No.3 / 2025, Vol. CXXVIII, May
Multiple sclerosis (MS) is an autoimmune disease in which the myelin sheath is damaged by the body itself. Because of the symptoms and progressive forms, in most cases, patients experience recurrent depressive disorder or anxious depression disorders. Depression treatment for MS patients stands in two categories, one is psychotherapy and the other is pharmacological. This article presents the research results on customized pharmacological treatment schemes applied to a group of relapsing-remitting multiple sclerosis (RRMS) patients with moderate, or severe, depression. All of them are included in the national treatment program for multiple sclerosis and their health state is continuously monitored. The therapeutic scheme based on four different antidepressants had encouraging results, meaning that any of the antidepressants used is efficient and with the patient's good tolerance. There were no side effects that could determine interruption of the treatment. Further research development would focus on improved therapeutic plans for patients with depression disorders in relapsing-remitting multiple sclerosis.
Combat aircraft pilots operate in highly demanding environments where their expertise and psychophysiological responses impact performance. This study evaluated the acute psychophysiological effects of simulated and real combat flight maneuvers. Twelve Spanish Air Force fighter pilots (mean age = 33.08 ± 5.21 years) participated, averaging 13.25 ± 5.15 years of military service, including deployments in international missions. Various physiological and metabolic variables—isometric hand strength, lower body strength, pulmonary capacity, blood oxygen saturation, urinary hydration levels, cortisol, and blood lactate concentrations— were measured before and after both simulated and real combat flights. Results showed no statistically significant differences between real and simulated flights for most variables, including blood oxygen saturation, lactate, glucose, cortisol, urine color, and physical fitness indicators. However, glucose levels significantly decreased after simulated flights (p = 0.021), and horizontal jump performance improved post-real flights (p = 0.004). The similarity in physiological responses suggests that simulators effectively replicate real combat conditions, reinforcing their value as a safe, effective training tool. Simulators enhance pilot preparedness while minimizing exposure to combat risks. These findings contribute to aviation psychophysiology, improving training protocols and operational readiness for both military and civilian applications, ultimately optimizing pilot performance and safety in high-risk environments.
Background: Labia minora hypertrophy can lead to aesthetic dissatisfaction and functional discomfort among women, affecting their quality of life and sexual self-esteem. Traditional surgical labiaplasty techniques are effective but are associated with higher complication rates and longer recovery times. This study aims to evaluate the efficacy, safety, and patient satisfaction of laser labiaplasty as a minimally invasive alternative for labia minora reduction. Methods: A retrospective analysis was conducted on 60 female patients who underwent laser labiaplasty. Preoperative assessments included medical history, gynecological examination, and patient-reported concerns. The procedure utilized a CO₂ laser for tissue excision without the need for sutures. Postoperative outcomes were evaluated through follow-up visits and telephone interviews, focusing on complications, recovery time, and patient satisfaction measured by the Subjective Global Aesthetic Improvement Scale (sGAIS). Results: The primary motivations for surgery were aesthetic concerns (85%) and functional discomfort (55%). The mean age was 34.7 years. Minor complications included transient postoperative bleeding (10%) and mild discomfort (25%), with no major complications reported. High satisfaction rates were observed, with 92% of patients reporting significant improvement (sGAIS scores of 4 or 5). Conclusions: Laser labiaplasty is an effective, minimally invasive procedure with high patient satisfaction and low complication rates. It offers a viable alternative to traditional surgical methods for women seeking labia minora reduction due to aesthetic or functional concerns.
Transcatheter valve-in-valve implantation in failing bioprosthesis is an emerging field in cardio-vascular surgery and cardiology. If a valve plasty is not possible, a biological valve is implanted with limited durability. Due to valve degeneration repeated valve exchanges are necessary in some patients. To expand the lifetime of a bioprosthesis in the tricuspid position percutaneous transcatheter valve-in-valve implantation was introduced recently. This is a promising new catheter interventional technology. There are no published outcomes of repeat surgical, but overall early mortality after tricuspid valve replacement (TVR) was 37% in patients undergoing TVR after prior tricuspid valve (TV) repair. The off-label use of transcatheter aortic valve prostheses for tri-cuspid valve– in–valve implantation within dysfunctional surgical tricuspid valve bioprosthesis has been described in small reports but has become of interest nowadays.
With the increase of the medium lifespan in developing countries, skin aging rise attention more and more. In 2007, Kaya and Saurat rebranded the extreme expression of skin fragility under the name of ‘‘dermatoporosis’’ or chronic cutaneous insufficiency/fragility syndrome. Dermatoporosis is still underused in medical literature and nurses and wound specialists know also about this condition, but they call it “skin tears”. There is obvious confusion cause the nursing literature talks about skin tears while dermatologists write about dermatoporosis. Clinical aspects comprise atrophy, purpura, and pseudo-stellate scars. Firstly, the British dermatologist Thomas Bateman described senile purpura in 1818 as purpuric patches arising in elderly people after minimal trauma, especially on the dorsum of the hands. Furthermore, between 1970 and the full documentation of Kaya and Saurat in 2007, we found medical papers about senile purpura, pseudoscars, skin tears, and so on. Starting from this historical data, they bring valuable information according to clinical aspects, histopathology, ultrasonographic aspects, pathophysiology, and therapeutics. This paper aims to analyze published data for improving the diagnosis and management of dermatoporosis.
Clinical research is the cornerstone of the progress recorded in psychiatry in the last six decades, or of what is called the psychopharmacological revolution. Regardless of the stage of clinical research, there are sensitive ethical and legal aspects that may appear during this process, and such challenges have to be acknowledged in order to preserve its scientific value, integrity, and centered-on-the-patient-wellbeing core principles. Also, adequate strategies focused on preventing the risk of ethical misconduct and litigation have to be found to avoid a loss of trust in the results of clinical research, to protect vulnerable populations from abuse, and to ensure a legally stable environment for investigators. In order to explore these practical problems, a narrative review was performed through a search in PubMed and Google Scholar databases. The main ethical risks detected in clinical research were related to errors in the methodology of obtaining informed consent, monitoring the participant's safety during the clinical trial, and falsifying collected data. Several famous cases of ethical misconduct were found and analyzed, and methods to decrease the risk of the re-appearance of such problems have been listed. In conclusion, this review is an invitation to explore the complexity of the methodology of clinical research and its ethical and legal risks, as well as to find new ways to mitigate the possibility of such risks related to the research process.
A significant number of neurological diseases are pathogenetically related to oxidative stress, including but not limited to cerebrovascular afflictions such as ischemic and hemorrhagic stroke, Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, amyotrophic lateral sclerosis, and so on. Natural nutrients may help limit the impact of oxidative stress and, therefore, delay or prevent the impairment of these diseases. Although these natural components have not entered routine use, many have been studied in preclinical or even clinical settings with promising results. Therefore, the need to find the stage of the research in the field of validating the properties and clinical usefulness of such nutrients represents the main reason this narrative review was conducted. This analysis explored the PubMed database for papers related to the influence of natural nutrients on the onset and evolution of some of the most severe neurological disorders. The results of the review provide an overview of the pathways oxidative stress may undertake and how the use of nutrients may counteract these pathways. In conclusion, natural nutrients may have beneficial effects that can be impactful on clinical outcomes, but more good quality research in this field is needed before formulating any clear recommendation.
The assessment of suicide risk is a highly debated topic in the literature due to the complex interplay between social, psychological, cultural, and biological factors that contribute to the pathogenesis of self-harm. There is no unanimously accepted predictive model of suicide and no widely recognized evidence-based algorithm for psychiatric and psychological evaluation in clinical and non-clinical populations for early detection of self-harm. Therefore, this narrative review is focused on identifying the validated clinical instruments that may contribute to the construction of a possible screening and monitoring plan for suicide risk in military and civilian populations. Four electronic databases were searched (PubMed, CINAHL, Google Scholar, and Clarivate/Web of Science) for relevant reports on psychometric tools for detecting suicide risk published between the inception of each archive and January 2025. Seventeen instruments dedicated to the measurement of suicide and suicide-related aspects were reviewed, as well as three tools for the evaluation of depression severity that include specific items for assessing self-harm. The advantages and vulnerabilities of each instrument were assessed, and the particular features of using these tools in the military population were also explored. In conclusion, although a large number of validated instruments for the assessment of suicide risk exist, it is not possible to recommend the use of a single tool, either for clinical and nonclinical populations or for military and civilian personnel. The endeavor of finding an algorithm for the assessment of suicide risk is still far from reaching its end, as new psychometric instruments and possibly a new paradigm for the phenomenon of self-harm are sorely needed.
Background/Objectives: Sepsis and septic shock are critical conditions associated with high mortality rates and substantial impacts on healthcare systems. Accurate and rapid diagnosis is essential for the management of these conditions. The objective of this study is to assess the accuracy of contemporary and traditional methods for diagnosing sepsis and to determine whether improvements have been made concerning the integration of novel diagnostic approaches, to facilitate a prompt diagnosis, taking into account the rapid progression of complications associated with this disease. For this purpose, studies published between 2014 and 2024 were examined to highlight the benefits and limitations of each approach. Methods: A systematic literature review was conducted, including randomized clinical trials, observational studies, and retrospective studies assessing both conventional diagnostic methods (blood cultures and clinical scoring systems) and modern methods (rapid molecular tests, specific biomarkers, and machine learning algorithms). The studies included were selected based on strict design and methodology criteria to ensure a rigorous comparative evaluation of the interventions and technologies used in diagnosing and monitoring patients with sepsis. Results: A total of 23,822 patients were reviewed across the studies included in this systematic analysis. Modern methods, such as continuous monitoring through integrated biosensors and the use of molecular panels for pathogen detection, demonstrated high potential for the early and accurate diagnosis of sepsis. The reviewed studies suggest that these methods can significantly reduce diagnostic time and improve the ability to stratify mortality risk compared to conventional methods. Conclusions: Integrating modern diagnostic technologies, such as rapid pathogen identification tests and specific biomarkers, may complement traditional methods and bring significant benefits in the management of sepsis.
Asymptomatic bacteriuria (ABU) is a common finding in everyday clinical practice. Many patients, many of them with significant comorbidities, will present, when tested, with bacterial colonization of the urine even if they have no lower urinary tract symptoms at all. Therefore, the clinician is having a dilemma: Should I prescribe antibiotics to sterilize the urine or not? This article aims to update and eventually support physicians in the difficult decision of whether to treat or not to treat patients with ABS and when.
