This study aims to establish whether the use of biomaterials, particularly polydimethylsiloxane (PDMS), for surgical reconstruction of the esophagus with templates, Montgomery salivary tube, after radical oncology surgery for malignant neoplasia is an optimal choice for patients’ safety and for optimal function preservation and organ rehabilitation. Structural analysis by Raman spectrometry and biomechanical properties with dynamic mechanical analysis are performed for fatigue strength and toughness, essential factors in durability of a prosthesis in the reconstruction practice of the esophagus. Nanocomposites with silicone elastomers and nanoparticles used in implantable devices and in reconstruction surgery present risks of infection and fatigue strength when required to perform a mechanical effort for long periods of time. This report takes into account the effect of silver (Ag) nanoparticles on the fatigue strength using polydimethylsiloxane (PDMS) matrix, representative for silicon elastomers used in implantable devices. PDMS with 5% (wt) Ag nanoparticles of 100–150 nm during mechanical fatigue testing at shear strength loses elasticity properties after 400 loading-unloading cycles and up to 15% shear strain. The fatigue strength, toughness, maximum shear strength, as well as clinical properties are key issues in designing Montgomery salivary tube and derivates with appropriate biomechanical behavior for each patient. Prosthesis design needs to indulge both clinical outcomes as well as design methods and research in the field of biomaterials.

Background and Objectives: Peri-implantitis is a biologically driven complication that jeopardizes dental implant longevity. While chemical decontamination is frequently employed as an adjunct to mechanical debridement, its impact on implant surface integrity and cellular compatibility remains insufficiently defined. This study aimed to evaluate the effects of several chemical agents used in peri-implantitis treatment on the surface morphology and potential biocompatibility of titanium dental implants. Materials and Methods: Twenty-five Ti6Al4V implants were exposed to one of the following agents: saline solution, 3% hydrogen peroxide, 40% citric acid, 17% EDTA, and a mixture (1:1) of citric (2%) and phosphoric (1N) acids. This in vitro study employed a 7-day immersion protocol to accentuate surface effects under controlled laboratory conditions, acknowledging that clinical exposures are substantially shorter. Surface topography was evaluated by Atomic Force Microscopy, while cellular response and corrosion products were assessed using Scanning Electron Microscopy. Surface roughness parameters were statistically analyzed. Results: Hydrogen peroxide induced selective corrosion of the β phase and formed a compact passivation layer that supported mesenchymal stem cell adhesion. Citric acid etched grain boundaries, producing localized roughness that also permitted cell proliferation. EDTA caused advanced grain dissolution and debris accumulation, increasing surface roughness but impairing cellular adhesion. The citric–phosphoric acid mixture led to the highest roughness values and visible corrosion debris. In all cases, macrostructural integrity of the implants was preserved. Conclusions: Chemical agents used in peri-implantitis treatment induce distinct surface alterations on titanium implants. Controlled use of hydrogen peroxide and citric acid may enhance surface biocompatibility, while aggressive protocols such as EDTA and acid combinations require caution due to their adverse effects on surface morphology and cellular response. These findings may inform the development of optimized decontamination protocols for clinical management of peri-implantitis.

Background: This study aimed to evaluate the impact of different chemical treatments on titanium implant surfaces and their biological compatibility. Methods: Titanium dental implants were immersed in Ringer’s solution, hydrogen peroxide (3%), citric acid (40%), EDTA (40%), or a citric–phosphoric acid mixture. Electrochemical behavior was analyzed using open-circuit potential monitoring and electrochemical impedance spectroscopy over 168 h. Cytocompatibility was assessed by culturing human gingival mesenchymal stem cells (MSCs) directly on treated implants and in conditioned media, followed by viability evaluation through CCK-8 assays. Results: Citric acid and Ringer’s solution preserved passive film stability and supported high MSC viability (>75%) with minimal cytotoxic effects. Hydrogen peroxide and the citric–phosphoric acid mixture caused pronounced surface corrosion, decreased impedance stability, and significantly reduced cell viability (57–65%). EDTA-treated surfaces showed intermediate results, with moderate viability but impaired cell adhesion. Conclusion: The findings highlight the dual influence of chemical decontamination on implant stability and biological response. Citric acid and Ringer’s solution appear to be safer protocols for surface decontamination, whereas hydrogen peroxide and mixed acid treatments should be applied with caution due to their detrimental electrochemical and cytotoxic effects.

Background: Dual mobility (DM) total hip arthroplasty (THA) was introduced to reduce postoperative instability, one of the most frequent causes of revision after hip replacement. Its use has progressively expanded beyond revision surgery to selected high-risk primary cases; however, comparative data integrating both clinical and radiographic outcomes from real-world tertiary centers remain limited. Methods: A retrospective comparative study was conducted including 78 patients who underwent THA with a DM acetabular component between January 2019 and December 2024, and 78 matched controls who received conventional fixed-bearing THA during the same period. Matching criteria were age, sex, and procedure type (primary versus revision). Clinical outcomes were assessed using the Harris Hip Score (HHS) and visual analogue scale (VAS) for pain. Radiographic evaluation focused on component positioning, radiolucent lines, and signs of loosening. Complications and revision rates were compared between groups. Results: The mean age was 71 ± 9 years, and 62% of patients were female. Mean follow-up was 38 months. HHS improved from 54 ± 10 preoperatively to 89 ± 8 postoperatively in the DM group (p < 0.001), with similar final functional outcomes in the conventional THA group (90 ± 9, p = 0.48), and comparable improvement between groups (p = 0.62). Radiographic parameters demonstrated stable fixation and appropriate component positioning in both groups, with no significant intergroup differences. The dislocation rate was numerically lower in the DM group (1.3% vs. 5.1%), although this difference did not reach statistical significance (p = 0.37). No cases of intraprosthetic dislocation occurred. Overall implant survival free from revision at five years was 96.5% for DM and 94.7% for conventional THA (p = 0.47). Conclusions: DM THA achieved excellent clinical and radiographic outcomes, with a numerically lower dislocation rate than conventional THA. Mid-term implant survivorship was comparable between groups, supporting DM as a reliable option for improving stability in appropriately selected patients.

Background/Objectives: Delayed bone healing remains a relevant complication after polytrauma, where fracture repair occurs in the setting of systemic inflammation and repeated physiologic stress. This study evaluated whether serial changes in interleukin-6 (IL-6), C-reactive protein (CRP), and fibrinogen are associated with delayed union in polytrauma patients with long-bone fractures. Methods: We performed an exploratory retrospective cohort study including 115 adult polytrauma patients with long-bone fractures treated at a single tertiary trauma center between 2 January 2022 and 14 December 2024. Serum IL-6, CRP, and fibrinogen were recorded at 24 h, 72 h, 1 week, 2 weeks, and 4 weeks after injury. IL-6 was measured in the institutional clinical laboratory using routine immunoassay methods, whereas CRP and fibrinogen were measured using standard hospital analytical methods, including an immunoturbidimetric assay for CRP and the Clauss clotting method for fibrinogen. Radiographic healing was assessed at 6, 12, and 24 weeks using an mRUST-based healing score. The primary endpoint was clinician-assigned delayed union at 24 weeks; nonunion at 9 months was assessed secondarily. Complete-case multivariable logistic regression was performed in 86 patients, and exploratory longitudinal biomarker analyses used generalized estimating equations. Results: Delayed union at 24 weeks occurred in 39/115 patients (33.9%), while nonunion at 9 months occurred in 7/115 patients (6.1%). Patients with delayed union had longer time to definitive fixation (35.3 ± 10.2 h vs. 29.0 ± 14.0 h; p = 0.003) and more frequent shock on admission (43.6% vs. 23.7%; p = 0.047). IL-6 was higher in the delayed-union group at 1 week (57.3 ± 30.3 vs. 46.5 ± 29.2 pg/mL; p = 0.043) and 4 weeks (21.2 ± 11.6 vs. 17.1 ± 10.3 pg/mL; p = 0.022), whereas CRP was markedly higher at 4 weeks (29.4 ± 14.2 vs. 16.3 ± 10.6 mg/L; p < 0.001). After false-discovery-rate correction, only CRP at 4 weeks remained significant among serial biomarker comparisons. In multivariable analysis of 86 complete cases, CRP at 4 weeks remained independently associated with delayed union (adjusted OR 2.16 per 10 mg/L, 95% CI 1.36–3.43; p = 0.001). The model showed apparent discrimination with an AUC of 0.80 and acceptable calibration (Hosmer–Lemeshow p = 0.41). In sensitivity analysis excluding deep surgical-site infection cases, the association between CRP and delayed union persisted (adjusted OR 2.02 per 10 mg/L, 95% CI 1.26–3.26; p = 0.004). Conclusions: In this exploratory retrospective cohort of polytrauma patients with long-bone fractures, persistent post-traumatic CRP elevation at 4 weeks was associated with clinician-assigned delayed union, whereas IL-6 findings were weaker and exploratory. Because CRP is a nonspecific inflammatory marker, the observed association may reflect delayed healing, infection, reoperation, and/or persistent postoperative inflammatory burden. These data support association rather than validated prediction and require prospective validation with standardized outcome adjudication.

Background/Objectives: Neural–tumor interactions are increasingly recognized in gastric cancer (GC), yet their relationship with circulating neuroactive mediators remains incompletely understood. This systematic review aimed to synthesize human evidence on circulating neurotransmitters, neuropeptides, and related mediators, assess their diagnostic, clinicopathological, treatment-associated, and prognostic relevance, and integrate clinical findings within a translational framework of neuro–tumor signaling. Methods: PubMed/MEDLINE, Scopus, and Web of Science Core Collection were systematically searched following PRISMA 2020 guidelines. Eligible studies assessed circulating neuroactive mediators in patients with GC. Clinical findings were synthesized by evidence domain and contextualized using complementary tumor-level receptor and signaling evidence. Results: Twenty-four publications representing 23 independent cohorts were included. Replicated circulating alterations were identified for galanin, motilin, and cholecystokinin, although gastrointestinal physiology and treatment-related changes complicated their interpretation. Progastrin-releasing peptide demonstrated diagnostic discrimination in a single study (AUC 0.713; sensitivity 85.9%; specificity 81.2%) and associations with clinicopathological characteristics. Dopaminergic and catecholamine-related alterations suggested systemic neuroendocrine involvement, while higher normetanephrine was associated with poorer survival in univariable analysis. Complementary mechanistic evidence implicated serotonergic, substance P/NK-1R, and neurotensin/NTSR1 pathways in tumor-associated signaling. The translational evidence map highlighted three overlapping biological dimensions: tumor-associated receptor-mediated signaling, systemic neuroendocrine and stress adaptations, and gastrointestinal physiological responses. However, small cohorts, heterogeneous biological matrices, historical assay variability, and limited independent validation restricted clinical interpretation. Conclusions: Circulating neuroactive mediators represent a biologically plausible but insufficiently validated biomarker domain in GC. Their clinical translation requires standardized prospective studies integrating circulating measurements with matched tumor biology, clinically relevant comparator populations, longitudinal outcomes, and independent validation. Pathway-oriented multimarker approaches may ultimately provide more informative neuroactive signatures than individual mediators.