Background: Autism spectrum disorder (ASD) is traditionally considered a neurodevelopmental condition typically identified in early childhood. However, a substantial proportion of individuals receive their first diagnosis only in adolescence or adulthood, which may affect mental health, access to support, and overall quality of life. Objective: This review examines late diagnosis of ASD in adults and summarizes current evidence on factors contributing to diagnostic delay, including camouflaging behaviours, psychiatric comorbidities, and suicidality. Methodology: A literature search was conducted using PubMed and Google Scholar to identify studies published between 2000 and 2025. Search terms included combinations of “autism,” “adult diagnosis,” “diagnostic delay,” “camouflaging,” “psychiatric comorbidity,” and “suicide.” Studies focusing on adult populations, diagnostic pathways, and mental health outcomes were prioritized. In total, 36 publications were included. Due to methodological heterogeneity across studies, findings were synthesized narratively. Results: Definitions of late ASD diagnosis vary across studies, with inconsistent age thresholds. Many adults diagnosed with ASD report prior psychiatric diagnoses, although registry data indicate that a substantial proportion had no documented psychiatric conditions during childhood. Camouflaging behaviours, particularly among women, may contribute to delayed recognition and are associated with increased psychological distress. Adults with ASD show elevated rates of depression and anxiety, with lifetime prevalence of depressive disorders reaching 30–40% in some studies. Population-based research also indicates increased risk of suicidality. Conclusions: Late identification of ASD in adulthood is associated with complex diagnostic pathways and a high prevalence of psychiatric comorbidity. Improving awareness of adult autism among clinicians may contribute to earlier recognition and more appropriate support for affected individuals. Further research is needed to refine diagnostic tools and to better understand long-term mental health outcomes in people diagnosed with ASD later in life.

Objective: This review aims to compare surgical and conservative treatment methods for degenerative meniscus injuries. Methods: A literature search was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library to identify randomized controlled trials published from 2012 onwards. Eligible studies evaluated adult patients with degenerative meniscal tears confirmed by magnetic resonance imaging or radiographs, comparing surgical interventions with non-operative treatments. Results: Evidence from high-quality trials indicates that conservative approaches are comparable to surgical interventions in improving long-term patient-reported outcomes. While arthroscopic partial meniscectomy (APM) yields significant initial clinical improvements, it offers no meaningful long-term advantage over structured physical therapy. Placebo-controlled trials demonstrate that the perceived therapeutic benefits of APM are predominantly due to the non-specific effects of the surgical act itself rather than the removal of damaged tissue. Conversely, APM exposes the knee to accelerated degenerative changes, including an increased risk of radiographic osteoarthritis progression and a five-fold higher likelihood of ultimately requiring a total knee replacement. Furthermore, patients who crossover from physical therapy to delayed surgery due to unsatisfactory results do not achieve superior functional outcomes compared to those who remain in conservative management. Conclusion: Current clinical guidelines advocate for at least three months of structured physical therapy as the primary, first-line treatment for degenerative meniscal lesions. Adopting a conservative approach maximizes patient benefit, prioritizes the preservation of the meniscus, and supports long-term joint longevity.

Introduction and Purpose: Carpal Tunnel Syndrome (CTS) is the most common peripheral neuropathy, causing significant functional impairment and socioeconomic burden. Relative effectiveness of conservative versus surgical interventions remains debated due to heterogeneity in study designs. This study aims to systematically review randomized controlled trials (RCTs) published from 2009 onwards to evaluate the comparative efficacy and durability of these treatment strategies in adult patients. Material and Method: A systematic search was performed in PubMed, Scopus, Web of Science, and the Cochrane Library for RCTs published between 2009 and 2022. The review included adults with clinically or electrophysiologically confirmed CTS. Analyzed interventions included conservative treatments, such as splinting, corticosteroid injections, perineural dextrose, platelet-rich plasma (PRP), manual therapy and surgical release techniques. Primary outcomes extracted included symptom severity and functional status (BCTQ), pain intensity, and neurophysiological parameters. Results: Conservative therapies, particularly corticosteroids and manual therapy, demonstrate significant short-term (1–3 months) symptom relief often comparable to surgery. Perineural dextrose and PRP show superior mid-term efficacy compared to steroids. Surgical decompression provides superior long-term durability (>6 months) with significantly lower recurrence rates and a reduced need for subsequent interventions. Conclusions: Conservative management serves as an effective first-line option for mild-to-moderate CTS, providing fast relief. Emerging regenerative injections offer better durability than traditional steroids. Nevertheless, surgical release remains the definitive treatment for ensuring long-term remission, particularly in severe cases. Therapy should be individualized, prioritizing non-invasive methods initially while reserving surgery for lasting anatomical correction.

Introduction and purposeAtrial fibrillation (AF) is the most common sustained supraventricular arrhythmia and a major cause of ischemic stroke and systemic thromboembolism. In non-valvular AF, most thrombi originate in the left atrial appendage (LAA). Oral anticoagulation with vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs) remains the cornerstone of stroke prevention; however, long-term therapy may be limited by bleeding risk and adherence challenges. Percutaneous left atrial appendage closure (LAAC) has emerged as an anatomy-based alternative. This review aimed to compare the efficacy and safety of LAAC with DOACs and VKAs in patients with permanent AF at high risk of adverse events. Material and methodsA qualitative literature review was conducted using PubMed, Embase, Cochrane Library, and Web of Science. Randomized controlled trials, meta-analyses, pooled analyses, and large cohort or registry studies published between 2015 and 2025 were included. Outcomes of interest included ischemic stroke, systemic embolism, major bleeding, mortality, and procedure-related complications. ResultsAcross randomized trials and observational studies, LAAC, DOACs, and VKAs demonstrated comparable efficacy in preventing ischemic stroke and systemic embolism. Randomized data confirmed the non-inferiority of LAAC compared with warfarin and DOAC therapy. Safety profiles differed: DOACs showed lower rates of major bleeding than VKAs, whereas LAAC presented higher early procedural risk but fewer late bleeding events. ConclusionsLAAC provides stroke prevention efficacy comparable to oral anticoagulation and may offer long-term safety advantages in selected high-risk patients. Individualized treatment strategies remain essential in permanent AF.

Background: Gallstone disease is a chronic condition characterized by the formation of calculi within the biliary tract. It represents a common health issue, particularly among obese populations or those with type 2 diabetes. An increasing number of clinical evidence suggests a potential association between an elevated risk of gallstone development and the chronic use of GLP-1 receptor agonists. Objective: The aim of this study was to analyze the impact of GLP-1 receptor agonist therapy on the risk of biliary complications, with particular emphasis on gallstone disease. Selected clinical studies and meta-analyses were reviewed, and the mechanisms of gallstone formation, as well as their clinical implications for patient management and therapy selection, were evaluated. Methods: We analyzed the effects of GLP-1 receptor agonists on gallstone development, gallbladder function, gastrointestinal hormonal regulation, and the impact of rapid weight loss, based on widely available randomized clinical trials and meta-analyses. Results: GLP-1 receptor agonists are associated with an increased risk of gallstone formation, primarily due to the promotion of rapid weight loss, as well as their effects on gastrointestinal hormonal regulation and gallbladder function, particularly in obese individuals and those with type 2 diabetes. Conclusions: Chronic therapy with GLP-1 receptor agonists constitutes a risk factor for the development of gallstone disease. However, further long-term clinical studies in larger populations are needed to clarify the underlying mechanisms of this association.

Background: Necrotizing enterocolitis (NEC) is a severe, multifactorial inflammatory disease and a leading cause of gastrointestinal mortality in preterm infants, particularly those with very low birth weight. Despite advances in neonatal care, its pathogenesis, early diagnosis, and effective prevention remain significant clinical challenges. Objective: This review aims to synthesize current knowledge (2018–2026) on the pathophysiology, diagnostic strategies, and preventive interventions in NEC, with a focus on improving early detection and clinical outcomes. Methodology: A narrative review of recent scientific literature was conducted, analyzing studies on molecular mechanisms, including immune dysregulation and gut microbiota, as well as advances in diagnostic tools and nutritional prevention strategies. Results: Contemporary evidence indicates that NEC arises from an exaggerated immune response mediated by Toll-like receptor 4 (TLR4) in the immature intestine, compounded by gut dysbiosis and hypoxic factors, as described in the “two-hit” hypothesis. Diagnostic approaches are shifting from reliance on the Bell classification toward multi-modal strategies integrating abdominal ultrasound and biomarkers such as C-reactive protein. Preventive measures, particularly the use of human milk, human milk oligosaccharides, probiotics, and standardized feeding protocols, significantly reduce disease incidence and severity. Conclusions: NEC management is evolving toward a proactive, precision-based model that integrates early diagnosis with targeted nutritional and microbiome-based interventions. These strategies offer substantial potential to reduce mortality and long term complications in this vulnerable population.