Medication related osteonecrosis (MRONJ) in the management of CTIBL in breast and prostate cancer patients. Joint report by SIPMO AND SIOMMMS.

Background: Low-doses of bone modifying agents (LD-BMAs) compared to those used to treat bone metastases are used in breast or prostate cancer patients on adjuvant endocrine therapy to prevent Cancer Treatment Induced Bone Loss (CTIBL). Their use is associated with an increased risk of developing Medication-Related Osteonecrosis of the Jaw (MRONJ). However, there is not clarity about strategies aimed to minimize the MRONJ risk in cancer patients at different conditions as low- vs high-doses of BMA.

Coblator Assisted-Barbed Relocation Pharyngoplasty (Co-BRP) in Obstructive Sleep Apnea Surgical Treatment.

Barbed reposition pharyngoplasty (BRP) is a new technique to manage velo-pharyngeal obstruction and collapse in OSA patients. Tonsillectomy is a preliminary step of BRP surgery. Dissection of the PPM with monopolar or hot instruments is an essential step of the BRP technique.

Patterns and predictors of statin therapy after ischemic stroke and TIA: insights from the LIPYDS multicenter study.

Background: Patients with ischemic stroke (IS) or TIA face an elevated cardiovascular risk, warranting intensive lipid-lowering therapy. Despite recommendations, adherence to guidelines is suboptimal, leading to frequent undertreatment. This study aims to evaluate the statin use after IS and TIA.

Female athletes: a state-of-the-art review of multiorgan influence of exercise training.

Endurance sports have witnessed an increase in female participation, demanding a constant and evolving reassessment of the specific physiological and health implications of female athletes. In the present review, we analyze cardiovascular, hematological adaptations and anthropometry and hormonal fluctuations highlighting sex-specific differences in response to exercise, with estrogen playing a fundamental role in modulating body composition and metabolic processes. Nutritional aspects, in particular energy availability, macronutrient distribution and hydration, are fundamental in supporting training demands and menstrual function.

Managing depression in the elderly: real-world clinical considerations and perspectives.

This study aims to elucidate current trends in clinical practice for managing depression in elderly patients, focusing on the utilization of pharmacotherapeutics and integrated care models to improve patient outcomes. A comprehensive survey was conducted among physicians from various European countries to gather insights into prescribing habits, treatment patterns, and the impact of comorbidities on therapeutic choices, with a focus on trazodone. The participants included psychiatrists, general practitioners, and neurologists actively involved in elderly depression care.

Indications for the addition of a patellofemoral joint arthroplasty following a previous unicondylar knee arthroplasty- a literature review and Delphi consensus.

Introduction: The aim of this study was to establish an international consensus statement on the indications for the addition of a patellofemoral joint arthroplasty (PFJA) in patients with a unicondylar knee arthroplasty (UKA) and symptomatic progression of patellofemoral compartment osteoarthritis.

Materials And Methods: A systematic review of the literature was conducted, and the results used to inform the development of a statement by an expert working group. This was then evaluated and modified, using a Delphi process, by members of the European Knee Society (EKS).

From Symptoms to Satisfaction: Optimizing Patient-Centered Care in Dry Eye Disease.

Dry eye disease (DED) is a multifactorial, chronic, and often relapsing condition with a significant impact on patient quality of life (QoL). Symptoms such as ocular discomfort and visual disturbances are diverse and frequently misaligned with objective clinical signs, complicating diagnosis and management. DED not only interferes with daily activities like reading, driving, and computer use but also imposes a substantial economic burden due to direct healthcare costs and reduced work productivity.

Integrated Lung, Diaphragm and Lower Limb Muscular Ultrasound: Clinical Correlations in Geriatric Patients with Acute Respiratory Illness.

: Point-of-care lung ultrasonography (LUS) represents an accurate diagnostic tool in older patients with respiratory failure. The integration of LUS with ultrasonographic assessment of diaphragm thickness and excursion, right vastus lateralis (RVL) muscle thickness and cross-sectional area (CSA) could provide real-time information on frailty and sarcopenia. The primary aim of this proof-of-concept prospective study was to evaluate clinical correlates of thoracic, diaphragmatic, and muscular ultrasound to characterize the associations between frailty, respiratory failure, and sarcopenia in older patients hospitalized for acute respiratory complaints.

Primary Peristalsis Is the Dominant Mechanism of Refluxate Clearance Following Gastroesophageal Reflux.

Background: Refluxate volume and pH drop following gastroesophageal reflux are mostly cleared by peristalsis. We evaluated the roles of primary volume clearing peristaltic wave (VCPW), secondary VCPW, post-reflux swallow-induced peristaltic wave (PSPW), and late primary peristaltic wave (LPPW) in refluxate clearance.

Methods: We retrospectively analyzed pH-impedance studies performed off therapy in 40 patients with typical esophageal symptoms.

Impact of a very low-calorie ketogenic diet on metabolic and microbiota outcomes in post-bariatric patients and bariatric-Naïve individuals: A comparative pilot study.

Aims: To date, bariatric surgery (BS) is the most effective long-term treatment for obesity, but weight regain (WR) is common. The very low-calorie ketogenic diet (VLCKD) is effective for weight loss and may influence gut microbiota (GM) composition, but it has been scarcely evaluated in post-bariatric patients. This study compared the efficacy and safety of a VLCKD in patients with WR post-bariatric surgery (BS+) and in bariatric surgery-naïve patients (BS-).

Exploring the antioxidant and antimicrobial properties of five indigenous Kenyan plants used in traditional medicine.

Defined by the World Health Organization (WHO) as indigenous knowledge and practices used for maintaining health and treating illnesses, traditional medicine (TM) represents a rich reservoir of ancient healing practices rooted in cultural traditions and accumulated wisdom over centuries. Five indigenous Kenyan plant species traditionally used in African TM, named Afzelia quanzensis, Azadirachta indica, Gigasiphon macrosiphon, Grewia bicolor, and Lannea schweinfurthii, represent a valuable resource in healing practices, yet their chemical composition and bioactivity remain understudied. To depict a primary bio-chemical characterization of these plants, their antioxidant and antimicrobial features have been evaluated by the use of methods validated in this context.

Effect of introduction of elastic compression bandages on quality of life in patients with lower extremity vascular skin ulcers: a prospective study correlating WOUND-Q patient-reported outcome measures and evidence-based medicine.

Background: Evidence-based medicine and patient-reported outcome measures (PROMs) are helpful tools in the wound care field, but few studies correlating quality of life (QoL) changes with objective changes exist.

Objective: To investigate the QoL changes following the shift from primary dressings alone to elastic compression bandages in patients with a new diagnosis of vascular skin ulcer, and to evaluate a possible correlation between objective and subjective changes.

Materials And Methods: This study included 122 patients with a new diagnosis of vascular skin ulcer, who had previously used only primary dressings alone.

Immunohistochemical insights into hypothermia-related deaths: a systematic review.

Purpose: Hypothermia occurs when core body temperature drops below 35 °C. The purpose of this review was to identify and analyze studies on the topic of hypothermia from an immunohistochemical perspective to determine robust markers of fatal hypothermia.

Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines.

Topical Protection of Esophageal Mucosa as a New Treatment of GERD.

Among the various factors implicated in the pathogenesis of gastroesophageal reflux disease (GERD), visceral hypersensitivity and mucosal resistance have been recently re-evaluated in relation to the increasing phenomenon of proton pump inhibitor failure, particularly in patients with nonerosive reflux disease (NERD). Intensive research has allowed us to understand that noxious substances contained in the refluxate are able to interact with esophageal epithelium and to induce the elicitation of symptoms. The frequent evidence of microscopic esophagitis able to increase the permeability of the mucosa, the proximity of sensory afferent nerve fibers to the esophageal lumen favoring the higher sensitivity to noxious substances and the possible activation of inflammatory pathways interacting with sensory nerve endings are pathophysiological alterations confirming that mucosal resistance is impaired in GERD patients.

Oral selective estrogen receptor degraders for breast cancer treatment: focus on pharmacological differences.

Purpose: The management of hormone receptor-positive (HR +) breast cancer (BC) relies on endocrine therapy (ET), with a primary focus on disrupting estrogen receptor (ER) signaling due to its critical role in BC tumorigenesis and progression. While effective for both early-stage and advanced breast cancers, ET frequently encounters resistance mechanisms, including both ligand-dependent and ligand-independent trajectories, ultimately leading to disease progression.

Methods: We searched PubMed, EMBASE and Scopus databases to review the current evidence on the use of novel oral selective estrogen receptor degraders (SERDs) for the treatment of HR+ BC.

Influence of Persistently Elevated LDL Values on Carotid Intima Media Thickness in Elite Athletes.

Introduction: Carotid IMT is a recognized marker for early atherosclerotic changes and a predictor of future CV events. Previous studies showed 11% increased risk of myocardial infarction with each 0.1 mm incremental increase of carotid IMT.

Osteoporosis in Older Men: Informing Patient Management and Improving Health-Related Outcomes.

Osteoporosis has been usually considered a female disease, generally causing more fracture risk and complications in adult and older women compared to older men. While vertebral fractures occur in a small proportion of men during middle age, men generally fracture about 10 years later than women, with significant increases in fracture risk after about age 75. Independent of age, men experiencing fragility fractures have a higher risk of life-threatening events compared to women, but the risk of secondary fragility fracture overlaps between men and women.

Clinical implications of epithelial-to-mesenchymal transition in cancers which potentially spread to peritoneum.

Epithelial-to-mesenchymal transition (EMT) is a biological process by which epithelial cells increase their motility and acquire invasive capacity. It represents a crucial driver of cancer metastasis and peritoneal dissemination. EMT plasticity, with cells exhibiting hybrid epithelial/mesenchymal states, and its reverse process, mesenchymal-to-epithelial transition (MET), allows them to adapt to different microenvironments and evade therapeutic intervention.

Differential expression of plasma proteins and pathway enrichments in pediatric diabetic ketoacidosis.

Background: In children with type 1 diabetes (T1D), diabetic ketoacidosis (DKA) triggers a significant inflammatory response; however, the specific effector proteins and signaling pathways involved remain largely unexplored. This pediatric case-control study utilized plasma proteomics to explore protein alterations associated with severe DKA and to identify signaling pathways that associate with clinical variables.

Methods: We conducted a proteome analysis of plasma samples from 17 matched pairs of pediatric patients with T1D; one cohort with severe DKA and another with insulin-controlled diabetes.

Helminthiasis and mpox vaccination: challenges in Sub-Saharan Africa.

The ongoing mpox outbreak in sub-Saharan Africa has highlighted the critical need for equitable vaccine access and robust logistical support. However, these factors alone are insufficient to ensure the success of vaccination campaigns in regions characterized by unique epidemiological and immunological challenges. One significant issue is the high prevalence of helminth infections, which are known to impair immune responses to vaccines, potentially reducing both short-term efficacy and long-term antibody titers.

Tracing the Dispersal Pathway of HIV-1 Subtype C to Bahia: Phylogenetic Connections to Southern Brazil.

The HIV-1 epidemic in Brazil is predominantly characterized by subtype B, except in the southern states, where subtype C (HIV-1C) is more prevalent. Continuous monitoring of this profile is essential to maintain an accurate understanding of the molecular landscape of the HIV epidemic in Brazil. In this study, we isolated and sequenced seven new HIV-1C strains from the state of Bahia, located in the Northeast region of Brazil.

Wolbachia-Based Approaches to Controlling Mosquito-Borne Viral Threats: Innovations, AI Integration, and Future Directions in the Context of Climate Change.

Wolbachia-based mosquito control strategies have gained significant attention as a sustainable approach to reduce the transmission of vector-borne diseases such as dengue, Zika, and chikungunya. These endosymbiotic bacteria can limit the ability of mosquitoes to transmit pathogens, offering a promising alternative to traditional chemical-based interventions. With the growing impact of climate change on mosquito population dynamics and disease transmission, Wolbachia interventions represent an adaptable and resilient strategy for mitigating the public health burden of vector-borne diseases.

Viral Metagenomics in Patients Who Underwent Allogeneic Hematopoietic Stem Cell Transplantation (HSCT): A Brazilian Experience.

Viral infections are one of the most important causes of morbidity and mortality among patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). Immunosuppression may lead to the reactivation of latent viruses or the acquisition of new infections, resulting in severe clinical outcomes. The early detection of viral reactivations is crucial for effective patient management and post-transplant care.