Recent evidence revealed that an adequate preoperative physiological reserve is crucial to overcome surgical stress response. Consequently, a new concept, called prehabilitation, emerged, aiming to improve the preoperative functional reserve of patients who will undergo major abdominal surgery. During the interval between diagnosis and surgery, a multimodal approach consisting of physical exercise and nutritional and psychological support could be employed to enhance physiologic reserve. Physical activity interventions aim to improve aerobic capacity, muscle strength and endurance. Nutritional support addressing malnutrition and sarcopenia also contributes to the achievement of the above-mentioned goals, particularly in patients undergoing cancer-related procedures. Psychological interventions targeting anxiety, depression and self-efficacy, as well as risk behavior modification (e.g., smoking cessation) seem to enhance recovery. However, there is a lack of standardization regarding these interventions, and the evidence about the impact of this multidisciplinary approach on the postoperative outcomes is still contradictory. This narrative review focuses on the physiological basis of surgical stress response and on the efficacy of prehabilitation, reflected mainly in the length of hospitalization and rates of postoperative complications. Multidisciplinary collaboration between surgeons, nutritionists, psychologists and physiotherapists was identified as the key to the success of prehabilitation programs. Synergizing prehabilitation and ERAS protocols significantly improves short-term surgical outcomes. Recent well-designed, randomized clinical trials revealed that this approach not only enhanced functional reserve, but also decreased the rates of postoperative complications and enhanced patient’s overall quality of life, emphasizing the importance of its implementation in routine, elective, surgical care.

Background: In recent years, the integration of large language models (LLMs) into healthcare has emerged as a revolutionary approach to enhancing doctor–patient communication, particularly in the management of diseases such as prostate cancer. Methods: Our paper evaluated the effectiveness of three prominent LLMs—ChatGPT (3.5), Gemini (Pro), and Co-Pilot (the free version)—against the official Romanian Patient’s Guide on prostate cancer. Employing a randomized and blinded method, our study engaged eight medical professionals to assess the responses of these models based on accuracy, timeliness, comprehensiveness, and user-friendliness. Results: The primary objective was to explore whether LLMs, when operating in Romanian, offer comparable or superior performance to the Patient’s Guide, considering their potential to personalize communication and enhance the informational accessibility for patients. Results indicated that LLMs, particularly ChatGPT, generally provided more accurate and user-friendly information compared to the Guide. Conclusions: The findings suggest a significant potential for LLMs to enhance healthcare communication by providing accurate and accessible information. However, variability in performance across different models underscores the need for tailored implementation strategies. We highlight the importance of integrating LLMs with a nuanced understanding of their capabilities and limitations to optimize their use in clinical settings.

Special areas of involvement in psoriasis include the scalp region, the palms and soles, genital areas, as well as intertriginous sites. The involvement of these topographical regions is associated with important physical and emotional implications, resulting in reduced quality of life, social isolation, and work disability. Palms and soles can be affected as part of the generalized form of psoriasis or can be exclusively affected as palmo-plantar psoriasis. Nail involvement may be encountered in 10–55% of patients with psoriasis, while scalp involvement occurs in 45–56% of individuals with psoriasis. Genital involvement may be the only manifestation of cutaneous psoriasis in 2–5% of patients. Inverse or intertriginous psoriasis represents a special variant of psoriasis as it may mimic and be difficult to differentiate from other dermatological entities that involve the intertriginous skin, such as bacterial or fungal infections, eczema, or lichen planus. Treatment of psoriasis in special areas is challenging due to the facts that special areas are more resistant to standard therapies and are more sensitive to potent local treatments. Biological therapies, proven to be more efficient than standard therapies, are not widely available in the absence of extensive skin involvement. This manuscript aims to provide an up-to-date literature review on psoriasis in special areas, benefiting the everyday clinical practice of physicians in optimizing the evaluation and treatment of their patients.

Background: As technology continues to shape society, younger generations are increasingly accustomed to its integration into daily life, making it mandatory for medical educators to adopt innovative tools like virtual reality (VR). This systematic review examines the efficacy of VR in obstetric training and patient care, focusing on its impact on educational engagement, procedural skill acquisition, and pain management in obstetric patients. Methods: A systematic review of the current literature was conducted using databases: PubMed, Web of Science, Science Direct, Scopus, Embase, The Cochrane Library, and Clinicaltrials.gov analyzing randomized controlled studies on VR’s use in obstetric training and patient care. Inclusion criteria focused on studies evaluating VR’s role in enhancing clinical skills, and pain and anxiety management during labor and procedures. Only randomized controlled trials published in English were considered. The risk of bias was assessed using RoB 2 for RCTs. Data extraction and quality appraisal were performed independently by two reviewers. Results: A total of 18 studies met the inclusion criteria. Among them, 13 studies focused on VR for pain relief and anxiety reduction, and 5 studies on medical training and skill acquisition. Most studies used immersive VR headsets, while some utilized interactive VR or serious gaming platforms. Adverse effects such as motion sickness and visual discomfort were reported in a few cases but did not significantly impact participant engagement. Conclusions: VR holds the potential to improve obstetric training and patient care by aligning with the learning preferences of younger generations and enhancing both educational and patient care experiences. However, heterogeneity in sample sizes, participants, and intervention types limits generalizability. Further large-scale, high-quality RCTs are needed to validate findings and standardize VR applications in obstetrics. This review was registered in PROSPERO (Registration ID: CRD42024619197).

This study assesses the effectiveness of chatbots powered by Large Language Models (LLMs)—ChatGPT 3.5, CoPilot, and Gemini—in delivering prostate cancer information, compared to the official Patient’s Guide. Using 25 expert-validated questions, we conducted a comparative analysis to evaluate accuracy, timeliness, completeness, and understandability through a Likert scale. Statistical analyses were used to quantify the performance of each model. Results indicate that ChatGPT 3.5 consistently outperformed the other models, establishing itself as a robust and reliable source of information. CoPilot also performed effectively, albeit slightly less so than ChatGPT 3.5. Despite the strengths of the Patient’s Guide, the advanced capabilities of LLMs like ChatGPT significantly enhance educational tools in healthcare. The findings underscore the need for ongoing innovation and improvement in AI applications within health sectors, especially considering the ethical implications underscored by the forthcoming EU AI Act. Future research should focus on investigating potential biases in AI-generated responses and their impact on patient outcomes.

Ustekinumab (UST), a biologic agent targeting interleukin-12 and interleukin-23, is widely used in the management of psoriasis and Crohn’s disease. Despite its efficacy, there have been instances of paradoxical psoriasis induction or exacerbation in some patients during UST therapy. This paper offers a comprehensive review of reported cases of UST-induced paradoxical psoriasis, including a case from our clinic. We focus on a 39-year-old female patient with a history of long-standing Crohn’s disease who developed a psoriasiform rash, as confirmed by biopsy, while undergoing UST treatment. The patient’s clinical journey, from initial diagnosis through the complexities of treatment adjustments due to various complications including drug-induced lupus and the subsequent onset of psoriatic manifestations, provides insight into the challenges encountered in the clinical management of such cases. This review emphasizes the necessity for clinicians to recognize the possibility of paradoxical psoriasis in patients receiving UST treatment and calls for further research to better understand this phenomenon and devise effective management strategies.