Search Results (1,327)

Background/Objectives: Electrochemotherapy (ECT) has been shown to be effective in treating colorectal liver metastases when combined with bleomycin (BLM). Based on this promising finding, we compared in this study the efficacy of BLM with oxaliplatin (OXP) and bevacizumab (BVZ) in ECT. Methods: WAG/Rij rats were randomized into three groups and underwent ECT with intravenous injection of BLM, OXP, or OXP with BVZ for eight days following hepatic tumor cell implantation. Ultrasound and photoacoustic imaging served to assess oxygen saturation (SO₂) and hemoglobin concentration (HbT) of the developing tumors. Tissue samples were analyzed by histology and immunohistochemistry. Results: BLM treatment significantly reduced SO₂ (33.7%) and HbT (12.7%) levels compared to pretreatment values. In contrast, the OXP-treated groups exhibited only modest reductions in both parameters. BLM also induced a markedly higher necrosis rate (82.6%) compared to OXP and OXP/BVZ (11.0% and 26.3%). Conversely, OXP-treated tumors exhibited higher apoptosis rates. Furthermore, BLM treatment led to a decrease in tumor cell proliferation and a reduction in inflammatory response compared to the other treatments. Notably, BLM caused a 26.2% reduction in CD31-positive microvessels, which was significantly higher than that observed in the OXP group. Conclusions: BLM showed a more effective anti-tumor activity than OXP, suggesting its preferred use as chemotherapeutic agent in ECT. Full article

An innovative ultrasound-assisted deep eutectic solvent-based three-phase partitioning (UA-DES-TPP) system was developed for the sustainable extraction of Ficus carica polysaccharide (FCP). Using a hydrophobic DES composed of dodecanoic acid and octanoic acid (1:1 molar ratio), a phase behavior-driven separation mechanism was established. The system was systematically optimized through single-factor experiments and response surface methodology (RSM), achieving a maximum FCP yield of 9.22 ± 0.20% under optimal conditions (liquid–solid ratio 1:24.2 g/mL, top/bottom phase volume ratio 1:1.05 v/v, ammonium sulfate concentration 25.8%). Structural characterization revealed that FCP was a heteropolysaccharide primarily composed of glucose and mannose with α/β-glycosidic linkages and a loose fibrous network. Remarkably, the DESs demonstrated excellent recyclability over five cycles. Furthermore, FCP exhibited significant concentration-dependent antioxidant activities: 82.3 ± 3.8% DPPH radical scavenging at 8 mg/mL, 76.8 ± 0.8% ABTS⁺ scavenging, and ferric ion reducing power of 45.53 ± 1.07 μmol TE/g. This study provides a new path for the efficient and sustainable extraction of bioactive macromolecules. Full article

The pods from Neltuma ruscifolia (vinal), an underutilized species, are rich in bioactive functional compounds. However, the extraction procedures to obtain the highest proportion of these compounds, considering sustainability aspects, have not been optimized. This study aimed to optimize and compare three affordable extraction methods—dynamic maceration (DME), ultrasound-assisted extraction (UE), and microwave-assisted extraction (ME)—to obtain enriched extracts. The effects of temperature, ethanol-to-water ratio in the solvent, extraction time, and frequency (for ME) were evaluated using a Box–Behnken design and response surface methodology to optimize total polyphenolic content (TPC), total flavonoids (TF), and antioxidant capacity (DPPH). Energy consumption and carbon footprints were also assessed, and phenolic compounds in the optimized extracts were identified by HPLC. The ethanol-to-water ratio emerged as the most influential factor, showing synergistic effects with both time and temperature, enabling optimal yields at intermediate ethanol concentrations. Gallic acid, rutin, and theobromine were found to be the most abundant components, followed by cinnamic, caffeic, and chlorogenic acids. Although UE exhibited the lowest energy consumption (0.64 ± 0.03 Wh/mg of TPC), the simple and easily implementable DME—optimized at 40 min, 50 °C, and 42% ethanol—proved to be the most efficient method, combining high extractive performance (TPC 1432 mg GAE/100 g Dw), reduced solvent use, and intermediate energy efficiency (1.84 Wh/mg of TPC). These findings highlight the potential of vinal as a natural source of bioactive ingredients obtained through simple and cost-effective techniques adaptable to small producers while underscoring the value of experimental design in optimizing sustainable extraction technologies and elucidating the interactions between key processing factors. Full article

Ultrasound-responsive nanomaterials represent a promising approach for achieving non-invasive and localized drug delivery within tumor microenvironments. In this study, we developed a piezocatalysis-assisted hydrogel system that integrates reactive oxygen species (ROS) generation with stimulus-responsive drug release. The platform combines piezoelectric barium titanate (BTO) nanoparticles with a ROS-sensitive hydrogel matrix, forming an ultrasound-activated dual-function therapeutic system. Upon ultrasound irradiation, the BTO nanoparticles generate ROS—predominantly hydroxyl radicals (^•OH) and singlet oxygen (¹O₂)—through the piezoelectric effect, which triggers hydrogel degradation and facilitates the controlled release of encapsulated therapeutic agents. The composition and kinetics of ROS generation were evaluated using radical scavenging assays and fluorescence probe techniques, while the drug release behavior was validated under simulated oxidative environments and acoustic fields. Structural and compositional characterizations (TEM, XRD, and XPS) confirmed the quality and stability of the nanoparticles, and cytocompatibility was assessed using 3T3 fibroblasts. This synergistic strategy, combining piezocatalytic ROS generation with hydrogel disintegration, demonstrates a feasible approach for designing responsive nanoplatforms in ultrasound-mediated drug delivery systems. Full article

Stimuli-responsive, cell-mediated drug delivery systems represent a dynamic interface between biological functionality and engineered control. Leveraging the inherent targeting properties of erythrocytes, immune cells, stem cells, and exosomes, these systems offer a promising strategy for precise therapeutic delivery. In this review, we provide a comprehensive analysis of the design principles and biological underpinnings of stimuli-responsive carriers that release payloads in response to endogenous triggers (e.g., pH, redox, enzymatic activity) or external stimuli (e.g., light, ultrasound, magnetic fields). We further examine current strategies for loading and functionalizing cellular carriers, highlight key therapeutic applications across oncology and regenerative medicine, and assess translational progress and regulatory challenges. This review underscores the emerging clinical potential of intelligent cell-based delivery vehicles and outlines future directions for their optimization and implementation. Full article

Using ultrasound-assisted extraction, we obtained a chlorophyll-rich extract from Opuntia ficus-indica cladodes (OFI) characterized through thin-layer chromatography (TLC), Fourier-transform infrared spectroscopy (FTIR), and spectrophotometric absorption analysis. The dye exhibited a strong fluorescence response in the visible range (400–800 nm) with a pronounced red emission when excited with a UV source. Antioxidant ability was evaluated via DPPH assay, showing an IC₅₀ of 185 µg/mL, highlighting its potential for reactive oxygen species scavenging. The extract was incorporated into polymethyl methacrylate (PMMA), polyvinylpyrrolidone (PVP), and polyvinyl alcohol (PVA), leading to fluorescence intensity enhancements of up to 40 times compared to the dye alone depending on matrix polarity, consistent with aggregation and polarity effects. Stability tests confirmed the dye’s resistance to CO₂ exposure, pH variations, and prolonged storage, positioning it as a viable alternative to synthetic fluorophores. These findings suggest that the OFI extract provides a functionally relevant, bio-derived dye platform promoting the valorization of agricultural by-products in high-value technological applications, highlighting a circular and scalable approach to developing ecofriendly fluorescent materials, aligning with sustainability and green technology goals. Full article

Coriander (Coriandrum sativum L.) has significant value in the food industry due to its unique flavor and health benefits. However, its polyphenol content and antioxidant activity have not been systematically analyzed during storage. This study optimized the extraction process of coriander polyphenols using ultrasound-assisted extraction combined with response surface methodology. The polyphenol composition was systematically identified, and changes in polyphenol content and antioxidant activity during storage were investigated. The optimal process conditions for extracting coriander polyphenols were determined as 40% ethanol concentration, 1:121 g/mL material-to-liquid ratio, 81 °C extraction temperature, and 10 min extraction time. This optimized protocol yielded 16.231 mg GAE/g, a 119.28% increase over conventional methods using the same raw material. Fifty polyphenolic compounds were identified using high-resolution mass spectrometry. The main types of polyphenols identified were quercetin, kaempferol, and hydroxycinnamic acid derivatives. Notably, 41 of these compounds were reported in coriander for the first time. In vitro tests revealed that coriander polyphenols exhibit potent antioxidant properties, with IC₅₀ values of 73.43 μg/mL for DPPH and 82.15 μg/mL for ABTS. Furthermore, the polyphenol content and antioxidant capacity of coriander increased significantly during storage, with total phenolic content rising by 40.5%, DPPH activity by 32.5%, and ABTS activity by 56.5%. Key individual polyphenols showed differential changes: rutin continuously accumulated, while chlorogenic acid and ferulic acid exhibited an initial increase followed by a decrease. This study provides strong technical support for the use of coriander polyphenols in functional foods and medicines. Full article

Leaves of Gentiana lutea L., traditionally used for treating heart disorders, represent a sustainable and underutilized source of bitter secoiridoids and xanthones, also found in Gentianae radix—an official herbal drug derived from the same, protected species. As root harvesting leads to the destruction of the plant, using the more readily available leaves could help reduce the pressure on this endangered natural resource. This study aimed to optimize the ultrasound-assisted extraction of the secoiridoid swertiamarin and the xanthone isogentisin from G. lutea leaves using response surface methodology (RSM). Subsequently, the stability of the bioactive compounds (swertiamarin, gentiopicrin, mangiferin, isoorientin, isovitexin, and isogentisin) in the optimized extract was monitored over a 30-day period under different storage conditions. The influence of extraction time (5–65 min), ethanol concentration (10–90% v/v), liquid-to-solid ratio (10–50 mL/g), and temperature (20–80 °C) was analyzed at five levels according to a central composite design. The calculated optimal extraction conditions for the simultaneous maximization of swertiamarin and isogentisin yields were 50 min extraction time, 30% v/v ethanol concentration, 30 mL/g liquid-to-solid ratio, and 62.7 °C extraction temperature. Under these conditions, the experimentally obtained yields were 3.75 mg/g dry weight for swertiamarin and 1.57 mg/g dry weight for isogentisin, closely matching the RSM model predictions. The stability study revealed that low-temperature storage preserved major bioactive compounds, whereas mangiferin stability was compromised by elevated temperature and light exposure. The established models support the production of standardized G. lutea leaf extracts and may facilitate the efficient separation and purification of their bioactive compounds, thereby contributing to the further valorization of this valuable plant material. Full article

Poorly differentiated thyroid malignancy, a rare histological type of aggressive thyroid malignancy with associated difficulties and gaps in its histological and molecular characterization, might lead to challenging clinical presentations that require a prompt multimodal approach. This case study involved a 56-year-old, non-smoking male with a rapidly developing goiter (within 2–3 months) in association with mild, non-specific neck compressive symptoms. His medical history was irrelevant. A voluminous goiter with substernal and posterior extension up to the vertebral bodies was detected using an ultrasound and computed tomography (CT) scan and required emergency thyroidectomy. He had normal thyroid function, as well as negative thyroid autoimmunity and serum calcitonin. The surgery was successful upon “Y” incision, which was used to give better access to the retrosternal component in order to avoid a sternotomy. Post-operatively, the subject developed hypoparathyroidism-related hypocalcemia and showed a very high serum thyroglobulin level (>550 ng/mL). The pathological report confirmed poorly differentiated, multifocal thyroid carcinoma (with an insular, solid, and trabecular pattern) against a background of papillary carcinoma (pT3b, pN0, and pM1; L1; V2; Pn0; R1; and stage IVB). The subject received 200 mCi of radioiodine therapy for 6 weeks following the thoracic surgery. Whole-body scintigraphy was performed before radioiodine therapy and showed increased radiotracer uptake at the thyroid remnants and pre-tracheal levels. Additionally, single-photon emission computed tomography combined with CT (SPECT/CT) was performed, and confirmed the areas of intense uptake, in addition to a moderate uptake in the right and left pulmonary parenchyma, suggesting lung metastasis. To conclude, an overall low level of statistical evidence exists regarding poorly differentiated malignancy in substernal goiters, and the data also remains scarce regarding the impact of genetic and molecular configurations, such as the BRAF-positive profile, in this specific instance. Furthermore, multimodal management includes additional diagnosis methods such as SPECT/CT, while long-term multilayered therapy includes tyrosine kinase inhibitors if the outcome shows an iodine-resistant profile with a poor prognosis. Awareness remains a key factor in cases of a poorly differentiated carcinoma presenting as a rapidly growing goiter with substernal extension in an apparently healthy adult. A surgical approach, while varying with the surgeon’s skills, represents a mandatory step to ensure a better prognosis. In addition to a meticulous histological characterization, genetic/molecular features provide valuable information regarding the outcome and can further help with the decision to use new anti-cancer drugs if tumor response upon radioiodine therapy is no longer achieved; such a development is expected in this disease stage in association with a BRAF-positive configuration. Full article

Objective: We aimed to quantify the mechanical pressure required to reach the deep cervical and thoracolumbar fasciae, to examine its association with pressure pain threshold (PPT) and adipose tissue thickness, and to determine whether PPT and adipose tissue thickness can predict the mechanical pressure needed to reach the fascia. Methods: Forty-three subjects’ PPT, mechanical pressure and skinfold in the trapezius and lumbar regions were evaluated using an algometer, an ultrasound scanner, and an adipometer. The Wilcoxon test, Student’s t-test, and Pearson and Spearman’s correlation tests were used (p < 0.05). Results: The values of mechanical pressure in the cervical and lumbar regions were 6.06 ± 0.186 N/cm² and 5.85 ± 5.280, 7.287 N/cm², respectively. PPT values were 18.88 ± 0.917 N/cm², and 46.46 ± 2.408 N/cm², respectively (p < 0.001), and the adipose tissue thickness values in the cervical and lumbar regions were 0.88 ± 0.675 cm, 1.08 and 1.48 ± 0.069 cm (p < 0.001). There was no correlation between the variables in either region under study. Conclusions: The mechanical pressure required to reach the deep cervical and thoracolumbar fasciae was similar with an average value of approximately 6 N/cm², suggesting a consistent mechanical response across these anatomical regions. Mechanosensitivity and subcutaneous adipose tissue thickness did not influence the mechanical pressure needed to access the deep fascial tissue. Full article

Background: Eximia is a non-invasive body-contouring technology combining ultrasound cavitation, radiofrequency, and vacuum suction to reduce adiposity. EMS Pro Bodytech delivers biphasic electrical impulses to stimulate muscular contractions and improve muscle performance. Methods: A 6-week observational study included 77 participants (58 women aged 28–55 and 19 men aged 20–49), who received twice-weekly sessions combining Eximia and EMS training. Anthropometric and body composition measurements were recorded before and after the intervention. Results: Participants showed reductions in fat mass (mean from 19.21 kg to 18.19 kg; SD from 8.23 to 8.42), BMI (mean from 26.03 to 25.68; SD from 4.26 to 4.16), and visceral fat index (mean from 4.97 to 4.74; SD from 2.88 to 2.99), alongside an increase in skeletal muscle percentage (mean from 37.34% to 38.3%, SD from 5.09 to 5.94). Statistical analysis revealed no significant differences in treatment response between genders (e.g., BMI: p = 0.080; fat-free mass: p = 0.089) or age groups (all p > 0.6), suggesting that the intervention was effective across demographics. Conclusions: The combined approach of Eximia body remodeling and EMS muscle stimulation led to measurable improvements in body composition, independent of age or gender. These findings support its potential as a non-invasive, inclusive strategy for body reshaping alongside peri-procedural dietary standardization. Full article

Objective: To evaluate patient perceptions regarding ultrasound-guided embryo transfer, visualisation of embryos prior to transfer, and continuity of care with the same physician during in vitro fertilisation (IVF) treatments. Setting: Between January and September 2023, this study was conducted at the IVF MOMO’ FertiLIFE centre in Bisceglie, Italy. Design: Descriptive and observational study based on an anonymous survey administered to IVF patients at the time of embryo transfer. The goal was to assess the subjective emotional and psychological response to selected procedural elements of the embryo transfer process. Participants: Out of 284 distributed questionnaires, 200 were included in the final analysis. Inclusion required fully completed responses. Questionnaires with incomplete, unclear answers or patient refusal were excluded. The study group was compared with the general IVF patient population treated at the centre over the past 5 years to ensure representativeness. Methods: Patients completed a structured questionnaire using a five-point Likert scale. Statistical analysis included descriptive statistics, Spearman’s rank correlation, Friedman test, and exploratory factor analysis. Ethical approval was obtained (CELFer no. 07/2021), and all participants provided written informed consent. Results: The majority of patients reported a heightened sense of calm and reassurance during ultrasound-guided embryo transfer. Viewing embryos on a monitor before transfer was also positively perceived. A strong preference emerged for continuity of care with the same physician throughout the IVF process. While this study did not assess objective stress levels or clinical outcomes, the findings highlight the psychological comfort associated with these patient-centred practices. Limitations: This single-centre study is based on self-reported data and lacks objective assessments of psychological well-being. Therefore, results reflect personal perceptions rather than measurable clinical outcomes. Broader, multicentre research using validated psychological tools is needed to confirm and expand these findings. Furthermore, the questionnaire used in this study was developed internally and not validated externally with standardised psychometric instruments. Conclusions: This study provides insight into IVF patients’ subjective experiences, emphasising the perceived emotional benefits of specific procedural and relational aspects of care. These findings support the integration of patient-centred strategies—such as visual engagement and physician continuity—into routine IVF practice to enhance overall patient well-being. Full article

Background: Abdominal wall endometriosis (AWE) is a rare but debilitating condition, often occurring in surgical scars after Caesarean sections. It is characterized by cyclic pain and a palpable mass, significantly impacting patients’ quality of life. Traditional treatments, including hormonal therapy and surgery, have limitations, prompting interest in minimally invasive techniques such as cryoablation. This study evaluates the efficacy and safety of percutaneous image-guided single-probe cryoablation using liquid nitrogen for symptomatic AWE. Purpose: To evaluate the effectiveness and safety of percutaneous image-guided single-probe cryoablation using liquid nitrogen in treating symptomatic AWE lesions, with a primary objective to assess pain relief using the Visual Analog Scale (VAS). Materials and Methods: This retrospective, single-center study included 14 patients (23 lesions) treated with percutaneous cryoablation between September 2022 and April 2025. Clinical, imaging (MRI and ultrasound), and procedural data were analyzed. Pain scores (VAS scale) were assessed before treatment and at 3-month follow-up. Hydro- and/or carbo-dissection were used to protect adjacent structures. Response to treatment was evaluated with MRI and clinical follow-up. Statistical analysis was performed using median, range, and percentage calculations, with comparisons made using the Mann–Whitney test. Results: A total of 23 AWE lesions were treated in 14 patients (mean age: 39.6 years). The median lesion volume was 3546 mm³, with a range from 331 mm³ (8 × 4.6 × 9 mm) to 45,448 mm³ (46 × 26 × 38 mm). Most of the lesions were located in the muscle (69.6%, n = 16), while 17.4% (n = 4) involved both muscle and subcutaneous tissue, and 13.0% (n = 3) were purely subcutaneous. Among the 23 treated lesions, 8.7% (n = 2) appeared as purely hemorrhagic, 13.0% (n = 3) as fibrotic, and 78.3% (n = 18) were classified as mixed, based on imaging characteristics. Procedures were performed under general anesthesia in 65% of cases and under sedation in 35%. Hydrodissection was used in 48% of lesions, carbo-dissection in 4%, and combined hydro–carbo-dissection in 26%. A single 13G cryoprobe was used in 83% of cases, and a 10G probe in 17%. The median ablation time was 15 min (range: 6–28 min), and the median total procedure time was 93 min (range: 22–240 min). Pain scores significantly decreased from a median of 8/10 (range: 6–10) before treatment to 0/10 (range: 0–2) at follow-up (p < 0.0001). MRI follow-up confirmed complete coverage of the ablation zone and disappearance of hemorrhagic inclusions in all cases. Two patients (14%) required re-treatment, both with satisfactory outcomes. No peri- or post-procedural complications were observed, and no visible scars were noted. Conclusions: Percutaneous cryoablation using a single probe with liquid nitrogen is a safe and effective treatment for AWE, offering significant pain relief, minimal morbidity, and excellent cosmetic outcomes. It should be considered as part of multidisciplinary care. Further prospective studies with longer follow-up are warranted to confirm these findings. Full article

Background/Objectives: Patients with breast cancer who do not achieve a complete response to neoadjuvant chemotherapy (NAC) may benefit from intensified adjuvant systemic therapy. However, such treatment escalation is typically delayed until after tumour resection, which occurs several months into the treatment course. Quantitative ultrasound (QUS) can detect early microstructural changes in tumours and may enable timely identification of non-responders during NAC, allowing for earlier treatment intensification. In our previous prospective observational study, 100 breast cancer patients underwent QUS imaging before and four times during NAC. Machine learning algorithms based on QUS texture features acquired in the first week of treatment were developed and achieved 78% accuracy in predicting treatment response. In the current study, we aimed to validate these algorithms in an independent prospective cohort to assess reproducibility and confirm their clinical utility. Methods: We included breast cancer patients eligible for NAC per standard of care, with tumours larger than 1.5 cm. QUS imaging was acquired at baseline and during the first week of treatment. Tumour response was defined as a ≥30% reduction in target lesion size on the resection specimen compared to baseline imaging. Results: A total of 51 patients treated between 2018 and 2021 were included (median age 49 years; median tumour size 3.6 cm). Most were estrogen receptor–positive (65%) or HER2-positive (33%), and the majority received dose-dense AC-T (n = 34, 67%) or FEC-D (n = 15, 29%) chemotherapy, with or without trastuzumab. The support vector machine algorithm achieved an area under the curve of 0.71, with 86% accuracy, 91% specificity, 50% sensitivity, 93% negative predictive value, and 43% positive predictive value for predicting treatment response. Misclassifications were primarily associated with poorly defined tumours and difficulties in accurately identifying the region of interest. Conclusions: Our findings validate QUS-based machine learning models for early prediction of chemotherapy response and support their potential as non-invasive tools for treatment personalization and clinical trial development focused on early treatment intensification. Full article

Background: Point-of-care ultrasound (POCUS) is gaining recognition as a valuable diagnostic tool in various fields of medicine, including pediatrics. Its application at the point of care enables real-time clinical decision-making, which is particularly advantageous in pediatric settings. Although global interest in POCUS is growing, many European countries—including Poland—still lack formal training programs for POCUS at both the undergraduate and postgraduate levels. Nevertheless, the number of pediatricians incorporating POCUS into their daily clinical practice in Poland is increasing. However, the extent of its use and perceived value among pediatricians remains largely unknown. This study aimed to evaluate the current level of POCUS utilization in pediatric care in Poland, focusing on pediatricians’ self-assessed competencies, perceptions of its clinical utility, and key barriers to its implementation in daily practice. Methods: This cross-sectional study was conducted between July and August 2024 using an anonymous online survey distributed to pediatricians throughout Poland via national professional networks, with a response rate of 7.3%. Categorical variables were analyzed using the chi-square test of independence to assess the associations between key variables. Quantitative data were analyzed using descriptive statistics, and qualitative data from open-ended responses were subjected to a thematic analysis. Results: A total of 210 pediatricians responded. Among them, 149 (71%) reported access to ultrasound equipment at their workplace, and 89 (42.4%) reported having participated in some form of POCUS training. Only 46 respondents (21.9%) reported frequently using POCUS in their clinical routine. The self-assessed POCUS competence was rated as low or very low by 136 respondents (64.8%). While POCUS was generally perceived as a helpful tool in facilitating and accelerating clinical decisions, the main barriers to implementation were a lack of formal training and limited institutional support. Conclusions: Although POCUS is perceived as clinically valuable by the surveyed pediatricians in Poland, its routine use remains limited due to training and systemic barriers. Future efforts should prioritize the development of a validated, competency-based training framework and the implementation of a larger, representative national study to guide the structured integration of POCUS into pediatric care. Full article