Introduction: Unruptured intracranial aneurysms (UIAs) can induce psychological stress, leading to anxiety, depression, and impaired quality of life (QoL). Most studies on this topic are limited by small sample sizes, cross-sectional designs, and a focus on treated rather than untreated cases, leaving a gap in the literature. We aimed to conduct a systematic review and meta-analysis to evaluate mental health and QoL outcomes in patients with untreated UIAs. Methods: A systematic search was conducted up to 30 November 2024 using PubMed, Scopus, and Cochrane Central for studies comparing patients with untreated UIAs to a control group. The outcomes of interest included anxiety, depression, and QoL. Statistical analysis was performed using RevMan 5.1.7 and R 4.3.1. Heterogeneity was assessed using I² statistics and the Cochrane Q test. Risk ratios (RR) and standardized mean differences (SMD) were computed using a frequentist random-effects model. Results: We included five studies with 417,152 patients, of whom 85,668 (20.53%) had untreated UIAs. In the pooled analysis, patients with untreated UIAs had significantly higher anxiety levels (SMD 0.66; 95% CI [0.16; 1.17]; p = 0.01; I² = 76%) and lower QoL (SMD −0.82; 95% CI [−1.12; −0.53]; p = 0.01; I² = 56%) compared to the control group However, no statistically significant differences were found in depression (RR 0.94; 95% CI [0.52; 1.72]; p = 0.84; I² = 88%) between groups. Conclusions: This meta-analysis indicates a potential association between untreated UIAs and increased anxiety levels and reduced QoL. Regarding depression, no significant differences were observed between groups.

Introduction: Asthma is a chronic respiratory disease affecting approximately 5 million children in the US, but little is known about whether asthma alters children’s attention and memory functions. Most studies on this topic focus on psychiatric and QoL outcomes rather than cognitive functions, leaving a gap in the literature. We aimed to conduct a systematic review and meta-analysis to evaluate the attention deficit and memory function outcomes in children with bronchial asthma. Methods: A systematic search was conducted in PubMed, Web of Science, and Cochrane Library from inception to 28 February 2025 for studies evaluating attention deficit and memory function in children with bronchial asthma. Outcomes of interest included attention deficit and memory function. Statistical analysis was performed with R 4.3.1. Heterogeneity was accessed using the I² statistics and Cochrane Q test. The standardized mean difference (SMD) with restricted maximum-likelihood estimator random-effects method was computed for all outcomes. Results: A total of seven studies were included in the final meta-analysis, comprising 104,975 patients, of whom 10,200 (9.7%) had bronchial asthma (mean age ± 8.98 years, mean 45% females). In the pooled analysis, children with asthma had a worsened attention deficit compared to the healthy group (SMD 0.29; 95% CI [0.07; 0.51]; p = 0.01; I² = 92%). However, no statistically significant difference was found in memory function between groups (SMD −0.24; 95% CI [−1.81; 1.33]; p = 0.77; I² = 96%). Conclusions: Children with asthma showed significantly higher attention deficit scores compared to healthy children. No statistically significant differences were observed in memory function between the groups. These findings may have implications for early cognitive screening in pediatric asthma management.

Gout is a crystal-induced inflammatory arthritis driven by hyperuricemia and monosodium urate (MSU) crystal deposition, yet urate burden alone does not explain why only a subset of hyperuricemic individuals develops clinical disease, why acute flares are usually self-limited, or why gout clusters with renal and cardiometabolic comorbidity. This structured narrative review uses a gout-specific redox-switch framework, defined as a context-dependent shift in uric acid biology according to concentration, compartment, crystallization state, xanthine oxidoreductase (XOR) activity, inflammatory priming, and disease stage rather than as a binary molecular event. We integrate evidence on XOR-derived reactive oxygen species (ROS), mitochondrial stress, NLRP3 inflammasome signaling, neutrophil oxidative responses, neutrophil extracellular traps (NETs), lipid peroxidation, and potential ferroptosis-related mechanisms. Evidence is classified into five categories: established, mechanistically supported, human-associative, conceptual, and emerging/unvalidated. The available human data support lipid-peroxidation and ferroptosis-associated molecular signatures, but do not yet establish ferroptotic cell death as a driver of gout. Therapeutic implications are therefore framed conservatively: urate-lowering therapy remains foundational, whereas redox-directed approaches require pathway specificity, disease-stage definition, and biomarker validation. The redox-switch concept is proposed as an organizing framework for mechanistic and translational research, not as a validated clinical algorithm.

Background/Objectives: The infraclavicular region contains a complex arrangement of the brachial plexus cords and axillary vessels. Accurate ultrasonographic characterization of these relationships is important for anatomical image interpretation and has direct relevance to ultrasound-guided infraclavicular procedures. This study aimed to evaluate the bilateral topographic distribution and morphometric relationships of the lateral, medial, and posterior cords relative to the axillary artery and axillary vein. Methods: This prospective, multicenter, observational anatomical–ultrasonographic study included 50 adults (25 women and 25 men), each examined bilaterally, yielding 100 potential side-specific examinations. The lateral cord (LC), medial cord (MC), posterior cord (PC), and axillary vein (AV) were mapped using a 12-sector radial model centered on the axillary artery (AA). Center-to-center intercord, cord-to-AA, and cord-to-AV distances were measured. Topographic confidence intervals were estimated using participant-level cluster bootstrap resampling, and bilateral morphometric data were analyzed using linear mixed-effects models. Results: The LC was located in sectors 10–11 in 85/94 examinations (90.4%; 95% CI, 84.4–95.7%), the MC in sectors 2–4 in 84/89 (94.4%; 95% CI, 89.2–98.9%), the PC in sectors 6–7 in 78/83 (94.0%; 95% CI, 88.6–98.8%), and the AV in sectors 4–5 in 95/100 (95.0%; 95% CI, 90.0–99.0%). Mean intercord distances were 11.20 ± 1.18 mm for LC/MC, 7.30 ± 1.61 mm for LC/PC, and 5.70 ± 1.10 mm for MC/PC. Mean cord-to-AA distances were 7.60 ± 0.74, 4.60 ± 0.93, and 6.60 ± 0.91 mm for the LC, MC, and PC, respectively. Mean cord-to-AV distances were 15.50 ± 2.01, 6.60 ± 1.22, and 8.50 ± 1.10 mm, respectively. Mixed-effects models demonstrated significant differences among measurements within each distance family (all p < 0.001), without significant overall side or sex effects. Conclusions: The brachial plexus cords and AV demonstrated a consistent topographic organization around the AA during bilateral mid-infraclavicular ultrasonographic assessment. The MC showed the shortest center-to-center distance to both the AA and AV, and the three cords formed a non-equidistant spatial configuration.

Background: The infraclavicular brachial plexus block is a widely used regional anesthesia technique for surgery of the distal upper limb. Although generally considered safe—particularly with ultrasound guidance—a range of vascular, neurological, respiratory, and anesthetic-related complications continues to be reported. Understanding how anatomic factors can influence the occurrence of these events is essential for improving procedural safety. Objective: This narrative review aims to correlate clinically reported complications of the infraclavicular block with underlying anatomical mechanisms that may predispose to their development. Methods: A narrative review of the literature was conducted using PubMed, Scopus and Web of Science to identify clinical studies, observational series, and case reports published between 1995 and 2025 that documented complications associated with infraclavicular brachial plexus block in adults. Publications were selected based on relevance to vascular, neurological, respiratory, infectious, and local anesthetic systemic complications. Findings were synthesized descriptively, with emphasis on anatomical-clinical correlations rather than quantitative meta-analysis. Results: Reported complications include vascular puncture and hematoma formation, transient or persistent neurological deficits, Horner’s syndrome, hemidiaphragmatic paralysis, pneumothorax, local anesthetic systemic toxicity, and infectious complications. The incidence of these events varies widely across studies, reflecting differences in block technique, use of ultrasound guidance, injected anesthetic volume, and operator experience. Anatomical factors—such as the close relationship of the cords of the brachial plexus to the axillary vessels and the continuity of fascial planes—provide plausible explanations for these variations. Conclusions: Most complications of the infraclavicular block can be understood and anticipated through careful consideration of regional anatomy. Integrating anatomical knowledge with ultrasound guidance and optimized injection strategies may substantially reduce the risk of adverse events. This review highlights key anatomical mechanisms underlying reported complications and outlines practical implications for clinical practice.

Background/Objectives: Quantitative MRI data describing the infraclavicular brachial plexus cords together with both axillary vessels remain limited. This study characterized artery-centered cord topography and neurovascular morphometry on 0.55 T MRI and discussed the potential anatomical implications for infraclavicular block. Methods: This prospective cross-sectional imaging study included 100 adults undergoing clinically indicated MRI. One infraclavicular region was analyzed per participant. Within the mid-infraclavicular retropectoral region posterior to the pectoralis minor muscle, the axial T1-weighted image providing the clearest simultaneous visualization of the lateral cord (LC), medial cord (MC), posterior cord (PC), axillary artery (AA), and axillary vein (AV) was selected. The LC, MC, PC, and AV were mapped using a 12-sector clock-face model centered on the AA, and center-to-center intercord, cord-to-AA, and cord-to-AV distances were measured. Results: The LC was most frequently located at 11 o’clock (62%), the MC at 3 o’clock (41%), the PC at 6 o’clock (40%), and the AV at 2 o’clock (71.1%; n = 90). Mean intercord distances were 11.73 ± 3.17 mm (LC-MC), 11.09 ± 2.43 mm (LC-PC), and 8.13 ± 2.83 mm (MC-PC). Mean cord-to-AA distances were 6.33 ± 1.69, 7.36 ± 2.03, and 7.13 ± 1.83 mm for LC, MC, and PC, respectively. In 92 participants with complete cord-to-AV measurements, corresponding means were 17.01 ± 5.01, 9.61 ± 2.90, and 16.54 ± 3.87 mm. Conclusions: At the mid-infraclavicular retropectoral level, 0.55 T MRI demonstrated a structured but non-equidistant neurovascular arrangement. These imaging-derived data provide quantitative anatomical reference information but are not procedural safety margins or predictors of block success.