Regional Anesthesia with Spontaneous Breathing for Trans-Axillary Surgery in Thoracic Outlet Syndrome: A Retrospective Comparative Study.

Thoracic outlet syndrome (TOS) is an uncommon condition defined by the compression of neurovascular structures within the thoracic outlet. When conservative management strategies fail to alleviate symptoms, surgical decompression becomes necessary. The purpose of this study is to evaluate and compare the efficacy and safety of regional anesthesia (RA) using spontaneous breathing in contrast to general anesthesia (GA) for patients undergoing surgical intervention for TOS.

Forensic analysis of an alleged improvised explosive device (IED) from a multidisciplinary perspective: Organisation and outcomes of the ENFSI 2023 exercise.

Interdisciplinary examination of test materials requires careful consideration of how forensic routines can influence each other. This influence can be direct and obvious, or indirect and subtle. A multidisciplinary collaborative exercise (MdCE) should test a forensic laboratory's ability to account for these difficulties.

Incidence of hospital-acquired infections due to carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa in critically ill patients in Italy: a multicentre prospective cohort study.

Background: Carbapenem-Resistant Gram-Negative Bacteria, including Carbapenem-Resistant Enterobacterales (CRE) and Carbapenem-Resistant Pseudomonas aeruginosa (CRPA), are common causes of infections in intensive care units (ICUs) in Italy.

Objective: This prospective observational study evaluated the epidemiology, management, microbiological characterization, and outcomes of hospital-acquired CRE or CRPA infections treated in selected ICUs in Italy.

Methods: The study included patients with hospital-acquired infections due to CRE and CRPA treated in 20 ICUs from June 2021 to February 2023.

Treating Presbyphonia in 2024: A Scoping Review.

Presbyphonia is a multi-dimensional pathology. Therefore, its treatment should address its different affecting factors, including a global health management to fight geriatric frailty, improve overall physical strength, and limit medication side-effects. The specific therapies should address glottal gap closure and vocal folds' pliability.

Presbyphonia: A Scoping Review for a Comprehensive Assessment of Aging Voice.

Background: Presbylarynx refers to age-related changes in the larynx that can manifest clinically as presbyphonia. Several underlying mechanisms remain unclear.

Objectives: Perform a scoping review of the published literature on the mechanisms of presbyphonia in order to provide an adequate, comprehensive assessment of aging voice.

Ultrasonographic Features of the Fallopian Tubes: An Overview on Main Tubal Pathologies.

Fallopian tubes are not usually visible on a transvaginal pelvic scan unless pelvic fluid or pathological processes are present. Depending on the underlying pathological process, they may exhibit different wall thicknesses, grades of vascularization, and variable echogenicity. Recognizing the affected tube and assessing the possible underlying process is of primary importance in clinical practice, as pathological tubes may represent benign pathologies, oncological state, or life-threatening conditions requiring different treatment to preserve fertility.

Anticoagulation Management for Veno-Venous ECMO in COVID-19 Patients: Argatroban as Rescue Therapy in Heparin-Associated Thrombocytopenia.

Extracorporeal membrane oxygenation (ECMO) has been widely used as a life support technique in COVID-19 acute respiratory distress syndrome (ARDS). The use of anticoagulation during ECMO support remains a topic of debate. The primary aim of this study is to demonstrate the safety and efficacy of using argatroban as an anticoagulant instead of heparin in patients with heparin-associated thrombocytopenia.

Surgical alternatives to classical phonomicrosurgery for vocal fold cysts: our experience.

Background: Treating options for vocal fold cysts became more diversified with office-based laryngological surgery advances, offering new soft interventions, promising a good vocal outcome within a shorter healing period.

Methods: We proposed two types of in-office surgeries, performed in the outpatient setting: a cyst punction-aspiration emptying the cyst, relieving its tension and improving the mucosal wave, with 4 cases showing no refilling within one year of follow-up, and a cyst marsupialization with Blue Laser, with 3 reported cases showing good vocal fold healing within three months.

Conclusion: Both techniques showed promising results in improving vocal function and minimizing recovery time.

Enhanced and Efficient Predictions of Dynamic Ionization through Constant-pH Adiabatic Free Energy Dynamics.

Dynamic or structurally induced ionization is a critical aspect of many physical, chemical, and biological processes. Molecular dynamics (MD) based simulation approaches, specifically constant pH MD methods, have been developed to simulate ionization states of molecules or proteins under experimentally or physiologically relevant conditions. While such approaches are now widely utilized to predict ionization sites of macromolecules or to study physical or biological phenomena, they are often computationally expensive and require long simulation times to converge.

The seventh blind test of crystal structure prediction: structure generation methods.

A seventh blind test of crystal structure prediction was organized by the Cambridge Crystallographic Data Centre featuring seven target systems of varying complexity: a silicon and iodine-containing molecule, a copper coordination complex, a near-rigid molecule, a cocrystal, a polymorphic small agrochemical, a highly flexible polymorphic drug candidate, and a polymorphic morpholine salt. In this first of two parts focusing on structure generation methods, many crystal structure prediction (CSP) methods performed well for the small but flexible agrochemical compound, successfully reproducing the experimentally observed crystal structures, while few groups were successful for the systems of higher complexity. A powder X-ray diffraction (PXRD) assisted exercise demonstrated the use of CSP in successfully determining a crystal structure from a low-quality PXRD pattern.

Outcome of adult acute myeloid leukemia patients with extramedullary disease and treatment with venetoclax/hypomethylating agents.

We evaluated response to VEN/HMA in 46 patients with acute myeloid leukemia (AML) characterized by extramedullary disease (EMD). Median age was 65 (range, 19-81) years. Patients had a median of two EMD sites (range, 1-5) and 35 (76%) patients had concurrent bone marrow involvement.

Lights and Shadows of Bacillus Calmette-Guérin (BCG)-exposed and BCG-unresponsive Definitions: A Practical Overview.

According to the current definitions of recurrence of non-muscle-invasive bladder cancer after bacillus Calmette-Guérin (BCG), patients in the BCG-exposed and late relapse categories might benefit from further instillations. Patients with BCG-unresponsive disease could be included in clinical trials, but otherwise radical cystectomy is the preferred treatment. BCG-intolerant disease still represents an area of debate, with limited evidence regarding the best treatment for these patients.

Follow-up strategies after trimodal treatment for muscle-invasive bladder cancer: a systematic review.

Purpose: Optimal follow-up strategies following trimodal treatment for muscle invasive bladder cancer play a crucial role in detecting and managing relapse and side-effects. This article provides a comprehensive summary of the patterns and risk factors of relapse, functional outcomes, and follow-up protocols.

Methods: A systematic literature search on PubMed and review of current guidelines and institutional follow-up protocols after trimodal therapy were conducted.

Tubal Cancer Clinical Management: Two Exceptional Scenarios and a Review of the Literature.

This article provides a literature review on tubal carcinoma to offer an updated insight into its preventative strategies, diagnosis, treatment and oncological surveillance. In addition to the search string utilized, the authors' focus extended to key scientific studies, consensus statements, guidelines and relevant case reports essential for the proper clinical management of the disease, providing a methodologically well-structured literature review combined with practical expertise in the oncological field. This article also includes two special clinical cases that emphasize the importance of understanding the physiopathology and the current state of the art in the anatomopathological advancements in tubal/ovarian/peritoneal carcinoma, often assimilated into a single clinical entity and to which many of the concepts extracted from the literature can apply.

Pelvic Sentinel Lymph Node Biopsy for Endometrial Cancer with Multi-Modal Infrared Signal Technology: A Video Article.

This video article summarizes a case study involving the use of pelvic sentinel lymph node (SLN) biopsy for endometrial cancer (EC) staging and treatment utilizing a multi-modal infrared signal technology. This innovative approach combines cervical injection of fluorescent dye indocyanine green (ICG) and near-infrared imaging to enhance SLN detection rates in early-stage EC patients. The study showcases the successful application of advanced technology in improving surgical staging procedures and reducing postoperative morbidity for patients.

Observation With or Without Subsequent Salvage Therapy for Pathologically Node-positive Prostate Cancer With Negative Conventional Imaging: Results From a Large Multicenter Cohort.

Background And Objective: More than 10% of patients with negative clinical metastatic status (cN0M0) on conventional imaging for prostate cancer (PCa) harbor lymph node involvement (pN+) at final pathology following radical prostatectomy (RP) and lymphadenectomy. Our aim was to assess outcomes of initial observation for cN0M0 pN+ PCa and identify prognostic factors that may help in clinical decision-making.

Methods: We performed a retrospective multicenter study of patients with cN0M0 PCa on conventional imaging (computed tomography and/or magnetic resonance imaging, and a bone scan) who were found to have pN+ disease at RP between 2000 and 2021.

Investigating pollution input to coastal groundwater-dependent ecosystems in dry Mediterranean agricultural regions.

The insufficient taking into account of groundwater as a basis for implementing protection measures for coastal wetlands can be related to the damage they are increasingly exposed to. The aim of this study is to demonstrate the pertinence of combining hydrogeological tools with assessment of pollutant fluxes and stable isotopes of O, H and N, as well as groundwater time-tracers to identify past and present pollution sources resulting from human activities and threatening shallow groundwater-dependent ecosystems. A survey combining physico-chemical parameters, major ions, environmental isotopes (O, H, N and H), with emerging organic contaminants including pesticides and trace elements, associated with a land use analysis, was carried out in southern Italy, including groundwater, surface water and lagoon water samples.

Comparative efficacy of subcutaneous versus intravenous natalizumab on annualized relapse rate: A post-hoc analysis of the REFINE study.

Background: The non-inferiority of the efficacy of subcutaneous (SC) vs intravenous (IV) administration of natalizumab (NTZ) once every 4 weeks in relapsing-remitting multiple sclerosis (RRMS) was recently demonstrated on the primary outcome of the REFINE study, i.e. MRI "combined unique active lesions number" (CUAL).

Impact of the in-office surgical activity on the classical phonomicrosurgical interventions in a laryngology referral center.

Office-based laryngology procedures evolved in the recent years with all the technology advances and have gained popularity among laryngologists. The indications enlarged, making it a valid surgical option for almost all voice disorders. This emerging technique raise the question of the place left for traditional phonosurgeries in the operating room under general anesthesia.