Current Issue : April-June Volume : 2026 Issue Number : 2 Articles : 6 Articles
Background: Ventilator-associated pneumonia (VAP) is a frequent complication in neurosurgical intensive care patients. This leads to prolonged mechanical ventilation, increased 30-day mortality rates, and extended hospital stays. However, early diagnosis remains a challenge. Biomarkers, such as IL-6, PCT, and CRP, are considered a cornerstone for recognizing VAP and initiating early treatment. Only a very limited number of studies have compared IL-6, PCT, and CRP, focusing on day-to-day dynamics and their albumin ratios. Therefore, we investigated whether, compared with their daily levels, the day-to-day dynamics and albumin-adjusted ratios of IL-6, PCT, and CRP offer improved diagnostic value for VAP. Second, we investigated these biomarkers in patients treated for VAP who did not meet the criteria for VAP. Methods: In this exploratory, matched case–control study, we investigated 171 neurosurgical ICU patients. Daily biomarker levels, their dynamics, and ratios to serum albumin were assessed beginning four days before VAP. Logistic regression and receiver operating curve (ROC) analyses were performed to evaluate the association between each biomarker and VAP. Results: IL-6 and its day-to-day dynamics demonstrated the largest differences between VAP patients and nonVAP patients (r = 0.631; r = 0.452) and were associated with VAP, yielding AUCs of 0.816 and 0.726, respectively. In contrast, for PCT, we did not demonstrate any associative utility, whereas CRP showed a significant, moderate effect size on the day of VAP occurrence (p = 0.015 *; r = 0.351). We could not demonstrate any superiority in the day-to-day dynamics or the albumin-adjusted ratios compared to the daily values. For patients who were treated for VAP without fulfilling the criteria for biomarkers, we did not observe any significant difference from nonVAP patients....
Background and Objective: Liquid biopsy has transformed the management of advanced prostate cancer, yet its clinical role in non-metastatic disease remains uncertain. Conventional biomarkers such as PSA, imaging, and pathology have limited ability to capture minimal residual disease and biological aggressiveness. The objective of this review was to critically evaluate the current evidence on circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) in non-metastatic prostate cancer, focusing on feasibility, prognostic value, and potential clinical applications. Methods: A narrative review of PubMed-indexed original studies evaluating liquid biopsy in clinically localized or non-metastatic prostate cancer was performed. Eligible studies included patients treated with curative-intent local therapy or experiencing biochemical recurrence without radiologic metastases. Study designs were predominantly prospective or retrospective observational cohorts. Liquid biopsy analytes included CTCs and ctDNA assessed from peripheral blood plasma using EpCAM-based enrichment, targeted nextgeneration sequencing, whole-genome sequencing, or ultra-sensitive tumor-informed assays. Primary outcomes included detection rates, associations with clinicopathologic features, biochemical recurrence, metastasis-free survival, and overall survival. Key Findings and Limitations: Across 11 studies, CTC detection using EpCAM-based platforms was infrequent in localized disease and biochemical recurrence and showed limited prognostic value (10–11% in preoperative settings). In contrast, ctDNA was detectable in a minority of patients but consistently identified biologically aggressive disease and a higher risk of recurrence when present, particularly using tumor-informed ultra-sensitive assays. Limitations include low detection rates, heterogeneous methodologies, small sample sizes, and predominantly exploratory study designs. Conclusions and Clinical Implications: Currently, its most promising application is not broad screening, but as a selective, biology-driven tool for detecting minimal residual disease and refining risk assessment. CtDNA acts as a biological risk modifier, potentially guiding the escalation or de-escalation of adjuvant therapy. However, prospective biomarker-driven trials are required to validate these strategies before routine clinical implementation....
Primary squamous cell carcinoma of the breast is rare. We report a case of primary squamous cell carcinoma of the breast. It is a 47-year-old woman. She has an ulcerated, budding mass measuring 11 cm in diameter in the right breast. She underwent a right mastectomy. The diagnosis was non-keratinizing, moderately differentiated squamous cell carcinoma of the breast, stage IIIB invasive. Immunohistochemical testing was negative for estrogen and progesterone receptors but positive for cytokeratin CK 5/6. Diagnosis is histological and it is important to differentiate its primary breast origin from skin tumors or metastases from other organs....
Background: The necessity of a pre-therapeutic biopsy for soft tissue tumors is assessed differently depending on imaging. We examined the concordance of histopathological and radiological imaging-based diagnoses of soft tissue tumors in a monocentric, multidisciplinary sarcoma board. Methods: From October 2022 to December 2024, we prospectively included 184 patients presenting with preoperative imaging but without prior histology who are presented at the multidisciplinary sarcoma board of the University Hospital of Erlangen. We evaluated tumor dignity (benign/malignant) and most probable tumor subtype based on cross-sectional imaging assisted by the demographic and anatomic characteristics of individual cases. This assessment was then compared with the final pathological results. Results: We classified 75 tumors as benign and 109 tumors as malignant. Of the 75 patients with a suspected benign tumor, 66 (88%) had a benign diagnosis confirmed by pathological assessment, while two (2.7%) had a malignant tumor and seven (9.3%) an intermediate biology tumor. Of the 109 patients with suspected malignant tumors, 69 (63.3%) had a malignant pathology, while 30 (27.5%) had a benign pathology, and 10 (9.2%) an intermediate tumor. Matching the multidisciplinary sarcoma board’s assessment with the pathological results revealed significant sensitivity and a negative predictive value for malignant tumors, as well as a significant positive predictive value and specificity for benign tumors. Conclusions: The study shows that, despite the high degree of predictability at an experienced sarcoma center, imaging cannot completely replace biopsies and caution should be exercised when deciding against a biopsy. It is emphasized that the decision not to perform a biopsy can only be made in cases where lipomatous tumors appear benign in imaging procedures, and only in an experienced center....
Sirenomelia, or mermaid syndrome, is an extremely rare, lethal congenital malformation, occurring at a frequency of between 1.5 and 4.2 cases per 100,000 pregnancies. It is characterized by the partial or complete fusion of the lower limbs, along with malformations of the gastrointestinal and urogenital tracts. Its pathogenesis is not fully understood, with a multifactorial etiology involving genetic, teratogenic, and vascular factors. Depending on the associated malformations, death occurs in utero or within the first few days after birth. Prenatal diagnosis and imaging studies allow for reliable recognition and diagnosis. We report a case of sirenomelia diagnosed after birth, following a clinical examination of the newborn....
Background/Objectives: Phospholipase C zeta (PLCZ1; PLCζ) is a sperm-specific enzyme responsible for the Ca2+ oscillations required for oocyte activation, and altered PLCζ expression has been associated with fertilization failure in assisted reproductive technologies, particularly intracytoplasmic sperm injection (ICSI). This study aimed to develop and analytically validate a flow cytometry–based protocol for PLCζ quantification in human spermatozoa. Methods: The assay was established using normozoospermic samples and included validated positive and negative technical controls. Antibody specificity was confirmed by Western blot analysis. A defined gating strategy was used to assess linearity between fluorescence intensity and PLCζ expression. Analytical performance was evaluated for precision, reproducibility, stability, and sensitivity, including applicability to low sperm concentrations. Results: A linear relationship between fluorescence intensity and PLCζ expression was demonstrated. The assay showed high precision, reproducibility, and stability, with consistent results in samples stored up to 24 h at room temperature or up to one week post-fixation at 4 ◦C. Sensitivity testing confirmed suitability for low sperm concentrations. Conclusions: This work provides a standardized and analytically validated framework for PLCζ quantification using flow cytometry. Although the assay measures protein expression rather than functional competence or subcellular localization, it establishes a solid analytical basis for future studies to define clinically relevant PLCζ thresholds and assess its value as a biomarker of fertilization capacity....
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