Copper Nanoclusters as Novel Podium for Cancer Detection, Imaging, and Therapy Applications.

Nanoclusters (NCs) are meticulously small, kinetically stable, crystalline materials which hold immense potential as multifaceted catalysts for a broad range of biomedical applications. Metal NCs are atomically precise and exist within the range of Fermi wavelength of electrons. They are highly advantageous as functional materials as their physicochemical properties can be customized to meet specific requirements. Copper NCs (CuNCs) are emerging as an efficient substitute to the other existing metal NCs. The synthesis of CuNCs is highly methodical, fast, cost effective and does not involve any complicated manipulation. On the contrary to gold and silver NCs, copper is a vital trace element for humans that can be excreted easily out the body. Further, the relatively inexpensiveness and easy availability of copper aids in potential nanotechnological applications in large quantity. As such, CuNCs have attracted great interest among the research community recently. The modern developments in the strategy, synthesis, surface modifications, and use of CuNCs in diagnosis of disease, imaging and treatment have been discussed in the present review. Approaches to regulate and augment the emission of CuNCs, challenges and drawbacks have also been considered. This review brings to light the multifarious applications of CuNCs and their potential as emerging theranostic agents. It is anticipated that the visions and directions for translating existing developments in CuNCs from the laboratory to the clinic can be further improved and enhanced.

The Need for Persistence in the Diagnosis of Mycobacterium Tuberculosis Mono-arthritis: A Unique Case Presentation.

Although tuberculosis (TB) is considered to be a common disease confined to undeveloped or developing countries, it may also appear in countries that accept great migrant influx from endemic areas. In terms of the skeletal system, it can be involved in 1-6% of tuberculosis patients while the knee joint is the third most frequently affected site after spine and hip. Given that systemic symptoms are present in only one-third of patients with skeletal tuberculosis and secondary septic arthritis, TB is often indolent and diagnosis can hence be missed or delayed. As a result, a high index of suspicion is imperative. Here, we aim to report a case of mono-arthritis caused by Mycobacterium tuberculosis in a native 77-year-old man who was suffering from low-grade knee pain for six months and despite multiple presentations to the Accident and Emergency department, diagnosis had not been established.

Angiolymphoid Hyperplasia With Temporal Artery Eosinophilia: A Case Report.

Angiolymphoid Hyperplasia with Eosinophilia (ALHE) is a benign vascular proliferative disorder with uncertain etiology and pathogenesis. The aim of this paper is to report a case of ALHE in the temporal artery and discuss the general aspects of this pathology. A 29-year-old female black patient sought the Vascular Surgery Outpatient Service, complaining of bulging in the right temporal region, associated with pain and local discomfort. Physical examination revealed pulsatile bulging in the right temporal region measuring approximately 2.5 × 1.5 cm. Nuclear Magnetic Resonance showed an expansive fusiform lesion in the superficial soft parts of the right temporal region, measuring 2.9 cm in the longest longitudinal axis. Surgical excision proved to be the best therapeutic option for the patient in this case. Histopathological sections showed the proliferation of vessels of different sizes, covered by swollen endothelium, prominent inflammatory infiltrate composed of lymphocytes, plasma cells, eosinophils, and scarce histiocytes. Immunohistochemical analysis of the lesion showed positivity for CD31, corroborating the diagnosis of ALHE.

Artificial Intelligence and Pathomics: Prostate Cancer.

Artificial intelligence (AI) has the potential to transform pathologic diagnosis and cancer patient management as a predictive and prognostic biomarker. AI-based systems can be used to examine digitally scanned histopathology slides and differentiate benign from malignant cells and low from high grade. Deep learning models can analyze patient data from individual or multimodal combinations and identify patterns to be used to predict the response to different therapeutic options, the risk of recurrence or progression, and the prognosis of the newly diagnosed patient. AI-based models will improve treatment planning for patients with prostate cancer and improve the efficiency and cost-effectiveness of the pathology laboratory.

Genomics and Artificial Intelligence: Prostate Cancer.

Artificial intelligence (AI) is revolutionizing prostate cancer genomics research. By leveraging machine learning and deep learning algorithms, researchers can rapidly analyze vast genomic datasets to identify patterns and correlations that may be missed by traditional methods. These AI-driven insights can lead to the discovery of novel biomarkers, enhance the accuracy of diagnosis, and predict disease progression and treatment response. As such, AI is becoming an indispensable tool in the pursuit of personalized medicine for prostate cancer.

Changing Epidemiology of Hepatocellular Carcinoma Within the United States and Worldwide.

Globally, hepatocellular carcinoma (HCC) is a major cause of cancer-related death and a leading cause of morbidity and mortality in patients with chronic liver disease and cirrhosis. The predominant cause of HCC is shifting from viral to nonviral causes, in parallel with the high global prevalence of nonalcoholic fatty liver disease and increasing alcohol consumption in many countries. There have been promising recent advances in the treatment of all stages of HCC; however, improvements in early detection, increased utilization of HCC surveillance, and equitable access to HCC therapies are needed to curb increases in HCC mortality.

Hepatocellular Carcinoma Surveillance: Evidence-Based Tailored Approach.

Hepatocellular carcinoma (HCC) surveillance is recommended by professional society guidelines given a consistent association with reduced HCC-related mortality. HCC surveillance should be performed using semiannual abdominal ultrasound and alpha-fetoprotein, although this combination has suboptimal sensitivity and can miss more than one-third of HCC at an early stage. There are promising emerging blood-based and imaging-based strategies, including abbreviated MRI and biomarker panels; however, these require further validation before routine use in clinical practice. HCC surveillance is underused in clinical practice due to patient-related and provider-related barriers, highlighting a need for interventions to improve surveillance utilization in clinical practice.

Overview of Current Hepatocellular Carcinoma Staging Systems: Is There an Optimal System?

Multiple hepatocellular carcinoma (HCC) staging systems have been proposed and used clinically over time. These may consider clinical, pathological, radiological, or treatment response factors, depending on the model. Given the heterogeneity of HCC treatment in its different stages and the validation of the systems in different populations, they are not universal. Likewise, the improvement in diagnostic tools, as well as novel therapeutic alternatives, have made these models more complex. Despite this, some have been modified over time in line with advances in the field, and although there is no universally accepted one, each has its usefulness, strengths, and weaknesses.

Up-to-Date Role of Liver Imaging Reporting and Data System in Hepatocellular Carcinoma.

This article overviews Liver Imaging Reporting and Data System (LI-RADS), a system that standardizes techniques, interpretation and reporting of imaging studies done for hepatocellular carcinoma surveillance, diagnosis, and locoregional treatment response assessment. LI-RADS includes 4 algorithms, each of which defines ordinal categories reflecting probability of the assessed outcome. The categories, in turn, guide patient management. The LI-RADS diagnostic algorithms provide diagnostic criteria for the entire spectrum of lesions found in at-risk patients. In addition, the use of LI-RADS in clinical care improves clarity of communication between radiologists and clinicians and may improve the performance of inexperienced users to the levels of expert liver imagers.

Phenotypes of Primary Sclerosing Cholangitis and Differential Diagnosis.

Primary sclerosing cholangitis is a heterogenous immune-mediated disorder characterized by chronic inflammation and stricturing of the bile ducts. Though the driving pathophysiologic mechanisms remain elusive, there are several observed clinical phenotypes of the disease. The distribution of bile duct involvement, presence of concomitant inflammatory bowel disease, significant infiltration of IgG4-positive plasma cells, and overlapping features with other autoimmune disease has significant implications for prognosis and treatment. As there remains no pathognomonic finding for primary sclerosing cholangitis, a broad differential diagnosis and extensive evaluation of other underlying causes is critical to appropriate management.

Autoimmune Hepatitis: Epidemiology, Subtypes, and Presentation.

Autoimmune hepatitis (AIH) is a chronic immunologic disorder in which the immune system targets the liver. The disease has a genetic basis and this accounts for the epidemiologic variation observed in serologic testing and clinical presentation across different populations. The incidence of AIH increases with age into the 70s and seems to be increasing in prevalence. Most patients test positive for antinuclear antibody, ASMA, or anti-LKM but about 20% of patients do not have these serologic markers. At clinical presentation, patients may be asymptomatic, symptomatic, have acute liver failure, or decompensated cirrhosis.

Primary Sclerosing Cholangitis: Epidemiology, Diagnosis, and Presentation.

Primary sclerosing cholangitis (PSC) is considered an immunologically mediated disease. However, some of its features are not consistent with the typical profile of autoimmune conditions. PSC is characterized by progressive biliary fibrosis that may ultimately result in the eventual development of cirrhosis. In recent years, multiple studies have reported that the incidence and prevalence of this disease are on the rise. Consequently, patients are often diagnosed without symptoms or signs of advanced liver disease, although many still present with signs of decompensated liver disease. This article discusses the epidemiology, clinical presentation, and diagnostic workup in patients with PSC.

Primary Biliary Cholangitis: Epidemiology, Diagnosis, and Presentation.

Using ursodeoxycholic acid as a standard treatment and for its ability to test for antimitochondrial antibody to accelerate diagnosis, survival of primary biliary cholangitis patients has approached that of the general population, leading to a change in nomenclature from primary biliary cirrhosis to primary biliary cholangitis to more accurately describe the disease.

Cholangiocarcinoma Surveillance Recommendations in Patients with Primary Sclerosing Cholangitis.

Cholangiocarcinoma (CCA) is a deadly complication observed in the setting of primary sclerosing cholangitis (PSC). When symptoms develop and CCA is diagnosed, it is usually at an advanced stage. Median survival is less than 12 months. Early identification of CCA leads to improved outcomes. Although diagnostic tests have excellent specificity, they are plagued by low sensitivity. No surveillance strategies have been widely agreed upon, but most societies recommend measurement of serum carbohydrate antigen 19-9 and MRCP every 6 to 12 months in patients with PSC. Advances in understanding of the genetic factors that lead to CCA are awaited.

Autoimmune Markers in Primary Biliary Cholangitis.

Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease. The most common antibody associated with PBC is the anti-mitochondrial antibody (AMA), present in 90% to 95% of patients. For patients who are AMA-negative, novel biomarkers, such as antinuclear antibody-specific antibodies Sp100 and gp210 and anti-kelch-like-12 and anti-hexokinase-1 antibodies, may further aid in the diagnosis of PBC. Several laboratory methods, including immunofluorescence, enzyme-linked immunosorbent assay, immunoblotting, and bead-based assays, exist to evaluate for the presence of antibodies. This article describes various methods used to evaluate antibodies as well as describe the antibodies present in PBC.

Attention-Deficit / Hyperactivity Disorder in Athletes.

ADHD is common among the general population and may be slightly more common among athletes. Diagnosis requires six or more DSM-5-TR symptoms to have been present prior to age 12 and to have an effect on functioning in multiple settings. Different sporting organizations have varying requirements for documentation when making a diagnosis. Stimulant medications are the mainstay of treatment; psychosocial interventions, exercise, and non-stimulant medications can serve as adjuncts. Future directions in research on ADHD in sports include determining whether ADHD is overrepresented among the population of elite athletes and parsing out the relationship between ADHD and concussion risk and recovery.

Mental Health and Disordered Eating in Athletes.

Disordered eating (DE) and eating disorders (EDs) are more prevalent in athletes than non-athletes, and can cause devastating health and performance consequences. Although they can affect any athlete, DE/EDs are more common among women and athletes in lean sports, where there is a perceived competitive advantage to being lean. The sports medicine provider plays a crucial role in screening, diagnosis, and treatment of DE/ED. Treatment should involve a multidisciplinary team with a physician, dietitian, and mental health provider. Preventative efforts should seek to educate athletes and their coaches/support staff and should foster a healthy environment, which deemphasizes weight or body image.

Review of Media Representation of Sport Concussion and Implications for Youth Sports.

Participation in sport can incur a risk of sport-related concussion (SRC). Media representation of SRC is frequently at odds with up-to-date scientific data. Our findings confirm a significant amount of false, confusing, or misleading terminology used in reporting on the topic, which is concerning as media is as a major source of SRC information. Individuals have a variable base of knowledge pertaining to this injury, and accurate understanding of SRC does not always correlate to appropriate action. Inaccurate portrayal of SRC media may contribute to the confusion surrounding it. Popular media presents an opportunity to convey evidence-based information on SRC.

Sleep in the Athlete.

Sleep is important for not only general health but also for lowering injury risk and maintaining athletic performance. Sleep disorders are prevalent in athletes, and taking a sleep history, evaluating sleep quality, and addressing other related factors including mental health are essential in diagnosing and understanding sleep disorders. Other methods such as polysomnography, actigraphy, and sheet sensors can also be used. Treatment options for sleep disorders include sleep hygiene, cognitive behavioral therapy, medication, and addressing contributing factors. For athletes, sleep can also be affected by factors such as travel fatigue and jet lag, which should be taken into consideration.

Using Physiology Pullback for Percutaneous Coronary Intervention Guidance: Is this the Future?

Modern coronary intervention requires integration of angiographic, physiologic, and intravascular imaging. This article describes the use and techniques needed to understand coronary physiology pullback data and how use it to make revascularization decisions. The article describes instantaneous wave-free ratio, fractional flow reserve, and the data that support their use and how they differ when used in tandem disease. Common practical mistakes and errors are discussed together with a brief review of the limited published research data.