Any nondigestible material ingested by an animal that cannot be broken down by digestive enzymes or rumen microorganisms and remains within the gastrointestinal tract, potentially causing mechanical or functional disturbances, is referred to as an indigestible foreign body. This study aims to evaluate the occurrence of indigestible foreign bodies in the rumen and reticulum of cattle slaughtered at the Kombolcha ELFORA Abattoir, identify the types of foreign bodies, and assess the associated risk factors that contribute to their ingestion. A cross-sectional study was conducted from November 2024 to June 2025 at the Kombolcha ELFORA Abattoir, Ethiopia. Postmortem examinations were employed to assess the animals and recover foreign bodies, respectively, from the rumen and reticulum of cattle slaughtered at the abattoir. The study animals were selected using a simple random sampling technique from the total cattle slaughtered during the study period. Data analysis included descriptive statistics and Pearson's chi-square (χ 2) test to check associations between the prevalence of indigestible foreign bodies and various potential risk factors. In this study, the overall occurrence of foreign bodies in slaughtered cattle was found to be 35.3% (n = 127/360). A higher prevalence was recorded in females (42%), crossbred cattle (36.36%), older animals (45.7%), and cattle with poor body condition scores (38.1%). Among the assessed associated factors, age (p = 0.025) and body condition score (p = 0.022) showed a statistically significant association with the occurrence of foreign bodies. Plastics were the most frequently encountered materials in the rumen, while the reticulum commonly retained metallic objects. The most commonly recovered nonpenetrating materials included plastic bags (19.68%), sand (18.1%), cloth (8.66%), rope (7.87%), and leather (3.87%). Penetrating foreign bodies primarily consisted of wire (6.29%) and nails (5.51%). Plastic bags were the most commonly recovered foreign materials, followed by sand, cloth, rope, and wire. The findings of this study highlight that the ingestion of both metallic and nonmetallic foreign bodies is a prevalent and significant health concern in cattle slaughtered at the abattoir. Implementing effective solid waste management practices is critically important for safeguarding cattle health in the study area.
Urethral foreign body insertion is a rare clinical condition and is often associated with autoerotic behavior or psychiatric disorders. This case is notable due to the unusual nature of the inserted object-a tree branch-and the absence of previously diagnosed psychiatric illness. It contributes to the literature by emphasizing the clinical, psychological, and procedural considerations required for effective management. A 24-year-old married Yemeni man presented with a two-day history of dysuria and urinary frequency following the self-insertion of a tree branch into his urethra for sexual stimulation. Physical examination revealed a firm mass in the mid-shaft of the penis. Urinalysis showed microscopic hematuria and pyuria. The diagnosis of a urethral foreign body was confirmed by imaging (ultrasound and KUB X-ray), which revealed a 9 cm rod-like object extending from the mid-penile urethra to the prostatic urethra. Under general anesthesia, cystoscopic removal of the foreign body was performed successfully. A small urethral tear was noted, for which a Foley catheter was inserted and left in place for one week to promote healing. The patient recovered without complications and was discharged the same day. This case underscores the importance of early diagnosis and minimally invasive management in patients presenting with urethral foreign bodies. It also highlights the need for psychological evaluation to address underlying behavioral causes. Clinicians should maintain a high index of suspicion in similar presentations and ensure a multidisciplinary approach involving both urological and psychological care.
While anxiety has been extensively studied, other emotions have remained largely unexamined in foreign language listening research, and their effects on listening achievement remain uncertain. This study aimed to investigate the predictive effects of anxiety, boredom, and enjoyment on listening achievement, while developing and validating foreign language listening boredom and enjoyment scales. Two sub-studies were conducted with three separate samples of Chinese English-as-a-foreign-language (EFL) university students (N₁ = 35; N₂ = 338; N₃ = 362). Based on open-ended data from Sample 1, Study 1 developed the preliminary Foreign Language Listening Boredom and Enjoyment Scales. These were then administered to Samples 2 and 3. Exploratory factor analysis with Sample 2 revealed a unidimensional structure for the boredom scale and a two-factor structure (private and social enjoyment) for the enjoyment scale. Confirmatory factor analysis with Sample 3 validated these structures, showing strong reliability (α = .89-.94) and multiple forms of validity. Study 2 collected listening achievement data from Sample 3, including IELTS and College English Test Band 4 listening scores and self-reported listening self-efficacy. Regression analysis indicates that boredom consistently and negatively predicted listening achievement, whereas enjoyment appeared to have a positive effect; anxiety showed varying and context-dependent predictive influence. The findings highlight the robust and distinct roles of multiple listening emotions in EFL listening success, supporting the need for emotion-sensitive listening pedagogy that fosters positive engagement and mitigates disengagement.
Traditional conveyor belt object detection methods often lack robustness and adaptability under challenging conditions such as low-light and low-resolution environments. This study proposes an improved detection method specifically designed for conveyor belt environments, built upon the YOLOv11 object detection framework. A custom dataset was created to support foreign object detection on factory conveyor belts. To overcome the low resolution of image recognition, the Enhanced Super- Resolution Generative Adversarial Network (ESRGAN) was employed to improve the input image clarity. Additionally, to enhance the performance under low-illumination conditions, several architectural improvements were embedded in the YOLOv11 framework, leading to the proposed Conveyor Belt Foreign Object Detection (YOLOv11-CBFD) algorithm. These enhancements included an optimized upsampling module, integrated attention mechanisms, a modified convolution module, an improved loss function, and a modified convolution module. Experimental results demonstrated that the proposed YOLOv11-CBFD algorithm significantly enhanced the accuracy of foreign object recognition. Based on a dataset collected from a factory conveyor belt, YOLOv11-CBFD achieved an accuracy of 86.1%, a recall of 86.7%, an [Formula: see text] of 89.1%, and a model size of only 2.17 M parameters. Compared to the original YOLOv11n model, the proposed method reduced the parameter count by 16.2% while demonstrating no significant degradation in recognition capabilities. In terms of computational efficiency, the optimized architecture demonstrated a 12.4% increase in the number of frames per second when deployed on a Jetson Orin NX-embedded AI computer. Field experiments conducted in industrial inspection scenarios validated the practical effectiveness of the system, demonstrating continuous operation over 48 h under real-time constraints (average latency <33 ms/frame), while consistently maintaining an accuracy of 86.1% across multiple deployment cycles. The experimental results highlight the ability of the model to effectively balance computational efficiency and detection performance on embedded AI platforms.
The reliable operation of Gas-Insulated Switchgear (GIS) is crucial for power system safety, yet automatic foreign object inspection within its cavities remains challenging due to low-light conditions and strong reflections. This paper proposes a multi-modal few-shot learning framework for high-precision foreign object segmentation in GIS. To overcome imaging interference, we first establish a dual-light (visible and ultraviolet) image acquisition system and design a lightweight fusion network to adaptively integrate multi-modal features, enhancing scene representation. For the core few-shot segmentation task, we introduce a novel Multi-Similarity Guided Branch Network (MSBNet). This network employs a support-query dual-branch architecture to extract sample prototypes. It features an improved background similarity guidance mechanism to suppress base-class feature interference and a multi-similarity fusion module that synergistically integrates multi-level and multi-metric information, which significantly improves the continuity and boundary accuracy of the segmentation masks. Experiments on our GIS dataset demonstrate that, under extremely limited sample conditions, the proposed method rapidly adapts to unseen foreign object classes and substantially outperforms existing few-shot segmentation baselines.
This study examines evidence-based pedagogical strategies aimed at enhancing communication competence, with a particular focus on foreign language speaking skills, among Deaf and Hard of Hearing (DHH) students at the primary education level. Acknowledging the distinct linguistic, cognitive, and communicative characteristics of DHH learners, the research addresses the central question: Which instructional techniques most effectively promote the development of speaking and broader communicative abilities in this population? Employing a qualitative research design, the study engaged 55 primary-level DHH students and utilized classroom observations, student questionnaires, and semi-structured interviews with teachers and educational specialists, thereby adopting a multi-perspective methodological framework that enables the triangulation of learner, classroom and professional perspectives. The findings underscore the efficacy of multimodal and visually enriched teaching approaches, the value of differentiated, learner-centered instruction, and the importance of collaborative learning environments in supporting oral foreign language development. The research provides empirical insights into the design of inclusive and responsive language education practices for DHH learners, including those relevant to foreign language speaking skills, drawing on triangulated qualitative evidence from multiple educational stakeholders, contributing to the advancement of both academic achievement and communicative competence in diverse classroom settings.
Endovascular clot retrieval (ECR) has revolutionised acute ischaemic stroke management. While procedural safety is well established, little attention has been paid to vascular responses to hydrophilic polymer coatings used on retrieval devices. This report presents postmortem histopathological findings implicating a foreign body giant cell reaction secondary to hydrophilic polymer exposure as a cause of recurrent stroke following ECR. A detailed clinical and neuropathological review was conducted on a 72-year-old patient who experienced three sequential ischaemic strokes within 4 months following ECR and angioplasty of a right middle cerebral artery (M2) occlusion. Limited postmortem examination of the heart and brain was undertaken with histopathological and immunoperoxidase staining to assess potential vascular inflammatory mechanisms. Postmortem examination demonstrated multiple infarcts of differing ages, diffuse atherosclerotic change and a florid multinucleated giant cell reaction containing non-polarisable basophilic material along the luminal surface of the right M2 segment and adjacent vessels. The internal elastic lamina remained intact, with only focal fibrinoid necrosis and sparse medial inflammation. No amyloid angiopathy, vasculitis or cardiac embolic source was identified. The morphological features were consistent with a chronic inflammatory response to embolised hydrophilic polymer coating material from prior endovascular instrumentation. This case highlights an under-recognised mechanism of post-ECR recurrent stroke linked to hydrophilic polymer-induced vascular inflammation. If recognised antemortem, immunosuppression may be more effective than usual secondary stroke prevention treatments.
Foreign body airway obstruction (FBAO) is a time-critical emergency. Although bystander removal maneuvers can improve outcomes, they are not consistently attempted even when events are witnessed. We aimed to identify patient-, witness-, and setting-related factors associated with the absence of bystander removal attempts in witnessed FBAO. We analyzed a prospective, nationwide, multicenter cohort from the MOCHI registry in Japan, including patients with witnessed FBAO. The primary outcome was absence of a bystander removal attempt. Multivariable logistic regression with multiple imputation for missing data was used to examine associations with patient age, sex, eating function, location (home, care facility, public), and witness/bystander age and sex. Among 325 witnessed FBAO events, 193 (59%) involved a removal attempt and 132 (41%) did not. The median patient age was 81 years. Attempt rates varied by location: 82% in care facilities, 52% at home, 43% in public places. Witnesses/bystanders were significantly older in events without an attempt (median 60 vs. 50 years). Older witness/bystander age was independently associated with higher odds of no attempt (OR 1.39 per 10-year increase; 95% CI 1.14-1.70). Compared with home, no attempt was less frequent in care facilities (OR 0.43; 95% CI 0.20-0.93) and more frequent in public places (OR 2.11; 95% CI 1.08-4.10). In witnessed FBAO, removal attempts were less likely when witnesses were older and when events occurred in public places. These findings may help inform age-tailored and setting-specific first-aid strategies to increase bystander intervention.
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Tissue-based inguinal hernia repair is traditionally performed with non-absorbable sutures or wire. Interest exists in absorbable sutures, particularly long-term materials. This review summarizes evidence as a basis for potential future pilot studies in non-mesh techniques aiming to reduce foreign body load. A narrative literature review was conducted between October 2025 and January 2026 using a structured and transparent search strategy. Four investigators independently searched PubMed/MEDLINE for clinical studies on non-mesh inguinal hernia repair using absorbable sutures. Eligible studies were qualitatively synthesized, and levels of evidence were assessed using the Oxford Centre for Evidence-Based Medicine (OCEBM) classification. The search included title and abstract terms for Shouldice, Bassini, and Desarda. Sixteen studies (1983-2023) were included, comprising randomized trials, prospective studies, and one registry analysis. In Shouldice Repair, recurrence ranged from 0.5% to 8.9% with 3-31 months follow-up, while registry data (9-year follow-up) showed increased reoperation risk versus non-absorbable sutures. Bassini repair using short-term absorbable sutures showed recurrence rates of 3.3% to 20%. Desarda repair demonstrated low recurrence rates (0-2.4%), particularly with long-term absorbable materials. Heterogeneity was substantial across design, materials, follow-up, and outcomes. Follow-up duration and reporting were inconsistent, limiting comparability and meta-analysis. Available evidence indicates that absorbable sutures in established tissue-based inguinal hernia repair are associated with higher recurrence and cannot currently be recommended, particularly for Shouldice and Bassini repair. However, reducing permanent foreign body load remains important. Future research should focus on long-term or ultra-long-term absorbable sutures and hybrid approaches to enable durable, mesh-free repair without permanent foreign material.
Endometrial osseous metaplasia is a rare cause of abnormal uterine bleeding that can mimic an intrauterine foreign body on imaging, leading to diagnostic uncertainty. We report a 48-year-old woman with long-standing abnormal uterine bleeding, prior term vaginal deliveries, and no history of uterine instrumentation or pregnancy loss. Transvaginal ultrasound suggested an intrauterine device. Diagnostic hysteroscopy revealed a firm, whitish, cylindrical lesion with multiple projections anchored at the isthmus and tightly adherent to the myometrium, precluding complete removal due to perforation risk. Representative biopsies were obtained with minimal bleeding. Histopathology confirmed mature bone consistent with endometrial osseous metaplasia, without malignancy or foreign material. The patient experienced symptomatic improvement post-procedure and had an uncomplicated outpatient follow-up. A brief review of the literature indicates that although most cases are linked to prior obstetric events or uterine instrumentation, osseous metaplasia can occur in their absence and may present as an apparent intrauterine device on ultrasound. This report underscores the importance of considering osseous metaplasia in the differential diagnosis of abnormal uterine bleeding and highlights hysteroscopy as the definitive diagnostic and therapeutic approach to obtain targeted tissue and guide management while avoiding unnecessary interventions.
Elimination of defects of the anatomical structures of the external nose is the most complex area of reconstructive surgery, from simple suturing of a small defect and adequate matching of the wound edges to the use of revascularized flaps from distant parts of the body. Difficulties arise due to the special anatomy of this area and the limited number of local and regional flaps. The article provides an overview of treatment methods based on the experience of Russian and foreign surgeons, as well as a series of our own observations. To analyze our own clinical cases of acquired defects of the anatomical structures of the external nose (features of surgical treatment) and compare them with the data of Russian and foreign literature. A retrospective review of case histories with the diagnosis of «Acquired defect of the external nose» was conducted from 2015 to June 2025 in the Pediatric Otolaryngology Department of the Federal State Budgetary Institution of Higher Education NMITSO FMBA of Russia, the Russian Children's Clinical Hospital - a branch of the Federal State Autonomous Educational Institution of Higher Education RNIMU named after N.I. Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. Complaints, anamnesis data, results of endoscopic examination and efficiency of the performed surgical treatment were analyzed. Over the last 10 years, 16 patients with the diagnosis of «Acquired defects of the external nose» were treated in the pediatric otolaryngology departments of the Federal State Budgetary Institution of Higher Education N.I. Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. The acquired defect of the external nose was located on the wings of the nose in 1 patient, the dorsum of the external nose - in 3 patients, the columella of the nose - in 7 patients, cicatricial obliterations of the vestibule of the nasal cavity - in 2 patients, combined defects of the external nose - in 3 patients. All patients underwent surgical treatment. A combined treatment method was used in all patients. No relapses were observed in any of the patients after surgical treatment using the methods we proposed for a period of 6 months to 5 years (3 years on average). The development of an algorithm for reconstruction and a surgical approach to the treatment of acquired defects of the external nose in children ensures not only an optimal functional result, but also an aesthetic one, and helps to anticipate problems that can be avoided through careful preoperative planning. Устранение дефектов анатомических структур наружного носа — это наиболее сложная отрасль реконструктивной хирургии, от простого ушивания дефекта при небольшом размере и адекватного сопоставления краев раны до применения реваскуляризированных лоскутов из отдаленных частей тела. Сложности возникают из-за особой анатомии данной области и ограниченного количества местных и региональных лоскутов. Представлен обзор методов лечения на основе опыта российских и иностранных хирургов, а также собственных наблюдений. Проанализировать клинические случаи приобретенных дефектов анатомических структур наружного носа из нашей практики и особенности хирургического лечения, сравнить с данными российской и зарубежной литературы. Проведен ретроспективный обзор историй болезни пациентов с диагнозом «приобретенный дефект наружного носа», лечившихся в детском оториноларингологическом отделении ФГБУ НМИЦО ФМБА России, в оториноларингологическом отделении РДКБ ФГБОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава России с 2015 г. по июнь 2025 г. Проанализированы жалобы, данные анамнеза, результаты эндоскопического осмотра и эффективность хирургического лечения. За последние 10 лет пролечено 16 пациентов с диагнозом «приобретенные дефекты наружного носа». Дефект наружного носа располагался на крыльях носа у 1 пациента, спинке наружного носа — у 3, колумелле — у 7, рубцовые облитерации преддверия полости носа выявлены у 2 пациентов, сочетанные дефекты наружного носа — у 3. Всем пациентам проведено хирургическое лечение. У всех пациентов использован комбинированный метод лечения. После хирургического лечения с применением предложенных нами методик ни у одного из пациентов не было рецидивов в период наблюдения от 6 мес до 5 лет (в среднем 3 года). Разработка алгоритма реконструкции и хирургического подхода в лечении приобретенных дефектов наружного носа у детей обеспечивает не только оптимальный функциональный результат, но и эстетический, а также помогает предвидеть проблемы, которых можно избежать путем тщательного предоперационного планирования.
Senecavirus A (SVA) is an emerging swine virus that causes vesicular lesions clinically indistinguishable from other high-consequence transboundary viral vesicular diseases, creating significant diagnostic and economic challenges. Rapid and specific detection of SVA is, therefore, critical for supporting foreign animal disease (FAD) investigations. In this study, we generated and characterized monoclonal antibodies (MAbs) targeting the SVA VP2 capsid protein, and assessed their performance in multiple immunoassay formats. Two MAbs, 2D1 and 7B3, demonstrated strong and specific binding to both recombinant VP2 and native SVA. Using these antibodies, we developed a sandwich ELISA (sELISA) capable of direct viral detection with a sensitivity of 60 pg/mL. This assay detects contemporary SVA strains and provides a rapid, high-sensitivity platform suitable for differential disease diagnosis of idiopathic vesicular disease. These VP2-directed immunoassays offer valuable tools to enhance SVA surveillance and streamline FAD investigative workflows.IMPORTANCESenecavirus A (SVA) produces vesicular lesions that are clinically indistinguishable from foot-and-mouth disease and other high-consequence transboundary viruses, making rapid and accurate differentiation essential during foreign animal disease (FAD) investigations. These investigations impose substantial operational and economic burdens, including movement restrictions and diagnostic delays caused by the lack of rapid, field-deployable testing tools. Current surveillance relies heavily on laboratory-based molecular assays, underscoring the acute need for a rapid, pen-side method capable of direct SVA detection. The monoclonal antibodies developed in this study target conserved, surface-exposed VP2 on the SVA capsid, enabling the first sandwich ELISA capable of detecting native virus with high sensitivity across circulating strains. This diagnostic platform provides a fast, inexpensive tool with the potential to improve differential diagnosis, accelerate FAD investigations, and reduce the operational disruptions associated with SVA-related outbreaks.
Second language (L2) writing is not only a cognitive activity but also an emotionally involving process. However, the joint influence of motivational self-guides and achievement emotions on L2 writing outcomes remains underexplored in Asia-Pacific contexts. Drawing on the L2 Motivational Self System and Control-Value Theory, this study examined how future L2 writing selves predict English as a Foreign Language (EFL) writing achievement through foreign language writing enjoyment (FLWE) and boredom (FLWB). This quantitative cross-sectional study involved 349 first-year Chinese EFL undergraduates. Data were collected through validated self-report scales and a standardized argumentative writing task. Confirmatory factor analysis (CFA) and parallel multiple mediation analysis (PROCESS Model 4) were conducted. Both the ideal L2 writing self (ILWS) and the ought-to L2 writing self (OLWS/own) positively predicted FLWE and writing achievement, and negatively predicted FLWB. FLWE positively predicted writing achievement, whereas FLWB negatively predicted it. FLWE and FLWB jointly and partially mediated the relationships between future L2 writing selves and writing achievement, with enjoyment emerging as the stronger mediator. These findings highlight the dynamic interplay between motivation and emotion in exam-oriented EFL settings and underscore the importance of fostering future-oriented writing identities alongside positive emotional experiences to enhance L2 writing performance.
Parental burnout (PB) was examined in 73 Chilean mother-child dyads (N = 73; children 3-5 years, M = 4.2; mothers, all women, M = 37.7). Children were 45 girls and 28 boys; mothers were 61 Chilean and 12 foreign-born. Groups were categorized as high PB (n = 17), at-risk (n = 20), and low PB (n = 36). Analyses adjusted for child age, sex, and maternal nationality. Omnibus effects were large for child hair cortisol (η2 = 0.30) and inhibitory control (η2 = 0.26). Compared to the low PB group, children of mothers in the high PB group showed higher hair cortisol (g = 1.14, 95% CI [0.53,1.75]) and poorer inhibition (g = -1.85, [-2.52,-1.18]); externalizing problems were higher (g = 1.23, [0.62,1.85]). Mothers with higher PB levels also showed higher hair cortisol (g = 1.36, [0.73, 1.99]). Results indicate significant multilevel associations between PB and children's biological, behavioral and cognitive outcomes.
The U.S. swine industry faces ongoing challenges in hiring and retaining a skilled workforce. Therefore, it heavily relies on foreign workers from the North American Free Trade Agreement (NAFTA) through the TN-visa program. TN-visa workers also experience high turnover rates, which shows a strong need to examine the retention of these workers in greater detail. The objectives of this research were to determine the demographics, motivation, and experience of this critical workforce. Furthermore, it was to determine predictive variables of career advancement and role attainment. A survey was conducted with 261 TN-visa workers. Thirty farms surveyed reported approximately 40% of TN-visa employees within their workforce. In addition, two-thirds of TN-visa holders move to the U.S. in their early to mid-thirties, have high educational attainment (10% earned a master's degree) and prefer to speak Spanish (80%). They expressed the desire for better salaries, and financially supporting family in Mexico was the primary driver for employment in the U.S. Professional motivations were highly rated as acquiring new skills and experiencing a positive and supportive work environment. Cultural adaptation was the greatest obstacle for resettling workers, particularly navigating language barriers, which hindered their ability to communicate effectively in the workplace and integrate into the local community.  The multivariable mixed-effects logistic regression revealed that TN-visa workers with 3-6 years and over 6 years of experience in the TN-visa program demonstrated three-fold (OR = 3.15; P = 0.005) and four-fold (OR = 4.00; P = 0.014) elevated odds of holding managerial positions, respectively, in comparison to those with less experience in the program. Moreover, employees that were aware of promotion opportunities at their workplace had over four-fold higher odds of working in upper management compared to workers that did not (OR = 4.4; P = 0.003). Also, females tended to have two-fold higher odds of holding a management position compared to males (OR = 2.00; P = 0.065). Furthermore, extensive organizational support designed to mitigate the social and linguistic obstacles associated with cross-border professional relocation is crucial for enabling TN-visa professionals to effectively integrate and thrive in their positions. Addressing these systemic issues will be crucial for the U.S. swine industry to stabilize its workforce and fully leverage the expertise of these skilled employees.
Inflamed epidermal cysts have traditionally been managed using a 2-stage approach based on the assumption that inflammation indicates active infection. However, emerging evidence suggests that sterile inflammation resulting from keratin-induced foreign body reactions may be more common than actual infections. This study aimed to evaluate the microbiological profiles and clinical outcomes of immediate excision and primary closure of inflamed and non-inflamed epidermal cysts without the use of routine antibiotic therapy. This retrospective cohort study was conducted using prospectively collected clinical data between May 2023 and May 2025. Adult patients with clinically suspected epidermal cysts underwent immediate surgical excision and primary closure regardless of inflammation status. Intraoperative bacterial cultures were performed, and antibiotics were administered only when clinically indicated. Among 444 histologically confirmed cases of epidermal cysts, 254 (62.4%) were classified as inflamed. Positive bacterial cultures were more common in the inflamed cyst group than in the non-inflamed cyst group (P = .003); however, most isolates were skin commensals. Staphylococcus aureus was isolated from 26 cases (24 inflamed and 2 non-inflamed), with methicillin-resistant S aureus detected in 13 of the 24 inflamed cases. The overall complication rate was 2.5%, with no significant difference between the groups (3.1% vs 1.3%, P = .332). Only 1 immunosuppressed patient harboring methicillin-resistant S aureus required reoperation. Immediate surgical excision with primary closure is a safe and effective treatment for both inflamed and non-inflamed epidermal cysts. Routine antibiotic therapy and delayed surgery may not be necessary in most cases, supporting a simplified, single-stage management approach.
Tinnitus is a serious medical and social problem of our time for many people, leading to significant psycho-emotional shock in some cases, disruption of social and professional adaptation. To date, there are several methods of treating tinnitus, the principle of which is based on pathogenetic concepts of brain neuroplasticity. The purpose of this work is to review existing tinnitus treatment methods from the point of view of modern neurophysiological concepts. Materials and methods: A keyword search and analysis of the works found in Russian and foreign databases (elibrary, CyberLeninka, PubMed, Scopus, Google Academic) over the past 5 years was carried out. A total of 387 keyword publications were found, and after eliminating duplicates and those that did not match the subject of the article, 21 papers were selected. Results. The use of non-medicinal tinnitus therapies such as sound therapy, transcranial magnetic stimulation, bimodal stimulation, and psychotherapeutic methods has shown statistically significant effectiveness in a number of systematic reviews and meta-analyses, both as part of monotherapy and as part of complex therapy aimed at retraining in tinnitus, which has shown the best results. The effectiveness of these methods has a neurophysiological explanation based on the neuroplasticity of the brain and the fact that changes occurring during the development of tinnitus can regress with certain measures. Thus, these options can be considered effective pathogenetic methods of treating tinnitus from the point of view of the principles of evidence-based medicine. Тиннитус представляет собой серьезную медико-социальную проблему, поскольку зачастую приводит к значительному психоэмоциональному потрясению, нарушению социальной и профессиональной адаптации. Предложен ряд немедикаментозных методов компенсации тиннитуса, принцип которых основан на патогенетических понятиях о нейропластичности мозга. Выполнить анализ немедикаментозных методов компенсации тиннитуса с точки зрения современных нейрофизиологических представлений. Проведены поиск и анализ работ, содержащихся в российских и зарубежных базах данных (eLibrary, КиберЛенинка, PubMed, Scopus, Google Academic), за последние 5 лет по ключевым словам: «тиннитус», «лечение», «терапия», «нейрофизиология», «нейропластичность», «tinnitus», «treatment», «neurophysiology», «neuroplasticity». Всего найдено 387 публикаций. После исключения дублирующихся, а также не отвечающих тематике статей отобрана 21 работа. По данным систематических обзоров и метаанализов, применение таких немедикаментозных методов лечения тиннитуса, как звуковая терапия, транскраниальная магнитная стимуляция, бимодальная (соматосенсорная) стимуляция, психотерапия, обеспечивало статистически значимую эффективность как в виде монотерапии, так и в составе комплексной терапии, направленной на переобучение при шуме в ушах. Наилучшие результаты получены при применении комплексной терапии. Эффективность данных методов имеет нейрофизиологическое объяснение, основанное на нейропластичности мозга и теории замещения активности нейронов при тиннитусе. Предложенные варианты можно считать эффективными патогенетическими методами компенсации тиннитуса с точки зрения принципов доказательной медицины.
Mesh repair reduces hernia recurrence compared with suture repair, but permanent synthetic meshes are associated with chronic foreign-body complications. Biosynthetic poly-4-hydroxybutyrate mesh (Phasix™) provides temporary reinforcement with gradual resorption; however, short-term real-world outcomes across different hernia types remain limited. This study evaluated short-term outcomes after Phasix™ hernia repair and identified factors associated with baseline recurrent hernia at presentation. This retrospective cohort included patients ≥ 16 years who underwent open or laparoscopic hernia repair with Phasix™ at King Abdulaziz Medical City (2020-2023). Patients receiving other mesh types were excluded. Demographic, operative, and postoperative data were analyzed. Multivariable logistic regression identified factors associated with baseline recurrent hernia. Among the 228 patients (51.8% female; mean age 55 years), hernia types were incisional (36.0%), paraumbilical (26.3%), and inguinal (24.6%). Early complications were uncommon: seroma in 2.2% and surgical site infection in 1.8% at 1 month. One-year recurrence occurred in 1.3% (3/228). Female sex, prior incisional hernia repair, previous mesh removal, and open repair independently predicted baseline recurrent hernia, while laparoscopic repair was protective. Phasix™ repair demonstrated low short-term complication rates and rare 1-year recurrence across ventral and inguinal hernias. Short-term outcomes were driven mainly by patient and procedural factors rather than mesh-specific effects.
Vallecular masses are uncommon lesions, typically benign. Non-Hodgkin lymphoma (NHL) arising in vallecular cysts is exceedingly rare, with only three previous case reports documented in the medical literature. A 58-year-old male presented with a two-month history of throat foreign body sensation without any systemic symptoms. Physical examination and initial assessment appeared unremarkable. Fibre optic laryngoscopy and contrast-enhanced computed tomography (CECT) revealed a 3 → 3-cm smooth cystic lesion in the right vallecula. Transoral collar-assisted surgical excision was performed, followed by a comprehensive histopathological examination. Histopathological findings confirmed the diagnosis of diffuse large B-cell lymphoma not otherwise specified (DLBCL NOS). Fluorodeoxyglucose positron emission tomography showed no additional mitotically active lesions in nodal or extranodal sites. This case represents the first reported case of DLBCL NOS in a vallecular cyst. Despite NHL being a rare aetiology for vallecular masses, clinicians must maintain a high index of suspicion. A comprehensive multidisciplinary approach is crucial for accurate diagnosis and targeted treatment. This case underscores the importance of a thorough diagnostic evaluation for unusual vallecular masses.