We would like to thank Leivaditis et al [...].

Background: Uterus transplantation (UTx) is a proven treatment for individuals affected by absolute uterine factor infertility (AUFI) who desire biological motherhood. Despite the fact that over 130 procedures have been performed worldwide in the past decade, UTx remains relatively unfamiliar, even among healthcare professionals. This study aimed to identify knowledge gaps regarding and evaluate attitudes toward UTx among Hungarian obstetricians/gynecologists and transplantation providers, in anticipation of the first procedure to be performed in the country. Methods: A Microsoft Forms® questionnaire was distributed electronically among Hungarian medical professionals via e-mail, including members of the Hungarian Society of Obstetrics and Gynaecology and the Hungarian Transplantation Society. Additionally, participants of the “Update 2024” OB/GYN conference (held 28–29 November 2024, in Visegrád, Hungary) were invited to complete the survey through a QR code displayed during the event. Results: A total of 290 medical professionals completed the survey (response rate: 27.6%, 290/1050). Most of the respondents specialized in obstetrics and gynecology (81.7%, n = 237), with the remainder representing transplantation fields (18.3%, n = 53). Over half (56.6%, n = 161) reported they would recommend UTx to patients with AUFI, and 64.1% (n = 186) agreed that UTx should be available as a treatment option. The medical risks associated with the procedure were deemed acceptable for both living donors (58.0%, n = 168) and recipients (54.8%, n = 159). Conclusions: This is the first study to explore perceptions of UTx among Hungarian medical professionals. The findings suggest there is a generally favorable professional attitude toward its future clinical implementation.

Background/Objectives: Recently, epigenetic mechanisms have been recognized as crucial in atopic dermatitis development. The emphasis of this research was on expanding existing knowledge about the epigenetic aspects of atopic dermatitis, as well as identifying new molecules that could serve as disease biomarkers. Methods: The research was conducted as a cross-sectional study examining two groups: the group with atopic dermatitis (50 patients) and the control group (50 healthy adults). The serum levels of total immunoglobulin E (IgE) and eosinophil count (Eos%) were performed in routine laboratory analyses, and the detection of microRNAs from peripheral blood was performed using RT-PCR. Results: Analysis of selected miRNA expressions in patients with atopic dermatitis and controls revealed that only the expression and the relative expression of miRNA-146a were statistically significantly higher in patients with atopic dermatitis than in the control group (p = 0.042 and p = 0.021, respectively). There was a weak positive correlation between miRNA-146a expression and the eosinophilia/IgE level (r = 0.22 and r = 0.25, respectively). MiRNA-21, miRNA-29b, miRNA-143 and miRNA-223 were significantly upregulated in patients with higher SCORAD (p < 0.001, p < 0.001, p < 0.001 and p = 0.015, respectively). ROC curve analysis revealed the specificity of miRNA-146a as 82% and the sensitivity as 62%. The area under the ROC curve (AUC) was 0.7, indicating its diagnostic potential. Conclusions: Our findings imply that miRNA-146a might serve as a biomarker of atopic dermatitis, suggesting its relevance in the development of the disease, while miRNA-21, miRNA-29b, miRNA-143 and miRNA-223 may have an impact on disease progression. Our findings provide a preliminary basis that should precede validation through larger, multicentric studies and use in diagnostics, targeted personalized treatments and monitoring of treatment efficacy in atopic dermatitis.

Objectives: Evaluate the agreement and interobserver variability between manual segmentation and the ellipsoid formula in estimating single kidney volume (SKV) in patients with autosomal dominant polycystic kidney disease (ADPKD). Methods: In this retrospective study, 130 unenhanced CT scans of ADPKD kidneys were analyzed. Three radiologists (one senior, two juniors) measured SKV using manual segmentation and the ellipsoid formula. Statistical analyses included intraclass correlation coefficient (ICC), Wilcoxon signed-rank test, Bland-Altman analysis, and paired t-tests to compare measurement values and computation times. Results: Both methods showed excellent interobserver agreement (ICC ≥ 0.977). No significant difference was observed in volume estimates between the two techniques (Wilcoxon p = 0.295). Bland-Altman analysis confirmed strong agreement between methods for the senior radiologist. The ellipsoid method was significantly faster for all readers (p < 0.05). Conclusions: The ellipsoid formula is a reliable, time-efficient alternative to manual segmentation for SKV estimation in ADPKD, offering comparable accuracy with reduced resource demands in clinical settings.

Background: Achieving low-density lipoprotein cholesterol (LDL-C) goals is essential for secondary prevention after atherosclerotic ischemic stroke or transient ischemic attack (TIA). This study assessed the prevalence of LDL-C goal attainment and identified associated determinants post-ischemic stroke/TIA. Methods: A cohort of Thai patients discharged on statin therapy after admission with acute ischemic stroke or TIA was evaluated for LDL-C goal attainment within 12 months post-discharge. Logistic regression determines factors associated with LDL-C goal attainment, and the generalized linear model confirmed the association between covariates and LDL-C reduction. Results: Among 487 patients (85.8% with ischemic stroke), the prevalence of LDL-C goal attainment differed across LDL-C target levels: 9.9% for <55 mg/dL, 29.0% for <70 mg/dL, 70.4% for <100 mg/dL, and 17.5% for ≥50% reduction from baseline. Logistic regression identified high-intensity statins as a significant predictor of goal attainment at <70 mg/dL (OR 1.91, 95% CI 1.09-3.34), <100 mg/dL (OR 1.64, 95% CI 1.01-2.67), and ≥50% reduction (OR 2.32, 95% CI 1.14-4.73), but not <55 mg/dL (OR 1.65, 95% CI 0.72-3.79). In the generalized linear model, high-intensity statin and baseline LDL-C were significant determinants of LDL-C reduction. Conclusions: LDL-C target attainment after ischemic stroke/TIA is modest overall, and remains low for the more stringent targets (<55 mg/dL). High-intensity statins improve goal attainment and produce greater LDL-C reductions, supporting wider use of more aggressive lipid-lowering strategies in this high-risk population.

Background: The number of publications related to rivaroxaban is growing, making it difficult for scientists to review relevant materials. Objectives: This bibliometric analysis is focused on highlighting hot spots and new trends associated with rivaroxaban studies and provides references and guidance for further research. Methods: A comparison between countries, journals, authors, and organizations was performed. Microsoft Excel 2021 and VOSviewer were used to process and visualize data extracted from Web of Science. The time range was set from 1991 to late 2024. A total of 6979 articles were analyzed and bibliometric maps of co-citations of references and co-occurrences of the keywords were built. Results: Relative research interest increased until 2021, when it started to drop. The new trends in publications related to rivaroxaban are associated with a comparison of NOAC therapy outcomes with previously used vitamin K antagonists (warfarin). The research was focused also on new NOAC representatives, medical conditions treated with NOAC, and safety of the therapy. New trending topics are related to ABCB1, peripheral artery disease, direct-acting oral anticoagulants, PCI, and SARS-CoV-2. Conclusions: This bibliometric analysis showed that increasing attention is being paid to the medical conditions treated with NOACs and issues related to the safety of this therapy.

During pregnancy, a series of physiological changes occur in women, particularly affecting the cardiovascular system with significant hemodynamic alterations. Subsequently, this leads to renal adaptations manifesting through variations in glomerular filtration rate. This close interconnection between the heart and kidneys implies that issues arising in one organ will disrupt this fundamental balance, inevitably involving all associated organs. The purpose of this review is to gather all possible nephrological conditions that may arise during pregnancy, as well as pre-existing conditions that may become apparent or worsen during this period. This review describes the natural history, treatment, and impact of these conditions on pregnancy itself. Among the most common conditions are preeclampsia and HELLP syndrome, severe complications characterized by hypertension, proteinuria, and multiorgan damage that require immediate clinical attention. Additionally, women with chronic kidney disease are at higher risk of developing maternal–fetal complications, such as preterm birth and intrauterine growth restriction. Common causes of acute renal failure are also analyzed, including thrombotic microangiopathy, acute fatty liver of pregnancy, acute onset or flare of systemic lupus erythematosus, and catastrophic antiphospholipid antibody syndrome. Given the importance of proper renal function during pregnancy, it is essential to have a thorough understanding of nephrological diseases that may affect this phase of women’s lives. This knowledge is crucial for managing these conditions effectively to avoid risks to the survival of both the mother and the newborn.

Background/Objectives: Coagulopathy is a common complication of liver cirrhosis, partly due to impaired synthesis of vitamin K-dependent coagulation factors. Despite its frequent use, the efficacy of vitamin K in this setting remains uncertain. This study aimed to evaluate the effect of vitamin K administration on coagulation parameters in patients with cirrhosis. Methods: We performed a retrospective study of 122 cirrhotic patients hospitalized between 2020 and 2024, who received vitamin K for coagulopathy correction. Coagulation and liver function parameters were monitored over time. Results: An early and progressive improvement in INR values was observed, in a subset of patients, following vitamin K administration. INR values across time points were strongly correlated, while only weak associations were observed with bilirubin levels. These findings support a selective therapeutic effect, rather than universal efficacy. Discussion: Despite current guidelines discouraging routine vitamin K use in cirrhosis, our findings suggest that selected patients—particularly those with reversible deficiency—may benefit from supplementation. The observed decrease in INR values supports a targeted, context-based approach rather than empirical management. Conclusions: However, due to the retrospective design and absence of a control group, the observed improvements cannot be conclusively attributed to vitamin K administration. Vitamin K may improve coagulation in cirrhotic patients with reversible deficiency, but its efficacy is not universal. Its use should be individualized and guided by clinical and biochemical context, as part of a broader treatment strategy.

Background: The clinical characteristics of patients who have a first episode of congestive heart failure (CHF) may have changed in recent years. Methods: A retrospective cohort study was performed on 19,796 patients discharged from medical departments with a diagnosis of CHF between 1 January 2000 and 31 December 2022. Data were drawn from two data sets of the Minimum Basic Data Set-Hospital Data Set (MBDS) of the Lucus Augusti University Hospital (Spain): hospitalizations and patients. Patient characteristics (including the period of their first admission) and the association rules between diseases determined using the Apriori algorithm were studied in five consecutive time periods. Results: The general characteristics of patients on first admission for CHF changed over time. There were increases in mean age (75.9 ± SD 11.2 vs. 81.6 ± SD 11.5 years; p < 0.0001), the proportion of women (48.3% vs. 51.4; p = 0.0001), the number of acute diseases (1.1 ± SD 1.4 to 2.7 ± SD 2.5; p < 0.0001), and the number of chronic diseases (3.6 ± SD 1.9 to 6.5 ± SD 2.6); p < 0.001). Accordingly, the median number of diagnoses (from 3 to 7) and itemsets per patient increased (mean number of items 1.75 vs. 3.4; p < 0.0001), and the associations of diseases leading to CHF became more complex. Conclusions: This single-center study shows that in the last two decades, the characteristics of patients with a first hospital admission for CHF have changed. Patients are older, there is a predominance of women, and they have a greater number of acute and chronic concomitant diseases, making their clinical management more difficult.

Vitamin D deficiency (VDD) is highly prevalent in pediatric critically ill patients and is a potentially modifiable risk factor during critical illness. There are no established national or international recommendations for vitamin D supplementation in Pediatric Intensive Care Unit (PICU) patients. This monocentric study aims to compare the practices regarding vitamin D supplementation before and after the introduction of a nutrition protocol (NP). We retrospectively analyzed vitamin D administration (time from PICU admission to initiation, amount of supplementation, accordance with existing guidelines) in children aged 0 to 16 who were admitted to the PICU of Lausanne University Hospital for more than 48 h the year before and the year after the introduction of a NP. Vitamin D supplementation increased after NP introduction (95 IU per day more, p < 0.0001). More patients received vitamin D during their stay (95% after vs. 77% before, p < 0.0001). The dose adhered to NP recommendations for children under 12 and was higher for older children. According to Swiss guidelines for the general pediatric population, vitamin D supplementation was accurate in children under one year old before and after NP implementation. However, it was less than recommended for patients over one year old. The implementation of a NP significantly enhanced the scope of vitamin D supplementation. This study also highlights the practical limitations in meeting the recommended requirements with certain galenic formulations.