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Strain Elastography in Urogynecology: Functional Imaging in Stress Urinary Incontinence
Get PDFStress urinary incontinence (SUI) is the most common subtype of female urinary incontinence, affecting up to one in four women and markedly reducing quality of life. Its pathophysiology primarily involves impaired suburethral and paraurethral support, resulting in decreased tissue stiffness and urethral hypermobility. Conventional imaging provides anatomical detail but is limited in its ability to assess pelvic floor biomechanics. This narrative review summarizes current evidence on strain elastography (SE) as a functional imaging modality in urogynecology, with emphasis on evaluating suburethral tissue stiffness in women with SUI. A narrative review was performed using PubMed (2000–2025). Primary searches (“strain elastography” AND “female stress urinary incontinence”; “stress incontinence” AND “elastography”) yielded 19 records, of which 12 were included after screening. Owing to the limited number of SE-specific studies, the review was expanded to include shear wave elastography research, key guidelines, and biomechanical literature on pelvic floor ultrasound in adult women with SUI. SE provides a non-invasive, real-time method for assessing tissue stiffness, bridging the longstanding gap between anatomical and biomechanical evaluation. Current evidence supports SE as a feasible and promising diagnostic adjunct for the functional assessment of SUI in women
Minimally invasive subperiosteal pocket technique for Osia 2 system- implantation without fixation
Get PDFThe CochlearTM Osia® 2 is an active transcutaneous implant designed to treat patients with different types of hearing loss. Due to its size, implantation needs appropriate practice since the necessity of extended flap creation and bone work can be an issue in some cases. The goal of our study was to determine whether fixation of the OSI200 implant was necessary for the performance of patients with conductive or mild mixed hearing loss. The vibroacoustic performance of the Osia 2 system, with and without BI300 fixation, was evaluated through tests conducted on a head model. In addition, three patients underwent surgery using the modified minimally invasive subperiosteal pocket technique; the OSI200 implant was placed in a tight subperiosteal pocket without fixing it with the BI300 implant. To evaluate the audiological performance of the non-fixated Osia 2 system, we compared the preoperative unaided pure tone and suprathreshold testing with the Baha 5 sound processor and the non-fixated Osia 2 system aided thresholds. Initial results indicate that omitting fixation does not significantly impair the function of the Osia 2 system. The findings of the clinical assessment support the fact that the Osia 2 system performed better than the Baha 5 system on Softband, both in pure tone and suprathreshold tests. According to our results, we have found that utilizing the subperiosteal pocket method and implanting Osia 2 without BI300 fixation may be a viable option. This approach has shown promising results in terms of improving hearing ability with minimalization of surgery related complications. © The Author(s) 2024
Sonochemically improved regeneration of mechanically amorphized Ca2Cr-layered double hydroxides – Synthesis, characterization and photocatalytic lidocaine decomposition
No full textChemoresistance in Pancreatic Cancer: The Role of Adipose-Derived Mesenchymal Stem Cells and Key Resistance Genes
Get PDFDrug resistance is a significant challenge in pancreatic ductal adenocarcinoma (PDAC), where stromal elements such as adipose-derived mesenchymal stem cells (ASCs) contribute to a chemoresistant tumor microenvironment (TME). This study explored the effects of oxaliplatin (OXP) and 5-fluorouracil (5-FU) on PDAC cells (Capan-1) and ASCs to investigate the mechanisms of chemoresistance. While OXP and 5-FU reduced Capan-1 viability in a dose- and time-dependent manner, ASCs demonstrated high resistance, maintaining > 90% viability even at cytotoxic doses. Transcriptomic analyses revealed OXP-induced transcriptional reprogramming in ASCs, with over 7000 differentially expressed genes, highlighting the pathways related to DNA damage response, cell cycle regulation, and stress-related signaling. In contrast, 5-FU elicited limited transcriptional changes, affecting only 192 genes. Cytokine proteome profiling revealed that OXP-treated ASCs significantly influenced the tumor microenvironment by promoting immune evasion (via IL-4, GM-CSF, IP-10, and GROα) and driving extracellular matrix remodeling (through EMMPRIN and DPPIV). In contrast, 5-FU induced comparatively weaker effects, primarily limited to hypoxia-related pathways. Although OXP reduced angiogenic factors, it paradoxically activated pro-survival pathways, thereby enhancing ASC-mediated tumor support. These findings underscore ASCs as modulators of chemoresistance via secretome alterations and stress adaptation. Therefore, future strategies should prioritize the precise targeting of tumor cells while also focusing on the development of personalized treatments to achieve durable therapeutic responses in PDAC
Gyógyszerrezisztens epilepsziás betegek pszichológiai vizsgálata: affektív tényezők és társas támogatás
Get PDFBevezetés: Az epilepszia krónikus agyi betegség, amelynek kezelése elsősorban antiepileptikus gyógyszerekkel történik. Célkitűzés: Vizsgálatunk célja a gyógyszerrezisztens epilepsziás páciensek társas támogatásának feltérképezése, illetve az affektív tényezők, azon belül a depresszió és a szorongás vizsgálata és összehasonlítása volt az egészséges kontrollszemélyek állapotával. Módszer: Kutatásunkba összesen 34 vizsgálati személyt vontunk be (22 nő és 12 férfi; életkoruk: 21–66 év [M = 43,1, SD = 14,0]). A vizsgálatban 17 személy gyógyszerrezisztens epilepsziás páciens (13 nő és 4 férfi; életkoruk: 21–66 év [ M = 46,6, SD = 13,5]) és 17 illesztett kontrollszemély (9 nő és 8 férfi; életkoruk: 23–59 év [M = 39,6, SD = 14,1]) vett részt. Az alkalmazott kérdőívek: Hospital Anxiety and Depression Scale (HADS), Caldwell-féle Társas Támogatás Skála (SDS). Eredmények: A vizsgált mintában a depresszió és a társas támogatás mértéke fordított összefüggést mutatott. A depresszió nagyobb mértéke szignifikáns kapcsolatban áll a kisebb társas támogatással: nehéz élethelyzetben (rs [15] = –0,498, p<0,003), gyakorlati támogatásban (rs [15] = –0,622, p<0,001), illetve azzal, hogy hány emberrel áll kapcsolatban a vizsgált személy (rs [15] = –0,513, p<0,002). A HADS-összpontszám alapján szignifikáns különbség mutatkozott a gyógyszerrezisztens epilepsziás és a kontrollszemélyek között ( t [24,4] = 3,40, p = 0,002, d = 1,16). Megbeszélés: A szociális közeg megtartó és segítő szerepe alapvető jelentőségű a krónikus gyógyszerrezisztens epilepsziás betegek ellátásában. A társas támogatás hiányában a depresszió mértéke jelentős növekedést mutat, ami tovább rontja a páciensek életminőségét. Következtetés: Pilotkutatásunk eredményei rávilágítanak a probléma időszerűségére, így elősegítheti a gyógyszerrezisztens epilepsziás betegek részletes neuropszichológiai diagnosztikáját, ezáltal növelve a terápiás hatékonyságot. Orv Hetil. 2025; 166(1): 20–26
AF-FLOW Global Registry Confirms Validity of Electrographic Flow Mapping as a Phenotyping Tool for Atrial Fibrillation
Get PDFElectrographic flow (EGF) mapping allows for the visualization of global atrial wavefront propagations. One mechanism of initiation and maintenance of atrial fibrillation (AF) is stimulation from EGF-identified focal sources that serve as driver sites of fibrillatory conduction. Electrographic flow consistency (EGFC) further quantifies the concordance of observed wavefront patterns, indicating that a healthier substrate shows more organized wavefront propagation and higher EGFC. Freedom from AF (FFAF) recurrence has accordingly been shown to be higher in patients with ablated vs. unablated sources and with high vs. low EGFC.(1) Measure FFAF across EGF-derived phenotypes in patients enrolled in the AF-FLOW Global Registry; (2) determine if a relationship exists between EGFC and percentage of healthy voltage as measured from bipolar voltage maps.The AF-FLOW Global Registry is a multicenter, prospective study of 25 all-comer AF patients who underwent concomitant high-density bipolar voltage mapping with a 16-electrode grid mapping catheter and EGF mapping with a 64-pole basket catheter. The EGF algorithm detects extra-pulmonary vein sources as origins of excitation from a singularity of divergent flow vectors and was used to localize RF ablation targets. Overall, EGFC per atrium was also computed as the average of the modulus of individual EGF vectors, where the vector length represents the consistency of flow patterns. Patients were then assigned phenotypes on the basis of source presence or absence and EGFC, and rates of FFAF at 1-year were compared across the four resulting phenotypes. Atrial EGFC was also compared to the percentage of healthy tissue determined by bipolar voltage mapping.Patients with paroxysmal AF had higher FFAF than persistent AF (PeAF) and long-standing PeAF patients; patients receiving de novo ablation had higher FFAF than those receiving redo ablation. Patient phenotyping revealed that those with high EGFC had higher FFAF than those with low EGFC (p = 0.015). Atrial EGFC was also correlated to the percent of high voltage tissue across all patients (r = 0.651, p < 0.0001).EGF mapping provides insights into the mechanistic nature of AF and the atrial health of the underlying substrate. Therefore, further studies are needed to develop phenotype-specific treatments for the disease.ClinicalTrials.gov identifier: NCT05481359
Plasma and Visceral Organ Kynurenine Metabolites Correlate in the Multiple Sclerosis Cuprizone Animal Model
Get PDFThe cuprizone (CPZ) model of multiple sclerosis (MS) is excellent for studying the molecular differences behind the damage caused by poisoning. Metabolic differences in the kynurenine pathway (KP) of tryptophan (TRP) degradation are observed in both MS and a CPZ mouse model. Our goal was to analyze the kynurenine, serotonin, and indole pathways of TRP degradation on the periphery, in the neurodegenerative processes of inflammation. In our study, mice were fed with 0.2% CPZ toxin for 5 weeks. We examined the metabolites in the three pathways of TRP breakdown in urine, plasma, and relevant visceral organs with bioanalytical measurements. In our analyses, we found a significant increase in plasma TRP, 5-hydroxytryptophan (5-HTP), and indole-3-acetic acid (IAA) levels, while a decrease in the concentrations of 3-hydroxy-L-kynurenine (3-HK), xanthurenic acid (XA), kynurenic acid (KYNA), and quinaldic acid in the plasma of toxin-treated group was found. A marked decrease in the levels of 3-HK, XA, KYNA, quinaldic acid, and indole-3-lactic acid was also observed in the visceral organs by the end of the poisoning. Furthermore, we noticed a decrease in the urinary levels of the TRP, KYNA, and XA metabolites, while an increase in serotonin and 5-hydroxyindoleacetic acid in the CPZ group was noticed. The toxin treatment resulted in elevated tryptamine and indoxyl sulfate levels and reduced IAA concentration. Moreover, the urinary para-cresyl sulfate concentration also increased in the treated group. In the present study, we showed the differences in the three main metabolic pathways of TRP degradation in the CPZ model. We confirmed the relationship and correlation between the content of the kynurenine metabolites in the plasma and the tissues of the visceral organs. We emphasized the suppression of the KP and the activity of the serotonin and indole pathways with a particular regard to the involvement of the microbiome by the indole pathway. Consequently, this is the first study to analyze in detail the distribution of the kynurenine, serotonin, and indole pathways of TRP degradation in the periphery
