A fusion-based deep-learning algorithm predicts PDAC metastasis based on primary tumour CT images: a multinational study.

Background: Diagnosing the presence of metastasis of pancreatic cancer is pivotal for patient management and treatment, with contrast-enhanced CT scans (CECT) as the cornerstone of diagnostic evaluation. However, this diagnostic modality requires a multifaceted approach.

Objective: To develop a convolutional neural network (CNN)-based model (PMPD, Pancreatic cancer Metastasis Prediction Deep-learning algorithm) to predict the presence of metastases based on CECT images of the primary tumour.

A predictive model of non-diabetic kidney disease in patients with diabetes mellitus and chronic kidney disease. A Spanish multi-center study.

Aims: Kidney biopsy is increasing in patients with diabetes and around 50-60% of patients with diabetes have non-diabetic kidney disease (NDKD). Identifying NDKD is crucial since these patients have a better renal prognosis and survival compared to patients with diabetic nephropathy (DN). The objective of this study is to provide a clinical practice tool for through a predictive model of NDKD.

Psychomotor Development in Infants Following Maternal Exposure to Biologics: Results From the DUMBO Registry.

Background & Aims: The impact of biologic treatment for inflammatory bowel disease (IBD) during pregnancy and lactation on infant psychomotor development is barely studied. We investigated the effect of exposure to biologics in utero or during breastfeeding on the psychomotor development of offspring during their first year.

Methods: The study included patients and infants from DUMBO, an ongoing prospective, observational registry of GETECCU enrolling pregnant women (aged ≥18 years) with IBD from 60 centers across Spain.

From indication to initiation of invasive intracranial pressure monitoring time differences between neurosurgeons and intensive care physicians: can intracranial hypertension dose be reduced? TIMING-ICP, a multicenter, observational, prospective study.

Background: The duration of episodes of intracranial hypertension is related to poor outcome, hence the need for prompt diagnosis. Numerous issues can lead to delays in the implementation of invasive intracranial pressure (ICP) monitoring, thereby increasing the dose of intracranial hypertension to which the patient is exposed. The aim of this prospective, observational, multicenter study was to assess the magnitude of this delay, evaluating the time required for initiation of invasive ICP monitoring, from indication (T1) to initiation of the maneuver (T2) when performed by neurosurgeons compared to intensive care physicians.

Baricitinib in rheumatoid arthritis-interstitial lung disease: national multicenter study of 72 patients and literature review.

Objective: To assess the effectiveness and safety of baricitinib (BARI) in Rheumatoid Arthritis-interstitial lung disease (RA-ILD) in clinical practice.

Methods: : National multicentre retrospective study of 72 RA-ILD patients treated with BARI. We analyzed the following outcomes at baseline and at 3, 6, 12, 18, 24 months, and last follow-up: a) dyspnea (modified Medical Research Council scale), b) forced vital capacity (FVC), c) diffusing capacity of the lungs for carbon monoxide (DLCO), d) chest high resolution computed tomography (HRCT), e) arthritis activity (DAS28-ESR), and f) corticosteroid-sparing effect.

Predictive value of liver enzymes in long-term prognosis of hepatic Wilson disease: results from the Wilson AEEH registry.

Background And Aims: Monitoring Wilson disease (WD) is challenging due to its variable presentation and the absence of reliable biomarkers. This study aims to assess the predictive value of liver enzymes, particularly transaminases, on long-term outcomes in patients with hepatic WD using data from the Spanish Wilson Registry.

Patients And Methods: We analysed data from 162 WD patients with hepatic involvement and over one year of follow-up.

Phase III Trial of Pirtobrutinib Versus Idelalisib/Rituximab or Bendamustine/Rituximab in Covalent Bruton Tyrosine Kinase Inhibitor-Pretreated Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (BRUIN CLL-321).

Purpose: Pirtobrutinib, a noncovalent, Bruton tyrosine kinase inhibitor (BTKi), has shown clinical efficacy and a favorable safety profile. BRUIN CLL-321 was an open-label, randomized phase III study conducted exclusively in patients with R/R chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) previously treated with cBTKi, and compared pirtobrutinib with investigator's choice (IC) of idelalisib/rituximab (IdelaR) or bendamustine/rituximab (BR).

Methods: Patients were randomly assigned 1:1 to receive pirtobrutinib (200 mg once daily) or IC of IdelaR or BR, and were stratified by previous use of venetoclax and del(17p).

Suprazygomatic Maxillary Nerve Block for Postoperative Pain Management in Cleft Lip and Palate Surgery.

Introduction: Cleft lip and palate are among the most common congenital defects and their surgical correction is associated with significant postoperative pain, the use of high-dose opioids, and prolonged hospital stay.

Objective: To evaluate the efficacy of suprazygomatic maxillary nerve block for postoperative pain management after cleft lip and palate surgery. The primary objective was to evaluate postoperative pain.

Stress Echo 2030 Study: A Flagship Project of the Italian Society of Echocardiography and Cardiovascular Imaging.

Over the past decade, stress echocardiography has evolved from a test for assessing epicardial artery stenosis to a comprehensive functional test, targeting multiple cardiovascular parameters. The new approach includes several structured steps: (a) evaluating regional wall motion abnormalities to detect epicardial artery stenosis or vasospasm; (b) assessing pulmonary congestion and diastolic function via B-lines with lung ultrasound; (c) gauging preload and contractile reserve with volumetric echocardiography; (d) measuring coronary microvascular reserve using Doppler-based coronary flow velocity in the middistal left anterior descending artery; and (e) determining cardiac sympathetic reserve by tracking heart rate reserve on an ECG. This evolution was supported extensively by the Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI), which played a key role in five areas: (1) developing the initial, curiosity-driven project; (2) disseminating protocols and results at national and international conferences, supporting logistic infrastructure and publication expenses; (3) establishing a digital platform (customized Redcap) for data entry and storage; (4) facilitating patient recruitment across 19 Italian centers; and (5) offering formal endorsement through six presidencies, adding credibility and reach beyond any single institution.

Role of VATS-US in identifying and characterizing pulmonary nodules: a narrative review.

The aim of this study was to show the efficacy described in the scientific literature of lung ultrasound (LU) during video-assisted thoracic surgery (VATS) to determine the location and characterization of pulmonary nodules. The results showed that intraoperative LU is especially useful in localizing lung lesions by VATS with a sensitivity close to 100%. It was also shown to be useful in planning very precise lung resections, reducing the resection of healthy lung tissue.

Bronchopulmonary colonization patterns in Spanish people with cystic fibrosis: Results of a national multicentre study.

Background: We investigate bronchopulmonary colonization patterns in Spanish people with CF (pwCF), gathering clinical, demographic, and microbiological data to supplement nine years of registry information, comparing 2021 findings with a similar multicenter study conducted in 2013.

Methods: Sixteen CF units from 14 hospitals across Spain participated, each randomly recruiting around 20 patients. Patients provided sputum samples for culture.

Usefulness of vector velocity imaging in the descending thoracic aorta.

Objective: To evaluate the Speckle Tracking values in the descending thoracic aorta (DTA) of a healthy population.

Desing: This is an observational study.

Setting: Hospital Universitario de Jaén.

Effects of a Hypotension-Avoidance Versus a Hypertension-Avoidance Strategy on Neurocognitive Outcomes After Noncardiac Surgery.

Background: Perioperative hemodynamic abnormalities have been associated with neurocognitive outcomes after noncardiac surgery.

Objective: To compare the effects of perioperative hypotension-avoidance versus hypertension-avoidance strategies on delirium and 1-year cognitive decline after noncardiac surgery.

Design: Randomized controlled trial.

Combination of encorafenib and binimetinib followed by ipilimumab and nivolumab versus ipilimumab and nivolumab in patients with advanced melanoma with BRAF or BRAF mutations (EBIN): an international, open-label, randomised, controlled, phase 2 study.

Background: Current first-line treatment for patients with metastatic melanoma with BRAF or BRAF mutations includes immunotherapy with immune checkpoint inhibitors and targeted therapy; however, the optimal sequencing of these treatments is unclear. We aimed to investigate the use of a targeted-therapy induction regimen before treatment with immune checkpoint inhibitors.

Methods: This open-label, randomised, controlled, phase 2 trial (EBIN) was conducted at 37 centres in eight European countries.

Beyond maximum grade: tolerability of immunotherapies, cellular therapies, and targeted agents in haematological malignancies.

The increasing use of immunotherapeutic approaches, cellular therapies, and targeted agents is rapidly and profoundly changing the treatment paradigms of haematological malignancies. These novel therapies are increasingly incorporated into earlier lines of treatment. Some are administered for a fixed duration, often with curative intent, whereas others are administered chronically for disease control.

Prevalence of chronic wounds in hospitalised patients in Catalonia, Spain: a multicentre cross-sectional descriptive observational study.

Background: Few studies have investigated the prevalence of chronic wounds and the clinical and sociodemographic characteristics of hospitalised patients affected by them. Understanding these characteristics within the inpatient setting can support improved follow-up, inform care strategies, enhance quality and safety and reduce associated healthcare costs. This study aimed to determine the prevalence and the sociodemographic profile of adult inpatients with chronic wounds admitted to the eight hospitals of the Catalan Institute of Health between 2016 and 2020.

A probabilistic model of bilateral lymphatic spread in head and neck cancer.

Current guidelines for elective nodal irradiation in oropharyngeal squamous cell carcinoma (OPSCC) recommend including large portions of the contralateral lymphatic system in the clinical target volume (CTV-N), even for lateralized tumors with no clinical lymph node involvement in the contralateral neck. This study introduces a probabilistic model of bilateral lymphatic tumor progression in OPSCC to estimate personalized risks of occult disease in specific lymph node levels (LNLs) based on clinical lymph node involvement, T-stage, and tumor lateralization. Building on a previously developed hidden Markov model for ipsilateral lymphatic spread, we extend the approach to contralateral neck involvement.

Treatment administration during a seizure in home-settings: Time to treat (TT).

Background And Objective: Early intervention on prolonged and cluster seizures can avoid serious consequences such as irreversible neuronal damage, late onset epileptogenesis, sudden unexpected death, and premature death, among others. In addition, it can prevent progression to status epilepticus, which has a mortality rate of 20%. However, prehospital diagnosis and treatment of seizures is often delayed, as patients receive treatment 30minutes past seizure onset even though most seizures last less than 2minutes.

Functioning Assessment Short Test (FAST): validity and reliability in adolescent and young adults with Borderline Personality Disorder (BPD).

Background: Borderline Personality Disorder (BPD) significantly impacts individuals, causing substantial distress and impairing social, occupational, and other critical areas of functioning. Current tools to assess functioning in BPD are limited and often lack validation in BPD-specific populations. Furthermore, available instruments focus primarily on global functioning rather than specific areas such as cognitive functioning or interpersonal relationships.

Endovascular Therapy for Late-Window M2-Segment Middle Cerebral Artery Occlusion: Analysis of the CLEAR Study.

Background: There is uncertainty about whether patients with M2 occlusion benefit from endovascular therapy (EVT) in the late (6-24-hour) time window. We evaluated the clinical outcomes of patients with M2 occlusion selected for EVT compared with those who received medical management (MM) in the late window.

Methods: This multinational cohort study was conducted at 66 sites across 10 countries (January 2014 to May 2022).

Expanding the clinical phenotype and understanding the biochemical consequences of Muscle Glycogen Synthase Deficiency (GSD0B).

Aims: Glycogen storage disease type 0b (GSD 0b) is an exceptionally rare metabolic disorder caused by biallelic pathogenic variants in the GYS1 gene, leading to deficient glycogen synthase (GS) activity. In 2022, two cases were reported for the first time with a phenotype presenting as adult-onset myopathy.

Methods: A 56-year-old woman with a history of progressive limb-girdle and axial weakness was evaluated.

Neuroplasticity and Rhinoplasty: Bridging Neuroscience and Aesthetic Surgery.

Neuroplasticity, the brain's ability to reorganize its structure and function, plays a pivotal role in adapting to anatomical changes introduced by surgical interventions such as rhinoplasty. This review explores the interplay between functional and aesthetic outcomes of rhinoplasty and their implications on cognitive and emotional processes. Key findings highlight the involvement of specialized neural circuits, including the fusiform face area, somatosensory cortex, and mirror neuron systems, in adapting to altered facial features.