Carbon footprint assessment and sensitivity analysis of diagnostic colonoscopy.

Objectives: We aimed to perform a multifactorial carbon footprint assessment and sensitivity analysis of the colonoscopy procedure.

Design: One-week single-center prospective study with all outpatients' diagnostic colonoscopies was realized (n=66). A cradle-to-grave life cycle assessment (LCA) methodology evaluated all essential supplies (accessories from 1 to 15), endoscopic procedure (energy consumption, CO2 insufflation, bowel preparation, and sedation), staff and patients transport and waste management.

Evaluating the evidence for sensor-based technologies and medical devices in fall prevention among hospitalized older adults: A systematic review.

Introduction: Falls among hospitalized older adults increase morbidity, prolong hospital stays, and raise healthcare costs. Sensor-based technologies and medical devices are emerging tools for fall prevention, but their clinical effectiveness remains uncertain. This systematic review aimed to assess their effectiveness in reducing inpatient falls, staff workload, and physical restraint use in hospitalized older adults.

The influence of obesity on the outcomes of endoscopic spinal surgery: a meta-analysis.

Obesity is an escalating health problem that has been increasingly associated with surgical complications. In general, open surgical techniques worsen these complications, because they are more tissue-destructive and associated with a relatively long recovery period. Minimally invasive techniques, such as endoscopic spine surgery, appear to be good substitutes, because they reduce tissue iatrogenic injury and hasten recovery.

Exploring early traumatic experiences as differential diagnostic factors between bipolar disorder and borderline personality disorder.

Background: Differential diagnosis between bipolar disorder (BD) and borderline personality disorder (BPD) presents significant challenges. Early traumatic experiences (ETE) are known to be associated with the development and prognosis of mental disorders in adulthood. This study aimed to characterize ETE that could serve as differentiating factors between BD and personality disorders as BPD.

"EX-VIVO RABBIT": A NOVEL HIGH-FIDELITY TRAINING MODEL FOR MICROSURGICAL AND SUPERMICROSURGICAL TRAINING.

Introduction The development of appropriate microsurgical and supermicrosurgical skills is essential for the reconstructive surgeon. Training courses frequently employ in-vivo models, which have various drawbacks: limited availability, high cost and/or ethical conflicts1. In order to overcome these limitations, we looked for an inert model that was analogous to the gold-standard in-vivo, surpassing at the same time the classic ex-vivo models.

Prognostic significance of molecular classification in high-risk endometrial cancer patients undergoing sentinel lymph node mapping.

Introduction: The adoption of selective sentinel lymph node biopsy (SLNB) as a viable alternative to lymphadenectomy, along with the redefinition of nodal risk groups based on molecular classification, has significantly changed the management of early-stage, high-risk preoperative endometrial cancer.

Materials And Methods: A retrospective, multicenter study was conducted under the auspices of the Spanish Gynecologic Oncology Group to evaluate recurrence rates and oncologic outcomes in patients stratified by molecular risk. Three groups were compared: SLNB alone (G1), SLNB combined with pelvic and/or para-aortic lymphadenectomy (G2), and pelvic and/or para-aortic lymphadenectomy without SLNB (G3).

Indocyanine green fluorescence angiography for bowel anastomosis assessment in ovarian cancer surgery.

Optimizing bowel anastomotic integrity is a key consideration in ovarian cancer cytoreductive surgery, as anastomotic complications can significantly impact postoperative recovery and delay systemic treatment. Conventional assessment techniques like visual inspection and palpation are inherently subjective and may not consistently predict the likelihood of anastomotic leakage. Due to the serious consequences of anastomotic failure and the impact of diverting ostomies, there is growing interest in fluorescence-based technologies to enhance the diagnostic accuracy of anastomoses and support more informed intraoperative decision-making.

Advancing deep learning-based segmentation for multiple lung cancer lesions in real-world multicenter CT scans.

Background: Accurate segmentation of lung cancer lesions in computed tomography (CT) is essential for precise diagnosis, personalized therapy planning, and treatment response assessment. While automatic segmentation of the primary lung lesion has been widely studied, the ability to segment multiple lesions per patient remains underexplored. In this study, we address this gap by introducing a novel, automated approach for multi-instance segmentation of lung cancer lesions, leveraging a heterogeneous cohort with real-world multicenter data.

Second Case of Type 9 Non-Photosensitive Trichothiodystrophy Caused by Homozygous Variant in the MARS1 Gene.

Trichothiodystrophy exhibits a broad clinical spectrum, and cases with an uncommon phenotype can go unnoticed, complicating the diagnosis. We present the second case of type 9 non-photosensitive trichothiodystrophy caused by a homozygous variant in the MARS1 gene. It presented with atypical features, including long hair, normal hair density of eyebrows and eyelashes, and precocious puberty.

Digital pathology and lipid droplet size as a key determinant of discrepancies between histology and MRI gradings in steatotic liver disease.

Background: Hepatic steatosis grades derived from magnetic resonance imaging proton density fat fraction (MRI-PDFF) might disagree with those determined by histology. We investigated whether the size distribution of lipid droplets (LDs) assessed with digital image analysis (DIA) explains the discrepancies between histology and MRI-PDFF.

Materials And Methods: Multicentric, prospective study of 355 patients with chronic liver disease, having paired biopsy and MRI.

Surgery for rectal cancer beyond the mesorectum: Indications, preparation, limits, and results.

Pelvic exenteration (PE) is a potentially curative surgical option for patients with locally advanced rectal cancer (LARC) orlocallyrecurrent rectal cancer (LRRC) involvingmultivisceralstructures. Originally conceived as a palliative procedure, advancements in surgical techniques and multidisciplinary management have broadened its indications, enabling R0 resections in over 60% of cases. Appropriate patient selection, based on advanced imaging and comprehensive functional assessment, is essential to optimize oncologic outcomes.

Clinical, Genetic, Morphological and Functional Correlations in a Large Series of Patients with Primary Ciliary Dyskinesia: A Heterogeneous Disease with a Controversial Diagnosis.

Background And Objective: Primary ciliary dyskinesia (PCD) is a rare genetic condition characterised by abnormal ciliary motility, primarily affecting the respiratory tract. Despite its clinical significance, there is currently no gold standard for PCD diagnosis. This study aims to address this diagnostic challenge by evaluating a comprehensive approach in a large cohort of patients with suspected PCD.

Is parvovirus B19 infection upsurge in 2023-2024 associated with adverse pregnancy outcome?

Objective: A surge in parvovirus B19 infections has been reported in 2023-2024 across Europe and the USA, raising concerns about the associated perinatal risks. The aim of this study was to compare perinatal outcomes following maternal parvovirus B19 infection during the 2023-2024 period with those from a pre-2023 cohort.

Methods: This multicenter, retrospective cohort study compared perinatal outcomes in women with maternal parvovirus B19 infection according to whether infection occurred pre-2023 (2012-2022) or between 2023 and 2024.

Risk assessment of spinal surgery in chronic kidney disease and dialysis patients: a systematic review and meta-analysis of over 5 million cases.

The purpose of this study was to conduct a systematic review and meta-analysis of the outcomes of spinal surgery in patients with chronic kidney disease (CKD), including those undergoing dialysis. A comprehensive literature search was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Statistical analyses were performed using Review Manager software, utilizing mean differences (MD), odds ratios (OR), and random effects models to account for heterogeneity.

Clinical and Histopathological Investigation of Stromal Vascular Fraction and Nanofat in Vulvar Lichen Sclerosus.

Background: Vulvar lichen sclerosus (VLS) is a chronic inflammatory dermatosis that impairs quality of life through symptoms like itching, pain, and atrophy, and has limited response to conventional corticosteroid therapy.

Objectives: To evaluate the safety and efficacy of the Lichen-SVF protocol, a regenerative treatment combining nanofat and mechanically isolated stromal vascular fraction (SVF) for moderate to severe VLS.

Methods: This prospective, open-label study included 18 women with moderate-to-severe VLS and participants ranged from 24 to 81 years old, reflecting the broad clinical spectrum of this condition.

Aortic coarctation and long-term morbidity after arterial switch operation: a multicentre international cohort study.

Background: In patients with dextro-transposition of the great arteries, cardiovascular interventions and complications are common after the arterial switch operation (ASO). While complex anatomy-typically defined by ventricular septal defects (VSDs)-is often linked to these outcomes, the independent role of aortic coarctation (CoA) remains unclear.

Methods: We analysed 502 adults from the EPOCH (European collaboration for Prospective Outcome research in Congenital Heart disease)-ASO multicentre registry (median age 25.

Management of urinary stones by experts in stone disease (ESD 2025).

The formation of kidney stones is a complex biologic process involving interactions among genetic, anatomic, dietary, and environmental factors. Traditional lithogenic models were based on urine supersaturation in relation to the activity of crystallization promoters and inhibitors. However, modern research has added new principles such as the "renal epithelial cell response" and the role of inflammation and oxidative stress leading to the development of a "multi-hit hypothesis".

Esophageal and Oropharyngeal Dysphagia: Clinical Recommendations From the United European Gastroenterology and European Society for Neurogastroenterology and Motility.

Dysphagia is a prevalent symptom of the upper gastrointestinal tract causing health related consequences, impacting quality of life and is associated with global economic burden. Swallowing difficulties are classified into oropharyngeal dysphagia (OD) and esophageal dysphagia. Despite its clinical importance, dysphagia is associated with several uncertainties regarding its optimal diagnostic work-up and management, particularly, considering the progress with diagnostic modalities and technologies.

Complications and Functional Outcomes of Total Hip Arthroplasty After Pelvic Radiation: A Systematic Review and Meta-Analysis.

Background: Total hip arthroplasty (THA) outcomes in patients who have prior pelvic irradiation require careful evaluation due to the growing cancer survivor population and increased radiotherapy use. Radiation's adverse effects on bone may compromise prosthesis integration.

Methods: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted across multiple databases examining THA complications in postpelvic radiation patients.