Search Results (45,488)

Pancreatic cancer (PC) remains one of the malignancies with the most unfavorable prognosis and limited treatment options. The lack of biomarkers for early diagnosis and the asymptomatic nature of the disease contribute to delays in diagnosis and high mortality rates. In recent years, the role of the human microbiota in cancer biology has become increasingly significant, and the oral microbiota in particular has been found to be involved in the pathogenesis and prognosis of several neoplasms. This review summarizes the current evidence relating the salivary microbiota to PC in three key areas: screening and diagnostic potential, pathophysiology and tumor progression, as well as presenting prognostic implications and potential influence on therapy. With regard to early diagnosis, it has been reported that patients with PC have reduced levels of Neisseria elongata (N. elongata) and Streptococcus mitis (S. mitis) and elevated levels of Granulicatella adiacens. Several studies have shown that bacteria present in the saliva can migrate from the oral cavity to pancreatic tissue via hematogenous or enteric routes, where they may actively contribute to tumor development and progression. In particular, it has been shown that Porphyromonas gingivalis (P. gingivalis) and Veillonella atypica (V. atypica) translocate from the mouth to pancreatic tumors, promoting carcinogenesis by inducing a pro-inflammatory tumor microenvironment. Furthermore, some studies have identified certain species associated with prognosis and response to PC treatment. Despite the encouraging results, differences in study methodology, the lack of standardized methods and the scarcity of longitudinal data currently hinder clinical application. Large-scale, multi-omics prospective studies are needed to clarify causality and validate their clinical utility. Overall, the salivary microbiota represents a promising and non-invasive tool for improving early diagnosis, understanding prognosis and enhancing the management of PC. Full article

Oral squamous cell carcinoma (OSCC) frequently develops within chronically injured oral mucosa and may be preceded by clinically recognizable oral potentially malignant disorders (OPMDs), which provide an important window for cancer interception. This review examines how etiological exposures, persistent inflammation, and lesion-specific epithelial–stromal–immune interactions cooperate during the transition from mucosal injury to dysplasia, carcinoma in situ, and invasive OSCC. Major carcinogenic exposures, including tobacco, alcohol, and areca nut, are considered together with context-dependent contributors such as microbial dysbiosis, viral infection, and immune-mediated epithelial injury. At the molecular level, inflammation-driven oral carcinogenesis involves cytokine and chemokine amplification, oxidative and nitrosative stress, NF-κB and STAT3 activation, the COX-2/PGE₂ axis, genomic instability, field cancerization, epithelial–stromal crosstalk, angiogenesis, immune dysregulation, and epigenetic and non-coding RNA-mediated reprogramming. Emerging tools such as molecular risk assessment, liquid biopsy, optical imaging, spatially resolved profiling, and artificial intelligence-assisted models may improve identification of high-risk lesions, although most biomarkers require further prospective validation. Prevention should therefore integrate exposure control, biopsy-based diagnosis, local treatment when indicated, long-term surveillance, and trial-based precision strategies according to lesion risk, intervention window, and safety profile. This review supports a shift from lesion-centered management toward risk-adapted precision prevention in inflammation-driven oral carcinogenesis. Full article

Search and rescue (SAR) dog–handler teams work under challenging conditions that may influence long-term physiological stress and arousal. Hair steroid analysis provides a reliable measure of chronic endocrine activity in SAR teams. Hair cortisol (HCL) and hair testosterone (HTL) offer non-invasive markers of chronic hypothalamic–pituitary–adrenal (HPA) and (the hypothalamic–pituitary–gonadal) HPG axis activity. This study examined long-term endocrine patterns in SAR dogs and their handlers and explored correlations within and between species. Hair samples were collected from 60 SAR dogs and their handlers. Dog hair was taken from the interscapular region, and human hair from the occipital area. Cortisol and testosterone were extracted using established methanol-based protocols and quantified via ELISA. Dogs showed a mean HCL of 10.974 pg/mg and a mean HTL of 3.008 pg/mg. Female dogs had significantly higher cortisol levels than males, and cortisol tended to increase with age. Testosterone did not differ by sex, breed, or castration status. Handlers showed a mean HCL of 10.874 pg/mg and a mean HTL of 2.925 pg/mg, with no sex differences. However, handler cortisol levels varied significantly by dog breed. Additionally, HCL levels of dogs and their handlers were negatively correlated. Full article

Background: Vertebrogenic low back pain (LBP) is a distinct subtype of chronic LBP (cLBP) arising from nociceptive sensitization of the basivertebral nerve (BVN) within pathologically altered vertebral endplates. Modic type 1 and type 2 changes on MRI are primary imaging biomarkers for patient selection. Basivertebral nerve ablation (BVNA), a minimally invasive intraosseous radiofrequency procedure, has emerged as a targeted treatment for this condition. This narrative review aims to synthesize current evidence on the pathophysiology of vertebrogenic LBP, patient selection criteria, procedural outcomes, safety profile, and cost-effectiveness of BVNA. Methods: We conducted this narrative review of the literature, encompassing randomized controlled trials (including the SMART and INTRACEPT studies), prospective registries, and real-world cohort studies evaluating BVNA for vertebrogenic LBP. Clinical and imaging-based selection criteria, procedural techniques, outcome measures, adverse events, opioid utilization, and healthcare utilization data were examined. Results: Evidence demonstrates consistent and durable reductions in pain and disability following BVNA, with a favorable safety profile. Complication rates are low, with vertebral compression fracture and procedure-related radicular pain reported as the most frequent adverse events. BVNA is associated with reduced opioid consumption and decreased overall healthcare utilization. Moreover, emerging data suggest efficacy beyond originally defined inclusion criteria, including cases of osteoporosis, multilevel Modic changes, adult spinal deformity, and complex comorbid presentations. Conclusions: BVNA represents an effective and safe treatment option within the multimodal management of vertebrogenic LBP. Current evidence supports a gradual expansion of procedural indications, with implications for healthcare resource optimization and opioid stewardship. Full article

To characterize the distinct expression profiles of microRNAs (miRNAs) in serum and tissue and to delineate the heterogeneity of their regulatory mechanisms in early-stage ovarian cancer (EOC), thereby identifying candidate biomarkers for non-invasive early diagnosis. Differentially expressed miRNAs were identified by integrating publicly available datasets of EOC tissues and serum samples from the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA). Core miRNAs were subsequently screened through integrated differential expression analysis, weighted gene co-expression network analysis (WGCNA), and feature importance ranking derived from optimized machine learning models. Protein–protein interaction (PPI) networks and functional enrichment analyses (GO and KEGG) were performed on predicted target genes to systematically compare the functional discrepancies between serum- and tissue-derived miRNAs. No overlapping core miRNAs were observed between the two compartments. Serum miRNAs exhibited an overall up-regulated trend, whereas tissue miRNAs were predominantly down-regulated. Although the regulatory pathways demonstrated significant heterogeneity, they ultimately converged on the cell cycle and the PI3K-Akt signaling pathway, indicating high functional homology. Furthermore, serum miRNAs are not merely passive leakage products from tissues; current evidence suggests they may be selectively packaged into exosomes to participate in tumor regulation. Despite divergent expression profiles, serum and tissue miRNAs share homologous regulatory functions in EOC. These findings suggest that serum miRNAs accurately reflect the core molecular status of tumor tissues, providing a robust molecular foundation for liquid biopsy-based early detection strategies. Full article

Background: The diagnostic value of surface electromyography (sEMG) for identifying muscles affected by myofascial trigger points (TrPs) remains controversial. However, advances in pain neurophysiology and discussions regarding TrPs within the International Classification of Diseases (ICD-11) have renewed interest in objective diagnostic approaches. Objective: To synthesize current evidence on the diagnostic utility of sEMG for detecting TrP-related muscle alterations across different electromyographic signal analysis domains. Methods: A scoping review was conducted following JBI guidance and PRISMA-ScR guidelines. PubMed, Scopus, Web of Science, CINAHL and Cochrane were searched for studies involving adults with symptomatic or asymptomatic TrPs, myofascial pain syndrome, or TrP-related referred pain. Fifteen studies met the inclusion criteria. Analyses included amplitude-, frequency-, time–frequency-, and spatial-domain sEMG parameters. Results: Muscles affected by TrPs showed increased resting electromyographic activity and reduced activation during maximal voluntary contraction in several studies. Frequency domain analyses indicated changes in median frequency and muscle fatigue index, whereas time–frequency analyses suggested redistribution of sEMG signal energy toward lower-frequency components or altered spectral power during experimentally provoked referred pain. Spatial analyses revealed altered activation patterns, although these findings did not consistently correspond with TrP anatomical locations. Overall, the limited number of studies assessing diagnostic sensitivity and specificity prevents firm conclusions. Conclusions: sEMG may be useful as a non-invasive complementary tool for functional assessment and monitoring of TrP-related muscle dysfunction. However, current evidence does not support its use as a standalone diagnostic method. Time–frequency, machine learning-supported and spatial analyses appear promising for future clinical research, but standardized protocols and external validation are required before clinical diagnostic criteria can be proposed. Full article

Head and neck cancer (HNC), particularly oral squamous cell carcinoma (OSCC), remains a major clinical challenge due to its aggressive behavior, high recurrence rates, and frequent resistance to conventional therapies. Natural compounds, especially curcumin and its derivatives, have gained increasing attention as potential anticancer agents due to their ability to target multiple molecular pathways involved in tumor progression. This review critically evaluates the current preclinical and translational evidence supporting curcumin and its derivatives as monotherapeutic agents in HNC, with particular emphasis on oral cancer. We integrate the available evidence to assess the biological rationale, therapeutic potential, and current limitations of curcumin-based approaches. The molecular mechanisms underlying their antitumor activity are discussed, including modulation of EGFR/ERK and PI3K/Akt signaling pathways, inhibition of NF-κB and STAT3 activation, induction of apoptosis, regulation of oxidative stress, and suppression of epithelial–mesenchymal transition and tumor invasiveness. In addition, we address the impact of curcumin on the tumor microenvironment and its role in overcoming intrinsic cellular resistance mechanisms. The review also highlights advances in drug delivery strategies, such as nanoformulations, that are designed to improve curcumin’s bioavailability and therapeutic efficacy. By critically integrating current evidence, this review highlights both the promise and the challenges associated with curcumin-based monotherapy in HNC, emphasizing the need for more robust and clinically relevant studies to support future translation. Full article

Deep unconventional oil and gas reservoirs are critical to hydrocarbon exploration and development in China. However, their complex geological and petrophysical features, including high temperature, high pressure, high salinity, multiple pressure systems, and intricate pore–fracture structures, make them highly susceptible to formation damage during drilling, completion, stimulation, and production. Effective reservoir protection is therefore essential for minimizing damage and improving development efficiency. This paper systematically reviews recent advances in reservoir protection for deep unconventional reservoirs, with a focus on evaluation methods and protective materials. Laboratory evaluation methods, including permeability recovery, nuclear magnetic resonance, pressure decay, and spontaneous imbibition, together with field-based approaches such as well testing and production decline analysis, are summarized and assessed for their applicability to complex damage characterization. Major damage mechanisms, including liquid-phase trapping, solid invasion, sensitivity damage, stress sensitivity, and wettability alteration, are analyzed with emphasis on working fluid–reservoir interactions under multi-field coupling conditions. Recent progress in protective materials is also reviewed, covering polymer-based materials such as gel sealing agents, delayed-swelling hydrogels, water-/oil-soluble temporary plugging agents, and film-forming polymers, as well as ultrafine CaCO₃ and fiber-based materials. In addition, related protection technologies, including temporary plugging, film-forming fluid-loss control, underbalanced drilling, and low-damage completion fluids, are discussed. Existing models developed for conventional sandstone reservoirs are insufficient for deep unconventional systems. Future research should prioritize integrated evaluation and protection methods tailored to deep tight, shale, and fractured–vuggy carbonate reservoirs. This review provides a basis for understanding complex damage mechanisms, developing functional protective materials, and advancing integrated reservoir protection technologies for the efficient development of deep unconventional resources. Full article

Non-thermal millimeter-wave (MMW) irradiation represents a promising non-invasive strategy for cancer therapy, yet its effects in physiologically relevant 3D systems remain poorly defined. Here, we evaluated the biological impact of MMW exposure in 3D non-small-cell lung cancer (NSCLC) spheroids (NCI-H1299, A549) and normal WI-38 fibroblasts under active cooling to suppress bulk heating. We demonstrate that cellular responses are governed primarily by power density (PD), irradiation geometry, and genotype-dependent susceptibility. High-PD pyramidal horn (PH) irradiation (~4.9 mW/cm²) induced rapid apoptosis, metabolic collapse, and near-complete loss of clonogenic survival, whereas lower-PD waveguide (WG) irradiation (~0.6 mW/cm²) produced depth-limited, cumulative cytotoxicity. Surviving cancer cells exhibited robust senescence-associated growth arrest, particularly in p53-deficient NCI-H1299 cells, indicating a dual apoptotic–senescent anti-proliferative response. In contrast, WI-38 fibroblasts showed minimal apoptosis and only transient stress-associated senescence, confirming selective tumor vulnerability. Mechanistic modeling suggests that MMW energy couples to glycan-rich membrane domains, generating localized electromagnetic hotspots that trigger calcium influx, mitochondrial dysfunction, and depth-dependent apoptosis. These findings establish a mechanistic basis for selective, non-thermal MMW-induced cytotoxicity in 3D NSCLC models and support further preclinical development of MMW-based therapeutic strategies. Full article

Early rectal cancer represents a challenging setting in which accurate locoregional staging is essential to guide appropriate treatment. Current diagnostic strategies primarily include magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS). However, both modalities show significant limitations in early-stage disease, particularly in T staging. This diagnostic gap impacts therapeutic decision-making, particularly in patients with lesions suggestive of deep submucosal invasion. In these cases, endoscopic submucosal dissection (ESD) may be insufficient to achieve adequate vertical negative margins, whereas radical surgery is associated with considerable morbidity and potential impairment of quality of life. In this gray zone, endoscopic intermuscular dissection (EID) has recently emerged as a novel therapeutic approach designed to overcome the limitations of standard endoscopic resection. By enabling dissection within the deeper intermuscular plane, it can achieve curative resections while preserving rectal wall integrity. This narrative review aims to explore the current diagnostic gaps in early rectal cancer and to define the potential role of EID within the current therapeutic algorithm. Full article

Introduction: The Iberian killifish (Apricaphanius iberus), an endemic cyprinodontid of the Spanish Mediterranean coast, is a key conservation species due to its restricted distribution, high sensitivity to habitat alteration and invasive fish, and ecological role in saline wetlands. Classified as Endangered by national administration and listed in Annex II of the EU Habitats Directive, its populations have undergone severe declines across its native range. Coastal salt pans have become critical refuges for the persistence of this species, often supporting some of the highest population densities recorded. However, the conservation value of these anthropogenic systems strongly depends on hydrological management, which directly influences habitat stability and suitability. Objectives: This study aims to assess the long-term population responses of A. iberus under contrasting hydrological management regimes in coastal salt pans. Methodology: We analysed ten years of monitoring data across five salt pan circuits in the perimeter area of the Mar Menor coastal lagoon (SE Spain), covering a salinity gradient and three management regimes: economic exploitation (EE), preventive management (PM), and non-management (NM). Population metrics (occurrence, abundance and breeder proportion) were evaluated. Results: Population performance differed markedly among management regimes. EE circuits showed consistently high occurrence and abundance, including in hypersaline ponds, high breeder proportions, low interannual variability, and weak dependence on meteorological conditions and ephemeral prey. PM circuits displayed intermediate patterns. In contrast, NM circuits exhibited low occurrence and abundance, low breeder proportions, high temporal fluctuations, and strong dependence on meteorological variability. Conclusions: Hydrological management is a key determinant of A. iberus population stability in coastal salt pans. Maintaining or restoring traditional management practices enhances habitat suitability, buffers environmental variability, and supports conservation actions such as reintroduction. These findings highlight the critical role of managed anthropogenic wetlands as refuges for endangered fishes and provide a transferable framework for conservation under global change. Full article

Background and Objectives: Uterine metastasis from breast carcinoma is rare but poses substantial diagnostic and therapeutic challenges. Invasive lobular carcinoma (ILC) demonstrates a documented predilection for unusual metastatic patterns including the female genital tract, while tamoxifen-associated endometrial pathology may complicate diagnosis in breast cancer survivors. Materials and Methods: We performed a structured PubMed/MEDLINE and Google Scholar search (1980–2025) for cases with histologically confirmed breast primary and uterine involvement; a pooled analysis of demographic, histological, molecular, and clinical variables was performed. Results: 105 individual cases were identified. ILC accounted for 58.0% of histologically classified cases despite representing only 10–15% of breast cancers. Endometrial involvement was present in 68.6%, myometrial in 25.7%, and cervical in 26.7%. Tamoxifen exposure was strongly associated with polyp-substrate metastasis (29.3% vs. 4.7%; Fisher’s exact p = 0.0009; OR 8.41, 95% CI 2.20–32.14). Abnormal uterine bleeding was the dominant presentation (68.1%); 19.8% were asymptomatic. Median latency was 36 months (range from 24 months before to 360 months after the breast cancer diagnosis). Conclusions: Uterine metastasis from breast carcinoma is dominated by invasive lobular histology and frequently involves tamoxifen-associated polyps. A combined immunohistochemical panel (GATA3, TRPS1, E-cadherin, hormone receptors, PAX8) is essential for distinguishing metastatic disease from primary uterine pathology. Endometrial sampling should be considered with a low threshold in breast cancer survivors with abnormal uterine bleeding, and breast imaging is warranted when discohesive cells are encountered without a known breast primary. These proportions describe the published case literature rather than population-based prevalence; because the evidence is limited to case reports and small series, they should not be read as the true frequency of uterine involvement among women with breast cancer. Full article

Medical infrared thermography, which involves the use of infrared thermal cameras for the non-invasive assessment of skin surface temperature distribution, has gained increasing interest in recent years as a tool supporting diagnosis and treatment monitoring. The aim of this article is to present the historical background and critically reassess the current role of infrared thermography in medicine, with particular emphasis on standardization as a key determinant of its clinical utility. This Perspective highlights the fundamental impact of methodological variability on diagnostic performance and reproducibility. A structured framework for standardization is proposed, encompassing patient preparation, environmental conditions, device parameters and calibration, image acquisition protocols, region-of-interest definition and analysis, as well as reporting and clinical interpretation. The analysis demonstrates how inconsistencies at each of these levels reduce measurement reliability, limit inter-study comparability, and weaken clinical confidence in infrared thermography. The article also addresses the growing availability of mobile thermal imaging systems and their integration with artificial intelligence, while emphasizing the need for stronger evidence-based support across all methodological domains. The presented analysis suggests that, despite existing limitations, medical infrared thermography holds considerable potential as a supportive clinical tool. However, its broader clinical implementation remains limited by several factors, with the lack of standardized protocols constituting a major and practically addressable translational barrier. Wider adoption will require standardization efforts alongside rigorous validation studies and application-specific interpretative guidelines. Addressing these challenges through technological advances and coordinated international standardization may facilitate meaningful progress over the next decade. Full article

Introduction: Freshwater fish communities in Mediterranean basins have undergone profound changes over recent decades due to biological invasions, habitat alteration, and hydrological regulation. The Segura River basin (SE Spain), particularly in the Region of Murcia, represents a paradigmatic case of these transformations, with increasing pressures on native ichthyofauna and growing relevance for recreational fisheries. Objective: This study aims to provide an updated inventory of fish communities in the rivers and reservoirs of the Region of Murcia, assessing current composition, relative abundance, and conservation status. Methodology: Fish assemblages were surveyed during sampling campaigns conducted in autumn 2023, 2024 and 2025. Sampling sites included representative reservoirs and river reaches within the middle sector of the Segura River basin, focusing on areas of interest for recreational fishing. Passive fishing gears were used in reservoirs, while electrofishing was conducted in riverine habitats. Presence and relative abundance data were recorded for all detected taxa. Results: A total of 15 taxa were identified (8 in reservoirs and 15 in river reaches). Reservoir communities were almost entirely dominated by non-native invasive species, including Cyprinus carpio, Alburnus alburnus, Sander lucioperca, Micropterus salmoides, Lepomis gibbosus, and Gambusia holbrooki, with Luciobarbus sclateri as the only native species. Riverine sections of the main channel also showed a strong dominance of exotic taxa, with additional species such as Esox lucius, Oncorhynchus mykiss, Gobio lozanoi, and Pseudochondrostoma polylepis. Native species detected included L. sclateri (dominant), Anguilla anguilla, and Salariopsis fluviatilis, the latter showing a recent expansion likely linked to human-mediated introduction. Isolated tributaries hosted the most valuable assemblages, including populations of L. sclateri, Squalius tartessicus, and the endangered Valencia hispanica (recently unauthorized translocations into the Segura river basin). Conclusions: Current fish communities in the Region of Murcia reflect a marked ecological degradation compared to historical conditions, driven by the proliferation of non-native species and habitat alteration. Changes over the last 30 years have been particularly pronounced in reservoirs and regulated sections of the main river channel, where local extinction of the native S. tartessicus has also been detected. Only the headwaters of certain tributaries retain fish assemblages of notable conservation interest, highlighting their priority for management and protection. Full article

Background/Objectives: Advanced implant anchorage techniques are increasingly used to manage severe maxillary bone deficiency and to avoid extensive bone augmentation procedures. This case series report aimed to describe the canine bypass anchorage technique and to evaluate the short- to medium-term clinical outcomes and survival of implants placed using this approach. Materials and Methods: Thirteen patients presenting with missing maxillary premolars or posterior segments and insufficient alveolar bone height for conventional axial implant placement were treated using the canine bypass technique. A total of 19 long one-piece implants were inserted palatally to the canine root, engaging distant cortical bone of the nasal cavity and/or palatal alveolar process. Pre- and postoperative cone-beam computed tomography (CBCT) examinations were performed to assess implant positioning and anchorage. Patients were followed up to 3.5 years. Results: The mean follow-up period was 26.1 ± 10.8 months. Nasal cortical anchorage was achieved in 84.2% of implants, and palatal cortical anchorage in 73.7%; both anchorage types were obtained simultaneously in 57.9% of cases. The mean distance between the implant and canine root was 1.27 ± 1.4 mm (range: −1.0 to 4.5 mm), including cases of direct implant–tooth contact and periodontal ligament space transgression. All implants remained functional throughout the observation period, yielding a cumulative survival rate of 100%. Canine pulp vitality was preserved in all non-endodontically treated teeth. Conclusions: Within the limitations of this case series report, the canine bypass anchorage technique appears to be a feasible and minimally invasive treatment option for maxillary rehabilitation with implant-supported restoration in selected patients with severe bone deficiency, potentially allowing avoidance of sinus augmentation procedures. Further prospective studies with larger patient cohorts and longer follow-up periods are required to confirm the long-term safety, predictability, and clinical applicability of this approach. Full article