Medical sciences (Basel, Switzerland)最新文献

{"title":"How Much Does Stress Cost? A Case-Control Study on Vagally Mediated Heart Rate Variability Responses in Anxious and Non-Anxious Individuals During a Cognitive Task.","authors":"Daniele Chirco, Sara Guidotti, Carlo Pruneti","doi":"10.3390/medsci13030205","DOIUrl":"10.3390/medsci13030205","url":null,"abstract":"<p><p><b>Background</b>: Heart rate (HR) and HR variability (HRV) are valid indices of psychophysical stress. Healthy individuals typically exhibit high vagal tone, as indicated by vagally mediated HRV (vmHRV) values. Despite current knowledge, HRV differences between anxious subjects and controls during a cognitive task have not yet been studied. <b>Methods</b>: Anxious people were compared to controls through the State-Trait Anxiety Inventory (STAI-Y), both considering State Anxiety (S-Anxiety) and Trait Anxiety (T-Anxiety) one at a time. Subsequently, a psychophysiological stress profile (PSP) was conducted to record HRV values (i.e., SDNN, RMSSD, and HF) at baseline and under induced stress with an electrocardiogram (ECG). During the stress test, the digit span forward task was conducted. <b>Results</b>: Significant differences were described by dividing the sample by S-Anxiety in the baseline values of log-HF (t = 2.68; <i>p</i> = 0.05; d = 0.85) and log-RMSSD (t = 2.34; <i>p</i> = 0.01; d = 0.74). Dividing the sample by T-Anxiety, significant differences were found in the reactivity (t = -2.26; <i>p</i> = 0.03; d = -0.70) and recovery (t = 2.11; <i>p</i> = 0.04; d = 0.66) log-HF values. Additionally, reactivity log-HF and recovery log-RMSSD values demonstrated significant discriminative power of 68% and 68%, respectively, in accurately identifying individuals with anxiety, as measured by T-Anxiety. Lastly, an association was found between the baseline HR value and the equivalent point of digit span forward in both the anxious (r = 0.59, <i>p</i> = 0.01) and control (r = -0.45, <i>p</i> = 0.05) groups. <b>Conclusions</b>: Although a high vmHRV is considered a protective factor against stress, our findings found that a reduced HRV modulation can distinguish a group of people with significant symptoms of anxiety and hinder cognitive efficiency.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12472099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Juvenile Fibromyalgia: A Level I Evidence-Based Systematic Review.","authors":"Filippo Migliorini, Nicola Maffulli, Michael Kurt Memminger, Francesco Simeone, Tommaso Bardazzi, Maria Grazia Vaccaro, Giorgia Colarossi","doi":"10.3390/medsci13030203","DOIUrl":"10.3390/medsci13030203","url":null,"abstract":"<p><strong>Background: </strong>Juvenile fibromyalgia (JFM) is a chronic pain disorder characterised by widespread musculoskeletal pain, functional impairment, fatigue, and mood disturbances. Treatment remains challenging, considering the multifactorial nature of the condition and the limited high-quality evidence supporting pharmacological or non-pharmacological interventions.</p><p><strong>Objectives: </strong>This review aimed to critically appraise level I evidence from randomised controlled trials assessing the efficacy and safety of pharmacological and non-pharmacological treatments for adolescents with JFM.</p><p><strong>Methods: </strong>Seven published peer-reviewed clinical trials were examined, including studies investigating duloxetine, milnacipran, pregabalin, cognitive-behavioural therapy (CBT), and the integrated Fibromyalgia Integrative Training Teens (FIT) program, which combines CBT with neuromuscular training. Outcomes of interest included pain intensity, functional disability, depression symptoms, physical activity, and adverse events.</p><p><strong>Results: </strong>Pharmacological agents such as duloxetine, milnacipran, and pregabalin demonstrated modest improvements in pain, but failed to produce consistent benefits in function or mood, and were associated with a high incidence of adverse effects. CBT significantly improved functional disability and depression symptoms, yet it had a limited impact on pain reduction or objectively measured activity levels. The FIT Teens program showed superior outcomes in pain intensity and biomechanical function compared to CBT alone, suggesting a synergistic effect of combining psychological and physical reconditioning strategies.</p><p><strong>Conclusions: </strong>Current evidence supports the use of multimodal treatment approaches in JFM. Non-pharmacological interventions, particularly when integrated with structured exercise, offer meaningful benefits with minimal safety concerns. Larger, methodologically rigorous trials are needed to establish optimal treatment pathways and long-term outcomes for this complex and underserved paediatric population.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunohistochemistry-Based Molecular Profiling of Muscle-Invasive Bladder Cancer: Analysis of 100 Consecutive Cases with Morphological Correlation.","authors":"Elitsa Kraevska, Savelina Popovska","doi":"10.3390/medsci13030202","DOIUrl":"10.3390/medsci13030202","url":null,"abstract":"<p><p><b>Background/Objectives</b>: This study aimed to profile the molecular variants of muscle-invasive bladder cancer (MIBC) based on immunohistochemical analysis and to make a correlation with morphological characteristics in a series of 100 consecutive patients. <b>Methods</b>: A retrospective single-center study was conducted on 100 consecutive cases of MIBC (2021-2024). A selected immunohistochemical (IHC) panel (including CK5/6, CK20, and p16) was applied in all cases to classify the tumors into known molecular variants (luminal papillary, luminal non-specified, luminal unstable, stroma-rich, basal/squamous, neuroendocrine-like). <b>Results</b>: Seven molecular subtypes are identified: basal (33%), luminal papillary (24%), luminal unstable (16%), luminal non-specified (10%), basoluminal (double-positive) (9%), neuroendocrine-like (double-negative with neuroendocrine morphology) (6%), and stroma-rich (2%). This distribution largely matches published data (Consensus Classification and The Cancer Genome Atlas (TCGA)), with minor differences (e.g., a lower share of the stroma-rich variant). A strong correlation is found between the histological subtypes of some tumors and their molecular variant (χ², <i>p</i> < 0.001): for example, all cases of urothelial carcinoma with squamous differentiation are basal, micropapillary tumors are entirely luminal, and small-cell carcinomas are neuroendocrine-like. <b>Conclusions</b>: The results demonstrate that the morphological subtype of urothelial carcinoma largely predetermines the molecular profile. Combining classic histopathology with IHC-based profiling allows for a more complete characterization of the tumor and aids prognosis and personalized treatment in MIBC.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmasking Left Ventricular Diastolic Dysfunction: Pathophysiology, Diagnosis, and Treatment Strategies.","authors":"Konstantina Vlasopoulou, Andreas Synetos, Nikolaos Ktenopoulos, Odysseas Katsaros, Leonidas Koliastasis, Anastasios Apostolos, Maria Drakopoulou, Konstantinos Toutouzas, Constantinos Tsioufis","doi":"10.3390/medsci13030204","DOIUrl":"10.3390/medsci13030204","url":null,"abstract":"<p><p>Left ventricular diastolic dysfunction (LVDD) is characterized by impaired ventricular relaxation and increased chamber stiffness during diastole, resulting in increased left ventricular filling pressures. It represents a highly prevalent yet frequently underdiagnosed cardiac condition with significant clinical implications, serving as a major contributor to heart failure with preserved ejection fraction (HFpEF), particularly among elderly individuals and those with hypertension, diabetes mellitus, obesity, or coronary artery disease. Multiple studies have identified the progression of LVDD as a marker of adverse prognosis, associated with increased morbidity and mortality, highlighting the importance of early recognition and targeted therapeutic strategies to improve diastolic function and clinical outcomes. This review summarizes the pathophysiology, current diagnostic strategies, and treatment options for LVDD, emphasizing its importance in clinical practice.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of VMAT-2 Inhibitors and Dopamine Stabilizers for Huntington's Chorea: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis.","authors":"Lautaro Manuel Floridia Rietmann, Candela Romano, Salma Alejandra Beltrán Covarrubias, Jose Antonio Gomez Miranda, Omar Enrique Briceño Cardeña, Shwetha Shenod, Ada Victoria Marrero Peralta, Genesis Mariana Ferrer Zavala, Prasanth Hanumanthu, Omar Borges Sosa, Ernesto Calderon Martinez","doi":"10.3390/medsci13030201","DOIUrl":"10.3390/medsci13030201","url":null,"abstract":"<p><strong>Background: </strong>Huntington's disease (HD) causes progressive motor dysfunction, with chorea as its hallmark symptom. Vesicular monoamine transporter 2 (VMAT 2) inhibitors (tetrabenazine, deutetrabenazine, valbenazine) are established symptomatic therapies, while dopamine stabilizers (pridopidine, ordopidine) are emerging therapies, but their net benefit and safety remain uncertain.</p><p><strong>Methods: </strong>Seven databases were searched through May 2025 following PRISMA guidelines. Random effects meta-analyses calculated mean differences (MDs) for the Unified Huntington Disease Rating Scale total motor score (UHDRS TMS) and total maximal chorea score (TMC), plus risk ratios (RRs) for adverse events (AEs). Trial Sequential Analysis (TSA) applied a Lan DeMets O'Brien Fleming α spending function with 80% power.</p><p><strong>Results: </strong>Seven randomized trials (1431 participants) met inclusion criteria. VMAT 2 inhibitors significantly improved motor outcomes versus placebo (UHDRS TMS: MD -3.80, 95% CI -5.76 to -1.83; TMC: MD -3.05, 95% CI -3.84 to -2.26; both I² = 0%). Dopamine stabilizers produced no meaningful change (UHDRS TMS: MD -0.98, 95% CI -2.48 to 0.51; I² = 32%). Neither class increased total AEs (VMAT 2: RR 1.21, 95% CI 0.99 to 1.48; dopamine stabilizers: RR 1.05, 95% CI 0.92 to 1.20; both I² = 0%). TSA confirmed robust evidence for VMAT 2 benefits on TMC but indicated additional data are required to verify dopamine stabilizer effects on UHDRS TMS. Trial sequential analysis confirmed the reliability of VMAT2 for TMC; however, the sample size was insufficient to draw conclusions about the effects of dopamine stabilizers on UHDRS TMS or their safety outcomes, indicating that additional data are needed.</p><p><strong>Conclusions: </strong>VMAT-2 inhibitors may suggest potential improvements in motor symptoms in Huntington's disease, while current evidence does not demonstrate a significant benefit of dopamine stabilizers. The safety profiles of both treatments appear generally comparable to placebo. Further rigorous and long-term studies are required to better establish their efficacy and safety.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual, Topographic and Aberrometric Outcomes After Phototherapeutic Keratectomy (PTK) for Salzmann Nodular Degeneration.","authors":"Simon Helm, Johanna Wiedemann, Niklas Reinking, Benjamin Rosswinkel, Björn Bachmann, Claus Cursiefen, Simona Schlereth","doi":"10.3390/medsci13030197","DOIUrl":"10.3390/medsci13030197","url":null,"abstract":"<p><p><b>Purpose:</b> The aim of this paper is to study the visual outcomes, changes in higher order aberration (HOA) and corneal densitometry after debridement and excimer laser phototherapeutic keratectomy (PTK) for the treatment of Salzmann nodular degeneration (SND). <b>Methods:</b> This monocentric study includes 69 eyes from 54 patients who underwent debridement and PTK for SND (mean follow-up time of 447.1 ± 597.7 days post-operatively). The following parameters were measured before and after PTK: best corrected visual acuity (BCVA) in logMAR, sphere, cylinder, calculated spherical equivalent (SPHQ), mean and maximum refractive power, astigmatism, HOA, corneal density and thickness. Patients were divided into two cohorts depending on additional visual acuity limitations (VAL). <b>Results:</b> Mean visual acuity improvement was 0.16 ± 0.21 logMAR (<i>p</i> < 0.001), independent of additional VAL, and was associated with normalization of the cornea (hyperopic reduction by 2.13 ± 2.60 dpt, <i>p</i> < 0.001), reductions in cylinder (1.49 ± 2.44 dpt, <i>p</i> < 0.001) and corneal astigmatism (3.01 ± 3.39 dpt, <i>p</i> < 0.001). HOA was reduced by 0.77 ± 1.11 µm (<i>p</i> < 0.001) and corneal density by 6.08 ± 16.45 gray scale units (GSUs) in the center (<i>p</i> = 0.019) and by 9.32 ± 12.08 GSUs in the mid-periphery (<i>p</i> < 0.001). Haze occurred in 26.1% of patients (15.9% mild; 10.1% moderate). Re-PTK was necessary in 5.8%. <b>Conclusions:</b> PTK is a low-complication method for visual improvement in patients with SND, regardless of additional VAL, and is associated with a normalization of corneal parameters. HOA, corneal density and K_max were reduced significantly and showed a correlation with visual acuity, implying that these objective parameters may have a good predictive value for visual acuity.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-Life Environmental Determinants of Allergic Conditions in Children with Atopic Heredity: A Single Center Cross-Sectional Study from Bulgaria.","authors":"Antoniya Hachmeriyan, Albena Toneva, Miglena Marinova-Achkar, Rouzha Pancheva","doi":"10.3390/medsci13030198","DOIUrl":"10.3390/medsci13030198","url":null,"abstract":"<p><strong>Background: </strong>Allergic diseases in early childhood are influenced by genetic predisposition and modifiable early-life exposures, including epigenetic mechanisms. Understanding the interplay between environmental factors and allergy development in children with atopic heredity is critical for prevention strategies.</p><p><strong>Objective: </strong>To investigate the associations between selected early-life environmental exposures and the development of allergic conditions in children with a positive family history of atopy.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 120 children aged 2 years (±5 months) with atopic heredity, recruited at the Medical University of Varna, Bulgaria (2017-2020). Data on sociodemographic background, prenatal exposures, birth mode, feeding practices, pet contact, daycare attendance, and infectious burden were collected via structured questionnaires and medical records. Allergic outcomes (food allergy and atopic dermatitis) were physician-confirmed. Statistical analyses included t-tests and chi-square tests.</p><p><strong>Results: </strong>Food allergy was diagnosed in 23.3% and atopic dermatitis in 21.7% of participants. Formula feeding was significantly more common in children with food allergy (66.7% vs. 38.1%; <i>p</i> = 0.020). A lower maternal pregnancy experience score was significantly associated with both food allergy (<i>p</i> = 0.021) and overall allergic outcomes (<i>p</i> = 0.004). Indoor smoking was more common in households of non-allergic children (<i>p</i> = 0.034). Children with food allergy had significantly more rhinopharyngitis episodes (<i>p</i> = 0.014) and longer infection duration. Higher gastroenteritis frequency and hospitalization rates were also noted in food-allergic children.</p><p><strong>Conclusions: </strong>In children with atopic heredity, early formula feeding, prenatal maternal stress, and infection burden were associated with increased risk of allergic conditions. This study underscores the importance of early-life psychosocial and environmental influences, possibly mediated by epigenetic mechanisms, in the development of childhood allergies. These findings highlight novel targets for early prevention and warrant further longitudinal research.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Vitamin D Levels and Long COVID Signs and Symptoms.","authors":"Karn Matangkha, Vichit Punyahotara, Jarasphol Rintra, Phakkharawat Sittiprapaporn","doi":"10.3390/medsci13030199","DOIUrl":"10.3390/medsci13030199","url":null,"abstract":"<p><strong>Background: </strong>\"Long COVID\" refers to a condition in which individuals continue to experience persistent signs and symptoms even after recovering from the initial COVID-19 infection. Signs and symptoms that persist can affect multiple organs in the body. Vitamin D is an essential nutrient that plays a crucial role, particularly in the immune system, and may be linked to the development of long COVID.</p><p><strong>Objective: </strong>The study aimed to investigate the association between vitamin D levels and the prevalence of long COVID signs and symptoms in COVID-19 patients.</p><p><strong>Materials and methods: </strong>The study enrolled 170 COVID-19 patients with mild signs and symptoms and confirmed COVID-Ag or RT-PCR tests. The subjects were aged 18-59 years. All patients had 25(OH)D levels measured within 60 days of COVID-19 diagnosis and had been followed for at least 3 months post-infection. Data collected included demographic characteristics, serum 25(OH)D levels, and self-reported long COVID signs and symptoms questionnaire responses.</p><p><strong>Results: </strong>The study results indicated a female-to-male ratio of 1.1:1 and a mean age of 45.87 ± 8.65 years; of these, 62.4% received three doses of the COVID-19 vaccine, and 64.7% developed long COVID. The most prevalent signs and symptoms were respiratory (55.3%), skin (50.6%), and general (39.4%). The median blood vitamin D level was 22.96 ng/mL, with 41.2% of subjects having insufficient levels, 30.6% having deficient levels, and 28.2% having sufficient levels. Patients with long COVID had significantly lower vitamin D levels compared with those without long COVID (21.52 ng/mL vs. 25.46 ng/mL; <i>p</i> < 0.05). Multivariable analysis found that vitamin D deficiency was significantly associated with overall long COVID signs and symptoms (Adj. OR, 5.80 [95% CI: 2.10, 16.13]). Additionally, vitamin D deficiency significantly increased the number of long COVID systemic signs and symptoms (Adj. IRR, 3.30 [2.12, 5.12]).</p><p><strong>Conclusion: </strong>Assessing and maintaining vitamin D levels, vitamin D supplementation, and sunlight exposure in COVID-19 patients can reduce the risk and severity of long-term COVID-19 signs and symptoms.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Tyrosine Kinase Inhibitors in ALK and EGFR-Mutated Non-Small Cell Lung Cancer with Brain Metastases.","authors":"Walid Shalata, Rashad Naamneh, Wenad Najjar, Mahmoud Abu Amna, Mohnnad Asla, Abed Agbarya, Ronen Brenner, Ashraf Abu Jama, Nashat Abu Yasin, Mhammad Abu Juda, Ez El Din Abu Zeid, Keren Rouvinov, Alexander Yakobson","doi":"10.3390/medsci13030200","DOIUrl":"10.3390/medsci13030200","url":null,"abstract":"<p><strong>Background: </strong>Brain metastases (BMs) are a common and challenging complication of non-small cell lung cancer (NSCLC), historically associated with a poor prognosis. The development of targeted therapies, specifically tyrosine kinase inhibitors (TKIs) for epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) gene alterations, has significantly improved treatment outcomes.</p><p><strong>Methods: </strong>This article reports and evaluates the efficacy of different generations of TKIs for NSCLC with BMs. The primary endpoints assessed are intracranial objective response rates (IC-ORR), progression-free survival (PFS), and overall survival (OS). The analysis considers TKIs as monotherapy and in combination with radiotherapy. It also examines the impact of newer generation TKIs with enhanced blood-brain barrier (BBB) penetration on intracranial control. The report further discusses the integration of systemic therapy with local modalities like stereotactic radiosurgery (SRS) and the safety profiles of these agents, including central nervous system (CNS) and metabolic adverse events.</p><p><strong>Results: </strong>Newer generation TKIs demonstrate significantly enhanced BBB penetration, resulting in superior intracranial control compared to older generations. These agents show remarkable intracranial activity, contributing to improved IC-ORR, PFS, and OS. The optimal integration of systemic therapy with local modalities, such as SRS, is still under investigation. Treatment with these TKIs is associated with distinct safety profiles, including novel CNS and metabolic adverse events, which require careful management due to prolonged treatment durations.</p><p><strong>Conclusions: </strong>The management of CNS metastases in NSCLC is evolving towards more proactive and personalized therapeutic strategies. Newer generation TKIs have profoundly reshaped the treatment landscape by offering superior intracranial control. Further research is needed to determine the optimal integration of these systemic therapies with local modalities and to effectively manage the associated adverse events.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Perceived Health Status and Life Satisfaction Associated with Emotional Eating in Nursing and Medical Students: A Cross-Sectional Study in a Region of Peru.","authors":"Jacksaint Saintila, Ana Valle-Chafloque, Luz A Barreto-Espinoza, Elmer López-López, Norma Del Carmen Gálvez-Díaz, Isabel G Lizarraga-De-Maguiña, Noemi Alejandrina Buenaño Cervera, Susan M Oblitas-Guerrero, Fátima Del Carmen Bernal-Corrales, Giovanna Larraín Távara","doi":"10.3390/medsci13030196","DOIUrl":"10.3390/medsci13030196","url":null,"abstract":"<p><p><b>Background</b>: Emotional eating (EmE) is a maladaptive eating behavior that has been frequently observed among university students, possibly due to academic stress and lifestyle changes. However, its specific assessment in health science students has been poorly addressed, even though this population faces high levels of academic stress and emotional burden. <b>Objective</b>: This study explores the association between self-perceived health status, life satisfaction, and EmE among university students in the health field on the north coast of Peru. <b>Methods</b>: A cross-sectional study was conducted on a sample of 1213 students. Self-perceived health, life satisfaction, and EmE were assessed using validated instruments. In addition, sociodemographic data were considered as covariates and possible confounding factors. T-tests, chi-square tests, and Poisson regression with robust variance were applied. <b>Results</b>: EmE was more prevalent in women (78.0%) than in men (66.8%; <i>p</i> < 0.001). In addition, an inverse association was observed between self-perceived health and emotional eating: students with average self-perceived health (adjusted OR = 0.88; 95% CI: 0.83-0.94) and those with high self-perceived health (adjusted OR = 0.75; 95% CI: 0.69-0.81) showed a progressively lower prevalence of EmE compared to those with low self-perceived health. Similarly, high life satisfaction was associated with a lower prevalence of EmE (adjusted PR = 0.88; 95% CI: 0.80-0.96). <b>Conclusions</b>: Low self-perceived health and life dissatisfaction were significantly associated with a higher probability of EmE in medical and nursing students. These results highlight the need to strengthen university programs on mental health, emotional regulation, and subjective well-being promotion as strategies to prevent maladaptive eating behaviors in academic settings, considering gender.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}