Traumatic injuries are a major public health problem, being one of the main causes of death, the subsequent decline in the quality of life of the patients involved, as well as the costs of ...hospitalization in the health system. Material and Method: We conducted a 5-year retrospective study on 798 hospitalized patients with traumatic injuries, by collecting a series of general, clinical, imaging and biological parameters.
The results showed a higher proportion of male patients, the main lesion mechanism being represented by road accidents, followed by falls from another level. The most common traumatic intraabdominal parenchymal lesions were splenic, followed by hepatic and renal lesions. In addition to intraabdominal trauma, the lesion balance also included thoracic, spinal cord, head and limb injuries. A total of 288 patients underwent emergency surgery, but there were also cases of delayed surgical procedures or reoperations. We had 67 deceased patients.
Trauma is a major public health problem, both socially and economically, being responsible for a significant number of deaths, but also in terms of the significant number of hospitalizations and the subsequent impact on the quality of life of those involved.
Alteration of tissue mechanical properties is a physical hallmark of solid tumors including gliomas. How tumor cells sense and regulate tissue mechanics is largely unknown. Here, we show that ...mechanosensitive ion channel Piezo regulates mitosis and tissue stiffness of Drosophila gliomas, but not non-transformed brains. PIEZO1 is overexpressed in aggressive human gliomas and its expression inversely correlates with patient survival. Deleting PIEZO1 suppresses the growth of glioblastoma stem cells, inhibits tumor development, and prolongs mouse survival. Focal mechanical force activates prominent PIEZO1-dependent currents from glioma cell processes, but not soma. PIEZO1 localizes at focal adhesions to activate integrin-FAK signaling, regulate extracellular matrix, and reinforce tissue stiffening. In turn, a stiffer mechanical microenvironment elevates PIEZO1 expression to promote glioma aggression. Therefore, glioma cells are mechanosensory in a PIEZO1-dependent manner, and targeting PIEZO1 represents a strategy to break the reciprocal, disease-aggravating feedforward circuit between tumor cell mechanotransduction and the aberrant tissue mechanics.
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•Drosophila Piezo regulates cell proliferation and tissue stiffening of gliomas•Human PIEZO1 is overexpressed in aggressive gliomas and predicts poor survival•Piezo/PIEZO1 interacts with integrin-FAK signaling to regulate tumor stiffness•PIEZO1 co-opts aberrant tissue mechanics to promote glioma aggression
PIEZO1 is an ion channel that converts mechanical stimuli into cellular signaling. Here, Chen et al. perform multi-species studies to define a feedforward circuit mediated by PIEZO1 and tumor tissue mechanics to promote glioma growth.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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Prenatal alcohol exposure (PAE) can result in fetal alcohol spectrum disorder (FASD), defined as a continuum of developmental defects including growth restriction, cognitive‐behavioral ...deficits, and craniofacial anomalies. Despite the known consequences of PAE, there is great variation in craniofacial and behavioral outcomes of affected children even when considering timing and quantity of exposure; phenotypic variation which could arise from maternal differences. In the present study, we asked: Does maternal age influence the nature and extent of growth restriction and craniofacial defects of PAE in offspring? To address this question, we used a C57BL/6 mouse model, as it enables precise control of dosing, gestational timing and maternal age. Dams were divided into four groups: 1. ethanol‐treated young dams (6–10 weeks); 2. control young dams; 3. ethanol‐treated old dams (6–7 months); and 4. control old dams. All dams were injected with either ethanol (treatment groups) or vehicle solution (control groups) on gestational day 7.5. Offspring growth restriction was analyzed by measures of body mass, liver mass, and body‐to‐liver mass ratio at birth. Micro‐CT scans of newborn soft tissue and skeletal craniofacial features underwent 3D analyses of shape and size to compare craniofacial phenotypes among treatment groups. Initial results of young ethanol‐treated and control groups demonstrated that ethanol‐treated offspring were born prematurely and showed significant growth restriction. Both soft tissue and skeletal craniofacial features were altered in the ethanol‐treated group, consistent with the FASD phenotype. Surprisingly, craniofacial shape of ethanol‐treated offspring was less variable than controls. Data collection for the old dam groups is ongoing, and we predict that offspring of old dams will have more severe growth and phenotypic consequences from PAE, exhibiting greater phenotypic variation compared to offspring of young dams. As many women are delaying childbirth, there is an increasing need to carryout preclinical studies with appropriate experimental controls to better understand the relative risk of PAE and maternal age, and ultimately contribute to public health policy for pregnant women.
Support or Funding Information
Funded by Children’s Health Research Institute, Internal Research Grant Fund to KEW “The Effects of Moderate Prenatal Alcohol Exposure on Craniofacial Morphology and Development” R5211A04
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
La fin de l’année 1860 coïncide avec la fin de l’autonomie du Banat et de la Voïvodine serbe. Ces deux régions, caractérisées par une importante diversité ethnique, sont en effet rattachées á la ...Hongrie. Cet événement a provoqué une vive réaction de la part des Roumains et des Serbes, solidaires face aux prétentions d’hégémonie de la classe politique hongroise. Notre étude se focalise sur un moment important de cette solidarité, celui de la lutte parlementaire de 1868, autour de l’élaboration de la loi des nationalités dans le cadre de la Monarchie Austro – Hongroise. Le projet de loi qui fut alors déposé conjointement par les députés serbes et roumains à la Diète de Budapest fut repoussé. Mais c’est autour de ce projet que se dont rejoints les stratégies et les programmes politiques nationaux des Serbes et des Roumains. Leurs partis respectifs, crées en 1869, se sont en effet construits sur l’idée d’une solidarité politique et culturelle des deux nations face à l’hégémonie de la thèse du dualisme austro-hongrois.
Background
Prenatal alcohol exposure (PAE) can result in developmental defects that include growth restriction, craniofacial anomalies, and cognitive behavioral deficits, though the presence and ...severity of these adverse outcomes can vary dramatically among exposed individuals. Preclinical animal models have demonstrated that the dose and timing of PAE account for much, but not all, of this phenotypic variation, suggesting that additional factors mitigate the effects of PAE. Here, we used a mouse model to investigate whether maternal age modulates the effects of PAE on the severity and variation in offspring growth and craniofacial outcomes.
Methods
Nulliparous C57BL/6N dams received either an intraperitoneal injection of ethanol (EtOH) or vehicle solution on gestational day 7.5. Dams were divided into four groups: (1) EtOH‐treated young dams (6 to 10 weeks); (2) control young dams; (3) EtOH‐treated old dams (6 to 7 months); and (4) old control dams. Neonate offspring growth restriction was measured through body mass and organ‐to‐body mass ratios, while skeletal craniofacial features were imaged using micro‐CT and analyzed for size, shape, and variation.
Results
PAE and advanced maternal age each increased the risk of low birthweight and growth restriction in offspring, but these factors in combination changed the nature of the growth restriction. Similarly, both PAE and advanced maternal age individually caused changes to craniofacial morphology such as smaller skull size, dysmorphic skull shape, and greater skull shape variation and asymmetry. Interestingly, while the combination of PAE and advanced maternal age did not affect mean skull shape or size, it significantly increased the variation and asymmetry of those measures.
Conclusion
Our results indicate that maternal age modulates the effects of PAE, but that the effects of this combination on offspring outcomes are more complex than simply scaling the effects of either factor.
We investigated whether advanced maternal age modulates the effects of prenatal alcohol exposure on offspring growth and craniofacial outcomes. Using a mouse model, we determined that the combination of advanced maternal age and prenatal alcohol exposure did not affect skull shape or size beyond either age or alcohol exposure singly. However, the combination increased skull shape and size variation, indicating that advanced maternal age increases the risk of adverse outcomes in offspring following prenatal alcohol exposure.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Rectal cancer is one of the most common malignant pathologies worldwide. Currently, the standard treatment of this pathology consists of radio-chemotherapy followed by low anterior resection with ...total mesorectal excision or abdominoperineal proctectomy for medium/low rectal cancer.
In recent years, another treatment strategy has been proposed, stemming from the finding that up to 40% of patients receiving neoadjuvant treatment had a complete pathological response. This method, also referred to as the watch and wait approach, implies delaying surgery and following a rigorous protocol for patients who have developed a complete response to neoadjuvant treatment with a good oncologic outcome. The objective of this study was to highlight the merits of this approach in selected patients.
In this study, we present two patients with low-rectal tumors who developed complete response post neoadjuvant therapy and for whom the watch and wait protocol has been applied over the past 4 years.
Although the watch and wait protocol appears to be a feasible option in the management of patients with a complete clinical and pathological response post neoadjuvant therapy, more prospective studies and randomized trials comparing this approach with standard surgical treatment are required before establishing it as the standard of care for distal rectal cancer. Therefore, establishing universal criteria for the selection and assessment of the patients with a complete clinical response following neoadjuvant treatment is required.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Reports about the implementation of recommendations from acute pancreatitis guidelines are scant. This study aimed to evaluate, on a patient-data basis, the contemporary practice patterns of ...management of biliary acute pancreatitis and to compare these practices with the recommendations by the most updated guidelines.
All consecutive patients admitted to any of the 150 participating general surgery (GS), hepatopancreatobiliary surgery (HPB), internal medicine (IM) and gastroenterology (GA) departments with a diagnosis of biliary acute pancreatitis between 01/01/2019 and 31/12/2020 were included in the study. Categorical data were reported as percentages representing the proportion of all study patients or different and well-defined cohorts for each variable. Continuous data were expressed as mean and standard deviation. Differences between the compliance obtained in the four different subgroups were compared using the Mann-Whitney U, Student's t, ANOVA or Kruskal-Wallis tests for continuous data, and the Chi-square test or the Fisher's exact test for categorical data.
Complete data were available for 5275 patients. The most commonly discordant gaps between daily clinical practice and recommendations included the optimal timing for the index CT scan (6.1%, χ
6.71, P = 0.081), use of prophylactic antibiotics (44.2%, χ
221.05, P < 0.00001), early enteral feeding (33.2%, χ
11.51, P = 0.009), and the implementation of early cholecystectomy strategies (29%, χ
354.64, P < 0.00001), with wide variability based on the admitting speciality.
The results of this study showed an overall poor compliance with evidence-based guidelines in the management of ABP, with wide variability based on the admitting speciality. Study protocol registered in ClinicalTrials.Gov (ID Number NCT04747990).
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Diaphragmatic injuries are produced by blunt or penetrating thoracoabdominal trauma. They are potentially life-threatening due to the herniation of abdominal organs into the pleural cavities and ...severe associated lesions. The aim of this retrospective study was to analyse the clinical presentation and management of patients admitted with diaphragmatic rupture in our institution. Material and Method: We performed a 5-year retrospective study of patients admitted with acute blunt or penetrating diaphragmatic rupture in the Department of General Surgery of "Bagdasar- Arseni" Emergency Hospital. We have studied sex, age, mechanism of trauma, side-location, timeto-diagnosis, concomitant injuries, surgical treatment and outcome.
Fifteen patients (8 males, 7 females, mean age: 42 years) with diaphragmatic rupture (left-side: 13, right-side: 2) following blunt (8 patients) or penetrating (7) trauma were included. Patients with blunt diaphragmatic injury had larger tears and abdominal viscera herniation was observed in 6of these cases. A direct suture was performed for all 15 patients. Laparotomy was the surgical approach preferred in most of the cases. Mortality rate was 20%, mainly caused by severe associated lesions. Conclusion: Although traumatic diaphragmatic lesions are frequently associated with severe cerebral and thoraco-abdominal trauma that is also the main cause of death, a prompt diagnosis and treatment can lead to good outcome.
BackgroundRectal cancer is one of the most common malignant pathologies worldwide. Currently, the standard treatment of this pathology consists of radio-chemotherapy followed by low anterior ...resection with total mesorectal excision or abdominoperineal proctectomy for medium/low rectal cancer. ObjectivesIn recent years, another treatment strategy has been proposed, stemming from the finding that up to 40% of patients receiving neoadjuvant treatment had a complete pathological response. This method, also referred to as the watch and wait approach, implies delaying surgery and following a rigorous protocol for patients who have developed a complete response to neoadjuvant treatment with a good oncologic outcome. The objective of this study was to highlight the merits of this approach in selected patients. Case ReportsIn this study, we present two patients with low-rectal tumors who developed complete response post neoadjuvant therapy and for whom the watch and wait protocol has been applied over the past 4 years. ConclusionAlthough the watch and wait protocol appears to be a feasible option in the management of patients with a complete clinical and pathological response post neoadjuvant therapy, more prospective studies and randomized trials comparing this approach with standard surgical treatment are required before establishing it as the standard of care for distal rectal cancer. Therefore, establishing universal criteria for the selection and assessment of the patients with a complete clinical response following neoadjuvant treatment is required.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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