PURPOSE OF REVIEW: Upper tract urothelial carcinoma (UTUC) is a rare malignancy posing significant diagnostic and management challenges. This review provides an overview of the evidence supporting various imaging modalities and offers insights into future innovations in UTUC imaging. RECENT FINDINGS: With the growing use of advancements in computed tomography (CT) technologies for both staging and follow-up of UTUC patients, continuous innovations aim to enhance performance and minimize the risk of excessive exposure to ionizing radiation and iodinated contrast medium. In patients unable to undergo CT, magnetic resonance imaging serves as an alternative imaging modality, though its sensitivity is lower than CT. Positron emission tomography, particularly with innovative radiotracers and theranostics, has the potential to significantly advance precision medicine in UTUC. Endoscopic imaging techniques including advanced modalities seem to be promising in improved visualization and diagnostic accuracy, however, evidence remains scarce. Radiomics and radiogenomics present emerging tools for noninvasive tumor characterization and prognosis. SUMMARY: The landscape of imaging for UTUC is rapidly evolving, with significant advancements across various modalities promising improved diagnostic accuracy, patient outcomes, and safety.

• MeSH
• Carcinoma, Transitional Cell * diagnosis   diagnostic imaging   therapy   pathology   MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Kidney Neoplasms diagnostic imaging   therapy   diagnosis   pathology   MeSH
• Ureteral Neoplasms diagnostic imaging   diagnosis   therapy   pathology   MeSH
• Tomography, X-Ray Computed methods   MeSH
• Positron-Emission Tomography methods   MeSH
• Neoplasm Staging MeSH
• Urologic Neoplasms diagnosis   diagnostic imaging   therapy   pathology   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

PURPOSE OF REVIEW: This review explores the design and endpoints of perioperative platforms in clinical trials for muscle-invasive bladder cancer (MIBC). RECENT FINDINGS: The choice of clinical trial design in perioperative platforms for MIBC must align with specific research objectives to ensure robust and meaningful outcomes. Novel designs in perioperative platforms for MIBC integrate bladder-sparing approaches. Primary endpoints such as pathological complete response and disease-free survival are highlighted for their role in expediting trial results in perioperative setting. Incorporating patient-reported outcomes is important to inform healthcare decision makers about the outcomes most meaningful to patients. Given the growing body of evidence, potential biomarkers, predictive and prognostic tools should be considered and implemented when designing trials in perioperative platforms for MIBC. SUMMARY: Effective perioperative platforms for MIBC trials are critical in enhancing patient outcomes. The careful selection and standardization of study designs and endpoints in the perioperative platform are essential for the successful implementation of new therapies and the advancement of personalized treatment approaches in MIBC.

• MeSH
• Cystectomy methods   adverse effects   MeSH
• Neoplasm Invasiveness * MeSH
• Clinical Trials as Topic MeSH
• Humans MeSH
• Urinary Bladder Neoplasms * surgery   pathology   therapy   mortality   MeSH
• Perioperative Care methods   standards   MeSH
• Endpoint Determination MeSH
• Treatment Outcome MeSH
• Research Design MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

In this systematic review, we report on the effects of diuretic deprescribing compared to continued diuretic use. We included clinical studies reporting on outcomes such as mortality, heart failure recurrence, tolerability and feasibility. We assessed risk of bias and certainty of the evidence using the GRADE framework. We included 25 publications from 22 primary studies (15 randomized controlled trials; 7 nonrandomized studies). The mean number of participants in the deprescribing groups was 35, and median/mean age 64 years. In patients with heart failure, there was no clear evidence that diuretic deprescribing was associated with increased mortality compared to diuretic continuation (low certainty evidence). The risk of cardiovascular composite outcomes associated with diuretic deprescribing was inconsistent (studies showing lower risk for diuretic deprescribing, or comparable risk with diuretic continuation; very low certainty evidence). The effect on heart failure recurrence after diuretic deprescribing in patients with diuretics for heart failure, and of hypertension in patients with diuretics for hypertension was inconsistent across the included studies (low certainty evidence). In patients with diuretics for hypertension, diuretic deprescribing was well tolerated (moderate certainty evidence), while in patients with diuretics for heart failure, deprescribing diuretics can result in complaints of peripheral oedema (very low certainty evidence). The overall risk of bias was generally high. In summary, this systematic review suggests that diuretic discontinuation could be a safe and feasible treatment option for carefully selected patients. However, there isa lack of high-quality evidence on its feasibility, safety and tolerability of diuretic deprescribing, warranting further research.

• MeSH
• Deprescriptions * MeSH
• Diuretics * adverse effects   administration & dosage   therapeutic use   MeSH
• Adult MeSH
• Hypertension drug therapy   MeSH
• Humans MeSH
• Evidence-Based Medicine MeSH
• Randomized Controlled Trials as Topic MeSH
• Practice Guidelines as Topic MeSH
• Heart Failure * drug therapy   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Systematic Review MeSH

Pancreas is a vital gland of gastrointestinal system with exocrine and endocrine secretory functions, interweaved into essential metabolic circuitries of the human body. Pancreatic ductal adenocarcinoma (PDAC) represents one of the most lethal malignancies, with a 5-year survival rate of 11%. This poor prognosis is primarily attributed to the absence of early symptoms, rapid metastatic dissemination, and the limited efficacy of current therapeutic interventions. Despite recent advancements in understanding the etiopathogenesis and treatment of PDAC, there remains a pressing need for improved individualized models, identification of novel molecular targets, and development of unbiased predictors of disease progression. Here we aim to explore the concept of precision medicine utilizing 3-dimensional, patient-specific cellular models of pancreatic tumors and discuss their potential applications in uncovering novel druggable molecular targets and predicting clinical parameters for individual patients.

• MeSH
• Carcinoma, Pancreatic Ductal * pathology   genetics   metabolism   MeSH
• Precision Medicine * methods   MeSH
• Humans MeSH
• Pancreatic Neoplasms * pathology   genetics   MeSH
• Cell Culture Techniques, Three Dimensional methods   MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

Hepatorenal tyrosinaemia (HT1) is an autosomal recessive disorder of tyrosine degradation resulting in hepatic and renal dysfunction, neurological sequelae may occur in some patients. The use of nitisinone (NTBC) has revolutionised treatment and outcome of this disorder. NTBC has to be combined with a low protein diet. While NTBC modulates the disease course in HT1 patients, several issues are open. Optimal dosage, doses per day, therapeutic range of NTBC concentration, mode of protein restriction and biomarkers are not well defined. HCC and neurocognitive deficits are long-term sequelae. Early diagnosis and treatment are essential to minimise the risk for these complications. Clinical guidance for management of HT1-patients is required. Randomised clinical studies are difficult in the presence of therapeutic options. We discussed these issues in a consensus group of 10 paediatricians, 1 adult hepatologist, 1 geneticist, 2 dieticians, 2 newborn screening specialists with experience in HT1, 1 psychologist and 2 representatives of a patient group from the German-speaking countries (DACH). Recommendations were based on scientific literature and expert opinion, also taking into account recent experience with newborn screening. There was strong consensus that newborn screening using succinylacetone (SA) and early treatment are essential for a good outcome. The dose of NTBC should be as low as possible without losing metabolic control. This has to be accompanied by a low protein diet, in some patients a simplified diet without calculation of protein intake. Specific education and psychosocial support are recommended. Indications for liver transplantation were defined. Monitoring shall include clinical findings, levels of SA, tyrosine, phenylalanine and NTBC in (dried) blood.

• MeSH
• Cyclohexanones * therapeutic use   MeSH
• Heptanoates MeSH
• Consensus MeSH
• Humans MeSH
• Nitrobenzoates * therapeutic use   MeSH
• Diet, Protein-Restricted MeSH
• Infant, Newborn MeSH
• Neonatal Screening * methods   MeSH
• Liver Transplantation MeSH
• Tyrosinemias * diagnosis   therapy   MeSH
• Check Tag
• Humans MeSH
• Infant, Newborn MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Geographicals
• Germany MeSH

CONTEXT.—: Non-smooth muscle uterine sarcomas are mostly represented by low-grade endometrial stromal sarcoma. However, several other rare, distinct types of uterine sarcoma are recognized, including high-grade endometrial stromal sarcoma, tumors with kinase fusions, uterine tumors resembling ovarian sex cord tumors, soft tissue-type sarcoma, and emerging entities such as KAT6A/B-rearranged tumors. The landscape of uterine sarcomas has changed, mostly because of the increasing knowledge concerning their molecular aberrations. OBJECTIVE.—: To offer a comprehensive review of the literature focusing on fusions occurring in tumors other than smooth muscle mesenchymal uterine tumors with respect to their type, frequency, and overlap between diagnostic categories and entities. DATA SOURCES.—: The data were mined from the PubMed/MEDLINE database covering the time period from January 1988 to June 2023. In total, 156 studies focusing on the problematics of fusions occurring in non-smooth muscle mesenchymal uterine tumors were selected, and thus became the basis for this review. CONCLUSIONS.—: One hundred ten fusions were identified in 703 tumors. The diagnostic significance of the molecular aberrations occurring in these tumors can be unclear in some cases. This can be related to the rare aberrations with a limited number of reported cases. Additionally, even well-known aberrations considered as specific for a certain distinct entity can occur in other lesions, the biological behavior and clinical significance of which can differ substantially.

• MeSH
• Endometrial Stromal Tumors genetics   pathology   diagnosis   MeSH
• Sarcoma, Endometrial Stromal genetics   pathology   MeSH
• Gene Fusion MeSH
• Humans MeSH
• Uterine Neoplasms * genetics   pathology   diagnosis   MeSH
• Sarcoma genetics   pathology   diagnosis   MeSH
• Check Tag
• Humans MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

• MeSH
• Infant Mortality MeSH
• Humans MeSH
• Emergencies * epidemiology   classification   MeSH
• Neonatology * MeSH
• Infant, Newborn MeSH
• Check Tag
• Humans MeSH
• Infant, Newborn MeSH
• Publication type
• Review MeSH
• Geographicals
• Czech Republic MeSH

• MeSH
• Respiratory Therapy classification   methods   MeSH
• Adaptation, Physiological MeSH
• Insufflation methods   MeSH
• Cardiopulmonary Resuscitation * classification   methods   MeSH
• Humans MeSH
• Infant, Newborn * MeSH
• Delivery Rooms MeSH
• Practice Guidelines as Topic MeSH
• Airway Management classification   methods   MeSH
• Check Tag
• Humans MeSH
• Infant, Newborn * MeSH
• Publication type
• Review MeSH

• MeSH
• Laryngeal Masks classification   MeSH
• Humans MeSH
• Infant, Newborn MeSH
• Pulmonary Surfactants * administration & dosage   pharmacology   classification   therapeutic use   MeSH
• Pulmonary Ventilation MeSH
• Respiratory Distress Syndrome diagnosis   drug therapy   nursing   MeSH
• Respiratory Distress Syndrome, Newborn * diagnosis   drug therapy   nursing   MeSH
• Check Tag
• Humans MeSH
• Infant, Newborn MeSH
• Publication type
• Review MeSH

• MeSH
• Fetomaternal Transfusion * diagnosis   drug therapy   classification   MeSH
• Case Reports as Topic MeSH
• Humans MeSH
• Infant, Newborn MeSH
• Placenta abnormalities   MeSH
• Check Tag
• Humans MeSH
• Infant, Newborn MeSH
• Female MeSH
• Publication type
• Review MeSH