Background: Research advancing effective treatments for breast cancer is crucial for eradicating the disease, reducing recurrence, and improving survival rates. Nipple-sparing mastectomy (NSM), a common method for treating breast cancer, often leads to complications requiring re-operation. Despite advancements, the use of hyperbaric oxygen therapy (HBOT) for treating these complications remains underexplored. Therefore, we analyze the efficacy of HBOT in the post-operative care of patients undergoing NSM. Methods: A systematic search was conducted using PubMed, Scopus, and the Cochrane Library. Studies were assessed for eligibility using the PICO (Population, Intervention, Comparison, Outcome) framework and classified based on American Society of Plastic Surgeons (ASPS) levels of evidence. Seven studies, totaling a pool of 63 female patients, met the inclusion criteria. Among these studies, four were categorized as Level III (57.1%), one as Level IV (14.3%), and two as Level V (28.6%). These studies focused on HBOT’s role in wound healing, the successful salvage of breast reconstruction, and the optimal timing for HBOT. Results: This review revealed that HBOT indeed has potential for improving tissue oxygenation, vascularization, and, consequently, wound healing. It is noted that HBOT is efficacious for mitigating post-NMS complications, including infections, re-operation, flap loss, seroma, and hematoma. Conclusions: Overall, HBOT could be beneficial in standard post-surgical care protocols for patients undergoing NSM due to its role in mitigating common adverse effects that occur after mastectomy. Despite promising outcomes, the recent literature lacks rigorous clinical trials and well-defined control groups, underscoring the need for further research to establish standardized HBOT protocols.

Purpose: To report the structural and functional outcomes of autologous neurosensory retinal transplant for closure of refractory macular holes (MHs) and to highlight the long-term follow-up findings. Methods: Nine eyes of 9 patients with full-thickness MH refractory to previous vitrectomy with internal limiting membrane (ILM) peeling and tamponade underwent pars plana vitrectomy, autologous retinal transplant with short-term perfluoro-n-octane heavy liquid, followed by gas tamponade. Patients were followed for 12.7 ± 10 months (range, 3-32 months). Results: Optical coherence tomography showed complete anatomic closure of the MH in 8 of 9 eyes (89%). Restoration of the outer retina and integration of the neurosensory retinal flap were noted in 5 eyes. The mean corrected Snellen visual acuity (VA) was 20/1600 and improved postoperatively to 20/200. The logMAR VA improved postoperatively from 1.9 ± 0.2 (range, 1.3-2) to 1.0 ± 0.3 (range, 0.59-1.3). Three grafts developed epiretinal membranes and were observed. Graft shrinkage over time was noted in 1 patient. One patient with a chronic large MH and previous panretinal photocoagulation (PRP) had a successful transplant from retinal tissue that had undergone PRP. One eye developed retinal detachment with proliferative vitreoretinopathy (PVR) that was managed with scleral buckle, PVR peeling, and silicone oil tamponade. This was followed by a successful repeat autologous retinal transplant from the detached nasal retina and nasal 120 degrees retinectomy. Conclusions: Autologous retinal transplant for large refractory MHs provides anatomic closure and safely improves VA.

Background: Richter’s transformation (RT) in chronic lymphocytic leukemia (CLL) is associated with poor prognosis and requires prompt modifications in patient care. CLL patients are susceptible to severe infections due to immune dysregulation induced by their malignancy and immunosuppressive therapies.Case presentation: We present a case of a 63-year-old man with CLL who previously achieved remission and presented with a right inguinal mass. He was diagnosed with Rai Stage I CLL with del6q, without TP53 mutation, and treated with 6 cycles of fludarabine, cyclophosphamide, and rituximab (FCR) 6 years prior. Transformed CLL was suspected based on his lymphadenopathy, elevated lactate dehydrogenase, and constitutional symptoms, but excisional biopsy unexpectedly revealed herpes simplex virus (HSV)-1 and HSV-2, indicating a diagnosis of HSV lymphadenitis concurrent with CLL relapse with no transformation but acquisition of 17p deletion consistent with clonal evolution. The patient received three courses of dexamethasone and acyclovir, leading to successful clearance of the infection, evidenced by the resolution of his B symptoms. Subsequently, he was treated for the CLL recurrence with rituximab and venetoclax, demonstrating a favorable response with significant improvement in adenopathy and resolution of lymphocytosis.Discussion: This case highlights the possibility of reactivated dormant viral infections in the context of CLL relapse, underscoring the importance of comprehensive evaluation in CLL patients presenting with lymphadenopathy. Due to immunosuppressive defects and iatrogenic hypogammaglobulinemia, patients with CLL face an increased risk of viral infections, with HSV reactivation occurring more frequently and severely in the setting of hematologic malignancies and dysregulated T-cell immunity. Timely administration of antiviral therapy is crucial for HSV lymphadenitis to prevent rapid progression and debilitating symptoms. This case demonstrates the importance of considering atypical viral infection presentations in CLL patients and emphasizes the necessity of timely and adequate biopsies to differentiate between CLL transformation, HSV lymphadenopathy, and other causes of lymphadenopathy while avoiding unnecessarily aggressive lymphoma therapy.

Cyclic thrombocytopenia (CTP) is a rare hematological disorder characterized by significant oscillations in platelet counts, alternating between phases of severe thrombocytopenia and periods of normal or elevated platelet levels. Due to its clinical similarities with Immune Thrombocytopenia (ITP), CTP presents a diagnostic challenge. We report the case of a 54-year-old woman who first presented at age 45 with a petechial rash, heavy menstruation, and severe thrombocytopenia with a platelet count of less than 5,000 × 10^9/L. Her severe thrombocytopenia was followed by marked rebound thrombocytosis, ultimately leading to a clinical diagnosis of idiopathic cyclic thrombocytopenia (CTP). Unlike other cyclic hematological disorders, CTP exclusively affects platelet counts distinguishing it from other conditions. It is unresponsive to conventional ITP treatments, and thus accurate diagnosis through vigilant platelet monitoring in unexplained thrombocytopenia can help CTP patients avoid unnecessary therapies and their associated side effects.

Aortic fistulas are a rare condition that can be fatal if not detected early. They can occur spontaneously or after trauma or vascular procedures. The most common aortic fistulas occur with the esophagus, intestines, atrium, and bronchi. Aorto-superior vena cava (SVC) fistulas are exceedingly rare finding. We present a patient with a dissected aortic pseudoaneurysm complicated by an aorto-SVC fistula, leading to left-to-right shunting. This caused increased pulmonary blood flow, left ventricular volume overload, and eventual high-output heart failure. This is a unique case of an aorto-SVC fistula as a complication of subacute/chronic ascending aortic dissection in a patient who underwent CABG. Clinicians should be aware of this condition, as it can be fatal despite treatment.