BACKGROUND Sepsis is a life-threatening inflammatory condition in which the invading pathogen avoids the host's defense mechanisms and continuously stimulates and damages host cells. Consequently, many immune responses initially triggered for protection become harmful because of the failure to restore homeostasis, resulting in ongoing hyperinflammation and immunosuppression. METHODS: A literature review was conducted to address bacterial sepsis, describe advances in understanding complex immunological reactions, critically assess diagnostic approaches, and emphasize the importance of studying bacterial bottlenecks in the detection and treatment of sepsis. RESULTS: Diagnosing sepsis via a single laboratory test is not feasible; therefore, multiple key biomarkers are typically monitored, with a focus on trends rather than absolute values. The immediate interpretation of sepsis-associated clinical signs and symptoms, along with the use of specific and sensitive laboratory tests, is crucial for the survival of patients in the early stages. However, long-term mortality associated with sepsis is now recognized, and alongside the progression of this condition, there is an in vivo selection of adapted pathogens. CONCLUSION: Bacterial sepsis remains a significant cause of mortality across all ages and societies. While substantial progress has been made in understanding the immunological mechanisms underlying the inflammatory response, there is growing recognition that the ongoing host-pathogen interactions, including the emergence of adapted virulent strains, shape both the acute and long-term outcomes in sepsis. This underscores the urgent need for novel high-throughput diagnostic methods and a shift toward more pre-emptive, rather than reactive, treatment strategies in sepsis care.

The circle of Willis (COW) refers to the anastomotic arterial network found on the brain base, tasked with provision of collateral circulation aimed at prevention of ischemia. The COW is of immense clinical importance especially with regard to the assessment of neurovascular diseases. Individuals portray significant variations in the COW’s anatomical configuration. The present study seeks to evaluate the existing anatomical variations of the COW and within the anterior and posterior segments of the COW. Thus, the study seeks to evaluate the different anatomical variations of the COW and its segments and components within the study population. To attain the set objectives, the present study has utilized the angiographic images for studying the COW variants in patients who underwent cerebral angiography during assessment of different types of cerebral anomalies and conditions. Therefore, this study used conventional angiography as an important tool in the evaluation of the different variations in the COW, and is most appropriate for evaluation of smaller anatomical variations owing to its perfect spatial resolution and portrayal of COW anatomy. The study findings indicated the existence between age and sex, and anatomical variations of the COW, particularly with regard to diameters of COW components like basilar artery (BA), P1, and internal carotid arterys (ICAs). Males had bigger BA, P1 and ICA diameters than females, while individuals aged below 40 years had bigger BA, A1, posterior communicating artery, and ICA diameters than those aged above 40 years.

Background: Pediatric malignant bone tumors constitute an important subgroup of solid tumors and need comprehensive multidisciplinary care for optimal management. We aimed to review our local practice of managing malignant bone tumors and identify gaps to improve service. Methods: We retrospectively reviewed disease characteristics and management of twenty-five pediatric patients with malignant bone tumors from Jan 2000 to Dec 2020. Results: Median age at diagnosis was 8.75 years, male to female ratio of 0.8:1, and median follow-up was 3.6 years. Pain and swelling were the predominant symptoms at presentation, while lung was the most common metastatic site in Osteosarcoma (OS) and Ewing’s Sarcoma Family Tumors (ESFT). Metastatic disease was not associated with developing an event in OS (P=0.26) but was significantly associated with developing an event in the ESFT subgroup (P=0.002). There was no association of tumor necrosis of ＜90% or positive histological margins with developing an event in the entire cohort. The relapsed disease was associated with a mortality risk in the OS group (P=0.01). At the same time, it did not return significant results for this association in ESFT; however, a trend was noted for poor outcomes (P=0.09). Event-free survival and overall survival in OS were 54% and 69%, while in the ESFT group, they were 50% and 66%, respectively. Conclusion Metastatic disease was associated with developing relapsed disease in the ESFT cohort, while relapsed disease was associated with mortality in the OS cohort.Positive histological margins and ＜90% necrosis on resected tumor specimens did not result in poor survival. Multicenter collaboration at the national level is needed to improve the outcome of this disease group, which needs specialized multidisciplinary management.

Background: Pediatric malignant bone tumors constitute an important subgroup of solid tumors and need comprehensive multidisciplinary care for optimal management. We aimed to review our local practice of managing malignant bone tumors and identify gaps to improve service. Methods: We retrospectively reviewed disease characteristics and management of twenty-five pediatric patients with malignant bone tumors from Jan 2000 to Dec 2020. Results: Median age at diagnosis was 8.75 years, male to female ratio of 0.8:1, and median follow-up was 3.6 years. Pain and swelling were the predominant symptoms at presentation, while lung was the most common metastatic site in Osteosarcoma (OS) and Ewing’s Sarcoma Family Tumors (ESFT). Metastatic disease was not associated with developing an event in OS (P=0.26) but was significantly associated with developing an event in the ESFT subgroup (P=0.002). There was no association of tumor necrosis of ＜90% or positive histological margins with developing an event in the entire cohort. The relapsed disease was associated with a mortality risk in the OS group (P=0.01). At the same time, it did not return significant results for this association in ESFT; however, a trend was noted for poor outcomes (P=0.09). Event-free survival and overall survival in OS were 54% and 69%, while in the ESFT group, they were 50% and 66%, respectively. Conclusion Metastatic disease was associated with developing relapsed disease in the ESFT cohort, while relapsed disease was associated with mortality in the OS cohort.Positive histological margins and ＜90% necrosis on resected tumor specimens did not result in poor survival. Multicenter collaboration at the national level is needed to improve the outcome of this disease group, which needs specialized multidisciplinary management.

The circle of Willis (COW) refers to the anastomotic arterial network found on the brain base, tasked with provision of collateral circulation aimed at prevention of ischemia. The COW is of immense clinical importance especially with regard to the assessment of neurovascular diseases. Individuals portray significant variations in the COW’s anatomical configuration. The present study seeks to evaluate the existing anatomical variations of the COW and within the anterior and posterior segments of the COW. Thus, the study seeks to evaluate the different anatomical variations of the COW and its segments and components within the study population. To attain the set objectives, the present study has utilized the angiographic images for studying the COW variants in patients who underwent cerebral angiography during assessment of different types of cerebral anomalies and conditions. Therefore, this study used conventional angiography as an important tool in the evaluation of the different variations in the COW, and is most appropriate for evaluation of smaller anatomical variations owing to its perfect spatial resolution and portrayal of COW anatomy. The study findings indicated the existence between age and sex, and anatomical variations of the COW, particularly with regard to diameters of COW components like basilar artery (BA), P1, and internal carotid arterys (ICAs). Males had bigger BA, P1 and ICA diameters than females, while individuals aged below 40 years had bigger BA, A1, posterior communicating artery, and ICA diameters than those aged above 40 years.

The circle of Willis (COW) refers to the anastomotic arterial network found on the brain base, tasked with provision of collateral circulation aimed at prevention of ischemia. The COW is of immense clinical importance especially with regard to the assessment of neurovascular diseases. Individuals portray significant variations in the COW’s anatomical configuration. The present study seeks to evaluate the existing anatomical variations of the COW and within the anterior and posterior segments of the COW. Thus, the study seeks to evaluate the different anatomical variations of the COW and its segments and components within the study population. To attain the set objectives, the present study has utilized the angiographic images for studying the COW variants in patients who underwent cerebral angiography during assessment of different types of cerebral anomalies and conditions. Therefore, this study used conventional angiography as an important tool in the evaluation of the different variations in the COW, and is most appropriate for evaluation of smaller anatomical variations owing to its perfect spatial resolution and portrayal of COW anatomy. The study findings indicated the existence between age and sex, and anatomical variations of the COW, particularly with regard to diameters of COW components like basilar artery (BA), P1, and internal carotid arterys (ICAs). Males had bigger BA, P1 and ICA diameters than females, while individuals aged below 40 years had bigger BA, A1, posterior communicating artery, and ICA diameters than those aged above 40 years.

Background: Pediatric malignant bone tumors constitute an important subgroup of solid tumors and need comprehensive multidisciplinary care for optimal management. We aimed to review our local practice of managing malignant bone tumors and identify gaps to improve service. Methods: We retrospectively reviewed disease characteristics and management of twenty-five pediatric patients with malignant bone tumors from Jan 2000 to Dec 2020. Results: Median age at diagnosis was 8.75 years, male to female ratio of 0.8:1, and median follow-up was 3.6 years. Pain and swelling were the predominant symptoms at presentation, while lung was the most common metastatic site in Osteosarcoma (OS) and Ewing’s Sarcoma Family Tumors (ESFT). Metastatic disease was not associated with developing an event in OS (P=0.26) but was significantly associated with developing an event in the ESFT subgroup (P=0.002). There was no association of tumor necrosis of ＜90% or positive histological margins with developing an event in the entire cohort. The relapsed disease was associated with a mortality risk in the OS group (P=0.01). At the same time, it did not return significant results for this association in ESFT; however, a trend was noted for poor outcomes (P=0.09). Event-free survival and overall survival in OS were 54% and 69%, while in the ESFT group, they were 50% and 66%, respectively. Conclusion Metastatic disease was associated with developing relapsed disease in the ESFT cohort, while relapsed disease was associated with mortality in the OS cohort.Positive histological margins and ＜90% necrosis on resected tumor specimens did not result in poor survival. Multicenter collaboration at the national level is needed to improve the outcome of this disease group, which needs specialized multidisciplinary management.

The circle of Willis (COW) refers to the anastomotic arterial network found on the brain base, tasked with provision of collateral circulation aimed at prevention of ischemia. The COW is of immense clinical importance especially with regard to the assessment of neurovascular diseases. Individuals portray significant variations in the COW’s anatomical configuration. The present study seeks to evaluate the existing anatomical variations of the COW and within the anterior and posterior segments of the COW. Thus, the study seeks to evaluate the different anatomical variations of the COW and its segments and components within the study population. To attain the set objectives, the present study has utilized the angiographic images for studying the COW variants in patients who underwent cerebral angiography during assessment of different types of cerebral anomalies and conditions. Therefore, this study used conventional angiography as an important tool in the evaluation of the different variations in the COW, and is most appropriate for evaluation of smaller anatomical variations owing to its perfect spatial resolution and portrayal of COW anatomy. The study findings indicated the existence between age and sex, and anatomical variations of the COW, particularly with regard to diameters of COW components like basilar artery (BA), P1, and internal carotid arterys (ICAs). Males had bigger BA, P1 and ICA diameters than females, while individuals aged below 40 years had bigger BA, A1, posterior communicating artery, and ICA diameters than those aged above 40 years.

The circle of Willis (COW) refers to the anastomotic arterial network found on the brain base, tasked with provision of collateral circulation aimed at prevention of ischemia. The COW is of immense clinical importance especially with regard to the assessment of neurovascular diseases. Individuals portray significant variations in the COW’s anatomical configuration. The present study seeks to evaluate the existing anatomical variations of the COW and within the anterior and posterior segments of the COW. Thus, the study seeks to evaluate the different anatomical variations of the COW and its segments and components within the study population. To attain the set objectives, the present study has utilized the angiographic images for studying the COW variants in patients who underwent cerebral angiography during assessment of different types of cerebral anomalies and conditions. Therefore, this study used conventional angiography as an important tool in the evaluation of the different variations in the COW, and is most appropriate for evaluation of smaller anatomical variations owing to its perfect spatial resolution and portrayal of COW anatomy. The study findings indicated the existence between age and sex, and anatomical variations of the COW, particularly with regard to diameters of COW components like basilar artery (BA), P1, and internal carotid arterys (ICAs). Males had bigger BA, P1 and ICA diameters than females, while individuals aged below 40 years had bigger BA, A1, posterior communicating artery, and ICA diameters than those aged above 40 years.

Background: Pediatric malignant bone tumors constitute an important subgroup of solid tumors and need comprehensive multidisciplinary care for optimal management. We aimed to review our local practice of managing malignant bone tumors and identify gaps to improve service. Methods: We retrospectively reviewed disease characteristics and management of twenty-five pediatric patients with malignant bone tumors from Jan 2000 to Dec 2020. Results: Median age at diagnosis was 8.75 years, male to female ratio of 0.8:1, and median follow-up was 3.6 years. Pain and swelling were the predominant symptoms at presentation, while lung was the most common metastatic site in Osteosarcoma (OS) and Ewing’s Sarcoma Family Tumors (ESFT). Metastatic disease was not associated with developing an event in OS (P=0.26) but was significantly associated with developing an event in the ESFT subgroup (P=0.002). There was no association of tumor necrosis of ＜90% or positive histological margins with developing an event in the entire cohort. The relapsed disease was associated with a mortality risk in the OS group (P=0.01). At the same time, it did not return significant results for this association in ESFT; however, a trend was noted for poor outcomes (P=0.09). Event-free survival and overall survival in OS were 54% and 69%, while in the ESFT group, they were 50% and 66%, respectively. Conclusion Metastatic disease was associated with developing relapsed disease in the ESFT cohort, while relapsed disease was associated with mortality in the OS cohort.Positive histological margins and ＜90% necrosis on resected tumor specimens did not result in poor survival. Multicenter collaboration at the national level is needed to improve the outcome of this disease group, which needs specialized multidisciplinary management.