This study aims to assess the role of Color Duplex Ultrasound with or without contrast media for surveillance following endovascular aortic aneurysm repair (EVAR). A systematic search of the literature published until April 2022 was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The pooled rates of endoleak detection through Contrast-Enhanced or Color Duplex Ultrasound (CEUS or CDUS) and Computed Tomography Angiography (CTA) with 95% confidence intervals (CIs) were estimated using random-effect analysis. Thirty-eight studies were considered eligible for inclusion. The total number of patients in the included studies was 5214 between 1997 and 2021. The overall pooled rate of endoleak detection using CDUS and CTA was 82.59% and 97.22%, while the rates for CEUS and CTA were 96.67% and 92.82%, respectively. The findings of the present study support the use of the CEUS for endoleak detection. However, it should be integrated into institutional protocols for EVAR surveillance to further evaluate its clinical utility in the post-EVAR period before it can be recommended as the sole imaging modality after EVAR.

Antimicrobial resistance (AMR) poses a critical global health threat. Wastewater surveillance has recently emerged as a valuable public health tool for monitoring AMR in communities and healthcare settings. This narrative review comprehensively examines the role of hospital wastewater surveillance (HWWS) in monitoring antimicrobial resistance. Methods to detect resistant bacteria and antimicrobial resistance genes (ARGs) in wastewater systems, ranging from culture-based techniques to advanced molecular approaches, including polymerase chain reaction (PCR) and next-generation sequencing (NGS), are explored. The review synthesizes data on key antimicrobial resistance genes commonly detected in hospital effluents and explores how HWWS contributes to understanding the dynamics of resistance within healthcare settings. Furthermore, it identifies methodological challenges and inconsistencies in data reporting and outlines necessary standardization steps to enhance the effectiveness of HWWS programs. Opportunities for integrating HWWS with clinical and public health frameworks are presented, emphasizing the need for robust metadata and transparent reporting. This review provides a comprehensive approach to HWWS strategies, which could complement robust infection control and antibiotic stewardship interventions to combat AMR.

Background: Anastomotic leakage (AL) still remains a common complication after colorectal anastomosis that leads to increased morbidity and mortality. The gut microbiota has been hypothesized as one of the risk factors associated with anastomotic leakage. The aim of the present study was to summarize all existing clinical and experimental studies that evaluate the impact of intestinal microbiota on anastomotic leakage after colorectal resection. Methods: The present scoping review was designed according to PRISMA recommendations and a systematic search in Medline, Scopus, EMBASE, Clinicaltrials.gov, Google Scholar, and CENTRAL was conducted until September 2024. Results: Overall, 7 clinical and 5 experimental studies were included. A diminished α-diversity of the gut microbiota in patients suffering from AL was demonstrated. Specific microbe genera, such as Lachnospiraceae, Bacteroidaceae, Bifidobacterium, Acinetobacter, Fusobacterium, Dielma, Elusimicronium, Prevotella, and Faecalibacterium, seem to be associated with AL. However, specific genera, like Prevotella, Streptococcus, Eubacterium, Enterobacteriaceae, Klebsiella, Actinobacteria, Gordonibacter, Phocaeicola, and Ruminococcus2, seem to be protective against AL. Experimental studies highlighted that the Western diet seems to affect microbiota diversity and increases the AL rate, whereas anastomotic healing seems to be impaired by high metalloproteinase production and increased collagenase activity. Conclusions: The intestinal microbiota seems to play an important role in anastomotic leakage after colorectal resection. Specific interventions targeting the microbiota’s composition and the pathophysiological mechanisms by which it impairs anastomotic healing could diminish the risk for anastomotic leakage and improve clinical outcomes. However, future studies should be based on prospective design and eliminate heterogeneity.

Neutrophil extracellular traps (NETs) are a neutrophil-generated extracellular network of chromatin and chromatin-bound molecules with antimicrobial potency. Recent data suggest that NETs are associated with cancer progression and cancer-associated hypercoagulability. Pancreatic adenocarcinoma (PDAC) is a lethal type of cancer in which hypercoagulability and cancer-related thrombosis are among the main complications. In the current report, we summarize the available data on the interplay between NET formation and PDAC development. We conclude that NETs support a dual role during PDAC progression and metastasis. Their formation is on the one hand an important event that shapes the cancer microenvironment to support cancer cell proliferation, invasion and metastasis. On the other hand, NETs may lead to cancer-associated thrombosis. Both mechanisms seem to be dependent on distinct molecular mechanisms that link inflammation to cancer progression. Collectively, NET formation may contribute to the pathogenesis of PDAC, while during cancer development, the proinflammatory environment enables the induction of new NETs and thrombi, forming a vicious cycle. We suggest that targeting NET formation may be an effective mechanism to inhibit both PDAC development and the accompanying hypercoagulability.

The concept of agnostic biomarkers—molecular modifications that guide therapy irrespective of tumor origin—has gained increasing relevance in oncology, including colorectal cancer (CRC). This review aims to critically evaluate the role of such biomarkers in CRC, highlighting their clinical significance as therapeutic targets and indicators of prognosis. Through a PubMed search using the terms “agnostic treatment AND colorectal cancer,” eight key studies were identified and qualitatively analyzed. We focus on several biomarkers commonly regarded as agnostic across tumor types, including BRAF V600E mutation, receptor tyrosine kinase (RTK) and PI3K fusions, the CpG island methylator phenotype (CIMP), high tumor mutational burden (TMB), and microsatellite instability (MSI). These markers are inspected for their prevalence in CRC, underlying pathophysiological mechanisms of cancer promotion, and predictive or prognostic implications. Moreover, we integrate findings from broader oncologic studies to contextualize the evolving role of agnostic biomarkers beyond organ-specific paradigms. Emerging evidence suggests that leveraging these molecular signatures may inform the use of targeted and immunotherapeutic agents as first-line options in select CRC populations. Collectively, agnostic biomarkers represent an auspicious avenue for personalizing CRC treatment, particularly in advanced-stage disease where traditional treatment options remain limited.

Cell-cycle analysis has shown the presence of aneuploidy to be associated with poor prognosis. We developed an innovative rapid cell-cycle analysis protocol (the Ioannina protocol) that permitted the intraoperative identification of neoplastic cells in a plethora of malignancies. Herein, we aimed to investigate the potential role of cell-cycle analysis in the intraoperative characterization of gynecological malignancies. Women who underwent surgery for gynecological malignancies in our institution over a three-year period were included in this study. Permanent section pathology evaluation was used as the gold standard for malignancy evaluation. Total accordance was observed between flow cytometry and pathology evaluation. In total, 21 aneuploid cancers were detected following DNA index calculation. Of these, 20 were hyperploid and 1 was hypoploid. In addition, tumor samples were characterized by a significantly lower percentage of cells in G0/G1, as well as an induced tumor index. The response time for flow cytometry to obtain results was 5–6 min per sample. It seems that flow cytometry analyses for intraoperative tumor evaluation can be safely expanded to gynecological malignancies. This is a novel practical approach that has been proven valuable in several tumor types to date, and also seems to be reliable for gynecological malignancies. Intraoperative flow cytometry is expected to be crucial in decisions of lymph node dissection in endometrial cancers, due to its rapid response regarding the tumor invasion of part or all of the myometrial thickness. In this way, the surgeon can quickly modify the plane of dissection. Our results warrant the further investigation of applying iFC in larger, multicenter studies.