An increasingly popular therapeutic approach for the treatment of cancer is the modification of signaling pathways mediated by oxidative stress. Epigenetic dysregulation serves as a key characteristic of human cancer, as almost half of all cancer cases involve mutations in epigenetic regulators like microRNAs (miRNAs). These small non-coding RNAs play a crucial role by generating functional RNA molecules that range from 18 to 25 nucleotides. miRNAs are essential for regulating gene expression at the mRNA level, but they have also been demonstrated in recent studies to influence the growth and development of cancer. miRNAs play a significant role in the generation of reactive oxygen species (ROS) and in various processes influenced by ROS. Therefore, exploring the relationship between ROS and miRNAs is becoming increasingly crucial, as it holds the potential to advance the development of effective cancer therapies and prevention strategies. This article aims to provide a comprehensive overview of the key characteristics and functional roles of miRNAs that are linked to oxidative stress in different cancers, paving the way for future research and therapeutic innovations. However, a lot of concerns and uncertainties regarding ROS-miRNAs and antioxidant defense systems still need to be resolved despite a great deal of research in this field.

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Coronary artery bypass grafting (CABG) remains a cornerstone in the management of complex coronary artery disease, particularly in patients with multivessel involvement, diabetes, or left main disease. As surgical practice enters a new era of precision medicine and digital innovation, the need to reimagine CABG—beyond its traditional framework—has never been more pressing. This review explores the future of CABG across three central themes: innovation, individualization, and integration. Technological advancements such as robotic-assisted procedures, hybrid revascularization strategies, and artificial intelligence-driven decision support are reshaping operative planning and execution. Concurrently, biological innovations—including regenerative therapies and tissue-engineered grafts—are expanding the therapeutic envelope, offering potential solutions for anatomically complex or high-risk patients. Personalized medicine is gaining traction through genomic profiling, biomarker-guided risk stratification, and machine learning-based outcome prediction. Enhanced recovery after surgery (ERAS) protocols and telemedicine-enabled follow-up are redefining postoperative care, emphasizing early mobilization, opioid minimization, and remote monitoring. Ethical and economic considerations remain pivotal as these innovations transition into practice. Issues of equitable access, algorithmic transparency, and cost-effectiveness must be addressed to ensure responsible integration. In parallel, the professional development landscape for cardiac surgeons is evolving, with calls for structured training in advanced techniques and interdisciplinary collaboration. Future research priorities include validation of regenerative adjuncts, predictive analytics, and advanced conduit strategies, alongside investigations into health equity and subspecialization. Ultimately, achieving durable, patient-centered outcomes in the next phase of CABG requires a system-level shift that embraces innovation while safeguarding safety, accessibility, and sustainability. This article provides a comprehensive, forward-facing overview of these themes, identifying key directions for clinical practice, research, and education in the evolving world of coronary revascularization.

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Cancer immunotherapy has revolutionized oncology by harnessing the immune system to target tumor cells. Cancer vaccines that trigger immune responses specific to tumors are becoming more and more popular among new approaches. Nevertheless, traditional tumour-associated antigens are susceptible to immune tolerance and frequently show low immunogenicity. The revolutionary potential of cryptic and non-canonical antigens as new targets for precision immunotherapy is examined in this review. Due to their enhanced tumor selectivity and ability to evade central tolerance, these unconventional antigens present encouraging options for vaccine development. This review examines the mechanisms underlying their antigen production, advanced technologies for their discovery, and various vaccine platforms, highlighting their potential to drive the next generation of cancer vaccines.

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Artificial intelligence (AI) is poised to transform clinical allergy practice by enhancing diagnostic accuracy, personalising treatment, and streamlining healthcare delivery. This narrative review critically examines the current landscape of AI in allergy care, spanning clinical workflows, diagnostics, immunotherapy, and research applications. AI-powered tools such as clinical decision support systems (CDSS), natural language processing (NLP), and conversational agents are being integrated into allergy services, offering improvements in documentation, risk stratification, and remote patient engagement—particularly in paediatric and multilingual settings. Diagnostic innovations include machine learning models that predict oral food challenge outcomes and interpret multi-omics data for personalised allergy phenotyping. AI also supports adaptive immunotherapy dosing, remote monitoring via wearable biosensors, and digital coaching to promote adherence. Federated learning and explainable AI (XAI) emerge as pivotal developments—enabling privacy-preserving collaboration and fostering trust among clinicians and patients. Despite these advancements, significant challenges remain. These include data inequities, algorithmic bias, lack of real-world validation, and regulatory ambiguity. The “black box” nature of many models risks undermining clinician confidence, while over-reliance on alerts could contribute to alarm fatigue. Ethical concerns—particularly around transparency, consent, and liability—require urgent attention. Equitable implementation demands robust governance, diverse training data, and inclusive design that prioritises patient safety. Looking ahead, AI has the potential to power digital twins, support augmented reality training, and enhance allergy surveillance through the integration of environmental and population-level data. With multidisciplinary collaboration, transparent oversight, and patient-centred innovation, AI can help build a more predictive, efficient, and equitable future for allergy care.

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As women transition to menopause, their risk of cardiovascular disease increases. The risk is mediated by a cluster of abnormalities, the ‘metabolic syndrome’: dyslipidemia, insulin resistance, hypertension, and obesity. The risk is proportional to the duration of menopause, although ethnic differences were reported. Other contributing factors include estrogen deficiency, inflammatory markers, history of gestational diabetes mellitus, preeclampsia, and polycystic ovary syndrome. Susceptibility to metabolic syndrome is mediated by genetic and lifestyle factors. Intervention to prevent metabolic syndrome must begin early with physical exercise, proper nutrition, and, where indicated, nutritional supplements. Although initial results of the Women’s Health Initiative suggested that hormone therapy after menopause led to adverse outcomes, further studies, such as the Early versus Late Intervention Trial with Estradiol (ELITE) study and the Kronos Early Estrogen Prevention Study (KEEPS), showed cardiovascular benefits if hormone replacement is begun early in women not at high risk of cardiovascular disease. A personalized preventive approach must be applied.

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Hepatitis A virus (HAV) is a spherical, non-enveloped, linear-positive single-stranded RNA virus that belongs to the Picornaviridae family. The virus attacks the liver, which leads to inflammation and the onset of jaundice. It represents a disease of the pediatric population and, in most cases, it causes an acute self-limited illness, but rarely a fulminant condition. HAV spreads from person to person through the fecal-oral route and ingestion of contaminated food or drink. It is highly endemic in large geographical areas of the world, including the Indian subcontinent, where most of the population is exposed to the virus in childhood. Most of the viral infections at this age cause asymptomatic disease that provides lifelong protection against HAV. However, our recent study showed an increased incidence of HAV infection in the adult population. This signifies a change in the pattern of age-specific seroprevalence of antibodies for hepatitis A and a huge number of non-immune susceptible individuals. Molecular epidemiological studies define various aspects of viral infection and transmission. Sequence characterization based on the VP1/P2A junction region confirmed IIIA and IA as the predominant genotypes circulating in the Indian subcontinent. The duration of the viremia is dependent on the host, and viral genotypes have no role in the severity of the disease. A mutational study confirmed the lack of genetic variations among Indian strains. Due to the high endemicity of this disease in the Indian subcontinent, vaccination is not recommended. However, individuals who are susceptible and seronegative for HAV-IgG should be targeted for vaccination. It will be a rational and cost-effective approach.

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Alzheimer’s disease (AD) is a chronic neurodegenerative disorder with declining memory and cognitive impairment, largely mediated by extracellular amyloid-beta (Aβ). Although the amyloid cascade and tau protein hypotheses have long served as established frameworks for AD pathology, recent evidence suggests that long-term infections, particularly with Chlamydia pneumoniae (C. pneumoniae), may contribute to disease progression. A systematic search strategy was used to identify relevant literature using PubMed, Scopus, Google Scholar, and Web of Science. Keywords and Boolean operators such as “Chlamydia pneumoniae and Alzheimer’s disease,” “neuroinflammation,” “amyloid-beta,” and “tau protein” were applied, with filters for peer-reviewed articles, human and experimental studies, and publications from the past 25 years. Epidemiological and background data were supplemented by official sources, including the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). This review examines the potential relationship of C. pneumoniae infection with AD pathogenesis. Studies have identified DNA and antigens of C. pneumoniae in AD-infected brain regions, often co-localized within Aβ plaques and neurofibrillary tangles (NFTs). Proposed mechanisms of CNS invasion include olfactory, hematogenous, and immune cell-mediated routes, leading to persistent glial activation, neuroinflammation, altered amyloid precursor protein processing, and tau protein hyperphosphorylation. Experimental models support these associations, with infected animals developing AD-like pathology. Diagnostic challenges persist due to the limitations of PCR and immunohistochemistry, though advanced approaches such as next-generation sequencing and TSPO-PET imaging are emerging. Potential therapeutic approaches include antimicrobial and immunomodulatory strategies, although human trials have shown mixed results. While current evidence suggests a possible link, causality remains unproven. Future research must prioritize large-scale, longitudinal, and mechanistic studies to clarify these relationships. Establishing a definitive role for C. pneumoniae in AD pathogenesis could reshape current understanding of disease etiology and inform the development of novel preventive and therapeutic strategies.

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Microsatellite-stable metastatic colorectal cancer (MSS mCRC) is currently treated with chemotherapy and targeted agents based on RAS and BRAF mutational status. Although these therapies offer initial benefit, most patients rapidly develop resistance, with fewer than 20% remaining progression-free at two years. This review aims to synthesize emerging evidence on the metabolic mechanisms driving treatment resistance in MSS mCRC, with a particular focus on the immune-metabolic signature (IMMETCOLS) classification. We conducted a comprehensive review of preclinical models, transcriptomic datasets, and clinical trial results addressing metabolic adaptations to chemotherapy and targeted therapies in MSS mCRC. The IMMETCOLS framework defines three metabolic subtypes—IMC1, IMC2, and IMC3—each associated with distinct resistance mechanisms. IMC1 exhibits glycolysis and transforming growth factor-β (TGF-β)-dependent signaling enriched in inflammatory fibroblasts, conferring resistance to chemotherapy. IMC2 relies on oxidative phosphorylation and glutamine metabolism, supporting antioxidant defenses and resistance to both cytotoxic agents and anti-EGFR therapies. IMC3 demonstrates lactate-fueled respiration and pentose phosphate pathway activation, contributing to redox balance, DNA repair, and resistance to targeted therapies such as anti-BRAF or KRAS inhibitors. All subtypes display metabolic plasticity under therapeutic pressure. Emerging clinical data support tailoring targeted therapy combinations based on IMMETCOLS subtype, particularly in BRAF- and HER2-positive populations. Understanding subtype-specific metabolic rewiring in MSS mCRC offers novel opportunities to overcome drug resistance. Targeting the metabolic vulnerabilities defined by the IMMETCOLS signature may improve response durability and inform precision treatment strategies.

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Resistant Kawasaki has been associated with the aggressive development of large coronary aneurysms, despite prompt treatment. In this paper, we present an infant who presented with resistant Kawasaki. Although initially he seemed to defervesce after the initial administration of intravenous immunoglobulin, he developed a new onset of fever, requiring a repeat dose of immunoglobulin. Coronary aneurysms developed rapidly, necessitating a second dose of immunoglobulins and second-line treatments such as anakinra and infliximab. High titers of COVID-19 antibodies have been a confounding factor in the management of that child, as the alternative diagnosis of multisystem inflammatory syndrome in children (MIS-C) was considered. Finally, the clinical and laboratory values were more in keeping with MIS-C.

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Phrenic nerve palsy (PNP) is a recognized complication of cryoballoon ablation (CBA) for atrial fibrillation (AF), particularly during the ablation of the right superior pulmonary vein (RSPV). We report the case of an 80-year-old female with a history of hypertension, who was admitted for CBA of paroxysmal AF. Despite optimal medical treatment with amiodarone, the patient experienced recurrent episodes of AF, prompting the decision to proceed with CBA. During the procedure, while isolating the RSPV, diaphragmatic movement was significantly weakened after 92 seconds of cryoablation at a temperature of –52°C. Immediate cessation of the procedure and intravenous methylprednisolone were administered, resulting in partial recovery of diaphragmatic movement. However, when the procedure resumed, diaphragmatic movement once again diminished, and despite further steroid treatment, the movement did not recover by discharge. The patient remained asymptomatic with stable oxygen saturation, and no respiratory distress was noted. At a six-month follow-up, the patient reported no symptoms of chest tightness or shortness of breath, and her general condition remained stable, although diaphragmatic movement had not fully recovered, indicating partial functional compensation. This case underscores the importance of continuous phrenic nerve monitoring during CBA, early detection of complications, and appropriate management to prevent irreversible injury, highlighting the need for careful procedural planning and postoperative follow-up in elderly patients with comorbidities.

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This case report documents the successful endodontic retreatment of a mandibular first molar exhibiting four mesial root canals in a 20-year-old male patient—an exceptionally rare anatomical configuration. Following the extraction of the perforated distal root, careful clinical exploration revealed two supplementary canals demonstrating apical convergence with the primary canals. The treatment protocol incorporated ultrasonically activated irrigation, precision rotary instrumentation, and warm vertical compaction obturation with bioceramic sealer. This case underscores the critical importance of thorough anatomical exploration in complex root canal systems.

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