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14 pages, 651 KB  
Article
Retrospective Cohort Study of Intrapericardial Cisplatin for Risk Reduction of Malignant Pericardial Effusion Recurrence
by Francisco Javier Muñoz-Carrillo, Roxana Maribel Reyes, David Pesántez, Gemma Carrera, Enric Cascos, Pedro Castro, Sara Fernández-Méndez, Carme Font, Laura González-Aguado, Ignacio Grafiá, Lucía Llavata, Inés Monge-Escartín, Joan Padrosa, Noemí Reguart, Adrián Téllez, Albert Tuca, Margarita Viladot, Carles Zamora-Martínez, Patrícia Amorós-Reboredo and Javier Marco-Hernández
Curr. Oncol. 2025, 32(10), 568; https://doi.org/10.3390/curroncol32100568 (registering DOI) - 11 Oct 2025
Abstract
Malignant pericardial effusion (MPE) is a life-threatening condition in patients with cancer, with common recurrences after simple pericardiocentesis. Consequently, the intrapericardial instillation of sclerosing or cytotoxic agents has been explored, with limited evidence from small studies with different methodologies. We undertook an observational, [...] Read more.
Malignant pericardial effusion (MPE) is a life-threatening condition in patients with cancer, with common recurrences after simple pericardiocentesis. Consequently, the intrapericardial instillation of sclerosing or cytotoxic agents has been explored, with limited evidence from small studies with different methodologies. We undertook an observational, retrospective, single-centre study, including all patients diagnosed with a solid neoplasm and clinically significant and/or recurrent, cytology-confirmed MPE, treated with Intrapericardial Instillation of Cisplatin (IPIC), between 2009 and 2022. Patients with hematological malignancies were excluded. The procedure followed a multidisciplinary approach and a standardized protocol. Variables collected included baseline patient characteristics, neoplasm details, MPE impact, adverse events (AEs) from procedures (pericardiocentesis and IPIC) and outcomes (time to MPE recurrence and survival). This study adhered to the STROBE guidelines. A total of 41 patients were included, 51% female, with a median age of 61 (51–69) years. Non-small cell lung cancer (NSCLC) was the predominant primary tumour (78%) and in 44% of the cohort, MPE was identified at cancer diagnosis. Most patients (90.2%) presented symptoms related to MPE at diagnosis, and 88% had cardiac tamponade on echocardiography. IPIC was administered a median of four times. IPIC-related AEs occurred in 10 patients (24.4%), with transient atrial fibrillation (AF) being the most frequent one. Two patients (4.9%) experienced MPE recurrence within 30 days after IPIC. The median survival time from MPE diagnosis was 161 days (5.4 months; IQR 73–455 days). IPIC appears to be a feasible, effective and safe option for reducing the risk of MPE recurrence, mainly in NSCLC. Full article
9 pages, 2750 KB  
Brief Report
Minimally Invasive Repair of Sinus Venosus Atrial Septal Defects and Anomalous Pulmonary Venous Connections via Vertical Right Axillary Thoracotomy
by Sameh M. Said, Ali H. Mashadi, Yasin Essa, Kristin Greathouse, Nicholas Brown, Mahmoud I. Salem and Joseph Giamelli
J. Cardiovasc. Dev. Dis. 2025, 12(10), 404; https://doi.org/10.3390/jcdd12100404 (registering DOI) - 11 Oct 2025
Abstract
(1) Background: There has been an increase in the utilization of the minimally invasive vertical right axillary thoracotomy approach for repairing congenital heart defects in children recently. We aim, in the current study, to evaluate the outcomes of this approach in repairing anomalous [...] Read more.
(1) Background: There has been an increase in the utilization of the minimally invasive vertical right axillary thoracotomy approach for repairing congenital heart defects in children recently. We aim, in the current study, to evaluate the outcomes of this approach in repairing anomalous pulmonary venous connections with or without an associated sinus venosus defect. (2) Methods: A total of 23 consecutive patients underwent surgical repair of anomalous pulmonary venous connections between April 2018 and February 2024. Perioperative and clinical follow-up data were obtained. (3) Results: The median age and weight were 36 months (1–277 months) and 14.4 kg (3.6–79.4 kg), respectively. More than half were females (13; 56.5%). There was no conversion to sternotomy. Partial anomalous pulmonary venous connections were the most frequent primary diagnoses (14; 60.9%), followed by scimitar syndrome (3; 13%), while two patients (8.7%) had total anomalous pulmonary venous connections. Repair techniques included single patch in 10 patients (43.5%), Warden in 6 (26.1%), and two-patch technique in 4 (17.4%). The median cardiopulmonary bypass and aortic cross-clamp times were 91 and 62 min, respectively. All patients were extubated in the operating room. The median length of hospital stay was 2 days. There were no mortalities or reoperations for pulmonary/systemic venous pathway obstruction. (4) Conclusions: Vertical right axillary thoracotomy is a valuable approach for repairing anomalous pulmonary venous connections with or without sinus venosus defects. All repair techniques, including Warden and scimitar, can be performed safely through this approach. The cosmetic superiority and short hospital stay make this approach worth considering. Full article
(This article belongs to the Section Cardiac Surgery)
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14 pages, 884 KB  
Article
Shifting Trends in Intensive Cardiovascular Care Unit Admission Patterns: Retrospective Insights and Prospective Implications
by Ranel Loutati, Louay Taha, Mohammad Karmi, Noam Fink, Pierre Sabouret, Mamas A. Mamas, Ari Naimark, Ariella Tvito, Yonit Wiener-Well, Amjad Abu-Salman, Mony Shuvy, Ofer Merin, Michael Glikson and Elad Asher
Diagnostics 2025, 15(20), 2563; https://doi.org/10.3390/diagnostics15202563 (registering DOI) - 11 Oct 2025
Abstract
Background: Intensive Cardiovascular Care Units (ICCUs) are critical in managing high-acuity cardiovascular conditions, yet contemporary data on evolving admission patterns and their association with outcomes are limited. Methods: We conducted a retrospective cohort study of all patients admitted to a tertiary-care [...] Read more.
Background: Intensive Cardiovascular Care Units (ICCUs) are critical in managing high-acuity cardiovascular conditions, yet contemporary data on evolving admission patterns and their association with outcomes are limited. Methods: We conducted a retrospective cohort study of all patients admitted to a tertiary-care ICCU between July 2019 and December 2024. Patients were stratified by admission period: early (2019–2021) and late (2022–2024). Baseline characteristics, index diagnosis, interventions, complications, and mortality outcomes were compared. The primary endpoints were in-hospital and one-year mortality. Results: The study included 6266 patients (median age 69 years, 32% female). Of them, 3125 and 3141 patients were admitted in the early and late periods, respectively. Patients in the later period exhibited a higher burden of co-morbidities, including increased rates of atrial fibrillation, cognitive impairment, and dialysis (p < 0.05 for all). The pattern of index diagnoses shifted, showing an increase in heart failure (5.6% vs. 3.7%, p = 0.001) and malignant arrhythmia admissions (13.9% vs. 9.3%, p < 0.001), alongside a decline in cases of NSTEMI and pulmonary embolism. The use of urgent percutaneous coronary intervention, transcatheter valvular interventions, and microaxial pumps increased, whereas intra-aortic balloon pump usage declined. In-hospital mortality remained consistent between the periods at 2.7%. However, adjusted one-year mortality was significantly reduced in the later period (adjusted HR 0.84, 95% CI 0.71–0.98, p = 0.037). Conclusions: Over five years, ICCU admissions showed increasing complexity and evolving procedural trends. Despite higher acuity, adjusted one-year survival improved, highlighting care advances and the value of continuous data-driven ICCU optimization. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Management in Cardiology)
14 pages, 996 KB  
Article
Predictors of Step-Up Therapy and Outcomes in Idiopathic Granulomatous Mastitis: A Retrospective Cohort Study in Singapore
by Kai Lin Lee, Jessele Shian Yi Lai, Peh Joo Ho, Hung Chew Wong, Karen Kaye Casida, Qin Xiang Ng, Mikael Hartman and Serene Si Ning Goh
J. Clin. Med. 2025, 14(20), 7157; https://doi.org/10.3390/jcm14207157 - 10 Oct 2025
Abstract
Background: Idiopathic granulomatous mastitis (IGM) is a rare, benign, chronic inflammatory breast condition that poses diagnostic and therapeutic challenges. While corticosteroids are standard first-line therapy, some patients require additional immunomodulation, such as methotrexate. Predictive factors for step-up therapy remain poorly characterized. This [...] Read more.
Background: Idiopathic granulomatous mastitis (IGM) is a rare, benign, chronic inflammatory breast condition that poses diagnostic and therapeutic challenges. While corticosteroids are standard first-line therapy, some patients require additional immunomodulation, such as methotrexate. Predictive factors for step-up therapy remain poorly characterized. This study aimed to identify clinical, imaging, and pathological factors predictive of step-up therapy in IGM and evaluate associations between treatment approach and outcomes. Methods: A retrospective cohort study of women diagnosed with IGM was conducted between May 2022 and June 2024 at a tertiary center in Singapore. Data on demographics, clinical presentation, imaging, histopathology, and treatment were extracted. Step-up therapy was defined as methotrexate use following corticosteroids. Primary outcome was predictors of step-up therapy; secondary outcomes included treatment success, relapse, surgery, and time to remission. Statistical analyses included chi-square/Fisher’s exact tests, Cox models, and Kaplan-Meier analysis. Results: Fifty-two women (median age 39 years) were included; 26 (50%) required step-up therapy. Predictors included oral contraceptive (OCP) use (RR 1.92; 95% CI 1.45–2.53; p < 0.001), smoking (RR 2.00; 95% CI 1.49–2.69; p < 0.001), flares (RR 2.33; 95% CI 1.44–3.79; p = 0.002), and percutaneous aspiration (RR 2.10; 95% CI 1.53–2.88; p = 0.025). Patients receiving methotrexate had lower relapse rates (RR 1.23; 95% CI 1.12–1.36; p < 0.001) but longer time to remission (adjusted HR 0.09; 95% CI 0.02–0.46; p = 0.004). Conclusions: OCP use, smoking, flares, and aspiration need may predict step-up therapy in IGM. Early identification could guide a more personalized, potentially top-down treatment. Full article
(This article belongs to the Section Immunology & Rheumatology)
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15 pages, 1041 KB  
Article
Opportunity Screening for Early Detection of Gestational Diabetes: Results from the MERGD Study
by Manju Mamtani, Kunal Kurhe, Ashwini Patel, Manisha Jaisinghani, Kanchan V. Pipal, Savita Bhargav, Shailendra Mundhada, Prabir Kumar Das, Seema Parvekar, Vaishali Khedikar, Archana B. Patel and Hemant Kulkarni
J. Clin. Med. 2025, 14(20), 7151; https://doi.org/10.3390/jcm14207151 - 10 Oct 2025
Abstract
Background: The definitions and approaches used to diagnose gestational diabetes (GD) are varied. The two-step approach recommended by the American College of Obstetricians and Gynecologists (ACOG) combines the sensitivity of a glucose challenge test (GCT) with the specificity of a 3-hour oral glucose [...] Read more.
Background: The definitions and approaches used to diagnose gestational diabetes (GD) are varied. The two-step approach recommended by the American College of Obstetricians and Gynecologists (ACOG) combines the sensitivity of a glucose challenge test (GCT) with the specificity of a 3-hour oral glucose tolerance test (OGTT). We investigated if minor modification of the two-step procedure can provide improved detection of GD by identifying a risk group of pregnant women with high risk of GD. Methods: We conducted a prospective cohort study of pregnant women enrolled early during pregnancy and followed till delivery. All participants underwent the ACOG-recommended two-step procedure for GD diagnosis. Based on GCT and OGTT results, the participants were divided into four risk groups (RGs): GCT-negative (RG0), GCT-positive but OGTT normal (RG1), single abnormal value on OGTT or raised HbA1c (RG2) and diagnosed GD (RG3). Baseline evaluation included dietary history (24 hour recall) and physical activity. A series of multivariable logistic regression analyses were conducted to estimate the odds of maternal and fetal outcomes. Results: A total of 1041 pregnant women were included in the study, of whom 16 (1.6%) were diagnosed as GD. Our two-step approach identified 48 (4.6%) women as GD, while RG2, RG1 and RG0 comprised 75 (7.2%), 218 (20.9%) and 700 (67.2%), respectively. Compared to RG0, RG2 showed a higher likelihood of antepartum complications [odds ratio and 95% confidence interval 2.38 (1.16–4.15)], any adverse outcome without [2.04 (1.17–3.55)] or with cesarean section [2.09 (1.21–3.61)] and primary cesarean section [1.68 (1.01–2.81)] after adjustment for potential confounders. RG2 was also significantly associated with pregnancy-induced hypertension, meconium-stained amniotic fluid and premature rupture of membranes. Conclusions: In the study participants, we identified a subgroup (RG2) at high risk of GD with perinatal outcomes showing profile consistent with that of GD. Full article
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15 pages, 852 KB  
Article
Effect of Influenza Vaccination on the Disease Severity and Viral Load Among Adult Outpatients and Inpatients
by Alexander Domnich, Vincenzo Paolozzi, Giada Garzillo, Andrea Orsi and Giancarlo Icardi
Vaccines 2025, 13(10), 1046; https://doi.org/10.3390/vaccines13101046 - 10 Oct 2025
Abstract
Background: Some studies suggest that, thanks to the mechanisms of immune-mediated attenuation, influenza vaccination reduces severity of influenza illness in breakthrough infections. This study aimed to assess whether influenza vaccination attenuates severity of laboratory-confirmed influenza among Italian adults. Methods: This secondary [...] Read more.
Background: Some studies suggest that, thanks to the mechanisms of immune-mediated attenuation, influenza vaccination reduces severity of influenza illness in breakthrough infections. This study aimed to assess whether influenza vaccination attenuates severity of laboratory-confirmed influenza among Italian adults. Methods: This secondary analysis included all influenza cases detected during respiratory surveillance studies conducted in outpatient and inpatient settings in Genoa (Italy), throughout the 2023/2024 and 2024/2025 seasons. Here, we compared viral load and the count of influenza-related symptoms in outpatients, alongside all-cause in-hospital mortality and radiologically confirmed pneumonia in inpatients, between vaccinated and unvaccinated adults. Results: The study included 188 influenza cases diagnosed in primary care and 281 influenza cases identified among inpatients. Of these, 37.2% and 31.7%, respectively, were vaccinated, constituting breakthrough infections. Compared to unvaccinated adults, vaccinated outpatients had a slightly lower viral load (difference in cycle threshold values of 1.36 corresponding to about 0.51 log10 reduction in the number of copies/mL; p = 0.077), primarily driven by influenza A(H1N1)pdm09. Vaccinated outpatients also reported 9% fewer influenza-related symptoms than unvaccinated counterparts [prevalence ratio 0.91; 95% confidence interval (CI): 0.84, 0.99]. Among hospitalized older adults, influenza vaccination was associated with 64% reduced odds of in-hospital death (odds ratio 0.36; 95% CI: 0.12, 0.94). Conversely, no association between vaccination and development of pneumonia was found. Conclusions: This study corroborates the idea that influenza vaccination attenuates disease severity in breakthrough infections. These effects are, however, dependent on the measure of severity used. Full article
(This article belongs to the Special Issue The Effectiveness of Influenza Vaccine)
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17 pages, 1861 KB  
Case Report
Porcine Collagen Injection Therapy Affects Proximal Hamstring Tendinopathy in Athletes by Reducing Time to Return to Sport
by Matteo Baldassarri, Sarino Ricciardello, Diego Ghinelli, Luca Perazzo and Roberto Buda
Sports 2025, 13(10), 359; https://doi.org/10.3390/sports13100359 - 10 Oct 2025
Viewed by 14
Abstract
Background: Proximal hamstring tendinopathy (PHT) is a challenging overuse injury, particularly in athletes, characterized by deep buttock pain localized to the ischial tuberosity and often exacerbated by sports activities. This condition can impact an athlete’s performance, limiting high-level athletic activity. Return to sport [...] Read more.
Background: Proximal hamstring tendinopathy (PHT) is a challenging overuse injury, particularly in athletes, characterized by deep buttock pain localized to the ischial tuberosity and often exacerbated by sports activities. This condition can impact an athlete’s performance, limiting high-level athletic activity. Return to sport (RTS) thus becomes a medical, physical, athletic, and economic necessity. Previous research has explored several conservative and injection-based therapies, but evidence regarding the efficacy of porcine collagen injections remains limited. Therefore, this study aims to compare the results obtained from ultrasound-guided porcine collagen injections versus a structured rehabilitation program in reducing time to return to sport (RTS) and improving Victorian Institute of Sport Assessment—Hamstring (VISA-H) scores with respect to athletes with clinically diagnosed PHT. Conservative approaches for PHT treatments include various options, such as physiotherapy, corticosteroids, plasma-rich-platelet, shockwave therapy, and collagen injection. Collagen demonstrated to be a validated option for tendinopathies treatment due its regenerative and restorative mechanism of action. Methods: Retrospective data were collected from twenty-eight athletes with a clinical diagnosis of PHT, confirmed based on pain provocation tests (Puranen–Orava, bent-knee, and modified bent-knee tests), who were divided into two groups: COL and REHAB. The VISA-H outcomes were recorded for all subjects. The COL group received three ultrasound-guided collagen injections at weekly intervals, plus standard care instructions. The REHAB group completed a progressive exercise program targeting hamstring and lumbopelvic stabilization. The primary outcomes were RTS time (days) and VISA-H scores at baseline and 8 weeks. Adverse effects were recorded. Results: The two groups of treatment were very homogeneous and showed parametric distribution concerning the biological and pathophysiological conditions. No adverse events were reported. The mean times to RTS were 57 and 72 days for COL and REHAB, respectively (p = 0.0083). The VISA-H results revealed better improvement for the COL group than the REHAB treatment (p < 0.0001), and the log-rank test showed a higher odds ratio (HR) for RTS, 5.35 (p = 0.0008), for the COL athletes. Conclusions: Ultrasound-guided porcine collagen injections, combined with standard care, significantly reduced RTS time and improved VISA-H scores compared with rehabilitation alone in athletes with PHT. However, a larger cohort of athletes might be needed to gather more information about this conservative treatment in PHT pathology. Full article
(This article belongs to the Special Issue The Prevention and Rehabilitation of Training Injuries)
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23 pages, 993 KB  
Review
Neutrophilic Asthma—From Mechanisms to New Perspectives of Therapy
by Ilona Iwaszko, Krzysztof Specjalski, Marta Chełmińska and Marek Niedoszytko
J. Clin. Med. 2025, 14(20), 7137; https://doi.org/10.3390/jcm14207137 - 10 Oct 2025
Viewed by 60
Abstract
Neutrophilic asthma (NA) is an inflammatory phenotype of asthma, characterized by predominantly neutrophilic infiltrations in bronchial mucosa. It is usually diagnosed on the basis of high neutrophil count in induced sputum (from >40% to >76%) with low eosinophils (<2%). The prevalence of NA [...] Read more.
Neutrophilic asthma (NA) is an inflammatory phenotype of asthma, characterized by predominantly neutrophilic infiltrations in bronchial mucosa. It is usually diagnosed on the basis of high neutrophil count in induced sputum (from >40% to >76%) with low eosinophils (<2%). The prevalence of NA ranges from 16% to 28% of the adult asthma population depending on the definitions and study methods applied. A clinical picture of NA is characterized by late onset of symptoms, higher exacerbation rate, lower level of symptoms control, and poorer response to steroids compared to eosinophilic phenotype. Comorbidities such as obesity and GERD as well as the influence of environmental factors (air pollution, smoking, bacterial infections) contribute to the development and severe course of the disease. NA is T2-low disease with predominantly Th1/Th17-type inflammation. Neutrophils are key cells responsible for initiating and sustaining inflammation. In addition to their primary functions like phagocytosis, degranulation, and NETosis, neutrophils release several pro-inflammatory cytokines (IL-1α, IL-1β, IL-6, TNF) and chemokines (CXCL-1, -2, -8, -9, -10) responsible for the recruitment of other neutrophils or T cells. Increasing knowledge about the biology of neutrophiles and their role in asthma results in new potential therapies that could improve control of NA, particularly new biologicals targeting Th1/Th17-related cytokines. In this review, we discuss the prevalence, mechanisms, and clinical features of neutrophilic asthma. Furthermore, current therapeutic options and some promising perspectives for the near future are presented. Full article
(This article belongs to the Special Issue Advances in Asthma: 2nd Edition)
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15 pages, 1013 KB  
Article
Divergent Trends in Esophageal Adenocarcinoma and Squamous Cell Carcinoma Incidence, 2000–2022
by Vinit H. Majmudar, Kyle Nguyen-Ngo and Michael Tadros
Gastroenterol. Insights 2025, 16(4), 37; https://doi.org/10.3390/gastroent16040037 - 9 Oct 2025
Viewed by 217
Abstract
Background: Esophageal adenocarcinoma (EAC) and squamous cell carcinoma (ESCC) follow divergent incidence trajectories in the United States. Rising use of electronic nicotine delivery systems (ENDS) and evolving demographic risk profiles may be reshaping these trends. We aimed to characterize national incidence patterns [...] Read more.
Background: Esophageal adenocarcinoma (EAC) and squamous cell carcinoma (ESCC) follow divergent incidence trajectories in the United States. Rising use of electronic nicotine delivery systems (ENDS) and evolving demographic risk profiles may be reshaping these trends. We aimed to characterize national incidence patterns of EAC and ESCC from 2000 through 2022—stratified by age, sex, and race/ethnicity—and to place these in the context of changing behavioral exposures. Methods: We performed a retrospective cohort study using Surveillance, Epidemiology, and End Results SEER 21 registry data (covering 48% of the U.S. population). We included first-primary, histologically confirmed EAC (ICD-O-3 codes 8140–8576) and ESCC (8050–8084) in individuals aged ≥ 15 years diagnosed between 2000 and 2022. Age-adjusted incidence rates (per 100,000 person-years; 2000 U.S. standard) and annual percent changes (APCs) were estimated via Joinpoint regression models. Results: A total of 90,290 EAC and 47,916 ESCC cases were identified. EAC incidence increased from 2.3 to 2.8 per 100,000 (APC +0.90%; 95% CI, 0.45–1.35), with the largest relative rises in ages 15–39 years (APC +1.50%) and among women (APC +2.65%). Non-Hispanic Black and American Indian/Alaska Native populations experienced the most pronounced EAC increases. Overall ESCC incidence declined (APC −0.78%; 95% CI, −1.10 to −0.46), though Asian/Pacific Islander (+3.59%) and American Indian/Alaska Native (+1.58%) groups saw rising rates. Conclusions: EAC incidence continues to climb—especially in younger adults, women, and select racial/ethnic minorities—while ESCC declines are uneven. These histology-specific patterns highlight the urgency of tailored prevention, targeted early-detection efforts, and mechanistic studies on emerging exposures such as vaping. Full article
(This article belongs to the Section Gastrointestinal Disease)
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11 pages, 1913 KB  
Article
Prognostic Insights into Orbital Metastases: A Comprehensive Analysis of Clinical Features and Survival Outcomes
by Burak Ulas, Altan Atakan Ozcan, Feyza Alara Celikten, Omer Kaya and Ertugrul Bayram
Diagnostics 2025, 15(19), 2542; https://doi.org/10.3390/diagnostics15192542 - 9 Oct 2025
Viewed by 147
Abstract
Background/Objectives: We aimed to evaluate the demographic characteristics, clinical findings, and survival outcomes of patients diagnosed with orbital metastasis, considering primary tumor type, age, and gender variables. Methods: In this observational study, demographic data, tumor localization, histopathological diagnoses, and survival times of 83 [...] Read more.
Background/Objectives: We aimed to evaluate the demographic characteristics, clinical findings, and survival outcomes of patients diagnosed with orbital metastasis, considering primary tumor type, age, and gender variables. Methods: In this observational study, demographic data, tumor localization, histopathological diagnoses, and survival times of 83 patients followed for secondary orbital metastasis at Çukurova University Ophthalmology Department between 2003 and 2023 were retrospectively reviewed. Subgroup analyses were performed according to age (<18 and ≥19), gender, and primary tumor groups. Results: The study included 83 patients (51 (61.4%) females and 32 (38.6%) males). The mean age at diagnosis was found to be 40.8 ± 24.6 years. A total of 24.1% of the cases were in the pediatric age group (mean age 5.9 years), and the most common tumor metastasizing to the orbit in this group was neuroblastoma (80%). In adult patients, the two most frequent tumors metastasizing to the orbit were breast cancer (33.3%) and lung cancer (14.3%). The most common clinical findings were proptosis (32.5%) and blurred vision (26.2%). Orbital metastases were observed more frequently in females than in males (61.4% vs. 38.6%). This ratio was similar in the pediatric age group (65.0% vs. 35.0%). The mean survival time after metastasis was calculated as 316.7 ± 68.6 days. Female patients had a significantly longer survival time after metastasis compared to males (mean 400.4 vs. 165.4 days; p = 0.037). The median survival after metastasis was 86 days for patients with breast cancer and 204 days for patients with neuroblastoma. Conclusions: The most common source of orbital metastases in females is breast cancer, while neuroblastoma is prominent in pediatric patients. Despite all available treatment options, the prognosis after orbital metastasis is poor; this highlights the importance of early diagnosis and a multidisciplinary approach. Full article
(This article belongs to the Section Clinical Diagnosis and Prognosis)
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11 pages, 2329 KB  
Case Report
Mimickers of Systemic Lupus Erythematosus: Case Series and Literature Overview
by Kaj L. Roest, A. (Liesbeth) E. Hak, Ester M. M. van Leeuwen, Godelieve J. de Bree and Arjan J. Kwakernaak
J. Clin. Med. 2025, 14(19), 7070; https://doi.org/10.3390/jcm14197070 - 7 Oct 2025
Viewed by 268
Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by a broad and varied clinical presentation. In the absence of definite diagnostic criteria, establishing an SLE diagnosis remains challenging. This case series illustrates that other diseases, such as primary immunodeficiencies and monogenic interferonopathies, [...] Read more.
Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by a broad and varied clinical presentation. In the absence of definite diagnostic criteria, establishing an SLE diagnosis remains challenging. This case series illustrates that other diseases, such as primary immunodeficiencies and monogenic interferonopathies, can closely mimic SLE, even in the presence of its typical serological markers. Recognizing these disease mimickers is crucial to avoid premature conclusions in clinical evaluation and to ensure the initiation of appropriate therapy. Especially in cases of atypical presentation, unusual disease progression, or resistance to standard therapy, alternative diagnoses should be considered. In this overview, we discuss the diagnostic approach for patients with SLE-like manifestations and provide a comprehensive review of diseases that may mimic SLE. Full article
(This article belongs to the Section Immunology & Rheumatology)
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10 pages, 372 KB  
Article
Circulating Cell-Free DNA in Neuroendocrine Lung Tumors: Preliminary Data from a Prospective Surgical Series
by Filippo Lococo, Elisa De Paolis, Carolina Sassorossi, Jessica Evangelista, Annalisa Campanella, Gloria Santoro, Angelo Minucci, Stefano Margaritora and Andrea Urbani
Appl. Sci. 2025, 15(19), 10766; https://doi.org/10.3390/app151910766 - 7 Oct 2025
Viewed by 170
Abstract
Pulmonary neuroendocrine tumors (PULMONARY NETs) are heterogeneous tumors ranging from well-differentiated to highly aggressive neoplasms. The aim of this study is to prospectively test pre-operative circulating free DNA (cfDNA) in PULMONARY NET patients undergoing surgery and evaluate its relationship to clinicopathological features. From [...] Read more.
Pulmonary neuroendocrine tumors (PULMONARY NETs) are heterogeneous tumors ranging from well-differentiated to highly aggressive neoplasms. The aim of this study is to prospectively test pre-operative circulating free DNA (cfDNA) in PULMONARY NET patients undergoing surgery and evaluate its relationship to clinicopathological features. From February to December 2024, 136 patients with suspected primary lung cancer underwent pre-operative blood sampling, of whom 21 were diagnosed with PULMONARY NETs. Total cell-free nucleic acid extraction was performed using the Genexus Purification System (Thermofisher). cfDNA was quantified using a fluorometric assay with the Qubit dsDNA HS Assay kit (Thermofisher) and a capillary electrophoresis-based assay (cell-free DNA ScreenTape kit) on the Tape Station 4200 systems (Agilent). A cfDNA quality assessment was also obtained (cfDNA sizing and % cfDNA). Most patients had Stage I (18/21.85.7%) typical carcinoids (16/21.76.2%). Nodal involvement was detected in one patient (0.5%). Six months after surgery, all patients were alive without recurrence. Larger tumors presented higher levels of cfDNA. The mean tumor size in patients with cfDNA > 40 ng was 266 mm (±16.7 mm), compared to 13.2 mm (±7.3 mm) for cfDNA < 40 ng (p-value = 0.018). Higher levels of cfDNA were observed in patients with pStages greater than IA (p-value = 0.007). Although limited by a small sample group and biases of a surgical series, we observed that larger/advanced PULMONARY NETs presented higher cfDNA levels pre-operatively. Full article
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13 pages, 872 KB  
Article
Corticosteroid Use and Recurrence Risk Factors in Granulomatous Mastitis: A 17-Year Saudi Arabian Cohort Study—Steroids in Granulomatous Mastitis
by Shoag J. Albugami, Rema F. AlRasheed, Hussam A. Alharbi, Sarah S. Alobaid, Hawazin S. Alqahtani, Mays N. Alharbi, Eyad AlKharashi and Khalid Alhajri
Clin. Pract. 2025, 15(10), 185; https://doi.org/10.3390/clinpract15100185 - 6 Oct 2025
Viewed by 210
Abstract
Background: Granulomatous mastitis (GM) is a rare, chronic inflammatory breast condition with poorly understood etiology and variable clinical presentation. The efficacy of corticosteroid therapy in reducing recurrence remains controversial, particularly in Middle Eastern populations where the condition appears more prevalent. This study aimed [...] Read more.
Background: Granulomatous mastitis (GM) is a rare, chronic inflammatory breast condition with poorly understood etiology and variable clinical presentation. The efficacy of corticosteroid therapy in reducing recurrence remains controversial, particularly in Middle Eastern populations where the condition appears more prevalent. This study aimed to describe the demographic and clinical characteristics of patients with GM, evaluate the efficacy of corticosteroid therapy in reducing recurrence rates, and identify risk factors associated with disease recurrence. Methods: A retrospective cohort analysis was conducted on 56 patients diagnosed with GM between 2003 and 2020 at a single tertiary referral center. Patients were stratified into two groups based on steroid use (n = 14 with steroids and n = 42 without steroids). Results: The mean age of the cohort was 46.3 ± 13.2 years, with no significant differences in baseline characteristics between the steroid and non-steroid groups. The most common presentation was a breast mass (32.69%), often associated with abscess formation (25%). Core biopsy was the primary diagnostic tool used (51.79%). Recurrence of GM occurred in 10 patients (18%) overall: 7 patients (17%) in the non-steroid group and 3 patients (21%) in the steroid group. The difference in recurrence rates between the treatment groups was not statistically significant (HR = 1.40, 95% CI:0.30–6.52, p = 0.671). A history of infection (HR = 5.85, 95% CI: 1.60–21.44, p = 0.008) and hormonal disorders (hyperprolactinemia in one patient) (HR = 13.90, 95% CI: 1.43–135.52, p = 0.024) were significantly associated with recurrence. Conclusions: GM remains diagnostically challenging with an 18% recurrence rate in our cohort. We observed no statistically significant reduction in recurrence with corticosteroids, though our analysis was limited by sample size. These findings suggest that targeted management of these conditions may be beneficial in GM patients, though larger multicenter studies are needed to confirm these associations and establish standardized treatment protocols. Full article
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17 pages, 1972 KB  
Article
A Retrospective Study in Colorectal Adenocarcinoma Uncovers the Potential of Circ-CCT3 as a Predictor of Tumor Recurrence
by Panagiotis Kokoropoulos, Spyridon Christodoulou, Panagiotis Tsiakanikas, Efthimios Poulios, Panteleimon Vassiliu, Christos K. Kontos and Nikolaos Arkadopoulos
Biomedicines 2025, 13(10), 2432; https://doi.org/10.3390/biomedicines13102432 - 6 Oct 2025
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Abstract
Background/Objectives: Colorectal cancer (CRC) is one of the most prevalent malignancies; this issue underlines the need for accurate molecular biomarkers for early detection and accurate prognosis. Circular RNAs (circRNAs) have recently emerged as very promising cancer biomarkers. The circular transcript of the chaperonin-containing [...] Read more.
Background/Objectives: Colorectal cancer (CRC) is one of the most prevalent malignancies; this issue underlines the need for accurate molecular biomarkers for early detection and accurate prognosis. Circular RNAs (circRNAs) have recently emerged as very promising cancer biomarkers. The circular transcript of the chaperonin-containing TCP1 subunit 3 (CCT3) gene, namely circ-CCT3, is a significant oncogenic driver. In gastrointestinal malignancies, circ-CCT3 promotes tumor growth by sponging tumor-suppressor miRNAs. In this study, we examined whether circ-CCT3 expression can predict the prognosis of patients diagnosed with colorectal adenocarcinoma, the most frequent type of CRC. Methods: Total RNA was extracted from pulverized, fresh frozen colorectal tissues and reverse-transcribed. A previously developed, highly sensitive quantitative PCR (qPCR) assay was applied to determine circ-CCT3 expression in 216 primary colorectal adenocarcinoma tissue specimens and 86 paired normal colorectal tissues. Results: circ-CCT3 was significantly upregulated in colorectal adenocarcinoma tissues, in comparison to their non-cancerous tissue counterparts. Higher circ-CCT3 expression was associated with a poorer disease-free (DFS) and overall survival (OS) of colorectal adenocarcinoma patients. Interestingly, multivariate Cox regression showed that the prognostic value of circ-CCT3 expression regarding DFS was independent of other established prognosticators used in clinical practice, including TNM staging. Furthermore, the stratification of patients based on the TNM classification of the tumors revealed that increased circ-CCT3 levels predicted shorter DFS and OS intervals, especially in the subgroup of TNM stage II or III patients. Conclusions: Our study provides evidence that circ-CCT3 overexpression constitutes a promising molecular biomarker of poor prognosis in colorectal adenocarcinoma, independently predicting tumor recurrence. Full article
(This article belongs to the Section Molecular and Translational Medicine)
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13 pages, 737 KB  
Article
Impact of the COVID-19 Pandemic on Hemato-Oncology Services: A Retrospective Dual-Center Cohort Study in Kazakhstan
by Maral Yerdenova, Aigulsum Izekenova, Akbope Myrkassymova, Gaukhar Mergenova, Mohammed Merzah, Balday Issenova, Maksat Mamyrkul, Aliya Atabayeva, Vytenis Kalibatas, Dejan Nikolic and Yineng Chen
Healthcare 2025, 13(19), 2520; https://doi.org/10.3390/healthcare13192520 - 4 Oct 2025
Viewed by 543
Abstract
Background: Numerous healthcare services have been affected by the COVID-19 pandemic worldwide. Specialized healthcare services were postponed or canceled, potentially compromising regular services for hemato-oncology patients. The current study aimed to analyze the impact of the COVID-19 pandemic on access to hemato-oncology services [...] Read more.
Background: Numerous healthcare services have been affected by the COVID-19 pandemic worldwide. Specialized healthcare services were postponed or canceled, potentially compromising regular services for hemato-oncology patients. The current study aimed to analyze the impact of the COVID-19 pandemic on access to hemato-oncology services in Almaty, the largest city in Kazakhstan. Methods: We retrospectively analyzed the socio-demographic characteristics of patients admitted to two large tertiary centers rendering hemato-oncology services, the City Clinical Hospital 7 (H7) and the Kazakh Institute of Oncology and Radiology (KazIOR). All data were retrieved for the period spanning from 1 March 2019 to 28 February 2022. The retrieved variables included age, gender, type of residence, hospitalization rate, treatment outcomes (discharged/deceased), bed days, diagnoses according to International Classification of Diseases (ICD-10) (acute leukemia and hematopoietic depression, lymphoproliferative diseases, and myeloproliferative diseases), and referral sources (ambulance, another hospital, consultative and diagnostic assistance, primary healthcare, self-referral, and referrals from hematologists’ offices). Results: In the 2019–2022 period, 6763 hemato-oncology hospitalizations were registered: 3583 in H7 and 3180 in KazIOR. The mean age at hospitalization was 55.04 (SD = 16.07) for females and 51.2 (SD = 16.7) for males. The proportion of hospitalized urban and rural patients differed significantly: 6191 (92%) and 571 (8,4%), respectively (χ2 = 13.8, p = 0.001). In the 2020–2021 period, fewer patients were discharged (n = 2047) compared to 2019–2020 (n = 2387) and 2021–2022 (n = 2081) (χ2 = 20.09, p = 0.003). However, the proportion of deaths in the 2020–2021 period (3.5%) was higher than in the 2019–2020 (3.2%) and 2021–2022 periods (2.6%) (χ2 = 20.09, p = 0.003). A total of 403 (19%) hospital admissions were carried out by ambulance (emergency cases) in the 2020–2021 period, 368 (14.8%) in 2019–2020, and 394 (18.3%) in 2021–2022 (χ2 = 2231, p < 0.001). The number of patients transferred from other hospitals to H7 and KazIOR increased by 12.4% in the 2020–2021 period. Conclusions: Our findings indicate a negative impact of the COVID-19 pandemic on access to hemato-oncology services, leading to increased mortality. Further studies are warranted to explore factors underlying the trends in hospitalizations and mortality of hemato-oncology patients during healthcare crises. Full article
(This article belongs to the Collection COVID-19: Impact on Public Health and Healthcare)
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