The choice of vascular access (VA) plays a key role in the success of hemodialysis (HD). Despite their widespread use, central venous catheters (CVCs) are associated with higher rates of dysfunction, thrombosis, and catheter-related bloodstream infections (CRBSI). We investigated current practices in pediatric HD across European pediatric nephrology centers, focusing on VA choices, infection control measures, and CRBSI management. An online questionnaire was e-mailed to 119 members of the European Society for Pediatric Nephrology (ESPN) Dialysis Working Group and European Pediatric Dialysis Working Group (EPDWG). Descriptive statistics were used to summarize practices across centers, comparative analyses between centers in countries with Human Development Index (HDI) > 0.90 and < 0.90. Thirty-one centers across Europe participated in the survey. CVCs were the primary VA in 73.1
This study aims to estimate the diagnostic accuracy of deep learning (DL) models for automated detection/classification of spinal degenerative disease (SDD) on spine MRI and explore clinically relevant heterogeneity. We searched Ovid MEDLINE, Ovid Embase and Web of Science (January 2010–5 December 2025) for diagnostic accuracy studies of DL applied to spine MRI with reconstructible 2 × 2 data (TP/FP/FN/TN). Risk of bias was assessed with QUADAS-2. Pooled sensitivity and specificity were synthesised using hierarchical bivariate/HSROC models with a prespecified arm-selection hierarchy. Prespecified subgroup/sensitivity analyses examined spinal region, severity threshold, validation type and target focus. Fourteen studies (2020–2025) were included from 2363 records. Sample sizes ranged from 29 to 2991. Overall pooled sensitivity was 0.94 (95
Ectopic air refers to the presence of air in unusual locations within the body, necessitating a thorough investigation into its underlying causes. The clinical implications of ectopic air can vary significantly, ranging from benign conditions to life-threatening circumstances, contingent upon the specific anatomical site involved and the rate and volume of air accumulation. The study aims to highlight that identifying the etiology of ectopic air poses substantial challenges, as air can be detected at considerable distances from its origin due to the interconnectivity of fascial planes. Intraosseous air foci, which occur in the absence of osteomyelitis, represent an unconventional site for the accumulation of ectopic air, as evidenced in the case presented herein. We report a case of a seventy-five-year-old immunocompetent woman who presented with features suggestive of septic shock. On computed tomography, a small colonic perforation along with ileal lipoma, pneumoperitoneum, pneumoretroperitoneum, subcutaneous and intermuscular emphysema, and intraosseous air foci in the right iliac bone and right sacral ala was found. Even after aggressive treatment, the patient succumbed to her illness. The case highlights the importance of early diagnosis and treatment in such cases to avoid a grave prognosis. The identification of ectopic air is critical, as it has the potential to result in life-threatening complications. A thorough interpretation of the imaging characteristics, along with an understanding of the underlying pathological mechanisms of abnormal air collection, helps refine the differential diagnosis of its etiology. This approach facilitates the initiation of prompt and optimal treatment.
OBJECTIVE:This systematic review aimed to synthesize and critically appraise molecular differences between oral squamous cell carcinoma arising in the background of oral submucous fibrosis (OSCC-OSMF) and OSCC without OSMF (OSCC-non-OSMF) across genomic, transcriptomic, proteomic, and immunohistochemical domains. DESIGN:A comprehensive literature search of PubMed/MEDLINE, Scopus, and Web of Science was conducted from database inception to November 2025 following PRISMA 2020 guidelines (PROSPERO: CRD420251152208). Human observational studies directly comparing molecular biomarkers between OSCC-OSMF and OSCC-non-OSMF were included. Risk of bias was assessed using the Newcastle-Ottawa Scale. Narrative synthesis was performed due to heterogeneity in study design, biomarkers, and analytical methods. RESULTS:Nineteen studies met inclusion criteria. Core carcinogenic pathways including p53 dysregulation, telomerase activation, and fibrosis-related mediators were largely comparable between OSCC-OSMF and OSCC-non-OSMF. In contrast, OSCC-OSMF consistently demonstrated enhanced epithelial-mesenchymal transition (EMT) and stemness signatures, increased genomic instability, and a markedly immunosuppressive tumor microenvironment characterized by regulatory T-cell predominance, PD-1/PD-L1 upregulation, and dendritic cell depletion. Paradoxically, OSCC-OSMF showed lower proliferative and angiogenic activity compared with OSCC-non-OSMF. CONCLUSIONS:Available evidence supports OSCC-OSMF as a fibrosis-conditioned clinic-molecular phenotype within the broader spectrum of OSCC. These findings highlight limitations of conventional prognostic markers and underscore the potential utility of immune, EMT, and genomic-related biomarkers for refined risk stratification and targeted therapy.
Introduction Chronic obstructive pulmonary disease (COPD) and heart failure (HF) frequently coexist, with COPD exacerbating cardiovascular complications and increasing mortality risk. This study analyzes CDC WONDER data (1999-2020) to examine trends in HF mortality among patients with COPD, highlighting age-related disparities and patterns that can inform public health strategies. Methods Using CDC WONDER data, we calculated AAMR per 100,000 for individuals aged 45-64 and 65+ who died from heart failure (HF) with chronic obstructive pulmonary disease (COPD). MCD analysis included HF (I50.0, I50.1, I50.9) and COPD (J40-J44.9). Joinpoint regression estimated APC and AAPC from 1999 to 2020. Results From 1999 to 2009, the AAMR for heart failure with COPD declined from 43.998 to 39.575 before increasing steadily, reaching 50.656 in 2020 (AAPC: 0.53, 95% CI: 0.22 to 0.85). A total of 1,109,491 deaths were recorded, with males (54.08) having higher AAMRs than females (36.22). NH White had the highest AAMR (47.31), followed by American Indian/Alaska Natives (43.9), NH Black (34.36), Hispanic (20.15) and NH Asian/Pacific Islanders (12.13). Mortality was higher in non-metropolitan (59.60) vs. metropolitan areas (39.81) and varied regionally (Midwest: 49.8; South: 44.8; West: 41.4; Northeast: 35.4). California had the most deaths (111,051), with most nationwide (375,021) occurring in medical inpatients. Mortality peaked in the 65+ group (CMR: 108.4). Conclusion Heart failure mortality among COPD patients increased from 1999 to 2020, with disparities by sex, race, and region. Higher mortality rates were observed in older adults, non-metropolitan areas, and NH White individuals. The rise in 2020 highlights the need for targeted interventions to improve outcomes in high-risk populations.
