Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. National Institute for Health and Care Research.

Objectives: There is no consensus regarding the surgical or immunosuppressive treatment of idiopathicgranulomatous mastitis (IGM). This study aimed to introduce a clinical classification system for IGM that might facilitateits treatment and predict recurrence. Methods: We analyzed the management of 68 patients with IGM at (Princess BasmaTeaching Hospital and King Abdulla University Hospital (1994-2016) to find out if distinct patterns of presentationexist according to the following parameters: presence of a painful or painless breast mass, local inflammation, abscessformation, communication to the skin, and extra-mammary manifestation. Results: We identified four distinct patterns ofIGM: A: (13.23 %) A hard, painless breast mass. B: (52.94 %) A hard, painful breast mass with gross inflammation.C: (26.47 %) A breast abscess-like presentation. D: (7. 35 %) A subacute presentation with ulceration, sinus, or fistulaformation. Erythema nodosum might complicate any of these patterns. Wide local excision in pattern A was curativewith zero recurrence rate. The recurrence rates in patterns B and C were 22.20 % and 50.00 %. Patterns B, C, andD were treated by a combination of surgery and prednisolone. In keeping with this, recent literature is in favor ofa wider use of immunosuppression especially in the presence of pus and extra-mammary findings. Conclusion: IGMcould be classified into 4 distinct patterns according to the presenting signs and symptoms. These patterns correlatedwith treatment, recurrence rate, and the gross operative findings. This is the first step toward a classification for IGM.Multicenter and Meta-analysis studies are essential for a comprehensive prognostic classification. Treatment of IGMin any institution should be the responsibility of a multidisciplinary team.

Introduction: Artificial Intelligence (AI) agents are rapidly transforming healthcare delivery, enabling real-time decision support and sophisticated patient interaction at scale. However, the scientific landscape of this rapidly growing, multidisciplinary field remains fragmented, with technical innovation outpacing translational research and the establishment of ethical governance frameworks. To address this gap, we conducted a comprehensive scoping review analysis of AI agent research in healthcare. Methods: We followed scoping review methodology (PRISMA-ScR guidelines). Searches across PubMed, Web of Science, arXiv, and medRxiv were conducted from January 2015 to December 7, 2025. Results: The search identified 1,070 records, of which 43 studies were ultimately included after full-text review. Of these 43 included studies, 36 were published in 2025. Systems were categorized into 8 conversational agents, 17 workflow/automation assistants, and 18 multimodal decision support agents. The core mechanism across all archetypes was external tool use (e.g., retrieval-augmented generation or code execution) for grounding and iterative self-correction (e.g., multi-agent debate or self-debugging loops) for refinement. Evaluation settings were predominantly simulated environments or laboratory studies, with few clinical pilots or real-world deployments. Primary reported outcomes focused on process measures (efficiency) and diagnostic accuracy; clinical outcomes and safety endpoints were rarely addressed. Conclusion: Agentic AI systems are rapidly evolving from conceptual frameworks to functional prototypes, primarily targeting complex decision-making and workflow automation. While agentic capabilities are increasingly integrated, research heavily favors simulated evaluations. Future research must prioritize clinical trials and the robust assessment of safety, usability, and clinical efficacy before widespread adoption.

Neurogenic tumors of the tracheobronchial tree are extremely rare and include neurofibroma and schwannoma. We report a case of primary recurrent tracheal schwannoma causing obstructive airway symptoms. A 60-year-old man presented with obstructive airway symptoms due to recurrent tracheal schwannoma. Due the recurrence, size of the tumor and low surgical risk, the patient was treated with tracheal resection. Primary endotracheal neurogenic tumors are extremely rare, but one should consider them in the differential diagnosis of persistent upper airway symptoms. While endoscopic therapies recur nearly a quarter of the time, surgical resections do not have any recorded recurrences.

Purpose: This study aims to determine the incidence and outcome of COVID-19 patients who required positive pressure ventilation (PPV) and subsequently developed pulmonary barotrauma (PBT). Also, to investigate the risk factors and predictors of these complications to better understand the disease pathogenesis. Patients and Methods: This retrospective analysis enrolled all adult COVID-19 patients admitted through the period from October 1, 2020, to December 31, 2020. All patients who received any form of PPV were included. Patients were then divided into two groups based on PBT development, including subcutaneous emphysema, pneumothorax, and pneumomediastinum. Medical records of all patients were reviewed. Patients’ demographics, laboratory data on admission, respiratory support modes, surgical interventions, and outcomes were collected and analyzed. Results: In the specified period, 1095 patients were hospitalized due to COVID-19 illness. A total of 239 (21.8%) of all admitted patients received PPV. PBT accounted for 21.3% (51/239) of the study cohort. While both groups were equally exposed to the same modes of PPV, receiving invasive ventilation significantly correlated with decreased PBT odds (OR = 0.891; 95% CI, 0.803– 0.988; p=0.029). PBT patients were significantly younger (p< 0.001). Diabetes mellitus was found to have a protective effect on developing PBT (OR = 0.867; 95% CI, 0.782– 0.962), while PO₂/FIO₂ ratio was inversely associated with higher odds of developing PBT in both univariate and multivariate analyses (p=0.03 and p=0.019, respectively). Conclusion: COVID-19-infected patients are at a higher risk of developing PBT. Invasive positive pressure ventilation was associated with less PBT compared to noninvasive ventilation and delaying intubation does not seem to reduce the risk of pulmonary barotrauma.

Pulmonary hydatid cyst is a parasitic disease causing an endemic and a health burden in many regions. Lung cysts are more common than liver cysts in children and patients may remain asymptomatic. Cyst rupturing is not uncommon, and it is considered the most feared complication. In this cohort study, we aimed to identify the risk factors related to cyst rupture in a Jordanian pediatric population. We retrospectively evaluated all pediatric patients who underwent cystostomy and capitonnage for pulmonary hydatid cyst between 2003 and 2020 at King Abdullah University Hospital. We found 43 patients with a mean age of 13 ± 4 years who suffered from 61 pulmonary cysts. 55.6% of them were males. The most prevalent symptom was shortness of breath. The rupture rate for patients was 39.5%, and 29.5% for cysts. None of the patients with cyst rupture had an anaphylactic reaction. The left lower lobe was the most common location for both intact and ruptured cysts. 25.6% of the patients had giant cysts (>10 cm) with a mean of 7.4 cm for all cysts. Patients with intact cysts had higher-rates of cough (42.3% vs. 29.4%) and lower-rates of shortness of breath (34.6% vs. 52.9%) than patients with ruptured cysts, which were not statistically significant. Although statistically insignificant, patients with ruptured cysts tended to have multiple cysts in one lung (29.4% vs. 7.7%, p = 0.180), and more complication rates (29.4% vs 7.7%, p = 0.09). Both groups had almost identical IgG-ELISA positive results. We found no significant association between cyst rupture and age, gender, presenting symptoms, cyst size, cyst location, and rate of postoperative complications. The rupture of pulmonary hydatid cyst has clinical consequences in pediatric patients, further studies on larger populations are needed to identify factors that make patients more prone to rupture and prioritize them for clinical monitoring and management.