Background: Low back pain (LBP) is an emerging disease. This review aims to investigate the role of gender-related factors in the diagnosis, clinical, and surgical management of LBP. Methods: From January 2002 to March 2023, EMBASE, SCOPUS, OVID-MEDLINE, Google Scholar, PubMed, and Web of Science were searched to identify relevant papers for further analysis. Results: Fifteen papers were included in this review. Sex- and gender-related differences were analyzed regarding the following points: (1) LBP epidemiology; (2) LBP physiopathology; (3) conservative management of LBP; (4) major vertebral surgery for LBP. The conservative treatment of LBP highlights that women claim services later in terms of poorer health status than men. In the postoperative phase, female patients show worse LBP, quality of life, and disability, but equal or greater interval change, compared with male patients complaining of lumbar degenerative disease. Conclusions: LBP epidemiology and clinical outcomes, following conservative and surgical management of patients complaining of back pain, might depend on both sex- and gender-related factors. It is mandatory to assess gender-related indicators in patients referred to LBP and address them to improve their clinical outcomes and quality of life.

Despite the recent advances in lung cancer biology, molecular pathology, and treatment, this malignancy remains the leading cause of cancer-related death worldwide and non-small cell lung cancer (NSCLC) is the most common form found at diagnosis. Accurate staging of the disease is a fundamental prognostic factor that correctly predicts progression-free (PFS) and overall survival (OS) of NSCLC patients. However, outcome of patients within each TNM staging group can change widely highlighting the need to identify additional prognostic biomarkers to better stratify patients on the basis of risk. 18F-FDG PET/CT plays an essential role in staging, evaluation of treatment response, and tumoral target delineation in NSCLC patients. Moreover, a number of studies showed the prognostic role of imaging parameters derived from PET images, such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG). These parameters represent three-dimensional PET-based measurements providing information on both tumor volume and metabolic activity and previous studies reported their ability to predict OS and PFS of NSCLC patients. This review will primarily focus on the studies that showed the prognostic and predictive role of MTV and TLG in NSCLC patients, addressing also their potential utility in the new era of immunotherapy of NSCLC.

High levels of somatostatin receptor type 2 (SSTR2) is a prerequisite for therapy with unlabeled or labeled somatostatin analogues. However, it is still unclear how the heterogeneity of SSTR2 expression could affect tumor response to therapy. The aim of our study was to test the ability of an imaging parameter such as coefficient of variation (CoV) derived from PET/CT with ⁶⁸Ga-peptides in the evaluation and quantification of the heterogeneity of SSTR2 expression within primary and metastatic lesions of patients with neuroendocrine tumors. Methods: Thirty-eight patients with pathologically proven neuroendocrine tumors who underwent ⁶⁸Ga-DOTATOC-PET/CT were studied. Primary tumors were localized in the gastroenteropancreatic, bronchopulmonary and other anatomical districts in 25, 7 and 6 patients, respectively. Malignant lesions were segmented using an automated contouring program and a threshold of SUV> 2.5 or in the case of liver lesions a threshold of 30% of the SUV_max. The imaging parameters SUVmean, CoV, SUV_max, RETV (receptor expressing tumor volume) and TLRE (total lesion receptor expression) of each lesion were obtained. SUVmean, CoV, SUV_max were also obtained in representative volumes of normal liver, spleen as well as in the whole pituitary gland. Results: A total of 107 lesions were analyzed including 35 primary tumors, 32 metastatic lymph nodes and 40 distant metastases. Average CoV values were 0.49±0.20 in primary tumors, 0.57±0.26 in lymph node metastases and 0.44±0.20 in distant metastases. CoV values in malignant lesions were up to 4-fold higher than those of normal tissues (p≤0.0001). Among malignant lesions the highest CoV value was found in bone metastases (0.68±0.20) and was significantly greater than that of primary lesions (P = 0.01) and liver metastases (0<0.0001). On the other hand, the lowest CoV value was found in liver lesions (0.32±0.07) probably due to the high background. Conclusion: Our findings indicate that the heterogeneity of tracer uptake, reflecting that of SSTR2, varies depending on type and site of malignant lesions as assessed by CoV values obtained from ⁶⁸Ga-DOTATOC-PET/CT scans. These observations may be related to different biological characteristics of tumor lesions in the same patient that may affect their response to treatment with both labeled and unlabeled somatostatin analogues.

The treatment of Paprosky Type III acetabular defects is a significant challenge in orthopedic surgery, as standard components often do not fit properly. This study aims to evaluate the biomechanical efficacy of a custom 3D-printed PEEK acetabular prosthesis compared to a conventional titanium implant. A 3D model of the pelvis was created using a computed tomography scanner and a custom-made acetabular implant was designed. Finite element analysis (FEA) was performed using Ansys Workbench to evaluate the stress and strain distribution of two materials on the pelvic bone. The results showed that the titanium prosthesis model had less strain transmitted to the bone, while the PEEK model had better stress transmission and bone stimulation. The use of custom implants reduced the risk of stress shielding, potentially improving long-term bone health. Three-dimensional-printed acetabular prostheses therefore offer significant advantages over traditional implants, suggesting improved implant stability and reduced failure rates.