Surgical treatment of extramedullary tumors of the craniovertebral junction (CVJ) remains a difficult task due to adjacent important neurovascular structures. International data indicate high incidence of postoperative complications following surgical intervention alone.

O analyze postoperative complications following resection of CVJ extramedullary tumors.

A retrospective study of treatment outcomes in 64 patients with CVJ tumors was performed between 2013 and 2024. Neurological status in pre- and postoperative period was assessed depending on location, histological variant of tumor and surgical approach. Surgical, neurological and somatic complications were specified.

Postoperative complications occurred in 23 (38%) patients. For meningiomas, complications occurred in 38.4% of cases, for schwannomas - in 23.5%, for neurofibromas - in 57.1% of cases. Lateral and median approaches had similar complication rates (35.7% and 33.3%, respectively). Surgical complications occurred in 11 (21.8%) patients, and infectious complications were the most common (meningitis in 6 (9.3%) patients). Neurological complications were detected in 13 (20.3%) patients, and dysfunction of bulbar nerves prevailed (7 (10.9%) patients). Somatic postoperative complications occurred in 8 (12.5%) patients, fatal outcomes - in 1 (1.5%) case.

Our results demonstrate high incidence of postoperative complications after surgical treatment of extramedullary CVJ tumors.

To analyze the clinical characteristics and prognosis of Epstein-Barr virus-positive diffuse large B-cell lymphoma (EBV⁺DLBCL) in a Chinese cohort.

Fifty-seven EBV⁺DLBCL patients (diagnosed between 2013 and 2020) and 228 EBV-negative DLBCL (EBV^-DLBCL) controls were included. Differences were compared and prognostic factors were identified using univariate and multivariate analysis.

EBV⁺DLBCL patients (median age, 56 years; 38 men [66.7%]) predominantly had non-GCB origin (70.2%). Compared with EBV^-DLBCL, EBV⁺DLBCL patients more frequently presented with B symptoms, hypoalbuminemia, anemia, >1 extranodal site involvement, and elevated LDH andβ2-microglobulin (all P < 0.05). The common extranodal sites were the digestive tract (stomach), nasopharynx, bone marrow, and bone. CD30 positivity was higher in EBV⁺DLBCL patients (42.1% vs. controls, P < 0.001). After R-CHOP-like therapy, EBV⁺DLBCL patients achieved complete and overall response rates of 55.5% (30/54) and 83.3% (45/54), respectively. With a median follow-up period of 28 months, the relapse rate was 22.2% (10/45). The response and relapse rates were similar between groups. Multivariate analysis identified elevatedβ2-microglobulin and bone marrow invasion as independent risk factors for worse progression-free survival (PFS), and elevatedβ2-microglobulin plus decreased hemoglobin for worse overall survival (OS) in EBV⁺DLBCL.

EBV⁺ DLBCL in this Chinese cohort was primarily non-GCB. Elevatedβ2-microglobulin and bone marrow invasion independently predicted inferior PFS, while elevatedβ2-microglobulin and anemia predicted inferior OS.

The Australian National Lung Cancer Screening Program commenced in July 2025. This study aimed to explore the views of community members and the health workforce on the content, language, design and presentation of the draft information materials developed for the general population and health workforce.

Semi-structured interviews and focus groups were conducted between September and October 2024. Community members potentially eligible for the program and those interested in screening were recruited. Members of the health workforce who would be involved in screening were invited to participate. The teach-back technique assessed community members comprehension of material content. An adapted user-experience honeycomb model, along with a deductive thematic analysis approach, were used to identify aspects needing improvement.

A total of 25 community members and 44 health workforce participants took part. Shared and specific themes targeted for community and health workforces were identified. These included an appreciation for clear language; content that is comprehensive, reliable, and transparent; and visually engaging design. Specific themes focused on enhancing the practical value of the materials for target audiences; clarifying and using professional terms and concepts; and adopting user-friendly designs that accommodated the diverse needs of audience. The role of family members in encouraging screening participation should be highlighted in the information materials. A standardised approach for assessing individuals smoking history in the program's eligibility criteria is warranted.

These findings have guided the refinement of the draft informational materials developed for the general population and health workforce in the lung cancer screening program and could inform the development of materials for other cancer screening programs.

Community members and the health workforce were involved in the development of information materials.

Thoracic duct resection (TDR) is frequently performed during radical oesophagectomy to improve locoregional control in oesophageal squamous cell carcinoma (ESCC). However, its impact on postoperative body composition-particularly skeletal muscle mass-remains unclear. This study aimed to evaluate the extent and temporal pattern of postoperative changes in adiposity- and sarcopenia-related indices following TDR.

In this prospective cohort study, 347 patients with ESCC who underwent curative oesophagectomy between May 2018 and June 2022 were included. Patients were classified into a TDR group (n = 288) and a thoracic duct preservation group (n = 59). Body composition was assessed using bioelectrical impedance analysis (BIA) at six time points: preoperatively and 1, 2, 3, 6 and 12 months postoperatively, yielding 1925 measurements. Metrics analysed included body mass index (BMI), fat mass index (FMI), skeletal muscle mass index (SMI) and fat-free mass index (FFMI). Sensitivity analysis was performed using 1:1 propensity score matching (PSM), based on key clinical variables.

Median age was 64 years, and ~90% of patients were male in both groups. Baseline operative variables were comparable between groups, including operative time (485 vs. 478 min), total lymph nodes (66 vs. 63) and complication rates (30% vs. 32%). BMI and FMI declined gradually over 12 months with no significant between-group differences (BMI at 12 months: TDR vs. preservation, 21.0 vs. 20.6 kg/m²; p = 0.809). In contrast, SMI and FFMI showed significant early postoperative declines, with more pronounced reductions in the TDR group during the first 3 months (SMI: -11.2% vs. -8.1%, p = 0.036). These early differences attenuated after PSM but remained directionally consistent. Recovery of muscle mass began around postoperative month 3, and by 12 months, sarcopenia-related indices were comparable between groups (SMI: p = 0.343; FFMI: p = 0.733). Subgroup analysis in patients with clinical stage I disease revealed similar patterns, suggesting that the observed muscle loss may reflect procedure-related effects, independent of tumour burden. Exploratory nutritional markers-including albumin, lymphocyte count and cholesterol-showed no significant intergroup differences at any interval.

This is the largest study to date to assess longitudinal body composition changes after TDR using serial BIA. TDR was associated with a greater decline in sarcopenia-related indices, particularly within the first 3 months. These effects were transient, reversible and reproducible in early-stage patients. Our findings support the oncologic role of TDR while underscoring the importance of early nutritional and rehabilitative care.

Colorectal cancer (CRC) represents a major challenge for public health in Brazil due to its high incidence and mortality. This study examines temporal trends, regional disparities and outcomes of CRC surgeries performed in Brazil between 2014 and 2024.

We conducted a retrospective observational analysis using data from the Hospital Information System of the Unified Health System (SIH-SUS). We included all patients who underwent CRC surgery financed by the SUS during the period. We analysed patient demographics, surgery rates per 100,000 inhabitants (excluding the population covered by voluntary private health insurance), in-hospital mortality and length of stay in the five geographic regions of Brazil.

In total, we identified 313,531 CRC surgeries. Most patients were between 60 and 69 years old (30.1%), with a similar distribution between genders (50.2% men). Surgery rates varied considerably across regions, from 51.4 per 100,000 inhabitants in the North to 319.9 in the South. In-hospital mortality ranged from 5.2% to 6.7%, with variation among geographic regions. The number of procedures increased by 74% during the period, except for a decline in 2020, possibly related to the COVID-19 pandemic.

Our findings reveal substantial regional heterogeneity in surgical provision and in-hospital outcomes for CRC within the Brazilian public health system, particularly affecting the North region. These descriptive patterns may inform health system monitoring and future policy-oriented research and decision making.

The aim of this study is to evaluate self-sampling devices as an innovative resource with high performance, acceptability, and implementation for improving Human Papillomavirus detection in cervical cancer screening.

This systematic review followed PRISMA 2020 guidelines and counts with the PROPERO register. A comprehensive literature search was conducted following the PRISMA guidelines using PubMed, EBSCO, and Scielo databases, including articles published between 2014 and 2025 in English and Spanish. MeSH terms related to "Uterine Cervical Neoplasms," "Papillomaviridae," "Molecular Diagnostic Techniques," and "Self-Testing" were used. Inclusion criteria included clinical trials and comparative studies evaluating self-sampling test performance in terms of sensitivity and specificity values. Exclusion criteria included studies without statistical analysis, duplicates, and test usage with no cervical cancer objective.

Seven eligible studies were included. Self-sampling devices, such as a brush-based device, swab-type device, and sponge-type swabs, demonstrated high acceptability and usability among women, especially in underserved populations. Sensitivity and specificity range oscillated between 75%-91% and 34%-74% respectively, depending on the device and reference method. Compared with clinician-collected samples, most self-collected tests showed comparable diagnostic accuracy, making them a viable option for early detection. Limitations included small sample sizes, heterogeneity in test platforms, and a lack of long-term outcomes.

Self-sampling devices offer an important potential to reduce cervical cancer morbidity and mortality globally, particularly in limited-access health care services. Their implementation in routine women's care and health screening contributes to reducing morbidity and mortality from cervical cancer. Further studies are needed to confirm long-term effectiveness and standardized implementation protocols.

Bronchiolar adenoma (BA) is a peripheral pulmonary neoplasm characterized by a bilayered cell structure composed of basal cells and luminal cells. Owing to its low incidence and limited research data, clinicians and pathologists still have an insufficient understanding of this disease. This study aims to characterize the morphological, immunohistochemical, and genetic features of BA and its variants, and to determine whether BA can progress to a malignancy.

Among these 33 cases, 21 were histologically characterized by double-layered tumors with continuous basal cell layers. Six patients exhibited a partial classic bilayer, transitioning from a bilayer to a monolayer in certain lesion areas (mixed-type BAs). Six other BA-like tumors with monolayered components might represent the early stage of malignant transformation of BA. Next-generation sequencing analysis was conducted on 33 cases to elucidate the genetic spectrum.

All the cellular components exhibited a relatively mild morphology. Immunohistochemical analysis revealed that basal cells coexpressed p40 and cytokeratin 5/6. Thyroid transcription factor 1 was expressed in the double-cell layer, which consists of ciliated columnar epithelial cells, basal cells, nonciliated columnar epithelial cells, and cuboidal epithelial cells. The pan-cancer gene panel was used to observe driver alterations in 9 of 21 classic bilayered BAs (43%), 2 of 6 mixed-type BAs (33%), and 3 of 6 monolayered BA-like lesions (50%). Genetically, monolayered BA-like lesions shared some alterations with classic BAs in mutational signatures, whereas NKX2-1 mutations were enriched only in monolayered BA-like lesions.

These findings underscore the histopathological and genetic characteristics of BA and its variants, suggesting that monolayered BA-like lesions have the potential to develop into lung adenocarcinoma. In the future, more cases should be recruited to further explore the malignant transformation of this specific entity via the multidimensional spectrum.

The growing demand for natural therapeutics with safer pharmacological profiles has renewed interest in aromatic plants traditionally used in folk medicine. Jasonia glutinosa (L.) Fourr. (Asteraceae), commonly known as "sticky fleabane", is a medicinal and aromatic species widely employed for its digestive and anti-inflammatory benefits. Despite its ethnopharmacological relevance, the bioactive potential of its essential oil remains poorly explored. This study provides a multifaceted investigation of the chemical composition, safety profile, and pharmacological activities of J. glutinosa essential oil (JGEO). Gas chromatography-mass spectrometry (GC-MS) analysis revealed nerolidol (51.29%) as the predominant constituent, accompanied by isoaromadendrene epoxide (17.39%) and cis-α-copaene-8-ol (9.92%). The genotoxicity assessment, conducted using the alkaline comet assay on rat leukocytes, demonstrated no significant DNA damage at concentrations up to 100 µg/mL, confirming the oil's genomic safety within the tested range. Pharmacological evaluation showed that JGEO exerted potent anti-inflammatory effects, significantly reducing nitric oxide (NO) and prostaglandin E₂ (PGE₂) production in LPS-stimulated macrophages - with NO levels decreasing to 18.4% of control values and PGE₂ from 720 µM to 108.2 µM (p < 0.001). Moreover, JGEO exhibited selective cytotoxicity against multiple human cancer cell lines, with IC₅₀ values of 15.43 µg/mL (MCF-7), 24.24 µg/mL (MDA-MB-468), 74.57 µg/mL (HCT-15), and 18.06 µg/mL (HepG2). Remarkably, high selectivity indices for MCF-7 (SI = 63.67) and HepG2 (SI = 54.40) surpassed those of doxorubicin, highlighting its favorable therapeutic window. Collectively, these findings provide a scientific basis for the traditional uses of J. glutinosa, emphasizing its safety, efficacy, and chemical richness. The study positions JGEO as a promising natural source of bioactive terpenoids for the development of anti-inflammatory and anticancer agents, supporting its further exploration in pharmaceutical and nutraceutical formulations.

Thymidine kinase 1 activity (TKa) has previously been demonstrated as a prognostic biomarker for progression-free survival (PFS) in hormone receptor-positive, HER2-negative metastatic breast cancer (MBC), but its optimal use remains undefined. This study evaluated the prognostic performance of TKa across multiple sampling time points and thresholds in patients receiving first-line CDK4/6 inhibitor plus aromatase inhibitor therapy.

TKa was measured (DiviTum® assay) at baseline (BL), cycle 1 day 15 (C1D15), and cycle 2 day 1 (C2D1) in patients enrolled in the PDM-MBC study (n = 90). Thresholds for PFS discrimination were identified using maximally selected rank statistics, with predefined cut-offs tested for comparison. Prognostic performance was assessed using the corrected Akaike information criterion (AICc) and Harrell's concordance index (C-index).

TKa was prognostic at all time points. Data-derived thresholds identified groups with differing PFS and overall survival (OS), and predefined cut-offs (≥ 50, ≥ 100, ≥ 250 DiviTum® units of Activity [DuA]) also discriminated survival outcomes. BL and C2D1 models performed better than C1D15 and comparably to multi-time-point models. Among patients with BL TKa ≥ 250 DuA, suppression to < 100 DuA at C1D15 was associated with longer median PFS (23.9 vs. 10.3 months; p = 0.034).

Baseline TKa provides prognostic information, with potential added value from repeated testing in those with high baseline levels. TKa behaves as a continuous biomarker of risk, and continuous modelling may offer more clinically informative individual risk estimation, while thresholds may retain value for specific clinical contexts. Validation in larger cohorts is warranted to support integration into routine practice.

The tumor bystander effect describes the ability of cells sustaining therapeutic treatment damage to transmit distress signals to neighboring unharmed cells and change their behavior. Photodynamic therapy (PDT), which uses light for activation of photosensitizing drugs in targeted lesions to produce cytotoxic damage, is one of the cancer treatment modalities inducing highly robust bystander effects. This is caused to a large extent by the propensity of PDT for creating extensive lipid peroxidation damage and related instigation of ferroptotic cell death. Lipid peroxides appear to be major participants in intercellular signaling generating the bystander effect and orchestrating ferroptosis that appears to have a pivotal role in propagating the lethal (therapeutically beneficial) form of bystander response. In contrast, nitric oxide (NO) released from PDT-treated cancer cells has emerged as a major signal for therapeutically detrimental bystander effects due to promoting tumor growth and metastasis. It is becoming increasingly evident that exploiting the bystander response can be an attractive strategy for improving tumoricidal depth with consequently elevated tumor cure rates following PDT treatment. A two-pronged approach is proposed for achieving this goal: (i) inactivating iNOS enzyme with a specific pharmacologic inhibitor, and (ii) amplifying the induction of cytotoxic ferroptosis in nearby cells initially unaffected by photodamage, thereby limiting their ability to promote tumor expansion.