Kyriacos Felekkis

Background: Cancer survivors face heightened risks of recurrence and persistent cancer-related fatigue (CRF), both of which impair quality of life. The Mediterranean Diet (MD), characterized by its antioxidant and anti-inflammatory profile, has been proposed as a potentially beneficial dietary pattern. This systematic review and meta-analysis evaluated the association between post-diagnosis MD adherence and outcomes of cancer recurrence and CRF among adult survivors, with particular attention to colorectal cancer. Methods: Systematic searches of PubMed, CINAHL, and the Cochrane Library (January 1995–May 2024) identified prospective cohort studies and randomized controlled trials (RCTs) reporting post-diagnosis MD adherence. Primary outcomes were cancer recurrence and CRF. Random-effects models were applied for recurrence analyses due to anticipated heterogeneity, while a fixed-effects model was used for CRF given the limited number of trials. Heterogeneity was assessed using the I² statistic. Risk of bias was evaluated using the Cochrane RoB 2 tool (RCTs) and ROBINS-I (cohort studies). This review was registered in PROSPERO (CRD420251248086). Results: Eight studies met inclusion criteria: six prospective cohort studies assessed recurrence (n = 6697), and two RCTs assessed CRF (n = 76). For recurrence, higher post-diagnosis MD adherence was associated with a lower hazard of recurrence or cancer-specific mortality (HR = 0.83; 95% CI: 0.70–0.99; I² = 49%). For CRF, the pooled effect from two independent RCTs showed no statistically significant overall effect (MD = 0.29; 95% CI: −0.58 to 1.16). Both outcomes were limited by small study numbers and methodological heterogeneity. Conclusions: Higher adherence to the Mediterranean Diet after cancer diagnosis was associated with recurrence-related outcomes in observational studies, while evidence for CRF remains exploratory and statistically imprecise. Larger, adequately powered randomized trials are needed to clarify the role of the Mediterranean Diet in survivorship care.

The dynamic transcriptomic landscape of the human genome, comprising both coding and non-coding RNA (ncRNA) transcripts, serves as a molecular fingerprint of cellular and tissue-specific physiological states

Biomarkers are measurable biological molecules that reflect normal physiological processes, pathological states, or responses to environmental exposures and therapeutic interventions

Heart failure (HF) is a leading cause of morbidity and mortality worldwide, underscoring the need for improved diagnostic, prognostic, and therapeutic strategies. Circulating microRNAs (c-miRNAs) have emerged as promising non-invasive biomarkers due to their stability, tissue specificity, and regulatory roles in cardiac pathophysiology. This review highlights the potential of c-miRNAs in enhancing HF diagnosis, risk stratification, and therapeutic monitoring, particularly when integrated with conventional biomarkers such as natriuretic peptides, galectin-3, soluble ST2, and high-sensitivity troponins. We explore the roles of key miRNAs in HF pathogenesis—including cardiac hypertrophy, fibrosis, inflammation, apoptosis, and vascular remodeling—and discuss their diagnostic and prognostic significance. The potential of multi-analyte liquid biopsy approaches that combine c-miRNAs with protein biomarkers is also examined within the context of precision medicine. Despite promising data, challenges related to standardization, assay variability, and clinical validation remain. Addressing these gaps through harmonized protocols and large-scale studies will be essential for translating c-miRNAs into routine HF management.

Cardiovascular diseases (CVDs) are the leading global cause of early mortality and disability, characterized by their complex, multifactorial nature, which demands personalized diagnostic and therapeutic strategies. Current diagnostic methods for CVDs, while essential, have limitations in sensitivity, specificity, and real-time monitoring, which can impede early and accurate disease detection. Biomarkers emerge as pivotal tools for the enhanced diagnosis and management of CVDs, yet the challenges in their discovery and validation persist. Integrating artificial intelligence with omics technologies promises to revolutionize this field by significantly improving the precision and speed of biomarker discovery. This innovative approach, merging the analysis of genetic variants with expression patterns linked to specific phenotypes, holds the potential to uncover novel biomarkers and facilitate the stratification of patient groups based on individual risk factors, thereby advancing personalized medicine in cardiovascular care.

Many studies have shown that COVID-19 caused many problems in mental health. This paper presents the results of the Cyprus sample, part of the global initiative named “The Collaborative Outcomes Study on Health and Functioning during Infection Times” (COH-FIT). Methods: The study took place from April 2019 to January 2022, using the Greek version of the online standard COH-FIT questionnaire on 917 Cypriot adults. Weighted t-tests were applied to test the differences between pre-pandemic and intra-pandemic scores using the anesrake package. Results: Participant responses indicated a significant negative impact of the pandemic on measures of mental health (−7.55; 95% CI: −9.01 to −6.07), with worsening in the scores for anxiety (12.05; 95% CI: 9.33 to 14.77), well-being (−11.06; 95% CI: −12.69 to −9.45) and depression (4.60; 95% CI: 2.06 to 7.14). Similar negative effects were observed for feelings of anger (12.92; 95% CI: 10.54 to 15.29), helplessness (9.66; 95% CI: 7.25 to 12.07), fear (22.25; 95% CI: 19.25 to 25.26), and loneliness (12.52; 95% CI: 9.94 to15.11). Increased use of social media (0.89; 95% CI: 0.71 to 1.09), internet (0.86; 95% CI: 0.67 to 1.04), and substance consumption (0.06; 95% CI: 0.00 to 0.11) were reported, along with a significant decrease in physical health (−3.45; 95% CI: −4.59 to −2.32), self-care (−7.10; 95% CI: −9.00 to −5.20), and social function (−11.27; 95% CI: −13.19 to −9.35), including support (−0.72; 95% CI: −1.09 to −0.34) and family function (−7.97; 95% CI: −9.90 to −6.05). Conclusions: The COVID-19 pandemic significantly affected the daily life and emotional well-being of Cypriots. Identifying factors that influence vulnerability and resilience is essential to prioritize mental health support and address the long-term effects of the pandemic.

The potential of liquid biopsy for the prognosis and diagnosis of diseases is unquestionable. Within the evolving landscape of disease diagnostics and personalized medicine, circulating microRNAs (c-miRNAs) stand out among the biomarkers found in blood circulation and other biological fluids due to their stability, specificity, and non-invasive detection in biofluids. However, the complexity of human diseases and the limitations inherent in single-marker diagnostics highlight the need for a more integrative approach. It has been recently suggested that a multi-analyte approach offers advantages over the single-analyte approach in the prognosis and diagnosis of diseases. In this review, we explore the potential of combining three well-studied classes of biomarkers found in blood circulation and other biofluids—miRNAs, DNAs, and proteins—to enhance the accuracy and efficacy of disease detection and monitoring. Initially, we provide an overview of each biomarker class and discuss their main advantages and disadvantages highlighting the superiority of c-miRNAs over the other classes of biomarkers. Additionally, we discuss the challenges and future directions in integrating these biomarkers into clinical practice, emphasizing the need for standardized protocols and further validation studies. This integrated approach has the potential to revolutionize precision medicine by offering insights into disease mechanisms, facilitating early detection, and guiding personalized therapeutic strategies. The collaborative power of c-miRNAs with other biomarkers represents a promising frontier in the comprehensive understanding and management of complex diseases. Nevertheless, several challenges must be addressed before this approach can be translated into clinical practice.

This systematic review aimed to identify different gut microbiome profiles across the human lifespan and to correlate such profiles with the body composition. PubMed, Scopus, and Cochrane were searched from inception to March 2022. Sixty studies were included in this systematic review. Overall, the gut microbiome composition in overweight participants exhibited decreased α-diversity, decreased levels of the phylum Bacteroidetes and its taxa, and increased levels of the phylum Firmicutes, its taxa, and the Firmicutes/Bacteroidetes ratio, in comparison to normal-weight participants. Other body composition parameters showed similar correlations. Fat mass and waist circumference were found to correlate positively with the Firmicutes taxa and negatively with the Bacteroidetes taxa. In contrast, lean body mass and muscle mass demonstrated a positive correlation with the Bacteroidetes taxa. Notably, these correlations were more pronounced in athletes than in obese and normal-weight individuals. The composition of the gut microbiome is evidently different in overweight individuals or athletes of all age groups, with the former tending towards decreased Bacteroidetes taxa and increased Firmicutes taxa, while a reversed relationship is observed concerning athletes. Further studies are needed to explore the dynamic relationship between energy intake, body composition, and the gut microbiome across the human lifespan.

In vitro glucose uptake in yeast cell facilitated by Abelmoschus esculentus L. (okra seed) for management of type 2 diabetes was studied. Plant material was collected, identified, processed, and stored for further use. 80% methanol was employed for extraction and sonicated to release antidiabetic-bioactive component in solution and was filtered, concentrated, freeze-dried, and fractionated using standard techniques. Glucose uptake at an initial concentration of 5mM/L and 10mM/L by the crude extract was consistent to that of the known standard drug while at 25mM/L glucose concentration was equivalent with the crude extract. Also, at 0.625 mg/mL the linear equations, and R2 demonstrations that the crude extract was higher in dose predictability than the standard drug as presented by the equation; y = 35.754x - 57.822, and R² = 0.9502 (95%). The extract-fractions were employed to evaluate the ability of yeast cell line culture to take up glucose from the system through DPPH, FRAP, lipid peroxidation and anti-diabetes effect of extract-fraction assays. Extract-fractions were found to poses antioxidant activity high enough to inhibit stress-related diseases. The extract fractions were active as drug candidates both at low and high concentrations and were better compared with the standard drug and standard antioxidant was comparable. The high bioactive extract fractions require encapsulation with a nanoparticle as a drug candidate for type 2 diabetes patients. And an animal trial of the drug candidate may be necessary to monitor the in vivo performances of the extract fractions and subsequent human volunteered trial.

Osteoarthritis (OA) is a prevalent degenerative joint disease characterized by progressive cartilage degradation and joint inflammation. As the most common aging-related joint disease, OA is marked by inadequate extracellular matrix synthesis and the breakdown of articular cartilage. However, traditional diagnostic methods for OA, relying on clinical assessments and radiographic imaging, often need to catch up in detecting early-stage disease or i accurately predicting its progression. Consequently, there is a growing interest in identifying reliable biomarkers that can facilitate early diagnosis and prognosis of OA. MicroRNAs (miRNAs) have emerged as potential candidates due to their involvement in various cellular processes, including cartilage homeostasis and inflammation. This review explores the feasibility of circulating miRNAs as diagnostic and prognostic biomarkers in OA, focusing on knee OA while shedding light on the challenges and opportunities associated with their implementation in clinical practice.