Acute kidney injury (AKI) is a common complication following liver transplantation (LT), with multifactorial etiology. It is believed that perioperative hemodynamic instability could lead to AKI. A temporary portocaval shunt (TPCS) could possibly prevent this, but its beneficial effect is still controversial, especially in caval-sparing LT. Therefore, the aim of this study was to evaluate whether the use of a TPCS during hepatectomy reduces the incidence and severity of post-LT AKI in caval-sparing LT, defined according to AKIN criteria. Between January 2005 and August 2023, all orthotopic LTs performed in a single center were retrospectively analyzed and were divided into a TPCS group (n = 134) and a no-TPCS group (n = 260). Serum creatinine was collected right before LT and daily during the first week post-LT. In multivariate analysis, TPCS was not related to AKI, while diabetes mellitus (p = 0.01) and LabMELD (p = 0.02) were. When comparing TPCS and no-TPCS groups, no differences were seen in median increase of serum creatinine post-LT (TPCS; 12 µmol/L (-4-52) versus no-TPCS; 14 µmol/L ± (-3-52) (p = 0.94)), number of post-LT AKI (TPCS; 31% versus no-TPCS; 33% (p = 0.57)), or severity of post-LT AKI (p = 0.90). In conclusion, the application of a TPCS during hepatectomy is not associated with less post-LT AKI or less severe post-LT AKI when using a caval-sparing LT technique.

All known inflammatory diseases of the pancreas, i.e., acute, chronic, hereditary, and autoimmune pancreatitis, carry a higher risk of developing pancreatic cancer. The risk is highest in hereditary and chronic pancreatitis and lowest in acute and autoimmune pancreatitis. Although established risk factors such as smoking have been known for decades, obesity, diabetes mellitus, and pancreatic exocrine insufficiency have emerged. In addition, the microbiome/use of antibiotics and microplastic are novel risk factors for the development of pancreatic cancer that have not been explored.

Malignant hypertension is defined as extremely elevated blood pressure (BP) with or without target organ damage. It can be either hypertensive urgency, characterized as malignant hypertension without any clear evidence of immediate organ damage, or hypertensive emergency with proof of new or worsening target-organ damage. The modern definition of hypertensive emergencies without retinopathy would be based on the presence of acutely raised BP with injury to at least three target organs. Pheochromocytoma is the rarest cause of malignant arterial hypertension, characterized by the classic triad of headache, sweating, and palpitations. It is rare in adolescents, and it often presents a unique surgical challenge due to catecholamine secretion. Laparoscopic adrenalectomy is the recommended surgical treatment of choice. Although it is a common procedure performed in adults, it has not yet been reported in adolescents in the Caribbean. This case report details the presentation of a 16-year-old boy from Trinidad and Tobago, who had a six-month history of episodic headaches, sweating, palpitations, blurry vision, and significantly elevated BP (up to 225/120 mmHg). His clinical picture was further complicated by new-onset diabetes mellitus and a family history of hypertension and diabetes on both maternal and paternal sides. Investigations revealed significantly elevated catecholamine levels, and imaging confirmed a right adrenal mass consistent with a pheochromocytoma. This case highlights both the clinical complexity and the feasibility of performing laparoscopic adrenalectomy in adolescent patients within a Caribbean healthcare setting.

Urinary tract infections (UTIs) are a common occurrence among patients with diabetes mellitus (DM); it also depends on the duration and associated comorbidities. Frequent urinary tract infections (UTIs) can lead to long-term complications such as glomerulonephritis and prostatitis, and in some cases, bacteria may spread through the bloodstream, leading to sepsis. The objective of the study is to assess the prevalence and predictors of UTI among patients with type 2 DM (T2DM).

A cross-sectional study was conducted among 400 primary health care centers (PHCCs) with attendees who had T2DM. A semi-structured, self-administered questionnaire was created on Google Forms (Google Inc., Mountain View, CA) to be shared with PHCC attendees by the principal investigator through WhatsApp (Meta Platforms, Inc., Menlo Park, CA). About 72.5% (n=290) responded in our study. A convenience sampling method was used to select participants based on criteria. Data were transferred, cleaned, and analyzed with IBM SPSS Statistics software, version 21.0 (IBM Corp., Armonk, NY). Logistic regression analysis was applied to identify the predictors of UTI among patients with T2DM and their associated risk factors.

This study found a significant prevalence of UTIs among patients with T2DM, with 67.9% (n=197) reporting at least one episode within 12 months. The mean age and standard deviation in the study population were 58.15 ± 12.71, with females being 54.5% (n=158). Frequent micturition (70%, n=203) and burning micturition (64.1%, n=186) were identified as major symptoms. Key risk factors included cervicitis and Foley catheter use, with notable odds ratios (OR): 3.55, CI: 1.266 to 9.959, P=0.016; OR: 2.29, CI: 0.858 to 6.160, P=0.098, respectively. Demographic factors such as age, education, and income showed no significant difference in UTI risk. The antibiotic adherence in the study group was 62.4% (n=181).

Nearly two-thirds (67.9%, n=197) had UTIs among patients with T2DM, with frequent and burning micturition as key symptoms. The predictors of UTI among patients with T2DM were major risk factors of cervicitis and Foley catheter use, while education and income showed no impact. The study highlights the need for early diagnosis of UTI, improved antibiotic adherence, and management strategies, including glycemic control, to reduce UTI risks.

Odontogenic infections are a leading cause of deep neck infections, with their incidence expected to rise due to the prevalence of contributing risk factors, such as uncontrolled diabetes mellitus and obesity. While the existing literature primarily focuses on the management of odontogenic infections in admitted patients, this study uniquely assesses clinical outcomes across all care settings and among a predominantly low socioeconomic status (SES) patient population. These data showed that definitive surgical source control (SC) was associated with an 88% reduction in the relative risk of 30-day all-cause readmission. The data further showed that, in patients admitted due to an odontogenic infection, 87% of those who had SC deferred until outpatient follow-up failed to return. Barriers such as lack of transportation, limited insurance coverage, and poor health literacy can contribute to this low follow-up rate. Therefore, in patient populations with predominantly low SES, clinicians must consider the benefit of immediate SC and the risk of the patient being lost to follow-up.

Introduction Metabolic syndrome (MS) is a disorder that groups conditions such as central obesity, hypertension, dyslipidemia, and hyperglycemia, and it is also associated with cardiovascular diseases and type 2 diabetes mellitus, in which an increase in biliary diseases such as choledocholithiasis, characterized by the presence of stones in the common bile duct, has been observed. This association may be explained by metabolic alterations that lead to increased cholesterol saturation in bile and impaired gallbladder motility due to insulin resistance, both of which contribute to the formation of stones. This study aims to investigate the relationship between MS and choledocholithiasis in patients treated at a second-level hospital in Ciudad Juárez between January 2024 and February 2025. Materials and methods Observational, analytical, retrospective, cross-sectional study with 59 patients over 17 years of age who were divided into two groups: with choledocholithiasis (29, 49%) and without choledocholithiasis (30, 51%). For each group, the ATP III diagnostic criteria for MS were evaluated. For statistical analysis, chi-square, Fisher's exact test, and odds ratio were used. Results The presence of MS was significantly associated with choledocholithiasis (p=0.002; OR=5.83, 95% CI: 1.93-19.33); BMI over 30 was the only MS component with a statistically significant association in both patients with and without choledocholithiasis (p=0.0016 and p=0.008, respectively). Conclusions The presence of MS is a risk factor for the development of choledocholithiasis in the studied population. A high BMI is confirmed as a relevant risk factor. These findings provide useful local evidence for the development of preventive strategies and clinical management.

Diabetic cardiomyopathy (DCM) is a specific type of cardiac dysfunction in diabetic patients, currently has no effective therapies. The TLR4 signaling pathway, activated through MyD88 and NF-κB, plays a critical role in DCM by triggering the release of pro-inflammatory cytokines and promoting pyroptosis through NLRP3 inflammasomes. Additionally, the TGF-β/Smad signaling pathway drives myocardial fibrosis, further compromising cardiac function. Recently, amniotic mesenchymal stem cells (AMSCs) have emerged as a promising therapeutic option due to their ease of access, low immunogenicity, and ability to differentiate into multiple cell types. In this study, a DCM mouse model was treated with AMSCs via tail vein injection every 2 weeks for four doses. Evaluations included glucose tolerance tests, echocardiography, serum analysis, and histopathological and molecular assessments. Results showed AMSCs improved pancreatic function, reduced blood glucose, and enhanced insulin secretion. Cardiac function and morphology improved, with reduced inflammation. Molecularly, AMSCs inhibited pyroptosis via TLR4/NF-κB/NLRP3 pathway suppression and reduced fibrosis through TGF-β/Smad modulation. These findings indicate AMSCs alleviate DCM cardiac dysfunction and pyroptosis, primarily by inhibiting the TLR4/NF-κB/NLRP3 pathway. The study underscores AMSCs as a promising therapeutic strategy for DCM, warranting further clinical exploration.

Research into diabetic foot complications is extensive; it remains challenging to identify critical literature. Evolving interprofessional boundaries, alongside advances in molecular medicine and pathophysiological understanding, necessitates mapping of the scientific literature (corpus). Impact of these advances on podiatric medicine remains unclear. This study explores topics, research performance, and evolution across the literature and disciplines to understand the corpus in its current state.

A retrospective-observational bibliometric analysis examined Web of Science publications using PRISMA search strategy (August 2023) to understand interconnectedness, direction, and intersectionality of subject disciplines, growth areas, and output. Curated phrases and disease focussed classification anchored investigation to diabetic peripheral neuropathy. Qualitative and quantitative approaches analysed publication meta-data (authors, citations, keywords) to map key concepts and scientific developments.

Analysis of 589 records (1991-2023) revealed observational studies as the dominant design. Prominent concepts included risk, polyneuropathy, and prevalence, with authors favouring accessible terms (peripheral neuropathy) across specialisms. Leading research hubs were in England, Demark, USA, Qatar, Germany, and Italy. Diabetic Medicine and Diabetes Care remained the highest-cited journals, whilst the International Journal of Molecular Science, Cell Stem Cell, and Nature Reviews Neurology provided contemporary insights. Post-2016, methodological rigour and objectivity increased.

Recurring topics included enhancing pre-clinical screening, addressing earlier diagnosis, pain management stratification with medicines optimisation, and reproducibility challenges. Case-controls increasingly replaced larger prospective, longitudinal study designs to improve diagnostic test accuracy and detection of diabetic neuropathy, particularly for neuropathic pain affecting small nerve fibres. Molecular approaches gained prominence signalling a shift from purely clinically derived approaches. The corpus responded to subjectivity and variable diagnostic criteria by prioritising objectivity. Emerging insights into channelopathies and mitochondrial dysfunction may augment current assessment/screening approaches to refine risk stratification and management strategies.

Eating disorders are a group of diseases with psychiatric background associated with physical manifestations related to weight and body image. We can classify patients with diabetes, into those who suffer from eating disorders or disordered eating behaviors, both being associated with the typical symptoms of eating behavior disorders. The objective was to analyze the frequency and factors associated with nutrition disorders in adolescents with type 1 diabetes.

Observational, cross-sectional, prospective and descriptive study of 100 adolescents with type 1 diabetes to whom the DEPS-R survey was applied to determine the frequency of nutrition disorders.

A positive DEPS-R survey score was presented for appearance of eating disorders in patients with type 1 diabetes in 33% of patients cases. There was a positive association using the χ² test between body mass index and a positive screening (p = 0.006) and with uncontrolled glycated hemoglobin (p < 0.05), without being related to the patients sex (p = 0.20).

The DEPS-R survey is applicable to the Mexican population to screen for risk of altered eating behaviors at pediatric age. Patients with poor glycemic control, overweight and obesity have higher prevalence of eating disorders.

The prevalence of type 2 diabetes mellitus (T2DM) is steadily increasing and has exceeded 20% in some rural Kentucky counties. In Kentucky, chronic diet-sensitive conditions and unhealthy behaviors are among the highest in the nation, with approximately 36.5% of adults with obesity and 13.3% diagnosed with T2DM, while only 15.3% meet physical activity recommendations, and 4.7% meet fruit and vegetable consumption recommendations. Family-based interventions can be used to promote health in rural communities that often comprise intergenerational households.

The purpose of the study is to determine whether leveraging family units as sources of social support promotes nutritional and physical activity changes among those who are overweight or have obesity and are diagnosed with T2DM.

This study consists of 3 phases (baseline, intervention, and postintervention). An overview of the study will be provided to interested participants, after which their consent will be sought. At baseline, demographic data, social support, physical activity, diabetes knowledge, diabetes self-management, dietary recall, obstructive sleep apnea, and sleep health, as well as social network data, will be collected using validated questionnaires. Anthropometric (weight, height, lean mass, and body fat) and T2DM-related (blood pressure, glycated hemoglobin A_1c [HbA_1c], total cholesterol, low-density lipoproteins, high-density lipoproteins, and triglycerides) clinical measures will also be obtained. During the intervention phase, participants will complete 6 months of medical nutrition therapy (MNT) alongside 1 member of their social network (eg, household member). In addition, participants will have the option to attend Dining with Diabetes program sessions that are offered at the county level through Cooperative Extension Service (Extension) agents. Follow-up data collection will include clinical measures, a dietary recall, and the assessment of participants' stage of behavior change at 3, 6, 9, and 12 months postintervention.

This study was funded in November 2022 by the American Diabetes Association (ADA). Data collection started on September 1, 2023, and is projected to end in November 2025. We have enrolled a total of 48 participants in the study.

T2DM is a growing problem, particularly among vulnerable populations in rural Kentucky. This study plans to leverage family units as sources of social support with MNT and nutrition education through the Dining with Diabetes program. If effective, this approach will inform future family-based interventions in rural communities.

ClinicalTrials.gov NCT06080425; https://clinicaltrials.gov/study/NCT06080425.

DERR1-10.2196/69301.