Visceral Pain in Preterm Infants with Necrotizing Enterocolitis: Underlying Mechanisms and Implications for Treatment.

Necrotizing enterocolitis (NEC) is a relatively rare but very severe gastrointestinal disease primarily affecting very preterm infants. NEC is characterized by excessive inflammation and ischemia in the intestines, and is associated with prolonged, severe visceral pain. Despite its recognition as a highly painful disease, current pain management for NEC is often inadequate, and research on optimal analgesic therapy for these patients is lacking.

International Consensus Guidance for the Management of Glucocorticoid Related Complications in Neuromuscular Disease.

Introduction/aims: Glucocorticoid (GC)-related adverse reactions and risks are commonly seen during the treatment of immune-mediated and inflammatory neuromuscular disorders. There is wide variation in the management of associated complications. The aim of this study is to develop international consensus guidance on the management of GC-related complications in neuromuscular disorders.

AI-based visualization of loose connective tissue as a dissectable layer in gastrointestinal surgery.

We aimed to develop an AI model that recognizes and displays loose connective tissue as a dissectable layer in real-time during gastrointestinal surgery and to evaluate its performance, including feasibility for clinical application. Training data were created under the supervision of gastrointestinal surgeons. Test images and videos were randomly sampled and model performance was evaluated visually by 10 external gastrointestinal surgeons.

'Real-life' approach to applying PK/PD principles in infectious diseases clinical practice without access to prompt TDM.

Introduction: Infectious disease treatments are transitioning from a one-size-fits-all approach to a more tailored approach. The increasing adoption of therapeutic drug monitoring (TDM) of antimicrobials is a clear example of this trend. Routine antimicrobial TDM in critically ill patients should be mandatory.

Sex-Based Differences in Endovascular Thrombectomy Outcomes for Large Ischemic Stroke: A SELECT2 Subanalysis.

Background: Several social and biological factors are shown to differentially affect stroke outcomes between men and women. We evaluated whether clinical outcomes and endovascular thrombectomy (EVT) treatment effects differed between the sexes in patients presenting with large ischemic stroke.

Methods: The SELECT2 trial (A Randomized Controlled Trial to Optimize Patient's Selection for Endovascular Treatment in Acute Ischemic Stroke) was a randomized controlled trial assessing the efficacy and safety of EVT in patients with large strokes across the United States, Canada, Europe, Australia, and New Zealand between October 2019 and September 2022.

Penile Reconstruction with Radial Forearm Free Flap-Present State of the Art.

 Patients with congenital or acquired penile defects face significant psychological trauma. Various methods for penile reconstruction have been described of which the free radial artery forearm flap using the tube-within-tube design is found to be the most commonly used. We have assimilated the best practices described at different times in our bid to standardize the technique and have strived to make it reproducible.

Melatonin, an Antitumor Necrosis Factor Therapy.

Tumor necrosis factor (TNF) is a biomarker of inflammation whose levels are elevated in patients with several diseases associated with dysregulation of the immune response. The main limitations of currently used anti-TNF therapies are the induction of immunodepression, which in many cases leads to serious adverse effects such as infection and cancer, and the inability to cross the blood-brain barrier in neuroinflammatory conditions. Melatonin, in addition to being a chronobiotic compound, is widely known for its antioxidant and immunomodulatory capacity to control inflammatory processes in different pathological contexts.

Ensemble learning driven Kolmogorov-Arnold Networks-based Lung Cancer classification.

Early Lung Cancer (LC) detection is essential for reducing the global mortality rate. The limitations of traditional diagnostic techniques cause challenges in identifying LC using medical imaging data. In this study, we aim to develop a robust LC detection model.

Metastatic sites and clinical outcomes in renal cell carcinoma patients receiving immune-based combinations: the MOUSEION-08 study.

Immune-based combinations have significantly improved the treatment of metastatic renal cell carcinoma (mRCC); however, immunotherapy has reported varying degrees of efficacy across different metastatic sites, with liver and bone metastases traditionally considered more challenging to treat. In MOUSEION-08 study, we aimed to investigate the association between lung, liver, and bone metastases and clinical outcomes such as Overall Survival (OS) and Progression- Free Survival (PFS) in mRCC patients receiving immune-based combinations. The present systematic review and study-level meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA).

Surveillance for surgical site infections developed during hospital stay & after discharge: A multicentric study.

Background & objectives Surgical site infections (SSIs) are among the most prevalent healthcare-associated infections (HCAIs). They cause significant morbidity, leading to excess health expenditures and increased length of hospital stay. Despite a high population burden, data on post-discharge SSIs is lacking from low-and middle-income countries (LMICs).

Functional Outcomes Following Partial Osteotomy of the Calcaneal Tuberosity for Haglund's Syndrome.

Background Haglund's syndrome, a common cause of pain in the posterior heel that consists of painful swelling of the local soft tissues and prominence of the posterosuperior calcaneal projection, presents significant challenges in treatment, particularly when conservative management fails. This study evaluates the functional outcomes following oblique partial excision of the posterosuperior portion (calcaneal tuberosity osteotomy) of the calcaneus for Haglund's syndrome. Methods A cohort of 30 patients, aged 18 years and older, with persistent heel pain unresponsive to conservative treatments, underwent partial osteotomy using a medial or lateral approach.

[Paraneoplastic opsoclonus-myoclonus syndrome].

Opsoclonus-myoclonus syndrome (OMS) is a rare neurological disorder characterized by a combination of main symptoms: opsoclonus, myoclonus, ataxia, psychoemotional and behavioral disturbances. OMS can develop in children as a result of immunopathological processes against the background of infectious or oncological pathology and lead to persistent neurological deficit. A case of ten-year observation of paraneoplastic OMS associated with neuroblastoma in a child is presented.

[Modern aspects of chronic cerebral ischemia pathogenetic therapy].

Chronic cerebral ischemia (CCI) is one of the most common forms of cerebrovascular disease, which affects a significant number of patients, often leading to disability, cognitive impairment and dementia. The analysis of modern data on the pathogenesis and risk factors for the development of CCI, as well as on the mechanisms of action of Mexidol on various links in the pathogenesis of CCI. A systematic search was conducted in the PubMed, MEDLINE and Google Scholar databases, on Russian and English-language sites with open access publications on the problem of CCI and on the drug Mexidol in the period from 2014 to 2024.

[Open observational study with a retrospective analysis of the efficacy and tolerability of aceclofenac in patients with acute non-specific low back pain].

Objective: To analyze the efficacy and tolerability of aceclofenac in the treatment of patients with acute non-specific musculoskeletal pain in the lower back (ANBP) compared with other NSAIDs (dexketoprofen, nimesulide and lornoxicam), as well as to assess the impact of NSAIDs therapy on the relative risk of recurrence and chronicity of this pathology.

Material And Methods: The study involved 80 patients (47 women and 33 men), average age 52.6 [47.

[Comprehensive rehabilitation of spinal trauma patients with extended involvement of nursing staff and neurometabolic therapy].

Objective: Analysis of the effectiveness of the use of the drug Cytoflavin and the organization of the activities of nursing staff, within the framework of nursing care, in the complex therapy of patients with spinal cord injury (PSMT).

Material And Methods: Material and methods. 40 patients with PSMT due to a gunshot wound were examined, who were divided into two equal groups depending on the type of therapy performed: group 1 patients received the full volume of stage I medical rehabilitation (with additional use of neurodevelopmental techniques under the supervision of a Bobata department nurse) and standard drug therapy, including a course of intravenous Cytoflavin infusions followed by tablet form; group 2 patients received the full volume of stage I medical rehabilitation and standard drug therapy, but did not receive Cytoflavin.

Designing a summative assessment blueprint in community medicine: an expert consensus approach at All India Institute of Medical Sciences.

Background: Despite the increasing integration of competency-based education in medicine, there remains a significant gap in effectively assessing educational outcomes, underscoring the urgent need for designed assessment blueprints that accurately reflect both curriculum content and competency standards in Community Medicine for undergraduate students. This study, conducted across the All-India Institute of Medical Sciences (AIIMS) network, develops a summative assessment blueprint aimed at standardizing evaluations in medical education across diverse geographic locations in India.

Methods: Twenty-five experts from 10 All India Institutes of Medical Science were invited via email and contributed for summative assessment for a theory paper.

Assessing Acute Pericarditis with T1 Mapping: A Supportive Contrast-Free CMR Marker.

Objective: The purpose of this study was to explore the impact of pericardial T1 mapping as a potential supportive non-contrast cardiovascular magnetic resonance (CMR) parameter in the diagnosis of acute pericarditis. Additionally, we investigated the relationship between T1 mapping values in acute pericarditis patients and their demographic data, cardiovascular risk factors, clinical parameters, cardiac biomarkers, and cardiac function.

Method: This retrospective study included CMR scans in 35 consecutive patients with acute pericarditis (26 males, 45.

Utility of Aprepitant in the Management of Pediatric Patients with Cyclical Vomiting Syndrome.

: Cyclical vomiting syndrome (CVS) is a recurrent debilitating illness characterized by intense episodes of nausea and emesis with widely varied pharmacological management across the country. Aprepitant is now increasingly used in patients with CVS. The impact of aprepitant as an abortive therapy in the readmission of pediatric patients with CVS is currently unknown.

Short-term evolution and dispersal patterns of fluconazole-resistance in clade III.

The rapid increase in infections caused by the emerging fungal pathogen is of global concern, and understanding its expansion is a priority. The phylogenetic diversity of the yeast is clustered in five major clades, among which clade III is particularly relevant, as most of its strains exhibit resistance to fluconazole, reducing the therapeutic alternatives and provoking outbreaks that are difficult to control. In this study, we have investigated the phylogenetic structure of clade III by analyzing a global collection of 566 genomes.

Venous Endothelial Cell Transcriptomic Profiling Implicates METAP1 in Preeclampsia.

Background: Preeclampsia is a hypertensive disorder of pregnancy characterized by systemic endothelial dysfunction. The pathophysiology of preeclampsia remains incompletely understood. This study used human venous endothelial cell (EC) transcriptional profiling to investigate potential novel mechanisms underlying EC dysfunction in preeclampsia.

A structure-based analysis of the Kell blood group system.

Kell is one of the most complex blood group systems, with a highly polymorphic genetic background. Extensive allelic variations in the gene affect the encoded erythrocyte surface protein Kell. Genetic variants causing aberrant splicing, premature termination of protein translation, or specific amino acid exchanges lead to a variety of different phenotypes with altered Kell expression levels or changes in the antigenic properties of the Kell protein.

WEE1 confers resistance to KRAS inhibitors in non-small cell lung cancer.

KRAS inhibitors sotorasib and adagrasib have been approved for the treatment of KRAS-mutant non-small cell lung cancer (NSCLC). However, the efficacy of single-agent treatments is limited, presumably due to multiple resistance mechanisms. To overcome these therapeutic limitations, combination strategies that potentiate the antitumor efficacy of KRAS inhibitors must be developed.

Cardiovascular-Liver-Metabolic Health: Recommendations in Screening, Diagnosis, and Management of Metabolic Dysfunction-Associated Steatotic Liver Disease in Cardiovascular Disease via Modified Delphi Approach.

There is a new awareness of the widespread nature of metabolic dysfunction-associated steatotic liver disease (MASLD) and its connection to cardiovascular disease (CVD). This has catalyzed collaboration between cardiologists, hepatologists, endocrinologists, and the wider multidisciplinary team to address the need for earlier identification of those with MASLD who are at increased risk for CVD. The overlap in the pathophysiologic processes and parallel prevalence of CVD, metabolic syndrome, and MASLD highlight the multisystem consequences of poor cardiovascular-liver-metabolic health.

High Shear Stress Reduces ERG Causing Endothelial-Mesenchymal Transition and Pulmonary Arterial Hypertension.

Background: Computational modeling indicated that pathological high shear stress (HSS; 100 dyn/cm) is generated in pulmonary arteries (PAs; 100-500 µm) in congenital heart defects causing PA hypertension (PAH) and in idiopathic PAH with occlusive vascular remodeling. Endothelial-to-mesenchymal transition (EndMT) is a feature of PAH. We hypothesize that HSS induces EndMT, contributing to the initiation and progression of PAH.