To assess the prevalence of the transitional cognitive syndrome (TCS) and evaluate the effectiveness of neurocognitive training in elderly individuals presenting with cognitive symptoms.

The study enrolled 198 elderly individuals with cognitive impairment symptoms from the Memory Clinics of the Moscow Department of Health and the N.A. Alekseev Psychiatric Clinical Hospital No. 1. Of these, 111 participants were assigned to the intervention group and received neurocognitive training (rehabilitation), while 87 participants formed the comparison group and received follow-up only. Neuropsychological assessments were conducted at baseline and after 12 months of follow-up.

In this sample, TCS accounted for approximately 5% of all cognitive impairments and remained stable over the one-year follow-up period. Annually, about 7% of mild cognitive impairment cases progressed to TCS, while 11-16% of TCS cases advanced to more severe dementia, irrespective of neurorehabilitation. These findings suggest the presence of an active neurodegenerative process. Neurorehabilitation was effective in improving regulatory functions, including among elderly participants.

The introduction of the TCS concept allows for more precise classification of patients at the transitional stage between mild cognitive impairment and dementia. This framework improves risk assessment for short-term progression to more severe cognitive impairment and provides clinical justification for pathogenetic therapy, including the use of Miladean. The TCS concept also supports patient management and reduces the stigma associated with diagnosis at this stage, which is significant for both patients and their families. Advanced age and concomitant diabetes mellitus were identified as the most significant adverse factors for cognitive impairment. The observed effectiveness of neurocognitive rehabilitation in patients aged 75 years and older indicates that rehabilitation should not be limited by age.

Melanoma of the foot and nail unit carries a worse prognosis than cutaneous melanoma elsewhere because lesions are frequently hidden, misdiagnosed, and therefore diagnosed at more advanced stages. Traditional ABCDE criteria are often insufficient for foot and nail presentations; the CUBED recognition tool was developed to improve detection of atypical plantar and subungual lesions.

To evaluate four consecutive cases of foot melanoma seen in a single NHS community podiatry department, compare case characteristics against ABCDE and CUBED recognition tools, and describe service responses that aimed to improve early detection.

A retrospective case series of four patients diagnosed with foot melanoma between 2019 and 2022 in one community podiatry service. Clinical features, referral timelines, diagnostic pathways, treatments, and outcomes were extracted and mapped against ABCDE and CUBED criteria. Shared-learning interventions developed by the department following these cases are described.

All four cases were toe-based melanomas (one lentigo maligna, one nail-bed malignant melanoma, two acral melanomas). Presentations commonly included irregular colour, bleeding or ulceration, delayed healing, diagnostic uncertainty, and lesion enlargement. CUBED criteria more consistently identified concerning features across the series than ABCDE criteria, prompting urgent dermatology referral in each case. Outcomes varied: one patient remains disease-free after excision, one developed distant metastasis and died, two underwent toe amputation and received systemic treatment. Departmental responses included case-based teaching and a poster campaign promoting CUBED and ABCDE recognition across local clinical networks.

Podiatrists are pivotal in early detection of foot melanoma. The CUBED tool demonstrated greater sensitivity for atypical foot and nail lesions in this series. Wider education and adoption of CUBED alongside ABCDE may reduce misdiagnosis, shorten diagnostic delay, and improve clinical outcomes.

This study aimed to develop a nomogram for predicting the 1-year volume reduction ratio (VRR) of the ablated area after thermal ablation of benign thyroid nodules (BTN) based on preoperative clinical, ultrasound, and serological features, and to explore the role of the ablation volume ratio (AVR).

This retrospective study included 243 BTN patients who underwent ultrasound-guided radiofrequency or microwave ablation between January 2020 and December 2024. Clinical, ultrasound, serological, and procedural data were collected. Contrast-enhanced ultrasound was performed immediately after ablation to assess the ablation zone and calculate AVR. Patients were followed at 1, 3, 6, and 12 months and classified as favorable (VRR ≥80%) or unfavorable. The cohort was randomly divided into training (70%) and validation (30%) sets. Logistic regression identified independent predictors, and a nomogram was constructed and evaluated using ROC, calibration, and decision curve analyses.

Among 243 patients, 142 (58.4%) achieved VRR ≥80%. Significant differences were observed in BMI, nodule size, vascularity, morphology, FT3 level, and location within the dangerous triangle (all p < 0.05). AVR was higher in the favorable group but was not an independent predictor. Multivariate analysis identified BMI, maximum diameter, FT3, morphology, vascularity, and dangerous triangle location as independent predictors. The model showed good performance (AUC 0.904 training, 0.815 validation).

A nomogram based on preoperative factors provides a noninvasive tool for predicting 1-year outcomes after BTN ablation. AVR reflects procedural adequacy but has limited prognostic value. Further multicenter validation is needed.

Medulloblastoma (MB) is a heterogeneous pediatric brain tumor characterized by distinct molecular subtypes. Although genomics and transcriptomics have improved subtype classification and informed targeted therapies, the clinical utility of integrated molecular profiling in real-world settings remains incompletely defined.

We conducted a retrospective analysis of 131 patients with MB from a Chinese cohort. All cases underwent both targeted genomic sequencing and NanoString-based transcriptomic profiling. We evaluated the impact of integrated molecular profiling on diagnostic refinement, identification of germline predisposition, and detection of actionable alterations.

Incorporation of genomic data led to optimized or revised molecular classification in 67.2% of patients. Germline variants in Fanconi anemia pathway genes (FANCL, FANCC, NBN) were significantly enriched among patients with Group 3 and Group 4 MB, suggesting a potentially inherited susceptibility component. Furthermore, 52.7% of patients harbored potentially actionable somatic mutations, supporting the feasibility of precision-targeted therapeutic approaches. Notably, we identified one case of WNT-subtype MB harboring a homozygous deletion of CDKN2A, which was associated with unusually poor clinical outcome.

Integrated genomic and transcriptomic profiling substantially improves molecular subtyping of MB and reveals inherited risk factors relevant to specific subgroups. Our findings support the implementation of combined molecular diagnostics in routine clinical management of MB and underscore their potential in guiding individualized treatment strategies.

Oral mucositis is a debilitating adverse effect of radiotherapy in head and neck cancer. It progresses from erythema to painful ulcerations, often causing infections, nutritional impairment, treatment interruption, and reduced survival. While treatment-related factors are well established, patient-related risk determinants remain insufficiently defined. Thus, this study investigated the association between the onset and peak severity of radiation-induced oral mucositis in patients with head and neck cancer and their clinicopathological, biobehavioral, and demographic characteristics. To carry out this study, patients diagnosed with head and neck cancer and undergoing mandatory radiotherapy treatment were recruited. Fifty patients undergoing radiotherapy were evaluated daily. The analysis focused on the onset and peak severity of oral mucositis. Chemotherapy was significantly associated (P = 0.034) with earlier oral mucositis onset. Diabetes (P = 0.017) and radiation dermatitis (P = 0.017) were statistically associated with the severity of mucositis at the time of onset, while hypertension (P = 0.030), diabetes (P = 0.016), mild and moderate alcohol consumption (P = 0.029), radiation dermatitis (P = 0.001), odynophagia (P = 0.022), burning mouth (P = 0.003), difficulty with hygiene (P = 0.020), and use of opioids (P = 0.045) were associated with the most severe degrees at the peak of lesion. Severe smokers were associated with a greater occurrence of mucositis lesions in the lip region at two times. This study demonstrated that the interaction between clinicopathological and biobehavioral factors exhibits distinct patterns depending on the stage of oral mucositis progression. A comprehensive understanding of these complex relationships is crucial for developing targeted strategies to prevent severe mucositis and optimize treatment outcomes.

This study aimed to develop an effective model for predicting Hodgkin lymphoma (HL) prognosis as to assist clinicians in making optimal clinical decisions.

This study screened HL patients from the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2021. Feature selection was performed using the Boruta algorithm. Four ML models were built based on the feature selection algorithm. The area under the curve (AUC), decision curve analysis, and Brier score were employed to evaluate the reliability of the four ML models. The feature importance was ranked through the Shapley Additive Explanation (SHAP). Based on the results of the SHAP plot, Kaplan-Meier analysis was used to compare the survival probabilities among different groups.

Among the 11,259 enrolled HL patients, 8,928 were alive and 2,331 had died. Primary site, year of diagnosis, B symptoms, surgery, marital status, Ann Arbor stage, radiation, SEER stage, chemotherapy, delay (diagnosis to treatment), age were associated with HL overall survival (OS). Of four ML models, the eXtreme Gradient Boosting (XGBoost) model exhibited superior predictive performance. For predicting 1-year OS, the net benefit of XGBoost, Cox proportional hazards (Coxph), and Random Survival Forest (RSF) models was significantly higher than that of the Light Gradient Boosting Machine (LightGBM) model, the treat-all model, and the treat-none model. Age, Ann Arbor stage, B symptoms, marital status, and radiation were the top five indicators in the feature importance ranking for HL OS.

The XGBoost had excellent predictive performance in the prognostic model, which further helps clinicians to select appropriate treatment options.

Not applicable.

This study aimed to determine whether an Effort Re-education Programme (ERP) delivered after hospital discharge yields greater improvements in functionality than Conventional Clinical Practice (CCP) in oncology patients with associated respiratory symptoms.

A stratified randomised clinical trial was conducted including 65 oncology patients recruited during hospitalisation and followed after discharge. Participants were allocated to either CCP or CCP plus a home-based functional Effort Re-education Programme. Functionality (Barthel Index) was the primary outcome. Secondary outcomes included dyspnoea severity (mMRC), general performance status (ECOG), and caregiver burden (Zarit scale). Assessments were performed at discharge (baseline), 15 days, and one month post-discharge.

Patients receiving ERP showed significantly greater improvements in functionality compared with the control group (mean change: + 20.3 vs. + 6.6 points; p < 0.001). Significant between-group differences were also observed for dyspnoea (p = 0.002), performance status (p < 0.001), and caregiver burden (p < 0.001). No hospital readmissions were recorded in the intervention group during follow-up. Length of hospital stay was shorter in the intervention group prior to discharge.

A home-based Effort Re-education Programme initiated at hospital discharge significantly improves functional outcomes, respiratory symptoms, and caregiver burden in oncology patients, supporting its integration into discharge planning and continuity-of-care models. The clinical trial was registered in ClinicalTrials.gov (NCT06035263). Registration Date: 2023-11-01; 04:11 h.

Mastocytosis is a disorder characterized by abnormal mast cell proliferation, leading to cutaneous mastocytosis (CM) or systemic mastocytosis (SM) when internal organs are affected. While adult mastocytosis is associated with osteoporosis, data on bone mineral density (BMD) in children are lacking. To our knowledge, this is one of the first studies investigating BMD in pediatric mastocytosis. We conducted a prospective cross-sectional study including clinical and laboratory data from a database (2004-2025), covering mastocystosis subtype, serum tryptase, and c-kit mutation status. BMD was measured in children aged 4-18 years using dual-energy X-ray absorptiometry (DEXA) at the lumbar spine and total body. 76 children were included (73 CM, 3 SM [ISM]). Low BMD (Z-score ≤ -2) was observed in 6.8% of CM patients, significantly more prevalent than in the general pediatric population (p = 0.0014). However, all normalized spontaneously during follow-up. None had osteoporosis. ISM patients had significantly higher tryptase levels but normal BMD. BMD was not correlated with disease specific characteristics, bone pain or fractures.

Our findings suggest that bone involvement is not a major concern in pediatric mastocytosis. DEXA scans could potentially be reserved for children with suspected systemic involvement. Future longitudinal studies are necessary to further elucidate bone involvement in these patients.

• Mastocytosis is a rare disorder, associated with osteoporosis and fractures in adults. Data on bone density in the pediatric population are lacking.

• Our results suggest that bone involvement is not a major concern in pediatric mastocytosis.

Synchronous cancers, defined as malignancies diagnosed concurrently or within 2 months of each other, are rare, with an incidence of 1%-6%. Environmental factors such as tobacco smoking play a significant role in their development. Patients with head and neck squamous cell carcinoma (SCC) are at increased risk of second malignancies, complicating treatment strategies and prognosis. This report presents a rare case of synchronous SCC of the lower lip and papillary thyroid carcinoma (PTC).

A 61-year-old male with a history of smoking presented with a 2.5 cm exophytic lesion of the lower lip, diagnosed as keratinizing SCC. A suspicious cervical lymph node was revealed, which intraoperatively demonstrated metastatic PTC. Following partial lip resection and neck dissection, total thyroidectomy was performed, confirming a 1.5 mm PTC focus with micrometastases. The patient underwent adjuvant conventional radiotherapy (RTH) for SCC (66 Gy in 33 fractions) and radioiodine therapy (131-I) for PTC. Post-therapeutic scintigraphy identified suspected micrometastases in the iliac bone, prompting further 131-I treatment. Following completion of therapy, the patient achieved a complete response, with no radiologic or clinical evidence of residual disease from both malignancies.

Synchronous SCC of the lip and PTC are exceedingly rare, lacking standardized treatment guidelines. This case highlights the necessity of a multidisciplinary approach, integrating surgery, RTH, and systemic therapy. Careful postoperative histopathological assessment of lymph nodes may reveal unexpected findings that necessitate further diagnostic work-up and a multidisciplinary approach, as this can significantly influence staging, treatment decisions, and patient prognosis, representing an important key learning point.

Hyperbaric oxygen therapy (HBOT) is widely used as a therapeutic intervention for various types of wounds. Studies have shown that in addition to improving local oxygen supply to the wound site, HBOT can also influence cytokine activity, promote the survival of tissue mesh, and thereby facilitate wound healing. Moreover, HBOT inhibits the growth and reproduction of various pathogenic bacteria and enhances the phagocytic capacity of leukocytes, effectively preventing and controlling infection.

This case study involves a 61-year-old female diagnosed with invasive micropapillary carcinoma, who underwent a combination of treatments including radiotherapy, chemotherapy, immunotherapy, and targeted therapy. Nine years post-surgery, the patient experienced a recurrence of left breast cancer, accompanied by cancer wounds with exudate, edema, and ulceration in multiple areas such as the chest and back. Following comprehensive treatment consisting of anti-infective therapy, nutritional support, and edema management, along with three courses of adjuvant HBOT, the patient showed significant improvement in wound exudate and odor, resolution of lymphedema, and a reduction in wound volume, although the wound area did not show notable change.

This study implemented a comprehensive care plan for patients with malignant wounds, including measures such as wound debridement, anti-infection treatment, nutritional support, and HBOT. Following the integrated intervention, symptoms including wound exudate, odor, and lymphedema were alleviated, and wound volume was reduced, although no significant change was observed in wound area. The primary benefit of HBOT in malignant wound management lies in symptom control, while its effect on structural wound healing appears limited. Its specific role within multidisciplinary comprehensive care requires further investigation.