Medicine and Pharmacy Reports最新文献

Introduction: Cervical lymphadenopathy encompasses a broad spectrum of malignant conditions, including metastatic involvement from head and neck or distant primaries, as well as primary lymphoid malignancies. Accurate imaging assessment is critical for the differential diagnosis, staging, and treatment planning. Advances in imaging now enable detailed evaluation of nodal morphology, vascularity, stiffness, and metabolic activity.

Methods: A narrative review was conducted using PubMed, Web of Science, and Google Scholar to identify studies published between January 2015 and June 2025 on imaging evaluation of cervical lymphadenopathy. The diagnostic performance, strengths, and limitations of various imaging techniques were summarized, with emphasis on recent advances and multimodal strategies.

Results: Conventional ultrasonography remains the first-line modality for superficial nodes, with Doppler and elastography improving characterization. Shear wave elastography offers quantitative stiffness assessment, enhancing specificity when combined with grayscale ultrasonography. Computed tomography and magnetic resonance imaging provide cross-sectional evaluation of deep or inaccessible nodal levels, with the latter offering superior soft-tissue contrast and functional techniques such as diffusion-weighted imaging. Fluorodeoxyglucose positron emission tomography contributes with metabolic information, improving detection of occult metastases and aiding systemic staging. No single modality is definitive; combined approaches yield higher accuracy and better surgical planning. Emerging technologies, including image fusion, and radiomics, show promise for refining diagnosis.

Conclusion: An integrated, multimodal imaging approach optimizes the evaluation of cervical lymph node metastases. Future developments in functional imaging, quantitative analysis, and artificial intelligence may further enhance diagnostic precision and enable personalized management strategies.

Background and aim: The artists of the avant-garde experienced numerous psychotropic drugs in order to stimulate their creativity. Between the two world wars, physicians, especially neurologists and psychiatrists, performed several studies on visual artists. The aim of this paper is to present a French medical journal, where the famous Romanian neurologist Gheorghe Marinescu published some of his studies on the effect of mescaline on two professional painters.

Methods: An anniversary issue of the French journal La Presse Médicale, including the work of Gheorghe Marinescu on mescaline and its influence on color vision is described. The publication belongs to the authors' private collection. The pharmacological effects of mescaline on visual sensitivity and some historical medical attempts to assess this effect are also included.

Results: Mescaline was administered by Gheorghe Marinescu to two visual artists who were asked to describe their sensations and cognitions under the effect of this substance. Their sensations and feelings were recorded. The paintings created by the artists are reproduced. They look like surrealistic and abstract art.

Conclusions: The famous Romanian neurologist Gheorghe Marinescu published in the French journal La Presse Médicale an interesting report of the visual effects of mescaline in two professional painters. This paper is important for the history of medicine and of the avant-gardist fine arts.

Aim: This study aimed to investigate whether chronic apical periodontitis (CAP) is influenced not only by microbial infection but also by systemic biomarkers, lifestyle, and dietary patterns.

Methods: An observational cross-sectional design was applied on a cohort of adult patients, who underwent radiographic diagnosis, blood and saliva collection for oxidative stress and advanced glycation end products (AGEs) analysis, and also completed structured dietary and lifestyle questionnaires.

Results: Biochemical analyses revealed no significant differences in oxidative stress or advanced glycation end products between CAP and non-CAP groups, suggesting that systemic markers may not adequately reflect localized periapical inflammation. Similarly, smoking habits and physical activity did not show relevant associations with disease presence.By contrast, diet emerged as a significant determinant. Higher consumption of fried potatoes, refined products such as croissants and white rice, and acidic fruits like oranges was associated with increased risk of CAP. Conversely, regular consumption of breakfast cereals demonstrated a protective effect, reducing disease likelihood. These associations were confirmed in multivariate analysis, highlighting the independent role of specific dietary patterns.

Conclusion: CAP appears to be shaped not only by infection but also by everyday nutrition, with fried and acidic foods favoring disease, while wholegrain cereals provide resilience. These findings emphasize the importance of integrating nutritional guidance into dental care to complement conventional endodontic therapy.

Background: Adrenal incidentaloma is an adrenal mass discovered incidentally during an imaging examination that was not conducted to investigate an adrenal pathology. Its etiologies are varied, which determines the choice of different therapeutic options. The objective of our study is to describe the clinical, biological, etiological, and therapeutic aspects of adrenal incidentalomas in our series.

Methods: This is a retrospective study including 55 patients who were managed for adrenal incidentalomas. Demographic characteristics, clinical evaluations, imaging features, and functional status were analyzed.

Results: The mean age was 55.49 ± 13.53 years with a female predominance (65.4%). The circumstances of discovery were predominantly digestive (54.5%). Computed tomography (CT) was the most frequent imaging method used in the first detection of adrenal incindentalomas. These adrenal masses were unilateral in 72.8% of patients, and bilateral in 27.2% of cases. Their sizes ranged from 10 to 135 mm. In terms of secretory profile, the etiologies of adrenal incidentalomas were predominantly non-functional, followed by pheochromocytomas, and hypercortisolism, then primary hyperaldosteronism. Adrenalectomy was indicated for 23.6% of our patients.

Conclusion: Our results are in agreement with those in the literature, showing that patients with an incidental adrenal mass need a multidisciplinary approach involving clinical and biological screening for endocrine hypersecretion, as well as radiological evaluation to ensure an effective etiological diagnosis and to establish a personalized and optimal therapeutic management plan.

Immune checkpoint inhibitors have markedly transformed cancer treatment paradigms but are frequently associated with immune-related adverse events (irAEs) affecting multiple organ systems. Among the rare and severe complications is the "triple M syndrome", encompassing myositis, myocarditis, and myasthenic syndrome. We present the case of an 83-year-old male with stage IIc melanoma who received pembrolizumab as adjuvant therapy following surgical excision of the primary tumor and regional lymph nodes, with no evidence of neoplastic invasion. Approximately one month post-infusion, the patient experienced episodes of syncope, leading to the diagnosis of a second-degree atrioventricular block. Despite normal findings on echocardiography, the patient subsequently developed profound proximal muscle weakness, dysphonia, and dysphagia. Pembrolizumab was promptly discontinued, and the patient was initiated on high-dose intravenous methylprednisolone; however, his clinical course rapidly deteriorated, culminating in the necessity for palliative care due to progressive respiratory failure. This case underscores the potential for severe, life-threatening irAEs associated with pembrolizumab therapy, particularly in the form of triple M syndrome. Notably, the manifestations of myocarditis and myasthenia gravis (MG) within this context may occur in the absence of typical autoantibody markers, thereby complicating the diagnostic process and contributing to poor prognostic outcomes. This case highlights the imperative for heightened clinical vigilance and a proactive approach to monitoring for irAEs in patients receiving immune checkpoint inhibitors. Early recognition, coupled with the prompt initiation of therapeutic interventions, is paramount in mitigating morbidity and improving clinical outcomes in these critical scenarios.

Aim of the study: This study aims to evaluate and compare the stress distribution patterns of two experimental tissue-level, convergent collar implants (one made of Ti-6Al-4V (control) and the other of Roxolid-based (Ti-15Zr) material) using 3D finite element analysis (FEA) under various simulated masticatory conditions.

Methods: A 3D finite element model replicating a tissue-level implant with convergent neck design was developed in ANSYS software, incorporating both cortical and trabecular bone geometry. Implants made of Ti-6Al-4V-Grade 5 and Roxolide-type-Ti-15Zr alloy were simulated under axial (0°) and oblique (45° angle) loading forces (50 N, 200 N, 300 N, and 400 N). The von Mises equivalent stress distribution was calculated to assess the biomechanical performance.

Results: Under masticatory forces simulation, titanium-alloy implants exhibited maximum stress values (400 N) of 260.38 MPa under axial load and 536.2 MPa under oblique load. Ti-15Zr implants exhibited a slightly lower peak stress of 506.95 MPa under a load of 400 N at a 45° inclination and 240.81 N under axial load. Based on 3D finite analysis, the stress distribution maps showed higher concentration in the implant-abutment connection and the cervical region, particularly under oblique loading.

Conclusions: Although titanium implants exhibited higher stress limits, Ti-15Zr implants showed biomechanical stability under oblique simulated forces. Ti-15Zr implants exhibited a more uniform stress distribution with a reduced peak concentration.

Background: The complete blood count is a widely used medical laboratory test that is essential for both diagnosis and treatment decisions. While pre-analytic factors, such as storage temperature, transport conditions, blood volume anticoagulant ratio, and testing delay, might impact the accuracy of the results, the degree of this influence requires further quantification. In the present study, we aim to look more closely at these factors and how they affect complete blood count test readings.

Methods: This study evaluates the effects of temperature, agitation, storage duration, and blood volume anticoagulant ratio on complete blood count reliability using a repeated-measures factorial design. A total of 224 CBC runs were performed on the samples of eight participants. Samples were tested at baseline T0 and again at 4, 12, and 24 hours after storage at either room temperature (22°C) or refrigeration (4°C), with and without agitation, and at both optimal (2 mL) and suboptimal (1 mL) blood volumes.

Results: The duration of storage was the main factor determining CBC accuracy. After 12 h, WBC counts decreased significantly (p < 0.001, η² = 0.129). Platelet counts also declined (p < 0.001, η² = 0.73), with greater loss at 4°C (-8.1%) than at 22°C (-5.2%) by 24 h. MCV remained stable at 4°C but increased at 22°C (p < 0.001). Hemoglobin decreased at 22°C (-2.3%, p < 0.05), and RBC counts dropped modestly (-2.2%, p < 0.05). MPV showed only a minor change (p > 0.05). Neither agitation nor suboptimal blood volume had significant effects (p > 0.05).

Conclusion: Specimens should ideally be tested within 12 hours or stored at 4°C to prevent degradation of the test variables, particularly white blood cell counts and platelet counts. The findings suggest that routine handling and transport conditions are appropriate, as agitation during transport and a decreased blood volume-to-anticoagulant ratio appear to have negligible effects. Incorporating measurement uncertainty benchmarks improves the distinction between genuine sample deterioration and assay variability, thereby enhancing diagnostic accuracy.

Portopulmonary hypertension (PoPH) is a condition characterized by the elevation of the arterial pulmonary pressure because of portal hypertension which leads to right heart failure and finally death. The most common cause of PoPH is hepatic cirrhosis, but patients with non-cirrhotic portal hypertension can also develop this complication. It is considered that between 2% and 10% of patients with portal hypertension can develop PoPH, and it is a major determinant factor of prognosis, especially in the context of liver transplantation. Clinically, the symptoms are nonspecific and are usually due to worsening right ventricular dysfunction. The treatment of PoPH consists of vasomodulating therapy, but several future challenges remain in the treatment of PoPH patients. In the absence of medical treatment or liver transplantation, the 1-year survival rate is 35%-46% and 5-year survival rate is 4-14%. Despite advances in understanding this disease, several unresolved questions remain regarding screening, diagnosis, treatment, and liver transplantation.

Background: Hepatocellular carcinoma (HCC) remains a major therapeutic challenge with limited treatment options. Nanotechnology, particularly the use of gold nanoparticles (GNPs), offers new perspectives for targeted photothermal therapies.

Objective: This study aimed to develop and evaluate the effectiveness of nanomediated photothermal therapy (PTT) using GNP functionalized with folate and anti-Cadherin-1 antibodies (Cad-1) in the treatment of HCC in a validated murine model.

Methods: A bionanosystem composed of gold nanoparticles conjugated with polyethyleneimine (PEI), folic acid (FA), and Cad-1 was synthesized and characterized. A HCC murine model was induced by administration of diethylnitrosamine and carbon tetrachloride. After tumor confirmation, animals were divided into four groups and treated with different doses of the nanoconstruct, followed by near-infrared (NIR) laser irradiation (808 nm). A total of 16 animals were allocated into four experimental groups (n = 4 per group). Histological analysis and serum biochemical assays (aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT)) were performed.

Results: The treatment induced focal coagulative necrosis within tumor regions, with minimal impact on surrounding healthy liver tissue. Significant reductions in AST and GGT levels were observed in animals treated with higher doses (p < 0.05), confirming the efficacy and selectivity of the therapy. Immunohistochemistry confirmed E-cadherin overexpression in tumor tissue, suggesting a possible diagnosic potential for the targeting system.

Conclusion: The GNPs-PEI-FA-Cad-1 system demonstrated promising results for targeted photothermal therapy in HCC, with selective tumor ablation and limited hepatotoxicity. The validated murine model provides a robust platform for preclinical assessment of similar nanotherapies.

Background: Brain metastases (BMs) are the most common intracranial tumors among adults, which exceed primary brain tumors by far. Surgery and radiotherapy represent the key local management of BM. However, the exact role of surgery is still under debate.

Objective: To comprehensively evaluate the safety and efficacy of surgical management in patients with brain metastases.

Methods: We searched four electronic databases from January 2023 until September 2024 (PubMed, Scopus, Web of Science, and Cochrane Library). All the studies assessing the role of surgery in managing BM were included. Our primary search targets were survival, mortality, and postoperative Karnofsky Performance Status (KPS). The results were reported as pooled mean or proportions with 95% confidence interval (CI) for continuous and dichotomous data, respectively.

Results: Eight observational studies comprising 1010 patients met our inclusion criteria. The pooled mean of overall survival was 10.482 with 95% CI [7.651, 13.314]. While the pooled proportion of one-year and two-year survival was (0.451, 95% CI [0.320, 0.582]) and (0.240, 95% CI [0.112, 0.367]), respectively. We found the pooled proportion of overall mortality to be 0.535 with 95% CI [0.278, 0.793]. Patients with immediate postoperative KPS improvement showed a pooled estimate of 0.463 with 95% CI [0.243, 0.683].

Conclusion: Surgical resection is an effective therapeutic option for patients with BMs. Yet, careful patient selection and surgical technique are crucial for reducing postoperative complications and death.