Type 2 diabetes mellitus (T2DM) is a chronic disorder associated with obesity and hyperglycemia. T2DM is linked to significant clinical complications such as delayed wound healing and diabetic foot ulcers. Tumor necrosis factor-stimulated gene 6 (TSG-6) is a protein with multiple functions including regulation of cytokine binding to glycosaminoglycans in extracellular matrices and on vascular endothelial walls. Loss of TSG-6 in knockout mice increases skin inflammation and delays wound healing. Here, in both a genetic model (db/db mice) and a dietary model that simulates human T2DM (mice treated with a high-fat diet [HFD] and streptozotocin [STZ]), we observed sustained hyperglycemia and a reproducible delay in wound closure. TSG-6 expression was markedly reduced in diabetic skin in these models, both before injury and post wounding. HFD+STZ diabetic mouse wounds showed elevated levels of pro-inflammatory cytokines (IL-6, TNF-α, and MIP-1α) and lower levels of the anti-inflammatory cytokine IL-10, relative to normoglycemic mice. Re-introduction of TSG-6 protein into the wounds normalized healing rates, corrected abnormal cytokine expression levels, and increased macrophage accumulation in dermal and adipose compartments. Thus, T2DM is associated with reduced levels of TSG-6 in diabetic skin, which contributes to the pro-inflammatory milieu and the delay in wound closure.

Type 2 diabetes mellitus (T2DM) is associated with musculoskeletal alterations that may affect joint mechanics, yet quantitative characterization of passive knee behavior remains limited. This study investigated passive knee mechanics in individuals with T2DM using an instrumented pendulum test combining kinematics with biomechanical modeling.

Twenty matched participants (10 with T2DM, 10 controls) underwent ten pendulum test trials of the right lower limb under electromyographic monitoring. Primary kinematic outcomes included flexion and extension amplitudes, angular velocities, relaxation indices, and oscillation duration, whereas model-derived stiffness and viscosity were secondary outcomes. Participant-level kinematic outcomes were compared using Wilcoxon rank-sum tests with Benjamini-Hochberg false discovery rate correction. Stiffness and viscosity across successive flexion-extension half-cycles were analyzed using aligned rank transform ANOVA models including Group, flexion-extension Half-Cycle, and their interaction.

Compared with controls, participants with T2DM showed reduced normalized first flexion and extension amplitudes and reduced extension velocity, whereas first flexion velocity was not significantly changed. Plateau amplitude and oscillation duration also differed between groups, while relaxation indices did not. Model-derived knee stiffness and viscosity showed no significant overall Group effect but varied across half-cycles and exhibited significant Group × Half Cycle interactions. However, post hoc comparisons did not identify significant between-group differences at corresponding individual Half-Cycles after correction for multiple comparisons.

Individuals with T2DM exhibited differences in passive knee behavior, primarily characterized by reduced oscillatory excursions and altered temporal characteristics. Exploratory analyses of model-derived stiffness and viscosity indicated differences in their phase-dependent patterns across the pendular response, although no specific half-cycle showed a significant between-group difference. These exploratory findings require confirmation in larger cohorts. Instrumented pendulum testing may provide complementary, non-invasive information on system-level passive knee kinematics beyond conventional clinical assessment.

Congenital dyserythropoietic anemia (CDA) is a rare hereditary disorder marked by ineffective erythropoiesis and iron overload. Data on endocrine involvement in CDA remain limited. This study aimed to evaluate endocrine complications in patients with CDA and to assess their association with clinical and laboratory parameters. We retrospectively analyzed data from 12 patients with CDA (mean age 19.8 years; range: 6-49 years). Two patients were transfusion-dependent, and 10 were non-transfusion-dependent. We collected demographic, clinical, and laboratory data, including ferritin levels, and comprehensively assessed endocrine abnormalities. Endocrine abnormalities were identified in 9 of 12 patients (75%), for a total of 20 abnormalities. The most common findings were low bone mineral density, diabetes mellitus, subclinical hypothyroidism, and hyperprolactinemia. After excluding vitamin D deficiency, ferritin levels showed a significant positive correlation with the number of endocrine abnormalities (p = 0.015). No significant associations were observed between endocrine abnormalities and age, sex, or hemoglobin levels. Endocrine complications are common in CDA and are associated with iron overload, even in non-transfusion-dependent patients. Regular endocrine evaluation and careful monitoring of iron burden are essential for all patients with CDA.

Diabetes mellitus (DM) is known to impair the quality of life. Natural products with high antidiabetic potential and fewer side effects have attracted considerable interest. Recently, investigations into plant materials for their antidiabetic properties have received greater attention. Therefore, in the current study, the dried pulp of custard apple (Annona squamosa) (AS) was investigated for its effects on Streptozotocin and nicotinamide (STZ-NA)-induced DM. The antidiabetic activity of AS was evaluated by measuring body weight, plasma glucose, plasma lipid levels, and liver glycogen content. The results show no alteration in glucose levels in normoglycemic rats. In contrast, the OGTT reduced glucose levels to 85.16 ± 3.19 mg/dL. There was a decrease in plasma total cholesterol, triglycerides (TGs), low-density lipoprotein, and very low-density lipoprotein (mg/dL) of 95.29 ± 4.07, 72.05 ± 1.20, 56.90 ± 3.26, 24.87 ± 4.26, and 11.38 ± 2.11, respectively, in diabetic rats. The AS treatment increased the high-density lipoprotein (35.80 ± 1.51 mg/dL), liver glycogen (21.65 ± 3.61 mg/g), and body weight (178.10 ± 5.81 g) in diabetic rats. AS also increased pancreatic enzyme levels while decreasing TBA-reactive substances in diabetic rats. Annona squamosa treatment reduced liver enzyme levels in diabetic rats. These findings suggest that dried AS pulp may improve diabetes by improving glucose, lipids, antioxidants, and liver enzymes.

Endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy (EBUS-TBNC) enables the acquisition of larger and higher-quality tissue samples than conventional endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA); however, evidence regarding its use and outcomes in Latin America remains limited. This retrospective observational study describes the clinical and procedural characteristics, the frequency of diagnosis obtained by histopathology, and the safety of patients subjected to EBUS-TBNC between June 2023 and December 2025. A total of 118 patients were included; 50.4% were female, and the mean age was 59.6 ± 17.8 years. Initial diagnosis was the main procedural indication (82.2%), and 79.7% of procedures targeted mediastinal lymph nodes, with station 7 being the most frequently biopsied (71.2%). A definitive histopathological diagnosis was obtained in 92.4% (109/118) of patients. The most common complications were pneumomediastinum (11.9%), bronchospasm (5.9%), and pneumothorax (4.2%), with no hemomediastinum or infectious complications reported. Lymphoma was the most frequent neoplasm (27.9%), whereas anthracosis was the predominant benign diagnosis (14.4%). Molecular testing was feasible, with PD-L1 (programmed death-ligand 1) being the most frequently assessed biomarker (37.3%). These findings suggest that EBUS-TBNC is a valuable technique for obtaining tissue suitable for comprehensive histopathological and molecular assessment, supporting its use in the diagnostic evaluation of mediastinal lesions. Its safety profile was characterized predominantly by non-severe complications, supporting its potential role as a diagnostic tool for mediastinal lesions, particularly in clinical scenarios where larger tissue samples are required, such as the evaluation of lymphoma.

Solid pseudopapillary neoplasm (SPN) of the pancreas occurs predominantly in young women and commonly contains hemorrhagic and degenerative components that can complicate imaging assessment. We report the case of a 19-year-old woman who presented with abdominal distension and decreased appetite. Multiphasic abdominal CT, including an unenhanced phase, demonstrated a well-circumscribed cystic and solid mass in the pancreatic head, with internally hyperattenuating areas on the unenhanced images and mild heterogeneous enhancement of the non-cystic component. MRI demonstrated peripheral and internal intrinsic T1 hyperintensity, compatible with blood products, markedly heterogeneous T2 signal, and restricted diffusion in a non-cystic portion that also showed post-contrast enhancement, along with an enhancing capsule. The measured apparent diffusion coefficient (ADC) was approximately 0.98 × 10⁻³ mm²/s. Because clotted blood may also restrict diffusion, the diffusion-weighted imaging (DWI) and ADC findings were interpreted together with the conventional and post-contrast images rather than being used alone to identify viable tumor tissue. The patient underwent laparoscopic pancreaticoduodenectomy. Gross examination revealed a cystic and solid tumor containing abundant bloody fluid, and microscopy confirmed conspicuous hemorrhage. Immunohistochemistry showed nuclear and cytoplasmic β-catenin positivity, nuclear progesterone receptor positivity, and CD10 and vimentin positivity, supporting the diagnosis of SPN. Resection margins and sampled lymph nodes were negative. Correlative analysis of CT and MRI findings with pathological and immunophenotypic features may improve diagnostic confidence.

Mucoepidermoid carcinoma(MEC) is the most common primary salivary gland neoplasm. The exact origin of intraosseous MEC remains uncertain and debated. Although rare, intraosseous MEC is the most common and well-recognized intraosseous salivary gland neoplasm. Histopathological examination revealed cystic and solid epithelial components comprising mucous, epidermoid, and intermediate cells, with strong intracytoplasmic mucicarmine positivity, supporting a diagnosis of low-grade primary intraosseous MEC. The patient subsequently underwent hemimandibulectomy at a higher oncology center and remained disease-free during the available follow-up period. The diagnosis of intraosseous MEC presents a diagnostic challenge due to its clinical and radiological resemblance to various benign odontogenic cysts and tumors. We present an interesting case of intraosseous MEC in a 23-year-old female patient.

Pilar cysts, also known as trichilemmal cysts, are benign keratin-filled lesions that arise from the outer root sheath of the hair follicle. Pilar cysts account for a small minority of cutaneous cysts and are most commonly found on the scalp, particularly in middle-aged women. Because they overwhelmingly occur on the scalp, presentation in other anatomical locations is uncommon and can create diagnostic uncertainty. We present the case of an 81-year-old male with a slowly enlarging, painless mass on the left upper arm that had been present for nearly eight years. The lesion was well-circumscribed and firm on examination, without associated erythema, drainage, or tenderness. Given its gradual growth, surgical excision was performed. Grossly, the mass was encapsulated and measured approximately 1.5 cm in diameter. Histopathologic evaluation demonstrated a keratin-filled cyst lined by stratified squamous epithelium with abrupt trichilemmal keratinization and absence of a granular layer, confirming the diagnosis of a benign pilar cyst. There was no evidence of proliferative or malignant transformation. The patient tolerated the procedure well and had an uncomplicated postoperative course. Although pilar cysts are benign, their presence in atypical locations such as the upper extremity may broaden the differential diagnosis to include epidermoid cysts, lipomas, and other soft tissue neoplasms. This case highlights the importance of maintaining clinical suspicion for pilar cysts outside of the scalp and emphasizes the role of histopathologic confirmation in establishing an accurate diagnosis. Recognizing these rare presentations can help prevent misdiagnosis and ensure appropriate surgical management.

Cervical cancer screening (CCS) is vital for its prevention. Morocco is implementing a screening program targeting women aged 30 to 49 years, who are invited to undergo screening tests such as visual inspection with acetic acid (VIA). This study aimed to explore the factors influencing compliance with CSS guidelines among these women. A cross-sectional study was conducted using a face-to-face questionnaire survey among women, attending health centers and recruited from the Department of Gynecology at the University Hospital Mohammed VI in Marrakech, Morocco. The study was conducted between 2024 and 2025, it included 398 women aged 30 to 49 years. The Chi-square test and binary logistic regression were used to identify factors associated with compliance. The CCS compliance rate was 7.8%. Factors associated with non-compliance included living area and fear of testing positive. Awareness campaigns and targeted interventions are recommended to increase the screening coverage among this population.

Smooth muscle tumors of uncertain malignant potential (STUMP) are rare mesenchymal neoplasms that exhibit histopathological features intermediate between benign leiomyoma and leiomyosarcoma. STUMP is overwhelmingly a disease of the uterus in perimenopausal and postmenopausal women; extra-uterine STUMPs are exceedingly uncommon, and involvement of the retroperitoneum in a male patient is exceptionally rare, with only a handful of cases described in the literature to date. We report a unique case of a young male who initially underwent excision of a retroperitoneal leiomyoma and subsequently developed a recurrent retroperitoneal STUMP after a six-year disease-free interval. A 25-year-old male initially presented with a progressively enlarging right flank mass and underwent complete excision. Histopathology revealed a benign retroperitoneal leiomyoma. The patient was lost to follow-up and re-presented six years later with a recurrent right retroperitoneal mass. Imaging demonstrated a heterogeneously enhancing, dumbbell-shaped lesion at the previous operative site with extension toward the deep subcutaneous plane and proximity to the right iliac crest. Wide local excision with periosteal margin resection and abdominal wall reconstruction using polypropylene mesh was performed. Histopathology demonstrated a cellular spindle cell neoplasm with elevated mitotic activity (18-20 mitoses/10 high-power fields) but without significant nuclear atypia, atypical mitoses, or coagulative tumor necrosis. Immunohistochemistry was positive for smooth muscle actin (SMA) and desmin, with aberrant MyoD1 expression, confirming smooth muscle differentiation. The lesion was diagnosed as a cellular, mitotically active STUMP. Follow-up imaging seven months postoperatively demonstrated no evidence of recurrence. This case highlights the rare occurrence of recurrent retroperitoneal STUMP in a young male - a sex in which this diagnosis is only anecdotally reported - and suggests possible biological progression along the leiomyoma-STUMP spectrum.