The aim of our study was to assess the sympathetic nervous system’s involvement in the evolution of gastric carcinoma in patients by analyzing the mediators of this system (epinephrine and norepinephrine), as well as by analyzing the histological expression of the norepinephrine transporter (NET). We conducted an observational study including 91 patients diagnosed with gastric carcinoma and an additional 200 patients without cancer between November 2017 and October 2018. We set the primary endpoint as mortality from any cause in the first two years after enrolment in the study. The patients were monitored by a 24-h Holter electrocardiogram (ECG) to assess sympathetic or parasympathetic predominance. Blood was also collected from the patients to measure plasma free metanephrine (Meta) and normetanephrine (N-Meta), and tumor histological samples were collected for the analysis of NET expression. All of this was performed prior to the application of any antineoplastic therapy. Each patient was monitored for two years. We found higher heart rates in patients with gastric carcinoma than those without cancer. Regarding Meta and N-Meta, elevated levels were recorded in the patients with gastric carcinoma, correlating with the degree of tumor differentiation and other negative prognostic factors such as tumor invasion, lymph node metastasis, and distant metastases. Elevated Meta and N-Meta was also associated with a poor survival rate. All these data suggest that the predominance of the sympathetic nervous system’s activity predicts increased gastric carcinoma severity.

Background: Heart rate variability (HRV) indices have been shown to be associated with prognosis in various types of cancer. This study aims to assess the ability of these indices to predict survival in hepatocellular carcinoma (HCC) patients after diagnosis. Methods: We retrospectively collected data from 231 patients diagnosed with HCC between January 2014 and March 2018. The baseline clinical-pathological variables and HRV indices (extracted from Holter electrocardiogram recordings) were analyzed. Results: Univariate and multivariate analyses were performed to identify the predictive value of the above factors for overall survival (OS). The univariate analysis revealed that an age > 60 years, hepatitis C, portal vein involvement (thrombosis), a tumor size > 5 cm, alpha-fetoprotein (AFP) > 400 ng/mL, serum albumin, and C-reactive protein (CRP) were risk factors for poor OS. Multivariable Cox regression analyses identified that a tumor size > 5 cm and AFP > 400 ng/mL predict poorer outcomes in HCC patients. It should be mentioned that, in both the univariate analysis and in the multivariate analysis, between HRV indices, SDNN (standard deviation of all normal-to-normal (NN) intervals) < 110 ms was an independent risk factor for OS with an HR of 3.646 (95% CI 2.143 to 6.205). Conclusion: This study demonstrates that HRV indices identify HCC patients at high risk of death and suggests that such monitoring might guide the need for early therapy in these types of patients, as well as the fact that HRV can be a potential noninvasive biomarker for HCC prognosis.

Clinical utility of ancillary features (AFs) in contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS^®) is yet to be established. In this study, we assessed the diagnostic yield of CEUS LI-RADS and AFs in hepatocellular carcinoma (HCC). We retrospectively included patients with risk factors for HCC and newly diagnosed focal liver lesions (FLL). All lesions have been categorized according to the CEUS LI-RADS v2017 by an experienced sonographer blinded to clinical data and to the final diagnosis. From a total of 143 patients with 191 FLL, AFs favoring HCC were observed in 19.8% cases as hypoechoic rim and in 16.7% cases as nodule-in nodule architecture. From the total of 141 HCC cases, 83.6% were correctly classified: 57.4%- LR-5 and 26.2%- LR-4. In 9.21% cases, CEUS indicated LR-M; 2.12% cases- LR-3. The LR-5 category was 96.2% predictive (PPV) of HCC. LR-5 had 60.4% sensitivity and 93.6% specificity. PPV for primitive malignancy (LR-4 + LR-5) was 95.7%, with 88% sensitivity, 89.3% specificity and 88.4% accuracy for HCC. LR-4 category had 94.8% PPV and 26.2% sensitivity. CEUS LR4 + LR5 had 81,8% sensitivity for HCCs over 2 cm and 78.57% sensitivity for smaller HCCs. CEUS LR-5 remains an excellent diagnostic tool for HCC, despite the size of the lesion. The use of AFs might improve the overarching goal of LR-5 + LR-4 diagnosis of high specificity for HCC and exclusion of non-HCC malignancy.

Hand trauma is a common and debilitating condition that can have significant physical, functional, and psychological effects on individuals. This study used a case–control design to investigate the frequency and factors associated with symptoms of post-traumatic stress disorder (PTSD) in a sample of individuals with complex hand and forearm injuries. Our hypothesis suggests that demographic data, among other factors, influences the intensity of PTSD symptoms measured by the PCL-5 scale three months post-surgery. This study included 166 individuals, 142 males and 24 females, with an average age of 42.14 years (SD = 12.71). Our study found significant associations between symptoms of PTSD and various demographic and clinical factors. PTSD symptoms were observed in females, individuals from specific regions, and certain socio-professional groups. Furthermore, educational attainment and personal background have been identified as significant factors in the development of PTSD. The role of trauma type was crucial, amputees and fractures were more prone to developing PTSD. A strong link was found between increased symptoms of PTSD and negative postoperative outcomes, including amputation of necessity and the need for additional surgery. The absence of family support exacerbates the psychological distress of trauma survivors. The findings highlight the intricate nature of PTSD development and underscore the significance of a comprehensive postoperative treatment strategy encompassing psychological assessment and support.

Background: The aim of our study was to evaluate sympathetic neuronal remodeling in patients with pancreatic cancer, together with its correlation with clinical outcomes. Methods: In this descriptive, retrospective study, we analyzed pancreatic cancer specimens and peritumoral pancreatic tissue from 122 patients. We also investigated tyrosine hydroxylase immunoreactivity for the analysis of sympathetic nerve fibers and beta 2 adrenoreceptors immunoreactivity. To investigate the potential interaction between tyrosine hydroxylase (TH), beta 2 adrenoreceptors (B2A) immunoreactivity, and clinicopathological outcomes, we used the median to classify each case as TH+, respectively, B2A+ (if it presented a value higher than the median). Results: Firstly, the overall survival was analyzed according to TH and B2A immunoreactivity, in both intratumoral and peritumoral tissue. Only B2A immunoreactivity in the peritumoral pancreatic tissue influenced overall survival at 5 years of follow-up; thus, B2A+ patients recorded a 5-year survival of only 3% compared to B2A− patients who recorded an overall survival at 5 years of follow-up of 14% (HR = 1.758, 95% CI of ratio 1.297 to 2.938, p = 0.0004). Additionally, the increased immunoreactivity of B2A in the peritumoral tissue was also associated with other factors of poor prognosis, such as moderately or poorly differentiated tumors, the absence of response to first-line chemotherapy, or metastatic disease. Conclusions: The increased immunoreactivity of beta 2 adrenoreceptors in pancreatic peritumoral tissue represents a poor prognostic factor in pancreatic cancer.

Oxidative stress and chronic inflammation are tightly interconnected biological processes that play central roles in colorectal cancer (CRC) initiation, progression, and resistance to therapy. Understanding their reciprocal interactions may identify novel biomarkers and therapeutic targets with translational relevance. Methods: This systematic review with qualitative synthesis was conducted in accordance with the PRISMA 2020 guidelines. A comprehensive literature search of PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar was performed from January 2005 to June 2025. Eligible studies investigated mechanistic links between oxidative stress and inflammation in colorectal cancer, assessed oxidative or inflammatory biomarkers, or explored redox- and inflammation-targeted therapeutic strategies. Study selection and data extraction were performed systematically. Due to heterogeneity in study designs and outcomes, a qualitative synthesis was undertaken without meta-analysis. Results: Twenty-six studies met the inclusion criteria. Evidence consistently demonstrated that redox-sensitive pathways—including NF-κB, NRF2, and IL-6/JAK/STAT3—drive colorectal carcinogenesis by promoting genomic instability, immune evasion, angiogenesis, and therapy resistance. Biomarkers such as 8-hydroxy-2′-deoxyguanosine, malondialdehyde, F₂-isoprostanes, C-reactive protein, interleukin-6, and tumor necrosis factor-α were frequently associated with tumor stage, prognosis, and treatment response. Therapeutic strategies targeting oxidative stress and inflammation showed promising preclinical and early translational results, particularly in combination with chemotherapy or immunotherapy. Conclusion: Oxidative stress and inflammation constitute a synergistic axis that critically influences colorectal cancer biology. Although several biomarkers and redox-targeted interventions demonstrate translational potential, robust clinical validation is still required before routine implementation. Integrative strategies guided by biomarker profiling may represent a future direction for personalized CRC management. Most therapeutic approaches discussed are supported by preclinical and early translational evidence, and their clinical applicability remains to be validated.