The therapeutic landscape for multiple sclerosis has evolved markedly in recent years, with an expanding arsenal of disease- modifying therapies offering clinicians more tools to manage the disease. This progress presents both opportunities and complexities, as treatment decisions increasingly require individualized strategies balancing efficacy, safety, and long-term outcomes. While current therapies effectively reduce inflammation and delay disease progression, they fall short in halting neurodegeneration, highlighting a critical unmet need. Treatment paradigms range from escalation strategies prioritizing safety to early high-efficacy approaches aimed at aggressive disease control. Data increasingly support early initiation of high-efficacy DMTs in patients with poor prognostic indicators, but concerns over long-term safety and tolerability remain. Shared decision-making, informed by patient preferences and evolving evidence, is central to modern MS care. The future is promising, with new therapies in advanced stages of research, which seek to exceed the limits of current therapy, to act in a targeted manner, limiting both inflammation and neurodegeneration, for better control of disease activity, with an improved safety profile.
Crimean-Congo hemorrhagic fever virus (CCHFV) is a highly pathogenic agent that causes severe hemorrhagic disease with high mortality. Outbreak control requires rapid and accurate diagnosis together with effective vaccination strategies. The nucleoprotein (NP) is a central component of viral replication and of innate and adaptive immune responses, making it a promising target for diagnostic and vaccine development. NP is highly conserved across CCHFV isolates, which supports broad molecular and serological detection. Several studies have demonstrated that NP-based assays provide sensitive and specific results, a critical requirement for outbreak management. In vaccine research, NP has been shown to induce strong cellular immune responses that contribute to long-term protection. Multiple platforms, including recombinant proteins, DNA constructs, and viral vectors, have successfully incorporated NP with promising preclinical immunogenicity. Despite this progress, challenges remain in ensuring safety and achieving consistent immune responses across populations. Advances in nanotechnology, structural vaccinology, and bioinformatics may further improve the effectiveness of NP-based products. In conclusion, NP represents a key element for both reliable diagnostics and the induction of protective immunity. Future research should focus on optimizing NP-based platforms for translation into clinical applications and improving global preparedness against CCHFV.
Heart failure with preserved ejection fraction (HFpEF) is a complex pathology that has undergone a paradigm shift in the last few years. As technology develops and diagnosis algorithms become more refined, early diagnosis leads to prompt medical management. This management has also changed in recent years. Moreover, HFpEF phenotyping attempts further nuance the management of patients with this disease. Whereas guidelines are not so firm on the medical classes of drugs that should be employed in HFpEF compared to HFrEF, new trials are on the way to change this. This literature review focuses on the evolution of diagnosis criteria for HFpEF, the clinical scores proposed by current guidelines, and also on the medical management of this pathology, focusing on medical management and how it has changed recently, by highlighting landmark trials that have been published on the topic or that are going to be published on the topic.
Abstract Quantum computing (QC) has emerged as a transformative technology with the potential to surpass classical computational limits, especially in complex domains like medical imaging. This study investigates the integration of QC and quantum machine learning (QML) into medical imaging, with a focus on MRI, EEG, and CT. A structured literature review was conducted to identify recent developments, focusing on studies using accessible open-source data and English-language peer-reviewed publications. By leveraging quantum principles such as superposition and entanglement, hybrid quantum-classical models have demonstrated enhanced accuracy, speed, and efficiency in diagnostic tasks. In MRI, QML has improved early detection and classification of neurological diseases like Alzheimer’s and brain tumours. In EEG analysis, quantum algorithms such as Quantum EEGNet and Quantum Support Vector Machines have shown superior performance in detecting disorders, including schizophrenia and autism spectrum disorder. Additionally, quantum algorithms for CT image reconstruction and classification have achieved faster processing with fewer artifacts and greater fidelity. Despite current hardware constraints, results highlight the promise of QC in addressing existing limitations in medical diagnostics. The findings support continued development of QML models and quantum- enhanced workflows, with potential to revolutionise clinical practice by offering more accurate, efficient, and personalised care in neurological imaging and analysis.
Mental health stigma (MHS) among military personnel requires a complex approach, as it is influenced by ethical challenges and organizational norms distinct from those in civilian milieus. Stigmatization encompasses multiple dimensions -including social, self, anticipated, cultural, and structural stigma- that must also be examined within military settings. This article presents a conceptual analysis of key research directions in the field of MHS, based on a literature review conducted across three electronic databases (PubMed, Google Scholar, and Clarivate/Web of Science), from the inception of each database up to June 2025. The review focuses on active-duty service members and veterans, and identified six major domains involving MHS: (1) structural stigma within military contexts, (2) risk factors and consequences associated with MHS, (3) self-stigma among active-duty personnel and veterans, (4) the role of military healthcare providers in mitigating stigma, (5) military sexual trauma and its relationship to stigma, and (6) interventions aimed at decreasing MHS among military personnel. Although relevant primary and secondary studies were identified across these domains, significant research gaps remain, particularly in the last three areas. Addressing MHS in military populations is essential not only for improving quality of life, psychological well-being, and daily functioning, but also for maintaining combat readiness, unit cohesion, and peer acceptance.
[¹⁸F]FDG PET/CT enables in vivo quantification of cerebral glucose metabolism, revealing functional abnormalities before morphological changes on CT or MRI. This review summarizes major clinical indications, methodological aspects, and key metabolic patterns. In cognitive impairment, [¹⁸F]FDG PET is a core biomarker within the amyloid/tau/neurodegeneration (A/T/N) framework, predicting conversion from mild cognitive impairment (MCI) to Alzheimer’s disease (AD) and differentiating AD, dementia with Lewy bodies (DLB), frontotemporal lobar degeneration (FTLD), vascular dementia, and atypical parkinsonian syndromes (APS). In movement disorders, it distinguishes Parkinson’s disease (PD) from APS – including multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal syndrome (CBS) – and supports prognosis in amyotrophic lateral sclerosis (ALS) and Huntington’s disease (HD). In epilepsy, interictal hypometabolism aids localization of the epileptogenic zone, especially in MRI- negative cases, while in neuro-oncology, [¹⁸F]FDG PET assists in primary central nervous system lymphoma (PCNSL), glioma grading, and recurrence assessment. The review also highlights roles in inflammatory and infectious diseases, such as autoimmune encephalitis, neurosarcoidosis, and post-coronavirus disease 2019 (COVID-19) sequelae. Standardized preparation, glucose control, and statistical comparison with normal databases remain essential for accurate interpretation.
Loneliness is receiving more and more attention for being an important psychosocial contributor to the deterioration of quality of life, psychological well-being, onset of mental health disorders, but also to the increased mortality and morbidity, through the mediation of general health problems and suicide. While studies on the impact of loneliness in the civilian population have been steadily increasing in number over the past decade, research on the same phenomenon in military settings has progressed at a comparatively slower pace. This article is a two-stage analysis of the perceived lack of social connectedness among active-duty and former military personnel, including (1) a conceptual exploration and literature review based on searches in three electronic databases (PubMed, Google Scholar, and Web of Science/Clarivate), and (2) a pragmatical set of recommended strategies to reduce the impact of loneliness in these populations. Based on the review of 42 primary and secondary sources, the paper explores the prevalence, risk and protective factors, characteristics, and consequences of loneliness, with particular attention to various minorities, female military personnel experiencing motherhood during active duty, civilian spouses of deployed service members, and other significant subgroups. Recommended directions of interventions are threefold, i.e., screening for loneliness and its risk factors, initiation of prophylactic strategies and therapeutic interventions targeting this phenomenon in vulnerable categories. In conclusion, further research on loneliness in both active and former military personnel is strongly warranted, given its significant consequences for multiple dimensions of health and overall functioning.
Clostridium difficile (C. difficile) is a Gram-positive sporogenous bacillus strictly anaerobic, which in the last decade has became the most important anaerobic bacterium in nosocomial human pathology. Cl.dificile is the etiological agent of more than 20% of diarrhea postantibiotics, over 95% of pseudomembranous colitis and the first cause of nosocomial infectious diarrhea in adults. Although this bacterium usually colonizes the intestine of vertebrates (the normal microbiota), the toxinogenic strains (tcdA and tcdB) are pathogenic in the digestive tract. Given the excessive use of antibiotics and the increased spores resistance, it is possible an environment contamination, with strains which may already be resistant to antibiotics. The main causes of this infection are decreased resistance to antibiotic-induced colonization, contamination with a pathogenic strain of Cl.difficile, secretion of A and/or B toxins and deficient immune response. Due to the increasing worldwide incidence of infections with C. difficile on one hand and to the discovery of new ways of transmitting the infection according with some studies regarding the genetic diversity of bacterium strains on the other hand, a new approach is necessary for C. difficile related topics..
Bio-terrorism involves using biological agents/toxins with the intent to intimidate or coerce a government or civilian population to further political or social objectives, usually leading to deaths or illnesses of humans but also of plants/animals. Their use would probably initially be considered as a natural or unintentional event, especially in case of live biological agents. Moreover, a natural occurring disease outbreak could have the same destructive outcome as an efficient biological weapon. There is a need for proper differentiation between natural and intentional events although in the first stages the medical response should be similar; however, the course of incident management would take different paths later on. Biological agents’ investigation of dangerous pathogens, from natural unusual outbreaks or bio- terrorist attacks/other intentional use, imply the collaboration of different institutions with responsibilities in public health but also in national security and defense. The National Security and the Defense System institutions think mainly in security terms while national health care system institutions think principally` in medical care/prevention terms. These two ways of acting have to be combined in order to deal properly with hazardous biological agents.
Sepsis, severe sepsis and septic shock are some of the most serious affections which threaten the lives of the patients who come to the Emergency Department and which require fast treatment because the more severe the sepsis was, the higher the mortality, up to 50% higher in severe sepsis. That is why, at present, the 2013 Guides of Surviving Sepsis Campaign recommend that the potential source of infection should be confirmed as soon as possible, in the first 6 hours since the patient arrived in the Emergency Unit if possible, moreover the large spectrum antibiotics therapy must be administered in one hour after the severe sepsis or the septic shock were identified. That is why the identification of these patients at risk is very important and this identification can only be made using POCT type devices. This type of devices has the capacity to make precise determinations, in a short time (15-17 minutes), using minimum quantities of integral blood, without using test tubes, sepsis biomarkers and other additional material. The possibility to fast diagnose sepsis, offers the doctors from the Emergency Department, the capacity to fast initiate an antibiotic treatment, to hospitalize the patient and at the same time, it gives them the certainty that they did not miss the sepsis diagnosis, thus avoiding the situation of malpractice. A preliminary study, regarding the sepsis biomarkers, which took place in the Emergency Unit of University Central Emergency Military Hospital, is also presented within this article.
