Purpose: Glioblastoma (GBM) remains the most common and lethal primary central nervous system tumor, with a median survival of only 14.6 months under standard care. The tumor’s characteristic "Warburg effect"—a dependency on aerobic glycolysis for energy—creates a metabolic vulnerability. This review evaluates the efficacy and safety of the ketogenic diet (KD) as an adjunctive metabolic therapy aimed at exploiting this glucose dependency. Methods: This PRISMA-compliant systematic review updates clinical evidence by synthesizing data from databases from 2000 to September 2025. We searched PubMed, Embase, Cochrane, and Web of science for human studies assessing the ketogenic diet (KD) in glioblastoma and high-grade gliomas. Primary outcomes included overall survival (OS), progression-free survival (PFS), feasibility, and adverse events. Study quality was assessed using Joanna Briggs Institute tools. Prospero registration: CRD420251232650. Results: Forty-one studies were included, ranging from randomized trials to case series and abstracts, utilizing interventions such as the classic 4:1 ketogenic diet, Modified Atkins Diet, and calorie restriction. Adherence was high (> 75% maintained nutritional ketosis). Recent data indicate significant survival benefits; adherent cohorts achieved a median OS of 29.4 months vs 14.6 months in historical controls; with 66.7% 3-year survival rate. The diet was well-tolerated, with adverse events limited to mild gastrointestinal symptoms and fatigue. No Grade 3/4 diet-related toxicities reported. Conclusion: Current evidence supports the KD as a safe, feasible, and biologically rational adjunct to standard glioblastoma treatment. It demonstrates potential to prolong survival without severe toxicity, highlighting the need for standardized Phase III trials to establish clinical guidelines.

UNSTRUCTURED Artificial-intelligence clinical decision support systems are proliferating across cardiovascular medicine, yet few validated models reach routine care. The binding constraint is no longer accuracy but the absence of an auditable procedure for deciding whether a tool is fit to be deployed, kept, or withdrawn — and for protecting the patients least represented in its training data. We synthesize current validation approaches, characterize the technical, workflow, regulatory, economic, and equity barriers to implementation, and propose an operational framework in which demographic fairness is a condition of deployment rather than an afterthought. Prospective and external validation remain scarce, and reporting is dominated by discrimination metrics, with calibration and subgroup performance under-reported. A few completed pragmatic trials — artificial-intelligence electrocardiography screening for low ejection fraction, and an alert that reduced all-cause mortality — show that well-implemented tools can change hard outcomes. Implementation is impeded by data heterogeneity, model drift, limited interoperability, regulation designed for static devices, immature reimbursement, and demographic performance disparities that constitute genuine patient-safety concerns. We propose the Equity-anchored Qualification and Implementation Pathway for Cardiovascular artificial intelligence, a five-phase pathway in which each phase carries an entry requirement, an equity gate, a binary go/no-go decision, and predefined stop-and-deimplementation triggers, with a stakeholder matrix and two decision aids that make these principles auditable. Realizing the promise of cardiovascular artificial intelligence requires prospective validation, equitable deployment, and lifelong monitoring. Fairness is not the last consideration but a recurring gate.

Adrenocortical tumors are infrequent neoplasms, ranging from benign adenomas to aggressive carcinomas. They usually have an unspecific clinical presentation, thus being a challenge in diagnosis and treatment. The following case report discusses the management of a large, non‐functional adrenocortical tumor with histologically aggressive features, underlining the diagnostic workup, the multidisciplinary surgical approach, and the short‐term postoperative outcome after adrenalectomy. We report the case of a 40‐year‐old female patient presenting with dull left flank pain and a large, non‐functional adrenal mass. She underwent open left adrenalectomy. The resected specimen measured 8.4 × 7.6 × 6.5 cm and was histopathologically diagnosed as adrenocortical carcinoma. She was discharged on the 4th post‐operative day and at the 3‐month follow‐up was found to be disease‐free on imaging.

Pediatric colonic adenocarcinoma remains an extremely rare, aggressive malignancy with non-specific gastrointestinal symptoms. We hereby report a case of a 10-year-old boy who had been suffering from intermittent abdominal pain, constipation, and rectal bleeding for 3 months. Colonoscopy showed an ulcerostricturing lesion in the sigmoid colon, and histology was consistent with poorly differentiated carcinoma with signet-ring cells. There was no metastasis. The child had complete excision of the involved part with an uneventful recovery. This case illustrates the difficulties in diagnosing children with suspected colonic carcinoma and points out the role of early colonoscopy in children with rectal bleeding or changes in bowel habits.