Autophagy is an important cellular repair mechanism, aiming at sequestering misfolded and dysfunctional proteins and damaged cell organelles. Dysfunctions in the autophagy process have been linked to several diseases, like infectious and neurodegenerative diseases, type II diabetes mellitus and cancer. Living organisms are constantly subjected to some degree of oxidative stress, mainly induced by reactive oxygen and nitrogen species. It has been shown that autophagy is readily induced by reactive oxygen species (ROS) upon nutrient deprivation. In recent years, research has increasingly focused on outlining novel therapeutic targets related to the autophagy process. With this review of the literature, we want to give an overview about the link between autophagy, oxidative stress and carcinogenesis.

(1) Background: Long COVID syndrome (LCS) is a heterogeneous long-standing condition following COVID-19 infection. Treatment options are limited to symptomatic measures, and no specific medication has been established. Hyperbaric oxygenation (HBO) has been found to have a positive impact on the treatment of COVID-19 infection. This study evaluates both the feasibility and outcome of supportive HBO in patients with LCS. (2) Methods: Within 17 months, 70 patients with proven LCS were prospectively included. Each patient underwent a cycle of 10 subsequent HBO treatment sessions administered for 75 min at 2.2 atmospheres. Evaluation of the patients was performed before the first and after the last HBO session and 3 months afterwards. Statistical evaluation was based on an intention-to-treat analysis using Fisher’s exact test and Student’s t-test for paired samples. (3) Results: In total, 59 patients (33 females, 26 males; mean age: 43.9 years; range: 23–74 years; median: 45.0) were evaluable. After HBO, a statistically significant improvement of physical functioning (p < 0.001), physical role (p = 0.01), energy (p < 0.001), emotional well-being (p < 0.001), social functioning (p < 0.001), pain (p = 0.01) and reduced limitation of activities (p < 0.001) was confirmed. (4) Conclusions: Physical functioning and both the physical and emotional role improved significantly and sustainably, suggesting HBO as a promising supportive therapeutic tool for the treatment of LCS.

Chronic obstructive pulmonary disease (COPD) serves as risk factor for the development of lung cancer and seems to have a prognostic impact after surgery for non-small cell lung cancer (NSCLC). The aim was to investigate the impact of COPD and postoperative mucostasis on the long-term survival after resected NSCLC. We retrospectively reviewed the data from 342 patients with curatively resected NSCLC. The prognostic long-term impact of COPD and postoperative mucostasis on overall survival (OS), recurrence free survival (RFS) and cancer specific survival (CSS) was calculated using univariable and multivariable Cox regression analyses. We found that 52.3% suffered from COPD and 25.4% had postoperative mucostasis. COPD was significantly more common among smokers (59.9%) compared with non-smokers (21.3%), (p < 0.001). There was a significant relationship between COPD and postoperative mucostasis (p = 0.006) and between smoking and mucostasis (p = 0.023). Patients with postoperative mucostasis had a significantly worse OS (p < 0.001), RFS (p = 0.009) and CSS (p = 0.008). The present analysis demonstrated that postoperative mucostasis, but not COPD, was associated with both worse short- and long-term outcomes for OS, RFS and CSS in curatively resected NSCLC.

Zusammenfassung: Einleitung Die Hyperhidrose (HH) geht mit einer physischen und psychischen Einschränkung einher. Die Behandlung umfasst sowohl konservative als auch operative Methoden und strebt eine dauerhafte Verbesserung der Lebensqualität (LQ) der Betroffenen an. Die endoskopische Sympathikusblockade (ESB) stellt eine etablierte operative Therapiemethode dar und gilt als ein effektives chirurgisches Verfahren bei Versagen der konservativen Therapieoptionen. Das Ziel unserer Studie war, die LQ-Veränderung und die Patientenzufriedenheit nach ESB durch umfangreiche Analyseverfahren zu untersuchen und entsprechende Einflussfaktoren zu identifizieren. Methoden Von Juli 2008 bis April 2016 wurden 105 Patienten wegen therapierefraktärer HH operiert. In allen Fällen wurde ein ESB entsprechend vorliegenden Hyperhidroseform und dem STS-Expertenkonsens (STS: Society of Thoracic Surgeons) durchgeführt. Die LQ und das Hyperhidrosestatus wurden anhand von detaillierten Fragebogen (ein selbst entwickelter Fragebogen, SF36, DLQI, Hyperhidrose LQ (HidroQoL)) selektiv prä- und postoperativ analysiert und bewertet. Die statistische Bearbeitung erfolgte anhand SPSS Statistics Version 21.0.0.2 für Windows (Armonk, NY: IBM Corp.). Die statistische Analyse erfolgte anhand deskriptiver Analyse und nicht parametrischer Tests. Ergebnisse 105 Patienten zwischen Juli 2008 bis April 2016 wurden mittels bilateralem ESB operiert und evaluiert: 73 Frauen (69,5%) und 31 Männer (29,5%) im Medianalter von 26 Jahren (16 – 64), mit fokaler palmarer und axillarer (HPA) 13 (12,4%), palmoplantarer (PPH) 20 (19%), palmoplantarer und axillarer (PPAH) 47 (44,8%), axillarer Hyperhidrose (HA) 11 (10,5%) und Gesichtshyperhidrose (HF) 14 (13,3%). HydroQoL-Score zeigte eine Verbesserung in allen HH-Formen. Das DLQI wies eine Verbesserung in allen Patientengruppen auf, während die LQ-Analyse mittels SF36 eine Verbesserung in sozialer Funktionsfähigkeit und dem psychischen Wohlbefinden in allen HH-Formen außer HA aufzeigte. Mit postoperativem Ergebnis waren 86,7% (91) Patienten zufrieden. Das kompensatorische Schwitzen (KS) wurde in 76,2% (80) der Fälle beobachtet ohne einen eindeutigen LQ-Einfluss. Keine signifikante Korrelation zwischen KS und der Hyperhidroseform war feststellbar. Schlussfolgerungen Die ESB geht mit einer dauerhaften LQ-Verbesserung in der sozialen Funktionsfähigkeit, dem psychologischen Wohlbefinden und der hohen Patientenzufriedenheit einher. Das Auftreten vom KS hat keine eindeutige Korrelation zu LQ und Patientenzufriedenheit.

Introduction: Sternoclavicular joint infections (SCJIs) are extremely rare, making up less than 1% of all septic arthritis cases. This retrospective study aims to evaluate the management and outcomes of SCJIs, including both surgical and non-surgical approaches. Methods: This retrospective study included 55 patients treated between January 2005 and December 2023 at the Division of Thoracic and Hyperbaric Surgery in Graz, Austria. Data on patient characteristics, treatment approach, and outcome were analyzed. Results: Out of the 55 patients, 50 (90.91%) underwent surgery. Among them, 21 (38.18%) had pleural involvement and 9 (16.36%) developed sepsis. Primary debridement and sternoclavicular joint resection with muscle flap closure were performed in 5 patients (9.3%), whilst debridement and negative pressure wound therapy (NPWT) followed by joint resection were applied in 32 patients (59.3%). In total, 15 (27.2%) of these cases required a secondary muscle flap. Positive cultures were found in 35 patients (63.64%), with Staphylococcus aureus being the most common pathogen. Multivariate analysis identified elevated CRP and leukocyte levels as significant predictors of sepsis. Defects requiring myoplastic procedures were associated with a higher risk of complications, sepsis, and prolonged hospital stays. Postoperative complications occurred in 20 patients (36.36%), but there was no 30-day mortality. Conclusions: SCJI is a rare but serious condition that requires prompt surgical intervention. Our findings suggest that combining surgical resection with NPWT and/or myocutaneous flap techniques is effective. Close monitoring of inflammatory markers is crucial for identifying sepsis risk and improving patient outcomes.

Summary: We present a case of bilateral cystic lung metastases originating from cutaneous angiosarcoma (cAS) of the scalp in a 73-year-old man. He presented with hemoptysis and recurrent bilateral pneumothorax. The clinical, radiological, and histological features and a potential pathophysiological mechanism of pulmonary changes in cutaneous angiosarcoma are discussed.