Search Results (4,589)

Background/Objectives: Recently, interest in studying food addiction (FA) in the context of behavioral addictions (BAs) has increased. However, research remains limited to determine the FA prevalence among various BAs. The current study aimed to investigate FA in a clinical sample of patients seeking treatment for gaming disorder, compulsive buying-shopping disorder (CBSD), compulsive sexual behavior disorder, and the comorbid presence of multiple BAs, as well as to determine the sociodemographic characteristics, personality traits, and general psychopathology of this clinical population. In addition, we analyzed whether FA is linked to a higher mean body mass index (BMI). Methods: The sample included 209 patients (135 men and 74 women) attending a specialized behavioral addiction unit. The assessment included a semi-structured clinical interview for the diagnosis of the abovementioned BAs, in addition to self-reported psychometric assessments for FA (using the Yale Food Addiction Scale 2. 0, YFAS-2), CBSD (using the Pathological Buying Screener, PBS), general psychopathology (using the Symptom Checklist-Revised, SCL-90-R), personality traits (using the Temperament and Character Inventory-Revised, TCI-R), emotional regulation (using Difficulties in Emotion Regulation Strategies, DERS), and impulsivity (using Impulsive Behavior Scale, UPPS-P). The comparison between the groups for the clinical profile was performed using logistic regression (categorical variables) and analysis of covariance (ANCOVA), adjusted based on the patients’ gender. The sociodemographic profile was based on chi-square tests for categorical variables and analysis of variance (ANOVA) for quantitative measures. Results: The prevalence of FA in the total sample was 22.49%. The highest prevalence of FA was observed in CBSD (31.3%), followed by gaming disorder (24.7%), and the comorbid presence of multiple BAs (14.3%). No group differences (FA+/−) were found in relation to sociodemographic variables, but the comorbidity between FA and any BA was associated more with females as well as having greater general psychopathology, greater emotional dysregulation, higher levels of impulsivity, and a higher mean BMI. Conclusions: The comorbidity between FA and BA is high compared to previous studies (22.49%), and it is also associated with greater severity and dysfunctionality. Emotional distress levels were high, which suggests that the group with this comorbidity may be employing FA behaviors to cope with psychological distress. However, a better understanding of the latent mechanisms that contribute to the progression of this multifaceted comorbid clinical disorder is needed. One aspect that future studies could consider is to explore the existence of FA symptoms early and routinely in patients with BAs. Full article

Changes in microRNA (miRNA) levels are closely associated with the pathological processes of many diseases. The sensitive and fast detection of miRNAs is critical for diagnosis and prognosis. Here, we report a platform employing CRISPR/Cas12a to recognize and report changes in miRNA levels while avoiding complex multi-thermal cycling procedures. A non-enzyme-dependent hybridization chain reaction (HCR) was used to convert the miRNA signal into double-stranded DNA, which contained a Cas12a activation sequence. The target sequence was amplified simply and isothermally, enabling the test to be executed at a constant temperature of 37 °C. The detection platform had the capacity to measure concentrations down to the picomolar level, and the target miRNA could be distinguished at the nanomolar level. By using photonic crystal microarrays with a stopband-matched emission spectrum of the fluorescent-quencher modified reporter, the fluorescence signal was moderately enhanced to increase the sensitivity. With this enhancement, analyzable fluorescence results were obtained in 15 min. The HCR and Cas12a cleavage processes could be conducted in a single tube by separating the two procedures into the bottom and the cap. We verified the sensitivity and specificity of this one-pot system, and both were comparable to those of the two-step method. Overall, our study produced a fast and sensitive miRNA detection platform based on a CRISPR/Cas12a system and enzyme-free HCR amplification. This platform may serve as a potential solution for miRNA detection in clinical practice. Full article

Alzheimer’s disease, an irreversible neurodegenerative disorder, manifests through the progressive deterioration of memory and cognitive functions. While magnetic resonance imaging has become an indispensable neuroimaging modality for Alzheimer’s disease diagnosis and monitoring, current diagnostic paradigms predominantly rely on single-time-point data analysis, neglecting the inherent longitudinal nature of neuroimaging applications. Therefore, in this paper, we propose a multi-task feature selection algorithm for Alzheimer’s disease classification based on longitudinal imaging and hypergraphs (THM2TFS). Our methodology establishes a multi-task learning framework where feature selection at each temporal interval is treated as an individual task within each imaging modality. To address temporal dependencies, we implement group sparse regularization with two critical components: (1) a hypergraph-induced regularization term that captures high-order structural relationships among subjects through hypergraph Laplacian modeling, and (2) a fused sparse Laplacian regularization term that encodes progressive pathological changes in brain regions across time points. The selected features are subsequently integrated via multi-kernel support vector machines for final classification. We used functional magnetic resonance imaging and structural functional magnetic resonance imaging data from Alzheimer’s Disease Neuroimaging Initiative at four different time points (baseline (T1), 6th month (T2), 12th month (T3), and 24th month (T4)) to evaluate our method. The experimental results show that the accuracy rates of 96.75%, 93.45, and 83.78 for the three groups of classification tasks (AD vs. NC, MCI vs. NC and AD vs. MCI) are obtained, respectively, which indicates that the proposed method can not only capture the relevant information between longitudinal image data well, but also the classification accuracy of Alzheimer’s disease is improved, and it helps to identify the biomarkers associated with Alzheimer’s disease. Full article

Aortic valve stenosis (AVS) is the most common valvular heart disease that was considered, for a long time, a passive degenerative disease due to physiological aging. More recently, it has been recognized as an active, modifiable disease in which many cellular processes are involved. Nevertheless, since aging remains the major risk factor for AVS, a field of research has focused on the role of early (biological) aging and its dependent pathways in the initiation and progression of AVS. Telomeres are regions at the ends of chromosomes that are critical for maintaining genome stability in eukaryotic cells. Telomeres are the hallmarks and molecular drivers of aging and age-related degenerative pathologies. Clonal hematopoiesis of indeterminate potential (CHIP), a condition caused by somatic mutations of leukemia-associated genes in individuals without hematologic abnormalities or clonal disorders, has been reported to be associated with aging. CHIP represents a new and independent risk factor in cardiovascular diseases, including AVS. Interestingly, evidence suggests a causal link between telomere biology and CHIP in several pathological disorders. In this review, we discussed the current knowledge of telomere biology and CHIP as possible mechanisms of aortic valve degeneration. We speculated on how a better understanding of the complex relationship between telomere and CHIP might provide great potential for an early diagnosis and for developing novel medical therapies to reduce the constant increasing health burden of AVS. Full article

On 24 February 2024, Italian physicians, dentists and oral care specialists, students, nurses, psychologists, dental hygienists, and other professionals met (live or online) to discuss controversial issues about medication-related osteonecrosis of the jaw (MRONJ). One section hosted international experts who gave lectures about MRONJ experiences in North America, Europe, and Italy. A second section summarized the principal points of an Italian MRONJ position paper published in February 2024 by experts from the Italian Societies of Oral Pathology and Medicine (SIPMO) and Maxillofacial Surgery (SICMF). The following section collates expert opinions about open issues and required fields of research: different definitions of MRONJ and impact on staging; the assessment of individual MRONJ risk before the start of antiresorptive therapy; surgery and implantology in patients at risk for MRONJ; cancer patients without metastases and prevention of cancer-treatment-induced bone Loss (CTIBL); the role of dental hygiene professionals; combined (medical and surgical) and surgical therapy for MRONJ in-patients and out-patients; and legal aspects and claims related to MRONJ diagnosis and treatment. Scientific contributions from hospitals and universities all over Italy were presented in specific sessions (epidemiology; case series; special case reports; prevention experiences; MRONJ treatment). Conclusions: the conference confirmed the importance of the adequate imaging study of bone in the diagnosis and staging of MRONJ cases, the role of surgery in MRONJ treatment, and the value of oral hygiene in the MRONJ prevention. Full article

The pathological mechanisms underlying the ligature mark in hanging involve the skin layers and an ischemic mechanism. The apoptotic process develops whenever ischemic mechanisms affect the dermal and epidermal layers. Effector caspase-3 appears to play a crucial role in both acute and chronic pressure-induced skin ischemia. The aim of this study is to identify the role of caspase-3 as a marker of supravitality in the diagnosis of premortem hanging. Skin samples from ligature marks in hanging cases were collected to investigate this apoptotic process. The caspase-3 levels in compressed skin were significantly higher compared to those found in healthy skin (p < 0.005). The apoptotic process in ischemic epidermal cells begins with stable mechanical stress, as seen in the hanging model. Caspase-3 expression seems to vary from minutes after the initial stress input. Caspase-3 activation is an ATP-dependent process and can only occur if the victim was alive before the pressure was applied. Caspase-3 is a reliable marker of supravitality in ligature marks in premortem hanging cases. Full article

The progress of artificial intelligence (AI), particularly its core algorithms—machine learning (ML) and deep learning (DL)—has been significant in the medical field, impacting both scientific research and clinical practice. These algorithms are now capable of analyzing ultrasound images, processing them, and providing outcomes, such as determining the benignity or malignancy of thyroid nodules. This integration into ultrasound machines is referred to as computer-aided diagnosis (CAD). The use of such software extends beyond ultrasound to include cytopathological and molecular assessments, enhancing the estimation of malignancy risk. AI’s considerable potential in cancer diagnosis and prevention is evident. This article provides an overview of AI models based on ML and DL algorithms used in thyroid diagnostics. Recent studies demonstrate their effectiveness and diagnostic role in ultrasound, pathology, and molecular fields. Notable advancements include content-based image retrieval (CBIR), enhanced saliency CBIR (SE-CBIR), Restore-Generative Adversarial Networks (GANs), and Vision Transformers (ViTs). These new algorithms show remarkable results, indicating their potential as diagnostic and prognostic tools for thyroid pathology. The future trend points to these AI systems becoming the preferred choice for thyroid diagnostics. Full article

Improved image quality, better scanners, innovative software technologies, enhanced computational power, superior network connectivity, and the ease of virtual image reproduction and distribution are driving the potential use of digital pathology for diagnosis and education. Although relatively common in clinical oncology, its application in liver pathology is under development. Digital pathology and improving subjective histologic scoring systems could be essential in managing obesity-associated steatotic liver disease. The increasing use of digital pathology in analyzing liver specimens is particularly intriguing as it may offer a more detailed view of liver biology and eliminate the incomplete measurement of treatment responses in clinical trials. The objective and automated quantification of histological results may help establish standardized diagnosis, treatment, and assessment protocols, providing a foundation for personalized patient care. Our experience with artificial intelligence (AI)-based software enhances reproducibility and accuracy, enabling continuous scoring and detecting subtle changes that indicate disease progression or regression. Ongoing validation highlights the need for collaboration between pathologists and AI developers. Concurrently, automated image analysis can address issues related to the historical failure of clinical trials stemming from challenges in histologic assessment. We discuss how these novel tools can be incorporated into liver research and complement post-diagnosis scenarios where quantification is necessary, thus clarifying the evolving role of digital pathology in the field. Full article

Background: Circulating tumor DNA (ctDNA) may be released from neoplastic cells into biological fluids through apoptosis, necrosis, or active release. In patients with non-small-cell lung cancer (NSCLC), ctDNA analysis is being introduced in clinical practice only for advanced disease management. Nevertheless, an interesting and promising field of application is the analysis of ctDNA in the management of early stage non-small-cell lung cancer, both for evaluation before treatment, such as diagnosis and screening, and for prediction of histology or pathological features. Methods: A thorough review of the literature published between 2000 and 2024 was performed on PubMed, utilizing the advanced search feature to narrow down titles and abstracts containing the following keywords: ctDNA, early stage, and NSCLC. A total of 20 studies that met all inclusion criteria were chosen for this review. Results: In this review, we summarize the increasing evidence suggesting that ctDNA has potential clinical applications in the management of patients with early stage NSCLC. ctDNA levels in early stage cancers are very low, posing many technical challenges in improving the detection rate and sensitivity, especially in clinical practice, if it is to be implemented for early detection. Presently, the main limitation of ctDNA experimental and clinical studies, especially in early stage settings, is the lack of definitive standardization and consensus regarding methodology, the absence of systematically validated analyses, and the lack of adoption of sensitive approaches. Conclusions: Possible applications of this analyte open up new fields of diagnosis, treatment, and follow up, which are less invasive and more precise than other approaches currently in use, especially in early stage NSCLC patients. Full article

Background and Objectives: Current guidelines recommend contrast-enhanced CT/MRI as confirmatory imaging tests for diagnosing hepatocellular carcinoma (HCC). However, these modalities are not always able to differentiate HCC from benign/dysplastic nodules that are commonly observed in cirrhotic livers. Consequently, many lesions require either pathological confirmation via invasive biopsy or surveillance imaging after 3–6 months, which results in delayed diagnosis and treatment. We aimed to develop noninvasive imaging biomarkers of liver cell size and cellularity, using magnetic resonance imaging (MRI), and to assess their utility in identifying HCC. Methods: MR cytometry combines measurements of water diffusion rates over different times corresponding to probing cellular microstructure at different spatial scales. Maps of microstructural properties, such as cell size and cellularity, are derived by fitting voxel values in multiple diffusion-weighted images to a three-compartment (blood, intra-, and extracellular water) model of the MRI signal. This method was validated in two phases: (1) histology-driven simulations, utilizing segmented histological images of different liver pathologies, and (2) ex vivo MR cytometry performed on fixed human liver specimens. Results: Both simulations and ex vivo MR cytometry of fixed human liver specimens demonstrated that HCC exhibits significantly smaller cell sizes and higher cellularities compared to normal liver and cirrhotic regenerative nodules. Conclusion: This study highlights the potential of MR cytometry to differentiate HCC from non-HCC lesions by quantifying cell size and cellularity in liver tissues. Our findings provide a strong foundation for further research into the role of MR cytometry in the noninvasive early diagnosis of HCC. Full article

Background: Ultrasonography is essential for diagnosing endometrial pathologies, such as hyperplasia, polyps, and endometrial cancer. The International Endometrial Tumor Analysis (IETA) group provides guidelines for using ultrasound to assess endometrial thickness, texture, and irregularities, aiding in the diagnosis of these conditions. The aim of this study was to evaluate the utility of various endometrial morphological features, as assessed by gray-scale ultrasound, and endometrial vascular features, as assessed by power Doppler ultrasound, in differentiating benign and malignant endometrial pathologies. A secondary objective was to compare the effectiveness of these ultrasound techniques in assessing myometrial invasion. Methods: A total of 162 women, both pre- and postmenopausal, with or without abnormal vaginal bleeding were enrolled in a prospective study. All participants underwent transvaginal gray-scale and color Doppler ultrasound examinations, conducted by examiners with over 15 years of experience in gynecological ultrasonography. Endometrial morphology and vascularity characteristics were evaluated based on the IETA group criteria, which include parameters such as endometrial uniformity, echogenicity, the three-layer pattern, regularity of the endometrial–myometrial border, Doppler color score, and vascular pattern (single dominant vessel with or without branching, multiple vessels with focal or multifocal origin, scattered vessels, color splashes, and circular flow). Sonographic findings were compared with histopathological results for comprehensive assessment. Results: The mean age of the study population was 56.46 ± 10.84 years, with a range from 36 to 88 years. Approximately 53.08% of the subjects were postmenopausal. The mean endometrial thickness, as measured by transvaginal ultrasonography, was 18.02 ± 10.94 mm with a range of 5 to 64 mm (p = 0.028), and it was found to be a significant predictor of endometrial malignancy. The AUC for the ROC analysis was 0.682 (95% CI: 0.452–0.912), with a cut-off threshold of 26 mm, yielding a sensitivity of 62.5% and a specificity of 89%. Vascularization was absent in 68.4% of patients with polyps. Among the cases with submucosal myomas, 80% exhibited a circular flow pattern. Malignant lesions were identified in 22.84% of the cases. Subjective ultrasound assessment of myometrial invasion, categorized as <50% or ≥50%, corresponded in all cases with the histopathological evaluation, demonstrating the effectiveness of ultrasound in evaluating myometrial invasion in endometrial cancer. Conclusions: In this study, cystic atrophic endometrium was identified as the most prevalent cause of postmenopausal bleeding. The most significant ultrasound parameters for predicting malignancy included heterogeneous endometrial echogenicity, increased endometrial thickness, and the presence of multiple vessels with multifocal origins or scattered vascular patterns. Additionally, color Doppler blood flow mapping was demonstrated to be an effective diagnostic tool for the differential diagnosis of benign intrauterine focal lesions. Full article

Background and Clinical Significance: Men who engage in anal fisting may experience full rectal and colon thickness injury resulting in an endoscopic emergency. The endoscopist does not routinely question patients about their sexual habits, nor are patients compliant with counseling during the endoscopy procedure as indicated by the infectious disease clinician. Case Presentation: A 47-years-old HIV- and monkeypox virus (MPXV)-negative Caucasian gay man underwent colonoscopy because of changes in bowel habits with anal discomfort and rectal bleeding. The first colonoscopy showed a vegetative annular neoformation of the anal canal. There was a concentric stenosis of the lumen. The endoscopist suspected the diagnosis of anal squamous cell carcinoma and a histopathology investigation was requested. Biopsy histology excluded a frank neoplasm or anal intraepithelial neoplasia (AIN). Then, the patient was referred to a multidisciplinary team. With adequate counseling, the patient disclosed his habitual anal fisting. Laboratory identification of L1–L3 Chlamydia trachomatis (CT) genovars was positive for CT L1, L2, real-time PCR for Neisseria gonorrhoeae (NG), and Mycoplasma hominis. Human Papillomavirus (HPV)-DNA detection identified HPV type 70, 68, and 61. We illustrate this case with plenty of histology and immunohistochemistry. We also review the differential diagnosis of AIN according to the 5th edition (2019) WHO Classification of Digestive System Tumours. Conclusions: Our patient emphasizes two important aspects of endoscopy and pathology: first, the significance of understanding patients’ sexual behaviors in diagnosing rectal and colon injuries, as well as the need for sexually transmitted infections (STI) screening especially for CT; and second, the effectiveness of a multidisciplinary communication model that encourages private discussions to alleviate patients’ fears and improve prevention efforts. Full article

(1) Background: Patellar and Achilles tendon injuries have become increasingly prevalent, particularly among active populations and athletes, leading to significant functional impairments. While B-Mode ultrasound has been useful in the diagnosis of these injuries, its capacity to assess tendon mechanical properties, such as stiffness, is limited. Shear wave elastography (SWE) offers a promising alternative by measuring tissue stiffness, which may enhance the evaluation of tendon health. Previous studies have established that SWE can differentiate healthy tendons from those with pathological changes. However, reference values for specific tendon types, including the patellar and Achilles tendons, remain limited. This study aims to provide preliminary baseline SWE values for these tendons in a healthy cohort. (2) Methods: In this cross-sectional study, healthy volunteers aged 18–65, with no history of lower extremity injury, were assessed using a Samsung RS85 Prestige ultrasound system with a 14L-2 MHz transducer. SWE measurements were obtained from the patellar tendon at a single location and from the Achilles tendon at both the midportion and insertional sites. All assessments followed a standardized protocol to ensure consistency and minimize variability. (3) Results: A total of 54 healthy adult participants were included. The mean SWE value for the patellar tendon was 96.3 (SD = 10.9 kPa), with males showing significantly higher stiffness than females (99.3 kPa vs. 93.8 kPa, p = 0.009). A higher BMI was associated with lower stiffness in the patellar tendon. The mean SWE values for the Achilles tendon were 101.7 (SD = 16.2 kPa) at the insertion and 145.6 (SD = 18.8 kPa) at the midportion. (4) Conclusions: This study provides SWE values for the patellar and Achilles tendons in healthy individuals, which can serve as a foundation for future research and clinical applications. These values may help in the comparison of healthy and pathological tendons, particularly in the context of tendinopathies, tendon tears, and treatment monitoring. While shear wave elasticity shows promise as a tool for diagnosing and monitoring tendon injuries and degeneration, more research is required to establish its precise reliability and validity in clinical practice. Full article

Anorexia nervosa (AN) is a severe psychiatric disorder characterized by substantial heritability and a high mortality rate among psychiatric disorders. While cerebrospinal fluid (CSF) metabolomics has emerged as a novel approach to investigating central nervous system pathologies, its specific causal relationship with anorexia nervosa remains to be fully elucidated. Using genome-wide association study (GWAS) summary statistics for human CSF metabolites and AN information from publicly available datasets, we performed a two-sample Mendelian randomization (MR) analysis using the inverse-variance weighted (IVW) method as the primary approach, complemented by sensitivity analyses. Through a comprehensive analysis of 338 CSF metabolites, we identified six metabolites with significant causal relationships with AN risk. 1-stearoyl-2-linoleoyl-gpc (18:0/18:2) (OR = 1.09, 95% CI 1.00–1.18) and alpha-tocopherol (OR = 1.36, 95% CI 1.00–1.83) showed positive associations, increasing AN risk. Conversely, sphingomyelin (d18:1/20:0, d16:1/22:0) (OR = 0.86, 95% CI 0.77–0.95), 2,3-dihydroxy-2-methylbutyrate (OR = 0.92, 95% CI 0.86–0.98), N-acetylhistidine (OR = 0.92, 95% CI 0.86–0.98), and oxalate (ethanedioate) (OR = 0.83, 95% CI 0.73–0.94) had protective effects, reducing AN risk. Sensitivity analyses showed no evidence of horizontal pleiotropy or heterogeneity in the MR results. An MR directionality test and a Steiger filtering test confirmed the absence of reverse causality, thereby substantiating the robustness of our findings. These findings suggest that these CSF metabolites could serve as potential biomarkers for early AN detection and highlight novel therapeutic targets, potentially improving diagnosis and intervention strategies for this challenging disorder. Full article

Background: Traumatic brain injury (TBI) is one of the main causes of death in trauma pathology, especially among the youngest victims. After having evaluated the causality relationship between damage to the brain tissue and death, pathologists should try to estimate the duration between the TBI and death. Immunohistochemistry could be used in this field as a personalized medico-legal approach. This study aims to evaluate the possible role of vimentin and p53 as TBI markers to assess vitality and date the TBI. Methods: Twelve cases of TBI deaths were selected (two women and ten men, with a mean age of 46.83 years). In seven cases, death occurred immediately after the trauma, while in the others, death occurred after some days. An immunohistological study of brain samples using anti-p53 and anti-vimentin antibodies was performed. A semi-quantitative scale was adopted to grade the immunohistochemical reaction. Results: Our results showed a strong relationship between the p53 immunoreaction grade and TBI (X-squared value 10.971, p-value < 0.01), suggesting that p53 expression is enhanced in TBI cases. Vimentin is more expressed when the PTI is longer. Vimentin-immunoreaction was weaker than p53-immunoreaction (+0.75 vs. +1.83 mean values, respectively) in a group predominantly including short post-traumatic interval cases. Conclusions: The present research is limited by the small sample size; however, the molecules tested, vimentin and p53, have shown great potential to be used, in addition to others, as biological markers for the diagnosis and timing of TBI. Full article