The value of fine needle aspiration cytology in the clinical management of rare salivary gland tumors

Salivary gland tumors are relatively rare neoplasms, mostly located in the parotid gland, and few are malignant. Preoperative evaluation of salivary gland tumors includes fine needle aspiration cytology (FNAC). Objective The purpose of this study was to determine the importance of FNAC in the evaluation of rare salivary gland neoplasms. Material and Methods Four cases of rare salivary gland tumors were included, which were preoperatively assessed by clinical investigation, computed tomography, and FNAC. Results The presented cases include myoepithelial carcinoma, oncocytic carcinoma, undifferentiated lymphoepithelial carcinoma, and marginal zone lymphoma. Conclusion FNAC is a reliable diagnostic tool for common salivary gland neoplasms; however, rare tumors often represent diagnostic challenges. Clinical relevance In such rare tumors, the role of aspiration cytology may be limited to establishing the dignity of the lesion (benign/malignant). This knowledge enables the surgeon to choose the most appropriate therapeutic procedure. A definitive diagnosis of rare tumors (either epithelial or nonepithelial) is obtained by histological examination; cytology is limited in this regard due to overlapping features

Cardiac Rehabilitation Early after Sternotomy Using New Assistive VR-Enhanced Robotic Exoskeleton—Study Protocol for a Randomised Controlled Trial

(1) Background and objective: Cardiac rehabilitation (CR) means delivering health education by structured exercises with the means of risk reduction, in a cost-effective manner. Well-conducted CR improves functional capacity, decreases re-hospitalization, and reduces mortality up to 25%. We bring to attention the protocol of a randomised control trial with the aim of validating the prototype of an assistive upper-body robotic exoskeleton system enhanced with a non-immersive virtual reality exergame (CardioVR-ReTone) in patients who undergone cardiac surgery. (2) Methods: Description of the CardioVR-ReTone system and the technical specification, followed by the group selection, randomization and evaluated variables. (3) Expected results: The primary outcome measurement is the modification of life quality at the end of the CR exercise training program. Secondary outcomes will encompass measurements of sternal stability, muscular activity, cardiac response to exercise, pain level and compliance/adherence to CR. (4) Conclusions: Implementing these novel features of the CardioVR-ReTone system, addressability, and efficacy of CR, so problematic in certain situations and especially in cardiac surgery, will be greatly facilitated, being independent of the skills and availability of the rehabilitation therapist

Upper-Limb Robotic Exoskeleton for Early Cardiac Rehabilitation Following an Open-Heart Surgery—Mathematical Modelling and Empirical Validation

Robotic exoskeletons have the potential to enhance the quality of life of patients undergoing cardiac rehabilitation. Recent studies found that the use of such devices was associated with significant improvements in physical function, mobility, and overall well-being for individuals recovering from a cardiac event. These improvements were seen across a range of measures, including cardiovascular fitness, muscle strength, and joint range of motion. In addition, the use of robotic exoskeletons may help to accelerate the rehabilitation process, allowing patients to make faster progress towards their goals. This article proposes a new robotic exoskeleton structure with 12 DOFs (6 DOFs on each arm) in a symmetrical construction for upper limbs intended to be used in the early rehabilitation of cardiac patients following open-heart surgery or a major cardiac event. The mathematical modelling and empirical validation of the robotic exoskeleton prototype are described. The matrix exponential algorithm, kinetic energy, and generalized forces were employed to overcome the problem of high complexity regarding the kinematic and dynamic model of the robotic exoskeleton. The robotic exoskeleton prototype was empirically validated by assessing its functionalities in a lab and medical environment

<i>Helicobacter pylori</i>-Positive Gastric Biopsies—Association with Clinical Predictors

Introduction: Although Helicobacter pylori’s role in gastric oncogenesis is well-known, only a fraction of infected patients develop cancer. Hence, more factors are supposed to be involved. The objectives of the present study were to investigate the impact of clinicopathological parameters on Helicobacter pylori status. Methods: The study included 1522 patients referred for endoscopy: study group consisted of 557 patients with Helicobacter pylori-positive biopsies confirmed using histochemical stains or immunohistochemistry methods; and the control group consisted of 965 patients with Helicobacter pylori-negative status on histology. Results: Severe endoscopic lesions were more frequent in the Helicobacter pylori group (p p = 0.82). Anemia and dyslipidemia were independent factors associated with Helicobacter pylori-positive biopsies (p Helicobacter pylori activity on histology (p Helicobacter pylori-positive biopsies had a more frequent history of gastrotoxic medication, severe endoscopic lesions, and anemia. Helicobacter pylori was unpredictable by gastrointestinal symptoms. The frequency of premalignant gastric lesions was similar irrespective of the actual status of infection, underlining the importance of unintentional clearance of bacteria in old infection and the remaining risk for cancer in this population

Factors Associated with Recurrent Ulcers in Patients with Gastric Surgery after More Than 15 Years: A Cross-Sectional Single-Center Study

Aim. We aimed to establish the independent predictive factors (from Helicobacter pylori infection, biliary reflux, histologic features of the gastric mucosa, drugs, comorbidities, and social habits) for gastric stump ulcer occurrence more than 15 years after surgery. Methods. 76 patients with previous gastric surgery were included: 21 patients with gastric ulcer (marginal ulcer or ulcer of the rest of the gastric remnant—study group) and 55 controls (nonulcer group). Results. Helicobacter pylori infection tended to be higher in the control group than in the ulcer group (14.5% vs. 4.8%, p=0.43), without statistical significance. Alcohol consumption had a significant positive association with ulcer (p=0.008), while smoking (p=0.064), low-dose aspirin (p=0.063), and biliary reflux (p=0.106) had a tendency toward statistical signification for positive association. On univariate analysis, smoking (p=0.048, OR = 3.15, 95% CI: 1.01–9.93) and low-dose aspirin consumption (p=0.067, OR = 2.63, 95% CI: 0.95–7.68) were significantly associated with ulcer. According to the multivariable regression model, alcohol consumption (OR = 6.68, 95% CI: 1.29–41.14) and biliary reflux (OR = 6.12, 95% CI: 1.36–38.26) remained significantly associated with increased odds of stump ulcer. Conclusion. Biliary reflux and alcohol consumption, but not Helicobacter pylori infection or gastrotoxic drug, seem to be the most important predictors for ulcer recurrence in patients with gastric surgery for peptic ulcer after more than 15 years