Search Results (196)

Wound care in military and combat environments poses distinct challenges that set it apart from conventional medical practice in civilian settings. The nature of injuries sustained on the battlefield—often complex, contaminated, and involving extensive tissue damage—combined with limited access to immediate medical intervention, significantly increases the risk of infection, delayed healing, and adverse outcomes. Traditional wound dressings frequently prove inadequate under such extreme conditions, as they have not been designed to address the specific physiological and logistical constraints present during armed conflicts. This review provides a comprehensive overview of recent progress in the development of advanced wound dressings tailored for use in military scenarios. Special attention has been given to multifunctional dressings that go beyond basic wound coverage by incorporating biologically active macromolecules such as collagen, chitosan, thrombin, alginate, therapeutic peptides, and growth factors. These compounds contribute to properties including moisture balance control, exudate absorption, microbial entrapment, and protection against secondary infection. This review highlights the critical role of advanced wound dressings in improving medical outcomes for injured military personnel. The potential of these technologies to reduce complications, enhance healing rates, and ultimately save lives underscores their growing importance in modern battlefield medicine. Full article

Acute myocardial infarction (AMI) in young adults, though less common than in older populations, is an emerging clinical concern with increasing incidence and diverse etiologies. Unlike classic atherosclerotic presentations, a significant proportion of AMI cases in individuals under 45 years are due to nonatherothrombotic mechanisms such as coronary vasospasm, spontaneous coronary artery dissection (SCAD), vasculitis, hypercoagulable states, and drug-induced coronary injury. This manuscript aims to explore the multifactorial nature of AMI in young adults through a focused review of current evidence and a series of illustrative clinical cases. We present and analyze four distinct cases of young patients with AMI, each demonstrating different pathophysiological mechanisms and risk profiles—including premature atherosclerosis, substance use, human immunodeficiency virus (HIV)-related coronary disease, and SCAD. Despite the heterogeneity of underlying causes, early diagnosis, individualized management, and aggressive secondary prevention were key to favorable outcomes. Advanced imaging, lipid profiling, and risk factor modification played a central role in guiding therapy. AMI in young adults requires heightened clinical suspicion and a comprehensive, multidisciplinary approach. Early intervention and recognition of nontraditional risk factors are essential to improving outcomes and preventing recurrent events in this vulnerable population. Full article

A water deer (Hydropotes inermis argyropus) was rescued following a vehicle collision and presented with suspected hip injury. Radiographic examination confirmed coxofemoral luxation, and a femoral head ostectomy (FHO) was performed to restore functional mobility. Postoperatively, the water deer underwent intensive rehabilitation, including controlled movement and physical therapy, to enhance limb function. Following successful recovery, the water deer was equipped with a GPS collar and released into its natural habitat. GPS tracking data were collected to evaluate the water deer’s post-release adaptation and movement patterns. The Minimum Convex Polygon (MCP) method was used to determine the home range, showing an overall home range (MCP 95%) of 8.03 km² and a core habitat (MCP 50%) of 6.967 km². These results indicate a successful post-surgery outcome, with the water deer demonstrating mobility comparable to healthy individuals. This case demonstrates the clinical feasibility of an FHO in managing hip luxation in water deer and underscores the critical role of post-release monitoring in evaluating functional rehabilitation success in wildlife medicine. This study underscores the importance of integrating surgical intervention, structured rehabilitation, and post-release monitoring to ensure the successful reintroduction of injured wildlife. GPS tracking provides valuable insights into long-term adaptation and mobility, contributing to evidence-based conservation medicine. Full article

Central nervous system diseases are highly complex in terms of etiology and pathogenesis, making their treatment and interventions for them a major focus and challenge in neuroscience research. Anthocyanins, natural water-soluble pigments widely present in plants, belong to the class of flavonoid compounds. As natural antioxidants, anthocyanins have attracted extensive attention due to their significant functions in scavenging free radicals, antioxidation, anti-inflammation, and anti-apoptosis. The application of anthocyanins in the field of central nervous system injury, particularly in neurodegenerative diseases, neurotoxicity induced by chemical drugs, stress-related nerve damage, and cerebrovascular diseases, has achieved remarkable research outcomes. However, anthocyanins often exhibit low chemical stability, a short half-life, and relatively low bioavailability, which limit their clinical application. Recent studies have found that the stability and bioavailability of anthocyanins can be significantly improved through nanoencapsulation, acylation, and copigmentation, as well as the preparation of nanogels, nanoemulsions, and liposomes. These advancements offer the potential for the development of anthocyanins as a new type of neuroprotective agent. Future research will focus on the innovative design of nano-delivery systems and structural modification based on artificial intelligence. Such research is expected to break through the bottleneck of anthocyanin application and enable it to become a core component of next-generation intelligent neuroprotective agents. Full article

Human adipose stem cells (ASCs) are multipotent cells expressing mesenchymal stem cell (MSC) markers that are capable of multilineage differentiation and secretion of bioactive factors. Their “homing” to injured tissues is mediated by chemokines, cytokines, adhesion molecules, and signaling pathways. Enhancing ASC homing is critical for improving regenerative therapies. Strategies include boosting chemotactic signaling, modulating immune responses to create a supportive environment, preconditioning ASCs with hypoxia or mechanical stimuli, co-culturing with supportive cells, applying surface modifications or genetic engineering, and using biomaterials to promote ASC recruitment, retention, and integration at injury sites. Scaffolds provide structural support and a biomimetic environment for ASC-based tissue regeneration. Natural scaffolds promote adhesion and differentiation but have mechanical limitations, while synthetic scaffolds offer tunable properties and controlled degradation. Functionalization with bioactive molecules improves the regenerative outcomes of different tissue types. Ceramic-based scaffolds, due to their strength and bioactivity, are ideal for bone healing. Composite scaffolds, combining polymers, ceramics, or metals, further optimize mechanical and biological properties, supporting personalized regenerative therapies. This review integrates concepts from cell biology, biomaterials science, and regenerative medicine to offer a comprehensive understanding of ASC homing and its impact on tissue engineering and clinical applications. Full article

Myocardial infarction (MI) remains a leading cause of morbidity and mortality worldwide. While timely reperfusion therapies such as percutaneous coronary intervention (PCI) and thrombolysis are essential for salvaging ischemic myocardium, they can paradoxically exacerbate tissue injury through a process known as myocardial infarction reperfusion injury (MIRI). MIRI can contribute to up to 50% of the final infarct size, significantly diminishing the benefits of revascularization and leading to worsened cardiac outcomes. The pathophysiology of MIRI involves complex, interrelated mechanisms including oxidative stress, calcium overload, mitochondrial dysfunction, inflammatory responses, apoptosis, and dysregulated autophagy. Post-reperfusion recovery is further complicated by structural and functional abnormalities such as microvascular obstruction, endothelial dysfunction, and myocardial stunning. Clinically, distinguishing reperfusion injury from ischemic damage is challenging and often requires the use of sensitive biomarkers, such as cardiac troponins, alongside advanced imaging modalities. Although a range of pharmacological (e.g., antioxidants, calcium channel blockers, mitochondrial stabilizers, anti-inflammatory agents) and non-pharmacological (e.g., hypothermia, gene therapy, stem cell-based therapies) interventions have shown promise in preclinical studies, their clinical translation remains limited. This is largely due to the multifactorial and dynamic nature of MIRI. In this context, network pharmacology offers a systems-level approach to understanding the complex biological interactions involved in MIRI, facilitating the identification of multi-target therapeutic strategies. Integrating network pharmacology with omics technologies and precision medicine holds potential for advancing cardioprotective therapies. This review provides a comprehensive analysis of the molecular mechanisms underlying MIRI, examines the current clinical challenges, and explores emerging therapeutic strategies. Emphasis is placed on bridging the translational gap through validated, multi-target approaches and large-scale, multicenter clinical trials. Ultimately, this work aims to support the development of innovative and effective interventions for improving outcomes in patients with myocardial infarction. Full article

Ensuring employee safety is a top priority for every enterprise, and it is especially critical in high-risk industries like coal mining. To achieve this goal, it is essential to focus efforts on identifying existing hazards and thoroughly assessing the associated risks. Accurate identification and detailed characterization of occupational hazards play a pivotal role in the occupational risk assessment process, providing the foundation for effective safety strategies. This article presents an analysis of the process of identifying occupational hazards in hard coal mining, based on applicable legal regulations and a review of the relevant literature. The analysis reveals, on the one hand, a diversity of approaches to hazard classification, and on the other, a limited use of the characteristic features of hazards in classification processes. The findings of this review form the basis for proposing a systematic classification of occupational hazards in hard coal mining, taking into account the specific features of hazards in relation to their sources and potential consequences. The proposed classification not only categorizes hazards but also describes the specifics of hazard sources, such as environmental conditions, machinery, chemicals, and human factors, as well as the possible outcomes of these hazards, including physical injury, health impacts, and even fatalities. The aim of this article is to present a proposed classification of occupational hazards in hard coal mining and to provide a detailed characterization of these hazards based on the description of their sources and potential consequences. The proposed approach, grounded in the identification of characteristic features of hazards, facilitates the effective selection of preventive measures that can be implemented to reduce risk and improve workplace safety. Due to the presence of the full spectrum of natural hazards in Polish hard coal mining, the analysis draws on available statistical data, focusing on those hazards that contribute most significantly to fatal accidents and serious injuries. In conclusion, the article emphasizes the importance of a structured and systematic approach to identifying and assessing occupational hazards in the coal mining industry. By drawing on legal and literature-based insights, it aims to contribute to the development of more effective safety practices that protect workers and minimize the occurrence of workplace accidents and illnesses. Full article

Critical-sized bone defects (CSBDs) are injuries that exceed the body’s natural capacity for repair and require external intervention. These defects are particularly challenging in the mandible, often resulting from trauma, tumor resection, or implant-related complications. Effective treatment involves scaffold designs that support vascularization, bone formation, and sufficient mechanical strength. This systematic review aims to assess whether ceramic-based scaffold properties, including porosity, pore size, and macroscopic characteristics, improve vascularization, bone formation, and the mechanical properties in the treatment of CSBDs in large animal models. A search of databases (PubMed, Embase, and Web of Science) identified 11 in vivo studies involving CSBDs (>2 cm), ceramic scaffolds, and histological analysis. Findings indicate that scaffolds with porosity exceeding 50% yield optimal outcomes by striking a balance between cell infiltration and mechanical stability. Pore sizes ranging from 300 μm to 700 μm are ideal for vascularization and bone ingrowth. Three-dimensional (3D) printing shows promise in creating scaffolds with precise and reproducible features. However, the studies varied significantly in their methodologies and outcomes, with no consensus on the optimal scaffold properties for mandibular CSBDs. Scaffold porosity and pore size play key roles in promoting vascularization and bone regeneration. Various animal models reinforce this finding, suggesting that scaffold architecture is crucial for biological integration and functional outcomes. This review highlights the importance of standardized research protocols and clear design criteria in enhancing the success of bone regeneration. Future research should investigate emerging biomaterials and new scaffold technologies to overcome current limitations in clinical applications. Full article

Background: Forensic investigation of child homicides presents unique challenges due to the vulnerability of children and the complexity of distinguishing between natural, accidental, and intentional manner of death. A multidisciplinary approach integrating traditional forensic methods with emerging technologies is crucial to ensure accurate diagnosis and effective legal outcomes. Methods: This review examines current and emerging forensic techniques used in neonate, infant, and older child homicide investigations. It highlights advancements in postmortem imaging, histological examination, microbiological analysis, toxicology, and molecular autopsy. Results: Traditional forensic autopsy remains the cornerstone of child homicide investigations, providing critical insights into external and internal injuries. Histological examination enhances diagnostic accuracy by detecting microscopic evidence of trauma and infectious diseases. Postmortem imaging techniques are complementary for better identifying fractures, soft tissue injuries, and vascular abnormalities. Forensic toxicology plays a key role in detecting poisoning, while postmortem microbiology aids in identifying infectious causes of death. Furthermore, advancements in molecular autopsy and genetic testing have significantly enhanced the identification of hereditary conditions linked to sudden unexplained deaths in children, especially in cases involving multiple child fatalities within the same family, where forensic investigations are needed to accurately differentiate between natural causes and potential criminal involvement. Conclusions: A multidisciplinary approach incorporating traditional autopsy with postmortem imaging, histological examination, toxicology, postmortem microbiology, and molecular autopsy is essential for comprehensive forensic analysis, promoting both justice and prevention of fatal child abuse/homicide. Future research should focus on standardizing forensic protocols and exploring the potential of artificial intelligence (AI) in forensic investigations. Full article

Public safety personnel and frontline healthcare professionals are at increased risk of exposure to potentially psychologically traumatic events (PPTEs) and developing post-traumatic stress injuries (PTSIs, e.g., depression, anxiety) by the nature of their work. PTSI is also connected to increased absenteeism, suicidality, and performance decrements, which compromise occupational and public health and safety in trauma-exposed workers. There is limited evidence on the cost effectiveness of proactive “prevention” programs aimed at reducing the risk of PTSIs. The purpose of this meta-analysis is to measure the economic effectiveness of proactive PTSI mitigation programs among occupational groups exposed to frequent occupational PPTEs, focusing on the outcomes related to PTSI symptoms, absenteeism, and psychological wellness. Findings from 15 included studies demonstrate that proactive interventions can yield substantial economic and health benefits, with Return On Investment (ROI) values ranging widely from −20% to 3560%. Shorter interventions (≤6 months) often produced higher returns, while longer interventions (>12 months) showed more moderate or negative returns. Notably, the level at which an intervention is targeted significantly affects outcomes—programs aimed at managers, such as the 4 h RESPECT training course, demonstrated a high ROI and broad organizational impact by enhancing leadership support for employee mental health. Sensitivity analyses highlighted significant variability based on the organizational context, program design, and participant characteristics. The majority of proactive interventions successfully reduced psychological distress and enhanced workplace outcomes, although thoughtful consideration of program design and implementation context is essential. Full article

Background: Popliteal venous aneurysms (PVA) are an uncommon but potentially severe condition due to their association with increased risk of recurrent pulmonary embolisms. Because of their rarity, their aetiology, natural history, and optimal treatment strategies have been poorly defined. The aim of this paper is to report a comprehensive systematic review on the treatment strategies and outcomes in PVA, summarizing current evidence. Methods: A systematic literature search was conducted in PubMed, Scopus, and Web of Science, covering studies published from database inception through February 2025 (protocol registered on PROSPERO CRD420251008927). The primary endpoint was the analysis of outcomes and complications associated with surgical and conservative management. Results: Nine studies, including 173 adult patients with popliteal venous aneurysms, were included. The mean age was 56 years (range 18–86 years, mean aneurysm diameter 25.4 mm). Most of the patients were female (73, 42.2%). Overall, 85 (49.1%) aneurysms were saccular and 74 (42.8%) fusiform, although morphology was not consistently reported across all studies. Intraluminal thrombus was reported in 26 cases (15.0%), and pulmonary embolism upon presentation in 21 (12.1%). Surgical treatment was performed in 119 patients (68.8%), while 54 (31.2%) were managed conservatively. Fifteen patients (13.0%) experienced postoperative complications, including wound infections (4, 3.5%), hematomas (7, 6.0%), and nerve injury (4, 3.5%), but no cases of postoperative pulmonary embolisms were observed. Following surgery, anticoagulation was indicated in most cases for 3–6 months or a long life. During follow-up (mean 35 months, range 1–262), thrombosis of the surgical reconstruction was observed in 1 patient (0.8%). Death occurred in 3 cases (5.5%), all in the non-surgical group: 2 (3.7%) due to malignancy and 1 (1.9%) from myocardial infarction. Conclusions: PVA is a rarely described condition potentially associated with the risk of PE. In their management, surgical strategies in association with oral anticoagulation represent the most commonly described approach, allowing for satisfactory results and a low rate of complications. Full article

Postoperative infection following anterior cervical spine surgery, particularly when complicated by esophageal injury, is a rare but serious condition associated with significant morbidity and mortality. This review elucidates the complex interplay between postoperative infection and esophageal injury. We systematically analyzed studies from 2000 to 2025 using PubMed, Scopus, and Web of Science, focusing on infection, esophageal injury, surgical outcomes, and management strategies, with emphasis on recent advances in diagnostics, surgical techniques, and postoperative care. Our findings highlight the multifactorial nature of these complications and the critical role of early recognition, accurate diagnosis, and timely management. Imaging modalities such as CT, MRI, and contrast esophagography, along with flexible esophagoscopy, are indispensable in assessing injury and infection extent. Effective management requires a multidisciplinary approach integrating broad-spectrum antibiotics, surgical debridement, vascularized flap reinforcement, negative pressure wound therapy, and antibiotic-loaded cement beads. Meticulous postoperative care with prolonged antibiotics, nutritional support, and imaging follow-up is vital for optimizing outcomes. Innovative approaches, including vascularized muscle flaps and hyperbaric oxygen therapy, show promise in enhancing healing and reducing infections. Our review underscores the need for future meta-analyses to strengthen evidence and refine protocols. As surgical techniques evolve, so too must our diagnostic, surgical, and postoperative strategies to minimize complications and improve patient outcomes. Full article

Bladder cancer, especially muscle-invasive bladder cancer (MIBC), poses significant treatment challenges due to its aggressive nature and poor prognosis, often necessitating cisplatin-based chemotherapy. While cisplatin effectively reduces tumor burden, its nephrotoxic effects, specifically cisplatin-induced acute kidney injury (AKI), limit its clinical use. This study investigates SH3YL1 as a potential biomarker for bladder cancer progression and AKI. Plasma and urine SH3YL1 levels were measured in bladder cancer patients undergoing cisplatin treatment, showing elevated baseline levels compared to controls, suggesting a link with bladder cancer pathology rather than cisplatin-induced AKI. Functional network and Gene Ontology (GO) enrichment analyses identified SH3YL1’s interactions with NADPH oxidase pathways, particularly NOX family genes, and highlighted its roles in cell adhesion, migration, and cytoskeletal organization—processes critical for tumor invasiveness. Notably, SH3YL1 and NOX4 expression were significantly higher in MIBC than in non-muscle-invasive bladder cancer (NMIBC), with a strong correlation between SH3YL1 and NOX4 (r = 0.62) in MIBC, suggesting a subtype-specific interaction. Kaplan–Meier survival analysis using The Cancer Genome Atlas bladder cancer (TCGA-BLCA) data further demonstrated that low SH3YL1 expression is significantly associated with poor overall and disease-specific survival in MIBC patients, reinforcing its role as a prognostic biomarker. In conclusion, SH3YL1 is a promising biomarker for identifying the invasive characteristics of MIBC and predicting patient outcomes. These findings underscore the importance of SH3YL1–NOX4 pathways in MIBC and suggest the need for further research into targeted biomarkers for bladder cancer progression and cisplatin-induced AKI to improve patient outcomes in high-risk cases. Full article

Peripheral nerve injury disrupts the function of the peripheral nervous system, leading to sensory, motor, and autonomic deficits. While peripheral nerves possess an intrinsic regenerative capacity, complete sensory and motor recovery remains challenging due to the unpredictable nature of the healing process, which is influenced by the extent of the injury, age, and timely intervention. Recent advances in microsurgical techniques, imaging technologies, and a deeper understanding of nerve microanatomy have enhanced functional outcomes in nerve repair. Nerve injury initiates complex pathophysiological responses, including Wallerian degeneration, macrophage activation, Schwann cell dedifferentiation, and axonal sprouting. Complete nerve disruptions require surgical intervention to restore nerve continuity and function. Direct nerve repair is the gold standard for clean transections with minimal nerve gaps. However, in cases with larger nerve gaps or when direct repair is not feasible, alternatives such as autologous nerve grafting, vascularized nerve grafts, nerve conduits, allografts, and nerve transfers may be employed. Autologous nerve grafts provide excellent biocompatibility but are limited by donor site morbidity and availability. Vascularized grafts are used for large nerve gaps and poorly vascularized recipient beds, while nerve conduits serve as a promising solution for smaller gaps. Nerve transfers are utilized when neither direct repair nor grafting is possible, often involving re-routing intact regional nerves to restore function. Nerve conduits play a pivotal role in nerve regeneration by bridging nerve gaps, with significant advancements made in material composition and design. Emerging trends in nerve regeneration include the use of 3D bioprinting for personalized conduits, gene therapy for targeted growth factor delivery, and nanotechnology for nanofiber-based conduits and stem cell therapy. Advancements in molecular sciences have provided critical insights into the cellular and biochemical mechanisms underlying nerve repair, leading to targeted therapies that enhance axonal regeneration, remyelination, and functional recovery in peripheral nerve injuries. This review explores the current strategies for the therapeutic management of peripheral nerve injuries, highlighting their indications, benefits, and limitations, while emphasizing the need for tailored approaches based on injury severity and patient factors. Full article

The rising prevalence of non-alcoholic fatty liver disease among patients with type 2 diabetes mellitus has emerged as a global health challenge. Gossypetin (GTIN) is a natural flavonoid which has recently demonstrated antihyperglycaemic, antioxidant, and anti-inflammatory effects. Despite these findings, no studies have investigated its effects on liver health in the pre-diabetic state. Hence, this study aimed to investigate the effects of GTIN on liver health in diet-induced pre-diabetic male rats in the presence and absence of dietary intervention and to compare these effects with those of metformin (MET). Following 20 weeks of pre-diabetes induction, the animals were divided into six groups (n = 6) as follows: non-pre-diabetic (NPD) control, pre-diabetic (PD) control, and PD groups treated with GTIN (15 mg/kg body weight (bw)) or metformin (500 mg/kg bw) on either a normal diet or a high-fat, high-carbohydrate diet for 12 weeks. The results showed that the PD group had significantly higher liver triglycerides (TAG), liver weights, sterol regulatory binding element regulatory protein-1c (SREBP-1c), malondialdehyde (MDA) levels, and liver injury enzyme levels, along with decreased liver superoxide dismutase (SOD) activity, glutathione peroxidase (GPx) activity, and plasma bilirubin levels in comparison to NPD. Histologically, there was an increased lipid droplet accumulation and structural disarray in the PD group. GTIN treatment significantly reduced liver TAGs, liver weights, and plasma SREBP-1c levels, as well as improved liver SOD and GPx activity while decreasing liver MDA levels and liver injury enzymes in comparison to the PD control. Notably, GTIN treatment increased plasma bilirubin levels. Liver histology in the GTIN-treated groups revealed decreased lipid droplet accumulation and improved tissue integrity. Similar results were observed for the liver parameters in the MET-treated groups. The findings of this study may suggest that GTIN and MET exhibit therapeutic effects on liver health in diet-induced pre-diabetes in both the presence and absence of diet intervention. Dietary intervention may confer beneficial effects on liver health, with the most favorable therapeutic outcomes observed through a combination of treatment with dietary intervention. Additionally, GTIN may exhibit greater hepatoprotective effects than MET in rats without dietary intervention. Full article