Human papillomavirus (HPV)-driven oropharyngeal squamous cell carcinoma (OPSCC) has emerged as a biologically distinct entity, typically affecting younger, non-smoking patients and showing improved survival compared to HPV-negative tumors. Accurate HPV status determination is essential for correct staging, prognostic assessment, and treatment de-escalation. Despite advances, substantial variability persists among diagnostic methods and clinical workflows. A narrative review of PubMed, Scopus, and Web of Science databases was conducted up to July 2025. Studies addressing HPV detection techniques in OPSCC—including p16^INK4a^ immunohistochemistry (IHC), HPV DNA and RNA assays, liquid biopsy approaches, and computational surrogates—were critically analyzed regarding diagnostic accuracy, clinical applicability, and emerging innovations. Tissue-based assays remain the diagnostic reference standard. p16 IHC provides high sensitivity but limited specificity and should be confirmed with nucleic acid-based methods such as DNA PCR, in situ hybridization (ISH), or E6/E7 mRNA detection. Combined or “orthogonal” testing minimizes discordance and refines risk stratification. Liquid biopsy detection of circulating HPV DNA using droplet digital PCR or next-generation sequencing has shown high sensitivity and specificity in cohorts of patients with HPV-associated OPSCC, supporting its potential role as a complementary biomarker for treatment monitoring and surveillance. However, circulating HPV DNA alone does not unequivocally identify the anatomic source of HPV DNA and should be interpreted together with clinical, radiologic, and tissue-based findings. Oral rinse and saliva assays show moderate diagnostic performance, while artificial intelligence-based radiomic and histopathologic models are emerging as complementary tools. Reliable HPV attribution in OPSCC requires a multimodal diagnostic strategy integrating p16 IHC, molecular confirmation, and ctHPV-DNA monitoring. Methodological standardization and prospective validation are essential to implement precision-guided, cost-effective workflows in routine clinical practice.

Lymph node metastasis (LNM) is one of the most powerful prognostic determinants in head and neck squamous cell carcinoma (HNSCC). The extent and pattern of nodal involvement critically influence staging accuracy, therapeutic decision-making, and patient outcomes. However, the biological and clinical implications of nodal disease remain complex and continue to evolve. We aim to synthesize current clinical and translational evidence regarding the prognostic and therapeutic impact of LNM in HNSCC and to highlight emerging trends relevant to precision staging. A narrative review was conducted through a structured literature search in PubMed and Scopus (2008-2025), with emphasis on studies published in the last five years. Meta-analyses, large cohort studies, and evidence-based guidelines addressing prognostic factors, biological mechanisms, and management strategies were critically appraised. LNM is consistently associated with reduced overall and disease-free survival across major head and neck subsites. Key independent prognostic variables include the number of metastatic nodes, extranodal extension, and involved cervical levels. Recent advances, such as refinements in the AJCC 8th edition, sentinel lymph node mapping, high-resolution imaging, and molecular profiling, have improved early detection and refined risk stratification. LNM remains central to prognostic evaluation and treatment selection in HNSCC. Integrating biological insights with molecular diagnostics and advanced imaging will be essential to achieving precision staging and individualized therapeutic strategies.

Background: Contralateral lymph node metastasis (CLNM) in oral squamous cell carcinoma (OSCC) represents a major clinical challenge, in patients with a clinically contralateral node-negative neck. Individualized risk stratification is crucial to guide decisions on elective contralateral neck dissection. This study aimed to synthesize existing evidence and apply Bayesian Monte Carlo Simulation (MCS) to estimate CLNM probability across various clinic-pathological scenarios. Methods: A systematic search of PubMed, PubMed Central, and Embase (2000–2024) identified 26 eligible studies. Effect sizes for seven key risk factors—midline-crossing tumours, extranodal extension (ENE), ≥2 ipsilateral lymph nodes, depth of invasion (DOI) >10 mm, perineural invasion and lymphovascular invasion (PNI-LVI), poor differentiation, and floor of mouth subsite—were computed and incorporated into a Bayesian logistic model. Using the No-U-Turn Sampler (NUTS) in RStan, 100,000 virtual patient profiles were simulated to generate posterior probabilities of CLNM. Results: The baseline CLNM risk for lateralized tumours without additional risk factors was 4.2%. Single risk factors increased probability substantially: midline-crossing tumours (31.7%), ENE (27.4%), and ≥2 ipsilateral nodes (24.9%). Combinations of risk factors amplified the risk non-linearly: the presence of a midline-crossing tumour, ENE, and ≥2 ipsilateral nodes yielded a 76.8% CLNM probability, and the presence of all seven risk factors increased it to 93.7%. Risk tiers were classified from minimal (<20%) to very high (>50%) to guide clinical decision-making. Conclusions: This MCS-based model reveals that CLNM risk increases multiplicatively with the presence of various high-risk features. The simulation supports bilateral neck management in high-risk patients and observation in low-risk cases. Prospective validation is needed to integrate this model into routine clinical practice and to guide patient-specific surgical planning.

Sinonasal tumors with orbital involvement present significant management challenges due to the complex anatomy of the orbital and sinonasal complex and the potential for severe tumor- and treatment-related morbidities. This comprehensive review examines evidence-based decision-making guidelines in the context of treating sinonasal malignancies involving the orbit. We evaluate pre-treatment assessment strategies, discuss the indications for orbital preservation versus its exenteration, explore the role of neo-adjuvant therapies, and analyze reconstruction techniques with ensuing rehabilitation approaches and quality of life. Our review underscores the need for a patient-centered multidisciplinary approach that optimizes treatment outcomes and quality of life for patients suffering from such advanced sinonasal malignancies with orbital involvement.

Myocardial infarction (MI) incidence and mortality vary following multi-modality treatment for head and neck cancer (HNC). This systematic review and meta-analysis evaluate these rates. We searched PubMed, Embase, ScienceDirect, and Web of Science (inception to March 2025) for studies reporting MI incidence or mortality after HNC treatment. A random-effects meta-analysis yielded pooled proportions. Subgroup analyses examined variations by treatment modality, time period (pre-/post-2010), and geography. Of 680 studies, 53 were included, encompassing 85,948 patients with HNC. The global pooled MI incidence was 1.7

Differentiated thyroid carcinoma (DTC) is the most common endocrine malignancy and typically has a favorable prognosis. However, a subset of patients experience aggressive disease, recurrence, or treatment resistance, underscoring the need for more precise diagnostic and therapeutic strategies. Advances in molecular profiling have improved the management of thyroid cancer by enabling risk-adapted treatment and targeted interventions. This narrative review offers a clinically focused synthesis of the current role of molecular diagnostics and personalized therapeutics in DTC. We examine key genetic alterations and their diagnostic, prognostic, and therapeutic implications, and discuss how molecular markers enhance traditional risk stratification systems, informing surgical decisions, radioactive iodine (RAI) use, and surveillance. The growing role of targeted therapies, such as tyrosine kinase inhibitors and agents against specific oncogenic drivers, is reviewed, particularly for RAI-refractory DTC. We also address real-world challenges in implementing precision medicine, including access, cost, and standardization. Future directions, such as liquid biopsy, artificial intelligence, and multi-omic integration, are explored as tools to achieve fully personalized care. This review aims to bridge the gap between molecular discovery and clinical application, offering practical insights for endocrinologists, surgeons, oncologists, and multidisciplinary teams managing DTC.

Introducción: Se cree que las cardiopatías congénitas son una de las enfermedades crónicas más comunes en los niños; con un conjunto complejo de síntomas, tratamientos, variables emocionales y sociales, estas variables afectan no sólo la salud mental del niño o niña, sino también de toda su familia. En la salud, estas variables inciden significativamente en los procesos dinámicos y funcionales de la vida familiar Desarrollo: El desarrollo aborda todo lo relacionado con el diagnostico de las cardiopatías congénitas. Además, se aborda el diagnóstico, tratamiento y los enfoques innovadores y perspectivas actuales en pediatría. Llegando a la conclusión. con las futuras líneas de investigación con respecto a la temática abordada en el artículo. Conclusiones: Las cardiopatías congénitas en la infancia presentan muchos síntomas y signos diferentes. Las complicaciones resultantes pueden tener consecuencias graves e incluso mortales, por lo que el diagnóstico temprano y oportuno, especialmente en el período prenatal, es muy importante. Es importante que los pediatras monitoreen la morbilidad y mortalidad por esta causa y tomen medidas que ayuden a orientar las prioridades de salud a partir de la evaluación de los resultados de los programas y servicios para estas enfermedades.

"Dermatología en la Práctica Médica General Vol. 9" emerge como un compendio esencial que trasciende las fronteras de la dermatología especializada, ofreciendo una guía integral y práctica para médicos generales y profesionales de la salud interesados en el manejo efectivo de enfermedades cutáneas en la práctica médica general. Este volumen, perteneciente a una serie distinguida, se destaca por su enfoque accesible y su atención a las necesidades específicas de los médicos que enfrentan una amplia variedad de problemas dermatológicos en su práctica diaria. Cada capítulo presenta información actualizada y basada en evidencia sobre el diagnóstico, tratamiento y manejo de enfermedades cutáneas comunes, brindando a los lectores las herramientas necesarias para abordar eficazmente estos desafíos clínicos.

En el campo de la imagenología médica, donde la precisión diagnóstica y la interpretación adecuada de las imágenes son cruciales para la atención al paciente, la actualización constante es fundamental. En este contexto, el libro "Compendio en Temas de Imagenología Vol. 8" se presenta como una obra de referencia imprescindible que aborda una amplia gama de temas relevantes en este campo en constante evolución.

El "Tratado de Cirugía General en Atención Primaria en Salud Tomo 15" emerge como una obra fundamental para la práctica médica en el ámbito de la atención primaria. Compilado por un equipo de expertos en cirugía general, este tomo representa un compendio exhaustivo y actualizado de los procedimientos quirúrgicos esenciales en la atención primaria en salud. Con un enfoque eminentemente práctico, cada capítulo de este tratado aborda de manera detallada y sistemática las técnicas quirúrgicas más relevantes para el médico de atención primaria. Desde la evaluación preoperatoria hasta el manejo postoperatorio, se ofrece una guía completa que abarca desde procedimientos simples hasta intervenciones más complejas.

Olfactory neuroblastomas are uncommon malignancies that arise from olfactory receptor cells located high in the nasal cavity. Accurate diagnosis plays a crucial role in determining clinical results and guiding treatment decisions. Diagnosis can be a major challenge for pathologists, especially when dealing with tumours with poor differentiation. The discovery of several molecular and immunohistochemical markers would help to overcome classification difficulties. Due to the paucity of large-scale studies, standardisation of diagnosis, treatment and prediction of outcome remains a challenge. Surgical resection by endoscopic techniques with the addition of postoperative irradiation is the treatment of choice. In addition, it is advisable to consider elective neck irradiation to minimise the risk of nodal recurrence. Molecular characterisation will help not only to make more accurate diagnoses but also to identify specific molecular targets that can be used to develop personalised treatment options tailored to each patient. The present review aims to summarise the current state of knowledge on histopathological diagnosis, the molecular biology and management of this disease.

El "Guía Esencial de Medicina Interna en el Primer Nivel de Atención Tomo 12" emerge como una obra fundamental que aborda los aspectos más relevantes de la medicina interna desde la perspectiva del primer nivel de atención en salud. Este tomo, perteneciente a una serie reconocida, constituye un recurso invaluable para médicos generales, residentes y estudiantes de medicina que desean fortalecer sus conocimientos y habilidades en el manejo de enfermedades comunes en la práctica clínica diaria. La obra se distingue por su enfoque práctico y accesible, diseñado para abordar las necesidades específicas de los profesionales de la salud que trabajan en entornos de atención primaria. Cada capítulo presenta información actualizada y basada en evidencia sobre el diagnóstico, tratamiento y manejo integral de una amplia variedad de condiciones médicas, desde enfermedades crónicas hasta emergencias médicas.

Intravenous lipomas (IVLs) of the head and neck are uncommon benign tumors that develop within the venous walls, often detected incidentally during imaging for unrelated issues. While usually asymptomatic, these IVLs can cause congestive venous symptoms like swelling, paresthesia or pain in the head and neck and upper limbs, or even venous thromboembolism. The precise diagnosis of IVLs is predominantly achieved through computed tomography (CT) and magnetic resonance imaging (MRI), with CT being the most frequently used method. Symptomatic patients generally undergo open surgery with excision of the IVL followed by venous reconstruction, which has shown safe and effective outcomes. However, the management of asymptomatic IVLs remains controversial due to the limited number of reported cases. Despite this, there is a notable trend toward recommending surgical removal of IVLs to prevent complications and rule out malignancy, driven by the challenges of differentiating IVLs from malignant tumors using imaging alone. This review highlights the key differential imaging characteristics of IVLs and the main surgical techniques to remove the tumor and repair the vascular defect. Further research is necessary to establish a robust, evidence-based approach for treating asymptomatic IVLs, balancing the risks of surgery against the potential for future complications.

Carotid artery disease has traditionally been assessed based on the degree of luminal narrowing. However, this approach, which solely relies on carotid stenosis, is currently being questioned with regard to modern risk stratification approaches. Recent guidelines have introduced the concept of the "vulnerable plaque," emphasizing specific features such as thin fibrous caps, large lipid cores, intraplaque hemorrhage, plaque rupture, macrophage infiltration, and neovascularization. In this context, imaging-based biomarkers have emerged as valuable tools for identifying higher-risk patients. Non-invasive imaging modalities and intravascular techniques, including ultrasound, computed tomography, magnetic resonance imaging, intravascular ultrasound, optical coherence tomography, and near-infrared spectroscopy, have played pivotal roles in characterizing and detecting unstable carotid plaques. The aim of this review is to provide an overview of the evolving understanding of carotid artery disease and highlight the significance of imaging techniques in assessing plaque vulnerability and informing clinical decision-making.

Other Supporting Colleagues from Clinical Predictors for Germline Mutations in Head and Neck Paraganglioma Patients: Cost Reduction Strategy in Genetic Diagnostic Process as Fall-Out

Supplementary Table 2 from Clinical Predictors for Germline Mutations in Head and Neck Paraganglioma Patients: Cost Reduction Strategy in Genetic Diagnostic Process as Fall-Out

PDF file, 794KB, Supplementary figure S1. Gross MAX deletion analysis Supplementary figure S2. Immunohistochemical assessment. Supplementary figure S3. Pedigree of 3 families with affected relatives in more than one generation.