Search Results (11,363)

Vascular diseases remain a major global health burden despite remarkable technological advances in vascular surgery and endovascular therapies. Conditions such as peripheral arterial disease, abdominal aortic aneurysm, carotid stenosis, chronic venous disease, diabetic vasculopathies, and vascular chronic ulcers are not only biological entities but are deeply shaped by social structures, cultural norms, and economic inequalities. This article introduces Vascular Sociology as an interdisciplinary field that integrates vascular surgery with medical sociology to provide a more comprehensive understanding of vascular health and disease. Drawing on classical and contemporary sociological theory, including concepts such as social determinants of health, embodiment, illness narratives, and the disease–illness–sickness triad, the article argues that vascular pathology reflects cumulative social exposures across the life course. Socially patterned behaviors, work conditions, food environments, healthcare access, gender norms, and geographic inequalities profoundly influence disease onset, progression, treatment decisions, and outcomes. The paper highlights how surgical success is contingent not only on technical excellence but also on patients’ social contexts, including health literacy, trust in institutions, caregiving resources, and the capacity to adhere to long-term follow-up and rehabilitation. By outlining conceptual foundations, epidemiological evidence, and mixed-methods research strategies, the article positions Vascular Sociology as a framework capable of bridging biomedical knowledge with lived experience. This approach expands the definition of vascular outcomes to include social reintegration, identity transformation, and equity of care, ultimately aiming to improve patient-centered practice, reduce disparities, and inform more socially responsive vascular health policies. Full article

Melanoma was once considered ‘incurable’; however, drug therapy for the condition has dramatically transformed with the advent of immune checkpoint inhibitors and molecular targeted therapies. In this review, we summarize the published literature on melanoma drug therapy, presenting the current landscape of melanoma treatments, and discuss potential future transformations in melanoma therapy. Although the prognosis of advanced-stage melanoma had been extremely poor in the past, new-age immunotherapy has made long-term survival possible. Several immunotherapies and their combinations, as well as personalized vaccines, cell therapies, and intratumoral agents, have been tested with success; however, adverse toxicities have also been detected. Therefore, patient selection and management are critical. Furthermore, new approaches to overcome the limitations of the current treatments are also being developed. To implement these therapies clinically, guideline-recommended treatment algorithms should be followed while optimizing the therapies by considering factors such as presence of BRAF mutations which may lead to treatment resistance, increased disease burden/progression rate, toxicity tolerance, and the presence of brain metastases. In practice, the choice of the initial therapy should depend on the patient, leading to personalized therapy and minimal adverse effects. Full article

Background/Objectives: Pleural mesothelioma (PM) frequently recurs despite multimodal therapy. Here, we aimed to retrospectively evaluate the safety and potential clinical benefit of radiofrequency ablation (RFA) for recurrent PM. Methods: Fourteen consecutive patients underwent CT-guided RFA between July 2019 and June 2025. The cohort comprised 13 men and 1 woman, with a median age of 69 (range, 54–77) years. All patients had previously received systemic therapy, and 12 had undergone surgery. Seven patients (50%) presented with multiple lesions, and 25 tumors (median diameter 1.8 cm; range, 0.5–7.0 cm) were treated in 23 sessions. Outcomes assessed were local tumor control, complications, and survival. Local progression and overall survival were estimated using Kaplan–Meier analysis. Adverse events were classified according to the Society of Interventional Radiology guidelines. Results: Technical success was achieved in all sessions. Two tumors showed local recurrence, corresponding to 1- and 2-year local progression rates of 10.6%. Seven patients showed distant metastases, most of whom subsequently received systemic therapy. Three patients died, two from disease progression and one from treatment-related gastrointestinal perforation during therapy for an unrelated cancer. The overall survival rates were 100%, 100%, and 60% at 1, 3, and 5 years, respectively. Major and minor complications occurred in one case each (4.3%): a refractory skin ulcer and retroperitoneal hematoma, respectively. Conclusions: RFA was technically feasible and generally well tolerated and helped achieve encouraging local control and survival in patients with recurrent PM, warranting further evaluation of RFA as a complementary approach in multimodal treatment strategies. Full article

Hair dyes are widely used across all socioeconomic groups and regions worldwide. However, some studies indicate that these products contain substances known to be toxic to a wide variety of organisms. Moreover, dyeing practices generate effluents that may carry the toxicity of hair dyes into the environment. Due to these facts, there is great concern about the impacts these products may have on the environment, as well as on the health of their users and professionals in the field of cosmetology. This scoping review analyzed 184 publications from major databases (PubMed, SciELO, Scopus, Google Scholar, and MEDLINE). Ultimately, 126 scientific studies published between 1981 and 2024 were included based on methodological rigor and their relevance to the One Health framework. According to the literature, the components of hair dyes can induce adverse responses in biological systems, ranging from reversible topical irritations to severe systemic effects. Among the studies evaluated, more than half reported significant toxicological or genotoxic associations related to oxidative dye components such as p-phenylenediamine and its derivatives. These compounds are frequently associated with various types of human cancers, including breast, prostate, bladder, skin, ocular cancers, and brain tumors. In addition to their effects on humans, hair dyes exhibit ecotoxicity, which may threaten the maintenance of ecosystems exposed to their residues. The reported environmental impacts result from effluent emissions after successive hair washes that release unreacted dye residues. Due to the low biodegradability of these compounds, conventional wastewater treatment methods are often ineffective, leading to environmental accumulation and changes in aquatic ecosystems, soil fertility, and trophic balance. Data on the toxicity of hair dye effluents remain scarce and sometimes contradictory, particularly regarding the effects of their transformation products and metabolites. Overall, the evidence underscores the need for continuous monitoring, updated risk assessments, and the adoption of advanced treatment technologies specific to beauty salon effluents. The information presented in this work may support further studies and guide public management agencies in developing policies for mitigating the impacts of hair dye pollutants within the One Health perspective. Full article

Background/Objectives: Despite the clinical success of immune checkpoint blockade (ICB), its efficacy remains limited in immunologically “cold” tumors, primarily due to poor immunogenicity and an immunosuppressive tumor microenvironment (TME). Chemo-immunotherapy offers a potential strategy to enhance ICB response, yet its application is often hindered by inadequate tumor-targeted delivery and systemic immunosuppressive side effects. Biomimetic nanotechnology represents a promising approach to overcoming these limitations by improving drug delivery and facilitating effective combination regimens. Methods: We developed a biomimetic nanosystem (NVs@DOX) through genetic engineering of cellular membranes and optimized nanoformulation techniques, enabling co-delivery of doxorubicin (DOX) and ICB agents. This design aims to maximize synergistic antitumor effects while minimizing adverse impacts. Results: In vitro studies demonstrated the potent cytotoxicity of NVs@DOX, including significant inhibition of cancer cell proliferation and complete suppression of colony formation. In a 4T1 murine breast cancer model, NVs@DOX treatment led to substantial tumor growth inhibition (approximately 72%) without notable body weight loss, underscoring a favorable safety profile alongside enhanced therapeutic efficacy. Conclusions: The NVs@DOX platform effectively integrates doxorubicin with ICB within a biomimetic nanocarrier, significantly improving chemo-immunotherapy outcomes. This strategy highlights the potential of genetically engineered cellular nanoparticles as a promising combinatorial approach for the treatment of breast cancer. Full article

Tuberculosis (TB) remains a global public health emergency, with multidrug-resistant TB (MDR-TB) and rifampicin-resistant TB (RR-TB) posing critical challenges. Conventional longer regimens are characterized by suboptimal effectiveness, high toxicity, and poor tolerability. Consequently, there is an urgent demand for more effective, safer, shorter regimens with enhanced tolerability to replace traditional treatments. The present study aimed to systematically assess the effectiveness and safety of bedaquiline-containing modified shorter regimens (adaptations of the WHO-recommended 9–12-month bedaquiline-containing shorter regimen, with ethionamide, ethambutol, isoniazid, and pyrazinamide partially or fully substituted by linezolid, cycloserine/terizidone, and/or delamanid) for MDR/RR-TB. Databases (PubMed, Cochrane Library, Embase, and Web of Science) were searched up to 17 December 2025. Data on treatment success, adverse events, and patient characteristics were extracted. Heterogeneity was assessed using Cochrane Q test and I² statistic. Eleven studies involving 8166 patients were included. The pooled treatment success rate was 78.5% (95% CI: 0.69~0.87, I²: 98.45%; p = 0.00). The incidence of serious adverse events was 10.0%. Bedaquiline-containing modified shorter regimens may offer a potentially viable treatment option for MDR/RR-TB patients, giving an option for patients who are ineligible for standardized regimens. In order to verify these findings, further large-scale trials are required. Full article

Background: Comprehensive conservative management (CCM) is a possible option in end-stage clinical disease, requiring multidisciplinary support and offering survival comparable to dialysis while improving quality of life in frail patients. Despite its potential benefits, CCM is often underutilized because nephrologists may perceive it as less effective compared to dialysis. We present two case reports of hemodialysis failure and of successful CCM. Case presentation: We present two case reports of elderly female patients—referred to as Patient 1 and Patient 2—who had multiple comorbidities but preserved urine output. Both patients, in accordance with their medical team, chose to discontinue hemodialysis due to poor treatment tolerance and declining overall health. They were successfully managed with CCM, leading to follow-up that revealed survival beyond 24 months, improvements in metabolic complications and quality of life, and a reduction in hospitalizations. Conclusions: These case reports demonstrate the effectiveness of dietary and medical management for end-stage kidney disease, particularly when dialysis negatively affects patients’ clinical conditions and quality of life. They also highlight the importance of considering CCM as a preferable option for frail elderly patients facing kidney failure. Full article

Objectives: Central airway obstruction (CAO) caused by malignant tumors may necessitate combined and prompt treatment. The aim is to recanalize and stabilize the airways as palliation. We present our multicentric experience managing malignant CAO through the placement of Y-shaped self-expanding covered metallic or silicone trachea-bronchial stents. Methods: This retrospective study includes patients who underwent placement of Y-shaped stents from 2002 to 2024 across six different centers in Italy and Great Britain. We evaluated outcomes related to the feasibility and safety of the procedure, as well as the palliation of dyspnoea on the Modified Borg Scale of Dyspnoea. Results: Eighty patients (56.2% female) with a mean age of 64.8 ± 9.6 years were included in the study. Successful placement was achieved in 76 (95%) cases, with no cases of intraoperative mortality. The mean procedure time was 36.64 ± 15.7 min. The complications noted included: 7 (8.7%) cases of periprocedural clinical complications and 7 (8.7%) patients requiring intensive care unit admittance after the procedure. Fifty patients (78.1%) received cancer treatment following the procedure. The mean dyspnoea score on the Borg scale decreased from 7.78 ± 0.98 to 4.02 ± 2.2 (p < 0.05). Conclusions: The placement of metal or silicone Y-shaped stents is a feasible and safe procedure for the palliative treatment of dyspnoea in patients with malignant stenosis of the trachea and main bronchi. Stabilizing the airway also enables these patients to access cancer treatments. Full article

Acid mine drainage (AMD) and acid-generating mine wastes exhibit low pH, high sulfate levels, and complex multi-metal loads that strain conventional treatment. Thermoacidophilic red algae of the order Cyanidiales, particularly Galdieria sulphuraria (G. sulphuraria), have attracted interest as a biological option because they tolerate extreme acidity and elevated temperatures, grow under low light in mixotrophic or heterotrophic modes, and display rapid metal binding at the cell surface. This review synthesizes about two decades of peer-reviewed work to clarify how G. sulphuraria can be deployed as a practical module within mine water treatment trains. We examine the mechanisms of biosorption and bioaccumulation and show how they map onto two distinct configurations. Processed freeze-dried biomass functions as a regenerable sorbent for rare earth elements (REEs) and selected transition metals in packed beds with acid elution for recovery. Living cultures serve as polishing units for divalent metals and, when present, nutrients or dissolved organics under low light. We define realistic operating windows centered on pH 2–5 and temperatures of approximately 25–45 °C, and we identify matrix effects that govern success, including competition from ferric iron and aluminum, turbidity and fouling risks, ionic strength from sulfate, and suppression of REE uptake by phosphate in living systems. Building on laboratory studies, industrial leachate tests, and ecosystem observations, we propose placing G. sulphuraria upstream of bulk neutralization and outline reporting practices that enable cross-site comparison. The goal is an actionable framework that reduces reagent use and sludge generation while enabling metal capture and potential recovery of valuable metals from mine-influenced waters. Full article

Background/Objectives: Carbapenem-resistant Klebsiella spp. (CRK) causes healthcare-associated infections with high mortality. This study evaluated the clinical outcomes of ceftazidime–avibactam (CZA) therapy in CRK infections. Methods: Patients hospitalized in a tertiary care hospital in Türkiye between June 2021 and December 2022 with CRK-positive cultures, CZA susceptibility, and ≥72 h of CZA treatment were retrospectively analyzed. Results: Ninety-nine patients (61.6% male; mean age 63.7 ± 17.5 years) were included, 89.9% of whom were treated in the intensive care unit (ICU). Hypertension (29.3%), diabetes (28.3%), and malignancy (26.3%) were the most frequent comorbidities. The main infection types were bloodstream infection (56.6%) and ventilator-associated pneumonia (29.3%). CZA was used as monotherapy in 49.5%, and in combination in 50.5% of cases. The mean treatment duration was 13.2 ± 6.3 days. Clinical improvement occurred at 3.4 ± 1.2 days and microbiological eradication at 4.7 ± 2.1 days. Treatment success was achieved in 76.8% of patients, while 30- and 90-day mortality rates were 48.5% and 72.7%, respectively. Only treatment duration significantly affected clinical outcome (p < 0.001). Conclusions: CZA demonstrates favorable outcomes in CRK infections, with no significant difference between monotherapy and combination therapy. These findings support the use of CZA as an effective treatment option for severe CRK infections in real-world clinical settings and may help guide antimicrobial stewardship strategies in high-risk hospitalized patients. Full article

Argania spinosa L. Skeels is an ecological pillar of the arid zones of South-West Morocco, currently threatened by the drastic climate change. This study investigates the effect of the combined application of compost (C) and subsurface water retention technology (SWRT) on field performances of one-(1Y) and two-year-old (2Y) argan seedlings. A randomized field trial was performed with four treatments: Control, C, SWRT, and C + SWRT. We evaluated soil properties, growth, and physiology, alongside biochemical parameters including stress markers, compatible solutes, antioxidant enzyme activities, and secondary metabolites. The results reveal the significant effect of C and/or SWRT on argan seedlings performances, particularly in 1Y subjects. The C + SWRT strongly stimulated stem elongation (246% vs. 163%), stomatal conductance (75% vs. 99%), photosynthetic efficiency (18% vs. 11%), and chlorophyll a content (80% vs. 65%) in 1Y and 2Y seedlings, respectively, compared to their corresponding controls. Under the same treatment, malondialdehyde levels were significantly reduced by 37% in 1Y seedlings and 23% in 2Y seedlings. In addition, catalase activity and soluble sugar, protein, and polyphenol content increased by 38, 43, 26, and 21%, respectively, in the younger seedlings and by 53, 51, 18, and 19%, respectively, in the elder seedlings. In terms of soil health, C + SWRT significantly enhanced total organic carbon and matter, available phosphorus, and reduced electrical conductivity. In summary, the C + SWRT application significantly improved argan plant performances, with a particularly marked effect on 1Y seedlings, which makes this combination an alternative solution to enhance the resilience of the argan tree in the era of climate change and promote the success of the reforestation program. Full article

Background and Objectives: Soft-tissue healing, particularly rapid epithelialization, is a critical determinant of successful periodontal regenerative therapy. Fibroblast growth factor-2 (FGF-2) and enamel matrix derivative (EMD) are regenerative biomaterials used clinically. However, their comparative effects on gingival epithelial and fibroblast cell behavior remain unclear. The objective of this study was to examine the effects of FGF-2 on the proliferation, migration, and wound closure dynamics of human gingival epithelial-like cells (Ca9-22) and human gingival fibroblasts (HGF-1) and to compare its effects with those of EMD. Materials and Methods: Ca9-22 and HGF-1 cells were stimulated with FGF-2 (10 µg/mL) or EMD (100 µg/mL) or left unstimulated (control). Wound closure was assessed via scratch assay, migratory capacity via Transwell assay, and proliferation via automated cell counting at pre-defined time points. Results: In Ca9-22 cells, both FGF-2 and EMD significantly accelerated wound closure in a time- and concentration-dependent manner and markedly enhanced cell migration and proliferation compared to controls. EMD consistently induced a stronger migratory response. In HGF-1 cells, FGF-2 significantly advanced wound closure by day 5, whereas EMD induced a non-significant favorable trend. Both treatments significantly increased cell proliferation and migration of HGF-1 cells, with EMD yielding the highest migratory cell count. Conclusions: FGF-2 promotes gingival soft-tissue healing by enhancing epithelial-like cell and fibroblast migration and proliferation, supporting rapid epithelialization. EMD produced comparable wound-healing effects, indicating that the activation of both epithelial and mesenchymal cells is a central mechanism shared by distinct regenerative agents. Full article

Herbaceous plants from dry forests respond to different levels of light availability over time and space through strategies that promote their establishment and survival. This study aimed to evaluate the tolerance of the perennial herb Talinum triangulare (Jacq.) Willd., which is pantropically distributed and forms dense populations in the Caatinga, under varying light availabilities. The treatments applied were full sun and 70%, 50%, and 30% light availability, each with 30 replicates. Vegetative, reproductive, and phenological responses were monitored over six months, during which the plant’s reproductive cycle was completed and water availability was higher. In T100, plants showed greater height, diameter, leaf production, flowers, fruits, and seeds. In contrast, reduced light availability led to lower values in these traits but resulted in increased leaf area, seed viability, and higher fruit/flower and seed/fruit ratios as compensatory responses. These findings suggest that higher light availability increases the establishment success of the studied species, although reduced light does not necessarily limit its reproductive success. The study highlights its adaptability to different light conditions and its potential for continued population expansion in dry tropical forests, despite fluctuations in light availability. Full article

A retrospective study on 135 cases of teat and udder surgical conditions in 129 small ruminants is described. On 19 repairs of teat lacerations, a primary- and a secondary-intention healing in 13 (68%) and in 4 (21%) cases, respectively, was observed; 2 (11%) had poor response and consequent mastitis. Good outcome and first-intention healing in 100% of the fistula repairs (2 cases), thelectomies (5 cases), teat neoplasm removals (14), and mastectomies (2 cases) were observed. Among 26 teat curettage cases, all 18 (69%) unilateral lesions treatment had a good outcome versus the 8 (31%) with bilateral lesion that suffered definitive relapse. In 67 skin udder neoplasm removals, a primary- and a secondary-intention healing in 59 (88%) and in 8 (12%) cases, respectively, was observed; however, 2 of the latter suffered mastitis. These procedures are associated with a good prognosis, and the percentage of favorable outcomes was high. Wound infections and dehiscence were the main complications observed. More interest in teat and udder surgery on small ruminants should be encouraged, and farmers should be made aware that the animal can often return into production at a reasonable cost; however, their post-operative care is the key to success. Full article

Objectives: Thoracic endovascular aortic repair (TEVAR) is rarely indicated on an urgent or emergent basis soon after open surgical repair of type A aortic dissection (TAAD), and systematic data on clinical outcomes are therefore missing. In the present study, we analyze a contemporary case series regarding the outcome after urgent and emergent endovascular treatment of the downstream thoracic aorta, following open surgery for TAAD. Methods: The study was conducted as a retrospective observational analysis. From January 2024 until April 2025, seven patients (four male, aged 56.8 ± 5.6 years) were treated with TEVAR on an urgent or emergent basis within 48 h after open surgical repair of TAAD at our institution. In all seven patients, the initial dissection extended from the ascending to the abdominal aorta. All seven patients had previously received emergent open surgical repair by ascending aortic repair combined with hemiarch replacement (five patients) or total arch replacement, utilizing the frozen elephant trunk (FET) technique (two patients). Results: In four patients, the indication for urgent TEVAR was due to true lumen collapse (TLC) of the downstream aorta with resulting visceral or peripheral malperfusion symptoms. Three patients were treated on an emergent basis, due to rupture of the descending thoracic aorta with a resulting hemorrhage. Technical success of the TEVAR procedure was 100%. Thirty-day mortality was 0% in the TLC cases but 66% in the ruptured cases, where two of three patients died postoperatively due to the consequences of severe hemorrhagic shock. Within the surviving patients, no subsequent aortic events occurred during follow-up. Late mortality was 0%. The follow-up period was 15.7 ± 2.0 months. Conclusions: In our case series, mortality of urgent or emergent TEVAR soon after open surgical repair for TAAD is substantial, especially in patients that were treated due to acute rupture of the descending thoracic aorta and consecutive hemorrhagic shock. On the other hand, true lumen collapse with resulting malperfusion was successfully treated by instant TEVAR application in all patients without late aortic complications by the midterm follow-up. Full article