Epstein-Barr virus status drives morphological and molecular intra-tumour heterogeneity in gastric cancer: insights from a case report and literature review.

This case report describes a rare case of bi-phenotypic gastric cancer with two distinct, but clonally related, histological components. The first component, associated with Epstein-Barr virus (EBV) infection, exhibited the morphological features of gastric carcinoma with lymphoid stroma, suggesting that EBV, as an effective immunogenic factor, may trigger a prominent immune response within the tumour microenvironment. The second component, which was EBV-negative, displayed tubular/papillary morphology and features of increased biological aggressiveness, such as high-grade areas and lymphatic invasion.

[Tolvaptan versus fluid restriction in the treatment of hyponatremia due to inappropriate antidiuretic hormone secretion: efficacy and safety analysis in a cohort study].

Background And Objectives: hyponatremia is a common in older and hospitalized patients, often caused by the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This study compares the efficacy and safety of tolvaptan versus fluid restriction in patients with hyponatremia and SIADH.

Materials And Methods: an observational cohort study was conducted with 186 patients with hyponatremia (Na+ < 135 mmol/L) due to SIADH, treated at the Hospital Universitario de Pontevedra between 2015 and 2022.

Woven EndoBridge 17 device for intracranial aneurysms: A systematic review and meta-analysis.

Background: The Woven EndoBridge 17 (WEB-17) is the latest advancement in the WEB device family. Comprehensive data on its occlusion rates, procedural complications, and mortality is lacking. This meta-analysis aimed to evaluate the efficacy and safety of the WEB-17 device in intracranial aneurysms (IAs).

Interrupted versus uninterrupted anticoagulation for cardiac rhythm management device insertion.

Background: Guideline-recommended strategies to interrupt chronic anticoagulation with warfarin or direct oral anticoagulants (DOAC) during the perioperative period of cardiac implantable electronic device (CIED) surgery differ worldwide. There is uncertainty concerning the benefits and harms of interrupted and uninterrupted anticoagulation in patients undergoing CIED surgery.

Objectives: To assess the benefits and harms of interrupted anticoagulation (IAC) with either warfarin or DOAC in the perioperative period of CIED surgery versus uninterrupted anticoagulation (UAC), with or without heparin bridging, during an equivalent time frame, for CIED surgery.

From gastroenteritis to myocarditis: a case series of Campylobacter-mediated cardiac involvement.

Background: While viruses remain the leading cause of infectious myocarditis, improved diagnostic methods have highlighted the role of bacteria as a possible cause. We report two cases of myocarditis as a complication of infection.

Case Summaries: Patient A, a 17-year-old Caucasian male with a history of asthma, presented to the emergency department (ED) after experiencing fever and nausea for four days, followed by 1 day of diarrhoea and chest discomfort.

Pharmaco-Invasive Strategy Vs Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction in Latin America: A Meta-Analysis.

Background: Primary percutaneous coronary intervention (PCI) is the established treatment for ST-segment elevation myocardial infarction (STEMI), but often it is not readily available in low-resource settings. We assessed the safety and efficacy of the pharmaco-invasive strategy compared to primary PCI for STEMI in Latin America.

Methods: MEDLINE, Embase, and Latin American and Caribbean Health Sciences Literature (LILACS) were searched for the period from their inception to September 2023, for studies that compared a pharmaco-invasive strategy vs primary PCI in Latin America.

Retinal Vasculitis as a Rare Presentation of Microscopic Polyangiitis.

Microscopic polyangiitis (MPA) is a rare, autoimmune, small-vessel vasculitis usually described with the presence of perinuclear antineutrophil cytoplasmic antibodies (p-ANCA). It encompasses a broad spectrum of clinical features, including fatigue, weight loss, fever, arthralgia, skin lesions, and involvement of the lungs or kidneys. Ocular manifestations, however, are extremely rare.

Emerging Trend of Central Precocious Puberty: A Retrospective Study of Cases Diagnosed Before and During the COVID-19 Pandemic in a Portuguese Tertiary-Level Hospital.

Introduction: In light of the recent evidence suggesting an increase in idiopathic central precocious puberty (ICPP) during the COVID-19 pandemic, this study aimed to assess the incidence of newly diagnosed ICPP cases and compare differences in demographic, anthropometric, and clinical characteristics pre-pandemic and during the pandemic.

Methods: We conducted a retrospective study at a national reference pediatric endocrinology unit in Portugal to evaluate the proportion of referrals for precocious puberty (PP) and, within this group, the number of ICPP cases diagnosed before (group 1: January 2018 to March 2020) and during the pandemic (group 2: April 2020 to June 2022). Additionally, we compared the demographic, anthropometric, and clinical characteristics of ICPP patients between the two groups.

Arthroscopic Humeroplasty in the Treatment of Acute Reverse Hill-Sachs Lesion Associated With Posterior Shoulder Instability.

Reverse Hill-Sachs lesions (RHSL) are common complications associated with posterior shoulder dislocations and represent a significant challenge for preserving joint stability and function. If untreated, these compression fractures of the anteromedial humeral head can compromise the integrity of the joint, predisposing patients to recurrent instability and arthropathy. While various treatment modalities exist, achieving an anatomic reduction of the defect while preserving the articular cartilage remains a desirable outcome, particularly in acute settings.

Blood levels of cytokines highlight the role of inflammation in Alzheimer's disease.

Inflammation and angiogenesis have been defined as potential mechanisms associated with clinical progression from a cognitively normal state to Alzheimer's disease (AD). In this observational case-control study, we aimed to determine plasma levels of cytokines as indicators of inflammation involved in cognitive decline. We measured 30 plasma proteins in 49 controls (CTL), 36 individuals with mild cognitive impairment (MCI) and 52 patients diagnosed with probable AD.

Developing a Prototype Machine Learning Model to Predict Quality of Life Measures in People Living With HIV.

Background: In the realm of Evidence-Based Medicine, introduced by Gordon Guyatt in the early 1990s, the integration of machine learning technologies marks a significant advancement towards more objective, evidence-driven healthcare. Evidence-Based Medicine principles focus on using the best available scientific evidence for clinical decision-making, enhancing healthcare quality and consistency by integrating this evidence with clinician expertise and patient values. Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) have become essential in evaluating the broader impacts of treatments, especially for chronic conditions like HIV, reflecting patient health and well-being comprehensively.

Targeting CRM1 for Progeria Syndrome Therapy.

Hutchinson-Gilford progeria syndrome (HGPS) is a premature aging disease caused by progerin, a mutant variant of lamin A. Progerin anchors aberrantly to the nuclear envelope disrupting a plethora of cellular processes, which in turn elicits senescence. We previously showed that the chromosomal region maintenance 1 (CRM1)-driven nuclear export pathway is abnormally enhanced in patient-derived fibroblasts, due to overexpression of CRM1.

Transcriptomic signatures and network-based methods uncover new senescent cell anti-apoptotic pathways and senolytics.

Cellular senescence is an irreversible cell cycle arrest caused by various stressors that damage cells. Over time, senescent cells accumulate and contribute to the progression of multiple age-related degenerative diseases. It is believed that these cells accumulate partly due to their ability to evade programmed cell death through the development and activation of survival and antiapoptotic resistance mechanisms; however, many aspects of how these survival mechanisms develop and activate are still unknown.

Portuguese consensus on first line treatment of moderate-to-severe psoriasis with a non-TNF inhibitor therapy - a delphi methodology.

Introduction: Psoriasis (PsO) is a common chronic, inflammatory, immune-mediated disease. In 2023, a 4.4% prevalence of PsO was reported in Portugal.

Home mechanical ventilation: a narrative review and a proposal of practical approach.

Growing evidence of the benefits of home ventilatory support in patients with chronic respiratory failure along with technological advances in ventilators have enabled their use in overly complex situations, shaping a new scenario for physicians. This has further given rise to new challenges related to their incorporation into current medical practice. However, this evolution needs to be coupled with knowledge and skills of physicians who are willing to prescribe Home Mechanical Ventilation (HMV), in order to prevent them from making inappropriate choices or adjustments that may ultimately have ethical and legal implications.

Infective endocarditis: a growing threat despite medical progress. A look at trends in Spain.

Introduction And Objectives: Infective endocarditis (IE) is a serious public health problem both in Spain and worldwide. This study aimed to analyze the trends in the incidence of IE in Spain from 1992 to 2021.

Methods: We used IE incidence data from the Global Health Data Exchange and population data from the Spanish National Statistics Institute to analyze changes in age-standardized incidence rates.

Primary and secondary cardiovascular prevention through life cycles in women. Consensus document of the SEC-WG CVD in Women, SEC-ACP, SEGO, AEEM, SEEN, semFYC, SEMERGEN, AEP, and AEM.

This consensus document on cardiovascular disease in women summarizes the views of a panel of experts organized by the Working Group on Women and Cardiovascular Disease of the Spanish Society of Cardiology (SEC-WG CVD in Women), and the Association of Preventive Cardiology of the SEC (SEC-ACP). The document was developed in collaboration with experts from various Spanish societies and associations: the Spanish Society of Gynecology and Obstetrics (SEGO), the Spanish Society of Endocrinology and Nutrition (SEEN), the Spanish Association for the Study of Menopause (AEEM), the Spanish Association of Pediatrics (AEP), the Spanish Society of Primary Care Physicians (SEMERGEN), the Spanish Society of Family and Community Medicine (semFYC), and the Association of Spanish Midwives (AEM). The document received formal approval from the SEC.

External validation of the "simplified hospital" scale as a predictor of 30-day readmission after hospitalisation in osi araba medical services.

Background: A readmission is defined as a new admission to hospital for at least one night in the 30 days following a discharge. Some are caused by events unrelated to the reason for the initial admission (unavoidable) and others caused by the same pathology (related). Different predictive models allow the identification of patients at higher risk of readmission.

Triatoma venosa and Panstrongylus geniculatus challenge the certification of interruption of vectorial Trypanosoma cruzi transmission by Rhodnius prolixus in eastern Colombia.

Reactivation of Trypanosoma cruzi transmission by native vectors with different domiciliation capabilities is a major concern for Chagas disease control programs. T. cruzi transmission via intra-domestic Rhodnius prolixus was certified as interrupted by the Pan American Health Organization in Miraflores municipality (Boyacá, Colombia) in 2019.

Ecological filters shape arbuscular mycorrhizal fungal communities in the rhizosphere of secondary vegetation species in a temperate forest.

The community assembly of arbuscular mycorrhizal fungi (AMF) in the rhizosphere results from the recruitment and selection of different AMF species with different functional traits. The aim of this study was to analyze the relationship between biotic and abiotic factors and the AMF community assembly in the rhizosphere of four secondary vegetation (SV) plant species in a temperate forest. We selected four sites at two altitudes, and we marked five individuals per plant species at each site.

Respiratory syncytial virus vaccination in older adults and patients with chronic disorders: A position paper from the Portuguese Society of Pulmonology, the Portuguese Association of General and Family Medicine, the Portuguese Society of Cardiology, the Portuguese Society of Infectious Diseases and Clinical Microbiology, the Portuguese Society of Endocrinology, Diabetes and Metabolism, and the Portuguese Society of Internal Medicine.

Background: Respiratory syncytial virus (RSV) is an important cause of lower respiratory tract infection, hospitalisation and death in adults.

Methods: Based on evidence regarding the impact of RSV on adult populations at risk for severe infection and the efficacy and safety of RSV vaccines, the Portuguese Society of Pulmonology, the Portuguese Association of General and Family Medicine, the Portuguese Society of Cardiology, the Portuguese Society of Infectious Diseases and Clinical Microbiology, the Portuguese Society of Endocrinology, Diabetes and Metabolism, and the Portuguese Society of Internal Medicine endorses this position paper with recommendations to prevent RSV-associated disease and its complications in adults through vaccination.

Conclusion: The RSV vaccine is recommended for people aged ≥50 years with risk factors (chronic obstructive pulmonary disease, asthma, heart failure, coronary artery disease, diabetes, chronic kidney disease, chronic liver disease, immunocompromise, frailty, dementia, and residence in a nursing home) and all persons aged ≥60 years.

The Patent Blue V Paradox: Hidden Offender, Serial Culprit.

Patent Blue V (PBV) is extensively used in sentinel lymph node identification in cancer surgery, potentially leading to an increased incidence of hypersensitivity reactions. A retrospective analysis was conducted on patients with suspected PBV hypersensitivity, at our center from 2010 to 2023. Skin prick tests (SPT) were performed on all patients, followed by intradermal tests (IDT) if SPT was negative.

Role of major cardiovascular surgery-induced metabolic reprogramming in acute kidney injury in critical care.

Purpose: Major cardiovascular surgery imposes high physiologic stress, often causing severe organ dysfunction and poor outcomes. The underlying mechanisms remain unclear. This study investigated metabolic changes induced by major cardiovascular surgery and the potential role of identified metabolic signatures in postoperative acute kidney injury (AKI).