Abstract: Background: Endovascular stenting for atherosclerotic stenosis in the intra- and extracranial arteries is a minimally invasive procedure, but comprehensive studies on long-term complications following COVID-19 infection are lacking. Given the potential for increased rates of stent thrombosis, stroke, myocardial infarction, and mortality among COVID-19 patients, understanding the long-term outcomes of stenting for extra- and intracranial atherosclerotic stenosis is crucial for public health. This study addresses the dearth of extensive research on the long-term adverse outcomes associated with endovascular stenting procedures in patients who have experienced atherosclerotic stenosis in intracranial and extracranial arteries following COVID-19 infection. Methods: This retrospective study analyzed data from a tertiary hospital database, focusing on individuals who underwent extracranial or intracranial atherosclerotic stenting procedures at the Central Clinical Hospital JSC, Department of Neurosurgery, between 2016 and 2017, before the COVID-19 pandemic. The primary outcome measures to be evaluated include the incidence of stent thrombosis, ischemic stroke, myocardial infarction, and all-cause mortality. Results: The study followed 93 patients via telephone survey, but 12 did not respond, leaving 81 participants. Of these, 32 reported a prior COVID-19 infection confirmed by PCR testing, forming the COVID-19 group. The remaining 49 without confirmed COVID-19 infection comprised the control group. The 81 participants included 32 in the COVID-19 group and 49 in the control group, with no statistically significant differences in sex or age between the two cohorts. The binary logistic regression analysis revealed that the number of cigarettes smoked per day was a statistically significant predictor of myocardial infarction. This risk factor accounted for 23.6% of the observed myocardial infarctions, demonstrating a direct relationship between the number of cigarettes smoked and the probability of experiencing a myocardial infarction. Conclusion: The study found no significant differences in mortality, stroke, and heart attack rates between the COVID-19 and control groups. However, high blood pressure, heavy smoking, and high stress were linked to worse long-term outcomes.

Abstract: "This case report describes a rare cause of dizziness in a patient who had a low pressure headache, subsequent to a an inadvertent dural perforation during treatment for post traumatic prolapsed lumbar vertebral discs. Subsequent to this, she developed acute vertigo and was left with chronic episodic vestibular symptoms. Investigation demonstrated bilateral otolithic VEMP abnormalities. This could be from damage to blood supply to both inner ears or traction causing damage to the vestibular nerves bilaterally."

Abstract: Climate change is a critical concern for public health. Its impact on human and animal health is becoming increasingly evident each year, as extreme weather events and the expansion of vectors to new areas increase the risk of transmission of zoonoses. These changes have far-reaching consequences, affecting not only human health but also the environment and the global economy. As such, it is essential that we take collective action to mitigate the effects of climate change and protect public health for future generations. This study aimed to investigate the level of perception, knowledge, and practices of Portuguese citizens regarding vector-borne zoonoses and their association with climate change. A descriptive cross-sectional study was conducted by distributing a survey to 147 individuals. The results showed that, on average, 80% of the respondents had knowledge about zoonoses and that the vector-borne zoonoses least recognized by the sample were Chikungunya virus and West Nile virus. About 93% of the study’s population reported feeling that, with each passing year, temperatures in the warmer months are getting higher, with more than half of the respondents reporting that they have felt an increase in the prevalence of vectors in the country in these months in recent years. The results also show that most of the participants, about 93%, considered that veterinarians did not provide sufficient information about vector-borne zoonoses. The results also showed that the sampled population was not prepared for the reality that is increasingly felt in Europe and Portugal, since only 42% of respondents used preventive measures for vectors, such as the use of repellents. Therefore, there is a need for increased education and awareness campaigns, as well as for veterinarians to play a more active role in the dissemination of information and prevention strategies.

Abstract: Background: We compared the safety and efficacy of Holmium Laser Enucleation of the Prostate (HoLEP) and Transurethral Resection of the Prostate (TURP) in elderly men (aged ≥75 years) with benign prostatic hyperplasia (BPH). Methods: A retrospective analysis of 151 patients (HoLEP: 72; TURP: 79) was conducted. Preoperative and postoperative parameters, including prostate size, International Prostate Symptom Score (IPSS), catheterization duration, hospital stay, and perioperative complications (incontinence and dysuria), were analyzed. Results: HoLEP significantly reduced catheterization (22 h vs. 50 h) and hospitalization times (1 d vs. 3 days) compared to TURP (p < 0.01). However, HoLEP was associated with longer operation times (81.89 min vs. 67.95 min; p < 0.01) and higher rates of dysuria (65.3% vs. 27.8%) and transient incontinence (27.8% vs. 8.9%; p < 0.001). Conclusion: HoLEP offers significant perioperative benefits over TURP, particularly in shortening recovery times; however, further investigation is required to address the higher rates of dysuria and incontinence. Although the retrospective design and surgeon experience constitute limitations, these findings underscore the need for prospective studies. The results support personalized surgical decision-making, emphasizing patient-specific factors such as BMI. These insights may help refine perioperative management and improve collaborative decision-making to enhance outcomes in elderly patients with BPH.

Abstract: Background/Objectives: Hypoglycemia in the case of non-diabetic persons is a rare event, being usually, initially misinterpreted based on the symptoms that can mimic various diseases, especially of a neuro-psychiatric nature. In case of identification of insulin-mediated hypoglycemia, the evaluation of pancreatic neuroendocrine tumors, which represent the most common and worrisome causes of non-diabetic insulin-mediated hypoglycemia, must be considered. Methods/Results: We present the case of a 57-year-old patient, hospitalized for a history of approximately one month of recurrent episodes of symptoms suggestive for severe hypoglycemia. The biological evaluation performed during an episode of hypoglycemia showed a plasma glucose value of 44 mg/dl, insulinemia 16.3 µU/ml, C peptide 3.72 ng/ml, HbA1c 4.99%, absence of urinary ketone bodies and anti-insulin antibodies &lt;0.03U/ml. The CT and MRI examination showed a 15.3/15 mm rounded tumor in the pancreatic corporeo-caudal region. The pancreatic tumor formation was enucleated and the histopathological and immunohistochemical analysis confirmed the diagnosis of pancreatic neuroendocrine tumor with a positive reaction for chromogranin A, synaptophysin and insulin, without malignancy features (Ki 67 positive in 1% of the tumor cells). The postoperative evolution was favorable, without episodes of hypoglycemia, the fasting insulinemia one day after surgery being 4.1 µU/ml and HbA1c at three weeks postoperatively being 5.51%. Conclusions: The management of patients with hyperinsulinemic hypoglycemia secondary to insulinoma involves multidisciplinary collaboration with an important role in recognizing symptoms suggestive of hypoglycemia in a person without diabetes, initiating biological and imaging evaluation, establishing the optimal therapeutic option and histopathological confirmation.

Abstract: Triple negative breast cancer (TNBC) is the most aggressive breast cancer subtype and maintains a low rate of overall survival despite the recent advances in treatments. This study investigates Na+ homeostasis of TNBC cells as a novel therapeutic target to induce TNBC inhibition. To this purpose BALB/c mice were injected with breast cancer 4T1 cells and treated with the Na+ ionophore Monensin (8 mg/kg) or vehicle. Tumor development and Na+ increase were monitored by In Vivo Imaging techniques. Intracellular Na+ variations and cytotoxicity were followed by Live Cell Analysis. Monensin increased Na+ content of transformed tissue and significantly reduced TNBC growth. Monensin induced extended TNBC tumor necrosis without affecting the integrity of healthy organs and proliferating activity of both tumor and normal tissue. Monensin did not influence PCNA expression of 4T1 cells but exerted a cytotoxic effect preceded by an increase of intracellular Na+. Absent Na+ in the extracellular medium prevented Na+ load and 4T1 cell death. Monensin inhibits TNBC by a Na+-dependent and cancer specific cytotoxic action without exerting cytostatic effects in both normal and transformed tissues. These observations support the potential of Na+ ionophores as innovative agents for TNBC therapy.

Abstract: Background The management of type 1 diabetes in pregnancy with new technologies is challenging. Sometimes the complexity of new-generation systems such as CSII (continuous subcutaneous insulin infusion) and patient or provider preference do not allow their use, so women with type 1 diabetes in pregnancy continue to be treated with subcutaneous multiple injection insulin therapy using pens. Smart insulin pens are new tools that allow data collection on insulin dose and time of administration and have additional connectivity features. Objective To retrospectively describe the use of a smart insulin pen coupled with rt-CGM (InPen TM system) in 3 pregnancies complicated by type 1 diabetes. The cases presented are the first report of the use of the smart insulin pen in type 1 diabetic patients during pregnancy.

Abstract:

Background
Intracranial atherosclerosis (ICAS) is a major cause of ischemic stroke, disproportionately affecting populations with significant vascular risk factors. Although ICAS imposes a considerable health burden, research on this condition in Central Asia remains scarce, especially among the Kazakh population. This study analyzes demographic characteristics, treatment outcomes, and procedural challenges associated with ICAS in 216 patients treated at a single institution. Methods: This retrospective study included patients with ≥70% intracranial artery stenosis confirmed by imaging and presenting with ischemic symptoms. All patients underwent angioplasty and stenting with dual antiplatelet therapy (DAPT). Data collected included demographics, comorbidities, stenosis characteristics, procedural details, and outcomes assessed by the modified Rankin Scale (mRS). Results The median age was 63.5 years (IQR: 57–68.6), and 73.7% were male. Hypertension was the most common comorbidity (98%), followed by ischemic heart disease (58%) and diabetes mellitus (40.9%). Multi-location ICAS was significantly associated with patients over 75 years of age (p=0.025). Additionally, obesity and stenosis severity greater than 70% showed trends toward significance, with p-values of 0.064 and 0.079, respectively. Stenosis predominantly affected the internal carotid artery (54.5%) and vertebrobasilar system (31.6%). The average hospital stay was longer for posterior circulation stenosis (7.1 days) compared to anterior circulation (4.7 days). The periprocedural complication rate was 0.7%, with two deaths attributed to ischemic complications. At follow-up, 4 patients experienced worsening mRS scores (>2), particularly those with severe stenosis in the basilar artery and M1 segment. Conclusion: 
ICAS in the Kazakh population is strongly associated with hypertension and aging, with posterior circulation stenosis contributing disproportionately to worse outcomes. The low complication rates highlight the safety of modern endovascular techniques. However, further research is needed to optimize treatment strategies for severe and multi-location ICAS, particularly in Central Asian populations.

Abstract: Consuming collagen hydrolysate (CH) may improve symptoms of exercise-induced muscle damage (EIMD), however its acute effects have not been compared to dairy protein (DP), the most commonly consumed form of protein supplement. Therefore, this study compared the effects of CH and DP on recovery from EIMD. Thirty-three males consumed either CH (n=11) or DP (n=11), containing 25 g of protein, or an isoenergetic placebo (n=11) immediately post-exercise and once daily for three days. Indices of EIMD were measured before and 30 minutes, 24, 48, and 72 hours after 30 minutes of downhill running on a -15% slope at 80% of VO2max speed. Downhill running induced significant EIMD, with time effects (all P &lt; 0.001) for delayed onset of muscle soreness (visual analogue scale), countermovement jump height, isometric midthigh pull force, maximal voluntary isometric contraction force, running economy, and biomarkers of muscle damage (creatine kinase) and inflammation (interleukin-6, high-sensitivity C-reactive protein). However, no group or interaction effects (all P &gt; 0.05) were observed for any outcome measures. The findings suggest that post-exercise consumption of CH or DP does not improve indices of EIMD during the acute recovery period, in recreationally active males.

Abstract: Background: Patient education is a key aspect of physical therapy practice, however, the differences in how experienced and novice physiotherapists perceive and apply patient education practice remain underexplored. Understanding these differences influences training approaches and improves physical therapy practice quality. The research aims to determine the difference in self-reported patient education practice between experienced and novice physiotherapists. Methods: A previously published online survey instrument was used to collect data from physiotherapists employed in public health institutions in Bosnia and Herzegovina. The survey questions included demographic characteristics and questions about approaches to patient education, perceived importance, and factors contributing to skills development. Participants were recruited in two groups: experienced physiotherapists with work experience ≥ 11 years (n = 139) and novice physiotherapists with work experience ≤ 5 years (n = 45). Descriptive statistics, such as numbers and percentages, were used to summarize participant responses. Results: Experienced physiotherapists more frequently provided advice on posture, movement correction, daily activity strategies, and pacing while addressing patient concerns and exploring perceptions (p < 0.05). In contrast, novice physiotherapists placed significantly greater value on continuing education courses, considering them an important factor in developing patient education skills (p < 0.05). Conclusion: Experienced physiotherapists prioritize patient education focusing on posture, movement, and self-care strategies compared to novice physiotherapists. However, novice physiotherapists place a higher importance role on continuous education. Identifying these differences may help tailor training and mentorship to improve physiotherapy practice, ensuring better patient outcomes.