Background: Systemic Lupus Erythematosus (SLE) is potentially associated with thyroid disturbances, which might remain underdiagnosed. The objective was to analyse the thyroid profile in adults newly diagnosed with SLE. Methods: In this observational, real-life, cross-sectional study, treatment-naïve SLE subjects were compared to (SLE-free) controls in terms of thyroid profile and clinical, hematologic, electrophoretic, immunologic, and metabolic parameters. Individuals with a prior history of autoimmune diseases, thyroidectomy, and thyroid ailments were excluded. The statistical significance cut-off was p < 0.05. Results: SLE patients (N=22) versus age- and gender-matched controls (N=50) had a higher prevalence of thyroid dysfunction (22.7% versus 2%, p=0.001), mostly subclinical hypothyroidism, with similar TSH (thyroid-stimulating hormone), free thyroxine, and anti-thyroperoxidase (TPO) antibody levels. The prevalence of autoimmune thyroiditis (as defined by positive TPO) in the SLE group (27.3%) versus controls (14%) was not statistically significant (p=0.236). Thyroid ultrasound findings, namely, the highest size-based nodules category rates, displayed no between-group differences. Additional parameters (25-hydroxyvitamin D and glucose status) showed a similar profile. SELENA-SLEDAI score correlated with gamma-globulins (rho=0.55, p=0.008) and glycated haemoglobin A1c (rho=0.50, p=0.017), but not with thyroid function or TPO. Conclusion: Commonalities in the fields of thyroid and SLE should be taken into account from SLE onset, especially thyroid function. Indirect interplay might involve the glucose profile and vitamin D status.
Background: Current nosographic systems, which include chapters dedicated to eating disorders (EDs), offer clinically useful criteria but insufficiently address symptom overlap, heterogeneity within the same diagnosis, or its changes in time, and emerging or context-dependent eating-related phenotypes (ERP). Therefore, a transdiagnostic dimensional approach may be useful because it can describe, in a more nuanced manner, the psychopathological processes shared across various clinical presentations. Objectives: To develop a dimensional eating psychopathology framework as a hypothesis-generating instrument for characterizing established EDs and emerging or context-dependent ERPs. Methods: A conceptual model-development approach was applied for extending a previously proposed integrative classification of EDs and related phenomena. A set of hypothesized dimensions was selected according to their transdiagnostic applicability, dimensional nature, conceptual distinction from diagnostic labels, and potential clinical relevance. Characteristics describing the circumstances in which psychopathology is expressed were represented separately as contextual modifiers. Applying this framework, 15 ERPs were mapped theoretically across eight dimensions using a five-level ordinal scale. Results: The proposed model is composed of eight core dimensions: body-image overvaluation, restrictive dietary control, loss of control over eating, compulsivity and cognitive rigidity, reward/addiction-like eating, emotion-regulation dependence, interoceptive dysregulation, and compensatory or body-modifying behavior. Six contextual factors with modifying properties were identified, i.e., circadian/sleep, medical treatment, substance use, reproductive, athletic/performance, and health/purity-related contexts. Conclusions: The currently proposed model offers a common descriptive framework for comparing recognized EDs, emerging constructs, behavioral phenotypes, and context-dependent presentations without implying equivalent diagnostic status. In its early stages of development, the model requires formal content validation, independent expert assessment, and patient-level empirical testing before it can be used as a classification or clinical instrument.
Fractal dimension (FD) analysis of ambulatory blood pressure monitoring (ABPM) may provide more information than conventional blood pressure variability (BPV) parameters. This study aims to assess the FDs of ABPM temporal series as a measure of BPV and its impact on optimized blood pressure (BP) control in patients(pts) with hypertension (HT) and type 2 diabetes mellitus (DM). Systolic (SBP) and diastolic (DBP) BP, dipping status, coefficient of variation (CV), and pulse pressure (PP) were analyzed on 24h-ABPM in pts with DM and HT. FDs were determined separately during daytime and nighttime for SBP, DBP, and pulse pressure (PP). 117 pts, 62.8±10.3 yo, 46% male, were divided into G1 (uncontrolled HT, 60 pts) and G2 (controlled HT, 57 pts). 61% were non- dippers or reverse-dippers, mean dipping % was 4.9 ± 8.7 in G1 and 9.6 ± 7.4 in G2 (p=0.002). 46 pts in G1 and 39 had CV > 10% (p=0.31). The mean diurnal SBP FDs were 1.229 ± 0.03 in G1 and 1.2431 ± 0.03 in G2 (p=0.02), associated with DM complications (p=0.005) and HT treatment (p<0.04). In conclusion, fractal analysis revealed a more complex, convoluted BP curve in diabetics with controlled HT, adding complementary data to conventional BPV parameters.
Bereavement constitutes a shared environmental exposure that may result in distinct psychopathological outcomes, including prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and major depressive disorder (MDD). The objective of this research was to construct a transdiagnostic conceptual model for interpreting bereavement-related pathologies that integrates core psychopathological data. A structured conceptual synthesis of the literature was conducted, focusing on diagnostic, epidemiological, pathophysiological, clinical, and therapeutic findings related to PGD and associated disorders. Shared and disorder- specific mechanisms were identified and mapped across diagnostic categories in order to construct an integrative framework. The proposed model suggests that bereavement-related psychopathology can be conceptualized as a spectrum of partially overlapping syndromes organized around three principal domains: attachment dysregulation and separation distress (PGD), trauma- and threat- processing abnormalities (PTSD, acute stress disorder, adjustment disorder), and depressive-cognitive vulnerability (MDD). This framework provides a clinically relevant perspective on the relationship between grief-, trauma-, and depression-related disorders following loss. More research is needed to empirically validate this model, but at a theoretical level, it can serve as an orienting aid for mapping bereavement-related diagnoses and treatments.
Introduction: Heart rate variability (HRV) reflects autonomic nervous system (ANS) activity and emotional responsiveness. Music influences autonomic regulation through the heart–brain axis, yet sex-specific autonomic responses to different musical genres remain insufficiently characterized. Materials and methods: HRV parameters were recorded in 24 healthy young adults (17 females, 7 males; mean age 27.04 ± 1.97 years) at rest and during exposure to six musical genres: Baroque, Jazz, Heavy Metal, Romantic, Traditional Romanian, and Ambient. Time-domain and frequency-domain HRV parameters, including low frequency (LF), high frequency (HF), normalized LF (nLF), normalized HF(nHF), LF/HF ratio, and normalized coherence (NCoh), were analyzed. Anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS).Results: Heart rate did not differ between rest and musical sessions. In contrast, significant changes were observed in HRV parameters, particularly in the frequency domain. Compared with rest, nLF and LF/HF increased, and nHF decreased during all musical sessions, with more pronounced effects in males. Differences between musical genres were limited, whereas sex-related differences were consistent across sessions. rMSSD and HF were strongly correlated in all conditions except Jazz in males. LF/HF correlated directly with nLF and NCoh and inversely with nHF. Conclusion: Music modulates cardiac autonomic balance without altering heart rate. Autonomic responses are predominantly sex-dependent rather than genre-dependent, underscoring the importance of sex-specific analysis in studies investigating music-induced autonomic modulation.
Background: Head and neck keratinocyte carcinomas are frequently managed surgically; anatomic constraints may increase the risk of incomplete excision and influence reconstructive choices. Objectives: To describe the clinicopathological characteristics of head and neck non-melanoma skin cancers (NMSC) treated in a tertiary care dermatology department and to explore factors associated with resection status (R0 vs R1) and reconstructive approach after conventional excision. Methods: We performed a retrospective observational study of 117 patients undergoing excision of 134 primary head and neck NMSC between September 2025 and January 2026. Demographic, clinical, histopathological, and procedure-related variables were extracted from medical records and pathology reports. Margin status was assessed for conventionally excised lesions. Results: Most lesions were basal cell carcinomas (113/134, 84.3%) and were located on the cheek (31.3%) or nose (29.8%). Conventional excision was performed in 126/134 lesions (94%). Among conventionally excised lesions, 92% had complete resection (R0) and 8% had positive margins (R1), most commonly involving the lateral margin. Conclusions: In this single-center cohort, head and neck NMSC clustered in high-risk anatomic regions, and a small proportion of conventionally excised tumors showed positive margins. Clear reporting of margin involvement and reconstruction patterns may support quality improvement and guide future prospective follow-up.
Helicobacter pylori (H. pylori) is recognized as a human gastric pathogen that is a major risk factor for the development of peptic and duodenal ulcers, gastric adenocarcinoma, and lymphoma in humans. Antibiotic treatment is not completely effective due to antibiotic resistance. Probiotics play an important role in regulating the immune system and exert antibacterial effects by producing metabolites. Probiotic strains were administered to infected mice, and immune responses were monitored to investigate their immunomodulatory effects. Pathogen-free male C57BL/6 mice were divided into 6 groups of 5, and treatments were administered. Fourteen days after the last treatment, their spleens were removed, and IFN-γ and IL-4 expression levels were measured by real-time PCR. After treatment of L. acidophilus ATCC4356 and L. rhamnosusPTCC1607, the expression of INF-γ increased, but IL-4 expression was decreased. It can be concluded that the functions of probiotic strains differ. Two probiotics, L. acidophilus ATCC4356 and L. rhamnosus PTCC1607, stimulate interferon-gamma production to increase the phagocytic activity of macrophages and facilitate the differentiation of T cells to Th1.
Objective: Currently, the global epidemiologic impact of obesity requires continuous seeking of practical biomarkers; hence, this current study aimed to address the gap of chemerin assays in obese versus non-obese females and to analyze its circulating levels in relationship with the glucose profile and other circulating adipokines. Methods: This is an exploratory, prospective, cross-sectional analysis in females aged between 50 and 80 years. We excluded individuals with diabetes, cancers, endocrine, kidney, cardiovascular, and bone conditions. Enzyme-linked immunosorbent assay-based circulating adipokines testing was performed. The final analysis was focused on circulating chemerin (ng/mL) in the obese [body mass index (BMI) ≥ 30 kg/sqm] versus non-obese (BMI < 30 kg/sqm) group. Results: The obesity (N=12) versus the non-obesity (N=12) group showed a statistically significantly higher HOMA-IR (p=0.04), fasting insulin (p=0.01), but similar circulating chemerin. Chemerin positively correlated with BMI only in the obesity group (r=0.881, p=0.0039), but not with patients’ age and glucose profile-based features in any group. Chemerin showed a statistically significant positive, strong correlation with VEGF-A level (r=0.857, p=0.0065) and an inverse statistically significant strong association with circulating leptin (r= -0.713, p=0.0092) and circulating IL-12 p40 (r= -0.829, p=0.0416) in the obesity group. Conclusion: As a potential hypothesis-generating analysis, this pilot study showed different statistical results in BMI-based groups, despite the fact that direct comparison of circulating chemerin and even leptin, VEGF-A, and IL-12 p40 did not reach between-group statistical significance. A larger sample size and a multimodal integration of the adipokines panel might serve for practical points in addressing obesity. Citation: Schipor SV, Manda D, Ciobica ML, Sima OC, Preda EM, Ciuche A, et al. Exploratory results of circulating chemerin testing in humans. R. J. Mil. Med. 2026, CXXIX(4): 404-412 https://doi.org/10.55453/rjmm.2026.129.4.6 Academic Editor: Raluca Mititelu
(1) Background: Severe COVID-19 frequently leads to intensive care unit-acquired weakness (ICU-AW), a complex neuromuscular syndrome that may result in enduring disability, delayed functional recovery, and extended mechanical ventilation. Conventional clinical assessment tools capture only a limited scope of this multifactorial condition and often fail to accurately depict the nonlinear dynamics of physiological deterioration and recovery observed in critically ill patients. (2) Methods: This study presents an integrative framework that combines Physical and Rehabilitation Medicine (PRM) with analytical tools derived from nonlinear dynamics and fractal physiology. A prospective observational design and a long-term clinical evaluation were used along with nonlinear signal analysis. Fractal complexity metrics, including Higuchi fractal dimension (HFD) and detrended fluctuation analysis (DFA), were utilized to characterize the dynamics of neuromuscular and cardiorespiratory signals during rehabilitation. Clinical outcomes included the Medical Research Council (MRC) muscle strength score, the Functional Status Score for the ICU (FSS-ICU), and measures of respiratory performance. (3) Results: Early PRM intervention was associated with a consistent increase in neuromuscular strength, functional mobility, and respiratory muscle performance. Fractal analysis showed that physiological complexity was restored at the same time, as shown by large increases in HFD and DFA values. The recovery paths were not linear, and clustering analysis identified three distinct recovery phenotypes. (4) Conclusions: The integration of fractal biomarkers and nonlinear modeling into ICU rehabilitation may enable early risk stratification, improve the monitoring of functional recovery, and strengthen personalized rehabilitation strategies for patients with ICU-acquired weakness following severe COVID-19.
Background: Behavioral addictions (BAs), including gambling disorder, gaming disorder, problematic pornography use, compulsive sexual behavior, and problematic internet use, have received increasing attention because of their potential impact on mental health, occupational functioning, and military readiness. Objectives: To identify military-specific risk factors, clinical and operational consequences, barriers to detection and treatment, and gaps in prevention strategies related to BAs among active-duty personnel and veterans, and to propose a framework for prevention and early intervention. Methods: A narrative evidence synthesis was conducted using studies evaluating BAs in military and veteran populations, and data were extracted regarding prevalence, risk factors, psychiatric comorbidities, functional outcomes, help-seeking barriers, and intervention approaches. Findings were analyzed thematically to identify common patterns across different BAs and to inform the development of a military-specific prevention framework. Results: Evidence consistently indicated that military personnel and veterans are at increased risk of confronting multiple vulnerability factors for BAs, including trauma exposure, deployment-related stress, social isolation, boredom, sleep disruption, risk- taking tendencies, and barriers to help-seeking. Gambling disorder and problematic gaming were the most extensively studied conditions and were associated with depression, anxiety, posttraumatic stress disorder, substance use disorders, suicidality, impaired occupational functioning, financial difficulties, and reduced operational readiness. Also, emerging evidence suggests similar associations for problematic pornography use, compulsive sexual behavior, and problematic internet use. Across studies, stigma, concerns about career repercussions, and limited awareness of available services represented important obstacles to treatment engagement. Conclusions: BAs represent an under-recognized challenge to military health and force readiness, while the available evidence supports implementing integrated prevention strategies that include routine screening, psychoeducation, commander training, confidential referral pathways, and early intervention programs. A comprehensive military-specific framework targeting behavioral addictions may improve individual well-being while reducing operational and organizational consequences.
