Swiss School of Archaeology in Greece
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First results from the international registry on liver venous deprivation (EuroLVD)
No full textAn international registry on liver venous deprivation (LVD, simultaneous portal and hepatic vein embolization) was created in 2020. This study assessed the outcomes after LVD in patients included in the registry.Eight international centers participated. Future liver remnant (FLR) and standardized FLR ratios were defined as FLR/total functional liver volume and FLR/total estimated liver volume.216 patients were included (80 women, median age 63). Main surgical indication was colorectal metastases (n=124). Median and standardized FLR ratios before LVD were 33% (IQR27-47) and 32% (IQR24-39). In one patient, right hepatic vein embolization failed. Complications after LVD occurred in 14 patients (6.5%). After LVD, median and standardized FLR ratios significantly increased to 46% (IQR38-60, p<0.001) and 44% (IQR35-51, p<0.001), corresponding to a median kinetic growth rate of 3.4%/week (IQR1.5-6.0). Hepatectomy was performed in 160 patients (72 extended hepatectomies), while 56 dropped out (4% insufficient hypertrophy, 13% tumor progression). Seventy-seven patients had postoperative complications (48%; 5 postoperative liver failures, 3%). Median Comprehensive Complication Index was 20.9 (IQR0-30.8).Preliminary data of this international registry showed that LVD had a high technical success rate with few post-procedural complications and significant kinetic growth. Major hepatectomy after LVD appeared to be safe.Crown Copyright © 2025. Published by Elsevier Ltd. All rights reserved
Mitochondrial lipid metabolism in tumor immunosurveillance and evasion
No full textMitochondrial lipid metabolism plays a pivotal role in tumor immunosurveillance and immune evasion. This review explores how mitochondrial regulation shapes immune cell metabolism within the tumor microenvironment (TME), focusing on the antitumor effects of the mitochondrial-fueled immune response and the detrimental impact of impaired mitochondrial function on immune cell cytotoxicity. Although current studies support this dual role, critical gaps remain, including how immune cells adapt differently to the lipid-rich TME, and how therapies can target lipid metabolism without harming immune memory. By synthesizing current findings and highlighting these uncertainties, this review highlights mitochondrial lipid metabolism as a promising therapeutic axis in cancer immunotherapy.
Copyright © 2025 The Author(s). Published by Elsevier Ltd.. All rights reserved
Retrospective comprehensive analysis of regional lymph node recurrence in breast cancer patients (REASON study).
No full textRandomized trials have progressively enabled the de-escalation of axillary surgery in breast cancer (BC) patients, reducing adverse events without compromising survival. Despite a not negligible rate of residual disease in the axilla after sentinel lymph node (SLN) procedure, the risk of regional lymph node recurrence (RLNR) is very low, due probably to multimodal adjuvant treatments. The characteristics of the small number of patients with RLNR remain poorly characterized and warrant further investigation, especially given their poor prognosis and the current context of ongoing studies exploring further de-escalation of axillary surgery.
In this retrospective and single institution study, we analyzed thoroughly a cohort of patients who experienced RLNR as first event between 2009 and 2020. MammaPrint and BluePrint analysis (MB) was performed in available primary invasive cancer tissues.
Forty patients, median age of 52, were analyzed. Disease-free interval was 8.7 years. Most of the patients (65%) had no special type BC. Majority (73%) had hormone receptor positive-HER2 negative (HR + /HER2-) BC, 13% triple negative (TNBC), 6% HER2 + , 8% ductal carcinoma in situ and 3% unknown. The median size of the primary tumor was 1.8 cm (range 0.3-7.0) and 57% had no initial LN involvement. Forty five percent had primary SLN procedure and 53% axillary LN dissection (ALND) of the patients received neo-/adjuvant chemotherapy, 63% endocrine therapy and 68% radiotherapy (50% only in breast). Sixty three percent had only RLNR and 38% had concomitant distant metastases. Among irradiated patients, 63% had some relapse in the radiation field. The MB analysis classified 70% of the analyzed cancers as low-risk luminal A (82% in HR + /HER2-), 15% high-risk luminal B, 10% high-risk basal type, and 5% high-risk HER2 type.
Our study confirms that patients treated with SLN do not show a higher risk of LRNR compared to ALND. LRNR is often diagnosed incidentally. Younger age, residual disease post-NAC, no regional radiation, stage II, and initial LN involvement were more represented, as well as patients with endocrine sensitive disease classified as low-risk luminal A by MB. Ongoing trials, including SOUND, INSEMA, and BOOG 2013-08, are further exploring axillary surgery de-escalation
Hypertension in chronic kidney disease and future heart failure.
No full textHypertension and chronic kidney diseases (CKDs) are known risk factors for the development or worsening of heart failure. In last years, several new therapeutic approaches for the management of people with diabetic and nondiabetic CKD and hypertension have been investigated. In this brief review, the most recent findings regarding the ability of SGLT-2 inhibitors and nonsteroidal mineralocorticoid receptor antagonists (nsMRA) and GLP-1 receptor agonists to prevent heart failure in patients with hypertension and CKD will be discussed.
In the last 3 years, several large clinical trials involving very large numbers of CKD patients have been published showing that these new therapeutic approaches significantly reduce the risk of heart failure events and hospitalizations in patients with diabetic and nondiabetic nephropathies and hypertension as well as in patients with heart failure without nephropathy. Moreover, these drugs retard the progression of CKD towards end-stage kidney disease.
These observations already have a major impact on the management of people with hypertension and CKD. SGLT-2 inhibitors are now recommended as first-line therapy in people with diabetes, CKD and heart failure. The use of nsMRA is increasing and could replace spironolactone over time in heart failure as well as in early CKD stages
Influence of Graft Type on Muscle Contractile Dynamics After ACL Reconstruction: A 9-Month Tensiomyographic Follow-Up
No full textBackground: Persistent neuromuscular deficits following anterior cruciate ligament reconstruction (ACLR) are frequently attributed to arthrogenic muscle inhibition (AMI). The type of autologous graft used may influence the trajectory of neuromuscular recovery. Objective: To investigate the influence of graft type-bone-patellar tendon-bone (BPTB), hamstring tendon (HT), and quadriceps tendon (QT)-on the contractile properties of periarticular knee muscles over a 9-month post-operative period. Hypothesis: Each graft type would result in distinct recovery patterns of muscle contractility, as measured by tensiomyography (TMG). Methods: Thirty-one patients undergoing ACLR with BPTB (n = 8), HT (n = 12), or QT (n = 11) autografts were evaluated at 3, 6, and 9 months post-operatively. TMG was used to measure contraction time (Tc) and maximal displacement (Dm) in the rectus femoris, vastus medialis, vastus lateralis, and biceps femoris. Results: Significant within-group improvements in Tc and Dm were observed across all graft types from 3 to 9 months (Tc: p < 0.001 to p = 0.02; Dm: p < 0.001 to p = 0.01). The QT group showed the most pronounced Tc reduction in RF (from 30.16 ± 2.4 ms to 15.44 ± 1.6 ms, p < 0.001) and VM (from 31.05 ± 2.6 ms to 18.65 ± 1.8 ms, p = 0.004). In contrast, HT grafts demonstrated limited Tc recovery in BF between 6 and 9 months compared to BPTB and QT (p < 0.001), indicating a stagnation phase. BPTB exhibited persistent bilateral deficits in both quadriceps and BF at 9 months. Conclusions: Autograft type significantly influences neuromuscular recovery patterns after ACLR. TMG enables objective, muscle-specific monitoring of contractile dynamics and may support future individualized rehabilitation strategies
Boosting Working Memory in ADHD: Adaptive Dual N-Back Training Enhances WAIS-IV Performance, but Yields Mixed Corsi Outcomes
No full textBackground/Objectives: This study investigates the efficacy of working memory training (WMT) using the dual N-back (DNB) task on cognitive performance in young adults with Attention-Deficit/Hyperactivity Disorder (ADHD). Methods: Over the course of at least 18 daily sessions conducted within one month, 106 participants (33 non-medicated ADHD, 42 medicated ADHD, and 45 controls) were randomly assigned to either a fixed dual 1-back (FD1B) training condition or an adaptive DNB condition, wherein the N-back level increased following successful completion of each trial block. Cognitive performance was assessed pre- and post-intervention using the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) Working Memory Index (WMI) and the Corsi Block-Tapping Task. Results: A mixed-design ANOVA revealed significant improvements in DNB performance across all groups, with the adaptive training condition producing larger gains (e.g., a 204.6% improvement in controls, Cohen's d=1.85). WAIS-IV WMI scores-particularly the Digit Span Backward subtest-also improved significantly post-training, with greater effect sizes in the adaptive condition (d=0.46) than in FD1B (d=0.27). Corsi performance showed very modest gains, showing a surprising tendency to be more associated with the FD1B condition than the adaptive condition. Control participants outperformed the medicated ADHD group on WAIS-IV subtests, although no significant differences emerged between medicated and non-medicated ADHD participants. Correlational analyses indicated task-specific training effects, with adaptive training enhancing associations between DNB and Corsi performance in both controls (r=0.60) and medicated ADHD participants (r=0.51). Conclusions: This study demonstrates that dual N-back training improves verbal working memory in young adults with ADHD, specifically in a sample without psychiatric comorbidities. Transfer benefit to visuospatial domains appears limited and may not generalize to adolescents, older adults, or individuals with complex clinical profiles. The results underscore the importance of tailoring training protocols to maximize cognitive outcomes across different domains
Considerations and recommendations from the ISMRM diffusion study group for preclinical diffusion MRI: Part 2-Ex vivo imaging: Added value and acquisition.
No full textThe value of preclinical diffusion MRI (dMRI) is substantial. While dMRI enables in vivo non-invasive characterization of tissue, ex vivo dMRI is increasingly being used to probe tissue microstructure and brain connectivity. Ex vivo dMRI has several experimental advantages including higher SNR and spatial resolution compared to in vivo studies, and enabling more advanced diffusion contrasts for improved microstructure and connectivity characterization. Another major advantage of ex vivo dMRI is the direct comparison with histological data, as a crucial methodological validation. However, there are a number of considerations that must be made when performing ex vivo experiments. The steps from tissue preparation, image acquisition and processing, and interpretation of results are complex, with many decisions that not only differ dramatically from in vivo imaging of small animals, but ultimately affect what questions can be answered using the data. This work represents "Part 2" of a three-part series of recommendations and considerations for preclinical dMRI. We describe best practices for dMRI of ex vivo tissue, with a focus on the value that ex vivo imaging adds to the field of dMRI and considerations in ex vivo image acquisition. We first give general considerations and foundational knowledge that must be considered when designing experiments. We briefly describe differences in specimens and models and discuss why some may be more or less appropriate for different studies. We then give guidelines for ex vivo protocols, including tissue fixation, sample preparation, and MR scanning. In each section, we attempt to provide guidelines and recommendations, but also highlight areas for which no guidelines exist (and why), and where future work should lie. An overarching goal herein is to enhance the rigor and reproducibility of ex vivo dMRI acquisitions and analyses, and thereby advance biomedical knowledge
Preoperative detection of perforating vessels in autologous abdominal flap-based breast reconstruction using a smartphone-based thermography device
No full textAbdominal-based microvascular perforator flaps remain the technique of choice in autologous breast reconstruction. Preoperative identification of the morphology, localization, and course of perforating vessels is of utmost importance. Various imaging modalities are currently used, including duplex sonography, computed tomography angiography, and magnetic resonance angiography. Thermography displays temperature variations on the skin surface and may help identify hotspots using a smartphone-based, handheld, low-cost device. This cross-sectional observational study evaluated such a thermography device and compared its accuracy with computed tomography and magnetic resonance angiography. Sixty patients undergoing abdominal tissue-based breast reconstruction between 2019 and 2022 were included. Preoperative skin perfusion was assessed using the device after cooling the abdominal skin with soaked towels at approximately 17 °C for five minutes, followed by spontaneous rewarming to room temperature. Thermographic images were taken at defined intervals. Hotspots were defined as the hottest 1 cm diameter areas on the skin surface. In patients with subcutaneous tissue thickness below 30 mm, hotspots at 3 min after cooling correlated with radiologically identified perforators in 42 percent of cases. In patients with thickness above 30 mm, the highest correlation (43 percent) was observed at 30 min. Across all timepoints, correlation ranged from 0 to 75 percent. Smartphone-based thermography provides a quick, non-invasive method to identify hotspots on the skin surface. However, correlation with computed tomography or magnetic resonance angiography was below 50 percent and highly dependent on subcutaneous thickness. As it does not show vessel caliber or intramuscular course, thermography cannot replace standard imaging but may serve as an adjunct.
© 2025 The Authors