"Complete" duplication of the posterior cerebral artery: a rare variant detected on computed tomography angiography.

The cerebral arterial circle morphologic variability has been extensively studied. The posterior cerebral artery (PCA) variants are rarely identified, except from the first segment (P1) hypoplasia or absence. Due to its unique morphology, the computed tomography angiography (CTA) of a 34-year-old female patient was further investigated.

Accessory Posterior Cerebral Artery-The Hyperplastic Anterior Choroidal Artery Variant.

Variants of the cerebral arterial circle, both common and rare, are frequently documented. The authors present a distinct case involving a 54-year-old male patient who underwent a computed tomography angiogram (CTA), which was analyzed using planar slices and 3-dimensional reconstruction. In this case, the left posterior cerebral artery (PCA) received the posterior communicating artery (PComA) 7 mm distal to its origin from the basilar artery (BA).

A Rare Arterial Congenital Variant: The Internal Carotid Artery Agenesis.

The cerebral arterial circle has been extensively investigated in recent literature. A scarce congenital arterial variant is considered the internal carotid artery (ICA) agenesis. The computed tomography angiogram of a 65-year-old female patient is reported.

The Coexistence of Accessory Anterior Cerebral and Anterior Communicating Arteries.

Variations in the cerebral artery circle are more prevalent than one might expect. This imaging report outlines the variability observed in the anterior circulation of a 47-year-old female patient, analyzed using a computed tomography angiogram. The first segments (A1) of the anterior cerebral arteries (ACAs) on the left and right side emanate from the internal carotid artery.

GLP-1 Receptor Agonists and Diabetic Kidney Disease: A Game Charger in the Field?

Kidney disease is a public health epidemic affecting 10% of the population worldwide with a constantly rising incidence, and it is an important contributor to morbidity and mortality. Type 2 diabetes mellitus (T2DM) is a chronic complex condition with a rising incidence worldwide. T2DM remains the principal cause of chronic kidney disease (CKD), which is related to a high risk for cardiovascular (CV) events, end-stage kidney disease (ESKD), and, overall, considerable morbidity and mortality.

The role of C-reactive protein-to-albumin ratio as a prognostic biomarker in patients hospitalized for cardiorenal syndrome.

Background: Cardio-renal syndrome, characterized by simultaneous cardiac and renal impairment, presents significant challenges in patient prognostication and management. This study aimed to investigate the C-reactive protein-to-albumin ratio (CRP/Albumin ratio) as a prognostic marker in patients with cardiorenal syndrome.

Methods: This observational cohort study included consecutive patients hospitalized for cardiorenal syndrome.

Implementing the Global Leadership Initiative on Malnutrition (GLIM) criteria in Crohn's disease: Prevalence of malnutrition and association with clinical outcomes.

Background & Aims: Limited data exist regarding the implementation of the Global Leadership Initiative on Malnutrition (GLIM) criteria for diagnosing malnutrition in Crohn's disease (CD), and its association with CD prognosis. In the present study eighteen GLIM combinations and a combined one were implemented to identify differences in the prevalence of malnutrition and to investigate potential associations with clinical outcomes at 6 months.

Methods: Different methodologies to diagnose malnutrition were used at baseline, namely the Subjective Global Assessment (SGA), eighteen different combinations of phenotypic and etiologic GLIM criteria and a combined version based on all GLIM combinations (GLIMcv) to test differences in the estimated prevalence and outcomes' prognosis.

Mpox and Lessons Learned in the Light of the Recent Outbreak: A Narrative Review.

According to the WHO, more than 90,000 cases of mpox have been reported since the 2022 worldwide outbreak, which resulted in 167 deaths, while a new outbreak in Africa since 2023 has resulted in over 18,000 cases and 617 deaths. Mpox is a zoonosis caused by the monkeypox virus, a double-stranded DNA virus belonging to the Orthopoxvirus genus, which causes smallpox-like illness. Until 2022, cases were predominately located in West and Central Africa, with only sporadic cases and outbreaks reported in other parts of the world.

Pilot study on the effect of flavonoids on arterial stiffness and oxidative stress in chronic kidney disease.

Background: Flavonoids, the main class of polyphenols, exhibit antioxidant and antihypertensive properties.

Aim: To prospectively investigate the impact of flavonoids on arterial stiffness in patients with chronic kidney disease (CKD) stages I-IV.

Methods: In this prospective, single-arm study, CKD patients with arterial hypertension and diabetes mellitus were enrolled.

Changes in Empathy and Mental Resilience in Health Professionals After Completing the Certified "Generic Instructor Course" Seminar.

Introduction: Factors that may affect the performance of healthcare professionals performing resuscitation include stress, social profile, fatigue, empathy, and resilience. Interpersonal skills are required for better performance. This study aimed at evaluating the change in empathy and mental resilience in health professionals who have the status of instructor potential achieved after successfully completing a certified training/intervention course and want to develop/certify as course instructors.

Navigating nephrotoxic waters: A comprehensive overview of contrast-induced acute kidney injury prevention.

Contrast-induced acute kidney injury (CI-AKI) is the third leading cause of acute kidney injury deriving from the intravascular administration of contrast media in diagnostic and therapeutic procedures and leading to longer in-hospital stay and increased short and long-term mortality. Its pathophysiology, although not well-established, revolves around medullary hypoxia paired with the direct toxicity of the substance to the kidney. Critically ill patients, as well as those with pre-existing renal disease and cardiovascular comorbidities, are more susceptible to CI-AKI.

Hybrid endoscopic approaches for complex colorectal polyps with a non-lifting sign: the Greek experience.

Background: Hybrid approaches combining endoscopic full-thickness resection (EFTR) with conventional techniques (endoscopic mucosal resection [EMR], endoscopic submucosal dissection [ESD]) have enabled the resection of difficult fibrotic colorectal adenomas exhibiting a "non-lifting" sign, and polyps in difficult positions. We present our cohort treated with either EMR+EFTR or ESD+EFTR as salvage hybrid endoscopic approaches for complex colorectal polyps not amenable to conventional techniques.

Methods: Retrospective analysis included technical success, histological confirmation of margin-free resection, assessment of adverse events and follow up with histological assessment.

Neurosurgery Training in Greece.

Objective: The structure and specifics of neurosurgery residency training vary substantially across programs and countries, potentially leading to differences in clinical reasoning, surgical skills, and professionalism. The Greek neurosurgical training system is unique in numerous respects. This manuscript delineates the current state of neurosurgical residency training in Greece and outlines future directions.

Oral Molnupiravir and Nirmatrelvir/Ritonavir for the Treatment of COVID-19: A Literature Review with a Focus on Real-World Evidence.

Vaccines remain the cornerstone of medical prevention and are highly effective in reducing the risk of severe disease and death due to coronavirus disease 2019 (COVID-19). In the context of expanding the therapeutic armamentarium against COVID-19, molnupiravir (Lagevrio) and ritonavir-boosted nirmatrelvir (Paxlovid) were developed, constituting the first effective oral treatments against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this narrative review, we retrospectively inquired into the clinical trials and real-world studies investigating the efficacy of these agents.

Endoscopic intermuscular dissection (EID) for removing early rectal cancers and benign fibrotic rectal lesions.

In the current era of screening colonoscopy and increasing incidence of early rectal cancer, interventional endoscopy moves toward resections in deeper planes than the submucosal layer. Several reports support the use of endoscopic intermuscular dissection (EID) instead of endoscopic submucosal dissection (ESD) for the removal of deeply invasive rectal submucosal cancers. The resection plane into the intermuscular space, the space between the longitudinal (external) and circular (internal) muscle layer, allows radical removal of rectal invasive submucosal cancers.

Serum leucine-rich alpha-2 glycoprotein in monitoring disease activity and intestinal mucosal healing for biotherapy-naïve cases with ulcerative colitis.

Background And Aim: Serum leucine-rich alpha-2 glycoprotein level has been reported to be a useful biomarker in assessing mucosal healing in patients undergoing biotherapy, where mucosal lesions caused by ulcerative colitis are difficult to assess endoscopically. However, no such reports have been reported in biotherapy-naïve cases.

Methods: Sixty-eight patients with ulcerative colitis (UC) who were biotherapy-naïve at Kindai University Hospital between October 2021 and October 2022 were enrolled.

Biofluid Biomarkers in the Prognosis of Chronic Subdural Hematoma: A Systematic Scoping Review.

The present systematic scoping review aimed at mapping and analyzing the available literature on biological fluid (biofluid) biomarkers showing promise in the prediction of chronic subdural hematoma (cSDH) recurrence and the prognosis of neurological/functional patient outcome. Twenty-three studies published between 2003 and 2023 investigating a diverse range of biomarkers in hematoma fluid and/or the circulation in 3749 patients were included. Immune cell populations and inflammatory/anti-inflammatory cytokines comprised the most studied category of biomarkers displaying significant findings.

Novel therapeutic approaches in the management of chronic kidney disease: a narrative review.

Chronic kidney disease (CKD) remains a pathologic entity with constantly rising incidence and high rates of morbidity and mortality, which are associated with serious cardiovascular complications. Moreover, the incidence of end-stage renal disease tends to increase. The epidemiological trends of CKD warrant the development of novel therapeutic approaches aiming to prevent its development or retard its progression through the control of major risk factors: type 2 diabetes mellitus, arterial hypertension, and dyslipidemia.

Reliability of Moral Distress Scale, Secondary Traumatic Stress Scale, and Jefferson Scale of Empathy Among Greek Nurses: A Pilot Study.

Moral distress (MD), secondary traumatic stress (STS), and empathy are of particular interest to the nursing profession. The availability of validated tools for the assessment of these parameters is of high importance. The primary aim of this pilot study was to evaluate the reliability of the Greek version of the MD Scale or the revised version (MDS-R), the Jefferson Scale of Empathy for Health Professionals (JSE-HP), and the STS Scale (STSS) in Greek nurses working in open and psychiatric wards.

Epidemiology, Pathophysiology, and Clinical Perspectives of Intradialytic Hypertension.

Background: Individuals with end-stage renal disease on chronic hemodialysis (HD) may encounter numerous HD-associated complications, including intradialytic hypertension (IDHYPER). Although blood pressure (BP) follows a predictable course in the post-HD period, BP levels during the session may vary across the individuals. Typically, a decline in BP is noted during HD, but a significant proportion of patients exhibit a paradoxical elevation.

The Inflammatory Bowel Disease-Disk Tool for Assessing Disability in Inflammatory Bowel Disease Patients: Validation of the Greek Version.

Background: The Inflammatory Bowel Disease-Disk (IBD-Disk) is a physician-administered tool that evaluates the functional status of patients with Inflammatory Bowel Disease (IBD). The aim of our study was to validate the content of the IBD-Disk in a Greek cohort of IBD patients.

Methods: Two questionnaires [the IBD Disk and the IBD-Disability Index (IBD-DI)] were translated into Greek and administered to IBD patients at baseline visit, after 4 weeks and 6 months.

The impact of physical activity, quality of life and eating habits on cardiometabolic profile and adipokines in youth with T1D.

Purpose: Individuals with Type-1-Diabetes (T1D) are at higher risk of having premature cardiovascular-disease (CVD). Physical activity and healthy lifestyle are major components in the prevention of diabetes' related comorbidities and complications. The aim of this study was to investigate the impact of physical activity, eating habits and quality of life in children and adolescents with T1D on diabetic control, cardiovascular and biochemical profile, infection indices, and adipokine levels.