Endoscopic-Ultrasound-Guided Radiofrequency Ablation for Pancreatic Tumors.

Endoscopic ultrasound (EUS)-guided radiofrequency ablation (RFA) is a promising minimally invasive technique for the treatment of pancreatic lesions. This review first focuses on the technical aspects in EUS-RFA: the procedure typically employs EUS probes with integrated radiofrequency electrodes, enabling accurate targeting and ablation of pancreatic lesions. Different types of RFA devices, monopolar and bipolar energy delivery systems, are discussed, along with considerations for optimal ablation, including energy settings, procedure time, and pre- and post-procedural management.

Metaverse-Aided Rehabilitation: A Perspective Review of Successes and Pitfalls.

: The evolution of technology has continuously redefined the landscape of rehabilitation medicine. Researchers have long incorporated virtual reality (VR) as a promising intervention, providing immersive therapeutic environments for patients. The emergence of the metaverse has recently further expanded the potential applications of VR to augment the possibilities in rehabilitation.

Prevalence and Clinical Risk Factors of Thyroid Cancer in Retrosternal Goiter: A Retrospective Comparative Study with Cervical Multinodular Goiter.

Surgical intervention in asymptomatic retrosternal goiter (RSG) is debated in the absence of suspicious cytology, while performing fine-needle aspiration (FNA) is challenging in thyroids with mediastinal extension. The rate of unexpected thyroid cancers found at the time of thyroidectomy varies widely, while the notion of increased cancer incidence in RSG with respect to cervical goiters is still controversial. We retrospectively reviewed 411 patients with a preoperative diagnosis of multinodular goiter (MNG) (114 retrosternal, 297 cervical) who underwent thyroidectomy at an academic endocrine surgery referral center between January 2019 and October 2022.

Anticancer-Drug-Related Cardiotoxicity from Adjuvant Goserelin and Tamoxifen Therapy.

Breast cancer is a prevalent malignancy with rising incidence globally. Advances in endocrine therapy have improved outcomes for premenopausal women with hormone receptor-positive breast cancer. However, these treatments may induce menopause-like states, potentially elevating cardiovascular risks, including left ventricular (LV) dysfunction.

Unexpected Clinically Relevant Findings Detected via Computed Tomography in Patients with Severe Aortic Stenosis Who Are Candidates for Transcatheter Aortic Valve Replacement.

The detection of unexpected findings (UF) during CT scans of patients undergoing TAVR is frequent; however, it is unclear whether such findings have a clinical impact on the TAVR pathway. We conducted a retrospective, single-center observational study enrolling patients who were candidates for TAVR. All enrolled patients underwent a CT scan before valve implantation.

Efficacy and Safety of Pericapsular Nerve Group Block (PENG) in Hip Surgery Under General Anaesthesia: A Systematic Literature Review and Meta-Analysis.

: The pericapsular nerve group (PENG) block is a novel ultrasound-guided regional technique that may provide analgesia to patients undergoing hip surgery. It has been extensively studied in recent years, but the evidence of superiority over other regional anaesthetic techniques is inconclusive. This review aimed to compare outcomes of the PENG block in patients undergoing hip surgery with standard techniques under general anaesthesia.

Repeatability of Pentacam HR in Keratoconus According to Two Different Scan Protocols: 25-3D Scan and 50-Cornea Fine.

This study aims to evaluate the repeatability of the Pentacam HR, comparing two different measurement modes (50-cornea fine and 25-3D scan) in patients affected by keratoconus. Multicenter retrospective study, conducted at Eye Clinic of the ASST-Spedali Civili-University of Brescia, Italy, and St. Paul's Eye Unit, Royal Liverpool University Hospital, United Kingdom.

Supra-Normal Ejection Fraction at Hospital Admission Stratifies Mortality Risk in HFpEF Patients Aged ≥ 70 Years.

During the last few years, significant pathophysiological differences between heart failure (HF) patients with "normal" ejection fraction (EF) (50% to 64%) and those with supra-normal EF (≥65%) have been highlighted. However, these distinct EF phenotypes have been poorly investigated in elderly patients aged ≥70 y. Accordingly, the present study aimed at assessing the clinical and echocardiographic characteristics of a retrospective cohort of elderly HFpEF patients (aged ≥ 70 y), categorized on the basis of "normal" EF (50 to 64%) or "supra-normal" EF (≥65%).

Frey's Syndrome Surgical Treatment After Parotidectomy: A Scoping Review.

Frey's syndrome surgical treatment may be either prophylactic or therapeutic. The aim of this study is to summarize the state of the art in Frey's syndrome surgical treatment after parotidectomy and review indications, advantages, and disadvantages of different surgical options. The study was conducted following the PRISMA guidelines for scoping reviews; to fulfill the research enquiries, four different electronic databases (PubMed, Scopus, Cochrane, and Web of Science) were searched using the PICO protocol and key words in Frey's syndrome surgical treatment.

Restoration of Genuine Sensation and Proprioception of Individual Fingers Following Transradial Amputation with Targeted Sensory Reinnervation as a Mechanoneural Interface.

: Tactile gnosis derives from the interplay between the hand's tactile input and the memory systems of the brain. It is the prerequisite for complex hand functions. Impaired sensation leads to profound disability.

Classifying Low Back Pain Through Pain Mechanisms: A Scoping Review for Physiotherapy Practice.

Low back pain (LBP) is a leading cause of disability worldwide, often driven by distinct pain mechanisms: nociceptive, neuropathic, and central sensitization. Accurate classification of these mechanisms is critical for guiding effective, targeted treatments. A scoping review was conducted following the Joanna Briggs Institute methodology and reported according to PRISMA-ScR guidelines.

Impact of Multidrug-Resistant Bacteria in a Cohort of COVID-19 Critically Ill Patients: Data from a Prospective Observational Study Conducted in a High-Antimicrobial-Resistance-Prevalence Center.

: Bacterial superinfections are common complications during viral infections, but the impact of multidrug-resistant (MDR) pathogens in critically ill patients affected by coronavirus disease 2019 (COVID-19) is still debated. : This is an observational, monocentric, and prospective study designed to investigate the incidence, risk factors, and outcomes of MDR bacterial superinfections in COVID-19 patients admitted to the intensive care unit (ICU). : A high incidence of superinfections (66%, 159/241) was observed: ventilator-associated pneumonia (VAP) (65%, 104/159) and bloodstream infection (BSI, 32%, 51/159) were the most common.

The Role of Stress Hyperglycemia on Delirium Onset.

Delirium is an acute neuropsychiatric syndrome that recognizes one or more underlying causal medical conditions. Stress hyperglycemia usually refers to transient hyperglycemia associated with stress conditions such as stroke, myocardial infarction, and major surgery. Both delirium and stress hyperglycemia share common pathways, such as activation of inflammation.

Early Surgical Resection in Pediatric Patients with Localized Ileo-Cecal Crohn's Disease: Results of a Retrospective Multicenter Study.

: Crohn's disease (CD) is an inflammatory bowel disease (IBD) that also affects pediatric patients. It frequently presents as a localized disease, affecting the ileocecal area, ileum, or colon. It requires targeted therapy to achieve a good quality of life and long-term control of disease activity.

PD-1 and PD-L1 Expression in Endometrial Cancer: A Systematic Review of the Literature.

Cancer immunotherapy through the use of PD-1/PD-L1 inhibitors have shown significant promise in endometrial carcinoma (EC), particularly in tumors with microsatellite instability (MSI) or mismatch repair deficiency (dMMR), present in approximately 30% of cases. This review evaluated PD-L1 and PD-1 expression as potential biomarkers for immunotherapy response in EC, focusing on their relationship with MSI status. A systematic review, adhering to PRISMA guidelines, analyzed studies from MEDLINE and Embase until February 2023 on PD-1/PD-L1 expression in EC stratified by MSI status, including diverse study designs but excluding conference abstracts, with independent screening, data extraction, and additional reference checks to ensure comprehensive coverage.

Non-Invasive Brain Stimulation to Improve Functional Recovery and Predict Outcome After Intracerebral Hemorrhage: A Narrative Review.

Intracerebral hemorrhage (ICH) is a leading cause of stroke-related mortality and long-term disability, with initial ICH volume, age, location of the hemorrhage, and clinical severity being key predictors of outcome. While clinical scores incorporating these elements are validated and exhibit good inter-rater reliability, their accuracy in predicting long-term recovery remains suboptimal. Non-invasive brain stimulation (NIBS) has emerged as a potential adjunct for improving both prognostication and functional recovery in ICH survivors.

Tyrosine Kinase Inhibitor Therapy Enhances Stem Cells Profile and May Contribute to Survival of Chronic Myeloid Leukemiastem Cells.

: Treatment with tyrosine kinase inhibitors (TKIs) in chronic myeloid leukemia (CML) has revolutionized disease management and has transformed CML from a life-threatening disease to a chronic condition for many patients. However, overcoming resistance, particularly related to leukemic stem cells (LSC) that can persist even when the bulk of the leukemic cells are eliminated, remains a significant challenge. : K562 and KU812 cell lines were treated in vitro with the TKI Imatinib (IM).

Diagnostic Approach to Pneumonia in Immunocompromised Hosts.

In immunocompromised patients, pneumonia presents a diagnostic challenge due to diverse etiologies, nonspecific symptoms, overlapping radiological presentation, frequent co-infections, and the potential for rapid progression to severe disease. Thus, timely and accurate diagnosis of all pathogens is crucial. This narrative review explores the latest advancements in microbiological diagnostic techniques for pneumonia in immunocompromised patients.

Lower Airway Diseases in the Paediatric Population: A Two-Year, Single-Centre, Retrospective Study.

: Lower airway diseases in children are one of the major causes of hospitalisation. This study aimed to evaluate the characteristics of children admitted to a tertiary pediatric hospital diagnosed with lower airway disease and to identify differences between age groups and the two years of the study. : In this single-centre retrospective observational study, demographic and clinical information about children hospitalised in the emergency pediatric ward and diagnosed with lower respiratory disease from 1 June 2021 to 30 June 2023 were retrospectively reviewed.

Remifentanil-Propofol-Ketamine- Based Total Intravenous Anesthesia with Spontaneous Breathing for Adult Rigid Bronchoscopy.

Rigid bronchoscopy (RB) is the gold standard for managing central airway obstruction (CAO), a life-threatening condition caused by both malignant and benign etiologies. Anesthetic management is challenging as it requires balancing deep sedation with maintaining spontaneous breathing to avoid airway collapse. There is no consensus on the optimal anesthetic approach, with options including general anesthesia with neuromuscular blockers or spontaneous assisted ventilation (SAV).

Efficacy and Risks of Posterior Vertebral Column Resection in the Treatment of Severe Pediatric Spinal Deformities: A Case Series.

: Surgery for adolescent idiopathic deformities is often aimed at improving aesthetic appearance, striving for the best possible correction. However, severe and rigid scoliotic curves not only present aesthetic issues but can also compromise cardiopulmonary health and cause early neurological impairment due to spinal cord compression, posing significant risks of morbidity and mortality if untreated. Conservative treatments are ineffective for severe curves, defined by scoliotic angles over 70° and flexibility below 30% on lateral bending X-rays.

Video Head Impulse Test in Children-A Systematic Review of Literature.

: The video head impulse test is a landmark in vestibular diagnostic methods to assess the high-frequency semicircular canal system. This test is well established in the adult population with immense research since its discovery. The usefulness and feasibility of the test in children is not very well defined, as research has been limited.

Partial Loss of NEMO Function in a Female Carrier with No Incontinentia Pigmenti.

: The nuclear factor (NF)-kB essential modulator (NEMO) has a crucial role in the NFκB pathway. Hypomorphic pathogenic variants cause ectodermal dysplasia with immunodeficiency (EDA-ID) in affected males. However, heterozygous amorphic variants could be responsible for Incontinentia Pigmenti (IP) in female carriers.

Physiology-Versus Angiography-Guided Complete Coronary Revascularization in STEMI Patients with Multivessel Disease: A Network Meta-Analysis.

: In patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD), complete revascularization (CR) is recommended over culprit-only PCI to reduce adverse cardiovascular outcomes. However, the optimal strategy for CR, whether angiography (Angio)-guided or physiology-guided, remains uncertain. : This network meta-analysis included 14 randomized controlled trials (RCTs) with 11,568 patients to compare the efficacy of angio-guided CR, physiology-guided CR, and culprit-only PCI in reducing major adverse cardiovascular events (MACE), all-cause mortality, recurrent myocardial infarction (MI), cardiovascular (CV) death, and unplanned revascularization.

Evolution of Hospitalisation Due to Stroke in Italy Before and After the Outbreak of the COVID-19 Epidemic: A Population-Based Study Using Administrative Data.

: Stroke is a leading cause of mortality and disability worldwide, ranking as the second most common cause of death and the third in disability-adjusted life-years lost. Ischaemic stroke, which constitutes the majority of cases, poses significant public health and economic challenges. This study evaluates trends in ischaemic stroke hospitalisations in Italy from 2008 to 2022, focusing on differences before and after the COVID-19 pandemic.