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Cryptogenic stroke and patent foramen ovale: endeavoring for clarity
(2025) Amini, Tohid
This review aims to summarize current knowledge and highlight recent findings on the association between cryptogenic stroke (CS) and patent foramen ovale (PFO). By presenting sometimes conflicting data, the review underscores the necessity for further research to clarify the complex mechanisms behind PFO-related CS and optimize its management. Results from research identifies specific conditions and scores, such as the risk of paradoxical embolism (RoPE) score, that help assess the likelihood of PFO-related cryptogenic stroke and guide treatment decisions. PFO closure has demonstrated substantial benefits in select cases, especially those with high-risk PFO features, though complications such as atrial fibrillation were frequently documented. Biomarker measurements, such as reduced total homocysteine (tHcy) level after PFO closure or high D-dimer levels indicating a higher risk of stroke recurrence, represent newer areas of study with a promising future in medical practice. Cryptogenic stroke (CS) remains a diagnostic challenge. This article reviews the current understanding of PFO-related CS, focusing on the interplay of concomitant pathological conditions, PFO closure, stroke recurrence, and some of the related biomarkers.
Hunting glioblastoma recurrence: glioma stem cells as retrospective targets
(2025) Mengüç Emir, Sümeyra; Karaoğlan, Birnur Sinem; Kaşmer, Ramazan; Şirin, Hilal Buse; Sarıyıldız, Batuhan; Karakaş, Nihal
Glioblastoma (GBM) remains one of the most aggressive and treatment-resistant brain malignancies in adults. Standard approaches, including surgical resection followed by adjuvant radio- and chemotherapy with temozolomide (TMZ), provide only transient control, as GBM frequently recurs due to its infiltrative nature and the presence of therapy-resistant subpopulations such as glioma stem cells (GSCs). GSCs, with their quiescent state and robust resistance mechanisms, evade conventional therapies, contributing significantly to relapse. Consequently, current treatment methods for GBM face significant limitations in effectively targeting GSCs. In this review, we emphasize the relationship between GBM recurrence and GSCs, discuss the current limitations, and provide future perspectives to overwhelm the challenges associated with targeting GSCs. Eliminating GSCs may suppress recurrence, achieve durable responses, and improve therapeutic outcomes for patients with GBM.
Disease X: Unraveling a mysterious outbreak in the Democratic Republic of the Congo
(2025) Verma, Manali; Verma, Amogh; Singla, Rahul; Sharma, Siddharth; Suresh, Vinay; Karim, Hajira; Tafawa, Chelsea Rachael
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Bridging theory and practice: how adult learning theories shape interactive lectures
(2024) Baig, Mukhtiar; Tariq, Saba; Tariq, Sundus
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Homozygous astn1 nonsense variant linked to epileptic encephalopathy: a detailed report with unique clinical presentation
(2025) Ayaz, Akif; Sager, Safiye Güneş; Gökşen, Ahmet Sercan; Kök, Kıvanç; Çalışkan, Emine; Alomari, Omar
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Skin cancer in patients who are co-infected with hiv/ hbv or hiv/hcv a systematic review
(2024) Lee, Woori; Cho, Daniel K.; Ragi, Sara D.; Khachemoune, Amor
Skin cancer, the most common cancer in the United States, has been well-described in the literature to be associated with environmental factors including ultraviolet (UV) radiation. However, the effect of chronic viral infections on risk of skin cancer development, particularly in individuals co-infected with Human Immunodeficiency Virus (HIV) and Hepatitis B or C Viruses (HBV/HCV), has yet to be elucidated. This systematic review aims to be one of the first to consolidate existing literature and examine the relationship between skin cancer and HIV/HBV and HIV/HCV co-infections. We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching MEDLINE, Embase, Cochrane CENTRAL, and Web of Science databases for studies published from inception to March 26, 2024. Inclusion criteria for studies included only those reporting on HBV and/or HCV in people living with HIV (PLWH). Five studies were ultimately included for analysis. The review identified multiple non-melanoma skin cancers (NMSC) and cutaneous adnexal carcinomas in HIV/HCV or HIV/HBV co-infected patients. Notably, Pilomatrical carcinomas were observed in co-infected individuals. Sarcomas including Kaposi sarcoma and low-grade fibroblastic sarcoma were also linked to HIV/HCV or HIV/HBV infections. However, the studies primarily focused on specific types of cancers without elucidating the underlying mechanisms for the association between HIV/HCV/HBV infection and sarcoma development. In summary, this review suggests a potential link between HIV/HCV and HIV/HBV co-infection and certain types of skin cancer, namely adnexal carcinomas. Further research is crucial to determine the underlying mechanisms, explore the association with different skin cancer types, and identify effective prevention and treatment strategies for co-infected individuals.
Correction: International alliance of urolithiasis (iau) consensus on miniaturized percutaneous nephrolithotomy
(2024) Zeng, Guo Hua; Zhong, Wen; Mazzon, Giorgio; Zhu, Wei; Lahme, Sven; de la Rosette, Jean J. M. C. H.; Choong, Simon
After publication of the article, it was brought to our attention that the author name Otas Durutovic was duplicated in the author list and the second one should be replaced by the author Chu Ann Chai, and the affiliations of Ji-Wen Cheng and Chu Ann Chai are incorrect, the correct author list with correct affiliations is shown below: Guo-Hua Zeng, Wen Zhong, Giorgio Mazzon, Wei Zhu, Sven Lahme, Sanjay Khadgi, Janak Desai, Madhu Agrawal, David Schulsinger, Mantu Gupta, Emanuele Montanari, Juan Manuel Lopez Martinez, Shabir Almousawi, Vincent Emanuel F. Malonzo, Seshadri Sriprasad, Otas Durutovic, Vimoshan Arumuham, Stefania Ferretti, Wissam Kamal, Ke-Wei Xu, Fan Cheng, Xiao-Feng Gao, Ji-Wen Cheng, Bhaskar Somani, Mordechai Duvdevani, Kah Ann Git, Christian Seitz, Norberto Bernardo, Tarek Ahmed Amin Ibrahim, Albert Aquino, Takahiro Yasui, Cristian Fiori, Thomas Knoll, Athanasios Papatsoris, Nariman Gadzhiev, Ulanbek Zhanbyrbekuly, Oriol Angerri, Hugo Lopez Ramos, Iliya Saltirov, Mohamad Moussa, Guido Giusti, Fabio Vicentini, Edgar Beltran Suarez, Margaret Pearle, Glenn M. Preminger, Qing-Hui Wu, Chu Ann Chai, Khurshid Ghani, Marcus Maroccolo, Marianne Brehmer, Palle J. Osther, Marek Zawadzki, Azimdjon Tursunkulov, Monolov Nurbek Kytaibekovich, Abdusamad Abdukakhorovich Abuvohidov, Cesar Antonio Recalde Lara, Zamari Noori, Stefano Paolo Zanetti, Sunil Shrestha, Jean de la Rosette, John Denstedt, Zhang-Qun Ye, Kemal Sarica & Simon Choong. The original publication has been updated.
Established focal therapy-hifu, ire, or cryotherapy-where are we now?-a systematic review and meta-analysis
(2025) Tay, Kae Jack; Fong, Khi Yung; Stabile, Armando; Dominguez Escrig, Jose Luis; Ukimura, Osamu; Rodriguez Sanchez, Lara; del Pilar Laguna Pes, Maria
Introduction: Focal Therapy (FT) is a treatment option for the treatment of limited volume clinically significant prostate cancer (csPCa). We aim to systematically review outcomes of established FT modalities to assess the contemporary baseline and identify gaps in evidence that will aid in further trial and study design. Methods: We conducted a systematic review and meta-analysis of all primary studies reporting outcomes of FT using cryotherapy, high-intensity focused ultrasound (HIFU), and irreversible electroporation (IRE). We described patient inclusion criteria, selection tools, treatment parameters, and surveillance protocols, and pooled overall survival (OS), cancer-specific survival (CSS), metastasis-free survival (MFS), biochemical progression (BP), biopsy, secondary treatment, sexual, and urinary function outcomes. Composite failure was defined as salvage whole gland ablation, radical treatment, hormonal therapy or transition to watchful waiting. Synthesis: We identified 49 unique cohorts of men undergoing FT between 2008 and 2024 (21 cryotherapy, 20 HIFU, and 8 IRE). Median follow-up ranged from 6 to 63 months. Pooled OS was 98.0%, CSS 99.3%, and MFS 98.5%. Pooled BP was 9.4%/year. Biopsy was mandated post-FT within 24 months in 36/49 (73.5%) cohorts, with pooled csPCa (GG ≥ 2) rates of 22.2% overall, 8.9% infield, and 12.3% outfield. The pooled rate of secondary FT was 5.0%, radical treatment 10.5%, and composite failure 14.1%. Of 35 studies reporting sexual function, 45.7% reported a low, 48.6% moderate, and 5.7% severe impact. For 34 cohorts reporting urinary function, 97.1% reported a low impact. No differences were noted between cryotherapy, HIFU, or IRE in any of the outcomes. Conclusion: FT with cryotherapy, HIFU, and IRE is associated with good short-intermediate term oncological and functional outcomes. However, outcome reporting is heterogeneous and often incomplete. Long-term follow-up and standardized reporting are required to better define and report FT outcomes.
Telehealth: A bridge divided? Bridging the digital divide for equitable healthcare access
(2024) Tariq, Sundus; Zaqout, Abdalrahman; Tariq, Saba
Telehealth, which is the use of telecommunications technology in health care delivery according to the Health Resources and Services Administration, is also a subset of e-health. Telehealth, which provides medical assistance to remote patients, is performed through a variety of different actions and services which include interactions between patients and healthcare providers happening through the phone, e-mails, video calls, the web, remote devices, as well as short message services (SMS).
Editorial: Excessive internet use and its impact on mental health
(2024) Višnjić, Aleksandar; Kök, Kıvanç; Terzić Šupić, Zorica; Stanković, Miodrag
The various forms of Internet use, including social networking, online shopping, gambling, and gaming are products of the time in which we live and represent an integral part of how we conduct and engage in social interaction. Internet platforms not only facilitate daily connection and efficient exchange of important information, but also provide educational functions and raise awareness of problems faced by individuals and societies globally. However, excessive use of Internet-related content has also increasingly been linked with mental health issues and aspects, such as addictive behavior, which is a central theme of this Research Topic.
Vaccine-induced strain replacement: theory and real-life implications
(2024) Mahroum, Naim; Karaoğlan, Birnur Sinem; Uluçam, Enes Sedat; Shoenfeld, Yehuda
The value of preventive medicine is superior to treatment with vaccinations occupying high priority. Nevertheless, heavy pressure has started to form in regard to strains not included in vaccines contributing to the changing epidemiology of pathogen subtypes leading to ‘vaccine-induced strain replacement’. Among other mechanisms, increasing fitness of nonvaccine strains and metabolic shifts in the subtypes have been described. Classical examples include pneumococcal infections and viral diseases, such as the human papilloma virus. Recently, it has been described in SARS-CoV-2, leading to the emergence of new subtypes, such as Omicron and Delta variants. The phenomenon has also been reported in Mycobacterium tuberculosis, Neisseria meningitidis and rotavirus. This study addresses the concepts, examples and implications of this phenomenon.
Reteplase: a promising alternative in acute ischemic stroke management
(2024) Akhtar, Muzamil; Karim, Hajira
[Abstract Not Available]
A survey of artificial intelligence/machine learning-based trends for prostate cancer analysis
(2024) Sailunaz, Kashfia; Beştepe, Deniz; Alhajj, Lama; Özyer, Tansel; Rokne, Jon; Alhajj, Reda
Different types of cancer are more commonly encountered recently. This may be attributed to a variety of reasons, including heredity, changes in the living conditions (food, drinks, pollution, etc.), advancement in technology which allowed for better diagnosis of diseases, among others. Prostate one of the main types of cancers witnessed in males; it has indeed been identified as the second type cancer leading to death in males. Accordingly, it has received considerable attention from the research community where computer scientists and data analysts are closely collaborating with pathologists to develop automated techniques and tools capable of classifying and identifying cancerous cases with high accuracy. These efforts are described in the literature in a large number of research articles which makes it hard and time consuming for researchers to grasp the current state of the art. Instead, review articles form a valuable source for researchers who are interesting in coping with the developments in the field. Generally, the literature includes several survey papers on prostate cancer; each of them tackles some aspect of the domain up to the time when the survey was prepared. Hence the need for the survey described in this paper which highlights the scope of each of the previous survey papers encountered in the literature and adds upon the latest developments in the field as described in more recent papers published mainly in 2023 and 2024. The survey focuses on the main artificial intelligence and machine learning techniques for diagnosing prostate cancer based on various types of data, including MRI. The most recent techniques employed in analyzing prostate cancer data, the various types of data, the available datasets, the reported results, etc. are all covered. This will help researchers in their efforts to keep track of the recent developments in the field and to realize the challenges which need more attention along the path towards developing robust and effect decision support systems for pathologists to have higher self confidence in handling their patients.
The role of digital health solutions in modern medicine
(2024) Tariq, Saba; Tariq, Sundus
[Abstract Not Available]
Retraction notice to "Combined metabolic activators improve metabolic functions in the animal models of neurodegenerative diseases" [Life Sci. 314 (2023) 121325]
(2024) Türkez, Hasan; Altay, Özlem; Yıldırım, Serkan; Li, Xiangyu; Yang, Hong; Bayram, Cemil; Bolat, İsmail; Öner, Sena; Özdemir Tozlu, Özlem; Arslan, Mehmet Enes; Arif, Muhammad; Yuluğ, Burak; Hanoğlu, Lütfü; Çankaya, Şeyda; Lam, Simon; Velioğlu, Halil Aziz; Coşkun, Ebru; İdil, Ezgi; Nogaylar, Rahim; Özşimşek, Ahmet; Hacımüftüoğlu, Ahmet; Shoaie, Saeed; Zhang, Cheng; Nielsen, Jens; Borén, Jan; Uhlén, Mathias; Mardinoğlu, Adil
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of Editor-in-Chief. The journal was alerted to concerns about the validity of the images shown in Figs. 3, 6 and 7 as also detailed in the following Pubpeer post: https://pubpeer.com/publications/BDEA6585A4941F7F97EB34426937FF. As per the journal policy, the authors were contacted on this matter, and they informed the journal that wrong images were included in the above-mentioned figures by accident. The authors claimed that the unintentional inclusion of the wrong images worsened the results and asked for a corrigendum in April 2023. The authors also offered to submit the raw data and physical pathology slides to be analysed by independent experts. The Editor has declined the authors' offer and decided to retract the article due to these concerns. The authors do not agree with the retraction and have maintained that the retraction of their article is not in line with Elsevier policy. They have included their explanation of the issues in the comments section of the Pubpeer post.
Protection of child health in emergencies
(2024) Büke, Övgü; Karabayır, Nalan
Natural disasters present a significant and growing threat to the well-being of children. Every year 175 million children globally are expected to be affected by natural disasters, including floods, cyclones, droughts, heatwaves, severe storms, and earthquakes. In emergencies, children of all age groups, especially those under 5, are the most affected part of the community, with child mortality rates 2-70 times higher than average. Clean water, sanitation and hygiene measures, vaccination to prevent infectious diseases, providing psychological support to vulnerable children in an age-appropriate approach, and paying particular attention to children with special needs are extremely important. Healthcare personnel and families should have adequate information and preparation to do what is necessary before, during, and after emergencies to minimize the negative effects on children. In this review, we aim to discuss the effects of emergencies on children and the prevention methods.
Associations of variability in body mass index with cardiovascular outcomes in the general population: A systematic review
(2024) Esfandiari, Mohammad Ali; Kazemzadeh, Kimia; Ansari, Akram; Alishiri, Goharsharieh; Afshari, Shaghayegh; Daliri, Sepand; Saleh, Mohammadreza; Balanian, Sahar; Tamannaeifar, Rozhina; Niazi, Alireza; Vosoughian, Fatemeh; Abdi, Amir; Mohebbi, Mahnaz Bakhshi; Hosseini, Reza Shah; Foroughi, Elaheh; Deravi, Niloofar; Bafrani, Melika Arab; Asadigandomani, Hassan
In today's world, high variability of body mass index (BMI) is known as a significant global health problem that can lead to many negative impacts on the cardiovascular system, including atrial fibrillation (AF) and coronary heart disease. The current systematic review aims to elucidate the effect of variability in BMI on the risk of cardiovascular outcomes. Four databases, including PubMed, Scopus, MEDLINE, and CENTRAL, were searched. All related articles up to 10 June 2022, were obtained. Titles, abstracts, and full texts were reviewed. After screening abstracts and full texts, four articles were included in our study. In these four cohort studies, 7,038,873 participants from the USA and South Korea were involved. These articles generally considered the BMI and outcomes including cardiovascular disease, AF, and coronary heart disease. All these articles reported an association between the variability of BMI and increased risk of cardiovascular outcomes. Due to the negative impact of the high variability of BMI on the risk of cardiovascular outcomes, health policymakers and practitioners should pay more attention to the significant role of BMI in health problems and physicians might better check the variability of BMI visits to visit.
Editorial: Osteoporosis and adipokines: the potential for future treatment
(2024) Tariq, Saba; Tariq, Sundus; Baig, Mukhtiar; Valjevac, Amina
Osteoporosis is a major health concern, particularly in older people. It is characterized by decreased bone density and a higher fracture risk. Globally, it affects 35.3% of women and 12.5% of men (1). Recent studies have concentrated on the role of adipokines in bone metabolism control and osteoporosis progression. Adipokines are signaling substances produced by adipose tissue. Leptin, resistin, chemerin, visfatin, and other proteins have been shown to alter bone metabolism, making them possible targets for future osteoporosis treatments (2–4).
Effects of varicocele repair on sperm dna fragmentation and seminal malondialdehyde levels in infertile men with clinical varicocele a systematic review and meta-analysis
(2024) Cannarella, Rossella; Shah, Rupin; Saleh, Ramadan; Boitrelle, Florence; Hamoda, Taha Abo-Almagd Abdel-Meguid; Singh, Rajender; Salvio, Gianmaria; Toprak, Tuncay; Falcone, Marco; Gül, Murat; Dimitriadis, Fotios; Rambhatla, Amarnath; Russo, Giorgio I.; Ko, Edmund; Zini, Armand; Kavoussi, Parviz; Phuoc, Nguyen Ho Vinh; Kandil, Hussein; Ghayda, Ramy Abou; Birowo, Ponco; Gherabi, Nazim; Ceyhan, Erman; Dong, Jie; Malhotra, Vineet; Durairajanayagam, Damayanthi; Kolbaşı, Bircan; Bahar, Fahmi; Çalık, Gökhan; Çayan, Selahittin; Pinggera, Germar Michael; Calogero, Aldo E.; Rajmil, Osvaldo; Mostafa, Taymour; Atmoko, Widi; Harraz, Ahmed M.; Le, Tan V.; de la Rosette, Jean J. M. C. H.; Hakim, Lukman; Pescatori, Edoardo; Sergeyev, Oleg; Rashed, Ayman; Saini, Pallavi; Agarwal, Ashok
Purpose: Varicoceles can be a source of elevated seminal oxidative stress (OS) and sperm DNA fragmentation (SDF). However, it remains unclear whether varicocele repair (VR) could reduce these parameters. This systematic review and meta-analysis (SRMA) aims to investigate the impact of VR on SDF and seminal malondialdehyde (MDA). Materials and Methods: A literature search was performed in Scopus, PubMed, Ovid, Embase, and Cochrane databases. This SRMA included randomized controlled trials and observational studies reporting the pre- and postoperative levels of SDF and seminal OS in infertile men with clinical varicocele that underwent VR. Subgroup analyses included techniques of VR and SDF testing. The effect size was expressed as standardized mean difference (SMD). Results: Out of 1,632 abstracts assessed for eligibility, 29 studies with 1,491 infertile men were included. The analysis showed a significant reduction in SDF after VR, compared to preoperative values (SMD -1.125, 95% confidence interval [CI] -1.410, -0.840; p<0.0001) with high inter-study heterogeneity (I2=90.965%). Reduction in SDF was evident with microsurgical technique and non-microsurgical inguinal approaches (SMD -1.014, 95% CI -1.263, -0.765; p<0.0001, and SMD -1.495, 95% CI -2.116, -0.873; p<0.0001), respectively. Reduction in SDF was significant irrespective of testing was done by sperm chromatin dispersion (SMD -2.197, 95% CI -3.187, -1.207; p<0.0001), sperm chromatin structure assay (SMD -0.857, 95% CI -1.156, -0.559; p<0.0001) or TUNEL (SMD -1.599, 95% CI -2.478, -0.719; p<0.0001). A significant decrease in seminal MDA levels was observed following VR (SMD -2.450, 95% CI -3.903 to -0.997, p=0.001) with high inter-study heterogeneity (I2=93.7%). Conclusions: Using pre- and post-intervention data, this SRMA indicates a significant reduction in SDF and seminal MDA levels in infertile men with clinical varicocele treated with VR. These findings may have important implications for the future management of this selected group of infertile patients.
Fecal microbiota transplantation in autoimmune diseases - an extensive paper on a pathogenetic therapy
(2024) Seida, İsa; Al Shawaf, Maisam; Mahroum, Naim
The role of infections in the pathogenesis of autoimmune diseases has long been recognized and reported. In addition to infectious agents, the internal composition of the "friendly" living bacteria, (microbiome) and its correlation to immune balance and dysregulation have drawn the attention of researchers for decades. Nevertheless, only recently, scientific papers regarding the potential role of transferring microbiome from healthy donor subjects to patients with autoimmune diseases has been proposed. Fecal microbiota transplantation or FMT, carries the logic of transferring microorganisms responsible for immune balance from healthy donors to individuals with immune dysregulation or more accurately for our paper, autoimmune diseases. Viewing the microbiome as a pathogenetic player allows us to consider FMT as a pathogenetic-based treatment. Promising results alongside improved outcomes have been demonstrated in patients with different autoimmune diseases following FMT. Therefore, in our current extensive review, we aimed to highlight the implication of FMT in various autoimmune diseases, such as inflammatory bowel disease, autoimmune thyroid and liver diseases, systemic lupus erythematosus, and type 1 diabetes mellitus, among others. Presenting all the aspects of FMT in more than 12 autoimmune diseases in one paper, to the best of our knowledge, is the first time presented in medical literature. Viewing FMT as such could contribute to better understanding and newer application of the model in the therapy of autoimmune diseases, indeed.

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