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Long-Term Health Consequences of SARS-CoV-2- Trigger for Still Disease in Adults
No full textStill disease is a rare inflammatory disorder often triggered by infections or malignancies, with SARS‐CoV‐2 as a possible factor. This paper explores a 56‐year‐old patient who developed adult‐onset Still disease after COVID‐19. Symptoms included fever, arthralgia, rash, hepatomegaly, and joint swelling. Diagnosis followed Yamaguchi criteria and treatment with glucocorticoids and immunosuppressants led to recovery. The paper discusses similarities between Still disease and severe COVID‐19 that suggest shared inflammatory mechanisms, particularly IL‐1 activation. Early diagnosis and treatment are vital. Further research is needed to clarify the link between Still disease and SARS‐CoV‐2 and improve treatment strategies
The forgotten third: understanding the ACL femoral insertion and lateral intercondylar ridge extension onto the notch roof
No full textPurpose This study assesses the positioning of the lateral intercondylar ridge (LIR) and the anterior cruciate ligament (ACL)
femoral insertion area (FIA) in relation to the femoral notch roof and the lateral notch wall and examines its correlation with
the width of the posterior notch outlet.
Method 45 dried femurs underwent 3D scanning. A cutting plane was established to divide the intercondylar roof from the
condylar wall based on three points. The length of the LIR on the roof and wall were measured, along with the distances from
key landmarks. The total ACL-FIA and the areas on the roof and wall of the intercondylar notch were measured.
Results A significant correlation was found between the LIR position on the roof and the width of the notch. LIR averaged
16.18 mm, with 30.86% on the roof, while ACL-FIA averaged 134.19 mm², with 31.55% on the roof. The width of the
posterior notch outlet was averaged at 24.34 mm. The distance between the most proximal part of the LIR and the posterior
intercondylar line averaged 4.87 mm and 12.46 mm to the most proximal and deepest point of the cartilage border of the
lateral femoral condyle.
Conclusion This study confirms that approximately 30% of the LIR and ACL-FIA extend to the intercondylar notch roof,
with a significant moderate positive correlation with the width of the posterior notch outlet. These findings highlight the
need to consider the notch roof in the placement of the femoral tunnel for improved anatomical reconstruction of the ACL
Impact of Angiotensin-Converting Enzyme Inhibitors on Disease Symptoms in Patients with Chronic Myeloproliferative Neoplasms
No full textIntroduction: Patients with chronic myeloproliferative neoplasms (MPNs) have upregulated renin-angiotensin-aldosteron system in the bone marrow and suffer from debilitating inflammation-linked symptoms. The use of angiotensin-converting enzyme inhibitors (ACEi) has been shown to improve hematocrit control and thrombotic risk in MPNs. Here, we investigated whether ACEi use may also have an impact on disease-related symptoms in MPNs. Patients and Methods: This cross-sectional two-center study included 100 consecutive MPN patients who fulfilled the Myeloproliferative Neoplasm Symptom Assessment Form (MPN-SAF) at the time of study entry. Results: The use of ACEi correlated with older age, presence of JAK2 mutation, prior thrombosis and different cardiovascular risk factors. Patients using ACEi also presented with higher total symptom score (p = 0.002), more abdominal discomfort (p = 0.031), concentration problems (p = 0.050) and bone pains (p = 0.001). To account for baseline variables that may have potentially impacted MPN symptom control, ACEi users and non-users were case-matched in a 1:1 ratio with respect to sex, age, cytoreductive treatment, and cardiovascular risk factors. Again, there were no differences in almost all MPN-SAF items with respect to ACEi use (p > 0.050 for all analyses). Conclusion: The use of ACEi does not seem to mitigate disease-related symptoms in MPNs. Prospective randomized trials are needed to fully elucidate their therapeutic potential in MPNs
Ultra-Processed Diets and Endocrine Disruption, Explanation of Missing Link in Rising Cancer Incidence Among Young Adults
No full textThe global increase in early-onset cancers among adolescents and young adults has happened at the same time as the rise in the consumption of ultra-processed foods (UPFs). Far beyond their poor nutritional quality, UPFs are increasingly seen as Trojan horses, complex biological agents that interfere with many functions of the human organism. In this review, we utilise the Trojan horse model to explain the quiet and building health risks from UPFs as foods that seem harmless, convenient, and affordable while secretly delivering endocrine-disrupting chemicals (EDCs), causing chronic low-grade inflammation, altering the microbiome, and producing epigenetic alterations. We bring together new proof showing that UPFs mess up hormonal signals, harm the body’s ability to fight off harmful germs, lead to an imbalance of microbes, and cause detrimental changes linked to cancer. Important components, such as bisphenols and phthalates, can migrate from containers into food, while additional ingredients and effects from cooking disrupt the normal balance of cells. These exposures are especially harmful during vulnerable developmental periods and may lay the groundwork for disease many years later. The Trojan horse model illustrates the hidden nature of UPF-related damage, not through a sudden toxin but via chronic dysregulation of metabolic, hormonal, and genetic control. This model changes focus from usual diet worries to a bigger-picture view of UPFs as causes of life-disrupting damage. Ultimately, this review aims to identify gaps in current knowledge and epidemiological approaches and highlight the need for multi-omics, long-term studies and personalised nutrition plans to assess and reduce the cancer risk associated with UPFs. Recognising UPFs as a silent disruptor is crucial in shaping public health policies and cancer prevention programs targeting younger people
New PSMA Targeted Radionuclides in the Diagnosis of Prostate Cancer in Nuclear Medicine
No full textImaging in PCa has evolved with new nuclear medicine techniques. PET/CT combined with PSMA targeted radionuclides has now been established as the new gold standard. 68-Ga-PSMA-11 and 18F-DCFPyL demonstrate superior spatial resolution, sensitivity and specificity, even with low PSA values which makes them suitable for many patients. However, due to their physical properties and their production requirements, their distribution is highly limited by infrastructure. Alternatively, 99mTc-PSMA I&S with SPECT/CT offers a widely available alternative, particularly in regions with limited access to PET/CT facilities although its main disadvantage is its lower spatial resolution. Non-PSMA targeted radiopharmaceuticals like 18F-FDG and 18F-Fluciclovine play a subordinate role in the diagnosis of PCa due to lower specificity and high incidence of false-positive results. However, 18F-Methylcholine still remains valuable in selected cases, especially in biochemical recurrence. In summary, while PSMA PET/CT imaging represents the best option for PCa detection, alternative imaging strategies remain important in the interim phase where resources are rare
The Preventive Power of the Mediterranean Diet Against Blue-Light-Induced Retinal Degeneration: Is the Secret in the Herbs and Spices?
No full textThe Mediterranean diet, rich in plant-based foods, healthy fats, and herbs, has long been associated with a range of health benefits, including cardiovascular, neuroprotective, and anti-inflammatory effects. Recent studies suggest that certain components of this diet, particularly spices such as bay laurel, thyme, oregano, sage, and rosemary, may play a critical role in protecting the retina from oxidative damage, a key factor in blue-light-induced retinal degeneration. Blue light, emitted by digital screens and artificial lighting, has been implicated in the development of retinal conditions like age-related macular degeneration by inducing oxidative stress and inflammation. This review explores the potential of the herbs and spices commonly present in the Mediterranean diet to mitigate blue-light-induced retinal damage. These herbs are rich in polyphenols, flavonoids, essential oils, and terpenes, which offer antioxidant, anti-inflammatory, and antimicrobial properties, contributing to retinal health and reducing oxidative damage. By focusing on bioactive compounds such as eucalyptol (1,8-cineole), rosmarinic acid, carnosic acid, eugenol, and thymol, this article investigates how these herbs and spices might act as natural protectants against blue-light-induced stress and retinal degeneration. The findings highlight the promising role of these culinary staples in preventing retinal damage and offer insights into future dietary recommendations for eye health in an increasingly digital world
The effect of aging on hearing outcomes after sudden sensorineural hearing loss (SSNHL): A retrospective study
No full textObjectives: To analyze the effect of aging on hearing outcomes following treatment for sudden sensorineural hearing loss (SSNHL). Materials and methods: This retrospective study reviewed records of 106 SSNHL patients categorized into younger (<65 years) and older (≥65 years). Hearing outcomes and related factors including sex, absolute gain, treatment timing, Hyperbaric Oxygen Therapy (HBOT), audiogram type, and contralateral ear thresholds were examined. Results: Treatment outcomes between age groups showed no statistically significant difference (p = 0.053), though younger age was consistently linked to better recovery. A significant negative correlation between age and absolute hearing gain was observed (r = -0.296, p < 0.05). Younger females showed superior outcomes compared to younger males (p < 0.05). Early treatment predicted better recovery (χ² = 9.04, p < 0.01). A normal contralateral ear threshold was associated with better recovery (p < 0.05). A multivariate logistic regression model was developed (AUC = 0.781). Symptom duration (p < 0.05) and intratympanic therapy (p < 0.05) were significant predictors of hearing outcomes. Age was not a significant independent predictor (p = 0.054), but it improved model fit, supporting its clinical relevance. Conclusions: The timing of treatment initiation is important for SSNHL prognosis. Although age did not reach statistical significance in the multivariate model, its consistent association with better outcomes and contribution to model fit highlight its continued clinical relevance. Early intervention is the key predictor of recovery, reinforcing the value of age-informed, personalized treatment strategies in managing SSNHL
Comparison of aortic valve repair, David procedure and biological Bentall : graduation thesis
No full textThe biological Bentall procedure and the David operation are two well-established surgical techniques for the treatment of aortic root aneurysms and aortic valve insufficiency, with differing approaches and indications. The Bentall procedure involves composite replacement of the aortic root and valve using a biological prosthesis, making it particularly suitable for patients with significant aortic root pathology and those who are not candidates for lifelong anticoagulation. It is often preferred in emergency settings and in patients with multiple comorbidities due to its durability and reliability, albeit with slightly higher perioperative risks and a longer-term advantage in valve competence. In contrast, the David procedure is a valve-sparing technique that preserves the native aortic valve, reducing the need for anticoagulation and thus offering significant benefit to younger patients or those with connective tissue disorders like Marfan syndrome or Loeys-Dietz syndrome. While technically more complex and associated with longer operative times, the David operation showed lower overall mortality (2% vs 6%) and better long-term survival (98% vs 94%) in this cohort. However, it carried a slightly higher risk of reoperation for bleeding and progression of valve regurgitation over time. Patient selection is therefore critical; Bentall is favoured for older, high-risk patients or when prosthetic valve durability is essential, while David is ideal for younger, lower-risk individuals with morphologically suitable valves. Ultimately, surgical strategy must be individualised, balancing anatomical factors, genetic conditions, operative risks, and long-term valve preservation goals
Neurogenic dysfunction of the lower urinary tract : graduation thesis
No full textNeurogenic lower urinary tract dysfunction (NLUTD) is a disorder affecting the lower urinary tract storage and voiding functions. This condition is due to the miscoordination of urethral sphincter contraction, bladder sensitivity, and detrusor muscle contraction. It can therefore also be classified urodynamically according to the International Continence Society classification. Causes of NLUTD are typically classified into two categories: suprasacral lesions, which are marked by simultaneous contractions of the detrusor muscle, and infrasacral lesions or peripheral nerve damage, which lead to a hypocontractile detrusor and variable sphincter tone. Etiologies contributing to neurogenic lower urinary tract dysfunction encompass traumatic injuries to the central nervous system, cerebrovascular accidents (stroke), neurodegenerative disorders such as dementia and Parkinson’s disease, demyelinating diseases including multiple sclerosis, congenital anomalies like spina bifida, acute inflammatory neuropathies such as Guillain-Barré syndrome, and neoplastic lesions involving the central nervous system or spinal cord. Complications of the disease can occur if the patient has a long-lasting residual volume, leading to stone formation or, in the case of Detrusor-sphincter dyssynergia, manifesting as UTIs, renal reflux, and renal injury. Assessments involve anamnesis, physical examination, and non-invasive tests such as uroflowmetric evaluation, electromyogram, and ultrasound. Invasive methods for diagnosis are bladder cystometrogram and micturating cystourethrography. Treatment options involve targeting the bladder or urethral sphincter for filling or emptying dysfunction. These treatments encompass conservative approaches, catheterization, non-pharmacological interventions, and electrical nerve stimulation. In more severe cases, minimally invasive and surgical interventions have proven effective
Impact of Light Pollution on the Development of Obesity by Influencing the Quality of Sleep : Graduation Thesis
No full textThe increasing prevalence of light pollution has been recognized as a significant environmental factor influencing sleep quality and metabolic health. This thesis investigates the hypothesis that light pollution contributes to obesity development by dysrupting sleep patterns. Exposure of artificial light at night interferes with the circadian rhythm, leading to melatonin suppression, fragmented sleep, delayed sleep onset and hormonal imbalances. Leptin, ghrelin and cortisol are mostly affected by ALAN and contribute to increased hunger and appetite, weight gain, fat accumulation and insulin resistance. This paper shows recent evidence, by presenting several studies and review papers linking higher obesity rates to light pollution. This thesis underlines the importance of recognizing light pollution as a modifiable risk factor in the obesity epidemic and advocates for integrated approaches to combine environmental, lifestyle and interventions to improve human health