Malignant melanoma and urological cancers originate from different tissues and organs, yet several studies highlight connections between these malignancies, including common risk factors, genetic predispositions, and immunological pathways. Evidence from recent studies suggests that a prior diagnosis of melanoma may increase the likelihood of subsequently developing renal cell carcinoma (RCC), and, conversely, patients with RCC appear to face a heightened risk of being diagnosed with melanoma. Shared factors such as a personal or family history of cancer, UV radiation exposure, smoking, and obesity have all been linked to an increased incidence of various cancer types. A major link between malignant melanoma and urological cancers is the presence of shared genetic mutations and familial cancer syndromes. Key mutations, including germline mutations in BRCA1, MITF, CDKN2A, TP53, and alterations in the PI3K/AKT pathway, significantly contribute to the risk of both types of malignancies. Personalized medicine, which tailors prevention and treatment strategies to an individual’s genetic, environmental, and lifestyle factors, has significantly improved cancer care. The primary aim is to select the most effective treatment for each patient, maximizing therapeutic outcomes, reducing side effects, and minimizing the risk of drug resistance. Advances in genomics and immunology are driving the development of personalized therapies that target specific molecular pathways and immune responses common to both melanoma and urological cancers. Angiogenesis inhibitors and checkpoint inhibitors have demonstrated notable success in treating these cancers, with tumor mutational burden serving as a valuable biomarker for predicting the efficacy of immune checkpoint inhibitors.
Neuroendocrine tumors (NETs) are a group of rare malignancies characterized by heterogeneous clinical and biological presentations. Their estimated annual incidence ranges from 3 to 6 cases per million inhabitants, with a notable rise in prevalence due to improved diagnostic capabilities and medical awareness. Gastrointestinal NETs predominantly affect the small intestine (~45%), followed by the rectum, appendix, colon, and stomach. Despite advancements in imaging modalities such as CT, MRI, and somatostatin receptor-based PET-CT scans, the diagnosis of small intestinal NETs remains challenging due to nonspecific symptoms, frequently leading to delayed recognition until advanced disease stages. Surgical resection with comprehensive lymphadenectomy remains the cornerstone of curative management for localized disease, offering improved survival outcomes when R0 resection is achieved. Nevertheless, recurrence rates remain high, underscoring the critical importance of postoperative surveillance. This review provides a comprehensive synthesis of recent literature regarding the epidemiology, clinical manifestations, diagnostic methods— including imaging and immunohistochemical markers—and therapeutic approaches, particularly emphasizing surgical management strategies. A clinical case example is integrated into the review to illustrate the real-world complexity and challenges in the diagnosis, treatment, and follow-up of patients with small intestinal NETs.
Colorectal cancer (CRC) ranks third worldwide in terms of morbidity and second in mortality. In Romania, CRC represents the second leading cause of malignancy, accounting for 13.3% of all diagnosed cancers and associated with a five-year survival rate close to 50%. Despite the availability of effective CRC screening programs proven to reduce incidence and mortality, low participation rates contribute to a high occurrence of advanced disease complications. As a result, bowel obstruction develops in approximately 25% of colorectal cancer cases, significantly worsening patient outcomes. This review aims to highlight the role of screening in reducing the incidence of such complications and to assess the outcomes associated with surgical management of malignant bowel obstruction. A comprehensive review of current literature was conducted, focusing on the incidence, clinical presentation, and management of intestinal obstructions in CRC patients. Emphasis was placed on studies evaluating screening programs, risk factors, and surgical interventions. Data indicate a continuous rise in emergency presentations due to obstructive CRC, correlating with low screening uptake. Early detection through organized screening significantly lowers the risk of obstruction and improves outcomes. Enhanced screening programs and early identification of high-risk individuals are crucial in preventing advanced CRC complications. Timely diagnosis not only reduces emergency surgical interventions but also improves prognosis and overall survival rates.
Aseptic bone necrosis (ABN), also known as avascular necrosis (AVN), is a serious and often overlooked complication of systemic lupus erythematosus (SLE), a chronic autoimmune disease with diverse symptoms. AVN in SLE is caused by multiple factors, including blood supply disruption due to clotting disorders, chronic inflammation, and especially prolonged use of moderate to high- dose corticosteroids. This review analyzes 17 out of 62 peer-reviewed European studies (2015–2024) from the PubMed database, focusing on osteonecrosis in lupus. ABN affects between 0.8% and 33% of SLE patients, with a mean symptomatic rate of 9%, while up to 29% may be asymptomatic. The femoral head is most commonly involved. Besides corticosteroid use, other risk factors include antiphospholipid antibodies (especially anticardiolipin IgM), endogenous hypercortisolemia, hypercoagulability, dyslipidemia, and active disease. In Romania, where no national registry exists, a representative case of a 27-year-old woman with undiagnosed SLE and bilateral femoral head necrosis without steroid exposure highlights the role of autoimmune coagulopathy. Misdiagnosis of her facial rash as rosacea delayed proper identification, emphasizing the importance of clinical awareness in atypical cases.
Psoriasis is a chronic and complex disease that consists of characteristic cutaneous lesions and is frequently accompanied by systemic comorbidities caused by the chronic inflammatory state. The most common such comorbidities are hypertension, diabetes mellitus, dyslipidemia, inflammatory bowel diseases, depression, anxiety, neoplasia, and non-alcoholic fatty liver disease. Therefore, it is of utmost importance to simultaneously treat both psoriasis and the associated conditions with the best therapies available to improve patients’ life quality. Therefore, this review aims to evaluate the effects of biological therapies on both psoriasis and its comorbidities and also to highlight other future options.
Ethnomedicine and ethnobotany have been at the forefront of current scientific focus. The focus of this review is Piper nigrum, for which there exists a wide host of traditional ethnomedical and ethnobotanical applications, recorded mostly from India and the surrounding regions where black pepper is native. These applications cover a wide range of pathologies, including cardiovascular, pulmonary, gastrointestinal, gynaecological, endocrine, integumentary and neurological, and viral diseases and colds. While some of these applications are confirmed by modern research, the majority have not been tested using modern scientific methods, and perhaps many more applications remain to be documented. Finally, it must be noted that some interesting non- medical applications comprise the application of black pepper, as an insecticide/larvicide, are worth further consideration, especially given the newer policies at a European and international level.
With the increase of the medium lifespan in developing countries, skin aging rise attention more and more. In 2007, Kaya and Saurat rebranded the extreme expression of skin fragility under the name of ‘‘dermatoporosis’’ or chronic cutaneous insufficiency/fragility syndrome. Dermatoporosis is still underused in medical literature and nurses and wound specialists know also about this condition, but they call it “skin tears”. There is obvious confusion cause the nursing literature talks about skin tears while dermatologists write about dermatoporosis. Clinical aspects comprise atrophy, purpura, and pseudo-stellate scars. Firstly, the British dermatologist Thomas Bateman described senile purpura in 1818 as purpuric patches arising in elderly people after minimal trauma, especially on the dorsum of the hands. Furthermore, between 1970 and the full documentation of Kaya and Saurat in 2007, we found medical papers about senile purpura, pseudoscars, skin tears, and so on. Starting from this historical data, they bring valuable information according to clinical aspects, histopathology, ultrasonographic aspects, pathophysiology, and therapeutics. This paper aims to analyze published data for improving the diagnosis and management of dermatoporosis.
Clinical research is the cornerstone of the progress recorded in psychiatry in the last six decades, or of what is called the psychopharmacological revolution. Regardless of the stage of clinical research, there are sensitive ethical and legal aspects that may appear during this process, and such challenges have to be acknowledged in order to preserve its scientific value, integrity, and centered-on-the-patient-wellbeing core principles. Also, adequate strategies focused on preventing the risk of ethical misconduct and litigation have to be found to avoid a loss of trust in the results of clinical research, to protect vulnerable populations from abuse, and to ensure a legally stable environment for investigators. In order to explore these practical problems, a narrative review was performed through a search in PubMed and Google Scholar databases. The main ethical risks detected in clinical research were related to errors in the methodology of obtaining informed consent, monitoring the participant's safety during the clinical trial, and falsifying collected data. Several famous cases of ethical misconduct were found and analyzed, and methods to decrease the risk of the re-appearance of such problems have been listed. In conclusion, this review is an invitation to explore the complexity of the methodology of clinical research and its ethical and legal risks, as well as to find new ways to mitigate the possibility of such risks related to the research process.
A significant number of neurological diseases are pathogenetically related to oxidative stress, including but not limited to cerebrovascular afflictions such as ischemic and hemorrhagic stroke, Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, amyotrophic lateral sclerosis, and so on. Natural nutrients may help limit the impact of oxidative stress and, therefore, delay or prevent the impairment of these diseases. Although these natural components have not entered routine use, many have been studied in preclinical or even clinical settings with promising results. Therefore, the need to find the stage of the research in the field of validating the properties and clinical usefulness of such nutrients represents the main reason this narrative review was conducted. This analysis explored the PubMed database for papers related to the influence of natural nutrients on the onset and evolution of some of the most severe neurological disorders. The results of the review provide an overview of the pathways oxidative stress may undertake and how the use of nutrients may counteract these pathways. In conclusion, natural nutrients may have beneficial effects that can be impactful on clinical outcomes, but more good quality research in this field is needed before formulating any clear recommendation.
The assessment of suicide risk is a highly debated topic in the literature due to the complex interplay between social, psychological, cultural, and biological factors that contribute to the pathogenesis of self-harm. There is no unanimously accepted predictive model of suicide and no widely recognized evidence-based algorithm for psychiatric and psychological evaluation in clinical and non-clinical populations for early detection of self-harm. Therefore, this narrative review is focused on identifying the validated clinical instruments that may contribute to the construction of a possible screening and monitoring plan for suicide risk in military and civilian populations. Four electronic databases were searched (PubMed, CINAHL, Google Scholar, and Clarivate/Web of Science) for relevant reports on psychometric tools for detecting suicide risk published between the inception of each archive and January 2025. Seventeen instruments dedicated to the measurement of suicide and suicide-related aspects were reviewed, as well as three tools for the evaluation of depression severity that include specific items for assessing self-harm. The advantages and vulnerabilities of each instrument were assessed, and the particular features of using these tools in the military population were also explored. In conclusion, although a large number of validated instruments for the assessment of suicide risk exist, it is not possible to recommend the use of a single tool, either for clinical and nonclinical populations or for military and civilian personnel. The endeavor of finding an algorithm for the assessment of suicide risk is still far from reaching its end, as new psychometric instruments and possibly a new paradigm for the phenomenon of self-harm are sorely needed.
ISSN: 1222-5126 (print), 2501-2312 (online)
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