Health care-associated bloodstream infections represent a major public health concern, significantly impacting morbidity, mortality, and the overall cost of pediatric medical care.
The Review type of an article
Tick-borne infections (TBIs) are increasingly recognized as a public health concern in North America and Europe, with Lyme disease being the most notable. The Centers for Disease Control and Prevention (CDC) acknowledges that official statistics likely underestimate the true incidence of TBIs due to diagnostic challenges and underreporting. Co-infections, where multiple pathogens are transmitted through a single tick bite or multiple bites, complicate diagnosis and treatment, leading to more severe symptoms and longer illness durations. Studies indicate a significant percentage of Lyme disease patients also have co-infections, with babesiosis being a common co-infection.
Follicular lymphoma (FL) is a slow-growing B-cell lymphoma with a generally favorable prognosis. Nevertheless, its clinical course is heterogeneous, with a significant subset of patients experiencing early progression or histological transformation into diffuse large B-cell lymphoma (DLBCL), both considered to be high-risk events associated with treatment resistance and markedly inferior outcomes. Importantly, clinical risk factors have limited value in predicting these complications. This review outlines the key biologic features of FL, discussing how the novel molecular biology approaches can explain the clinical heterogeneity and high-risk disease evolution of FL.
Adult epilepsy generates a burden that extends beyond seizure counts and includes adverse treatment effects, role restriction, emotional distress, and the social devaluation attached to the diagnosis. The methodological problem is not the absence of patient-reported measures, but the heterogeneity with which disease-specific quality-of-life and stigma instruments are selected, interpreted, and combined in adult studies.
Introduction. Circadian rhythms are endogenous, approximately 24-hour oscillations that coordinate nearly all physiological systems, including cardiovascular function. The suprachiasmatic nucleus serves as the central pacemaker, synchronizing peripheral clocks in the heart, vasculature, and kidneys to generate daily fluctuations in blood pressure, heart rate, endothelial function, coagulation, myocardial metabolism, and autonomic tone. Disruption of circadian organization – through extrinsic factors (shift work, irregular light exposure, altered feeding schedules) or intrinsic factors (aging, inflammation, genetic clock-gene variants) – has been strongly linked to increased cardiovascular morbidity and mortality.
Material and methods. A bibliographic search was conducted in PubMed, Scopus, and Web of Science for English-language publications (2000–2025), focusing on the circadian rhythm, cardiovascular disease, hypertension, chronotherapy, and critical illness. Keywords included “circadian rhythm,” “cardiovascular disease,” “hypertension,” “chronotherapy,” and “intensive care.” Original research, clinical trials, meta-analyses, and experimental studies were eligible; studies addressing circadian blood pressure variability and its relation to outcomes in critically ill patients were specifically examined. Filters required full-text availability and publication dates from 2000 to 2025. The search yielded 276 full-text articles, of which 79 representative sources were selected for this narrative review.
Results. This review synthesizes current evidence demonstrating that circadian clocks regulate essential cardiovascular processes and that their disruption contributes to disease pathogenesis. Observational data on circadian blood pressure variability are discussed, showing that the attenuation of normal hemodynamic oscillations is associated with a worse prognosis. Particular attention is given to the extrinsic and intrinsic factors that modulate circadian alignment, with implications for the management of patients in intensive care.
Inflammation is a state driven by pathogenic stimuli. Trauma is one of the causes of acute onset of the inflammatory pathway. Multiple proteases are capable of inducing distant multiple organ lesions (lungs, brain or spinal cord, heart, kidney, liver and systemic vessel endothelium). The onset of corresponding syndromes will complicate the clinical course of that particular patient. These molecules are potential biomarkers in trauma patients.
Chronic suppurative otitis media represents a major public health concern in both children and adults, particularly in developing countries. The condition poses not only a medical challenge requiring complex clinical management but also a public health issue with significant socioeconomic implications and costs.
Rheumatoid arthritis (RA) is a chronic autoimmune disease affecting approximately 0.5% of the global population. It represents a major cause of disability, reduced quality of life, and healthcare burden. The prevalence of RA is rising, especially in older populations and in low-income regions.
Systemic rheumatoid vasculitis accounts for 1 to 5% of complications seen in rheumatoid arthritis, while autopsy studies report an average of 23% incidence. This enormous difference in numbers emphasizes the rate of misdiagnosis or underdiagnosis of systemic rheumatoid vasculitis. It mainly affects people with a median age of 65 years. It is particularly noteworthy, as systemic rheumatoid vasculitis has a high mortality and relapse rate. Also, the multifactorial aetiology: cytokines/immune cells and other particles determines clinical complexity of this type of angiitis
The therapeutic landscape of multiple sclerosis has undergone a remarkable transformation over the past two decades. The paradigm has shifted from reliance on moderate-efficacy, first-generation injectable therapies toward earlier adoption of high-efficacy disease-modifying treatments, particularly in relapsing forms of MS. This evolution reflects an increasing focus on early intensive treatment strategies aimed at preserving long-term neurological function and brain health.