Gallstones are a common digestive disorder whose development is influenced by abnormal liver function, metabolic disorders, and inflammatory states. The albumin-bilirubin (ALBI) score is a comprehensive indicator for assessing liver function and has been widely applied in liver cancer and chronic liver diseases; however, its association with gallstones remains unclear. This study analyzed NHANES data from 2017 to 2020, including 6332 adult participants. Survey-weighted multivariable logistic regression was performed to assess the association between ALBI and gallstone prevalence. Furthermore, the dose-response relationship was examined using restricted cubic spline (RCS) modeling. Subgroup analyses were conducted to assess the robustness of this association across different demographic and clinical strata. In addition, an exploratory mediation analysis was performed to examine whether body mass index (BMI) statistically accounted for part of the observed association between ALBI and gallstone prevalence. Multivariable logistic regression indicated that higher ALBI was associated with higher odds of gallstone prevalence (OR = 2.670, 95% CI: 1.778 - 4.008, P = 0.001). RCS analysis indicated that the relationship between ALBI and gallstones is approximately linear (P-overall < 0.0001, P-nonlinearity = 0.7779). The results of the subgroup analyses were consistent and robust. Exploratory mediation analysis suggested that BMI statistically accounted for 23.95% of the observed association between ALBI and gallstone prevalence in the mediation model. Higher ALBI levels were associated with a higher prevalence of gallstones, showing an approximately linear dose-response pattern. BMI statistically accounted for part of this association in exploratory mediation models, but this finding should not be interpreted as evidence of causal mediation given the cross-sectional design. Because gallstone status was self-reported, these findings should be interpreted with caution. Prospective studies are warranted to clarify temporal relationships, validate these associations, and determine whether ALBI provides clinically meaningful information beyond established gallstone risk factors.

Childhood poisoning is a significant health concern in South Africa (SA), especially in densely populated informal housing settlements where children are frequently exposed to various household poisons. Poisoning accounts for 4 - 5% of paediatric hospital admissions in SA. The most common causes are fuels, pesticides and medicines, although many cases have unidentifiable causes. In this case series, three children, aged 3 - 5 years, were declared dead upon arrival at a public healthcare facility. Prior to death their symptoms included vomiting of a foam-like substance and distress (crying, shaking, fatigue). Postmortem fine-needle liver biopsies were obtained and underwent atmospheric pressure matrix-assisted laser desorption/ionisation mass spectrometry imaging (AP-MALDI-MSI) analysis. MSI analysis identified the presence of naphthalene-associated metabolites, the active component in household mothballs, suggesting death due to accidental ingestion. These cases highlight the urgent need for novel toxicology screening tools to accurately determine causes of death and guide targeted preventive strategies. Strategic efforts are needed to reduce childhood poisoning through robust toxicovigilance to monitor and regulate the sale of toxic substances and enhance access to toxicology testing.

Non-alcoholic fatty liver disease (NAFLD) is strongly linked to systemic low-grade inflammation and adverse dietary exposures. Hematologic indices derived from routine blood counts have emerged as accessible indicators of inflammatory and metabolic imbalance. The white blood cell-to-platelet (WBC/PLT) ratio may reflect immune activation in the context of metabolic liver disease; however, data regarding its association with dietary composition and cardiometabolic markers remain limited. This study aimed to examine whether the WBC/PLT ratio is associated with lipid disturbances and dietary components in adults diagnosed with NAFLD. In a cross-sectional analysis of 256 individuals with NAFLD attending a tertiary referral center, participants were stratified into tertiles according to WBC/PLT values. Anthropometric measurements, biochemical profiles, and complete blood counts were obtained using standardized procedures. Habitual dietary intake was evaluated through a validated food frequency questionnaire. Intergroup comparisons were performed using one-way ANOVA, and generalized linear models were applied to adjust for potential confounders including age, sex, body mass index, total energy intake, smoking status, and physical activity. General demographic and anthropometric variables did not differ significantly across tertiles. However, participants in the highest WBC/PLT tertile exhibited significantly elevated triglyceride (TG) concentrations and reduced high density lipoprotein cholesterol (HDL-C) levels after multivariable adjustment. Higher WBC/PLT values were also associated with lower consumption of vitamins C and E. A progressive rise in leukocyte count accompanied by a decline in platelet count was observed across increasing tertiles (P < 0.001 for both). An elevated WBC/PLT ratio is linked to an unfavorable lipid profile and suboptimal dietary components characterized by low antioxidant intake in individuals with NAFLD. These findings suggest that WBC/PLT may serve as a simple, non-invasive indicator of inflammation-related metabolic risk, potentially influenced by dietary quality.

Von Hippel-Lindau (VHL) disease is a hereditary cancer syndrome predisposing to renal cell carcinoma (RCC), typically considered more indolent than sporadic RCC. The '3 cm rule' has guided nephron-sparing interventions, as tumours smaller than 3 cm rarely metastasise. However, accumulating evidence suggests this paradigm is not universal, with some VHL-associated RCCs demonstrating aggressive biological behaviour despite their small size. We report two cases of aggressive clear cell RCC (ccRCC) in patients with suspected VHL. The first case involved a middle-aged male presenting with bilateral renal tumours, an inferior vena cava tumour thrombus and synchronous liver metastases. He underwent right radical nephrectomy with thrombectomy and contralateral partial nephrectomy, with histopathology confirming ccRCC, WHO/ISUP grade 2, with metastatic deposits. The second case was a young male with a large unilateral renal mass showing sarcomatoid and rhabdoid differentiation, WHO/ISUP grade 4, staged pT3a, consistent with aggressive ccRCC. Both presentations deviated from the traditionally indolent course of VHL-associated RCC, underscoring the heterogeneity of tumour biology. These cases highlight the limitations of strict size-based management, emphasising the importance of vigilant surveillance, histopathological assessment and early genetic evaluation. Recognition of aggressive variants is essential to optimise surgical planning and multidisciplinary management in VHL patients.

Molecular and structural abnormalities triggered by oxidative stress are key determinants of diabetes pathophysiology, and research into natural therapeutic agents targeting these mechanisms is gaining speed. This study aimed to evaluate the effects of Artemisia haussknechtii leaves ethanolic lyophilized and nanoparticle extract forms on glycemic regulation, oxidative stress markers, and tissue integrity in an experimental diabetes model. A total of 48 female rats were divided into six groups; diabetes was induced with 45 mg/kg STZ (i.p.). DYEE and DYNE were administered orally at doses of 50 and 100 mg/kg for 21 days. Weekly fasting glucose and body weight were monitored. At the end of the study, serum biochemistry, erythrocyte and tissue oxidative stress markers (MDA, GSH, CAT, GPx, SOD, GR, TAS, TOS) were analyzed; liver, kidney, and pancreas tissues were evaluated histopathologically. Diabetic rats exhibited persistent hyperglycemia, body weight loss, dyslipidemia, elevated liver and kidney injury biomarkers, increased lipid peroxidation (MDA), and total oxidant status (TOS), accompanied by marked suppression of antioxidant defense systems. Treatment with Artemisia haussknechtii extracts significantly ameliorated these alterations in a dose-dependent manner. Notably, the high-dose nanoparticle formulation (DYNE2) produced the most pronounced improvements, reflected by reduced blood glucose levels, improved lipid profile, normalization of insulin, HbA1c and c-peptide levels, decreased MDA and TOS, and restoration of antioxidant parameters toward control values. Histopathological findings corroborated the biochemical data, demonstrating substantial attenuation of diabetes-induced tissue damage, particularly in the DYNE2 group. Artemisia haussknechtii extract, particularly in its nanoparticle form, has demonstrated antihyperglycemic, antioxidant, and tissue-protective effects in experimental diabetes. The findings suggest that the plant is a promising candidate for complementary treatment against diabetes-related oxidative stress and organ damage.

Titanium (Ti-6Al-4 V) alloys are widely utilized in dental and orthopedic implants for their strength, corrosion resistance, and biocompatibility. However, the oral environment's corrosive conditions can promote ion release, raising concerns regarding potential long-term public health risks. In this investigation, samples of titanium alloy were submerged in artificial saliva for six months to simulate long-term oral exposure. The concentrations of corrosion derived metal ions were subsequently determined using Inductively Coupled Plasma Mass Spectrometry. Cytotoxicity, inflammatory, and apoptotic responses were assessed in fibroblast cell lines. Additionally, an in vivo study in male mice assessed systemic oxidative stress, antioxidant defense mechanisms, and liver and kidney function. Titanium alloy released ions treated cells showed a marked decline in fibroblast viability and a significant elevation (p < 0.05) in pro-apoptotic and inflammatory markers, including Bax, TNF-α, and IL-6, compared with untreated cells. In vivo findings demonstrated significant increases in TBARS and DNA fragmentation, accompanied by a depletion of antioxidant enzymes, particularly in renal tissues. Biochemical evaluation of serum samples demonstrated significant changes in lipid profiles and marked impairments in liver and kidney function. Histopathological assessments confirmed these findings, showing inflammatory infiltration and degenerative changes in hepatic and renal tissues. Overall, ions released from the titanium alloy induced pronounced cytotoxicity accompanied by increased oxidative imbalance and inflammatory reactions, emphasizing the need for developing safer biomaterials and implementing long-term patient monitoring to mitigate chronic complications.

The effects of time-restricted feeding (TRF) on immune responses during bacterial infection are not well-studied. Here, we subjected mice (6-8 weeks, male) to 8 h of TRF for 30 days and then infected them with a low dose of Mycobacterium tuberculosis (Mtb) H37Rv. During the first 15 days, TRF improved glucose tolerance with marginal weight loss. However, global serum and liver metabolomics alongside liver proteomics indicated that TRF perturbed fatty acid biosynthesis and degradation, steroid hormone biosynthesis, and tyrosine metabolism. Together, these results indicate that TRF potentially affected the distribution and functionality of host immune cells. TRF mice had similar mycobacterial burdens in lungs and spleen at 21 days postinfection but had significantly lower CD3[+] T cells in bone marrow and CD4[+] T cells in both bone marrow and lungs. Ultimately, we show that TRF induced changes in amino acid and lipid metabolism persist during Mtb infection.