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22. Endocrine adaptations to prolonged fasting women who had developed gestational diabetes : from physiology, clinical uncertainties, translational challenges to healthspan implicationsRok Herman, Jure Tršan, Luka Lipar, Mojca Jensterle Sever, Andrej Janež, 2025, review article Abstract: Objectives: Intermittent fasting regimens that include periods of prolonged fasting may mimic certain well-documented benefits of calorie restriction. In this narrative review, we synthesize preclinical and human data on endocrine adaptations during prolonged fasting protocols. Methods: We conducted a structured search of relevant databases, followed by data extraction and synthesis, with a focus on endocrine adaptations during prolonged fasting and their potential implications for healthspan. Results: Across various endocrine axes, prolonged fasting appears to induce a reproducible pattern marked by diminished anabolic signaling and transient activation of potential stress resilience pathways. However, the evidence is limited by small sample sizes, short follow-up durations, methodological heterogeneity, and dependence on surrogate endpoints. Endocrine outcomes are frequently secondary and reported inconsistently. Potential risks include transient hypogonadism, relative hypothyroidism, hypercortisolemia, orthostatic intolerance, electrolyte imbalances, catabolic loss of lean mass, and refeeding challenges. Conclusions: Overall, prolonged fasting activates conserved endocrine mechanisms that may confer plausible cardiometabolic benefits; however, their translation to clinical practice remains speculative. We highlight key knowledge gaps and propose directions for future research in this emerging field.
Keywords: prolonged fasting, endocrine adaptations, metabolic switch
Published in DiRROS: 19.12.2025; Views: 6; Downloads: 7
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23. Isoeugenol hydrodeoxygenation over sustainable biochar-supported cobalt catalysts : synergistic Co⁰/Co²⁺ sites and mechanistic insightsLilia Longo, Dmitry Murzin, Davide Baldassin, Päivi Mäki-Arvela, Johan Wärnå, Anssi Peuronen, Matej Huš, Blaž Likozar, Atte Aho, Mark Martinez-Klimov, Olha Yevdokimova, Kari Eränen, Mika Lastusaari, Michela Signoretto, 2026, original scientific article Published in DiRROS: 19.12.2025; Views: 10; Downloads: 12
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24. A broad spectrum of liver manifestations in common variable immunodeficiency syndrome : two case reports and a literature overviewEva Supovec, Jan Drnovšek, 2025, original scientific article Abstract: Background and Clinical Significance: Common variable immunodeficiency (CVID) is a primary B-cell immunodeficiency disorder, characterized by severe hypogammaglobulinemia and disturbed antibody production. In addition to increased susceptibility to recurrent respiratory and gastrointestinal infections, CVID can lead to a wide array of complications associated with immune dysregulation, which can also affect the liver. Liver involvement occurs in about 10% of patients with CVID, and can result from a range of causes, including infections, autoimmune disorders, lymphoproliferative conditions, granulomatous inflammation, and infiltrative processes. The most common liver manifestations include nodular regenerative hyperplasia, granulomatous or autoimmune hepatitis, and lymphocytic infiltration. The prevalence, pathophysiology, extent, and prognosis of liver involvement in CVID have not been systematically studied. Case Presentation: The object of this article is to present two patients with CVID-related liver disease and to illuminate the most relevant causes of liver involvement in CVID, describe the clinical features of their liver disease, and summarize the diagnostic and therapeutic approaches for its management. Conclusions: Liver involvement is an expected complication in patients with CVID syndrome. The delayed recognition of this pathology significantly worsens the disease prognosis, making the early detection of this potential complication crucial.
Keywords: CVID, common variable immunodeficiency, liver involvement, nodular regenerative hyperplasia
Published in DiRROS: 18.12.2025; Views: 25; Downloads: 10
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25. Inflammation - a link between arterial atherosclerotic and venous thromboembolic diseasesPavel Poredoš, Peter Poredoš, 2025, review article Abstract: An increasing body of evidence suggests the likelihood of a link between arterial atherosclerotic disease (AAD) and venous thromboembolic disease (VTED). Inflammation is accepted as a basic pathogenetic mechanism of both diseases. The involvement of inflammation in the pathogenesis of AAD and VTED is supported by increased levels of circulating inflammatory markers, particularly interleukins, which are involved in the development and progression of atherosclerosis as well as in thrombus formation in arterial and venous beds. A consideration supporting a close link between these diseases is also based on the evidence of common risk factors which promote the development of both diseases through stimulation of systemic inflammation. Further, the relationship between arterial and VTED is supported by findings of the simultaneous appearance of clinical or preclinical AAD and VTED. The aim of this narrative review is to report evidence of the inflammatory basis of arterial and venous diseases, which is important for common therapeutic procedures. Besides classical drugs used in the prevention of arterial and venous diseases with their pleotropic anti-inflammatory activity, new anti-inflammatory drugs provide the possibility for treatment of both AAD and VTED and could represent a unified therapeutic approach to both diseases.
Keywords: arterial atherosclerotic disease, venous thromboembolism, deep venous thrombosis, inflammation, interleukins
Published in DiRROS: 18.12.2025; Views: 32; Downloads: 16
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26. Abdominal imaging in precocious puberty in girls : can imaging determine onset of puberty?Anne M. Smets, Carmelo Sofia, Costanza Bruno, Damjana Ključevšek, Maria-Luisa Lobo, Marcello Napolitano, 2025, original scientific article Abstract: Precocious puberty in girls is defined by the appearance of secondary sex characteristics before the age of 8 years. Precocious puberty is either peripheral or central. In most cases, the cause of central precocious puberty is unknown. Rapidly progressive forms of central precocious puberty may benefit from puberty suppression to prevent compromised final height and psychosocial problems related to the physical changes. Idiopathic central precocious puberty in girls can be a challenging diagnosis. Clinical examination, evaluation of growth charts, bone age, and hormonal tests are part of the workup. The role of pelvic ultrasound to evaluate pubertal features of the internal genitalia in this context is controversial. In this paper, we have reviewed the literature to find the scientific bases for several proposed ultrasound parameters and cutoff values for the determination of onset of puberty in girls with suspected central precocious puberty. There are no reliable cutoffs for the measurements of uterus and ovaries for the diagnosis of central precocious puberty and there is overlap in the appearance of the organs in both prepubertal and pubertal girls. The interpretation of the findings on pelvic ultrasound must be done with caution and always in close communication with the referring clinicians.
Keywords: precocious, puberty, ultrasound, uterus, ovary
Published in DiRROS: 18.12.2025; Views: 29; Downloads: 11
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27. Chronic lung allograft dysfunction after lung transplantation : prevention, diagnosis and treatment in 44 European centresJens Gottlieb, Robin Vos, Peter Jaksch, Merel Hellemons, Are Martin Holm, Letizia Corinna Morlacchi, Matevž Harlander, 2025, original scientific article Abstract: Background: There are limited data on optimal management of chronic lung allograft dysfunction (CLAD). We aimed to describe the variability of diagnostic and therapeutic practices in Europe. Methods: A structured questionnaire was sent to 71 centres in 24 countries. Questions were related to contemporary clinical practices for workup, monitoring and treatment of CLAD. The number of lung transplant procedures and patients in follow-up were collected. Results: 44 centres (62%) responded from 20 countries, representing 74% of European activity. The prevalence of CLAD was estimated at 9.1 cases per million population (25th and 75th percentiles of 4.4, 15.7). Preferred initial workup for probable CLAD consisted of chest computed tomography (CT) (inspiratory 91% and expiratory 74%), donor-specific antibody (DSA) measurement (86%), bronchoalveolar lavage (BAL) (85%) and transbronchial biopsy (81%). For monitoring of definite CLAD, inspiratory CT (67%), DSA (61%) and BAL (43%) were preferred. Body plethysmography was unavailable for 16% of cases. Prophylaxis was based on preventing infections (cytomegalovirus 99%, inhaled antibiotics 70% and antifungals 65%), tacrolimus-based immunosuppression (96%), azithromycin (72%) and universal proton pump inhibitor treatment (84%). First-line treatment of CLAD was based on azithromycin (82%) and steroid augmentation (74%). Photopheresis was used in 26% of cases. Conclusion: Current European practice CLAD detection is based on spirometry, inspiratory CT and DSA, with limited access to plethysmography and expiratory CT. Prophylactic treatment is based on azithromycin, tacrolimus-based immunosuppression and treatment of risk factors. No single treatment strategy is universally used, highlighting the need for an effective treatment of CLAD. The preferred firstline strategy is azithromycin and steroid augmentation.
Keywords: lung transplantation, rejection, CLAD, chronic lung allograft dysfunction
Published in DiRROS: 18.12.2025; Views: 36; Downloads: 17
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30. FAIR foundations of a novel indicator vault for non-communicable diseases in the European Union : feasibility study for effective contextualisation of indicatorsIztok Štotl, Fabrizio Carinci, Stephen Fava, Astrid Lavens, Jana Lepiksone, Massimo Massi Benedetti, Tamara Poljičanin, Scott G. Cunningham, 2025, original scientific article Abstract: Background: Comparing health indicators across the European Union (EU) is a challenging endeavour. A feasibility study was conducted to explore opportunities for improvement through the contextualisation of indicators for major non-communicable diseases (NCDs). We aimed to improve the usability and transparency of indicators in the domain of NCDs by describing the contextual information about the data from which they draw and the related data processes. In particular, we sought to illustrate how semantic linkage could be achieved to facilitate interoperability with other metadata models using FAIR data principles. Finally, we aimed to provide recommendations for the implementation of the proposed metadata model at the EU level. Methods: A number of expert group meetings were held between March 2023 and October 2024 to agree on the approach and related technologies to meet the standard requirements for the meaningful comparison of indicators across countries and regions of Europe in the domain of NCDs. Results: The Semantic Ontology-Labelled Indicator Contextualisation Integrative Taxonomy (SOLICIT) was selected as a suitable generic metadata model for contextualising indicators. In this work, we adapted the SOLICIT generic framework to the diabetes sub-domain and extended its applicability more generally across all NCDs. As a proof of concept, we present an example of how to adapt a diabetes indicator and its related contextualisation within SOLICIT. Conclusion: The accurate contextualisation of NCD indicators can substantially improve their use and comparability across national and regional boundaries. This study delivered a set of seven recommendations for implementation in three different areas: (a) contextualisation of common data elements and indicators (use of contextual information; common schema for semantic linkage), (b) generic contextualisation framework (adoption of the framework; use of SOLICIT), and (c) implementation at EU level (pilot test of the model on federated networks; development of European portals; implementation of a user-friendly interface for SOLICIT). The proposed concepts provide a way of validating indicator values and their comparisons, as well as their provision, including all relevant details, encouraging secondary use and potential integration with additional indicator sets. Further studies are needed to test and refine the proposed model.
Keywords: health indicator framework, non-communicable diseases, indicator contextualisation, FAIR, SOLICIT, EHDS, health indicator, metadata
Published in DiRROS: 18.12.2025; Views: 34; Downloads: 20
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