TDP-43: a critical amplifier of Alzheimer's disease beyond amyloid and tau.

Chronic infections of the spine: A systematic review of microbial etiologies, diagnostic approaches, and treatment outcomes.

Infectious complications of burns in the intensive care unit.

Diagnostic criteria for sarcopenia in patients undergoing vertebroplasty and kyphoplasty: a systematic review.

Theranostics in Neuroendocrine Neoplasms: The Multifaceted Aspects Integrating Imaging, Therapy, and Dosimetry.

Artificial intelligence in biomaterials for oral oncology.

Varicella-zoster virus (VZV), a neurotropic α-herpesvirus, establishes lifelong latency in the nervous system after primary infection. Reactivation leads to herpes zoster (HZ), which can result in severe neurologic complications including postherpetic neuralgia, vasculopathy, encephalitis, meningitis, myelopathy, cranial neuropathy, and optic neuritis. These complications may occur even in the absence of a characteristic rash, making early recognition crucial for timely antiviral therapy to maximize the likelihood of a good outcome. Clinical manifestations of VZV-associated neurologic disorders vary and often mimic other infectious and inflammatory conditions, further complicating timely diagnosis. Among available diagnostic imaging modalities, MRI is the most useful modality for diagnosis of VZV-related neurologic disorders. Recent high-resolution MRI techniques, such as three-dimensional fluid-attenuated inversion recovery and MR neurography, increase the sensitivity for detecting subtle signal intensity abnormalities, and vessel wall imaging is capable of noninvasively demonstrating vascular involvement. Accurate diagnosis requires the integration of imaging findings, clinical assessment, and cerebrospinal fluid (CSF) analysis. In particular, the detection of VZV DNA with a polymerase chain reaction test and testing for anti-VZV immunoglobulin G antibodies in CSF are essential. Given the myriad clinical manifestations of HZ, radiologists may be the first to recognize nervous system pathologic conditions that are related to VZV, which is particularly important because the incidence increases in the aging population. The authors provide a comprehensive update on the epidemiologic, pathophysiologic, and imaging features of VZV-related neurologic disorders. Increased awareness and accurate imaging interpretation can expedite diagnosis and facilitate appropriate clinical management of these patients to improve outcomes. ©RSNA, 2026.

Efficacy of artificial intelligence-assisted upper gastrointestinal endoscopy for neoplasm detection: a systematic review and meta-analysis of randomized controlled trials.

High-resolution manometry (HRM) is the gold standard for evaluating esophageal motility but may be inconclusive, poorly tolerated, or unavailable. The Endoluminal Functional Lumen Imaging Probe (EndoFLIP) provides real-time assessment of esophageal distensibility and contractility and is emerging as a complementary diagnostic modality. To evaluate the impact of routine EndoFLIP use across diverse esophageal pathologies, particularly when HRM is inconclusive or unavailable and to contextualize findings within current evidence. We retrospectively analyzed 106 adults with dysphagia who underwent endoscopy with EndoFLIP (16-cm catheter). Indications included inconclusive/unavailable HRM ( n = 27), suspected esophagogastric junction outflow obstruction (EGJOO, n = 14), eosinophilic esophagitis (EoE, n = 29), achalasia ( n = 13), and postsurgical dysphagia ( n = 23). Distensibility index, cross-sectional area, and maximal diameter were correlated with endoscopic, histologic, and clinical data. EndoFLIP clarified diagnoses in 92.6% of inconclusive HRM cases and prompted management changes in 81.1% overall. Only 2/14 EGJOO patients showed reduced esophagogastric junction distensibility, avoiding unnecessary interventions in the remainder. In EoE, 86.2% exhibited reduced distensibility, leading to dilation ( n = 6) or escalation to biologic therapy ( n = 3). In achalasia, EndoFLIP-guided referral for peroral endoscopic myotomy or Heller myotomy enabled posttreatment assessment. In postsurgical dysphagia, reduced distensibility was detected in 45% of cases, prompting intra-procedure intervention in 44%. EndoFLIP provides objective, real-time evaluation of esophageal mechanics, enhancing diagnostic accuracy and facilitating targeted therapy in complex or indeterminate cases. These findings, consistent with contemporary literature, support its integration into routine esophageal assessment.

A systematic review of the clinical utility of retinal optical coherence tomography in childhood acquired demyelinating syndromes.

Pediatric post-acute sequelae of SARS-CoV-2 infection in Taiwan: Insights from the DISCOVER cohort.

To identify commonly presented dog breeds and potentially heritable ophthalmic diseases encountered by veterinarians practicing ophthalmology in Japan. A survey was distributed through the Japanese Society of Comparative and Veterinary Ophthalmology. Respondents reported frequently presented breeds for ophthalmic complaints, common ocular diseases by breed, and utilization of diagnostic modalities, including screening eye examinations, gonioscopy, electroretinography (ERG), optical coherence tomography (OCT), and DNA testing. A total of 105 responses from veterinarians providing ophthalmologic service exclusively or alongside or as part of primary care were analyzed. The most frequently reported breeds were Toy Poodles (n = 99), Shiba Inus (n = 67), Shih Tzus (n = 44), Chihuahuas (n = 41), Miniature Dachshunds (n = 27), and French Bulldogs (n = 19), differing somewhat from the current most popular dogs according to the Japanese Kennel Club. Cataracts were reported across most popular breeds. Progressive retinal atrophy (PRA) was prevalent in Miniature Dachshunds and Toy Poodles, glaucoma in Shiba Inus, ocular surface diseases in Shih Tzus, and corneal endothelial dystrophy in Chihuahuas. Screening eye examinations are being performed by 14% of clinicians for puppies and 25% for adult dogs, most frequently by specialists. Gonioscopy and ERG were each utilized by 69% of respondents, OCT by 23%, and DNA testing by 31% through providers offering variable tests and formats. Commonly encountered breeds and heritable ophthalmic diseases were characterized, highlighting possible focus of future clinical and molecular research. Implementation of standardized screening, advanced diagnostics, and genetic testing may improve control of these diseases in Japan's canine population.

Large bowel obstruction (LBO) accounts for approximately one-quarter of all intestinal obstructions. LBO may arise from mechanical obstruction due to benign or malignant etiologies, or from functional obstruction such as acute colonic pseudo-obstruction. Because clinical presentation varies by acuity, etiology, and ileocecal valve competency, early recognition and prompt evaluation are essential to prevent complications, including ischemia and perforation with potential for sepsis and mortality. Patients with acute obstruction typically present with abdominal pain, distension, and obstipation, whereas malignant obstruction often develops gradually with progressive constipation and abdominal distension, leading to dehydration, electrolyte abnormalities, and malnutrition. Computed tomography has become the preferred diagnostic modality due to its ability to identify the transition point, help define the cause and severity of obstruction, and potentially detect complications such as ischemia or perforation. Endoscopy serves both diagnostic and therapeutic roles in selected patients, including detorsion for sigmoid volvulus, decompression for pseudo-obstruction, and tissue diagnosis or stent placement in malignant obstruction. Initial management focuses on resuscitation, correction of electrolyte abnormalities, mitigation of aspiration risk, and gastrointestinal decompression. Definitive management depends on the underlying etiology. Malignant LBO requires individualized planning based on tumor location, patient physiology, and institutional expertise, with options including oncologic resection with or without colostomy, proximal surgical diversion and staged resection, or endoscopic stenting with staged resection. Self-expanding metallic stents may serve as bridges to surgery and reduce the need for a stoma. Benign causes, including diverticular strictures, volvulus, inflammatory bowel disease-related strictures, anastomotic strictures, and fecal impaction, require tailored endoscopic or operative interventions. Across etiologies, short delays to intervention may be appropriate for stable patients undergoing optimization; however, early definitive management should be the usual approach. In cases where intervention is delayed, careful surveillance for developing ischemia or perforation is mandatory. ( J Trauma Acute Care Surg . 2026;101: 1-12. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved).

Hereditary spherocytosis (HS) is a genetically and clinically diverse red cell membrane disorder, with limited clinical and molecular data on pediatric patients from India. This ambispective study, conducted at a North Indian tertiary center over a period of 6 years, evaluated HS patients for clinical, laboratory, genetic, and treatment outcomes. Forty-seven patients (33 males, 14 females; mean age 12.1±8.7 yrs) were analyzed. Family history was contributory in 40.4%. Around 72.3% patients required at least one PRBC transfusion by the time of analysis, while 9 were transfusion dependent. Hemolytic facies and growth retardation were seen in 25.6% and 30.7%, while gallstones were found in 42.5%. MCHC was 32.2±1.92% and was not found to be a useful screening test. Incubated osmotic fragility testing (iOFT) was positive in 36 cases (sensitivity 76.6%), while eosin-5-maleimide (EMA) binding by flow cytometry was positive in 41 cases (sensitivity 87.2%), detecting all cases missed or equivocal on iOFT and demonstrating superior diagnostic yield. The remaining 6 cases were confirmed by genetic testing, which served as the definitive diagnostic modality. Among 34 patients tested genetically, mutations were found in ANK1 (n=14), SPTB (n=12), SLC4A1 (n=3), EPB42 (n=4), and SPTA1 (n=1). Beyond classic HS mutations, additional findings included PKLR mutations (n=2), hereditary elliptocytosis (n=2), dehydrated stomatocytosis (n=2), and Gilbert syndrome (n=4) with cholelithiasis. Genetic testing refined diagnoses, reclassifying one Congenital Dyserythropoietic Anemia (CDA) case as HS and 4 HS cases as alternative etiologies. This study underscores the clinical and genetic heterogeneity of Indian HS, demonstrating the value of combining the EMA dye test with genetic sequencing. The disease impacted facial features and growth, while splenectomy showed good outcomes in severe cases.

Changes to management influenced by next-generation sequencing of pancreatic duct aspirates among patients with main pancreatic duct dilatation of unclear etiology: a multicenter cohort study.

HeartMate 3 (HM3) left ventricular assist devices (LVADs) have improved hemocompatibility and reduced morbidity; however, late device-related complications continue to be recognized. External outflow graft obstruction at the bend relief region (EOGO-BR) is an uncommon but potentially life-threatening condition, and data regarding its diagnosis and management remain limited. Three symptomatic male patients with biomaterial-related EOGO-BR following HM3 implantation were retrospectively reviewed. Clinical presentation, diagnostic imaging, surgical management, and outcomes were evaluated. All patients presented with low-flow alarms associated with heart failure symptoms, including dyspnea, fatigue, and reduced exercise tolerance. Computed tomography angiography (CTA) demonstrated external compression of the outflow graft in all cases and was the primary diagnostic modality. Surgical evacuation of accumulated biomaterial via left thoracotomy resulted in immediate restoration of LVAD flow in all patients. Two patients showed favorable postoperative recovery with sustained clinical improvement during follow-up. One patient, who presented with concomitant sepsis, died despite surgical intervention and advanced mechanical circulatory support. External outflow graft obstruction at the bend relief region represents an uncommon but serious late complication of HM3 LVAD support. Computed tomography angiography is a valuable diagnostic tool for timely identification. Surgical removal of accumulated biomaterial provides immediate hemodynamic improvement and appears to be an effective and durable treatment strategy in selected patients.

The management of meconium ileus (MI) has yet to reach a unified consensus among pediatric surgeons, particularly regarding diagnostics and variants, conservative treatment strategies, surgical approaches, and clinical outcomes. This topic was therefore selected for the 2024 Consensus Session of the Annual Congress European Paediatric Surgeons' Association (EUPSA). A structured literature review was conducted across Cochrane, Medline, and EMBASE databases up to April 2024. Nine pediatric surgeons appointed by the European Paediatric Surgeons' Association (EUPSA) Consensus Committee reviewed the evidence and developed topic-specific recommendations relating to (1) diagnostics and variants, (2) Gastrografin® (Bracco Diagnostics Inc, Monroe Township, NJ) application and outcomes, and (3) surgery-related outcomes. Findings were presented at the 2024 EUPSA Annual Congress, with consensus statements formulated through iterative discussion and refinement, incorporating feedback from congress participants. The consensus addresses antenatal and postnatal diagnosis, differentiation between simple and complex MI, conservative management using contrast enemas, surgical strategies, and short- and long-term outcomes, particularly in relation to cystic fibrosis (CF). Key recommendations include the use of contrast enema as the primary diagnostic modality and first-line treatment in uncomplicated cases, with surgical intervention indicated for complicated MI or failed conservative management. Enterostomy remains a widely used surgical approach, with technique guided by intraoperative findings and patient factors. Recommendations regarding stoma reversal emphasize the role of multidisciplinary assessment and preoperative evaluation including CF workup and confirmation of distal bowel patency. A peer-reviewed consensus statement on the diagnosis and management of MI has been developed, informed by current evidence and expert practice. This statement provides pragmatic guidance in the diagnosis and management of MI, including the role of contrast enema in uncomplicated cases and surgical intervention for complicated disease. It is recognized by the EUPSA as a valuable resource to support pediatric surgeons in clinical decision-making for this pathology.

BACKGROUND Aortoduodenal fistula (ADF) is a rare, often catastrophic condition characterized by an abnormal communication between the abdominal aorta, or an aortic graft, and the duodenum. Although infrequently encountered, ADF is associated with massive gastrointestinal hemorrhage and high mortality if not promptly recognized and treated. This manuscript summarizes the epidemiology, pathogenesis, clinical manifestations, diagnostic modalities, management strategies, particularly in techniques for repairing the duodenum, and outcomes of ADF. CASE SUMMARY We present a case report of a 79-year-old male with a history of an open repair for a ruptured abdominal aortic aneurysm, complicated by an ADF. He was successfully treated with in-situ aortic reconstruction using a bovine pericardial graft, followed by a Roux-en-Y duodenojejunostomy. The postoperative recovery was uneventful. A review of current literature shows that primary two-layer duodenorrhaphy with omental interposition remains the most commonly reported approach for small, viable defects. For larger or complex injuries, reinforcement with a jejunal serosal patch or vascularized tissue flaps provides additional protection. Roux-en-Y duodenojejunostomy offers durable reconstruction in extensive duodenal involvement. Pyloric exclusion and other diversionary techniques have shown limited benefit and are now reserved for selected cases. CONCLUSION Optimal management of ADF requires an individualized strategy for duodenal repair in conjunction with definitive aortic reconstruction and infection control. While current evidence supports tailoring the repair technique to defect size and tissue quality, prospective data are lacking. Multicenter reporting is essential for establishing evidence-based guidelines.

Intestinal ultrasound (IUS) has been shown to be an accurate, non-invasive, point-of-care tool for monitoring disease activity in inflammatory bowel disease (IBD). While its diagnostic performance is well-established, there is a notable gap in research related to patient perspectives regarding the role of IUS in IBD management, including its impact on the patient-provider relationship, which has not been previously studied. We conducted a quantitative study with a 21-question Likert scale (0-10) survey administered to patients undergoing IUS during routine IBD clinic visits. Survey questions assessed four domains: (1) patient experience with IUS, (2) preference of IUS versus other diagnostic modalities, (3) impact on the patient-provider relationship, and (4) the enhancement of disease understanding. Fifty-seven patients completed the survey. Overall, patients reported high satisfaction with IUS (mean score: 9.15), preferred IUS over bloodwork, stool testing, CT/MRI, and colonoscopy (mean score: 7.64), and felt it positively impacted patient-provider relationship (mean score: 8.07), and disease understanding (mean score: 7.74). IUS was strongly preferred over stool testing and colonoscopy (mean scores: 10 for both). Patients on steroids reported greater enhancement of the patient-provider relationship (8.70 vs. 7.82, p = 0.03), and those with Crohn's disease reported greater improvement in disease understanding compared to ulcerative colitis (8.16 vs. 7.18, p = 0.04). Patients expressed high satisfaction with IUS across all survey domains. These findings support the broader use of IUS into IBD care, highlighting its value not only as a diagnostic tool but also in enhancing patient experience and engagement.

Orthoebolaviruses, like Ebola, Sudan, and Bundibugyo viruses, are responsible for causing sporadic and unpredictable outbreaks of severe disease throughout Sub-Saharan Africa. Accurate and reliable diagnostic tests are key to identifying cases of disease and restricting its spread, yet options are mostly limited to molecular assays, such as reverse transcriptase quantitative PCR, that require time, training, and complex equipment to run. To complement existing diagnostic modalities, and to address some of their shortcomings, we developed a prototype immunochromatographic lateral flow rapid diagnostic test (ILF-RDT) that detects the glycoproteins (GPs) from all known orthoebolaviruses, including Bundibugyo virus, which is currently causing a large outbreak in the Democratic Republic of the Congo and Uganda. This test depends on a pair of novel, broadly cross-reactive monoclonal antibodies capable of binding the viral GP-including the secreted GP-in a non-competitive manner. Here, we show that this ILF-RDT detects both recombinant GP and authentic virus in a variety of substrates, including samples spiked with human blood and blood samples taken from experimentally infected animals. Indeed, the ILF-RDT was able to detect Ebola virus in nonhuman primate samples at 4 days post-infection, before the animals began exhibiting signs of severe disease. Given the uniquely broad cross-reactivity of this diagnostic assay, its ability to detect low levels of virus early during infection, and its suitability for use at the point-of-care in resource-limited settings, this ILF-RDT could have a significant impact on the management and mitigation of future orthoebolavirus outbreaks.