Aikaterini Marini

Carpal tunnel syndrome (CTS) is a common compressive neuropathy, caused by entrapment of the median nerve within the carpal tunnel. CTS has a vast range of symptoms, resulting in sensory and motor dysfunction of the hand. Whether psychosocial factors are associated with CTS remains obscure. The present study examined the relationship between median nerve ultrasonographic cross-sectional area (CSA) and stress and depression among asymptomatic young individuals. The study involved 169 healthy Greek medical students (67 men and 102 women). Age, gender, dominant hand, medical history, daily hours of computer use, and family background were recorded. Two validated psychiatric questionnaires estimating stress and anxiety were self-completed. Median nerve status was examined using ultrasonography. A CSA of < 10 mm² was considered normal and > 12 mm² pathological. Data were analyzed using Pearson linear correlation and t-test. Mean CSA of the median nerve was 0.082 cm (SD = 0.018). Total daily time of computer use was positively correlated with CSA ( p = 0.012). Mean Zung Scale Score for depression was 38.89 (± 8.76), while STAI-Y1 and STAI-Y2 for anxiety estimation were 37.28 (± 9.78) and 41.14 (± 11.21) respectively. CSA of the median nerve was positively associated with ZUNG ( p = 0.001), STAI-Y1 ( p < 0.001) and STAI-Y2 ( p < 0.001) scores. The daily hours of computer use, depression and anxiety are positively associated with median nerve CSA among healthy young adults. The correlation between anxiety, depression and CSA highlights the need for both biomechanical and psychiatric interventions in asymptomatic subjects with psychological distress.

Background/Objectives: This study investigates the relationship between Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP), neurophysiological markers assessed via Visual Evoked Potentials (VEPs), and functional capacity. Methods: A total of 190 participants, comprising 95 patients and 95 healthy controls, underwent specialized assessments of VEP latencies and amplitudes (P100 and N145), as well as dominant and non-dominant grip strength. Statistical analyses using independent-samples t-tests and linear regression revealed that patients exhibited significantly prolonged P100 and N145 latencies and reduced P100 amplitudes compared with controls, reflecting impaired neural conduction and heterogeneous fiber involvement. Results: Patients also demonstrated markedly reduced bilateral grip strength, confirming the disease’s impact on gross motor skills and sensorimotor integration. Although gender did not broadly differentiate clinical expression, patients receiving intravenous immunoglobulin (IVIg) therapy showed significant improvements in P100 latency and bilateral grip strength, compared with those not receiving treatment. Conclusions: These findings underscore the utility of VEPs and grip strength as reliable biomarkers for monitoring demyelination and functional status, suggesting that their combined evaluation can enhance clinical management and the assessment of therapeutic response in CIDP.

Purpose Squamous cell carcinoma of the tongue (TSCC) is the most common cancer of the oral cavity accounting for 25–40% of the cases. Its unfavorable prognosis is partly attributed to the high incidence of lymph node metastasis, while lymphatic vessel density (LVD) is a potential predictor of tumor progression, metastasis, and patient survival. The purpose of this study was to conduct a systematic review and meta-analysis, that evaluates the prognostic significance of LVD regarding nodal metastasis in TSCC, focusing on intratumoral and peritumoral LVD. Methods The studies included referred to patients with TSCC who underwent tumor resection and LVD was estimated via immunohistochemistry (D2-40, LYVE-1). Literature search and data extraction were performed by two independent reviewers. Hazard ratios (HRs) and mean differences were calculated using fixed-effects or random-effects models and heterogeneity was assessed via I² statistics. A total of 26 studies were identified, with 6 meeting eligibility criteria. Results The principal outcome was the significant association between high overall LVD and increased nodal metastasis (summary mean difference: 0.85; 95% CI: 0.21, 1.49; p= 0.010, I²=77.6%). No statistically significant association was observed for intratumoral (summary HR: 0.23; 95% CI: -0.45, 0.92; p = 0.501, I²=81%) or peritumoral LVD (summary HR: 0.10; 95% CI: -0.80, 0.99; p = 0.832, I²=89.8%). Conclusion The major conclusion of this study is that overall LVD is an indicator of aggressiveness of TSCC and a negative prognostic factor strongly associated with nodal metastasis. LVD assessment can improve risk stratification and lead to personalized treatment approaches in TSCC management.

Thyroid carcinoma showing thymic-like differentiation (CASTLE) comprises a rare neoplasm of the thyroid gland which arises from ectopic thymic tissue or remnants of brachial pouches. CASTLE is regarded as an indolent neoplasm with a favorable prognosis, irrespective of its metastatic potential. Diagnosis is difficult as clinicopathological features have not been yet well-defined. Radiological findings are not specific and only immunohistochemical positivity for CD5 and CD117 staining is highly suggestive of CASTLE. Despite lack of universally accepted treatment recommendations, the mainstay treatment includes thyroidectomy and systematic lymph node dissection. We report a case of CASTLE tumour with very uncommon characteristics developed in a 76-year-old man, who presented with rapidly deteriorating dyspnea and severe cough, resulting in respiratory failure. At surgery, a suspicious looking tumour arising from the upper pole of the right lobe of the thyroid gland, surrounding the trachea and displacing the right common carotid artery, was identified. The patient underwent en bloc resection of the tumour with the thyroid gland and regional lymph node dissection. This is the first reported case of CASTLE causing tracheal ring fracture. Thyroid carcinoma showing thymic-like differentiation (CASTLE) comprises a rare neoplasm of the thyroid gland which arises from ectopic thymic tissue or remnants of brachial pouches. CASTLE is regarded as an indolent neoplasm with a favorable prognosis, irrespective of its metastatic potential. Diagnosis is difficult as clinicopathological features have not been yet well-defined. Radiological findings are not specific and only immunohistochemical positivity for CD5 and CD117 staining is highly suggestive of CASTLE. Despite lack of universally accepted treatment recommendations, the mainstay treatment includes thyroidectomy and systematic lymph node dissection. We report a case of CASTLE tumour with very uncommon characteristics developed in a 76-year-old man, who presented with rapidly deteriorating dyspnea and severe cough, resulting in respiratory failure. At surgery, a suspicious looking tumour arising from the upper pole of the right lobe of the thyroid gland, surrounding the trachea and displacing the right common carotid artery, was identified. The patient underwent en bloc resection of the tumour with the thyroid gland and regional lymph node dissection. This is the first reported case of CASTLE causing tracheal ring fracture.

The temporomandibular joint is a unique bi-condylar joint involved in mastication and speech. Temporomandibular joint disorders (TMD) have a range of symptoms, including aural symptoms, and are present in approximately 75% of normal populations. The present study examined the relationship between signs and symptoms of TMD and mouth opening, gender, joint and aural symptoms, and hearing loss.

The radioulnar carpal joint is critical for hand and wrist function. Radioulnar deviation indicates distal radioulnar joint flexibility and reflects the structure and function of the carpal bones, ulna, radius and ligaments. The present study examined whether radioulnar deviation is affected by gender, manual labor, playing a musical instrument, playing sport, handedness, previous fracture or prior inflammation. The study used clinical findings based on anatomical landmarks

Eosinophilic granuloma is very rare benign bone tumor which presents in more than 90% in children under the age of ten. There is predominance for males. It is usually found at flat and long bones. The skull and vertebral spine is often affected. We report a case of 57 year-old man who gradually developed local pain at his skull and orbit. A soft, movable, palpable and tender mass was found at the left temporal bone. The pain deteriorated after an accidental injury at skull and remained so. The clinical examination revealed no pathological findings. The patient was a doctor who smoked and consumed alcohol daily. He had a history of cardial infraction and psoriatic arthritis. X-rays and CT revealed a round lytic defect at the skull. Its borders were sharp and its size was 1.6 × 1.8 cm. No periostic reaction or bone formation was noted. Scintigraphy depicted a lytic lesion without radionuclide enhancement. Thus we suspected an eosinophilic granuloma. An attempt to excise the tumor failed as it had already eroded the underlying temporal bone. The external meninga was affected but not the internal one. Histological diagnosis with dominance of Langerhans cells set the diagnosis. A second surgery was done and the eosinophilic granuloma was extracted. After eight months the gap was bridged with plastic heterologous transplant. After the curettage the patient received antibiotics and five cycles of radiotherapy. The aesthetic result was excellent. The patient's head has a normal hairy appearance. No tenderness, swelling or recurrence is recorded until now.

Adamantinoma is one of the rarest low-grade malignant bone tumours, representing less than 1% of them. Fisher in 1913 named this tumour adamantinoma because of its similarity to ameloblastoma of the jaw. It usually arises in the center of long bones, and 97% of all reported cases were in long tubular bones and mainly in the tibial mid shaft (80-85%). Other long bones not uncommonly affected are the humerus, ulna, femur, fibula and radius. Ribs, spine, metatarsal and carpal bones are very rarely affected. The symptoms are not specific but most frequently the patient complains about swelling, redness, pain and sensitivity of the bone where the tumour is located. Young males are more prone to develop adamantinoma than females. The tumour usually spreads to the lungs, the regional lymph nodes, or other bones. Wide tumour excision and limb salvage reconstruction surgery, or an amputation, are the current surgical treatment options. Radiotherapy and chemotherapy have not been shown to be effective modalities of treatment.