University hospitals play akey role in research, clinical care and medical education; however, the number of pediatric anesthetic procedures performed at German university hospitals, including complex cases requiring specialized expertise and those relevant for training remains unknown. All chairs of anesthesiology at German university hospitals were invited via email to participate in asurvey. For the years 2022-2024, the number of anesthetic procedures, patient age groups (< 1, 1-4, 5-11, 12-17, ≥ 18years) and the American Society of Anesthesiologists (ASA) classification of pediatric cases were collected. The primary endpoint was the percentage of pediatric anesthetic procedures relative to the total number of anesthetic procedures. Secondary variables included age distribution, relative proportion, ASA classification and case volume-dependent structure of pediatric anesthesia services. In this study 23university hospitals participated (response rate: 43.6%). On average, 24,910 ± 9325 anesthetic procedures were performed per hospital and year. The proportion of children was 13.6% (of whom 11.6% were < 1year and 31.8% aged 1-4years). The relationship between total case volume and the pediatric proportion was positive and linear (y = 0.0017x + 7.0785; R2 = 0.69). The ASA classification of children was distributed as follows: 47.9% ASAI, 28.5% ASAII, 20.0% ASAIII, 3.3% ASAIV and 0.2% ASAV. Hospitals with the largest total caseloads had the highest pediatric proportion (16.5%), including the largest share of children aged 0-5years (52.2%) and the highest proportions of ASAIV-V cases (27.6%). There were marked differences in case volume among university hospitals; however, aclear correlation was observed between total anesthetic case volume and the pediatric proportion. The findings suggest that pediatric anesthesia services are increasingly concentrated in large centers.

Malaria remains a major public health concern in Jayapura, Indonesia. Limited microscopy availability in primary healthcare facilities has increased reliance on rapid diagnostic tests (RDTs) for early case detection. This study aimed to evaluate the diagnostic performance of two malaria RDTs, AllCheck® and Orient Gene®, using microscopy as the reference standard. A cross-sectional study was conducted at a primary healthcare center in Jayapura in December 2025, involving 49 patients with clinical symptoms suggestive of malaria. Capillary blood samples were collected for RDT testing and preparation of thick and thin blood smears. Diagnostic accuracy was assessed by calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), as well as agreement analysis using Cohen’s Kappa and McNemar test. Both RDTs demonstrated comparable diagnostic performance, with sensitivities of 93.75% (95% CI: 69.77–99.84) and specificities of 100% (95% CI: 89.42–100.00). The PPV was 100% (95% CI: 78.20–100.00), and the NPV was 97.06% (95% CI: 84.67–99.93). Agreement analysis showed almost perfect concordance between each RDT and microscopy (? = 0.953; p &lt; 0.001). No significant difference was observed between AllCheck® and Orient Gene® results based on the McNemar test (p = 1.000). No significant association was found between diagnostic outcomes and patient sex or age group (p &gt; 0.05). The RDTs showed good performance in detecting Plasmodium falciparum and Plasmodium vivax, but reduced sensitivity for Plasmodium malariae. In conclusion, AllCheck® and Orient Gene® RDTs demonstrate strong diagnostic performance and almost perfect agreement with microscopy, supporting their suitability for malaria screening and initial diagnosis in primary healthcare settings in Jayapura. Nevertheless, microscopy remains essential for confirming non-falciparum infections and ensuring comprehensive case detection.

Body Dysmorphic Disorder (BDD) is a distressing mental-health condition, associated with significant impacts to quality of life. As such, treatments for BDD require research attention. In this manuscript we systematically review the present psychotherapeutic treatment literature for BDD with a focus on efficacy and retention. We examine 40 studies, including 27 treatment studies and 13 additional studies that included observational and long-term data, or examined predictors of treatment response. Using meta-analysis, our results suggest that current psychotherapies for BDD achieve reasonable response rates (pooled response rate = 71.9 %), though estimates are more conservative among RCTs (pooled response rate = 69 %) and the available long-term data highlights the strong possibility of relapse following treatment. Our narrative synthesis explores the relationship between treatment and sample characteristics, efficacy and retention, revealing several important considerations when selecting appropriate treatments for BDD, including the incidence of comorbidities, a patient's willingness to engage in exposure response prevention and group-based treatment components, patient age group and the treatment's capacity to retain patients for the treatment course. Based on these findings we provide recommendations aimed at maximising therapist time to achieve efficacy and patient retention, in the context of global pressures on mental health systems.

Pharmacoresistant epilepsy remains a significant challenge in modern neurology, affecting around 30 % of patients who do not respond to medication. Conventional neuroimaging methods often fail to provide sufficient diagnostic information in patients with MRI-negative findings and discordant EEG and MRI data. Optimizing preoperative mapping through noninvasive, high-precision neuroimaging techniques is critical to improving surgical outcomes and patient prognosis. Hybrid PET/MRI imaging with 18 F-FDG offers new possibilities for enhanced preoperative localization in such patients. Objective . To evaluate the diagnostic value and clinical applicability of hybrid PET/ MRI with 18 F-FDG in the preoperative mapping of epileptogenic zones in patients with pharmacoresistant epilepsy, including MRI-negative cases. To perform a quantitative analysis of 18 F-FDG hypometabolism in relation to the type of epilepsy, as well as the frequency and duration of epileptic seizures. Materials and Methods . A screening of 10 healthy volunteers and an evaluation of 130 patients with drug-resistant epilepsy were performed according to the hybrid PET/MRI protocol with 18 F-FDG. Both qualitative and quantitative analyses of hypometabolic brain regions were conducted, with findings correlated to clinical data, video-EEG monitoring results, and MRI findings. This approach enabled integrated assessment of functional and structural abnormalities, provided improved localization of epileptogenic zones, and facilitated the interpretation of metabolic, electrophysiological, and neuroanatomical correlates in the study cohort. Results . The use of interictal brain PET/MRI with 18 F-FDG significantly improved the detection rate of epileptogenic zones compared with standalone epilepsy-protocol MRI. This effect was particularly pronounced in MR-negative cases and in patients with subtle structural abnormalities, which were subsequently recognized upon targeted MRI re-evaluation guided by metabolic findings from PET imaging. In healthy individuals, no significant interhemispheric asymmetry of glucose metabolism was observed; physiologically, temporal regions demonstrate lower SUV values compared with frontal, parietal, and occipital cortices. Across all age groups of patients with pharmacoresistant epilepsy, moderate interhemispheric asymmetry of 18 F-FDG metabolism was identified (asymmetry index range ~ 0.25–0.5). Disease duration and seizure frequency showed no clear linear relationship with focal SUV values. However, in MRI-positive cases with daily seizures, a relative increase in SUV within the epileptogenic focus was noted, likely reflecting postictal metabolic activity without materially affecting overall hemispheric asymmetry. The most pronounced 18 F-FDG hypometabolism was observed in structural focal epilepsy, while higher metabolic activity characterized focal epilepsy of unknown etiology and mixed focal-generalized forms. These findings emphasize that hybrid 18 F-FDG PET/MRI provides an advanced diagnostic advantage through its ability to integrate metabolic and structural data, allowing for improved localization of epileptogenic foci — even in subtle or MRI-negative cases — and thereby enhancing presurgical evaluation and treatment planning. Conclusion . The use of hybrid 18 F-FDG PET/MRI expands the diagnostic capabilities of neuroimaging in patients with focal pharmacoresistant epilepsy. Incorporation of PET/MRI into the presurgical planning workflow has the potential to improve the effectiveness of surgical treatment and enhance patient quality of life.

Abstract Objective: This study aims to evaluate age-related patterns pertaining to the anatomical sites of second primary cancers occurring within five years of an initial breast cancer diagnosis. Methods: Our analysis focuses on patients (n=68,109) whose first recorded cancer diagnosis was early-stage breast cancer, diagnosed between 2008 and 2019. Age, diagnosis dates, and all anatomical cancer sites of these 68,109 patients were extracted from the Q-Centrix Clinical Data Warehouse. The Q-Centrix Clinical Data Warehouse is a proprietary database of de-identified clinical data produced through expert-driven human abstraction. The subset sourced from the Clinical Data Warehouse includes information from 78 hospitals, health systems, and cancer centers across the country. Patients were split into 6 age groups: &amp;lt;40 (n=2,628), 40-49 (n=10,306), 50-59 (n=16,508), 60-69 (n=19,486), 70-79 (n=13,209), and 80+ (n=5,967). Five patients did not have a recorded age group in the data warehouse. The occurrence of a second cancer within 5 years of the initial breast cancer diagnosis was categorized as “Yes” or “No”. Logistic regression was used to assess the odds of a patient developing a second non-same-day cancer within 5 years in patients &amp;gt;40 years of age compared to those &amp;lt; 40 years of age. A p-value cutoff of &amp;lt;0.05 was considered significant. A second analysis was conducted on the subset of patients who developed a second non-simultaneous cancer within five years of the initial breast cancer diagnosis. Of the 68,109 patients who had breast cancer logged as their first cancer in our data warehouse, 4680 (∼7%) fit these criteria. The site of the second cancer was categorized as breast or non-breast. 29 patients in this group did not have a second cancer site stored in the data warehouse. 2 additional patients did not have their age stored in the data warehouse. These patients were dropped from the final set, bringing the total to 4,649. A logistic regression model was then run to determine the odds of the second primary site being located outside the breast versus inside the breast in patient age-groups &amp;gt;40 years of age compared to those &amp;lt;40 years of age. A p-value cutoff of &amp;lt;0.05 was considered significant. The age distribution of this group included 119 patients &amp;lt;40 years of age, 40-49 (n=561), 50-59 (n=1070), 60-69 (n=1426), 70-79 (n=1038), and 80+ (n=435). Results: The odds of developing a second non-simultaneous cancer within 5 years of an initial early-stage breast cancer diagnosis relative to the &amp;lt;40 age group was .68 in the 50-59 age group, .60 in the 60-69 age group, .55 in the 70-79 age group and .59 in the 80+ age group (p-value &amp;lt;0.05). The odds of the 40-49-year age group relative to the &amp;lt;40-year age group was not statistically significant. In the group that did develop a second cancer diagnosis within 5 years, the odds of the tumor location being outside the breast versus inside the breast were 2.05 times greater for patients aged 50-59 years. A 60-69-year-old patient was 3.49 times likelier, a 70-79-year-old patient was 4.76 times likelier, and a patient 80 years or older was 5.05 times likelier to have a second cancer site outside of the breast relative to a patient who was &amp;lt;40 years of age (p-value&amp;lt;.05). The odds of the 40-49-year age group developing a cancer located outside the breast versus inside the breast relative to the &amp;lt;40-year age group was not statistically significant. Conclusions: The odds ratios in the second analysis suggest that the odds of developing a second cancer outside the breast, relative to within the breast, within five years of an initial early-stage breast cancer diagnosis, increase progressively with patient age. Further analyses are required to determine how this relationship differs with respect to the original breast cancer diagnosis receptor type, stage, and anti-neoplastic treatment modality. Citation Format: B. Zigler, V. Wang, V. Smith. Analyzing Age-Related Patterns of Second Primary Cancer Sites Following a Primary Breast Cancer Diagnosis [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS5-05-26.

Ewing sarcoma is an atypical and aggressive bone malignancy, most commonly observed in the pediatric population. Looking at epidemiological data shows that individuals of Caucasian descent are most susceptible to the disease, which additionally show a slight male predominance. We present the case of a 46-year-old male of South Asian descent who came into an outpatient clinic complaining of ongoing pain in the left posterior flank. The clinical picture initially raised suspicion for recurrent Nephrolithiasis because of the patient's previous medical history. The patient was advised to get a CT scan when imaging revealed a 7cm unidentified mass in the left retroperitoneum. The mass appeared to be developing under the sub aorta and was partially encasing it. Due to the conclusive findings, the patient proceeded to get sampling done by a pathologist. Pathologic examination identified small round blue cells, a key identifier and comparable biologic characteristics of Ewing's Sarcoma. This case emphasizes the diagnostic and clinical significance of encountering a destructive malignancy, specifically Extraskeletal Ewing's Sarcoma; such as anatomical site, patient age group, proximity to vital body structures, and ethnic group. Factors that challenge the traditional scope of Ewing's Sarcoma and the importance of widening diagnostic perspective.

The Barthel Index (BI) is a standard, widely used measure of dependence in activities of daily living (ADL), particularly in stroke care. The Longshi Scale (LS) offers a simpler, more user-friendly alternative; however, it lacks a validated, age-stratified mapping to BI scores. This gap limits consistent outcome interpretation and application. This study aims to establish and validate a standardized, age-stratified concordance between BI scores and LS grades, thereby providing a practical conversion tool for clinical and research settings. In a multi-center study of 16,412 stroke inpatients (3months post-stroke), BI scores and LS grades were analyzed across age groups: <60years (n = 12,662), 60-79years (n = 2,596), and ≥80years (n = 1,154). Sensitivity (correct identification) and specificity (correct exclusion), along with receiver operating characteristic (ROC) curves were used to determine optimal BI cutoff points for each LS grade. Spearman correlation and the Kruskal-Wallis test were applied across age groups. Key BI cutoffs were identified for LS grades: ≥75 for LS ≥ 2, ≥45 for LS ≥ 4, and <5 for LS = 6. These cutoff values were consistent across age groups. The BI scores were negatively correlated with LS disability level (e.g., r = -0.879 in patients aged ≥80years, p < 0.001). Correlations remained strongest at severe disability levels (LS grades 5-6) across age groups (r = -0.60 to -0.65). AUC analysis demonstrated excellent discriminative ability, particularly for the mildest (LS 1) and most severe (LS 6) disability levels (AUC >0.95). The study provides age-stratified BI cutoff values to guide resource allocation, emphasizing the need to prioritize care for individuals aged ≥80years with BI scores below 5.

Colorectal cancer is a malignancy that arises from the epithelial tissue of the large intestine. The large intestine is part of the digestive tract consisting of the colon, rectum, and anal canal. Colorectal cancer is the third most common type of cancer in the world. Its incidence in China is 23.7 per 100,000 people. In Indonesia, colorectal cancer currently ranks third as the most common cancer diagnosis. Research on the profile of colorectal cancer patients in North Kalimantan. This study aims to determine the profile of colorectal cancer patients at RSUD Jusuf SK. All patients at RSUD Jusuf SK diagnosed with colorectal cancer in the period 2023-2025 were the sample of this study. The results showed that the number of colorectal cancer patients from 2023-2025 was 55 patients. The largest age group of colorectal cancer patients was over 50 years old at 87.27%. The majority of the subjects in this study were male at 70.91%. The most common location for colorectal cancer is the rectum, at 67.27%. Stage II is the most common stage of colorectal cancer, at 56.36%. Adenocarcinoma is the most common histopathological type, at 92.7%.

As societies continue to age, brain tumors increasingly affect older patients. Still, large-scale evidence on whether the relationship between age and brain tumor has been evolving over time is scarce. We examined longitudinal trends among different age groups of patients with brain tumors at 78 German hospitals. Two time periods were compared as follows: phase 1 (1 January 2016-31 December 2019; pre-pandemic) and phase 2 (1 January 2020-31 December 2022; pandemic). Patients were categorized as non-elderly (<65 years) or elderly (≥65 years), and according to 10-year age brackets. The clinical condition was quantified using the Elixhauser Comorbidity Index (ECI) and the Hospital Frailty Risk Score (HFRS). Among the 20,005 patients included, changes in characteristics of non-elderly/elderly patients over time behaved similarly, with improvements in ECI (19.3 to 18.4/15.2 to 14.3; each p < 0.01) and HFRS (2.1 to 1.6/4.7 to 4.1; each p < 0.01), and increases in rates of brain tumor resection (26.1% to 31.8%/22.7% to 27.8%; each p < 0.01). Only patients aged 75-84 years did not follow any of those trends. Over the examined 7-year period, general trends in brain tumor care in elderly subjects resembled those observed in non-elderly patients, except for those aged 75-84 years.

Dynamic shifts in outpatient antibiotic prescribing for pediatric upper respiratory infections in South Korea, 2002-2019: A national cohort study.

BackgroundHow deformities associated with unilateral lesser-form cleft lip progress with age remains one of the most pressing concerns for patients and their families. This study aimed to preoperatively assess the characteristics and severity of labial and nasal deformities across different age groups of patients with unilateral lesser-form cleft lip.MethodsWe conducted a retrospective analysis of patients with unilateral lesser-form cleft lip who received treatment at a single center between 2018 and 2023. The severity of labial and nasal deformities was evaluated through photogrammetric measurements of linear and angular parameters. Differences in deformity severity across age groups were assessed using one-way ANOVA with post-hoc testing. The correlations between ages and the severity of deformities were analysed using Spearman correlation analysis.ResultsA total of 194 patients aged 2 months to 33 years (mean age: 9.11 ± 8.81) were included. Significant differences were observed in index A (lateral lip height), K (nasal width), L (alar width), M (alar convexity), and N (subalar width) in the one-way ANOVA test. For the subsequent post-hoc tests, non-significant differences in index A, while significant differences in index K, L, M, and N were observed between specific age groups. Notably, no differences were observed between the pairwise comparisons of age groups that were older than 9–12 years. Positive correlations were observed between ages and index K, L, and N while negative correlation was observed between ages and index M. (rK = 0.645, rL = 0.308, rM =−0.363, and rN = 0.427 with all p value < 0.000).ConclusionsWithout surgical intervention, labial deformities showed no statistically significant differences across age groups. In contrast, the severity and asymmetry of nasal deformities progressed rapidly in patients younger than 9–12 years. Age was significantly correlated with the severity of nasal deformities—including nasal width, alar width, alar convexity, and subalar width. Timely surgical intervention is therefore recommended for patients with unilateral lesser-form cleft lip, particularly those presenting with nasal deformities, to prevent further progression.Trial registrationNot applicable since this study did not involve clinical intervention.

SLE is associated with increased cardiovascular morbidity and mortality. Although arterial stiffness (ArS) is a well-recognized surrogate marker of cardiovascular risk in the general population, its role in SLE is uncertain. We examined the prevalence of ArS in SLE vs healthy controls (HCs), potential ArS predictors and associations with subclinical atherosclerosis. ArS was assessed in 194 SLE patients and 194 age/sex/mean arterial pressure (MAP)-matched HCs using the carotid-femoral pulse wave velocity (cfPWV) and augmentation index at 75 beats/min (AΙx@75). Atherosclerotic plaque presence was evaluated in all participants using carotid/femoral ultrasonography. ArS was examined in different age (18-37, 38-57, 58-75 years) and cardiovascular risk (low-moderate/high-very high) groups, classified by Systematic Coronary Risk Evaluation (SCORE) and plaque presence. Linear regression models identified ArS predictors, including traditional and disease-related cardiovascular risk factors (CVRFs). SLE patients had increased AΙx@75 (β = 3.458, P=0.014) vs HCs, but not cfPWV (P = 0.578). Patients aged 18-37 had higher cfPWV (P = 0.028) and AIx@75 (P < 0.001) than HCs. Low-moderate risk patients had higher AΙx@75 than HCs (P = 0.029), and after reclassification by plaque presence (P = 0.009). Both cfPWV (P = 0.042) and AΙx@75 (P = 0.0141) were independently associated with atherosclerotic plaques. In SLE, cfPWV and AIx@75 were associated with age (P < 0.001 for both), MAP (P < 0.001 for both) and sum of modifiable CVRFs (hypertension, dyslipidaemia, smoking, exercise, body weight) (P = 0.013 and P = 0.006, respectively). cfPWV was also associated with SCORE (P < 0.001). Increased ArS in SLE and associations with subclinical atherosclerosis highlights its importance in cardiovascular risk stratification, particularly in young low/moderate-risk adults.

SUMMARY. The relevance of the study lies in the need for scientific substantiation of the effectiveness of the state reimbursement program for medical devices intended for self-monitoring of blood glucose levels under the conditions of healthcare system reform in Ukraine. The program aims to improve accessibility, quality of life, and pharmaceutical care for patients with type 1 diabetes mellitus. The aim – to examine the commodity characteristics of test strips for self-monitoring of blood glucose levels and to analyze their economic accessibility within the framework of the “Available Medicines” state reimbursement program. Material and Methods. The research object comprised medical devices included in the reimbursement lists of the National Health Service of Ukraine for the period from August 2023 to March 2025. A comparative commodity analysis, content analysis of regulatory legal acts of the Ministry of Health of Ukraine, and a retrospective analysis of data from NHSU analytical dashboards were conducted. Statistical and analytical methods, along with graphical data interpretation, were applied to summarize the research findings. Results. It has been established that test strips for blood glucose determination are single-use medical devices that are sensitive to external factors, thus requiring specific storage conditions (temperature 4–30 °C, relative humidity ≤65%). The packaging serves both protective and informational functions: the primary packaging is a hermetically sealed tube containing a desiccant; the secondary packaging consists of a cardboard box with labeling and instructions; and the transport packaging is a corrugated container. A retrospective analysis revealed an expansion in the range of medical devices subject to reimbursement – from 23 items in 2023 to 43 in 2024, along with an increase in the proportion of fully reimbursed products. According to the National Health Service of Ukraine (NHSU), there has been a growth in the number of redeemed e-prescriptions in 2025, indicating improved physical and financial accessibility of medical devices for patients with type 1 diabetes mellitus. Conclusions. The conducted study confirmed that the expansion of the reimbursement program enhances the accessibility of test strips for blood glucose self-monitoring, contributes to improving patients’ quality of life, supports the prevention of complications, and promotes the rationalization of healthcare system expenditures. It is considered advisable to further improve the assortment policy and state reimbursement mechanisms, taking into account the needs of different age groups of patients.

Most contemporary clinical trials of mechanical thrombectomy (MT) have often excluded patients over the age of 80 years. Thus, evidence regarding efficacy of endovascular treatment in the octogenarians is still scanty. The present study assesses the efficacy of MT in octogenarians. Between January 2015 to December 2020, clinical records of 27 patients (age ≥80 years), who underwent MT for stroke were queried from our database. Out of total 229 patients, who underwent mechanical thrombectomy during the study period, 29 patients were of age ≥80 years, with a baseline disability (mRS score 0-3). We excluded two patients, who showed recanalization following iv-tPA. Recanalization through MT was achieved in 25 (93%) patients, without any event of symptomatic intracranial hemorrhage. Three had mortality and three patients required a decompressive craniectomy. Eighteen (66%) patients received intravenous thrombolysis prior to MT and nine underwent direct MT. Out of the latter group, three presented beyond the window period for thrombolysis, five were on anticoagulants, and one was in immediate post-surgical period. Baseline National Institutes of Health Stroke Scale (NIHSS) was 17 (range 8-22) and ASPECT score was six (range 3-9). Mean post-procedure NIHSS was three (range 1-10). 90-day mRS of 0-2 was achieved in 21/27 (78%) patients. Contrary to the prevalent apprehensions of poor outcomes in elderly stroke patients treated with MT, our study showed favorable radiological and clinical results. Accordingly, more optimistic pre-procedural counselling before MT is probably advisable even in this age group of patients.

Purpose:To assess the spectrum of bacterial flora from preoperative conjunctival swabs and analyze their antimicrobial susceptibility patterns.Design:This is a retrospective observational clinical study.Methods:This retrospective, observational study analyzed conjunctival swab cultures collected 24–48 hours prior to elective ophthalmic surgeries at a tertiary eye care center in North India from January 2015 to December 2022. Aerobic bacterial cultures were performed using standard microbiological techniques. Isolates were identified and tested for antibiotic susceptibility using the Kirby–Bauer disk diffusion method following CLSI guidelines. Data were stratified by patient age groups and analyzed using descriptive statistics and Chi-square testing.Results:Of the 8671 conjunctival swabs analyzed, 1287 (14.8%) showed significant bacterial growth. The most prevalent isolates were Coagulase-negative Staphylococci (CoNS, 53.3%), Corynebacterium species (32.9%), and Staphylococcus aureus (10.7%). Methicillin resistance was observed in 40% of Staphylococcal isolates, with significant coresistance to fluoroquinolones, macrolides, and tetracyclines. No Vancomycin resistance was observed. Gram-negative bacteria, though infrequent (1.7%), were predominantly isolated from adult and elderly patients. Resistance trends showed a rising pattern over the 8-year period, particularly against fluoroquinolones and cefoxitin. Agewise, bacterial positivity was similar across pediatric (12.0%), adult (15.1%), and elderly (15.1%) groups (P = 0.1462).Conclusion:This large-scale study highlights the predominance of CoNS and Corynebacterium in the conjunctival flora and the rising resistance among Staphylococcal isolates, particularly to fluoroquinolones. These findings underscore the importance of region-specific surveillance and antimicrobial stewardship in guiding perioperative prophylaxis in ophthalmology. Vancomycin and aminoglycosides remain effective options, while empirical use of fluoroquinolones warrants cautious re-evaluation.

This study systematically analyzed the current approaches to analgesic therapy in dental practice based on scientific publications of the last decade. This study examined the main groups of analgesic medications used in dentistry, including nonsteroidal anti-inflammatory drugs, opioid analgesics, local anesthetics, and their combinations. Particular attention is paid to the mechanisms of action of various classes of medications, their efficacy, and safety profiles when used in various patient categories. The current trends in multimodal analgesia and personalized pain relief approaches tailored to individual patient characteristics, age groups, and comorbidities are analyzed. Innovative drug delivery technologies, including nanosomal formulations, extended-release systems, and transdermal systems, are considered. Data on the use of artificial intelligence and digital technologies to optimize analgesic therapy are presented. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, and 42 sources selected from 1,247 initially identified publications in international databases were analyzed. The results of this study demonstrate the evolution of approaches to dental pain relief from universal protocols to personalized medicine. This study demonstrated the importance of combining different analgesic groups to achieve an optimal balance of efficacy and safety. Promising areas for developing analgesic therapy related to the integration of advances in molecular biology, nanotechnology, and digital technologies into dental clinical practice are identified.

Colonoscopy plays a key role in colorectal cancer (CRC) screening. It is effective in reducing morbidity and mortality from CRC. To optimize quality of colonoscopy, performance measures (PM) have been identified and published by major international societies. While adenoma detection rate (ADR) is an imperative quality measure, the sessile serrated lesion detection rate (SSLDR) is not currently a quality indicator for screening colonoscopy. Objective — to determine the trend of polyp detection rate (PDR), ADR, and SSLDR in participants in different age groups. Materials and methods. We performed a retrospective observational study of patients who underwent colonoscopy at Olymed, Kyiv, Ukraine from April 2021 through December 2023. We calculated the polyp detection rate (PDR), ADR, and SSLDR for all colonoscopies performed during the specified period, taking into account the exclusion criteria (non-total colonoscopy (not reaching the blind bowel or &lt; 6 on the Boston Bowel Preparation Scale (BBPS), CRC or inflammatory bowel disease). Patients were stratified into 10 main and 2 additional age groups. Particular attention is paid to the analysis of the prevalence of serrated lesions on a broad basis among young people, which is important for understanding the potential role of these lesions in the pathogenesis of colorectal cancer. Statistical analysis was performed using Stata 17 (StataCorp LLC, USA). Comparisons between independent groups were conducted using Pearson’s chi-squared test. Differences were considered statistically significant at p &lt; 0.05. Results. The initial sample included 2676 patients, with 2402 examinations analyzed after applying exclusion criteria. The largest age group was 50 — 54 years (13.9%, n=335). Two key subgroups were analyzed: 45 — 49 years (n=323) and ≥ 50 years (n=1216). There was a clear trend of increasing PDR and ADR with age. The highest ADR was observed in patients aged ≥ 75 years (88.2%). SSLDR showed a nonlinear pattern, peaking at 31.3% in the 60 — 64 age group. Compared to the ≥ 50 group, patients aged 45 — 49 had significantly lower ADR (44.9% vs. 66.8%; p &lt; 0.001) and PDR (66.8% vs. 80.9%; p &lt; 0.001), while SSLDR was similar (26.7% vs. 26.6%; p=0.893), indicating notable SSL prevalence among younger individuals. Conclusions. The findings highlight the importance of recognizing SSLs as potential CRC risk markers, especially in younger adults. Further research is necessary to establish optimal SSLDR benchmarks and appropriate detection targets for endoscopists.

BACKGROUND: Pectus excavatum is the most common congenital chest wall deformity. To date, there is no consensus on whether this deformity interferes with normal lung growth. AIM: This study work aimed to evaluate the effect of age at clinical onset of pectus excavatum on pulmonary function. METHODS: A comparative analysis of pulmonary function was performed in 38 patients with pectus excavatum before thoracoplasty according to the Nuss procedure and before removal of the chest wall fixation bar. The inclusion criteria were congenital chest wall deformity, a Haller index greater than 3.25, a compression index less than 0.89, and age 9–15 years at the time of the Nuss procedure. The non-inclusion criteria were scoliosis greater than grade III, congenital heart defects, recurrence of chest wall deformity, verified genetic or systemic diseases, and refusal of the patient or legal representative to participate in the study. The patients were divided into two groups. Group 1 included all patients with pectus excavatum aged 9–11 years who underwent evaluation and surgery during the study. Group 2 included a stratified sample of 19 patients with the same deformity aged 12–15 years. RESULTS: Before thoracoplasty, group 2 demonstrated lower vital capacity than group 1 (p = 0.037). The ratio of forced expiratory volume in 1 second to forced vital capacity was also lower in group 2 (p = 0.079), as was the mean forced expiratory flow between 25% and 75% of forced vital capacity (p = 0.027). No significant differences in pulmonary function parameters were identified between the two groups before removal of the chest wall fixation bar. Significant differences in pulmonary function parameters were also observed between measurements obtained before thoracoplasty and before chest wall fixation bar removal in both groups. CONCLUSION: The identified statistically significant differences in pulmonary function parameters between age groups of patients with pectus excavatum before thoracoplasty suggest age-related deterioration of lung function in the absence of surgery. However, long-term prospective studies in patients from childhood through adolescence are required to confirm this assumption.

In recent years, the development of malignant neoplasms has been increasingly regarded not only as a consequence of genetic damage but also as the result of persistent disturbances of innate immunity, chronic inflammation, and cellular ageing. A unified pathogenetic mechanism — inflammation–ageing–carcinogenesis — has been proposed, which is formed under the influence of diverse endogenous and exogenous factors and determines the transition from normal tissue homeostasis to tumour transformation. Chronic low-grade inflammation represents a universal inducer of organismal ageing and contributes to carcinogenesis. Both ageing and carcinogenesis develop under conditions of oxidative stress, mitochondrial malfunction, replicative exhaustion, and oncogene activation. Key triggers include tissue microenvironment remodelling during the development of post-COVID syndrome (PCS) symptoms, viral persistence and dysbiotic shifts, activation of Toll-like receptors (TLRs), formation of the NLRP3 inflammasome, which enhances synthesis of complement component C3, maturation of IL-1β, production of TNF-α, generation of damage-associated molecular patterns (DAMPs) under oxidative stress, an increase in CD22⁺ memory cells, a reduction in proliferative capacity in vitro, and an increase in exhausted natural killer (NK) CD16⁺ cells. Together, these processes sustain the inflammatory cascade, mitochondrial damage, and the formation of a specific spectrum of autoantibodies across different age groups of patients with varying stages and degrees of dissemination of gastric adenocarcinoma.

Cryptorchidism, defined as the failure of the testes to descend into the scrotum, is a common condition in male children. The authors aimed to assess the testicular volume in children of different ages with cryptorchidism and to investigate its potential effects on testicular development. This retrospective study was approved by the institutional ethics committee. The study included 480 patients with abnormal scrotal ultrasonography findings and 67 control cases between January 2024 and January 2025. Testicular volume was calculated. Measurements were conducted by a pediatric radiologist with at least 10 years of experience. The mean age of the enrolled male children was 21 months. A significant difference was observed between right testicular volumes (0.24 Å} 0.1) and left testicular volumes (0.27 Å} 0.13) in patients with right cryptorchidism (t = -4.568; P < .001). Similarly, there was a significant difference between right testicular volumes (0.26 Å} 0.12) and left testicular volumes (0.23 Å} 0.09) in patients with left-sided cryptorchidism (t = 4.661; P < .001). There were statistically significant differences in testicular volumes according to age groups in patients with cryptorchidism, hydrocele, and descended testis (F = 3.216; P = .013, F = 3.428; P = .013, F = 26.135; P < .001, respectively). Testicular volumes in males under 3 years with cryptorchidism are significantly smaller than in healthy children. Cite this article as: Konukoğlu O, Kaya M, Cindemir E, Pirimoglu RB. Evaluation of testicular volume in children aged 6-36 months with cryptorchidism: a retrospective ultrasonographic study. Eurasian J Med. 2025, 57(4), 1097, doi: 10.5152/eurasianjmed.2025.251097.