Visual-textual integration in LLMs for medical diagnosis: A preliminary quantitative analysis.

Background And Aim: Visual data from images is essential for many medical diagnoses. This study evaluates the performance of multimodal Large Language Models (LLMs) in integrating textual and visual information for diagnostic purposes.

Methods: We tested GPT-4o and Claude Sonnet 3.

Metformin intake and risk of metabolic acidosis after radical cystectomy with urinary diversion: A comparative study using data from the TriNetX research network.

Purpose: To investigate the association of diabetes mellitus and metformin use with metabolic acidosis risk after radical cystectomy (RC) and urinary diversion for bladder cancer.

Materials And Methods: This retrospective cohort study used TriNetX Research Network data. Patients undergoing RC with continent diversion or ileal conduit for bladder cancer were identified using International Classification of Diseases, 10th Revision (ICD-10) and ICD-10 Procedure Coding System (ICD-10-PCS) codes.

Precision Oncology: A Global Perspective on Implementation and Policy Development.

Despite the acknowledged merits of precision oncology (PO) and its increasing global implementation, its full potential for advancing care and prevention remains unrealized. The benefits are currently accessible to only limited patient segments because of multifaceted barriers. Successful implementation hinges on various factors-scientific complexities not limited to technical, clinical, regulatory, economic, administrative, and health care policy-related challenges.

Cushing's syndrome related to higher rates and earlier onset of cataract: A nationwide retrospective cohort study.

Purpose: To investigate the risk of cataract in patients with Cushing's syndrome (CS) and evaluate whether disease onset occurs at an earlier age compared to general population.

Methods: A nationwide retrospective matched-cohort study including individuals diagnosed with endogenous CS from 2000 to 2023. Patients with CS were matched in a 1:5 ratio with a control group individually matched for age, sex, socioeconomic status, and body mass index.

In Vivo Imaging of Cobalt-Induced Ocular Toxicity in a Mouse Model.

Cobalt is a trace element, crucial for red blood cell formation and neurological function. Cobalt toxicity is often only diagnosed after severe manifestations, including visual impairment. We aimed to investigate whether optical coherence tomography (OCT) and magnetic resonance imaging (MRI) can effectively detect cobalt-induced ocular toxicity in a murine model.

Effects of the Transcutaneous Electrical Stimulation System on Heartburn, Regurgitation and Esophageal Acid Exposure in GERD Patients-An Uncontrolled Feasibility Study.

Background: Proton pump inhibitors (PPI) for gastroesophageal reflux disease (GERD) are associated with a high failure rate. Our uncontrolled feasibility study aimed determining the effect of a transcutaneous electrical stimulation system (TESS) on GERD symptoms and acid exposure time (AET).

Methods: Recruited patients with heartburn and regurgitation.

Mesenchymal stem cell-derived exosomes mitigate amyloid β-induced retinal toxicity: Insights from rat model and cellular studies.

Amyloid β (Aβ) has emerged as a pathophysiological driver in age-related macular degeneration (AMD), emphasizing its significance in the aetiology of this prevalent sight-threatening condition. The multifaceted nature of AMD pathophysiology, presumably involving diverse retinal cascades, corresponds with the complexity of Aβ-induced retinopathy. Therefore, targeting a broad array of pathogenic processes holds promise for therapeutic intervention in AMD-associated retinal pathology.

The Safety Profile of Amiodarone Among Older Adults (age ≥ 75 years): A Pharmacovigilance Study from the FDA Data.

Background: Amiodarone is a widely used antiarrhythmic agent with significant toxicities and drug interactions more likely to affect older adults. Nevertheless, data regarding amiodarone safety in this population are limited.

Methods: We conducted a retrospective analysis of FDA Adverse Event Reporting System (FAERS) data from 2003 to 2024 .

Reanalysis of Urothelial Cancer Chemoimmunotherapy Trials With Differential Censoring.

Importance: Three similar phase 3 randomized clinical trials have investigated PD-1/PD-L1 (programmed cell death 1 protein/programmed cell death 1 ligand 1) inhibitors in combination with platinum-based chemotherapy vs chemotherapy alone as first-line treatment for advanced urothelial carcinoma (IMvigor130, atezolizumab; KEYNOTE-361, pembrolizumab; and CheckMate901, nivolumab). Only CheckMate901 reported overall survival (OS) benefit for the combination. The reason for these inconsistent results is unclear.

Art of TIL immunotherapy: SITC's perspective on demystifying a complex treatment.

In a first for solid cancers, cellular immunotherapy has entered standard of care in the treatment of patients with metastatic melanoma. The infusion of autologous tumor-infiltrating T lymphocytes (TIL) is capable of mediating durable tumor regression and is now Food and Drug Administration-approved for patients with disease refractory to immune checkpoint inhibitors. Since the advent of chimeric antigen receptor (CAR) T cells for patients with hematological malignancies, a growing network of centers capable of delivering effector T cell products to patients has developed.

Polycystic ovary syndrome and morphokinetic embryonic development: A case-control study evaluating 791 embryos.

Objective: To investigate the association between Polycystic Ovary Syndrome (PCOS) and the rate of embryo development, using time-lapse monitoring systems (TLM), compared to a control group of women with mechanical (tubal) factor infertility.

Design: A retrospective case-control study conducted in a university affiliated IVF unit.

Patients: Women with PCOS undergoing in-vitro fertilization (IVF) treatments and those with non-PCOS controls with tubal factor infertility only.

Intrahepatic portosystemic shunt: salvage mechanism for oligohydramnios complicating fetal growth restriction.

Objective: Portosystemic shunts in growth-restricted fetuses are more common than previously thought. We aimed to describe fetuses with growth restriction and transient oligohydramnios in which a congenital intrahepatic portosystemic shunt (CIPSS) was noted during follow-up.

Methods: This was a retrospective study of all fetuses diagnosed with growth restriction and transient oligohydramnios during a 5-year period in a large tertiary referral center.

Cancer therapy and reproductive impact.

All patients where the cancer treatment has gonadotoxic potential should be referred for oncofertility advice. The effect of chemotherapy and radiotherapy on the human ovary can vary from no impact to full-blown premature ovarian failure due to hormonal and follicular depletion. Total contraindications to fertility cryopreservation include acute malignancy that requires immediate lifesaving therapy.

Evaluating the Effect of Various Pure Tone Averages on Cochlear Implant Candidacy Screening.

Objective: To provide evidence to use an extended frequency pure tone average to screen for cochlear implant evaluation candidates as recommended by the American Cochlear Implant Alliance. Additionally, to determine whether traditional low frequency, high or low frequency, high frequency, or extended frequency pure tone average most accurately predicts cochlear implant candidates based on speech perception scores from aided AzBio sentence testing or aided consonant-nucleus-consonant (CNC) testing.

Method: Adults from a tertiary care center who completed aided sentence testing during cochlear implant evaluation between 2014 and 2024 were assessed.

En bloc resection of large bladder tumor: is it feasible and reasonable?

Purpose Of Review: Transurethral resection of bladder tumor (TURBT) remains the basis of bladder tumor diagnosis and an effective means of treating nonmuscle invasive bladder cancer (NMIBC). There are several limitations to this procedure: TURBT may cause free floating of malignant cells in the bladder and as a result re-implantation and early recurrence. Also, it does not allow the pathologist to define the correct spatial orientation of the specimen.

Differences in lasers and laser technologies: what does a clinician need to know?

Purpose Of Review: This review focuses on recent advancements in laser technologies used in urology, particularly in enucleation, vaporization, lithotripsy, and focal laser ablation (FLA). The growing use of the thulium fiber laser (TFL) and the development of pulsed thulium lasers (p-Tm:YAG) highlight the relevance of this review, as these innovations aim to improve precision and outcomes in urological procedures.

Recent Findings: Recent studies have shown the advantages of TFL in achieving precise tissue ablation, reduced retropulsion offered by the Moses technology in holmium lasers, and the potential of pulsed thulium lasers for more precise control of the effects on tissues.

Pregnancy and cardiovascular outcomes among patients post Fontan surgery: a 25-year single-centre retrospective cohort study.

Introduction: Data on the characteristics and outcomes of pregnancy and among patients with Fontan physiology are limited. We aimed to evaluate the immediate and long-term outcomes among these patients who were followed at our centre.

Methods: We included adult patients who had undergone Fontan surgery for congenital heart disease and were pregnant between 1994 and 2021.

Inter-Rater Disagreements in Applying the Montreal Classification for Crohn's Disease: The Five-Nations Survey Study.

Background: The Montreal classification has been widely used in Crohn's disease since 2005 to categorize patients by the age of onset (A), disease location (L), behavior (B), and upper gastrointestinal tract and perianal involvement. With evolving management paradigms in Crohn's disease, we aimed to assess the performance of gastroenterologists in applying the Montreal classification.

Methods: An online survey was conducted among participants at an international educational conference on inflammatory bowel diseases.

Surgical Bailout in Patients Undergoing Transfemoral Transcatheter Aortic Valve Replacement: Incidence, Trends, and Clinical Outcomes.

Background: Transcatheter aortic valve replacement (TAVR) harbors the risk of periprocedural complications that require emergent cardiac surgery, or "surgical bailout." Surgical bailout intends to be lifesaving but is associated with high mortality. This has given rise to discussion on the necessity of surgical backup during TAVR.

Clinical Characteristics and Outcomes of Patients Undergoing 3 Aortic Valve Interventions: The THIRD Multicenter Registry.

Background: Lifetime treatment of aortic valve disease is a matter of increasing debate. Although the risks of a second aortic valve intervention are recognized, little attention has been given to the challenges of a third.

Objectives: This study delves into the clinical characteristics, indications, and outcomes of patients undergoing 3 aortic valve interventions.

Mechanistic implications of the Mediterranean diet in patients with newly diagnosed Crohn's disease- multi-omic results from a prospective cohort.

Background: To decipher the mechanisms underlying the protective role of the Mediterranean diet (MED) in Crohn's disease (CD), we explored the implications of adherence to MED on CD course, inflammatory markers, microbial and metabolite composition.

Methods: Patients with newly diagnosed CD were recruited and followed prospectively. MED adherence was assessed by repeated food frequency questionnaires (FFQ), using a predefined IBDMED score, alongside validated MED adherence screeners.

Long-term Breast Shape Analysis After Short-scar Reduction Mammaplasty: A Critical View.

Background: Over the past 2 decades, vertical scar reduction mammaplasty techniques have been gaining more acceptance. However, many surgeons are still hesitant to use it routinely because of the uncertainty of the effectiveness of vertical scar techniques in managing lower pole skin excess. We aimed to test its efficacy by using objective anthropometric measurements to evaluate long-term breast shape and lower pole stability.

Transcatheter edge-to-edge repair in severe mitral regurgitation following acute myocardial infarction - aetiology-based analysis.

Aims: To evaluate the association between transcatheter edge-to-edge repair (TEER) and outcomes in patients with significant mitral regurgitation (MR) following acute myocardial infarction (MI), focusing on the aetiology of acute post-MI MR in high-risk surgical patients.

Methods And Results: The International Registry of MitraClip in Acute Mitral Regurgitation following Acute Myocardial Infarction (IREMMI) includes 187 patients with severe MR post-MI managed with TEER. Of these, 176 were included in the analysis, 23 (13%) patients had acute papillary muscle rupture (PMR) and 153 (87%) acute secondary MR.

Parental Compliance with Preschool Vision Screening Test.

To assess the barriers to parental compliance with preschool vision screening tests and the recommended follow-up eye care. This prospective study included children aged 3-6 years attending 46 preschools. Parents were asked for consent for their children to participate in a vision screening test.