Illuminating epilepsy: A deep NIR-I fluorogenic sensor reports peroxynitrite dynamics in vivo.

Weight management remains a significant challenge for patients with class II-III obesity, even after metabolic bariatric surgery (MBS). This study aimed to investigate the association between early, short-term adjunctive semaglutide therapy and postoperative weight-loss outcomes after laparoscopic sleeve gastrectomy (LSG) in patients with class II-III obesity. In this prospective, non-randomized controlled clinical study, patients with class II-III obesity, defined as a body mass index (BMI) ≥ 35kg/m² scheduled for LSG were enrolled. Semaglutide was administered as adjunctive therapy in the treatment group from 1 to 6 months postoperatively, while the control group received LSG alone. The primary outcome was the percentage of total weight loss (%TWL) at 12 months after surgery. The main secondary outcomes included the percentage of excess weight loss (%EWL) at 12 months, the %TWL and %EWL at 6 months, the distributions of %TWL and %EWL, and metabolic parameters. Exploratory analyses were also performed for body composition parameters. A total of 103 participants were included in the study, including 48 in the treatment group and 55 in the control group. At 12 months postoperatively, patients in the treatment group showed significantly greater weight loss than the control group, as reflected by a larger %TWL (-35.14 ± 6.88% vs. -30.73 ± 6.91%, P = 0.002) and a higher %EWL (86.42 ± 19.94% vs. 76.87 ± 22.95%, P = 0.026). Similarly, at 6 months postoperatively, %TWL was significantly greater in the treatment group (-29.74 ± 5.38% vs. -26.32 ± 4.10%, P < 0.001), whereas no significant between-group difference in %EWL was observed at 6 months. In addition, the distributions of %TWL and %EWL were more favorable in the treatment group. These results were generally consistent after propensity score adjustment for baseline confounders, although the between-group difference in %EWL distribution was not significant. Both groups showed comparable improvements in metabolic indicators from baseline. Exploratory analyses further showed a greater increase in lean body mass percentage and a greater reduction in visceral fat area in the treatment group, although these body composition findings should be interpreted cautiously. This non-randomized, single-center study indicates that, among patients with a BMI ≥ 35kg/m2, early adjunctive semaglutide therapy initiated at one month and continued until six months after LSG was associated with greater weight loss at one year postoperatively. These findings provide hypothesis-generating evidence for the potential role of early short-term adjunctive semaglutide therapy after MBS in this population.

Children with Crohn's Disease (CD) who develop internally penetrating complications (IPCs; abscesses and inflammatory masses) are at high risk for surgery and other adverse events. Early anti-tumor-necrosis-factor therapy (anti-TNF) improves outcomes among children with CD and anti-TNF initiation soon after IPC resolution decreases surgical risk. We aimed to evaluate the safety and effectiveness of early anti-TNF therapy among children hospitalized with active IPCs. We conducted a multicenter retrospective study of children (age ≥6 years) diagnosed with IPCs from 2007-2021. The exposure was anti-TNF within 30 days of IPC diagnosis. Outcomes included 1) infectious serious adverse events (iSAE) within 90 days, 2) non-infectious CD-related SAE (cdSAE), 3) CD-related surgery, and 4) combined clinical-biochemical-corticosteroid-free remission within 1 year. Outcomes were compared via inverse-probability-of-treatment-weighted Kaplan-Meier curves (log-rank test) and Cox proportional hazards models stratified by percutaneous drainage (PD) status. Among 203 patients (median age 16 years, 50% female), 87 (43%) received early anti-TNF within 30 days of IPC diagnosis. In Cox analyses, early anti-TNF was not linked to iSAE, cdSAE, or surgeries, but was associated with increased combined clinical-biochemical-corticosteroid-free remission (HR 1.65, 95%CI 1.20, 2.27). However, surgical risk differed by PD status: patients receiving early anti-TNF and PD had lower risk versus PD alone (event-free survival 58% versus 15%, log-rank P=0.04). Early anti-TNF therapy in children with IPCs was not associated with iSAE or cdSAE. Notably, in those undergoing PD, early anti-TNF was associated with decreased surgeries. These findings support early anti-TNF initiation within a multidisciplinary treatment framework. Prospective studies with standardized treatment protocols are needed.

The objective of this study is to investigate the individualized use of triptorelin in children diagnosed with central precocious puberty (CPP) and short stature. Twenty-six children with CPP and short stature who received triptorelin treatment from June 2018 to May 2022 were included in the study. Treatment-related conditions, including treatment purpose, indications, protocols, monitoring and changes in predicted adult height (PHA), were summarized and analysed. Of the 26 cases, 24 children were treated to improve height, while two cases were treated for suppression of premature sexual development. Among the 24 cases treated with the goal of improving height, there were 13 cases of PHA-defined short stature, eight had severely impaired target height (TH) and three showed low TH. The distribution of bone age (BA) of the study participants upon undergoing triptorelin treatment ranged from 9 to 11.5 years in 21 cases, 11.5 to 13 years in three cases and over 14 years in one case. Additionally, one 9-year-old boy with congenital adrenal hyperplasia (CAH) had a BA of 16 years. Four children received triptorelin monotherapy, while 22 were treated with a combination of triptorelin and growth hormone (GH). Significant improvements in PHA were observed in the 24 children who completed a 1-year treatment course. Triptorelin is effective not only in the treatment of CPP but also for children with short stature who exhibit premature sexual development, short PHA or impaired TH. In girls with early menarche, the BA indication can be relaxed to 12.5 or even 13 years, with early triptorelin-GH combination therapy recommended to maximize height potential. For those showing adequate pubertal suppression, triptorelin administration intervals can be extended from 4 to 5 weeks. In cases of insufficient suppression, the interval may need to be shortened to 3 weeks. Individualized triptorelin and GH combination therapy appears to offer superior height outcomes, with careful consideration required for optimal timing and duration of treatment.

Psoriatic disease, including psoriasis and psoriatic arthritis, is associated with increased risk of comorbidities (cardiovascular disease, mental health disorders, type 2 diabetes mellitus and obesity), placing substantial burden on patients and health systems. We aimed to quantify the lifetime economic burden of these four comorbidities in populations with moderate-to-severe psoriasis and psoriatic arthritis. We subsequently estimated the potential comorbidity-related gross cost offsets from timely systemic therapy across three diverse country settings (Denmark, the USA and Vietnam). We conducted a literature review to identify data on prevalence, comorbidity risk, treatment-associated risk reduction and cost inputs, followed by development of a static cohort-based economic model from a societal perspective. The model compared untreated/undertreated moderate-to-severe psoriasis/psoriatic arthritis; and systemic treatment scenarios (conventional systemic disease-modifying antirheumatic drugs [csDMARDs]; biologic DMARDs [bDMARDs]; and targeted synthetic DMARDs [tsDMARDs]) over a lifetime horizon in Denmark, the USA and Vietnam, reporting total comorbidity cost offsets across direct (healthcare) and indirect (societal) costs. Systemic treatment reduced lifetime comorbidity-related direct and societal costs across settings. In the USA, patients with moderate-to-severe psoriasis incurred annual direct costs of approximately 4.6 billion USD (indirect 0.6 billion USD), and untreated lifetime burden of about 153.0 billion USD. Treating all patients with bDMARDs yielded an estimated cost offset of 62.9 billion USD in the direct costs and an offset of 8.1 billion USD in the societal costs compared with a fully undertreated population. Equivalent analyses in Denmark and Vietnam reflected similar effects on comorbidity-related costs. The model shows that early systemic therapy yields substantial effect on the direct and societal costs via reduced comorbidity incidence. Timely and efficacious systemic treatment of psoriatic disease can significantly reduce lifetime economic burden of comorbidities across diverse healthcare settings. These findings underscore the value of early, proactive management of psoriatic disease and highlight the need for further cost-effectiveness research, including treatment uptake and real-world comorbidity prevention.

Understanding tumor microenvironment dynamics and immune checkpoint inhibitor efficacy following mEGFR-targeted near-infrared photoimmunotherapy.

Successful treatment of balamuthia mandrillaris amebic encephalitis diagnosed by MetaCAP in China: A case report and review of 25 survival cases.

Lung cancer, the leading cause of global cancer-related mortality, is categorized into small-cell and non-small-cell subtypes. The heterogeneous non-small-cell lung cancer group is further subcategorized primarily into adenocarcinoma, squamous cell carcinoma, and large cell carcinoma, each underpinned by distinct molecular alterations. Although traditional serum biomarkers aid in subtype differentiation and treatment monitoring, their utility is limited by challenges such as poor specificity due to inflammatory confounders and the difficulty of dynamically tracking therapeutic resistance. Recent advances have identified emergent subtype-specific biomarkers that reflect metabolic reprogramming, epigenetic dysregulation, stemness signatures, and interactions within the immune microenvironment. By integrating analytes such as ctDNA, exosomal RNAs, and urinary DNA with multi-analyte panels and advanced imaging, liquid biopsies offer a promising avenue to enhance early detection accuracy, prognostication, and dynamic therapy monitoring. Nevertheless, the clinical adoption is hindered by several challenges, including incomplete validation, the need for technical standardization, intratumoral heterogeneity, and inter-ethnic variability. The convergence of artificial intelligence (AI)-enhanced multi-omics with biomarker-guided therapeutics represents a transformative strategy with the potential to overcome resistance, mitigate ethnic disparities, and ultimately transform lung cancer into a chronic, manageable disease. Therefore, prioritizing clinically validated AI-integrated platforms is pivotal to achieve precision oncology.

Little is known about how pain influences physical function in people with mild Parkinson disease (PwPD). The purpose of this study was to investigate the association between physical function and pain presence, location, and intensity in PwPD who were evaluated in an early physical therapy program. Retrospective cross-sectional analysis of electronic medical records from patients with PD evaluated at a single center (2016-2023). Pain presence, location, and intensity (0-10 scale) were recorded at the initial physical therapy evaluation. Functional outcomes included 5-time sit-to-stand, 10-meter walk test, 6-minute walk test, timed up and go, mini-BESTest, and Functional Gait Assessment. Multivariable linear and proportional-odds regression models assessed associations between pain (presence and intensity by location) and function, adjusting for age and sex, with significance set at P < 0.05. Ninety-eight (28%) of the 355 patients with PD reported pain. The presence of pain was associated with worse performance on the 10-meter walk test, 6-minute walk test, and 5-time sit-to-stand test. Those with lower extremity pain had worse gait performance as pain intensity increased. There were no associations between pain intensity and functional performance for those with axial or upper extremity pain. Even in individuals with early PD, pain was associated with worse gait, endurance, and sit-to-stand performance. Surprisingly, increasing axial pain intensity was not associated with poorer gait performance, but increasing lower extremity pain was. There are opportunities for future studies on integrated pain assessment and management within neurologic Parkinson's care.

Artificial intelligence in clinical oncology: Multimodal integration and translational development.

Early dual antiplatelet therapy (DAPT) after intravenous thrombolysis is safe but ineffective in improving 90-day functional outcomes in minor stroke. Given the effect of diabetes mellitus (DM) with antiplatelet treatment, we investigated whether DM status modifies the effect of early DAPT. This secondary analysis of the Early Antiplatelet for Minor Stroke following Thrombolysis trial included patients from the modified intention-to-treat population. Participants were stratified by DM status (history of DM, newly diagnosed DM, non-DM). Outcomes were compared between early DAPT and placebo groups within each subgroup. The primary outcome was excellent functional outcome (modified Rankin Scale score 0-1) at 90 days. Among 995 analysed patients, early DAPT was associated with a significantly higher rate of excellent functional outcome in patients with a history of DM (91.2% vs. 81.7%; adjusted OR 2.76, 95% CI 1.22-6.22, p = 0.02). No significant benefit was observed in the newly diagnosed DM (81.8% vs. 83.3%; OR 1.20, 95% CI 0.24-5.95, p = 0.83) or non-DM subgroups (89.6% vs. 92.5%; OR 0.70, 95% CI 0.41-1.17, p = 0.17). The interaction across subgroups was not significant (p for interaction = 0.09). For Chinese patients with minor stroke receiving intravenous thrombolysis, early DAPT was potentially associated with a higher likelihood of excellent functional outcome at 90 days in those with a pre-existing history of DM. It warrants further confirmation. ClinicalTrials.gov identifier: NCT05193071.

Bariatric surgery is the most effective intervention for obesity, but suboptimal early weight loss remains common and challenging to manage. Identifying predictors of early inadequate weight loss is increasingly relevant as glucagon-like peptide-1 (GLP1) therapies emerge as adjunctive treatments. We conducted a retrospective cohort study of 166,843 patients with BMI > 30kg/m² and complete six-month follow-up data from the 2023 MBSAQIP registry. Suboptimal weight loss was defined as < 10% total weight loss (TWL) at six months. Predictors of suboptimal weight loss were assessed using LASSO logistic regression, random forest, and gradient boosting models, considering demographic, clinical, and procedural variables. Model performance was evaluated using the area under the receiver operating characteristic curve (AUROC). Overall, 12.6% of patients experienced suboptimal weight loss. Incidence was lower for primary surgical procedures (7-13%) compared with endoscopic interventions (34-50%). Across all models, consistent predictors of suboptimal weight loss included female sex, higher baseline BMI, older age, diabetes, and black race. Predictive performance of clinical variables alone was modest (AUROC 0.57-0.60), indicating substantial unexplained variability. Suboptimal early weight loss is common and varies widely between procedures. Baseline demographics and comorbidities can guide preoperative counseling, but additional behavioral, socioeconomic, and genetic factors may be required to improve prediction and guide individualized interventions, including early GLP1 therapy.

Our retrospective observational cohort study investigated the effect of the timing of escalation to dual salvage therapy utilizing ceftaroline with vancomycin or daptomycin for the treatment of persistent methicillin-resistant Staphylococcus aureus bacteremia on patient outcomes. Eligibility criteria included age ≥18 years old, at least one positive blood culture for methicillin-resistant Staphylococcus aureus, and receipt of salvage therapy consisting of ceftaroline in combination with either vancomycin or daptomycin for any duration during their bloodstream infection within our health system over a 10-year period. This resulted in the inclusion of 189 adult patients. Patients were stratified by the timing of ceftaroline initiation: ≤5 days (early initiation) versus >5 days (late initiation) from index positive culture. The study populations were similar, although there was a higher prevalence of persons who inject drugs started on early salvage therapy (36.0% versus 18.0%, P = 0.005) and fewer patients with type II diabetes (25.8% versus 41.0%, P = 0.028). Analysis revealed no statistically significant differences between 90-day all-cause mortality or readmission rates in either group; however, there was less 90-day microbiologic recurrence in the early initiation group (3.4% versus 11.0%, P = 0.046). Patients started on early salvage therapy also had fewer total days of bacteremia (7.0 versus 10.5 days, P < 0.001), fewer metastatic foci of infection (61.8% versus 82.0%, P = 0.002), and a shorter duration of treatment (46.0 versus 50.0 days, P = 0.013).IMPORTANCETreatment of methicillin-resistant Staphylococcus aureus bacteremia remains a challenge due to its high morbidity and mortality. Ceftaroline has been studied for off-label utilization in dual salvage therapy with daptomycin or vancomycin in these patients, although current data regarding the optimal timing for its addition are limited. We sought to address this knowledge gap with our retrospective review of patient outcomes at our hospital system who received ceftaroline for this indication. Overall, earlier initiation of ceftaroline-based dual therapy was beneficial, as evidenced by reduced microbiologic recurrence, shorter duration of bacteremia, reduced metastatic disease, and subsequent shorter duration of therapy if patients were escalated to dual salvage therapy with ceftaroline within 5 days of the index culture.

Despite global recommendations for early antiretroviral therapy (ART) initiation and the well-established benefits of timely treatment, delayed ART initiation remains a concern in some settings. Previous studies have identified multiple barriers to ART initiation, including limited treatment knowledge, stigma, disclosure concerns, side-effect fears, and service-related barriers. Less is known, however, about how these factors become organized in everyday life into a sustained process of delay after diagnosis. This study explored how people living with HIV in southwestern China experienced delayed ART initiation, with attention to social visibility, family relationships, informal information, and changing perceptions of treatment urgency. A descriptive phenomenological design was used. Semi-structured, in-depth interviews were conducted with 23 people living with HIV who had delayed ART initiation and were recruited from two HIV-designated hospitals in Yunnan Province, China. Interviews were audio-recorded, transcribed, and analyzed using Colaizzi's seven-step method. The analysis was primarily inductive, while an HIV-related stigma framework informed the research question, interview domains, and later interpretation. Four themes were identified. First, delayed ART initiation often began when treatment entry was experienced as a risk of being recognized, leading to concealment, stigma-related shame, and avoidance. Second, delay was sustained through family negotiation, informal information, symptom-free periods, concerns about side effects, and the normalization of waiting. Third, treatment initiation became more likely when family or significant-other support, continued healthcare-provider contact, symptoms, or complications changed participants' perceptions of risk. Fourth, cross-theme patterns showed that delayed ART initiation was experienced as unfolding from concealment and waiting toward treatment entry when support, symptoms, or changing perceptions of risk made continued delay less acceptable. The local context functioned primarily as a contextual condition shaping social visibility, mobility-related experience, informal information, and treatment urgency, rather than as a standalone mechanism. Delayed ART initiation in this study was not solely attributable to insufficient knowledge or poor treatment awareness. Participants described delay as an experience shaped by social visibility concerns, stigma-related shame, family negotiation, informal information, symptom experiences, and changing perceptions of risk. Efforts to promote timely ART initiation may need to address not only treatment knowledge, but also confidentiality concerns, stigma-sensitive support, family context, and the social conditions in which treatment decisions are made.

Statin-induced necrotizing autoimmune myopathy is a rare but serious complication of statin therapy, marked by progressive muscle weakness and elevated creatine phosphokinase levels that persist despite discontinuation of the drug. We present a case in which statin-associated myopathy was initially misattributed to hepatic dysfunction due to elevated liver enzymes. Despite early recognition and immunosuppressive therapy, the patient experienced relentless decline, ultimately leading to death. This case highlights the progression and potential severity of SINAM, emphasizing the need for early consideration/screening and intervention. A 59-year-old White male with a history of hypertension, hyperlipidemia, type II diabetes, and benign prostatic hyperplasia was started on statin therapy (atorvastatin 20mg daily) for primary prevention of coronary artery disease. He developed progressively worsening generalized fatigue and weakness, most prominently affecting the upper extremities. Lab tests revealed elevated liver enzymes (ALT and AST), prompting discontinuation of statins. Despite this, symptoms and enzyme levels did not improve. Extensive evaluation, including viral, autoimmune, and gastrointestinal workups, yielded negative or normal results, except for elevated inflammatory markers and creatine phosphokinase, which suggested muscle involvement. Imaging and liver biopsy were unremarkable. Neurological assessment did not explain the symptoms. Given the elevated CPK and persistent symptoms, statin-related myopathy was suspected. A positive anti-HMG-CoA reductase antibody and muscle biopsy confirmed the diagnosis of statin-induced necrotizing autoimmune myopathy. Treatment with corticosteroids prednisone, immunosuppressants (methotrexate, azathioprine), and eventually IVIG failed to treat the disease. The patient's condition deteriorated over 3 years, with worsening muscle weakness, recurrent aspiration, respiratory failure requiring multiple hospitalizations, intubation, and ultimately tracheostomy and gastrostomy tube placement. Despite the treatment, he experienced a continuous decline in functional status. In alignment with his wishes, he transitioned to hospice care and passed away. This case highlights the importance of considering statin-induced necrotizing autoimmune myopathy (SINAM) in patients presenting with unexplained muscle weakness and persistently elevated liver enzymes, even after discontinuation of statin therapy. The diagnostic complexity and overlap with hepatic pathology can delay recognition and treatment. Despite immunosuppressive therapy, this case demonstrates that SINAM can follow a severe, progressive, and ultimately fatal course. Early identification and prompt intervention are crucial, and this case highlights the importance of heightened clinical awareness of this rare but serious adverse effect of statins.

The efficacy of intravenous thrombolysis (IVT) versus early antiplatelet therapy (APT) in small artery occlusion (SAO) stroke remains debated. Ischaemic stroke (IS) patients with SAO who received IVT or early APT without IVT≤4.5 hours from stroke onset were screened from a prospective multicentre IS registry study from 1 January to 1 June 2021. The primary outcome was unfavourable functional outcome (FO) at 3 months. The secondary outcome was early neurological deterioration (END). The safety outcome was symptomatic intracerebral haemorrhage (sICH). There were 1125 SAO patients with 394 receiving IVT. 411 patients (36.5%) exhibited unfavourable FO, and sICH occurred in 3 cases (0.27%), all in IVT group, at the follow-up. END was observed in 213 patients (18.9%). After propensity score matching and multivariable adjustment, IVT significantly reduced the likelihood of unfavourable FO at 3 months (aOR 0.447, 95% CI 0.305 to 0.656), but no significant difference was found in END (aOR 0.867, 95% CI 0.569 to 1.321). Clustering analysis identified two distinct phenotypes: phenotype 0 (characterised by traditional cardiovascular risk factors) and phenotype 1 (marked by prominent inflammatory markers). A significant treatment-by-phenotype interaction was observed (p=0.002), with a comparable magnitude of benefit in phenotype 0 (aOR 0.405, 95% CI 0.244 to 0.673) compared with phenotype 1 (aOR 0.414, 95% CI 0.218 to 0.783). IVT significantly reduced the likelihood of unfavourable FO at 3 months in SAO patients but did not significantly reduce END. Patients with traditional risk factors may benefit more from IVT than those with elevated inflammatory markers. ChiCTR2100045258.

Early dapagliflozin therapy after STEMI in patients with preserved ejection fraction: a prospective cohort study

Intrapleural fibrinolytic therapy (IPFT) is widely used in pediatric empyema thoracis. Some physicians administer it early (when empyema is confirmed) whereas others try it after intercostal drainage (ICD)has failed. The optimal timing of IPFT administration is unclear. To compare early IPFT (i.e. as an initial therapy when empyema is diagnosed), versus IPFT administered after failure of ICD, in children with empyemathoracis. Literature search was conducted through PubMed, EMBASE, Scopus, Web of Science, Cochrane Library, and two grey literature databases. Additional searches in four clinical trials registries, and hand-searching were conducted. The goal was to identify randomized controlled trials (RCT) comparing early IPFT (as an initial therapy, upon the diagnosis of empyema), versus delayed IPFT (i.e. administered after failure of ICD), in children with empyema thoracis (diagnosed by standard criteria). The outcomes recorded were clinical recovery, need for surgery, hospital stay, and safety. The literature search yielded 2907 citations across the 11 databases examined. However, there were no RCTs directly addressing the review question. Indirect evidence from pediatric trials suggested that early IPFT may reduce pleural thickening and hospital stay, although decrease in surgery was not demonstrated consistently. In contrast, some observational studies reported high success rates with IPFT administered after failure of ICD, with avoidance of surgery in many cases. There is no RCT evidence comparing the initial administration of IPFT versus administration after failure of ICD. Well-designed RCTs are urgently needed.

Renal suppurative infections (RSIs), including pyonephrosis, renal abscess, and perinephric abscess, are rare but potentially life-threatening conditions. This study aimed to evaluate the epidemiological, diagnostic, therapeutic, and outcome aspects of RSIs. We conducted a retrospective descriptive study of patients admitted for renal suppurative infections in the urology department of CHU Yalgado Ouédraogo between November 2021 and December 2023. Epidemiological, clinical, biological, radiological, and therapeutic data were analyzed. Among 1.377 admitted patients, 32 cases of RSIs were identified (hospital prevalence: 2.32%). The mean age was 37.48 ± 15.68 years, with a female predominance (sex ratio 1.4). Fever-associated flank pain was the main presenting symptom (84.38%). Obstructive uropathy, particularly urolithiasis and schistosomiasis-related ureteral lesions, was the main etiological factor. Pyonephrosis was the most frequent diagnosis (68.75%). All patients underwent ultrasonography, complemented by computed tomography in 78.12% of cases. Biological findings showed anemia, leukocytosis, and impaired renal function in a substantial proportion of patients. Escherichia coli was the most frequently isolated pathogen. Management combined broadspectrum antibiotic therapy and systematic percutaneous drainage. Secondary etiological surgery was performed in 56.06% of cases. The mean hospital stay was 30.13 ± 26.83 days. The mortality rate was 12.9%, mainly associated with underlying malignancy. Conclusions: RSIs remain severe infections requiring prompt diagnosis and multidisciplinary management. Early antibiotic therapy combined with effective drainage improves outcomes; however, prognosis is strongly influenced by underlying comorbidities. Optimizing the management of obstructive uropathies and associated conditions is essential to reduce morbidity and mortality.

Hyperuricemia is implicated in neonatal acute kidney injury. Although rasburicase effectively lowers uric acid (UA) in malignancy-associated hyperuricemia, evidence in preterm infants is scarce. We retrospectively studied 74 preterm neonates ( ≤ 32 weeks or <1500 g). Infants with hyperuricemia (serum UA levels ≥8 mg/dL; n = 20) received single-dose intravenous rasburicase (0.2 mg/kg). Serial clinical data were collected. Median serum UA levels peaked on day 1 (5.0 mg/dL), declining by day 28 (1.6 mg/dL). Hyperuricemia occurred in 20 infants (27.0%). Rasburicase was administered at a median postnatal age of 3 days with a median UA level of 9.6 mg/dL, a median postmenstrual age of 25 weeks and body weight of 667 g at the time of treatment. Rasburicase reduced UA by >90% within 24 h, increased urine output, and normalized electrolytes (all p < 0.05). Exposure to rasburicase was associated with a significant reduction in serum UA, independent of postnatal age, with a significant time-by-treatment interaction. Blood urea nitrogen and creatinine levels improved by day 7. No adverse effects were observed. Early rasburicase administration was associated with a marked reduction in serum UA levels and improvement in renal parameters without major adverse effects, suggesting a potential therapeutic role in preterm neonates. Hyperuricemia contributes to neonatal acute kidney injury (AKI) and is closely linked to prematurity and illness severity. Although rasburicase is established for malignancy-associated hyperuricemia, evidence in preterm infants remains limited. This is the first study to evaluate the efficacy and safety of early rasburicase in extremely preterm infants with hyperuricemia. Early rasburicase administration resulted in a rapid uric acid reduction of >90% and an association with favorable changes in renal parameters without observed adverse effects. Our findings provide novel evidence supporting rasburicase as a potential therapeutic option in neonatal intensive care to reduce hyperuricemia-related AKI risk.