Objective: To identify the most informative metabolic biomarkers associated with newly diagnosed cancer and to evaluate the potential of interpretable machine learning methods for their identification and patient classification. Materials and methods: This single-center retrospective study included 210 patients: 110 subjects without cancer and 100 patients with newly diagnosed malignancies. Clinical, anthropometric, laboratory, and metabolic variables were analyzed, including body mass index, waist circumference, visceral adiposity index, fasting glucose, immunoreactive insulin, insulin resistance indices, lipid profile, adipokines, and inflammatory markers. After preprocessing and stratified splitting into training, validation, and test sets, a family of Logistic Regression models, Elastic Net, Decision Tree, and CatBoost were used for binary classification. Model interpretation was performed using SHAP analysis, CatBoost feature importance, decision tree structure, SHAP Waterfall plots, and standardized Elastic Net coefficients. Results: CatBoost demonstrated the best classification performance on the test set (AUROC=0.9805; AUPRC=0.9711; Recall=0.9091; Precision=0.9524; F1-score=0.9302). Independent interpretation methods consistently identified the hyperglycemia criterion, fasting glucose, HOMA-IR, oral glucose tolerance test parameters, and the number of metabolic syndrome components as the leading predictors. Distribution analysis confirmed a shift of these biomarkers toward more pronounced carbohydrate metabolism disorders in the oncology group. Conclusion: Interpretable machine learning can support the identification of metabolic biomarkers associated with newly diagnosed cancer. Carbohydrate metabolism and insulin resistance markers were the most informative predictors and may be useful for early oncometabolic risk stratification and future clinical decision-support models.
In recent years, the incidence of ischemic strokes in young people worldwide has been increasing, leading to early disability, loss of work capacity, and reduced quality of life. Platelets play an active role in the pathogenesis of ischemic stroke. The main drugs for secondary prevention of ischemic stroke are acetylsalicylic acid (ASA) and clopidogrel (CL). ASA inhibits cyclooxygenase-1 (COX-1), which prevents the production of thromboxane A2 (TXA2), thereby inhibiting platelets, while CL acts by inhibiting ADP, which binds to two protein receptors on platelets (P2Y1 and P2Y12) and leads to platelet aggregation. Effective antiplatelet therapy can significantly reduce the risk of recurrent ischemic stroke. Aim . To identify clinical and genetic factors contributing to the development of laboratory resistance to antiplatelet agents in a patient with a previous ischemic stroke. Materials and methods . The medical history of a patient who had a previous ischemic stroke of unknown origin was studied In Sverdlovsk Regional Clinical Hospital No 1 (SOKB 1). To identify laboratory resistance, we used the optical aggregometry method and a set of genes ( ABCB1, CYP2C19*2, CYP2C19*3, CYP2C19*17, ITGA2, ITGB3, PAI-1 ) that affect the development of high residual platelet reactivity. Results . For the first time, the patient was examined 3 months after the development of an ischemic stroke, against the background of regular ASA intake. Laboratory resistance to this antiplatelet agent was detected using optical aggregometry. Subsequently, against the background of ASA correction, the introduction of clopidogrel (CL) was repeatedly revealed ineffective disaggregation. When analyzing anamnestic data, it was revealed that the development of high residual platelet reactivity could be influenced by the presence of obesity, hypertension, which are present in this patient. Genetic studies have identified mutations in two genes (ABCB1, CYP2C19*2) that may also contribute to the development of laboratory resistance. Conclusions . Conclusions. Effective disaggregation against the background of ASA and CL intake is an important factor in the secondary prevention of ischemic stroke. The study and identification of clinical and genetic risk factors that may affect the development of high residual platelet reactivity remains an important clinical task that requires further study.
Thermal burns represent a serious clinical challenge due to extensive tissue damage, high susceptibility to microbial contamination, prolonged inflammatory response, and delayed regenerative processes. The development of multifunctional wound-healing agents combining antimicrobial, anti-inflammatory, and regenerative properties remains a priority in experimental and clinical medicine. Chitosan and its derivatives are natural polysaccharide-based biopolymers characterized by biocompatibility, biodegradability, low toxicity, and pronounced biological activity, including antimicrobial, hemostatic, and tissue-regenerative effects. The present experimental study aimed to investigate the regenerative potential and prolonged antimicrobial, osmotic, and adsorptive properties of chitosan derivatives in the treatment of third-degree thermal burns. The experiment was performed on 40 white outbred male rats with standardized full-thickness thermal burns. The animals were randomly divided into four groups: (1) chitosan-furacilin composition, (2) chitosan derivative alone, (3) Levomekol ointment (reference treatment), and (4) physiological saline (control). Treatment was administered topically under standardized conditions. Wound healing dynamics were evaluated by planimetric measurement of wound area and assessment of epithelialization rates on days 3, 7, and 10 post-injury. Quantitative analysis demonstrated significantly accelerated wound contraction and epithelialization in the chitosan-treated groups compared to both control and reference therapy groups (p < 0.05). The chitosan-furacilin composition showed the most pronounced regenerative and antimicrobial effect, indicating a synergistic action. The results confirm that chitosan derivatives enhance reparative processes, reduce inflammatory manifestations, and improve overall wound healing dynamics. These findings suggest that chitosan-based formulations represent promising therapeutic agents for the management of thermal burn injuries and warrant further experimental and clinical investigation.
Maintaining intestinal epithelial barrier integrity is essential for mucosal homeostasis and immune defense. Bioactive compounds derived from natural sources have attracted interest for their potential to modulate inflammatory responses in the gut. Eggshell membrane, a proteinaceous layer rich in collagen, glycosaminoglycans (including hyaluronic acid and chondroitin sulfate), and bioactive peptides, has demonstrated anti-inflammatory properties in preclinical and clinical settings, although its effects on intestinal inflammatory markers remain largely unexplored. The aim of this study was to evaluate the anti-inflammatory effects of soluble eggshell membrane powder on lipopolysaccharide (LPS)-induced inflammatory gene expression in human intestinal epithelial Caco-2 cells. Cells were pre-stimulated with LPS (50 µg/mL) for 1 h, then co-treated with the eggshell membrane product at concentrations of 0.01% and 0.1% in the continued presence of LPS for an additional 3 h. Gene expression of TNFα, IL1α, IL1β, IL6, and IL10 was quantified by qRT-PCR (n = 4) using the 2−ΔΔCt method and analyzed by one-way ANOVA with Dunnett's post hoc test. Treatment at 0.01% significantly reduced TNFα expression by 55.1 ± 16.7% (p < 0.05), IL1α by 86.5 ± 12.0% (p < 0.0001), and IL1β by 64.3 ± 15.2% (p < 0.01), relative to LPS-only controls, corresponding to 99.0%, 126.9%, and 129.2% attenuation of the LPS-induced increases, respectively. At 0.1%, IL1α was also significantly reduced (−56.9 ± 11.1%, p < 0.01), while an inverse dose–response pattern was observed for TNFα and IL1β. IL6 expression was not reduced by treatment and showed a significant increase at 0.1%. IL10 was not significantly affected by either LPS or treatment. The MTT assay confirmed that the product did not affect cell viability at any concentration tested (0.001–0.1%). These results suggest that soluble eggshell membrane powder exerts selective anti-inflammatory activity targeting early NF-κB/TLR4-dependent proinflammatory mediators, and may have potential applications in intestinal health management.
Background: Case-based learning (CBL) has been widely adopted in clinical medical education across both Chinese and Western contexts. However, systematic and critical comparisons of CBL with lecture-based learning (LBL) and other emerging pedagogical approaches remain limited, particularly given the cultural differences between these regions. Thus, this study aimed to investigate variations in the effectiveness of CBL implementation in clinical medical education across different cultural contexts through a systematic review. Methods: The search period spanned from the inception of each database to December 2024, covering PubMed, Embase, Web of Science, CNKI, VIP, and Wanfang databases. This study incorporated CBL teaching effectiveness data from medical students and clinical education research subjects in Chinese and Western countries, with comparative analyses conducted against LBL and other innovative pedagogical approaches. The primary outcome measures included objective theoretical assessment scores and clinical practice skill evaluations, while secondary outcome measures consisted of learner satisfaction ratings obtained through standardized questionnaires. The meta-analysis was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions (version 6.3) and adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: Following systematic screening, 14 eligible studies involving 1,696 participants were ultimately included. The analysis revealed that compared to LBL, CBL demonstrated a statistically significant improvement in both theoretical assessment scores (SMD = 0.30, 95% CI [-0.09, 0.70]) and clinical practice performance (P < 0.001) among students. Furthermore, CBL demonstrated significant improvements in students' self-directed learning capability (SMD = 1.78, 95% CI [1.46, 2.11], large effect size), clinical analytical skills, and critical thinking abilities (all p < 0.001). Conclusions: CBL demonstrated positive effects in both Chinese and Western educational systems, as evidenced by the improved objective academic performance and increased learner satisfaction. Moreover, CBL exhibited marked consistency in its implementation outcomes across clinical education systems in different countries. Overall, it can be regarded as an effective approach for enhancing students' objective assessment scores and learning engagement.
Nasopharyngeal carcinoma (NPC) has an insidious onset and lacks obvious early symptoms, often leading to diagnosis at middle or late stages and significantly worsening patient prognosis. Regional medical big data platforms integrate clinical, genomic, and imaging data sources. These platforms provide advanced technical support and novel research perspectives, such as the identification of new biomarkers and predictive modeling approaches, to facilitate early detection of NPC. This review summarizes recent advances in NPC early detection enabled by these platforms. It highlights the application and benefits of multimodal screening strategies, including Epstein-Barr virus (EBV)-related biomarker assays, DNA methylation analysis, imaging screening techniques, and machine learning algorithms. We synthesize the latest research findings and analyze the potential of multi-omics data integration and artificial intelligence technologies to improve screening accuracy. Moreover, we discuss how these approaches can reduce false-positive findings in NPC early detection. We also explore future directions for achieving precise and personalized NPC early detection through big data platforms. This review aims to provide both theoretical foundations and practical guidance for building regional medical big data platforms, thereby facilitating the optimization and wider implementation of NPC early detection systems by enhancing data integration and analytical capabilities.
Drug resistance, recurrence, and metastasis are the main challenges that can lead to treatment failure and deteriorate outcomes of patients with breast cancer. Breast cancer metastasizes to different organs and may present with different phenotypic features. However, the underlying mechanisms of phenotypic plasticity of breast cancer still remain unclear. We herein report a case of HER2-positive breast cancer in which the patient developed acquired therapeutic resistance following standard postoperative adjuvant chemotherapy combined with anti-HER2 targeted therapy. The patient initially responded to treatment; however, one year after completion of therapy, new bilateral pulmonary nodules emerged. Subsequent pathological examination confirmed metastatic carcinoma with a transdifferentiated squamous cell phenotype. Comprehensive biomarker analyses, including immunohistochemistry (IHC), fluorescence in situ hybridization (FISH), and next-generation sequencing (NGS), were performed on matched samples from the primary breast tumor and the corresponding lung metastatic lesions. Integrated diagnostic results confirmed that the pulmonary lesions were metastatic in origin from the breast, harboring HER2 amplification as well as PIK3CA and TP53 mutations. In contrast to the primary lesion, the metastatic lung lesions demonstrated acquisition of a squamous phenotype, accompanied by multiple chromosomal heterozygous/homozygous deletions and copy-number gain that may have contributed to this phenotypic transformation. Despite HER2 amplification, the pulmonary metastases showed negative HER2 protein expression, possibly reflecting tissue-specific gene expression differences. These findings provide new insights for the clinical management of HER2-positive breast cancer.
Single-incision laparoscopic cholecystectomy (SILC) represents a significant direction in the evolution of minimally invasive surgery. Performed through a single umbilical incision, SILC offers the distinct advantage of achieving a "scarless" abdominal wall and significantly improving patient cosmetic satisfaction. However, this technique faces considerable technical challenges, including the "chopstick effect" inherent to coaxial instrument manipulation, limited visual field, and a steep learning curve. These factors may contribute to an elevated risk of complications such as bile duct injury and incisional hernia. Currently, SILC is primarily indicated for carefully selected patients with low-to-moderate surgical complexity benign gallbladder diseases. While it achieves comparable major clinical outcomes to conventional laparoscopic cholecystectomy (LC), debates persist regarding its operative duration, postoperative pain profiles, and health economic implications. To address these technical bottlenecks, innovative modifications such as suspension exposure techniques, magnetic anchor technology, and robotic single-port platforms continue to emerge. This review contends that SILC serves not as a replacement for conventional LC, but as a valuable complement, specifically designed to meet the higher demands for aesthetics and minimal invasiveness in particular patient populations. Future advancement of SILC urgently requires robust high-quality evidence, establishment of standardized training protocols, and systematic progress in instrument innovation and healthcare reimbursement policies. Such developments are essential to steer SILC towards a more precise and personalized surgical paradigm.
Objective: Shivering is a frequent and undesirable complication of cesarean section with spinal anesthesia. The present study aimed to determine the effects of ketamine on the levels of cytokines, immunoglobulins and brain-derived neurotrophic factor (BDNF) during cesarean section-mediated perioperative shivering. Methods: In this randomized controlled trial, eighty patients undergoing cesarean section were enrolled. They were randomly allocated to one of two groups: a control group (n = 40) that received normal saline, and a ketamine group (n = 40) that received ketamine at a dose of 0.25 mg/kg. Maternal blood samples were collected at three predefined time points: after study drug administration (T1), after umbilical cord clamping (T2), and at the end of surgery (T3). Results: At the T2 time point, the ketamine group exhibited a significant reduction in maternal cytokine concentrations compared to the saline control. Umbilical cord immunoglobulin concentrations were comparable between groups. Moreover, no correlation was found between umbilical cord BDNF and maternal cytokine levels at T2. Conclusions: Ketamine alleviated cesarean section-mediated perioperative shivering via diminishing cytokines, without impacting the levels of BDNF or immunoglobulins. Moreover, ketamine treatment decreased the levels of cytokines in the maternal blood; thus, abrogating the risk of transferal into the neonate.
Background: Traditional diagnostic approaches for major depression disorder (MDD) or clinical depression rely on subjective assessment of clinical symptoms while heart rate variability (HRV) metrics provide an objective alternative to support clinical assessments and facilitate early depression detection. However, the imperceptibility of non-stationarity and unpredictability in noticing a factor for its HRV outcome highlight the challenges in modelling of predictive AI. Methods: In this study, totally 139 participants were recruited including 40 patients and 99 healthy controls. Only 28 of the 40 depression patients and 34 of the 99 healthy controls were enrolled for HRV data collection according to inclusion criteria. Our experiment provided evidence for evaluation of the validation method using a photoplethysmography (PPG) derived parameter representing beat-to-beat stress-induced vascular response in terms of labelling performance and applicability. Results: The results demonstrated the link between depression and the autonomic nervous system (ANS) measured using HRV both in statistical analysis and AI-driven classification, as seen in the GPT-4-based LLM outperformed baseline models across multiple data sets. The validity labeling contributed significantly to model performance and robustness, especially in small-sample scenarios. Although small sample size was used in HRV-based depression prediction training via a large language model (LLM) with in-context learning (ICL), the performance was definitely improved with validity labeling activated compared to labeling disabled. Conclusions: Through comparison of observational accuracy in predictive models, the reliability of HRV recordings is crucial for improving AI-driven depression prediction and aligning AI analysis with the expectations on physiological and psychological effects. Among factors that could cause HRV value to change in unexpected ways, stationarity is a prerequisite for short-term HRV (ST-HRV), thus validation strategy, a labeling method capable of identifying and rejecting recordings of false signals, is necessarily needed.
Idiopathic Pulmonary Fibrosis (IPF) is a disease that leads to respiratory failure and subsequent death. To prevent chronic lung diseases from rising further up the list of leading causes of death worldwide, new innovative therapeutic approaches are needed. This work aims to present a literature review on advances in regenerative therapies in the treatment of IPF. The bibliographic strategy of this research used papers published in last ten years taken from the electronic databases PubMed and Capes Periodical Portal, which include the current understanding of this pathology, and the different treatment modalities. The majority of selected articles were concentrated in the last three years of this review, corroborating the expectation of recent advancements given the current massive scientific research on IPF. This review focused on current treatments, their limitations and investigated cutting-edge research in regenerative therapies. The research resulted in the presentation of ongoing studies and therapies segregated between pharmacological manipulation and the use of stem cells. Both categories of treatment focus on restoring endogenous lung repair or targeting pathways that inhibit dysregulated regeneration. Genetic and epigenetic factors were constantly highlighted as extremely necessary for the diagnosis. Conclusively, given the heterogeneity of this pathology, the authors propose, for the next general IPF treatment protocol, the inclusion of a combination of therapies, accentuating the pro and post-installed disease components. Encouraging the established of specialized health centers is also part of the findings of this research. They promote close cooperation between pulmonologists, radiologists, biomedical geneticists, pathologists, among others.
With the increase of incidence rate of type 2 diabetes worldwide and the shortening of the onset time, coronary heart disease (CHD) poses a major threat to young and middle-aged patients with type 2 diabetes (T2D), and cardiovascular events are the main cause of death in this population. Although established risk factors such as age, hypertension, and dyslipidemia can lead to CHD in T2D patients, their effects may vary by gender. However, gender specific studies on CHD risk in middle-aged and young T2D populations, particularly large-scale systematic analyses, are still limited. This study aimed to assess sex-specific differences in the risk of CHD among young and middle-aged individuals T2D. A total of 1071 adults with both CHD and T2D were recruited from the National Population Health Data Center, and weighted univariate and multiple logistic regression analyses were applied to calculate odds ratios (ORs) with 95% confidence intervals (CIs). The results showed an overall CHD prevalence of 35.29% in the T2D population, with slight sex differences: 36.47% in males and 32.49% in females. Notably, CHD prevalence increased with body mass index (BMI), reaching 33.22% in the <25 kg/m2 group, 34.69% in the 25–<30 kg/m2 group, and 41.83% in the ≥30 kg/m2 group. Weighted logistic regression analyses identified age, hypertension, triglycerides (TG), high-density lipoprotein (HDL), and C-reactive protein (CRP) as significant correlates of CHD in males with T2D. In contrast, only age and hypertension showed significant associations with CHD in females. These findings confirm sex disparities in CHD risk factors among young and middle-aged T2D patients, emphasizing the need for sex-specific strategies in CHD prevention and management for this population.
Today, hypothyroidism of various origins affects about 10% of the Earth's population. The relevance of this work is due to the absence of original harmless and effective natural products on the domestic and global pharmaceutical market, which can be used both to normalize the immune system and to restore the functional activity of the thyroid gland and reduce the level of associated complications. In modern endocrinology, fetal biological products, including cord blood products, can be a certain alternative to replacement therapy (or in combination with it). The aim of the work was to find new therapeutic approaches for the correction of the most common thyropathies. The study was conducted on 75 sexually mature male Wistar rats in a model of autoimmune hypothyroidism, which developed in rats against the background of autoimmune thyroid damage, which was caused by immunizing animals with thyroid antigen in combination with Freund's complete adjuvant. The animals were injected with a cryopreserved cord blood preparation "Cryocell-Cryocord" (CC) and a reference preparation "L-thyroxine" (LT4) (Berlin-Chemie, Germany). The AIH model leads to persistent pathological changes in the structure and function of the thyroid gland and immunological disorders. It was determined that at all times of the study, the biological preparation of СС had a positive effect on the restoration of the hormone-producing function of the thyroid gland in rats with AIH, increasing the content of both fractions of thyroid hormones, i.e. the biological preparation of СС showed itself as a powerful stimulator of the hormone-producing function of the thyroid gland. In addition, the use of the cord blood preparation significantly reduced the titer of antithyroid antibodies. The normalizing effect of СС on the indicators of specific humoral and cellular immunity was maintained throughout the experiment, which indicated the effectiveness of its use in thyroid pathologies. The multipotent properties of СС allow us to consider this biological preparation as a promising potential tool in the complex therapy of hypothyroidism of various genesis. The use of such approaches in the therapy of thyroid dysfunction is pathogenetically justified.
This study explores the complex relationship between air pollution and non-communicable diseases (NCDs) in Sub-Saharan African cities. By conducting a comprehensive review of 200 scholarly papers, the research synthesizes existing knowledge to elucidate the extent and nature of this association. Sub-Saharan Africa faces unique challenges due to rapid urbanization, industrialization, and transportation growth, which significantly contribute to deteriorating air quality. The review reveals that air pollution in Sub-Saharan Africa, driven by biomass burning, vehicular emissions, industrial activities, and dust, substantially contributes to high rates of NCDs such as respiratory diseases, cardiovascular diseases, cancer, and diabetes in urban areas. Notably, asthma affects 10-15% of the urban population, chronic obstructive pulmonary disease (COPD) impacts 8-12% of adults, and acute respiratory infections occur in 20-30% of children. Hypertension and ischemic heart disease affect 15-20% and 5-10% of the population, respectively, while lung cancer and type 2 diabetes affect 2-5% and 5-8% of the population, respectively. Addressing air pollution is crucial for improving public health in the region. The review identifies key pollutants of concern, including particulate matter, nitrogen dioxide, and sulfur dioxide, and examines their linkages to prevalent NCDs. Furthermore, the study discusses the methodological approaches employed in existing literature, identifies gaps, and proposes avenues for future research to enhance understanding and mitigate the health impacts of air pollution in this region.
Chemotherapy-induced oral complications significantly affect patient quality of life. 5-Fluorouracil (5-FU), a commonly used chemotherapeutic agent, being particularly associated with mucosal toxicity. This study aimed to evaluate the histological and Histomorphometrical effects of Sidr honey and Moringa oleifera on chemotherapy-induced oral mucosal damage in a rat model. Eighteen male albino rats were divided into three groups: control, 5-FU only, and 5-FU combined with Moringa oleifera and Sidr honey. Tongue tissues were harvested at 14 and 28 days for histological examination and histomorphometric analysis using H&E staining and ImageJ software, with statistical analysis performed via one-way ANOVA and paired t-tests (p<0.05). Results indicated that the 5-FU-only group exhibited progressive epithelial thinning, loss of rete pegs, and increased inflammatory infiltration, while the group receiving Moringa oleifera and Sidr honey showed significant epithelial regeneration, including increased thickness, intact keratinized surfaces, and partial restoration of rete pegs. Statistically significant differences in epithelial thickness were observed across all groups at both time points (p<0.001). Within-group analysis indicated improvements in both the control and treatment groups, whereas a decline was noted in the 5-FU-only group over time. These findings suggest that Moringa oleifera and Sidr honey possess protective and restorative properties against 5-FU-induced lingual mucosal damage, enhancing epithelial regeneration and reducing inflammation. Future research should focus on clinical trials to validate their therapeutic potential in human patients, explore the underlying molecular mechanisms of their protective action.
Objective: To investigate the correlation between blood glucose, blood lipids, and renal function with the prevalence of cognitive impairment in elderly individuals aged 65 and above in this region, and to analyze the influencing factors. Methods: This study adopted a cross-sectional design, selecting 11,510 residents from nine communities in this region who participated in elderly health examinations from 2022 to 2023 as the study subjects. Demographic data (age, gender, education level), medical history, and other baseline information were collected through standardized questionnaires. Laboratory data such as fasting blood glucose, blood lipids, and renal function were measured, and cognitive function status was assessed using the Mini-Mental State Examination (MMSE) to determine the prevalence of cognitive impairment in individuals aged ≥65 in this region. Data analysis was performed using SPSS 25.0 software, and univariate and multivariate logistic regression analyses were conducted to examine the impact of blood glucose, blood lipids, and renal function on cognitive impairment. Results: Among the 11,510 elderly individuals, 2,803 had cognitive impairment, with a prevalence rate of 24.4%. The results showed that hypoglycemia, hyperglycemia, triglycerides, cholesterol, low-density lipoprotein, glomerular filtration rate, age, gender, and education level had significant effects on cognitive impairment (P < 0.05), while high-density lipoprotein cholesterol showed no significant association. Conclusion: Female gender, advanced age, low education level, hypoglycemia, hyperglycemia, high triglycerides, high cholesterol, low-density lipoprotein cholesterol, and decreased glomerular filtration rate are risk factors for cognitive impairment in the elderly population of this region.
Rhabdomyosarcoma (RMS) is a common malignant soft tissue tumor in children and adolescents. Usually, the incidence of mediastinal RMS is extremely low. Traditional radiotherapy causes great damage to normal tissues around the tumor. Proton beams have a unique Bragg peak that can significantly reduce damage to the surrounding normal tissues while ensuring sufficient dose of the tumor. We report a case of a 33-year-old Chinese female with primary mediastinal RMS, and introduce a treatment plan involving photon radiotherapy and proton beam therapy (PBT) for this rare and interesting case. The patient started to have chest tightness and shortness of breath two months prior to presentation at the local hospital. The cardiac color ultrasound showed pericardial effusion and pericardiocentesis was performed. She was discharged after the procedure. She had a Positron Emission Tomography (PET)/ Computerized Tomography (CT) examination and the results suggested mediastinal tumor and enlarged mediastinal lymph nodes and her puncture pathology through bronchoscopy showed RMS. The following month, the patient developed chest tightness and shortness of breath again. In our hospital a multidisciplinary treatment was conducted to formulate a plan for radiotherapy of the mediastinal RMS. She received the photon and proton beam therapy. After PBT, the tumor had significantly decreased in size. PBT may improve the tumor control and the patient’s quality of life with symptomatic mediastinal RMS. The present case illustrates that PBT may be also useful for cases that are difficult to treat with photon radiotherapy and surgery.
The development of new approaches and the search for effective means for restoring thyroid function in primary hypothyroidism against the background of autoimmune damage is an urgent need. Currently, preparations made from placenta tissue and amniotic membrane are attracting attention. The placenta, as an organ that ensures the growth and development of the fetus, has in its composition active metabolites and immunosuppressive agents that ensure the preservation of pregnancy, and can have a positive effect when using such drugs in patients with autoimmune disorders. At present, the concept of a comprehensive approach to the treatment of autoimmune thyroiditis, which leads to hypothyroidism and subsequent complications using biologically active compounds, has not been finally formed. The solution to this problem will contribute to reducing the pharmacological burden on the patient with hypothyroidism and improving his quality of life. The aim of the work was to study the effect of the placenta extract preparation in combination with L thyroxine on the parameters of thyroid status in patients with primary hypothyroidism of autoimmune genesis. As part of the study, it was found that the combined use of placenta extract and L thyroxine led to a significant decrease in the level of ab-TPO already a month after therapy. After 6 and 12 months, the tendency to a gradual decrease in the content of ab-TPO was maintained. As for the functional state of the thyroid gland, the level of free fractions of thyroid hormones gradually reached the level of reference indicators. Thyroid-stimulating hormone after 12 months and 6 months after the repeated course was within the physiological norm. The use of monotherapy with L thyroxine restored the level of thyroid hormones and TSH, but the level of ab-TPO a year after the start of therapy was within the range of indicators before the start of therapy. The drug "placental extract" leads to a decrease in the tension of antithyroid immunity in patients with primary hypothyroidism at all studied periods and helps to slow down the progression of primary hypothyroidism in patients with autoimmune thyroiditis and normalize the parameters of thyroid status, which allows to reduce the daily dose of replacement therapy with levothyroxine.
Maternal and infant mortality remain critical public health challenges in Haut-Katanga, particularly during epidemic periods that strain limited healthcare infrastructure. This study evaluates the impact of Artificial Intelligence (AI) on reducing maternal and infant mortality through a retrospective analysis using generated data from 2015 to 2023. During this period, AI adoption increased from 2% to 25%, accompanied by a decline in maternal mortality from 940 to 840 deaths per 100,000 live births, and infant mortality from 85 to 62 deaths per 1,000 live births. Linear regression analysis indicates that a 1% increase in AI adoption is associated with a reduction of approximately 1.2 maternal deaths per 100,000 and 0.15 infant deaths per 1,000, respectively. Pearson correlation analysis reveals a strong negative relationship between AI adoption and both maternal (r ≈ -0.96) and infant mortality (r ≈ -0.96), and a strong positive correlation between maternal and infant mortality (r ≈ +0.98). Additionally, trends in infectious diseases show notable declines in malaria (r = -0.84) and HIV/AIDS (r = -1.00), while measles (r = +0.83), cholera (r = +0.98), and COVID-19 (r = +0.88) increased over time. AI-based interventions, particularly in epidemic prediction and diagnostics, have contributed to measurable health gains. However, implementation remains constrained by infrastructural deficiencies, limited funding, and low digital health capacity. The findings underscore AI's emerging role in improving health outcomes and emphasize the need for strategic investments in infrastructure, workforce training, and supportive policy frameworks to enhance healthcare delivery and epidemic preparedness in resource-limited settings.
Background Diabetic foot ulcers represent one of the most persistent and complex complications in clinical management. These ulcers pose significant challenges, often leading to morbidity and impaired mobility. Total contact casts (TCC) are often utilized in treatment for diabetic foot ulcers. A TCC may result in a functional iatrogenic limb length discrepancy (LLD) due to the inherent structure and material composition of the cast. While a TCC is effective in offloading pressure from affected diabetic foot ulcers and promoting healing, it may also alter gait mechanics and pressure distribution, affecting the contralateral limb. Recognizing and addressing these consequences is crucial for developing comprehensive treatment strategies that not only facilitate wound healing but also preserve functional mobility and prevent secondary complications. The central questions guiding this research are: What is the impact of a TCC-induced Leg Length Discrepancy (LLD) on contralateral limb loading? Can a contralateral lift effectively mitigate these effects? Methods We conducted a study involving thirty healthy adults (16 female, 14 male; mean age 26.5 years). Gait analysis was conducted using a CAREN instrumented treadmill under four experimental conditions: (1) Baseline: shoes only (no cast or lift); (2) TCC: TCC on the right foot, no lift on the left; (3) TCC+Heel: TCC on the right foot, heel lift in the left shoe; and (4) TCC+Full: TCC on right foot, full-length shoe lift on the left. The TCC introduced an approximate 1.9 cm limb length discrepancy (LLD). Gait parameters and ground reaction forces (GRFs) were recorded and analyzed using repeated-measures ANOVA to assess the effects of TCC and lift conditions on contralateral limb loading. Results Key outcomes included walking with a TCC (without a lift) increased peak contralateral foot GRFs by approximately 6% (p<0.05), indicating greater stress on the non-casted foot. Introducing a contralateral heel lift significantly reduced contralateral GRFs (p<0.01), suggesting partially restoring of normal loading patterns. However, a full-length shoe lift did not provide a comparable reduction in contralateral limb loading, showing no statistically significant benefit. Significance This study highlights the importance of recognizing a TCC-induced LLD increases contralateral limb loading. This study demonstrates that a simple contralateral heel lift effectively reduces excess loading and improves gait symmetry, whereas a full-length shoe lift offers little benefit. These findings support the routine use of heel lifts as an adjunctive measure during TCC treatment to improve gait symmetry and protect the non-casted limb.
