Mild cognitive impairment (MCI) is a nosological entity that requires special attention from a therapeutic perspective, because annual conversion rates to dementia of 5–15% in these cases are considered typical. This narrative review aimed to identify available data supporting the efficacy and tolerability of various pharmacological therapeutic interventions by searching PubMed/MEDLINE, the Cochrane Database of Systematic Reviews, and the Web of Science (WoS) Core Collection for primary and secondary reports published over the last 25 years on the pharmacological treatment of MCI. The retrieved interventions were distributed in five large categories: (1) conventional cognitive enhancers; (2) disease-modifying therapeutic interventions; (3) strategies mitigating vascular risk and management of concomitant medications; (4) adjuvant and nootropic formulations; (5) case management of non-cognitive symptoms in MCI. The most broadly applicable pharmacological strategies in MCI include systematic deprescribing and optimisation of concomitant therapies, reducing anticholinergic and sedative load, avoiding iatrogenic hypoglycaemia and excessive blood pressure lowering, and careful, individualised treatment of vascular risk factors. Based on the randomised controlled trials, meta-analyses, and contemporary guidelines, a pragmatic pharmacological approach to MCI is suggested. Further trials with better design are urgently needed to document the efficacy and safety of pharmacological interventions in patients diagnosed with MCI.

Background: Acute necrotizing esophagitis (ANE), also known as “black esophagus,” is a rare but life-threatening condition typically occurring in critically ill patients with profound systemic disturbances. Extreme hyperglycemic crises represent an underrecognized precipitating factor, capable of inducing severe metabolic, inflammatory, and microvascular injury. Case Presentation: We report the case of a 54-year-old male admitted with altered mental status and severe dehydration, in whom initial laboratory evaluation revealed extreme hyperglycemia (serum glucose ~1000 mg/dL), metabolic acidosis, and early multiorgan dysfunction. During intensive care unit hospitalization, the patient developed anemia and severe thrombocytopenia, followed by evidence of upper gastrointestinal bleeding. Urgent upper gastrointestinal endoscopy demonstrated diffuse circumferential black necrosis of the distal esophageal mucosa with abrupt demarcation at the gastroesophageal junction, consistent with acute necrotizing esophagitis, along with associated erosive hemorrhagic gastritis. Comprehensive laboratory evaluation documented marked inflammatory activation and hematologic instability. Management and Outcome: Treatment consisted of aggressive metabolic correction, strict glycemic control, hemodynamic stabilization, infection management, and supportive gastrointestinal care. Progressive clinical and biological improvement was observed, with resolution of bleeding and partial recovery of hematologic parameters. Conclusions: This case highlights a severe hyperglycemic crisis as a major contributing factor within a multifactorial ischemic and inflammatory cascade leading to acute necrotizing esophagitis.

Drug use–associated infective endocarditis (DUA-IE) is an increasingly important clinical problem that affects younger patients and poses substantial diagnostic, therapeutic, and surgical challenges. We conducted a retrospective cohort study of adults with definite infective endocarditis treated at a tertiary referral center between 2017 and 2022, comparing patients with DUA-IE to those with non–drug use–associated infective endocarditis. Of the 189 patients, 43 (22.8%) had DUA-IE. These patients were significantly younger and had higher rates of HIV and hepatitis C coinfections. Staphylococcus aureus was the predominant pathogen, and right-sided valve involvement was more frequent; however, left-sided disease predominated among patients requiring valve surgery. Compared with non-DUA-IE patients, those with DUA-IE had larger vegetations, higher inflammatory markers, more frequent complications(including sepsis, embolic events, and heart failure), higher rates of emergency surgical intervention, longer hospitalizations, and increased in-hospital mortality rates. In conclusion, DUA-IE represents a distinct and more aggressive form of infective endocarditis, characterized by severe infection, increased complication rates, and a substantial surgical burden despite the younger patient age, underscoring the need for integrated infectious disease, surgical, and addiction-focused care models for these patients.

Background: The concept of emotional eating (EE) originates in the early psychosomatic accounts of overeating, but its nosological status remains contested more than four decades after it was first scientifically explored. Although neither the DSM-5-TR nor the ICD-11 recognizes EE as a discrete entity, clinically significant presentations of EE are described in the literature and can currently be captured under residual diagnostic categories in the absence of specific criteria. Objective: To examine whether EE is best conceptualized as an independent disorder or a dimensional, transdiagnostic, nutritional-behavioral phenotype, and to identify requirements for its clinical validation. Methods: A conceptual analysis supported by a critical synthesis of the literature focused on phenotypic heterogeneity, nutritional correlates, measurement approaches, diagnostic boundaries, and clinical implications of EE. Results: Negative-affect EE (N-EE) has been linked to changes in food choice, diet quality, processing degree, eating patterns, and potential abdominal adiposity, but these associations do not resolve the contentious question of whether EE is a distinct clinical entity. Eating in response to emotional states has also been linked to depression, emotion dysregulation, dietary restraint, binge eating, body-image concerns, sleep disturbance, and obesity-related outcomes. However, these associations are heterogeneous and do not define a unique disorder. One important asymmetry further complicates classification: N-EE is more consistently associated with psychopathology, while positive EE (P-EE) often occurs in normative social contexts. The proposed framework positions EE as a dimensional, transdiagnostic phenotype and identifies convergent multimethod validity, clinically meaningful thresholds, and discriminant, longitudinal, nutritional, prognostic, and treatment validity beyond established eating and mood disorders as requirements for potential categorical recognition. Conclusions: The literature considered suggests that EE may be usefully approached as a dimensional, transdiagnostic nutritional-behavioral phenotype. This remains a provisional conceptual position rather than an empirically validated classification. Further multimethod and longitudinal research is needed to clarify clinical significance, diagnostic boundaries, and utility before considering independent diagnostic recognition.

Background: Clinical high-risk states for psychosis (CHR-P) are associated with heterogeneous symptomatic and functional outcomes, only one of which is transition to psychosis. Objective: To propose a structured approach to current care needs and longitudinal clinical formulation alongside established syndromic assessment. Methods: This perspective integrates a targeted, non-systematic appraisal of instrument studies, evidence syntheses, longitudinal cohorts, and guidance with an explicitly author-proposed assessment architecture. Supplementary PubMed searches conducted during revision have been reported separately from the original search. Results: The framework retains validated CHR-P interviews as the syndromic anchor and organizes symptoms, functioning, cognition, comorbidity, developmental context, and longitudinal change into descriptive clinical profiles. A minimal clinical dataset is distinguished from optional structured assessments and investigational biological or digital measures. Descriptive profiles document source measures, current burden, change, and uncertainty without numerical weighting. A staged validation program prioritizes reproducibility, feasibility, and functioning, with transition assessed separately. Conclusions: The current framework offers a candidate structure for documenting needs and discussing care priorities; it does not establish prognostic accuracy or treatment benefit. Prospective evaluation is required before profile-based decisions based on this interpretative model can be recommended. A clinically useful approach to CHR-P research may need to move beyond reductionist conversion/non-conversion predictive models toward more calibrated, externally validated paradigms capable of predicting multiple clinically meaningful trajectories.