Histoplasmosis is an endemic mycosis in certain regions of Brazil and represents a rare opportunistic infection in solid organ transplant recipients. This report describes the case of a 68-year-old female liver transplant recipient (due to Caroli disease) who presented with abdominal pain, nausea, vomiting, and a distended, tender abdomen. Abdominal computed tomography revealed parietal thickening of the bowel wall, and colonoscopy identified polymorphic ulcers and ileocecal stenosis. Given the suspicion of tuberculosis, chest computed tomography was performed, which demonstrated pulmonary opacities. Although testing for acid-fast bacilli was negative, fungal staining was positive for Histoplasma capsulatum. Antifungal therapy with amphotericin B was initiated; however, due to clinical refractoriness, surgical intervention was required, including ileocecal resection with ileo-ascending anastomosis. A reoperation was performed due to postoperative complications, resulting in the creation of a terminal ileostomy. Following this intervention, the patient showed clinical improvement and tolerated an oral diet. This case highlights an atypical presentation of disseminated histoplasmosis with pulmonary and intestinal involvement, culminating in intestinal subocclusion in a late-stage liver transplant recipient. It underscores the importance of considering histoplasmosis in the differential diagnosis of immunosuppressed patients and the need for early investigation and treatment.

Patients undergoing transarterial chemoembolization or hepatic arterial infusion chemotherapy frequently experience nausea, vomiting, pain, fatigue, sleep disturbance, and appetite loss during hospitalization, yet standardized nonpharmacologic supportive care protocols remain limited. This study aimed to describe a standardized auricular acupressure protocol integrated into peri-interventional nursing care and to evaluate its feasibility, tolerability, and symptom-related outcomes. In this single-center, prospective, nonrandomized, quasi-experimental study, 102 consecutive eligible patients treated between January 2022 and December 2024 received either auricular acupressure plus routine nursing care (n = 52) or routine nursing care alone (n = 50). After receiving standardized information about both nursing care pathways, patients selected their preferred pathway. No random sequence or allocation concealment was used. Because the auricular patches were visible and the intervention required active nursing instruction, neither the participants nor the intervention nurses were blinded. The protocol included standardized acupoint selection, vaccaria seed application, nurse-guided self-acupressure training, fidelity monitoring, and symptom assessment before intervention, at 24 h and 48 h after treatment, and before discharge. Auricular acupressure was associated with lower nausea scores at 24 h (3.9 ± 1.2 vs. 4.8 ± 1.4, p = 0.002), 48 h (2.8 ± 1.1 vs. 4.1 ± 1.3, p < 0.001), and before discharge (1.9 ± 0.9 vs. 3.2 ± 1.2, p < 0.001). Vomiting occurrence at 48 h was also lower (26.9% vs. 52.0%, p = 0.009). Patients receiving auricular acupressure additionally showed lower pain and fatigue scores, earlier oral intake, less rescue antiemetic use, and higher satisfaction. No severe intervention-related adverse events occurred. These findings support the feasibility of this nursing protocol but should be interpreted as associations, given the nonrandomized allocation of treatment.

Chronic non-specific low back pain (CNLBP) is a common condition associated with persistent pain, functional limitation, reduced quality of life, and substantial healthcare and socioeconomic burden. Mindfulness-based cognitive therapy (MBCT) has been increasingly used in chronic pain management and may provide a promising therapeutic approach for CNLBP. The emergence of virtual reality (VR) further provides an immersive, standardized, and accessible platform for delivering MBCT. This study aims to evaluate the effects and safety of a CNLBP-specific VR-integrated MBCT intervention in patients with CNLBP.

Ventricular fibrillation (VF) is a life-threatening complication of acute coronary syndrome (ACS) and requires rapid identification and correction of reversible ischemic triggers. ST-segment elevation in aVR with diffuse ST depression reflects global subendocardial ischemia but is not specific for left main or proximal left anterior descending disease.

Chemotherapy-induced nausea and vomiting (CINV) are among the most distressing side effects of cancer therapy. Younger age is a risk factor for CINV, and cancer incidence is rising among young adults (YAs) ages 18-39. However, the comparative burden of CINV in YAs versus non-YAs remains insufficiently understood. This study compared acute and delayed CINV between YAs and non-YAs (i.e., ages ≥40) after the first infusion of moderately- or highly-emetogenic chemotherapy. Of 1,609 participants, 159 (10%) were YAs. Rates of guideline-consistent antiemetic prophylactic care were similar between groups (65% YAs, 71% non-YAs; p = 0.11). Despite this, acute nausea was more prevalent (69% vs. 40%, p < 0.001) and severe (M = 3.9, SD = 2.6 vs. M = 3.0, SD = 2.3 on 0-10 scale, p < 0.001) among YAs vs. non-YAs. Similarly, delayed nausea was more prevalent (85% vs. 69%, p < 0.001) and severe (M = 4.5, SD = 2.4 vs. M = 3.7, SD = 2.5, p < 0.001) among YAs. Findings may inform clinical approaches to managing CINV among YAs.

Isolated fallopian tube torsion (IFTT) is a rare form of adnexal torsion. A 2024 review described fewer than 150 cases over several decades. The clinical presentation of IFTT is highly variable and nonspecific, which may result in delayed diagnosis. Most patients present with acute unilateral abdominal pain with nausea and/or vomiting, while other patients may present with more gradual symptoms. Risk factors for IFTT include adnexal lesions, hydrosalpinx, previous pelvic surgery, and pelvic inflammatory disease. Ultrasound is particularly useful in identifying the imaging signs of IFTT, which include normal ovarian size and flow, a distended cylindrical structure that tapers to a "beak" adjacent to the ovary, thickened endosalpingeal folds resulting in a "cogwheel" appearance, and, lastly, a twisted vascular pedicle. We present an imaging-focused case in which the diagnosis of IFTT using ultrasound, following equivocal CT, resulted in prompt and confirmatory surgical management. Our goal is to raise awareness of IFTT as a possibility in females with abdominal pain and to discuss ultrasound characteristics that may increase clinical suspicion and diagnostic confidence. Prompt recognition and surgical management may prevent tubal necrosis and loss of fertility.