Review Article
A Multicenter Data Comprehensive Analysis of Rehabilitation Strategies for COVID-19 Sequelae: Current Status, Challenges, and Future Perspectives
Issue:
Volume 14, Issue 4, December 2025
Pages:
52-77
Received:
30 August 2025
Accepted:
13 September 2025
Published:
9 October 2025
Abstract: The COVID-19 pandemic has led to a substantial proportion of survivors experiencing persistent, multisystem sequelae, encompassing respiratory dysfunction, neuromuscular impairments, cardiovascular complications, and psychological disorders. These heterogeneous and complex late effects pose significant challenges for rehabilitation professionals in conducting comprehensive assessments and designing tailored interventions. This review integrates data from multicenter studies to elucidate the clinical manifestations of COVID-19 sequelae, evaluate the validity and reliability of existing assessment instruments, and examine the efficacy of diverse rehabilitation modalities. Emphasis is placed on the pivotal role of multidisciplinary teams, the feasibility of tele-rehabilitation platforms, and the incorporation of innovative technologies—such as virtual reality, wearable sensors, and artificial intelligence—in optimizing rehabilitation outcomes. By systematically analyzing rehabilitation pathways across different sequelae, this paper aims to furnish evidence-based recommendations to refine clinical protocols, enhance the efficiency of rehabilitation services, and ultimately facilitate functional recovery and quality-of-life improvements for individuals affected by long COVID.
Abstract: The COVID-19 pandemic has led to a substantial proportion of survivors experiencing persistent, multisystem sequelae, encompassing respiratory dysfunction, neuromuscular impairments, cardiovascular complications, and psychological disorders. These heterogeneous and complex late effects pose significant challenges for rehabilitation professionals in...
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Review Article
Fundamentals of ctDNA Biomarkers in Tumor Precision Medicine
Issue:
Volume 14, Issue 4, December 2025
Pages:
78-94
Received:
30 August 2025
Accepted:
13 September 2025
Published:
10 October 2025
Abstract: Circulating tumor DNA (ctDNA) has emerged as a transformative biomarker in tumor precision medicine, enabling noninvasive insights into tumor genetics and dynamics across the entire disease continuum from diagnosis to treatment monitoring. Over the past two decades, significant advances from early cell-free DNA discovery to sophisticated high-sensitivity digital PCR and next-generation sequencing technologies have successfully facilitated the accurate detection and precise quantification of ctDNA at extremely low variant allele frequencies in peripheral blood samples. Comprehensive mechanistic studies reveal that ctDNA release reflects multiple biological processes including tumor cell apoptosis, necrosis, active secretion mechanisms, and complex microenvironmental influences that affect circulating DNA stability. Recent analytical innovations—including advanced droplet digital PCR platforms, targeted deep sequencing approaches, sophisticated variant-filtering algorithms, miniaturized microfluidic devices, and integrated artificial intelligence/machine learning pipelines—have substantially enhanced both sensitivity and specificity for ctDNA detection across diverse clinical scenarios. Current clinical applications span multiple domains including early cancer detection, minimal residual disease assessment, real-time tumor progression monitoring, comprehensive heterogeneity profiling, and personalized treatment guidance across multiple cancer types including colorectal, lung, breast, pancreatic, melanoma, hematologic, and gynecologic malignancies. Ongoing collaborative efforts in standardization protocols, analytical optimization, and comprehensive ethical governance frameworks aim to systematically address persistent challenges including low ctDNA abundance in early-stage disease, false positives/negatives, patient data privacy concerns, and ensuring equitable global access to these advanced diagnostic technologies. Future research directions emphasize developing ultrasensitive nanotechnology platforms, implementing long-read sequencing methodologies, advancing multi-omics integration strategies, and deploying AI-driven interpretation systems to fully realize ctDNA's transformative potential in precision oncology.
Abstract: Circulating tumor DNA (ctDNA) has emerged as a transformative biomarker in tumor precision medicine, enabling noninvasive insights into tumor genetics and dynamics across the entire disease continuum from diagnosis to treatment monitoring. Over the past two decades, significant advances from early cell-free DNA discovery to sophisticated high-sensi...
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Research Article
Difficult-to-treat Spondyloarthritis: What Are the Associated Factors
Séiny Kanta*
,
Najlae El Ouardi,
Mahamadou Sagara,
Hajar Zouaki,
Houda El Assad,
Alassane Alidou Garba,
El Kacem El Marbouh,
Laila Taoubane,
Abderrahim Majjad,
Hamza Toufik,
Ahmed Bezza
Issue:
Volume 14, Issue 4, December 2025
Pages:
95-100
Received:
27 October 2025
Accepted:
10 November 2025
Published:
31 December 2025
DOI:
10.11648/j.sjcm.20251404.13
Downloads:
Views:
Abstract: Introduction: There have been significant advances in the treatment of spondylarthritis (SpA) in recent years. Despite these advances, there is still a proportion of patients who experience multiple changes in biologic, which may correspond to difficult-to-treat spondylarthritis (SPA DaT). Unlike rheumatoid arthritis, there is no consensus definition for this concept. The aim of our study is to determine the prevalence of multi-switchers with spondylarthritis, identify their characteristics, and analyse the number and reasons for switching in a Moroccan population. Patients and methods: This is a comparative cross-sectional study that included patients with SpA diagnosed according to the 2009 ASAS criteria admitted to our department for targeted treatment. Sociodemographic data, comorbidities, and clinical, paraclinical, and therapeutic characteristics were collected for each patient. Multi-switchers who had received at least two biologics were considered to be SpA DaT. Their prevalence was estimated, and a comparison was made with a control group of non-multi-switchers (SpA-non-DaT). Results: Two hundred and ten patients were included, 56.2% of whom were men, 63% with a long average disease duration. The prevalence of multi-switchers was 32.7%. Compared to the control group, patients in the DaT group were predominantly female (53.6% versus 39%, p=0.04), had more axial involvement (76.8% versus 91.5%, p=0.003) and peripheral joint involvement (88.4% versus 67.4%, p= 0.001) and associated fibromyalgia (33.3% versus 66.7%, p = 0.980), CsDMARD use (97.1% versus 31.9%, p= < 0.001), and corticosteroid use (34.8% versus 11.3%, p= < 0.001). Disease activity, BASDAI, ASDAS and CRP at the start of biotherapy were higher in the SPA DaT group (BASDAI: 21.8% versus 20.6%, p=0.08), (ASDAS: 46.4% versus 54.6%, p = 0.03), BASFI (27.5% versus 41.8% p=0.04) CRP (: 14.19±4.73 mg/l versus 13.7±2.1 mg/l, p = 0.01). Similarly, the time between diagnosis and use of the first biologic was longer (4 [2.25–6] years versus 3 [1–4] years, p = 0.03). All patients in the DaT group had received anti-TNFα, and 22.9% had received anti-IL17. Analysing switches between biologics in this difficult-to-treat group, the first switch was linked to primary failure in 59% of cases, secondary failure in 29% of cases, and an adverse effect in 12% of cases. In the second switch, primary and secondary failure were observed in 64% and 33% of cases, respectively, and adverse effects in 3%. Regarding the third switch, 83% had primary failure and 17% had secondary failure. Conclusion: This study reveals a significant prevalence of patients with multiple treatment changes in the Moroccan population, highlighting the need for a larger patient sample to better define this condition.
Abstract: Introduction: There have been significant advances in the treatment of spondylarthritis (SpA) in recent years. Despite these advances, there is still a proportion of patients who experience multiple changes in biologic, which may correspond to difficult-to-treat spondylarthritis (SPA DaT). Unlike rheumatoid arthritis, there is no consensus definiti...
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