External Fixation of Clavicle Fractures with Comminution or in Highly Active Patients.

Conservative treatment of clavicle fractures has the disadvantage of substantial pain and discomfort, whereas internal fixation of these fractures has a high rate of non-union. External fixation is an alternative method permitting early mobilization without disrupting the surrounding soft tissue envelope. These are extremely beneficial in young, athletic and highly functional patients as well as in patients with comminuted fractures.

Aberrant anatomy in the context of the critical view of safety.

Background: The protective impact of the Critical View of Safety (CVS) approach on the vasculo-biliary injuries during laparoscopic cholecystectomy (LC) depends largely upon the understanding of the normal and variant anatomy. Structures exposed during the acquisition of the CVS can deviate from the typical dual configuration of the cystic duct and artery (gallbladder pedicle) representing either a third (supernumerary) or atypical in course (heterotopic) element. The aim of this study was to determine the identity and the frequency of these anatomical elements and to propose anatomic schemata that can guide the achievement of CVS by surgeons.

Renal survival and treatment of adult patients with Primary Focal Segmental glomerulosclerosis: A historical cohort study of the National Greek Registry.

Background/objective: Primary Focal and Segmental glomerulosclerosis (FSGS) is one of the most common causes of idiopathic nephrotic syndrome. Our aim was to describe a large cohort of patients with primary FSGS, identify risk factors associated with worse renal survival and assess the impact of different immunosuppressive regiments on renal survival.

Methods: This was a historical cohort study of adults who were diagnosed with primary FSGS from March 26, 1982, to September 16, 2020.

Characteristics, outcomes and the necessity of continued guideline-directed medical therapy in patients with heart failure with improved ejection fraction.

Background: Much remains to be learned about patients with heart failure with improved ejection fraction (HFimpEF).

Objective: This study sheds light on the characteristics and clinical outcomes of HFimpEF patients, including the consequences of halting guideline-directed medical therapy (GDMT).

Methods: This retrospective study was conducted on patients diagnosed with heart failure with reduced ejection fraction (HFrEF) who underwent a second echocardiogram at least 6 months apart between January 2009 and February 2023.

Proteomics and Metabolomics in Varicocele-Associated Male Infertility: Advancing Precision Diagnostics and Therapy.

Varicoceles are a common contributor to male infertility, significantly impacting male-factor infertility cases. Traditional diagnostic methods often lack the sensitivity to detect the molecular and cellular disruptions caused by varicoceles, limiting the development of effective, personalized treatments. This narrative review aims to explore the advancements in proteomics and metabolomics as innovative, non-invasive diagnostic tools for varicocele-associated male infertility and their potential in guiding personalized therapeutic strategies.

Evaluating Plastic Surgery Resident Satisfaction Globally: Predictors and Recommendations for Training Enhancement.

Background: Measures of quality in resident training in plastic and reconstructive surgery (PRS) programs are scarce and often methodologically inconsistent. Our research provides insights from current PRS trainees globally, mapping their training inputs, expected outputs, and recommendations for program improvements.

Methods: A global online survey was conducted among PRS residents across 70 countries to gauge their satisfaction with residency training, capturing training inputs such as the number of surgeries attended and seminars they participated in.

Atrial and ventricular functional mitral regurgitation: prevalence, characteristics, outcomes, and disease progression.

Aims: Limited data exist on the natural history of functional mitral regurgitation (FMR), including atrial (AFMR), ventricular (VFMR), and dual FMR. This study examined the prevalence, characteristics, outcomes, and progression of these FMR subtypes.

Methods And Results: Consecutive patients with ≥mild to moderate FMR were included and classified as AFMR, VFMR, or dual FMR.

An Unusual Case of Pelvic Congestion Syndrome: A Case Report.

This manuscript presents a case of a 35-year-old nulligravida premenopausal woman who presented with acute abdominal pain due to pelvic congestion syndrome (PCS). PCS is characterized by multiple pathophysiological mechanisms and various clinical presentations. Our patient was nulliparous with no history of abdominal surgery.

Survival prospects of pulmonary arterial hypertension associated with congenital heart disease: Insights from the HOPE registry.

Background: Pulmonary arterial hypertension (PAH) is a severe complication among adult patients with congenital heart disease (ACHD). This study presents real-world data on risk stratification, pharmacotherapy and survival rates in PAH-ACHD.

Methods: Data from PAH-ACHD patients were analyzed using The Hellenic Pulmonary Hypertension Registry (HOPE), spanning eight specialized centers between 2015 and 2023.

Imaging presentations of foreign bodies that make for a challenging diagnosis: pictorial essay.

Foreign bodies (FBs) can pose a diagnostic dilemma because a wide range of objects, comprising items incidentally detected or deliberately retained in the body, can be discovered on imaging investigations. Single or multiple FBs may be retained at different sites including the gastrointestinal tract, the genitourinary system, the respiratory tract, and the soft tissues, all of which warrant medical attention. More importantly, ensuing, serious complications related to harmful positioning of these objects can significantly hamper normal function of any involved organ system.

The cornerstones of randomized clinical trials.

Randomized clinical trials (RCTs) are pivotal in medical research, offering critical evidence on the efficacy and safety of treatments. This paper explores the distinct purposes and designs of superiority, non-inferiority, equivalence, and pragmatic trials, each addressing unique research questions. Superiority trials aim to demonstrate a new treatment's effectiveness over existing standards, while non-inferiority and equivalence trials focus on ensuring new treatments are not significantly worse or are similar to existing ones, respectively.

What Is the Role of the Gut Microbiota in Anastomotic Leakage After Colorectal Resection? A Scoping Review of Clinical and Experimental Studies.

Anastomotic leakage (AL) still remains a common complication after colorectal anastomosis that leads to increased morbidity and mortality. The gut microbiota has been hypothesized as one of the risk factors associated with anastomotic leakage. The aim of the present study was to summarize all existing clinical and experimental studies that evaluate the impact of intestinal microbiota on anastomotic leakage after colorectal resection.

The SGLT2 inhibitor empagliflozin exerts neuroprotective effect against hydrogen peroxide-induced toxicity on primary neurons.

Oxidative stress has been implicated in several chronic pathological conditions, leading to cell death and injury. Alzheimer's disease (AD) and type 2 diabetes mellitus (T2DM) have several overlapping mechanisms as they are both characterized by increased oxidative stress, inflammation, insulin resistance, and autophagy dysfunction. The objective of this study was to elucidate the possible neuroprotective effect of empagliflozin, a sodium-glucose co-transporter 2 inhibitor (SGLT2i), against hydrogen peroxide-induced neurotoxicity in primary hippocampal neurons derived from wild-type (WT) and transgenic AD rats (TgF344-AD).

Natural Compounds and Cancer: Current Evidences.

Natural compounds are constantly gaining ground in the treatment of various chronic diseases and in cancer research. Recent efforts have been focusing on them due to their special features consisting of low toxicity and high bioavailability. These compounds have already demonstrated important antitumor activity against several cancers in vitro through several mechanisms, including cell viability reduction, suppression of cell proliferation, cell death induction and cell cycle arrest.

Molecular Alterations in Paired Epithelial Ovarian Tumors in Patients Treated with Neoadjuvant Chemotherapy.

Background: Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) and adjuvant chemotherapy is a therapeutic choice for women with advanced ovarian cancer. Whether NACT affects the tumor's molecular profile has not been determined.

Methods: This was a retrospective study of patients with advanced-stage epithelial ovarian cancer treated with NACT at oncology departments affiliated with the Hellenic Cooperative Oncology Group (HeCOG).