Primary hepatic masses in dogs represent a heterogeneous group of lesions with variable biological behavior and challenging preoperative characterization. The objective of this retrospective study was to describe the clinical presentation, diagnostic findings, surgical management, and outcome of dogs with primary hepatic lesions treated surgically. Ten dogs with resectable hepatic lesions and no evidence of extrahepatic metastasis were included. Clinical records, imaging findings, histopathological diagnoses, treatment, and follow-up data were reviewed. Histopathological diagnoses included hepatocellular carcinoma (n = 3), nodular hyperplasia (n = 2), lobular hyperplasia (n = 1), hepatocellular adenoma (n = 1), undifferentiated sarcoma (n = 1), osteosarcoma (n = 1), and one case without a definitive histological diagnosis. Tumor size ranged from 3.3 to 18 cm. Both benign and malignant lesions were represented across this size range. Cytological findings were discordant with the final histopathological diagnosis in three dogs, whereas one sample was non-diagnostic due to blood contamination. Abdominal ultrasound identified solitary lesions in all evaluated dogs, although surgery revealed previously undetected multifocal disease in two cases. Six of the ten lesions involved the right medial hepatic lobe, although the small sample size precludes conclusions regarding lesion distribution. All dogs underwent surgical resection. Two perioperative deaths occurred secondary to postoperative renal failure. Among the surviving dogs, clinical status during follow-up was generally reported as improved compared with preoperative presentation, and survival times ranged from 4 to more than 730 days, including dogs with malignant neoplasms. Four dogs remained alive and disease-free at the end of the follow-up period (>730 days). This retrospective case series illustrates the clinical and pathological heterogeneity of primary hepatic masses in dogs. Discrepancies between preoperative assessment and intraoperative or histopathological findings were observed in some cases. Given the small sample size, heterogeneous diagnoses and non-standardized diagnostic workup, these observations should be interpreted cautiously and considered hypothesis-generating.

Early-onset colorectal cancer (EOCRC) is increasing disproportionately among Hispanic/Latino (H/L) populations and demonstrates substantial molecular and clinical heterogeneity. Although Wingless/Integrated (WNT) pathway alterations are among the most common genomic events in colorectal cancer, their prognostic significance in the context of contemporary systemic therapies, including Bevacizumab, remains incompletely understood. We conducted an integrative clinical-genomic analysis of colorectal cancer cohorts stratified by age at diagnosis, ancestry, and Bevacizumab exposure, interrogating somatic alterations across curated WNT signaling pathway genes. Conversational artificial intelligence agents (AI-HOPE and AI-HOPE-WNT) enabled dynamic cohort construction, treatment-specific subgroup analyses, and pathway-level interrogation through natural language-driven clinical-genomic integration. WNT pathway alterations, predominantly involving APC, were highly prevalent across all cohorts; however, their distribution and clinical associations demonstrated strong treatment-, ancestry-, and age-dependent variability. Bevacizumab-treated tumors exhibited lower mutation frequencies in several WNT regulators, including RNF43, AXIN1/2, TCF7L2, and AMER1, suggesting potential biologic interaction or treatment-related selective pressure. Importantly, WNT pathway alterations were associated with improved overall survival in H/L EOCRC and Non-Hispanic White (NHW) late-onset colorectal cancer, but with worse survival in NHW EOCRC, highlighting distinct ancestry- and age-specific prognostic effects. These findings support the role of the WNT pathway dysregulation as a disparity-aware biomarker framework in colorectal cancer and demonstrate the utility of conversational AI systems for scalable multidimensional clinical-genomic integration in precision oncology.

Malignant pleural mesothelioma (MPM) is an aggressive pleural tumor associated with asbestos exposure. Poor clinical outcome of MPM is often driven by late-stage diagnosis due to non-specific clinical presentation, similarity to pleural lesions (e.g., inflammatory changes, metastatic adenocarcinoma), and limitations of current diagnostic methods. We employed Fourier transform infrared (FTIR) spectroscopy combined with convolutional neural networks (CNNs) to analyze formalin-fixed paraffin-embedded (FFPE) pleural tissue samples from patients with MPM, metastatic adenocarcinoma, pleural inflammation, and normal (healthy) pleura. Glycan analysis of FFPE normal pleura and MPM was performed using ultra-high-performance liquid chromatography (UPLC) and mass spectrometry (MS). Our FTIR-spectral analysis uncovered a strong spectral fingerprint of MPM that was especially apparent in the region typical for C-O and C-C stretches as well as local symmetry region typical for deformation vibrations of CH₂ and C-OH groups, all appearing in carbohydrates. Our orthogonal validation of these findings through a targeted glycomics approach using UPLC confirmed that the MPM N-glycome exhibits a distinct fingerprint that distinguishes it from normal pleural tissue. Through utilization of MS for identifying the exact structures of differentially expressed N-glycan peaks, we also identified two high-mannose N-glycan structures that show a specific biomarker potential for MPM and need to be examined in future studies.

Accurate assessment of early indicators of breast cancer (BC) is critical to improve detection strategies and patient prognosis. Our research group takes a comparative species approach to study early BC detection by capitalizing on data from species with inherently low or high incidence of mammary cancer to supplement rare human samples. Circulating microRNAs (c-miRNAs) are a promising class of molecules that have the potential to serve as biomarkers for BC risk and disease detection. The expression of these non-coding RNAs controls numerous cellular processes and their dysregulation is associated with various pathological conditions, including cancer. To explore whether c-miRNA expression profiles can identify individuals with early-stage BC, we conducted a multi-species pilot study. We analyzed biofluid samples (i.e., saliva, serum, and plasma) from patients with early-stage BC and patients with no prior history of cancer and mammosphere-derived epithelial cells (MDECs) from dogs (canines) and horses (equines), species with a relatively high and low incidence of mammary cancer, respectively. We identified 16 candidate c-miRNAs that were upregulated in saliva from patients in the early-stage BC group when compared to the control patient group. Notably, 6 of these c-miRNAs (i.e., miR-361, miR-148b, miR-205, miR-186, miR-223, and miR-197) were also found to be secreted at higher levels by canine MDECs when compared to equine MDECs. Although individual and combinatorial assessment of these six c-miRNAs in a larger human cohort did not confirm their potential association with early breast cancer detection, the data in this study do introduce a novel comparative framework in which species-to-species variation in cancer susceptibility may inform the identification of candidate biomarkers for human disease.

Sulbactam-durlobactam (SUL-DUR) was approved in China in 2024 for the treatment of carbapenem-resistant Acinetobacter baumannii (CRAB) infections. However, real-world clinical data-particularly in critically ill patients and against isolates harboring diverse β-lactamases-are limited.

We conducted a multicenter, retrospective case series across three hospitals in Hubei Province, China (January 2025 - March 2026), to evaluate the clinical efficacy, safety, and preliminary pharmacoeconomic profiles of SUL-DUR in patients with CRAB infections.

Twenty-one patients were included; SUL-DUR was administered as primary (n=12) or salvage (n=9) therapy. Infections primarily involved the respiratory tract (n=20) and bloodstream (n=3). Genetic profiling of available isolates (n=18) identified OXA-23 (94.4%) as the predominant β-lactamase, alongside the co-production of KPC and ESBLs in a subset of strains. Despite critical illness-with 38.1% of patients requiring continuous renal replacement therapy (CRRT) and 14.3% requiring extracorporeal membrane oxygenation (ECMO)-the overall clinical improvement rate was 57.1%. Notably, both patients receiving SUL-DUR as salvage therapy for bacteremia survived. Mild, reversible renal or hepatic laboratory abnormalities occurred in 28.6% of cases. Pharmacoeconomic analysis indicated that although SUL-DUR carries a higher defined daily cost, patients achieving clinical improvement had a shorter median length of stay and lower total daily treatment costs compared to those experiencing clinical failure.

SUL-DUR, administered exclusively as part of combination regimens, was associated with favorable clinical outcomes and a manageable short-term safety profile in this small cohort, including in patients requiring extracorporeal life support and those infected with strains co-harboring multiple β-lactamases. These descriptive findings are hypothesis-generating and, given the small sample size, the absence of a comparator group, and the use of combination therapy in all patients, should be interpreted with caution; any apparent pharmacoeconomic advantage associated with early clinical improvement requires confirmation in controlled studies.

<p><strong>Introduction:</strong> Pollen monitoring plays an important role in modern allergy care.<br />Quantitatively determining airborne pollen concentrations serves as a clinically relevant<br />tool for diagnosis, treatment, disease monitoring, and prevention.<br /><strong>Aim:</strong> The study provides an overview of current clinical applications of pollen monitoring<br />in allergology and otolaryngology, and its integration with new technologies<br />that support precision medicine.<br /><strong>Methods:</strong> A narrative review of the current scientific literature was conducted, critically<br />analysing publications that connect pollen monitoring, molecular aerobiology,<br />climate change, and digital medical technologies in relation to their clinical applications<br />in allergology and otolaryngology.<br /><strong>Results:</strong> Conventional aerobiological monitoring with Hirst-type volumetric samplers<br />remains the established method for quantifying airborne pollen. It provides<br />data on the duration, intensity, and regional variation of exposure to allergenic pollen<br />from sensitising plants. Such information supports the interpretation of clinical<br />symptoms, skin test results, and molecular diagnostics. It is essential in specific<br />allergen immunotherapy, assisting with allergen selection, optimising treatment<br />courses and evaluating outcomes. These data form the basis for allergen avoidance<br />strategies, which are fundamental to prevention. Pollen monitoring also contributes<br />to otolaryngology, informing the diagnosis and treatment of inflammatory diseases<br />of the upper respiratory tract. Integrating pollen monitoring with electronic symptom<br />diaries, mobile health applications, and portable measuring devices supports<br />personalised assessment of allergen exposure and advances precision medicine. Automated<br />monitoring systems and artificial intelligence facilitate near real-time transmission<br />of information. Developments in molecular aerobiology have improved the<br />understanding of the relationship between environmental exposure and respiratory<br />symptoms. Long-term pollen monitoring provides insight into the biological impacts<br />of climate change, including changes in the timing, duration, and intensity of pollen<br />seasons, as well as the spread of invasive allergenic species.<br /><strong>Conclusions:</strong> Pollen monitoring is a clinically significant component of personalised<br />management of allergic respiratory diseases. Integration with advanced technologies<br />is expected to improve diagnostic accuracy, optimise allergen immunotherapy,<br />strengthen preventive strategies, and support the ongoing development of precision<br />medicine.</p&gt.

Cutaneous co-infection with Mycobacterium tuberculosis (MTB) and Mycobacterium avium complex (MAC) is extremely rare and easily missed due to overlapping histopathological features. We report a previously healthy, HIV-negative middle-aged woman who presented with a progressive destructive mass in the left inguinal-perineal region. Imaging revealed sinus tract formation, osteolytic bone lesions, and chronic inflammation in the right middle lobe of the lung. Initial metagenomic next-generation sequencing (mNGS) detected 3756 reads of the Mycobacterium tuberculosis complex (MTBC) and 111 reads of Mycobacterium intracellulare (M. intracellulare); the latter was interpreted as possible colonization or contamination because of its low abundance. Empirical anti-tuberculosis therapy produced only transient partial improvement, followed by paradoxical worsening, local recurrence, and new bone destruction. After a high suspicion of mixed infection, a MAC-directed combination regimen (including azithromycin and a short course of amikacin) was added, leading to complete clinical cure; subsequent repeat cultures confirmed the presence of MAC. This is the first report of cutaneous MTB-MAC co-infection in the inguinal-perineal region of an adult without overt immune abnormalities, accompanied by disseminated bone lesions. This case highlights that in regions where nontuberculous mycobacteria (NTM) are co-endemic, atypical destructive skin lesions with paradoxical worsening despite initial response to anti-tuberculosis therapy should raise suspicion of MAC co-infection. The combination of mNGS and conventional culture facilitates identification of mixed infections and guides precision therapy, but mNGS results must be interpreted cautiously in the clinical context.

Cardiovascular diseases (CVDs) are the leading cause of mortality globally and a growing burden in India. This study aimed to assess prescribing patterns for CVDs across government and private healthcare sectors in Goa, India, focusing on rational drug use and safety.

A retrospective, cross-sectional prescription audit of 400 CVD-related prescriptions (200 each from government and private facilities) was conducted between February to April 2025. Data were sourced from digitized prescription records and dispensing databases of government and private healthcare pharmacies. All data were extracted in an anonymized and de-identified format to ensure patient privacy. Primary outcomes measured included polypharmacy, National list of essential medicines (NLEM) compliance, generic and branded drug use, fixed dose combination (FDC) frequency, high-risk drugs used, drug-drug interactions (DDI), and prescribing errors. All records were validated by experienced healthcare professionals. Mann-Whitney U test was employed to evaluate the statistical significance between the prescribing patterns across government and private healthcare sectors.

There were significant (U = 8813.5, Z = -9.69, p < 0.001) sectoral disparities observed in prescribing trends. Government prescriptions exhibited use of generic drugs, and fewer FDCs, but had higher incidence of polypharmacy and prescription errors. Private prescriptions exhibited lower NLEM adherence, fewer drugs per prescription, greater use of branded drugs, fixed dose combinations, high-risk medications and potentially greater drug-drug interactions.

Substantial sectoral differences in prescribing patterns highlight the need for standard guidelines and prescriber education on rational drug use to optimize patient safety in both healthcare settings.

Background/Objectives: Street and restaurant foods constitute a major component of daily diets in low-resource settings due to their affordability, accessibility, and convenience. However, they are frequently characterised by high sodium content, posing significant public health risks, particularly for hypertension and cardiovascular diseases. Empirical data on sodium levels in Nigerian street and restaurant foods remain limited. This study assessed the sodium content of commonly consumed street and restaurant foods in Kano and Ogun States and the Federal Capital Territory in Nigeria using a multilevel analytical framework. Methods: A total of 2583 food samples were collected from street vendors and three categories of restaurants (self-service, quick-service, and hotel restaurants) between August and October 2024. Sodium concentration was measured using a validated digital salt meter. In all three states, rice-based dishes were the most commonly available street and restaurant foods. Results: More than half (55.4%) were classified as high-sodium (>600 mg/100 g), while only 4.1% were classified as low-sodium (<120 mg/100 g). Median sodium content was highest in the FCT (720 mg/100 g), followed by Kano (650 mg/100 g) and Ogun (600 mg/100 g). Soups and stews had the highest median sodium levels (1360 mg/100 g), with several traditional dishes exceeding 1000 mg/100 g. Multilevel mixed-effects modelling demonstrated that sodium exposure was driven primarily by food type (p < 0.001) and vendor environment (p = 0.009), rather than geographic location (state effect: p = 0.217), indicating structurally embedded issues with sodium content throughout the Nigerian food system. Conclusions: These findings support multilevel sodium reduction interventions targeting high-sodium food categories, vendor preparation practices, and strengthened surveillance to monitor progress toward World Health Organization population sodium reduction targets.

Recurrent pericarditis is an interleukin-1-mediated chronic autoinflammatory disease. The phase 3 study RHAPSODY (Rilonacept Inhibition of IL-1 Alpha and IL-1 Beta for Recurrent Pericarditis: a Pivotal Symptomatology and Outcomes Study; NCT03737110) and long-term extension demonstrated that rilonacept reduced the risk of recurrence. After 3 years of rilonacept treatment in RHAPSODY, Italian patients returned to standard management, as rilonacept was not commercially available.

Clinical records from Italian RHAPSODY patients were retrospectively reviewed for the 18-month period post-long-term extension completion to assess recurrent pericarditis disease persistence and time to recurrence after rilonacept cessation/washout. The primary outcome was pericarditis recurrence (ie, pericarditis pain plus C-reactive protein elevation). Safety was also assessed.

Seventeen patients were included in this analysis. The median disease duration (from incident episode to long-term extension completion) was 48 (interquartile range, 41-56) months; the median duration of continuous rilonacept treatment was 28 (interquartile range, 27-30) months. Fourteen (82%) of 17 patients experienced a post-trial off-treatment recurrence; the remaining patients (n=3) had no pericarditis recurrences and remained offtreatment. The median time to recurrence (n=14) was 8.0 (interquartile range, 6.0-9.0 weeks). Most patients' (n=8) post-trial off-treatment recurrences were managed with interleukin-1 pathway inhibition. Some (n=4) were managed with glucocorticoids, and few (n=2) were managed with NSAIDs/colchicine. No serious adverse events were experienced.

The vast majority (86%) of the patients who experienced an off-treatment recurrence after 28 months of rilonacept restarted interleukin-1 pathway inhibition or corticosteroids, suggesting that NSAIDs/colchicine are insufficient in the management of patients with prolonged advanced disease. Rilonacept cessation and subsequent passive gradual washout is an evidence-based pragmatic approach to determine if continued therapy is warranted to prevent subsequent recurrences.