Cervical cancer is the fourth leading cause of cancer-related deaths among women worldwide, causing over 660,000 new cases and 350,000 deaths in 2022, with a disproportionately high burden in low-resource countries where access to treatment is limited. Human papillomavirus (HPV) is a common sexually transmitted infection that accounts for approximately 95% of cervical cancer cases. Persistent HPV infection can progress to cervical dysplasia, categorized into varying severities (CIN1, CIN2, and CIN3), which significantly increases cancer risk. The mechanism of HPV-induced malignancy involves the disruption of cellular apoptosis by integrating viral genetic material into cervical cells, particularly within the transformation zone. The viral proteins E6 and E7 play pivotal roles in cervical carcinogenesis by inhibiting tumor suppressor proteins, promoting uncontrolled cell proliferation, and evading immune responses, ultimately driving progression toward malignancy. Timely detection and intervention are essential for managing HPV-related cervical cancers. Preventative measures such as HPV vaccination have demonstrated substantial efficacy. Six vaccines targeting high-risk (HR) HPV strains are recommended before sexual activity or exposure. Despite these advancements, barriers, such as misinformation, logistical challenges, and limited healthcare infrastructure, persist, particularly in underserved regions. Advances in diagnostic and therapeutic technologies have offered new avenues for addressing these challenges. Next-generation sequencing and CRISPR gene editing are emerging as promising tools for HPV-related cancer treatment that enable precise and targeted interventions. Furthermore, artificial intelligence (AI) and imaging innovations have significantly enhanced diagnostic accuracy and personalized care. Pap smears and HPV DNA testing are indispensable tools for early detection. To tackle HPV-related cervical cancer globally, a multifaceted approach is required. Public health education, vaccination programs, research, and international collaboration are crucial. Public health campaigns should combat misinformation, strengthen vaccination programs, and focus on novel therapies, screening technologies, and next-generation sequencing.

Esketamine, the S-enantiomer of ketamine, has gained prominence as an adjunct in pain management during general anesthesia due to its higher potency and ability to achieve therapeutic effects at lower doses than ketamine. While its benefits for pain relief and mental health are well-established, the specific effects of esketamine on cardiac function during anesthesia remain under investigation. Anesthesia itself induces physiological changes in the cardiovascular system, and esketamine can exacerbate these effects by increasing sympathetic activity, heart rate, blood pressure, and cardiac output. Additionally, it can induce peripheral vasoconstriction, raising systemic vascular resistance. These cardiovascular effects are particularly concerning in patients with pre-existing heart conditions, underscoring the importance of preoperative assessment, continuous monitoring, and potential dose adjustments. This review examined the hemodynamic effects of esketamine, the associated cardiovascular risks, and the clinical implications for patients with cardiac conditions, offering recommendations for its safe use in anesthesia.

This review explored the physiological mechanisms underlying arginine vasopressin deficiency (AVP-D, formerly central diabetes insipidus) and AVP resistance (AVP-R, formerly nephrogenic diabetes insipidus), with a focus on water balance regulation. Vital components include the hypothalamic-pituitary-AVP axis, renal AVP responsiveness, and neural mechanisms of thirst regulation. Recent insights on thirst generation within circumventricular brain nuclei (subfornical organ, median preoptic nucleus, and organum vasculosum of the lamina terminalis) are discussed, along with the diagnostic utility of copeptin in polyuric states. This review highlighted the critical role of hypothalamic-pituitary integrity and renal AVP responsiveness in maintaining water-electrolyte homeostasis. Understanding these mechanisms provided the foundation for optimizing therapeutic strategies and advancing research on AVP-related disorders.

Team-based care is a patient management strategy involving a team of at least two healthcare professionals working collaboratively toward a shared clinical goal. This approach is now increasingly recommended by international hypertension guidelines mainly to improve medication adherence and hence, blood pressure control. The goal of this paper was to review the most recent evidence on the benefits of a team-based care approach in the management of hypertension. The results show that in recent years, numerous controlled clinical trials have demonstrated the efficacy of this strategy to lower blood pressure, achieve blood pressure targets more rapidly, and obtain more hypertensive patients under control. These improvements are due essentially to two factors: improved drug adherence/persistence and a reduction of therapeutic inertia. Best results are obtained when physicians collaborate with pharmacists and/or nurses, but other healthcare professionals may be involved successfully as well. Recent data have also demonstrated that the team-based care approach is cost-effective. These observations should be a strong incentive for hypertension centers to engage in the development of a team-based care strategy.

Chronic pain, affecting approximately 30.3% of adults worldwide, presents a significant global health issue, severely impacting individuals’ quality of life and creating substantial socioeconomic challenges. Traditional pain management methods, such as physical therapy and pharmacological treatments, primarily focus on the biological aspects of pain while often neglecting the psychological and social factors. However, recent advancements in neuroscience have revealed that chronic pain is influenced by changes in the central nervous system, including mechanisms like central sensitization and neuroplasticity. This paper examines contemporary neuroscience-informed interventions, including Pain Neuroscience Education (PNE), mindfulness practices, and cognitive functional therapy (CFT), which target these neurobiological changes to improve pain perception and behaviors. These interventions help rewire the brain’s pain pathways, promoting long-term pain relief and functional recovery. Additionally, combining neuroscience-based approaches with conventional therapies has been shown to enhance treatment outcomes. This work emphasizes the need for personalized approaches and the integration of emerging technologies to enhance the accessibility and effectiveness of chronic pain management.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is an emerging and rapidly growing health problem that currently affects more than one-third of the world general population and more than two-thirds of patients with obesity or type 2 diabetes. MASLD is associated with one or more cardio-metabolic risk factors (CMRFs) that determine the complexity of its natural history and management. Although the term MASLD encompasses a single disease, each CMRF has a different impact on MASLD, and the number of overlapping CMRFs results in a different rate of progression and outcomes of both liver and systemic disease. Its pathogenesis is characterized by insulin resistance, lipotoxicity and a complex cross-talk between liver, adipose tissue, muscle, intestine through the release of hepatokines, cytokines, myokines and inflammatory products. The stage of liver fibrosis is the best predictor of liver outcomes, such as liver failure and mortality, and also predicts the high risk of all-cause mortality associated with the disease. In many cases, the development of hepatocellular carcinoma (HCC) is associated with advanced fibrosis or cirrhosis, although it can occur at all stages of the disease, making prevention difficult. MASLD is characterized by increasing very low-density lipoprotein (VLDL) secretion and chronic low-grade systemic inflammation, which increase the risk of cardio-vascular, renal, and endocrine diseases and extrahepatic cancer. Thus, the management of MASLD requires a holistic approach and treatment of CMRFs through multispecialty collaboration. Currently, diet and physical activity are the effective first-line approaches. There are no approved drugs for the treatment of MASLD, apart from resmetirom, which in a percentage of cases improves metabolic dysfunction-associated steatohepatitis (MASH) and fibrosis. We summarize the wide and varied recent literature on the complex etiopathogenetic, clinical and therapeutic aspects of MASLD, connecting and interpreting it to facilitate clinical and management approaches.

The International Agency for Research on Cancer (IARC) Monographs Programme plays an important role in cancer prevention by identifying potential carcinogenic hazards. However, the terminology used in IARC’s classifications and Monographs can confuse the public, health professionals, and policymakers. Terms like “carcinogenic to humans” imply causation, although classifications only indicate increased risk under certain conditions. For example, the lifetime incidence of mesothelioma among firefighters is approximately 14 in 10,000, compared to 7 in 10,000 in the general population. Despite doubling the risk, occupational exposure as a firefighter does not cause this type of cancer in 9,986 out of 10,000 firefighters. However, the IARC concludes that “occupational exposure as a firefighter causes mesothelioma” (IARC Working Group on the Identification of Carcinogenic Hazards to Humans. Occupational Exposure as a Firefighter. Lyon: IARC; 2023. pp. 1–730. PMID: 37963216). In addition, the lack of essential information about dosage and context in the IARC carcinogen lists can lead to agents with health benefits under certain conditions (e.g., solar radiation, red meat consumption, approved drugs) being perceived as universally harmful, discouraging beneficial exposures, behaviors, or treatments. Here, I propose renaming the groups of agents classified by the IARC and adding basic labels to specific agents to improve the accuracy and interpretability of the IARC classification lists. These adjustments do not interfere with the IARC’s objective of identifying potential hazards, are easy to implement, and enhance accuracy and clarity, providing stronger support to guide cancer prevention strategies.

Regenerating gene (Reg) was first isolated in 1988 and proposed to be specifically expressed in rat regenerating pancreatic islets. Since then, many genes homologous to Reg have been discovered in other species, including humans, mice, hamsters, rabbits, sheep, dogs, cats, pigs, giant pandas, chickens, and frogs. Moreover, Reg and its related genes (Reg family genes) have been classified as types I, II, III, and IV. They are closely associated with cell and tissue regeneration, cell proliferation, and anti-apoptosis in various tissues and cells including pancreatic β cells. In particular, focusing on the digestive organs and tissues, there have been reports that they play important roles not only in stomach, colon, liver, and pancreatic duct cancer, but also in intestinal epithelial cells, especially inflammatory bowel diseases (IBD), such as Crohn’s disease (CD) and ulcerative colitis (UC). This review describes and discusses the expression of Reg family genes in intestinal epithelial cells of those affected by IBD and the molecular mechanisms underlying this expression.

The Age-Friendly Health System movement has been a unifying factor in caring for older adults at the University of Utah Health. Despite progress, challenges to efficient healthcare collaboration exist, particularly between geriatric primary care and oral health. This manuscript presents four of those challenges (lack of communication between medical and dental providers, the distance between medical and dental services, patient discomfort with the inclusion of oral health in primary health care, and provider discomfort in requesting oral health information in medical encounters) with the solutions derived at the University of Utah Health. Leaders at University of Utah Health developed five interventions to address these challenges (participation in the development of EPIC Wisdom^©, a fully integrated oral health record in the electronic health record (EHR), co-location in new centers and oral health consultation in existing centers, implementing a geriatric health assessment that included oral health, widespread adoption of the 4 Ms framework). Applying the lessons learned from these challenges can benefit all older adults and may help prevent the conditions associated with periodontal disease.

Systemic hypertension, a significant global health issue and a leading risk factor for cardiovascular mortality affects half of the adult population, with increasing prevalence notably in low- and middle-income countries. Despite advancements in diagnosis and treatment, only one in four individuals with hypertension achieve satisfactory control over their condition. Medication adherence, critical for effective hypertension management, is complex and multifaceted. Non-adherence, encompassing late or non-initiation, sub-optimal implementation, and early discontinuation of treatment, is prevalent worldwide, with reported rates of anti-hypertensive medication non-adherence ranging from 30% to 40%. Adherence is influenced by various factors including drug regimen complexity, patient education, and socioeconomic status. Poor adherence is linked to increased cardiovascular risks and is compounded by clinical inertia among physicians. Addressing barriers to adherence and implementing evidence-based interventions can significantly reduce the global burden of hypertension and its associated complications. This review highlighted the critical need for improved adherence strategies to enhance hypertension management. It focused on novel tools such as mobile health interventions and regimen-simplification through single-pill combinations, which can improve treatment persistence and blood pressure control.

The gut microbiota, a complex ecosystem of microorganisms, plays an essential role in maintaining immune and metabolic homeostasis. Disruption of this microbial balance, known as dysbiosis, has been increasingly implicated in the pathogenesis of chronic inflammatory conditions, including cardiovascular, gastrointestinal, and autoimmune diseases, as well as metabolic disorders such as diabetes and obesity. A crucial mechanism through which the gut microbiota exerts its effects on host physiology is via the production of bioactive metabolites. These metabolites, including short-chain fatty acids, bile acids, and tryptophan derivatives, are key in modulating immune responses and regulating metabolic functions. Dysbiosis disrupts the production and function of these metabolites, thereby contributing to immune dysregulation, chronic inflammation, and disease progression. This review examines the role of gut microbiota-derived metabolites in chronic inflammatory diseases, with a focus on their immunomodulatory and metabolic effects. A deeper understanding of these mechanisms may open the way for novel therapeutic strategies aimed at restoring immune homeostasis and mitigating the global burden of chronic inflammatory diseases.

Alcohol is a well-known toxic etiologic factor for liver injury. Metabolic substrates of alcohol (especially acetaldehyde) have a major responsibility and genetic susceptibility, alterations in microbiota and immune system are important co-factors for this injury. Major injury in liver is hepatocellular lipid accumulation. Therefore the relationship between non-alcoholic and alcoholic fatty liver diseases should have been defined clearly. Recently two major liver committees adopted new terminologies such as metabolic-associated fatty liver disease (MAFLD), metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-related liver disease (MetALD), and alcoholic liver disease (ALD) instead of non-alcoholic fatty liver disease (NAFLD). These terminologies were based on the effects of metabolic syndrome on liver. Alcohol consumption was defined differently according to these nomenclatures. MAFLD defined alcohol intake (regardless of amount) as “dual etiology fatty liver disease” and the Delphi consensus defined MASLD, MetALD, or ALD according to daily consumption of alcohol amount.

According to research, hepatocellular carcinoma (HCC), ranks third globally in terms of cause of death and is the fifth most common type of cancer overall. Finding novel means of diagnosis and treatment is therefore crucial. The use of nanotechnology as a cancer treatment has drawn a lot of interest recently. Despite significant advancements in detection and treatment, there is still a long way to go before this disease is completely eradicated. Therefore, it’s critical to find innovative ways to diagnose and cure conditions. In particular, the substantial inertness of metallic nanoparticles (NPs) and their nanoscale structures, which have sizes comparable to many biological molecules, attract a great deal of interest in the biomedical field. Due to their exceptional optical qualities, chemically modified surface through the attachment of various ligands, biocompatibility (bio-inertness and low cytotoxicity), and superior optical properties, gold NPs (AuNPs) have garnered significant interest. The current review discusses the efficiency of AuNPs in various fields, including imaging, immunotherapy, and photothermal therapy for treating liver cancer. Finally, this review summarized the limitations of the prospects of the AuNPs.

Ventilator-associated pneumonia (VAP) is a common and serious complication in critically ill patients, particularly those requiring prolonged mechanical ventilation. Extensively drug-resistant (XDR) Acinetobacter baumannii has emerged as a significant threat in VAP cases, complicating treatment due to its exceptionally high level of antibiotic resistance. We present a case of a 62-year-old male patient with severe acute ischemic stroke, who developed VAP during his stay in the intensive care unit (ICU). Cultures confirmed XDR Acinetobacter baumannii as the causative organism. The infection was further complicated by the development of a lung abscess, a rare but severe consequence of VAP. The patient was treated with a targeted antimicrobial regimen consisting of colistin, vancomycin, and tigecycline. Despite the pathogen’s resistance profile, the patient’s infection showed gradual improvement with sustained treatment. However, the recovery process was significantly prolonged due to the complexity of the infection, necessitating extended supportive care during hospitalization. This case highlights the challenges posed by XDR infections in critically ill patients and the importance of a tailored antimicrobial approach to effectively manage severe complications such as lung abscess.

Oral cancer is rare in Western nations but widespread in high-risk regions around the globe. Risk factors, such as tobacco usage, alcohol intake, and betel nut chewing, enhance the chance of the illness, making it mostly avoidable. Due to its high mortality, early detection is crucial. Prevention and diagnosis begin with oral mucosa lesions that may be malignant and local diseases that cause persistent inflammation. Clinical therapies for oral cancer mostly include surgery, radiation, and chemotherapy. Unsatisfactory therapeutic impact and harmful side effects remain clinical treatment’s key issues. Future research should examine the cancer microenvironment and treatment. This review examined oral cancer risk factors, preventative strategies, and early diagnostic approaches. This review also discusses immunotherapy methods for countering this fatal disease. Immunotherapy targeting the cancer microenvironment may provide a novel oral cancer treatment.