The tight junction (TJ), a type of cell-cell junction, regulates the permeability of solutes across epithelial and endothelial cellular sheets and is believed to maintain cell polarity. However, recent studies have provided conflicting views on the roles of TJs in epithelial polarity. Membrane proteins, including occludin, claudin, and the junction adhesion molecule, have been identified as TJ components. TJs are predominantly found at the stratum granulosum and stratum corneum. Although it remains unclear whether the disruption of TJs is the cause or consequence of certain dental diseases, evidence suggests that TJ dysfunction may be a crucial factor in gingival epithelial barrier impairment and the progression of oral diseases. Bacterial infection is among the most specific factors we found that may contribute to the breakdown of the epithelial barrier formed by TJs in dental diseases. Bacteria and their products may weaken the epithelial barrier by directly destroying intercellular junctions or altering the expression of junctional proteins. Additionally, they may induce the production of inflammatory cytokines, which could lead to the downregulation of TJ proteins and, consequently, impair the epithelial barrier. This review introduces a novel perspective by exploring, for the first time, the role of TJs dysfunction in the breakdown of the oral epithelial barrier and its potential link to the progression of dental diseases such as gingivitis, periodontitis, Sjӧgren syndrome, and oral squamous cell carcinoma.

BACKGROUND Aging population is a significant issue in Viet Nam and across the globe. Elderly individuals are at higher risk of chronic kidney disease (CKD), especially those with diabetes. Several studies found that the estimated glomerular filtration rate (eGFR) determined using creatinine-based equations was not as accurate as that determined using cystatin C-based equations. Cystatin C-based equations may be beneficial in elderly patients with an age-associated decline in kidney function. Early determination of eGFR decline and associated factors would aid in appropriate interventions to improve kidney function in elderly patients with diabetes. AIM To determine the utility of cystatin C-based equations in early detection of eGFR decline and to explore factors associated with eGFR decline in elderly patients with diabetes. METHODS This cross-sectional study included 93 participants aged ≥ 60 years evaluated in Can Tho University of Medicine and Pharmacy Hospital between October 2022 and July 2023, including 47 and 46 participants with and without diabetes respectively, according to the American Diabetes Association criteria for diabetes. The kappa coefficient, Student’s t, Mann-Whitney, χ 2, Pearson’s correlation, multivariate logistic regression, and multiple linear regression analyses were employed. RESULTS The eGFRs were lower with the cystatin C-based equations than with the creatinine-based equations. Good agreement was found between the Modification of Diet in Renal Disease (MDRD) and CKD Epidemiology Collaboration (CKD-EPI) 2021 creatinine-cystatin C equations (kappa = 0.66). In the diabetes group, 30% of the participants had low eGFR. Both plasma glucose and glycated hemoglobin were associated with an increased risk of eGFR decline (P < 0.05) and negatively correlated with eGFR (P = 0.001). By multivariate logistic regression, total cholesterol, and exercise were independently associated with low eGFR. By multiple linear regression, higher plasma glucose levels were correlated with lower eGFR (P = 0.026, r = -0.366). CONCLUSION Cystatin C-based equations were superior in the early detection of a decline in eGFR, and the MDRD equation may be considered as an alternative to the CKD-EPI 2021 creatinine-cystatin C equation. Exercise, plasma glucose, and total cholesterol were independently associated with eGFR in patients with diabetes.

The escalating global temperature, with 2024 as the hottest year, emphasizes the critical link between climate change and kidney health. Extreme heat, a consequence of global warming, causes multifaceted effects on human physiology, including renal function alterations. This review investigates physiological and molecular mechanisms of heat stress-induced kidney injury, including acute kidney injury, chronic kidney disease (CKD), and urinary stone formation. It highlights how heat stress contributes to renal dysfunction via dehydration, electrolyte imbalances, and activation of the renin-angiotensin-aldosterone system and antidiuretic hormone pathways, particularly in vulnerable populations like outdoor workers, the elderly, and pregnant women. The review also emphasizes the roles of heat shock proteins (HSPs)-HSP27, HSP60, HSP70, and HSP90-in maintaining cellular integrity by preventing protein aggregation and repairing damaged proteins in renal tissues. Dysregulation of these proteins under prolonged heat stress is implicated in CKD progression. This review highlights the urgent need for targeted public health interventions: (1) Hydration; (2) Workplace cooling; (3) Community education; and (4) Developing pharmacological therapies targeting HSPs. A multidisciplinary approach involving nephrology, environmental science, and public health is essential to mitigate the increasing burden of heat-related kidney disease in the era of global climate change.

Objective: This review was conducted to explain how menopausal hormone therapy (MHT) benefits cardiovascular diseases (CVDs) and how to control the risk of breast cancer. Mechanism: Estrogen deficiency, altered energy homeostasis, adipocyte changes, inflammation, and insulin resistance are responsible for the development of metabolic syndrome and CVDs. Estrogen influences hypothalamic function and maintains the energy balance, protecting menopausal women from these cardiovascular risk factors. However, estrogen metabolism plays a crucial role in the genotoxic pathway that leads to breast cancer. Moreover, MHT is associated with cell proliferation and mutation signaling pathways in breast cancer, as well as the process of growing the breast cancer stem cell. Findings in Brief: While MHT may have favorable effects when started early, introducing it later in the course of atherosclerosis may pose major dangers, underlining the importance of timing in hormone therapy. Estrogen-only therapy has a greater favorable effect on CVDs than the estrogen-progesterone combination. Although the connection between MHT and breast cancer is well-documented, significant knowledge gaps remain, especially regarding the long-term effects of newer MHT formulations. Current studies support using the lowest effective dose for the shortest possible duration, with a focus on tailoring therapy to individual risk factors, such as obesity, smoking, and alcohol consumption. Thus, MHT should be customized due to the intricacy of individual risk factors and differences in responses to therapy. Conclusions: Although MHT is effective for controlling CVDs in women entering menopause, it must be used with caution, especially in women at high risk of breast cancer.

Peripheral arterial disease is becoming more common worldwide. In Vietnam, its prevalence is rising due to increasing cases of diabetes and high blood pressure. Rheography is a non-invasive method used to diagnose peripheral arterial disease, but it is not widely used in healthcare centers, especially in the Mekong Delta. This study aims to summarize current rheography knowledge and suggest future research directions. Rheography measures changes in electrical resistance (impedance) in body tissues as blood flow changes. This technique, also known as impedance plethysmography, helps assess blood circulation in the limbs. At Can Tho University of Medicine and Pharmacy Hospital, a rheometer with six electrodes is used to measure these changes. The rheography procedure starts with healthcare professionals explaining the procedure to patients, then body measurements are taken, and the electrodes are positioned based on the examined blood vessels. The results appear as waveforms, which help assess vascular tone (the state of blood vessels) and blood flow intensity, which correspond to different phases of the heartbeat. Rheography is useful in diagnosing blood vessel problems such as peripheral arterial disease, deep vein thrombosis, and cardiac autonomic neuropathy. However, the effectiveness of rheography depends on the expertise of the reader. In addition, certain conditions, such as calf thrombi or nonocclusive proximal clots, are harder to diagnose because these conditions only partially block the blood vessels. Future research should focus on the use of rheography in combination with other diagnostic methods and the effectiveness of this combination in disease scanning.