Tendon injuries constitute a significant challenge to musculoskeletal health, comprising approximately 50% of all related injuries in the United States and resulting in considerable treatment expenditures. Conventional conservative and surgical interventions frequently do not succeed in mitigating peritendinous adhesions, resulting in compromised functionality, pain, and an increased risk of re-rupture. This analysis investigates the underlying mechanisms of adhesion formation in the context of tendon healing, highlighting the disparity between intrinsic and extrinsic factors throughout the phases of inflammation, proliferation, and remodeling. The restoration of tendon gliding and mobility underscores the significance of adhesion prevention. This review concentrates on anti-adhesive compounds, encompassing physical barriers such as collagen and chitosan, as well as pharmacological agents including 5-fluorouracil and platelet-rich plasma. The analysis covers their mechanisms of action and preclinical efficacy demonstrated in vitro and in animal models, along with their diverse bioactivities, which include anti-inflammatory and antibacterial effects. The principal findings indicate significant reductions in adhesions; however, they also highlight challenges such as inconsistent degradation rates, potential toxicity, and a paucity of clinical evidence. Future directions encompass the implementation of randomized controlled trials, the establishment of standardized protocols, and the development of multifunctional biomaterials aimed at addressing research gaps and improving patient outcomes in the field of orthopedic surgery.

Introduction: Gallbladder fistulas primarily connect to the duodenum (up to 83.3 % of cases) or colon (up to 24.5 %), with rare connections to other gastrointestinal organs. This report documents the clinical, pathological, and laboratory features and the management of a unique case involving a combined cholecystoduodenocolic and gastrocolic fistula with a common orifice in the colon. Presentation of the case: A 46-year-old Iranian male with methadone addiction was hospitalized on December 12, 2024, due to abdominal pain, significant weight loss, and severe diarrhea with melena, who had delayed seeking medical attention because methadone alleviated his symptoms. Discussion: Biliary fistulae can involve multiple organs and often present with non-specific symptoms, complicating diagnosis. Imaging revealed severely hypoechoic tissue in the gallbladder, suggesting a fistula. Upper endoscopy showed only a duodenal ulcer fistulized to the transverse colon, allowing the endoscope probe to be easily inserted into the colon without pressure. The surgical approach included cholecystectomy, resection and anastomosis of the involved colon, antrectomy, and removal of a portion of the proximal duodenum (D1), followed by a Billroth II reconstruction. Conclusion: Simultaneous fistulization involving the gallbladder, stomach, duodenum, and colon is possible, though rare. This case underscores the importance of thorough individualized surgical approaches to optimize outcomes in similar cases. Highlights:

Ewing sarcoma (ES) is a malignant small round-cell tumor that typically arises in the bones or soft tissue of children and young adults. Although most case

Background: Examining the survival rate in breast cancer patients serves as a metric for assessing and advancing various treatment modalities. In light of the significant incidence of breast cancer in Iran, this study is aimed at examining and comparing the disease‐free survival (DFS) and overall survival (OS) rates among breast cancer patients who underwent axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB). Patients and Methods: This retrospective cohort research included 1071 patients at Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, from 1991 to 2021. The recurrence and survival rates of patients undergoing ALND and SLNB in both groups were examined and evaluated. The data were analyzed using SPSS statistical software using descriptive statistical techniques (percentage, frequency, mean, and standard deviation), Kaplan–Meier analysis, and Cox regression tests. A significance threshold of 0.05 is used. Results: The average OS among all patients was 18.08 ± 0.51. The average OS in the ALND group was 18.1 ± 0.53; in the SLNB group, it was 12.8 ± 0.39, which was insignificant ( p < 0.05). The average DFS among all patients was 17.13 ± 0.51. The average DFS in the ALND group was 16.95 ± 0.54; in the SLNB group, it was 11.96 ± 0.3; the difference was insignificant ( p = 0.11). Conclusion: OS and DFS in the ALND group were higher than in the SLNB group, but they were not statistically significant.

Background: Cell‐free fat extract (CEFFE), an adipose‐derived biologic, offers a potent alternative to cell‐based therapies by delivering a complex milieu of growth factors (e.g., VEGF, EGF, and BDNF) and regulatory proteins without the tumorigenic, immunogenic, or ethical challenges associated with stem cell applications. Objective: The objective of this study is to systematically evaluate CEFFE′s regenerative efficacy across diverse tissue systems—including musculoskeletal, neural, reproductive, dermal, ocular, and systemic applications—while synthesizing its underlying molecular mechanisms, clinical outcomes, and translational challenges. Methods: A comprehensive literature review was conducted utilizing databases such as PubMed, Scopus, and Web of Science, focusing on preclinical and clinical studies published from January 2018 to May 2026. Over 55 articles were analyzed to evaluate CEFFE′s efficacy, dosage–response patterns, and molecular pathways. Results: CEFFE accelerates tissue repair through three conserved mechanistic axes: antiapoptotic survival (e.g., PI3K–Akt/mTOR activation and NRF2‐mediated antiferroptosis), context‐specific immunomodulation (e.g., Annexin A5–mediated M2 macrophage polarization and NLRP3 inflammasome disruption), and extracellular matrix remodeling alongside angiogenesis (e.g., TGF‐ β /Smad signaling). Emerging evidence highlights CEFFE′s efficacy in novel domains such as intervertebral disc degeneration, corneal neurodegeneration, systemic sepsis, and as an IVF culture media supplement. Clinical trials confirm its safety and efficacy in dermatological applications (e.g., infraorbital aging and hyperpigmentation) and demonstrate superiority over standard treatments, such as hyaluronic acid, for early‐to‐mid‐stage osteoarthritis. Conclusions: CEFFE represents a highly versatile and precise cell‐free biologic capable of driving multitissue regeneration. To fully realize its clinical and commercial potential, future research must address donor variability by establishing standardized dosing protocols, implementing key‐molecule quantification for batch consistency, and conducting large‐scale, multicenter randomized controlled trials.

Prolidase deficiency (PD) is a rare autosomal recessive metabolic disorder caused by pathogenic variants in the PEPD gene, which is responsible for making prolidase and collagen resynthesize. It leads to a wide range of clinical symptoms, including skin ulcers, intellectual disability, and recurrent infections. Diagnostics are based on the presence of dipeptides in the urine and prolidase activity in various cells, as well as the detection of the pathogenic variant in the PEPD gene; however, no standard method is currently known for its diagnosis nor for its treatment. Case 1 presents a 17‐year‐old male with dyspnea, cyanosis, and pulmonary arteriovenous malformations (AVMs), an atypical presentation for PD. Case 2, a one‐year‐old female with fever, seizures, productive coughs, erythematous ulcers, and developmental delays, highlights the disease’s broad symptoms. This study widens our understanding of PD, especially for lesser‐known populations, such as the population in Iran. It indicates considering PD in the differential diagnosis of various diseases and also a global collaboration for managing PD. The study also recommends a standard approach to diagnosing PD and a personal management system due to its broad manifestations. In addition, it indicates the need to consider different ethnic and geographical groups in future PD studies to further enhance our understanding of this rare disease.