Breast cancer remains a significant health concern, with predictions indicating a rise in global incidence. While the primary focus is on oncological radicality, the aesthetic and psychological impacts of surgical interventions, such as radical mastectomy, cannot be ignored. This study, conducted over 8 years, aimed to identify factors that can prevent unnecessary lymphadenectomy. The research analyzed various parameters, including age, BMI, tumor size, and immunohistochemistry, to determine their correlation with axillary lymph node invasion. The results highlighted the importance of tumor size and estrogen receptor status in predicting axillary lymph node metastasis. The study underscores the value of sentinel lymph node biopsy in early breast cancer treatment, emphasizing its benefits over complete axillary lymph node dissection.
Background: Cardiovascular disease can be triggered and accelerated by hypertension and the underlying changes in the structure and function of arteries. The purpose of this review is to explore some vascular changes that occur in hypertension as a consequence of the imbalance between cell proliferation and cell death, processes that play an important role in stabilizing the thickness of the arterial wall during vascular remodeling. Methods: The authors conducted research through PubMed and Google Scholar databases using the following search formula: (hypertensive*) AND ((vascular modifications)) OR (vascular changes)) AND (cell death). Results: From 40 articles, only 17 publications were included in this study, taking into account four processes that can be preceded or followed by inflammation and depend on the interaction between local growth factors, vasoactive substances, and hemodynamic stimuli: Cell proliferation and growth; Cell migration; Cell death; Degradation or reorganization of extracellular matrix. Conclusions: To summarize, maladaptive vascular changes in hypertension can represent a major argument for prompt and maximal therapeutic intervention in patients with high cardiovascular risk. Moreover, they can represent an important step in discovering new markers of cardiovascular risk and in the development of new targeted therapies for different pathways of cellular signaling through which the reversibility of abnormal vascular changes could be obtained.
Background and Aim: Abdominal compartment syndrome is a life-threatening complication that can occur in trauma patients and greatly increase their mortality. Although there is a better scientific understanding of the general phenomena involved in the pathogenesis of this complication, the particular risk factors and their implications in the trauma patient population are yet to be deciphered. Methods: The authors conducted research through 3 electronic databases (PubMed, Scopus, and ScienceDirect) using the following search formula: “(ACS OR abdominal compartment syndrome) AND (*trauma*) AND (risk factor)”. Subsequently, additional search formulas were used, including the risk factors taken into consideration (i.e. “shock”, “hypotension”, “acidosis”, “base deficit”, ”coagulopathy”, “retroperitoneal hematoma”, “HOB elevation”, “fluid resuscitation”, “damage control laparotomy”). Results: Throughout the 41 articles analyzed in this paper, 7 risk factors transcended and were further discussed: head of bed elevation/patient positioning, fluid resuscitation, the “lethal triad” of acidosis hypothermia and coagulopathy, Damage Control Laparotomy, shock/hypotension, retroperitoneal hematoma and demographics (age, gender, and race). Conclusions: To summarize, many potential risk factors were evaluated for the envisagement of the present paper, but the ones that prevailed the most were excessive fluid resuscitation, shock/hypotension, retroperitoneal hematomas, and the lethal triad. Consistent with other studies, no connection was found between age, gender, or race and the development of ACS. Further studies should focus more on the likely involvement of damage control laparotomy and patient positioning, as well as hypocalcemia, in the unfolding of ACS in trauma patients.
The interparietoperitoneal (IPP) space, by a broad definition, is the space between the musculo-fascial walls of the abdomen and the parietal peritoneum. A review of the literature on this subject has been performed through a search in the databases according to the following
Health literacy, representing the ability to understand and apply health information, is a key determinant of public health. In Eastern Europe, decades of underinvestment in health education, socioeconomic disparities, and institutional mistrust have contributed to persistently low levels of health literacy. Objective: This review synthesizes evidence on the social consequences of inadequate health literacy in Eastern Europe, focusing on behavioral, structural, and policy-related outcomes. Methods: A narrative literature review was conducted using PubMed, Scopus, Web of Science, Google Scholar and institutional reports. Studies were included if they examined health literacy, public medical education, and social outcomes in Eastern European populations. Results: The synthesis of evidence identified four major thematic domains through which inadequate health literacy is associated with negative outcomes in Eastern European populations. Low health literacy is consistently associated with preventable disease, poor health behaviors, limited uptake of preventive services, and reduced adherence to medical advice. Vulnerable groups bear a disproportionate burden. Inadequate health knowledge is also associated with increased and inappropriate healthcare utilization, delayed care-seeking, and higher rates of avoidable mortality. Furthermore, low health literacy is plausibly linked to the proliferation of health misinformation, erosion of trust in healthcare systems, and has contributed to excess mortality during public health crises such as the COVID-19 pandemic. Discussion: The observed patterns are shaped by historical and structural factors, including the postcommunist legacy of under-resourced health systems and the persistent under-prioritization of preventive care. Eastern Europe is a heterogeneous region, and the availability of health literacy data varies considerably across countries, limiting the generalizability of findings. At the clinical level, healthcare providers play a key role in identifying low health literacy, adapting communication strategies, and addressing vaccine hesitancy and misinformation. Addressing these challenges requires coordinated strategies, investment in education, culturally tailored communication, and cross-sectoral collaboration. Improving public health literacy can enhance health outcomes, reduce system costs, and strengthen societal resilience. Conclusions: This review underscores the challenges associated with health literacy in Eastern Europe, illustrating how insufficient health literacy contributes to detrimental behaviors, undermines trust in healthcare systems, exacerbates misinformation, and ultimately imposes a significant societal and systemic burden on public health.
