Cardiac dysfunction after acute ischaemic stroke: Long-term outcomes from the SICFAIL cohort.

Distinct mechanisms of otitis media with effusion before/after treatment in nasopharyngeal carcinoma.

B-cell prolymphocytic leukemia (B-PLL) is a rare, aggressive leukemic B-cell malignancy historically associated with poor outcomes and recently reclassified in the WHO Fifth Edition but retained as a distinct entity in the ICC. We analyzed 950 patients labeled as B-PLL in the National Cancer Database (2004-2019), identified using ICD-O-3 morphology code 9833/3. Median age was 72 years, and 72% received systemic therapy at diagnosis. Median overall survival (OS) was poor (2.8 years) and did not improve over time. Patients initially managed with active surveillance had longer OS (7.8 years). Outcomes varied by age, comorbidity, and facility type. Patients historically diagnosed with B-PLL experience persistently poor outcomes, highlighting the real-world clinical consequences of diagnostic heterogeneity and evolving disease classifications.

Endogenous α-Klotho is a common target in atherosclerosis and calcific aortic valve disease.

Rewriting the history of Paget's disease: From Arderne's medieval case to Crocker's first extramammary description (1370-1889).

Lymph node involvement, surgery and adjuvant treatment in primary Endometrioid Ovarian carcinoma PAtients with eaRly-stage Disease (LEOPARD) - a multinational team initiative.

Advances in the diagnosis and classification of B-ALL: comparative insights from updated guidelines.

Along with the emergence of coronavirus disease 2019 (COVID-19), a hyperinflammatory multisystemic syndrome in children called PIMS appeared. Despite its close similarity to the Kawasaki disease (KD), the conclusion of PIMS being a distinct disease entity was reached quickly. Since then, research projects have been implemented to find differences and reliable distinction parameters with conflicting results. Therefore, the aim of this study was to explore existing prognostic models on their ability to distinguish the diagnoses. Two externally developed prognostic models were applied to 2 distinct datasets: one consisting solely of 26 KD and PIMS cases from Bayreuth, the other comprising 632 cases of both diagnoses reported by pediatricians from all over Germany and Innsbruck, Austria. The potential of the models to distinguish the diagnoses on a phenotypic level was evaluated based on their sensitivities and specificities, κ-coefficients by Cohen and correlation analysis. The sensitivity and specificity of both prognostic models did not display a reliable distinguishability between KD and PIMS. Moreover, correlation analysis cannot confirm the correlation of most parameters utilized in the models with the PIMS diagnosis. The only parameter showing a positive correlation in both datasets was the patients' older age. These findings are congruent with the general inconclusiveness in research concerning the distinction of KD and PIMS. We could not reproduce a distinguishability using the models or a correlation between the utilized parameters and PIMS except for one. Henceforth, research will need to focus on nonphenotypical properties for differentiation of KD and PIMS.

Acute myocardial infarction comprises two distinct entities, myocardial infarction with obstructive coronary artery disease (MI-CAD) and myocardial infarction with nonobstructive coronary arteries (MINOCA), characterized by divergent pathogenesis and potential links to particulate air pollution. This study aimed to investigate the differential impacts of such pollution on the onset of MI-CAD and MINOCA to inform precise prevention and control of myocardial infarction. Based on the Chinese Cardiovascular Association Database-Chest Pain Center Registry, we performed a nationwide, time-stratified, case-crossover study from 2015 to 2021. Hourly concentrations of fine particulate matter (PM2.5) and inhalable particulate matter (PM10) were acquired through nearby fixed-site monitoring. We combined a conditional logistic regression model with polynomial distributed lag nonlinear models to differentiate the exposure-response relationships of the hourly concentrations of PM2.5 and PM10 with the onset of MI-CAD and MINOCA over 72 hours. We further calculated the attributable fractions (AFs) due to particulate air pollution accordingly. A total of 918,730 patients with MI-CAD and 83,802 patients with MINOCA were included. The risks of MINOCA and MI-CAD onset were highest at the concurrent exposure hour and diminished within 30 hours. Exposure to PM2.5 and PM10 was associated with a 1-2-fold higher risk of MINOCA compared with MI-CAD. Each interquartile range increase in the concentrations of PM2.5 and PM10 resulted in a 2.17% (95% CI: 0.82-3.53%) and 1.57% (95% CI: 0.23-2.94%) increased risk of MINOCA onset, respectively. The corresponding effect estimates for MI-CAD were 1.14% (95% CI: 0.74-1.55%) and 0.47% (95% CI: 0.13-0.81%), respectively. There were no apparent thresholds for these associations. The AFs of MINOCA attributable to PM2.5 and PM10 were 2.43% and 1.72%, respectively, which were almost one to two times greater than those of MI-CAD (1.27% and 0.54%, respectively). This nationwide study provides robust evidence that, compared with MI-CAD, MINOCA is more sensitive to particulate air pollution. This effect could occur during concurrent hours and under health-based air quality guidelines.

A longitudinal single-cell and spatial multiomic atlas of pediatric high-grade glioma.

CIC::DUX4 sarcomas are aggressive soft tissue tumours that often mimic Ewing sarcoma but are distinct in their molecular and clinical behaviour. We describe a young adult male initially managed for a presumed primitive neuroectodermal tumour, later confirmed to have a CIC::DUX4 fusion-positive sarcoma through fluorescence in situ hybridisation and NGS analysis. Despite initial response to Ewing-like chemotherapy (vincristine, doxorubicin and cyclophosphamide regimen), the disease rapidly progressed with widespread visceral metastases, including lungs, spleen, kidneys and soft tissues, eventually leading to death. This case highlights the diagnostic challenges posed by CIC::DUX4 sarcomas, their poor response to conventional chemotherapy and the need for early molecular characterisation to guide prognosis and management. Increased awareness and tailored therapeutic approaches are critical in improving outcomes for this molecular subtype.

Noncanonical inflammasomes: New insights into their roles in inflammation and immunopathology.

The clinicopathological spectrum of FET-CREB sarcomas is evolving with several distinct tumors entities described across various body sites, apart from the soft tissues. Lately, there are tumors primarily identified in the abdominal and extra-abdominal sites, including the soft tissues with an epithelioid morphology and displaying FET-CREB fusions, which are different from the established tumors showing the similar underlying gene fusions. An 18-year-old female patient presented with pain in her upper back. She underwent An An 18-year-old female patient presented with pain in her upper back. She underwent magnetic resonance imaging (MRI), which revealed a large lobulated, intraspinal, extra-axial mass, measuring 4.1cm in the largest dimension. Histopathological examination of the biopsy revealed a tumor composed of moderate to focally, markedly pleomorphic, round to polygonal to spindle-shaped cells, including vacuolated forms in a myxoid-rich stroma with intervening branching blood vessels. By immunohistochemistry, the tumor cells were patchily positive for epithelial membrane antigen (EMA), and focally for pan keratin (AE1/AE3), S100 and desmin. A 43-year-old lady presented with a gradual, left-sided hearing loss of one year duration. On clinical examination, there was a soft palatal bulge. Computed tomogram (CT) scan showed a 4.9cm-sized mass in the left parapharyngeal space. Microscopic examination of the excised mass revealed an infiltrating tumor composed of round to oval cells arranged in solid sheets, cords and cribriform pattern in a densely hyalinized and myxoid stroma. Few mitotic figures were noted. By immunohistochemistry, the tumor cells were focally positive for EMA, ALK and diffusely positive for S100 and SOX10. Fluorescence in-situ hybridization (FISH) revealed EWSR1 rearrangement. Next-generation sequencing (NGS) revealed EWSR1::CREB1 fusion in the former and EWSR1::ATF1 fusion in the latter tumor. The former patient is alive with the disease and the latter patient in on maintenance chemotherapy. The two tumors, occurring at distinct sites, histopathologically exhibiting a relatively atypical immunophenotype, including "myoepithelial-like" differentiation seem to further expand the clincopathological spectrum of tumors with epithelioid morphology and underlying FET-CREB fusions.

Symptomatic small-sized lumbar disc herniation (small LDH) presents a significant challenge in elite athletes, where rapid return to competition is paramount. This study aimed to characterize the clinical and imaging features of small LDH in this population and to evaluate the efficacy of transforaminal endoscopic lumbar discectomy (TELD) under local anesthesia. We retrospectively reviewed the medical records of 11 elite athletes (12 discs) who underwent TELD for small LDH, defined as a herniation not exceeding 25% of the spinal canal's anteroposterior diameter on magnetic resonance imaging. Preoperative assessments included neurological status and magnetic resonance imaging findings, focusing on T2 hyperintensity within or posterior to the posterior longitudinal ligament (PLL). Outcomes were time to return to sport, recurrence, and patient-reported outcomes by modified MacNab criteria at final follow-up. All athletes presented with function-limiting radiculopathy despite radiographically small herniations (mean anteroposterior diameter, 3.3 ± 1.0 mm; mean canal occupancy ratio, 16.7% ± 6.6%). T2 hyperintensity in or behind the PLL was present in all 12 discs. Following TELD, all athletes returned to unrestricted competition at a median of 2.0 months (range, 1.5-5.0). At a median final follow-up of 26.0 months, modified MacNab outcomes were excellent in 63.6% and good in 36.4%. No recurrences requiring reoperation occurred. Symptomatic small LDH with associated T2 hyperintensity in the PLL is a distinct clinical entity in elite athletes. TELD under local anesthesia is a safe and effective intervention that facilitates a rapid and reliable return to sport with favorable mid-term outcomes. This study provides evidence that TELD under local anesthesia is an effective treatment for elite athletes with symptomatic small LDH, facilitating a predictable and rapid return to high-level competition. The identification of T2 hyperintensity in the PLL as a key imaging marker may help guide surgical decision-making in this specific patient population.

Benign prostatic hyperplasia (BPH) with median-lobe enlargement (MLE) is a distinct and challenging clinical entity contributing to lower urinary tract symptoms (LUTS). Minimally invasive treatments, such as transperineal laser ablation (TPLA), offer potential advantages in treating this subgroup, but limited data exist regarding their outcomes. The aim of this study is to evaluate the efficacy and safety of EchoLaser TPLA of symptomatic BPH with MLE. This study retrospectively evaluated 31 patients with symptomatic BPH and MLE who underwent EchoLaser TPLA at a private clinic. EchoLaser TPLA was performed with a proprietary 1064-nm continuous-wave diode laser. Baseline and 6-month follow-up assessments included International Prostate Symptom Score (IPSS), quality of life (QoL), prostate volume (PV), postvoid residual (PVR), peak urinary flow rate (Qmax), and International Index of Erectile Function (IIEF-15). Safety outcomes were categorized using the Clavien-Dindo classification system. EchoLaser TPLA significantly improved IPSS (median 22 to 6.5; p < 0.001), QoL (median 5 to 1; p < 0.001), PV (median 105 mL to 43 mL; p < 0.001), PVR (median 120 mL to 23.5 mL; p < 0.001), and Qmax (median 7.6 mL/s to 15.95 mL/s; p < 0.001) at 6 months. IIEF-15 scores remained stable, indicating preservation of erectile function. No intraoperative adverse events occurred; two mild periprocedural events (urinary tract infection, hematuria) were successfully managed conservatively. Nine of 10 catheter-dependent patients resumed normal voiding. EchoLaser TPLA is an effective and safe minimally invasive treatment for BPH with MLE, offering significant symptomatic relief, functional improvement, and a favorable safety profile while preserving sexual function. These findings position EchoLaser TPLA as a promising alternative to conventional treatments for this challenging patient subgroup.

Intraoperative fluorescence-guided surgery is an important adjunct to brain tumor resection. However, fluorescent probe performance varies across molecularly and histopathologically distinct entities, including IDH-wildtype glioblastoma, metastatic brain tumors (MBTs), and primary central nervous system lymphoma (PCNSL), and the mechanisms underlying this variability remain poorly understood. We propose a mechanistic framework integrating biomechanical constraints, molecular barrier heterogeneity, and probe-specific pharmacokinetics to explain cross-tumor differences in fluorescence signal. Probe performance is conceptualized through three sequential bottlenecks: extravasation (blood–brain barrier/blood–tumor barrier permeability and transcytosis), interstitial penetration (extracellular matrix density and hydraulic resistance), and retention/clearance (efflux transporters and metabolic processing). An overlying optical layer, including tissue absorption, scattering, and autofluorescence, further modulates the detected signal. Tumor-specific molecular heterogeneity critically shapes these processes. In IDH-wildtype glioblastoma and legacy high-grade glioma cohorts, heterogeneous expression of ATP-binding cassette transporters has been associated with reduced intracellular accumulation of protoporphyrin IX after 5-aminolevulinic acid administration and may contribute to false-negative fluorescence in selected tumor regions. In MBTs, stage-dependent blood–tumor barrier integrity and vascular programs influence probe delivery, whereas in PCNSL, corticosteroid-sensitive restoration of endothelial barrier function may compromise the performance of leakage-dependent tracers. Together, this framework highlights how tumor biology, barrier function, and probe pharmacology jointly shape fluorescence contrast. Rational probe selection informed by tumor-specific transport and barrier constraints may improve intraoperative visualization of brain tumors and optimize surgical decision-making.

Surgical outcomes of cerebellar liponeurocytomas: A systematic review and individual patient data meta-analysis.

Subventricular zone involvement and cortico-spinal tract infiltration as predictors of outcome in Glioblastomas: a distinct surgical, clinical and prognostic entity.

Hyperglycemia Following Pancreas Transplantation: Rethinking Graft Function and Metabolic Control.

Immunotherapeutic strategies in HPV-positive and HPV-negative recurrent/metastatic oropharyngeal squamous cell carcinoma: From PD-1 blockade to EGFR-directed bispecifics and therapeutic HPV vaccines.