Background/Aim. Breast cancer progression is driven by dysregulated signaling pathways and epigenetic alterations. Plant-derived terpenoids have attracted significant attention as promising anticancer agents due to their ability to modulate key molecular and cellular targets. Ten-eleven translocation 1 (TET1) has been identified as an oncogenic factor in aggressive breast cancer subtypes, promoting tumor-supporting transcriptional activities at specific DNA sites and contributing to resistance against oxidative stress-mediated cell death. The aim of this study was to examine the potential of plant-derived terpenoids to target TET1 and to explore the correlation between TET1 modulation, oxidative stress, and apoptosis-mediated cell death in breast carcinoma. Methods. Molecular docking using a curvature-based docking approach and in vitro assessment of the effects of cryptotanshinone on cell viability, reactive oxygen species (ROS) generation, apoptosis, and the mRNA expression levels of TET1, SLC7A11, and GPX4 in MCF-7 cells were performed to investigate the anti-cancer potential of plant-derived terpenoids mediated by modulation of TET1 activity in breast cancer. Results. A high binding affinity of cryptotanshinone for the CXXC domain of TET1 was found, along with favorable drug-like properties, and cryptotanshinone was selected as the potent terpenoid for further analysis. In vitro evaluation revealed a dose-dependent reduction in cell viability of cryptotanshinone-treated MCF-7 cells and apoptotic induction. Additionally, gene expression analysis showed decrease in the mRNA levels of TET1, SLC7A11, and GPX4 in a dose-dependent manner, suggesting alterations in antioxidant defense pathway signaling. Conclusion. Cryptotanshinone may exert anticancer effects associated with apoptosis induction and oxidative stress modulation, potentially involving the epigenetic regulator TET1, in breast cancer cells. Further studies using animal models and clinical samples are necessary to confirm the therapeutic potential of cryptotanshinone in the treatment of breast can-cer.
Background. Catheter ablation of premature ventricular complexes (PVCs) originating from the left ventricular outflow tract (LVOT) is highly challenging in patients with dual prosthetic mechanical cardiac valves due to restricted ventricular access and the high risk of valvular damage. We report a case of successful catheter ablation of symptomatic, frequent PVCs from LVOT in a patient with mechanical aortic and mitral valves. Case Report. A 39-year-old man with previous mechanical aortic and mitral valve replacements presented with symptomatic, frequent PVCs in a bigeminal pattern refractory to medical therapy. Baseline electrocardiography suggested an LVOT origin. Given the double mechanical valves, standard retrograde or transseptal approaches into the left ventricle were precluded. Instead, electroanatomical mapping was safely restricted to the aortic root, superior to the mechanical aortic valve. Intracardiac echocardiography (ICE) was used throughout the procedure for continuous visualization of cardiac structures and precise catheter positioning. Applying radiofrequency energy within the right coronary sinus of Valsalva immediately suppressed the PVCs. Post-procedural ICE ruled out pericardial effusion as well as mechanical valvular interference. At the 12-month clinical follow-up, the patient remained entirely free of PVC recurrence. Conclusion. This case demonstrates that catheter ablation of PVCs from LVOT is feasible and safe in patients with mechanical aortic and mitral valves using a supravalvular approach, strictly guided by ICE.
Introduction/Aim. Arterial hypertension (HTN) and diabetes mellitus (DM) represent the most common chronic non-communicable diseases in the working population and are an important cause of reduced work ability. The aim of this study was to examine the impact of working conditions, psychosocial risks, and work organization on the work ability of employees with HTN and/or DM compared with employees without these chronic diseases. Methods. A cross-sectional study was conducted among 100 employed participants diagnosed with HTN and/or DM (cases group) and 100 employees without these diseases (control group) in two state-owned public sector companies in Nis, Serbia. The control group was frequency-matched to the cases group by sex, age group, company, and shift/night work schedule. Work ability was assessed using the Work Ability Index (WAI), stress level via the 10-item Perceived Stress Scale (PSS-10), and psychosocial factors using a questionnaire on job demands, autonomy, support, and satisfaction. Descriptive statistical methods, Pearson correlation, t-test, multiple linear regression, and logistic regression were applied. Results. The mean WAI score in the cases and control groups was 28.34 ± 3.18 and 41.76 ± 2.27, respectively, with a statistically significant difference (t = -34.32; p < 0.001; Cohen’s d = 4.85). Impaired work ability (WAI ≤ 27) was recorded in 44% of diagnosed cases, compared with 0% in the control group (χ² = 53.88; p < 0.001). The strongest correlates of WAI in the cases group were job autonomy (r = 0.549; p < 0.001) and supervisor support (r = 0.516; p < 0.001), whereas no psychosocial factor reached statistical significance in relation to WAI within the control group. Fear of job loss was reported by 86% of cases and 32% of controls (4.28 vs. 3.03; p < 0.001), and negatively correlated with WAI in the cases group (r = -0.317; p = 0.001). The regression model with organizational factors in the cases group explained 56.5% of the variance in WAI (F = 9.43; p < 0.001). In logistic regression, the diagnosis of HTN and/or DM independently increased the risk of impaired work ability [odds ratio (OR) = 156.36; 95% confidence interval (CI): 9.44-2,588.59; p < 0.001], with pronounced fear of job loss (OR = 3.62) and low autonomy (OR = 2.74) also identifying as independent predictors of impaired WAI. Conclusion. Work ability of employees with HTN and DM is significantly lower than that of healthy employees and is influenced by organizational workplace factors. Job autonomy, supervisor support, and job satisfaction are key protective factors, whereas fear of job loss has a negative impact. Comparison with the control group shows that the same psychosocial conditions do not affect work ability equally in healthy and diseased employees-their influence is considerably more pronounced in individuals with chronic illness. The results highlight the need for organizational interventions aimed at preserving work ability.
Background/Aim. Acute ischemic stroke remains a major cause of long-term disability, and optimal rehabilitation following mechanical thrombectomy is still being researched. The aim of this prospective randomized controlled study was to evaluate whether the continuous multidisciplinary rehabilitation (CMR) program, initiated within 24-72 hrs after mechanical thrombectomy and maintained for 3 months, was associated with improved neurological and functional outcomes. Methods. A total of 100 patients with acute ischemic stroke who underwent mechanical thrombectomy between October 2021 and October 2024 were randomly assigned (1 : 1) to either the CMR group or the control group (CG) (50 patients each). Patients in CG received routine post-procedural medical treatment and nursing care, whereas the patients in the CMR group received a structured multidisciplinary rehabilitation program in addition to routine care. The primary outcome was the National Institutes of Health Stroke Scale (NIHSS) score at 3 months. Secondary outcomes included Fugl-Meyer Assessment (FMA), Barthel Index (BI), Montreal Cognitive Assessment (MoCA), Motor Assessment Scale (MAS), patient satisfaction, complication incidence, and favorable prognosis. Longitudinal changes were analyzed using mixed-design repeated-measures analysis of variance - ANOVA. Results. Baseline demographic and clinical characteristics were comparable between groups (all p > 0.05). Compared with CG, the CMR group demonstrated significantly greater improvements in MoCA, MAS, FMA, BI, and NIHSS scores at 1 and 3 months post-intervention (all p < 0.05). Furthermore, the CMR group demonstrated a significantly higher patient satisfaction rate and favorable prognosis rate, as well as a lower incidence of complications (p < 0.05). Conclusion. A CMR program initiated within 24-72 hrs after mechanical thrombectomy and maintained for 3 months was associated with improved short-term neurological, cognitive, motor, and functional recovery. The observed benefits should be interpreted as the cumulative effects of sustained rehabilitation rather than early initiation alone.
Background/Aim. When cesarean scar pregnancy (CSP) is diagnosed, it is proposed in clinical practice to remove the pregnancy tissue as soon as possible. Contrast-enhanced ultrasonography (CEUS) has higher diagnostic value for CSP compared to three-dimensional transvaginal ultrasonography (3D-TVUS). The aim of the study was to assess the efficiency of combining 3D-TVUS with CEUS in the prognosis of lauromacrogol sclerotherapy (LSC) for CSP. Methods. The study included patients with CSP admitted to our hospital and treated with LSC from January 2023 to January 2024 (CSP group, n = 150), and women with normal pregnancy after cesarean section (normal pregnancy group, n = 150). The CSP group was additionally divided into good and poor prognosis groups. Both groups received 3D-TVUS and CEUS, with quantitative parameters measured [3D-TVUS parameters: vascular index (VI), flow index (FI), and vascular FI (VFI)]. CEUS parameters included the area under the time-intensity curve (AUCTIC), arrival time (AT), time to peak (TTP), and peak intensity (PI). Results. After treatment, both CSP and normal pregnancy groups exhibited significant decreases in VI, FI, VFI, PI, and AUCTIC, alongside a significant increase in TTP compared with baseline (p < 0.05). Conversely, compared with the good prognosis CSR group, the poor prognosis CSR group demonstrated higher VI, FI, VFI, PI, and AUCTIC, as well as a shorter TTP, both before and after treatment (p < 0.05). The combined parameters of 3D-TVUS and CEUS showed the best predictive performance of LSC prognosis in CSP, significantly outperforming any single parameter. Conclusion. A considerable proportion of patients with CSP had poor short-term prognosis after LSC. Pretreatment 3D-TVUS and CEUS parameters may help in the early evaluation of short-term prognosis.
