Frontiers in Medicine

Immune checkpoint inhibitors (ICIs) have transformed cancer care but can cause immune-related adverse events (irAEs) involving almost any organ system. Delayed recognition may permit reversible inflammation to progress to organ dysfunction, treatment interruption, prolonged immunosuppression, or death. Biomarker surveillance offers an objective complement to symptom assessment, yet no single mark…

Hospice care centers on interdisciplinary-driven, patient-focused, comprehensive and individualized care at the end of life. Effective pain management has been a cornerstone of hospice care, with up to 80% of patients experiencing moderate to severe pain at the end of life. Although central to hospice care, opioid prescribing faces major challenges: wide variability in response, frequent adverse …

Germline predisposition syndromes are increasingly recognized in young patients presenting with myelodysplastic syndromes (MDS) and bone marrow failure. Among these, GATA2 deficiency represents a well-established cause of hereditary susceptibility to myeloid malignancies, whereas constitutional STAG2 alterations are rare and mainly associated with cohesinopathies and neurodevelopmental disorders.…

Background Patients with inflammatory bowel disease (IBD) often have low levels of physical activity, which may be related to kinesiophobia. However, the associations of independence in basic activities of daily living, fatigue, and disease activity with kinesiophobia remain insufficiently understood. This study examined factors associated with kinesiophobia in patients with IBD, focusing on inde…

Infective endocarditis (IE) may present with non-specific systemic symptoms and embolic complications, making early diagnosis challenging, particularly when initial transthoracic echocardiography (TTE) is non-diagnostic. We report a case of atypical mitral valve IE in a 40-year-old man who presented with persistent fever and left upper abdominal pain rather than overt cardiac symptoms. On admissi…

Background Proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) is an exceptionally rare glomerular disease, accounting for only 0.17–3.7% of all renal biopsies, and no consensus–based treatment algo-rithm has been established. Although daratumumab, a humanized anti-CD38 monoclonal antibody, has shown promising efficacy in PGNMID, the existing evidence is limited to s…

Background Vaginal candidiasis is the second most common cause of vaginal infection worldwide, affecting nearly 70–75% of women at least once during their lifetime, with recurrence in approximately 45%. In Ayurveda, its clinical presentation resembles Ś laiṣmik &# x00131;̄ Yonivyāpad . Preliminary clinical evidence suggests Yoni Prakṣālana (vaginal douche) with Triphalā Kaṣāya improves th…

Background Herpes zoster causes substantial morbidity in older adults, and US herpes zoster vaccination shifted from the live-attenuated Zostavax to the recombinant Shingrix after 2017 We describe the post-marketing adverse-event profile of these vaccines reported to the US Vaccine Adverse Event Reporting System (VAERS) and identify events reported disproportionately for herpes zoster vaccines. M…

Introduction Severe proximal celiac trunk stenosis or occlusion following blunt trauma is exceedingly rare, with potential etiologies including acute traumatic vascular injury, thrombosis, and underlying median arcuate ligament syndrome (MALS). In patients complicated by type 1 diabetic ketoacidosis (DKA), overlapping symptoms such as nausea and vomiting may arise from both metabolic derangement …

Introduction The automated classification of dermoscopic skin lesions is inherently challenging due to pronounced class imbalance, minimal inter-class variance, visual similarity across lesion types, and the requirement for clinically interpretable predictive outcomes. Methods The present study designed a heterogeneous Vision Transformer ensemble framework for seven-class skin lesion classificati…

Non-traumatic splenic rupture is an uncommon, life-threatening event and may be the first sign of an unrecognized hematological malignancy. We describe a 60-year-old man who presented with hemorrhagic shock due to splenic rupture. Emergency splenectomy controlled the bleeding and provided the diagnostic specimen. Histology supported diffuse large B-cell lymphoma, not otherwise specified (DLBCL, N…

Introduction Precise segmentation of pulmonary nodules plays a vital role in differentiating benign from malignant lesions and in tracking their progression over time, however, the substantial variability of nodules in size, morphology, and texture frequently results in either excessive or insufficient segmentation. Methods This paper proposes the spatial-frequency dual-domain collaborative segme…

Ankle osteoarthritis (OA) is commonly staged by pain, deformity, and radiographic joint-space loss, but this morphology-first view leaves much of its clinical heterogeneity unexplained. An ankle-specific precision framework is biologically and technically plausible because ankle OA is strongly enriched for post-traumatic mechanisms, has cartilage and synovial biology that differs from knee OA, an…

Purpose To highlight that in retinal racemose hemangioma (RRH) complicated by central retinal vein occlusion (CRVO), intravitreal anti-VEGF may only partially resolve macular edema, and timely laser photocoagulation is the decisive adjunct. Case presentation A 46-year-old female presented with vision loss in the left eye. Fundus examination revealed CRVO and a superotemporal RRH. Optical coherenc…

Background Programmed death-ligand 1 (PD-L1) expression and CD8+ tumor-infiltrating lymphocyte (TIL) density are established biomarkers of tumor–immune interaction in breast cancer; however, the biological and prognostic significance of their combined assessment across molecular subtypes remains incompletely defined. This study aimed to characterize combined PD-L1/CD8 immune phenotypes, evaluate …

Background Leptospirosis is a global zoonotic infection. Severe leptospirosis typically manifests as Weil’s syndrome with jaundice and acute kidney injury, while isolated diffuse alveolar hemorrhage (DAH) without jaundice or acute kidney injury (the classic features of Weil’s syndrome) is rare and easily misdiagnosed. Traditional diagnostic methods have notable limitations in the acute phase of i…

Diabetic foot ulcer (DFU) is a heterogeneous chronic wound in which the orderly sequence of inflammation, repair, and remodeling is replaced by persistent non-healing. Although bulk transcriptomic profiling and histopathology have revealed inflammatory imbalance and protease dysregulation, they cannot resolve the cell states, intercellular communication, and spatial niches that sustain chronicity…

Objective This study aimed to comprehensively analyze the prenatal phenotype, genetic basis, and postnatal trajectory of a large cohort of fetuses with fetal cardiac tumors (FCTs). Methods This retrospective study included 81 fetuses diagnosed with FCTs at our center between 2014 and 2024. We reviewed prenatal ultrasound and MRI findings, genetic testing results, and postnatal follow-up data, ext…

Background This study aimed to evaluate the performance of ChatGPT in identifying hemodialysis (HD) indications from authentic nephrology consultation notes and to compare its recommendations with both real-world clinical decisions and expert nephrologist consensus. Methods This exploratory observational study included 22 anonymized nephrology consultation notes from routine inpatient care at a t…

Objectives This study aimed to investigate the relationship between metabolic syndrome (MetS) and the risk of 1-year readmission in patients with alcohol-associated cirrhosis and to identify the independent predictors of this outcome. Methods This retrospective cohort study included 379 patients with alcohol-associated cirrhosis who were hospitalized between January 2012 and December 2023. Patien…