Adolescence is of particular importance in the prevention of non-communicable chronic diseases, as health behavior patterns established during this life stage may influence adult morbidity in the long term. The healthcare system and societal burden of chronic diseases justify the development of prevention programs initiated early in life and adapted to the needs of the target population.

The aim of our study was to assess program awareness, health behavior characteristics and perceptions of prevention programs among the target population of the "Youth for a Healthy Future" (YHF) program.

A cross-sectional quantitative questionnaire-based study was conducted in 2025 using convenience sampling. The 26-item online questionnaire was completed by 427 examined individuals; data processing was performed using IBM SPSS Statistics 30.0 software. In addition to descriptive statistics, cross-tabulation, Pearson's χ² test and Cramér's association coefficient were applied.

The sample comprised 46% boys and 52.0% girls; the mean age was 18.0 years (SD = 1.73). The YHF program was known by 16% of respondents, and 29 examined individuals reported direct participation. Regular smoking was reported by 16% and occasional smoking by 17% of respondents. A significant association was found between school type and smoking status (χ² = 36.798; p<0.001; Cramér's V = 0.29): a lower smoking rate was observed among grammar school students, whereas regular smoking was more frequent among vocational secondary school and technical school students. Awareness of the YHF program was also associated with school type (χ² = 12.070; p = 0.002; Cramér's V = 0.17), with higher awareness among grammar school students. Among barriers to participation, insufficient information was reported by 61% of respondents, lack of free or discounted participation by 58%, and the insufficiently practical nature of programs by 38%. Among future program topics, stress management, mental health and sports events attracted the greatest interest.

Based on our findings, improving the reach of the YHF program and similar prevention initiatives requires more targeted communication, program structures better adapted to differences by school type and sex, and a stronger emphasis on practical and interactive program elements. Due to the cross-sectional design, causal conclusions cannot be drawn; however, the results may provide a basis for future longitudinal and controlled studies. Orv Hetil. 2026; 167(30): 1207-1212.

The global food system faces compounding pressures: a world population projected to reach approximately 9.7 billion by 2050, an escalating burden of diet-related non-communicable diseases, persistent micronutrient deficiencies affecting approximately 2 billion people globally, and robust scientific evidence that conventional agriculture cannot sustainably expand within planetary boundaries. Against this backdrop, next-generation food technologies have emerged as potentially transformative approaches to restructuring how humanity produces and consumes nutrition. This narrative review examines five technological pillars: (i) precision fermentation and microbially produced proteins, (ii) cultivated (cell-based) meat and seafood, (iii) plant-based, mycoprotein, and microalgae innovations, (iv) biofortification and functional food engineering, and (v) three-dimensional (3D) food printing with novel ingredients. Each technology is evaluated for its nutritional profile, environmental footprint, scalability, regulatory status, and public health implications, alongside its documented limitations and scientific uncertainties. Cross-cutting challenges, including regulatory fragmentation, consumer neophobia, energy intensity, equity of access, and citation integrity, are critically examined. The review concludes that while each pillar holds genuine promise, significant technical, regulatory, and socioeconomic uncertainties remain underemphasized in much of the existing literature. A synergistic, evidence-anchored portfolio approach, grounded in sustainability science and guided by global health equity, is most credible. Priority research gaps are identified, including the need for long-term dietary intervention trials, full-system life cycle assessments incorporating renewable energy scenarios, and independent verification of bibliographic claims in rapidly evolving technology fields.

This study examined the association between healthcare decision-making and cervical cancer screening among ever-partnered women in SSA and assessed whether this relationship varies across countries.

This cross-sectional study pooled Demographic and Health Survey data (2019-2024) from 114,764 ever-partnered women aged 25-49 years across fourteen SSA countries. Multivariable logistic regression models estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Country-by-healthcare decision-making interaction terms and adjusted predicted probabilities assessed contextual variation.

Overall, 13.00% of women reported ever being screened for cervical cancer. Compared with women making healthcare decisions independently, women whose partners made healthcare decisions alone (aOR = 0.85, 95% CI = 0.81, 0.91) and those involved in shared decision-making (aOR = 0.94, 95% CI = 0.90-0.99) had lower odds of screening. Screening uptake was higher among older, more educated, and wealthier women and those with media exposure, but lower among women with inequitable gender attitudes and living in rural areas and those reporting distance barriers. Significant country-level variation was observed.

Healthcare decision-making is an important, context-dependent determinant of cervical cancer screening uptake in SSA. Context-specific, gender-responsive strategies that strengthen women's participation in healthcare decision-making are needed to accelerate cervical cancer elimination.

Latin America is a key region in advancing efforts to end the HIV epidemic globally. Despite breakthroughs in HIV treatment and prevention in the last 20 years, as well as region-wide improvements in health infrastructure and policies, there has been a 13% increase in new acquisitions in Latin America from 2010 to 2024. The Caribbean, Central and South America network for HIV epidemiology (CCASAnet), established in 2006, is one of seven regions in the International epidemiology Databases to Evaluate AIDS (IeDEA). CCASAnet contributes substantially to regional science and the development of national and region-wide policies. Here, we describe data sources and operational methodologies employed by CCASAnet, as well as the current state of the cohort.

CCASAnet data are collected using standardized data elements, including demographic information, HIV disease history, laboratory data, antiretroviral regimens, co-infections and comorbidities. Data collection has expanded to include prospective data such as substance use, antiretroviral therapy adherence, geriatric syndromes and tuberculosis treatment. All clinical sites retain ownership of their data, and CCASAnet data contribute as able to global IeDEA-level projects. Robust data quality initiatives and statistical methods have strengthened the cohort.

CCASAnet consists of nine clinics across seven countries (Argentina, Brazil, Chile, Haiti, Honduras, Mexico and Peru). Over 61,000 adults and children living with HIV have contributed observational data through December 2023. While CD4 at enrolment has remained largely unchanged, time to antiretroviral therapy initiation has decreased, retention in care has improved and the proportion with undetectable HIV RNA has dramatically increased. Co-infections and AIDS-defining malignancies remain a cause of morbidity and mortality, but non-communicable diseases have also increased. Overall mortality trends in the region have improved over time, with some notable exceptions.

Underscoring the importance of maintaining longitudinal collaborations and data collection, CCASAnet remains the largest source of high-quality data for HIV epidemiology in Latin America and serves as an important evidence base for informing global and regional policy and stakeholder decisions related to the HIV epidemic.

Objective - to evaluate the experience of implementing a digital clinical calculator for individual clinical and metabolic control goals in routine outpatient medical care for elderly patients with type 2 diabetes mellitus (DM2). A cross-sectional observational sample study was performed in a sample of elderly patients with DM2 who sought routine medical care at an outpatient medical organization (n=77); participants were examined according to the standard protocol of outpatient follow-up of an elderly patient with DM2, including 124 clinical and laboratory indicators; a developed digital calculator was used to assess individual therapeutic control goals The frequency of achieving treatment goals and the structure of drug therapy are determined. A high incidence of atherogenic pathology was confirmed: coronary heart disease (41,6%), chronic heart failure (27,3%), hypertension (62,3%), obesity (50,6%), dyslipidemia (46,8%), exceeding population values; an imbalance in achieving therapeutic goals was revealed: indicators glycemic control levels are close to optimal values (HbA1c 7,5±1,5%), while LDL exceeds the target level by 2 times (3,1±0,9 mmol/l); 88% of participants do not achieve the goal of lipidemic control calculated according to regulatory criteria; biguanides predominate in the structure of drug therapy (55,8%). For elderly patients with DM2, diseases associated with increased cardiovascular risk pose the greatest danger; insufficient detection of dyslipidemia in conditions of limited outpatient admission may be due to the complexity of the algorithm for stratifying lipid control goals; the use of digital tools allows to identify reserves for prescribing lipid-lowering and hypoglycemic therapy and optimize the trajectory of drug treatment if the target values of biomarkers of clinical and metabolic control; to focus the doctor's attention on the priority task of increasing the effectiveness of evidence-based risk management.

Type 2 diabetes mellitus (T2DM) is increasingly prevalent among young adults and is associated with early cardiovascular complications, including diabetic cardiomyopathy and left ventricular diastolic dysfunction. Early identification of subclinical cardiac dysfunction may facilitate risk stratification and clinical evaluation of cardiovascular involvement. The present study aimed to assess left ventricular diastolic function and its association with glycemic control and duration of diabetes in young adults with T2DM using echocardiography.

This hospital-based cross-sectional observational study was conducted in the Department of Cardiology at Meenakshi Medical College Hospital and Research Institute, Kanchipuram, Tamil Nadu, over a period of 12 months. A total of 150 young adults aged less than 40 years with T2DM were enrolled. Detailed clinical evaluation, biochemical investigations, and two-dimensional transthoracic echocardiography were performed in all participants. Echocardiographic assessment included left ventricular mass, interventricular septal thickness, E/A ratio, E/e' ratio, and ejection fraction. Left ventricular diastolic dysfunction was graded according to available standard echocardiographic criteria.

The mean age of the study population was 34.8 ± 4.2 years, with males constituting 88 (58.7%) participants. Left ventricular diastolic dysfunction was observed in 68 (45.3%) participants, with Grade I dysfunction being the most common abnormality (48 (32.0%)). The mean E/A ratio was reduced (1.02 ± 0.28), while the E/e' ratio was elevated (11.2 ± 2.6), suggestive of impaired diastolic function. Significant associations were observed between diastolic dysfunction and poor glycemic control (χ²=16.84, p<0.001) and longer duration of diabetes (χ²=12.31, p=0.002).

Young adults with T2DM demonstrated a high frequency of subclinical left ventricular diastolic dysfunction despite preserved systolic function. Poor glycemic control and longer duration of diabetes were significantly associated with diastolic dysfunction. Given the cross-sectional design of the study, these findings should be interpreted as associations rather than causal relationships. Further prospective studies are required to determine the clinical significance and prognostic implications of these findings.

Tirzepatide, a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, induces significant weight loss and glycemic improvement. Dopaminergic pathways are critically involved in appetite regulation and reward processing, and the pharmacological modulation of dopamine signaling may influence metabolic responses to incretin-based therapies. We report the case of a 54-year-old woman with obesity and newly diagnosed type 2 diabetes mellitus (T2DM) who initiated tirzepatide therapy while receiving levosulpiride for functional dyspepsia. During the co-administration of tirzepatide 5 mg weekly and levosulpiride, only modest weight reduction was observed, followed by a plateau. After the discontinuation of levosulpiride and the titration of tirzepatide to 7.5 and 10 mg weekly, a marked and progressive reduction in body weight occurred, with an overall loss of 11 kg from baseline. Glycemic control improved substantially (glycated hemoglobin {HbA1c}: 5.0%), and no episode of pancreatitis occurred despite asymptomatic lipase elevation. This case raises the hypothesis of a potential pharmacodynamic interaction between dopaminergic antagonism and incretin receptor agonism, possibly mediated by opposing effects on gastric motility and central reward pathways. Although causality cannot be established, clinicians should consider concomitant neuroactive medications in cases of suboptimal early weight response to dual incretin therapy.

Traditional classifications of atrioventricular nodal reentrant tachycardia (AVNRT) based on cardiac symptomatology, electrocardiographic findings, and reentrant circuits do not capture the full heterogeneity of AVNRT.

This study sought to identify distinct phenotypes among patients with AVNRT by using two-step cluster analysis and to determine differential effects of phenotypes on clinical and procedural outcomes.

All patients (n = 305) underwent catheter ablation and ajmaline challenge testing. A two-step cluster analysis was conducted using 17 demographic/clinical, anthropometric, electrocardiographic, echocardiographic, and anatomic variables.

Three distinct clinically and mechanistically relevant clusters were identified. Cluster 1 (Metabolic/Structural Phenotype, n = 44) patients were characterized by older age of onset of AVNRT (53.5 ± 8.5, 43.5 ± 15, and 24.7 ± 10.5 years, p = 4.9 × 10^-31), shorter distance between coronary sinus floor and His bundle potential (22.7 ± 6.1, 24.7 ± 6.8, and 29 ± 7.5 mm, p = 1.3 × 10^-7), higher prevalence of "correlated" (diagnosed ≥ 4 years before AVNRT onset) type 2 diabetes (100%, 0%, and 0%, p = 5.9 × 10^-67) and "correlated" (diagnosed ≥ 6 years before AVNRT onset) structural heart disease (86.4%, 100%, 0%, p = 3.5 × 10^-62) compared to Cluster 2 (Structural Phenotype, n = 78) and Cluster 3 (Anatomic/Genetic Phenotype, n = 183) patients, respectively. Cluster 1 patients had higher prevalence of "pro-arrhythmia" (new-onset and/or symptom worsening/intolerance) with anti-arrhythmic therapy and/or non-cardiac drugs (74.2%, 46.5%, and 31.6%, p = 1.5 × 10^-4), AH prolongation/AV-VA block (20.5%, 7.7%, and 2.2%, p = 8.9 × 10^-5) and aborted ablation (11.4%, 1.3%, and 0%, p = 8.6 × 10^-5) during EP study compared to Clusters 2 and 3 patients, respectively.

Phenomapping identified three clinically and mechanistically relevant phenotypes of AVNRT associated with clinical and procedural outcomes, underscoring the considerable heterogeneity of AVNRT and the importance of comorbidities and substrates.

To identify the optimal 2-h glucose reduction and baseline level for preventing progression from impaired glucose tolerance to type 2 diabetes using meta-regression.

We systematically reviewed randomized clinical trials of lifestyle modifications and/or anti-hyperglycemic medications reporting both 2-h glucose and diabetes prevention in impaired glucose tolerance. PubMed (1997), Cochrane Library (1995), and Ichushi-Web (Japanese medical literature database; 2000) were searched from inception through January 26, 2025. A meta-regression model examined log-transformed hazard ratios for diabetes progression, with 2-h glucose reduction and baseline level as predictors.

From 1372 candidates, 32 studies (n = 33,839 participants) were analyzed. The model indicated linear relationship and the early intervention at a baseline 2-h glucose of 140 mg/dL (7.8 mmol/L) could prevent 44% of diabetes with only a 10 mg/dL (0.56 mmol/L) reduction. Conversely, later interventions at a baseline 2-h glucose of 170-190 mg/dL (9.4-10.6 mmol/L) require larger 2-h glucose reductions of 20-30 mg/dL (1.1-1.7 mmol/L) for similar preventive effects (40-42%); which may necessitate pharmacotherapy.

This meta-regression analysis demonstrates that early and minimal interventions for impaired glucose tolerance are optimal, suggesting that its timely detection is vital for diabetes prevention.

High-dose trimethoprim-sulfamethoxazole (TMP-SMX) combined with corticosteroids is the first-line treatment for severe Pneumocystis jirovecii pneumonia (PJP) in HIV patients but carries a risk of severe hyperkalemia and muscle weakness.

We report a 56-year-old male with advanced HIV (CD4: 14 cells/μL) and type 2 diabetes mellitus, treated for PJP with TMP-SMX 20 mg/kg/day and methylprednisolone 80 mg/day. On day 10 of treatment, the patient developed severe muscle weakness and life-threatening hyperkalemia (8.2 mmol/L) unresponsive to medical management, requiring emergency intermittent hemodialysis (IHD). After one hemodialysis session and switching to clindamycin-primaquine, potassium levels normalized within 2 days, and muscle weakness gradually improved and resolved after 4 days. The patient was discharged in a stable condition after 21 days of treatment.

This case represents a rare clinical complication with extremely severe hyperkalemia (8.2 mmol/L) accompanied by muscle weakness, likely due to the synergistic effect of hyperkalemia and steroid myopathy. Hemodialysis is an effective and safe intervention for hyperkalemia unresponsive to medical management. Close monitoring of electrolytes and muscle function is crucial in patients receiving high-dose TMP-SMX in combination with corticosteroids, particularly during the first 10 days of treatment.