Breast cancer progression and therapeutic response are profoundly influenced by tumor immune interactions, yet the molecular regulators linking cell death pathways with immune modulation remain incompletely understood. Pyroptosis, a gasdermin-mediated inflammatory form of programmed cell death, has emerged as a key determinant of tumor immunity, while long non-coding RNAs are increasingly recognized as critical upstream regulators of cancer signaling. Recent transcriptomic analyses have identified numerous pyroptosis-associated lncRNAs and generated prognostic signatures that stratify patients into distinct risk groups with significantly different survival outcomes. These signatures are closely associated with the tumor immune microenvironment: low-risk tumors exhibit increased infiltration of CD8[+] T cells, NK cells, and B cells, together with elevated immune checkpoint expression, whereas high-risk tumors display immunosuppressive features, including M2 macrophage enrichment and higher tumor mutation burden. Mechanistic studies demonstrate that lncRNAs regulate pyroptosis through inflammasome activation, gasdermin-mediated signaling, and epigenetic modulation, thereby influencing tumor growth, metastasis, and therapeutic resistance. Despite these advances, clinical translation remains limited by dependence on retrospective transcriptomic datasets, insufficient mechanistic validation, lack of standardized assays, and scarce prospective clinical evidence. pyroptosis-associated lncRNAs represent a promising link between tumor progression and immune regulation, with considerable potential as prognostic biomarkers and therapeutic targets in breast cancer.

The administration of parenteral nutrition (PN) to neonates presents challenges related to the stability and incompatibility of both 2-in-1 and 3-in-1 admixtures when co-administered with drugs. Incompatibility data derived from adult patients cannot be applied to neonates because of distinct clinical conditions and differences in components of the admixture (e.g., neonatal amino acid formulation). This review presents an overview of the stability and influencing factors, along with the incompatibility of drug-PN mixtures in neonates within the neonatal intensive care unit setting. Various nutritional components and non-nutritional factors such as oxygen, light, pH, temperature, containers, and drugs affect the stability of PN. Patient conditions and the dosage of PN and drugs influence the stability and incompatibility of drug-PN admixtures, whether 2-in-1 or 3-in-1. Furthermore, assessing identification methods is crucial to ensure precise data regarding the stability and incompatibility of drug-PN. The standardization of PN formulas is essential for the safe administration of PN in neonates; however, individualized PN formulas offer more advantages in addressing specific nutritional requirements. Collaboration among healthcare professionals, including inter-institutional efforts, is essential to establish a consensus on the safe administration of PN to neonates.

Background. The spread of home hemodialysis is increasing in Italy and across Europe, as noted in the document ("La diffusione dell'emodialisi domiciliare sta aumentando in Italia ed in Europa"). Its main feature enabling hospital use is its portability and independence from centralized water treatment systems, thanks to the use of sterile pre-mixed dialysate bags. This allows treatments to be delivered in environments not traditionally equipped for dialysis, such as isolation rooms on inpatient wards, emergency departments, or temporary units prior to definitive intrahospital transfer. Materials and Methods. Dialysis therapy used: The NxStage VersiHD system was employed to perform hemodialysis in three clinical scenarios: 1. Non-transportable patient with anasarca and acute kidney injury. The patient, hospitalized in the pulmonology ward and receiving oxygen therapy via tracheostomy, developed acute kidney injury with anuria requiring renal replacement therapy. The NxStage VersiHD device, already available in the dialysis unit, was transported to the patient's room. Two treatments were performed using 25 L of dialysate: the first lasting 3 hours and the second 4 hours. The system was used emergently for ultrafiltration and solute clearance until spontaneous diuresis resumed, despite a logistically challenging setting. 2. Chronic hemodialysis patient presenting to the emergency department with severe dyspnea due to fluid overload and SARS-CoV-2 infection. Because timely isolation in the dialysis unit was not feasible, urgent hemodialysis was performed using the NxStage VersiHD in a day-hospital room of our department, achieving reduction of pulmonary edema. 3. A 61-year-old woman with cirrhosis presented with splenic hemorrhage and acute renal failure. Admitted to intensive care, she underwent CVVHDF for 72 hours. She was transferred to the nephrology ward, which was not transportable due to the risk of hemorrhage. The NxStage VersiHD and the necessary equipment for dialysis scheduled for the following day were transported to the ward. Conclusions. The report aims to highlight the feasibility of using a home-designed dialysis technology safely within specific intrahospital contexts, offering an alternative strategy for dialysis support when infrastructural limitations or patient immobility prevent standard approaches. Staff training on NxStage operation, emergency procedures, and complication management is essential to minimize human error. The main challenges in training hospital nursing teams for occasional NxStage use include limited operational familiarity, management of device-specific complications, and integration of safety protocols. Operational unfamiliarity arises because, although NxStage is designed to simplify setup through preassembled cartridges and sterile dialysate bags, it differs technically from conventional dialysis systems. Lack of routine use is the primary reason for failure of NxStage implementation projects in hospital settings. To address this issue, our center adopted continuous use of NxStage in the dialysis unit for selected patients, ensuring regular machine operation. To avoid inadequate clearance with a thrice weekly schedule, 4 hour sessions were performed in patients with a distribution volume compatible with achieving a weekly Kt/V of 2.2, in accordance with international guidelines.

Renal rehabilitation is increasingly recognized as a complementary strategy to address the clinical and functional complications of maintenance hemodialysis. This review evaluated the effects of renal rehabilitation, including structured exercise, nutritional support, and multidisciplinary interventions, on anemia, nutritional status, and activities of daily living in adults undergoing maintenance hemodialysis. Studies published between 2015 and 2025 were reviewed according to PRISMA criteria, and 42 studies were included in the qualitative synthesis. Overall, renal rehabilitation was associated with modest improvements in hemoglobin levels and erythropoiesis-stimulating agent responsiveness, as well as favorable changes in nutritional and muscle-related parameters. The most consistent benefits were observed in functional outcomes, including exercise capacity, muscle strength, frailty, and activities of daily living. These findings support renal rehabilitation as a promising multidimensional approach in maintenance hemodialysis, although heterogeneity among interventions and study designs highlights the need for standardized, adequately powered long-term trials.

Ultrasound is nowadays widely used in nephrological practice as a first-line clinical tool. Despite this widespread adoption of the technique, the medico-legal aspects of ultrasound reporting have so far received limited attention, even though the report represents the formal completion of the medical act and the only document endowed with probative value. In the legal context, in fact, the ultrasound examination can be assessed exclusively through what is documented in the report, regardless of the technical quality of the examination itself. The present paper analyzes the main medico-legal aspects of ultrasound reporting, with particular reference to the activity of the nephrologist, focusing on the essential requirements of the report, the most common critical issues with medico-legal relevance, and the implications in terms of professional liability. The role of declaring the limitations of the examination and of structured reporting as possible tools for clinical risk management and professional protection will also be examined.

Background Scaling and root planing (SRP) is the standard nonsurgical treatment for chronic periodontitis; however, complete mechanical debridement may be limited in deep periodontal pockets, prompting interest in adjunctive laser therapy to enhance clinical outcomes. Objective To compare the clinical effectiveness and safety of adjunctive 940-nm diode laser therapy combined with SRP versus SRP alone in patients with chronic periodontitis. Methods This prospective nonrandomized comparative clinical study included 60 patients with Stage II-III, Grade B periodontitis who were allocated to receive either SRP alone (n = 30) or SRP with adjunctive 940-nm diode laser therapy (n = 30) based on participant preference following an informed discussion at a single tertiary care center. Clinical attachment level (CAL) was the primary outcome. Secondary outcomes included probing pocket depth (PPD), plaque index (PI), gingival index (GI), bleeding on probing (BOP), and treatment-related safety. Clinical assessments were performed at baseline and at 4, 12, and 24 weeks by a blinded, calibrated examiner who was not involved in treatment delivery. Within-group comparisons were analyzed using paired t-tests, between-group comparisons using independent t-tests, and longitudinal changes using repeated-measures ANOVA. Multivariable linear regression was used to identify independent predictors of CAL gain. Results Both treatment groups demonstrated significant improvements in all clinical parameters over 24 weeks (p < 0.001). Compared with SRP alone, adjunctive diode laser therapy produced significantly greater PPD reduction (3.58 ± 0.64 vs. 3.22 ± 0.58 mm; p = 0.026) and CAL gain (3.42 ± 0.78 vs. 3.01 ± 0.69 mm; p = 0.034) at 24 weeks. Significant time × treatment interactions were observed for PPD and CAL (p < 0.05). Multivariable regression confirmed adjunctive laser therapy as an independent predictor of CAL gain. No significant between-group differences were observed in PI, GI, BOP, or adverse events. Conclusions Adjunctive 940-nm diode laser therapy was associated with additional clinical benefits over conventional SRP, including enhanced periodontal pocket reduction and attachment gain, without compromising safety. These findings support its use as a complementary nonsurgical treatment modality for appropriately selected patients with chronic periodontitis and provide prospective clinical evidence to guide periodontal practice.