Unraveling the Efficacy of Therapeutic Interventions for Short Cervix: Insights from a Retrospective Study for Improved Clinical Management.

Background and Objectives: Preterm birth (PTB) is associated with important neonatal mortality and morbidity. The aim of this study was to retrospectively evaluate the average treatment effects on the treated and the efficacity of various therapeutic interventions for PTB in a cohort of patients with singleton pregnancies and short cervical lengths. Materials and Methods: This observational retrospective study included 1146 singleton pregnancies at risk of PTB that were segregated into the following groups: intravaginal progesterone (group 1), Arabin pessary (group 2), McDonald cerclage (group 3), intravaginal progesterone and Arabin pessary (group 4), and intravaginal progesterone and cerclage (group 5). Their treatment effects were evaluated and compared. Results: All evaluated therapeutic interventions significantly reduced the occurrence of late and early preterm births. The risk of late and early PTB was lowered for those pregnant patients who received progesterone and pessaries or progesterone and cerclage in comparison with those who received only progesterone. The extremely PTB risk of occurrence was significantly lowered only by the administration of progesterone in association with cervical cerclage in comparison with progesterone monotherapy. Conclusions: The combined therapeutic interventions had the highest efficacy in preventing preterm birth. An individualized evaluation is needed to establish the best therapeutic approach in particular cases.

Managing Fetal Ovarian Cysts: Clinical Experience with a Rare Disorder.

Background and Objectives: Fetal ovarian cysts (FOCs) are a very rare pathology that can be associated with maternal-fetal and neonatal complications. The aim of this study was to assess the influence of ultrasound characteristics on FOC evolution and therapeutic management. Materials and Methods: We included cases admitted to our perinatal tertiary center between August 2016 and December 2022 with a prenatal or postnatal ultrasound evaluation indicative of FOC. We retrospectively analyzed the pre- and postnatal medical records, sonographic findings, operation protocols, and pathology reports. Results: This study investigated 20 cases of FOCs, of which 17 (85%) were diagnosed prenatally and 3 (15%) postnatally. The mean size of prenatally diagnosed ovarian cysts was 34.64 ± 12.53 mm for simple ovarian cysts and 55.16 ± 21.01 mm for complex ovarian cysts (p = 0.01). The simple FOCs ≤ 4 cm underwent resorption (n = 7, 70%) or size reduction (n = 3, 30%) without complications. Only 1 simple FOC greater than 4 cm reduced its size during follow-up, while 2 cases (66.6%) were complicated with ovarian torsion. Complex ovarian cysts diagnosed prenatally underwent resorption in only 1 case (25%), reduced in size in 1 case (25%), and were complicated with ovarian torsion in 2 cases (50%). Moreover, 2 simple (66.6%) and 1 complex (33.3%) fetal ovarian cysts were postnatally diagnosed. All of these simple ovarian cysts had a maximum diameter of ≤4 cm, and all of them underwent size reduction. The complex ovarian cyst of 4 cm underwent resorption during follow-up. Conclusions: Symptomatic neonatal ovarian cysts, as well as those that grow in size during sonographic follow-up, are in danger of ovarian torsion and should be operated on. Complex cysts and large cysts (with >4 cm diameter) could be followed up unless they become symptomatic or increase in dimensions during serial ultrasounds.

Brief acceptance and commitment therapy for children and adolescents with type 1 diabetes.

Introduction: Children and adolescents with diabetes face challenges that can significantly impact their quality of life. Investigating psychological interventions for stress management can equip them with the skills needed to cope with type 1 diabetes. This study investigated the impact of a brief Acceptance and Commitment Therapy (ACT) intervention on stress management, diabetes acceptance, psychological flexibility, and patient-doctor relationships among this population. Methods: A total of 55 children, and adolescents from Romania participated in a four-session ACT intervention for type 1 diabetes. The evaluation instruments used were the Perceived Stress Scale for Children (PSS-C), Acceptance and Action Diabetes Questionnaire (AADQ), Children's Psychological Flexibility Questionnaire (CPFQ), and Patient-Doctor Relationship Questionnaire (PDRQ-9). Results: The participants (mean age = 14.14, SD = 2.26; 67% girls) reported lower stress levels, increased acceptance of diabetes, and greater psychological flexibility after the intervention. Additionally, the patient-doctor relationship was enhanced, potentially improving patient adherence to treatment. Positive qualitative feedback mirrored previous ACT research in the paediatric population, highlighting the beneficial role of experiential activities and metaphors when working with this target group. Discussion: This study adds to the growing body of evidence supporting the effectiveness of ACT in enhancing healthy coping strategies among children and adolescents with chronic illnesses.

Impact of the Patient-Doctor Relationship on Treatment Outcomes in Children with Type 1 Diabetes: A Meta-Analysis and Systematic Review.

(1) Background: Despite the recognized importance of the patient-doctor relationship (PDR) for pediatric diabetes management, the literature presents diverse and emerging findings regarding its impact on treatment outcomes for children with type 1 diabetes (T1D). (2) Methods: Using a meta-analytic approach, a comprehensive search for relevant studies was conducted across major databases, from the earliest study to June 2024. Inclusion criteria were studies on PDR and T1D outcomes in underaged individuals, providing quantitative results. (3) Results: Fifteen reports were included, showing a small but significant overall effect size (r = 0.165, p < 0.05) of PDR on T1D outcomes. Moderator analyses revealed significant associations from elements of PDR, duration of diagnosis, outcome assessment methods, information reporters, and being Caucasian. Demographic variables like gender, age, not being Caucasian, and caregiver's marital status did not significantly impact the association. Specific elements of PDR, such as clinician's objectives, communication, partnership, respect, and supportive care, showed significant positive effect sizes, while telecommunication did not. (4) Conclusions: A strong PDR is essential for managing diabetes in children, particularly in the early years of diagnosis. Future studies should use quantitative designs and include diverse demographics to better understand PDR's connection to T1D outcomes.

Enhanced Immunohistochemistry Interpretation with a Machine Learning-Based Expert System.

BACKGROUND: In recent decades, machine-learning (ML) technologies have advanced the management of high-dimensional and complex cancer data by developing reliable and user-friendly automated diagnostic tools for clinical applications. Immunohistochemistry (IHC) is an essential staining method that enables the identification of cellular origins by analyzing the expression of specific antigens within tissue samples. The aim of this study was to identify a model that could predict histopathological diagnoses based on specific immunohistochemical markers. METHODS: The XGBoost learning model was applied, where the input variable (target variable) was the histopathological diagnosis and the predictors (independent variables influencing the target variable) were the immunohistochemical markers. RESULTS: Our study demonstrated a precision rate of 85.97% within the dataset, indicating a high level of performance and suggesting that the model is generally reliable in producing accurate predictions. CONCLUSIONS: This study demonstrated the feasibility and clinical efficacy of utilizing the probabilistic decision tree algorithm to differentiate tumor diagnoses according to immunohistochemistry profiles.

Efficient Method for Rapid Diagnosis of Streptococcal Pneumoniae in the Context of Co-Infection in Children-Case Report.

Background: Bacterial pneumonia caused by Streptococcus pneumoniae continues to be one of the most common medical conditions in the pediatric population under 5 years of age, sometimes requiring prolonged hospitalizations and high costs. The time period (3 to 7 days) from the collection of biological samples (ie nasal exudate, pharyngeal exudate, sputum, blood culture and various secretions) to the arrival of the results has been a much discussed issue. Thus, the use of a rapid diagnostic test for Streptococcus pneumoniae urinary antigen, which is easy to use, may lead after the result is known to a targeted therapeutic management and thus to a favorable prognosis of the disease for the patient. Methods: This case report presents the case of a 4 years and 5 months old patient diagnosed with invasive pneumococcal-associated pneumococcal infection in the context of SARS-COV2 infection. Results: The clinical course was slowly favorable with complications that required a long hospitalization. Conclusion: In conclusion, some rapid diagnostic techniques, clinician judgment and some prevention methods, such as vaccination, can improve a patient's quality of life. One prospect for the future would be the development of new vaccines covering other aggressive Streptococcus pneumoniae serotypes.

Revolutionizing Pathology with Artificial Intelligence: Innovations in Immunohistochemistry.

Artificial intelligence (AI) is a reality of our times, and it has been successfully implemented in all fields, including medicine. As a relatively new domain, all efforts are directed towards creating algorithms applicable in most medical specialties. Pathology, as one of the most important areas of interest for precision medicine, has received significant attention in the development and implementation of AI algorithms. This focus is especially important for achieving accurate diagnoses. Moreover, immunohistochemistry (IHC) serves as a complementary diagnostic tool in pathology. It can be further augmented through the application of deep learning (DL) and machine learning (ML) algorithms for assessing and analyzing immunohistochemical markers. Such advancements can aid in delineating targeted therapeutic approaches and prognostic stratification. This article explores the applications and integration of various AI software programs and platforms used in immunohistochemical analysis. It concludes by highlighting the application of these technologies to pathologies such as breast, prostate, lung, melanocytic proliferations, and hematologic conditions. Additionally, it underscores the necessity for further innovative diagnostic algorithms to assist physicians in the diagnostic process.

Brief online acceptance and commitment therapy for adults with type 1 diabetes: a pilot study.

Recognizing the pivotal role of psychosocial factors in triggering and maintaining Type 1 Diabetes Mellitus (T1DM), the integration of psychoeducational and psychotherapeutic interventions is associated with comprehensive management of the disease. This study aimed to evaluate the impact of a four-week online individual Acceptance and Commitment Therapy (ACT) intervention in mitigating diabetes-associated stress, fostering diabetes acceptance, enhancing the patient-doctor relationship, and promoting psychological flexibility in adults diagnosed with T1DM. Employing a single-arm trial design with mixed methodology, thirteen participants (Mage = 39.04, SDage =13.74) engaged in the intervention and completed self-report measures before and after the intervention. Quantitative analysis with the Wilcoxon signed-rank test indicated a statistically significant difference in diabetes-associated stress, diabetes acceptance, and psychological flexibility pre- and post-intervention. Notably, stress levels and psychological inflexibility diminished, while psychological flexibility and diabetes acceptance improved. However, the patient-doctor relationship did not exhibit a significant change. Furthermore, narrative feedback obtained from participants reflected overall satisfaction with the intervention. These preliminary findings contribute to the expanding body of literature supporting the affirmative influence of ACT interventions on individuals with T1DM.

AI-Enhanced ECG Applications in Cardiology: Comprehensive Insights from the Current Literature with a Focus on COVID-19 and Multiple Cardiovascular Conditions.

The application of artificial intelligence (AI) in electrocardiography is revolutionizing cardiology and providing essential insights into the consequences of the COVID-19 pandemic. This comprehensive review explores AI-enhanced ECG (AI-ECG) applications in risk prediction and diagnosis of heart diseases, with a dedicated chapter on COVID-19-related complications. Introductory concepts on AI and machine learning (ML) are explained to provide a foundational understanding for those seeking knowledge, supported by examples from the literature and current practices. We analyze AI and ML methods for arrhythmias, heart failure, pulmonary hypertension, mortality prediction, cardiomyopathy, mitral regurgitation, hypertension, pulmonary embolism, and myocardial infarction, comparing their effectiveness from both medical and AI perspectives. Special emphasis is placed on AI applications in COVID-19 and cardiology, including detailed comparisons of different methods, identifying the most suitable AI approaches for specific medical applications and analyzing their strengths, weaknesses, accuracy, clinical relevance, and key findings. Additionally, we explore AI's role in the emerging field of cardio-oncology, particularly in managing chemotherapy-induced cardiotoxicity and detecting cardiac masses. This comprehensive review serves as both an insightful guide and a call to action for further research and collaboration in the integration of AI in cardiology, aiming to enhance precision medicine and optimize clinical decision-making.

Drugs Associated with Adverse Effects in Vulnerable Groups of Patients.

In recent years, a series of recommendations have been issued regarding the administration of drugs because of awareness of the serious side effects associated with certain classes of drugs, especially in vulnerable patients. Taking into account the obligation of the continuous improvement of professionals in the medical fields and the fact that we are in the midst of a "malpractice accusations pandemic", through this work, we propose to carry out a "radiography" of the scientific literature regarding adverse effects that may occur as a result of the interaction of drugs with the physiopathological particularities of patients. The literature reports various cases regarding different classes of drugs administration associated with adverse effects in the elderly people, such as fluoroquinolones, which can cause torsade de pointes or tendinopathy, or diuretics, which can cause hypokalemia followed by torsade de pointes and cardiorespiratory arrest. Also, children are more prone to the development of adverse reactions due to their physiological particularities, while for pregnant women, some drugs can interfere with the normal development of the fetus, and for psychiatric patients, the use of neuroleptics can cause agranulocytosis. Considering the physiopathological particularities of each patient, the drug doses must be adjusted or even completely removed from the treatment scheme, thus requiring the mandatory active participation both of clinician pharmacists and specialists in the activity of medical-pharmaceutical analysis laboratories within the structure of hospitals.

Carbohydrate Antigen 125 (CA 125): A Novel Biomarker in Acute Heart Failure.

BACKGROUND: Heart failure is a global major healthcare problem with millions of hospitalizations annually and with a very high mortality. There is an increased interest in finding new and reliable biomarkers for the diagnostic, prognostic and therapeutic guidance of patients hospitalized for acute heart failure; Our review aims to summarize in an easy-to-follow flow recent relevant research evaluating the possible use and the clinical value of measuring CA 125 serum levels in acute HF. METHODS: A thorough search in the main international databases identified a relevant pool of 170 articles, providing recently published data for this narrative review that used PRISMA guidelines. RESULTS: There are data to sustain the role of carbohydrate antigen 125 (CA 125), a worldwide used marker of ovarian cancer, in patients with heart failure. Several studies have shown links between CA 125 levels and congestion seen in acute heart failure, high mortality and readmission rates at 6 months follow-up after discharge from acute heart failure and also a role of CA 125 in the guidance of heart failure therapy. There are also clinical trials that showed that several particularities of CA 125 make it even better than N-terminal pro b-type natriuretic peptide (NT-pro BNP)-a classical and more utilized marker of heart failure) in several scenarios of acute heart failure. CONCLUSIONS: Although the mechanism behind the upregulation of serum CA 125 in patients with congestive HF has not been confirmed nor fully understood.

Acute Myocardial Infarction in COVID-19 Patients-A Review of Literature Data and Two-Case Report Series.

Background/Objectives: The newly emergent COVID-19 pandemic involved primarily the respiratory system and had also major cardiovascular system (CVS) implications, revealed by acute myocardial infarction (AMI), arrhythmias, myocardial injury, and thromboembolism. CVS involvement is done through main mechanisms-direct and indirect heart muscle injury, with high mortality rates, worse short-term outcomes, and severe complications. AMI is the echo of myocardial injury (revealed by increases in CK, CK-MB, and troponin serum markers-which are taken into consideration as possible COVID-19 risk stratification markers). When studying myocardial injury, physicians can make use of imaging studies, such as cardiac MRI, transthoracic (or transesophageal) echocardiography, coronary angiography, cardiac computed tomography, and nuclear imaging (which have been used in cases where angiography was not possible), or even endomyocardial biopsy (which is not always available or feasible). Two-case-series presentations: We present the cases of two COVID-19 positive male patients who were admitted into the Clinical Department of Cardiology in "Sfântul Apostol Andrei" Emergency Clinical Hospital of Galați (Romania), who presented with acute cardiac distress symptoms and have been diagnosed with ST elevation AMI. The patients were 82 and 57 years old, respectively, with moderate and severe forms of COVID-19, and were diagnosed with anteroseptal left ventricular AMI and extensive anterior transmural left ventricular AMI (with ventricular fibrillation at presentation), respectively. The first patient was a non-smoker and non-drinker with no associated comorbidities, and was later discharged, while the second one died due to AMI complications. Conclusions: From this two-case series, we extract the following: old age alone is not a significant risk factor for adverse outcomes in COVID-19-related CVS events, and that the cumulative effects of several patient-associated risk factors (be it either for severe forms of COVID-19 and/or acute cardiac injury) will most probably lead to poor patient prognosis (death). At the same time, serum cardiac enzymes, dynamic ECG changes, along with newly developed echocardiographic modifications are indicators for poor prognosis in acute cardiac injury in COVID-19 patients with acute myocardial injury, regardless of the presence of right ventricular dysfunction (due to pulmonary hypertension).

Oral Cavity Microbiome Impact on Respiratory Infections Among Children.

Background: The respiratory system, traditionally considered antiseptic, harbors a diverse and dynamic bacterial microbiome. Recent advancements in microbiome research have revealed its significant influence on both innate and adaptive immunity, particularly in the context of respiratory infections in children. This article also provides an overview of the types of bacteria that commonly affect the respiratory system, including Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae. These bacteria are prevalent in pediatric populations and significantly contribute to the development and severity of respiratory tract infections (RTIs). Purpose: This review aims to evaluate the impact of the oral cavity and upper respiratory microbiome on the susceptibility and severity of respiratory infections in pediatric populations. We specifically focus on how early colonization patterns of bacteria such as Moraxella and Streptococcus contribute to the development of respiratory tract infections in children from birth through adolescence. Methods: A thorough literature review was performed, focusing on studies publishing between 2004 and 2023. The review included research exploring the role of the upper respiratory microbiome in pediatric populations, with a specific focus on children aged birth to 18 years. Emphasis was placed on microbial characterization, the modulation of immune responses in respiratory tract infections, and the potential therapeutic applications of microbiome-targeted interventions. Results: The findings suggest that the composition and disruption of the upper respiratory microbiome significantly influence clinical outcomes in children with respiratory infections. Notably, dysbiosis in the microbiome has been linked to increased susceptibility to repeated infections, highlighting the importance of maintaining microbial balance for optimal respiratory health. Conclusion: Understanding the impact of oral cavity and upper respiratory microbiome could lead to improved management and prevention strategies for respiratory infections in children. This review underscores the potential of microbiome modulation, including the use of probiotics as a therapeutic approach to enhance clinical outcomes in pediatric respiratory infections.

The Impact of Cardiovascular Antecedents on the Prognosis of COVID-19 Critically Ill Patients.

Background/Objectives: The objective of the study is to analyze the impact of cardiovascular history on mortality in COVID-19 patients, hospitalized in the intensive care unit with indications for continuous positive airway pressure (CPAP) and subsequently mechanical ventilation, without oncological disease. Methods: A retrospective observational study was carried out on a group of 108 critical COVID-19 patients. We compared demographic data, paraclinical and clinical parameters, days of hospitalization, and mortality rate between two groups of patients, one group with a history of cardiovascular disease (81 patients) and a group without a history of cardiovascular disease (27 patients). Results: Patients with cardiovascular antecedents had a higher mortality rate than those without cardiovascular antecedents, presenting severe forms with shorter survival time in the intensive care unit and increased inflammatory evidence. Compared to patients without a history of cardiovascular illness, those with cardiovascular disease had a lower average age, and developed a severe form of COVID-19. Conclusions: Cardiovascular antecedents can worsen the prognosis of patients with COVID-19, requiring a careful screening and multidisciplinary approach.

Antiviral Therapy of Chronic Hepatitis B Virus between Present and Future.

Background/Objectives: The objective of this study was to analyze the results of clinical trials regarding long-term antiviral therapies in chronic hepatitis with HBV to compare current therapeutic protocols and to analyze the results of preliminary studies with new antiviral therapies for HBV. Methods: Clinical studies and meta-analyses from PubMed, Google Scholar, and Research Gate from 2011 to 2024 were analyzed on patients undergoing chronic antiviral therapy for HBV, and a retrospective observational study performed in our clinic on a group of 76 patients undergoing chronic therapy with entecavir was presented. Also, a summary of the results of preliminary studies with various innovative antiviral molecules for HBV was performed. Results: The results of extensive clinical trials reveal that current therapies for chronic HBV are well tolerated and maintain good viral suppression if the patient is adherent to therapy. Innovative therapies aim to eliminate HBsAg and, thus, significantly shorten the duration of treatment, and the preliminary results of the studies are promising. Conclusions: Being an asymptomatic condition that requires life-long therapy, adherence to therapy is a real problem. Also, the risk of decompensation of liver cirrhosis and adenocarcinoma remains important in these patients. Future research is needed to perfect some antiviral therapy schemes that shorten the treatment period but also decrease the rate of progression towards decompensated cirrhosis and liver adenocarcinoma.

Chromophobe renal cell carcinoma with massive sarcomatoid differentiation.

Chromophobe renal cell carcinoma (CRCC) is a distinct subtype of renal cell carcinoma with unique histological, immunohistochemical, cytogenetic, and ultrastructural features, which usually has a favorable clinical course, with only a small percentage of patients developing recurrence, metastasis, or death due to its complications. Sarcomatoid differentiation can occur in any subtype of renal cell carcinoma and currently represents the transformation into a higher degree of malignancy, its presence being associated with a reserved prognosis, with a reported incidence of average survival of less than 1 year after diagnosis. In this study, we present an unusual case of CRCC with massive sarcomatoid differentiation, which infiltrated the left adrenal gland and was surgically resected. The histological features of this tumor as well as a brief review of literature are presented.

The Use of Brain Natriuretic Peptide in the Evaluation of Heart Failure in Geriatric Patients.

Heart failure is one of the main morbidity and mortality factors in the general population and especially in elderly patients. Thus, at the European level, the prevalence of heart failure is 1% in people under 55 years of age but increases to over 10% in people over 70 years of age. The particularities of the elderly patient, which make the management of heart failure difficult, are the presence of comorbidities, frailty, cognitive impairment and polypharmacy. However, elderly patients are under-represented in clinical trials on the diagnosis and treatment of heart failure. The need for complementary methods (biomarkers) for differential and early diagnosis of heart failure is becoming more and more evident, even in its subclinical stages. These methods need to have increased specificity and sensitivity and be widely available. Natriuretic peptides, in particular B-type natriuretic peptide (BNP) and its fraction NTproBNP, have gained an increasingly important role in the screening, diagnosis and treatment of heart failure in recent years.

Study on the Influence of Regular Physical Activity on Children's Oral Health.

The benefits of physical activities conducted systematically on the harmonious development, intellectual performance, and general health of children are unanimously accepted. This study's aim is to determine whether differences in oral health between young athletes and children not engaged in competitive sports are present. A total of 173 children aged between 6 and 17 years, 58 hockey players, 55 football players, and 60 in the control group were divided into groups according to their activity, age, and biological sex and examined for oral hygiene and dental and periodontal health, using clinically determined indices. Statistical analysis showed significant differences between the groups, with lower (better) values for athletes, regardless of age, sex, or activity. Oral hygiene showed the most relevant differences for males aged 14 to 17, as did the index for dental health. Periodontal health, on the other hand, was significantly better for females aged 6 to 13. Based on this data, the beneficial influence of regular physical activity also has an impact on oral health. Identifying the mechanisms behind this needs to be explored in depth and may be a topic for further research.

Pathogenesis of Musculotendinous and Fascial Injuries After Physical Exercise - Short Review.

Purpose: The identification of sports and physical exercises with injury risk is necessary to preserve the capacity of athletes and people who perform physical education and also to prevent the installation of functional deficiencies. Methods: We have selected the articles related to the pathogenic mechanisms involved in musculotendinous and fascial injuries produced as a result of physical exercise. Results and Discussions: The lesional pathogenesis is complex and incompletely clarified. Recent theories put in a new light the mechanisms of muscle pain and tendinopathy production. The accumulation of lactate anion, known to be a residue that induces fatigue and muscle pain, has been reconsidered by some authors. It appears that lactate anion is an excellent fuel for the myocardial fiber. Moreover, the accumulation of lactic acid after intense physical exercise could prevent the inexcitability of the sarcolemma induced by the increased concentration of interstitial K+. Most of the time, overuse injuries are not limited to muscles. They can cause myofascial, myotendinous or purely muscular injuries. The muscular fascia is more susceptible to injuries produced under the action of large external forces. Also, fascia is more sensitive to pain compared to muscle when external forces act eccentrically. Overloading the tendon and putting it under tension repeatedly is followed by ruptures of the tendon fibers. The regeneration of the degenerated tendon is defective in the context of the inflammation produced by the injury. Tendon fibers undergo a process of fibrosis, scarring, adhesion and heterogeneous calcification. Oxidative stress is responsible for inflammation, degeneration and apoptosis of tenocytes. Conclusion: The benefits brought by physical education and sports are indisputable, but their practice requires a coordinated program to prevent possible traumatic and overuse injuries.

Basal Cell Carcinoma Perineural Invasion and Suggestive Signs of Perineural Invasion-Findings and Perspectives.

Basal cell carcinoma (BCC) is a malignant tumor with a rising incidence and is the beneficiary of several innovative evaluation techniques. Histopathology remains the gold standard for assessment, having the possibility of addressing multiple high-risk factors such as perineural invasion (PNI). The current study included a number of 244 BCC patients and targeted the identification of positive PNI and its suggestive signs, and whether they correlated or not with other high-risk tumor signs. PNI was found in 20.1% of patients, with 30.7% of patients having perineural chronic inflammation (PCI), which is a suggestive sign of PNI. PNI was also found in larger tumors, with deeper Clark levels, in high-risk BCCs and high-grade tumors. PNI and PCI are both important for pathology reporting, aiding in treatment choice and further patient management, with possibly positive outcomes concerning morbidity and mortality.