Search Results (340)

Intimate partner violence-related brain injury is the most recent condition in a 150-year arc in which biological brain injury has been misattributed to psychological or moral causes before formal clinical recognition emerged. Earlier conditions in this pattern were each recognized only after decades of delay. In each prior case, that delay was constrained by limits in available diagnostic technology. Intimate partner violence-related brain injury is the first condition in which diagnostic technology, including computed tomography, magnetic resonance imaging, diffusion tensor imaging, and neurocognitive assessment, has been continuously available throughout the period of non-recognition. This review identifies three structural barriers that sustain this recognition gap: a diagnostic barrier that leaves the injury without formal criteria, an administrative coding barrier that leaves it absent from ICD architecture, and a population surveillance barrier that leaves it indistinguishable from broader assault categories. Each barrier reinforces the others, limiting visibility, resource allocation, and access to care. Across these conditions, this review argues that deferred recognition reflected an institutional dynamic that shaped which injured populations became clinically legible. Recent neuroimaging and cognitive studies make the biological imperative explicit. A cognitive entrapment framework reframes the reduced capacity to engage the cognitive and material resources leaving requires as injury-driven rather than as ambivalence or motivational deficit. The framework offers a mechanistic account of how brain injury may disrupt the multistep planning that leaving demands. Intimate partner violence-related brain injury is not only underdiagnosed but structurally underserved; correcting the mechanisms of recognition failure is necessary for access to treatment and rehabilitation. Full article

Aortitis—inflammation of the aortic wall—presents at the interface of vasculitis, infection, structural aortic disease, and cardiovascular risk. It may occur in giant cell arteritis (GCA), Takayasu arteritis, immunoglobulin G4 (IgG4)-related disease, drug-induced injury, infection, or as an isolated finding after aortic surgery. Modern imaging detects aortic inflammation more frequently, but the main challenge is classification rather than detection: determining whether disease is infectious or immune-mediated, active or dominated by fixed structural damage, systemic or isolated, and whether the dominant threat is aneurysm, dissection, undertreated infection, or avoidable immunosuppression. This review considers aortitis as a high-risk vascular syndrome requiring aetiology-first classification rather than descriptive labelling. Before escalating immunosuppression, infection must be actively excluded and inflammatory activity distinguished from fixed vascular damage. Treatment should be individualised according to phenotype, age, vascular territory, comorbidity, and toxicity risk, with surveillance continuing even after symptoms and inflammatory markers improve. Optimal care depends on multidisciplinary assessment integrating rheumatology, infectious diseases, vascular surgery, radiology, and cardiology expertise. Progress will require standardised imaging definitions, registries linking inflammatory control with structural vascular outcomes, and validation of artificial intelligence (AI) tools before clinical adoption. Full article

Breast cancer is associated with systemic inflammation and increased cardiovascular risk, and anthracycline chemotherapy may contribute to persistent myocardial injury. This study aimed to evaluate acute changes in inflammatory cytokines and plasma redox status after the first anthracycline cycle and to assess long-term ventricular function after 10 years in women with breast cancer. We conducted a prospective study of 17 patients with breast cancer treated with anthracycline-based chemotherapy at Salvador Hospital, Santiago, Chile. Plasma cytokines were measured at baseline (day −7) and on day +3 after the first cycle using a MILLIPLEX Luminex^® assay. Echocardiographic assessment of left ventricular systolic and diastolic function, together with oxidative stress parameters, was performed at baseline and after 10 years of follow-up. Anthracycline exposure was associated with an acute increase in several cytokines related to inflammatory and vascular remodeling, including EGF, eotaxin, MCP-1, and VEGF. In addition, markers of redox imbalance suggested an acute pro-oxidant response after treatment. At long-term follow-up (10 years), left ventricular ejection fraction (LVEF) remained within the normal range in all patients. However, integrative echocardiographic assessment revealed impaired left ventricular relaxation, evidenced by significant reductions in the mitral inflow E/A ratio, and septal and lateral e′ velocities with respect to baseline, despite preserved estimated filling pressures. These alterations were accompanied by persistent oxidative stress, reflected by persistently elevated levels of lipid peroxidation markers, such as in vivo 8-isoprostanes. In this pilot cohort, anthracycline chemotherapy induced an early inflammatory and oxidative response that was not associated with overt long-term systolic dysfunction but was accompanied by persistent biochemical and diastolic alterations. These findings support the concept of a long-term subclinical cardiotoxic phenotype and highlight the potential value of combining echocardiographic assessment with circulating redox and inflammatory biomarkers to improve long-term cardiovascular surveillance in breast cancer survivors. Full article

Previous analyses of substance-involved craniofacial trauma have often combined alcohol and drug/medication involvement. We conducted a cross-sectional analysis comparing alcohol-only and drug/medication-only facial injury encounters in the public Consumer Product Safety Commission National Electronic Injury Surveillance System (NEISS), 2019–2023. Primary facial injuries (Body_Part = 76) were classified using the released Alcohol_Involved and Drug_Involved fields. Survey-weighted estimates and Taylor-linearized 95% confidence intervals incorporated the released PSU, stratum, and weight variables; design-based logistic regression evaluated code-4 hospitalization. Among 146,857 observed facial injury encounters, 4117 were alcohol-only and 2302 were drug/medication-only. Weighted annual alcohol-only proportions were stable (trend odds ratio [OR] per year, 0.99; 95% CI, 0.96–1.03; p = 0.716), whereas drug/medication-only proportions increased (OR, 1.15; 95% CI, 1.04–1.27; p = 0.009). Compared with alcohol-only encounters, drug/medication-only encounters involved older patients (weighted mean age, 63.1 vs. 47.6 years) and a lower weighted male proportion (55.6% vs. 67.5%). Weighted code-4 hospitalization was 23.1% versus 11.8%; the adjusted OR was 1.91 (95% CI, 1.45–2.53; p < 0.001). Adult-only and alternative-period sensitivity analyses supported the main conclusions. Separate classification of alcohol and drug/medication involvement revealed distinct demographic, temporal, and disposition patterns among NEISS-captured product-associated ED encounters. Full article

Background: Although advances in critical care have improved short-term outcomes, sepsis survivors continue to face substantial chronic morbidity and impaired long-term survival. Conventional threshold-based tools such as the Sequential Organ Failure Assessment (SOFA) and Modified Early Warning Score (MEWS) show moderate and variable discrimination across cohorts. Reported areas under the receiver operating characteristic curve (AUROCs) must therefore be interpreted in relation to the population, prediction horizon, and outcome used in each study rather than as direct head-to-head comparisons. Objectives: This review evaluates how artificial intelligence (AI) could be linked with dynamic plasma metabolites, particularly citrulline and β-hydroxybutyrate (3-HB), to support biologically informed sepsis phenotyping, while critically examining mechanistic evidence, clinical limitations, and translational readiness. Data Synthesis: Machine-learning and natural language processing architectures have shown promising discrimination in many early-detection studies, with pooled AUROCs near 0.87 and reported prediction windows extending to 48 h. However, performance estimates vary with cohort composition, outcome definition, and validation design, and they should not be ranked against unrelated biomarker studies. Human sepsis studies generally associate low or persistently low citrulline with impaired intestinal function and organ injury, but no sepsis-specific decision cutoff has been externally validated. For 3-HB, an AUROC of 0.8429 for septic liver injury was derived from a cohort of 57 patients and has not been shown to add value beyond routine liver tests or illness-severity measures. Murine experiments provide mechanistic hypotheses for ketone-mediated organ protection, but model-specific and sometimes opposing nutritional effects limit direct translation. These metabolites are therefore best considered candidate longitudinal features for multimodal phenotyping rather than stand-alone clinical triggers. Conclusions: Biologically informed algorithmic surveillance is a promising direction, but clinical implementation requires prospective serial sampling, explicit adjustment for renal, hepatic and nutritional confounders, head-to-head comparison with routine markers, and external validation of calibration and clinical utility. Until these requirements are met, citrulline and 3-HB should support research phenotyping rather than direct treatment selection. Full article

Background: Drug-induced liver injury (DILI) is a leading cause of acute liver failure worldwide, yet epidemiological data from Central Asia remain scarce. Infodemiology—the study of online health information-seeking behavior—offers a novel approach to population-level health surveillance. Objective: Our aim was to investigate online information-seeking behavior related to DILI, hepatotoxic medications, and dietary supplements among the population of Kazakhstan using Google Trends data over a five-year period. Methods: A quantitative, retrospective, observational infodemiology study was conducted using Google Trends data from Kazakhstan (May 2021–May 2026). A total of 21 search terms were organized into five thematic sets: DILI symptoms, hepatotoxic medications, self-treatment and detoxification, liver-related symptoms, and general medication queries. Sets 1–4 were searched in Russian and Set 5 in Kazakh. Descriptive statistics, the Mann–Kendall trend test, and Spearman’s rank correlation analysis were performed using PAST software version 5. Results: A statistically significant trend was identified for 20 out of 21 search terms (p < 0.05). The majority of terms showed decreasing trends over the study period. In contrast, dietary supplements (BAD) demonstrated the strongest increasing trend (S = +1275, Z = +7.93, p < 0.001). Search interest for the general term “liver” was the highest of all 21 terms (mean RSV 84.30), while specific DILI symptoms such as dark urine (mean 1.28) and skin itching (mean 0.07) showed minimal search activity. Strong positive correlations were found between paracetamol and antibiotic searches (rs = 0.812, p < 0.001), consistent with self-medication patterns. Dietary supplements showed significant negative correlations with all detox-related terms (rs = −0.650, p < 0.001). Conclusions: This is the first infodemiology study on DILI in Central Asia. The significant increase in dietary supplement searches, combined with the low public awareness of specific DILI symptoms, highlights a critical public health concern. These findings underscore the need for enhanced regulation of dietary supplements, targeted public health education, and the integration of digital surveillance tools into pharmacovigilance systems in Kazakhstan. Full article

Background/Objectives: Infective endocarditis (IE) is a life-threatening cardiovascular infection with in-hospital mortality of 15–30% despite modern therapy. Contemporary IE demonstrates non-random valve involvement: aortic and mitral 35–45%, tricuspid 5–10% (30–50% in intravenous drug users [IVDU]), and pulmonary < 1%. These patterns implicate valve-specific anatomy and hemodynamics as central determinants of susceptibility. This narrative review examines the reported distribution of IE across the aortic, mitral, tricuspid and pulmonary valves and summarises the anatomical, haemodynamic, structural, microbial and patient-related factors associated with valve-specific susceptibility. Methods: A structured narrative review of English-language literature was conducted using PubMed/MEDLINE, Embase, Scopus, and Google Scholar (January 1990–March 2026). Search terms included “infective endocarditis,” “valve anatomy,” “hemodynamics,” “bicuspid aortic valve,” “prosthetic valve endocarditis,” and “transcatheter aortic valve replacement (TAVR) endocarditis.” We included anatomical studies, clinical cohorts, surgical series, imaging research, and international guidelines. Evidence was synthesized narratively using Oxford Centre for Evidence-Based Medicine (CEBM) levels. Results: IE susceptibility follows a biologically coherent gradient determined by the interaction between valve anatomy, hemodynamic stress, endothelial injury, and structural substrate. The aortic valve is most vulnerable because of high shear stress, congenital abnormalities such as bicuspid aortic valve, and direct continuity with the cardiac fibrous skeleton, predisposing to peri-annular extension. Mitral valve IE is largely conditional upon pre-existing structural disease, particularly mitral valve prolapse, rheumatic heart disease, and mitral annular calcification, and is characterized by a high risk of systemic embolization. Tricuspid valve IE reflects the interaction between low-pressure hemodynamics and acquired patient-specific modifiers, including intravenous drug use, cardiovascular implantable electronic devices, and congenital heart disease. Pulmonary valve IE remains uncommon because of favorable native hemodynamics but occurs predominantly in repaired congenital heart disease, right ventricular outflow tract reconstruction, and prosthetic pulmonary valves. Across all valve types, multimodality imaging and anatomical assessment consistently influence complication detection, surgical planning, and long-term surveillance. Conclusions: IE involvement is unevenly distributed among the cardiac valves. Aortic and mitral involvement predominate, tricuspid involvement is strongly influenced by injection drug use and intracardiac devices, and pulmonary-valve IE remains rare and is principally associated with congenital abnormalities or prosthetic material. These patterns highlight the possible contributions of haemodynamic stress, pre-existing structural abnormalities, and age-related valvular changes to the greater susceptibility of left-sided valves. Full article

Traumatic spinal cord injury (SCI) is a catastrophic condition associated with profound neurologic disability, psychosocial disruption, high long-term healthcare utilization, and reduced life expectancy. Globally, SCI remains a major cause of morbidity, most commonly resulting from traumatic mechanisms such as motor vehicle collisions and falls, with a bimodal age distribution affecting both younger adults and older individuals. This narrative review provides a comprehensive, clinically oriented overview of SCIs with emphasis on classification, initial evaluation, imaging, and contemporary management strategies. The review highlights the dual-phase pathophysiology of SCIs—primary mechanical insult followed by secondary injury cascades—underscoring the rationale for rapid stabilization and timely, injury-specific interventions. Initial care is framed around immobilization and trauma resuscitation principles, with cervical spine clearance guided by validated decision tools and early, appropriate imaging acquisition. We discuss adjunctive imaging considerations and address the ongoing debate regarding MRI use in obtunded patients with negative initial studies. Acute inpatient management priorities include prevention of secondary complications, hemodynamic optimization, respiratory support, and vigilant surveillance for autonomic dysfunction. Pharmacologic neuroprotection with high-dose methylprednisolone remains controversial; current guideline recommendations are reviewed. Finally, we outline operative decision-making and evidence supporting early decompression in selected patients, as well as common surgical approaches and their indications. This review consolidates foundational concepts and current standards to support practical, evidence-informed SCI evaluation and management. Full article

Basilar trunk aneurysms (BTAs) are rare intracranial aneurysms. These aneurysms pose substantial clinical risk because they are located close to vital cranial structures and perfusion-sensitive perforating arteries. In addition, outcomes from BTA repair are dependent upon several factors, which include proximity to the brainstem, preservation of perforators, corridor access to the aneurysm, successful clipping of the aneurysm through reconstruction, the need for intraoperative rescue manoeuvres and the ability of the patient to recover from complications. Many previous studies have documented the outcomes associated with BTA repair; however, few studies have examined how the anatomy of the BTA directly relates to surgical decisions made by surgeons. Therefore, we developed an explainable AI framework for documenting surgeon reasoning regarding the open microsurgical treatment of BTAs. The primary objective was to develop and internally evaluate an explainable microsurgical intelligence framework for structuring surgeon reasoning during open microsurgical treatment of BTAs. The secondary objectives were to explore the relationships between the proposed constructs and postoperative pontine infarction, angiographic occlusion, functional outcome, hidden disability, operative difficulty, and composite technical-safety failure. Methods: We retrospectively analysed the cases of 31 adult patients who underwent open microsurgical treatment of a basilar trunk aneurysm at our hospital between October 1999 and March 2025. The cohort included 18 women (58.1%) and 13 men (41.9%), with a median age of 55 years (interquartile range, 44–63 years); 14 patients (45.2%) presented with ruptured aneurysms. A database containing more than 300 variables collected information about each patient’s imaging studies, operative strategies employed during surgery, intraoperative events encountered during surgery, intraoperative angiographic verification, occurrence of new injuries or complications resulting from surgery, and degree of recovery in each patient. Temporally separated scores were generated to quantify perforator-aware hazard, compression burden imposed by proximity to the brainstem, constraints imposed by corridors available for clipping of the BTA, burden imposed by clip reconstruction, degree of surgical precision adjusted based on the need for rescue manoeuvres, degree of dataset/model readiness, and degree of case-level learning density. The framework was evaluated internally using methods that included leave-one-out cross-validation, Firth regression modelling, Bayesian modelling, bootstrap optimism correction, calibration assessments using Brier score, decision-curve analysis, evaluations of explainability, conformal uncertainty estimation, and retrieval of similar cases. Results: Complete occlusion of the aneurysm was successfully achieved in 27 patients (87.1%), whereas residual neck or sac remained in four patients (12.9%). New pontine infarction occurred in six patients (19.4%), including four perforator-related infarctions (12.9%). A favourable last-follow-up modified Rankin Scale (mRS) score of 0–2 was achieved in 25 patients (80.6%); however, hidden disability was noted in 11 of these 25 patients (44.0%). Mortality was 6.5% and was limited to two patients with high-grade rupture. PAH-S-pre predicted pontine infarction (OR, 1.19 for every five-point increase; leave-one-out cross-validated AUC, 0.92). The composite technical-safety failure model had an ROC AUC of 0.91, optimism-corrected AUC of 0.88, calibration slope of 0.96, Brier score of 0.10, and permutation p < 0.001. Explainability indicated that PAH-S-pre, BPCI, and CCR represented the most important features. Conformal prediction resulted in abstention from prediction in four patients (12.9%). Conclusions: Expert microsurgical thought processes involved in repairing BTAs can be systematised and recorded into time-relevant and clinically meaningful measures that preserve anatomical interpretability. Clinical use will require external validation before implementation; however, this framework may provide a clinically interpretable foundation for risk-adapted planning, verification, surveillance, education, and future decision-support research for complex neurovascular surgery. Full article

Background: Sodium–glucose co-transporter-2 (SGLT-2) inhibitors are widely prescribed for type 2 diabetes mellitus (T2DM) because of their cardiovascular and renoprotective benefits. However, their use is associated with euglycemic diabetic ketoacidosis (EDKA), a rare but potentially life-threatening complication characterized by severe ketoacidosis despite relatively normal blood glucose levels. Failure to discontinue SGLT-2 inhibitors before surgery, as recommended in current guidelines, together with perioperative fasting and surgical stress, increases the risk of EDKA. Diagnostic complexity is compounded when concurrent postoperative surgical complications provide an alternative explanation for persistent metabolic acidosis. Methods: A 71-year-old man with T2DM receiving uninterrupted empagliflozin underwent direct lateral interbody fusion under general anesthesia. On postoperative day 2, he developed severe high anion-gap metabolic acidosis (pH 7.204, HCO₃⁻ 10.1 mEq/L) with near-normal blood glucose levels (178 mg/dL). Pneumoperitoneum identified on imaging was attributed to Hemovac drain-related peritoneal injury, and emergent laparoscopic exploration was performed under a working diagnosis of surgical sepsis. Although surgical source control was successfully achieved, severe metabolic acidosis persisted postoperatively (pH 7.275). Euglycemic diabetic ketoacidosis is an uncommon diabetic complication associated with several perioperative risk factors, including prolonged fasting and surgical stress. Subsequent serum ketone analysis demonstrated markedly elevated beta-hydroxybutyrate levels (4.8 mmol/L), confirming co-existing EDKA. Results: Following empagliflozin discontinuation, targeted treatment with concurrent insulin–dextrose infusion resulted in complete resolution of acid-base imbalance within five days. Conclusions: A concurrent surgical complication appeared to mask EDKA and contributed to a delay in its recognition. In patients receiving SGLT-2 inhibitors, metabolic acidosis that persists after an apparent surgical cause has been addressed should prompt measurement of serum ketones, irrespective of the blood glucose concentration. Structured perioperative protocols for SGLT-2 inhibitor management and postoperative ketone surveillance may help to prevent similar events. Full article

Background/Objectives: School-age athletes occupy a paradoxical position in the adolescent opioid crisis, combining health-oriented activity with elevated risk of sports-related injury and prescription opioid exposure. In response to the opioid epidemic, states enacted opioid prescribing limit laws (OPLLs) beginning in 2016–2017, yet whether these supply-side policies reached high-risk youth subgroups remains unclear. This study evaluated national temporal trends in prescription opioid misuse among U.S. high school students during the period of OPLL implementation and examined differences across athletic participation, concussion history, sex, grade, race/ethnicity, and substance-use profiles. Methods: Using four biennial waves of the Youth Risk Behavior Surveillance System with a consistent prescription pain-medicine measure (2017, 2019, 2021, and 2023; total N = 44,501), we conducted survey-weighted multivariable logistic regression models producing adjusted odds ratios (aORs) for lifetime prescription opioid misuse, controlling for survey year, sports participation, sex, grade, race/ethnicity, alcohol use, and other illicit drug use. Interaction and stratified models examined differences associated with sports participation, concussion history, demographic characteristics, and substance use. Results: Weighted prescription opioid misuse declined from 13.9% in 2017 to 12.0% in 2023, with a significant unadjusted linear decline per two-year survey wave (OR = 0.936; 95% CI: 0.879–0.997; p = 0.040). This overall trend was attenuated after adjustment (aOR = 0.967; 95% CI: 0.914–1.024; p = 0.248). Temporal patterns differed significantly across race/ethnicity, sex, grade, and selected substance-use groups. White and male students demonstrated significant adjusted linear declines, whereas Hispanic/Latino and female students remained flat. Black/African American students showed significant year-to-year variation, with elevated adjusted odds in 2019 and 2021 relative to 2017. Concussion history was independently associated with misuse among athletes (aOR = 1.645; 95% CI: 1.417–1.909; p < 0.001), with significant associations observed among White, Asian, Black/African American, and Hispanic/Latino athletes. The pooled concussion-by-race/ethnicity interaction, however, was not significant (p = 0.295). Conclusions: Although prescription opioid misuse declined descriptively between 2017 and 2023, adjusted analyses did not identify a significant overall national temporal change. Since subgroup patterns diverged, prevention planning and surveillance should be disaggregated by race/ethnicity and sex rather than guided by national totals, and groups whose misuse did not decline may require strategies extending beyond clinical prescribing controls. Full article

Mesenchymal stromal cells (MSCs) are a versatile platform for regenerative medicine and gene delivery because they combine multipotency, immunoregulatory activity, and injury-directed trafficking. Translation is nevertheless limited by donor- and tissue-dependent heterogeneity, variable biodistribution, and engineering-related risks. This review evaluates genetically modified MSCs as medicinal products rather than as a general MSC class. We compare self-inactivating lentiviral (SIN-LV) transduction, which provides efficient and durable expression and has limited early clinical experience, with targeted genome editing, which can define the integration locus and copy number but remains constrained by variable precise knock-in efficiency, off-target and double-strand-break-associated effects, manufacturing cost, and the absence of long-term clinical safety data. We integrate preclinical and clinical evidence with GMP-compatible manufacturing, potency testing, genomic surveillance, and release criteria. Particular attention is given to safe-harbor integration and B2M/CIITA-based hypoimmunogenic designs as strategies to reduce engineering-related batch variability and HLA-dependent donor variability. Together, these developments support a transition from empirically optimized MSC preparations toward molecularly defined cellular medicines with predefined genotype, expression, potency, and safety attributes. Full article

Electric scooters (e-scooters) and electric bicycles (e-bikes) are established urban micromobility modes, and children and adolescents form a growing share of riders. This narrative review synthesises peer-reviewed evidence on e-scooter and e-bike injuries in patients aged 18 years or younger, covering epidemiology, mechanisms, injury patterns, clinical outcomes, comparisons with conventional devices, and prevention. Each source was classified as dedicated paediatric evidence, mixed-age evidence with extractable paediatric results, adult or mixed-age evidence used only for context, or an adult-dominated systematic review, so that the basis of every claim is explicit. The reported burden has risen across national surveillance data and single-centre series, and one population-adjusted analysis found injury rates increasing by 293% for e-bikes and by 88% for powered scooters between 2019 and 2022. Most studies lack exposure denominators, so exposure-adjusted paediatric risk remains poorly quantified and rising counts cannot be equated with rising risk. Injuries affect adolescent boys disproportionately and peak at ages 11 to 14 years. Extremity and soft-tissue injuries predominate, while a clinically important minority sustain traumatic brain injury, craniofacial and dental trauma, or severe multisystem injury. Low helmet use and higher device speeds are consistently associated with more severe outcomes, although observational designs cannot establish causal effects and device type is confounded with rider age and road exposure in every available paediatric comparison. Powered devices are associated with greater severity than non-powered counterparts. Speed limitation and helmet promotion appear promising, but paediatric-specific effectiveness evidence remains limited. Prospective paediatric research incorporating exposure denominators is the priority. Full article

Background and Clinical Significance: Endoscopic ureterocele incision is the preferred initial treatment for ureteroceles associated with duplex collecting systems due to its capability for rapid decompression via a minimally invasive technique with generally favorable outcomes among pediatric patients. However, the postoperative trajectory in children with solitary functioning renal units remains inadequately characterized. We present a severe, yet reversible, case of postrenal acute kidney injury (AKI) following endoscopic ureterocele incision in an infant with a contralateral multicystic dysplastic kidney (MCDK). This case emphasizes the pathophysiological implications of failed ureterocele decompression and the vital importance of rigorous postoperative monitoring. Case Presentation: A female infant with a right MCDK and a left duplex collecting system featuring an upper pole ureterocele underwent transurethral endoscopic incision due to progressive hydronephrosis. Within 24 h following surgery, the patient exhibited oliguria, oedema, worsening hydronephrosis, hyponatremia (125 mmol/L), metabolic acidosis, and increasing serum creatinine levels, indicative of postrenal AKI. Arterial blood gas analyses indicated severe renal-driven metabolic acidosis with bicarbonate levels of 13.9 mmol/L, accompanied by respiratory compensation and normal lactate levels. Imaging studies revealed deteriorating hydronephrosis of the upper and lower poles of the left kidney. Emergency open nephrostomy placement in the lower pole, after failed jj insertion in the lower pole ureteral orifice, resulted in the immediate restoration of urinary drainage and progressive biochemical recovery. The patient required a brief period of intensive care monitoring, followed by hospitalization in pediatric and urological departments. Longitudinal imaging demonstrated persistent but stable upper pole dilatation with preserved parenchyma. Definitive management was later achieved through right nephrectomy of the non-functioning MCDK. Conclusions: In patients with solitary functioning renal units, the endoscopic ureterocele incision may result in postoperative local oedema, potentially leading to clinically significant obstructive AKI. This case underscores the necessity for intensified surveillance and individualized postoperative management strategies in anatomically complex pediatric patients. Full article

Hip-Hop dance is physically demanding, yet epidemiological data in female dancers remain limited. This mixed observational cohort study described musculoskeletal injury and physical complaint burden, evaluated core endurance and balance, compared female Hip-Hop dancers with healthy non-dancer controls, and examined associations with prospective complaints. Adult female Hip-Hop dancers (n = 31) and controls (n = 34) completed the McGill test battery, Unipedal Stance Test, and modified Star Excursion Balance Test. Dancers also reported prior-year injuries and musculoskeletal complaints and were followed for 12 weeks to record physical complaints and dance exposure. Dancers and controls showed similar anthropometric characteristics, core endurance, and balance scores (all p > 0.05). Musculoskeletal complaint incidence exceeded injury incidence during the previous year (46.1 vs. 0.72 per 1000 dance hours). During follow-up, 41.9% of dancers reported at least one physical complaint, corresponding to 36.6 physical complaints per 1000 dance hours. Trunk extensor endurance was inversely associated with physical complaint counts, whereas prior-year injury and musculoskeletal complaint counts were positively associated. Female Hip-Hop dancers demonstrated substantial overuse-related physical complaint burden despite relatively low injury incidence. Full article