Traumatic Brain Injury (TBI) is a major global public health problem. Neurological damage from TBI may be mild, moderate, or severe and occurs both immediately at the time of impact (primary injury) and continues to evolve afterwards (secondary injury). In mild (m)TBI, common symptoms are headaches, dizziness and fatigue. Visual impairment is especially prevalent. Insomnia, attentional deficits and memory problems often occur. Neuroimaging methods for the management of TBI include computed tomography and magnetic resonance imaging. The location and the extent of injuries determine the motor and/or sensory deficits that result. Parietal lobe damage can lead to deficits in sensorimotor function, memory, and attention span. The processing of visual information may be disrupted, with consequences such as poor hand-eye coordination and balance. TBI may cause lesions in the occipital or parietal lobe that leave the TBI patient with incomplete homonymous hemianopia. Overall, TBI can interfere with everyday life by compromising the ability to work, sleep, drive, read, communicate and perform numerous activities previously taken for granted. Treatment and rehabilitation options available to TBI sufferers are inadequate and there is a pressing need for new ways to help these patients to optimize their functioning and maintain productivity and participation in life activities, family and community.

The surface of the eye is directly exposed to the external environment, protected only by a thin tear film, and may therefore be damaged by contact with ambient particulate matter, liquids, aerosols, or vapors. In the workplace or home, the eye is subject to accidental or incidental exposure to cleaning products and pesticides. Organic matter may enter the eye and cause infection. Ocular surface damage can trigger a range of symptoms such as itch, discharge, hyperemia, photophobia, blurred vision, and foreign body sensation. Toxin exposure can be assessed clinically in multiple ways, including via measurement of tear production, slit-lamp examination, corneal staining, and conjunctival staining. At the cellular level, environmental toxins can cause oxidative damage, apoptosis of corneal and conjunctival cells, cell senescence, and impaired motility. Outcomes range from transient and reversible with complete healing to severe and sight-compromising structural changes. Classically, evaluation of tolerance and safety was carried out using live animal testing; however, new in vitro and computer-based, in silico modes are superseding the gold standard Draize test. This review examines how environmental features such as pollutants, temperature, and seasonality affect the ocular surface. Chemical burns to the eye are considered, and approaches to protect the ocular surface are detailed.

Androgen deprivation therapy (ADT) is a mainstay treatment for metastatic prostate cancer, improving progression-free survival. ADT suppresses the production of testosterone and reduces circulating levels of the hormone. Luteinizing hormone-releasing hormone (LH-RH) agonists are the most commonly used ADT modality. They can be given alone or in combination with androgen synthesis inhibitors or androgen receptor antagonists. An estimated 40% of prostate cancer patients will receive ADT as part of their therapy during their lifetime. However, ADT has numerous adverse effects, including an increased cardiovascular risk that impacts quality of life. Relugolix is an alternative form of ADT. It is the only oral gonadotropin-releasing hormone antagonist, circumventing injection site reactions, making it easier for patients to take, and thus increasing compliance. Testosterone suppression with relugolix is excellent and testosterone recovery after discontinuation is rapid. This paper reviews the ADT and anti-androgen treatment options for men with prostate cancer and the cardiovascular effects of these therapies. There is accumulating evidence that cardiovascular risk with relugolix is lower than with other ADT medications and also lower than with androgen synthesis inhibitors and androgen receptor antagonists. This paper provides insight into the use of different ADT regimens based on the cardiovascular status and circumstances. It explores strategies to mitigate negative cardiovascular consequences and highlights the need for further study.

Background: Prenatal 3D and 4D ultrasound provide impressive anatomic detail which aid in craniofacial diagnosis. When micrognathia is detected in utero (suggestive of Pierre Robin Sequence), opportunities for prenatal counseling may provide important information for families. However, the psychosocial implications have not been well studied. Methods: Perinatal newborns diagnosed with Pierre Robin Sequence were grouped into (1) those diagnosed prenatally via ultrasound screening and had extensive multidisciplinary counseling: and (2) those not diagnosed prenatally (“birthday- surprise”) (n = 31). The 2 groups were also subdivided into isolated Pierre Robin Sequence (PRS)-Isolated, PRS-Plus (additional anomalies), or PRS syndromic and compared. PROMIS (Patient-Reported Outcomes Measurement Information System) surveys given at 6 weeks after birth were used to compare psychosocial scores from families of these 2 groups. Results: The prenatal diagnosed families with counseling (PRS treatment algorithm, feeding, and surgical options) reported less anxiety (61% ± 3 vs 74% ± 4), less depression (58% ± 3 vs 72% ± 5), and less feelings of social isolation (57% ± 2 vs 68% ± 3) than postnatal diagnosed families with no counseling (numbers based on the standard deviation from US population mean of 50). When the groups were subdivided and compared, this difference in psychosocial indicators between prenatal diagnosis and postnatal diagnosis (“Birthday Surprise”) was more profound in families with PRS-Plus and PRS-syndromic babies than with PRS-Isolated babies. In addition, there was a delay in surgical treatment for the “Birthday Surprise” patients (32 ± 5 vs 13 ± 2 days). Conclusions: Prenatal imaging diagnosis coupled with prenatal counseling offer improved psychosocial indicators for families of newborns with Pierre Robin Sequence.

Study Design: Systematic review. Objective: To evaluate perioperative and clinical outcomes after open versus endoscopic lumbar decompression in patients with obesity. Summary of Background Data: Obesity is associated with increased technical difficulty and perioperative morbidity in lumbar spine surgery. Endoscopic spine surgery (ESS) may reduce soft tissue disruption and wound morbidity, but comparative data in obese patients remain limited. Materials and Methods: A systematic review was performed according to PRISMA guidelines. PubMed, Embase, and Web of Science were searched from inception through January 21, 2026. Studies were included if they enrolled adult patients with obesity undergoing lumbar decompression without fusion for degenerative pathology and reported at least one operative or perioperative outcome. Pediatric patients, nonlumbar or nondegenerative procedures, fusion-only cohorts, and nonprimary literature were excluded. Demographics, operative outcomes, complications, reoperation, and patient-reported outcomes were extracted and synthesized qualitatively. Results: Fourteen studies were included after screening 667 titles/abstracts and 93 full texts; 11 primary clinical studies informed the results synthesis. Two studies directly compared endoscopic and open decompression in obese patients. Ma and colleagues reported lower estimated blood loss after unilateral biportal endoscopic decompression compared with open surgery and shorter hospitalization. Castel and colleagues reported shorter hospitalization after full endoscopic lumbar discectomy compared with open surgery, although operative time was longer in the endoscopic cohort. Complications included surgical site infection, durotomy, nerve root injury, and recurrent disc herniation, with low event rates. BMI-stratified studies showed comparable pain and disability improvement between obese and nonobese patients. Conclusion: Based on limited comparative evidence from two studies, endoscopic decompression in obese patients was associated with similar clinical improvement and potential perioperative advantages compared with open surgery, including lower reported blood loss and shorter length of stay. Limitations include retrospective designs, heterogeneous techniques, only two comparative studies, and inconsistent reporting. These findings should be considered preliminary, and prospective comparative studies are needed. Level of Evidence: Level III.