Medical sciences (Basel, Switzerland)最新文献

{"title":"Anatomy of a Rescue: Explantation and Reconstruction After Complex Endovascular Aortic Repair-A Systematic Review of Case Reports.","authors":"Luis O Bobadilla-Rosado, Luis H Arzola-Flores, Carlos Arturo Hinojosa-Becerril, Maria José Sanabrais-López, Alberto Azueta-Cervera, Fabiola Velazquez-Castro, Osvaldo Huchim-Mendez, Nina Mendez-Domínguez","doi":"10.3390/medsci14050574","DOIUrl":"10.3390/medsci14050574","url":null,"abstract":"<p><p><b>Background:</b> Explantation after chimney, fenestrated, or branched endovascular aortic repair is technically demanding because major arterial branches are incorporated into the device. Objective: To identify recurring principles of operative decision-making for partial or complete explantation, with an emphasis on infection extent, incorporated branch management, reconstruction, and staging. <b>Methods:</b> PubMed/MEDLINE and Scopus were searched from inception through 21 August 2026 for patient-level reports of surgical explantation after complex endovascular aortic repair. Two reviewers independently selected studies, extracted data, and assessed methodological quality with the Joanna Briggs Institute checklist and reporting completeness with CARE. Findings were synthesized descriptively; the protocol was registered in PROSPERO (CRD420261412667). <b>Results:</b> Ten single-patient reports published from 2015 to 2025 were included. Patients were aged 51-78 years (median, 73), and nine were men. Infection prompted eight explantations; renal chimney-stent thrombosis with type Ia endoleak and persistent type II endoleak with sac enlargement accounted for two mechanical failures. Computed tomography or computed tomography angiography was reported in all cases and FDG-PET/CT in five. Eight patients underwent complete and two partial explantations. Nine survived the index hospitalization. No recurrent infection was reported during the available, heterogeneous follow-up of 3-48 months. <b>Conclusions:</b> These selected reports identify anatomy- and source-control considerations that may guide operative planning, but they do not establish comparative effectiveness, procedural safety, or population-level outcomes.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042380","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":"Nasoalveolar Molding and Feeding in Infants with Cleft Lip and Palate: An Exploratory Study of Parents' and Caregivers' Perceived Experiences.","authors":"Enrique España-Guerrero, Esther Liceras-Liceras, Alba España-Guerrero, Adoración Martínez-Plaza, Ingrid Garzón, Ricardo Fernández-Valadés, Fernando Campos, Antonio España-López","doi":"10.3390/medsci14050573","DOIUrl":"10.3390/medsci14050573","url":null,"abstract":"<p><strong>Background/objectives: </strong>Patients with cleft lip and palate (CLP) typically experience feeding difficulties due to an abnormal communication between the oral and nasal cavities, and novel therapies such as palate tissue engineering and nasoalveolar molding (NAM) are in need to improve the final outcomes. This study aims to evaluate the parents and caregivers perceptions on the potential of NAM to improve feeding in patients with CLP.</p><p><strong>Methods: </strong>42 infants with unilateral or bilateral CLP treated with NAM at a reference craniofacial unit were included in the study. Parents or caregivers completed a four-item questionnaire at 3 months of age, before cheiloplasty, evaluating the effects of NAM to improve nasal regurgitation, choking, air swallowing, and feeding time using a 4-point Likert scale. A total perceived feeding benefit score (range 4-16) was calculated.</p><p><strong>Results: </strong>Parents and caregivers perceived a positive effect of NAM to improve choking (3.67 ± 0.53), nasal regurgitation (3.62 ± 0.58), and feeding time (3.50 ± 0.67), while air swallowing showed lower scores (3.19 ± 0.55). The total perceived feeding benefit score was 13.98 ± 1.57, indicating a high perceived benefit. No significant differences were found between males and females or between unilateral and bilateral clefts.</p><p><strong>Conclusions: </strong>Parents and caregivers consistently perceived a beneficial effect of NAM on patients' feeding. Although further research is required to determine the actual effectiveness of NAM, examining the perspectives reported by parents and caregivers could contribute to understand treatment experiences and guide family-centered care.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042443","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":"Is Milk Elimination Enough? A Systematic Review and Meta-Analysis of One-Food Elimination Diet in Eosinophilic Esophagitis.","authors":"Stefani Tsaggaridou, Constantinos Pitsios","doi":"10.3390/medsci14050575","DOIUrl":"10.3390/medsci14050575","url":null,"abstract":"<p><strong>Background/objectives: </strong>Dietary management, particularly through food elimination, has emerged as an effective therapeutic strategy for eosinophilic esophagitis (EoE). In this context, a one-food elimination diet (1-FED) targeting cow's milk has been proposed as a targeted and less restrictive alternative to broader elimination approaches. The aim of this systematic review and meta-analysis was to systematically assess the effectiveness of 1-FED in achieving histological remission and to compare its efficacy with broader elimination diets in patients with EoE.</p><p><strong>Methods: </strong>A systematic review of the literature was conducted across five databases (PubMed, Scopus, CINAHL, MEDLINE, and ClinicalTrials.gov). The primary endpoint was histological remission (<15 eosinophils/HPF). Comparative studies were pooled using a random-effects meta-analysis.</p><p><strong>Results: </strong>Eight studies met the eligibility criteria for the systematic review, of which seven were included in the meta-analysis. Overall, 156 of 306 patients achieved histological remission following 1-FED, corresponding to a pooled remission rate of 51% (95% CI: 43-60%). Histological remission rates ranged from approximately 34% to 65% across individual studies. Compared with broader elimination diets, 1-FED showed no significant difference in histological remission (OR 1.00, 95% CI 0.64-1.58; <i>p</i> = 0.99).</p><p><strong>Conclusions: </strong>Compared to multi-food elimination diets, 1-FED requires a less restrictive dietary pattern, which may offer practical advantages for treatment adherence in routine clinical practice, although this was not systematically or objectively measured in the included studies. The findings lend preliminary support to a step-up dietary strategy, in which 1-FED may be considered as an initial intervention and broader elimination diets are reserved for patients who fail to achieve remission.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042139","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":"COVID-19 mRNA Vaccines as Antigen-Agnostic Immunomodulators: A Repurposing Perspective.","authors":"Piercarlo Minoretti, Enzo Emanuele","doi":"10.3390/medsci14050572","DOIUrl":"10.3390/medsci14050572","url":null,"abstract":"<p><p>Since 2020, billions of doses of COVID-19 messenger RNA (mRNA) lipid nanoparticle vaccines have been administered worldwide, generating one of the largest pharmacovigilance databases for a modern therapeutic class. Intriguingly, their immunopharmacologic profile-including the engagement of innate nucleic acid sensors, systemic type I interferon signaling, dendritic cell-mediated cross-priming of CD8+ T cells, and upregulation of programmed cell death ligand 1 (PD-L1)-may extend beyond COVID-19 prophylaxis. Retrospective evidence from six independent cohorts, one of which is a multinational health-data network, indicated that vaccination within 100 days of immune checkpoint inhibitor (ICI) initiation may improve survival of patients with malignancies, including in immunologically cold tumors, although a substantial fraction of the original effect may be attributed to pandemic-era selection bias. Here, we examine the mechanistic basis and available evidence for the repurposing of licensed COVID-19 mRNA vaccines as antigen-agnostic immunomodulators. We identified five candidate contexts for prospective evaluation-namely, (1) PD-L1-negative non-small cell lung cancer initiating ICI therapy, (2) perioperative immune dysfunction in major cardiac surgery, (3) chronic hepatitis B, (4) chronic HIV with persistent immune exhaustion, and (5) sepsis-induced immunoparalysis. Methodological foundations for confirmatory assessment-comprising target trial emulation, Mendelian randomization, and pragmatic trial design-are now sufficiently developed to enable implementation. Prospective evaluation of the antigen-agnostic repurposing hypothesis is operationally feasible, albeit constrained by residual confounding and uncertainty about the durability of vaccine-induced innate reprogramming.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042519","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":"Personalized Medicine in Pediatric Urology: From Diagnosis to Individualized Risk Assessment.","authors":"Zenon Pogorelić, Andrea Cvitković Roić","doi":"10.3390/medsci14050570","DOIUrl":"10.3390/medsci14050570","url":null,"abstract":"<p><strong>Background: </strong>Pediatric urology has traditionally relied on anatomical classifications, standardized diagnostic pathways, and disease-specific treatment algorithms. However, children with the same anatomical diagnosis may have substantially different risks of disease progression, renal injury, complications, and need for intervention. Personalized and precision medicine aim to integrate clinical, imaging, functional, biological, genomic, and longitudinal information to support individualized risk assessment and decision-making.</p><p><strong>Methods: </strong>This narrative review was based on a targeted literature search of PubMed/MEDLINE, Scopus, Embase and Web of Science databases. Search terms included combinations of \"personalized medicine,\" \"precision medicine,\" \"risk stratification,\" \"pediatric urology,\" \"biomarkers,\" \"genomics,\" and \"artificial intelligence,\" together with terms related to major pediatric urological conditions. Additional relevant publications were identified from reference lists of key articles. The literature was narratively synthesized according to its relevance to individualized risk assessment and clinical decision-making.</p><p><strong>Results: </strong>Current evidence supports an evolving role for individualized risk assessment in vesicoureteral reflux, antenatal hydronephrosis and ureteropelvic junction obstruction, congenital anomalies of the kidney and urinary tract, hypospadias, undescended testes, and disorders of sex development. Biomarkers, genomic testing, advanced imaging, and artificial intelligence may provide additional information for phenotyping and outcome prediction. However, most predictive and AI-based models remain insufficiently validated, with limitations related to external validation, calibration, reproducibility, clinical utility, and generalizability. Longitudinal reassessment is particularly important because risk may change with growth, disease progression, and treatment response.</p><p><strong>Conclusions: </strong>Personalized pediatric urology should move beyond diagnosis-based algorithms toward dynamic, risk-adapted decision-making. The goal is not to increase the number of investigations or interventions, but to identify which child is most likely to benefit from additional testing, surveillance, or treatment. Future implementation will depend on robust validation of predictive models and demonstration that personalized approaches improve clinically meaningful outcomes.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042520","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":"Therapeutic Vulnerabilities of the Key Genetic Drivers in Leiomyosarcoma.","authors":"Ekaterina A Lesovaya, Timur I Fetisov, Beniamin Yu Bokhyan, Varvara P Maksimova, Evgeny P Kulikov, Gennady A Belitsky, Kirill I Kirsanov, Marianna G Yakubovskaya","doi":"10.3390/medsci14050571","DOIUrl":"10.3390/medsci14050571","url":null,"abstract":"<p><p>Leiomyosarcoma (LMS) is a rare, aggressive soft-tissue sarcoma arising from smooth muscle cells. It has a high metastatic potential and limited therapeutic options. Despite advances in oncology, the molecular landscape of LMS remains incompletely understood, particularly regarding the genetic and epigenetic alterations that affect key signaling pathways. This review summarizes the current knowledge of mechanisms driving LMS pathogenesis, including somatic mutations in genes such as <i>TP53</i> and <i>RB1</i>, chromosomal instability, dysfunction of DNA damage response and repair, aberrant DNA methylation, histone modifications, and non-coding RNAs. Emerging treatment strategies include inhibitors of PI3K/AKT/mTOR and CDK4/6 signaling, epigenetic drugs, immunotherapy, and combinations of these approaches. However, the coexistence of multiple genetic abnormalities complicates diagnosis, prognosis, and therapeutic selection. Companion diagnostic tools that test candidate therapies ex vivo or in vitro may help exclude potentially ineffective targeted treatments.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042611","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":"Thoracic Skeletal Muscle Attenuation Predicts Sex-Specific Mortality After Coronary Artery Bypass Grafting-Sex-Specific Insights into Risk Stratification and Frailty Assessment.","authors":"Philipp Krombholz-Reindl, Andreas Winkler, Christian Dinges, Klaus Linni, Manuela Pilz, Stephanie Rassam, Matthias Hammerer, Nikolaus Clodi, Roman Gottardi, Stefan Hecht, Johannes Holfeld, Elke Boxhammer, Andreas Voetsch","doi":"10.3390/medsci14050569","DOIUrl":"10.3390/medsci14050569","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Frailty and impaired muscle quality are strong determinants of adverse outcomes after coronary artery bypass grafting (CABG), yet conventional risk scores overlook this biological dimension. The Hounsfield Unit Average Calculation (HUAC) obtained from routine preoperative computed tomography (CT) scans quantifies skeletal muscle attenuation, reflecting intramuscular fat infiltration and metabolic reserve. This study evaluated the prognostic value of HUAC measured at two thoracic levels and explored sex-specific differences in its predictive performance. &lt;b&gt;Methods:&lt;/b&gt; In this retrospective single-center study, 479 patients (382 men, 97 women) undergoing isolated CABG with available preoperative CT scans were analyzed. Mean HUAC was measured bilaterally at the fourth (TH4) and twelfth (TH12) thoracic vertebral levels. Sex-specific HUAC quartiles were generated, with the lower quartile defining low thoracic muscle attenuation, representing a radiographic phenotype of impaired muscle quality. Associations with 1-, 3-, and 5-year mortality were assessed by Kaplan-Meier analysis, receiver-operating-characteristic (ROC) curves, and sex-stratified Cox regression models incorporating inverse probability weighting (IPW). Incremental prognostic value beyond EuroSCORE II was assessed by comparing Harrell's C-statistics of Cox models with and without low HUAC. &lt;b&gt;Results:&lt;/b&gt; Patients with low HUAC showed reduced survival at all time points. HUAC measured at TH4 demonstrated higher discriminative ability compared with TH12. In women, TH4 yielded area under the curve (AUC) of 0.773 and 0.807 for 1- and 3-year survival, respectively, compared with 0.670 and 0.640 in men. In sex-specific Cox analyses, women in the lower HUAC-TH4 quartile had markedly increased mortality risk (unweighted HRs 6.6, 9.5, and 6.4 for 1-, 3-, and 5-year follow-up; all &lt;i&gt;p&lt;/i&gt; ≤ 0.03), which remained significant after IPW adjustment. In men, the association was weaker and lost significance after weighting. Formal interaction testing demonstrated significant sex × low-HUAC interactions at TH4 for 3- and 5-year mortality (&lt;i&gt;p&lt;/i&gt; interaction = 0.046 and 0.045, respectively), whereas no significant interaction was observed at TH12. Addition of low TH4 HUAC to EuroSCORE II improved model discrimination in the overall cohort, with C-statistics increasing from 0.665 to 0.711 at 3 years and from 0.658 to 0.690 at 5 years (both likelihood-ratio &lt;i&gt;p&lt;/i&gt; &lt; 0.001); the largest incremental gains were observed in women (ΔC = +0.115 and +0.081, respectively). &lt;b&gt;Conclusions:&lt;/b&gt; Low thoracic muscle attenuation, particularly HUAC at TH4, independently predicts long-term mortality after CABG. Formal interaction testing supports an exploratory sex-dependent prognostic association at TH4, with a stronger association of low muscle attenuation with mortality in women than in men. HUAC represents a simple, objective biomarker of physiological reserve that can be derived from e","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042602","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":"Asthma and Sinonasal Diseases: Shared Clinical Comorbidities, Inflammatory Pathways and Management Strategies.","authors":"Francesca Cefaloni, Enrico Schiavi, Matteo Morviducci, Eugenio De Corso, Marco Brunori, Simonetta Masieri, Matteo Bonini","doi":"10.3390/medsci14050568","DOIUrl":"10.3390/medsci14050568","url":null,"abstract":"<p><p>Asthma and sinonasal diseases, particularly chronic rhinosinusitis with nasal polyps (CRSwNP), frequently coexist as part of the United Airway Disease (UAD), reflecting shared inflammatory pathways and physiopathologic mechanisms. They both significantly contribute as additional comorbidities to patient burden of symptoms and disease severity, and may guide the treatment approach, particularly when presenting together. The aim of this review was to explore the clinical interplay between asthma and sinonasal diseases, emphasizing epidemiologic links, shared immunologic pathways, and emerging management strategies, namely biologic therapies targeting type 2 (T2) inflammation. This approach enables integrated diagnostic and therapeutic approaches by targeting specific inflammatory mediators in a precision-medicine perspective. This may lead to a higher chance of achieving better outcomes in both upper and lower airways. Future studies should refine the treatment selection and evaluate long-term effects of biologic therapy across the upper and lower airways.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042366","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":"Bicuspid Aortic Valve Disease-Associated Aortopathy in Pediatric Subjects-From Traditional Assessment to Current Advances and Future Perspectives: A Narrative Review.","authors":"Oana Iulia Man, Lucia Agoston-Coldea, Cecilia Lazea","doi":"10.3390/medsci14050567","DOIUrl":"10.3390/medsci14050567","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background&lt;/b&gt;: Bicuspid aortic valve disease (BAVD) is the most frequent congenital heart disease, occurring either as an isolated lesion or in association with other congenital cardiovascular malformations, with variable patterns of progression and risk of valvular and vascular complications. Studies addressing pediatric bicuspid aortopathy are still in their infancy. This narrative review aims to provide a comprehensive perspective on the current scientific evidence regarding BAVD-associated aortopathy in pediatric patients, underscoring multiple challenges in initial diagnosis, long-term surveillance, and therapeutic decision-making, and focusing on the potential roles of circulating biomarkers and advanced multimodal imaging tools that may improve individualized risk stratification. &lt;b&gt;Methods&lt;/b&gt;: Despite the narrative design of this review, a structured search of the current available literature was performed to identify studies addressing pediatric BAV, associated aortopathy, biomarkers, vascular remodeling, and multimodal imaging. Priority was given to pediatric cohorts, longitudinal studies, consensus documents, and contemporary guidelines. The search was conducted in the online databases PubMed/Medline and Web of Science for English-language original articles published in the last 10 years, up to May 2026. We used the following main terms: \"Bicuspid Aortic Valve Disease\" [MeSH], \"Aorta\" [MeSH], \"Infant\" [MeSH], \"Child\" [MeSH], \"Adolescent\" [MeSH], combined by Boolean operators with secondary keywords: \"pathogenesis\", \"mechanism\", \"progression\", \"multimodal imaging\", \"echocardiography\", \"cardiovascular magnetic resonance imaging\", \"computed tomography\", \"circulating biomarkers\". The retrieved studies were screened for eligibility using previously established inclusion and exclusion criteria. A total of 63 studies were included in the analysis for this narrative review. &lt;b&gt;Results&lt;/b&gt;: Two main theories underpin the etiopathogenesis of aortopathy associated with the bicuspid aortic valve, positing that genetic factors predispose the aortic wall to remodeling in an abnormal hemodynamic environment. Embryological development and dysregulation of molecular and cellular structures are also intertwined during the formation and progression of the aortic valve with two semilunar cusps, resulting in consequent alterations in the aortic wall's architectural organization. Advances in molecular studies have highlighted circulating biomarkers with potential utility in predicting aortopathy, as they are involved in extracellular matrix remodeling, endothelial dysfunction, and aortic valve calcification, including matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs), transforming growth factor-β (TGF-β), and microRNAs. In addition, multimodal imaging techniques have emerged as essential tools for assessing the morphology and function of cardiovascular structures, particularly aortic biomechanical properties and hemodynamic abn","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042130","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":"Dynamics of Borrelial Antibodies in European Lyme Borreliosis Patients with Erythema Migrans.","authors":"Petra Bogovič, Martina Jaklič, Katarina Ogrinc, Vera Maraspin, Tereza Rojko, Mirijam Nahtigal-Klevišar, Eva Ružić-Sabljić, Gary P Wormser, Franc Strle","doi":"10.3390/medsci14050563","DOIUrl":"10.3390/medsci14050563","url":null,"abstract":"<p><p><b>Background/Objectives:</b> The diagnosis of typical erythema migrans (EM) is clinical, and serological testing for <i>Borrelia</i>-specific antibodies is not required. However, characterization of the immune response in patients with a reliable clinical diagnosis may improve the interpretation of serological findings in early Lyme borreliosis (LB) without characteristic skin lesions. <b>Methods:</b> Serum IgM and IgG antibodies to <i>Borrelia burgdorferi</i> sensu lato were evaluated in 1356 Slovenian adults with EM at baseline and at a follow-up visit approximately two months after treatment initiation, using a chemiluminescence immunoassay based on recombinant borrelial antigens. <b>Results:</b> At baseline, 41.5% of patients were IgM-seropositive, 55.5% IgG-seropositive, and 70.1% positive for either IgM or IgG. Patients with multiple EM were significantly more often seropositive than those with solitary EM. In previously untreated patients, baseline IgG seropositivity showed a clearer positive association with longer lesion duration and larger lesion diameter, whereas the corresponding IgM patterns were less consistent. Multiple EM remained strongly associated with both IgM and IgG seropositivity in adjusted analyses. Seroconversion at follow-up was uncommon, occurring in 8.0% of initially IgM-negative and 8.2% of initially IgG-negative patients. <b>Conclusions:</b> The low frequency of newly detectable antibody responses indicates that repeat qualitative serologic testing approximately two months after treatment initiation provides limited additional diagnostic information in European adults with EM.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"14 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042498","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}