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Introduction: Most breast cancers require neoadjuvant chemotherapy and the response to primary systemic therapy (PST) is crucial for deciding on the surgical technique and predicting patient outcomes. However, chemotherapy also brings numerous side effects, with cardiovascular issues being some of the most significant, common and challenging to manage.

Case presentation: We present the case of a 71-year-old woman diagnosed with stage T2N1M0 Luminal B breast cancer. It was decided to initiate chemotherapy consisting of four cycles of FEC (5-fluorouracil 600 mg/m² on days 1 and 8, epirubicin 60 mg-90 mg/m² and cyclophosphamide 600 mg/m²), followed by four cycles of docetaxel (75 mg/m² every three weeks). Near the end of the treatment cycles, she developed new-onset angina with complex critical coronary lesions. This required assembling a multidisciplinary team to determine the optimal management strategy from cardiological, surgical, and oncological standpoints. Just when we thought we had found the optimal approach for managing ischemic heart disease, the situation became more complicated with the development of deep vein thrombosis, requiring a reassessment of the entire treatment plan.

Conclusions: Neoadjuvant chemotherapy is an important weapon against breast cancer but also a veritable enemy of cardiovascular diseases. The association of two major diseases requires a multidisciplinary team capable of making the best decisions to maximize benefits and minimize adverse effects.

Background: Breast cancer remains the most frequently diagnosed cancer in female population worldwide. However, germline mutations are responsible for a small proportion of these cases. The aim of our study is to assess how germline mutations influence the management and outcome of these patients taken into consideration both their cancer diagnosis and genetic assessment.

Methods: We performed a retrospective analysis in a women's single-center during a period of six years to assess the contribution of germline mutation in the treatment, prognosis and survival of breast cancer patients. Statistics were collected from both the patients' medical records and genetics department.

Results: From the total number of patients treated for breast cancer in our department between 2017 and 2022, 243 were eligible for genetic testing, comprising either BRCA1/2 or extended panel, taking into consideration their personal and family history. Of all subjects included in our study cohort, 5% were carriers of a pathogenic(P) or likely pathogenic(LP) variant of cancer susceptibility gene, of which 78% were diagnosed before the age of 50; triple negative disease was diagnosed in the majority of cases, and therefore, 62% of patients started treatment with systemic neoadjuvant chemotherapy and 32% of subjects underwent upfront surgery. Prophylactic surgery for contralateral breast and bilateral salpingo-oophorectomy was considered and performed for 20% of patients. Less than 2% of cases had metastatic disease and received PARP inhibitors, with excellent treatment response and a very low rate of mortality in the study group.

Conclusion: Carriers of pathogenic variants with breast cancer diagnosis may have a greater benefit from a tailored approach, including both surgical and oncological treatment, with better long-term outcomes.

Background: Although several studies have assessed corticosteroid therapy as a pivotal treatment for SARS-CoV-2, the net effectiveness of corticosteroids in the treatment of COVID-19 remains controversial. This study aimed to compare the conventional use of methylprednisolone and pulse therapy to determine the best method of administration of corticosteroids in patients with SARS-CoV-2.

Methods: A total of 52 patients with a diagnosis of moderate to severe COVID-19 with the same conditions were retrospectively enrolled in the present study. Participants were divided into two groups based on the corticosteroid therapy regimen received during hospitalization: low-dose and high-dose methylprednisolone. Clinical outcomes, including laboratory tests, improvement of oxygen saturation, the need for invasive mechanical ventilation, length of hospital stay (LOHS) and mortality, were compared between the two groups.

Results: The distribution of sex, age, oxygen saturation on admission, pattern and location of lung involvement, and other medical conditions were similar between the two groups to avoid the effect of any possible confounding factor. There were no differences in laboratory tests (P=0.389), LOHS (P=0.107), improvement of oxygen saturation (P=0.721), the need for invasive mechanical ventilation and mortality (P=0.695) between groups.

Conclusion: Based on the results of this study, there was no significant difference in clinical outcomes of patients with COVID-19 between low- and high-dose corticosteroid regimens. Further research is warranted to determine the best method of administration of corticosteroids in these patients.

Objective: As far as childbirth is concerned, it is well known that it constitutes a major life process for every woman. Many women experience negative emotions during pregnancy because of the normal hormonal changes. However, if fear becomes severe, it gives rise to a specific pathology termed tocophobia. Especially, tocophobia adversely affects women's pregnancy and childbirth, including increased caesarean sections. Consequently, midwives need to detect women with tocophobia in order to support them. The aim of the present systematic review was to analyze the risk factors for tocophobia, the impact of this health condition on caesarean sections and the midwife's role.

Materials and methods: The present systematic review comprised 32 full-text cross-sectional, qualitative, experimental studies and cohort studies published in English between 2017 and 2022, that were obtained from PubMed and Google Scholar databases, and it was conducted according to the PRISMA guideline.

Results: The present analysis found that sociodemographic, obstetric and psychological factors were associated with tocophobia. Moreover, women with severe fear had increased obstetric interventions, particularly caesarean sections. Studies have also shown that psycho-education, preparation classes and specific counselling by trained midwives are effective methods in reducing tocophobia.

Conclusions: Midwives should be aware of the risk factors for tocophobia in order to detect women with fears and support them in the attempt to avoid non-urgent obstetric interventions. Antenatal and intrapartum care should be offered to women with tocophobia to reduce their fear as well as the prevalence of caesarean section and to promote vaginal birth with a positive experience.

Bacterial antimicrobial resistance (AMR) is a major public health concern in modern society caused by bacterial changes that impair the efficacy of infection-treating drugs. Non-antibiotic techniques are critical for controlling the antimicrobial resistance concern because they provide a means of alleviating symptoms without needing antibiotics. This prospective study aims to determine whether administering L-methionine reduces mechanical and bacterial problems associated with long-term indwelling urinary catheters. The trial focused on administering only L-methionine for a three-month period to patients who had long-term bladder catheters, either indwelling or suprapubic. The catheter exchange rates were categorized according to acute urinary tract infection, macroscopic haematuria and symptomatic urinary tract infection. During the time of inclusion, catheter-related incidents were recorded. The primary incident observed was acute urine retention caused by catheter obstruction in 63.6.

Pleomorphic adenoma is a non-cancerous neoplasm that develops in the salivary glands. Originating from minor salivary glands, it is extremely uncommon and primarily affects females. The peak incidence is observed between 40 and 60 years of age. It usually presents as a slowly growing, painless, solid tumor that does not cause ulcers on the overlying mucosa. Here, a 47-year-old woman experienced repeated swelling on the buccal mucosa following surgical extraction of a pleomorphic adenoma three years ago. The swelling was solid with clearly defined boundaries. An excisional biopsy was conducted under general anesthesia, resulting in total mass removal. The histological evaluation revealed the existence of a recurring pleomorphic adenoma. This instance emphasizes the significance of addressing this entity as a potential etiology for persistent painless and intraoral swellings.

Sleeve gastrectomy (SG) is the most frequently performed bariatric procedure globally. However, data regarding short- and long-term results remain insufficient. This study aimed to evaluate the short- and longterm effects of SG. We performed a thorough PubMed search for references that mentioned sleeve gastrectomy was carried out. In terms of weight loss and resolution of comorbid disorders, the immediate results have been encouraging. Although long-term results are still being obtained, a large number of individuals have experienced persistent weight loss. Eight short-term studies were extracted for the present review. Each study clarified that SG was utilized as a management technique for a high-risk patient population or as a component of a stepwise therapeutic procedure. The laparoscopic SG method was examined in all studies. The percentage of patients who were followed up for 30 days or longer after LSG was reported. Significant weight loss has been observed in studies that evaluated short-term results. An excess weight loss of 67.3% and a significant decrease in body mass index (BMI) were observed in a systematic evaluation of 5,218 patients. In long-term studies, SG was administered to 2713 patients, of whom 1626 completed the five-year follow-up period. Among all patients, 71.3% were women and 28.7% men. The mean BMI before surgery was 46.9 kg/m². The follow-up durations ranged from 5 to 11 years. The mean five-year follow-up rate was 66% (range 57-100%). At 5, 6, 7, 8 and 11 years, the mean percentage excess weight decreases were 58.4%, 59.5%, 56.6% and 62.5%, respectively. Five years after SG, resolution of type 2 diabetes resolved in 77.8% of patients, and arterial hypertension, dyslipidemia, obstructive sleep apnea, gastroesophageal reflux disease and degenerative joint diseases improved or resolved in 68.0%, 65.9%, 75.8%, 30.6% and 55.7% of patients, respectively. Laparoscopic SG is more technically straightforward and has fewer surgical complications than other more complex surgical techniques. Laparoscopic SG is an effective treatment option for bariatric surgery. It is relatively easy to perform, well tolerated by patients and effective for longterm excessive weight loss and resolution of comorbidities.

This study aimed to evaluate the effect of silver diamine fluoride (SDF) in combination with or without glutathione (Glu) and potassium iodide (KI) on the fluoride release and the enhancement of dentin microhardness. In this et al study, 90 intact premolar teeth from human subjects were allocated into nine groups, each consisting of ten samples: A) control; B) SDF; C) SDF combined with 5% Glu; D) SDF combined with 10% Glu; E) SDF combined with 20% Glu; F) KI after SDF; G) 5% Glu after SDF; H) 10% Glu after SDF; and I) 20% Glu after SDF. Data were analyzed using SPSS version 22 software and ANOVA and post-hoc and repeated measure test (P value <0.05). Dentin microhardness exhibited variations across different treatments, with the highest value being observed in the SDF-5% Glu group and the lowest in the control group. However, there was a significant difference between the mean values of SDF-5% Glu group and the SDF group. Significant increases in microhardness were observed when comparing SDF-5% Glu to SDF+5% Glu and SDF-10% Glu to SDF+10% Glu in peer groups (P value <0.05). Over time, there was a significant increase in the amount of fluoride released as compared to the initial day. The utilization of SDF-5% Glu group exhibited the most favorable effect on improving dentin hardness. Additionally, utilizing Glu in concentrations of 5% and 10% after SDF application proved more effective in increasing dentin microhardness than combining it with SDF. Moreover, in all three fluoride measurement periods, adding 5% Glu to SDF and using 20% Glu following SDF administration led to a significant increase in fluoride release compared to the application of SDF alone.

Orthopaedic implant-associated infections (OIAIs) is one of the most catastrophic complications following joint arthroplasty or fracture fixation. Given the increasing number of orthopaedic implants which are used annually, periprosthetic infections emerge as a global problem. Their diagnosis and consequent therapeutic management remain challenging for clinicians. Biofilm formation is a complex and only partially understood process that has not been extensively studied. Understanding the underlying mechanisms involved in biofilm formation is crucial in the amelioration of both diagnosis and therapeutic management of OIAIs. We performed a literature review of the molecular mechanisms of biofilm formation and discussed the four most common and thoroughly researched microbes of biofilm-related OIAIs.

Introduction and aim: Ovarian cancer is a prevalent neoplastic condition among females. Early diagnosis is essential in improving patient outcomes. This study aimed to determine the diagnostic value of magnetic resonance imaging (MRI) compared to histopathological diagnosis to distinguish between benign and malignant ovarian masses. Methods:The present cross-sectional study, which was conducted between 2021 and 2022, included a cohort of women with ovarian mass. Gyneco-oncologists referred all patients to the MRI center. The imaging protocol encompassed T1 and T2 weighted images, T1 fat-suppressed sequence, post-contrast and diffusion-weighted images (DWI). After surgery, the histopathological results were compared to the MRI diagnosis. Statistical analysis was done by using SPSS v.25 software. Results:A total of 67 women aged 15-82 years old were included in this study. Compared to histopathological diagnosis, MRI had a sensitivity of 96%, a specificity of 69%, a positive predictive value of 64.9% and a negative predictive value of 96.7%. Among patients under 40 years old, MRI showed a sensitivity of 100%, a specificity of 76.2%, a positive predictive value of 72.2% and a negative predictive value of 100%. Solid component and contrast enhancement within the solid component was significantly more frequent in patients with malignant diagnoses than those with benign masses (p<0.05). Conclusion:According to the results of the study, MRI is valuable for discriminating between benign and malignant ovarian masses, especially in patients under 40.