hormone patches (Lyrelle / Lyrelle 50 / Lyrelle 80)

Experience of biological implants in thoracic surgery for soft tissue and chest wall reconstruction in clean and contaminated environments.

Jesani Hannah H, Surendrakumar Veena V, Walji Hasanali H, Ahmed Mostafa M et al.

Biological mesh has become an integral tool in surgery for reconstructive procedures. Acellular dermal matrices derived from porcine or bovine collagen scaffolds provide a durable implant material for use in reconstruction of the chest wall, and soft tissues including the pericardium and diaphragm. We aimed to present our experience of biological meshes used for thoracic reconstructive procedures for a wide range of clinical indications by a single surgeon, comparing the effect of contaminated and clean surgical environments and implant materials. We retrospectively reviewed all patients who had undergone thoracic surgery reconstructive procedures under a single surgical team with biological mesh material over a 16-year period from March 2009 to April 2025. Data included indication for surgery, operative procedure, surgical site, biological implant material (cross-linked or non-cross-linked), postoperative infection, in-hospital mortality and reoperation rate. We directly compared the results between patients undergoing the procedure in infected/contaminated versus clean cases. In total 152 consecutive procedures were performed utilising 212 patches. Median age was 65 years (range, 24-84 years) and majority treated were males 104/152 (68%). Indications for surgery included total pleurectomy for mesothelioma (38%), resection of extended thoracic malignancy (33%), surgery for trauma or related complications (19%), and benign conditions including adult congenital abnormalities (10%). Cross-linked biological mesh had a significantly reduced surgical site infection rate compared to non-cross-linked biological mesh (n=6; 7% vs. n=16; 23%, P=0.008). This remained significant following adjustment for key clinical confounding factors [adjusted odds ratio (OR) 0.289, 95% confidence interval (CI): 0.105-0.793, P=0.02]. Direct comparison of contaminated environments versus clean showed surgical site infections postoperatively were not significantly different (24% vs. 12% P=0.09). No biological patch necessitated explantation due to infection. In-hospital mortality and reoperation rates remained low at 4% and 9% respectively. Our study evaluates and supports the continued use of biological patches for thoracic reconstruction of soft tissues and chest wall. Biological patches have a role in a diverse range of surgical indications including extended resection of malignancy and traumatic injuries and can be feasibly used in high risk contaminated surgical fields.

Spatial control of parathyroid hormone receptor-1 signaling dictates ligand-specific biological outcomes.

Höppner Jakob J, Jüppner Harald H, Reyes Monica M, Yadav Prem Swaroop PS et al.

Parathyroid hormone receptor-1 (PTH1R) is a class B GPCR that regulates mineral ion homeostasis via parathyroid hormone (PTH) and skeletal development via parathyroid hormone-related peptide (PTHrP). While PTHrP signaling is thought to occur predominantly at the plasma membrane, PTH is considered to also signal from endosomes; however, the mechanisms that encode subcellular PTH1R actions, as well as the biological relevance of plasma membrane vs internalized PTH1R activation, remain unclear. Here, by examining the Eiken syndrome mutant R485X-PTH1R, in which C-tail truncation removes key βarrestin docking sites, we identified βarrestins as critical modulators of compartmentalized PTH1R signaling in response to endogenous ligands. Patients with Eiken syndrome display delayed bone mineralization, consistent with enhanced PTHrP actions, as well as hypocalcemia along with elevated PTH, which paradoxically indicates impaired PTH function. Mechanistic studies in cell-based assays and humanized R485X-PTH1R knock-in mice revealed that βarrestins dampen PTHrP-driven Gαs signaling at the plasma membrane but promote PTH-induced endosomal PTH1R signaling. βarrestins thus appear to impose bimodal, compartment-specific modulation of PTH1R signaling, thereby resolving the paradoxical Eiken phenotype. The findings support the notion that differences in subcellular PTH1R localization determine ligand-specific signaling outcomes in skeletal physiology and mineral ion homeostasis.

Correction: Patient derived xenograft models of hormone receptor positive and HER2 negative breast cancer from Indian patients.

Gandhi Khusbhoo A KA, Chaubal Rohan R, Talker Elizabeth E, Aadhi Jaya Chitra JC et al.

Retraction: Intracrinology and Testosterone Pellet Therapy: An Enzyme-Aware, Symptom-Driven Approach to Hormone Optimization in Aging.

Glaser Rebecca R

[This retracts the article DOI: 10.7759/cureus.106377.].