Barrett’s esophagus (BE) is a precursor condition for esophageal adenocarcinoma (EAC). This case report describes the in vivo use of a fluorescently-labeled peptide heterodimer specific for epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor (HER2) to identify residual neoplasia in a 52-year-old female patient with BE. This targeted contrast agent was topically administered after an incomplete endoscopic mucosal resection of high-grade dysplasia with carcinoma in situ. A flexible fiber-coupled multi-modal scanning fiber endoscope was used to capture near-infrared fluorescence images. This instrument was passed through the working channel of a standard upper endoscope for use as an accessory. Increased fluorescence intensity was observed from nodular mucosa as a real-time “red flag” to identify the presence of neoplasia. Pathologic tests were conducted on the resected tissues, confirming the presence of stage T1a EAC. The expression EGFR and HER2 was confirmed by immunohistochemistry ex vivo. These findings support integrated imaging as a potential strategy to detect Barrett’s neoplasia.

Ocular neuropathic pain refers to persistent post-operative perception of ocular discomfort in the absence of painful stimuli. This study investigates persistent ocular pain following 23-gauge pars plana vitreoretinal surgery. In the present study, patients who underwent either 23-gauge vitrectomy or silicone oil removal, under local or general anesthesia, were included. The symptoms of ocular neuropathic pain were evaluated using the brief pain inventory questionnaire before and 2 months after surgery. In addition, the impact of reported ocular symptoms on quality of life was assessed. We also evaluated the correlation between ocular pain and factors such as patient demographics and underlying systemic conditions. This study includes 75 eyes of 75 patients with an average age of 58.93 ± 12.05 years. Of the included patients, 31 (41.3%) were female. Among the participants, 67 (89.3%) underwent pars plana vitrectomy, and 8 (10.7%) experienced silicone oil removal surgery. Analysis using paired t-test or Wilcoxon signed-rank test, based on data normality, indicated no significant change in eye pain scores 2 months after surgery. However, the percentage of patients using analgesics increased from 4% before surgery to 17.3% 2 months after surgery (P = 0.021). Furthermore, based on a linear regression model, patients who reported increased analgesic usage 2 months after surgery also scored worse on the quality-of-life questionnaire (P < 0.05). We also found that those who reported ocular pain, facial pain, and photophobia before surgery had a higher likelihood of using analgesics after surgery (P = 0.03, 0.003, and 0.001, respectively). In addition, regression analysis revealed that patients with migraine headaches and lower levels of education were more likely to develop eye symptoms postoperatively (P = 0.017 and 0.044, respectively). In conclusion, surgeries involving 23-gauge scleral incisions do not significantly induce ocular neuropathic pain within 2 months after surgery. However, there is an observed increase in the use of analgesics following surgery.

Surgery is the final frontier in global medicine; yet, access to essential surgical services in low- and middle-income countries remains a significant barrier to equitable care. With a rise in non-communicable diseases and a shortage of skilled surgeons, the need for mentorship becomes crucial to capacity building. The COVID-19 pandemic acted as a catalyst for remote mentorship, leading to the development of innovative solutions such as Rods&Cones®. Herein, we describe one example of remote mentorship conducted across a distance of more than 7,700 miles between King Faisal Hospital in Rwanda and the University of Wisconsin Hospital in the US. This paper aims to demonstrate how advances in remote mentorship technology can overcome existing barriers and aid in expanding the global surgical workforce in thoracic surgery.

Recent advancements in omics techniques have enabled deep profiling of an individual’s molecular makeup. The wealth of data produced offers insights into genetic predispositions, early disease markers, and personalized treatment strategies. However, the full potential of omics data emerges when combined into longitudinal and personal multi-omics space. Another interesting venue is the inclusion of continuous monitoring of physiological parameters through wearable technology. Wearable health devices, including smartwatches and biosensors, provide real-time data on heart rate, oxygen saturation, sleep patterns, activity levels, and much more. By integrating with omics data, wearables offer a comprehensive view of an individual’s health, allowing for early detection of deviations from normalcy. This convergence allows for the prediction and prevention of diseases at the individual level and provides a powerful monitoring tool in clinical and drug developmental settings. This review explores the fusion of omics and wearable technology, envisioning their synergy as a catalyst for a transformative shift in modern healthcare. Their merging enables predictive and personalized medicine. As these technologies continue to evolve, their translation into routine clinical practice holds the promise of a healthier future for all. Provided herein is a step-by-step vision for how longitudinal personalized multi-omics, combined with wearable devices, will guide proactive healthcare and transform drug discovery in translational medicine.

Coronary artery disease (CAD) is a prevailing global health issue and a leading cause of death worldwide. Its accurate and timely diagnosis is crucial for effectively managing the disease and improving patient outcomes. In this study, we conducted a comparative analysis of machine learning (ML)-based approaches to detect and diagnose CAD. A dataset of 918 instances from the UCI ML repository, comprising 11 typical risk factors and CAD predictors, was used for this investigation. The study deployed ML models in Google Colaboratory and PyCaret, testing their efficacy in diagnosing CAD. Our study provides a detailed overview of these ML methodologies, their strengths, and limitations, underscoring the potential of these algorithms to revolutionize CAD diagnosis and treatment. The overall goal of the study is to create a model that can predict the presence or chance of presence of CAD based on different parameters of the patient’s history. Findings include the showcased logistic regression model, which was proven to be particularly effective, with an area under curve of 0.88, indicating a high ability to differentiate between patients with and without CAD, and a successful ability to identify clinically key features of CAD such as the presence of exertional angina and chest pain. This study emphasizes the importance of further research in this field to establish ML as a cornerstone of modern healthcare diagnostics.

In response to the challenge of spinal cord injury (SCI) rehabilitation, this study aimed to investigate the effect of applying a non-invasive interface of surface neuroelectrical signals and functional electrical stimulation (sNES-sFES) with a static magnetic field on the motor outcome of the quadriceps femoris muscle in an individual with a complete SCI. The participant, who had a complete SCI in the chronic stage, was evaluated before (pre) and after nine (post) interventions using surface electromyography (sEMG). In addition, spasticity (modified Ashworth scale [MAS]) was observed in all sessions. Moreover, the user learning curve process (classifier percentage and correct success of the sFES hits) was evaluated. In general, we observed: (i) No voluntary muscle contraction (pre- and post-root mean square of sEMG = 0%) improvement; (ii) spasticity decrease (average one point in MAS); (iii) gradual improvement in the user learning effect on the interface, reaching 84% in classifier accuracy and a maximum percentage of correct sFES activation of 53%. In conclusion, no improvement in voluntary muscular contraction was observed within 9 weeks of the intervention (1 session/day; 1 h/week). However, our study demonstrates the safety and feasibility of our methodology for future research involving continuous physical rehabilitation training and the implementation of assistive technology.

Overweight and obesity are associated with alterations in the reproductive system, which affect the anabolic supply to peripheral muscle tissues. The study aimed to investigate the effects of a high-calorie diet (HCD) on the development of obesity, reproductive hormone levels, and morphofunctional characteristics of muscle tissues in Wistar rats (i.e., 54 sexually mature male and female Wistar rats) for 16 weeks. Male rats fed with an HCD displayed (i) visceral obesity and hypogonadism, (ii) a decrease in the mass of the musculus triceps surae, (iii) increased levels of total protein, cholesterol, glucose, lactate, lactate dehydrogenase, and malonic dialdehyde (MDA) and superoxide dismutase (SOD) activities, and (iv) stable concentrations of estradiol and testosterone in the muscle tissues. In contrast, female rats fed with HCD displayed (i) visceral obesity, (ii) alterations in reproductive hormones toward hyperandrogenism, (iii) decreased metabolism in the muscle tissues, and (iv) increased levels of estradiol and MDA (without SOD activation). The cross-sectional area of the muscle fiber was significantly reduced by 20% in male and 44% in female rats on HCD. In addition, the total muscle edema was reportedly increased by twofold in both male and female rats. In summation, obese male and female rats developed an imbalance of reproductive hormones and alterations in muscle tissue metabolism.

Carbon monoxide (CO) poisoning is characterized by non-specific and protean clinical manifestations, exhibiting a highly variable presentation. We present a case of an 83-year-old female Alzheimer’s patient, a non-smoker, who was found unconscious in her wheelchair by her caregiver at home. The heating in the apartment was powered by liquefied petroleum gas. On admission to the emergency department, her vital signs were normal, but she was unconscious and slightly dyspneic. The examination revealed red-colored skin lesions in the submammary area, where the wheelchair safety belt was firmly fastened. The rest of the physical examination results were unremarkable. The carboxyhemoglobin level was 23%, and there was an increase in creatine phosphokinase and troponin I levels. On the 2nd day of hospitalization in the emergency ward, the electrocardiogram revealed negative T waves in the V1–V6 leads, while the bedside echocardiogram revealed apical ballooning of the left ventricle. The myocardial perfusion examination yielded a negative result for myocardial ischemia. In the management of patients with CO poisoning, it is important for emergency physicians to assess the presence of multiple organ and tissue disorders. Consequently, the patient was diagnosed with CO poisoning with skin, skeletal, and cardiac muscle involvement.

Despite the rarity, leishmaniasis may occur in tandem with malignancy. This co-occurrence contributes to a postulation that anergy to parasite antigens may predispose an infected patient to the development of diffuse cutaneous leishmaniasis and also increase the risk of developing squamous cell carcinoma due to decreased host immune response. We, herein, present a 63-year-old man suffering diffuse cutaneous leishmaniasis that was poorly responsive to treatment. Furthermore, the patient had several nodule-like, infiltrative, and coalescent lesions on his right face. The Montenegro skin test revealed signs of anergy and the biopsy test revealed squamous cell carcinoma (SCC) coexisting with Leishmania sp. Bodies. The patient was given a treatment with amphotericin B and later with radiation therapy, but the tumors showed a poor response to the treatment, and the patient was lost on follow-up. Our observations of the current case highlight the role of a weakening host immune response as a result of diffuse cutaneous leishmaniasis in the development of SCC. Such postulation points to and corroborates the involvement of anergy, a condition probably caused by parasite-induced suppression of the immune response, linking leishmaniasis, and skin malignancy development.

The COVID-19 pandemic outbreak has profoundly challenged global public health over the last couple of years. Throughout this period, numerous mutant strains of SARS-CoV-2 have emerged, presenting diverse pathophysiology and immune response challenges for infected individuals. Among these, variant of concern strains, including Alpha (B.1.1.7), Delta (B.1.617.2), and Omicron (B.1.1.529), has garnered the most significant attention for their role in causing epidemiological dynamics, ultimately leading to elevated infectivity and significant mortality rates. This review aims to provide a comparative analysis of the immune-pathophysiological mechanisms associated with these aforementioned strains of SARS-CoV-2.