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.
Background: Patent foramen ovale (PFO) is an anatomical variant in which the normal fetal interatrial passage persists after birth. It is estimated to be present in approximately 25% of adults. Furthermore, it appears to be involved in 50% of cryptogenic strokes. A cryptogenic stroke means the etiology remains unknown despite a thorough assessment (including arterial imaging, echocardiography, rhythm monitoring, and relevant laboratory testing, such as lipid profile and hemoglobin A1c). Secondary prevention options after a PFO-associated stroke consist of antiplatelet therapy, anticoagulant therapy, or percutaneous closure of the PFO, and it is still debatable which option is better. Objective: To critically review the available evidence regarding PFO closure vs. medical therapy as the optimal therapeutic option for secondary prevention after PFO-associated cryptogenic stroke, and to discuss relevant factors for patient selection. Methods: We conducted a focused review and searched the PubMed database for relevant literature on the subject. We included records about patients with PFO and a history of stroke. We chose to include only the free full-text sources. On the other hand, studies regarding children, studies comparing different devices or techniques, and observational studies on long-term complications and recurrence predictors were excluded. Results: Eight records were included, comprising 3750 participants, all diagnosed with PFO and stroke, to compare different therapeutic strategies for preventing stroke recurrence (PFO closure versus medical therapy). Conclusions: The results indicated that closure of PFO may provide greater protection against recurrent stroke than medical therapy alone in adequately selected patients with PFO-associated cryptogenic stroke. Additionally, given the lack of recent studies, further research is warranted to improve patient selection and evaluation of medium- and long-term prognosis.
Dental implants have risen as the gold standard for oral rehabilitation, offering predictable outcomes and improved quality of life for patients with missing teeth. However, postmenopausal women constitute a distinct patient population due to the systemic effects of estrogen deficiency, particularly on bone metabolism. The decline in estrogen levels following menopause can negatively impact bone remodeling, potentially influencing osseointegration and the long-term success of dental implants. This review aims to evaluate the current evidence regarding implant outcomes in postmenopausal women, examine the biological implications of hormonal changes on bone physiology, quality, and quantity, and provide evidence-based clinical recommendations to enhance treatment planning and optimize outcomes in this demographic segment.
Introduction: Athletes generally seek alternatives for muscle recovery after exercise in order to alleviate the resulting pain and accelerate muscle recovery. One of the commonly used procedures is the intermittent pneumatic compression (IPC) method. Objective: Analyze the effects of IPC on muscle pain and physical recovery after fatigue. Methods: A systematic review with meta-analysis registered in the PROSPERO platform (CRD42024530298) was conducted, following the PRISMA guidelines, using the PICOS approach. Eligible studies focused on individuals who used IPC as an intervention method and its effects on the components of physical conditioning and recovery. Quality, certainty of evidence, and completeness of descriptions were assessed using different tools. Results: 10 articles met the eligibility criteria. Meta-analysis data showed that interventions through IPC had a significant effect in favor of the experimental group in the outcome flexibility (SMD = -0.30; CI = 95%; -0.56 to -0.05), subjective perception of recovery (SMD = -0.22; CI = 95%; -0.40 to -0.05) and delayed onset muscle soreness (SMD = - 0.34; CI = 95%; -0.51 to -0.17). Conclusion: IPC can become a superior option to passive recovery. In turn, the meta-analysis suggested a beneficial effect of IPC on flexibility, PSR, and DOMS after intervention.
Health literacy, representing the ability to understand and apply health information, is a key determinant of public health. In Eastern Europe, decades of underinvestment in health education, socioeconomic disparities, and institutional mistrust have contributed to persistently low levels of health literacy. Objective: This review synthesizes evidence on the social consequences of inadequate health literacy in Eastern Europe, focusing on behavioral, structural, and policy-related outcomes. Methods: A narrative literature review was conducted using PubMed, Scopus, Web of Science, Google Scholar and institutional reports. Studies were included if they examined health literacy, public medical education, and social outcomes in Eastern European populations. Results: The synthesis of evidence identified four major thematic domains through which inadequate health literacy is associated with negative outcomes in Eastern European populations. Low health literacy is consistently associated with preventable disease, poor health behaviors, limited uptake of preventive services, and reduced adherence to medical advice. Vulnerable groups bear a disproportionate burden. Inadequate health knowledge is also associated with increased and inappropriate healthcare utilization, delayed care-seeking, and higher rates of avoidable mortality. Furthermore, low health literacy is plausibly linked to the proliferation of health misinformation, erosion of trust in healthcare systems, and has contributed to excess mortality during public health crises such as the COVID-19 pandemic. Discussion: The observed patterns are shaped by historical and structural factors, including the postcommunist legacy of under-resourced health systems and the persistent under-prioritization of preventive care. Eastern Europe is a heterogeneous region, and the availability of health literacy data varies considerably across countries, limiting the generalizability of findings. At the clinical level, healthcare providers play a key role in identifying low health literacy, adapting communication strategies, and addressing vaccine hesitancy and misinformation. Addressing these challenges requires coordinated strategies, investment in education, culturally tailored communication, and cross-sectoral collaboration. Improving public health literacy can enhance health outcomes, reduce system costs, and strengthen societal resilience. Conclusions: This review underscores the challenges associated with health literacy in Eastern Europe, illustrating how insufficient health literacy contributes to detrimental behaviors, undermines trust in healthcare systems, exacerbates misinformation, and ultimately imposes a significant societal and systemic burden on public health.
Background: Health promotion and prevention are becoming increasingly important in the context of the growing prevalence of chronic diseases, population aging, and the shift towards patient-centered care. Objective: This review examines the relationship between health promotion, lifestyle medicine, and medical prevention, with particular emphasis on the convergence between general medicine and dentistry and on the positioning of the conceptual framework of Individual Health–General Health– Primordial Health–Total Health. Methods: A narrative review with a conceptual component was conducted. Relevant literature was identified through thematic searches in PubMed and Google Scholar. Sources were selected according to their relevance to the objectives of the review. The quality and applicability of the evidence were considered in relation to the type and authority of the source, its relevance, and its consistency with the literature and reference frameworks used. Results: The literature identifies several risk factors shared by oral and systemic health, including diet, smoking, obesity, chronic inflammation, and stress. These interrelationships support the integration of prevention, health education, and interventions targeting modifiable behaviors into both medical and dental practice. Conclusions: Closer collaboration between general medicine, dentistry, and public health may facilitate a more coherent framework for preventive care. The proposed conceptual model may provide a starting point for future research.
Introduction: Operational cardiology is an emerging field of military medicine focused on cardiovascular risk assessment and maintaining mission fitness. Military activities involve intense physical exertion, operational stress, sleep deprivation, and occupational exposures that can trigger acute cardiovascular events, including in apparently healthy individuals. The aim of this review is to synthesize data on cardiovascular risk in the military population and its implications for determining mission fitness. Materials and Methods: This review included 52 studies published between 2000 and 2026, identified in PubMed/MEDLINE, Web of Science, and Scopus. The papers were analyzed thematically: cardiovascular epidemiology, sudden cardiac death, specific risk factors, impact of exertion and operational stress, cardiovascular screening, and physiological monitoring. Results: Cardiovascular events occur predominantly during intense exertion and are frequently associated with previously undiagnosed pathology. Traditional risk factors coexist with operational stressors, increasing cardiovascular load. Cardiovascular screening and cardiorespiratory fitness assessment allow risk stratification and identification of overload. Conclusions: Integration of cardiovascular screening, fitness assessment, and physiological monitoring may reduce the risk of cardiovascular events and optimize operational safety. Standardized protocols adapted to the military environment are needed.
Objectives: This review examines the current role of stackable surgical guides in full-arch implant rehabilitation, with particular attention to what these systems can reliably achieve in clinical practice and where the available evidence remains insufficient to support broader claims. Materials and methods: A critical narrative review of PubMed/MEDLINE and Scopus was conducted and updated through August 2026. The search combined the terms “stackable,” “sequential,” and “modular” surgical guides with “dental implant,” “full arch,” “bone reduction,” “accuracy,” and “immediate loading.” Clinical studies, evidence syntheses, and relevant laboratory investigations were assessed individually. Because of the heterogeneity of the available literature and the narrative design of the review, no meta-analysis or formal risk-of-bias assessment was performed. Results: Stackable systems use a stable base with interchangeable components to maintain the planned reference throughout bone management, implant placement, and prosthetic transfer. The available clinical evidence remains limited. A 2024 scoping review identified only 12 case reports or case series, including 25 patients, 27 arches, and 173 implants, and accuracy was quantified in only four of these reports. More recent clinical studies provide additional information, although their findings remain specific to the protocols investigated. In one retrospective series involving 60 implants placed with a rigid, bone-fixed base, mean angular, neck, and apical deviations were 1.25°, 0.96 mm, and 1.07 mm, respectively. The first in vivo comparison with other forms of static guide support found no overall accuracy advantage for stackable guides and reported the greatest vertical discrepancy in the stackable group (0.26 mm; P<.001). In the 43-arch STAGE cohort, approximately 93% of arches were loaded on the day of surgery, while 274 of 284 implants had osseointegrated at four months. Implant replacements and provisional fractures were nevertheless reported. Conclusions: Current evidence supports stackable guides primarily as a method for maintaining a common planned reference throughout successive surgical and restorative steps. In appropriately selected cases, they can facilitate prosthetically driven implant placement, guided or selective bone reduction, and immediate provisionalization. Available studies, however, do not establish superiority over conventional guidance, identify one stackable design as preferable to another, provide validated criteria for bone reduction, or demonstrate advantages in patient-reported outcomes or cost-effectiveness
