Does Total Neoadjuvant Therapy Impact Surgical Precision in Total Mesorectal Excision? A Nationwide Survey of the Experiences of Expert Surgeons.

Background: The treatment of locally advanced rectal cancer (LARC) has steadily progressed over the past four decades, with recent focus shifting towards total neoadjuvant therapy (TNT). This survey aims to elucidate the perceived surgical challenges faced by Austrian colorectal surgeons performing total mesorectal excision (TME), focusing on the increased complexity and surgical difficulty introduced by intensified treatment regimens.

Methods: A comprehensive survey was conducted among Austrian colorectal surgeons to explore various aspects of managing and performing TME following TNT.

Post-Traumatic Left Subclavian Artery Pseudoaneurysm Secondary to Clavicular Fracture: A Case Report and Literature Review.

Subclavian artery pseudoaneurysms are rare but potentially life-threatening vascular injuries frequently associated with trauma such as clavicle fractures. In this paper we describe the case of a 49-year-old male who developed a post-traumatic pseudoaneurysm of the subclavian artery after a bicycle accident. The diagnosis was delayed due to non-specific symptoms and an initially missed aneurysm on computed tomography imaging.

D1S-Neuro Program: Frequency and Risk Factors for the Development of Diabetic Neuropathy in Pediatric Patients with Type 1 Diabetes Mellitus, a Single Center Study.

Diabetic neuropathy is the most common long-term complication of diabetes mellitus, widely studied in the adult population, but its prevalence in children and adolescents has not yet been clearly defined. Diabetic patients over 11 years old and with at least 5 years of diabetes were subjected to specific tests for the screening of diabetic peripheral neuropathy (DPN) and for the diagnosis of cardiac autonomic neuropathy (CAN). Additionally, all data related to the patients' average hemoglobin (HbA1c) levels over the last year and the past 5 years and the monitoring and insulin delivery technology used were collected.

Minimally Invasive Surgical Approach in Granulomatosis with Polyangiitis Complicated with Intramural Descending Aorta Hematoma Followed by Aortic Wall Rupture.

: Granulomatosis with polyangiitis (GPA) represents a rare autoimmune disease with granulomatous inflammation, tissue necrosis, and systemic vasculitis of the small and medium blood vessels. Although the clinical elements vary, aortic involvement is exceptional and it represents a challenge that requires a rapid intervention with the potential of displaying a fulminant evolution. : We report a 64-year-old male with an 18-year history of GPA who presented atypical low back pain.

Classifying Food Items During an Eating Occasion: A Machine Learning Approach with Slope Dynamics for Windowed Kinetic Data.

Background: Wearable devices equipped with a range of sensors have emerged as promising tools for monitoring and improving individuals' health and lifestyle.

Objectives: Contribute to the investigation and development of effective and reliable methods for dietary monitoring based on raw kinetic data generated by wearable devices.

Methods: This study uses resources from the NOTION study.

Foodborne Event Detection Based on Social Media Mining: A Systematic Review.

Foodborne illnesses represent a significant global health challenge, causing substantial morbidity and mortality. Conventional surveillance methods, such as laboratory-based reporting and physician notifications, often fail to enable early detection, prompting the exploration of innovative solutions. Social media platforms, combined with machine learning (ML), offer new opportunities for real-time monitoring and outbreak analysis.

V3+ extends the V3 framework to ensure user-centricity and scalability of sensor-based digital health technologies.

We propose the addition of usability validation to the extended V3 framework, now "V3+", and describe a pragmatic approach to ensuring that sensor-based digital health technologies can be used optimally at scale by diverse users. Alongside the original V3 components (verification; analytical validation; clinical validation), usability validation will ensure user-centricity of digital measurement tools, paving the way for more inclusive, reliable, and trustworthy digital measures within clinical research and clinical care.

Lipid-Lowering and Antihypertensive Drugs on Aortic Disease Risk: Insights from Mendelian Randomization Analysis and Real-World Pharmacovigilance Data.

Objective: To assess the impact of lipid-lowering drugs (LLDs) and antihypertensive drugs on the risk of aortic diseases.

Methods: Mendelian randomization was utilized to analyze data from 500,000 participants in the UK Biobank to evaluate the effects of statins, PCSK9 inhibitors (PCSK9i), beta-blockers, and calcium channel blockers on the risks of thoracic aortic aneurysm (TAA), abdominal aortic aneurysm (AAA), and aortic dissection (AD) using genetic variants as proxies. Real-world pharmacovigilance data from the FAERS database was used.

Peripheral Venous Pressure-Guided Decongestive Therapy in Heart Failure 2 (PERIPHERAL-HF2).

Congestive symptoms are the primary cause of hospitalizations in heart failure (HF), and diuretics remain the cornerstone of their management. However, clinical practice varies widely due to a lack of a reliable measure of congestion guiding diuretic use. Consequently, many HF patients are discharged prematurely without adequate decongestion, leading to increased readmissions and mortality.

Outcomes and Predictors of Different Flow-Gradient Patterns of Aortic Stenosis Following Transcatheter Aortic Valve Replacement.

This study sought to explore the clinical factors associated with classical low-flow low-gradient (C-LFLG) and normal-flow low-gradient (NFLG) aortic stenosis (AS) compared to high-gradient (HG) AS. We also compared clinical and echocardiographic outcomes after transcatheter aortic valve replacement (TAVR) across flow-gradient patterns. Patients with C-LFLG AS have a higher mortality rate after TAVR than those with HG AS.

Patent foramen ovale: a variant of normal or a true congenital heart disease?

Foramen ovale plays a key role in foetal circulation, however it may remain patent after birth throughout the life. Its patency is so frequent in healthy people (27-35%), such as to be considered a variant of normal. It is at risk of complications, like paradoxical embolism by right to left shunt with stroke, migraine, temporary blindness, as well as aneurysm, thrombosis and endocarditis of the fossa ovalis.

Current trends and evidence on post-TEVAR aorto-pulmonary and -bronchial fistula: a narrative review.

Introduction: Aorto-bronchial or aorto-pulmonary fistulas (ABPF) are a rare but life-threatening complication following thoracic endovascular aortic repair (TEVAR). This narrative review aims to provide an overview of the current trends and available evidence on ABPF following TEVAR, evaluating risk factors, diagnostic approaches, and possible preventive and therapeutic strategies.

Methods: Relevant publications on post-TEVAR ABPF were selected through a literature search on PubMed.

Critical Review of Guidelines for Type B Aortic Dissection.

The management of type B aortic dissection is one of the most challenging and debated topics in contemporary cardiovascular surgery practice. Patients with acute or chronic dissection-related complications, face high morbidity and mortality if not treated promptly. For most patients requiring intervention, thoracic endovascular aortic repair (TEVAR) is considered the gold standard.

Trends and Updates in the Management and Outcomes of Acute Uncomplicated Type B Aortic Dissection.

Type B aortic dissection (TBAD) presents a complex clinical challenge requiring coordinated, multidisciplinary care to optimize patient outcomes. While rapid intervention is crucial for complicated TBAD, the optimal management of uncomplicated cases remains less well-defined. Historically, uncomplicated TBAD was managed medically, but recent years have seen a shift toward selective interventional approaches.

Rupture of huge thoracic aortic aneurysm in a young man: Case report and literature review.

Thoracic aortic aneurysms are considered more dangerous than abdominal aneurysms because they are often silent until rupture and, therefore, are more challenging to diagnose and have a high mortality rate. In addition, a thoracic aneurysm differs from an abdominal one in terms of causes and risk factors: the former is associated with the degeneration of the vessel's middle tunica, while the latter is related to atherosclerosis. We report the case of the sudden death of a 20-year-old man, with no apparent risk factors and suffering only from a persistent cough for a month, in whom the autopsy revealed the rupture of a massive aneurysm of the ascending thoracic aorta.

Development and validation of the infant nursing assessment scale: Results from exploratory factor analysis and Rasch modeling.

Purpose: The primary challenge in infant care is developing a comprehensive, rapid, and reliable assessment tool that is minimally dependent on subjective evaluations and applicable in various inpatient settings. This study aims to develop and assess the structural validity of the Infant Nursing Assessment Scale (INA), enabling a comprehensive evaluation of hospitalized newborns and infants.

Design And Methods: A development and validation study based on cross-sectional design was undertaken.

Right coronary sinus of Valsalva pseudoaneurysm after a motorcycle accident: A case report.

Rationale: Traumatic pseudoaneurysm of the sinus of Valsalva (PSV) is a rare but life-threatening condition, often resulting from blunt chest trauma. Rapid progress and a high risk of rupture highlight the importance of prompt diagnosis and intervention. We present a case of a rare pseudoaneurysm linked to the right coronary sinus after blunt chest trauma.

Recurrent Thymic Carcinoma Treated With Median Sternotomy, Innominate Vein Replacement for Superior Vena Cava, and Iodide Implantation: A Case Report and Review of the Literature.

Background: Neuroendocrine tumors of the thymus (NETT) are rare and malignant tumors that arise in the anterior mediastinum. These tumors can exhibit aggressive behavior and may involve surrounding critical structures, such as the superior vena cava. This case contributes to the literature by presenting a recurrent thymic carcinoma with invasion of major blood vessels, including the superior vena cava, and the complexities involved in its surgical management.

Evaluating human ability to distinguish between ChatGPT-generated and original scientific abstracts.

This study aims to analyze the accuracy of human reviewers in identifying scientific abstracts generated by ChatGPT compared to the original abstracts. Participants completed an online survey presenting two research abstracts: one generated by ChatGPT and one original abstract. They had to identify which abstract was generated by AI and provide feedback on their preference and perceptions of AI technology in academic writing.

Novel anatomical variations of the internal thoracic artery: implications for coronary artery bypass grafting surgery and autologous breast reconstruction.

The unique structure and location of the internal thoracic artery make it an ideal conduit for coronary artery bypass grafting surgery and autologous breast reconstruction. Variants with different characteristics have the potential to impact surgical success. This report presents a female body donor with a novel bilateral variation of the internal thoracic artery.

Direct Axillary Artery Cannulation as Standard Perfusion Strategy in Minimally Invasive Coronary Artery Bypass Grafting.

Objective: Cardiopulmonary bypass (CPB) via the right axillary artery (RAA) has become an alternative perfusion strategy, especially in complex aortic procedures. This study delineates our technique and outcome with direct axillary cannulation utilizing the Seldinger technique, which we adopted as the standard perfusion strategy in the sternum-sparing minimally invasive total coronary revascularization via left anterior thoracotomy (TCRAT) using CPB.

Methods: From November 2019 to December 2023, a total of 413 consecutive patients underwent nonemergent isolated coronary artery bypass grafting (CABG) via left anterior minithoracotomy on CPB with peripheral cannulation via the RAA and cardioplegic cardiac arrest, using this technique as a default strategy in the daily routine.

Artificial Intelligence in Cardiac Surgery: Transforming Outcomes and Shaping the Future.

Artificial intelligence (AI) has emerged as a transformative technology in healthcare, with its integration into cardiac surgery offering significant advancements in precision, efficiency, and patient outcomes. However, a comprehensive understanding of AI's applications, benefits, challenges, and future directions in cardiac surgery is needed to inform its safe and effective implementation. A systematic review was conducted following PRISMA guidelines.

Accuracy of Intraoperative Transesophageal Echocardiographic Doppler Parameters in Assessing the Right Ventricular Diastolic Function After Repair of Tetralogy of Fallot in Pediatric Patients.

Background: This study aimed to assess the accuracy of tricuspid spectral Doppler (E/A) and tissue Doppler parameters (E/E') to diagnose right ventricular diastolic dysfunction (RVDD) in comparison to American Society of Echocardiography (ASE criteria) in pediatric tetralogy of Fallot (TOF) patients after surgical repair.

Methods: This prospective, observational study was done at a tertiary care hospital involving 40 pediatric TOF patients aged less than 2 years who underwent complete intracardiac repair with cardiopulmonary bypass (CPB). Echocardiographic observations were made using a pediatric transesophageal echocardiography probe after surgical repair in the post-CPB period.

Wastewater Monitoring During the COVID-19 Pandemic in the Veneto Region, Italy: Longitudinal Observational Study.

Background: As the COVID-19 pandemic has affected populations around the world, there has been substantial interest in wastewater-based epidemiology (WBE) as a tool to monitor the spread of SARS-CoV-2. This study investigates the use of WBE to anticipate COVID-19 trends by analyzing the correlation between viral RNA concentrations in wastewater and reported COVID-19 cases in the Veneto region of Italy.

Objective: We aimed to evaluate the effectiveness of the cumulative sum (CUSUM) control chart method in detecting changes in SARS-CoV-2 concentrations in wastewater and its potential as an early warning system for COVID-19 outbreaks.