A readily interpretable rule involving multiple forms of pairwise molecule comparisons with applications for clinical make-decision of breast cancer management.

Dyslipidemia is a major metabolic disorder and a key risk factor for atherosclerotic cardiovascular disease (ASCVD), particularly in the geriatric population. Elderly patients frequently present with multiple comorbidities, such as hypertension and hyperuricemia, which complicate clinical management and substantially increase cardiovascular risk. Moreover, acute conditions, including trauma-related injuries, may further disrupt metabolic control, functional capacity, and adherence to long-term therapy. This case report describes a 70-year-old male patient (RE) who presented to a primary healthcare center with swelling and intermittent pain in the right lower extremity following a fall. The patient had a known history of dyslipidemia, hypertension, and hyperuricemia. Laboratory investigations revealed elevated total cholesterol (242 mg/dL), borderline fasting plasma glucose (102 mg/dL), and uric acid level of 6.6 mg/dL. Physical examination was unremarkable except for edema and localized tenderness in the affected limb, consistent with a soft tissue injury. A holistic management approach was implemented, integrating pharmacological and non-pharmacological interventions. Statin therapy was initiated to address dyslipidemia, antihypertensive treatment was optimized, and analgesic therapy combined with limb elevation was provided to manage acute pain and edema. Non-pharmacological strategies included comprehensive lifestyle modification, encompassing dietary counseling (low saturated fat, low salt, and low purine diet), gradual resumption of physical activity following injury recovery, and structured patient–family education to improve adherence and prevent recurrent falls. Follow-up evaluation demonstrated clinical improvement, including resolution of edema, improved functional mobility, and better metabolic control. The novelty of this case lies in demonstrating how acute trauma in geriatric patients can act as a critical entry point for integrated chronic disease management within primary care settings. This case emphasizes that holistic, biopsychosocial–spiritual management not only improves lipid and blood pressure control but also enhances functional outcomes and quality of life in elderly patients with complex comorbidities.

Clinicians' perspectives of pain in older adults with heart failure.

Global epidemiological trend of Klebsiella pneumoniae ST23: Emergence of KL57 lineage carrying dual carbapenemases.

Hormonal Modulation of Keratoconus: A Systematic Review and Screening Strategy for At-Risk Populations.

Nutraceuticals in the clinical management of women with breast cancer; a narrative review

Illness perception profiles and psychological and subjective physical symptoms in atrial fibrillation.

This review summarises recent findings from the past decade on infraoccluded primary molars, focusing on diagnosis, aetiology, prevalence, associated findings and clinical consequences, and to compare these with earlier literature to support improved clinical management. A systematic literature search was conducted according to PRISMA guidelines, evaluating MEDLINE (PubMed), Cochrane Library, Web of Science, and Embase from 2014 to 2025. Randomized controlled trials (RCT), non-randomized studies of interventions (NRSI), cohort studies, case-control studies and cross-sectional studies published in English and German were included. Case series, case reports, expert opinions and commentaries were excluded. Of 2816 publications identified, 30 met the inclusion criteria after screening and full-text review. These studies addressed prevalence (n = 17), retained molars (n = 4), retained molars without successors (n = 5), aetiology (n = 1), diagnosis (n = 1), mandibular growth impact (n = 1), and interventions (n = 1). Current evidence provides new insights into the aetiology and clinical management of infraoccluded primary molars. Genetic factors, particularly those related to epithelial development and inflammatory signalling pathways, are increasingly recognised. Conservative treatment approaches have gained traction, emphasizing alveolar preservation over orthodontic considerations of craniofacial growth. Most cases are mild and occur unilaterally in mandibular first primary molars. Early-onset infraocclusion is linked to a less favourable prognosis. Root resorption shows age-related variability. However, conflicting evidence exists regarding the association of infraocclusion with root resorption, especially in cases of tooth agenesis, and its correlation with mandibular growth rotation. Additionally, prevalence data remain inconsistent due to heterogenous classification, underscoring the need for further research.

Candidozyma (Candida) auris has emerged over the past two decades as a formidable global health threat due to its multidrug resistance, persistence in healthcare environments, and rapid nosocomial spread. Recently reclassified into the genus Candidozyma based on phylogenomic analysis, C. auris poses major challenges for both clinical management and infection control. Its ability to tolerate heat, salinity, and disinfectants supports long-term survival on surfaces and medical devices, facilitating transmission. Biofilm formation further enhances virulence and resistance to antifungal therapy. Clinical presentations range from asymptomatic colonization to invasive infections, with mortality rates approaching 50%. Echinocandins remain an important first-line treatment option, but their fungistatic activity, limited tissue penetration, and emerging resistance contribute to suboptimal outcomes, highlighting the need for new agents and optimized dosing strategies. The role of triazoles and amphotericin B is significantly limited by resistance and associated toxicities, while newer agents such as ibrexafungerp, fosmanogepix, and rezafungin show promising invitro activity but lack substantial supporting clinical data. Combination therapy may also offer potential benefit, though supporting evidence is sparse. Infection control methods including active surveillance, contact precautions, and environmental disinfection with sporicidal agents and avoidance of ineffective quaternary ammonium compounds are key to preventing the nosocomial spread of C. auris. Despite growing awareness, effective decolonization strategies are lacking, and recurrence and transmission continue to pose challenges. Ongoing efforts to refine antifungal therapy, improve rapid diagnostics, and strengthen infection control practices are essential to mitigating the spread of this pathogen and optimizing outcomes for patients.

Routine preprocedural pathology testing is no longer recommended for minor and intermediate-risk elective procedures. British Thoracic Society guidelines advise hemoglobin, platelet count, and coagulation studies only in patients with risk factors for bleeding. Despite this, such tests are commonly ordered without a clear clinical indication before bronchoscopic procedures, incurring unnecessary financial and environmental costs. We conducted a retrospective review of outpatient bronchoscopic procedures over a 12-month period at an Australian tertiary hospital. Preprocedural pathology testing was defined as any test ordered at bronchoscopy referral or repeated within 6 weeks before the procedure. We evaluated the impact on clinical management and complication rate. Financial cost was estimated using Australian Medical Benefits Schedule (MBS) prices, and environmental impact via carbon dioxide equivalent (CO2e) emissions. A total of 436 bronchoscopic procedures were performed, with all with preprocedural pathology testing. Abnormal results occurred in 8.3% of cases, but only 4.0% led to clinical intervention-all in patients with established risk factors. No interventions were required for patients without risk factors, and no procedures were delayed or cancelled. There was no correlation between abnormal blood test results and adverse outcomes. Routine testing cost AUD 30,441.20 (19,548.12 USD) and produced an estimated carbon footprint of 103.2kg CO2e. Routine pathology testing before bronchoscopic procedures offers limited value, with most results not influencing management. Clinically significant abnormalities occurred only in patients with established risk factors, supporting a targeted approach. Given the significant financial and environmental costs, transitioning to selective, evidence-based testing is essential to optimize resource use and improve sustainability.

Background: Male breast cancer (MBC), although rare, represents less than 1% of all breast cancer (BC) cases and has been gradually increasing in incidence, with significant geographic and demographic variation. It primarily affects older men and is often diagnosed at advanced stages due to a lack of awareness and screening, leading to poorer survival outcomes compared to female breast cancer (FBC). Risk factors include genetic mutations (e.g., BRCA2), hormonal imbalances, obesity, exposure to environmental carcinogens, and a family history. MBC is characterized by high hormone receptor positivity and unique genomic features, such as BRCA2 mutations and homologous recombination deficiency (HRD). Current treatments are similar to those for FBC, highlighting the need for male-specific clinical trials and guidelines. Psychosocial challenges, including stigma and limited support, affect patients' quality of life. Objective: This review aims to explore the epidemiology, clinical characteristics, and management strategies of MBC, highlighting the need for male-specific therapeutic approaches, public health campaigns, and improved screening programs to enhance early detection and clinical outcomes. Methods: An extensive literature review was conducted using selected databases such as PubMed, ScienceDirect, and Springer Link. The review focused on keywords like "Male breast cancer," "BRCA2 mutation," "Hormone receptors," "Molecular profiling," and "Clinical management." Key Content and Findings: The review shows that the incidence of MBC has increased globally, with older men being more affected. Genetic and hormonal factors are similar to those in women, with BRCA2 mutations and HRD being more prevalent in MBC. However, the lack of male-specific treatment protocols remains a major challenge Conclusions: The review emphasizes the importance of male-specific clinical trials, tailored management guidelines, and personalized therapies to improve early detection and clinical outcomes for men with BC

New progress in the global expansion and prevention of chikungunya fever.

En Face Optical Coherence Tomography and OCT Angiography in the Pathoanatomy of Inflammatory Macular Disease.

Endometriosis in adolescents: A state-of-the-art review.

Accessibility as a Key Factor in the Clinical Evolution and Therapeutic Management of Patients With Hidradenitis Suppurativa.

Introduction: Presacral tumours are an extremely rare entity. Schwannomas account for only 3% of tumours in this region. Schwannomas are benign, unifocal and often asymptomatic. Presacral lesions are usually asymptomatic, although a few of these patients may present with compressive symptoms or neurogenic pain. Diagnosis and characterisation of nerve sheath tumours, of which schwannoma is a part, is usually done with Magnetic Resonance Imaging (MRI). Surgical excision is the mainstay of management, although it is associated with high morbidity. Although a few case reports are available, large datasets are sparse. Aim: To study the clinical presentation, imaging features and management of patients who underwent excision of presacral schwannomas. Materials and Methods: The present retrospective descriptive study was conducted in General Surgery Unit-IV in Christian Medical College and Hospital, Vellore, Tamil Nadu, India, from July 2013 to July 2024. All patients above 18 years of age, histopathologically confirmed presacral schwannomas, were identified and included. The demographic profile, presenting symptoms, imaging findings, preoperative assessment, surgical details, postoperative complications, and follow-up were recorded. Descriptive statistics were calculated, with mean and median serving as the measure of central tendency and the standard deviation representing the measure of dispersion. Results: A total of 20 patients were identified with a mean age of 41.3 years (±14.05), with 13 patients being male and the remaining female. Eleven patients presented with pressure symptoms due to direct compression of the pelvic organs. Imaging of choice was MRI in 19 patients. Seventeen patients had preoperative biopsy done, of which 16 were schwannoma and one was neurofibroma. Median largest diameter of these tumours at the time of presentation was 10.55 cm with a range of 6.8 to 25 cm. 19 patients underwent a laparotomy (transperitoneal approach) with intracapsular excision of the tumour. The mean operating time was 2.85 hours (±1.12), with a mean blood loss of approximately 500 mL (±240). 10% of patients developed postoperative neurological deficits. Three patients had neuropathic pain, which settled with medication in the postoperative period. Five patients developed a surgical site occurrence. The mean duration of hospitalisation for these patients was 7.7 days. The mean follow-up period was 27.8 months. 90% (18) of the patients had classical schwannoma on histopathology. Conclusion: Management of large presacral tumours is a daunting task even for the most experienced surgeons. Intracapsular excision of these tumours needs to be considered while planning these operations, based on the possible morbidity profile for these patients.

Bioactive peptides-incorporated photo-crosslinking hydrogel for suture-free repair of corneal injuries.

Chronic liver disease is a frequently encountered disorder and a major concern worldwide with a complex pathophysiology, which often affects the hemostatic system. Such alterations, which affect both primary and secondary hemostasis, are heterogenous, including prohemorrhagic (i.e., decreased coagulation factors, increased fibrinolysis, thrombocytopenia, and platelet dysfunction) and prothrombotic (i.e., decreased natural anticoagulants) changes. As a consequence of this unstable balance, patients with liver cirrhosis may experience both hemorrhagic complications and venous thromboembolic events, which are often unpredictable and whose management is particularly challenging for clinicians. This narrative review will address the most recent advances in the pathophysiology of key derangements of hemostasis in patients with chronic liver disease, focusing on their clinical implications and management.

Sleep disturbances in children and adolescents with epilepsy: Clinical, polysomnographic and management aspects.

Identification of mitochondrial dysfunction-related biomarkers and immune infiltration in liver ischemia-reperfusion injury via integrated bioinformatics and machine learning.