Search Results (216)

Background: Diabetes-related foot diseases represent a global health problem because of the associated complications, the risk of amputation, and the economic burden on health systems. Negative pressure wound therapy (NPWT) is a technique that uses sub-atmospheric pressure to help promote wound healing by reducing the inflammatory exudate while keeping the wound moist, inhibiting bacterial growth, and promoting the formation of granulation tissue. Objective: This study aimed to assess the effectiveness of NPWT in preventing major amputation in diabetic patients with complicated foot or lower limb infections and to contextualize the results through a review of the existing literature. Materials and methods: We conducted a retrospective study at the First Surgical Department of “Dr. I. Cantacuzino” Clinical Hospital in Bucharest, Romania, over a 15-year period, including 30 consecutive adult patients with diabetes and soft tissue foot or lower limb infections treated with NPWT. Patients with non-diabetic ulcers, incomplete medical data, or aged under 18 were excluded. All patients underwent initial surgical debridement, minor amputation, or drainage procedures, followed by the application of NPWT using a standard protocol. Dressings were changed every 2–4 days for a total of 7–10 days. Antibiotic therapy was adapted according to the culture results. The primary outcome was limb preservation, defined as avoidance of major amputation. Secondary outcomes included in-hospital mortality and wound status at discharge. Results: NPWT was associated with a favorable outcome in 24 patients (80%), defined by wound granulation or healing without the need for major amputation. Five patients (16.6%) underwent major amputation because of failure of the primary lesion treatment, and one patient died. No statistically significant association was observed between the outcomes and standard classification scores (WIFI, IWGDF, and TPI). A comprehensive literature review helped to integrate these findings into the existing pool of knowledge. Conclusions: NPWT may support limb preservation in selected diabetic foot cases. While the retrospective design and the small sample size of the study limit generalizability, these results reinforce the need for further controlled studies to evaluate NPWT in real-life clinical settings. The correct use of NPWT combined with etiological treatment may offer a maximum chance to avoid major amputation in patients with diabetes-related foot diseases. Full article

Corn stunt complex, transmitted by the corn leafhopper (Dalbulus maidis), poses significant yield risks to corn production. This study evaluated the effects of two corn hybrids and top-dressed nitrogen (N) and potassium (K) fertilization on D. maidis incidence and corn stunt symptom expression under field conditions. Eighteen treatments were tested in a randomized complete block design with six replications over two seasons. Leafhopper populations were monitored using yellow sticky traps, and symptom incidence and severity were assessed at R₁ and R₃ stages, respectively. While D. maidis populations varied substantially between seasons, neither N nor K fertilization, nor hybrid selection, significantly affected vector abundance. Importantly, symptom frequency and severity were not directly proportional to leafhopper density. Top-dressed fertilization, particularly with K, reduced the visual expression of corn stunt symptoms although it did not prevent infection. Hybrid responses to fertilization varied, with a genotype exhibiting greater symptom mitigation. Grain yield was not significantly influenced by nutrient rates or hybrid choice. These findings suggest that balanced N and K fertilization enhances crop resilience to corn stunt disease without directly suppressing vector populations. Integrating nutritional management with hybrid selection presents a promising strategy to add in corn stunt control and deepens our understanding of the environmental factors that mitigate severe symptoms. Full article

Single electron capture in collisions involving neutral hydrogen atoms impacted by highly charged dressed projectiles is theoretically investigated using the distorted wave formalism. A series of continuum distorted wave approximations is employed to investigate the electron capture from neutral hydrogen atom impact by boron and carbon projectiles. The projectile potential is described using a two-parameter analytical Green–Sellin–Zachor (GSZ) model potential. The theoretical prediction of total cross sections are compared against other theories and experiments. We looked at a very broad range of collision energies, from 10 keV/u up to 10 MeV/u. In addition, the state-selective cross sections for boron ions are presented. Full article

Objectives: Sternal wound infections (SWIs) after cardiac surgery remain a major complication and represent a significant clinical challenge. This article aims to evaluate the effectiveness of closed-incision negative-pressure wound therapy (ciNPWT) in preventing postoperative wound complications in high-risk patients undergoing coronary bypass surgery via full median sternotomy. Methods: Data on all consecutive patients undergoing coronary artery bypass surgery at our facility between March 2021 and March 2023 were retrospectively collected. The ciNPWT group consisted of 71 patients. A control group receiving conventional wound dressings was selected by propensity matching. The primary outcome was postoperative sternal wound complication of any severity, as well as superficial and deep SWIs. The secondary outcomes were hospital stay length, in-hospital mortality, and need for perioperative wound revision. Results: The incidence of postoperative SWIs was significantly higher in the ciNPWT group than in the control group (18 [25.4%] vs. 7 [9.9%], p = 0.03). Of these 25 cases, 20 had received postoperative ciNPWT and 5 conventional wound dressings, which was statistically different (15 [21.1%] vs. 5 [7.0%], p = 0.03). ciNPWT was also significantly associated with positive bacterial cultures (13 [18.3%] vs. 4 [5.6%], p = 0.04) and perioperative wound revision (11 [15.5%] vs. 6 [8.5%], p = 0.05). Conclusions: In consecutive high-risk patients undergoing coronary bypass surgery, the use of prophylactic ciNPWT did not improve wound healing compared to conventional wound dressings, raising concerns about its effectiveness in high-risk patients. Our results do not support the routine use of ciNPWT in this setting. Its potential value may instead lie in carefully defined patient subgroups, underscoring the relevance of our findings for patient-tailored care strategies in cardiac surgery. Full article

A total of 700 broiler chicks (350 Indian River and 350 Ross 308) were obtained from a local hatchery. Birds were randomly allocated in a completely randomized design by strain into two dietary groups: a control group (corn–soybean meal) and a treatment group in which 7.5% of soybean meal (SBM) was replaced with fermented soybean meal (FSBM). Each group included 175 birds, distributed across seven replicates (pens) with 25 birds per pen. Birds were weighed at the start of the trial and at the end of each rearing phase (starter (1–14 days of age), and grower phases (15–35 days of age)). Mortality was monitored daily throughout the experiment. Weekly feed intake was recorded for each pen. On day 35, 14 birds were randomly selected from each treatment–strain combination for carcass and meat quality evaluation. Data were analyzed with linear models; strain, diet, and their interaction were the investigated effects. No strain–diet interaction was detected for growth performance, carcass and meat quality, and intestinal morphology traits (p > 0.05). Significant interaction effect on crude protein digestibility is found (p < 0.001). The FSBM improved crude protein digestibility for the Indian River broiler strain, while the opposite occurred in the Ross 308 strain. Fermented soybean meal supplementation did not significantly affect body weight gain, feed conversion ratio (FCR), or feed intake during the study period (p > 0.05). The Ross strain exhibited a higher dressing percentage (p = 0.04) and greater cooking loss (p = 0.01), whereas the Indian River strain showed higher abdominal fat percentage (p = 0.04) and shear force (p = 0.003). The dressing percentage, pH, color parameters, cooking loss, water-holding capacity, and breast fillet yield for FSBM and control groups did not differ (p > 0.05). Ileum villus length and width were significantly higher (p < 0.05) in the FSBM group compared to the control group. In conclusion, Fermented soybean meal can enhance intestinal morphology and crude protein digestibility in a strain-specific manner; however, its impact on growth and carcass attributes is limited at this inclusion level. Full article

Background and objectives: Antibiotic resistance in Cutibacterium acnes is undermining topical macrolides and clindamycin, prompting renewed interest in zinc oxide nanoparticles (ZnO-NPs) as non-antibiotic alternatives. We aimed to (i) determine the antimicrobial and anti-inflammatory performance of topical ZnO-NP formulations across in vitro, animal and early human models; (ii) identify physicochemical parameters that modulate potency and tolerance; and (iii) delineate translational gaps and priority design elements for randomised trials. Methods: We systematically searched PubMed, Scopus and Web of Science until 1 June 2025 for in vitro, animal and human studies that evaluated ≤100 nm ZnO-NPs applied topically to C. acnes cultures, extracting data on bacterial load, lesion counts, biophysical skin parameters and acute toxicity. Eight eligible investigations (five in vitro, two animal, one exploratory human) analysed particles 20–50 nm in diameter carrying mildly anionic zeta potentials. Results: Hyaluronic acid-coated ZnO-NPs achieved a sixteen-fold higher selective kill ratio over Staphylococcus epidermidis at 32 µg mL¹, while centrifugally spun polyvinyl alcohol dressings reduced C. acnes burden by 3.1 log₁₀ on porcine skin within 24 h, and plant-derived nanogels generated inhibition zones that were 11% wider than benzoyl-peroxide’s 5%. In human subjects, twice-daily 0.5% hyaluronic–ZnO nanogel cut inflammatory-lesion counts by 58% at week four and lowered transepidermal water loss without erythema. Preclinical safety was reassuring, zero mortality among animals at 100 µg mL¹ and no irritation among patients, although high-dose sunscreen-grade ZnO (20 nm) delayed rat wound closure by 38%, highlighting dose-dependent differences. Conclusions: Collectively, the evidence indicates that nanoscale reformulation markedly augments zinc’s antibacterial and anti-inflammatory performance while maintaining favourable acute tolerance, supporting progression to rigorously designed, adequately powered randomised trials that will benchmark ZnO-NPs against benzoyl peroxide and retinoids, optimise dosing for efficacy versus phototoxicity, and establish long-term dermatological safety. Full article

Background/Objectives: Upper limb amputation presents considerable physical and psychological challenges, especially in young, active individuals. This case study outlines the rehabilitation journey of a 33-year-old patient, an Italian national Paralympic snowboard cross athlete, who underwent elective transradial amputation followed by advanced surgical and prosthetic interventions. The objective was to assess the combined impact of upper limb Targeted Sensory Reinnervation (ulTSR) and the Adam’s Hand prosthetic system on functional recovery and user satisfaction. Methods: After a partial brachial plexus injury caused complete paralysis of his right hand, the patient opted for transradial amputation. He subsequently underwent ulTSR, performed by plastic surgeon, Alexander Gardetto, MD, which involved rerouting sensory nerves to defined regions of the residual limb in order to reestablish a phantom limb map. This reinnervation was designed to facilitate improved prosthetic integration. The Adam’s Hand, a myoelectric prosthesis with AI-based pattern recognition, was selected for its compatibility with TSR and intuitive control. Outcomes were evaluated using the OPUS questionnaire, the DASH, and patient feedback. Results: ulTSR successfully restored meaningful sensory input, allowing intuitive and precise control of the prosthesis, with minimal cognitive and muscular effort. The patient regained the ability to perform numerous activities of daily living such as dressing, eating, lifting, and fine motor tasks—which had been impossible for over 15 years. OPUS results demonstrated significant improvements in both function and satisfaction. Conclusions: This case highlights the synergistic benefits of combining ulTSR with user-centered prosthetic technology. Surgical neurorehabilitation, paired with advanced prosthetic design, led to marked improvements in autonomy, performance, and quality of life in a high-performance amputee athlete. Full article

This study investigated the effects of genotype and sex on carcass traits, myosin heavy chain (MyHC) isoforms, and meat quality in pigs raised under Thai commercial conditions. Fifty pigs (25 barrows and 25 gilts) from five genotypes—purebred Duroc (D), LWLR1 (Large White_old × Landrace_old), LWLR2 (Large White_new × Landrace_new), DLWLR1 (Duroc × LWLR1), and DLWLR2 (Duroc × LWLR2)—were slaughtered at ~110 kg body weight. LWLR1 is traditional maternal line, whereas LWLR2 is a newly selected line for higher intramuscular fat (IMF). Significant genotype × sex interactions were observed for dressing percentage, carcass length, bone percentage, purge loss, pH₂₄, and L* (lightness) (p < 0.05). The Longissimus lumborum (LL) muscle of Duroc pigs showed the lowest pH₄₅ and shear force but highest IMF, whereas LWLR1 pigs exhibited higher crude protein, polyunsaturated fatty acids, and flavor-enhancing nucleotides. The LL muscle of LWLR2 and DLWLR2 pigs showed greater expression of MyHC I and IIA, as well as calpain 1 (CAPN1), calpain 2 (CAPN2), and calpastatin (CAST) genes. In contrast, Duroc pigs had the highest MyHC IIX and lowest IIB expression, opposite to patterns in LWLR1 and DLWLR1. Principal component analysis revealed distinct genotype-based clustering, emphasizing the influence of maternal lineage on pork quality and offering valuable insights for genetic selection strategies. Full article

Background/Objectives: Diabetic foot ulcers (DFUs) are a common and serious complication of diabetes, often leading to infection, amputation, and reduced quality of life. Platelet-rich plasma (PRP) therapy has emerged as a promising treatment due to its potential to accelerate wound healing through growth factors and cytokines. Despite growing interest, evidence on PRP’s efficacy and safety in DFU management remains variable. This article critically reviews recent studies to evaluate the effectiveness of PRP in promoting ulcer healing, while examining methodological rigor, ethical considerations, and research parameters to provide a comprehensive, evidence-based assessment for clinical application. Materials and Methods: This review explores the biological mechanisms underlying platelet-rich plasma (PRP) as an adjunctive therapy for DFUs, focusing on its regenerative capabilities. PRP is an autologous concentration of platelets containing growth factors and bioactive molecules that promote angiogenesis, cellular proliferation, and extracellular matrix remodeling. Various application methods—topical, injectable, gel-based, and PRP-enhanced dressings—are examined. The review also evaluates the efficacy of PRP as monotherapy and in combination with other interventions such as debridement and split-thickness skin grafting. Results: Clinical studies suggest that PRP, particularly when used alongside surgical debridement or skin grafting, significantly enhances healing outcomes in patients with non-healing DFUs. It provides a biologically favorable environment for tissue regeneration while reducing inflammation and potentially exhibiting antimicrobial properties. However, variability in PRP preparation techniques, application protocols, and patient selection criteria presents challenges to standardization and broader clinical adoption. Conclusions: While PRP therapy demonstrates significant potential in the management of diabetic foot ulcers, further randomized controlled trials with standardized methodologies are essential to establish optimal treatment protocols and confirm long-term benefits. PRP offers a minimally invasive, autologous, and biologically active treatment modality that may serve as a vital component in the multidisciplinary approach to DFU management. Full article

Hydrogels are water-rich polymeric networks mimicking the body’s extracellular matrix, making them highly biocompatible and ideal for precision medicine. Their “tunable” and “smart” properties enable the precise adjustment of mechanical, chemical, and physical characteristics, allowing responses to specific stimuli such as pH or temperature. These versatile materials offer significant advantages over traditional drug delivery by facilitating targeted, localized, and on-demand therapies. Applications range from diagnostics and wound healing to tissue engineering and, notably, cancer therapy, where they deliver anti-cancer agents directly to tumors, minimizing systemic toxicity. Hydrogels’ design involves careful material selection and crosslinking techniques, which dictate properties like swelling, degradation, and porosity—all crucial for their effectiveness. The development of self-healing, tough, and bio-functional hydrogels represents a significant step forward, promising advanced biomaterials that can actively sense, react to, and engage in complex biological processes for a tailored therapeutic approach. Beyond their mechanical resilience and adaptability, these hydrogels open avenues for next-generation therapies, such as dynamic wound dressings that adapt to healing stages, injectable scaffolds that remodel with growing tissue, or smart drug delivery systems that respond to real-time biochemical cues. Full article

Chronic infected wounds remain a major medical challenge, particularly in the context of increasing antibiotic resistance. The objective of this study was to develop and evaluate chitosan-based (CS) sponges enhanced with graphene oxide (GO) as potential antimicrobial wound dressings. The composite sponges were fabricated using microcrystalline CS (MKCh) and 5% (w/w) GO, followed by freeze-drying and γ-sterilization (25 kGy). Physico-mechanical characterization showed that GO incorporation did not significantly alter tensile strength, while absorption and sorption capacities were improved, especially after sterilization. Structural and spectroscopic analyses confirmed increased porosity and molecular interaction between CS and GO. Cytocompatibility was verified in vitro using L-929 fibroblasts, with no cytotoxic effects observed in indirect contact. Antimicrobial activity tests demonstrated that GO-modified dressings exhibited enhanced activity against E. coli and S. aureus, though results were strain-dependent and not uniformly superior to CS alone. Notably, antifungal efficacy against C. albicans was reduced with GO addition. Overall, the developed GO-enriched CS sponges present favorable biocompatibility, mechanical resilience, and selective antimicrobial activity, supporting their potential application in chronic wound management. Further optimization of GO concentration and formulation is warranted to maximize antimicrobial efficacy across a broader spectrum of pathogens. Full article

This study evaluated the antimicrobial efficacy of cefiderocol and various forms of silver (ionic and nanoparticulate) as potential components of wound-dressing reagents against both reference and multidrug-resistant (MDR) Gram-negative bacteria. The anticipated synergistic effect between cefiderocol and nanosilver was not consistently observed; in fact, for reference strains, the combination was less effective than cefiderocol alone. However, in MDR and cefiderocol-resistant A. baumannii strains, combining both agents enhanced antibacterial efficacy. Notably, the effectiveness of silver did not increase with concentration, and low or medium nanosilver concentrations were often more effective. Mechanistically, high concentrations of silver may antagonize cefiderocol’s action by inhibiting bacterial surface proteins involved in siderophore-mediated uptake. Generalized linear modeling confirmed that the strain type, silver form, concentration, and their interactions significantly influenced inhibition zones. These findings highlight the importance of agent selection, concentration, and formulation in designing effective antimicrobial wound dressings. They also suggest that further research is needed to optimize such combination therapies for clinical use. Full article

Background/Objectives: Growing antibiotic resistance is one of the most significant problems of current medicine. Various research efforts are focused on the search for new substances and their combinations as potential solutions to this problem. Essential oil compounds (EOCs) are considered promising candidates in this regard. However, the interactions between these natural compounds remain understudied. This study conducted a preliminary evaluation of the antimicrobial action of various commercial EOCs (1,8-cineole, eugenol, linalyl acetate, (-)-α-pinene, limonene, α-terpineol, DL-menthol, geraniol, farnesol, carvacrol, and myrcene) alone and in combination (n = 56) against methicillin-resistant Staphylococcus aureus strain (ATCC 43300). Methods: The following parameters were studied: antibacterial activity of EOCs alone and in combination using microdilution and checkerboard assays. Results: After the initial screening, geraniol, farnesol, linalyl acetate, carvacrol, (−)-α-pinene, α-terpineol, 1,8-cineole, and eugenol exhibited antibacterial activity against the tested strain and were, therefore, selected for further evaluation in the checkerboard assay. The checkerboard assay revealed 10 synergistic interactions, with farnesol demonstrating the highest number of synergistic combinations among the tested compounds. The results highlighted its high synergistic potential in combination with eugenol, linalyl acetate, (-)-α-pinene, α-terpineol, geraniol, and carvacrol. Conclusions: In conclusion, the results help elucidate the different interactions between EOCs and may be helpful in further applications of natural compounds as antimicrobial agents in wound dressings. Overall, the most promising compound was found to be farnesol. Full article

Background/Objectives: Pressure injuries (PIs), a recognized indicator of care quality, have a higher incidence in intensive care units (ICUs). Our objective was to assess whether critically ill patients identified as “unprotected” (COMHON ≥ 11) developed pressure injuries despite additional preventive measures. Methods: A historical cohort study of an adult ICU was carried out. Of the 811 patients admitted in 2022, 400 were selected. All of them were subjected to the ICU’s PI Prevention Protocol, and those with a moving average of the COMHON Index ≥ 11 were given two additional measures: a multilayer dressing on the sacrum, and anti-equinus and heel-pressure-relieving boots. Results: A total of 36 patients presented with PIs (cumulative incidence of 9%). Significant differences were observed in their mean length of stay and in their disease severity score (APACHE-II). Most of the PIs were located on the sacrum, followed by the heel. Prior to the appearance of the PIs, a sacral dressing was applied to 100% of the patients, while anti-equinus and heel-pressure-relieving boots were only applied to 58.3%. Of the 36 patients with PIs, 52.8% had a PI on the sacrum and 22.2% on the heel. Conclusions: Focusing only on those who presented with PIs, we observed that the considered measures were not effective for preventing PIs in all the patients. Not all PIs are preventable, and individual risk factors should be considered. In the future, we will analyze the individual characteristics of these patients and verify whether the Prevention Protocol was followed, in order to determine how they could have been prevented or whether they were so-called unavoidable PIs. Full article

Local horse breeds, particularly cold-blood types, are often marginalized in economic and social contexts, primarily due to the neglect of their economic, genetic, and cultural potential, as well as their role in preserving the identity of rural areas, local communities, and ecosystems. The valorization of these breeds is a crucial prerequisite for their economic repositioning. The Croatian Posavina horse is a local breed, well adapted to harsh, extensive production systems. Its sustainability is achieved through pasture-based meat production, primarily targeting foreign European markets. Ensuring the sustainability of conservation programs requires a thorough understanding of growth dynamics, carcass traits, and meat quality. This study assessed growth performance and carcass characteristics in a sample of 30 male foals, with ten animals selected for detailed analysis of fatty acid, amino acid, and volatile aromatic compound profiles. At eleven months of age, the foals reached a live weight of 347 kg and a dressing percentage of 60.62%. Color, tenderness, and water-holding capacity parameters were favorable for consumers. The meat’s high protein content (22.37%) and low intramuscular fat (3.61%) make it suitable for health-conscious or sensitive consumer groups. A high proportion of polyunsaturated fatty acids (28.5%) and a nutritionally balanced ω-6/ω-3 ratio (3.46) highlight the meat’s functional properties. The essential-to-non-essential amino acid ratio (0.81) further supports its nutritional value. Sensory analysis confirmed an attractive appearance, desirable texture and flavor, and a rich aromatic profile. The carcass and meat quality results, when compared with the production traits of other horse breeds, indicate that Croatian Posavina foal meat is a high-quality and nutritionally valuable alternative to conventional red meat. With optimized conservation and production strategies, the Croatian Posavina horse holds strong potential for market repositioning within sustainable and functional meat production systems. Full article