Future Science OA最新文献

This article addresses the complex relationship between childhood trauma and adolescent substance use. Drawing on evidence from neurodevelopmental, psychological/emotional, behavioral, and social research, we determined that childhood trauma, which includes early life stress, adverse childhood experiences (ACEs), and toxic stress, can upset brain development, emotion regulation, and stress-response systems, thereby creating lasting vulnerabilities. These neurological changes both generate and interact with behavioral traits such as impulsivity, poor coping, and emotional dysregulation, thus increasing the risk of substance use as a dysfunctional coping strategy. Social and environmental factors, such as caregiver substance use, peer influences, and community-level disadvantage, further compound these effects. However, individual traits, including effortful control and supportive relationships can attenuate these risks. Moreover, evidence-based interventions that address integrated, trauma-informed, and developmentally appropriate approaches have demonstrated promise in reducing the risks of adolescent substance use among trauma-exposed youth. The article concludes by calling for more conceptual integration across disciplines, longitudinal studies, and culturally responsive prevention, intervention, and treatment approaches.

Introduction: In the past, total gastrectomy (TG) was the most common surgical method, but now proximal gastrectomy (PG) has gradually become an alternative surgical method for proximal gastric and esophagogastric junction cancer. However, there is no recognized preferred anastomosis method after PG. In view of this, Hao's esophagogastrostomy by fissure technique (HEFT) proposed by the author's team can reduce the difficulty of the operation and the occurrence of postoperative complications. 13 cases that underwent this technique were free of complications during postoperative follow-up, and the intraoperative anastomosis time was significantly shorter than that reported in the literature for Double-flap technique (45 min vs. 79-114 min).

Methods and analysis: This is a single-center, single-arm, prospective clinical study. We will recruit 30 eligible patients consecutively to undergo HEFT. The primary objective is to assess perioperative safety. The secondary objectives: (1) Incidence of postoperative reflux esophagitis and anastomotic stenosis; (2) Assess the quality of life at 3 Months Postoperatively by EORTC QLQ-C30 and EORTC QLQ-STO22 scales. Measurement data will be presented as mean ± standard deviation ($\overline{x}\hspace{0.17em}\pm \text{\hspace{0.17em}s}$). Count data will be presented as rates (%).

The prevalence of obesity and OSA are increasing world-wide. Concomitantly, the number of surgical procedures being performed in an outpatient setting is increasing. Both the American Society of Anesthesiology (ASA) and the Society of Anesthesia and Sleep Medicine (SASM) have published guidelines for the perioperative care of the OSA patient. These guidelines were published in 2014 and 2016, respectively. While they serve as an excellent resource for the perioperative management of the OSA patient, the increasing number of obese, OSA patients having procedures performed in the ambulatory setting call into question the feasibility of some of these recommendations in 2024. This review highlights the current recommendations as well as the challenges in caring for the OSA patient in the perioperative setting.

Oral mucositis (OM) is a prevalent complication of cancer therapy, frequently associated with oral pain, dysphagia, malnutrition, and systemic infections. OM that develops during cancer treatment can result in delays or interruptions in anti-cancer therapies, significantly impacting patients' quality of life. Oral cryotherapy (OC) involves the use of crushed ice, specialized cryotherapy devices, and other cooling methods to lower the temperature in the oral cavity during chemotherapy or radiotherapy, thereby reducing the incidence and severity of cancer treatment-related OM. This review aims to elucidate the role of OC in managing OM induced by anticancer therapy by summarizing the mechanisms, specific operational procedures, and potential adverse reactions associated with cryotherapy for OM. It also compares the efficacy of cryotherapy with other preventive and therapeutic approaches for OM, as well as their combined applications. While cryotherapy demonstrates effectiveness in preventing the incidence and severity of cancer treatment-related OM, it is not effective for OM that has already been formed because of previous treatments. Therefore, integrating cryotherapy with basic oral care, photobiomodulation therapy, pharmacological interventions, traditional Chinese medicine, and other modalities is essential for optimal prevention and management of cancer treatment-related OM.

Background: Tobacco use, obesity, and type 2 diabetes are risk factors for colorectal cancer, but whether they generate distinct tumor mutation patterns is unclear. Tobacco is a known mutagen, while obesity and diabetes may act through metabolic and inflammatory pathways.

Methods: We analyzed colon cancer patients from the University of California Health Data Warehouse, linking clinical sequencing data to diagnosis-based indicators of tobacco dependence, obesity, and type 2 diabetes. For each gene-behavior pair, we conducted reverse logistic regressions and calculated a combined score reflecting the strength and specificity of association adjusting for demographic covariates and cancer stage. Multidimensional scaling and clustering assessed behavioral differentiation.

Results: Of 981 gene-behavior tests, 87 pairs exhibited a behavioral association at p < 0.001 in adjusted models. Of these, 60 tobacco, 12 obesity, and 9 diabetes pairs had affinity ≥0.5; 48 tobacco pairs exceeded 1.0. Mean (SD) combined scores were 1.39 (0.79) for tobacco, 1.24 (0.88) for obesity, and 0.74 (0.39) for diabetes. Exemplars included KEAP1 and CDKN2A (tobacco), ASPSCR1 and PGR (obesity), and a smaller diabetes signal led by MAF.

Conclusions: Tobacco dependence is associated with a more mutagenic and distinct somatic mutation profile in colon cancer, suggesting fundamental differences in behavioral mechanisms of carcinogenesis.

Background: Ewing Sarcoma (ES) ranks second among mesenchymal malignancies in children and young adults. Scapular Ewing sarcoma (SES) represents <4% of ES cases with limited literature. We report a case of SES with uncommon respiratory symptoms in a 37-year-old male and conduct a systematic review to improve comprehension of SES demographics, clinical attributes, and management.

Literature review: A systematic search was conducted in PubMed, Scopus, and Google Scholar including SES case reports and series from 1983 to 2024. Using Covidence, references were screened. Two reviewers independently assessed eligibility, resulting in the inclusion of 32 studies. Risk of bias was assessed using Joanna Briggs Institute (JBI) checklists. A total of 124 SES cases were analyzed. SES predominantly affected adolescents with median age of 16 years; IQR: 12-24, and most commonly presented with shoulder swelling. A case within this cohort exhibited respiratory symptoms. Metastases occurred in 30% of cases, mainly to the lungs and bones. Remission was achieved in 64% of cases, while 29.7% had fatal outcomes.

Conclusion: This review highlights the predominance of shoulder symptoms and identifies a unique respiratory presentation. Given the high metastatic rate, standardized protocols are needed to ensure oncological control and preserve shoulder function.

Registration: PROSPERO,CRD420251008692.

Background: Sleeve gastrectomy (SG) is an effective treatment for morbid obesity, promoting weight loss and resolving related comorbidities.

Methods: This prospective, observational study involved 100 patients undergoing SG at Farhat Hached Hospital, Sousse, between February 2009 and December 2019.

Results: Patients had a mean age of 34 ± 9.9 years and a mean BMI of 46.2 ± 7.8 kg/m². Preexisting conditions included type 2 diabetes (16%), hypertension (18%), dyslipidemia (13%), and obstructive sleep apnea (OSA) (29%). Eating disorders were prevalent (98%), notably binge eating (87%). Mortality was 0%, with 12% early morbidity. Maximum of Excess weight loss (EWL) reached 59 ± 19% at 24 months (with a maximum Total Weight Loss (%TWL) of 30 ± 7.9%) but declined to 30% by 10 years. Comorbidity remission rates were significant: 68.7% for diabetes, 27.7% for hypertension, and 46% for dyslipidemia. OSA improved in 86% of cases. The overall success rate (EWL >50%) was 61%, with 39% experiencing insufficient weight loss or regain. Predictors of failure identified through multivariate analysis included hypertension, diabetes, age >40 years, preoperative BMI > 40 kg/m², postoperative dietary lapses, and a sedentary lifestyle.

Conclusions: Our findings demonstrate that sleeve gastrectomy offers substantial initial weight loss, with the maximum Excess Weight Loss (EWL) achieved at 2 years. However, this weight loss diminishes over the long term, with long-term data (up to a decade) requiring cautious interpretation due to high attrition. A comprehensive understanding of factors influencing long-term success is vital for improving patient care.

Background: Colonic stenosis in Crohn's disease (CD) is uncommon, and data on surgery-free survival are limited. This study aimed to determine surgery-free survival rates and identify associated factors.

Patients and methods: A retrospective study was conducted from 2003 to 2022, including patients with CD complicated by colonic stenosis. Patients with uncertain diagnoses or follow-up periods of less than six months were excluded.

Results: Fifty-six patients were included (median age 44 years [range 14-65], male-to-female ratio = 0.93). Surgery-free survival rates were 58.9% at 6 months, 43.7% at 2 years, and 31.7% at 5 years, with an average surgery-free survival of 46.7 months. Univariate analysis showed that joint manifestations (p = 0.01), corticosteroids (p = 0.02), anti-TNF alpha (p = 0.02), salicylates (p = 0.02), and azathioprine (p = 0.01) increased surgery-free survival. Complications such as collections or internal fistulas (p = 0.03), parietal ulceration on imaging (p = 0.01), and acute intestinal obstruction (p = 0.01) were associated with reduced surgery-free survival. In multivariate analysis, biologic therapy was the only independent protective factor against surgery (p = 0.001, OR = 0.19).

Conclusion: The early introduction of biologic therapy is crucial for increasing surgery-free survival in patients with colonic stenosis in CD, given the limited effectiveness of conventional treatments.

Aims: This study investigates the potential effects of essential oils (EOs) in enhancing the efficacy of clindamycin against Methicillin-resistant Staphylococcus aureus (MRSA) using in vitro and computer simulations. The research seeks to identify essential oils that exhibit synergistic activity with clindamycin and determine their potential key active components.

Materials and methods: Essential oils commonly used in traditional medicine were tested for their antimicrobial activity against MRSA. The minimum inhibitory concentration (MIC) was determined using in vitro microdilution assays. A synergistic test with clindamycin was performed, and molecular docking studies evaluated the interaction between a key compound (trans-cinnamaldehyde) and MRSA protein.

Results: EOs from Cinnamomum verum, Rosmarinus officinalis, Salvia officinalis, and Thymus vulgaris demonstrated significant inhibitory and synergistic activities against MRSA, standard strain, and human clinical isolates. Gas Chromatography/Mass Spectroscopy identified trans-cinnamaldehyde, eucalyptol, and thymol as prominent antibacterial compounds. Molecular docking studies confirmed trans-cinnamaldehyde's strong binding to MRSA's AgrA protein, elucidating its enhanced efficacy.

Conclusion: The study underscores the potential of plant-based therapies to augment the effectiveness of conventional antibiotics like clindamycin in combating MRSA and addressing antibiotic resistance by integrating traditional plant remedies with modern medical approaches.

Background: To better understand the factors associated with Helicobacter pylori infection, it is important to quantify the prevalence of H. pylori and identify the clinical and demographic characteristics of individuals with the infection.

Method: In this cross-sectional study 369 participants underwent a structured questionnaire, urease breath test, and endoscopy to determine their H. pylori status.

Results: The frequency of H. pylori in the sample was 27.64%, and erosive antral gastritis, gastric ulcers, and duodenal ulcers were found to be significantly associated with infection. However, no differences were found in social status, family size, or shared utensil use between individuals with and without the infection.

Conclusion: These findings suggest that H. pylori is a significant risk factor for gastrointestinal conditions.