Genomic score testing is increasingly being integrated into the management of prostate cancer (PCa) to overcome the limitations of traditional clinical and pathological parameters. Genomic tools will represent essential components of precision medicine, supporting risk stratification, therapeutic decision-making, and personalized screening strategies. Genomic score tests can be broadly classified into two main categories: polygenic risk scores (PRSs) and tumor-derived genomic classifiers (GCs). While not yet standard in routine practice, several international guidelines recommend their selective use when results are likely to impact clinical management. PRSs estimate an individual’s susceptibility to PCa based on the cumulative effect of multiple low-penetrance germline genetic variants. These scores show promise in enhancing early detection strategies and identifying men at higher genetic risk who may benefit from tailored screening protocols. Tumor-based GCs assays provide prognostic information that complements conventional clinical and pathological parameters, and are used to guide treatment decisions, including eligibility for active surveillance (AS) or adjuvant therapy after treatment of the primary tumor. This review summarizes and analyzes the current evidence on genomic testing in PCa, with a focus on the available assays, their clinical applications, and their predictive and prognostic value across the disease spectrum. When integrated with clinical and pathological parameters, these tools have the potential to significantly enhance personalized care and should be increasingly considered in routine clinical practice.

Purpose of Review: In approximately 10–15% of patients with prostate cancer (PCa), pathological lymph node metastases (pN1) are detected at radical prostatectomy (RP). The aim of this review is to describe the various treatment options for pN1 patients, with a focus on the most recent evidence reported in the literature. Evidence Synthesis: Due to the lack of prospective studies, several retrospective analyses were conducted according to different types of treatment. Most common strategies are represented by observation plus early salvage radiotherapy (RT) in case of PSA rising, adjuvant androgen deprivation therapy (ADT) alone, or adjuvant RT with or without ADT. Patients with pN1 disease and favorable disease characteristics (lower T stage and ISUP ≤ 2 at RP, 3) were detected at RP. Lastly, few studies analyzed the rate of adverse events following adjuvant ADT or RT, leaving the issue of treatment-related side effects still open. Summary: There is no clearly established standard of care for men with pN1 PCa, and disease characteristics should guide the choice of optimal post-operative management for these patients. Prospective data and clinical trials are clearly needed to define the most effective therapeutic strategy.

Background: Cardiac involvement (CI) in systemic sclerosis (SSc) is frequently subclinical and it can be identified in up to 80% of autopsied hearts. If present, symptoms are related to adverse prognosis, and CI represents one of the predominant causes of SSc-related mortality. Methods: A total of 20 patients with a diagnosis of SSc were included and followed up, and 37 volunteers were included and subsequently scanned on a 1.5T MR system. Results: Overall, thirteen (65%) patients had one or more abnormal cardiac findings in CMR (defined as CI[+]), of which in seven (35%), baseline ECGs and standard echocardiograms were normal or unspecific. Compared to healthy volunteers, SSc patients had a lower LVEF% (56.6% vs. 61.6%; p = 0.0131), longer T1 (1028.3 ms vs. 993.1 ms; p = 0.0049) and T2 relaxation times (48.24 ms vs. 43 ms p = 0.0011), and higher extracellular volume (ECV, 27.9% vs. 26.0%; p = 0.0112). However, no difference in CMR-derived, feature-tracking GLS values between patients and healthy controls was found (−15.5[2,8] vs. −16.3[1,1], respectively, p = 0.11). Over 3.4 (1.9–5.5) years, three patients (15%) died, and two others (10%) sustained major cardiac complications. Conclusions: Cardiac magnetic resonance with modern quantitative techniques reveals subtle morpho-functional alterations and thus allows for early diagnosis of myocardial involvement in systemic sclerosis. Our findings emphasize the need for extended diagnostic workup in these patients and demonstrate the ability of cardiac MR to select patients requiring closer follow-up and/or treatment decisions.

Prostate cancer (PCa) screening has long relied on PSA testing, a strategy that has shaped diagnostic pathways for decades but remains limited by substantial overdiagnosis and downstream overtreatment. As screening practices evolve, the relevance of historical evidence must be reconsidered in the context of contemporary diagnostic workflows that now incorporate imaging, refined biopsy techniques, and risk-adapted management. This narrative review examines the transition from PSA-only screening toward modern, risk-adapted early detection strategies. We synthesize evidence supporting the integration of mpMRI, refined biopsy techniques, and active surveillance (AS) as key components of contemporary screening pathways aimed at improving the detection of clinically significant disease while minimizing unnecessary interventions. Particular emphasis is placed on second-line MRI-based approaches, which consistently reduce the number of avoidable biopsies and enhance the diagnostic precision. In addition, we review the role of blood-based and genomic biomarkers in pre-biopsy risk stratification, discussing established tools within a unified framework of individualized screening. The review also contextualizes very recent regulatory developments, including the FDA approval of a novel structure-based PSA assay, as part of the ongoing evolution of biomarker-supported screening rather than a paradigm shift. Overall, this article provides a timely synthesis of mature randomized evidence and emerging diagnostic innovations, offering a clinically grounded perspective on how PCa screening is being reshaped toward more personalized and harm-aware strategies.

Background Sjogren’s Syndrome (SS) is a common autoimmunological disorder characterized by infiltration of exocrine glands by autoreactive immune cells that lead to the disease’s two most common symptoms — dry eyes and a dry mouth, also known as sicca syndrome. The etiopathogenesis considers the coexistence of genetic predisposition and environmental factors, such as viral infections or sex hormones imbalance. Objectives The aim of the study was to determine whether major stressful life events are also risk factors for developing SS. Methods We performed a matched case-control study. Cases were patients with an established diagnosis of primary SS (pSS) within the previous five years. Controls were patients with osteoarthritis in whom systemic connective tissue disease has been ruled out. Data on major stressful life events were collected using the modified Holmes-Rahe stress scale. Data were collected for the period of the year before the disease onset. Results 100 patients were enrolled in the study (pSS group = 50, control group = 50), mean age was 55.8±10.4 years for pSS and 61.3±9.59 years for control group, in both groups 96 % of patients were female. pSS patients had significantly higher total score on Holmes-Rahe stress scale within the preceding 1 year before the onset of disease symptoms than control group (pSS group = 152±66.3 vs control group = 50±54.6; p<0.001). In pSS group 50 % of patients reported the subjective impression that the symptoms were caused by stress, while in control group it was 12 % (p<0.001). The most frequently mentioned life events in the pSS group were divorce or marital separation, death or change in health of family member and stress related to work. Conclusion Patients with pSS are significantly more likely to have had a major stressful life event within the preceding 1 year before the disease onset. The relationship between stress and the occurrence of many diseases and their exacerbations is well documented, especially within autoimmune diseases. Stress is a ubiquitous problem these days, therefore it is of fundamental importance to understand the biological mechanisms underlying its influence on the development of diseases. It is crucial to properly recognize the stressful situation in the patient’s life and undertake appropriate interventions in order to prevent health consequences. References [1]Sandhya P, Kurien BT, Danda D, Scofield RH. Update on Pathogenesis of Sjogren’s Syndrome. Curr Rheumatol Rev. 2017;13(1):5-22. doi: 10.2174/1573397112666160714164149. PMID: 27412602; PMCID: PMC5280579. [2]Sharif K, Watad A, Coplan L, Lichtbroun B, Krosser A, Lichtbroun M, Bragazzi NL, Amital H, Afek A, Shoenfeld Y. The role of stress in the mosaic of autoimmunity: An overlooked association. Autoimmun Rev. 2018 Oct;17(10):967-983. doi: 10.1016/j.autrev.2018.04.005. Epub 2018 Aug 14. PMID: 30118900. [3]Skopouli FN, Katsiougiannis S. How stress contributes to autoimmunity-lessons from Sjögren’s syndrome. FEBS Lett. 2018 Jan;592(1):5-14. doi: 10.1002/1873-3468.12933. Epub 2017 Dec 22. PMID: 29223133. [4]Roberts AL, Malspeis S, Kubzansky LD, Feldman CH, Chang SC, Koenen KC, Costenbader KH. Association of Trauma and Posttraumatic Stress Disorder With Incident Systemic Lupus Erythematosus in a Longitudinal Cohort of Women. Arthritis Rheumatol. 2017 Nov;69(11):2162-2169. doi: 10.1002/art.40222. Epub 2017 Oct 12. PMID: 28929625; PMCID: PMC5659907. [5]Lee YC, Agnew-Blais J, Malspeis S, Keyes K, Costenbader K, Kubzansky LD, Roberts AL, Koenen KC, Karlson EW. Post-Traumatic Stress Disorder and Risk for Incident Rheumatoid Arthritis. Arthritis Care Res (Hoboken). 2016 Mar;68(3):292-8. doi: 10.1002/acr.22683. PMID: 26239524; PMCID: PMC4740283. [6]Warren S, Greenhill S, Warren KG. Emotional stress and the development of multiple sclerosis: case-control evidence of a relationship. J Chronic Dis. 1982;35(11):821-31. doi: 10.1016/0021-9681(82)90047-9. PMID: 7142361. Disclosure of Interests None declared