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The lumbopelvic junction is a biomechanically complex region that necessitates robust stabilization, especially following spinopelvic dissociation, unstable sacral fractures, or sacrectomy. Lumbopelvic fixation techniques, such as triangular osteosynthesis and dual S2-alar-iliac (S2AI) screw placement, optimize load transfer, restore spinal-pelvic continuity and reduce mechanical failure risks. Triangular osteosynthesis achieves up to 80% of native spine stiffness under load, while dual S2AI screws restore up to 96% stiffness and show lower screw loosening rates than single screws. Comparative studies reveal that S2AI screws outperform traditional iliac screws in biomechanical stability, pullout strength and reduced hardware-related complications. Multi-rod and quad-rod constructs further enhance construct rigidity, distribute mechanical stress and lower the risk of rod breakage and revision surgeries. Novel anchoring strategies, including sacral hooks and clamps, contribute to improved stability in cases with complex fractures or bone loss. The integration of navigation and robotics ensures higher accuracy in screw placement, minimizes complications and enhances surgical precision. Collectively, these advancements facilitate early mobilization, improved fusion rates, superior pain relief and better functional outcomes, underscoring the evolving landscape of lumbopelvic fixation strategies.

Background: Corticotomy-assisted orthodontics (CAOT) has shown potential in accelerating tooth movement by reducing alveolar bone resistance. However, the biomechanical effects of varying corticotomy designs on canine retraction remain insufficiently explored.

Materials and methods: A cone-beam computed tomography (CBCT) scan of a 26-year-old male with bimaxillary protrusion was used to create a three-dimensional finite element model of the maxillary dentition, including alveolar bone, periodontal ligament (PDL), teeth and orthodontic appliances. Twenty-four corticotomy configurations were modeled based on varying anatomical positions (e.g., mesial, distal, labial, lingual), proximity (2 mm and 4 mm from distal cut) and cut widths (0.6 mm, 0.8 mm). A standardized 100-cN retraction force was applied using miniscrews in a segmented arch technique. ANSYS 14.5 software was used to analyze stress (von Mises), strain (in PDL) and initial displacement.

Results: The continuous circumscribing cut showed the greatest canine displacement and PDL strain, followed by distal + labial + lingual and distal cut configurations. The highest stress in trabecular bone was seen with 0.8 mm wide cuts, while the greatest strain in PDL occurred with mesial cut. Tooth displacement decreased as the distance of corticotomy from the canine increased (distal > 4 mm > 2 mm). Among widths, 0.4 mm distal cuts (not explicitly simulated but inferred) were biomechanically more favorable than 0.6 mm and 0.8 mm.

Conclusion: Distal corticotomy cuts, particularly those closer to the canine and of optimal width, exhibit biomechanical advantages similar to circumscribing cuts with lower surgical morbidity. These designs may reduce resistance to movement, optimize force distribution and enhance clinical outcomes during canine retraction.

The purpose of this study was to evaluate any protective role of anti-platelet and/or anticoagulation therapy in preventing retinal vascular occlusions, whether arterial or venous. We have described the case of a 47-year-old male who presented with a left-eye branched retinal artery occlusion despite being on both anticoagulation and anti-platelet therapy. A narrative literature review of reports published between 2000 and 2024 identified twelve relevant articles, which collectively indicated no protective or preventive benefit of anti-platelet or anticoagulant therapy against retinal vascular occlusions.

Objectives: The purpose of this study is to investigate the morphological differences of the placentas, between normal and complicated with fetal growth restriction (FGR) gestations.

Methods: In the present study, 60 women were prospectively enrolled between 2022-2024 and equally divided into a control group and a FGR one. We measured the weight and dimensions of the collected placentas as well as the diameter and insertion point of the umbilical cord.

Results: The mean values of placental weight, surface, volume and maximum diameter showed a statistically significant difference between FGR and controls (p<0.001). Birth weight was positively corelated with umbilical cord diameter (r= 0.666, p<0.001) and placental weight (r= 0.803, p<0.001). Also, umbilical cord's peripheral insertion site and FGR were statistically significantly associated (χ²=7.048, p<0.001). However, in linear regression, only placental weight was identified as an independent factor associated with birth weight. Moreover, FGR pregnancies had statistically significant higher mean placental coefficient values compared to pregnancies with normal growth (p=0.035).

Conclusion: Our results further support the current literature, demonstrating significant placental morphological differences between normal and FGR pregnancies. Considering the severe complications in FGR gestations, translating these findings in ultrasound imaging may introduce novice imaging biomarkers for early detection.

Objectives: This review aimed to synthesize and analyze morphological changes of the larynx in patients with voice disorders, as identified through imaging and endoscopic methods, and to evaluate their diagnostic value.

Materials and methods: We performed a comprehensive PubMed search using MeSH and Title/Abstract keywords related to laryngeal morphology, voice disorders and imaging modalities. Filters restricted results to human studies in adults which were published as full text, in English, during the last 10 years. Seventeen studies met the inclusion criteria after screening and were included for analysis. Data on imaging modalities, morphological features, diagnostic accuracy and correlations with voice function were extracted.

Results: Across the 17 studies, imaging revealed morphological features such as vocal fold edema, nodules, polyps, motion impairment, glottal insufficiency and arytenoid asymmetry. Magnetic resonance imaging demonstrated significant correlations between vocal cord thickening, impaired adduction and dysphonia severity. High-speed videoendoscopy and stroboscopy showed good sensitivity (up to 92%) and specificity (79.2%) for identifying motion impairment and dysphonia classification. Some structural findings, such as arytenoid asymmetry in singers, did not correlate with acoustic deficits.

Conclusions: Imaging and endoscopic evaluations provide valuable diagnostic insights into voice disorders, though variability in protocols and outcome measures limits cross-study comparability. Standardization of imaging methods and reporting is essential for improving diagnostic reproducibility and clinical applicability.

Background: Patient satisfaction, a key outcome in healthcare evaluation, is strongly influenced by the human dimension of care. Emotional intelligence, particularly empathy and emotion regulation, plays a crucial role in shaping patient experiences in primary care settings. This research study focuses on evaluating patients' satisfaction with primary healthcare services and exploring the relationship with the level of their emotional intelligence.

Methods: A cross-sectional study was conducted at the Agioi Anargyroi Health Center in Ilion, Greece. A total of 102 patients completed two validated questionnaires: the Patient Satisfaction Questionnaire (Aletras-Niakas) and the Wong & Law Emotional Intelligence Scale (WLEIS). Data were analyzed with descriptive statistics and correlation tests (Spearman, Pearson, Mann-Whitney, t-test).

Results: The results revealed high levels of satisfaction, particularly in areas such as service, appointment procedures, waiting time, provision of medical services and discharge from the center. The mean overall satisfaction score was 4.01 for medical consultation and 4.09 for discharge (scale 1-5). Overall, 68% of respondents were satisfied or very satisfied, while 3% were dissatisfied. The average rating of the National Health System was 69.3/100. Emotional intelligence scores were high, with mean values ranging from 5.22 to 5.77 (scale 1-7). There were statistically significant correlations between emotional intelligence dimensions and patient satisfaction (Spearman's rho = 0.237-0.424, p < 0.05). Patients with public health insurance reported higher satisfaction with access and arrival compared to other groups.

Conclusion: Patient satisfaction in primary care was high and positively associated with emotional intelligence, especially in emotion management and empathy. These findings highlight the importance of strengthening emotional intelligence skills among both patients and healthcare providers to improve service quality and foster more human-centered care.

The development of a second primary malignancy in patients with head and neck cancer (HNC) is not a rare event. According to the literature, the incidence of multiple HNCs is increasing in recent years due to improved diagnostic tests, meliorated screening and surveillance of patients with cancer, more sophisticated treatment, increased life expectancy and high population survival. The risk of developing second primary cancer increases by 3% per year in patients who have survived HNC. Second tumors can be diagnosed either simultaneously (synchronous) or more than six months after the index tumour (metachronous). Nowadays, the situation of patients with multiple primaries HNCs is of increasing relevance and importance and follow-up of those patients is recommended, not only to detect relapse and manage treatment-related toxicities but also for early detection of metachronous HNCs. This review focuses on practical clinical implications of the management of patients with multiple HNCs. Diagnostic challenges and distinction from recurrence, treatment planning and surveillance, prognostic implications and risk stratification, precision oncology and future directions are the main topics contained in it confirming the necessity of a highly customized and interdisciplinary clinical and treatment approach for the management of HNCs, both synchronous and metachronous.

Background: Gut-brain axis is a bidirectional interaction between the gut and the nervous system. Antibiotics disrupt this axis. We designed this systematic review and meta-analysis to show if there is an association between antibiotic administration and the risk of multiple sclerosis (MS).

Methods: PubMed, Scopus, EMBASE, PsycINFO, Web of Science and Google Scholar were systematically searched by two independent researchers on February 1^st 2025. The first author of the publication, country of the study, publication year, number of study participants, total female and male population, total use and types of antibiotics were extracted.

Results: A literature search revealed 3606 records, 22 full texts were evaluated and finally, six studies remained for systematic review. The pooled odds ratio (OR) for the use of penicillin and MS risk was 1.01 [95% confidence interval (CI): 0.84-1.22] (I²=81.6%, P<0.001). The pooled OR for the use of tetracycline and MS risk was 1.20 (95% CI: 1.02-1.4) (I²=82.8%, P<0.001). The pooled OR for the use of sulfonamides and MS risk was 1.30 (95%CI: 1.23-1.38) (I²=22.1%, P<0.001). The pooled OR for the use of macrolides and MS risk was 1.19 (95% CI: 1.07-1.32) (I²=71.3%, P=0.01). The pooled OR for the use of quinolones and MS risk was 1.24 (95% CI: 1.18-1.30) (I²=7.8%, P=0.001).

Conclusions: The results of this systematic review and meta-analysis show that, except for penicillin, the use of other antibiotics may increase the risk of MS.