Thyroid cancer in adolescents and young adults

In adolescents and young adults, thyroid cancer accounts for 13% of all invasive neoplasms, being three times more frequent in females, but overdiagnosis and overtreatment are common. There are two therapeutic approaches, one radical and no longer preferred in all instances, and the other conservative. Permanent complications of surgery and metabolic irradiation can affect quality of life and carry an economic burden. The overall survival rate approaches 100% for patients with differentiated thyroid cancer regardless of the extent of treatment. Medullary thyroid carcinoma is a very different entity, occurring most frequently in the context of hereditary tumor susceptibility syndromes.     

Trace Element Contents in Petrol-Contaminated Soil Following the Application of Compost and Mineral Materials

The global use of petroleum hydrocarbons as raw materials and an energy source in industry results in serious environmental, health, and ecological problems. Consequently, there is growing interest in the development of technologies for the rehabilitation of contaminated areas. This study was undertaken in order to determine the effect of different phytostabilising materials (compost, bentonite, and CaO) on the trace element content in soil contaminated with unleaded petroleum 95 (0, 2.5, 5, and 10 cm³ kg⁻¹ of soil). The doses of petroleum applied to the soil were based on the previously conducted preliminary experiment. The highest petroleum dose (10 cm³ kg⁻¹ of soil) significantly reduced the chromium, zinc, and cobalt contents in the soil. Petroleum increased the cadmium, lead, nickel, and copper contents in the soil. The materials used for phytostabilisation (compost, bentonite, calcium oxide) had a significant effect on the trace element content in the soil. The application of mineral materials (bentonite and calcium oxide) was more effective than the application of compost, compared to the control series (without soil amendments) as they reduced the contents of cadmium, chromium, nickel, and cobalt in the soil to the greatest extent. The reduction effect of bentonite and calcium oxide on the content of these trace elements in the soil was stronger than compost.     

Extracellular vesicles mediate the communication between multiple myeloma and bone marrow microenvironment in a NOTCH dependent way

Multiple myeloma (MM) is an incurable hematologic neoplasm, whose poor prognosis is deeply affected by the propensity of tumor cells to localize in the bone marrow (BM) and induce the protumorigenic activity of normal BM cells, leading to events associated with tumor progression, including tumor angiogenesis, osteoclastogenesis, and the spread of osteolytic bone lesions. The interplay between MM cells and the BM niche does not only rely on direct cell-cell interaction, but a crucial role is also played by MM-derived extracellular vesicles (MM-EV). Here, we demonstrated that the oncogenic NOTCH receptors are part of MM-EV cargo and play a key role in EV protumorigenic ability. We used in vitro and in vivo models to investigate the role of EV-derived NOTCH2 in stimulating the protumorigenic behavior of endothelial cells and osteoclast progenitors. Importantly, MM-EV can transfer NOTCH2 between distant cells and increase NOTCH signaling in target cells. MM-EV stimulation increases endothelial cell angiogenic ability and osteoclast differentiation in a NOTCH2-dependent way. Indeed, interfering with NOTCH2 expression in MM cells may decrease the amount of NOTCH2 also in MM-EV and affect their angiogenic and osteoclastogenic potential. Finally, we demonstrated that the pharmacologic blockade of NOTCH activation by γ-secretase inhibitors may hamper the biological effect of EV derived by MM cell lines and by the BM of MM patients. These results provide the first evidence that targeting the NOTCH pathway may be a valid therapeutic strategy to hamper the protumorigenic role of EV in MM as well as other tumors.     

Bacteriophage Cocktails in the Post-COVID Rehabilitation

Increasing evidence suggests that gut dysbiosis is associated with coronavirus disease 2019 (COVID-19) infection and may persist long after disease resolution. The excessive use of antimicrobials in patients with COVID-19 can lead to additional destruction of the microbiota, as well as to the growth and spread of antimicrobial resistance. The problem of bacterial resistance to antibiotics encourages the search for alternative methods of limiting bacterial growth and restoring the normal balance of the microbiota in the human body. Bacteriophages are promising candidates as potential regulators of the microbiota. In the present study, two complex phage cocktails targeting multiple bacterial species were used in the rehabilitation of thirty patients after COVID-19, and the effectiveness of the bacteriophages against the clinical strain of Klebsiella pneumoniae was evaluated for the first time using real-time visualization on a 3D Cell Explorer microscope. Application of phage cocktails for two weeks showed safety and the absence of adverse effects. An almost threefold statistically significant decrease in the anaerobic imbalance ratio, together with an erythrocyte sedimentation rate (ESR), was detected. This work will serve as a starting point for a broader and more detailed study of the use of phages and their effects on the microbiome.     

Non-Wetting and Non-Reactive Behavior of Liquid Pure Magnesium on Pure Tungsten Substrates

The wetting behavior of liquid magnesium drop on pure tungsten substrates was investigated, for the first time, with the sessile drop method combined with non-contact heating and capillary purification of a Mg drop from a native oxide film. A specially designed apparatus dedicated to the investigation of the high-temperature interaction of dissimilar materials was used. The comparative experiments were performed under isothermal conditions at temperatures of 700 °C and 740 °C using two atmospheres: Ar + 5 wt.% H₂ and pure Ar, respectively. During high-temperature tests for 180 s, the images of the Mg/W couples were recorded with CCD cameras (57 fps) from two directions of observation. The solidified drop/substrate couples were subjected to structural characterization using scanning electron microscopy (SEM) coupled with energy-dispersive X-ray spectroscopy (EDS). Under the applied measurement conditions, liquid Mg revealed non-wetting behavior on W substrates (a contact angle θ > 90°). The average value of the contact angle under the flowing Ar atmosphere at 740 °C was θ_av = 115°, whereas it was higher under the flowing Ar + 5 wt.%. H₂ atmosphere at a lower temperature of 700 °C, showing θ_av = 122°. Independently on employed atmosphere and temperature, SEM + EDS analysis of solidified sessile drop couples did not display any new phases and mass transfer between the Mg drop and the W substrate, whereas the presence of discontinuities at the Mg/W interface of cross-sectioned couples were well-distinguished. Non-wetting and a lack of permanent bonding between the Mg drop and W substrates have a good agreement with the Mg–W phase diagram calculated with the help of FactSage software and FTlite database, i.e., the non-reactive nature of the Mg/W couple because W does not dissolve in liquid Mg and it does not form any compounds with Mg. These findings allow for the recommendation of tungsten as a suitable refractory material for long-time contact with liquid Mg in different container-assisted methods of materials characterization as well as in liquid-assisted processing of Mg components.     

The Role of Intramedullary Nailing for Proximal Humerus Fractures: What Works and What Does Not

Purpose of ReviewThe evaluation of proximal humerus fractures (PHFs) should be aimed to answer the following four questions: (1) does the fracture need surgery in each particular patient? (2) if surgery is recommended, is it better to proceed with internal fixation or shoulder arthroplasty, (3) if internal fixation is recommended, what is the ideal fixation device strategy, and (4) how can outcomes be optimized? This review article tries to answer these questions and provides some clarity regarding what works and what does not in PHFs treated with intramedullary nailing.Recent FindingsAccording to published articles on the treatment of PHFs with intramedullary nails, it is difficult to draw conclusions about outcomes and complications due to great variation in age, type of fracture, and nail designs included in the studies. However, the literature seems to support the use of modern nail designs for PHFs, especially in fractures of the surgical neck as well as varus posteromedial and valgus fractures with no tuberosity involvement.SummaryAlthough the results of IMN in PHF seem to be better in two-part fractures, in more complex fractures, the quality of the reduction achieved seems to influence functional outcomes. Tuberosity malreduction leads to poor clinical outcomes, high rate of complications, and an increased risk of avascular necrosis. Malreduction of the humeral head increases the risk of postoperative loss of reduction, especially for varus posteromedial impacted fractures. A medial nail entry point decreases the risk of postoperative varus malunion, preserves the rotator cuff tendon, and avoids iatrogenic fractures of the GT. To decrease the risk of postoperative stiffness, fracture fixation should be stable enough to allow early mobilization.     

The Role of Vitamin D in Stroke Prevention and the Effects of Its Supplementation for Post-Stroke Rehabilitation: A Narrative Review

Hypovitaminosis D is a serious public health problem, representing an independent factor in mortality among the general population. Vitamin D deficiency may affect up to one billion people worldwide. Recently, the potential association between vitamin D levels and stroke has gained increasing attention. Many studies suggest that maintaining normal serum vitamin D levels is associated with improvement of the cardiovascular system and a reduction in stroke risk. As a neurosteroid, vitamin D influences brain development and function and immunomodulation and affects brain neuroplasticity. It supports many processes that maintain homeostasis in the body. As stroke is the second most common cause of death worldwide, more studies are needed to confirm the positive effects of vitamin D supplementation, its dosage at different stages of the disease, method of determination, and effect on stroke onset and recovery. Many studies on stroke survivors indicate that serum vitamin D levels only offer insignificant benefits and are not beneficial to recovery. This review article aims to highlight recent publications that have examined the potential of vitamin D supplementation to improve rehabilitation outcomes in stroke survivors. Particular attention has been paid to stroke prevention.     

Vitamin D Treatment Prevents Uremia-Induced Reductions in Aortic microRNA-145 Attenuating Osteogenic Differentiation despite Hyperphosphatemia

In chronic kidney disease, systemic inflammation and high serum phosphate (P) promote the de-differentiation of vascular smooth muscle cells (VSMC) to osteoblast-like cells, increasing the propensity for medial calcification and cardiovascular mortality. Vascular microRNA-145 (miR-145) content is essential to maintain VSMC contractile phenotype. Because vitamin D induces aortic miR-145, uremia and high serum P reduce it and miR-145 directly targets osteogenic osterix in osteoblasts, this study evaluated a potential causal link between vascular miR-145 reductions and osterix-driven osteogenic differentiation and its counter-regulation by vitamin D. Studies in aortic rings from normal rats and in the rat aortic VSMC line A7r5 exposed to calcifying conditions corroborated that miR-145 reductions were associated with decreases in contractile markers and increases in osteogenic differentiation and calcium (Ca) deposition. Furthermore, miR-145 silencing enhanced Ca deposition in A7r5 cells exposed to calcifying conditions, while miR-145 overexpression attenuated it, partly through increasing α-actin levels and reducing osterix-driven osteogenic differentiation. In mice, 14 weeks after the induction of renal mass reduction, both aortic miR-145 and α-actin mRNA decreased by 80% without significant elevations in osterix or Ca deposition. Vitamin D treatment from week 8 to 14 fully prevented the reductions in aortic miR-145 and attenuated by 50% the decreases in α-actin, despite uremia-induced hyperphosphatemia. In conclusion, vitamin D was able to prevent the reductions in aortic miR-145 and α-actin content induced by uremia, reducing the alterations in vascular contractility and osteogenic differentiation despite hyperphosphatemia.