Search Results (939)

Background: Diabetic foot ulcers (DFUs) are a serious complication of diabetes and are often difficult to treat. Hyperbaric oxygen therapy (HBOT) has been proposed as an adjunctive treatment to promote healing, but its long-term clinical and biological effects remain insufficiently characterized. This study aimed to evaluate the impact of HBOT on systemic biomarkers, local microvasculature, and clinical outcomes in patients with DFUs. Methods: In this non-randomized prospective study, 20 patients with ischemic DFUs were followed over a 36-month period. Fourteen received HBOT in addition to standard care, while six received standard care alone. Clinical outcomes—including DFU resolution, recurrence, lower extremity amputation (LEA), and mortality—were assessed alongside systemic inflammatory and angiogenic biomarkers and wound characteristics at baseline and at 3, 6, 12, and 36 months. CD31 immunostaining was performed on available tissue samples. Results: The two groups were comparable at baseline (mean age 62 ± 12 years; diabetes duration 18 ± 9 years). At 3 months, the HBOT group showed significant reductions in erythrocyte sedimentation rate and DFU size (p < 0.05), with downward trends observed in C-reactive protein (CRP), vascular endothelial growth factor (VEGF), and placental growth factor (PlGF), and an increase in stromal-derived factor-1 alpha (SDF1-α). No significant changes were observed in the control group. CD31+ microvessel density appeared to increase in HBOT-treated DFU tissue after one month, although the sample size was limited. Patients receiving HBOT had lower rates of LEA and mortality, improved wound healing, and sustained outcomes over three years. DFU recurrence rates were similar between groups. Conclusions: HBOT was associated with improved wound healing and favorable biomarker profiles in patients with treatment-resistant ischemic DFUs. While these findings are encouraging, the small sample size and non-randomized design limit their generalizability, highlighting the need for larger, controlled studies. Full article

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

Colorectal cancer (CRC) remains a predominant cause of global cancer-related mortality, highlighting the pressing demand for innovative therapeutic strategies. Natural polysaccharides have emerged as promising candidates in cancer research due to their multifaceted anticancer mechanisms and tumor-suppressive potential across diverse malignancies. In this study, we enzymatically extracted a polysaccharide, named ERPP, from Ruditapes philippinarum and comprehensively evaluated its anti-colorectal cancer activity. We conducted in vitro assays, including CCK-8 proliferation, clonogenic survival, scratch wound healing, and Annexin V-FITC/PI apoptosis staining, and the results demonstrated that ERPP significantly inhibited HT-29 cell proliferation, suppressed colony formation, impaired migratory capacity, and induced apoptosis. JC-1 fluorescence assays provided further evidence of mitochondrial membrane potential (MMP) depolarization, as manifested by a substantial reduction in the red/green fluorescence ratio (from 10.87 to 0.35). These antitumor effects were further validated in vivo using a zebrafish HT-29 xenograft model. Furthermore, ERPP treatment significantly attenuated tumor angiogenesis and downregulated the expression of the vascular endothelial growth factor A (Vegfaa) gene in the zebrafish xenograft model. Mechanistic investigations revealed that ERPP primarily activated the mitochondrial apoptosis pathway. RT-qPCR analysis showed an upregulation of the pro-apoptotic gene Bax and a downregulation of the anti-apoptotic gene Bcl-2, leading to cytochrome c (CYCS) release and caspase-3 (CASP-3) activation. Additionally, ERPP exhibited potent antioxidant capacity, achieving an 80.2% hydroxyl radical scavenging rate at 4 mg/mL. ERPP also decreased reactive oxygen species (ROS) levels within the tumor cells, thereby augmenting anticancer efficacy through its antioxidant activity. Collectively, these findings provide mechanistic insights into the properties of ERPP, underscoring its potential as a functional food component or adjuvant therapy for colorectal cancer management. Full article

Dietary protein is an essential macronutrient derived from both plant and animal sources required for muscle building, immune function, and wound healing. However, in the United States, protein consumption worsens as individuals age, with 30% of men and 50% of women over 71 consuming inadequate dietary protein due to a variety of factors, including changes in gut function, loss of appetite, tooth loss, financial concerns, and social isolation. The aim of this review is to underscore the need for increased protein requirements in aging populations, highlight potential barriers, synthesize these protein requirements, and also recommend strategies to meet these increased protein needs. Achieving adequate protein status, especially when facing chronic or acute health concerns, is essential to promote muscle and bone strength (because aging is associated with significant decreases in postprandial muscle protein synthesis), to support immune health (due to immunosenescence), and to maintain a good quality of life. For older adults, the literature suggests that a dietary protein intake of at least 1.0–1.2 g/kg/day is required in healthy, aging populations, and intakes of 1.2–1.5 g/kg/day are necessary for those with chronic or acute conditions. These protein intake recommendations can increase to 2.0 g/kg/day in more severe cases of illness, malnutrition, and chronic conditions. The reviewed literature also suggests that evenly balanced protein distributions of 25–30 g of dietary protein (0.4 g/kg) per meal from animal and plant protein sources alike are sufficient to maximize muscle protein synthesis (MPS) rates in older populations. Additionally, pre-sleep protein feeds of 40 g/night may be another strategy to improve daily MPS and amino acid utilization. Full article

Appendage autotomy frequently occurs during the cultivation of Exopalaemon carinicauda, which severely impacts its survival and economic benefits. To investigate the molecular mechanism underlying appendage regeneration in E. carinicauda, this study presents a comparative transcriptome analysis on samples from different stages of appendage regeneration in individuals of the same family of E. carinicauda. A total of 6460 differentially expressed genes (DEGs) were identified between the samples collected at 0 h post-autotomy (D0) and those collected at 18 h post-autotomy (D18h). Additionally, 7740 DEGs were identified between D0 and 14 d post-autotomy (D14d), with 3382 DEGs identified between D18h and D14d. Among them, differentially expressed genes such as EcR, RXR, BMP1, and Smad4 are related to muscle growth or molting and may be involved in the regeneration process. qRT-PCR results revealed that EcBMPR2 was expressed at relatively high levels in the gonad and ventral nerve cord tissues and that the highest level of expression was detected in the regenerative basal tissue at 24 h post-autotomy. In situ hybridization results indicated strong signals of this gene in the cells at the wound site at 72 h post-autotomy. Following knockdown of EcBMPR2, the expression levels of both EcBMPR1B and EcSmad1 were significantly downregulated, and long-term interference with the EcBMPR2 gene resulted in a significantly slower appendage regeneration process compared to the control group. When the downstream transcription factor EcSmad1 was knocked down, the two receptor genes EcBMPR2 and EcBMPR1B were downregulated, whereas EcBMP7 was upregulated. After inhibiting the BMP signaling pathway, the degree of cell aggregation at the autotomy site in the experimental group was significantly lower than that in the control group, the wound healing rate was delayed, and the blastema regeneration time was prolonged from 5 d to 7 d. Collectively, these results indicate that the BMP signaling pathway plays a critical role in the early stages of appendage regeneration in E. carinicauda. This study provides important theoretical insights for understanding limb regeneration in crustaceans. Full article

Background and Clinical Significance: Breast reconstruction following mastectomy is a critical aspect of treatment for many patients, offering both physical and psychological benefits. Traditional methods include autologous tissue flaps and implants, with implant-based techniques being the most prevalent in the Western world. However, complications such as capsular contracture remain a concern. Acellular dermal matrices (ADM) have emerged as a valuable alternative, improving outcomes by reducing capsular contracture rates and enhancing tissue integration. Case Presentation: This case report presents the first use of a novel ADM, biocade^® (biotrics bioimplants AG, Berlin, Germany) in breast reconstruction following a mastectomy. A 55-year-old female patient underwent a left-sided nipple-sparing mastectomy, followed by prepectoral direct-to-implant reconstruction using an ADM-wrapped implant. The patient tolerated the procedure well, with no immediate complications observed. Postoperative monitoring focused on wound healing and assessing for signs of complications related to the implant. The use of the ADM resulted into satisfactory aesthetic and functional outcomes. Conclusions: The successful outcome of this case highlights the potential benefits of using collagen matrices in breast reconstruction, particularly in preserving mastectomy scenarios. The immediate results and improved aesthetics offered by prepectoral direct-to-implant reconstruction with ADM align well with patient expectations for a more natural appearance and faster recovery. However, this case report also highlights the need for ongoing research to fully explore the potential of these biomaterials and address associated challenges. Full article

Background/Objectives: Oral cavity wound recovery presents unique challenges due to constant moisture exposure and functional mechanical stresses. Nanoscale extracellular vesicles (exosomes) with regenerative properties offer promising therapeutic potential for tissue regeneration, contributing to improved health outcomes. This study evaluated human exosomal preparations in promoting oral mucosal regeneration. Methods: We established standardized full-thickness wounds in the buccal mucosa of SD rats and divided subjects into experimental (receiving 50 billion human exosomes) and control (receiving carrier solution only) groups. Comprehensive wound assessment occurred at predetermined intervals (days 0, 3, 7, and 10) through photographic documentation, histological examination, and quantitative measurement. Results: Exosomal-treated tissues demonstrated statistically significant acceleration in closure rates (p < 0.05), achieving 87.3% reduction by day 10 versus 64.1% in the controls. Microscopic analysis revealed superior epithelial development, reduced inflammatory infiltration, and enhanced collagen architectural organization in exosomal-treated specimens. Semi-quantitative evaluation confirmed consistently superior healing metrics in the experimental group across all assessment timepoints. Conclusions: These findings demonstrate that human exosome preparations significantly enhance oral mucosal regeneration in SD rats, suggesting potential clinical applications for accelerating recovery following oral surgical procedures. Full article

Aim: To prepare two different kinds of wound care creams containing plant extracts and examine their effectiveness in comparison with a placebo cream and a commercial wound care cream, Madecassol^®. Methods: The two cream formulations were developed using the same placebo cream (PC) as base cream. One formulation contained balsam of oriental sweet gum, or Levant storax, named as Levant Storax Cream (LSC); the other contained oil of Calendula, extract of St. John’s Wort, aescin (an extract of horse chestnut), and freeze-dried powder from Aloe vera (L.) Burm. f. leaf juice, designated as Complex Cream (CC). In the characterization of the creams, organoleptic properties, pH, viscosity, size distribution, and zeta potential of oil globules were measured. Furthermore, the stability of the creams was assessed under different environmental conditions. In vitro studies were performed by using an excisional wound model in rats to assess the potential of the creams for stimulating wound healing. The efficacy of LSC and CC was compared with a commercial reference cream, Madecassol^® (M), and the placebo control. The study was also designed with a negative control group of rats that were not treated but handled the same way as the other treatment groups. The wound contraction rate, total skin thickness recovery, and results of histopathological parameter examinations were used to compare the effectiveness of the treatments. Results: The stability of formulated creams confirmed that they were stable for the duration of the study. In vivo studies showed that rats treated with LSC achieved the highest wound healing rates when compared with the other groups. A better response was recorded for the CC-treated population when compared to both control and placebo groups, but there was no significant difference seen in healing score between CC and M groups. Full article

Diabetic foot ulcers (DFUs) are a serious complication of diabetes, associated with high recurrence and amputation rates. Adherence to offloading devices is critical for wound healing but remains inadequately monitored in real-world settings. This study evaluates the SmartBoot edge-computing system—a wearable, real-time remote monitoring solution integrating an inertial measurement unit (Sensoria Core) and smartwatch—for its validity in quantifying cadence and step count as digital biomarkers of frailty, and for detecting adherence. Twelve healthy adults wore two types of removable offloading boots (Össur and Foot Defender) during walking tasks at varied speeds; system outputs were validated against a gold-standard wearable and compared with staff-recorded adherence logs. Additionally, user experience was assessed using the Technology Acceptance Model (TAM) in healthy participants (n = 12) and patients with DFU (n = 81). The SmartBoot demonstrated high accuracy in cadence and step count across conditions (bias < 5.5%), with an adherence detection accuracy of 96% (Össur) and 97% (Foot Defender). TAM results indicated strong user acceptance and perceived ease of use across both cohorts. These findings support the SmartBoot system’s potential as a valid, scalable solution for real-time remote monitoring of adherence and mobility in DFU management. Further clinical validation in ongoing studies involving DFU patients is underway. Full article

Resveratrol is one of the most extensively studied natural products due to its pleiotropic health benefits. However, its low water solubility and limited stability hinder its application in the nutraceutical, cosmetic, and pharmaceutical sectors. In this work, we investigated the ability of a cationic mono-choline-β-cyclodextrin derivative to complex trans-resveratrol. The complex was prepared using a phase solubility method without using organic solvents and was found to be stable after freeze-drying. The complex was characterized by a phase solubility study, NMR spectroscopy, and molecular modeling simulations, which revealed a 1:1 stoichiometry, a stability constant of 2051 M⁻¹ (K_C), and structural details. Complexation improved resveratrol’s solubility and dissolution rate, reduced its photoinduced trans-to-cis isomerization, and preserved its radical scavenging activity. The wound-healing activity of the complex was demonstrated via in vitro experiments on human keratinocyte cells. Full article

Point-of-care (POC) diagnostic technologies have become essential for the real-time monitoring and management of chronic wounds, where maintaining a moist environment and controlling pH levels are critical for effective healing. In this study, a flexible pH sensor based on a graphene/molybdenum disulfide (graphene/MoS₂) composite interdigitated electrode (IDE) structure was fabricated using pulsed laser ablation. The pH sensor, with an active area of 30 mm × 30 mm, exhibited good adhesion to the polyethylene terephthalate (PET) substrate and maintained structural integrity under repeated bending cycles. Precise ablation was achieved under optimized conditions of 4.35 J/cm² laser fluence, a repetition rate of 300 kHz, and a scanning speed of 500 mm/s, enabling the formation of defect-free IDE arrays without substrate damage. The influence of laser processing parameters on the surface morphology, electrical conductivity, and wettability of the composite thin films was systematically characterized. The fabricated pH sensor exhibited high sensitivity (~4.7% change in current per pH unit) across the pH 2–10 range, rapid response within ~5.2 s, and excellent mechanical stability under 100 bending cycles with negligible performance degradation. Moreover, the sensor retained > 95% of its stable sensitivity after 7 days of ambient storage. Furthermore, the pH response behavior was evaluated for electrode structures with different pitches, demonstrating that structural design parameters critically impact sensing performance. These results offer valuable insights into the scalable fabrication of flexible, wearable pH sensors, with promising applications in wound monitoring and personalized healthcare systems. Full article

To solve the technical bottleneck caused by the absence of a feasible method for removing the spermatheca in social insects, we developed a microsurgical technique specifically designed for bumblebee females. In this study, the invention of this technique is based on the anatomical characteristics of the sting chamber of bumblebees and uses a bespoke scalpel to precisely remove the spermatheca, which is small in size and deeply embedded within the body. During the removal operation, a small wound was observed and a small amount of hemolymph flowed out. The wound healed very quickly and the survival rate of treated individuals was high. The results showed that there was no significant impact on the critical life activities of queens and workers, including longevity, mating behavior, oviposition capacity, and overwintering survival rate after the spermatheca was removed using this technique. These findings further confirm the feasibility and applicability of the technique and provide strong technical support for exploring the evolutionary dynamics and potential function of the spermatheca in social insects. Full article

Background/Objectives: Diabetic foot (DF) is among the leading causes of diabetes-related disability. It is important to maintain regular follow-up and patient education in the prevention and treatment of DF ulcers. In extraordinary situations such as a pandemic, there are disruptions in regular clinical follow-up and patient education, and the effects of this disruption need to be investigated. The aim of this study was to investigate the impact of the pandemic on the clinical condition of patients hospitalised for DF. Methods: Patients were divided into two groups according to the date of admission to the clinic: the pre-pandemic (1 January 2019–11 March 2020) and the pandemic period (12 March 2020–1 June 2021). Comparisons were made between the two groups in terms of DF data and clinical parameters. Data were analysed with SPSS using chi-square, Student’s t-test and Mann–Whitney U analysis. Results: As a result of the screening, data from 125 DF patients (45 pre-pandemic and 80 pandemic) were collected. The DF stage, according to the Wagner classification, was significantly more advanced in patients during the pandemic period (p = 0.015). However, the time between the onset of symptoms and hospitalisation was longer for patients during the pandemic period (p = 0.035). When analysing treatment outcomes, the rate of wound healing was found to be lower (62.2% vs. 30%), and the rate of transtibial amputation was higher (11.2% vs. 20%) during the pandemic period (p = 0.002). Conclusions: This study found that the number of patients hospitalised for DF increased during the pandemic period, as did the severity of the wound, length of admission and radical treatment interventions. Full article

Background: Diabetic foot disease is a public health problem. The challenges of its management lie in the complexity of wound healing and, in particular, the high rate of lesion recurrence. Objectives: The primary objective of the study was to evaluate whether optimized post-healing follow-up by a multidisciplinary team can reduce the recurrence rate of foot ulcers in people living with diabetes. The secondary objectives were to assess patient needs in terms of hospitalization for recurrence, the number of amputations, pedicure care, and the use of adapted footwear. Participants: The study included 129 patients with diabetes presenting a healed foot ulcer. A total of 38 patients underwent an annual post-healing follow-up visit with a multidisciplinary team (optimized follow-up), while 91 had a visit every 2 years (minimum follow-up). Results: Of the 38 patients with optimal follow-up, 8 presented a wound recurrence (21.1%) compared with 38 out of 91 patients (41.8%) receiving minimum follow-up. The recurrence rate decreased significantly between the two groups (p < 0.05). The use of adapted shoes was also significantly better in the group with optimized follow-up (p = 0.02). Conclusions: Regular post-healing follow-up with a multidisciplinary team seems to be a contributing factor to reducing the recurrence of diabetic foot ulcers among people living with diabetes. Full article

Introduction: Gastrointestinal (GI) cancers are associated with high morbidity and mortality. Surgical resection, the primary treatment, often induces immunosuppression and increases the risk of postoperative complications. Perioperative immunonutrition (IMN), comprising formulations enriched with omega-3 fatty acids, arginine, nucleotides, and antioxidants, has emerged as a potential strategy to improve surgical outcomes by reducing complications, enhancing immune function, and promoting recovery. Methods: A systematic search of PubMed, Scopus, and the Cochrane Library was conducted on 28 October 2024 in accordance with PRISMA guidelines. Systematic reviews and meta-analyses evaluating perioperative IMN versus standard care in adult patients undergoing GI cancer surgery were included in the search. The outcomes assessed included infectious and non-infectious complications, wound healing, hospital stay, and nutritional status. The study quality was evaluated using AMSTAR 2, and the meta-analysis was conducted using random-effects models to calculate the pooled effect sizes (risk ratios [RRs], odds ratios [ORs], mean differences [MDs]) with 95% confidence intervals (CIs). Results: Sixteen systematic reviews and meta-analyses, including a total of 41,072 patients, were included. IMN significantly reduced infectious complications (RR: 0.62, 95% CI: 0.55–0.70; I² = 63.0%), including urinary tract infections (RR: 0.74, 95% CI: 0.61–0.89; I² = 0.0%) and wound infections (OR: 0.64, 95% CI: 0.55–0.73; I² = 34.4%). Anastomotic leak rates were notably lower (RR: 0.68, 95% CI: 0.62–0.75; I² = 8.2%). While no significant reduction in pneumonia risk was observed, non-infectious complications decreased significantly (RR: 0.83, 95% CI: 0.75–0.92; I² = 30.6%). IMN also reduced the length of hospital stay by an average of 1.92 days (MD: −1.92, 95% CI: −2.36 to −1.48; I² = 73.5%). Conclusions: IMN provides significant benefits in GI cancer surgery, reducing complications and improving recovery. However, variability in protocols and populations highlight the need for standardization and further high-quality trials to optimize its application and to validate its efficacy in enhancing surgical care. Full article