Bevezetés: A posztoperatív hasi hegsérvek helyreállítása a mai napig kihívást jelent, annak ellenére, hogy steril műtétről van szó. Gondot jelent a sebfertőzés, amelyhez hozzájárul a betegpopuláció komorbiditása is. Idegen anyag beépítése mindig magában hordozza a fertőzés kockázatát. Sebfertőzés esetén a sérvkiújulás lehetősége 0,2–8%, míg ha a hálót is el kell távolítani, a kiújulás valószínűsége már 30% fölött van. A nyitott sebkezeléssel szemben a negatív nyomású terápia hatékonyabban segíti a sebgyógyulást és a beépített háló megmentését. Anyag és módszer: Tanulmányunkban összesen 30 beteg esetét elemezzük, akik 2015 és 2023 között estek át olyan ’onlay’ hálós hasfali sérvműtéten, amelynél sebgennyedés lépett fel. Mindegyik esetben sebváladék-tenyésztést és negatív nyomású sebkezelést végeztünk. 15 betegnél pálcás, míg a másik 15-nél pálcás, szivacsmintás és szövethengeres mintavétel történt. A pálcás mintavételek eredménye főleg bőrflórát mutatott ki, amely 71%-ban Gram-pozitív kórokozó volt. A szövethengeres és szivacsmintás tenyésztések eredményei már 50%-ban mutattak ki Gram-negatív kórokozókat. Eredmények: A szivacsmintás és szövethengeres tenyésztések többletinformációt hordoztak a bakteriális terhelésre vonatkozóan. A negatív nyomású sebkezelés hatására a háló eltávolítására nem volt szükség. Következtetés: A negatív nyomású sebkezelés során az antibiotikumválasztásban is segítséget nyújtott a többféleképpen levett tenyésztés. A hálómentés céljából alkalmazott vákuumkezeléssel a bakteriális terheltség csökken, és a granuláció mértéke felgyorsul. A sérvkiújulás és a háló eltávolítása jelentősen mérséklődik. Orv Hetil. 2026; 167(18): 714–721.
Quality of life in later life extends beyond physical health to include psychological and social domains. The CASP-19 is one of the most widely used instruments for assessing psychosocial quality of life in ageing populations; however, previous studies have reported inconsistencies in its factor structure across cultural contexts, particularly regarding the distinction between the control and autonomy dimensions. The present study evaluated the psychometric properties and structural characteristics of the Hungarian CASP-19 and the methodological implications of adapting its response format. A cross-sectional study was conducted among 223 Hungarian-speaking participants aged 50 years and above. The Hungarian adaptation of the CASP-19 was administered using a modified agreement-based response format. Psychometric evaluation included principal axis factoring with varimax rotation, with parallel analysis and oblique rotation as sensitivity analyses, followed by confirmatory factor analysis comparing six structural models estimated from polychoric correlations with WLSMV. Internal consistency was assessed using Cronbach’s alpha and McDonald’s omega, while convergent validity was examined using the EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5 L), the 36-Item Short Form Health Survey (SF-36), and the Mental Health Quality of Life questionnaire (MHQoL). CASP-19 total scores of respondents completing the paper-based and the online version were compared in a propensity score-matched subsample using matched-pair t-tests; no participant completed both formats. The Hungarian CASP-19 demonstrated high internal consistency (Cronbach’s α = 0.91). Principal axis factoring yielded a four-factor solution explaining 53.1
Radiotherapy and systemic therapies have revolutionised cancer treatments and improved survival, with generally acceptable toxicity. Modern radiotherapy techniques offer precision in targeting tumours, while minimising harm to the surrounding tissues. Novel systemic therapies represent opportunities for combining innovative treatments with radiotherapy. New agents are increasingly more tumour-specific than chemotherapy, and new rational combinations with radiotherapy are emerging, allowing for a more personalised approach. The European Society for Radiotherapy and Oncology (ESTRO) has formed a focus group to explore the integration of innovative agents with radiotherapy. This Policy Review highlights the potential of combining radiotherapy with novel drugs, while addressing current evidence gaps and unmet needs in cancer care. The group emphasises a collaborative approach involving multiple stakeholders to drive sustainable improvements in oncological therapies, suggesting careful selection of combinations based on robust preclinical data. Key insights and proactive strategies can shape future clinical practices, particularly with the early introduction of radiotherapy in the development of novel agents.
IntroductionColorectal cancer (CRC) is a heterogeneous malignancy and a major cause of cancer-related mortality worldwide. Cancer-associated fibroblasts (CAFs) accumulate in tumors and correlate with poor patient survival, suggesting a central role in immune regulation. Patient-derived organoids (PDO) maintain the intra-tumoral cellular heterogeneity of the original tissue, thus, they represent one of the best methods to study human cancers. The tumor microenvironment (TME) contains diverse immune cell populations, including innate lymphoid cells (ILCs), yet how stromal components influence cytokine-driven tumor–immune interactions remains unclear.MethodsPDOs from CRC patients were used to screen TME-derived cytokines affecting tumor growth. Organoid-forming efficiency and signaling pathway activation were analyzed following cytokine stimulation in the presence or absence of CAFs. Tumor-infiltrating ILC subsets were characterized in patient samples, and co-culture systems were employed to assess cytokine production and stromal–immune interactions.ResultsIL-22 was identified as a cytokine that increased PDO-forming efficiency without activating fibroblasts. Although IL-22 typically signals through the JAK–STAT pathway, it unexpectedly activates MAPK signaling in PDO cells. Interestingly, interferon-γ (IFNγ) showed only partial cytotoxic effects on CRC cells. Tumor tissues contained both IFNγ-producing ILC1 and IL-22/IL-17A–producing ILC3 populations. Co-culture with PDOs selectively induced IL-22, but not IL-17A, production in ILC3 cells. Importantly, IL-22 enhanced organoid formation only in the absence of CAFs, whereas IFNγ activity was largely unaffected by stromal context.DiscussionThese findings demonstrate that CAFs modulate local immunity by selectively masking ILC3-derived IL-22 signaling while preserving ILC1-mediated IFNγ responses. This study emphasizes the importance of stromal context in interpreting cytokine function in CRC and reveals a previously unrecognized mechanism of stromal–immune crosstalk within the TME.
BACKGROUND Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms most commonly originating in the pleura but may also arise in extrapleural sites, including the head and neck region. Subcutaneous SFTs in the chin area are exceptionally rare; only a few cases have been reported. CD34 and Bcl-2 are commonly used immunohistochemical markers in the initial diagnostic workup, and their co-expression is strongly suggestive of an SFT. However, CD34 negativity can be misleading and complicate diagnosis. Accurate identification of SFTs is potentially difficult because of histologic variability and overlap with other spindle cell tumors. CASE REPORT We encountered a rare subcutaneous SFT in the chin of a 22-year-old woman who presented with facial asymmetry and a tender mass. Imaging revealed a well-circumscribed, contrast-enhancing lesion in subcutaneous soft tissue over the anterior mandible. Histologically, the tumor lacked typical staghorn vasculature but showed spindle cell proliferation within a fibrous stroma. Immunohistochemistry demonstrated strong nuclear STAT6 positivity; expression of CD99, Bcl-2, and SMA; and focal H-caldesmon staining. CD34, S100, and ALK1 displayed negative staining. Based on these findings, the patient was diagnosed with an SFT. CONCLUSIONS This case highlights the importance of considering SFT in the differential diagnosis of spindle cell tumors in the head and neck region. It also underscores the critical role of immunohistochemistry, particularly STAT6 staining, in distinguishing SFT from histologic mimics. Vigilant follow-up remains essential, especially in atypical or CD34-negative cases, given their potential for aggressive behavior.
