The immune checkpoint axis PD-1/PD-L1 is a cornerstone of cancer immunotherapy. However, its efficacy in breast cancer is often limited by a complex and immunosuppressive tumour microenvironment (TME). The IL-33/ST2 signalling pathway, a key player in type 2 inflammation, is increasingly recognized for its pro-tumoral roles in various cancers, contributing to immune evasion and metastasis. This review explores the synergistic potential of combining PD-1/PD-L1 blockade with IL-33/ST2 inhibition to overcome therapeutic resistance and enhance anti-tumour immunity in breast cancer. Current literature on the PD-1/PD-L1 and IL-33/ST2 pathways in breast cancer progression was synthesized, focusing on their mechanisms of immune suppression and TME modulation. It examines preclinical and clinical data on the individual and combined therapeutic strategies targeting these pathways. Evidence suggests that IL-33 signalling promotes a suppressive TME by recruiting regulatory T cells, myeloid-derived suppressor cells, and M2 macrophages, which can limit the effectiveness of PD-1/PD-L1 inhibitors. Conversely, blocking the IL-33/ST2 pathway has been shown to reprogram the TME, leading to increased infiltration of cytotoxic T lymphocytes and enhanced anti-tumour responses. Therefore, a dual-targeting approach is proposed to simultaneously disarm these two distinct but cooperative immune evasion mechanisms. Dual blockade of PD-1/PD-L1 and IL-33/ST2 signalling pathways represents a novel and promising strategy to enhance the efficacy of immunotherapy in breast cancer. This approach has the potential to revert the immunosuppressive TME, leading to more durable and robust anti-tumour responses. Further research is warranted to validate this hypothesis and translate it into effective clinical trials.

Background: The aim was examination of the intimamedia thickness of carotid arteries in COVID-19 infection. Methods: In 50 patients, the thickness of the intimomedial complex (IMT) in the common carotid arteries was measured. The values were compared with the control group in 2006-9. The condition of the lungs was assessed by ultrasound score (It score) (0-42) as mild (0-14) or mediumsevere (15-28) Covid. IMT thickening risk factors and the value of fibrinogen, IL-6 and CRP were recorded. Two IMT prediction models were formed. The socio-epidemiological model predicts the development of IMT based on epidemiological factors. Apart from these factors, the second model also includes the values of the mentioned biomarkers. Results: It score 20±6, IMT values right: median 0.99 mm, p25=0.89, p75=1.14; left: 1±0.22 mm. Control: IMTright: median 0.7 mm, p25=0.68 mm; p75=0-9 mm; left: median=0.75 mm, p25=0.6 mm, p75=1.0 mm. The group/control difference is highly significant. Epide mio - logical model: logit (IMT)= 4.463+(2.021+value for GEN)+(0.055x AGE value)+(-3.419x RF value)+(-4.447x SM value)+(5.115x HTA value)+(3.56x DM value)+ (22.389x LIP value)+(24.206x CVD value)+(1.449x other value)+(-0.138x It score value)+(0.19xBMI value). Epidemiological-inflammatory model: logit (IMT)=5.204+ (2.545x GEN value)+(0.076x AGE value)+(-6.132x RF value)+(-7.583x SM value)+(8.744x HTA value)+(6.838x DM value)+(25.446x LIP value)+(28.825x CVD value)+ (2.487x other value)+(-0.218xIt score value)+(0.649x BMI value) +(-0.194x fibrinogen value)+(0.894x IL-6 value)+(0.659x CRP value). Values for both models Exp(B)=4.882; P of sample=0.83; logit=-0.19; OR= 23.84; model accuracy for the first model 87% and for the second 88%; Omnibus test of the first model c2=34.324; p=0.000; reliability coefficient -2LogLH=56.854; Omnibus test of the second model c2=39.774; p=0.000; and -2LogLH=51.403. Conclusions: The ageing of blood vessels in COVID-19 can be predicted.

Charles Bingham Penrose (1862-1925) was a renowned American surgeon and physicist who secured his place in the history of surgery with the invention of a drain named after him. Penrose attended Harvard College, where he graduated at the age of 19 with highest honors in physics. At 22, he earned his Doctor of Medicine degree from the University of Pennsylvania. Following his graduation, he worked as an ambulatory surgeon, participated in various research projects, and ran a medical practice specializing in gynecology. In 1887, he founded the first hospital in Philadelphia dedicated exclusively to gynecological issues. For his contributions to this field, he was awarded the title of Professor of Gynecology at the University of Pennsylvania in 1893. In the late 19th century, Penrose focused primarily on surgical drainage and the education of surgeons in this field, encouraging them to use this procedure more frequently. He described a rubber drain used for abdominal cavity drainage, which remained in use until the mid-20th century. This drain came to be known as the Penrose drain. Penrose contracted tuberculosis at a young age, and due to the advanced form of the disease, he had to withdraw from medical practice at the age of 38. He was married and a father to three children. Charles Bingham Penrose passed away on February 28, 1925, at the age of 64, while on a train near Washington, D.C.

Introduction: Colorectal cancer (CRC) is one of the most common gastrointestinal malignancies, and patients' nutritional status plays a crucial role in postoperative recovery. Aim: This study aimed to assess the impact of nutritional status on postoperative outcomes in patients undergoing colorectal cancer surgery. Materials and Methods: This observational study included 50 patients who underwent colorectal cancer surgery. Data on anthropometric, laboratory, and clinical parameters were collected, including body weight, BMI, NRS-2002, SGA, and mGPS. Surgical variables such as type and duration of the procedure, as well as postoperative complications classified according to the Clavien-Dindo classification, were also evaluated. Statistical analysis was performed using t-test, χ² test, ANOVA, and logistic regression to assess the impact of nutritional status on postoperative outcomes. Results: Anthropometric, laboratory, and clinical parameters were analyzed using validated nutritional screening tools (NRS-2002, SGA). The results showed that patients with higher nutritional risk had prolonged hospital stays and an increased risk of postoperative complications. Inflammatory status, measured by the mGPS score, was significantly correlated with recovery time. Nutritional interventions, including preoperative supplementation, demonstrated potential in improving treatment outcomes. Conclusion: This study confirms the importance of early nutritional screening and individualized nutritional support in reducing postoperative complications and improving the quality of life of patients with colorectal cancer.

Objective. To evaluate the short-term outcomes of laparoscopic colorectal resections for colorectal cancer in a single Serbian tertiary centre. Methods. A retrospective cohort study included 97 patients who underwent elective laparoscopic colorectal resections between January 2013 and March 2018. Demographic, perioperative, and oncologic data were analysed. Primary outcomes were 30-day morbidity and mortality; secondary outcomes included operative time, conversion, re-intervention, length of stay, and lymph-node yield. Logistic regression identified independent predictors of complications. Results. The cohort comprised 59 men (60.8%) and 38 women (39.2%), with a median age of 71 years. Conversion to open surgery occurred in 6 patients (6.1%), while re-intervention was required in 3 (3.1%). The median operative time was 120 minutes for colonic and 175 minutes for rectal resections. Median lymph-node yield was 15, with all achieving R0 resection. The overall 30-day morbidity rate was 17.5%, with no perioperative deaths. General complications occurred in 12.4% and surgery-specific complications in 11.3%, with partial overlap. Median length of stay was 9 days, significantly longer in men and diabetic patients. Logistic regression confirmed cardiomyopathy as an independent predictor of postoperative complications (OR 7.5, p = 0.008). Conclusion. Laparoscopic colorectal resections in this series were associated with acceptable morbidity, no mortality, low conversion, and adequate oncologic quality. Cardiomyopathy was identified as a major perioperative risk factor, highlighting the need for tailored perioperative management.

Background and Objectives: A number of published studies comparing transanal haemorrhoidal dearterialization (THD) and conventional haemorrhoidectomy (CH) have primarily focused on short-term outcomes, while data on long-term results remains scarce. This study aimed to compare Doppler-guided THD and CH with emphasis on both early and long-term postoperative results. Methods: This retrospective study included 336 patients who underwent CH (Group 1, n = 189) or Doppler-guided THD (Group 2, n = 147). The groups were compared according to demographic data, HD stage, symptoms, complications, duration of hospital stay, postoperative pain, patient satisfaction, and recurrence rates after 18 months of surgery. Results: There was no difference between groups regarding gender, although there were statistically significant distinctions in terms of disease stage and age (p < 0.001), with the emphasis that in CH group patients had advanced stage of disease and were older. THD was associated with significantly lower postoperative pain, with median visual analogue scale (VAS) scores on postoperative days 1, 2, and 7 of 5, 3, and 1, compared with 7, 5, and 3 after CH (p < 0.001). There was no difference in VAS on POD 30 between groups. Median hospital stay was significantly shorter after THD (1 vs. 3 days; p < 0.001). Patients undergoing CH required more analgesics, laxatives, and follow-up visits within the first postoperative month (p ≤ 0.008). Postoperative complications occurred in nine patients, without significant differences between groups. During the 18-month follow-up period, HD recurrence occurred in seven patients and was more frequent after THD. Additionally, two THD patients developed anal fissures. Conclusions: Doppler-guided THD is a safe and effective treatment for HD, providing reduced postoperative pain, faster recovery, and shorter hospitalization. Long-term outcomes were favourable in both groups, with a trend of lower recurrence rate in the CH group.