Irritant contact dermatitis (ICD) is the most common form of contact dermatitis and a leading cause of occupational skin disease, but remains underrecognized relative to allergic contact dermatitis (ACD). Direct chemical or physical injury to the epidermal barrier causes ICD, which can develop in anyone when exposure intensity or duration exceeds the skin’s repair capacity. ICD is increasingly understood to involve more than barrier disruption: it is an innate immune-mediated inflammatory disorder involving keratinocyte-derived cytokines, neutrophil recruitment, C-C motif chemokine ligand 2–C-C motif chemokine receptor 2–interleukin-1β signaling, Toll-like receptor 3, and inflammasome activation. Host factors, particularly atopic dermatitis and filaggrin loss-of-function variants, further influence susceptibility. Clinical phenotypes range from acute irritant reactions to chronic cumulative dermatitis, and occupational wet work is a major preventable exposure. Distinguishing ICD from ACD is difficult because their clinical and histopathological features overlap, they may coexist, and ICD-related barrier damage may facilitate subsequent allergic sensitization. Diagnosis therefore requires assessment of exposure history, lesion distribution, symptom quality, and temporal course, with patch testing when ACD is suspected. Molecular biomarker panels and noninvasive imaging or barrier-assessment techniques may improve diagnostic precision, but remain investigational. Management should prioritize identifying and removing irritants, reducing exposure, implementing appropriate protective measures, and restoring the epidermal barrier. Recognizing ICD as a distinct clinical entity, rather than simply a diagnosis of exclusion, is essential for accurate diagnosis and effective management of contact dermatitis in clinical practice.

Purpose
Neck pain is a leading musculoskeletal cause of disability in the United States. This study aimed to assess temporal, geographic, and demographic disparities in its burden across US states from 1990 to 2021.
Methods
Global Burden of Disease 2021 data for all 50 US states and the District of Columbia were analyzed for 1990–2021. Counts and age-standardized rates per 100,000 population for prevalence, incidence, and years lived with disability (YLD) were compared by region, state, sex, age group, and sociodemographic index (SDI) level.
Results
In 2021, neck pain accounted for 9,430,000 (95% uncertainty interval [UI], 7,400,000–11,590,000) prevalent cases, 1,900,000 (95% UI, 1,490,000–2,320,000) incident cases, and 920,000 (95% UI, 620,000–1,300,000) YLD, increases of 41.17%, 37.44%, and 38.72%, respectively, from 1990. Although age-standardized incidence increased globally by 1.18% (0.07%–2.39%) over 1990–2021, the United States had small declines in age-standardized incidence (−0.11%; 95% UI, −0.18% to −0.06%), prevalence (−0.20%; 95% UI, −0.32% to −0.10%), and YLD (−1.12%; 95% UI, −2.02% to −0.22%). Neck pain rates were highest in the District of Columbia, Georgia, and Delaware and lowest in North Carolina, Alaska, and Wyoming. The burden peaked at ages 40–49 years and was higher in females. Age-standardized YLD rates for neck pain were significantly positively correlated with the SDI (Spearman’s ρ=0.601, P<0.001).
Conclusion
The geographic and demographic disparities in neck pain burden across US states indicate a need for targeted interventions.

Purpose
This study aimed to address gaps in Korean Standard Series (KSS) information, highlight allergens with increasing patch test positivity, describe potential sources encountered in daily life, and provide guidance on selecting allergen-free alternatives.
Methods
Relevant information was identified from KSS patient instruction sheets (Chemotechnique, Sweden), T.R.U.E. TEST patient instruction sheets (SmartPractice, United States), the Contact Dermatitis Institute allergen database, the American Contact Dermatitis Society allergen information sheets, and searches of the PubMed database. English-language review articles, case series, and case reports identified using keywords related to the 25 KSS allergens were selected.
Results
Information was updated for the following allergens: nickel, cobalt, potassium dichromate, balsam of Peru, paraben mix, N-isopropyl-N'-phenyl-p-phenylenediamine, formaldehyde, p-tert-butylphenol formaldehyde resin, methylchloroisothiazolinone/methylisothiazolinone, colophonium, imidazolidinyl urea, and 2-mercaptobenzothiazole. Emerging sources included electronic devices, personal protective equipment, including masks whose use increased during the COVID-19 (coronavirus disease 2019) pandemic, nail products, and children’s toy slime. In addition, occupational allergen information sheets were developed for hairdressers, healthcare workers, dentists, dental hygienists, and cooks. The Korean-language allergen sheets are provided in the Supplementary Materials.
Conclusion
Because the KSS has not been revised for more than 2 decades, emerging allergen sources may be inadequately represented in the existing patient information. Accordingly, updated patient instruction sheets were developed to improve patient understanding and facilitate the practical application of patch test results.

An 83-year-old woman presented with a 10-day history of sudden-onset diplopia in the left eye, with no preceding trauma or anticoagulant use. Initial orbital magnetic resonance imaging (MRI) on day 10 revealed a well-circumscribed retrobulbar lesion along the left inferior rectus muscle. The lesion showed heterogeneous T1 hyperintensity, low-to-intermediate T2 signal, and no definite solid enhancement, raising concern for a hemorrhagic orbital mass or neoplasm. Serial noncontrast computed tomography (CT) on days 20 and 49 showed progressive decreases in lesion size and attenuation. Follow-up MRI on day 180 confirmed complete spontaneous resolution, with no residual abnormality or underlying neoplasm. This case demonstrates that serial CT and MRI can guide safe conservative management of spontaneous retrobulbar hematoma and help avoid unnecessary surgery in clinically stable patients.

Purpose
Clinical fieldwork in genetic counseling education is constrained by limited training sites, shortages of clinical supervisors, and administrative burdens. Simulation-based learning, including role-play, has therefore been used to support development of counseling competencies. This study described the development, implementation, operational structure, and feasibility of a role-play-based practicum in a graduate genetic counseling program.
Methods
This retrospective descriptive report was based on Genetic Counseling Practicum, a spring 2024 course for 11 third-semester students in a graduate genetic counseling program in South Korea. Twenty-two role-play scenarios were developed, including 11 hereditary cancer cases and 11 pediatric or adult genetic disorder cases. The scenarios simulated pretest and posttest encounters during a 6-week, 2-block practicum. Students alternated between counselor and counselee roles, recorded sessions outside class time, and received domain-guided peer and faculty feedback.
Results
The scenarios covered patient ages from infancy to late adulthood and included somatic and germline pathogenic variants, a negative multigene panel result, and chromosomal or epigenetic abnormalities. All 22 planned sessions were completed and recorded as scheduled, and all 11 students completed their assigned sessions. The planned assignment, recording, review, and feedback procedures were completed without documented omissions. Approximately 11 scheduled class hours were devoted to feedback, and no external clinical sites or supervisors were required.
Conclusion
This study presents an operationally feasible model for a role-play-based practicum with diverse scenarios in a graduate genetic counseling curriculum. It may serve as a practical reference for programs considering similar simulation-based training.

Pneumocephalus is a rare complication of neuraxial procedures and is usually associated with inadvertent dural puncture or the use of air during epidural space identification. Epiduroscopic epidural neuroplasty (EEN) is performed without air injection and permits direct visualization of the epidural space; therefore, pneumocephalus after this procedure is extremely uncommon. A 71-year-old woman with a history of lumbar spine surgery underwent EEN via a caudal approach without sedation. No dural puncture was identified during the procedure. Approximately 12 hours later, she developed a non-orthostatic headache. Brain computed tomography revealed pneumocephalus in the basal cistern and left lateral ventricle. Her symptoms improved with oxygen therapy but worsened 5 days later despite radiologic resolution of the pneumocephalus. Suspected cerebrospinal fluid (CSF) leakage was treated with an epidural blood patch, which resolved her symptoms. Pneumocephalus may occur after EEN without clinically or endoscopically recognized dural injury and may coexist with CSF leakage; an occult microdural defect cannot be excluded as the underlying mechanism. Prompt imaging should be considered in patients who develop early or atypical postprocedural headache.

Purpose
Rectus sheath block (RSB) is a simple abdominal wall block that can be readily applied. This study evaluated the postoperative analgesic efficacy of ultrasound-guided bilateral RSB in robotic single-site gynecologic surgery.
Methods
Sixty patients were randomly assigned to the RSB group (n=30) or the control group (n=30). After induction of general anesthesia, patients in the RSB group received ultrasound-guided bilateral RSB with 30 mL of 0.25% ropivacaine. Pain intensity was assessed using a verbal numerical rating scale (VNRS) at 0, 1, 6, 12, 24, and 48 hours postoperatively. Intravenous patient-controlled analgesia was provided to all patients, and fentanyl was administered as rescue analgesia on request.
Results
VNRS scores at 0, 1, and 6 hours were significantly lower in the RSB group than in the control group (all P<0.05). Rescue fentanyl use in the post-anesthesia care unit was also significantly lower in the RSB group than in the control group (19.8±21.0 μg vs. 46.3±27.6 μg, P<0.001). Subgroup analysis showed that RSB was associated with lower VNRS scores in patients undergoing ovarian surgery or myomectomy, whereas no significant difference was observed in patients undergoing hysterectomy.
Conclusion
Ultrasound-guided bilateral RSB reduced early postoperative pain and rescue analgesic requirements after robotic single-site gynecologic surgery.

Appendiceal mucinous adenocarcinoma is a rare gastrointestinal malignancy that may metastasize to the ovaries and closely mimic advanced primary ovarian cancer, creating diagnostic and therapeutic challenges. A 61-year-old postmenopausal woman presented with postmenopausal bleeding, abdominal distension, abdominal pain, and weight loss. Imaging demonstrated bilateral adnexal masses with omental caking and ascites, suggestive of advanced ovarian malignancy. Cancer antigen 125 was elevated, and carcinoembryonic antigen (CEA) levels were markedly increased. She had a history of acute appendicitis 1 year earlier. Biopsy revealed mucinous adenocarcinoma with signet-ring cells. Endoscopic evaluation was unremarkable. Despite neoadjuvant chemotherapy for presumed ovarian cancer, the disease progressed, necessitating cytoreductive surgery. Histopathological examination demonstrated bilateral mucinous adenocarcinoma with peritoneal spread. Immunohistochemistry showed positivity for cytokeratin 20, caudal-type homeobox 2, and special AT-rich sequence-binding protein 2 and negativity for cytokeratin 7 and paired-box gene 8, supporting an appendiceal origin. She was started on fluorouracil, leucovorin, and oxaliplatin chemotherapy. Metastatic appendiceal carcinoma can closely resemble primary ovarian malignancy. Bilateral mucinous ovarian tumors with elevated CEA levels and poor chemotherapy response should prompt evaluation for a gastrointestinal primary tumor.

Purpose
This study aimed to characterize co-occurrence patterns, statistical associations, and phenotypic clusters of clinical manifestations reported in human toxocariasis case reports indexed in PubMed from 2005 through 2025, inclusive.
Methods
PubMed-indexed case reports from 2005 through 2025 were identified using the query (“Toxocariasis” OR “Toxocara”) AND “Case Reports” [Publication Type] AND 2005:2025[dp] AND ffrft[Filter]. Free full-text articles were retrieved through PubMed Central and other links indexed in PubMed using the ffrft filter. After 7 nonhuman reports and 5 reports without objective diagnostic confirmation were excluded, 139 case reports were included. Antigravity was used to support data extraction, standardization, statistical analysis, and figure generation. Clinical features were mapped to standardized symptom and organ-involvement variables. Pairwise co-occurrence was assessed using 2×2 contingency tables and Fisher’s exact test; association strength was measured using Pearson correlation coefficients; and k-means clustering was used to identify distinct clinical phenotypes.
Results
Four principal clusters were identified: subclinical disease, ocular larva migrans, visceral larva migrans, and neurotoxocariasis/multisystemic disease. The ocular larva migrans and visceral larva migrans clusters were largely distinct, whereas ocular features were frequently co-reported in the neurotoxocariasis/multisystemic cluster. Eosinophilia was strongly associated with systemic manifestations, including fever, dyspnea, cough, pruritus, hepatomegaly, headache, and meningitis, but was not significantly associated with ocular features. Neurotoxocariasis-related features, including headache, meningitis, and seizures, clustered closely.
Conclusion
This artificial intelligence-assisted scoping review identified exploratory clinical association and clustering patterns in human toxocariasis case reports. These findings may support clinical awareness, but they require validation in curated clinical datasets before they are used for diagnosis, risk stratification, or practice guidance.

Citations

• Letter regarding a herpes zoster outbreak in Korean children: insights from an additional 14 months of data
  Joowon Lee
  Infectious Diseases.2026; 58(7): 738.     CrossRef

Primary leiomyosarcoma of the breast is an extremely rare malignancy, accounting for less than 1% of all breast tumors. Diagnosis is challenging because its morphology overlaps with that of other spindle cell lesions, and standardized treatment guidelines are currently unavailable. A 44-year-old woman presented with a rapidly enlarging, firm, 15×15 cm mass in the left breast. She had previously undergone surgery elsewhere, with diagnoses of leiomyoma and desmoid-type fibromatosis. Imaging demonstrated a lobulated mass without evidence of metastasis. Excision revealed pleomorphic spindle cells arranged in intersecting fascicles, with necrosis and dermal invasion. Primary breast leiomyosarcoma was confirmed by immunohistochemistry, which demonstrated smooth muscle actin and desmin positivity and negative staining for pancytokeratin, p63, S100, CD34, and BCL2. The patient underwent modified radical mastectomy followed by adjuvant radiotherapy and chemotherapy. Primary breast leiomyosarcoma is a rare entity that remains diagnostically challenging. Immunohistochemistry is essential for accurate diagnosis, and optimal management requires a dedicated multidisciplinary approach.

Probiotics have gained increasing clinical attention as adjunctive treatment for lower gastrointestinal disorders. However, evidence supporting their therapeutic efficacy remains limited, particularly with regard to sex-related differences. This expert review provides evidence-based insights and practical recommendations for the use of probiotics in patients with irritable bowel syndrome (IBS), functional constipation (FC), and Clostridioides difficile infection (CDI), considering possible sex-related differences. Evidence from randomized controlled trials and meta-analyses indicates that probiotics can modestly improve global symptoms, abdominal pain, and bloating in IBS and enhance bowel movement frequency and stool consistency in FC. However, these effects are strain-specific and heterogeneous. Although clinical studies on probiotics in IBS have not confirmed significant sex-related differences, experimental animal studies using stress-induced IBS models have demonstrated sex-dependent responses to specific probiotic strains, supporting the biological plausibility of such differences. For CDI, the efficacy of probiotics in preventing primary or recurrent infections remains inconsistent across large trials, and current guidelines usually do not recommend their routine use. However, sex- and age-related immunologic differences support the clinical differences of CDI. Probiotics are generally considered safe for healthy individuals, although caution is advised in patients who are immunocompromised or critically ill. Clinicians should select probiotic products based on strain-specific clinical evidence, adequate viable doses, patient characteristics and sex. In conclusion, probiotics might play a role as adjunctive therapy for IBS and FC, with variability in responses influenced by microbial, host, and potential sex-related factors. Further research is needed to establish optimized personalized probiotic strategies.

We present a rare case of a 68-year-old woman who experienced dizziness, nausea, vomiting, and imbalance for 2 months. Imaging studies, including magnetic resonance imaging, magnetic resonance angiography, and digital subtraction angiography, revealed an intrasellar course of the persistent trigeminal artery (PTA) with atherosclerotic changes. Additionally, hypoplasia of the basilar artery and left vertebral artery was observed. The anatomically rare intrasellar PTA, combined with atherosclerosis and vertebrobasilar hypoplasia, likely contributed to compromised posterior circulation and the patient’s symptoms. This case highlights the importance of considering vascular anomalies and the associated pathological changes in patients with otherwise unexplained posterior circulation symptoms.

Elastofibroma dorsi is a rare, benign soft tissue tumor that typically arises in the infrascapular region. Although it is often asymptomatic, some patients experience pain or a snapping sensation during shoulder movement, which warrants surgical excision. We report a symptomatic case in a middle-aged male patient, highlighting the diagnostic imaging features and surgical management of this condition.

Itching is a representative manifestation of urticaria. However, under certain conditions, urticaria may be characterized by nociceptive sensations, such as stinging or tingling, either instead of or in addition to itching. Three patients with chronic urticaria (CU) who experienced nociceptive pain accompanied by itching were identified and treated with immunoglobulin/histamine complex (IHC) therapy. Nociceptive pain resolved along with improvement in CU symptoms after 8 injections of IHC in the first patient and after 4 injections in the second and third patients. Nociceptive pain may present as a symptom of CU. The clinical characteristics of the transition from itching to nociceptive pain, together with the observed outcomes of IHC therapy, appear to support the intensity theory explaining this shift, which may be mediated by histamine. Further clinical and basic immunological studies are warranted to clarify the underlying mechanisms.

Citations

• Histamine-Mediated Syndrome (HMS): Beyond Allergy and Therapeutic Potential of Immunoglobulin/Histamine Complex (IHC)
  Hyuk Soon Kim, Geunwoong Noh
  International Journal of Molecular Sciences.2026; 27(10): 4494.     CrossRef

Methylenetetrahydrofolate reductase (MTHFR) gene mutations, particularly homozygous mutations, have been associated with a higher incidence of venous thrombosis, coronary heart disease, and obstetric complications. We report the case of a 41-year-old man who presented with multiple vascular thrombotic events over a period of 4–5 years, including deep vein thrombosis with pulmonary thromboembolism, cerebral venous thrombosis and posterior circulation stroke. The patient was found to have elevated serum homocysteine levels and subsequently underwent genetic testing for MTHFR mutations after other potential prothrombotic conditions were excluded. This case is notable because compound heterozygous mutations of the MTHFR gene (C677T and A1298C) were identified in association with recurrent vascular thrombotic events. Management focused on long-term anticoagulation and supplementation with vitamin B6, vitamin B12, and folic acid.

When the physician–government conflict was triggered by the Korean government’s plan to increase medical school enrollment by 2,000 students, the government proposed the establishment of a "Jokbo Sharing Center." In Korean medical education, jokbo refers to collections of previous examination questions, summarized notes, and anticipated topics compiled by senior students and transmitted across cohorts. Their scope extends beyond preclinical education and written examinations to include practical tips and informal norms passed down during clinical clerkships and internship rotations. More than a mere compilation of study resources, jokbo functions as a form of hidden curriculum within medical education. As a learning culture that has emerged organically among students, it operates implicitly beneath the formal curriculum. The creation and sharing of jokbo can foster solidarity and a sense of belonging, and may serve as a process through which students begin to internalize the professional culture essential to their future roles as physicians. Nevertheless, reliance on jokbo- based learning may undermine the depth and quality of learning over time, impeding critical thinking, problem-solving skills, and the acquisition of integrated medical knowledge. Unregulated distribution of such materials also raises concerns about examination fairness, and their reproduction without faculty consent raises legitimate ethical concerns. At the same time, given their demonstrable educational benefits, some argue for institutionalizing jokbo through transparent procedures for constructive use in medical education. Despite its widespread presence, research on jokbo remains virtually nonexistent. This study aims to establish a scholarly and policy foundation for discussion of jokbo in Korean medical education by reviewing international cases of examination material sharing and providing a comprehensive analysis of jokbo in Korea.

Cardiovascular disease, particularly ischemic heart disease, remains a leading cause of death worldwide. Although advances in pharmacological and device-based therapies have improved clinical outcomes, effective strategies for myocardial repair and regeneration remain limited. T-cadherin, a glycosylphosphatidylinositol-anchored atypical cadherin, has recently been identified as a functional receptor for both low-density lipoprotein cholesterol and adiponectin, a cardioprotective adipokine. Notably, the interaction between T-cadherin and adiponectin has emerged as a key regulator of exosome biogenesis and paracrine signaling within cardiovascular tissues. Exosomes are nanosized extracellular vesicles that carry protective molecular cargo, including microRNAs and proteins, and contribute to anti-inflammatory, antifibrotic, and angiogenic effects in the ischemic myocardium. However, their clinical translation is challenged by factors such as variability in yield, heterogeneity of exosome populations, and inefficient tissue targeting. Enhancing endogenous exosome production through the T-cadherin–adiponectin pathway may therefore offer a novel cell-free therapeutic strategy. This review explores the biological roles of T-cadherin and adiponectin in cardiovascular diseases, their regulatory influence on exosome formation, and the future potential of leveraging this axis for myocardial repair and regeneration.

Purpose
Human papillomavirus is the dominant etiological factor underlying atypical cervical squamous epithelial cell abnormalities and cervical carcinoma. Currently, only a limited number of drugs targeting specific biomarkers in cervical cancer are available. This study aimed to assess the expression of estrogen receptor (ER), human epidermal growth factor receptor 2 (HER2), and the Ki-67 proliferative index (Ki-67) in p16-positive cervical squamous premalignant and malignant lesions, which may help clarify the potential role of targeted therapies in cervical cancer. Methods: In p16-positive, histologically proven premalignant and malignant cervical lesions, ER, HER2, and Ki-67 expression were evaluated according to predefined criteria. Results: p16 showed strong nuclear and cytoplasmic positivity in 54 of 56 cases. Patchy nuclear positivity was mainly observed in low-grade squamous intraepithelial lesion (LSIL) cases (2/56). Ki-67 demonstrated a variable proliferative index ranging from 5% to 95% across all cases, with higher indices predominantly observed in squamous cell carcinomas (SCC). ER positivity in LSIL, high-grade squamous intraepithelial lesion, and SCC was 100% (2/2), 66.7% (10/15), and 46.15% (18/39), respectively. HER2 expression was predominantly negative, observed in 78.6% (44/56) of cases, equivocal in 17.8% (10/56), and positive in 3.6% (2/56). Both HER2-positive cases were SCC. ER and HER2 interpretations were analyzed and were not significantly correlated with clinical or pathological parameters. Conclusion: ER positivity decreased with progression of cervical squamous lesions, and HER2 expression was rare in cervical squamous neoplasia. No statistically significant correlation was identified between ER or HER2 expression and clinicopathological parameters. The findings of the current study may help fill gaps in the existing literature and provide essential foundational knowledge for optimizing emerging therapeutic strategies, including ER- and HER2-related therapies.

Purpose
Endoscopic vacuum therapy (EVT) has emerged as a highly effective approach for managing gastrointestinal transmural defects and may offer advantages over traditional methods, such as stenting. This study evaluated the clinical outcomes of EVT for gastrointestinal transmural defects resulting from leakages, perforations, and fistulas.
Methods
We retrospectively reviewed patients who underwent EVT for gastrointestinal transmural defects at Ewha Womans University Medical Center between February 2018 and September 2025 and analyzed clinical outcomes, adverse events, and risk factors associated with adverse events.
Results
Fourteen patients were included (mean age, 63.9 years; 85.7% male). Stomach surgery was the most common etiology (50.0%), and malignancy accounted for 71.4% of cases. The median number of EVT sessions was 2.5, and the mean interval from the index event to the first EVT session was 10.5 days. EVT achieved a 100% technical success rate, with no 30-day mortality; there was 1 in-hospital death (7.1%), 2 cases of stricture (14.3%), and 1 major bleeding event (7.1%). Adverse events were observed more frequently in patients who underwent ≥3 EVT sessions (57.1%) compared with those who underwent <3 sessions, in whom no adverse events occurred.
Conclusion
This study suggests that EVT is a safe and effective treatment for gastrointestinal transmural defects, with high technical success rates. The number of EVT sessions and the timing of treatment initiation appeared to be associated with complications and overall clinical outcomes.

A 28-year-old woman developed drug-induced tachycardia in the left lateral decubitus (LLD) position following intravenous administration of glycopyrrolate. The tachycardia was unresponsive to esmolol, labetalol, and fentanyl but resolved unexpectedly after the tidal volume was reduced from 8 to 6 mL/kg. Drug-induced tachycardia or arrhythmia occurring in the LLD position under mechanical ventilation may be attenuated by adopting a low tidal volume ventilation strategy (6 mL/kg).

Citations

• Glycopyrrolate
  
  Reactions Weekly.2026; 2102(1): 94.     CrossRef

Citations

• Building on a strong foundation: a new chapter for the Ewha Medical Journal
  Ji Yeon Byun
  Ewha Medical Journal.2026; 49(1): e1.     CrossRef

Patients with congenital insensitivity to pain and anhidrosis (CIPA) exhibit an inability to perceive pain, recurrent fractures, self-mutilation, and impaired thermoregulation, which lead to severe complications and high morbidity. Children with CIPA often sustain multiple unnoticed fractures that may be mistaken for child abuse because of the presence of fractures at different stages of healing. If unrecognized or inadequately managed, these injuries can cause permanent damage. We report the case of a 9-year-old boy who presented with recurrent fractures, chronic osteomyelitis, heterotrophic ossification, and gangrene. This case underscores the need for heightened awareness among healthcare providers regarding the clinical manifestations and management challenges of CIPA. It also emphasizes the importance of early diagnosis, meticulous follow-up, and a multidisciplinary approach to optimize outcomes and prevent severe complications in affected children.

멘델 무작위화(Mendelian randomization, MR) 연구는 조절 가능한 노출(modifiable exposure)이 건강결과에 미치는 인과효과(causal effect)를 더 잘 이해하게 해 주지만, 그 근거는 종종 보고가 불충분함으로 인하여연구 결과의 해석과 적용에 한계가 있을 수 있다. 보고지침은 흔히 무슨 연구를 하고 무엇을 발견했는지 독자가 쉽게 이해하도록 돕는다. STROBE-MR(관찰연구의 멘델 무작위화를 활용한 보고지침)은 MR 연구를 명확하고 투명하게 보고하도록 돕는다. STROBE-MR을 논문 작성에 활용하면 독자, 심사자, 학술지 편집인이 MR 연구의 보고 품질과 완성도를 평가하는 데 도움이 될 것이다. 이 글은 STROBE-MR 체크리스트 20개 항목의 의미와 근거를 설명하고, 각 항목마다 사례를 제시해 독자가 잘 이해할 수 있는 논문 작성법을 설명하려고 하였다.

Citations

• Detection of Hemorrhagic Transformation of Cerebral Infarcts with Ultra-low Field MRI
  Dimah Hasan, Julian Sauer, Clara Heller, Annika Rieder, Konstantin Ueffing, Frederic de Beukelaer, Jörg Schulz, Johannes Schiefer, Manuel Dafotakis, Arno Reich, Martin Wiesmann, Florian Holtbernd, Charlotte Weyland
  Clinical Neuroradiology.2026; 36(3): 1103.     CrossRef

Purpose
This review aims to synthesize the most up-to-date evidence on effective lifestyle prescriptions for managing patients with obesity in the primary care setting.
Methods
A comprehensive literature search was conducted through June 2025 using major domestic and international databases, including PubMed, Google Scholar, and RISS, as well as the websites of relevant academic societies. The search strategy employed keywords such as “obesity,” “primary care,” “lifestyle intervention,” “diet,” “exercise,” and “behavioral therapy” in both English and Korean.
Results
Effective obesity management should be grounded in the new paradigm of adiposity-based chronic disease, which focuses on preventing and treating the medical complications associated with excessive fat accumulation. The essential components of a successful lifestyle prescription comprise 3 pillars: diet, exercise, and behavioral therapy. An individualized dietary plan that achieves an energy deficit of 500–750 kcal is fundamental. Exercise prescriptions should recommend a combination of aerobic and resistance training, along with strategies to minimize sedentary time. In behavioral therapy, high-intensity behavioral counseling, the 6A model (ask, assess, advise, agree, assist, arrange), self-monitoring, and cognitive-behavioral therapy techniques have all demonstrated efficacy.
Conclusion
Primary care physicians are not only capable but also uniquely positioned to lead long-term, patient-centered obesity management. Their comprehensive and integrative perspective makes them one of the most efficient and scalable resources in addressing the obesity epidemic.

Citations

• Obesity Management in Primary Care: Clinical Approaches and Policy Implications in the Era of Incretin-Based Therapies
  Chung-woo Lee
  Korean Journal of Family Practice.2026; 16(2): 81.     CrossRef
• Nutrition and Chronic Disease Management for the Clinical Endocrinologist: Leveraging the Malnutrition-Based Chronic Disease Model
  Jeffrey I. Mechanick
  Endocrine Practice.2026;[Epub]     CrossRef

Hypertension is one of the leading chronic diseases globally and a major contributor to cardiovascular morbidity and mortality. Despite advances in pharmacological therapy, medication alone remains limited in achieving optimal control. This review synthesizes recent hypertension management guidelines, including those from the European Society of Cardiology (ESC, 2024), American Heart Association/American College of Cardiology (AHA/ACC, 2025), Taiwan Society of Cardiology/Hypertension Society (2022), and Korean Society of Hypertension (KSH, 2018). All guidelines consistently emphasize sodium restriction, weight reduction, regular exercise, moderation of alcohol intake, smoking cessation, and adoption of healthy dietary patterns such as the Dietary Approaches to Stop Hypertension, Mediterranean, or culturally adapted diets. The ESC 2024 guideline elevates lifestyle modification to Class I, Level A, specifying targets for sodium (<2 g/day) and potassium (≥3.5 g/day). The AHA/ACC 2025 guideline provides quantitative estimates, reporting approximately 1/1 mm Hg blood pressure reduction per kilogram of weight loss, and incorporates newer strategies such as glucagon-like peptide-1 receptor agonists and bariatric surgery when lifestyle measures alone are insufficient. Taiwan’s 2022 guideline frames recommendations under the S-ABCDE (sodium restriction, alcohol limitation, body weight reduction, cigarette cessation, diet adaptation, exercise adoption) mnemonic and uniquely includes genetic factors such as ALDH2 polymorphisms. The KSH 2018 guideline emphasizes salt restriction (<6 g/day), maintaining a body mass index <25 kg/m2, and adherence to traditional Korean diets. Lifestyle modification remains the cornerstone of hypertension prevention and management, particularly in primary care. Future directions should focus on integrating these approaches with pharmacotherapy, digital health strategies, and personalized prescriptions.

Citations

• Association of Lifestyle Factors With Blood Pressure Control Among Hypertensive U.S. Adults: An Analysis of the National Ambulatory Medical Care Survey (NAMCS) 2010–2015
  Moses C Odoeke, Afi T Djaba, Adedoyin Olawoye, Taiwo G Adekanmbi, Hillary C Ugwu, O. B Bomide, Kosisochi E Achara
  Cureus.2026;[Epub]     CrossRef
• Lifestyle Interventions for Blood Pressure Control: A Narrative Review of Global Evidence and Indonesian Perspectives
  Hery Kurniawan, Avril Bella Audyna
  Journal of Tropical Pharmacy and Chemistry .2026; 10(1): 57.     CrossRef
• Nutraceuticals for the Management of Cardiovascular Health: A Mechanistic and Evidence-Based Review Focusing on Atherosclerosis and Hypertension
  Phaniendra Alugoju, Charanraj Goud Alladi, Nyshadham Chaitanya, Luxitaa Goenka, Kishoree Kumaree, Sudarshan SJ, Krishnaswamy Duraisamy, Naeem Ullah
  Nutrients.2026; 18(14): 2226.     CrossRef

This study aimed to provide a comprehensive understanding of aging with disability among polio survivors who continue to live with long-term sequelae. Although poliomyelitis has been eradicated in most regions, survivors entering older age face a dual challenge, as age-related decline overlaps with pre-existing impairments, creating a need for integrated management strategies. This narrative review examined the epidemiology, clinical manifestations, and late effects of polio, with particular attention to post-polio syndrome, secondary musculoskeletal disorders, and other systemic conditions. International and Korean studies were compared to highlight similarities and contextual differences. Polio survivors frequently experience accelerated functional decline due to post-polio syndrome, fatigue, pain, musculoskeletal disorders (e.g., arthritis, osteoporosis, fractures), and cardiopulmonary dysfunction. Approximately 64% report major falls, with 35% sustaining fractures, often at vulnerable sites such as the hip or distal femur. Psychological distress, sleep disturbances, metabolic syndrome, and cardiovascular disease are also prevalent, further compounding frailty. In Korea, where most survivors are now over 60 years of age, epidemiological patterns differ from those of Western cohorts; however, systematic investigations remain limited. Polio survivors exemplify the dual burden of aging and long-term disability, underscoring the need to move beyond fragmented, symptom-focused care toward integrated, life course–oriented approaches. Anticipating and managing late effects, strengthening preventive strategies, and ensuring equitable healthcare access are essential for maintaining function, independence, and quality of life. Lessons drawn from polio survivors offer valuable insights for understanding aging with disability more broadly.

Citations

• A silent epidemic? Poliomyelitis, disability burden, and social impact in Turkey (1942–1968)
  Ayşe Erkmen, Nevim Tüzün, Osman Erkmen
  BMC Public Health.2026;[Epub]     CrossRef

Fragility fractures, particularly hip fractures, represent a major public health concern among older adults and are associated with high morbidity, mortality, functional decline, and socioeconomic burden. Cognitive impairment is common in older adults with hip fractures and contributes to increased fracture risk, poor postoperative outcomes, delayed recovery, and higher rates of institutionalization. This review aimed to examine rehabilitation strategies for older adults with hip fractures, with a specific focus on considerations for those with cognitive impairment. Evidence suggests that individuals with mild-to-moderate cognitive impairment can achieve meaningful functional gains through structured, intensive, multidisciplinary rehabilitation programs incorporating progressive resistance training, balance and mobility exercises, and individualized approaches tailored to cognitive and physical abilities. However, the implementation of such programs is often hindered by insufficient staff training and awareness in dementia-specific rehabilitation, limited resources, and the lack of standardized protocols defining eligibility, intensity, and adaptation. Optimizing outcomes requires structured, tailored rehabilitation protocols, enhanced staff education, interprofessional collaboration, and proactive management of delirium and secondary fracture prevention through fracture liaison services, while concurrently addressing systemic barriers such as resource constraints. Integrated, coordinated care across the continuum is essential to maximize recovery, independence, and quality of life in older adults with hip fractures and cognitive impairment.

Citations

• Encouraging recovery or avoiding risk? A proposed clinical framework for rehabilitation decision-making after fragility fractures
  Mariam A. Ibrahim, Hager Abdelzaher, Ahmed Abdullah Alghamdi, Abdulaziz Khalid Bakhaider, Osama Farouk, Mohammad Kamal Abdelnasser
  Injury.2026; 57(6): 113195.     CrossRef
• Management of hip fracture in older adults with cognitive impairment: a narrative review
  Hao Rao, Li Luo, Jialing Cheng, Gang Wu, Hongmei Zhang, Xuxing Zhang, Jian Qin, Zidong Wang
  Frontiers in Public Health.2026;[Epub]     CrossRef
• Does an Innovative PT Program Targeting Mobility Benefit Veterans With Executive Function Deficit?
  Elisa F. Ogawa, Rebekah Harris, Ildiko Halasz, William Milberg, Jonathan F. Bean
  Journal of the American Geriatrics Society.2026; 74(8): 2373.     CrossRef
• Early recovery after surgery in frailty and hip fracture: where are we now?
  Ben Ollivere, Katie E. Rollins
  Bone & Joint 360.2026; 15(3): 7.     CrossRef
• Peri-operative nutrition in femoral neck fracture arthroplasty: a pragmatic framework to mitigate dual-hit catabolism and improve outcomes
  Leonard Muhango, Dyllan B. Geldenhuys, Nena Elebo, Winifred Mukiibi, Nkhodiseni Sikhauli, Jurek R.T. Pietrzak
  Orthopedic Reviews.2026;[Epub]     CrossRef
• Beyond bone density: toward an integrated bone– muscle–function framework for fragility fracture prevention
  Shengzhu Lu, Chaodong Liu, Yinyao Gou, Hao Liu
  Frontiers in Medicine.2026;[Epub]     CrossRef
• Apathy as a Predictor of Functional Recovery in Older Adults With Hip Fracture: A Multicentre Prospective Study
  Kazuya Takeda, Mineko Wada, Ryouichi Nakamura, Junko Okajima, Manami Harada, Yuiko Nishiguchi, Hideaki Sakai, Masaru Sakai, Yuri Kanemoto, Miwako Tsunematsu, Hideaki Hanaoka
  Psychogeriatrics.2026;[Epub]     CrossRef
• Sarcopenia and cognitive impairment after hip fracture in older adults: a narrative review and conceptual rehabilitation framework
  Qi Han, Hong-zhao Bai
  Frontiers in Medicine.2026;[Epub]     CrossRef

Pediatric anesthesia presents unique challenges due to children’s distinct physiological and anatomical characteristics, including variations in drug metabolism, airway structure, and respiratory and circulatory regulation. Despite significant advances in patient safety that have reduced anesthesia-related mortality over recent decades, the declining pediatric population has made specialized training and clinical practice increasingly difficult. This narrative review addresses practical aspects of pediatric anesthesia, emphasizing patient monitoring, airway management, and recent clinical advances. Oxygen supply targets in children require careful titration to ensure adequate tissue oxygenation while avoiding oxygen toxicity and its associated complications, such as bronchopulmonary dysplasia and retinopathy of prematurity. Quantitative monitoring of neuromuscular blockade, such as with train-of-four stimulation, is essential to prevent postoperative respiratory complications. Temperature monitoring is equally critical in pediatric surgery because children and neonates are highly susceptible to intraoperative hypothermia. Airway management in infants and young children is complicated by anatomical differences, and while video laryngoscopy offers advantages, evidence for its benefits in neonates remains inconclusive. Extubation strategies must be individualized, taking into account risks such as laryngospasm and airway obstruction, as both deep and awake extubation have demonstrated comparable safety profiles. Emerging modalities, such as transfontanelle ultrasonography, provide real-time cerebral blood flow assessment and enhance perioperative brain monitoring. Regional anesthesia techniques in neonates and infants reduce exposure to general anesthetics and facilitate faster recovery but require meticulous technique and monitoring to ensure safety. Multidisciplinary collaboration and effective communication with parents are essential to achieving optimal outcomes.

Citations

• The Pediatric Anesthesia Parent Satisfaction (PAPS) Questionnaire: A Focused Review of its Development, Validation, Cross-Cultural Adaptation, and Clinical Utility
  Seni Potsangbam, Rupesh M Thete, Abdelaziz Yehya, Sanjot Ninave, Tuhin Mistry, Abhijit Nair
  Cureus.2026;[Epub]     CrossRef

Globally, rapid population aging—particularly in Korea—has extended life expectancy but not proportionally extended healthy life expectancy, resulting in longer periods of illness or disability and a higher demand for complex medical and social care. Therefore, prolonging healthy life and improving health-related quality of life have become primary objectives in geriatric medicine and rehabilitation. Geriatric rehabilitation is a critical intervention aimed at optimizing the functioning of older adults and pre-morbidly frail individuals who have lost independence due to acute illness or injury. For many older patients, the goal shifts from complete recovery to achieving a new equilibrium, maximizing autonomy despite greater dependency. Geriatric rehabilitation also targets key geriatric syndromes such as frailty, recognizing it as a dynamic and potentially reversible state that provides a crucial “time window” for intervention. This review summarizes the core principles and structural elements essential for geriatric rehabilitation, emphasizing the implementation challenges within the Korean healthcare system. Unlike the European consensus, which supports structured inpatient and outpatient services with seamless transitions of care guided by Comprehensive Geriatric Assessment, the Korean healthcare system remains fragmented and heavily centered on acute hospitals. This highlights the urgent need for a systematic model to integrate care facilities and strengthen interprofessional collaboration to support community-based “aging in place.” Effective geriatric rehabilitation requires multidisciplinary teams and multifaceted approaches to optimize quality of life, social participation, and independent living. Despite its importance, substantial awareness gaps and policy barriers persist, underscoring an urgent call to action.

Citations

• MOST FREQUENTLY ASKED QUESTIONS BY OLDER ADULTS IN GERIATRIC REHABILITATION: EVALUATING LARGE LANGUAGE MODELS AS A SOURCE OF INFORMATION
  Uğur SÖZLÜ, Selim Mahmut GÜNAY, Sevda Demir TÜRE, Gül ÖZKAZANÇ
  Turkish Journal of Geriatrics.2026;[Epub]     CrossRef
• Analysis of Research Hotspots and Trends in Rehabilitation of Disabled Elderly Based on CiteSpace
  鸿 张
  Advances in Clinical Medicine.2026; 16(07): 96.     CrossRef
• Effects of High-Intensity Interval Training in Older Adults: A Systematic Review of Randomized and Non-Randomized Intervention Studies
  Paula Moreira, Sérgio Ferreira, Nuno Domingos Garrido, António M. Monteiro, Pedro Afonso, Alexandra Malheiro, Joana Ribeiro, Pedro Forte
  Journal of Clinical Medicine.2026; 15(17): 6701.     CrossRef
• Current Knowledge and Gaps in Geriatric Rehabilitation among Physical and Rehabilitation Medicine Specialists
  Paolo Capodaglio, Eleftheria Antoniadou, Mooyeon Oh-Park, Walter R. Frontera, Der-Sheng Han, Carmen M. Terzic, Anne Felicia Ambrose, Francesca Gimigliano, Marta Supervia Pola, Yesim Gokce Kutsal, Dale C. Strasser, Vu Q Nguyen, Jonathan F. Bean, Vanessa Se
  Annals of Geriatric Medicine and Research.2026; 30(3): 305.     CrossRef

Diabetes mellitus is a complex chronic disease with a rapidly increasing global prevalence. For this condition, non-pharmacological lifestyle modification is as important as pharmacological treatment. This review aims to comprehensively examine lifestyle prescriptions for diabetes across multiple domains to integrate current insights and understanding. In medical nutrition therapy, which is central to diabetes treatment and management, excessive carbohydrate intake should be restricted, while individualized consumption of high-quality carbohydrates, protein, and unsaturated fatty acids is recommended. Intake of added sugars and sodium should also be limited. Physical activity should similarly be tailored to the individual, with a combination of aerobic exercise and resistance training recommended. Careful consideration of hypoglycemia risk and diabetes complications is essential. Additional strategies include limitations on uninterrupted sedentary time to less than 30 minutes, maintenance of a healthy body weight, smoking cessation, alcohol abstinence, sleep health improvements, and attention to psychosocial care. In primary care settings, patient-specific assessment, multidisciplinary lifestyle prescriptions, and education to support behavior modification are expected to play a pivotal role in the treatment and management of diabetes.

Citations

• Knowledge, attitude, and practice of allied healthcare professionals about lifestyle medicine for diabetes: A cross-sectional study
  Mona Mohamed Taha, Shaima A Alothman, Rana Alawafi, Rahaf Mohammed Alshareef, Sarah Mohammed Al-Subaie, Najd Abdullah AlKhushaiban, Najd A Al-Salem, Asmaa Rafeeq, Ali Mohamed Ali Ismail
  WORK: A Journal of Prevention, Assessment & Rehabilitation.2026;[Epub]     CrossRef

South Korea is experiencing a rapid demographic transition, with the proportion of older adults projected to exceed 20% by 2025. This unprecedented pace has intensified the demand for healthcare and social support, creating complex challenges in the management of multimorbidity, frailty, and functional dependency. Historically, Korea has relied on a rigid, provider-centered model, with healthcare financed through National Health Insurance and long-term care through long-term care insurance. Although these systems expanded service availability, they also entrenched fragmentation between long-term care hospitals and nursing homes. Recent reforms mark a paradigm shift toward person-centered, integrated care. The Community Care pilot programs (2019–2022) and the Integrated Community Care Support Act (2024) introduced coordinated models that link healthcare, housing, and social services under local government leadership. Evidence from domestic and international studies underscores the risks of prolonged institutionalization and highlights the benefits of integrated approaches, including reduced hospitalizations, improved functional independence, and higher satisfaction among older adults and their families. At the same time, experiences from Korea and Japan suggest that institutional care remains indispensable for individuals with high medical needs or at the end of life, emphasizing the need for balanced strategies. Successful implementation of the 2026 reforms will require redefining the role of institutions, expanding community-based alternatives, developing a professional care manager workforce, achieving interoperability of data systems, and undertaking financing reforms to align incentives. Beyond structural change, embedding a cultural ethos that values dignity, autonomy, and personhood will be essential. Korea’s evolving model not only responds to urgent demographic challenges but also offers lessons for other aging societies.

Citations

• Narrative nursing to address negative emotions, body image disturbance, and satisfaction in patients after axillary odor surgery: a sequential explanatory mixed-methods study
  Jianhua Tan, Jianfei Zhang, Kaixi Tan, Qiao Hu, Chuqing Wang
  Frontiers in Medicine.2026;[Epub]     CrossRef
• Dynamics of satisfaction and health data of patients over 65 years old after integration of care assistants into mobile medical teams
  D.R. Davidov, I.B. Shikina, D.S. Oprishchenko
  Russian Journal of Preventive Medicine.2026; 29(8): 38.     CrossRef

Generative artificial intelligence (GenAI), including large language models such as GPT-4 and image-generation tools like DALL-E, is rapidly transforming the landscape of medical education. These technologies present promising opportunities for advancing personalized learning, clinical simulation, assessment, curriculum development, and academic writing. Medical schools have begun incorporating GenAI tools to support students’ self-directed study, design virtual patient encounters, automate formative feedback, and streamline content creation. Preliminary evidence suggests improvements in engagement, efficiency, and scalability. However, GenAI integration also introduces substantial challenges. Key concerns include hallucinated or inaccurate content, bias and inequity in artificial intelligence (AI)-generated materials, ethical issues related to plagiarism and authorship, risks to academic integrity, and the potential erosion of empathy and humanistic values in training. Furthermore, most institutions currently lack formal policies, structured training, and clear guidelines for responsible GenAI use. To realize the full potential of GenAI in medical education, educators must adopt a balanced approach that prioritizes accuracy, equity, transparency, and human oversight. Faculty development, AI literacy among learners, ethical frameworks, and investment in infrastructure are essential for sustainable adoption. As the role of AI in medicine expands, medical education must evolve in parallel to prepare future physicians who are not only skilled users of advanced technologies but also compassionate, reflective practitioners.

Citations

• Using virtual reality to support the transition from preclinical to clinical training in paediatric dentistry
  Marion Lautier, Faustine Béal, Amélie Reibel Domergue, Sophie Jung, François Clauss, Marion Strub
  BMC Medical Education.2026;[Epub]     CrossRef
• Generative and Large-Scale Artificial Intelligence in Exercise and Sports Medicine: A Narrative Review
  Bokyoung Kim, Junseok Kang, Yun Jae Jung, Jihyun Ahn
  The Asian Journal of Kinesiology.2026; 28(1): 58.     CrossRef
• Bridging the Implementation Gap in Medical AI Education: 3-Lever Framework for Concurrent Reform
  Sherrie L Kelly, Melissa Forgie, Mark C Walker
  JMIR Medical Education.2026; 12: e88778.     CrossRef
• A dialectical lens for AI and medical humanities: advancing responsible augmented humanism in Digital Public Health
  Sifan Chen, Zining Peng, Nian Liu
  Frontiers in Public Health.2026;[Epub]     CrossRef
• Artificial Intelligence in Psychiatry Training: Comparative Insights from Nine Large Language Models Across Cultural and Exam Contexts
  Yusuf Selman Çelik, Nagihan Özer, Makbule Esen Öksüzoğlu, Şeyma Selcen Macit, Hande Günal Okumuş, Meryem Kaşak, Ayşegül Efe, Yusuf Öztürk
  Psychiatric Quarterly.2026;[Epub]     CrossRef
• AI-supported case-based learning in medical education: a comprehensive scoping review
  Syed Hani Abidi, Joseph Almazan, Olaoluwa Fabiyi, Fatin Zehra, Muhammad Tariq
  Frontiers in Medicine.2026;[Epub]     CrossRef
• Evaluation of the Effectiveness of Psychological First Aid Training for Community Nurses in China: A Quasi‐Experimental Study on Knowledge and Skills Enhancement
  Yazhou He, Yulan Ding, Jiaqin Yan, Xiaoning Xiong, Shan Huang, Sijian Li
  Nursing Open.2026;[Epub]     CrossRef
• Generative AI–Assisted Microlearning for Erectile Dysfunction Myth Reduction: Single-Center Pre–Post Quasi-Experimental Study
  Ali Can Albaz, Oğuzcan Erbatu, Okan Yiğit, Oktay Üçer, Gökhan Temeltaş, Talha Müezzinoğlu
  JMIR Formative Research.2026; 10: e88818.     CrossRef
• Implementation of artificial intelligence in the 2025 medical parasitology course at Hallym University
  Eun Hee Ha
  Journal of Educational Evaluation for Health Professions.2026; 23: 4.     CrossRef
• Bridging theory and practice in generative artificial intelligence for medical education: insights from clinical teaching experience
  Yoo Kyung Lee
  Ewha Medical Journal.2026; 49(2): e16.     CrossRef
• Design and Evaluation of a Faculty Development Workshop Series on Integrating Generative Artificial Intelligence in Medical Education: Mixed Methods Pilot Study
  Rajalakshmi Anand, Nicole Bowers, Mange Festo Manyama
  JMIR Medical Education.2026; 12: e89815.     CrossRef
• An exploration of undergraduate nursing students' heavy use of generative artificial intelligence in academic practice: A descriptive phenomenological study
  Xiaoqing Wang, Kai Yu, Weiliang Wang, Jiyue Li, Yuexian Shi
  International Journal of Nursing Studies.2026; 180: 105557.     CrossRef
• Use of large language models for providing automated feedback in medical imaging education: a systematic review
  Mustafa Mohammed Al-Mashhadani, Faika Ajaz, Shaista Salman Guraya, Farah Ennab
  Frontiers in Medicine.2026;[Epub]     CrossRef
• Generative artificial intelligence and large language models in competency-based medical education: applications, challenges, and future directions
  In Hwa Jeong, Heeyoung Kim, Hyunyong Hwang
  Kosin Medical Journal.2026; 41(2): 114.     CrossRef
• The role of artificial intelligence in personalising the teaching process at medical universities
  Daniel Ślęzak
  Humanities & Social Sciences Reviews.2026; 14(2): 67.     CrossRef
• The Pocket Tutor - Generating Competency-Based Clinical Vignettes with Artificial Intelligence for Medical Postgraduate Competitive Exam Preparation
  Swapnil Banerjee, Manisha Agarwal
  Galore International Journal of Health Sciences and Research.2026; : 69.     CrossRef
• Benefits and challenges of integrating generative AI in health technology education—a case study
  Minna Pikkarainen, Marko Lukic, Safora Johanssen, Wilfried Admiraal, Arild Berg, Yngve Røe
  Frontiers in Education.2026;[Epub]     CrossRef
• Benchmarking five large language models in medical genetics: a bilingual comparative evaluation using published and novel expert-authored questions
  Özge Beyza Gündoğdu Öğütlü, Benjamin D. Solomon, Yusuf Selman Çelik
  Frontiers in Medicine.2026;[Epub]     CrossRef
• Epistemología de la Praxis Médica en la Era de la Inteligencia Artificial: Metacognición, Metodologías Activas y Personalización del Aprendizaje por Competencias en el Siglo XXI
  Fernando Vanegas Lara, Roberto Méndez Pérez, Omar Hassiri Gómez Gómez, Mariel Gonzalez Calatayud
  Educación Médica.2026; : 101246.     CrossRef

Perioperative pain management has shifted from standardized, procedure-based protocols toward individualized, patient-centered approaches. Inadequate pain control can result in short-term adverse outcomes, including delayed ambulation, prolonged hospitalization, and increased complications, as well as long-term sequelae such as chronic persistent postsurgical pain. Early models of preemptive and preventive analgesia emphasized pain relief primarily through the use of opioids. Growing concern about opioid-related adverse effects established the basis for multimodal and opioid-sparing strategies. Nevertheless, with the onset of the global opioid crisis, heightened awareness of the risks of opioid overuse has fueled interest in opioid-free techniques. However, evidence does not demonstrate that opioid-free methods are superior to opioid-sparing approaches. This underscores the importance of returning to the central goals of enhanced recovery after surgery: early restoration of function and reduction of complications. Within this framework, personalized pain management has emerged as a practical paradigm that tailors interventions to individual characteristics, including comorbidities, psychological status, pain sensitivity, and recovery objectives. This review outlines the rationale, current practices, and future directions of personalized perioperative pain management and proposes a framework for integrating new strategies into clinical care.

Citations

• Personalized Multimodal and Opioid-Sparing Analgesia for Postoperative Pain Management: Enhancing Recovery and Addressing the Post-Discharge Gap
  Marie Louise Sezerano, Emery Niyonkuru
  Journal of Pain Research.2026; Volume 19: 1.     CrossRef
• Future directions in anesthesia: expanding the role of anesthetic drugs in sedation, analgesia, and recovery
  Min Kyoung Kim, Hyun Kang
  Journal of the Korean Medical Association.2026; 69(4): 294.     CrossRef
• Effect of lidocaine on acute pain after modified radical mastectomy: a secondary analysis of a randomized trial
  Jiao Liu, Wenjuan Zhang, Xiaohui Li, Danting Jia, Zhixia Bai, Xuexin Chen
  Frontiers in Medicine.2026;[Epub]     CrossRef
• Digital Pain Medicine in the Era of Precision Healthcare: Integrating Artificial Intelligence, Wearable Biosensors, and Predictive Analytics for Personalized Pain Management
  Dr. A. Devasena, Dr. Glad Mohesh, Sujit Kumar Sadhukhan, Dr. Shivendra Pal Singh
  PAIN, JOINTS, SPINE.2026; 16(6S): 736.     CrossRef

Citations

• The primary emphasis in expanding medical school admissions quotas in Korea should be on the quality of education and training, not the number of students admitted
  Young Hwan Lee
  Journal of the Korean Medical Association.2026; 69(3): 180.     CrossRef
• An Analysis of Judicial Precedents on Medical Practice in Criminal Litigation in Obstetrics and Gynecology
  Jeong Hyeon Lee, Jun Won Park, Joon Cheol Park, Dong Ja Kim
  Korean Journal of Medical Ethics.2026; 29(1): 31.     CrossRef
• Rates and Complications of Transfusion in Primary Total Hip Arthroplasty and Revision Total Hip Arthroplasty: A Nationwide Population-Based Cohort Study in Korea
  Jung-Wee Park, Soon Young Park, Ki-Tae Park, Dong-Hoon Lee, Min-Ji Han, Young-Kyun Lee
  Journal of Korean Medical Science.2026;[Epub]     CrossRef
• HeLP-BAG score: a novel data-driven scoring system for predicting post-operative 30-day mortality using 24-hour preoperative data
  Hyun Sik Kim, Hyo Seop Shin, Jinhyong Goh, Seung Ho Jun, Chang Hyun Lee, Joo Heung Yoon, Choon Hee Chung
  BMC Anesthesiology.2026;[Epub]     CrossRef
• Beauty and Fatality: A Forensic Perspective on Periprocedural Deaths after Aesthetic Procedures, and Insights for Death Investigation and Public Health Safety
  Sohyung Park, Sung Wook Choi, Duk Hoon Kim, Minjung Kim, Min Jee Park, Jung Sik Jang, Seon Jung Jang, Jeong Hwa Kwon, Yooha Don, Hyejeong Kim
  Korean Journal of Legal Medicine.2025; 49(4): 133.     CrossRef

The integration of regional anesthesia (RA) with general anesthesia (GA) has become a central component of multimodal strategies to improve perioperative pain management. This approach not only enhances analgesic efficacy but also reduces opioid requirements and mitigates opioid-related adverse effects. By targeting peripheral or neuraxial nociceptive pathways, RA attenuates the surgical stress response and decreases central sensitization, complementing the systemic actions of GA. The combined application of RA and GA has shown substantial benefits across a wide range of surgical procedures, including abdominal, thoracic, orthopedic, and pediatric operations. Reported advantages include improved hemodynamic stability, enhanced pulmonary function, earlier ambulation, faster gastrointestinal recovery, and greater patient satisfaction. Moreover, recent evidence indicates a positive association between effective postoperative pain control and long-term outcomes, such as reduced incidence of persistent postsurgical pain, better functional independence, and even improved immune function and survival following cancer surgery. The development of sustained-release local anesthetic delivery systems, which provide localized and prolonged analgesia, further extends the benefits of RA-GA integration into the postoperative period. This review summarizes the mechanistic rationale, clinical applications, and future directions of RA-GA combinations in modern surgical care, with special emphasis on their role in enhanced recovery after surgery protocols.

Citations

• Results and Future Perspectives of the Sustainable Anesthesia Project: A Large-Scale, Real-World Implementation Study at the Largest Spanish Private Healthcare Provider
  Juan Acha-Ganderias, María del Pino Henríquez-de Armas, Luis Enrique Muñoz-Alameda, Ion Cristóbal, Cristina Caramés, Leticia Moral-Iglesias
  Healthcare.2026; 14(3): 300.     CrossRef
• Effect of transcutaneous electrical nerve stimulation on patients after coronary artery bypass grafting: a systematic review and meta-analysis
  Enyu Zhang, Jihe Kang, Yan Liu, Lulu Wang, Bo Wan, Xiaoling Li
  Frontiers in Cardiovascular Medicine.2026;[Epub]     CrossRef
• From repair to reconstruction: a holistic perspective in abdominal wall hernia surgery
  Xin-liang Hou, Ting Zeng, Xu Wang, Li-ye Tan
  Frontiers in Surgery.2026;[Epub]     CrossRef
• Future directions in anesthesia: expanding the role of anesthetic drugs in sedation, analgesia, and recovery
  Min Kyoung Kim, Hyun Kang
  Journal of the Korean Medical Association.2026; 69(4): 294.     CrossRef
• Letter to the Editor re: “Opioid prescribing patterns and the effect of chronic kidney disease in pediatric urology population: A retrospective cohort analysis”
  Yashkumar Kiranbhai Rajvi, Mohit Kumar, Shubham Singh
  Journal of Pediatric Urology.2026; 22(5): 105964.     CrossRef
• Integrating Regional Anesthesia and Early Physiotherapy for Enhanced Recovery Following Joint and Spine Surgery: Advances, Challenges, and Future Directions
  Dr.Y.Praveen Kumar, Dr. Pallavi Yellarthi, Dr. Sujata Haridas Nair (PT), Dr Akshay Sreedharan, Vasantakumarnaik N.K, Singireddy Dattakshaya, Dr Rutambhara Sahu
  PAIN, JOINTS, SPINE.2026; 16(6S): 875.     CrossRef
• Intraoperative opioid-sparing effect of a quadratus lumborum block using low-concentration bupivacaine and dexmedetomidine in cats undergoing ovariohysterectomy
  Fumihiko Takusagawa, Yoshimi Takusagawa, Taro Kimura
  Journal of Feline Medicine and Surgery.2026;[Epub]     CrossRef