INTRODUCTION:We aim to present a peculiar case of a patient we treated, who underwent surgical excision of what at first were HPV-related condylomas of the urethral meatus. The second time he underwent surgical excision of what seemed a recurrence the histology showed a low grade noninvasive papillary urothelial carcinoma. CASE DESCRIPTION:A 56-year-old man who underwent surgical excision of multiple lesions of the gland and distal urethra in April 2023; the histological examination of the neoformations in distal urethra confirmed the presence of condyloma acuminatum. He experienced a recurrence of distal urethral lesion; therefore, he underwent to a new surgical excision in September 2023 and this time the histological examination showed a transitional cell carcinoma. CONCLUSION:There is still no clear evidence of the link between HPV infection and TCC, however attention must be placed in order to enhance awareness on HPV infection prevention and on TCC screening for patient with other HPV infection related diseases.
To compare MRI-based graft maturation and tibial tunnel behavior in all-inside anterior cruciate ligament (ACL) reconstruction using either a quadrupled semitendinosus (ST4) graft or a standard doubled semitendinosus–gracilis (DSTG) technique and to assess mid-term clinical outcomes. This is a single-center prospective comparative cohort with sequential, non-randomized allocation. Primary imaging endpoints were graft signal-to-noise quotient (SNQ, PD-FS) and tibial tunnel cross-sectional area (CSA) change; clinical endpoints included PROMs and laxity at ≥ 24 months. Reliability was assessed with two independent evaluators and reported using ICC (two-way random, absolute agreement) with 95
Cancer-related pain is a multidimensional phenomenon, and key determinants of pain intensity remain unclear. The aim of this study was to identify the clinical determinants of cancer-related pain intensity using a convergent, multimethod analytical framework. Prospective observational study of patients with cancer-related pain. Pain was assessed using a 0–10 numeric rating scale (NRS), the Douleur Neuropathique 4, and the Brief Pain Inventory (BPI). Clinical variables included Eastern Cooperative Oncology Group Performance Status (ECOG-PS), metastatic status, comorbidities, and treatments. Multivariable regression, unsupervised clustering, and supervised machine-learning (ML) models were applied. Eighty-six patients were included (median age 64 years). In bivariate analyses, higher pain intensity was associated with opioid use and poorer functional status, while neuropathic pain features were prevalent but not independently associated with pain intensity. Spearman correlation analysis demonstrated significant associations between ECOG-PS and pain intensity, BPI severity, and BPI interference. In multivariable regression, ECOG-PS emerged as a key independent predictor of pain intensity, whereas metastatic status and cancer type were not independently associated. Unsupervised clustering identified two clinically meaningful phenotypes primarily distinguished by pain intensity and functional interference, rather than neuropathic mechanisms. In supervised ML models predicting high pain burden (NRS ≥ 7), ECOG-PS consistently ranked as the most influential feature, although overall predictive performance was modest. Functional impairment represents a central determinant of cancer-related pain intensity, surpassing pain phenotype and disease-related variables across complementary analytical approaches. These findings support function-centered pain assessment frameworks and underscore the need to systematically integrate functional evaluation into cancer pain management strategies. The study was prospectively registered on ClinicalTrials.gov (identifier: NCT07038434).
Long-term (> 24 weeks) real-world evidence of eptinezumab’s effectiveness is limited. We evaluated ≥ 50
BACKGROUND:Unilateral vocal cord paralysis (UVCP) is characterized by the immobility of a hemilarynx resulting from neurological dysfunction. The laryngeal intrinsic muscles are innervated by the recurrent laryngeal nerve (RLN), a branch of the vagus nerve (VN). Pathological processes affecting the motor nucleus of the VN (nucleus ambiguus), the VN itself, or the RLN can result in UVCP. Crucially, UVCP must be distinguished from mechanical vocal cord hypomobility caused by local laryngeal factors. AIM:This review aims to provide a structured radiological guide for the evaluation of UVCP, focusing on the relevant clinical assessment, optimized imaging protocols, laryngeal anatomy, radiological signs of UVCP, and the anatomical pathways of the vagus and recurrent laryngeal nerves. METHODS:A comprehensive review of current literature and clinical imaging standards was performed to synthetize a diagnostic approach for identifying UVCP ant its underlying causes from the brainstem to the neck and mediastinum. RESULTS:Condition causing UVCP may occur anywhere from the brainstem to the mediastinum and include inflammatory, vascular, and neoplastic diseases. By utilizing a structured anatomical approach, radiologists can systematically evaluate the nerve's entire course. However, while imaging is highly effective at detecting organic lesions, a significant number of cases remains idiopathic. CONCLUSION:Imaging is critical for identifying the site and nature of damage causing UVCP. A structured diagnostic approach ensures accurate evaluation of all potential causative lesions from the central nervous system to the chest, significantly impacting patient management.
