Search Results (216)

Background and Objectives: Obesity has been increasing sharply worldwide and is related to diabetes, cardiovascular diseases, liver disease, and cancer. Sleeve gastrectomy is the most used surgical approach to reduce body weight and treat metabolic implications observed in patients with moderate-to-severe obesity. On the other hand, this procedure affects the musculoskeletal system, and investigating skeletal muscle is not routinely recommended for bariatric surgery. This study aimed to evaluate the psoas muscle in patients in the preoperative period of sleeve gastrectomy and six months after the procedure using abdominal computed tomography scans. Materials and Methods: This clinical, exploratory, and observational study, with a prospective longitudinal observational study design, was conducted at a single center with 31 women who underwent sleeve gastrectomy. The evaluations were performed before and after six months of the procedures. Results: Anthropometric, muscle strength, hepatic ultrasound, and psoas computerized tomography evaluations were performed. A significant reduction in body weight, body mass index, waist, neck, and calf circumference was observed. There was also a substantial reduction in right-hand strength and the area and index of the psoas muscle (but with an increase in density). Most presented a routine abdominal ultrasound. Conclusions: Our results suggest that muscle evaluation provides valuable information for clinical monitoring before and after bariatric surgery, helping to identify potential risks and guide multidisciplinary follow-up. Psoas muscle area and psoas muscle index decreased, but psoas muscle density increased, all significantly. These results indicate that conducting a muscle evaluation is helpful for patients undergoing bariatric surgery, supporting the use of the clinical approach before and after the procedure, predicting possible complications, and providing more accurate prognoses. Full article

Cisplatin, a platinum-based compound, is a cornerstone of modern chemotherapy and remains widely used against a variety of solid tumors, including testicular, ovarian, lung, bladder, and head and neck cancers. Its anticancer activity is primarily attributed to the formation of DNA crosslinks, which obstruct replication and repair, ultimately leading to apoptosis. However, the clinical value of cisplatin is constrained by two major challenges: its toxic profile and the development of resistance. Cisplatin toxicity arises from its interaction not only with tumor DNA but also with proteins and nucleic acids in healthy tissues, resulting in a range of adverse effects, including, but not limited to, nephrotoxicity, ototoxicity, neurotoxicity, and gastrointestinal injury. In pediatric patients, permanent hearing loss represents a particularly debilitating complication. On the other hand, tumor cells can evade cisplatin cytotoxicity through diverse mechanisms, including reduced intracellular drug accumulation, enhanced DNA repair, detoxification by thiol-containing molecules, and alterations in apoptotic signaling. These resistance pathways severely compromise treatment outcomes and often necessitate alternative or combination strategies. This review examines the chemical structure of cisplatin, the molecular mechanisms of cisplatin cytotoxicity and cisplatin-induced resistance, as well as the main applications in cancer management and the complications associated with its clinical use. Full article

Introduction: “The dog is a man’s best friend” and research has showed that this idea is extended beyond the degree of loyalty. Dog ownership has been linked to several positive health outcomes for the owner. The aim of the present cross-sectional case–control study was to assess differences in the physical activity level (PAL), body composition, quality of life (QoL), and diet quality and dietary knowledge between dog owners and non-owners. Methods: A total of 55 dog owners and an equal amount of non-dog owners (all aged between 18 and 60 years old) formed the case and control groups, respectively. Basic anthropometric measurements were performed, including body fat (BF) and diet, assessed with the Mediterranean Diet Score (MedDietScore) and the Eating Assessment Table (EAT). Physical activity was recorded for 3 consecutive days using activity monitors. QoL was evaluated using the brief version of the World Health Organization QoL (WHOQOL-BREF) tool. Results: The two groups demonstrated a similar PAL, but lower BF% (p = 0.009), hip circumference (p < 0.001), triceps (p = 0.012), and subscapular skinfolds (p = 0.003) were recorded among dog owners. The EAT score was greater among dog owners (p = 0.0023), indicating improved dietary intake and knowledge, even after adjustment for education attained and BMI (p = 0.026). On the other hand, greater adherence to the Mediterranean diet was exhibited among those not having dogs (p = 0.018). Regarding dog measurements and their owners’ anthropometry, dog neck circumference was negatively correlated to the owners’ biceps and triceps skinfolds (r = −0.327, p = 0.016; r = −0.320, p = 0.018, respectively). Additionally, dog breed size was negatively correlated to the owners’ triceps skinfold (r = −0.325, p = 0.015), sum of skinfolds (r = −0.311, p = 0.021), hip circumference (r = −0.341, p = 0.011), body fat (r = −0.357, p = 0.007), and fat mass index (r = −0.307, p = 0.023). Conclusions: Dog ownership is associated with improved body composition and smaller skinfold thickness at specific body sites, as well as with a more health-conscious lifestyle, including better diet quality and knowledge. Full article

(1) Background: Subclinical neck pain is mild-to-moderate neck pain that has not yet been treated, and where individuals experience pain-free days. Alterations in sensorimotor integration, motor control, proprioception, and cerebellar inhibition have been observed in individuals with subclinical neck pain. Upregulation of the cervico-ocular reflex is documented in subclinical neck pain, with no difference in the gain of the vestibulo-ocular reflex. Vestibulo-ocular reflex gain adaptation and associated differences in visuo-motor control have not been successfully measured in this population. This study aims to investigate the vestibulo-ocular reflex gain adaptation and visuo-motor control in individuals with subclinical neck pain. (2) Methods: 30 right-hand-dominant participants (19 healthy controls: 10 male and 9 female; 16 subclinical neck pain: 6 male and 10 female) aged 18 to 35 performed an eye tracking task. Participants were seated 90cm away from a monitor and instructed to hold their gaze on a stationary or moving target projected onto a screen while performing active head rotations. Trials were divided into 12 blocks (pre-adaptation, 10 adaptation, and post-adaptation) for a total of 192 trials. During adaptation, the target would move at increasing speeds during each block, increasing by 10% of active head velocity up to a maximum of 100%. (3) Results: The subclinical neck pain group demonstrated significantly higher total saccades (p = 0.006, ƞ² = 0.240) and overt catch-up saccades (p = 0.041, ƞ² = 0.141) than the healthy control group. (4) Conclusion: Subclinical neck pain alters the visual–vestibular interaction. Full article

Recent studies have identified phosphorylated α-synuclein in the skin of individuals with neurodegenerative disease. The levels of this protein in the skin have been correlated with disease severity. This protein has been specifically studied in alpha-synucleinopathies such as Parkinsons’ Disease (PD) and Multiple System Atrophy (MSA). Given that skin biopsy studies have often shown high levels of phosphorylated α-synuclein in the neck area, and that other clinical studies have described easily identifiable changes in facial skin features, this systematic review explores whether age spots, which are very common in sun-exposed areas (hands and face), could serve as early indicators of neurodegenerative disease. We performed a systematic review of the literature in three databases (Google, Scopus and Pubmed) following PRISMA guidelines. We used the following keywords: “alpha-synuclein and skin”, “alpha-synuclein and skin spots”, “alpha-synuclein and solar lentigo”, “alpha-synuclein and age spots”, “alpha-synuclein and melanocytes”, “skin biopsy and synucleinopathies”, “skin biopsy and neurodegenerative disease”, and “Parkinson’s Disease. Eleven studies were identified and included. Based on the study results and preliminary evidence in the literature evaluating the effect of α-synuclein on keratinocytes and melanocytes, we propose that the accumulation of this protein within the skin may produce visible alterations that can be quantified to enable early, noninvasive detection of neurodegenerative disease. Full article

In the lateral neck area (LNA), the parotid glands and submandibular glands can be diagnosed with various lesions, especially cysts and tumors of different etiology. In the submandibular area, many lesions are related to salivary stones and some inflammations, causing a secondary gland enlargement. When no sialolithiasis is present, a close relation to other local inflammation causes, IgG4, or related chronic sclerosing disease should be estimated. Ultrasound evaluation seems to be sufficient to indicate any occurrence of salivary retention, inflammation, dilatation of ducts, and gland swelling, and to confirm the initial diagnosis of sialolithiasis or sialadenitis. Any possible tumor formation or tumor-like solid mass evaluation requires adequate computed tomography or magnetic resonance imaging. A very important question should be raised if clinical symptoms like neck asymmetry, submandibular swelling, and solid-mass formation always correspond with radiological as well as some worrisome oncological symptoms. On the other hand, when radiological imaging is insufficient or lacking, a fine needle biopsy would be useful. Problems arise when any signs of potential disease or other tumor-like lesions are inconclusive or indicate inflammation, and possible treatment options are limited. Secondly, when patient anamnesis and blood examination are normal, but a worrisome tumor-like appearance progresses in time, a serious question about improved diagnostics and scheduling for surgery should be raised. Not all cases of elevated serum IgG4 levels correspond with IgG4 lesions and the typical spectrum of those diseases, and therefore histopathological examination of excised lesion provides the scope of the following disease intensity. In the following interesting images, it is worth noticing that radiological, clinical, needle biopsy, and cytological examinations do not always correlate with each other, and in some cases, an open surgery should be considered to improve the diagnosis. Full article

Head-and-neck squamous cell carcinoma (HNSCC) remains a lethal malignancy with stagnant survival despite advances in surgery, radiotherapy, and systemic therapy. Beyond cetuximab and PD-1 inhibitors, there are only a few targeted options, which benefit only a minority of patients, underscoring the need for new biomarkers and druggable dependencies. Genome-wide clustered regularly interspaced short palindromic repeats (CRISPR) Cas9 screening now enables systematic, high-specificity investigation of gene function to reveal determinants of tumor proliferation, survival, and therapy response. Compared with RNA interference, CRISPR provides cleaner on-target knockout and more interpretable phenotypes, allowing efficient discovery of essential genes and synthetic-lethal interactions. Although the Cancer Dependency Map profiled 89 OSCC/HNSCC lines to nominate baseline dependencies, drug-perturbed states critical for understanding platinum resistance remain underexplored. Only a handful of HNSCC studies have applied genome-wide CRISPR cas9 screening: two mapped core essential genes; two mapped cisplatin resistance and radiation resistance; and others uncovered synthetic-lethal targets, including vulnerabilities to mTOR inhibition, EGFR inhibition, glutamine metabolism inhibition, and host determinants of oncolytic HSV-1 efficacy. This review synthesizes these findings, highlights methodological considerations (library design, coverage, and treatment duration), and integrates complementary functional data to prioritize targets for rational combinations. This review also provides information on the TCGA database and in vivo CRISPR screening that can accelerate precision therapeutics for patients with HNSCC. Full article

Background/Objectives: Neck muscle vibration alters neural processing, sensorimotor integration, and proprioception in healthy adults. Significant differential changes in the N18 and N24 somatosensory evoked potential (SEP) peak amplitudes, coupled with altered motor learning, occurred when completion of a force-matching task took place following neck muscle vibration. It is currently unknown if neck muscle vibration also impacts acquisition of skills from visuomotor tracking tasks, a gap this research addresses. Methods: A total of 25 right-handed, healthy participants were divided into vibration (age: 21.7 ± 1.89, n = 13; 8 females) (V) and no-vibration (NV) control (age: 21.2 ± 3.03, n = 12; 6 females) groups. The vibration was device applied over the right sternocleidomastoid and left cervical extensor muscles. The participants underwent right-median-nerve stimulation at 2.47 Hz and 4.98 Hz to elicit SEPs. A total of 1000 sweeps were recorded and averaged using an ANT Neuro Waveguard 64-lead EEG cap (ANT Neuro, the Netherlands, Manufactured by Eemagine, Berlin, Germany)pre- and post-completion of a novel visuomotor tracing task (MTT). Post-acquisition, the NV group had a 10 min rest, and the V group received 10 min of vibration at 60 Hz before motor task completion, followed immediately by post-acquisition and retention 24 h after. Results: N18 peak: The V group exhibited a proportional amplitude increase of 19%, while the NV group exhibited a 36% decrease. There was a trend toward decreased retention in the V group. P25 showed a significant effect of time, with increases of 11% for V and 9% for NV. Conclusions: V resulted in N18 SEP changes post-MTT-skill-acquisition. Both groups appeared to learn, with the V trending towards less retention. Full article

Background/Objectives: The preoperative length of hospital stay (PLHS) is the only major modifiable factor in hip fracture surgery. Identifying the optimal timing for the procedure is crucial for reducing the risk of death. We aimed to explore the association between PLHS and all-cause mortality within six years among adult trauma care patients, as well as to identify independent predictors of mortality. Methods: This retrospective study included all patients ≥ 18 years with primary hip fractures who were admitted to our level I trauma center from 1 January 2015, to 31 December 2018, and who underwent surgery. We subdivided the PLHS into four categories—≤24 h, 24 to 36 h, 36 to 48 h, and >48 h—and performed survival and subgroup analyses. Results: The inclusion criteria yielded 1604 females and 700 males, comprising 1235 intertrochanteric and subtrochanteric fractures and 1069 femoral neck fractures. Performing surgery in any of the first three categories was not independently associated with a reduced risk of mortality within six years compared to surgery delayed for more than 48 h. The independent predictors of mortality were older age, male gender, ASA ≥ 3, CCI ≥ 3, in-hospital complications, and a longer postoperative hospital stay. Patients with intertrochanteric fractures had a significantly higher mortality risk compared to those with femoral neck fractures. Conclusions: The timing of hip fracture surgery is not an independent predictor of mortality. Surgical delay correlates with mortality, but may reflect comorbidity-related selection rather than a direct causal effect. Full article

Background/Objectives: Incomplete cut marks produced during dismemberment are often interpreted as indicative of saw class characteristics. However, empirical validation of these associations remains limited, with prior studies examining six or fewer saws. Considering the wide variety of saws available, it is critical to assess the reliability of reported relationships between kerf features and saw classification using a larger sample, particularly in light of the serious legal consequences of erroneous conclusions. This study examines the statistical relationships between five incomplete cut traits—kerf profile shape (KPS), kerf length shape (KLS), floor dip (FD), kerf flare (KF), and floor striae (FS)—and saw class characteristics, including tooth set, tooth shape, teeth-per-inch, power, handle orientation, and cut direction. Methods: Kerf features were scored on a sample of 472 incomplete cuts made with 34 power and hand saws. Results: In reciprocating saws, W-shaped KPS was exclusively associated with crosscut, alternating saws (100%; p < 0.001), with hourglass-shaped KLS also primarily made by alternating sets (95.6%). Necked KLS was linked to wavy sets (76.8%; p < 0.001). FD, though rare, could be correctly assigned to teeth-per-inch groups (86.4%), and was also predominantly associated with alternating saws (90.9%; p < 0.001). Undulating FS were indicative of alternating saws with less than 20 teeth-per-inch (100%, p < 0.001). In contrast, KF showed no strong relationship with saw class characteristics, including handle side. Conclusions: The results of this large-scale analysis support most reported relationships in the saw mark literature but challenge assumptions that KF reliably indicates handle orientation or cut direction, suggesting instead that its location may reflect sawyer technique. Full article

Background and Clinical Significance: Tandem pathology at the dominant-hemisphere middle cerebral artery (MCA)—combining a wide-neck bifurcation aneurysm that shares the neck with both M2 origins and a short dorsal M1 fusiform dilation embedded in the lenticulostriate belt—compresses the therapeutic margin and complicates device-first pathways. We aimed to describe an anatomy-led, microscope-only sequence designed to secure an immediate branch-definitive result at the fork and to remodel dorsal M1 without perforator compromise, and to place these decisions within a pragmatic perioperative framework. Case Presentation: A 37-year-old right-handed man with reproducible, load-sensitive cortical association and capsulostriate signs underwent high-fidelity digital subtraction angiography (DSA) with 3D rotational reconstructions. Through a left pterional approach, vein-respecting Sylvian dissection achieved gravity relaxation. Reconstruction proceeded in sequence: a fenestrated straight clip across the bifurcation neck with the superior M2 encircled to preserve both M2 ostia, followed by a short longitudinal clip parallel to M1 to reshape the fusiform segment while keeping each lenticulostriate mouth visible and free. Temporary occlusion windows were brief (bifurcation 2 min 30 s; M1 < 2 min). No neuronavigation, intraoperative fluorescence, micro-Doppler, or intraoperative angiography was used. No perioperative antiplatelets or systemic anticoagulation were administered and venous thromboembolism prophylaxis followed institutional practice. The bifurcation dome collapsed immediately with round, mobile M2 orifices, and dorsal M1 regained near-cylindrical geometry with patent perforator ostia under direct inspection. Emergence was neurologically intact, headaches abated, and preoperative micro-asymmetries resolved without new deficits. The early course was uncomplicated. Non-contrast CT at three months showed structurally preserved dominant-hemisphere parenchyma without infarction or hemorrhage. Lumen confirmation was scheduled at 12 months. Conclusions: In dominant-hemisphere tandem MCA disease, staged, perforator-sparing clip reconstruction can restore physiologic branch and perforator behavior while avoiding prolonged antiplatelet exposure and device-related branch uncertainty. A future-facing pathway pairs subtle clinical latency metrics with high-fidelity angiography, reports outcomes in branch- and perforator-centric terms, and, where available, incorporates patient-specific hemodynamic simulation and noninvasive lumen surveillance to guide timing, technique, and follow-up. Full article

Background and Objectives: Spinopelvic alignment may affect the outcomes of total hip arthroplasty (THA), with pelvic version influencing the risk of mechanical complications occurring after surgery. On the other hand, THA surgery itself may contribute to the modification of pelvis version. The sacro-femoro-pubic (SFP) angle is measured on anteroposterior (AP) radiographs of the pelvis in a supine position, and is used to estimate pelvic tilt (PT), representative of pelvic version, which requires lateral views of the sacrum for its calculation; however, these X rays are not routinely performed in the preoperative setting of hip surgery. This study aims to analyze how THA determines changes in the pelvic version of operated patients; the SFP angle will be used to assess pelvic version on standard AP radiographs. Materials and Methods: This retrospective study included 182 consecutive patients undergoing THA for unilateral primary degenerative hip osteoarthritis (HOA-study group, n = 104) or femoral neck fracture (FNF-control group, n = 78) at the author’s institution. The SFP angle was measured on AP pelvic radiographs of the non-replaced hip preoperatively, postoperatively, and at the last follow-up. PT values were derived from SFP angles. Pre- and postoperative PT and its variations ΔPT were assessed. Study groups were compared in terms of native and postoperative variations of pelvic version. Results: The average absolute value of ΔPT was 2.99° ± 3.07° in the HOA group and 3.57° ± 2.92° in FNF group. There was no significant overall difference in preoperative or postoperative PT values between groups. In both groups, THA surgery led to a certain improvement, still not significant, in pelvic orientation, with FNF patients presenting a greater tendency toward retroversion. No significant differences in complication rates were found comparing patients with different pelvic orientations. Conclusions: THA can lead to a “normalization” of pelvic version in a certain number of patients with preoperative anteversion or retroversion. Although statistically non-significant, this observation may have clinical implications for spinopelvic balance and could support prioritizing THA in patients with concurrent spinal disease. Further research is needed to confirm these findings and to evaluate the long-term impact of THA on spinopelvic alignment. Full article

Objective: Retained primitive reflexes are associated with delayed motor and behavioral development in children with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). This study examined the effects of a 12-week structured exercise intervention on reflex integration, motor coordination, and socio-behavioral outcomes in these populations. Method: Fifteen children with ASD (13 boys, 2 girls) and twelve with ADHD (8 boys, 4 girls), aged 6–12 years, participated in rhythmic, balance, and coordination-based exercises. Primitive reflexes, including the asymmetrical tonic neck reflex (ATNR), were assessed using standardized protocols, and fine motor coordination was evaluated using the Finger and Thumb Opposition Test (FOT). Behavioral outcomes were measured using the Social Responsiveness Scale-2 (SRS-2) for the ASD group and the Conners 3 for the ADHD group. Results: The ASD group showed significant reductions in left-standing ATNR retention scores (p = 0.012) and improvements in right-hand FOT scores (p = 0.023). In the ADHD group, significant improvements were also observed in right-hand FOT scores (p = 0.007). Furthermore, Conners 3 Total and Global Index scores significantly decreased in the ADHD group (p = 0.016 and 0.020, respectively). Reflex retention patterns appeared broader and more bilateral in ASD than in ADHD, suggesting distinct motor developmental profiles. Conclusions: Short-term rhythmic, balance, and whole-body coordination exercise interventions may support behavioral and motor development in children with ASD and ADHD. Tailored programs emphasizing reflex integration hold promise for clinical and educational applications. Full article

The demeanour of a human during an interaction with an animal may influence the animal’s emotional response. We investigated whether the emotional responses of laying hens to a threatening or neutral human and a novel environment were lateralised, from which their emotional state can be inferred. Twenty-five DeKalb white laying hens reared in furnished cages under environmentally controlled conditions were individually assessed for their responses to these stimuli. They were contained in a box before emerging into an arena with a threatening human, who attempted direct eye contact with the bird and had their hands raised towards it, or a neutral person, who had no eye contact and sat with their hands on their knees. When initially placed in the box adjacent to the test arena, birds that remained in the box used their left eye more than their right eye, and they showed evidence of nervousness, with many head changes, neck stretching, and vocalisation. Birds showed lateralised behaviour in both the box and arena. Birds entering the arena with the threatening person used their left eye (connected to the right brain hemisphere) more than their right eye, usually with their body less vertical, and were more likely to be standing than sitting, compared with those viewing the neutral person. This confirms the bird’s interpretation of the person as threatening, with left eye/right brain hemisphere processing of flight or fight situations. We conclude that lateralised responses of chickens suggest that a threatening person is viewed more fearfully than a neutral person. However, further investigation is required with a larger sample of birds to strengthen these findings and enhance the generalisability of behavioural responses. Full article

Especially in real-world circumstances with uneven road surfaces and impulsive shocks, nonlinear dynamic effects in vehicle systems can greatly skew biometric data utilized to track passenger and driver physiological states. By creating a thorough multibody human–seat–chassis model, this work tackles the effect of vehicle-induced vibrations on the accuracy and dependability of biometric measures. The model includes external excitation from road-induced inputs, nonlinear damping between structural linkages, and vertical and angular degrees of freedom in the head–neck system. Motion equations are derived using a second-order Lagrangian method; simulations are run using representative values of a typical car and human body segments. Results show that higher vehicle speed generates more vibrational energy input, which especially in the head and torso enhances vertical and angular accelerations. Modal studies, on the other hand, show that while resonant frequencies stay constant, speed causes a considerable rise in amplitude and frequency dispersion. At speeds ≥ 50 km/h, RMS and VDV values exceed ISO 2631 comfort standards in the body and head. The results highlight the need to include vibration-optimized suspension systems and ergonomic design approaches to safeguard sensitive body areas and preserve biometric data integrity. This study helps to increase comfort and safety in both traditional and autonomous car uses. Full article