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Surgical management of ocular symptoms in spheno-orbital meningiomas. Is orbital reconstruction really necessary?

Spheno-orbital meningioma (SOM) is an intriguing tumor because of the many different factors that can influence clinical and oncological outcome after treatment. Reasoning that outcome indicator measurement is key to improving therapy, we retrospectively evaluated the management of proptosis and other ocular symptoms in 47 patients surgically treated for SOM at our department in the last 10 years. This patient series was characterized by a high rate of tumor infiltration of the extradural cranial base. Clinical outcome was assessed by comparing preoperative and postoperative ophthalmological a

Epidemiologic associations of carpal tunnel syndrome and sleep position: Is there a case for causation?

INTRODUCTION: Carpal tunnel syndrome (CTS) is thought to be due to compression of the median nerve in the carpal tunnel. It is known that carpal tunnel pressures are elevated in wrist postures of flexion and extension and in those patients with CTS. Classic symptoms of CTS include night waking with pain, tingling, and numbness. These classic symptoms stimulated our interest in the relationship of sleep to the development of CTS. METHOD: We reviewed the literature surrounding the epidemiology of CTS and the literature regarding sleep disturbances. Through careful distillation of these studies

Does the medical college admission test predict global academic performance in osteopathic medical school?

OBJECTIVE: To investigate the extent to which Medical College Admission Test (MCAT) subscores predict the overall academic performance of osteopathic medical students. METHODS: We examined the value of MCAT subscores in predicting students' global academic performance in osteopathic medical school, as defined by grade point average in basic science (basic GPA), clinical instruction (clinical GPA), cumulative grade point average (total GPA), and national licensing examination scores on the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1 and Level 2. Subjects we

Evolving drivers of preexposure prophylaxis discontinuation among US MSM, 2018-2024.

OBJECTIVE: To examine temporal trends in reasons for stopping preexposure prophylaxis (PrEP) among MSM from 2018 to 2024, including how reasons co-occur and vary by demographics. DESIGN: Pooled repeated cross-sectional analysis of seven annual waves of the American Men's Internet Survey (AMIS), a national behavioral survey of US cisgender MSM (N = 54 612). METHODS: Among 3074 noncurrent PrEP users who reported reasons for stopping, we collapsed checklist items into six thematic categories and estimated adjusted prevalence by survey year using multivariable logistic regression with g-computat

Factors influencing antiretroviral therapy switching in people with virologically suppressed HIV-1: a cross-sectional multicenter study in France.

INTRODUCTION: In France, over 90% of people with HIV-1 (PWH) achieve virological suppression with effective combination of antiretroviral therapies (ART), but limited data exist on the motivation for switching ART. OBJECTIVE: To describe the reasons and determinants for switching ART, with a particular focus on doravirine-based regimens, in routine clinical practice in France. DESIGN: This analysis of cross-sectional baseline data is part of the DoraVIH study, a French, multicenter (15 sites), two-step observational cohort study that includes prospective follow-up for a subset of participant

[A social study of a group of depressed patients recovering in a private clinic].

Depression is a widespread illness in Sardinia and is treated mainly in private clinics which accept National Health patients. The aim of the present study was to evidence socio-demographic and clinical characteristics of depressed subjects who turn to these clinics. Furthermore we will examine the reason which led to the choice of a private clinic on the basis of services provided by the same, of those available in public hospitals and of patients' psychopathological history and socioeconomic characteristics. We examined 122 depressed patients who had been admitted to a private clinic in Cagl

Expanding the living donor pool, "Ist Act": analysis of the causes of exclusion of potential kidney donors.

BACKGROUND: The evaluation of a potential living kidney donor (LKD) leads to exclusion of at least 50% of candidates. The aim of this study was to analyze the reasons for exclusion of potential LKDs referred to our center. METHODS: We retrospectively analyzed historic and clinical data of all potential LKDs who were evaluated over 7 years from January 2005 to March 2012. Data were obtained by review of an electronic database. RESULTS: Among 79 (50 female, 29 male) candidates, 24 (30.3%) successfully donated, comprising 22 related and 2 unrelated donors. We excluded 45 (56.9%), and 10 (12.6%)

Benchmark evaluation of large language models for clinical decision support in headache management.

BACKGROUND: Headache disorders are a major cause of disability worldwide. In routine practice, diagnosis and guideline-based management are difficult because symptoms can overlap between primary and secondary headaches, and clinicians must combine clinical, imaging, and pathological information. Large language models (LLMs) are being proposed to assist clinical reasoning, but their performance on headache cases and their sensitivity to prompting have not been systematically assessed. METHODS: We evaluated seven leading LLMs using 13 headache cases from the New England Journal of Medicine (NEJ…

Exploring the use of AI-generated counterfactual chest X-rays to enhance diagnostic learning in medical education.

Accurate interpretation of chest X-rays is a critical clinical skill, yet radiology training in medical education remains limited and often fails to provide broad exposure to a wide variety of conditions, including those that are rare, subtle, or easily confused with one another. Although artificial intelligence (AI) has shown impressive performance in medical image classification, its potential to actively improve clinical education has not been fully realised. In this study, we introduce AI-generated counterfactual chest X-rays-real patient images digitally altered to show a different but st

Comparison of autopsy, clinical and death certificate diagnosis with particular reference to lung cancer. A review of the published data.

Some clinicians and some epidemiologists appear to be under the illusion that techniques available for the diagnosis of internal diseases such as lung cancer have improved so much that autopsies are not necessary on the bodies of most people who die. Partly for this reason, partly for economic reasons and partly because clinicians fear litigation if autopsy shows that they treated patients for the wrong disease, autopsy rates have been falling in most developed countries. The object of the present review was to ascertain how much reliance can reasonably be put on clinical diagnoses made and de

Large Language Models and Metabolic Bariatric Surgery: A Pilot Concordance Study Between ChatGPT and Multidisciplinary Team Recommendations.

INTRODUCTION: Operation selection in metabolic surgery is a complex decision making process led by a multidisciplinary team that integrates … in an autonomous fashion. This study establishes the requirement for larger scale evaluation of LLM clinical reasoning and supports the future exploration of them as adjunctive rather than autonomous decision support tools in metabolic surgery.

FedMediFormer-XAI: Federated Multimodal Transformers with Diffusion Augmentation and Graph-Based Drug Recommendation for Diabetes.

Diabetes management faces a number of obstacles, such as fragmented healthcare data, privacy concerns, poor explainability, and the lack of personalized therapeutic guidance. This research work introduces FedMediFormer-XAI, a unified and proper framework that incorporates federated learning, multimodal transformers, diffusion-based data augmentation, Graph Neural Networks (GNNs) for drug recommendation, and Explainable Artificial Intelligence (XAI) for diabetes intelligence. The system utilizes diverse healthcare data types, e.g., clinical records, population health indicators, continuous gluc

Data-reflector: an agentic exploratory data analysis platform for researchers.

OBJECTIVES: Exploratory data analysis (EDA) is foundational to clinical research yet inaccessible to clinician-scientists without programming training. Existing large language model (LLM) tools improve accessibility but struggle with hallucinations. We developed and evaluated data reflector (DR), a hybrid agentic platform pairing natural language interaction with deterministic statistical computation. MATERIALS AND METHODS: Data reflector restricts the LLM to intent interpretation, tool selection, and filter parsing while routing all numerical computation through predefined deterministic func

Effect of virtual reality assimilated the BOPPPS model on evidence-based healthcare curriculum: A mixed-methods study.

OBJECTIVE: Evidence-based healthcare (EBHC) has emerged as a global standard in clinical practice, offering a structured approach to improving patient outcomes. For nurses, EBHC serves as a critical framework for identifying and applying the best available evidence when addressing clinical challenges. This study aimed to examine the effectiveness of integrating virtual reality (VR) into the BOPPPS (Bridge-in, Objective, Pre-test, Participatory Learning, Post-test and Summary) teaching model to enhance the design and delivery of EBHC courses. MATERIALS AND METHODS: Participants were first-year

Viewpoint on the Consequences and Mitigation of Cognitive Bias in the Radiological Interpretation of Breast Cancer Imaging Using Artificial Intelligence.

Artificial intelligence (AI) is increasingly integrated into breast imaging workflows, offering the potential to enhance diagnostic accuracy, efficiency, and early cancer detection. Image interpretation plays a pivotal role in the breast cancer diagnostic pathway, directly influencing therapeutic decisions and patient outcomes. However, the effective implementation of AI-assisted systems relies not only on technical performance but also on radiologists' trust, acceptance, and readiness to incorporate these tools into clinical practice. In addition, system-related, perceptual, and cognitive fac

Artificial Intelligence in Obstetrics and Gynecology Nursing: Clinical, Educational, and Ethical Perspectives.

Artificial intelligence (AI) is rapidly transforming healthcare by enabling advanced data analysis, predictive modeling, and intelligent cli … nursing education, including adaptive learning platforms and simulation-based training that enhance clinical reasoning and preparedness for obstetric emergencies. Ethical and implementation challenges, including algorithmic bias, data privacy, transparency, and equitable access, are also discussed. While AI shows promising potential to improve diagnostic accuracy, s …

агитационные рамки ИИ, связывающие языковые модели с электронными медицинскими записями, и график биомедицинских знаний для реальных доказательств.

Доступ к крупномасштабным клиническим и биомедицинским базам данных по-прежнему является серьезным препятствием для клинических и научных работников, требующим значительных вычислительных знаний. Агентские системы искусственного интеллекта, в которых крупные языковые модели (МПМ) организуют многоэтапное рассмотрение и выполнение запросов под интерактивным контролем человека, открывают возможности для демократизации доступа к данным и ускорения процесса получения доказательств. MethodsWe применяли Типовой контекстный протокол (МКП) для интеграции в рамках одного агентского рабочего процесса ста

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… Recent studies emphasize that integrating external knowledge can bolster an LLM's clinical reasoning and reduce errors. …

Lifestyle Interventions to Tackle Cardiovascular Risk in Thyroid Hormone Signaling Disorders.

Thyroid hormones (THs) play a central role in cardiovascular and metabolic regulation, influencing lipid metabolism, insulin sensitivity and … on pathophysiological insights into the effects of thyroid hormones on target organs, combined with clinical reasoning and evidence extrapolated from related disorders. Physical exercise and diet may complement pharmacological treatments (e.g., levothyroxine or TRIAC) to improve cardiovascular and metabolic outcomes. In RTHβ, aerobic exercise enhances cardiovascular …

Perception of simulation-based education among nursing and midwifery students in Tanzania: a qualitative study.

BACKGROUND: While many nursing programs in developed countries have implemented simulation-based education as a pedagogic method of teaching, implementation of simulation in developing countries like Tanzania is rare. Traditional methods of auditorium lectures are widely conducted in low-income nursing and midwifery education institutions. Such pedagogy provides students with theoretical knowledge yet with limited hands-on exposure for clinical skills, which might affect the professional integration of students and quality care delivery. This study explored perceptions of simulation-based educ

Approach to Adult Patients with Musculoskeletal Complaints and Normal Findings: A Guide for Clinical Practice.

BACKGROUND: Musculoskeletal (MSK) complaints are among the most common reasons for visits to primary care and outpatient clinics. While many … dings benefit most from a structured, individualized, and patient-centered approach that integrates clinical reasoning, effective communication, and functional rehabilitation. Applying this framework enables clinicians to address the multidimensional nature of such presentations while avoiding unnecessary investigations or interventions.