Aortic hemorrhage following anastomotic leakage after esophagogastric surgery before and after implementation of endoscopic vacuum therapy.

Background: Endoscopic vacuum therapy (EVT) has been established as a safe and effective treatment for anastomotic leakage. While rare, major aortic hemorrhage has been reported as a severe complication potentially associated with EVT. However, significant hemorrhages have also been observed in patients with transmural defects in the upper gastrointestinal tract, without the use of EVT.

Vulvar and vaginal cancer during pregnancy: A pooled analysis of 15 cases from the International Network on Cancer, Infertility and Pregnancy and review of the literature.

Introduction: Vulvovaginal cancer in pregnancy is rare. Limited data complicate decision-making and patient counseling. Our review, coupled with new case data, fills a current gap in the literature and provides practical insights.

A myotropic AAV vector combined with skeletal muscle -regulatory elements improve glycogen clearance in mouse models of Pompe disease.

Pompe disease is a glycogen storage disorder caused by mutations in the acid α-glucosidase (GAA) gene, leading to reduced GAA activity and glycogen accumulation in heart and skeletal muscles. Enzyme replacement therapy with recombinant GAA, the standard of care for Pompe disease, is limited by poor skeletal muscle distribution and immune responses after repeated administrations. The expression of GAA in muscle with adeno-associated virus (AAV) vectors has shown limitations, mainly the low targeting efficiency and immune responses to the transgene.

Hypertension care: the knowledge and attitudes of the community pharmacists.

Background: Hypertension is a major global risk factor for cardiovascular disease and mortality. In Greece, prevalence is about 40%, with many cases undiagnosed or poorly managed. While doctors remain central to diagnosis and treatment, community pharmacists, as accessible healthcare professionals, can support early detection and ongoing management.

Rapid Atrial Pacing After TAVI for Pacemaker Prediction.

Despite continued advancements in transcatheter aortic valve implantation (TAVI) techniques, the incidence of permanent pacemaker implantation (PPI) remains substantial. Established predictors of PPI include advanced age, pre-existing electrocardiographic conduction abnormalities, prosthetic valve type, implantation depth, and anatomical parameters, such as membranous septum length, which are currently under active investigation. In routine clinical practice, the management strategy often involves the temporary placement of a transvenous pacemaker lead, followed by a period of observation.

[Pain education for patients with chronic facial pain].

In dental practice, it regularly happens: a patient presents with a prolonged pain complaint where there appears to be no sign of tissue damage (any longer). Patients with chronic facial pain may be experiencing altered nociception. This is associated with processes of sensitization and impaired signal inhibition in the somatosensory system.

Extreme MetaboHealth scores in three cohort studies associate with plasma protein markers for inflammation and cholesterol transport.

The MetaboHealth score is an indicator of physiological frailty in middle aged and older individuals. The aim of the current study was to explore which molecular pathways co-vary with the MetaboHealth score. Using a Luminex cytokine assay and liquid chromatography-mass spectrometry-based proteomics we explored the plasma proteins associating with the difference in 100 extreme scoring individuals selected from two large population cohorts, the Leiden Longevity Study (LLS) and the Rotterdam Study (RS), and discordant monozygotic twin pairs from the Netherlands Twin Register (NTR).

A clinical and genotype-phenotype analysis of MACF1 variants.

Microtubule-actin cross-linking factor 1 (MACF1) is a large protein of the spectraplakin family, which is essential for brain development. MACF1 interacts with microtubules through the growth arrest-specific 2 (Gas2)-related (GAR) domain. Heterozygous MACF1 missense variants affecting the zinc-binding residues in this domain result in a distinctive cortical and brain stem malformation.

Impact of a nurse-led and a web-based psychoeducational program for advanced cancer patients and their caregivers: Results of a three-arm randomized controlled trial.

Background: Advanced cancer impacts the lives of both patients and their family caregivers. They often experience substantial declines in quality of life and physical, emotional, and spiritual distress that generate significant unmet psychosocial care needs. These effects are interrelated.

The association between the MIND-NL diet, Dutch dietary guidelines, and global cognitive function in an older population at risk for cognitive decline.

Objectives: This study examined the association between adherence to the Dutch MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay, MIND-NL) and the Dutch dietary guidelines (DHD2015-index) with global cognitive function in older adults at risk of cognitive decline.

Design And Setting: A cross-sectional study was conducted using baseline data of the FINGER-NL trial.

Participants: A total of 1,135 older adults, aged 60-80 years, at risk for cognitive decline with complete dietary data and complete neuropsychological tests were included in the analyses.

Sex differences in allostatic load profiles and incident dementia: The AGES-Reykjavik Study.

BackgroundAllostatic load (AL), an umbrella term for the physiological response to chronic stress, is different in women and men. AL has also been associated with all-cause dementia.ObjectiveThe current study investigates if AL clusters differently in men and women, and if these sex-based clusters are associated with all-cause dementia.

Experiences and challenges of implementing clinical medication reviews in daily practice: a mixed-methods study.

Introduction: Organisational problems still prevent widespread implementation of clinical medication reviews. The Opti-Med2 method was developed to facilitate the process of performing clinical medication reviews. The method includes patient involvement by means of a questionnaire and expert teams of community pharmacists and general practitioners (GPs) to perform pharmacotherapeutic analyses, providing the patients' own GP with pharmacotherapeutic advice.

Improving Access to Adult Hearing Care: A Retrospective Review of an Awareness Campaign and Community Hearing Test Service.

Introduction: Age related hearing loss is in the top ten contributors to the global burden of disease and one of the largest modifiable risk factors for age-related dementia. However, awareness of the consequences of untreated hearing loss is poor and many adults do not seek hearing assessment. Despite World Health Organisation recommendations, no EU country currently has a national adult screening programme.

Eye tracking for the classification of visual function in individuals with vision impairment: A validation in Para athletes.

Eye tracking has the potential to be used as a meaningful measure of the consequences of vision impairment (VI), yet a comprehensive test battery is lacking. In this study, we sought to evaluate the feasibility and validity of a test battery of eye movements as a tool to measure visual performance in individuals with VI. A test battery including fixation stability, smooth pursuit, saccades, free viewing, and visual search was administered to 46 athletes with VI and 10 control participants.

Better movers, better friends? A test for the environmental stress hypothesis in typically developing primary school children.

Relations between children's motor skills and internalizing problems are poorly understood. The environmental stress hypothesis (ESH), originally developed for motor-impaired children, may provide understanding, yet has been scarcely examined in typically developing children. Therefore, we examined: (1) relations between children's motor skills and internalizing problems; (2) the role of secondary stressors, specifically interpersonal conflicts and externalizing problems; and (3) the role of personal resources, namely, prosocial behaviour and social self-efficacy (SSE).

Quantification of neuroinflammation in spinal cord and neuroforamina of patients with painful cervical radiculopathy using [C]DPA713 PET/CT.

Background: Animal models of nerve compression have revealed neuroinflammation not only at the entrapment site, but also remotely at the spinal cord. However, there is limited information on the presence of neuroinflammation in human compression neuropathies. The objectives of this study were to: (1) assess which tracer kinetic model most optimally quantified [C]DPA713 uptake in the spinal cord and neuroforamina in patients with painful cervical radiculopathy, (2) evaluate the performance of linearized methods (e.

Gender Identity and Gender-Related Medical Outcomes of Autistic Young Adults Who Experienced Transgender Identity as Adolescents.

Purpose: We examined gender identity and gender-affirming care outcomes of autistic transgender adolescents followed into young adulthood, as well as relationships between gender-related medical care receipt and mental health across time.

Methods: This longitudinal two-timepoint study was conducted between 2018 and 2024, with 4 years between timepoints. Twenty-seven autistic transgender youth participated, with one lost to follow-up.

A Unique LHCE Light-Harvesting protein Family is involved in Photosystem I and II Far-Red Absorption in Euglena gracilis.

Photosynthetic organisms have evolved diverse strategies to adapt to fluctuating light conditions, balancing efficient light capture with photoprotection. In green algae and land plants, this involves specialized light-harvesting complexes (LHCs), non-photochemical quenching, and state transitions driven by dynamic remodeling of antenna proteins associated with Photosystems (PS) I and II. Euglena gracilis, a flagellate with a secondary green plastid, represents a distantly related lineage whose light-harvesting regulation remains poorly understood.

A different lens on diagnosis: value of the CFI in asylum seekers' psychiatric diagnostic assessment.

Background: Asylum seekers face significant mental health challenges but underutilise mental health services and are at increased risk of misdiagnosis. The Cultural Formulation Interview (CFI) could be helpful by introducing individuals' culture and context to psychiatric evaluation. However, its impact on the diagnostic process for asylum seekers remains underexplored.

The association between intrinsic capacity and functional ability in older adults - exploring the role of the physical environment.

Background: Ageing in place has been promoted in the Netherlands to encourage optimal functional ability (FA) and independent living among older adults. FA is likely dependent on intrinsic capacity (IC), a composite measure of an individual's mental and physical capacities-and its interaction with the physical environment in which people live. This study aimed to examine the association between IC and FA, as well as to explore how the physical environment may modify this relationship in older adults.

Balancing palliative care needs and medication appropriateness: Initiation and reinitiation of medications at the end of life.

Background: Medications deemed inappropriate and discontinued in the earlier stages of life-limiting disease may become relevant in palliative care context at the end of life. This study aims to determine the incidence of and factors associated with initiation and reinitiation of medications deemed inappropriate according to the STOPPFrail guideline.

Methods: A retrospective cohort study using linked healthcare reimbursement data.

Phenylketonuria: A guide through the complex maze of its neurological pathophysiology providing a new perspective on treatment strategies.

Phenylketonuria (PKU), an autosomal recessive disease caused by a deficiency in the phenylalanine-4-hydroxylase enzyme or its cofactor tetrahydrobiopterin, is characterized by excessive phenylalanine (Phe) and reduced tyrosine (Tyr) levels and typically manifests neurologically. Even early treated PKU patients with proper metabolic control, obtained immediately after birth upon diagnosis of the disease, show late-onset neurological complications. Although the disease has already been researched for over 90 years, the complexity of its neurological pathophysiology has only recently been unraveled.