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MODERN SURGICAL STRATEGIES IN DRUG-RESISTANT EPILEPSY: RESECTION OF EPILEPTIC FOCI, MINIMALLY INVASIVE METHODS, AND NEUROSTIMULATION
No full textIntroduction: Drug-resistant epilepsy (DRE) affects approximately one-third of patients with epilepsy and represents a significant clinical challenge. When adequate seizure control cannot be achieved with antiseizure medications, alternative therapeutic strategies, including surgical and neuromodulatory approaches, must be considered to reduce seizure burden and improve quality of life.
Methodology: This review is based on an analysis of contemporary scientific literature focusing on surgical, minimally invasive, and neuromodulation-based treatments for drug-resistant epilepsy. Studies published in recent years were reviewed to evaluate treatment efficacy, safety profiles, and long-term outcomes.
Results: Resective surgery, particularly anterior temporal lobectomy and selective amygdalohippocampectomy, remains one of the most effective treatment for appropriately selected patients, achieving long-term seizure freedom in approximately 60–70% of cases. Minimally invasive techniques such as laser interstitial thermal therapy (LITT) and stereotactic radiosurgery (Gamma Knife) offer favorable seizure outcomes with reduced morbidity and shorter hospitalization. Neuromodulation methods, including vagus nerve stimulation, responsive neurostimulation, and deep brain stimulation, provide significant seizure reduction and improved quality of life in patients who are not candidates for resective surgery.
Conclusion: The management of drug-resistant epilepsy requires an individualized, multidisciplinary approach. Advances in minimally invasive surgery and neuromodulation expand therapeutic options, allowing for tailored treatment strategies that balance efficacy and safety. Continued research and technological development remain essential to optimize outcomes for patients with DRE
DIAGNOSTIC CHALLENGES AND CARE PATHWAYS IN YOUNG-ONSET DEMENTIA – A NARRATIVE REVIEW
No full textYoung-onset dementia (YOD), defined as the onset of dementia symptoms before the age of 65, is a clinically and diagnostically complex condition that significantly impacts patients and families during peak social and economic stages of life. Compared to late-onset dementia, YOD more frequently presents with atypical features such as personality changes, executive dysfunction, psychiatric symptoms, or language impairments, often leading to delayed diagnosis and misclassification as primary psychiatric disorders. This narrative review provides a comprehensive overview of current evidence on the etiology, clinical presentation, diagnostic workup, and management of YOD. Alzheimer’s disease and frontotemporal dementia are the most common neurodegenerative causes, though a broad differential including autoimmune, infectious, metabolic, and hereditary disorders must be considered. Improving clinician awareness and access to age-appropriate diagnostic services is critical to reducing diagnostic delays and improving quality of life for individuals affected by YOD.
Aim of study: The aim of this study is to provide a comprehensive and updated overview of YOD, focusing on its diverse etiologies, clinical presentations, diagnostic challenges, and current management strategies. By synthesizing evidence from recent literature, the study seeks to offer practical guidance for clinicians in improving the timely recognition, differential diagnosis, and multidisciplinary care of individuals affected by YOD
THE ROLE OF NASAL BREATHING IN SLEEP OPTIMIZATION: A CLINICAL ANALYSIS OF THE EFFICACY AND RISKS OF THE MOUTH TAPING METHOD
No full textBackground. Nasal breathing is obligatory for maintaining airway patency, humidifying and delivering Nitric Oxide (NO). In contrast, mouth breathing increases airway resistance and leads to significant nocturnal dehydration and sleep fragmentation. Nocturnal Mouth Taping (NMT) has gained popularity as a tool to enforce the nasal route.
Aim. To explore the physiological advantages of nasal respiration, and to study the clinical effect and safety for mouth taping approach.
Materials and Methods. A narrative review of 20 peer-reviewed sources (2003–2025) was conducted using databases such as PubMed, Scopus, and Google Scholar, focusing on respiratory physiology and clinical outcomes of nocturnal mouth taping.
Results. In mild OSA (Obstructive Sleep Apnea) patients NMT reduces significantly Apnea/Hypopnea Index (from 8.3 to 4.7 events/h) and snoring (by47%). However, it is ineffective for moderate-to-severe OSA, where "mouth puffing" indicates persistent airway collapse despite mechanical lip closure.
Conclusions. The existing evidence is inadequate for clinical use of NMT. The practice is explicitly discouraged for the general population, especially those with moderate-to-severe OSA or nasal obstructions, due to life-threatening risks of asphyxiation and aspiration. NMT cannot replace medical treatment and potentially dangerous delay of appropriate surgery may occur for underlying anatomical pathologies
THE DAWN PHENOMENON AND GLYCEMIC VARIABILITY MEASURED WITH CONTINUOUS GLUCOSE MONITORING
No full textThe dawn phenomenon (DP), defined as an early-morning rise in glucose unrelated to preceding nocturnal hypoglycemia, represents a significant yet often underrecognized contributor to fasting hyperglycemia and overall glycemic instability in individuals with diabetes. The expansion of continuous glucose monitoring (CGM) technologies over the past decade has enabled more precise characterization of nocturnal glucose patterns, offering new insights into the prevalence, magnitude, and clinical implications of DP across diverse glycemic states. This review synthesizes original observational, retrospective, and prospective studies published between 2010 and 2025 that used CGM to evaluate DP in type 1 diabetes, type 2 diabetes, impaired glucose tolerance, and non-diabetic populations. Data extraction focused on DP definitions, nocturnal glucose trajectories, glycemic variability metrics, associations with HbA1c and time-in-range, and emerging evidence linking severe DP to adverse clinical outcomes.
Findings indicate that DP is highly prevalent in both type 1 and type 2 diabetes, with magnitude varying widely depending on residual β-cell function, insulin sensitivity, and methodological differences in CGM-based definitions. DP correlates with increased total glucose exposure and greater glycemic variability, and may influence long-term metabolic risk. Understanding DP within the context of CGM-derived metrics is essential for optimizing individualized therapeutic strategies and improving morning glycemic control. Further standardized research is required to unify definitions and clarify the prognostic significance of DP
MODERN BIOLOGICAL TREATMENT METHODS FOR ALOPECIA AREATA: A COMPREHENSIVE REVIEW
No full textIntroduction: Alopecia areata (AA) is a chronic, immune-mediated hair-loss disorder driven by cytotoxic T-cell activation and loss of hair-follicle immune privilege. Janus kinase (JAK) inhibitors and emerging targeted biologics have reshaped treatment options for moderate-to-severe AA. This review compared three approved JAK-based therapies (ritlecitinib, baricitinib, deuruxolitinib) and summarized evidence on investigational biologic agents.
Materials and Methods: This narrative review was based on a structured search of PubMed and Google Scholar for English-language publications available up to 2025. Search terms included “alopecia areata,” “biologic therapy,” “JAK inhibitors,” “ritlecitinib,” “baricitinib,” “deuruxolitinib,” and “immunomodulation.” Phase 2 and 3 trials, early-phase studies, observational research, and review articles were screened. Full texts were assessed to extract information on mechanisms of action, JAK-isoform selectivity, clinical efficacy measured by SALT outcomes, safety, and emerging therapeutic strategies.
Results: All three JAK inhibitors showed significant efficacy compared with placebo but differed in selectivity and response dynamics. Ritlecitinib (JAK3/TEC) demonstrated a rapid onset of action and a favorable safety profile. Baricitinib (JAK1/2) produced gradual, sustained improvement supported by extensive long-term data. Deuruxolitinib (JAK1/2/TYK2) achieved high SALT ≤20 response rates across THRIVE-AA trials. Emerging biologics such as bempikibart (anti–IL-7Rα) and early investigational agents (ALD-102, DR-01) showed preliminary efficacy, though evidence remains limited by short follow-up and lack of predictive biomarkers.
Conclusions: JAK inhibitors constitute a major therapeutic advance for moderate-to-severe AA, providing meaningful clinical benefit with acceptable safety. Novel biologic agents may offer more selective and durable immune modulation. Long-term studies and development of precision-medicine approaches will be essential to optimize future AA management
ZINC AND HUMAN HEALTH: IMPLICATIONS OF ZINC DEFICIENCY IN IMMUNE, GASTROINTESTINAL, DERMATOLOGICAL, AND METABOLIC DISORDERS
No full textZinc is an essential trace element involved in key biological processes, including enzymatic activity, gene expression, and immune regulation. Zinc deficiency remains a relevant health issue in specific populations and has been associated with the development and progression of several disease states.
This narrative review summarizes current evidence on the role of zinc in selected immune-related, gastrointestinal, dermatological, and metabolic disorders. Data from clinical and observational studies are discussed in relation to disease-specific outcomes, dosage, formulation, and population characteristics. The aim of this review is to provide an evidence-based overview of the clinical relevance of zinc supplementation in the context of human health and disease.
Methodology: This narrative review was conducted using a structured literature search to identify and analyze scientific publications addressing the role of zinc in human health and disease. The PubMed and Google Scholar databases were searched for relevant articles.
The search strategy included the following keywords: “zinc”, “zinc supplementation”, “zinc deficiency”, “human health”, “immune function”, “gastrointestinal disorders”, “dermatological conditions”, and “metabolic disorders”. Additional publications were identified through manual screening of reference lists of selected articles.
Clinical studies, observational studies, and relevant reviews published in English were considered for inclusion based on their relevance to the selected disease states and clinical outcomes
THE NATIONAL APPLICATION OF FOREIGN LAW
No full textWhen a dispute is brought before a judge which is related to a legal relation in the field of private law, and includes a foreign element, the judge looks for the most appropriate law to govern the dispute. In this area, the legislator gives the judge, as an exception, the possibility to apply a foreign law instead of his own law, when the rules of reference (conflict rules) established by the legislator direct him to that. Here, a jurisprudential theory appeared, trying to put a legal basis upon which it is possible to rely when the national judge applies the foreign law
DIGITAL COGNITIVE-BEHAVIORAL THERAPY FOR INSOMNIA: SAFETY, LIMITATIONS, AND PATIENT-SPECIFIC CONTRAINDICATIONS
No full textIntroduction & objective: Insomnia is a well-established clinical problem that places a burden on the healthcare system. Due to low accessibility to professional therapists, high costs, and geographical barriers, cognitive-behavioural therapy, which is a first-line treatment for insomnia, is rarely prescribed in clinical practice. The development of digital CBT-I was aimed at overcoming those issues. However, there is still limited data regarding the safety and implementation of dCBT-I in real-life settings. Our aim was to select a specific patient group in which the traditional approach to CBT-I is preferred/advised.
Review methods: This review is based on a non-systematic review of PubMed articles published between 2015 and 2026.
Brief description of state knowledge: In numerous studies, dCBT-I has been proven to be an effective alternative to face-to-face therapy. It can be delivered in several technological forms and may vary in the level of therapist oversight. Although each form of digital CBT-I is to some extent automated, fully automated platforms raise the greatest concerns regarding safety and patient outcomes. Thus, some research suggests that there are patients for whom face-to-face therapy would be advisable.
Summary: Digital CBT‑I with therapist oversight may be particularly important for patients with psychiatric disorders, epilepsy, obstructive sleep apnea, safety‑critical occupations, and older adults; however, limited real‑world safety data highlight the need for further research to better define high‑risk groups and refine clinical guidelines
CRSTDLA-ARAFREQ: AN ARABIC LEXICAL DATABASE FOR SPEECH-LANGUAGE ASSESSMENT IN ALGERIAN PRIMARY SCHOOLS
No full textLexical databases are increasingly recognized as indispensable resources for both speech-language pathology and education. This paper presents CRSTDLA-Arafreq, the first Modern Standard Arabic lexical database specifically constructed from Algerian textbooks (Preschool to Grade 3), integrating written and oral frequencies as well as student productions. While such tools enable clinicians to design sensitive assessments and support teachers in selecting age-appropriate materials, Algeria has lacked a reference database tailored to its specific school and clinical contexts.
To address this gap, the CRSTDLA-Arafreq project was launched at the Scientific and Technical Research Center for the Development of the Arabic Language. Conducted over three years by a multidisciplinary team, the project provides a robust, evidence-based lexical resource grounded in authentic Algerian primary school corpora to support inclusive education and validated diagnostic instruments
LEGAL FRAMEWORK FOR CORPORATE RESTRUCTURING AND GOVERNANCE
No full textGovernance has emerged as a central concern for both developed and developing countries, driven by global transformations and recurring economic crises over recent decades. In response, increasing attention has been directed toward governance frameworks as essential tools for creating an effective economic environment capable of confronting future challenges—an outcome that can only be achieved through the implementation of clear procedures and regulations. This study seeks to examine governance by exploring its conceptual foundations and practical mechanisms, while also highlighting its core principles and its role in corporate restructuring. Through an analysis of both the theoretical and procedural dimensions of governance, the research emphasizes its critical importance in promoting transparency, accountability, and sustainable organizational