Frantz tumor, or solid pseudopapillary neoplasm (SPN), is a rare pancreatic tumor of low malignant potential that predominantly affects young women. Its clinical presentation is often nonspecific, and the differential diagnosis from other cystic pancreatic lesions, such as pseudocysts, represents a significant challenge. We report the case of a 31-year-old previously healthy woman who presented with abdominal pain, initially diagnosed and treated as an infected pancreatic pseudocyst. Following the initial surgical intervention and antibiotic therapy, the persistence of imaging findings and subsequent histopathological results led to the definitive diagnosis of a Frantz tumor. The patient subsequently underwent a curative-intent pancreatoduodenectomy. This case highlights the difficulty in distinguishing cystic pancreatic lesions. The patient's initial presentation, with a large fluid collection, gas foci, and elevated inflammatory markers, strongly suggested an infectious process, such as a complicated pseudocyst. Only histopathological examination of the surgical specimen enabled the correct diagnosis of the underlying neoplasm. SPN may show cystic and hemorrhagic degeneration, mimicking other lesions. Frantz tumor should be considered in the differential diagnosis of cystic pancreatic lesions in young women, even when the initial presentation suggests an inflammatory or infectious process. Histopathological confirmation is essential for proper management, which consists of complete surgical resection and is associated with an excellent prognosis.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder often associated with disturbances in glucose metabolism and insulin resistance (IR), increasing the risk of type 2 diabetes (T2DM). Standard assessment of glucose dysregulations and IR requires laboratory tests, but simple anthropometric indices, including BMI, WHtR, WHR, VAI, LAP, BAI, BRI and ABSI, may provide non-invasive tools for early risk screening. Their predictive value and optimal cut-off points for detecting glucose dysregulation and IR in PCOS remain unclear.

This study aims to evaluate the clinical utility of anthropometric indices in identifying glucose dysregulation in women with PCOS, and to provide prognostic insight with potential cut-off points for these indices.

This cross-sectional study included 49 women with PCOS according to Rotterdam criteria. Anthropometric measurements (BMI, WC, WHR, WHtR, VAI, BAI, LAP, BRI, ABSI) and fasting biochemical parameters (glucose, insulin) were collected. Correlations between indices and carbohydrate disturbances were assessed using Pearson or Spearman coefficients. The predictive ability of anthropometric indices for glucose dysregulations and IR were evaluated using ROC curve analysis, including AUC, sensitivity, specificity, and optimal cut-off points, while logistic regression quantified the strength of associations.

BMI, WHtR, BAI, VAI, LAP, and BRI were significantly correlated with fasting glucose and insulin levels, indicating a strong link between adiposity and IR in women with PCOS. Among these indices, VAI showed the highest predictive performance for elevated HOMA-IR (AUC = 0.933, cut-off point 0.99; sensitivity 85.7, specificity 90.5%), followed by LAP (AUC = 0.883, cut-off point 27.9) and BMI (AUC = 0.852, cut off point 27 kg/m²). WHtR, WC, and BRI also demonstrated significant predictive value (AUCs 0.821-0.831). Logistic regression revealed the strongest associations for BMI ≥27.25 kg/m² and VAI ≥1.07 (OR = 57.0; 95% CI 9.41-345.15; p<0.001), with WC, WHtR, LAP, BAI, and BRI also showed significant predictive value for IR.

Anthropometric indices, particularly VAI, LAP, and BMI, reliably predicts glucose dysregulations and IR in women with PCOS. These simple, non-invasive measurements may serve as useful screening tools for early identifications of glucose dysregulation, aiding risk stratification and guiding further metabolic assessment.

This study analyzed global trends in incidence, mortality, disability-adjusted life years (DALYs), and economic burden of tracheal, bronchus, and lung (TBL) cancer from 1990 to 2021, focusing on regional and sex differences, with projections to 2050.

Using joinpoint regression to assess temporal trends. Decomposition analysis quantified the effects of population growth, aging, and changes in disease fatality. Health inequalities were evaluated using the concentration index (CI), and the economic burden was estimated through a value of statistical life (VSL).

Globally, TBL cancer deaths increased from 1.08 million in 1990 to 2.02 million in 2021, and DALYs rose from 28.46 million to 46.54 million, with a sharper rise among females. Population growth (94.18%) and population aging (36.07%) were the major components to the observed increase in the global TBL cancer burden. East Asia accounted for over half of the global increase, with China contributing the largest national share. The global economic burden is projected to rise from $3.86 trillion in 2021 to $7.15 trillion by 2050. China's economic loss from TBL cancer is estimated to increase from $688 billion in 2021 to $2.49 trillion by 2050, surpassing the United States and reflecting the rapid escalation of burden in Asia.

TBL cancer remains a major global health challenge, requiring urgent, region-specific action to reduce its growing impact.

Solar ultraviolet radiation (UVR) is one of the main causes of skin cancer, with squamous cell carcinoma (SCC) being particularly prevalent among outdoor workers due to chronic UVR exposure. Despite the increasing incidence of SCC in this group, cases remain under-reported and are not always classified as an occupational disease. Current guidelines for UVR exposure are established for a limit of 30 J/m² over an 8-h workday, and they are implemented for both solar and artificial UVR (non-specific). This study aimed to calculate the excess risk of SCC among gardeners, gravediggers, pavers, asphalters, sanitation workers, and sailors in Lisbon based on measured solar UVR, in comparison with indoor workers.

A prospective observational study using personal dosimeters was conducted to assess solar UVR in 90 outdoor workers from Lisbon Municipality, from April to October 2023. This data was used to calculate the relative risk (RR) of SCC for each of the investigated occupations as well as for each individual using a formula developed by Milon et al.

Solar UVR exposure was associated with an increased risk of developing SCC by values ranging from 22 to 437%, in terms of individual UVR dose assessment. Pavers had an increased risk of developing SCC by 65%, Asphalters by 133%, Sanitation Workers by 179%, Gravediggers by 187%, and Gardeners by 193%. Despite some limitations, a novel approach was tested by using direct UVR dose measurements in real environmental exposure conditions to estimate the risk of developing SCC.

Outdoor work is associated with a substantially increased risk of SCC. However, the current model needs to be refined to improve the accuracy of risk assessment and to support the development of targeted prevention interventions. The relevance of the study provides valuable insights for health and safety policies in reducing UVR exposure and SCC risk among outdoor workers.

To examine global retinoblastoma(RB) burden from 1990 to 2021, its cross-national inequalities, the effect of public health policies, and to project disease burden trends to 2035.

The study examined the global, regional, and national disease burden of RB from 1990 to 2021, applying data from the Global Burden of Disease (GBD) to assess incidence, prevalence, disability-adjusted life years (DALYs), and death. Estimated annual percentage change (EAPC), connection point regression, and autoregressive moving average (ARIMA) models were used to evaluate the overall, segmented, and projection trend of the disease burden. In addition, we also examined the inequity of disease burden at various levels of the socio-demographic index (SDI) and compared the policy effects for rare diseases in countries with differing levels of socio-economic development.

From 1990 to 2021, the global incidence and prevalence of RB continued to rise, while the death rate and DALYs generally trended downward; however, significant differences were observed between regions and countries. By 2035, the number of incidence and prevalence is expected to decline slightly year by year, while the number of DALYs and deaths is expected to continue to rise. Countries with low Socio-demographic Index (SDI) bear a disproportionately higher disease burden. Moreover, between 1990 and 2021, absolute inequality decreased, while relative inequality increased. In addition, the impact analysis on the policy of rare diseases in countries at different levels of development shows that there is a clear correlation between a more comprehensive policy framework and the reduction of the burden of RB, among which the improvement in Central Europe is the most significant.

The study reveals that the global burden of RB is generally in a downward trend; however, low SDI regions continue to bear a disproportionately higher burden, underscoring persistent health inequalities. Policy improvement plays a key role in reducing the burden of disease. To further narrow regional disparities and reduce the overall burden, policy building needs to be strengthened globally, particularly in underdeveloped areas. The findings of this study may also provide valuable references for the prevention and treatment of other rare diseases and the promotion of health equity.

Cervical cancer remains a leading cause of morbidity and mortality among women, disproportionately affecting low- and middle-income countries (LMICs). We sought to: (1) characterize temporal and geographic patterns of cervical cancer burden (1990-2021), with a focus on age-related differences; (2) identify attributable risk factors for cervical cancer, emphasizing the impact of HPV vaccination; (3) forecast cervical cancer burden through 2050.

We combined: (a) age-specific female population estimates (UN World Population Prospects 2024), (b) cervical cancer incidence, mortality and disability-adjusted life-years (DALYs) from Global Burden of Disease (GBD) 2021, and (c) HPV vaccination coverage (WHO). We calculated age-standardized incidence (ASIR), mortality (ASMR), and DALYs rate (ASDR) using the WHO world standard population. Stratified analyses were performed by Socio-demographic Index (SDI) category and 5-year age groups. Future burdens were projected under current intervention coverage.

From 1990 to 2021, global ASIR, ASMR and ASDR declined by 15, 31 and 32%, respectively, yet absolute cases rose due to population growth and ageing. The greatest burdens remain in low-SDI regions, especially Southern Sub-Saharan Africa, which uniquely saw rising ASIR and ASMR. Women aged 55-59 bear the highest rates, while young women (15-39) experienced a small but significant incidence increase in 92 countries (notably Russia, Brazil and China). Unsafe sex and smoking accounted for the majority of cervical cancer DALYs. A profound disparity in HPV vaccine coverage persists between high- and low-SDI regions. Projections to 2050 indicate a continued rise in absolute case numbers, despite modest declines in age-standardized rates (ASRs).

While ASRs show improvement, the growing absolute burden and profound geographic inequities highlight an urgent public health challenge. Accelerating the scale-up of HPV vaccination, screening, and other preventive measures, with a strategic focus on LMICs, is critical to achieving the WHO elimination targets for cervical cancer.

The accumulation of lactate in the tumor microenvironment (TME), driven by the Warburg effect, is closely associated with immunosuppression. Lactate can contribute to this process through lysine lactylation, a novel post-translational modification. We propose a conceptual framework, the "Lactylation-immunosuppression network," that links tumor metabolic reprogramming to immune cell signaling and gene expression. This network highlights a metabolic-epigenetic axis linking lactylation to immunosuppression via a synergistic dual mechanism: long-term epigenetic programming via histone lactylation establishes a stable immunosuppressive transcriptome, while rapid, dynamic non-histone lactylation directly modulates protein activity and stability, thereby potentiating function. This review summarizes how lactylation may undermine anti-tumor immunity by remodeling myeloid and T cell compartments, fortifying immune checkpoint barriers, and creating self-reinforcing metabolic feedback loops. By elucidating this mechanism, we highlight novel therapeutic targets, propose a "kinetic threshold" model to resolve the paradoxical role of lactate, and provide a unified conceptual framework for developing next-generation immunotherapies and guiding future mechanistic studies.

Pembrolizumab is approved for treating patients with advanced solid tumors exhibiting high tumor mutation burden (TMB), including pancreatic cancer. However, owing to the rarity of TMB-high pancreatic cancer, its genetic and clinical characteristics, alongside the therapeutic effectiveness of pembrolizumab, remain unclear.

To investigate the characteristics and assess the effectiveness of pembrolizumab in this patient population.

We retrospectively reviewed data of 293 patients with unresectable or recurrent pancreatic cancer who underwent comprehensive genomic profiling at our hospital between December 2019 and April 2023. TMB-high was observed in 13 cases (4.4%), including four patients with microsatellite instability-high (MSI-H) (1.4%). Two patients exhibited germline BRCA2 mutations: one with adenocarcinoma and the other with acinar cell carcinoma. Germline mutations in MLH1 and MSH6 were each identified in one case, both exhibiting MSI-H plus TMB-high. The frequency of pathogenic mutations in KRAS, TP53, CDKN2A, and SMAD4 was notably high. KRAS mutations were detected in 12 of the 13 patients (92.3%). Pembrolizumab was administered to six patients, yielding an objective response rate of 33.3% and a disease control rate of 66.7%. Among the three patients with MSI-H plus TMB-high, two achieved partial response, and the median progression-free survival for all three patients was 227 days. Among the three microsatellite stable (MSS) plus TMB-high cases, two exhibited stable disease, and the median progression-free survival for all three patients was 90 days.

The frequency of TMB-high was 4.4%, which is slightly higher than that previously reported. Pembrolizumab demonstrated greater efficacy in patients with MSI-H plus TMB-high while also exhibiting some efficacy in patients with MSS plus TMB-high.

Modern anesthetic methods can provide successful brain mapping in almost any patient. Despite integration of awake craniotomy in the world's leading neurosurgical clinics, some anesthesiologists and neurosurgeons still believe that awake craniotomy for resection of brain tumors is difficult for patients.

To analyze patient satisfaction and subjective feelings after awake craniotomy.

There were 30 participants after awake craniotomy. Mean age of patients was 43.2 years. Original checklist for assessment of patient satisfaction after awake craniotomy was developed by Sinbukhova E.V. and Lubnin A.Yu. Pain was assessed using visual analogue scale. We estimated anxiety using Hanin-Spielberger and HADS scales.

About 86% of patients had high satisfaction scores for "memories before surgery", 56.7% of patient - for "memories during surgery", 33.7% of patients - for "memories after surgery".

When evaluating awake craniotomy according to 10-point scale (10 points - very comfortable anesthesia), only one patient chose 9 points, and all other ones chose the highest score.

Posterior petrous meningiomas (PPM) are located anterior and posterior to internal auditory meatus. Their relationships with cerebellopontine angle are variable, and they present with various symptoms.

To create a classification of PPMs depending on location in relation to internal auditory meatus, and to compare clinical symptoms, anatomical relationships and postoperative outcomes for different groups of PPM.

A retrospective study included 112 patients undergoing surgery for PPM (97 women and 15 men aged 25-80 years). There were 61 left-sided and 51 right-sided tumors (mean size 32.4 mm, range 10-66 mm).

PPMs were divided into retromeatal (R) in 44 cases, antemeatal (A) in 62 cases and anteretromeatal (AR) in 6 cases. PPM size in the R group was 34 mm (15-66 mm), in the A group - 30 mm (10-64 mm), in the AR group - 49 mm (38-65 mm). Total resection was performed in 84 patients (36, 47 and 1 in three groups, respectively). Anatomical integrity of cranial nerves was preserved in most patients. Postoperative deterioration of cranial nerve dysfunction was noted in 24 patients in groups A and AR.

Antemeatal meningiomas more often present with cranial nerve dysfunction, retromeatal meningiomas - with cerebellar symptoms. Retromastoid approach enables total/subtotal resection of PPM, and postoperative cranial nerve dysfunction is more common in antemeatal meningiomas. Preservation of anatomical and functional integrity of neurovascular structures is important for favorable postoperative outcomes.