Search Results (752)

Background: Outpatient departments operate as interconnected service nodes through which patient and information flows must be coordinated across multiple handoffs. However, the role of patient value co-creation in shaping perceived outpatient process performance remains underexplored. Methods: This study examined how patient citizenship behavior (VCC_C) and participation behavior (VCC_P) are associated with patient satisfaction (SAT) across four outpatient processes and the overall outpatient pathway of a Thai university hospital. A process-level design was used, combining a cross-sectional survey of 400 patients with PLS-SEM, bootstrapping, multi-group analysis, Kruskal-Wallis tests, IPMA, and semi-structured interviews. Results: Across all processes, VCC_C showed greater explanatory importance for SAT than VCC_P and was strongly associated with VCC_P, indicating a citizenship-dominant pattern. Structural associations were statistically stable across processes, whereas satisfaction levels varied by operational context, with medication dispensing outperforming diagnosis and treatment. IPMA identified feedback and tolerance as high-importance, lower-performance priorities, whereas helping and advocacy emerged as strengths. Conclusions: Interpreted through a service logistics perspective, the findings suggest that queue visibility, handoff coordination, process transparency, and feedback management are important priorities for outpatient service improvement efforts. Full article

Cytokines are key regulators of immune responses and tissue remodeling, playing a central role in physiological homeostasis and pathological inflammation. Dysregulation of cytokine signaling networks has been implicated in a wide range of diseases, where persistent inflammatory activation leads to progressive tissue destruction and impaired repair mechanisms. In the oral environment, cytokines critically influence the balance between tissue resorption and regeneration, particularly in processes involving dentin and alveolar bone remodeling. Pathological root resorption (PRR) represents a clinically significant model of cytokine-driven tissue destruction, characterized by the loss of dental hard tissues mediated by osteoclast-like cells within a dysregulated inflammatory microenvironment. Although mechanical, infectious, and iatrogenic factors are well-established triggers, they alone do not fully explain the variability in clinical outcomes, suggesting an important role for host-related factors. New research highlights the relationship between inflammatory signaling pathways, genetic susceptibility, and molecular biomarkers in shaping the onset and progression of PRR. In particular, the RANK/RANKL/OPG axis, cytokine networks, and gene polymorphisms have been identified as key determinants of osteoclast activation and resorptive activity. At the same time, advances in salivary and gingival crevicular fluid biomarker research provide new opportunities for early detection and real-time monitoring. Despite these advances, current knowledge remains fragmented, with heterogeneous study designs, inconsistent genetic associations, and a lack of standardized diagnostic protocols, all of which limit clinical translation. Therefore, a comprehensive and integrative synthesis of cytokine-mediated mechanisms in PRR is needed. This review aims to provide an updated and critical overview of cytokine and chemokine involvement in PRR, integrating molecular pathways, genetic determinants, and emerging biomarkers within a unified framework while highlighting translational implications for precision dentistry. Full article

Microbiome dysbiosis has become recognized as an important interface connecting environmental exposures to chronic inflammatory and degenerative diseases. Although prior research has largely considered heavy metals as biomarkers of exposure and toxicity, their function as ecological modulators of host-associated microbial communities remains underexplored. The oral cavity is a distinct exposome–microbiome interface where environmental, behavioral, and intraoral metal sources converge and interact with structured biofilms and mucosal immunity. This review adopts an ecological systems perspective, interpreting chronic low-dose exposure to metals such as cadmium, lead, mercury, nickel, chromium, arsenic, and aluminum as a sustained selective force on oral microbial networks. A resilience–threshold model is proposed in which cumulative metal pressure progressively diminishes microbial community stability, alters network topology, and drives transitions toward persistent dysbiosis. These modifications are further reinforced by oxidative–inflammatory feedback loops at the host–microbiome interface, facilitating a self-sustaining ecological imbalance. Sketching on insights from microbial ecology, environmental toxicology, and host response biology, this review presents a framework that links metallomic patterns to microbial restructuring, redox imbalance, immune activation, and regulatory adaptation. The analysis emphasizes ecological perturbations from stable dysbiotic states and identifies key methodological limitations that currently restrict causal inference. By conceptualizing heavy metals as active ecological drivers rather than passive exposure indicators, this work establishes a foundation for understanding microbiome-mediated disease susceptibility within an exposome-informed systems biology framework. Full article

Objectives: Bone mineral density (BMD) assessment, the gold standard for diagnosing osteoporosis, does not account for bone quality and fracture susceptibility. Trabecular bone score (TBS) adds value to traditional densitometry. No studies have been conducted in the Polish population to date to confirm the association between TBS and fracture occurrence. This study aimed to evaluate the TBS derived from lumbar spine (L1–L4) dual-energy X-ray absorptiometry (DXA) scans in Polish women aged 40–76 years, both with and without osteoporotic fractures. The relationship between TBS, fracture risk (assessed by FRAX and TBS-adjusted FRAX), and BMD at the lumbar spine, femoral neck, and total hip was investigated. Methods: A total of 933 Caucasian women (760 without fracture and 173 with fracture) who underwent DXA examinations (Hologic Discovery A) between 2022 and 2024 were included. Lumbar TBS, BMD, and clinical fracture risk factors were analyzed, excluding subjects with scan artefacts or extreme BMI. Group differences were assessed using t-tests and chi-square tests. Pearson correlation was used to evaluate associations between TBS, age, and BMI. Logistic regression models assessed TBS and BMD as fracture discrimination, and model performance was compared using the Akaike Information Criterion (AIC) and the area under the receiver operating characteristic (ROC) curve (AUC). Results: TBS values were significantly lower in the fracture group (p < 0.001). TBS demonstrated negative correlations with age (r ≈ −0.36) and BMI (r ≈ −0.14). Low TBS values (≤1.23) were associated with the highest fracture prevalence (28.8%) and a threefold increased risk compared to high TBS (odds ratio = 3.0). Each one standard-deviation decrease in BMD or TBS T-score increased fracture risk by 56–67% (both p < 0.001). Models combining TBS and BMD improved discrimination, as indicated by higher AUC and lower AIC, with TBS remaining an independent predictor. In subgroups with osteopenia or osteoporosis, TBS retained statistical significance. Conclusions: TBS combined with BMD effectively discriminates fracture risk in Polish women and offers superior diagnostic accuracy compared to BMD alone. Integrating TBS with BMD enhances fracture accuracy. Routine assessment of TBS may improve clinical management of osteoporosis. Prospective studies are needed to confirm its long-term predictive value. Full article

Background: Breast cancer (BC) survivors frequently experience depression, which is associated with poorer quality of life (QoL), increased healthcare utilization, and worse prognosis. Although traditional Chinese medicine (TCM) is commonly used as an adjunctive therapy among Chinese populations for cancer-related symptom relief and supportive care, population-based evidence remains limited regarding whether integrated Chinese and Western medicine (ICWM) confers measurable benefits over Western medicine (WM) alone in terms of healthcare utilization and survival. Taiwan’s National Health Insurance (NHI) system offers a unique nationwide setting to address this gap because it reimburses patients for both WM and TCM services and captures care from a large number of TCM clinics across Taiwan, allowing evaluation of adjunctive TCM use in routine clinical practice at a scale rarely possible in prior studies. We used emergency department visits, hospitalization, and length of stay as pragmatic proxy indicators of patients’ daily functioning and disease burden. Leveraging a 10-year enrollment window (2004–2013) and up to 17 years of follow-up, we hypothesized that ICWM would be associated with a reduced risk of acute care events and lower healthcare expenditures compared with WM alone. This hypothesis was examined in a large cohort of breast cancer patients treated across nearly 4000 medical facilities nationwide, encompassing the entire Taiwanese population. Methods: A retrospective cohort study was performed to analyze Taiwan’s National Health Insurance Research Database and Cancer Registry. Women newly diagnosed with breast cancer between 2004 and 2013 who subsequently developed depression (≥3 outpatient diagnoses or 1 hospitalization) were followed until death or 31 December 2021. Patients receiving ≥30 cumulative days of TCM after diagnosis were classified as the ICWM group, whereas those receiving <30 days were classified as the WM group. Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for all-cause mortality. Healthcare utilization, including emergency department visits, hospitalization, and medical expenditures, was analyzed on a per-person-year basis. Results: A total of 1193 patients were included, with 488 in the WM group and 705 in the ICWM group. Compared with WM users, ICWM users were younger, had lower body mass index, and were more likely to have stage 0–II disease. ICWM was associated with lower total, inpatient, and emergency healthcare expenditures per person-year, as well as fewer emergency visits per person-year, although outpatient and overall visits were higher. In stage-stratified multivariable analyses, ICWM was associated with lower all-cause mortality in both stage 0–II disease (aHR = 0.61, 95% CI: 0.39–0.94) and stage III–IV disease (aHR = 0.38, 95% CI: 0.21–0.67). Kaplan–Meier analyses likewise showed significantly better overall survival in the ICWM group in both early-stage and advanced-stage disease. Conclusions: In this nationwide retrospective cohort of breast cancer patients with depression, adjunctive ICWM was associated with better survival, lower acute care utilization, and lower healthcare expenditures compared with WM alone. However, because quality of life was not directly measured and the study was based on observational data, QoL-related interpretations should be made cautiously, with healthcare utilization outcomes viewed as indirect proxy indicators rather than direct evidence of improved daily QoL. Full article

Background/Objectives: Heat waves are increasingly frequent and intense climate events with significant implications for public health, particularly among frail older adults. While most evidence has focused on mortality and morbidity, healthcare service utilization represents an additional and potentially more sensitive indicator of heat-related health burden. Methods: A systematic review and meta-analysis was conducted following the PRISMA guidelines and prospectively registered in PROSPERO (CRD420251107598). PubMed/MEDLINE, Scopus, and Web of Science were searched up to August 2025. This study aimed to systematically review and quantitatively synthesize the evidence on the association between heat wave exposure and healthcare utilization—including hospitalizations, emergency department (ED) visits, and outpatient care—among frail older adults. Pooled effect estimates (RRs, IRRs, and ORs) were calculated using random-effects models. Heterogeneity was assessed using the I² statistic, and sensitivity analyses were performed by outcome type, effect measure, and risk of bias. Results: Fifty-five studies met the inclusion criteria. Heat wave exposure was consistently associated with increased healthcare utilization. Both hospitalizations and ED visits showed significant increases during heat wave periods, with results remaining robust across sensitivity analyses. Evidence on outpatient care was limited but suggested a similar pattern. Substantial heterogeneity was observed across studies, reflecting variability in exposure definitions, populations, and study designs. Overall, the methodological quality of the included studies was acceptable, with most presenting a low-to-moderate risk of bias. Conclusions: Heat waves are associated with increased healthcare utilization among frail older adults, indicating a relevant burden on healthcare systems. Healthcare utilization may represent a sensitive indicator of heat wave impact, complementing traditional clinical outcomes. Full article

Targeted inhibition of the MAPK pathway with BRAF and MEK inhibitors (BRAFi/MEKi) produces rapid tumor regressions in BRAF V600-mutant melanoma, yet most patients ultimately develop acquired resistance. Resistance is not solely a tumor-cell-intrinsic phenomenon; it is accompanied by time-dependent remodeling of the tumor immune microenvironment (TIME) that can shape sensitivity to immune checkpoint inhibitors (ICIs) and inform rational combination or sequencing strategies. Early during MAPK inhibition, melanomas often display increased melanoma antigen expression and enhanced CD8⁺ T-cell infiltration, along with reduced immunosuppressive cytokines, suggesting a transient “immune-permissive” window. However, the same period can show induction of PD-L1 and T-cell exhaustion markers, foreshadowing adaptive immune resistance. At progression, immune-favorable features may diminish and immune evasion mechanisms, such as impaired antigen presentation and MHC-I downregulation, can become prominent and associate with resistance to immunotherapy. Here we review the temporal dynamics of TIME under MAPK inhibition, mechanistic links between resistance programs and immune remodeling, including signaling adaptation, focal adhesion/FAK signaling, dendritic cell dysfunction, antigen-presentation defects, and lymphatic/perilymphatic adipose remodeling, and practical biomarker opportunities across baseline, on-treatment, and progression timepoints. We also summarize emerging therapeutic strategies for post-resistance disease, including optimized ICI combinations, triple therapy concepts, and novel approaches such as combining FAK inhibition with RAF-MEK “clamp” therapy. Finally, we highlight key gaps and propose a framework for longitudinal sampling, standardized multi-omics integration, and TIME-informed trial design. The key distinguishing feature of this review is its time-resolved perspective on TIME remodeling, which links baseline immune contexture, early treatment-induced immune permissiveness, and the immune-evasive state that emerges during acquired resistance. Full article

Background: In this study, we radiologically assessed potential increases in microvascularity, extracellular matrix-related changes, and tissue viscoelasticity following carboxytherapy for periorbital hyperpigmentation (POH). We also analyzed the correlation between radiological changes and clinical outcomes and explored implications for future outpatient selection, as well as the potential to predict treatment success based on radiological–clinical correlations. Materials and Methods: The present study included 78 patients (76 women and 2 men) aged over 18 years with Fitzpatrick skin types I–V and moderate-to-severe infraorbital dark circles who applied for treatment at the Dermatology Department in the Cosmetology Unit of Cerrahpaşa Medical Faculty Hospital. Each patient was given manual, pressure-controlled injections of sterile CO₂ into the upper and lower eyelids for 7 weeks, with one round of treatment per week. We conducted dermatoclinical and radiological evaluations, including measurements of epidermis–dermis thickness and SWE, musculus orbicularis oculi pars pretarsalis thickness, and cSMI vascular index percentage, as well as SOOF tissue SWE (measured in kPa). These analyses were performed on both lower eyelids before treatment and at 1 month and 6 months after treatment. Results: After treatment, VAS scores improved significantly. Grayscale ultrasonography showed significant increases in epidermis–dermis and orbicularis oculi thickness at 1 and 6 months (p < 0.05). SMI presented a significant increase in vascular index at both follow-ups (p < 0.05). SOOF SWE values increased significantly at 1 and 6 months, whereas epidermis–dermis SWE did not. Procedural pain was common, and 25 participants withdrew during the 7-week period due to discomfort. Injection depth was not confirmed by real-time imaging, and adverse events were not graded using a standardized classification system. Therefore, tolerability and procedural safety should be interpreted with caution. Conclusions: Carboxytherapy was associated with improvements in clinical outcomes and radiological parameters among patients who were able to tolerate the procedure, including increased microvascularity on SMI and changes suggestive of extracellular matrix-related alterations. These improvements were maintained at the 6-month follow-up, indicating temporal persistence of the observed findings. However, due to the absence of a control group, the results should be interpreted with caution, and further randomized controlled studies are required to confirm these findings and establish causality. Full article

Pediatric psychiatric emergency department (ED) visits have increased globally, yet many children do not receive timely outpatient follow-up. Although South Korea provides universal health coverage through its National Health Insurance (NHI), additional financial barriers may impede the continuity of mental health care. This study examined whether supplemental private insurance is associated with improved outpatient mental health follow-up after pediatric psychiatric ED visits within a universal coverage system. A retrospective cohort study was conducted at a tertiary children’s hospital in South Korea including 520 psychiatric ED visits (480 unique patients aged <18 years) from 2016 to 2024. The primary outcome was attendance at an outpatient mental health visit within 30 days of ED discharge. Multivariable logistic regression was used to assess the association between insurance type (NHI-only versus NHI plus supplemental private insurance) and follow-up, adjusting for age, sex, clinical presentation, and prior mental health care. Overall, 53.7% of patients attended a 30-day follow-up visit. Patients with supplemental private insurance had significantly higher follow-up rates than those with NHI alone (58.8% vs. 45.5%, p = 0.019). In adjusted analysis, supplemental private insurance was independently associated with increased follow-up (adjusted odds ratio 1.50, 95% confidence interval 1.10–2.05, p = 0.02). A significant interaction was observed between insurance type and prior mental health care (p_interaction = 0.03): the insurance effect was pronounced among patients without prior outpatient mental health treatment (45.6% vs. 38.8%) but negligible among those with prior treatment (71.9% vs. 72.5%). Prior outpatient mental health treatment (adjusted odds ratio 2.00, 95% confidence interval 1.30–3.10) and suicidal presentation were also significant predictors. Even within a universal health coverage system, supplemental private insurance is associated with better outpatient follow-up after pediatric psychiatric emergencies, particularly among patients new to the mental health system. Reducing financial barriers, expanding community-based mental health services, and strengthening care coordination are essential to ensure equitable continuity of care for all children. Full article

Background: Antibiotic misuse and prescribing errors are significant concerns in clinical practice, contributing to unnecessary antibiotic exposure, increased adverse effects, rising healthcare costs, and the escalation of antibiotic resistance. Understanding the prevalence, patterns, and risk factors of these prescription errors is essential for improving patient safety and healthcare efficiency in the future. Aim: Our aim was to evaluate the prevalence, patterns, and risk factors of antibiotic prescription errors in Saudi Arabia. Methods: A comprehensive search of three databases (PubMed, Scopus and ProQuest) was conducted to identify eligible cohort and cross-sectional studies in Saudi Arabia published up to January 2025. Studies that reported on error rates of antibiotic prescription errors and those that did not provide quantitative data were excluded. The primary outcome was the prevalence and patterns of inappropriate antibiotic use, while the secondary outcomes included the pooled prevalence of specific errors (i.e., selection, dose, duration, etc.). The quality of the studies was assessed using the Newcastle–Ottawa scale. This review was registered in PROSPERO (CRD42024611747). Results: Fourteen eligible cohort (n = 2) and cross-sectional (n = 12) studies conducted in Saudi Arabia were included in the review. Two studies reviewed medical records and orders of patients. Patient selection varied from emergency department to intensive care units and outpatients. The pooled prevalence of antibiotic prescription errors was 42.7% [95% CI: 37.5–47.8], with common errors including dosage (29.3%), duration (24.3%), selection (15%) and frequency (11.1%) errors. However, there was a high heterogeneity among the results. Overall, the quality assessment revealed a low risk of bias, except for one study with a high risk of bias. Conclusions: These findings highlight the high prevalence of antibiotic prescription errors. Future efforts should strengthen antibiotic stewardship, enhance clinician training, and ensure adherence to evidence-based guidelines to reduce prescription errors and combat antibiotic resistance. Full article

Emerging evidence suggests that psychological trauma, chronic stress, and unresolved emotional conflict may influence cancer-related processes through neuroendocrine and immunological pathways. However, the clinical relevance of trauma-related psychological profiles in oncology remains insufficiently defined, particularly in women with breast and gynecological cancers. This exploratory observational study included 135 women with breast, cervical, ovarian, and endometrial cancers undergoing multimodal oncological treatment. Psychological assessments were performed using validated instruments, including the PTSD Checklist (PCL), Hamilton Anxiety and Depression Scales (HAM-A, HAM-D), the Adult Attachment Scale (AAS), and a Lazarus-based checklist of stressful life events to assess cumulative stress exposure. Descriptive and exploratory analyses were conducted to identify clinically relevant patterns. A high prevalence of anxiety, depressive symptoms, and trauma-related distress was observed. Insecure attachment patterns were frequent and associated with increased psychological burden. Many patients reported moderate-to-high cumulative stress exposure, suggesting broader vulnerability profiles characterized by emotional dysregulation. These findings support a biopsychosocial model in which trauma, attachment insecurity, and cumulative stress are associated with psychological vulnerability in oncology. Although causal relationships cannot be established, these factors may influence coping and adaptation to disease. Integrating trauma-informed psychological assessment into oncology care may enhance patient-centered management. Full article

Background and Objectives: For patients on anticoagulants, the risk of possible drug–drug interactions (pDDIs) is particularly higher due to complex polypharmacy. Clinical decision-making is largely guided by drug interaction databases (DIDs); however, inconsistencies in programming may compromise therapeutic safety and effectiveness. The current study is designed to assess and contrast the consistency of severity rating, evidence classification, and clinical management of pDDIs across three DIDs. Materials and Methods: The study was conducted using real patient data from the outpatient medicine and cardiology department of a public hospital in the United Arab Emirates. Prescriptions containing anticoagulants were evaluated using three databases for pDDI screening: Micromedex, Lexicomp, and Drugs.com. Consensus was assessed using Fleiss’ kappa, and correlations between variables were evaluated using Spearman’s rank correlation coefficient, using a threshold of p < 0.05 to assess statistical significance. Results: A total of 130 prescriptions were analyzed, and 3237 pDDIs involving 1143 interaction pairs were retrieved. Of these, 107 pDDI pairs were consistently identified across all three databases. Significant inter-database variability was observed in the severity classification and management recommendations of pDDIs across the three databases. Regarding evidence classification, both Micromedex and Lexicomp rated most interactions with fair evidence, while Drugs.com provided no evidence ratings. Although some correlations were observed—particularly between Lexicomp’s and Drugs.com—overall agreement across databases was slight to fair (p < 0.05). Conclusions: Marked inconsistencies across the databases were identified in the classification and categorization of pDDIs and their associated parameters. Category-wise agreement analysis provides more meaningful insights beyond overall agreement by revealing clinically relevant concordance and divergence among databases. Full article

Background: Hand trauma accounts for up to one-third of trauma-related emergency department (ED) visits and ranges from minor lacerations to complex multi-structural injuries. As healthcare systems, workflows, and patient behavior evolve, contemporary epidemiological data are crucial to guide triage, optimize resource allocation, and adapt patient care pathways. Methods: We performed a retrospective observational study of all hand-related ED consultations at a Swiss university hospital in 2013, 2016, 2019, and 2022. In total, 8644 cases were analyzed for demographics, diagnosis, anatomical localization, injury complexity (≥2 functional structures), seasonal distribution, and animal-related injuries. Temporal trends and demographic or clinical shifts were assessed using descriptive and inferential statistics. Results: Among 8644 cases, most patients were male (63.8%) with a median age of 38 years (IQR 26–55). Lacerations (32.2%) and blunt trauma (29.1%) were the most frequent diagnoses, primarily involving digits II–V. The proportion of complex injuries declined significantly from 40.0% in 2013 to 32.5% in 2022 (p < 0.001), while cat-bite injuries almost doubled from 1.3% in 2013 to 2.3% in 2022. Case volumes peaked in spring and early summer. Conclusions: Over the analyzed decade, hand trauma cases in the ED have shifted toward a rising proportion of minor, low-acuity conditions, possibly reflecting reduced primary care access and evolving referral patterns. These trends highlight the need for adaptive triage models, strengthened outpatient care, and structural responses to primary care shortages to ensure efficient resource use and maintain high-quality hand trauma management. Full article

Hepatitis B virus (HBV) is the smallest partially double-stranded, reverse-transcribing DNA virus, with four open reading frames (ORFs) encoding viral proteins. It is classified into nine geographically distributed genotypes (A–I). In Kenya, the molecular characterization of HBV among patients seeking medical care remains poorly defined. This observational study aimed to characterize HBV among patients seeking medical care in Kenya’s endemic region, focusing on circulating genotypes and ORF mutations. Serum samples were collected from the outpatient departments of selected health facilities, with demographic and clinical information extracted from patients’ medical records. Hepatitis B surface antigen (HBsAg) was tested at the facilities, and 85 HBsAg-positive samples were collected for molecular analysis. The basal core promoter and pre-core (BCP/PC), polymerase, and surface regions of the viral genome were amplified and sequenced to determine genotypes and to profile their mutations. Out of 85 HBsAg-positive samples, 38 samples tested positive for HBV DNA, and 26 samples were successfully sequenced. HBV genotype A was prevalent at 73.1% (19/26), followed by genotype D at 23.1% (6/26), and genotype E at 3.8% (1/26). Genotype A sequences clustered with both A1 Asian and African subgenotypes, whereas genotype D clustered with subgenotypes D6 and D1. All HBV genotype A, D, and E sequences were serotypes adw2, ayw2, and ayw4, respectively. HBV core promoter mutations (A1762T/G1764A) were detected in both genotype D and genotype A isolates. The pre-core G1896A mutation was highly prevalent in genotype D samples (5/6; 83.3%) but was not observed in genotypes A or E. Analysis of mutations within the “a” determinant region revealed genotype-specific patterns: genotype A predominantly harbored V14A, P46H, S58C, and P67Q substitutions; genotype E showed N59S; and genotype D exhibited V14A, C69stop, S104T, and W182stop mutations. Two drug resistance mutations (V191I and A194T) were present in two chronic patients, one with genotype A and the other with genotype D. In conclusion, HBV genotypes A and D are the most prevalent among Kenyan patients with chronic HBV infection. The presence of point mutations in the ORFs among patients seeking medical care highlights the need for molecular surveillance to better understand the viral diversity and its potential clinical and public health implications. Full article

Introduction: Soft tissue sarcomas (STS) exhibit profound molecular heterogeneity. While recurrent gene fusions hold significant diagnostic and therapeutic value—guiding treatment selection and identifying novel molecular targets—our understanding of their broader clinical implications remains limited. Materials and Methods: We performed next-generation sequencing (NGS; FusionPlex Sarcoma v2, Archer™) and bioinformatic analysis (STAR v.2.7, Arriba) on formalin-fixed paraffin-embedded (FFPE) core needle biopsy specimens. The cohort consisted of patients enrolled in a phase II clinical trial (NCT03651375) who received preoperative chemoradiotherapy according to the UNRESARC protocol. Results: The analysed cohort comprised nine adult patients (median age 66 years; range 44–73) diagnosed with undifferentiated pleomorphic sarcoma (UPS; n = 3), malignant peripheral nerve sheath tumour (MPNST; n = 3), myxofibrosarcoma (MFS; n = 2), and leiomyosarcoma (LMS; n = 1), predominantly high-grade (G3; 5/9) and extremity-localised (6/9). Gene fusions were detected in one-third of patients (3/9), exclusively in G3 tumours. Specifically, we identified an SGSH-PRKCA fusion in MFS (thigh), a LINC01133-OGA fusion in MPNST (thorax), and a concurrent JAZF1-MYH7B (chr7:27995037 intronic-chr20:33563203 exon/splice-site, out-of-frame but preserving myosin domains) with a PRKCA-associated intergenic rearrangement (chr1, retaining C1/kinase domains) in UPS (upper back). Notably, the SGSH-PRKCA and JAZF1-MYH7B pairs have not been previously described in the literature for these STS subtypes. Fusion-positive (F1) cases showed stable radiological disease (RECIST 1.1 SD) and EORTC C/D pathological responses with 5–20% residual viable tumour, whereas fusion-negative (F0) cases showed a wider range of radiological and pathological outcomes, including partial response, progression, and stable disease. Conclusions: Our analysis suggests that broad genomic profiling may provide complementary molecular information in diagnostically challenging cases managed at specialised sarcoma centres, particularly when morphology and immunohistochemistry are insufficient. In the present series, however, the detected rearrangements did not alter systemic treatment, and the data do not support claims of prognostic, predictive, or therapeutic actionability. Full article