Given the widespread use of dietary supplements (DS) and herbal products (HP), healthcare professionals (HCPs) will increasingly encounter patients who use these preparations with conventional drugs and who need their services to reduce the consequences of adverse therapeutic outcomes. The aim of our survey was to assess the knowledge and behaviors of HCPs regarding the risk of potential drug–dietary supplement (DDSIs) and drug–herbal product (DHPIs) interactions. This cross-sectional survey collected data via on paper-based questionnaire among general practitioners (GPs) (n = 105), specialty doctors (n = 87) and nurses (n = 154). The HCPs were mostly familiar with the interaction of doxycycline with magnesium (83%) and were least familiar with interaction of warfarin with glucosamine (14%). The results on DDSIs and DHPIs knowledge showed that GPs scored significantly higher than nurses (p < 0.001 and p = 0.003, respectively), while specialty doctors scored significantly higher than nurses only on DDSIs knowledge (p < 0.001). Only 28% of respondents reported that they often or always ask patients on drug therapy about the use of DS or HP, and 25% of respondents record such data in the medical documentation of patients. Our results showed that HCPs have sufficient knowledge about most major DDSIs and DHPIs, but insufficient knowledge about most moderate interactions. However, their overall knowledge and behavior regarding the risk of these interactions indicate the need for further continuing education and training.

Background: Cephalosporins are considered safe antibiotics. However, serious hematological abnormalities may occur, although rarely, after their therapeutic use. Case Presentation: We present a case of pancytopenia in a 72-year-old female patient treated with ceftriaxone for a urinary tract infection. After five days of therapy, pancytopenia was observed. Other causes were excluded through extensive diagnostic evaluation, including immunological tests, viral serologies, bone marrow aspiration, and peripheral blood smear. The patient’s clinical condition significantly improved following the discontinuation of ceftriaxone and the administration of granulocyte colony-stimulating factor (G-CSF). Bone marrow findings revealed hypocellularity without malignant infiltration, and peripheral smear showed no dysplasia, blasts, or hemolysis. Conclusions: This case demonstrates that ceftriaxone, although widely regarded as a safe antibiotic, can induce rare but serious hematologic complications such as pancytopenia. A high index of suspicion is required when patients on antibiotic therapy develop unexplained cytopenias. Detailed medication history, exclusion of other causes, and prompt discontinuation of the suspected drug are essential. The patient’s favorable outcome supports the likelihood of an idiosyncratic, immune-mediated mechanism. Future research should explore pharmacogenomic screening in patients at increased risk, particularly involving HLA variants.

Photobiomodulation (PBM) may improve diabetic wound repair, but the temporal relationship between local angiogenic signaling and tissue-level healing remains incompletely defined. We examined previously unreported tissue vascular endothelial growth factor (VEGF) and histopathological outcomes from 72 ulcer-bearing male Wistar rats from a previously reported experimental cohort, using a balanced 2 × 2 × 3 design comprising metabolic status, PBM treatment, and healing day (3, 7, or 10; n = 6 per cell). Tissue VEGF was quantified by ELISA and normalized to total protein; histopathological outcomes included exploratory inflammation/injury and tissue repair composite scores. In the factorial log-VEGF model, diabetes × day (p = 0.0017) and LLLT × day (p = 0.0010) interactions demonstrated phase-dependent responses. On day 3, PBM-treated animals had an adjusted VEGF ratio of 2.13 versus untreated animals (95% CI 1.63–2.78; Holm-adjusted p < 0.001), whereas diabetic animals had lower VEGF than healthy animals (ratio 0.50, 95% CI 0.39–0.66; adjusted p < 0.001). VEGF concentrations converged by day 10. PBM remained associated with a higher exploratory tissue repair score after adjustment for healing day, diabetes status, and contemporaneous VEGF, whereas VEGF itself was not independently associated with repair. These findings demonstrate phase-dependent differences in tissue VEGF and suggest that contemporaneous VEGF concentrations do not fully explain treatment-associated variation in exploratory histopathological repair scores.

Background/Objectives: Inflammatory indices are increasingly studied in heart failure (HF), but direct comparisons remain limited. We compared eight indices across New York Heart Association (NYHA) classes and assessed the leading indices against N-terminal pro-B-type natriuretic peptide (NT-proBNP). Methods: This analysis included 85 patients with established HF. The systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-HDL ratio (NHR), lymphocyte-to-HDL ratio (LHR), monocyte-to-HDL ratio (MHR), platelet-to-HDL ratio (PHR), and uric acid-to-HDL ratio (UHR) were evaluated using group comparisons, Spearman correlations, ordinal logistic regression, and multivariable models for NYHA III/IV versus I/II. Primary multivariable models used a parsimonious adjustment set comprising age, smoking status, and HF duration, while broader covariate adjustment was examined in sensitivity analyses. Internal validation used 1000 bootstrap resamples. Results: NHR and PHR differed across NYHA classes after FDR correction. In parsimoniously adjusted ordinal models, SII, SIRI, NLR, NHR, MHR, and PHR were associated with increasing NYHA class after FDR correction. In the NYHA III/IV versus I/II analysis, only NHR (OR per doubling 2.01, 95% CI 1.19–3.39) and MHR (OR 1.96, 95% CI 1.17–3.25) remained significant after FDR correction (q = 0.022 for both). AUCs were 0.688 for the reference model, 0.775 with NHR, 0.777 with MHR, and 0.978 with NT-proBNP. Bootstrap optimism-corrected AUCs were 0.739 for NHR, 0.739 for MHR, and 0.969 for NT-proBNP. Neither ratio improved model fit beyond NT-proBNP. Conclusions: NHR and MHR showed the most consistent adjusted associations with NYHA-defined symptomatic severity and remained robust across sensitivity analyses. They should be viewed as compact routine inflammatory-metabolic indices rather than independent biomarkers or replacements for NT-proBNP. External and prospective longitudinal validation is warranted.

Cephalosporins are considered safe antibiotics. However, serious hematological abnormalities may occur, although rarely, after their therapeutic use. We present a case of pancytopenia in a patient treated with ceftriaxone, where, after ruling out other potential causes through extensive diagnostic evaluation, an idiosyncratic drug reaction was established. The patient's clinical condition significantly improved following the discontinuation of ceftriaxone and the administration of filgrastim. This case highlights the importance of recognizing the potential for rare but serious hematologic adverse effects associated with commonly used antibiotics such as ceftriaxone. Early identification and prompt management of these adverse effects are critical to ensure optimal patient outcomes and prevent serious complications.