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Nov 2025 DOI 10.14302/issn.2326-0793.jpgr-25-5573
Advancements in proteomic and genomic technologies have transformed molecular biology by enabling comprehensive analysis of biological systems at the molecular level. This literature review explores the evolution, methodologies, and practical applications of key proteomic and genomic techniques. In proteomics, tools such as two-dimensional electrophoresis, mass spectrometry, Western blotting, Edman degradation, and functional protein microarrays have facilitated high-throughput protein identification, post-translational modification analysis, and biomarker discovery. Similarly, genomic methodologies like PCR, recombinant DNA technology, gel electrophoresis, and Southern blotting have revolutionized gene detection, manipulation, and expression profiling. The review also highlights the interdisciplinary impact of these technologies across clinical diagnostics, oncology, autoimmune disorders, infectious disease surveillance, cardiovascular research, and personalized nutrition. Integrative approaches combining proteomics and genomics are enabling the discovery of novel therapeutic targets, improving disease classification, and advancing precision medicine. Despite current limitations, such as the absence of amplification techniques for proteins and challenges in data interpretation, ongoing innovations promise to bridge these gaps. This synthesis underscores the pivotal role of molecular techniques in deepening our understanding of human biology and accelerating biomedical advancements for improved healthcare outcomes.
Sep 2025 DOI 10.14302/issn.2768-0207.jbr-25-5706
Artificial Intelligence (AI) is emerging as a transformative force across many sectors, with healthcare representing both one of the most promising and most challenging areas of application. This review summarizes current and future applications of AI in healthcare, focusing on its potential to improve diagnosis, therapy, chronic disease management, and overall patient care, while also alleviating physicians’ workload. Recent literature demonstrates that AI systems can reduce diagnostic errors/delays by mitigating cognitive biases, support imaging and pathology through improved accuracy and speed, and prevent prescribing errors by integrating pharmacogenomic and clinical data into decision-support systems. In chronic disease management, AI-powered wearable devices enable continuous monitoring and early detection of conditions such as atrial fibrillation, thereby reducing the risk of stroke and long-term disability, particularly in elderly people. Therapeutic applications include AI-driven drug discovery, personalized oncology, and tailored medicine that integrates multi-omics and lifestyle data. Beyond direct medical intervention, AI contributes by automating routine tasks, optimizing workflows, and facilitating greater patient–clinician interaction. Despite these benefits, significant challenges remain, including issues of data quality, privacy, security, equity, and the need for transparency and trust in “black box” systems. Looking ahead, the integration of multimodal data, digital twins, and robotics is expected to advance more comprehensive, equitable, and human-centered care. We conclude that, when applied ethically and responsibly, AI should not replace clinicians but rather serve as a powerful partner that enhances medicine by restoring empathy and humanity.
May 2023
Background and Aim Breast cancer is the second most common cause of brain metastases after lung cancer. However, the incidence of cerebral metastases from breast cancer has increased during the last years. The purpose of this study is to determine the prognostic value of chemotherapy after whole-brain radiotherapy for patients with brain metastases from breast cancer. Methods We analyzed retrospectively 63 records of patients diagnosed with brain metastases from breast cancer and treated in the radiotherapy department at the Salah Azaiz Institute of oncology over a 5-year period between 2007 and 2011. All patients received whole-brain radiotherapy. Only 4 patients had surgical resection of the metastases before radiotherapy and 36.5% of patients received systemic treatment after irradiation. Results Overall survival was 19% at 1-year and median survival was 4,5 months. Univariate analysis indicated that systemic treatment after irradiation was correlated significantly with longer survival. (p=0,046). Conclusion Determining prognostic factors might help optimize individual treatment for metastatic breast cancer. The results of our study suggest that chemotherapy is more effective on brain metastases after irradiation. This can be explained by the fragilization of the blood-brain barrier by radiation and subsequently a better passage of cytotoxic agents.
May 2022 DOI 10.14302/issn.2379-7835.ijn-22-4190
Background Nutrition support during the acute phase post allogeneic haematopoietic stem cell transplantation (HSCT) is required to optimise short- and long-term outcomes for children. An algorithm was developed and evaluated to assist clinicians to make objective and consistent enteral feeding decisions. Methods The algorithm was evaluated on all patients who underwent allogeneic HSCT treatment between November 2017 - February 2019. Results Of the 48 patients, 43 had a nasogastric tube (NGT) inserted, of which 36 patients received a hydrolysed peptide-based formula, 5 patients received a whole protein formula only and 2 patients were fed an amino acid-based formula. Parenteral nutrition (PN) was used in 41 of the patients. Eleven did not have an NGT in-situ at the commencement of HSCT. Of the remaining 37 patients, 26 followed the algorithm and 11 patients did not comply. The group of patients who did not follow the algorithm had the longest median length of stay (LOS) of 49 days. Patients receiving only EN had the lowest median LOS of 30 days. The two groups that reported better weight outcomes were those who followed the algorithm and those who were fully EN fed. Conclusions Effective use of the HSCT feeding algorithm indicated improved patient outcomes for children undergoing HSCT, with better weight outcomes and reduced LOS. Recommendations to improve the efficacy and compliance of the algorithm include regular education/input to the oncology medical teams to better understand objective thresholds for EN and PN commencement.
Jan 2022 DOI 10.14302/issn.2379-7835.ijn-21-4059
Aim There is limited published data describing the characteristics of the paediatric population prescribed semi elemental formulas. This retrospective observational audit aimed to describe the characteristics of the paediatric patients who have been prescribed a hydrolysed whey protein, medium chain triglycerides (MCT) based formula, Peptamen Junior® and the nutritional outcomes. Methods A retrospective observation audit was completed on a cohort of patients that was prescribed a semi elemental formula between 2016 and 2019 from a single tertiary paediatric medical centre. Data variables were collated such as patient characteristics, indications and modalities of administration, duration and tolerance to the formula. Results Data was collated on 375 patients with a median age of 6.2 years. The main underlying medical conditions were haematological/oncology (67%), gastrointestinal disorders (10.7%) and neurological conditions (9.4%). The most common indications for use were chemotherapy related side effects (36.2%), post bone marrow transplant (25.8%) and gastrointestinal symptoms (17.9%). The formula was rarely used as a sole source of nutrition, with 88% patients requiring accompanying forms of nutrition support. The majority of orders prescribed were of standard concentration (80.8%) and tolerance was recorded in 82.8% of patients. Conclusion The semi elemental formula Peptamen Junior® appears to be well tolerated in paediatric patients with a variety of medical conditions that have complex pathologies and may have wider scope of use in a more diverse group of medical conditions than currently indicated.
Jan 2022 DOI 10.14302/issn.2372-6601.jhor-22-4061
Background Human malignant cell models which reflect the structural and physiological complexity of tumor tissue are of great importance for preclinical research in oncology. Spheroids/tumoroids derived from solid tumors are of great interest as cellular models mimicking the first vascular-free growth phase of a tumor node. The fact of the identity between artificially created tumor multicellular aggregates and the real tumor tissue, however, needs to be specified, described and validated in order to see how closely the spheroids are biologically similar to the malignized tissues in vivo compared to the monolayer cell cultures traditionally used. We present here a comparison study of the characteristics of solid tumor cells of different histogenesis (melanomas, soft tissue sarcomas and bone sarcomas, epithelial tumors) cultured in two dimensions (monolayer culture) and three dimensional space (spheroid), namely: spatial organization, multiplication, metabolic activity. Patients and Methods For the creation of 2 D and 3D cell models the cells isolated from the patient's solid tumor fragments obtained intraoperatively were used. 15 samples of skin melanoma, 20 samples of soft tissue and osteogenic sarcomas (STBS), and 9 samples of epithelial tumors (ET). The tumor cells were all cultivated for at least 10 passages. We used phase contrast, confocal microscopy, and immunohistochemistry to investigate spheroids and monolayer cultures. The supernatants of tumor cells grown in 2D and 3D cultures were studied using ELISA and multiplex analysis for the production of a spectrum of chemokines and cytokines supporting the immunosuppression, invasion and metastasis processes. Results Tumor specimens received were predominantly of metastatic origin (75%). In 100% of cases 2D cultures were received, in 88.6% of cases (39 out of 44) we succeeded in obtaining spheroids. There was no direct correlation between the efficiency of tumoroid formation and the tumor's histogenetic origin and the stage of the cancer process (primary tumor, recurrence, metastasis). The median size of spheroids by 4-5 days of cultivation with a starting concentration of 10000 cells per well was 657.14 μm for melanoma (min 400 - max 1000 μm), 571.42 μm (min 400 - max 700 μm), 507.14 μm (min 300 - max 600 μm) for soft tissue sarcomas, 650.0 μm (min 400 - max 900 μm) for osteogenic sarcomas. Immunochemical analysis of Ki-67, GLUT1, and Ecadherin markers was carried out for tumor tissue samples, single-layer tumor cultures, and tumoroids of every patient. The distribution of the stained groups in the spheroids was distinct from the monolayer cultures and more in accordance with the distribution of such in the tissue tumor, the number of Ki-67+ cells was increasing in the spheroids. We detected no dependence of Ki-67+ and GLUT1+ cell localization grade on spheroid size. We identified E-cadherin in tumor tissue and tumoroids of breast carcinoma and one melanoma culture. Monolayer cultures did not express it. The increase in secretory cell activity of the solid tumor cells from 2D to 3D system was observed when CCL2, CCL3, CXCL1, CXCL16, MIF, IL10, MICA (p<0.01) were investigated. Conclusion The presence of patient-specific cells of solid tumors in a 3D environment causes activation of the proliferative and metabolic processes as compared to monolayer cultures, which makes these models approximate the real world clinical picture. The production of chemokines that can attract to the tumor various types of immune system cells, to include their immature versions, as well as production of cytokines and Immunosuppression factors that, when present in the tumor microenvironment in the high concentrations, contribute to the formation of immune cells having suppressive capacities occurs in the 3D cell system. Three-dimensional model of the initial tumor nodule formation stage thus demonstrates the forming process of tumor cells favorable for them microenvironment. Construction of three-dimensional models - spheroids of tumor cells of differing histogenesis demands individual approach and more thorough investigation.
Nov 2021 DOI 10.14302/issn.2470-0436.jos-21-4016
Malignant transformation of peripheral nerve sheath tumor (MPNST) may develop from a plexiform type of Neurofibromatosis 1 (NF1) or previously irradiated areas. Generally, MPNSTs occur in about 2% to 5% of neurofibromatosis patients. In this paper, we present a 58-year-old male patient with neurofibromatosis who developed MPNST of the eyelids and nasal area. The patient had a history of multiple excision biopsies for facial tumors in 22 years at different institutions, allegedly revealing neurofibromas on histopathological evaluation. A recent consult with the Otorhinolaryngology Service (ORL) prompted an excision biopsy with results consistent with neurofibroma. The mass recurred and enlarged even more rapidly compared to the previously excised tumor. The patient also developed four tumors on the eyelids hence the referral to Ophthalmology Service. The eyelid masses and nasal mass were excised by the Ophthalmology and ORL Services. Histopathology revealed identical MPNST characteristics on all excised tumors. The patient was eventually referred to the Oncology Service to evaluate radio and chemotherapy. A rapid change in the size of a preexisting neurofibroma, infiltration of the adjacent structures, intralesional hemorrhage, and pain usually indicates a possible malignant transformation into MPNST. A high index of suspicion is helpful for clinicians when presented with a case of a recurrent neurofibromatosis, even if the only sign is the rapid growth of the mass since management of MPNST is very different from neurofibromatosis.
Oct 2019 DOI 10.14302/issn.2641-7669.ject-19-3040
Many lay people along with some so called “key opinion leaders” have a common slogan “There's no answer for cancer”. Again, mistake delays proper treatment and make situation worse, more often. Compliance is crucial to obtain optimal health outcomes, such as cure or improvement in QoL. Patients may delay treatment or fail to seek care because of high out-of- pocket expenditures. Despite phenomenal development, conventional therapy falls short in cancer management. There are two major hurdles in anticancer drug development: dose-limiting toxic side effects that reduce either drug effectiveness or the QoL of patients and complicated drug development processes that are costly and time consuming. Cancer patients are increasingly seeking out alternative medicine and might be reluctant to disclose its use to their oncology treatment physicians. But there is limited available information on patterns of utilization and efficacy of alternative medicine for patients with cancer. As adjuvant therapy, many traditional medicines shown efficacy against brain, head and neck, skin, breast, liver, pancreas, kidney, bladder, prostate, colon and blood cancers. The literature reviews non-pharmacological interventions used against cancer, published trials, systematic reviews and meta-analyses.
Oct 2018 DOI 10.14302/issn.2326-0793.jpgr-18-2418
A brief review surveys molecular biomarkers across discovery, validation, and clinical translation, with examples in oncology and chronic disease.
May 2018 DOI 10.14302/issn.2576-9383.jhhr-18-2111
The continuous waves of refugees from Africa and the Middle East to Europe present major inter¬cultural challenges to European health professionals and to society at large. A recent workshop in Sicily brought together local physicians, nurses, psychologists and managers of governmental agencies, along with representatives from Lebanon, Israel, Iraq, Iran, Sudan, Tunisia, Jordan and the European Society of Medical Oncology (ESMO) to develop training programs aimed at formulating dialogue between regional professionals and refugees. A major barrier refugees face is a lack of verbal and cultural communication, which hinders their smooth absorption into the new society. Cultural mediators who speak Arabic and Italian and understand the refugees' faith, tradition and beliefs are vital to successfully build bridges of trust between caregivers and refugees. Most asylum seekers experience anxiety, fear, and depression upon arrival in Europe. To achieve trust, all workshop participants agreed to develop a palliative care model that would best suit the unique circumstances now facing some Mediterranean countries and assist in overcoming the suffering of refugees during their initial stay in Europe. Such a model would include bio-psychosocial elements, essential for a culturally sensitive approach and based on core ethical principles.
Dec 2017 DOI 10.14302/issn.2576-9383.jhhr-17-1811
Homecare is very important in oncology care since cancer patients are discharged more and more earlier from the hospital and receiving ambulatory treatments. Homecare nurses have a more general broad educational background, with less specialization regarding specific care, like oncology care. The aim of this study is to develop and test a cross-platform application (named Oncopunt) for homecare nurses involved in oncology care to provide specific nurse-centred information via digital media about skill guidelines specific for oncology care. This study was set-up as a non-experimental feasibility and satisfaction study with one measurement moment to collect information about usability, user-experience and added value of Oncopunt using the System Usability Scale (SUS) and an additional questionnaire. The cross-platform application Oncopunt was build using Drupal and Vimeo and consists of a homescreen, filter/search function and watch-function (full video panel, chapter panel and FAQ). Seventeen homecare nurses completed all questionnaires. The mean SUS score was 83,8 (stdev 11,6) and Oncopunt was rated positively regarding video content, technical issues, website layout, quality of care and user satisfaction. Oncopunt is developed to provide homecare nurses specific nurse-centred information about skills specific for oncology care via digital media . It was rated good on usability, user-experiences and added value for clinical practice.
Dec 2017 DOI 10.14302/issn.2576-9383.jhhr-17-1788
Integration of music therapy into medical treatment facilities is very uneven in different countries. Scientific evidence of successful examples and sharing of good practices between countries is essential for the further development of music therapy and the improvement of the quality of complex medical services. The goal of this study was to analyse the situation of music therapy implementation into the health services in Lithuania. Analysis of historical background, legislation and overview on music therapy training has been made. Music therapy in Lithuania has gone through more than thirty years of development. Acqaintance and acceptance of music therapy as a relevant and fruitful component to the complexity of the existing medical services was long but successful process. Overview of current initiatives and achievements of the implementation of music therapy into clinical practice and research has shown promissing positive results in developmental pediatrics, psychiatry, special education, neurology, neonatology, oncology, somatic and preventive medicine, rehabilitation. The Music Therapy Master program in Lithuania is being implemented. Possibilities to use music therapy as an inovative service and resourse in various medical settings are in the process of the rapid growth. Collaboration involving music therapists in interdisciplinary teams would help to achieve a comprehensive, versatile patient-centered and health-centered complex service.
Aug 2017
Aim: To assess the extent and directions of internal hospital turnover of registered nurses and to examine the associated factors and stressors. Background: Internal turnover of hospital nurses is mainly horizontal. Occurring on a large scale, it could lead to dropout of skilled personnel, burdening hospitals both financially and in terms of human resources, affecting the quality of care. Methods: A secondary analysis based on data from the national study on "Patterns and trends of the nursing workforce in Israel". A structured telephone interview was conducted of 2,098 hospital nurses (October 2008-February 2009). Results: The rate of internal turnover between hospital departments was 29.7%. The main departments from which nurses moved were medical and surgical. The main departments from which nurses moved were oncology departments, Intensive Care Units, nursing administration. The major work-related stressor concerned salary (59%), two predictors of internal turnover were nurses with children under the age of 18 and academic degree nurses. Conclusions and Implications for Health Policy: Internal turnover rate in Israeli hospitals is moderate, with high rates in medical and surgical departments. It is vital to identify the main factors associated with high turnover rates and implement focused managerial retention strategies and other intervention programs.
Apr 2017 DOI 10.14302/issn.2372-6601.jhor-17-1463
Melanoma is considered to be a very aggressive cancer due to its rapid growth, early and multiple metastases and limited response to standard treatment. Many researchers have hypothesized that the combination of radiation therapy and immunotherapy in the treatment of melanoma primary tumors and metastases improves the efficiency of these methods as compared to their use separately. Therefore, combined therapy is an increasingly popular topic in radiation oncology. Although the mechanism of immune response to ionizing radiation remains unclear, known are the factors involved in the immune response, including NK and CD8(+) T cells. Many studies have demonstrated the importance of inflammatory factors, primarily cytokines, in the response to ionizing radiation. In turn, many cytokines released in an irradiated organ, such as tumor necrosis factor α (TNFα), interleukins IL1 and IL6 and transforming growth factor beta (TGFβ), can induce the production of significant amounts of reactive oxygen species that are associated with the induction of DNA damage in tumor cells. In relation to anticancer immunotherapy, the clinical data obtained to date can encourage future studies combining radiation therapy and the inhibitors of cell division checkpoints in the treatment of advanced melanoma. In a recent study, melanoma cell lines became more sensitive to radiation after BRAF inhibition, which provides a potential synergistic mechanism of BRAF inhibitor (BRAFi) combined with radiation therapy for better effects of treatment. In this article, we present a systematic review of the literature on the use of the combination of radiation therapy and immunotherapy in the treatment of melanoma.
Dec 2015 DOI 10.14302/issn.2372-6601.jhor-15-799
Objective: Hospital construction work, among other environmental factors, is a risk factor for invasive aspergillosis (IA). Methods: We retrospectively surveyed the incidence of IA in hematology-oncology patients before and during hospital construction and studied the effectiveness of prophylactic oral itraconazole (ITCZ) treatment. We compared the rates of galactomannan (GM)-positive cases and probable IA cases among 224 patients discharged before the start of construction work and among 67 patients hospitalized within two months after the start of the construction work. Results: Our results showed that, during the 12 months before the construction work was started, only four patients were GM-positive, and one had a probable diagnosis; in contrast, among patients hospitalized within two months from the start of the construction work, seven patients were GM-positive, and four had a probable diagnosis. Therefore, we started to administer oral ITCZ to 40 patients with hematological diseases. Although the construction work continued, after the ITCZ prophylaxis, no new probable cases of IA were detected. Conclusion: From our experience, GM surveillance among hematological patients is necessary during hospital construction work, and the administration of ITCZ to prophylactically prevent IA is suggested upon detection of an increase in GM-positive patients.
Jul 2015 DOI 10.14302/issn.2372-6601.jhor-15-657
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a known side effect of several oncology drugs, but it is rarely seen secondary to vinblastine with only a few cases reported worldwide. Herein we present a patient with nodular lymphocyte-predominant Hodgkin disease that developed a severe acute hyponatremia seven days after her first cycle of chemotherapy with R-ABVD. After fluid restriction, symptoms and concentration of blood sodium were restored. After a comprehensive review of the literature vinblastine was thought to be the cause and avoided in the second infusion of chemotherapy without recurrence of the SIADH.