Ischemic stroke is a significant public health concern, with its incidence expected to double over the next 40 years, particularly among individuals over 75 years old. Previous studies, such as the DAWN trial, have highlighted the importance of correlating clinical severity with ischemic stroke volume to optimize patient management. Our study aimed to correlate the clinical severity of ischemic stroke, as assessed by the NIHSS score, with ischemic stroke volume measured using DWI, and short-term prognosis quantified by the mRS score at discharge. Conducted at the largest hospital in Gorj County from January 2023 to December 2023, this study enrolled 43 consecutive patients with acute ischemic stroke. In our patient cohort, we observed a strong positive correlation between NIHSS score and ischemic stroke volume (Spearman correlation coefficient = 0.982, p < 0.01), and a strong negative correlation between ASPECTS-DWI score and mRS score (Spearman correlation coefficient = −0.952, p < 0.01). Multiple linear regression analysis revealed a significant collective relationship between ASPECTS score, ischemic stroke volume, and NIHSS score (F(1, 41) = 600.28, p < 0.001, R² = 0.94, R²_adj = 0.93). These findings underscore the importance of DWI in assessing ischemic stroke severity and prognosis, warranting further investigation for its integration into clinical practice.

The research article highlights the significance of acute myocardial infarction (AMI) and its impact on depression and anxiety among patients’ post-primary percutaneous coronary interventions (PCI). The study aims to determine the frequency of depression and anxiety occurrence in patients with acute myocardial infarction after primary PCI. The objective of this study is to investigate the frequency of depression and anxiety in patients with acute myocardial infarction after primary PCI. The method used in the study involved the collection of data from 88 patients with acute myocardial infarction who underwent primary PCI treatment. The patients were tested before PCI and then at intervals of 1 month, 6 months, and 12 months post-PCI using the Hamilton Depression Scale (HAM-D17) and the Hamilton Anxiety Scale (HAM-A) to identify depression and anxiety symptoms, respectively. The study performed a comprehensive analysis of the collected data to determine the frequency of depression and anxiety occurrence in post-PCI patients. The study found evidence that primary PCI reduces depression and anxiety in patients who have experienced a myocardial infarction. However, mental health issues continue to be a significant psychological concern for patients post-PCI, impacting their lifestyle, self-care, and treatment adherence. The study suggests that healthcare providers should actively screen and manage psychiatric disorders in patients who have suffered from AMI as they are at an increased risk of mental disorders. In conclusion, the study indicates that depression and anxiety are common issues in acute myocardial infarction survivors, and interventions addressing these conditions should be a routine part of care. The study highlights the need for healthcare providers to be aware of the increased risk of mental disorders in individuals who have suffered from AMI. Understanding the impact of anxiety and depression on post-PCI patients is essential for the development of effective interventions that support patients’ recovery.

Gastric cancer is a significant health concern worldwide, and lymphadenectomy plays a crucial role in its treatment. However, there is ongoing debate regarding the optimal approach—D1 or D2 lymphadenectomy. This paper aims to synthesize the available evidence by conducting a comprehensive literature review and comparing the advantages and disadvantages of both techniques. The analysis includes studies, clinical trials, and systematic reviews that assess survival outcomes, morbidity, and quality of life. The selected studies revealed different outcomes associated with D1 and D2 lymphadenectomy, including lymph node harvest, disease control, recurrence rates, and overall survival. Postoperative complications also varied between the two techniques. These findings highlight the complex considerations involved in selecting the most suitable lymphadenectomy approach for individual patients. Therefore, the decision requires an individualized assessment that considers the potential benefits and risks of D1 and D2 techniques. A collaborative approach involving interdisciplinary teams is crucial for developing personalized treatment plans that optimize both oncological outcomes and postoperative quality of life.

Background: Despite advances in surgical techniques and perioperative management, reliable intraoperative predictors of adverse postoperative outcomes in cardiac surgery remain elusive. This study aimed to identify perioperative factors associated with prolonged intensive care unit (ICU) stay and in-hospital mortality while defining actionable thresholds. Methods: A retrospective analysis was conducted on 130 adult cardiac surgery patients (with a median age of 61 years, 66.2% men) from October 2022 to November 2024. Data on preoperative risk factors, intraoperative variables (cardiopulmonary bypass time-CPBT, aortic cross-clamp time-AXCT), and postoperative outcomes (ICU length of stay, in-hospital mortality) were extracted from electronic medical records. Results: Prolonged ICU stay (≥7 days) occurred in 38.5% of patients, and in-hospital mortality was 10%. AXCT was the sole independent predictor of prolonged ICU stay (OR = 1.046, 95% CI = 1.014–1.080, p = 0.005), with a 110-min cut-off (sensitivity 71%, specificity 61%, AUC = 0.729). A Kaplan–Meier analysis showed significantly longer ICU stays above this threshold (p = 0.006). For in-hospital mortality, prolonged CPBT (OR = 1.030, 95% CI = 1.003–1.057, p = 0.030), emergency surgery (OR = 0.043, 95% CI = 0.002–0.863, p = 0.040), and higher AXCT (OR = 0.965, 95% CI = 0.934–0.997, p = 0.034) were the independent predictors. A receiver operating characteristic analysis identified 140 min for AXCT (sensitivity 67%, specificity 70%, AUC = 0.707) and 227 min for CPBT (sensitivity 83%, specificity 69%, AUC = 0.824) as the optimal cut-offs. A combined model (emergency surgery yes/no, AXCT > 140 min, CPBT > 227 min) yielded excellent discrimination (AUC = 0.846). Conclusions: These findings suggest perioperative benchmarks that may guide surgical teams in refining operative strategies, reducing ICU resource utilization, and improving survival following cardiac surgery.

Chylopericardium represents a rare condition of chyle accumulation within the pericardial sac, caused by abnormal thoracic duct anatomy or prolonged increased pressure. Nothing by mouth (NPO) policy and total parenteral nutrition (TPN), even in combination with pericardial drainage, render only a temporary solution. Surgical intervention with thoracic duct ligation and creation of a pericardial window is believed to be the most effective treatment. An 18-year-old male was referred with a persisting idiopathic chylopericardium for five months. Various drainages and conservative treatment failed. To more permanently treat the chylopericardium, we created a pericardial window and ligated the thoracic duct by right-sided uniportal video-assisted thoracoscopic surgery. Postoperative NPO and TPN for 1 week were initiated, followed by medium-chain-triglycerides diet for 1 week. Clinical improvement occurred and the chest drain was removed two weeks after surgery. Magnetic resonance imaging of the whole body showed multiple cystic lesions in spleen and skeleton compatible with generalized lymphatic anomaly (GLA), proven by the anatomopathological examination of the thoracic duct and lung biopsy. Sirolimus was initiated for further treatment. In this case of idiopathic chylopericardium, we successfully performed thoracoscopic thoracic duct ligation and creation of a pericardial window, diagnosing a GLA.

Background: A popliteal vein aneurysm (PVA) is a rare vascular abnormality that can lead to the formation of venous thrombi, resulting in potentially life-threatening pulmonary embolism (PE). Methods: We present the case of a 30-year-old female who presented with recurrent pulmonary embolism complicated by cardiorespiratory arrest. Emergency thrombolysis was initiated, which successfully stabilized the patient. Further diagnostic evaluation, including imaging studies, revealed the presence of a giant popliteal vein aneurysm (60/70 mm) as the underlying cause of recurrent embolism. Results: The patient underwent surgical repair of the popliteal vein aneurysm to prevent further thromboembolic events. The procedure was performed successfully, and the patient recovered favorably. Conclusions: This case underscores the importance of recognizing PVA as a potential cause of recurrent PE, particularly in young patients without typical risk factors.