Chronic rhinosinusitis (CRS) is a prevalent and debilitating condition characterized by persistent inflammation of the sinonasal mucosa. Despite advances in understanding its pathophysiology, the role of microbial communities and their interactions with the host immune system remains poorly understood. This review aims to elucidate the complex interplay between microbial dysbiosis, host immune responses, the dysregulated, cancer-like behavior of inflamed sinus tissue, and the production of antimicrobial peptides (AMPs) and lipids in CRS. A systematic literature review was conducted across databases such as PubMed, Scopus, and Web of Science. Keywords included “chronic rhinosinusitis,” “microbial interactions,” “antimicrobial peptides,” “antimicrobial lipids,” and “immune system.” Studies published between 2020 and 2025 were included, focusing on microbial-immune interactions, AMPs, and lipids in CRS. Data were synthesized to identify key mechanisms and therapeutic implications. Microbial dysbiosis in CRS is associated with altered immune responses and impaired production of AMPs and lipids. Studies demonstrate that microbial interactions can either exacerbate or mitigate inflammation, depending on the balance between pathogenic and commensal species. Immune system dysregulation, particularly in T-cell responses and cytokine production, further exacerbates chronic inflammation. Emerging therapies, such as probiotics and AMP-based treatments, show promise in restoring microbial-immune balance. Future research should focus on developing targeted therapies that restore microbial balance and enhance innate immune defenses. Understanding the role of microbial interactions in CRS offers new avenues for personalized treatment strategies, potentially improving outcomes for patients with this challenging condition.

Advances in oncology are successfully shifting clinical focus beyond initial tumor control to address the complex, lifelong needs of a growing survivor population. This review examines the evolution of therapeutic paradigms, dissecting the mechanistic underpinnings and clinical impact of modern immunotherapies and gene-based modalities. It further addresses the multifaceted challenges in survivorship care, from managing persistent morbidity and psychological distress to overcoming systemic barriers in care coordination. Central to this discussion is the promise of multi-omics—which offers a high-resolution lens into tumor and host biology—to enable preemptive risk profiling. Concurrently, artificial intelligence (AI) emerges as the computational engine to distill these complex datasets into actionable intelligence for personalized surveillance. Furthermore, this review explores the translational hurdles facing AI, with a critical examination of inherent vulnerabilities, such as algorithmic bias, model opacity, and ethical pitfalls, in clinical deployment. By synthesizing these domains, this article provides a conceptual framework to steer the evolution of evidence-based, equitable, and patient-focused survivorship care.

Libidibia ferrea var. ferrea (Mart. ex Tul.) L.P. Queiroz (syn. Caesalpinia ferrea), popularly known as jucá, is widely distributed in the Amazon region and northeastern Brazil and is conventionally used to treat various diseases, including diabetes, infections, and inflammatory conditions. This study evaluated the healing effects of topical formulations derived from L. ferrea fruits on cutaneous wounds induced in Wistar rats. Three topical preparations were assessed: A glycolic extract of L. ferrea, a fruit infusion formulation (InLf), and a carbopol gel formulation (GLf). The phytochemical compounds present in the formulations, such as tannins and flavonoids, are known for their antioxidant, anti-inflammatory, and antimicrobial properties, which are essential for the healing process. Histopathological methods were used to evaluate healing, including analysis of epithelialization, granulation tissue formation, and collagen deposition. The results demonstrated that InLf and GLf significantly accelerated healing, with greater type I collagen deposition in the groups treated with these formulations, suggesting a more advanced tissue repair process. Among the formulations, InLf demonstrated the most pronounced healing effects, possibly due to its higher flavonoid content. The in silico study showed that the main markers of this species—gallic acid and ethyl gallate—are involved in the observed pharmacological response, modulating vascular proliferation and fibroblast activity. Overall, these findings reinforce the therapeutic potential of L. ferrea in the development of natural healing agents.

Type 2 diabetes mellitus (T2DM) is one of the top 10 global killers. The association between oxidative stress and T2DM has been reported, in which oxidative stress triggers the life-threatening consequences, including stroke, nephropathy, and myocardial infarction. MicroRNA (miRNA)-based therapies are thought to revolutionize early medical interventions, potentially enabling the treatment of T2DM. miRNAs are 20-22 nucleotide non-coding sequences used to silence genes at the post-transcriptional level. Gene testing registry, TargetScan, and other bioinformatic databases were used to identify the oxidative- and endoplasmic reticulum (ER) stress-linked genes and their targeted miRNAs (8-mers and species conserved) associated with T2DM. ShinyGO was used to establish links between T2DM and its associated genes. We identified putative common miRNAs, such as miR-26-5p/miR-124-3p.1/miR-124-3p.2/miR-98-5p/miR-17-5p/miR-519-3p/miR-20-5p/miR-93-5p/miR-106-5p, which may involve in the regulation of T2DM-associated genes. In addition, several common miRNAs were also considered in the regulation of pathological conditions. The miRNAs for T2DM associated with oxidative stress are as follows: miR-33-5p/miR-506-3p/miR-7-5p/miR-107/miR-93-5p, and for T2DM associated with ER stress are as follows: miR-195-5p/miR-181-5p/miR-101-3p.1/miR-424-5p/miR-145-5p/miR-519-3p/miR-16-5p. Overall, this study provides a framework for the rational selection of miRNAs for nucleic acid-based therapies and guides future studies in maximizing the potential of miRNAs against oxidative- and ER-stress associated with T2DM.

Goiter remains prevalent in iodine-deficient communities of developing countries, such as Nigeria. It may present with cardiovascular abnormalities, including impaired heart rate variability (HRV) and arrhythmias. Impaired HRV has not been fully studied among patients in Nigeria despite the endemicity of goiter. We, therefore, aim to evaluate HRV and arrhythmic patterns among goiter patients in southwest Nigeria. A cross-sectional study involving 40 hyperthyroid, 40 euthyroid, and 20 hypothyroid participants, as well as 20 age- and gender-matched control participants, who all had cardiovascular evaluation, thyroid function tests, and 24-h Holter electrocardiogram monitoring. The mean ages among the hyperthyroid, euthyroid, hypothyroid, and control populations were 41.53 ± 14.90, 40.67 ± 12.29, 43.78 ± 11.49, and 46.92 ± 13.85 years, respectively. Cardiac arrhythmia was more prominent in the hyperthyroid and hypothyroid groups (p<0.001). The most common abnormalities of rhythm in the hyperthyroid group were sinus tachycardia and atrial fibrillation, while sinus bradycardia was the most common rhythm abnormality in the hypothyroid group. HRV indices (SD of all normal-normal intervals [SDNN], SD of the averages of normal-normal intervals [SDANN], and root mean squares of differences between adjacent normal-normal intervals [RMS-SD]) were all impaired in the hypothyroid and hyperthyroid goiter groups but normal in both the control and the euthyroid population (p<0.01). The duration of goiter, left atrial, and left ventricular dimensions were the predictors of cardiac arrhythmias and impaired HRV. In summary, cardiac arrhythmias and HRV abnormalities are relatively common in hypothyroid and hyperthyroid goiter patients. Early diagnosis and treatment of thyroid abnormalities will help prevent cardiac dysfunctions associated with thyroid diseases.

Individuals with cerebral palsy (CP) are at an increased risk of developing respiratory diseases due to various factors, including motor impairments, postural abnormalities, and comorbidities, such as dysphagia and gastroesophageal reflux disease. This paper reviews evidence-based strategies and recommendations for the prevention and management of respiratory diseases in young adults with CP. It highlights the importance of early screening, vaccination, and infection control, as well as the role of pulmonary rehabilitation and physical therapy in improving respiratory function. Non-invasive ventilation and pharmacological management, including bronchodilators and mucolytics, are critical for individuals with compromised lung function. Multidisciplinary care, postural management, and swallowing therapy are key components of a comprehensive treatment approach. In addition, innovations in telemedicine and caregiver education are emerging as effective tools to enhance respiratory care and prevent complications. While challenges remain in accessibility and training, future directions, such as personalized medicine and rehabilitation technologies, offer promising solutions to further improve the respiratory health of individuals with CP. This review underscores the importance of early intervention, coordinated care, and ongoing support to optimize outcomes for individuals with CP and reduce the burden of respiratory diseases.

Prevention of chronic kidney disease (CKD) progression represents a critical challenge in global health care. However, the effectiveness of current pharmacologic interventions remains limited, requiring further therapeutic advancements. Traditional herbal medicine (THM) has been used worldwide in the treatment of CKD, but its effect remains uncertain. This review aims to evaluate the efficacy of THM in managing CKD and to identify appropriate methods for assessing its therapeutic effect. A literature search of six databases was conducted. The inclusion criteria comprised (i) ≥100 sample sizes, including retrospective studies, reviews, randomized controlled trials (RCTs), quasi-RCTs, crossover trials, and meta-analyses; (ii) CKD patients as the target; (iii) the use of oral THM as interventions; and (iv) reported primary and secondary outcomes. There were 18 RCTs with 3452 participants, 12 systematic reviews, 4 meta-analyses, and 4 retrospective studies. Although THM improved glomerular filtration rate, its therapeutic effect was uncertain due to major limitations, such as small sample sizes and short follow-up periods. THM formulas are prescribed based on THM diagnosis in a timely manner, meaning that patients sharing the same Western medical diagnosis may receive different formulas, and that prescriptions for a single patient may change during treatment. This approach may be a key reason for the small sample sizes and short follow-up periods of most THM studies against CKD. The use of quality-assured and ready-to-use Kampo extracts in a timely manner may be a promising method for the clinical application of THM in CKD treatment and the evaluation of its actual therapeutic effects.

Ultraviolet A (UVA)-induced collagen crosslinking can mechanically reinforce collagenous tissues and is being translated as a minimally invasive treatment for pathological eyelid laxity, yet the extent of irradiation-related heating at the conjunctival-tarsal interface remains unclear. In this study, we developed a novel procedure to treat pathological eyelid laxity. The methodology is based on the photocrosslinking of tarsal collagen, leading to mechanical reinforcement of the entire eyelid. In our previous studies, exposure to ultraviolet A (UVA) radiation at fluences below 20 J/cm² did not cause histopathological alterations to the eyelid tissues. Here, we further evaluated biological safety by quantifying conjunctival surface temperature increases during UVA irradiation to inform clinical translation. Using ex vivo sheep eyelids as a model, we used infrared thermography to measure the temperatures attained on the tarsal conjunctival surface during UVA irradiation (365 nm) at four irradiances for a maximum exposure time of 3 min, corresponding to fluences of 8.1, 13.5, 27, and 45 J/cm². Both the exposure time and irradiance caused an asymptotic increase in temperature, while a linear dependence was observed between fluence and temperature increase (ΔT). The recorded values for ΔT ranged from 3.3°C to 14.0°C. In summary, at clinically practicable fluences (<20 J/cm²), such increments are not expected to raise the final temperature to the threshold for collagen denaturation and tissue damage.