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Povzetek: Background/Objectives: Sodium glucose co-transporter 2 inhibitors (SGLT2is) improve outcomes in heart failure; however, data in left ventricular non-compaction cardiomyopathy (LVNC) patients are limited. We sought to analyze the clinical effects of the SGLT2is dapagliflozin and empagliflozin in patients with LVNC. Methods: Thirty consecutive LVNC patients diagnosed by CMR were prospectively enrolled. Clinical, biochemical and echocardiography data were obtained at the initiation of the SGLT2is and at the 12-month follow-up. All patients were on stable guideline-directed medical therapy. A response to SGLT2i therapy was defined as an improvement in LVEF ≥ 5% at 12 months. Results: Of the 30 enrolled patients, 25 were male, with a mean age of 49 ± 16 years and few comorbidities. Dapagliflozin 10 mg was prescribed to 23 patients and empagliflozin 10 mg to 7 patients. Five patients experiened an adverse event during follow-up (one sudden cardiac death; four heart transplantations or LVAD implantations). During follow-up, significant improvements were observed in LVEF (32.1 ± 6.9% vs. 43.5 ± 9.7%; p = 0.003), LVOT VTI (14.8 ± 6.5 cm vs. 17.6 ± 3.3 cm; p = 0.008), E/e′ (14.8 ± 4.7 vs. 10.0 ± 4.1; p < 0.001), and TAPSE (2.0 ± 0.4 cm vs. 2.3 ± 0.4 cm; p = 0.012). NT-proBNP levels decreased significantly (2025 ± 2198 pg/mL vs. 582 ± 803 pg/mL; p = 0.005). Eighteen patients responded favorably to SGLT2i therapy (Group A), whereas seven showed no significant LVEF improvement (Group B). The groups did not differ significantly in age, sex, baseline creatinine, or bilirubin. Compared to Group B, Group A had a smaller baseline LV end-diastolic diameter (6.3 ± 0.8 cm vs. 7.1 ± 0.9 cm; p = 0.025) and lower NT-proBNP levels (1720 ± 1662 pg/mL vs. 4527 ± 4397 pg/mL; p = 0.02). Conclusions: In patients with LVNC, SGLT2i therapy is associated with significant reverse remodeling and functional improvement. Benefits may be greater in those with less advanced disease.
Ključne besede: non-compaction cardiomyopathy, guideline-directed heart failure medical therapy, myocardial recovery
Objavljeno v DiRROS: 15.12.2025; Ogledov: 0; Prenosov: 0
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Ključne besede: vsebnost vitaminov pri ljudeh, vitamin D, vpliv pomanjkanja na respiratorna obolenja, priporočila
Objavljeno v DiRROS: 15.12.2025; Ogledov: 7; Prenosov: 6
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Povzetek: Methylmercury (MeHg) represents the most toxic form of mercury, owing to its ability to permeate both the blood-brain and placental barriers, leading to bioaccumulation in organisms. In the marine food web, MeHg concentrations can reach levels millions of times higher than those found in the surrounding environment, posing significant ecological and human health risks. This review provides a comprehensive overviews and critical evaluation of the available biosensor detection platforms for the detection of MeHg, with a focus on their performance based on key parameters such as (i) sensitivity, (ii) selectivity, (iii) response time, and (iv) adaptability to diverse environmental matrices. We examine recent advancements in MeHg biosensing technologies, emphasizing innovative approaches that surpass current methodologies regarding detection limits, reversibility, response time, and operational stability. Furthermore, we present an in-depth discussion on future directions for the development of in situ MeHg detection platforms, with potential applications in both biomedical and environmental monitoring. The review concludes by outlining the challenges and opportunities for advancing MeHg sensing technologies to enhance real-time detection in aqueous environments.
Objavljeno v DiRROS: 15.12.2025; Ogledov: 3; Prenosov: 3
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Povzetek: The present review explores the influence of the gut microbiota on antibiotic resistance dynamics, particularly those associated with dysbiosis. The improper use of antibiotics can induce resistance in pathogens through various pathways, which is a topic of increasing interest within the scientific community. This review highlights the importance of microbial diversity, gut metabolism, and inflammatory responses against the dysbiosis due to the action of antibiotics. Additionally, it examines how secondary metabolites secreted by pathogens can serve as biomarkers for the early detection of antibiotic resistance. Although significant progress has been made in this field, key research gaps persist, including the need for a deeper understanding of the long-term effects of antibiotic-induced dysbiosis and the specific mechanisms driving the evolution of resistance in gut bacteria. Based on these considerations, this review systematically analyzed studies from PubMed, Web of Science, Embase, Cochrane Library, and Scopus up to July 2024. This study aimed to explore the dynamics of the interactions between gut microbiota and antibiotic resistance, specifically examining how microbial composition influences the development of resistance mechanisms. By elucidating these relationships, this review provides insights into management strategies for drug resistance and improves our understanding of microbial contributions to host health.
Ključne besede: gut microbiota, antibiotic resistance, dysbiosis, homeostasis
Objavljeno v DiRROS: 15.12.2025; Ogledov: 8; Prenosov: 7
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Povzetek: Background: Advanced Combination Treatment (ACT) refers to the dual use of two advanced therapies—either two biologics, two small molecules, or one biologic and one small molecule. There is a lack of guidance regarding clinical trial design for ACT in patients with inflammatory bowel disease (IBD). Key uncertainties remain regarding aspects such as eligibility criteria, pharmacotherapy regimens, safety considerations, and standardised trial design configurations for both induction and maintenance phases. We aimed to formulate expert recommendations regarding the design of ACT clinical trials in IBD. Methods: A systematic search was performed in June 2023. Modified RAND/University of California, Los Angeles Appropriateness Methodology (RAM) was employed to evaluate 287 statements related to the design of ACT clinical trials in patients with IBD. A multidisciplinary panel of gastroenterologists and precision medicine scientists rated statement appropriateness on a 9-point Likert scale. Statements were subsequently categorised as appropriate, uncertain, or inappropriate based on the median panel rating and the presence of disagreement. The consensus meetings were held on February 6, 2024 and June 4, 2024. Findings: ACT should consist of drugs with distinct mechanisms of action, avoiding combinations targeting the same biological pathway. Appropriate eligibility criteria included prior treatment failure and high risk for disease complications. Safety considerations were prioritised, with short-term use of high-risk regimens acceptable for induction therapy. Trial designs should compare ACT to monotherapy and allow for longitudinal evaluation. Co-primary endpoints of clinical remission and endoscopic response were endorsed, with safety outcomes including adverse events and infections. Precision medicine approaches, guided by biomarker analysis, were considered essential for further defining mechanistic pathways and monitoring treatment response. Interpretation: Implementing standardised design elements for eligibility criteria, pharmacotherapy regimens, safety considerations, and trial design configurations will facilitate the conduct of efficient clinical trials of ACT.
Ključne besede: Crohn's disease, ulcerative colitis, combination treatment, dual therapy, inflammatory bowel disease
Objavljeno v DiRROS: 15.12.2025; Ogledov: 6; Prenosov: 7
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