Sarcopenia refers to a disorder involving the gradual and overall reduction in skeletal muscle mass and physical capability. It occurs in over one-third of individuals with liver cirrhosis and serves as an independent predictor of increased mortality risk. Assessment of sarcopenia is necessary in all patients with liver cirrhosis, as recommended by the European Association for the Study of the Liver (EASL) and the European Society for Clinical Nutrition and Metabolism (ESPEN). The evaluation of muscle mass can be performed using several validated methods such as the multislice computed tomography (MSCT), abdominal magnetic resonance imaging (MRI), dual X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), or muscle ultrasound. Assessment of muscle function encompasses measurements of both muscle strength and physical performance. Sarcopenia has a significant negative impact on the course of the disease, quality of life and outcomes of patients with liver cirrhosis. Considering the global healthcare impact and the significant influence on the course of disease, characteristics of simplicity, swiftness, safety, availability, reproducibility, and diagnostic accuracy are certainly the key factors to consider when choosing the proper diagnostic method for nutritional assessment. The aim of this review is to analyze the pathophysiological mechanisms underlying muscle mass loss in patients with liver cirrhosis, as well as to assess strengths and limitations of the methods currently in use to diagnose sarcopenia.

Background and Objectives: Perforated peptic ulcers are a common surgical emergency and rank among the leading causes of acute peritonitis worldwide. Previous studies have suggested a seasonal pattern in the occurrence of symptomatic perforated peptic ulcers. With the advancement of modern medicine, including the widespread use of proton pump inhibitors, and the effects of climate change, this study aimed to assess potential seasonal variations in the incidence of peptic ulcer perforation in our region. Methods: This retrospective analysis included 104 adult patients (mean age: 61.5 ± 14.7 years) who underwent surgical treatment for peptic ulcer perforation between January 2021 and April 2024. Patients were analyzed by gender, age, risk factors (smoking and alcohol consumption), the location of the perforation (gastric or duodenal), and discharge outcome (survived or deceased). Additionally, cases were categorized by the month and season of the ulcer perforation. Results: Among the 104 patients (mean age 61.5 ± 14.7 years), 68 (65.4%) were male. Gastric and duodenal perforations were nearly equally observed (51% vs. 49%). A statistically significant difference in overall perforation rates by gender was observed (p = 0.009), though not between ulcer sites (p = 0.628 and p = 0.739). The highest number of perforations occurred in July (n = 12), while the lowest occurred in November (n = 4); however, no significant variation was found by month (p = 0.916) or season (p = 0.891), despite a predominance in spring. Comorbidities were present in 60% of patients. Smoking (33.6%) and alcohol use (22.1%) were common. Alcohol abuse was noted in 22.1% of patients and was significantly associated with both gastric (p < 0.001) and duodenal (p < 0.001) perforations, though not with the overall incidence (p = 0.284). Smoking, reported in 33.6% of patients, showed no significant association with the perforation site or overall incidence (p = 0.946). The combination of smoking and alcohol use favored gastric perforations, but without statistical significance (p = 0.157). Conclusions: Alcohol consumption appeared to increase the risk of ulcer perforation, while smoking did not demonstrate a statistically significant association. Although spring exhibited the highest observed incidence of peptic ulcer perforation, seasonal variation did not show a statistically significant difference overall.

Accurate sex estimation is critical in forensic anthropology for developing biological profiles, with the mandible serving as a valuable alternative when crania or pelvic bones are unavailable. This study aims to enhance mandibular sex estimation using deep learning on 3D models in a southern Croatian population. A dataset of 254 MSCT-derived 3D mandibular models (127 male, 127 female) was processed to generate 4096-point clouds, analyzed using an adapted PointNet++ architecture. The dataset was split into training (60%), validation (20%), and test (20%) sets. Unsupervised analysis employed an autoencoder with t-SNE visualization, while supervised classification used logistic regression on extracted features, evaluated by accuracy, sensitivity, specificity, PPV, NPV, and MCC. The model achieved 93% cross-validation accuracy and 92% test set accuracy, with saliency maps highlighting key sexually dimorphic regions like the chin, gonial, and condylar areas. A user-friendly Gradio web application was developed for real-time sex classification from STL files, enhancing forensic applicability. This approach outperformed traditional mandibular sex estimation methods and could have potential as a robust, automated tool for forensic practice, broader population studies and integration with diverse 3D data sources.

Objectives: This study aimed to investigate whether the apparent diffusion coefficient (ADC) maps values of breast lesions presenting as non-mass enhancement (NME) on MRI could predict benign or malignant pathohistological findings. Materials and Methods: This retrospective single-center study included 136 female patients with NME and corresponding ultrasound correlate and a subsequent ultrasound-guided core needle biopsy. The patients were subdivided into benign or malignant subgroups based on pathology reports, which served as the gold standard. Blinded to the pathological results, two radiologists independently measured the ADC values of the depicted NME using punctate, 10 mm and whole tumor regions of interest (ROIs) wherever applicable. The mean of all measurements was also analyzed and compared with the pathologic subdivision. Results: The sensitivity of whole tumor ROI in detecting benign NME is 91% compared to 74% for 10 mm ROI and 78% for punctate ROI. No significant differences in ADC values were observed when comparing fatty breast tissue and dense breast tissue. Conclusions: There were differences in ADC values between benign and malignant findings using all types of measurements, where the whole tumor ROI was the most sensitive.

Background: Non-small cell lung cancer (NSCLC) harboring activating epidermal growth factor receptor (EGFR) mutations has undergone a therapeutic paradigm shift with the introduction of third-generation EGFR tyrosine kinase inhibitors (TKIs), particularly osimertinib. Despite these advances, disseminated disease remains challenging, and treatment selection for cytotoxic chemotherapy is still largely guideline-driven rather than individualized. Functional chemosensitivity testing using liquid biopsy-derived tumor cells represents an emerging strategy to personalize systemic therapy beyond molecular profiling alone. In addition, consolidative stereotactic ablative body radiotherapy (SABR) may enhance durable disease control after systemic response. Case Description: We report the case of a 75-year-old woman diagnosed with stage IV disseminated lung adenocarcinoma involving mediastinal, cervical, and hilar lymph nodes, pleura, and bone. Molecular analysis revealed an EGFR exon 19 deletion, low programmed death-ligand 1 (PD-L1) expression (1%), and no other actionable alterations. A liquid biopsy-based chemosensitivity assay demonstrated marked tumor cell susceptibility to oxaliplatin and pemetrexed, guiding selection of a non-standard chemotherapy regimen. The patient received six cycles of oxaliplatin-pemetrexed in combination with continuous osimertinib (80 mg daily). Interim positron emission tomography combined with computed tomography (PET/CT) imaging showed near-complete metabolic regression of systemic disease. Residual activity within the primary lung lesion was subsequently treated with SABR, resulting in complete radiographic and metabolic remission. At 1-year follow-up, the patient remains disease-free on maintenance osimertinib alone, with minimal toxicity and preserved performance status. Conclusions: This case illustrates the potential clinical value of integrating functional chemosensitivity testing with targeted therapy and consolidative SABR in disseminated EGFR-mutated NSCLC. Personalized chemotherapy selection based on tumor-specific drug responsiveness, rather than guideline-driven regimens alone, may contribute to exceptional treatment responses. These findings support further investigation of functional precision oncology approaches to optimize outcomes in advanced lung cancer.