiuk,&nbsp;Karol Adam Kamiński,&nbsp;Małgorzata Knapp","doi":"10.1016/j.advms.2026.09.003","DOIUrl":"10.1016/j.advms.2026.09.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Atrial fibrillation is one of the most common arrhythmias, affecting 1–2% of the population worldwide. Pulmonary vein isolation by cryoballoon ablation is an established treatment strategy; however, arrhythmia recurrence remains a challenge. The aim of this study was to evaluate fibrosis-related biomarkers and advanced echocardiographic parameters in patients undergoing cryoablation and assess their role in predicting AF recurrence.</div></div><div><h3>Patients and methods</h3><div>The study included 91 patients with AF treated with cryoablation at the Department of Cardiology, University Hospital in Bialystok, Poland. Before the procedure, blood samples were collected for laboratory analyses, and transthoracic echocardiography with assessment of left atrial (LA) mechanics was performed. Patients underwent a 12-month follow-up to evaluate sinus rhythm maintenance.</div></div><div><h3>Results</h3><div>AF recurrence occurred in 31 patients (34%). Significant differences between the AF and control groups were found in galectin-3 concentration (p = 0.021), total cholesterol (p = 0.004), HDL cholesterol (p &lt; 0.001), left ventricular diameter (p = 0.007), left ventricular ejection fraction (p &lt; 0.01), and LA strain during conduit, reservoir, and active pump phases (all p &lt; 0.001). No differences were observed between patients with and without AF recurrence.</div></div><div><h3>Conclusions</h3><div>A classification tree model incorporating left atrial reservoir strain, body mass index, LA diameter, and age identified variables potentially associated with arrhythmia recurrence. Although these findings require validation in larger cohorts, they suggest that combining clinical and echocardiographic parameters may improve risk stratification. Advanced echocardiographic techniques and fibrosis-related biomarkers may contribute to assessment of atrial remodeling, although their prognostic value remains uncertain.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 2","pages":"Pages 313-321"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of menstrual blood for human papillomavirus detection in cervical cancer screening: A systematic review and meta-analysis","authors":"Prayash Paudel,&nbsp;Asutosh Sah","doi":"10.1016/j.advms.2026.09.004","DOIUrl":"10.1016/j.advms.2026.09.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Cervical cancer is a major global health burden, disproportionately affecting women in low- and middle-income countries (LMICs), where access to traditional human papillomavirus (HPV) screening is limited. Menstrual blood (MB), a non-invasive and passively collectable biospecimen, may offer a culturally acceptable alternative. This review evaluates the diagnostic accuracy of MB-based high-risk HPV detection compared to clinician-collected cervical samples.</div></div><div><h3>Methods</h3><div>We included diagnostic accuracy studies and randomized controlled trials (RCTs) evaluating self-collected MB for high-risk HPV detection in asymptomatic women aged 25–65 years. Eligible studies reported sensitivity, specificity, or 2×2 data using clinician-collected cervical samples as the reference. We searched PubMed, Embase, and Google Scholar up to July 7, 2025. Risk of bias was assessed via QUADAS-3, and a bivariate random-effects model estimated pooled sensitivity and specificity. Certainty of evidence was assessed using GRADE.</div></div><div><h3>Results</h3><div>Seven studies (n = 1297 participants; 586 reference-positive, 711 reference-negative) met inclusion criteria. The pooled sensitivity and specificity of MB-based HPV testing were 0.86 (95% CI: 0.80–0.90) and 0.90 (95% CI: 0.72–0.97), respectively. The diagnostic odds ratio was 56 (95% CI: 19–166), and the area under the hierarchical SROC curve was 0.90 (95% CI: 0.87–0.92), indicating high overall diagnostic performance. However, high heterogeneity (I² = 94%) and threshold effects were observed. No significant publication bias was detected (Deeks’ p = 0.62).</div></div><div><h3>Conclusions</h3><div>MB-based HPV testing demonstrates high diagnostic accuracy and emerges as a non-invasive alternative for cervical cancer screening, especially in underserved settings. Further validation in diverse populations is warranted.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 2","pages":"Pages 330-340"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982170","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":"Respiratory oscillometry reference values in Polish children and adolescents: a nationwide multicenter cross-sectional study (OSCILLONiCA-PL-Kids) – Study Protocol","authors":"Eliza Wasilewska,&nbsp;Jakub Radliński,&nbsp;Alina Minarowska,&nbsp;Joanna Peradzyńska,&nbsp;Katarzyna Walicka-Serzysko,&nbsp;Katarzyna Krenke,&nbsp;Zbigniew Doniec,&nbsp;Henryk Mazurek,&nbsp;Hanna Dmeńska,&nbsp;Joanna Połomska,&nbsp;Hanna Sikorska-Szaflik,&nbsp;Irena Wojsyk-Banaszak","doi":"10.1016/j.advms.2026.09.002","DOIUrl":"10.1016/j.advms.2026.09.002","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to establish nationwide reference values for respiratory oscillometry parameters (Rrs, Xrs, Fres, and AX) in healthy Polish children and adolescents aged 3–18 years and to develop prediction equations and percentile charts to facilitate the interpretation of oscillometry results in pediatric clinical practice.</div></div><div><h3>Materials and methods</h3><div>This nationwide multicenter cross-sectional study (OSCILLONiCA-PL-Kids) is being conducted in 12 pediatric centers across Poland. Healthy participants aged 3–18 years are recruited through schools and kindergartens. Standardized operating procedures, centralized data management, and quality control ensure methodological consistency across centers. Anthropometric data, health questionnaires, and oscillometry measurements (Jaeger; Vyaire) are collected according to European Respiratory Society standards. Statistical modeling applies Generalized Additive Models for Location, Scale and Shape (GAMLSS) to derive prediction equations and z-scores. The primary outcome is the development of age- and height-specific reference equations for oscillometric parameters in healthy children. This study is registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (NCT07207720).</div></div><div><h3>Results</h3><div>Approximately 2500 participants are expected to provide a large multicenter dataset for developing nationwide oscillometry reference equations. Participant recruitment and data collection are ongoing. Final analyses will be performed after completion of data collection and data processing; results will be reported in a separate publication.</div></div><div><h3>Conclusions</h3><div>The OSCILLONiCA-PL-Kids study represents the first nationwide multicenter initiative to establish oscillometry reference values in the Polish pediatric population. The resulting normative equations and percentile charts will facilitate the standardized interpretation of oscillometry and contribute to improved diagnosis and monitoring of pediatric respiratory diseases.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 2","pages":"Pages 341-348"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thrombospondin-1 and Thrombospondin-2 are associated with biatrial fibrotic remodeling in human valvular heart disease","authors":"Daniel-Dumitru Nișulescu,&nbsp;Ariana Violeta Nicoraș,&nbsp;Cornel Baltă,&nbsp;Alina Ciceu,&nbsp;Paul Adrian Bărbătei,&nbsp;Bianca Mladin,&nbsp;Iulia Musteață,&nbsp;Adrian P. Merce,&nbsp;Cristian Mornoș,&nbsp;Anca Hermenean","doi":"10.1016/j.advms.2026.10.004","DOIUrl":"10.1016/j.advms.2026.10.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Atrial fibrosis is a key structural substrate of atrial fibrillation and atrial cardiomyopathy. Thrombospondin-1 (TSP-1) and thrombospondin-2 (TSP-2) regulate TGF-β signaling and matrix organization, but their roles in human atrial remodeling remain incompletely understood. Therefore, this study aimed to compare atrial TSP-1 and TSP-2 expression in mitral and aortic valve disease and examine their associations with fibrosis, inflammation, and adhesion-related remodeling.</div></div><div><h3>Methods</h3><div>This observational cross-sectional study included 67 cardiac surgery patients: 30 with mitral valve disease, 23 with aortic valve disease, and 14 undergoing coronary artery bypass grafting without significant valvular disease. Left and right atrial tissues were examined using RT-qPCR, ELISA, histology, and immunofluorescence. Molecular assays used pooled tissue preparations. Systemic inflammation was evaluated using the neutrophil-to-lymphocyte ratio.</div></div><div><h3>Results</h3><div>TSP-1 and TSP-2 transcript levels were increased in both valve disease groups, alongside greater collagen deposition and increased inflammatory gene expression. Transcript changes were particularly marked in left atrial tissue from patients with mitral valve disease. TSP-1 protein was significantly increased in right atrial tissue from the mitral valve group, whereas TSP-2 protein did not differ significantly between groups. Cadherin transcript levels were also altered. The neutrophil-to-lymphocyte ratio was higher in both valve disease groups than in the surgical comparator group.</div></div><div><h3>Conclusions</h3><div>Atrial TSPs expression was associated with fibrotic and inflammatory remodeling in valvular heart disease. Differences between transcript and protein findings and the use of pooled preparations warrant cautious interpretation. These observational findings require validation in independent cohorts and do not establish causality.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 2","pages":"Pages 385-393"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selected risk factors for mortality in children with HUS – a single-center analysis","authors":"Ewelina Jarosz-Wójcik,&nbsp;Mateusz Zajączkowski,&nbsp;Dorota Drożdż,&nbsp;Magdalena Błasiak,&nbsp;Monika Miklaszewska","doi":"10.1016/j.advms.2026.10.003","DOIUrl":"10.1016/j.advms.2026.10.003","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of the study was to describe clinical and laboratory characteristics of hemolytic-uremic syndrome (HUS), and identify prognostic factors, including risk factors for mortality and complications.</div></div><div><h3>Materials and methods</h3><div>It is a retrospective study of 74 pediatric patients (69 survivors and 5 non-survivors) with the first episode of HUS who were hospitalized in our tertiary reference center during 10-year period.</div></div><div><h3>Results</h3><div>Compared to survivors, non-survivors significantly more frequently developed neurological symptoms (100% vs. 31.9%), suffered from respiratory tract infections (80% vs. 27.5%), respiratory insufficiency (100% vs. 21.7%), circulatory failure (80% vs. 2.9%), and more often required renal replacement therapy (100% vs. 52.2%). In this group, there was a significant reduction in complement C3c and C4 components (0.67 vs. 0.97, 0.08 vs. 0.18, respectively). Elevated PCT, CRP, D-dimers, APTT, lipase, AST, GGTP and reduced C3c and C4 were associated with increased mortality risk. Severe neurological and ophthalmological complications, as well as circulatory insufficiency were the strongest predictors of death. Overall mortality rate was 6.8%.</div></div><div><h3>Conclusions</h3><div>Neurological (ischemic stroke, ophthalmological anomalies) and systemic (circulatory failure) complications may represent important determinants of outcome in pediatric HUS. Mortality also appears to be associated with systemic inflammatory activation and coagulopathy.</div></div>","PeriodicalId":7347,"journal":{"name":"Advances in medical sciences","volume":"71 2","pages":"Pages 360-368"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}