Medical sciences (Basel, Switzerland)最新文献

{"title":"Safety and Efficacy of Thermal Ablation for Cervical Lymph Node Metastasis from Papillary Thyroid Carcinoma: A Systematic Review of Available Evidence.","authors":"Ilias Karakitsos, Stefanos Triaridis, Petros Karkos","doi":"10.3390/medsci14050584","DOIUrl":"10.3390/medsci14050584","url":null,"abstract":"<p><strong>Background/objectives: </strong>Cervical lymph node metastasis and nodal recurrence remain clinically significant problems in papillary thyroid carcinoma (PTC). Thermal ablation techniques, including laser ablation (LA), radiofrequency ablation (RFA), and microwave ablation (MWA), have increasingly been investigated as minimally invasive alternatives to repeat surgery, when the latter is rejected by patients or is associated with high morbidity and technical challenges. The aim of this systematic review was to analyze the available evidence on efficacy and safety of LA, RFA, and MWA for cervical lymph node metastasis from PTC.</p><p><strong>Methods: </strong>A literature search was conducted in PubMed, Embase, and Cochrane Library, and extracted outcomes included technical success, volume reduction rate (VRR), complete disappearance rate (CDR), serum thyroglobulin (Tg) response, local recurrence, and complications. Twenty-nine (N = 29) studies were included, eight on LA (<i>n</i> = 8), eleven on RFA (<i>n</i> = 11), and ten on MWA (<i>n</i> = 10).</p><p><strong>Results: </strong>Across the included studies, all three modalities showed high technical success, progressive reduction in nodal volume, and meaningful local disease control. Safety outcomes were generally favorable across all three approaches, with most complications being mild, transient, and resolving in limited time periods.</p><p><strong>Conclusions: </strong>Thermal ablation appears to be an effective and safe treatment option for selected patients with cervical lymph node metastasis from PTC, especially when repeat surgery is undesirable or high risk.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042604","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":"Pleomorphism in Soft Tissue Sarcomas: Molecular Characteristics and Clinical Features.","authors":"Elena E Kopantseva, Alexey S Rzhevskiy, Ekaterina A Lesovaya, Vlada E Tuliavko, Nikolay A Kozlov, Timur I Fetisov, Kirill I Kirsanov, Evgeny V Denisov, Marianna G Yakubovskaya","doi":"10.3390/medsci14050585","DOIUrl":"10.3390/medsci14050585","url":null,"abstract":"<p><p>Pleomorphism in cells encompasses a variety of morphological features, such as heterogeneity in the size and shape of cells and nuclei, irregularity of the nuclear membrane, hyperchromasia, and peculiarities of cell organelles. Pleomorphism in mammalian cells is associated with genetically unstable neoplasms and is frequently accompanied by high rates of proliferation and low differentiation status. Among soft tissue sarcomas, a group of tumors characterized by the pleomorphic phenotype can be distinguished. Pleomorphic soft tissue sarcomas are a rare, understudied group of soft tissue sarcomas with aggressive behavior, low survival rates, and high resistance to standard chemotherapy treatment. Knowledge of the mechanisms behind the pleomorphic features, common genetic and epigenetic alterations, and their association with aggressive tumorigenesis is essential for advancing patient care for this group of sarcomas. In this narrative review, we consolidate existing evidence concerning clinical features of pleomorphic sarcomas, their possible histogenesis, the common drivers and transcriptional networks, and the potentially available approaches for treatment.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042505","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":"Translating Population-Based Epidemiology into Clinical Recognition of Coronary Artery Spasm: Prevalence, Incidence, and Geographic-Seasonal Variation in Taiwan.","authors":"Alexander T H Wu, Ming-Jui Hung, Claire Hung, Nicholas G Kounis, Ian Y Chen, Patrick Hu, Chi-Tai Yeh, Ming-Yow Hung","doi":"10.3390/medsci14050582","DOIUrl":"10.3390/medsci14050582","url":null,"abstract":"<p><p><b>Background:</b> Coronary artery spasm (CAS) is a reversible cause of myocardial ischemia, infarction, and sudden cardiac death. Often under-recognized and influenced by ethnicity, geography, and environment, CAS requires population-level data. This study examined nationwide CAS epidemiology in Taiwan by age, sex, region, and season. <b>Methods:</b> This cross-sectional population-based study used the Taiwan National Health Insurance Research Database (2004-2018). Diagnosis-coded CAS was operationalized using ICD-9-CM code 413.1 or ICD-10-CM code I20.1 recorded on at least three outpatient encounters or one inpatient encounter. Age- and sex-standardized prevalence and incidence were calculated, and temporal, geographic, and seasonal variations assessed. <b>Results:</b> Among 27,974 patients with diagnosis-coded CAS, the mean age at diagnosis was 57.9 years, with nearly equal sex distribution (49.7% female). In 2018, the age-standardized prevalence was 35.1 per 100,000 population, with comparable rates in men (35.4) and women (34.8 per 100,000). The incidence was 11.5 per 100,000 in both sexes. Both prevalence and incidence increased linearly from 2004 to 2018 (<i>p</i> < 0.001), peaked at ages 75-79 years, and then declined. Geographic analysis revealed the highest disease burden in central Taiwan, particularly in Taichung City, Changhua County, and Yunlin County. Seasonal analysis showed a clear pattern, with incidence peaking in winter (December-February) and spring (March-May), and notably lower counts in summer and autumn. <b>Conclusions:</b> From 2004 to 2018, CAS prevalence and incidence increased in Taiwan, affected both sexes similarly, peaked at ages 75-79 years, and were highest in central western regions during winter and spring. These findings may improve CAS recognition and resource allocation.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042127","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":"Artificial Intelligence and the Ethical Foundations of Cardiothoracic Surgery: Evidence, Accountability, and the Limits of Delegated Judgment.","authors":"Vasileios Leivaditis, Francesk Mulita, Vasiliki Androutsopoulou, Sofoklis Mitsos, Periklis Tomos, Ioannis Panagiotopoulos, Konstantinos Nikolakopoulos, Elias Liolis, Theodora Skoura, Efstratios Koletsis","doi":"10.3390/medsci14050586","DOIUrl":"10.3390/medsci14050586","url":null,"abstract":"<p><p>Artificial intelligence (AI) is moving rapidly from retrospective prediction and image analysis into treatment selection, operative planning, intraoperative guidance, and postoperative prognostication in cardiothoracic surgery. This transition raises an ethical problem that cannot be resolved by model accuracy alone: when an algorithm begins to shape a high-stakes clinical decision, the distribution of knowledge, authority, and responsibility also changes. This review synthesizes cardiothoracic and closely related medical evidence available through August 2026, with emphasis on quantitative performance, human-AI interaction, bias, patient autonomy, and liability. The available evidence is simultaneously encouraging and cautionary. Machine-learning approaches can improve predictive performance and AI-assisted thoracic planning can reduce errors and increase procedural consistency; however, these gains have not consistently translated into superior patient outcomes. Human-AI studies similarly demonstrate that improved accuracy may coexist with automation bias and overacceptance of algorithmic recommendations. Evidence of demographic performance disparities and limitations in the representativeness of training and validation datasets further raises concerns regarding fairness and equitable access to care. On this basis, we argue that cardiothoracic AI should be governed according to the level of decision influence rather than by technology type alone. We distinguish non-delegable professional duties, distributed system responsibilities, and non-transferable patient authority, and propose an Ethical Heart Team Framework for converting algorithmic output into ethically defensible clinical action.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042427","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":"Insights on Aortoenteric Fistulas from a Tertiary Referral Center: Diagnostic Algorithm, Management and Outcomes.","authors":"Hassan Al-Thani, Khalid Ahmed, Ayman El-Menyar, Ahmed Sadek, Ahmed Hussein, Eman Elmenyar, Hazem El Beyrouti, Abdulwahid Almulla","doi":"10.3390/medsci14050578","DOIUrl":"10.3390/medsci14050578","url":null,"abstract":"<p><p><b>Background</b>: Aortoenteric fistulas (AEFs) are uncommon emergency surgical conditions associated with high mortality. We explored the presentation and management of AEFs in a tertiary hospital in Qatar, a rapidly developing Middle Eastern country. By highlighting our institutional experience with ADFs and AOFs, we aim to contribute to the growing body of literature on this rare condition and to emphasize the importance of early diagnosis, appropriate surgical planning, and multidisciplinary care in optimizing patient outcomes. We also proposed a diagnostic classification of AEFs to better understand their location, relationship to the aorta, and pathology on both sides (the gastrointestinal tract and Aorta) for further studies. <b>Methods</b>: This was an observational, descriptive, retrospective, single-center case series that included 10 consecutive cases presenting with AEFs. We reviewed the clinical presentation, surgical management, and outcomes of AEF cases from 2008 to 2024. Data were extracted from electronic medical records and operative notes. Additionally, we reviewed the literature over the last two decades to summarize recently published English-language literature on aortoenteric fistulas (types, presentations, management and outcomes). <b>Results</b>: This observational case series included nine males and one female; four with aortoesophageal (AOF) and six with aortoduodenal (ADF) fistulas. The main presentations were hypotension and upper gastrointestinal bleeding. Blood cultures were positive in four cases, including Escherichia coli, Candida albicans, and Klebsiella. Foreign bodies were the underlying cause in two cases, while an old aortic coarctation repair was found in one case. Surgical repair was not completed in two patients who deteriorated quickly and died with hypovolemic shock. Two patients had thoracic endovascular aortic repair, and others had open surgeries. The overall AEF-related mortality was 60% (<i>n</i> = 6; open surgery group). <b>Conclusions</b>: This case series could support the importance of prompt diagnosis and multidisciplinary management. It also underscores the importance of individualized treatment to optimize survival. The proposed diagnostic algorithm still requires further evaluation and validation within large samples before its implementation on a large scale.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041615","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":"Platelet-Rich Plasma in Recurrent Pregnancy Loss: Toward a Precision Medicine Framework for Biologically Guided Patient Selection.","authors":"Sofoklis Stavros, Anastasios Potiris, Maria Anastasia Daskalaki, Stefanos Dafopoulos, Efthalia Moustakli, Theodoros Karampitsakos, Dimos Sioutis, Konstantinos Dafopoulos, Nikolaos Thomakos, George Daskalakis, Peter Drakakis","doi":"10.3390/medsci14050576","DOIUrl":"10.3390/medsci14050576","url":null,"abstract":"<p><p>Recurrent pregnancy loss (RPL), a multifactorial condition in reproductive medicine, affects approximately 1-3% of couples. Increasing evidence implicates endometrial dysfunction, immune dysregulation, impaired angiogenesis, and oxidative stress (OS) in its pathophysiology, highlighting the need for biologically targeted therapeutic strategies. In this context, platelet-rich plasma (PRP) has emerged as a regenerative approach with the potential to modulate these underlying mechanisms. This narrative review critically evaluates the biological rationale and current clinical evidence supporting PRP as an adjunctive treatment for RPL while proposing a precision medicine framework for biologically guided patient selection. A comprehensive narrative synthesis of the literature was performed, focusing on studies investigating PRP in RPL and related reproductive conditions, including thin endometrium and recurrent implantation failure (RIF). Mechanistically, PRP promotes angiogenesis through vascular endothelial growth factor (VEGF)-mediated pathways, enhances endometrial regeneration by stimulating stromal and epithelial cell proliferation, and modulates immune responses by promoting regulatory T-cell activity while attenuating pro-inflammatory signaling. In addition, PRP-derived extracellular vesicles (EVs) and microRNAs may contribute to the post-transcriptional and epigenetic regulation of implantation-related genes, including leukemia inhibitory factor (LIF) and HOXA10. Clinical studies in RIF and thin endometrium populations suggest that PRP may improve endometrial thickness, implantation, and clinical pregnancy outcomes; however, these findings constitute indirect evidence for RPL. Direct RPL-specific evidence remains very limited and is insufficient to establish a reduction in miscarriage or an improvement in live birth. These biological features instead provide a rationale for investigating PRP in defined patient subgroups characterized by impaired endometrial receptivity, defective angiogenesis, immune dysregulation, or unexplained RPL with suspected endometrial dysfunction. Accordingly, we propose that future clinical investigation of PRP should move beyond empirical use toward biomarker-informed, precision reproductive medicine strategies. Although PRP represents a biologically plausible and promising adjunctive therapy, robust randomized controlled trials incorporating standardized PRP protocols and biologically stratified patient populations are required before its routine clinical use can be recommended.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042465","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 Detection of Glottic Cancer Through Machine Learning and Acoustic Voice Analysis: A Systematic Review.","authors":"Himanshu Verma, Roshani Mishra, Banumathy Nagamani, Sourabha Kumar Patro, Anurag Snehi Ramavat, Jaimanti Bakshi, Padmavati Khandnor, Sudesh Rani, Trilok Chand","doi":"10.3390/medsci14050581","DOIUrl":"10.3390/medsci14050581","url":null,"abstract":"<p><p><b>Purpose</b>: Early detection of glottic cancer is essential for better outcomes, but current diagnostic methods remain largely invasive, highlighting the need for reliable non-invasive alternatives. Acoustic voice signals offer a non-invasive screening input, but their clinical value depends on whether signal-processing features and learned models can distinguish malignancy from acoustically similar benign lesions rather than merely separate pathological from healthy voices. Despite growing research on acoustic analysis combined with machine learning (ML) techniques, no systematic synthesis of this evidence currently exists. Therefore, the present review aimed to identify acoustic features that differentiate early glottic malignancies from both benign vocal fold lesions and normal vocal function using various ML techniques. <b>Method</b>: Following PRISMA 2020 guidelines, a comprehensive literature search was conducted across Scopus, EBSCO, Ovid (Embase), and PubMed databases through November 2025. Eighteen studies met inclusion criteria, and PROBAST was used for quality appraisal of included studies. Data extraction focused on acoustic feature categories, ML techniques, classification performance metrics, and validation strategies. <b>Results</b>: Nine acoustic feature categories emerged, with cepstral coefficients (particularly MFCCs) most prevalent across 55.6% of studies. Binary pathological-versus-normal classification achieved consistently high accuracy (96-98.3%) across both traditional machine learning and deep learning approaches. However, malignant-versus-benign discrimination demonstrated substantially lower performance (81-87.88% accuracy, AUC 0.631-0.91), with voice-only models proving insufficient. Multimodal models incorporating clinical variables or laryngoscopic images achieved higher performance, but their results cannot be attributed to voice features alone. All 17 prediction studies were judged at high overall risk of bias, predominantly because of small effective sample sizes, model-selection optimism, possible data leakage, and limited independent validation. <b>Conclusions</b>: ML can detect broad voice pathology, but current evidence is insufficient to support stand-alone acoustic screening for early glottic cancer. Future studies require clearly defined cancer-specific targets, patient-level analysis, standardized acquisition, nested model development, calibration, and independent multicentervalidation.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042454","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":"Update on the Physiopathology of Keratoconus.","authors":"Raul Hernan Barcelo-Canton, Alejandro Rodriguez-Garcia, Enrique O Graue-Hernandez, Jodhbir S Mehta","doi":"10.3390/medsci14050579","DOIUrl":"10.3390/medsci14050579","url":null,"abstract":"<p><p>Keratoconus (KC) is a progressive corneal ectasia characterized by stromal thinning, steepening, and biomechanical instability. Although historically considered primarily a structural disorder, current evidence supports a multifactorial pathogenesis involving complex interactions among biomechanical, molecular, cellular, inflammatory, neurobiological, and environmental mechanisms. This narrative review provides an updated overview of KC pathophysiology, integrating current evidence across these interconnected domains. Focal reductions in corneal stiffness, altered viscoelasticity, collagen disorganization, and lamellar slippage contribute to progressive deformation under physiological stress. Oxidative stress and mitochondrial dysfunction promote reactive oxygen and nitrogen species accumulation, impaired antioxidant defenses, keratocyte apoptosis, and abnormal cellular metabolism. Dysregulated extracellular matrix turnover, characterized by increased matrix metalloproteinase activity, reduced inhibitor enzymes, altered cross-linking, and aberrant growth factor signaling, further compromises stromal integrity. Chronic low-grade para-inflammation, neurotrophic imbalance, and subbasal nerve plexus alterations may amplify proteolysis and defective tissue repair. Genetic and epigenetic susceptibility interacts with environmental and behavioral modifiers. Together, these processes form pathways that converge on focal stromal weakening and cone formation. Emerging technologies, including advanced biomechanical imaging, molecular biomarkers, multi-omics approaches, and artificial intelligence, may enable earlier detection and improve risk stratification. Further understanding the pathophysiology of KC may ultimately support the development of targeted therapies aimed at modifying the underlying disease mechanisms rather than addressing the structural consequences solely.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042257","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":"Combined Molecular Hydrogen and Vitamin C Treatment in Irradiated Normal and Cancer Cell Models: An Exploratory In Vitro Study and Case Reports.","authors":"Michiko Miyakawa, Songbai Zhang, Jinan Behnan, Yu Ivy Zhang, Claudia Morganti, Keisuke Ito, Pauline Isakson, Per Uhlén, Ayako Miyakawa","doi":"10.3390/medsci14050580","DOIUrl":"10.3390/medsci14050580","url":null,"abstract":"<p><p><b>Background:</b> Radiation therapy is widely used to treat cancer but frequently causes normal tissue toxicities that compromise patients' quality of life, highlighting the need for strategies that protect healthy tissue without reducing antitumor efficacy. Here, we investigated whether a redox-modulating intervention combining vitamin C and molecular hydrogen could mitigate radiation-induced injury while preserving or enhancing anticancer effects. <b>Methods:</b> Normal endothelial cells together with breast cancer and glioma cell lines were treated with vitamin C and hydrogen before and/or after irradiation, followed by assessments of cell viability, apoptosis, reactive oxygen species (ROS), and epithelial-mesenchymal transition (EMT)-associated gene expression. To explore the potential clinical relevance of these findings, two patients undergoing radiotherapy received the combination treatment as supportive care. <b>Results:</b> In normal cells, the combination treatment increased post-irradiation viability and reduced intracellular ROS levels, consistent with a cytoprotective antioxidant effect. In contrast, cancer cells exhibited reduced viability and increased apoptosis following the combined treatment, effects that were further enhanced by irradiation. In glioma cells, the combination treatment also suppressed the expression of EMT-associated genes. In the two clinical cases, improvements in radiation-associated toxicities were observed, including dermatitis, oral mucositis, gastrointestinal symptoms, and hair loss, along with improved treatment tolerability. <b>Conclusions:</b> Collectively, these exploratory findings suggest that the combination of vitamin C and hydrogen produces distinct responses among the cell models examined, with increased viability and reduced ROS in HUVECs and reduced viability, increased apoptosis, and altered EMT-associated gene expression in the cancer cell lines. These findings warrant further investigation of this combination as a potential adjunct to radiotherapy.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042349","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":"The Possible Hematological Cost of Metabolic Success: Do Incretin-Based Therapies Silently Trigger Anemia?","authors":"Maja Mizdrak, Darko Batistić, Ivan Mizdrak","doi":"10.3390/medsci14050577","DOIUrl":"10.3390/medsci14050577","url":null,"abstract":"<p><p>Diabetes mellitus and obesity represent a growing global health burden with high morbidity and mortality. In the last several years, novel incretin-based therapies have been developed, and their use has risen dramatically. Beyond their proven metabolic, glycemic, cardiovascular, renal, and many other benefits, there are some observational data linking anemia development with their use. From the era of gliptins to retatrutide, in this review we tried to explore whether erythroid suppression is the hidden paradigm of advanced incretin-based therapies. Potential pathophysiological explanations include micronutrient vulnerabilities due to reduced food intake, lower dietary diversity, gastrointestinal intolerance, delayed gastric emptying, and weight loss. The most important concerns involve deficiencies in iron, vitamin B12, vitamin B2, vitamin D, calcium, magnesium, and zinc, along with others such as thiamine, folate, vitamin A, and potassium. The available evidence indicates a complex and heterogeneous relationship between incretin-based therapies and hematological parameters, with findings differing across therapies, study populations, and outcomes. Although observational studies suggest possible associations with anemia, iron deficiency, and nutritional deficiencies in selected populations, current evidence is insufficient to establish a direct causal relationship or a class-wide adverse effect. Further large-scale studies are needed, as well as increased clinician awareness of potential hematological and nutritional consequences that require laboratory follow-up before and during medication prescription.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042625","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}