Optimizing the life of vascular access during follow-up.

Optimizing the longevity of vascular access in hemodialysis patients remains a critical aspect of patient care, given the significant role of arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs) in enabling effective dialysis. Vascular access complications, such as stenosis, thrombosis, and cannulation-related damage, continue to challenge both the functionality and the sustainability of these access points. Recent advancements underscore the importance of a robust follow-up strategy, integrating clinical evaluations with diagnostic tools like color Doppler ultrasound (CDU) and emerging interventional approaches such as drug-coated balloon (DCB) angioplasty.

Hyperbaric Oxygen Therapy (HBOT) for Management of Complex Regional Pain Syndrome (CRPS).

Objectives: Complex regional pain syndrome remains a challenging condition characterized by severe, persistent pain and a variety of inflammatory and trophic symptoms. This study aimed to analyze the current literature to evaluate hyperbaric oxygen therapy (HBOT)'s efficacy in treating complex regional pain syndrome (CRPS), focusing on both sympathetically-maintained pain (SMP) and sympathetically-independent pain (SIP) subtypes.

Methods: A comprehensive literature search was conducted in PubMed Clinical Queries using the MeSH term "Complex Regional Pain Syndromes" OR the keyword "CRPS" AND "Hyperbaric Oxygen Therapy" OR the keyword "HBOT".

Preventing and Treating Delayed Gastric Emptying (DGE) after Pancreatic Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Objective: To identify strategies to prevent and treat delayed gastric emptying (DGE) after pancreatic surgery.

Background: Among all complications of pancreatic surgery, DGE has the largest impact on prolonged hospital stay. Several randomized controlled trials (RCTs) have addressed DGE after pancreatic surgery, either as primary or as secondary outcome.

Deep immunophenotyping of circulating immune cells in major depressive disorder patients reveals immune correlates of clinical course and treatment response.

Major Depressive Disorder (MDD) is a widespread psychiatric condition impacting social and occupational functioning, making it a leading cause of disability. The diagnosis of MDD remains clinical, based on the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 criteria, as biomarkers have not yet been validated for diagnostic purposes or as predictors of treatment response. Traditional treatment strategies often follow a one-size-fits-all approach obtaining suboptimal outcomes for many patients who fail to experience response or recovery.

Radiological images of an advanced invasive carcinoma with mucinous aspects: A case report.

Mucinous carcinoma of the breast, also known as colloid carcinoma, is an uncommon type of differentiated adenocarcinoma, representing only 2% of all invasive breast carcinomas. It usually occurs in women ≥ 60 years of age. Mucinous carcinoma is characterized by clusters of epithelial tumour cells suspended in pools of extracellular mucin and is further divided in 2 subgroups, pure and mixed.

Non-invasive brain stimulation in cognitive sciences and Alzheimer's disease.

Over the last four decades, non-invasive brain stimulation techniques (NIBS) have significantly gained interest in the fields of cognitive sciences and dementia care, including neurorehabilitation, for its emerging potential in increasing the insights over brain functions and in boosting residual cognitive functions. In the present paper, basic physiological and technical mechanisms and different applications of NIBS were reviewed and discussed to highlight the importance of NIBS in multidisciplinary and translational approaches in clinical and research settings of cognitive sciences and neurodegenerative diseases, especially in Alzheimer's disease. Indeed, NIBS strategies may represent a promising opportunity to increase the potential of neuromodulation as efficacious interventions for individualized patients care.

Analyzing the Effectiveness of Different Delivery Methods for Remineralization Agents in Pediatric Dental Health: A Systematic Review.

Pediatric dental health is critically impacted by enamel demineralization and early-stage caries, with remineralization therapies playing a vital role in preventing progression. This systematic review evaluates the effectiveness of various delivery methods for remineralization agents in pediatric patients aged 3-15 years, focusing on varnishes, gels, foams, and sprays. Studies were included if they were randomized controlled trials (RCTs), cohort studies, or case-control studies involving pediatric patients with early-stage caries or enamel demineralization, while studies with non-pediatric populations, unrelated treatments, or significant methodological flaws were excluded.

Phytolith assemblages from palm leaves and palm-leaf manuscripts: what is the difference and what it could mean?

We studied freshly collected, dried and herbarized leaf fragments of two palms, namely L. and L., most commonly used for palm-leaf manuscript (PLM) production in South (S) and Southeast Asia (SE) in order to reveal differences in their phytolith assemblages.

A protein corona modulates the function of mineralization-competent matrix vesicles.

Mineralizing cells release a special class of extracellular vesicles known as matrix vesicles (MV), crucial for bone mineralization. Following their release, MV anchor to the extracellular matrix (ECM), where their highly specialized enzymatic machinery facilitates the formation of seed mineral within the MV's lumen, subsequently releasing it onto the ECM. However, how MV propagate mineral onto the collagenous ECM remains unclear.

Targeting accuracy of neuronavigation: a comparative evaluation of an innovative wearable AR platform vs. traditional EM navigation.

Wearable augmented reality in neurosurgery offers significant advantages by enabling the visualization of navigation information directly on the patient, seamlessly integrating virtual data with the real surgical field. This ergonomic approach can facilitate a more intuitive understanding of spatial relationships and guidance cues, potentially reducing cognitive load and enhancing the accuracy of surgical gestures by aligning critical information with the actual anatomy in real-time. This study evaluates the benefits of a novel AR platform, VOSTARS, by comparing its targeting accuracy to that of the gold-standard electromagnetic (EM) navigation system, Medtronic StealthStation S7.

Naxos Disease and Related Cardio-Cutaneous Syndromes.

Naxos disease is a rare autosomal recessive condition combining arrhythmogenic right ventricular cardiomyopathy, woolly hair, and palmoplantar keratoderma. The first identified causative variant was in the gene encoding the desmosomal protein plakoglobin. Naxos disease exhibits fibro-fatty myocardial replacement with immunohistological abnormalities in cardiac protein and signaling pathways, highlighting the role of inflammation and potential anti-inflammatory treatments.

The mCHEST Score for Incident Atrial Fibrillation: MESA (Multi-Ethnic Study of Atherosclerosis).

Background: Assessing individuals' risk of developing incident atrial fibrillation (AF) is important for making preventive and screening strategies.

Objectives: The performance of the mCHEST score for predicting incident AF has scarcely been evaluated, especially in a multi-ethnic population.

Methods: Participants from the MESA (Multi-Ethnic Study of Atherosclerosis were enrolled in the present study, which involved population of different ethnicities (Caucasian, African-American, Chinese-American, and Hispanic) aged between 45 and 84 from 6 communities in the United States.

Pouchitis unveiled: exploring clinical features, diagnosis, and cutting-edge treatments.

Last decades led to a revolution in the management of ulcerative colitis (UC), due to the development of novel advanced therapies and the identification of increasingly ambitious therapeutic goals. Nevertheless, a subset of patients, refractory to available therapies, still requires proctocolectomy with ileal pouch-anal anastomosis (IPAA). Pouchitis, an inflammatory condition of the ileal pouch, is the most common long-term complication of IPAA, affecting almost one-half of patients in the first 10 years after surgery.

The Global RAdical Cystectomy Evaluation and Management (GRACEM) pathway: single-centre prospective observational cohort study protocol.

Background: Despite guideline recommendations, few institutions have implemented clinical pathways that incorporate frailty into routine decision-making for patients undergoing radical cystectomy (RC). This paper presents an integrated clinical pathway designed to address the needs of frail patients undergoing RC. The purpose of the study is to determine whether a multifaceted prevention programme that tailors interventions to the syndromic components of frailty can improve postoperative morbidity and recovery time for patients.

The impact of preoperative venous thromboembolism on patients undergoing TURBT: Perioperative outcomes and healthcare costs from US insurance claims data.

Objectives: To assess the impact of a positive history of venous thromboembolism (VTE) on perioperative outcomes, including length of in-hospital stay, readmission rates, 90-day postoperative complications, and healthcare costs in bladder cancer (BCa) patients undergoing transurethral resection of bladder tumour (TURBT) in the United States.

Patients And Methods: Patients aged ≥18 years with a BCa diagnosis undergoing TURBT were identified in the Merative® Marketscan® Research de-identified databases between 2007 and 2021. Multivariable logistic regression adjusted by relevant perioperative confounders was used to investigate the association between diagnosis of VTE before TURBT and 90-day complication rates, new postoperative VTE events, re-hospitalization, and total hospital expenditures (2021 US dollars).

PARP inhibitor-based treatment in metastatic, castration-resistant prostate cancer (mCRPC): A systematic review and meta-analysis.

Background: We present a systematic review and meta-analysis of randomized clinical trials (RCTs) with PARPi either as monotherapy or in combination with an androgen receptor-targeted agent (ARTA) in first- and second-line settings.

Methods: Primary endpoints are radiographic progression free survival (rPFS) and overall survival (OS) in patients with mCRPC and either unselected, homologous recombination repair wild-type (HRR-), homologous recombination repair mutated (HRR+) or with BRCA1, BRCA2, or ATM mutation. The effect of PARPi + ARTA in the second-line setting is also explored.

In silico tools for mechanical analysis of extra- and intra-luminal artificial urinary sphincters.

Objectives: To analyse and compare the functionality of extraluminal and intraluminal artificial urinary sphincters (AUSs), an in silico procedure has been defined and applied. Design and reliability assessments of the AUS are typically performed using a clinical approach, which does not provide data on mechanical stimulation of urethral tissues. Mechanical stimulation may determine tissue degeneration, such as urethral atrophy or erosion, the main causes of AUS failure.

The significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer: Results from the IDENTIFY study.

Objectives: To assess the contemporary malignancy rate in isolated de novo red patches in the bladder and associated risk factors for better selection of red patch biopsy.

Patients: Patients from the IDENTIFY dataset; Patients referred to secondary care with suspected urinary tract cancer and found to have isolated de novo red patches on cystoscopy.

Methods: We reported the unadjusted cancer prevalence in isolated de novo red patches that were biopsied; multivariable logistic regression was used to explore cancer-associated risk factors including age, sex, smoking, type of haematuria, LUTS, UTIs and a suspicious-looking red patch (as reported by the cystoscopist).

Novel NOTCH3 mutation c.1564 T > A (p.Cys522Ser) presenting with early-onset Parkinsonism and white matter lesions.

CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy) is a hereditary small vessel disease caused by mutations in the NOTCH3 gene, characterized by recurrent strokes, cognitive decline, and psychiatric symptoms. This report presents a novel NOTCH3 c.1564 T > A (p.

Growth Hormone Increase Induced by Oral Administration of Melatonin in a Young Woman With Sleep Disturbances.

Growth hormone (GH) secretion by the pituitary is regulated by stimulatory and inhibitory pathways such as growth hormone releasing hormone (GHRH) and somatostatin, respectively, being also modulated by different neurotransmitters acting at the hypothalamic/pituitary level. The pineal gland hormone melatonin regulates GH secretion in many mammals, including humans, although its role in modulating GH secretion has been debated. We describe the case of a young woman chronically taking melatonin for sleep disturbances, referring to her general practitioner for flushing that appeared just after starting melatonin intake.