Background: Periorbital rejuvenation is often challenging and requires comprehensive evaluation of its various components to obtain satisfying results. Considering the crucial role of the orbicularis muscle in the periorbital aging process, the first author recently described his personal technique for temporal lifting through a subcutaneous approach in conjunction with an orbicularis muscle flap. In the current article, the authors present a modified and extended temporal lift approach, which allows for remarkable improvement not only in the temporal and brow region, but in the whole periorbital area up to the malar region, therefore named “Temporal MORE” (Modified Orbicularis REpositioning). Methods: 212 consecutive patients underwent Temporal MORE by the same surgeon between May 2021 and September 2022. Each patient filled a FACE-Q© questionnaire preoperatively and 12 months postoperatively. 5 independent surgeons were asked to score the results evaluating patients’ preoperative and postoperative pictures. Results: No major complications were recorded. The most satisfying aspect of this technique was dramatic periorbital rejuvenation noticeable in all patients. FACE-Q pre-operative score was 34.29±5.872, while the post-operative was 80.11±6.796 (p<0.05); delta (post-pre) mean value was 45.82±8.925. Surgeons’ questionnaire mean value was 41.92±6.010. Statistical analysis showed a strong correlation between surgeons’ and patients’ satisfaction (“r” value 0.7488). Conclusions: Temporal MORE proved to achieve a comprehensive rejuvenation of the periorbital area in a straightforward and reproducible way, with a fast recovery and a low complication rate. In this cohort, patient satisfaction with the result was remarkable and comparable to the judgment of the surgeons interviewed.
BackgroundFibromyalgia is a chronic syndrome with widespread pain and multisystem symptoms. Hydrokinesitherapy, combining exercise and water immersion, may reduce pain, improve function, and enhance quality of life. It may be more effective than land-based therapy, though protocols remain unstandardized. This study evaluated its effectiveness in fibromyalgia.ObjectiveThis systematic review aimed to evaluate the effectiveness of hydrokinesitherapy compared to land-based exercise or placebo intervention in women with fibromyalgia, with particular focus on its impact on pain, physical function, well-being, and quality of life assessed through the fibromyalgia impact questionnaire (FIQ).MethodsA literature review was conducted using the following databases until may 28th 2025: PubMed, Scopus, and Web of Science. Studies were deemed eligible based on the following PICO criteria: P) Participants: women diagnosed with fibromyalgia; I) Intervention: hydrotherapy; C) Control: land-based exercise or placebo/sham treatments; O) Outcome: Fibromyalgia Impact Questionnaire (FIQ). Only randomized controlled trials RCTs with two groups and full text in English were included.ResultsThis review included 10 RCTs with 469 participants, 238 treated with hydrokinesitherapy. Results showed significant improvements in pain, function, sleep, depression, and quality of life in women with fibromyalgia. Outcomes were better than land-based exercise, but benefits decline without continued therapy; long-term studies are needed to define optimal duration and structure.ConclusionHydrokinesitherapy combined with exercise benefits from warm-water immersion, reducing joint stress and improving movement tolerance in fibromyalgia. This review confirms its effectiveness in reducing pain, enhancing physical and psychological well-being, and improving quality of life.
This multisociety, multidisciplinary consensus—formally endorsed by the European Society of Surgical Oncology, the Cardiovascular and Interventional Radiological Society of Europe, and the Society of Interventional Oncology—was developed to standardise the assessment of ablation margins in liver tumour thermal ablation. A modified Delphi process, consisting of two online surveys and a hybrid (online and in-person meeting in Innsbruk) consensus meeting of 72 experts from North America, South America, Europe, and Asia. Formal consensus was reached for 150 (75%) of 199 statements. Strong agreement was observed between interventional and surgical oncologists, with only 12 (6%) of 199 statements showing significantly different ratings. Participants agreed that ablation margins should be assessed and documented for every treated tumour. Margins should be assessed quantitatively in three dimensions, with contrast-enhanced CT or MRI, preferably intraprocedurally with ablation confirmation software. Ablation margins should be categorised as A0 (tumour completely covered with sufficient margin), A1 (tumour completely covered but insufficient margin), or A2 (portion of tumour remains unablated). This effort is, to our knowledge, the first international consensus initiative to define best-practice recommendations for margin assessment in liver tumour thermal ablation to standardise practices, aiming to improve and promote uniform outcomes.
BACKGROUND:The purpose of this study was to report the outcome of primary localized pleomorphic rhabdomyosarcoma (P-RMS). PATIENTS AND METHODS:Patients with primary localized P-RMS, aged >40 years, and surgically treated with curative intent from January 2013 to December 2023 were enrolled from 25 institutions across 12 countries. Pathological inclusion criteria were predefined by expert pathologists per established World Health Organization guidelines. Primary endpoint was overall survival (OS). Secondary endpoints were disease-free survival (DFS), crude cumulative incidence (CCI) of local recurrence (LR), CCI of distant metastases (DM), post-relapse OS, and post-metastasis OS. RESULTS:A total of 93 patients were eligible and included in the present study. At a median follow-up of 39.8 months (interquartile range 22.83-85.69 months), 32/93 (34%) patients died and 53/93 (57%) recurred. The corresponding 5-year OS and DFS were 57.7% [95% confidence interval (CI) 46.7% to 71.2%] and 35.8% (95% CI 26.3% to 48.9%), respectively. Younger age, R0 surgical margins, and administration of radiotherapy were positive prognostic factors in multivariable analysis for DFS. LR and DM were developed in 14/93 (15%) and 39/93 (42%) patients, respectively. The corresponding 3-year CCI-LR and DM were 16% (95% CI 8.9% to 25%) and 44% (95% CI 33% to 55%). Post-metastasis median OS was 14.3 months (95% CI 9.4 months-not reached). CONCLUSIONS:While P-RMS is known to be an aggressive histologic sarcoma subtype, one-third of patients with primary localized disease may be cured. The contribution of chemotherapy and radiotherapy to the cure rate remains unclear. Post-metastatic outcomes mirror those observed in other sarcomas.
Cloud-based medical AI systems raise concerns regarding data privacy and regulatory compliance under GDPR and EU AI Act frameworks. We present a privacy-preserving, edge-deployable clinical decision support system achieving 81.20% accuracy on Italian National Medical Specialization Exams (2020-2024) while operating entirely on local hardware. The system combines a T5-base retriever with a 6-bit quantized Meditron3-8B model (8B parameters), requiring no external APIs and processing queries in 0.45s on consumer GPUs. While proprietary models (GPT-4.1, Claude-4.5) achieve 96% accuracy with 1T+ parameters and cloud dependencies, our system demonstrates that optimized open-source models can deliver clinically relevant performance at two orders of magnitude fewer parameters while preserving complete data sovereignty required for GDPR and EU AI Act compliance
