Annals of Medicine and Surgery最新文献

Cardiometabolic diseases remain the leading causes of global morbidity and mortality, with early detection often hindered by nonspecific symptoms and reliance on systemic biomarkers. The retinal nerve fiber layer (RNFL), a microvascular and neurodegenerative biomarker, is highly sensitive to systemic metabolic and vascular insults. Artificial intelligence (AI)-driven metabolomics integrates high-resolution RNFL imaging with circulating metabolite profiling, enabling precise risk stratification for mortality and cardiometabolic disease. By combining optical coherence tomography data with machine learning algorithms, this approach deciphers complex biochemical signatures and correlates them with systemic outcomes. Recent studies demonstrate that AI-powered RNFL metabolomics achieves superior sensitivity and specificity compared to conventional diagnostic tools, with applications extending to diabetes, hypertension, neurodegenerative disorders, and chronic kidney disease. However, challenges such as dataset bias, limited accessibility of metabolomic assays, and regulatory hurdles remain. Synthesizing current evidence, AI-driven RNFL metabolomics represents a transformative innovation in precision medicine, offering a scalable, noninvasive pathway for early detection, personalized care, and improved survival outcomes in cardiometabolic disease.

Introduction and importance: Peritoneal hydatidosis is a rare manifestation of echinococcosis, typically secondary to the rupture of hepatic or splenic hydatid cysts or accidental intraoperative dissemination. Herein, we report a rare case of small bowel obstruction caused by a primary peritoneal hydatid cyst, emphasizing the extreme rarity of primary peritoneal involvement leading to bowel obstruction.

Case presentation: We report the case of an 87-year-old male presenting with acute small bowel obstruction. Clinical examination revealed abdominal distension and tympanism. Imaging identified small bowel dilation proximal to a right iliac fossa transitional point and a calcified-walled cystic mass. Emergency laparoscopy revealed dilated small bowel loops and a fibrous band tethering the omentum to the peritoneum at the site of a solid-cystic mass. Following conversion to laparotomy, the mass was resected, and cystotomy expelled hydatid material. Histological analysis confirmed the diagnosis of hydatid disease. Postoperative recovery was uneventful, and the patient was discharged on postoperative day three.

Clinical discussion: Hydatid disease remains endemic in Mediterranean, African, and South American regions. Primary peritoneal hydatidosis is exceptionally uncommon, representing less than 2% of abdominal hydatid cases, and its presentation as small bowel obstruction is exceedingly rare. It may be caused by either compression of the bowel or a fibrous band. Diagnosis relies on clinical suspicion, imaging, and serology. Surgical excision remains the mainstay of treatment, ideally with complete removal to avoid recurrence.

Conclusion: This case highlights the importance of considering hydatidosis in the differential diagnosis of an acute abdomen, particularly in endemic areas.

As artificial intelligence evolves from reactive computation to adaptive cognition, its interfaces increasingly engage not only with our attention but also with the neural architecture that sustains it. This paper introduces the concept of neural parasitism - a framework describing how adaptive artificial intelligence systems may subtly inhabit human cognitive processes, shaping behavior and emotion to maintain engagement. Drawing an analogy with biological parasitism, we explore how algorithmic agents could exploit neuroplasticity for their own persistence, transforming learning and reward mechanisms into vectors of digital dependence. However, the deeper question extends beyond pathology: when cognition is continuously co-shaped by non-human agents, can autonomy remain an individual property, or does it become a shared construct negotiated between biological and artificial systems? We argue that the ethical challenge of adaptive artificial intelligence lies not merely in data privacy or bias, but in its potential to reconfigure the substrates of thought itself. If the brain's adaptive capacity is its greatest strength, could it also be its point of entry for algorithmic colonization? Understanding this dynamic demands an interdisciplinary reckoning, uniting neuroscience, ethics, and artificial intelligence design to ensure that technological evolution does not outpace the mind's capacity to remain its own.

Aim: The research aimed to access the antihyperglycemic and antioxidant properties of the methanolic extract of Curcuma caesia (MECC) in mitigating oxidative stress and tissue damage in mice with streptozotocin (STZ)-induced diabetes.

Objective: The objective aims to examine the effects of MECC on fasting blood glucose (FBG), glucose tolerance, antioxidant enzyme activity, lipid peroxidation, and histopathological alterations in the liver and kidneys of diabetic mice.

Method: Male Swiss albino mice were categorized into normal untreated control, diabetic untreated control, and diabetic + ascorbic acid-treated, diabetic + MECC treated (350 mg/kg body weight [b.w.]). Diabetes was induced using STZ, and the effects of MECC were assessed through FBG, intraperitoneal glucose tolerance tests, and measurement of oxidative stress markers such as thiobarbituric acid reactive Substances (TBARS), superoxide dismutase (SOD), and catalase (CAT). Histopathological analysis of kidney and liver tissues was performed to evaluate tissue damage and recovery.

Results: MECC treatment at 350 mg/kg b.w. significantly decreased the FBG levels in diabetic control mice, with effects comparable to standard antihyperglycemic drugs like metformin and glibenclamide. Glucose tolerance was notably improved, and oxidative stress markers, including TBARS, were normalized in treated groups. Antioxidant enzyme activity (SOD and CAT) was restored in the liver and kidneys. Histopathological analysis revealed substantial recovery of tissue architecture, with nearly normal glomeruli and hepatocytes in diabetic-MECC-treated mice, indicating protection against diabetes-induced damage.

Conclusion: MECC demonstrated potent antihyperglycemic, antioxidant, and tissue-protective effects in diabetic mice, suggesting its capability as a treatment option for diabetes management. Further evaluation is needed to investigate its potential clinical uses.

Background: The rise of photo-specific social media platforms has significantly impacted body image and mental health. Although studies have shown a link between social media use and body dissatisfaction, most prior research has focused on adult and Western populations, leaving a gap in understanding these relationships among adolescents and young adults in non-Western contexts like Pakistan. Furthermore, the specific roles of active photo-editing behaviors and exposure to influencer content remain under-investigated.

Methods: This cross-sectional study investigated the prevalence of body dissatisfaction, anxiety, and depression among social media users in Pakistan aged 16-25 years. A total of 511 participants completed a survey assessing social media engagement including time spent on Instagram, TikTok, and Snapchat, usage of filters and photo-editing tools, and exposure to beauty and fitness content. The Body Shape Questionnaire (BSQ-8C), the Sociocultural Attitudes Toward Appearance Questionnaire (SATAQ-4), GAD-7, and PHQ-9 scales were used. Data analysis was conducted in SPSS and included descriptive statistics, non-parametric independent sample test, and multinomial regression analysis.

Results: Out of 511 participants, 212 (41.5%) were in the 21-23 years age category, and 315 (61.6%) were female. Snapchat was the most frequently used platform for photo-filters (178, 51.8%). The median (IQR) BSQ-8C score was 21 (19). Significant positive correlations were observed between BSQ-8C, SATAQ-4, GAD-7, and PHQ-9 (all P < 0.001). Multinomial regression identified gender and the perceived importance of photo-filter use as significant predictors of body dissatisfaction. The negative coefficients indicate that being female (B = -3.778, P = 0.008) and attributing greater importance to filters (B = -6.383, P = 0.029) were associated with significantly higher body dissatisfaction.

Conclusion: This study provides evidence from a Pakistani cohort that engagement with photo-specific social media is associated with body dissatisfaction and poorer mental health, with females being particularly vulnerable. The finding that the importance placed on photo filters is a key predictor highlights a critical risk factor. These results emphasize the need for targeted public health strategies, including media literacy programs that critically address photo-editing and curated content and accessible mental health support for young people.

Background: Gastroesophageal reflux disease (GERD) is commonly treated with surgical interventions such as magnetic sphincter augmentation (MSA) or fundoplication (FP). This meta-analysis evaluates postoperative outcomes of MSA versus FP in GERD management.

Methods: A systematic literature search was conducted across PubMed, Cochrane Library, ScienceDirect, and Embase up to April 2025, identifying studies comparing MSA and FP for GERD. Pooled odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was assessed with the I ² statistic, and statistical significance was set at P < 0.05.

Results: Twelve studies, published between 2014 and 2024, were included. No significant differences were observed in postoperative proton pump inhibitors (PPI) use (OR: 0.70, 95% CI: 0.30-1.67, P = 0.40, I ² = 85%) or GERD-HRQL scores (MD: 0.67, 95% CI: -0.57-1.91, P = 0.29, I ² = 68%) and dysphagia (OR: 1.12, 95% CI: 0.59-2.14, P = 0.72, I ² = 72%) between MSA and FP. MSA significantly improved the ability to belch (OR: 6.78, 95% CI: 4.49-10.22, P < 0.00001, I ² = 43%) and ability to vomit (OR: 5.85, 95% CI: 2.39-14.33, P = 0.0001, I ² = 82%) and reduced gas bloating risk (OR: 0.43, 95% CI: 0.25-0.75, P = 0.003, I ² = 54%) compared to FP.

Conclusions: MSA and FP demonstrate comparable efficacy in GERD symptom control, PPI use, and dysphagia. MSA offers significant advantages in preserving the ability to belch and vomit and reducing gas bloating. Substantial heterogeneity in GERD-HRQL scores, postoperative PPI use, dysphagia, and ability to vomit warrants cautious interpretation, and further studies are needed to optimize surgical approaches.

Importance: Craniosynostosis, the premature fusion of cranial sutures, carries significant clinical implications beyond skull morphology. Its restriction of brain growth and potential for raised intracranial pressure pose notable risks for long-term neurocognitive development. Both syndromic and nonsyndromic forms have been increasingly associated with deficits in cognition, behavior, and academic performance, underlining the need for careful neurodevelopmental monitoring even after surgical intervention.

Observations: Current literature demonstrates heterogeneous neurocognitive outcomes post-surgery. While early surgical correction, particularly before 6 months of age, is associated with improved cognitive trajectories, especially in sagittal synostosis, results remain inconsistent across craniosynostosis subtypes and surgical approaches. Syndromic cases generally fare worse than nonsyndromic ones, regardless of surgical timing. Notably, emerging evidence reveals that even children with single-suture, nonsyndromic craniosynostosis may experience subtle yet meaningful impairments in executive function, language, and attention. Variability in surgical technique, assessment tools, and follow-up duration complicates the interpretation of outcomes.

Conclusions and relevance: Although surgical correction remains the cornerstone of management, it does not uniformly normalize neurocognitive development. The findings underscore the necessity of a multidisciplinary, longitudinal approach to care - integrating neurosurgical, neuropsychological, and rehabilitative strategies. Future research must prioritize standardized cognitive assessments, extended follow-up into adolescence, and controlled comparisons across surgical methods. Understanding genetic, environmental, and procedural moderators of outcome is essential to optimizing long-term quality of life for affected children.