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Several experimental studies performed since 1975, using smooth muscles richly innervated by sympathetic nerves to exclude the autonomic influence of adjusting reflex (rodent vas deferens), showed that L-type voltage-activated Ca2++ channels (VACC) blockers completely inhibited neurogenic contractions induced by electrical field stimulation (EFS) in high concentrations (>10-6 M), but paradoxically increased these EFS-contractions in low concentrations (<10-6 M), suggesting that other mechanisms than only autonomic adjusting reflex are involved in these paradoxical effects. In 2013, we showed that these paradoxical effects of L-type VACC blockers, named by us “calcium paradox” phenomenon, were potentiated by drugs which increase cytosolic cAMP concentration ([cAMP] c-enhancers), such as rolipram, IBMX and forskolin, indicating that this sympathetic hyperactivity drug-induced is due to interaction of the Ca2+/cAMP intracellular signaling pathways (Ca2+/cAMP interaction). Then, the pharmacological manipulation of this interaction produced by combination of the L-type VACC blockers used in the antihypertensive therapy, and [cAMP] c-enhancers used in the antidepressive therapy, could represent a potential cardiovascular risk for hypertensive patients due to sympathetic hyperactivity. Then, we discussed the role of Ca2+/cAMP interaction for antihypertensive pharmacotherapy.

The current situation of bioethics illustrates what has become known as “the anthropological halt”, described with great lucidity by C. S. Lewis in his book The Abolition of Man as the neglect of the “Tao”, a not very extensive body of basic axioms which enable the overall integrity of reason, both in theory and practice. One of these principles, visible to everyone and which provide the cornerstones of the Judeo-Christian tradition, is the sanctity of human life.

Purpose: This study aimed to determine the relevance of first- and high-order radiomic features derived from Diffusion-Weighted Imaging (DWI) and Apparent Diffusion Coefficient (ADC) maps for predicting treatment response in patients with Undifferentiated Pleomorphic Sarcoma (UPS).Methods: This retrospective study included 33 extremity UPS patients with pre-surgical DWI/ADC and surgical resection. Manual volumetric tumor segmentation was performed on DWI/ADC maps acquired at Baseline (BL), Post-Chemotherapy (PC), and Post-Radiation Therapy (PRT). The percentage of pathology-assessed treatment effect (PATE) in surgical specimens categorized patients into responders (R; PATE ≥ 90%; 16 patients), partial-responders (PR; 89% - 31% PATE; 10 patients), and non-responders (NR; PATE ≤ 30%; 7 patients). 107 radiomic features were extracted from BL, PC, and PRT ADC maps. Statistical analyses compared R vs. PR/NR.Results: Pseudo-progression at PC and universal stability at PRT were observed in R and PR/NR based on RECIST, WHO, and volumetric assessments. At PRT, responders displayed a 35% increase in ADC mean (p = 0.0034), a 136% decrease in skewness (p = 0.0001), and a 363% increase in the 90th percentile proportion (p = 0.0009). Comparing R vs. PR/NR at BL, statistically significant differences were observed in glrlm_highgraylevelrunemphasis (p = 0.0081), glrlm_shortrunhighgraylevelemphasis (p = 0.0138), gldm_highgraylevelemphasis (p = 0.0138), glcm_sumaverage (p = 0.0164), glcm_jointaverage (p = 0.0164), and glcm_autocorrelation (p = 0.0193). At PC, firstorder_meanabsolutedeviation (p = 0.0078), firstorder_interquartilerange (p = 0.0109), firstorder_variance (p = 0.0109),    and firstorder_robustmeanabsolutedeviation (p = 0.0151) provided statistically significant differences.Conclusion: Observing a high post-therapeutic ADC mean, low skewness, and high 90th percentile proportion with respect to baseline is predictive of successfully treated UPS patients presenting > 90% PATE. Highly significant higher-order radiomic results include glrlm-highgraylevelrunemphasis (BL) and first-order-mean absolute deviation (PC).

In the context of the global pandemic, public health screening has become paramount as the whole world including developed countries is going through a health crisis. A face mask prevents transpiration and protects against airborne transmitted bacteria or viruses. In the previous scenario of coronavirus, it was critical to eradicate this sickness and preserve our lives. Hence, prevention is better than cure becomes true. Accordingly, many precautionary measures were taken to reduce the spread of the virus. One such method of prevention is wearing a mask and regular monitoring of body temperature. This research dealt with the design and construction of an automatic entry barrier machine that integrates both facemask detection and scanning of individuals exhibiting elevated body temperature functionalities without any human interference. This was accomplished by simulating and synergizing a microprocessor (Raspberry Pi 3 Model B+), a Pi camera, an Infrared Non-contact Temperature sensor, a servo motor, and other components. The barrier arm opens and allows entrance at normal temperature by indicating a green light, displaying ‘allow’ on the LCD, and signaling once or preventing entrance at an elevated unacceptable temperature by indicating a red light, displaying ‘not allowed’ on the LCD, and signaling five (5) times.

Previous clinical, observation and epidemiologic studies have demonstrated strong association between serum uric acid (SUA) and cardiovascular disease (hypertension, heart failure, and asymptomatic atherosclerosis), metabolic states (abdominal obesity, diabetes mellitus, metabolic syndrome, insulin resistance) and kidney disease. There is a large body of evidence regarding the role of SUA as predictor of CV events and CV mortality in general population and individuals with established CV disease and metabolic diseases. However, SUA may exhibit protective effects on endothelium and vasculature as well as attenuate endogenous repair system through mobbing and differentiation of cell precursors. Although SUA lowering drugs are widely used in patients with symptomatic hyperuricemia and gout beyond their etiologies, there is no agreement of SUA below target level 6.0 mg/dL in asymptomatic individuals with kidney injury and CV disease and data of ones are sufficiently limited. The short communication is depicted on the controversial role of SUA as primary cell toxicity agent and secondary cell protector against hypoxia, ischemia and apoptosis

Bartholinitis, or Bartholin's gland abscess, is a relatively common gynecological condition among women of reproductive age. Its annual incidence is estimated at approximately 0.5 per 1,000 women, which corresponds to a lifetime cumulative risk of about 2%. The condition primarily affects patients between 20 and 50 years old, with a peak frequency observed between 35 and 50 years.After menopause, due to the natural involution of the gland, Bartholin's cysts and abscesses become less frequent, although they can still occur. Moreover, in women over 50, the appearance of a new mass in the gland region should prompt caution, as it may, in rare cases, indicate a carcinoma of the Bartholin's gland or an adjacent vulvar cancer. Therefore, for patients over 40 presenting with a newly emerged cyst or abscess, clinical guidelines recommend performing a biopsy or excision to rule out malignancy. We present the case of a 50-year-old woman with no significant medical history, who was urgently referred to the gynecological emergency department due to confusion, unexplained fever of 40 °C, and resistant leucorrhoea following a week of corticosteroid antibiotic therapy. Clinical examination revealed a large, tender right vulvar mass, indicative of an acute Bartholin's abscess. The patient exhibited signs of septic shock and was admitted to the ICU. Following a diagnosis of sepsis, broad-spectrum antibiotic therapy was initiated, alongside fluid resuscitation and norepinephrine support. Surgical drainage of the abscess confirmed the presence of E. coli. The patient's condition improved rapidly, and she was discharged on postoperative day 8 with no complications. This case underscores that while Bartholin's abscess is typically benign, severe complications, including septic shock, can occur—especially in patients over 50. The appearance of a new Bartholin's region mass in older women should prompt consideration of malignancy, necessitating biopsy or excision. Recent studies compare various therapeutic approaches including simple incision and drainage, Word catheter placement, marsupialization, silver nitrate application, and complete gland excision. Each method has its advantages and drawbacks, with marsupialization offering lower recurrence rates and higher patient satisfaction in many instances. 

Two major challenges face the practicing physicians and medical community regarding the management of hypertension. First is accurate diagnosis and finding who is the truly hypertensive patient in need of life-long treatment. Second is to improve blood pressure control through addressing hypertension risk factors, adherence to treatment and frequent monitoring. - Current Challenges in Management o Accurate diagnosis of hypertension o Improving blood pressure control - What Do We Need For The Future?

Stevia is a natural sweetener that has gained attention as a potential sugar substitute for glycemic control and weight management. Extensive research has shown that high sugar consumption is linked to obesity, dental caries, and other health issues. Stevia, derived from the Stevia rebaudiana plant, offers sweetness without calories and has a favorable glycemic profile. Studies have demonstrated its effectiveness in regulating blood glucose levels and reducing overall sugar and caloric intake. Consumer attitudes suggest a positive reception of Stevia as a sugar substitute among health-conscious individuals. However, further research is needed to understand its long-term effects and consumer sentiments. Future investigations should prioritize human clinical trials, targeted studies in diabetic populations, and exploration of Stevia’s interaction with gut microbiota, among other aspects. Stevia shows promise as a health-conscious alternative in glycemic control and weight management.

Background: Supporting our adolescent people in realizing his/her self ability to reorganize and to establish a cross-linked paraspinal muscle control can be considered the most effective approach for muscle rehabilitation in adolescents affected by “AIS. Aim of this study was to evaluate the SEMG activity of paraspinal erector muscles by using an innovative dynamic and asymmetric spine brace called “BRIXIA” in the conservative treatment of patients affected by adolescent idiopathic scoliosis (AIS). Methods: Five patients affected by adolescent idiopathic scoliosis were recruited for the aim of this study in line with an informed consent and simple inclusion criteria. Each patient underwent a first task-specific evaluation at time T0 and T1 and a secondary experimental course at time T2, T3 and T4. After a first postural and total spine X-ray evaluation, recruited patients began to use our innovative spine brace called BRIXIA (time T0 and T1). During the second experimental phase, a SEMG bilateral activity of the trunk large rhomboid, the latissimus dorsi and the quadratus lumborum was investigated without spine brace, by using a common Chenêau brace and afterwards the dynamic BRIXIA spine brace, with the acquisition of the so-called RMS SEMG Ratio value. The SEMG measurements were acquired in six study conditions: a. SiRP=Sitting Resting Position; b. SiRCP=Sitting Recruiting Position with a so-called pneumothorax thrust; c. StRP = Standing Resting Position; d. StRCP = Standing Recruiting Position; e. BA = Anterior Trunk Bending; f. BARC = Anterior Trunk Recruiting Bending. At the end of this SEMG evaluation, each patient received (for a daily use around 18 hours per day) the final version of the BRXIA spine brace and began an individualized educational postural rehabilitative treatment course (time T2). At time T3 and T4 a second and third SEMG assessment was made without using a spine brace and by using BRIXIA, with each patient evaluated in a resting condition and realizing a self-made cross-linked postural correction. Finally, a functional, radiographic and postural evaluation were made to define and quantify an amelioration and modification of patients’ postural attitude at the end of a combined rehabilitative and device supported treatment. Findings: A comparative analysis of our SEMG data acquired in six study conditions showed different trends in all patients recruited proceeding from time T2 to time T5. Particularly, we observed at time T2 an homogeneous grade of paraxial muscle recruitment acquisition, expressed by the RMSsEMG ratio index, without using spine brace (53,3%) and by using Chêneau and BRIXIA brace (46,7%); specifically, a 57,14% of our patients used BRIXIA brace and a 42,86% Chêneau brace; the most homogeneous response was acquired in BA study condition; a symmetric paraxial muscle recruitment acquisition without using spine brace was observed in an 80% of our patients; the most grade of not homogeneous muscle activity response was observed in SiRP and StRCP study conditions; at time T3, an homogeneous grade of symmetric paraxial muscle recruitment activity, expressed by the RMSsEMG ratio index, was observed by using BRIXIA brace (56,7%); all patients recruited (100%) showed in SiRCP study condition the most homogeneous and symmetric paraxial muscle recruitment by using BRIXIA brace; in SiRP and StRCP study condition this trend was observed in an 80% of our patients with a reversion of this trend in StRP and BRAC conditions; at time T4, an immodification of the grade of symmetric paraxial muscle recruitment acquisition, expressed by the RMSsEMG ratio index, was observed in a 56,7% of patients who were using BRIXIA brace; all patients recruited (100%) showed in BARC study condition the most homogeneous and symmetric paraxial muscle recruitment by using BRIXIA brace, while in SiRP condition this trend was observed in an 80% of our patients. In a comparative and time-related analysis between our clinical and RMS data, Cobb angle trend showed a statistical significant correlation with RMS data, acquired at time T4 in BARC condition and without BRIXIA brace, and similarly with RMS data acquired at time T4 with BRIXIA brace. In line with the Visual Postural Analysis trend, our rehabilitative model showed a sensible capacity to modify patient’s individual sense of posturality, to increase the acquisition of cross-linked self-correction strategies and to induce a progressive rebalancing between the anterior and posterior kinetic muscle chains recruitment. These rehabilitative principles were perfectly in line with the perceptive and pro-rehabilitative value of our innovative BRIXIA brace. Interpretation: This study will underline the professional attitude of all physiotherapists to use in a critical and task-specific way our dynamic and asymmetric spine orthesis called “BRIXIA”. This innovative brace allows to achieve: a. an individualized peripheral neuromodulation of patient’s sense of postural attitude (peripheral perceptive re-modulation of paraxial muscle recruitment); b. a neurorehabilitative re-learning device of postural self-correction strategies (peripheral neurosensitive facilitation of a dynamic process of motor corticalization device-related); c. an increase of patient’s quality of life in term of appearance and relational sense (life-impact device-related).

Background: Proximal humerus fractures (PHFs) are common injuries particularly in older adults. Evidence-based protocols for PHF rehabilitation are lacking and physiotherapists use a variety of interventions. Purpose: To determine practice patterns and perceptions of physiotherapists who treat adults with PHF in Ontario, Canada. Method: A paper and pencil survey asking about respondent demographics and management of Neer Group 1 (minimally/nondisplaced) and complex (displaced 3- and 4-part) PHF was mailed to 875 randomly selected physiotherapists who were registered with the College of Physiotherapists of Ontario in 2013/2014 and working in practice areas likely to be accessed by adults with PHF. Results: The response rate was low (10%); 83 physiotherapists completed the survey - 80% had experience managing PHF. Respondents treated 1-5 individuals with PHF annually; more treated Neer Group 1 PHF (89%) than complex PHF (68%). Most individuals with PHF were older than 60 years (64%), female (76%) and accessed physiotherapy through a doctor’s referral (91%) more than 1 month post injury (33%). Main findings: Physiotherapists manage PHF using multi-component interventions and a minimum of 76% include the following elements: education and progression of passive, active assisted, active range of motion exercises and muscle retraining to build coordination and strength. Use of other elements was variable. The main factors influencing the treatment plan were the ability of the individual with PHF to comply, bone quality, and fracture type. Most respondents were unsure that there is sufficient PHF rehabilitation literature to guide treatment. Conclusions:This environmental scan is the first North American study to document practice patterns and attitudes of physiotherapists providing PHF rehabilitation. Elements used by physiotherapists in Ontario treating small numbers of individuals with Neer Group 1 or complex PHFs each year align well with the limited PHF rehabilitation literature available. Potential implications:Multi-disciplinary collaborations to design and conduct large, high quality, multi-centre prognostic studies and RCTs that evaluate the effectiveness of key aspects of non-surgical PHF rehabilitation in various patient groups are needed. Meanwhile, consensus guidelines should be developed in the context of region-specific physiotherapy service models to inform best practice in PHF rehabilitation management.