Laparoscopic partial nephrectomy (LPN) and robot-assisted partial nephrectomy (RAPN) are widely used organ-sparing treatment methods for T1 renal cell carcinoma (RCC). Numerous international meta-analyses on this topic have shown that RAPN provides perioperative outcomes comparable to those of LPN, while offering additional advantages such as significantly lower blood loss and a shorter warm ischemia time. However, no superiority of either technique over the other has yet been demonstrated with regard to oncological outcomes and preservation of renal function.

To compare functional and oncological outcomes of laparoscopic and robot-assisted partial nephrectomy for RCC at A.S. Loginov Moscow Clinical Scientific Center with data from international studies.

A search of current literature on outcomes of RAPN and LPN was performed using PubMed. The most relevant publications were analyzed and served as the basis for this study. In addition, we retrospectively analyzed the surgical outcomes of 277 patients who underwent surgery for RCC using the Da Vinci robotic surgical system (n=175, group 1) or a laparoscopic technique (n=102, group 2) at A.S. Loginov Moscow Clinical Scientific Center between 2019 and 2024. Functional and oncological outcomes were collected and compared between the two groups.

The postoperative decline in creatinine clearance was significantly greater in patients in group 2. Positive surgical margins and recurrence of RCC were also significantly more common in group 2.

The use of a robotic system for partial nephrectomy is an alternative to the laparoscopic technique, providing reliable functional and oncological outcomes. This is supported both by studies from a number of international centers and by the results obtained at A.S. Loginov Moscow Clinical Scientific Center.

The early postoperative period after surgical intervention for extramedullary spinal cord tumors is critical for the recovery of neurological function, including voiding function. Inadequate diagnosis and treatment lead to secondary complications associated with delayed recovery and increased treatment costs. At this stage, the supportive role of a urologist familiar with the basic principles of neurosurgery and neurourology is important for choosing an individualized strategy for treatment and rehabilitation of voiding function, taking into account tumor size, histology, and location, as well as other risk factors.

The data of 221 patients (155 women and 66 men; age range, 19 to 84 years) who underwent surgery for extramedullary spinal cord tumors at the N.N. Burdenko National Medical Research Center for Neurosurgery, Ministry of Health of Russia, from January 2019 to December 2022 were analyzed. Of these, 178 patients were included in the prospective analysis and 43 patients in the retrospective analysis based on medical record data. In the prospective group, urinary symptoms were assessed by a urologist of the Center before and after neurosurgical intervention. Neurological syndrome and voiding function were evaluated by a neurologist and a urologist of the department using the modified mJOA scale.

The significant differences in changes in voiding function, according to mJOA scores, after neurosurgical interventions in patients with and without urological follow-up were observed. Urological supervision allowed to assess baseline voiding function and the functional outcomes of surgical treatment of extramedullary spinal cord tumors more objectively.

Urological support of patients with extramedullary spinal cord tumors in the perioperative period allows objective and detailed monitoring of the clinical course, both neurological and urological, which is important for a clearer understanding of the functional outcomes of neurosurgical treatment.

This study examined whether cardiopulmonary exercise test (CPET) performance parameters are associated with chronic cancer-related fatigue in patients receiving immunotherapy checkpoint inhibitors (ICI) and healthy controls. Also, the differences in energy expenditure of steady-state cycling and gross efficiency were assessed during submaximal cycling efforts. This study involved patients (n = 19, 48 ± 13 years) receiving PD-1, PD-L1 checkpoint inhibitors and controls of similar age (n = 21, 49 ± 17 years). During the first visit, data on medical history, previous physical activity records, and CPET to voluntary exhaustion were collected. The second visit involved body composition assessment, the MFI-20 fatigue questionnaire, and 30-min steady-state cycling at 90% gas exchange threshold. There were no significant differences observed between the groups in age, stature, BMI, or resting blood pressure. Peak V̇O₂ was 33% lower, and the group under ICI treatment had lower cycling efficiency (22.49% vs. 20.07%, p = 0.031), compared to controls. All self-reported fatigue items derived from MFI-20 were significantly higher in the ICI group compared to controls (p = 0.001). The regression analysis found no association between the self-reported general fatigue and data collected during CPET. Patients under ICI treatment reported higher levels of chronic fatigue, lower peak V̇O₂, and reduced cycling efficiency. Interestingly, variables collected during CPET did not explain self-reported chronic fatigue, underlying the complexity of this phenomenon.

Perfusion MRI, especially dynamic susceptibility contrast (DSC), is vital for glioma diagnosis and monitoring. While gradient-echo DSC is the current recommended implementation, combined spin- and gradient-echo (SAGE) DSC additionally allows for vessel size imaging (VSI) and has shown feasibility for microvascular characterization at 3 T. Higher field strength MRI offers increased contrast, resolution and signal-to-noise ratio, providing potential to improve microvascular characterization. This feasibility study aimed to implement a protocol for SAGE-DSC at 7 T and study its potential for microvascular characterization. SAGE-DSC was acquired in eight patients undergoing treatment for glioma (four females, median age 57 years) at 3 and 7 T. Data were analyzed using the temporal signal-to-noise ratio (tSNR) and contrast-to-noise ratio (CNR) and by comparing perfusion maps, VSI and vascular architectural imaging (VAI). Simulations were performed to study the relationship between vessel size and ∆ R 2 * for SAGE-DSC at 3 and 7 T. Contrast agent dosage could be reduced while maintaining higher CNR at 7 T (but lower tSNR). Assessment by an experienced neuroradiologist showed similar rCBV map quality at 3 and 7 T. VSI maps showed the same normal-appearing gray-to-white matter ratios while in-plane resolution improved at least 52% at 7 T. VAI hysteresis loops at both field strengths traversed the same counter-clockwise direction, with increased loop areas reflecting increased susceptibility effects at 7 T. Simulations confirmed the higher sensitivity of gradient-echo and the higher specificity of spin-echo to the microvasculature, with peak spin-echo specificity moving from 3 μm at 3 T towards 1.5 μm at 7 T. This study confirmed the feasibility of using SAGE-DSC at 7 T for microvascular characterization. rCBV and VSI maps show similar behavior while allowing for reduced contrast agent dosage and improved resolution. The spin-echo specificity shifted towards smaller vessel radii for increasing field strengths. These findings form the basis for exploration and validation in larger patient populations.

BACKGROUND The clinical profile of patients hospitalized with hepatitis B virus (HBV) is increasingly influenced by coexisting conditions and death patterns. This study aimed to assess comorbidities and fatality rates among patients hospitalized for the first time with HBV between 2012 and 2023. MATERIAL AND METHODS A 12-year retrospective nationwide analysis of first-time HBV hospitalizations in Poland was conducted using data from the Nationwide General Hospital Morbidity Study. RESULTS Digestive diseases (15.6%), cardiovascular diseases (10.5%), and endocrine and metabolic disorders (9.6%) were the most prevalent comorbidities. Between 2012 and 2023, marked increases were observed in digestive (12.3%-27.4%) and metabolic (8.5%-18.5%) disorders, while circulatory diseases rose from 7.4% to 18.6% with post-2019 stabilization. Immune-related and genitourinary disorders demonstrated sustained post-2019 growth, whereas several categories, including neoplasms and respiratory diseases, showed growth-decline patterns. Hypertension and liver fibrosis were the most frequent individual diagnoses, with sustained or stepwise increases over time. Age-stratified analyses revealed a shift from infection-related conditions in younger patients toward cardiometabolic and advanced hepatic diseases in older groups. Fatality rates increased from 6.8-15.9 per 1000 hospitalizations (2012-2019) to 23.1-30.7 per 1000 (2020-2023), peaking during 2020-2021, with higher mortality in men. CONCLUSIONS First-time HBV hospitalizations are increasingly characterized by multimorbidity and rising fatality rates, particularly in older patients. These findings highlight a growing clinical and public health burden, underscoring the need for integrated, age-tailored management and improved surveillance to reduce mortality and optimize HBV care.

Advances in molecular characterization have significantly redefined our understanding of breast tumor heterogeneity, enabling improved diagnostics and the development of tailored therapeutic strategies. In particular, integrative omics approaches offer a broader scope for exploring the molecular and biochemical complexity of breast cancer. Notably, metabolomics through high-resolution magic angle spinning (HR-MAS) NMR spectroscopy enables nondestructive metabolic profiling of intact tissue samples, preserving the native biochemical context and offering unique potential for refining breast cancer subtyping and gaining deeper insight into disease biology. However, the reproducibility and comparability of HR-MAS-based metabolomics across studies are still limited by methodological variations, underscoring the need for standardized and reliable protocols to manage the complexity of breast cancer tissue spectra. In this study, LCModel analysis in combination with the Electronic REference To access In vivo Concentrations (ERETIC2) method as a quantitative reference was implemented for absolute metabolite quantification of breast cancer samples, providing a robust metabolic profiling approach. Generalized linear models were applied to evaluate the associations between quantified metabolites and tumor immunohistochemical classification, and transcriptomic correlation analysis was used to explore gene expression profiles underlying the observed metabolic alterations. A total of 27 metabolites were quantified from breast tumor samples spanning the Luminal A, Luminal B (human epidermal growth factor receptor 2-negative, HER2-), Luminal B (HER2+), and triple-negative breast cancer (TNBC) subtypes. Strong positive associations were observed between phosphocholine (PCho), betaine (Bet), total choline (tCho), and total creatine (tCr) and immunohistochemical subtype, whereas alanine, glucose, and myo-inositol showed negative associations. Notably, Luminal B (HER2-) tumors exhibited the highest PCho levels, linked to upregulated expression of choline kinase alpha (CHKA) and other enzymes of the Kennedy pathway. In contrast, Luminal B (HER2+) tumors exhibited elevated levels of alanine (Ala), glucose (Glc), and myo-inositol (Ins), indicating distinct metabolic reprogramming within the luminal subgroups. Additionally, this study highlights the potential role of betaine (Bet) in interconnecting metabolic and epigenetic pathways in breast cancer, as its concentrations were found to vary across subtypes and correlate with genes involved in fatty acid metabolism, DNA methylation, and estrogen signaling. Robust HR-MAS NMR profiling captured subtype-dependent metabolic signatures, and integrative analysis with transcriptomics identified gene expression differences associated with these signatures, thereby advancing the understanding of breast cancer heterogeneity.

To investigate the prognostic value of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score in patients with locally advanced nasopharyngeal carcinoma (LANPC) receiving concurrent chemoradiotherapy (CCRT), and to clarify its predictive significance for overall survival (OS), progression-free survival (PFS), locoregional failure-free survival (LRFFS), and distant metastasis-free survival (DMFS).

Clinical data of 295 patients with LANPC who received CCRT between April 2021 and April 2022 were retrospectively analyzed. Routine blood and biochemical indices were collected within 1 week before CCRT. The HALP score was calculated as follows: HALP = [hemoglobin (g/L) × albumin (g/L) × lymphocytes (10⁹/L)]/platelets (10⁹/L). Patients were divided into high and low HALP groups with the median as the cutoff point. Kaplan-Meier analysis was used to draw survival curves. The log-rank test was used to compare the survival differences between the high and low HALP groups. Univariate and multivariate Cox regression models were applied to identify independent prognostic factors for patients with LANPC.

Survival analysis showed that the 3-year OS of the high and low HALP groups were 95.27% and 93.20%, the 3-year PFS were 87.84% and 74.15%, and the 3-year DMFS were 87.84% and 78.91%, respectively. The differences between the groups were statistically significant (p < 0.05). While the 3-year LRFFS were 97.30% vs. 96.60%, there were no statistically significant differences between the groups. Multivariate Cox regression analysis confirmed that a low HALP score was an independent risk factor for OS and PFS.

The HALP group is an effective predictor of prognosis in patients with LANPC. A low HALP group indicated higher disease progression and death. This measurement can be used for prognostic stratification and individualized treatment decision-making, both simply and economically, and provides a reference for clinical decision-making and individualized treatment.

Carbon nanotube field-effect transistor (CNT-FET) biosensors are promising platforms for point-of-care testing (POCT) of biomarkers because they offer high sensitivity, miniaturization, and integration capability. Nevertheless, the analysis of whole blood using a CNT-FET biosensor is constrained by interference from blood cells and cellular metabolites. To address this challenge, we developed a pressure-driven microfluidic system that uses passive gravitational separation and integrates the separated plasma stream with a CNT-FET biosensor. The platform combines dimensional confinement with blood cell aggregation at low shear rates to separate plasma from whole blood, achieving a plasma yield of 84.9% and a blood cell removal efficiency of 99.9%. This plasma extraction step reduces blood-cell interference and enables CNT-FET detection of the pancreatic cancer biomarker CA19-9 directly from whole blood samples, with a limit of detection (LOD) of 0.80 mU/mL. This work provides a microfluidic strategy for applying CNT-FET biosensors to real biological samples and offers an integrated approach for blood biomarker analysis in POCT and resource-limited settings.

The increased use of computed tomography (CT) scans results in increased detection of small pulmonary lesions. Navigational bronchoscopy systems that integrate technologies, such as three-dimensional (3D) imaging and radial endobronchial ultrasound (r-EBUS), have been developed to aid in sampling these lesions. These systems enhance diagnostic precision, improve biopsy success rates, and reduce complications compared to conventional invasive techniques.

To evaluate the diagnostic yield, safety, and effectiveness of the Archimedes system for navigational bronchoscopy in identifying and sampling small and peripheral lung lesions.

A retrospective analysis was conducted on 43 patients who underwent navigational bronchoscopy using the Archimedes system at Meir Medical Center. The system utilizes advanced CT imaging, 3D virtual pathway construction, and real-time fluoroscopy guidance. Data collection focused on lesion size, location, and diagnostic yield.

The average lesion size was 15.2 ± 7.9 mm, and the overall diagnostic yield was 84.2%, with a 100% success rate for ground-glass opacity (GGO) lesions. No cases of pneumothorax were reported, and only two minor bleeding incidents occurred, requiring no further intervention. A high diagnostic yield was observed for lesions under 20 mm as well as for complex cases.

The Archimedes system demonstrates the clinical potential of navigational bronchoscopy, particularly for small and peripheral pulmonary lesions. Its implementation results in a significant increase in diagnostic yield and enhanced procedural safety. Integrating this technology into high-volume medical centers could improve early and accurate lung cancer diagnosis while maintaining a low complication profile.

Urticaria pigmentosa (UP) is the most common form of cutaneous mastocytosis. UP presents with pruritic, red-brown macules and papules, and can be associated with systemic involvement. Currently, there is no cure for UP. Treatment options have been historically limited to antihistamines, which are effective for symptoms but not cosmesis of the lesions. While phototherapy is a recognized treatment for cutaneous mastocytosis, there is sparse evidence addressing the efficacy of narrowband UVB (NB-UVB) phototherapy for UP specifically. We describe three cases of long-standing UP successfully treated with NB-UVB.

A retrospective chart review was performed to collect demographic characteristics, disease features, prior treatments, phototherapy parameters, adverse events, pruritus severity, and clinical response using investigator global assessment.

All three patients demonstrated clinical improvement with NB-UVB despite differences in disease duration, prior treatment history, and phototherapy adherence. Pruritus resolved during therapy for all patients, and two patients had documented improvement in lesion appearance. Treatment was well tolerated, with adverse events limited to mild, transient erythema in two patients and no severe or long-term complications documented.

These cases support NB-UVB as a durable and well-tolerated treatment option for selected adult patients with UP, particularly those with inadequate response to conventional therapies or need for adjunctive treatment.