In this report, we describe a rare clinical presentation of a 56-year-old asymptomatic female patient who was diagnosed with a right upper lobe pulmonary mass during a routine chest CT scan. Further examination was conducted using a CT-guided biopsy, which revealed the mass to be a plasmacytoma. Serological and electrophoretic analyses indicated elevated levels of gamma-globulin and M-protein, with IgG λ M-protein positivity. A bone scan and subsequent CT-guided bone biopsy confirmed the presence of plasmacytoma, and genetic analysis revealed 17p deletion and 1q21 amplification.

The patient was treated with a combination chemotherapy regimen consisting of bortezomib, dexamethasone, and thalidomide. Following four cycles of chemotherapy, the pulmonary mass was resolved completely, and the patient achieved stringent complete remission based on comprehensive blood and bone marrow analyses.

Extramedullary plasmacytomas (EMPs) are relatively uncommon, occurring in approximately 7%-18% of multiple myeloma patients. Pulmonary plasmacytoma, in particular, is a rare occurrence. While thalidomide has demonstrated limited efficacy in managing EMPs, our patient responded remarkably to the combined chemotherapy regimen.

This case highlights the importance of prompt diagnosis and effective treatment strategies for such rare presentations of plasmacytoma. Early detection and appropriate management can lead to favorable outcomes, as demonstrated in this case. Further research is needed to explore the efficacy of combined chemotherapy regimens in managing rare presentations of plasmacytoma and to identify optimal treatment strategies for these patients.

This study aimed to investigate the association between the plasma levels of high-mobility group box-1 (HMGB-1) and galectin-9 (Gal-9) and patient outcomes in severe trauma cases. We conducted a prospective observational study involving 78 patients with severe trauma admitted to a tertiary care emergency center, including 10 patients who died within 28 days post-admission. Blood samples were collected on days 1, 2, 3, 5, and 7 after admission, measuring plasma HMGB-1 and Gal-9 levels. HMGB-1 was highest on day 1, followed by a rapid decline within 24 hours, remaining elevated compared to normal levels. Conversely, Gal-9 peaked on day 1 but returned to normal within 48 hours. HMGB-1 levels demonstrated a significant ability to distinguish between survivors and non-survivors, with a moderate diagnostic power (AUC 0.7213), as shown by the receiver-operating characteristic (ROC) analysis. Combining HMGB-1 with other biomarkers, such as lactate and base excess, improved the specificity, indicating the potential utility of HMGB-1 as a prognostic biomarker for trauma-related mortality. Gal-9, however, showed no predictive value for patient outcomes in this cohort. These findings suggest that while HMGB-1 holds promise as a biomarker for assessing mortality risk in trauma patients, Gal-9 in its full-length form may not be suitable for prognostic use. Further studies with a larger patient sample are recommended to validate these findings and explore the use of specific molecular forms of HMGB-1 and Gal-9 in clinical settings.

Introduction: Head and neck squamous cell carcinoma (HNSCC) is a common and challenging malignancy, showing limited response rates to immune checkpoint inhibitors (ICIs). Accurate blood-based biomarkers for predicting responses to immunotherapy are urgently needed, particularly to aid in stratifying patients in neoadjuvant settings.

Methods: Baseline peripheral blood samples were collected from 52 newly diagnosed HNSCC patients undergoing neoadjuvant ICI therapy. Immune cell phenotypes were assessed using flow cytometry across three staining panels: Panel A (CD3, CD4, CD8, PD-1, CD28, HLA-DR), Panel B (CD3, CD4, CD8, KLRG-1, CD57), and Panel C (CD3, CD4, CD8, CD45RA, CCR7, CD28, CD38). Retrospective analysis included routine blood counts, biochemical markers, and cytokine levels. The predictive accuracy of individual and combined biomarkers was evaluated using receiver operating characteristic (ROC) curve analysis.

Results: Six immune markers were significantly elevated in good responders compared to poor responders. These included four percentage-based markers—PD-1ᵈⁱᵐ/CD8⁺T (p = 0.0197), PD-1ʰⁱ/CD8⁺T (p = 0.0011), PD-1⁺/CD8⁺T (p = 0.0034), and CD28⁻PD-1⁺/CD8⁺T (p = 0.0012)—and two mean fluorescence intensity (MFI) values, HLA-DR⁺/CD8⁺T (p = 0.0415) and HLA-DR⁺/CD28⁺PD-1⁻CD8⁺T (p = 0.0425). Among the inflammation-related markers, white blood cell count (WBC, p = 0.0042), neutrophils (Neut, p = 0.0076), and C-reactive protein (CRP, p = 0.0073) were significantly higher in good responders. A combined model of CD28⁻PD-1⁺/CD8⁺ T cells and WBC achieved an area under the curve (AUC) of 0.81 (95% CI: 0.70–0.93), outperforming the Combined Positive Score (CPS) (AUC = 0.59, 95% CI: 0.43–0.76).

Conclusions: This study indicates that peripheral immune and inflammatory markers, particularly the combination of CD28⁻PD-1⁺/CD8⁺ T cells and WBCs, provide a robust predictive model for neoadjuvant immunotherapy response in HNSCC. These findings support the development of personalized treatment strategies and precision immunotherapy, ultimately aiming to enhance clinical outcomes in HNSCC patients.

Abstract

Background
Osteoarthritis (OA) is a common joint disorder impacting populations worldwide. In the United Arab Emirates (UAE), urbanization, sedentary lifestyles, and dietary habits have contributed to its growing prevalence. This study aims to assess public awareness of OA and its preventive measures in the UAE to identify knowledge gaps and emphasize the need for targeted educational interventions to promote healthier lifestyle choices.

Methods
A cross-sectional study was conducted using a self-administered online questionnaire distributed across various internet platforms. The questionnaire included demographic data, factors influencing OA prevention knowledge, and awareness of OA prevention methods and risk factors. A total of 394 individuals from the UAE participated. Data were analyzed using SPSS software, version 29.

Results
Among the 394 participants, 45.4% were aged 18–29, with a balanced gender distribution. Most were Arab non-Emiratis (57.4%), and 57.6% held undergraduate degrees. While 44.2% had low knowledge of OA, 21.8% were highly aware. Nearly all (95.7%) recognized OA as a joint disorder, and 73.6% understood the role of healthy weight in prevention, though misconceptions were present: 27.9% incorrectly believed OA affects both genders equally, and 22.8% attributed OA to weather. Awareness of advanced treatments was limited (38.8% knew about intra-articular injections). Significant associations were found between OA knowledge and age, ethnicity, education level, employment, and income.

Conclusion
Public awareness of OA and its preventive measures in the UAE is limited, with common misconceptions. Enhanced public education on OA is crucial, along with further research to assess the knowledge of this condition in the region.

Orthopedic implant technology has historically seen difficulties in attaining long-term stability and biological integration, leading to complications such as implant loosening, wear debris production, and heightened infection risk. Nanotechnology provides a revolutionary method for addressing these constraints through the introduction of materials characterized by exceptional biocompatibility, durability, and integration potential. Nanomaterials, characterized by distinctive surface topographies and elevated surface area-to-volume ratios, facilitate improved osseointegration and provide regulated medication release, thereby creating a localized therapeutic milieu surrounding the implant site. To overcome the long-standing constraints of conventional implants, such as poor osseointegration, low mechanical fixation, immunological rejection, and implant-related infections, nanotechnology is causing a revolution in the field of orthopedic research. Nanomaterials are ideally suited for orthopedic applications due to their exceptional features, including increased tribology, wear resistance, prolonged drug administration, and excellent tissue regeneration. Because of their nanoscale size, they can imitate the hierarchical structure of real bone, which in turn encourages the proliferation of cells, lowers the risk of infection, and helps with the mending of bone fractures. This article will investigate the wide-ranging possibilities of nanostructured ceramics, polymers, metals, and carbon materials in bone tissue engineering, diagnostics, and the treatment of implant-related infections, bone malignancies, and bone healing. In addition, this paper will provide a basic overview of the most recent discoveries in nanotechnology driving the future of translational orthopedic research. It will also highlight safety evaluations and regulatory requirements for orthopedic devices.

Introduction: Exposure to teratogens such as alcohol, drugs, tobacco, etc. before or during pregnancy is a well-established risk factor for adverse birth outcomes, including low birth weight, preterm birth, and congenital heart disease (CHD). While maternal exposure has been extensively studied, the impact of paternal addictions on CHD risk in offspring remains underexplored, despite their potential effects on sperm quality and maternal health. This study investigates the role of paternal teratogen exposure in CHD development, with a focus on its correlation with socio-demographic and socio-economic factors.

Methods: A retrospective case–control study was conducted on children screened for CHD during 2022-2024. Data were analyzed using SPSS and MS Excel, employing ꭓ2 test, Fisher’s exact test, and multivariate logistic regression.

Results: Of the 8798 children screened, 7626 (86.7 %) were diagnosed with CHD, and 1172 were controls. Paternal addictions included alcohol (10.9 %), chewable tobacco (18.1 %), and pan-masala/supari (4.9 %). Alcohol consumption, prevalent in northeast India (p = 0.055; OR = 3.92) and among nuclear families (p < 0.001; OR = 1.76) in urban areas (p < 0.001; OR = 1.54), was linked to a reduced risk of total anomalous pulmonary venous connection [p = 0.03; OR (95 % CI) = 0.55 (0.32-0.94)]. Tobacco and pan-masala consumption was associated with nearly double the risk of cyanotic CHD (p < 0.001) and complex CHD manifestations (p < 0.05), particularly in families from eastern and central India (p < 0.05) with low socio-economic status (p = 0.04; OR = 19.43), and contributed to low birth weight (p = 0.003; OR = 1.25).

Conclusion: Our study highlights the significant role of paternal addiction in CHD prognosis, revealing critical socio-economic and regional risk factors. It underscores the need for targeted preventive strategies and further research on paternal teratogen exposure and its impact on offspring health.

Introduction:

Bell's palsy is a neurological disorder characterized by sudden unilateral facial paralysis, primarily affecting individuals aged 15 to 40, with a lifetime risk of approximately 1 in 60. Symptoms include facial weakness, pain around the ear, and altered taste, often resulting from herpes simplex virus reactivation. Around one-third of patients may experience incomplete recovery, leading to long-term complications such as synkinesis and facial asymmetry. This study investigates the efficacy of hyperbaric oxygen therapy (HBOT) as an adjunct treatment alongside corticosteroids in enhancing recovery outcomes in patients with moderate to severe Bell's palsy.

Methods:

The case series included four patients (n=4) with moderate to severe Bell's palsy, each initially assessed using the House–Brackmann (HB) scale. Treatment involved corticosteroids (Prednisolone 60 mg daily for five days, followed by tapering) and antiviral medications (Valacyclovir 1 g three times daily for 5-7 days), combined with daily HBOT sessions at 2.0 to 2.5 ATA for 90 minutes. Vital signs were monitored throughout treatment.

Results:

The results indicated improvements in facial nerve function, measured using the HB scale. Specifically, patient scores improved from an initial range of 3 to 5 over treatment durations of 5 to 11 days. The average improvement across 4 patients was 1.5 HB grades, with greater benefits observed in the patient with a higher initial score.

Discussion:

The findings suggest that combining corticosteroids, antivirals, and HBOT can significantly enhance recovery from Bell's palsy. The most improvement was noted in the patient with severe initial dysfunction (HB score of 5), indicating that HBOT may be particularly beneficial in severe dysfunction.

Conclusion:

The combination of corticosteroids, antiviral therapy and HBOT appears promising in accelerating recovery from Bell's palsy, warranting further investigation through large multicentric controlled trials to establish HBOT as a standard adjunct therapy in clinical practice.

INTRODUCTION

Increased circulating galectin-9 (Gal-9) is associated with COVID-19 severity. Gal-9 structurally consists of two homologous carbohydrate-recognition domains (NCRD and CCRD) linked by a linker peptide highly susceptible to proteolysis. Plasma Gal-9 NCRD with an attached truncated linker peptide (N-cleaved-Gal9) is a severity marker for COVID-19, indicating higher AUC than full-length (FL)-Gal9. This study aims to determine whether N-cleaved-Gal9 in plasma on admission serve as a reliable predictor of the hospitalization period in COVID-19.

METHODS

We examined 44 COVID-19 patients admitted to Sendai City Hospital. FL-Gal-9 ELISA and Tr-Gal9 ELISA measured FL-Gal9 and both Gal-9 containing NCRD (FL-Gal9 and N-cleaved-Gal9), respectively. N-cleaved-Gal9 levels were calculated by subtracting FL-Gal9 levels from Tr-Gal9 levels. The time course of FL-Gal-9 and N-cleaved-Gal9 levels from the day of admission to after discharge were monitored.

RESULTS

FL-Gal-9 and N-cleaved-Gal9 levels on admission positively correlated with the hospitalization period (r = 0.3964 and 0.5676, respectively). N-cleaved-Gal9 levels on admission in the hospitalization ≥ 7 days group were higher than those in the hospitalization ≤ 6 days and the levels in both groups converged to the same extent at discharge and after. N-cleaved-Gal9 (AUC = 0.7900) but not FL-Gal9 on admission significantly discriminated both groups, whereas CRP and P/F ratio on admission indicated AUC values of 0.7727 and 0.8268, respectively. The sensitivity of N-cleaved-Gal9 was higher than that of CRP. N-cleaved-Gal9 levels positively correlated with CRP levels during hospitalization but not at discharge and after suggesting Gal9 proteolysis is upregulated along with abnormal CRP. N-cleaved-Gal9 levels negatively correlated with P/F ratio only on admission, suggesting that Gal-9 proteolysis is associated with respiratory failure.

CONCLUSION

Plasma N-cleaved-Gal9 on admission predicted the hospitalization period more accurately than CRP in COVID-19 and demonstrated its performance by simultaneously measuring the CRP and P/F ratio. These findings contribute to the management of prognosis in COVID-19 although larger, more diverse cohorts are needed to validate the findings.

Uterine leiomyomas (ULs), commonly known as fibroids, are the most prevalent benign tumors affecting the smooth muscle of the uterus, impacting up to 60% of women of reproductive age. Emerging studies indicate an association between VDR polymorphisms and various cancers of the female reproductive system, including breast, ovarian, cervical, endometrial, uterine, and vaginal cancers. In relation to uterine fibroids, several gene polymorphisms exist, including those within the VDR gene. This study seeks to examine the influence of Fokl variants of the VDR gene—specifically focusing on susceptibility to ULs and their effects on VDR mRNA and serum vitamin D concentrations. A total of 200 participants, including 100 cases of UL and 100 controls matched for age and gender, underwent genotyping using TETRA ARMS PCR, followed by Sanger sequencing validation. Levels of VDR mRNA and vitamin D were also assessed through quantitative real-time PCR and ELISA methods, respectively. The association between this variant and leiomyomas was analyzed, along with clinico-pathological (obesity) associations. FokI exhibited a significant association with UL, especially with the CC genotype (odds ratio [OR]: 2.2; confidence interval [CI]: 1.00–4.93). VDR mRNA expression was found to be two times lower in UL patients (p < .001), along with decreased serum vitamin D levels (p < .0001). Correspondingly, homozygous genotypes of FokI were associated with lower serum vitamin D levels (p < .001). This research highlights the complex connection between VDR genetic variations, altered VDR functionality, and vitamin D metabolism in UL. Additional studies involving various populations are essential to confirm and generalize these results, potentially leading to tailored therapeutic approaches for vitamin D-associated disorders.

Adult T-cell leukemia/lymphoma (ATL) is caused by human T-cell leukemia virus type 1 (HTLV-1) after a long latent infection. HTLV-1 induces the indolent or aggressive type of leukemia in 5% of HTLV-1 carriers. The aggressive type is resistant to multi-agent chemotherapy. The indolent type often progresses to the aggressive type. Even in the most indolent cases, that is, smoldering ATL, the median survival time is 55.0 months. Natural killer (NK) cells have T-cell-like memory functions, especially in viral infections. We treated patients with ATL and its related diseases with ANK therapy, in which NK cells from the patient’s blood were expanded and amplified ex vivo and infused back into the patient. Case presentation: ANK therapy was administered to five patients, including one with acute crisis and one with HTLV-1-associated bronchioloalveolar disease (HABA).

Even in these cases of smoldering leukemia with acute crisis and HABA, their condition improved with ANK therapy, leading to complete remission (CR).

Three of these cases were in watchful waiting but had skin lesions. In the case of smoldering leukemia with acute crisis, multiple erythema was observed, and high soluble IL-2 receptor (sIL-2R) levels were elevated. The case of smoldering leukemia with HABA showed dyspnea and a decrease in pulmonary function, and a CT scan showed signs of HABA. After the ANK therapy, the five patients achieved CR and maintained CR with no other supportive care required. The NK activity of the two smoldering leukemia patients showed a higher value compared to that of healthy controls even after a long period of time. These results indicate the possibility that ANK cells kill ATL cells and/or improve the dysregulation of the cytokine network induced by the ATL cells by inducing a memory-like NK function and maintaining high NK activity to prevent the risk of the relapse.