.
Multi-dimensional voice assessment is critical for monitoring recovery in patients treated with radiotherapy (RT) for early glottic carcinoma. This study investigated the longitudinal cross-parametric correlations between subjective (AVHI-10), functional (LVS), and objective (acoustic) voice measures at baseline and 6 months post-RT. Thirty-seven patients with T1–T2N0M0 glottic carcinoma were prospectively evaluated. Spearman correlation matrices (ρ) were employed to analyze the relationships between the Voice Handicap Index-10 (AVHI-10), laryngeal videostroboscopy (LVS), and acoustic parameters (HNR, Jitter, Shimmer and MPT). All parameters showed significant clinical improvement at 6 months (P < 0.001). Post-RT, the AVHI-10 demonstrated exceptionally strong concordance with objective efficiency measures, specifically HNR (ρ = − 0.893) and MPT (ρ = − 0.844), as well as robust correlations with perturbation metrics (Jitter: ρ = 0.761; Shimmer: ρ = 0.753). In contrast, while functional LVS parameters remained significantly correlated with acoustic output, these associations were more moderate (ρ ranging from = 0.41 to 0.67). Glottic closure was the most prominent functional predictor of acoustic spectral purity (ρ = − 0.674 with HNR), whereas mucosal wave parameters (Phase Symmetry and Periodicity) exhibited a relative weakening in their correlation with acoustic instability, suggesting a complex interplay following radiation-induced tissue changes. Subjective handicap (AVHI-10) serves as a highly reliable surrogate for objective acoustic efficiency in the post-RT larynx. While functional laryngeal dynamics improve universally, the attenuation of correlations observed between mucosal wave parameters and acoustic output highlights the complex, non-linear impact of radiation-induced fibrosis. Residual glottic closure remains the primary functional determinant of vocal efficiency, emphasizing its role as a key clinical biomarker for post-treatment success.
Depression rates among young adults (aged 18–25) continue to rise, and suicide remains one of the leading causes of death in this population. The aim of this study was to examine risk factors impacting depression severity, suicidal behavior (SB), and non-suicidal self-injury (NSSI) in young adults with depression, focusing on childhood trauma, impulsivity, and resilience. Young adults with a clinical diagnosis of depression were included in this observational study. Clinical assessments included validated measures of depression severity, SB, NSSI, childhood trauma, impulsivity, and resilience. Spearman’s correlation showed that demographic factors, childhood trauma, and impulsivity were significantly associated with depression severity, SB, and NSSI. However, multiple regression analyses showed that resilience was a significant protective factor for depression severity (p = .042), while other factors did not reach significance. In contrast, total childhood trauma score was a significant risk factor for SB (p < .001) and NSSI (p = .008). A positive family history of mental disorders was also a significant risk factor for SB (p = .009). These findings may contribute to the development of therapeutic interventions aimed at modifying these risk factors and protective factors. Such an approach may contribute to decreasing depression severity and the risk of SB and NSSI in young adults with depression.
Early glottic carcinoma primarily affects the vocal folds and most commonly presents with the symptom of dysphonia, which is an effect of the tumor interfering with normal vocal fold vibration. Radiotherapy for early glottic carcinoma is highly effective in controlling the tumor while preserving the larynx and voice. The aim of this study was to evaluate changes over time in voice outcomes among patients with early stage glottic cancers treated with definitive radiotherapy using stroboscopy as well as voice acoustic analysis. The assessment was applied on 24 patients with T1 and T2 glottic carcinoma. It was conducted pre-radiotherapy, 3 months and 6 months post-radiotherapy as follow-ups. The assessment included laryngoscopic, videostroboscopic examination, and voice acoustic analysis. Marked improvement was found in videostroboscopic parameters, with parameters highly significant differences across the three phases for nearly all stroboscopic parameters, p-values (<0.001), with a significant difference noted specifically for the periodicity of mucosal waves in the right vocal fold p-value (0.005). Significant improvement was detected in voice acoustic analysis parameters, including the increase in harmonic to noise ratio and maximum phonation time, and reduction in jitter and shimmer by 6 months (p < 0.001). The overall outcomes of the current study pointed to improved glottic manifestations based on videostroboscopy parameters and voice acoustic analysis parameters by 6 months post-radiotherapy.
Background/Objectives: Diffuse large B-cell lymphoma (DLBCL) is an aggressive and heterogeneous malignancy, for which predicting clinical outcomes remains challenging. Although immune-checkpoint pathways are known to influence tumor biology, the impact of their germline variants on DLBCL susceptibility and prognosis has not been fully elucidated. Methods: Variants in PD-L1 gene CD274 (rs4143815, rs822336), and miR-155 gene MIR155HG (rs767649, rs1893650), assessed by TaqMan assays in 99 DLBCL patients and 113 age- and sex-matched healthy controls, were associated with clinicopathological features, treatment response, overall survival (OS), relapse-free survival (RFS), and disease susceptibility. Results: The PD-L1 variant rs822336 was significantly associated with relapse status (p = 0.005) and RFS (p = 0.008), with the wild-type GG genotype showing the poorest RFS that remained independent in the multivariate Cox analysis (HR = 2.387, p = 0.003). Conversely, rs4143815 showed a nominal association with treatment resistance (p = 0.026), while patients carrying the GG genotype had worse OS (p = 0.006). In susceptibility analyses, miR-155 variant rs767649 showed a nominal association with DLBCL risk, with the rare AA genotype showing an increased risk of DLBCL (OR = 5.234, p = 0.045), which did not remain significant after Bonferroni correction. Conclusions: In a hypothesis-generating manner, these findings suggest that PD-L1 genetic variants may predominantly influence disease progression and outcomes, while miR-155 variation may contribute to DLBCL susceptibility. These findings highlight germline immunogenetic variants as stable, treatment-independent markers that may inform future studies on risk stratification and prognosis in DLBCL.
Short bowel syndrome (SBS) develops when the remaining intestine is unable to sustain adequate nutrient and electrolyte absorption following extensive bowel resection. The condition is characterized by malabsorption and significant fluid losses which lead to dehydration and progressive weight loss, thus promoting patient dependence on parenteral fluids or nutrition. After an initial acute phase marked by accelerated intestinal transit and gastric hypersecretion, long-term clinical outcomes are largely determined by the capacity of the remaining bowel for intestinal adaptation-a sustained process of structural, functional, and molecular remodeling that enhances absorptive efficiency and restores fluid and nutrient homeostasis. This review summarizes the key histological and cellular features of the adaptive response, including crypt and villus remodeling, mucosal hyperplasia, and smooth muscle hypertrophy, and integrates emerging concepts in crypt biology that define the dynamic cross-talk between intestinal stem cells and the mesenchymal niche, together with their upstream regulatory pathways.
