Objectives: This study aimed to evaluate clinical characteristics and treatment outcomes in a cohort of pediatric patients with glaucoma over 10-year period at a tertiary referral center. Methods: Medical records of patients younger than 18 years diagnosed with glaucoma between 1 January 2013 and 31 December 2023 were retrospectively reviewed. Diagnoses were classified according to the Childhood Glaucoma Research Network (CGRN). Demographic data, clinical characteristics and surgical outcomes were analyzed. Statistical analyses included Student’s t-test, one-way ANOVA, and corresponding non-parametric methods (α = 0.05). Results: A total of 105 patients (168 eyes) were included, with a mean age of 5.52 ± 5.61 years, and a mean duration of follow-up of 5.41 ± 3.37 years. Mean baseline intraocular pressure (IOP) was 24.41 ± 10.85 mmHg. Secondary glaucoma was the predominant category (69%), led by glaucoma following cataract surgery (26%). Bilateral disease occurred in 60% of cases, more frequently in secondary forms. Surgery was performed in 57.4% of glaucomatous eyes. All subtypes except glaucoma following cataract surgery (GFCS) achieved significant reductions in IOP from baseline (p < 0.01). Despite effective IOP control, final visual acuity remained limited in many patients, especially those with glaucoma associated with non-acquired ocular anomalies or following cataract surgery. Worse baseline vision and higher presenting IOP were associated with poorer final acuity. Conclusions: Secondary glaucoma, particularly GFCS, was the most common form of pediatric glaucoma in this cohort. Although IOP control was generally successful, visual outcomes frequently remained suboptimal, highlighting the importance of early detection, comprehensive management, and close long-term monitoring.

Background: Cardiovascular disease remains the leading cause of mortality worldwide. In recent years, several non-invasive imaging techniques have been introduced to improve the assessment of atherosclerotic burden and cardiovascular risk, including computed tomography and vascular ultrasound. Three-dimensional ultrasound has emerged as a promising method for the non-invasive quantification of plaque volume in peripheral arteries. Methods: In this prospective single-centre study, 63 patients with low to moderate cardiovascular risk (6–20% according to the Framingham Risk Score) were included. All participants underwent baseline examinations, and 38 patients completed follow-up after a mean period of 2 years. The assessment included coronary artery calcium scoring (CACS) by computed tomography and three-dimensional ultrasound to measure peripheral plaque volume in carotid and femoral arteries. Baseline values and progression of coronary and peripheral atherosclerosis were analysed using Spearman’s correlation. Results: Sixty-three patients were included in the final analysis. A significant correlation was observed between baseline CACS and peripheral plaque volume (r = 0.32; p = 0.010). In addition, the progression of coronary calcium scores was significantly associated with the progression of peripheral plaque volume (r = 0.34; p = 0.037). Conclusions: Coronary artery calcium is significantly associated with peripheral plaque burden, both at baseline and over time. The parallel progression of coronary and peripheral atherosclerosis suggests that peripheral plaque volume assessed by 3D ultrasound may serve as a surrogate marker for coronary disease progression.

Background: Dental caries in children has been explored not only as a local oral condition but also in relation to potential systemic inflammatory changes. This study evaluated systemic inflammatory biomarkers and hematologic indices in children with dental caries and examined their association with caries severity, as assessed by the DMFT index. Methods: In this exploratory cross-sectional sibling-controlled study, 114 participants were included: 75 children with dental caries and 39 unaffected siblings serving as controls. All participants underwent blood testing, including inflammatory biomarkers (TNF-α, NGAL) and hematologic indices (NLR, LMR, PLR, IIC, MCVL, SII, SIRI, AISI). Group comparisons were performed using parametric or nonparametric tests, depending on data distribution. Correlation analyses were conducted within the caries group. Age- and sex-adjusted univariate and multivariable linear regression models were used to identify predictors of DMFT, and logistic regression was applied to evaluate associations with high caries burden (DMFT ≥ 6). Results: Children with caries showed higher NGAL, PLR, and MCVL, and lower LMR than controls, while IIC showed a non-significant upward trend. Correlation analysis revealed strong associations among several inflammatory indices, largely reflecting shared computational components. DMFT showed a modest positive correlation with LMR, whereas associations with classical inflammatory biomarkers such as TNF-α and NGAL were weak or absent. In age- and sex-adjusted models, several markers showed borderline associations with DMFT, but none remained independently significant in multivariable analyses. Age was the strongest predictor of DMFT, while sex showed no significant effect. Logistic regression for high DMFT confirmed age as the only significant determinant. Conclusions: In this exploratory pediatric cohort, children with dental caries showed differences in selected systemic inflammatory and hematologic biomarkers compared with unaffected siblings. However, most biomarkers showed only limited independent associations with caries severity after adjustment, with age emerging as the primary determinant of DMFT. These findings suggest that systemic inflammatory markers have limited independent explanatory value for caries severity and should be interpreted as exploratory rather than clinically definitive.

Background/Objectives: Connective tissue disease-associated interstitial lung disease (CTD-ILD) is linked to substantial morbidity and mortality. While nintedanib (NTB) slows lung function decline in progressive pulmonary fibrosis (PPF), real-world data—particularly regarding radiographic outcomes—remain limited. We aimed to evaluate the real-world effectiveness and tolerability of antifibrotic therapy—predominantly NTB—on radiographic and functional outcomes in a Hungarian CTD-ILD cohort. Methods: We conducted a retrospective observational cohort study including 72 patients with progressive CTD-ILD who initiated antifibrotic therapy at two Hungarian tertiary centers between January 2021 and June 2025. The primary endpoint was the proportion of patients without significant radiographic progression at 6–12 months, based on blinded assessment of paired high-resolution computed tomography (HRCT) scans by two thoracic radiologists. Secondary endpoints included changes in forced vital capacity (FVC) and diffusing capacity for carbon monoxide (DLCO) at 6 and 12 months, safety and tolerability, and correlations between lung function and disease-related factors. Results: The cohort comprised systemic sclerosis–ILD (n = 25), rheumatoid arthritis–ILD (n = 23), and other CTD-ILD (n = 24). Radiographic stability was observed in 65.8–78.9% of patients, with improvement most commonly seen in ground-glass opacities, while traction bronchiectasis remained largely unchanged. Radiographic disease extent showed the strongest inverse correlation with baseline FVC and DLCO (p < 0.05). Significant improvements in FVC and DLCO were observed at 6 and 12 months (p < 0.001). Antifibrotic therapy was well tolerated, including in combination with immunosuppressive treatment. Conclusions: These real-world data support the effectiveness and safety of NTB in PPF–CTD-ILD and highlight radiologic disease burden as a key determinant of functional impairment.

Background: Hypertension remains the single most important modifiable risk factor for cardiovascular disease, stroke, and premature mortality worldwide. Despite major pharmacological advances, awareness, treatment, and control rates remain globally inadequate, particularly in low- and middle-income settings. Türkiye occupies a unique epidemiological position at the intersection of European and Asian cardiovascular risk patterns, with national surveys documenting a stable hypertension prevalence of approximately 30% but persistent deficits in disease control. Methods: This cross-sectional study was conducted on World Hypertension Day (17 May 2025) across nine provinces in Türkiye representing five geographic regions (Marmara, Aegean, Mediterranean, Black Sea, and Southeastern Anatolia). A total of 1967 adult volunteers were enrolled. Blood pressure was measured following standardized protocols and classified per ESH 2023 guidelines. A structured questionnaire captured sociodemographic data, lifestyle factors, medication adherence, and hypertension-related awareness. Results: The median participant age was 51 years; 55.4% were female. Screening-detected hypertension (BP ≥ 140/90 mmHg) was identified in 26.6% and above-optimal blood pressure in 41.6%. A prior hypertension diagnosis was reported by 35.1%. Among the 1277 participants without a known diagnosis, 51.1% had above-optimal or hypertension-range blood pressure readings, including 11.6% with screening-detected hypertension-range blood pressure. Independent predictors in multivariate analysis included age (OR = 1.048), male sex (OR = 1.528), BMI (OR = 1.096), and alcohol consumption (OR = 1.536); regular exercise was protective (OR = 0.796). Among known hypertensive patients, only 50% monitored blood pressure regularly, 30% skipped doses, and awareness of renal (40.4%) and visual (30.6%) complications was notably low. Conclusions: This large multi-center screening study reveals a substantial proportion of previously undetected hypertension-range blood pressure readings and persistent management gaps in a volunteer-based Turkish community sample. The observed screening rate below national prevalence averages likely reflects a healthy volunteer effect inherent to this study design. World Hypertension Day offers an effective framework for simultaneous multi-center screening. Targeted interventions should address non-cardiovascular complication awareness, sodium intake, and medication adherence.

Background/Objectives: Chronic obstructive pulmonary disease (COPD) management increasingly relies on patient self-management; however, medication non-adherence, inhaler misuse, delayed exacerbation recognition, and suboptimal engagement in pulmonary rehabilitation remain highly prevalent across disease stages. Cognitive impairment is increasingly recognised in this population, particularly in moderate-to-severe disease and in those with greater systemic burden, yet it is most often treated as a descriptive comorbidity rather than a determinant of disease control. Methods: This conceptual narrative review synthesises biological, neuropsychological, and clinical evidence to examine the extent to which cognitive impairment contributes to variability in self-management performance and clinical outcomes, and to propose a structured framework linking disease burden, neurocognitive vulnerability, behavioural execution, and downstream outcomes. Results: COPD-related processes—including chronic hypoxaemia, hypercapnia, systemic inflammation, oxidative stress, vascular comorbidity, and recurrent exacerbations—provide biologically plausible pathways to neurocognitive vulnerability. Reported deficits in executive function, attention, working memory, processing speed, and visuomotor integration may affect the execution of cognitively demanding tasks central to disease management, including inhaler technique, medication adherence, symptom appraisal, and sustained participation in pulmonary rehabilitation. Across studies, cognitive impairment is consistently associated with inhaler errors, reduced adherence and independence, rehabilitation dropout, impaired symptom recognition, increased healthcare utilisation, functional decline, and mortality. Conclusions: Collectively, these findings support the interpretation that cognitive vulnerability may act as an intermediary mechanism through which disease burden translates into behavioural instability and adverse outcomes. Although this framework remains hypothesis-generating, it provides a coherent basis for future longitudinal and interventional studies to formally evaluate the mediating role of cognition in disease management and outcome trajectories.

Background/Objectives: The preliminary experience with new dual-mobility system for small Japanese patients was introduced in this paper. Methods: Twenty-nine hips which underwent primary THA were retrospectively reviewed. All cups were inserted via Hardinge lateral approach. The ability to perform formal Japanese sitting in a kneeling position (Seiza in Japanese) and bowing while sitting (Zarei in Japanese) was evaluated. The mean follow-up was 6 months. Results: The mean age at surgery was 70 years, mean height was 156 cm, mean weight was 58 kg, and mean body mass index was 23.6. The acetabular cups utilized were a hemispherical hydroxy-apatite coated cup (25 hips) and a hemispherical trabecular titanium cup (4 hips), with diameters of 46 mm in 5, 48 mm in 15, 50 mm in 3, 52 mm in 1, 54 mm in 3, 56 mm in 1, and 62 mm in 1; mean diameter was 49.4 mm. No postoperative dislocations including intraprosthetic dislocation or metal allergy were observed. The mean Harris hip score improved significantly from 39 points preoperatively to 89 points postoperatively (p < 0.05). Radiographic evaluation demonstrated bone ingrowth stability in all cases according to Engh’s criteria and no aseptic loosening of the implants. Mean hip flexion increased from 75° preoperatively to 90° postoperatively (p < 0.05). The ability to perform Seiza increased from 8 patients preoperatively to 23 patients postoperatively (p < 0.05). The ability to perform Zarei (deep bowing) increased from 7 patients preoperatively to 20 patients postoperatively (p < 0.05). Conclusions: This novel dual-mobility system designed for smaller Japanese patients offers three distinct advantages: (1) availability of 42, 44, 46 and 48–66 mm outer diameter cups, (2) 1 mm deeper center of rotation, providing increased jumping distance compared to other designs, and (3) improved assembly instrumentation (cement-gun-type bearing press). Early clinical results suggest that this newly developed dual-mobility THA system is well-suited to the lifestyle and anatomical characteristics of Japanese patients.

Background: A non-penal bicycle helmet mandate was implemented in the Republic of Korea on 28 September 2018, yet post-implementation epidemiologic evidence remains limited. This study evaluated changes in helmet wearing and injury outcomes before and after the mandate and identified factors associated with helmet non-use. Methods: We conducted a retrospective observational study using Korea Trauma Data Bank records from January 2017 to December 2022. After exclusions, 7653 bicycle-injured patients were identified, and 1:1 optimal propensity score matching (caliper 0.10) produced 4798 patients (2399 pairs). Outcomes included helmet use, physiological status (AVPU scale and Revised Trauma Score), Injury Severity Score (ISS), Abbreviated Injury Scale by body region, and mortality. Monthly helmet use trends were analyzed using a regression tree to detect data-driven breakpoints and segmented logistic regression at the legal implementation point (22 months) and the regression-tree-identified split (19.5 months). Multivariable logistic regression identified factors independently associated with helmet non-use. Results: Helmet use increased modestly from 17.4% pre-mandate to 21.9% post-mandate (p < 0.001). Interrupted time-series analyses showed no immediate level or slope change at either breakpoint, suggesting gradual uptake. ISS values were higher post-mandate, with ISS > 15 increasing from 21.5% to 24.4% (p = 0.02). Total mortality rose from 3.9% to 5.3% (p = 0.02). Helmet non-use was independently associated with age 80–89 years, female sex, non-Korean nationality, and residence in Jeollabuk-do. Conclusions: The mandate was associated with a modest increase in helmet wearing without an abrupt behavioral shift. These findings suggest that legislation without enforcement may have limited impact as a stand-alone measure and should be complemented by targeted education, visitor-focused communication, and region-specific safety measures.

Background: The latissimus dorsi (LD) flap remains a reliable option for breast reconstruction in irradiated, salvage, and non-microsurgical candidates. Despite the availability of multiple LD-based variants, practical guidance for technique selection remains limited. Methods: We retrospectively analyzed 40 consecutive LD-based breast reconstructions performed over 5 years at two Italian centers. Cases were categorized as classic LD, hybrid LD, extended LD, V-FALD, or KISS flap. Clinical variables, reconstructive setting, complications, and reoperations were described, and a decision-making algorithm was derived from institutional practice and literature integration. Results: The cohort was characterized by a high-complexity profile, with 36/40 patients (90%) exposed to radiotherapy and 22/40 (55%) treated in a salvage setting. Hybrid LD was the most frequently used technique, accounting for 23/40 cases (57.5%), followed by KISS flap in 6/40 (15%), extended LD in 5/40 (12.5%), V-FALD in 4/40 (10%), and classic LD alone in 2/40 (5%). Technique selection was primarily driven by skin-envelope adequacy, breast volume requirement, and the feasibility of a fully autologous reconstruction. Major complications occurred in 2/40 patients (5%), revision surgery occurred in 3/40 (7.5%), and no total flap necrosis was observed. Donor-site morbidity occurred in 10/40 (25%) of cases and was managed conservatively. Conclusions: LD-based breast reconstruction should be viewed as a versatile reconstructive platform rather than a single technique. A pragmatic algorithm may support surgical planning and help tailor the most appropriate LD variant to defect characteristics and reconstructive goals.

Background/Objectives: A psychiatric consultation is a professional evaluation aimed at establishing a diagnosis, a prognosis, and developing a treatment plan. The objective was to assess psychiatric consultations (PCs) at the Community Mental Health Center (CMHC), Emergency Room (ER) and General Hospital (GH) to highlight differences across settings. Methods: With a retrospective design, we examined all PCs performed between 1 January 2024 and 31 December 2024 at the CMHC, ER and GH of Baggiovara in Modena. Descriptive statistical analysis and a multivariate logistic regression were performed. Results: We collected a total of 3174 PCs for 1801 patients, performed in the three settings: 52% in ER, 30% in CMHC and 18% in GH. In ER, PCs were most frequently requested for suicide risk (26%), psychomotor agitation (14%) and substance intoxication (14%). In CMHC, the most common diagnoses were depressive disorders (22%), acute anxiety (20%) and acute psychotic episodes (13%). In GH, consultations mainly addressed psychiatric symptoms associated with medical and eating disorders. The overall rate of psychiatric hospitalization after PCs was 16.2%, reaching 23.4% for consultations in ER. Discontinuation of pharmacological therapy was significantly associated with an increased risk of hospitalization (p < 0.001), which rose to 17% when therapy had been interrupted for more than one year. Conclusions: PCs at ER were the access point for most hospitalizations. Therapeutic discontinuation, acute psychosis and substance use represented the main predictors of hospitalization. Strengthening shared care pathways among CMHC, ER and GH represents an effective model of integration between hospital and community services, ensuring continuity of care.