Objective. In this pilot study, we aimed to analyze the blood irisin levels in relation to glucose and mineral metabolism assays in menopausal women with non-diabetic altered glucose regulation: impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Methods. This was a prospective, transversal, non-interventional, bi-centric (bi-country) study, between December 2024 and October 2025. Results. The patients (N=47) with IGT (N=21) or IFG (N=26) had a similar age (63±9.24 versus 63.46±8.16years, p=0.856), menopause duration (14.05±9.37 versus 16.76±8.07years, p=0.297), and body mass index with mean values within the obesity range (34.84±5.07 versus 31.34±6.46kg/sqm, p=0.765). Average 25-hydroxyvitamin D showed an insufficiency (28.62±8.09 versus 28.06± 6.99ng/mL). The IGT versus IFG group were found with statistically significantly higher 1-hour glycaemia in the oral glucose tolerance test (207.04±34.72 versus 179.40±33.91mg/dL, p=0.009), 2-hour insulin (101.44±67.26 versus 48.97±34.35 µUI/mL, p=001), fasting insulin (13.00±7.38 versus 8.36±3.96µUI/mL, p=0.008); HOMA-IR (3.53±2.32 versus 2.27±1.17; p=0.21) with mean levels sustaining insulin resistance. Conclusion. Circulating irisin was marginally elevated in the IGT versus the IFG group and positively correlated with body mass index in both. We found no correlation with the glucose profile, but with selective mineral metabolism assays. This pilot study requires an expansion of the sample size to pinpoint the potential practical utility of irisin as a biomarker.
Cone-beam computed tomography (CBCT) has expanded from dento-maxillofacial radiology to otorhinolaryngology, being proposed as a low-dose alternative to multidetector computed tomography (MDCT) for evaluating uncomplicated sinonasal disease and for surgical planning. Major guidelines (EPOS, ICAR-RS, ACR) recommend native high-resolution CT for bone and MRI for loco- regional complications, while the role of CBCT remains focused on bone anatomy and the oro-sinusal interface. The objective of this review was to systematically synthesize the evidence on the diagnostic performance, radiation dose, indications/contraindications, and limitations of CBCT in sinonasal pathology, and to propose a practical algorithm for its use. The methodology consisted of searching PubMed/Medline and “gray” literature (professional society positions, guidelines) until September 2025; relevant guidelines/consensuses and original/comparative studies reporting the utility of CBCT for rhinosinusitis (acute/chronic), odontogenic sinusitis, fungal pathology, anatomical variations, pre- and intraoperative planning, doses/technical parameters were included. Papers focused exclusively on non-sinonasal pathology or on contrast-enhanced CBCT were excluded. The synthesis is narrative, oriented towards clinical questions. The key results were: (1) CBCT provides an excellent representation of the bone anatomy of the osteomeatal complex, with superior spatial resolution to MDCT, but with clearly inferior tissue contrast (limiting the evaluation of complications, soft tissues, and perisinusal extension); (2) the effective dose of CBCT for sinuses typically varies ~0.05–0.48 mSv depending on the protocol/FOV, usually below conventional MDCT, but not consistently below ultra-low-dose MDCT or photon- counting CT (PCCT) protocols, which can achieve even lower doses with superior image quality; (3) tor uncomplicated chronic rhinosinusitis (CRS), CBCT correlates well with endoscopy and is adequate for scoring (e.g., LM analog), assessing anatomical variations, and planning FESS; for orbital/intracranial complications, suspected tumors, or invasive fungal rhinosinusitis, CBCT does not replace CT/MRI; (4) In odontogenic sinusitis (ODS), CBCT is the first-line investigation because it finely delineates dental pathology, oro-antral defects, and foreign bodies, and consensus recommendations support its use guided by indications; (5) Intrinsic limitations: poor tissue contrast, uncalibrated/unreliable HU values, metal artifacts, and sometimes restrictive FOV; (6) In the clinical setting, “point-of-care” CBCT shortens the diagnostic pathway and can reduce costs/delays, but careful case selection and adherence to the justification principle are essential. In conclusion, CBCT has robust diagnostic value for uncomplicated rhinosinusal disease and for the dento-sinusal interface, with the advantage of dose and access, but it does not substitute MDCT/MRI in risk/complication scenarios. Responsible implementation, according to guidelines and radioprotection principles, maximizes benefits and minimizes risks.
Objective: To analyze the psychological impact of exposure to conflict zones on active-duty soldiers and to evaluate the role of physical activity as a mitigating factor against stress-related effects. Background: Combat exposure is associated with increased psychological stress, sleep disturbances, and reduced well-being among military personnel. Understanding modifiable protective factors like physical activity is crucial for improving resilience and mental health in operational settings. Method: A total of 261 male Colombian Army personnel participated in the study. Standardized psychological scales (STAI, LES, UCLA Loneliness Scale, AAQ-II, PSS-14) and custom questionnaires assessing sleep, happiness, and physical activity were used. Statistical analyses included t-tests and ANOVAs to examine group differences and correlations. Results: Soldiers exposed to traumatic events or prolonged time in red zones reported significantly lower sleep quality and happiness levels. Those engaging in more than 120 minutes of physical activity per day reported significantly lower perceived stress scores compared to less active peers. Conclusion: Exposure to conflict zones adversely affects psychological well-being, particularly in sleep quality and happiness. However, increased physical activity is associated with lower perceived stress, suggesting its protective role. Application: These findings support the integration of structured physical activity programs as a practical and scalable intervention to promote resilience and reduce stress among active- duty military personnel.
Background: The COVID-19 pandemic exposed substantial shortcomings in emergency hospital systems, demonstrating that conventional linear models fail to accurately depict the intricate interdependencies among clinical, operational, and infrastructural components. This research employs nonlinear and fractal analytical frameworks to characterize and forecast the dynamic behavior of the principal emergency clinical hospital in Iași, Romania, for the years 2020–2022. Methods: The study employed a mixed-methods approach, combining retrospective analysis of hospital risk factors (infection rates, staff absenteeism, and ICU occupancy) with computational simulations. We analyzed time-series data using several nonlinear metrics, including the Higuchi fractal dimension, Lyapunov exponents, Shannon entropy, and multifractal detrended fluctuation analysis (MF-DFA). A modified Lotka–Volterra system was utilized to simulate feedback mechanisms between clinical and operational stressors. Results: The analyzed variables demonstrated nonlinear dynamics and fractal self-similarity across temporal scales (Hurst exponent = 0.73 ± 0.04; D_H = 1.35–1.49). Positive Lyapunov exponents (λ > 0) indicated deterministic chaotic behavior, whereas the multifractal spectrum width (Δα ≈ 0.62) indicated heterogeneous scaling patterns across hospital departments. Increasing fractal complexity was closely associated with diminished clinical efficiency and staff availability. Conclusions: The progression of pandemic-related risk followed a trajectory consistent with self-organized criticality, transitioning from stable to oscillatory and ultimately to chaotic phases as system load intensified. Adding nonlinear markers such as fractal dimension, Lyapunov exponents, entropy, and multifractal parameters to hospital monitoring systems could improve early warning systems and make it easier for healthcare organizations near critical thresholds to manage risk
Mental health stigma (MHS) among military personnel requires a complex approach, as it is influenced by ethical challenges and organizational norms distinct from those in civilian milieus. Stigmatization encompasses multiple dimensions -including social, self, anticipated, cultural, and structural stigma- that must also be examined within military settings. This article presents a conceptual analysis of key research directions in the field of MHS, based on a literature review conducted across three electronic databases (PubMed, Google Scholar, and Clarivate/Web of Science), from the inception of each database up to June 2025. The review focuses on active-duty service members and veterans, and identified six major domains involving MHS: (1) structural stigma within military contexts, (2) risk factors and consequences associated with MHS, (3) self-stigma among active-duty personnel and veterans, (4) the role of military healthcare providers in mitigating stigma, (5) military sexual trauma and its relationship to stigma, and (6) interventions aimed at decreasing MHS among military personnel. Although relevant primary and secondary studies were identified across these domains, significant research gaps remain, particularly in the last three areas. Addressing MHS in military populations is essential not only for improving quality of life, psychological well-being, and daily functioning, but also for maintaining combat readiness, unit cohesion, and peer acceptance.
Loneliness is receiving more and more attention for being an important psychosocial contributor to the deterioration of quality of life, psychological well-being, onset of mental health disorders, but also to the increased mortality and morbidity, through the mediation of general health problems and suicide. While studies on the impact of loneliness in the civilian population have been steadily increasing in number over the past decade, research on the same phenomenon in military settings has progressed at a comparatively slower pace. This article is a two-stage analysis of the perceived lack of social connectedness among active-duty and former military personnel, including (1) a conceptual exploration and literature review based on searches in three electronic databases (PubMed, Google Scholar, and Web of Science/Clarivate), and (2) a pragmatical set of recommended strategies to reduce the impact of loneliness in these populations. Based on the review of 42 primary and secondary sources, the paper explores the prevalence, risk and protective factors, characteristics, and consequences of loneliness, with particular attention to various minorities, female military personnel experiencing motherhood during active duty, civilian spouses of deployed service members, and other significant subgroups. Recommended directions of interventions are threefold, i.e., screening for loneliness and its risk factors, initiation of prophylactic strategies and therapeutic interventions targeting this phenomenon in vulnerable categories. In conclusion, further research on loneliness in both active and former military personnel is strongly warranted, given its significant consequences for multiple dimensions of health and overall functioning.
Uncomplicated and small lesions (under 5cm) CE1,2 and 3 can be treated with oral albendazole (10- 15mg/kg/day) and close monitoring. However, large CE1 and CE3 cysts need treatment with both albendazole and PAIR (percutaneous aspiration, introduction of scolicide and reaspiration), performed after initiation of albendazole. Primary surgical treatment has been replaced with less invasive methods since the relapse rate can reach 20%. In patients with complicated cysts, surgery is the treatment of choice. CE4 and 5 only need to be monitored [1][3].
Periodontal disease is a chronic pathology, resulting from the action of microbial communities that become dysbiotic, accompanied by immune response impairment in periodontal tissues, leading to an inflammatory process that promotes progressive tissue destruction. Abnormal activation of nucleotide-binding oligomerization domain (NOD-), leucine-rich repeat (LRR-), and pyrin domain (PYD)-containing protein 3 (NLRP3) promotes chronic inflammation. Research shows that leptin and oxidative stress (OS) are involved in the activation of the inflammatory pathways, including the activation of the NLRP3 inflammasome. In this context, the main objective of our study was to determine the levels of the NLRP3, leptin, and total antioxidant capacity (TAC) in the saliva of patients with periodontal disease. The present cross-sectional study included 44 patients with periodontitis, while the control group was represented by 19 clinically and biologically healthy adults. Saliva samples were collected from all participants in the study, and salivary levels of NLRP3, leptin, and TAC were determined using the Enzyme-linked immunosorbent assay (ELISA) and commercial kits. The results show that NLRP3 had statistically significantly increased levels in the study group versus the control group (p< 0.00001). Although TAC was also increased in the patients compared to the healthy subjects (p=0.491), no statistically significant differences were found. On the other hand, leptin levels were significantly lower in periodontitis patients compared to the control group (p< 0.00001). The results obtained in the present study are promising, but further studies are needed to obtain a more comprehensive understanding of the complex molecular mechanisms underlying periodontal disease.
Background Medical rescue transfer and handover in manned spaceflight is a critical component of space rescue operations, directly impacting the safety and well-being of astronauts. Objective This study aims to develop a comprehensive checklist for the medical rescue transfer and handover processes associated with manned spaceflight, thereby enhancing the efficiency of these procedures. Methods The checklist was designed and implemented during practical training sessions focused on manned space medical rescue. Participants were divided into two groups: one utilizing the checklist for transfer handover and another relying on verbal communication. Key metrics such as transfer time, quality of handover, and satisfaction scores were collected and analyzed for both groups. Results The group employing the checklist demonstrated significantly improved outcomes compared to the verbal group in terms of transfer time, quality of handover, and overall satisfaction scores (P < 0.001). Conclusion The implementation of checklist management has been shown to enhance both the efficiency and quality of transportation and handover processes, establishing a robust foundation for successfully executing manned space medical rescue missions.
