Medical sciences (Basel, Switzerland)最新文献

{"title":"Artificial Intelligence and Extended Reality in the Training of Vascular Surgeons: A Narrative Review.","authors":"Joanna Halman, Sonia Tencer, Mariusz Siemiński","doi":"10.3390/medsci13030126","DOIUrl":"https://doi.org/10.3390/medsci13030126","url":null,"abstract":"<p><strong>Background: </strong>The rapid shift from open to endovascular techniques in vascular surgery has significantly decreased trainee exposure to high-stakes open procedures. Simulation-based training, especially that incorporating virtual reality (VR) and artificial intelligence (AI), provides a promising way to bridge this skill gap.</p><p><strong>Objective: </strong>This narrative review aims to assess the current evidence on the integration of extended reality (XR) and AI into vascular surgeon training, focusing on technical skill development, performance evaluation, and educational results.</p><p><strong>Methods: </strong>We reviewed the literature on AI- and XR-enhanced surgical education across various specialties, focusing on validated cognitive learning theories, simulation methods, and procedure-specific training. This review covered studies on general, neurosurgical, orthopedic, and vascular procedures, along with recent systematic reviews and consensus statements.</p><p><strong>Results: </strong>VR-based training speeds up skill learning, reduces procedural mistakes, and enhances both technical and non-technical skills. AI-powered platforms provide real-time feedback, performance benchmarking, and objective skill evaluations. In vascular surgery, high-fidelity simulations have proven effective for training in carotid artery stenting, EVAR, rAAA management, and peripheral interventions. Patient-specific rehearsal, haptic feedback, and mixed-reality tools further improve realism and readiness. However, challenges like cost, data security, algorithmic bias, and the absence of long-term outcome data remain.</p><p><strong>Conclusions: </strong>XR and AI technologies are transforming vascular surgical education by providing scalable, evidence-based alternatives to traditional training methods. Future integration into curricula should focus on ethical use, thorough validation, and alignment with cognitive learning frameworks. A structured approach that combines VR, simulation, cadaver labs, and supervised practice may be the safest and most effective way to train the next generation of vascular surgeons.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981189","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":"Eryptosis in Liver Diseases: Contribution to Anemia and Hypercoagulation.","authors":"Saulesh Kurmangaliyeva, Kristina Baktikulova, Anton Tkachenko, Bibigul Seitkhanova, Liliya Tryfonyuk, Farida Rakhimzhanova, Rustam Yussupov, Kairat Kurmangaliyev","doi":"10.3390/medsci13030125","DOIUrl":"https://doi.org/10.3390/medsci13030125","url":null,"abstract":"<p><p>Eryptosis is a type of regulated cell death of mature erythrocytes characterized by excessive Ca²⁺ accumulation followed by phosphatidylserine externalization. Eryptosis facilitates erythrophagocytosis resulting in eradication of damaged erythrocytes, which maintains the population of healthy erythrocytes in blood. Over recent years, a wide array of diseases has been reported to be linked to accelerated eryptosis, which leads to anemia. A growing number of studies furnish evidence that eryptosis is implicated in the pathogenesis of liver diseases. Herein, we summarize the current knowledge of eryptosis signaling, its physiological role, and the impact of eryptosis on anemia and hypercoagulation. In this article, upon systemically analyzing the PubMed-indexed publications, we also provide a comprehensive overview of the role of eryptosis in the spectrum of hepatic diseases, its contribution to the development of complications in liver pathology, metabolites (bilirubin, bile acids, etc.) that might trigger eryptosis in liver diseases, and eryptosis-inducing liver disease medications. Eryptosis in liver diseases contributes to anemia, hypercoagulation, and endothelial damage (via ferroptosis of endothelial cells). Treatment-associated anemia in liver diseases might be at least partly attributed to drug-induced eryptosis. Ultimately, we analyze the concept of inhibiting eryptosis pharmaceutically to prevent eryptosis-associated anemia and thrombosis in liver diseases.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981396","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":"Sociodemographic Factors, Healthy Habits, and Quality of Life in Relation to Insulin Resistance Risk in a Large Cohort of Spanish Workers.","authors":"María Dolores Marzoa Jansana, Pedro Juan Tárraga López, Juan José Guarro Miquel, Ángel Arturo López-González, Pere Riutord Sbert, Carla Busquets-Cortés, José Ignacio Ramírez-Manent","doi":"10.3390/medsci13030122","DOIUrl":"https://doi.org/10.3390/medsci13030122","url":null,"abstract":"<p><p><b>Background:</b> Insulin resistance (IR) is a key pathogenic mechanism underlying numerous cardiometabolic disorders. While sociodemographic and lifestyle determinants of IR are well-established, their association with health-related quality of life (HRQoL) remains understudied. This study explores the relationship between IR risk, as measured by TyG, METS-IR, and SPISE-IR indices, and HRQoL in a large cohort of Spanish workers. <b>Methods:</b> This cross-sectional study included 100,014 Spanish workers aged 18-69 years evaluated between January 2021 and December 2023. Exclusion criteria included incomplete clinical, laboratory, or questionnaire data. IR was assessed using TyG, METS-IR, and SPISE-IR indices. HRQoL was measured using the SF-12 questionnaire. Sociodemographic factors, physical activity (IPAQ), dietary habits (MEDAS-14), and social class (based on CNAE-11 and Spanish Society of Epidemiology criteria) were also evaluated. Statistical analysis was conducted using SPSS v29.0. <b>Results:</b> Higher IR risk was consistently associated with older age, male sex, lower social class, current smoking, low adherence to the Mediterranean diet, and physical inactivity. Lower HRQoL scores (both physical and mental components) were significantly associated with higher IR indices, particularly with METS-IR and SPISE-IR. These associations persisted after adjusting for sociodemographic and behavioral covariates. <b>Conclusions:</b> This study demonstrates a robust association between insulin resistance risk and diminished health-related quality of life. The integration of validated IR indices and subjective health perception tools such as the SF-12 may enhance early identification of at-risk individuals in occupational health settings.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981506","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":"Bowel Dysfunctions in Young Adults with Multiple Sclerosis: A Retrospective Study.","authors":"Edoardo Sessa, Lilla Bonanno, Carla Susinna, Daniela Ivaldi, Gabriele Triolo, Roberta Lombardo, Giangaetano D'Aleo, Carmela Rifici, Viviana Lo Buono","doi":"10.3390/medsci13030123","DOIUrl":"https://doi.org/10.3390/medsci13030123","url":null,"abstract":"<p><strong>Background/objectives: </strong>Multiple sclerosis (MS) is a chronic neurodegenerative disorder mainly affecting young adults and can greatly impair quality of life (QoL). Among its often overlooked but significant symptoms are bowel dysfunctions (BD), such as constipation and fecal incontinence, which can impact physical, emotional, and social well-being, especially in younger patients. This study aims to investigate the impact of BD on the QoL in young adults diagnosed with relapsing-remitting MS (RRMS) and mild disability.</p><p><strong>Methods: </strong>This retrospective cross-sectional study examined the effect of BD on QoL in 110 young adults with RRMS and mild disability (EDSS ≤ 3.5). Bowel symptoms were assessed using the Wexner Incontinence and Constipation Scales, while QoL was measured with the MSQoL-54 questionnaire. Statistical analyses were performed to examine correlations between BD severity and QoL domains.</p><p><strong>Results: </strong>Our findings showed significant correlations between the severity of intestinal symptoms and different domains of QoL, like physical functioning, emotional well-being, and social functioning. Abdominal pain and liquid fecal incontinence were especially linked to lower mental and physical health scores. Subgroup analyses also indicated gender-specific vulnerabilities, with women showing distinct effects on social and emotional dimensions.</p><p><strong>Conclusion: </strong>BD represents an important burden on bowel dysfunctions for young people with MS, deeply impacting various dimensions of QoL. This underscores an urgent need for an integrated, multidisciplinary care model that tackles physical symptoms but also psychological and social challenges. A holistic clinical strategy is vital to improving the overall well-being of this population.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981359","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":"Risk of Permanent Dysfunction of Facial Nerves After Open Rigid Internal Fixation in the Treatment of Mandibular Condylar Process Fracture.","authors":"Paulina Agier, Marcin Kozakiewicz, Szymon Tyszkiewicz, Izabela Gabryelczak","doi":"10.3390/medsci13030121","DOIUrl":"https://doi.org/10.3390/medsci13030121","url":null,"abstract":"<p><strong>Background: </strong>Facial nerve palsy is a relatively common complication following open rigid internal fixation (ORIF) of a mandibular condylar fracture. The aim of this study was to investigate the risk factors that influence post-operative facial nerve function and the recovery process.</p><p><strong>Methods: </strong>A retrospective study was conducted based on the medical records of 329 patients who underwent ORIF treatment for condyle fractures, with the follow-up period being 24 months long.</p><p><strong>Results: </strong>During the initial post-operative examination, 50.45% of patients exhibited some signs of facial nerve dysfunction, ranging from slight to severe, and 48.63% of patients presented transient palsy, while only 1.82% presented permanent facial nerve palsy. Female patients were found to be more susceptible to post-operative facial nerve palsy. Patients with multiple mandibular fractures and bilateral condyle fractures had a worse prognosis. The preauricular approach and its modifications were identified as posing the greatest risk to the facial nerve. The safest approach was the retromandibular approach. Patients treated for injuries resulting from traffic accidents or falls had a worse prognosis than those treated for assault injuries.</p><p><strong>Conclusions: </strong>Post-operative facial nerve palsy following ORIF of the mandibular condyle is, in most cases, transient and can be effectively treated. However, it is important to choose the safest possible surgical approach. The safer approach, the retromandibular approach, should be considered when possible.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981483","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":"Disease Burden and Unmet Medical Needs in Patients with Ulcerative Colitis in Greece: A Cross-Sectional Patient Survey.","authors":"George Gourzoulidis, Vasiliki-Rafaela Vakouftsi, George Mavridoglou, Marina Psarra, Charalampos Tzanetakos","doi":"10.3390/medsci13030117","DOIUrl":"https://doi.org/10.3390/medsci13030117","url":null,"abstract":"<p><p><b>Background</b>: Ulcerative colitis (UC) requires life-long disease management. This study aimed to investigate the disease burden and unmet medical needs in UC patients in Greece. <b>Methods</b>: Between October 2023 and January 2024, adult UC patients who were members of the Hellenic Society of Crohn's Disease and Ulcerative Colitis Patients (HELLESCC) completed a structured self-reported questionnaire. The survey questionnaire included sociodemographic characteristics, smoking habits, history of comorbidities, disease activity, disease characteristics, medications, and patient-reported outcomes (PROs; Short Inflammatory Bowel Disease Questionnaire [SIBDQ], Work Productivity and Activity Impairment [WPAI], Patient Health Questionnaire-9 [PHQ-9], treatment satisfaction, and treatment adherence). Univariate and multivariate logistic regression analyses were used to identify associated factors. <b>Results:</b> Datasets were obtained from 181 UC patients, of whom 48% were on advanced therapies (biological/small-molecule agents) and 54% had active disease. Around 74% reported impaired quality of life (QoL) (SIBDQ < 60), 25% work productivity loss, and 29% daily activity impairment. About 40% reported moderate to severe depressive symptoms (PHQ-9 ≥ 10). Reduced adherence and treatment dissatisfaction were reported by approximately one-third of patients. Female gender and disease activity were associated with moderately to severely impaired QoL, work productivity, and mental health. Interestingly, three out of four patients receiving advanced therapy reported moderately to severely impaired QoL and had increased odds of experiencing moderate to severe depression. <b>Conclusions</b>: The disease burden remains very high in UC, characterized by poor QoL and increased work impairment, depression, and disease activity among Greek patients. Marked treatment dissatisfaction and non-adherence were observed in approximately one-third of patients.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981352","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":"Salivary Cortisol and Periodontitis Severity: A Cross-Sectional Biomarker-Based Assessment of Stress and Inflammation.","authors":"Velitchka Dosseva-Panova, Antoaneta Mlachkova, Marina Miteva, Dimitar Dimitrov","doi":"10.3390/medsci13030120","DOIUrl":"https://doi.org/10.3390/medsci13030120","url":null,"abstract":"<p><p><b>Background:</b> Psychological stress is increasingly recognized as a potential modifier of periodontal disease through both behavioral and biological mechanisms. Cortisol, a key stress hormone, exerts complex immunomodulatory effects and may influence periodontal inflammation and tissue breakdown. This study aimed to compare salivary levels of cortisol, interleukin-1β, and interleukin-6 in patients with varying periodontitis severity and examine their associations with clinical periodontal parameters. <b>Methods:</b> A total of 67 patients diagnosed with periodontitis were classified according to the 2017 World Workshop Classification into Stage I/II vs. Stage III/IV and Grade B vs. Grade C. Unstimulated saliva samples were collected and analyzed for cortisol using electrochemiluminescence immunoassay, and for IL-1β and IL-6 using ELISA. Statistical analyses included Mann-Whitney U test, Spearman's correlations, and multivariate regression. <b>Results:</b> Median salivary cortisol levels were significantly higher in Stage III/IV (11.90 nmol/L) than in Stage I/II (7.64 nmol/L; <i>p</i> = 0.014) and in Grade C (10.60 nmol/L) vs. Grade B (7.70 nmol/L; <i>p</i> = 0.019). In multivariate analysis, cortisol independently predicted both Stage III/IV (OR = 1.23, <i>p</i> = 0.007) and Grade C (OR = 1.24, <i>p</i> = 0.026) periodontitis. ROC analysis showed that salivary cortisol had moderate diagnostic performance for Stage III/IV periodontitis (AUC = 0.68, cut-off 11.57 nmol/L) and Grade C (AUC = 0.67, cut-off 9.76 nmol/L). Cortisol showed significant positive correlations with clinical markers of disease severity and with IL-1β (r = 0.399, <i>p</i> = 0.001) and IL-6 (r = 0.424, <i>p</i> < 0.001). <b>Conclusions:</b> Salivary cortisol is a promising non-invasive biomarker reflecting both stress-related physiological burden and clinical severity in periodontitis. Cortisol measurement may represent a valuable addition to multifactorial assessments and risk stratification in periodontitis, pending further validation in longitudinal studies.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981485","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":"Adherence, Persistence, and Blood Pressure Control in Hypertensive Patients: A Cross-Sectional Study in Mureș County, Romania.","authors":"Radu Tatar, Marius-Stefan Marusteri, Dragos-Gabriel Iancu, Razvan Gheorghita Mares, Diana-Andreea Moldovan, Andreea Varga, Ioan Tilea","doi":"10.3390/medsci13030119","DOIUrl":"https://doi.org/10.3390/medsci13030119","url":null,"abstract":"<p><p><b>Background:</b> Nonadherence to antihypertensive therapy affects nearly half of treated patients worldwide, and persistence often falls below 60% within the first year, contributing substantially to uncontrolled blood pressure and cardiovascular morbidity. Adherence and persistence to antihypertensive therapy among primary care patients in Mureș County, Romania, were assessed using validated measures, and modifiable risk factors for targeted interventions were identified. <b>Methods:</b> A cross-sectional study of 399 hypertensive adults (≥18 years) receiving treatment for ≥1 year across primary care clinics in Mureș County, Romania, was performed. Adherence was evaluated using the Romanian-validated Hill-Bone Compliance to High Blood Pressure Therapy Scale (HBCTS) and confirmed by mean arterial pressure (MAP) < 100 mmHg. Receiver operating characteristic (ROC) curve analysis was employed to determine the optimal HBCTS cutoff, and multivariate logistic regression was used to identify independent predictors of adherence. Persistence was assessed via healthcare-engagement metrics over a 360-day observation period. <b>Results:</b> Effective blood pressure control (MAP < 100 mmHg) was achieved by 45.9% of participants. The HBCTS demonstrated good reliability (McDonald's ω = 0.82). ROC analysis established 51 points as an optimal threshold (sensitivity = 88.0%, specificity = 38.9%). Male gender (OR = 0.47, 95% CI: 0.29-0.75, <i>p</i> = 0.002) and younger age (OR = 1.04 per year, 95% CI: 1.01-1.06, <i>p</i> = 0.001) independently predicted poor adherence. Treatment coverage days showed the strongest correlation with blood pressure control (r = -0.50, <i>p</i> < 0.001). Among participants, 67.7% demonstrated persistence, achieving significantly better blood pressure control than non-persistent patients. <b>Conclusions:</b> The validated HBCTS (≥51 points) provides an efficient screening tool for Romanian primary care settings. Treatment coverage days emerged as the strongest modifiable predictor of blood pressure control (r = -0.50), highlighting medication availability as a key intervention target. Targeted approaches for male and younger patients, combined with systematic medication continuity monitoring, represent evidence-based strategies for reducing cardiovascular morbidity in this population.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981525","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":"Plasma Biomarkers of Mitochondrial Dysfunction in Patients with Myasthenia Gravis.","authors":"Elena E Timechko, Marina I Severina, Alexey M Yakimov, Anastasia A Vasilieva, Anastasia I Paramonova, Natalya V Isaeva, Semen V Prokopenko, Diana V Dmitrenko","doi":"10.3390/medsci13030118","DOIUrl":"https://doi.org/10.3390/medsci13030118","url":null,"abstract":"<p><p><b>Background</b>. Myasthenia gravis is an autoimmune neuromuscular disease characterized by fatigue of striated muscles due to impaired neuromuscular transmission. Mitochondrial dysfunction, according to published data, contributes significantly to metabolic abnormalities, oxidative stress and, as a consequence, the persistence of inflammation. MicroRNAs, which are post-transcriptional regulators of expression, are able to contribute to the aberrant functioning of mitochondria. In this study, with the aim of searching for biomarkers at the level of circulating microRNAs and proteins, the expression of three microRNAs was analyzed and the concentration of mitochondrial proteins was measured in the blood plasma of patients with myasthenia gravis (<i>n</i> = 49) in comparison with healthy volunteers (<i>n</i> = 31). <b>Methods</b>. Expression analysis was performed by RT-PCR, mathematical data processing was carried out using the Livak method, and protein concentration was determined by enzyme immunoassay. <b>Results</b>. Our plasma expression analysis revealed a statistically significant increase in hsa-miR-194-5p expression (Log10 Fold Change = 1.46, <i>p</i>-value < 0.0001) and a statistically significant decrease in hsa-miR-148a-3p expression (Log10 Fold Change = -0.65, <i>p</i>-value = 0.02). A statistically significant decrease in plasma COQ10A concentration was also found (0.911 [0.439; 1.608] versus 1.815 [1.033; 2.916] for myasthenia gravis and controls, respectively, <i>p</i>-value = 0.01). <b>Conclusion</b>. Our data suggest hsa-miR-148a-3p and hsa-miR-194-5p, as well as COQ10A, as potential biomarkers of mitochondrial dysfunction in myasthenia gravis.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981385","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":"Risk Stratification in Acute Coronary Syndromes: The Systemic Immune-Inflammation Index as Prognostic Marker.","authors":"Elena Emilia Babes, Andrei-Flavius Radu, Noemi Adaus Cretu, Gabriela Bungau, Camelia Cristina Diaconu, Delia Mirela Tit, Victor Vlad Babes","doi":"10.3390/medsci13030116","DOIUrl":"https://doi.org/10.3390/medsci13030116","url":null,"abstract":"<p><strong>Background/objectives: </strong>Inflammation plays a key role in acute coronary syndromes (ACS). The systemic immune-inflammation index (SII), which integrates immune and inflammatory markers, may serve as a valuable prognostic tool. This study aimed to evaluate the utility of SII as a short-term predictor of mortality and major adverse cardiovascular and cerebral events (MACCE) in ACS patients.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 964 ACS patients admitted in 2023. SII was calculated from admission hematological parameters. Primary and secondary outcomes were 30-day mortality and MACCE, respectively.</p><p><strong>Results: </strong>SII levels differed significantly across ACS subtypes (<i>p</i> < 0.001), highest in ST-segment elevation myocardial infarction (STEMI) and lowest in unstable angina. SII was markedly higher in deceased patients (2003.79 ± 1601.17) vs. survivors (722.04 ± 837.25; <i>p</i> < 0.001) and remained an independent predictor of mortality (OR = 1.038, <i>p</i> < 0.001). Similarly, SII was elevated in MACCE cases (1717 ± 1611.32) vs. non-MACCE (664.68 ± 713.11; <i>p</i> < 0.001) and remained predictive in multivariate analysis (OR = 1.080, <i>p</i> < 0.001). Predictive accuracy for MACCE was moderate (AUC = 0.762), improved when combined with GRACE 2, especially in specificity (<i>p</i> = 0.07). In STEMI, SII had excellent accuracy (AUC = 0.874), outperforming neutrophil-lymphocyte ratio and C-reactive protein. SII rose at 24 h and declined at 48 h in STEMI, with a slower decline in MACCE patients.</p><p><strong>Conclusions: </strong>SII proved to be a cost-effective biomarker reflecting inflammation, immunity, and thrombosis. Elevated SII predicted short-term MACCE and mortality in ACS, with improved prognostic power when combined with GRACE 2. Persistent elevation may signal ongoing inflammation and increased MACCE risk.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981546","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}