Background/Objectives: Glioblastoma ranks among the most aggressive brain tumors, with poor prognosis. Currently, there are insufficient data regarding the prognostic value of isocitrate dehydrogenase (IDH) mutation status and inflammatory markers. This study demonstrates the prognostic value of IDH mutation status and preoperative inflammatory markers in glioblastoma. Methods: This single-center retrospective study encompassed 66 glioblastoma patients who had surgical treatment in our institution from January 2020 to March 2022. The patients were categorized into two groups: IDH-mutant (n = 30) and IDH-wild-type (n = 36). We made a comparative assessment of demographic characteristics, clinical parameters, preoperative blood parameters, and survival outcome across the two groups. Statistical analyses included Kaplan–Meier survival curves, ROC analysis, and multivariate Cox regression. Results: The IDH-mutant group demonstrated a significantly lower mean age (53.93 ± 12.00) compared to the wild-type group (62.39 ± 10.12) (p = 0.003). Median overall survival was notably longer in the IDH-mutant group, at 16.0 months, versus 6.5 months in the wild-type group (p = 0.030). An elevated neutrophil/lymphocyte ratio above 3.39 (sensitivity 95.12%, specificity 52.0%) and a platelet/lymphocyte ratio exceeding 136.25 (sensitivity 80.49%, specificity 64.0%) were associated with poor prognosis. Cox regression analysis identified IDH-wild-type status (HR = 2.84, 95% CI: 1.56–5.18) and elevated NLR (HR = 1.84, 95% CI: 1.16–2.92) as independent poor prognostic factors. Conclusions: We show that IDH-wild-type glioblastomal patients have a significantly poorer overall prognosis. In this case, the metrics of preoperative neutrophil/lymphocyte ratio and platelet/lymphocyte ratio seem to be supplied with some value as biomarkers for the expansion of the disease and predicting likely outcomes.

Background/Objectives: Cranial gunshot injuries represent severe traumatic brain injuries associated with high mortality rates. This study investigated whether integrating clinical findings at admission, including GCS score and pupillary response, with a CT-derived anatomical burden score and midline shift improves the prediction of in-hospital mortality. Methods: Adult patients aged 18 years and older with penetrating cranial gunshot injuries (n = 143) treated at a tertiary referral centre between 1 January 2005 and 31 December 2025 were retrospectively analysed using a single-centre cohort design. All included patients completed in-hospital follow-up, defined as hospital discharge or in-hospital death. Clinical variables, the anatomical burden score, and midline shift were evaluated using a multivariable logistic regression model where the primary outcome was in-hospital mortality. Model performance was assessed using ROC analysis, calibration measures, and bootstrap internal validation. Results: The in-hospital mortality rate was 56.6%, with early mortality occurring in 33.6% of patients. In the multivariable analysis, a low admission GCS score (≤8), bilateral non-reactive pupils, an increased anatomical burden score, and midline shift were independently associated with a higher risk of mortality. The model demonstrated good discrimination (AUC = 0.87; 95% CI 0.81–0.93), and similar performance was maintained following internal validation (optimism-corrected AUC = 0.86). The addition of radiological parameters to clinical variables improved model discrimination (ΔAUC = 0.07; 95% CI 0.02–0.11). Conclusions: The combined evaluation of admission clinical findings and CT-based anatomical parameters may support a more structured early estimation of in-hospital mortality risk in adult patients with penetrating cranial gunshot injuries.

Background and Aim: Metabolic dysfunction-associated steatotic liver disease (MASLD) is more prevalent in patients with psoriasis. Reliable non-invasive tools are needed to evaluate hepatic steatosis and to identify patients at risk for significant liver fibrosis. This study aimed to assess the discriminative performance of commonly used non-invasive scoring systems for identifying patients with vibration-controlled transient elastography (VCTE)-defined signifi-cant liver fibrosis and hepatic steatosis in patients with psoriasis. Materials and Methods: A total of 113 patients with psoriasis were prospectively enrolled. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were assessed using VCTE. Significant fibrosis (F2–F4) was defined as LSM ≥8 kPa, and significant steatosis (S2–S3) as CAP ≥259 dB/m. The discriminative performance of non-invasive fibrosis and steato-sis scores was evaluated using area under the receiver operating characteristic (AUROC) curves. Results: Of the 113 patients, 76 (67%) were diagnosed with MASLD following VCTE assess-ment. The body mass index, aspartate aminotransferase–alanine aminotransferase ratio, and diabetes (BARD) score (AUROC=0.692) showed the highest performance in identifying significant fibrosis, while FIB-4, aspartate aminotransferase to platelet ratio index, non-alco-holic fatty liver disease fibrosis score (NFS), and steatosis-associated fibrosis estimator (SAFE) demonstrated lower predictive accuracy. Among patients with MASLD, the SAFE score (AU-ROC=0.776), followed by the BARD score (AUROC=0.716), yielded the highest discriminative performance. The SAFE score showed the highest negative predictive value (95%) for ruling out significant fibrosis in MASLD patients. For detecting significant steatosis, the fatty liver index (FLI) score (AUROC=0.867) provided the highest performance, while hepatic steatosis index (HSI) (AUROC=0.813) and metabolic dysfunction–associated fatty liver disease screen-ing score (MAFLD-S) (AUROC=0.833) also demonstrated good discriminative ability. Conclusion: In patients with psoriasis, commonly used non-invasive fibrosis scores showed limited discrimination for VCTE-defined significant fibrosis, but they may have value as rule-out tools in low-prevalence settings. In contrast, FLI, HSI, and MAFLD-S showed good discrimination for VCTE-defined significant hepatic steatosis.

Aim: Preoperative evaluation is essential for anesthesia planning, risk assessment, and perioperative safety. However, the optimal extent of preoperative history-taking in low-risk patients remains debated, particularly in low-risk patients. This study compared the effects of short- versus long-form preoperative history-taking on anesthesia management and perioperative complications in American Society of Anesthesiologists (ASA) I patients. Methods: This prospective, randomized observational study included 750 ASA I adult patients undergoing elective surgery at a single center. Participants were randomly assigned to either a short-form (5-question, n = 375) or long-form (26-question, n = 375) preoperative questionnaire. The short-form was developed based on expert consensus. The primary outcome was the duration of preoperative evaluation. Secondary outcomes included the number of consultation requests, anesthesia techniques used, perioperative hemodynamic and respiratory parameters, and complication rates. Results: The mean duration of preoperative history-taking was significantly shorter in the short-form group (38.52 ± 7.99 seconds) than in the long-form group (103.17 ± 19.27 seconds; p < 0.001). Consultation requirements were identical (4 patients per group), with no significant differences in anesthesia techniques (p = 0.340), intraoperative complications (p = 0.70), or postoperative complications (p = 0.36). Conclusion: In ASA I patients, the short-form questionnaire is effective in collecting sufficient data and significantly reduces preoperative evaluation time without affecting anesthesia techniques, consultation needs, or complication rates compared to the long-form questionnaire. These findings support the use of concise history-taking protocols in low-risk surgical candidates to enhance clinical efficiency.

Background and Objectives: Prognostic assessments in grade 4 diffuse astrocytic tumors primarily depend on clinical and molecular characteristics, with radiological attributes frequently assessed in isolation. In this study, we explored whether an integrated radiological approach combining tumor burden, anatomical spread, and mass effect could contribute to survival prediction. Materials and Methods: A total of 310 adult patients with histopathologically confirmed grade 4 diffuse astrocytic tumors, diagnosed between January 2022 and January 2025, were included in this retrospective single-center cohort. Preoperative MRI was used to assess contrast-enhancing tumor volume, edema volume, and brain volume, combined with anatomical spread and midline shift as a marker of mass effect. Tumor burden was defined as the ratio of enhancing tumor volume to brain volume (ETV/BV). Overall survival was analyzed using Kaplan–Meier and Cox regression methods. Model performance was evaluated with the C-index, bootstrap internal validation, and 12-month calibration. Results: Tumor burden was higher in IDH-wildtype tumors, which also showed higher midline shift and more frequent deep structure involvement and contralateral extension. In multivariable analysis, IDH status, age, tumor burden, midline shift, and deep structure involvement were independently associated with overall survival. A greater tumor burden was associated with reduced survival. The addition of molecular and imaging-derived variables improved discrimination, increasing the C-index from 0.69 to 0.76. Following bootstrap validation, the corrected value was 0.73. Calibration at 12 months demonstrated acceptable agreement between predicted and observed outcomes. Conclusions: An integrated radiological approach that combines tumor burden, anatomical spread, and mass effect may support prognostic assessment in addition to established clinical and molecular variables.