Introduction. Renal angiomyolipoma (AML) is an uncommon benign renal neoplasm with a diverse body of literature spanning diagnosis, pathology, molecular biology, surveillance, and treatment. This study aimed to identify and characterize the 50 most-cited publications on renal AML and to examine the bibliometric, methodological, authorship, and thematic features associated with their citation performance. Methods. A retrospective bibliometric analysis was performed using the Web of Science Core Collection. The database was searched on July 22, 2026, for publications indexed from 1975 to 2026 using terms related to renal AML. Citation counts were recorded as of August 5, 2026. Of 1,414 retrieved records, the 100 most-cited were screened for eligibility, and the 50 highest-ranked eligible publications were included. Citation performance, source journals, geographic and institutional contributions, study designs, levels of evidence, authorship characteristics, and research themes were analyzed. Keyword co-occurrence, reference co-citation, and bibliographic coupling analyses were also performed. Exploratory associations with citation rate within the selected corpus were assessed using negative binomial regression. Results. The 50 articles were published between 1986 and 2020 and accumulated 7,764 citations, with a median of 122.5 citations per article (IQR 103.2–194.8). The Journal of Urology contributed the largest number of publications (n = 8), while the United States was the leading country of first-author affiliation (n = 28, 56.0%). Retrospective observational studies were the most common design (28.0%), and Level IV evidence predominated (66.0%). Multi-country authorship was present in 23 of 48 articles with available address data (47.9%). In exploratory adjusted analysis within the selected corpus, review articles had a higher citation rate than primary clinical studies (IRR 1.83, 95% CI 1.37–2.46), while multi-country publications had a higher citation rate than single-country publications (IRR 1.66, 95% CI 1.29–2.14). Major research themes included tuberous sclerosis complex pathology and molecular biology, diagnosis and imaging, embolization, surgery and follow-up, epithelioid and atypical variants, and mTOR inhibition and lymphangioleiomyomatosis. Conclusions. The most-cited literature on renal AML is multidisciplinary and reflects the evolution of the field across diagnosis, pathology, surveillance, and treatment. Review articles and multi-country authorship were associated with higher citation rates within the selected corpus. Future bibliometric studies could include newer and less-cited publications to assess patterns beyond this citation-selected corpus.
Introduction. This retrospective cohort study aimed to estimate the return‑to‑work (RTW) proportion among stroke survivors in metropolitan Shanghai, China, who were employed pre-stroke and to explore factors associated with RTW. Methods. A retrospective cohort study included stroke patients admitted to a tertiary rehabilitation center in Shanghai, China, between 2018 and 2023, with telephone follow-up conducted in 2024. Data were collected from electronic medical records and structured interviews. The primary outcome was RTW status. Eligibility required pre-stroke employment. The primary model included age group and social dysfunction, selected based on clinical plausibility and prior literature. Results. Of 79 eligible patients, 20 had returned to paid work at follow‑up (median: 12 months; IQR, 9–18 months), yielding an RTW proportion of 25.32% (20/79). In the primary Firth regression model, absence of social dysfunction was associated with higher odds of RTW (adjusted OR 10.57, 95% CI 2.38–100.76; p < 0.001), whereas age < 60 years did not reach statistical significance (adjusted OR 3.09, 95% CI 0.96–11.59; p = 0.058). In the sensitivity analysis restricted to participants aged < 60 years, absence of social dysfunction remained associated with RTW (OR = 8.66, 95% CI: 1.81–85.07; p = 0.005). Conclusions. Only a minority of participants had returned to paid work at follow-up. Absence of social dysfunction showed a notable association with RTW in this exploratory analysis. These findings suggest that vocational rehabilitation programs addressing social dysfunction merit further investigation in larger prospective studies.
Introduction. Dengue haemorrhagic fever (DHF) is characterized by plasma leakage during the critical phase of illness, typically occurring around defervescence between illness days 4 and 7. Delayed plasma leakage beyond this period is rarely described. Case Report. We report a diagnostically challenging case of dengue in a previously healthy young woman from a dengue-endemic region, in whom plasma leakage was detected on illness day 13, raising the possibility of a delayed critical phase, though a sequential febrile illness followed by dengue infection could not be excluded. The patient initially developed high-grade fever, vomiting, arthralgia, and myalgia, which resolved after three days. After a three-day period of transient clinical improvement, severe headache, abdominal pain, and recurrent vomiting developed without recurrence of fever. She was admitted on day 12 with thrombocytopenia and marked transaminitis. On day 13 of illness, ultrasonography demonstrated free fluid in the hepatorenal pouch and right pleural cavity, consistent with plasma leakage, while dengue IgM and IgG antibodies were positive. The patient was managed as DHF with careful fluid monitoring and recovered uneventfully. Conclusion. This case highlights the importance of considering dengue in patients from endemic settings even when presentation is atypical, afebrile, or temporally delayed. Although a delayed critical phase is possible, sequential febrile illnesses with subsequent dengue infection could not be excluded because early virological confirmation was unavailable. Careful monitoring for thrombocytopenia and plasma leakage remains essential even in apparently recovering patients.
Introduction. Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal neoplasm characterized by differentiated myofibroblastic spindle cells accompanied by an inflammatory infiltrate of plasma cells and lymphocytes. While typically localized in the lungs, its primary manifestation within the thyroid gland is exceptionally rare, posing significant diagnostic challenges due to its ability to mimic aggressive thyroid malignancies on clinical and radiological assessments. Case Report. A 48-year-old female healthcare professional with a history of a benign contralateral thyroid lobectomy 10 years prior presented with a painless left neck swelling. Ultrasonography revealed a 40 × 22 mm solid, hypoechoic, lobulated nodule (TI-RADS 4). Following the 5-month observation period, the lesion exhibited rapid dimensional growth to 47 × 27 mm and demonstrated severe stiffness on shear-wave elastography. Considering the American Thyroid Association guideline criteria and clinical concern, completion thyroidectomy was performed. Histopathological examination and immunohistochemical analysis revealed a neoplastic spindle cell proliferation that was diffusely positive for smooth muscle actin (SMA) but completely negative for anaplastic lymphoma kinase-1 (ALK-1) and thyroid transcription factor-1 (TTF-1), establishing a definitive diagnosis of primary thyroid IMT. No recurrence was observed during the 1-year follow-up. Conclusion. Primary thyroid IMT is a unique entity that should be considered in the differential diagnosis of rare spindle cell thyroid lesions. Definitive diagnosis relies on postoperative histopathological and immunohistochemical characterization rather than preoperative biopsy alone.
Introduction. Superior mesenteric artery syndrome (SMAS), or Wilkie’s syndrome, is a rare vascular compression disorder characterized by the compression of the third portion of the duodenum between the abdominal aorta and the superior mesenteric artery (SMA). This study aimed to describe computed tomography angiography (CTA)-derived aortomesenteric distance and angle measurements and to evaluate their associations with age and sex in surgically treated patients with Wilkie’s syndrome at a single tertiary center. Methods. We retrospectively reviewed records of 50 patients who underwent surgical treatment for SMAS between January 2015 and May 2024. Aortomesenteric measurements were performed on abdominal CTA images using TomoCon®, a Slovak DICOM viewing software. Descriptive and inferential statistics were applied to analyze the aortomesenteric distance (AMD), aortomesenteric angle (AMA), and demographic variables. Results. The median AMD was 6.55 mm [4.63 – 7.98], and the median AMA was 18.20° [13.98 – 21.38], both within the ranges commonly reported in SMAS and lower than published reference values. The median patient age was 33.95 years [23.78 – 47.83], with a pronounced female predominance (female-to-male ratio of 4.56:1). A moderate positive correlation was observed between AMD and AMA. No significant differences in AMD, AMA, or age were found between females and males. Conclusions. Surgically treated patients with Wilkie’s syndrome had lower CTA-derived AMD and AMA than those reported in published reference populations. The cohort was characterized by a predominance of younger female patients, consistent with previous reports.
