Cushing syndrome (CS) is an endocrine disease characterized by hypercortisolemia, which not only affects the function of the body’s multi-system organs, but also significantly increases the risk of venous thromboembolic events (VTE) due to the hypercoagulable state caused by the disease. However, VTE in CS patients has not received enough clinical attention. Current domestic guidelines for pulmonary thromboembolism (PTE) do not include CS as a risk factor for VTE. In view of the high incidence, morbidity and mortality of venous thromboembolism (VTE), this paper summarized 5 cases of Cushing syndrome complicated with pulmonary embolism admitted to our hospital recently, and reviewed the literature, aiming to improve clinicians’ awareness of this complication and reduce missed diagnosis or delayed diagnosis.

For over two centuries, the stethoscope has been a cornerstone of clinical medicine, yet traditional acoustic models are limited by environmental noise, user experience, and the subjective nature of auscultation. Digital stethoscopes, augmented by signal processing, visualization tools, and Artificial Intelligence (AI), represent a transformative evolution in auscultatory practice. These devices convert acoustic signals into digital data, enabling amplification, noise reduction, and objective analysis through phonograms and spectrograms. AI integration enhances diagnostic accuracy by detecting and classifying cardiac and respiratory abnormalities, while connectivity features facilitate telemedicine, remote monitoring, and longitudinal patient care. Clinical studies consistently demonstrate the superiority of digital over acoustic stethoscopes in detecting subtle heart murmurs, lung sounds, and arrhythmias, particularly in complex or noisy settings. Beyond clinical diagnostics, digital stethoscopes serve as educational tools, providing visualized, recordable, and analyzable auscultatory data. As part of the emerging Medicine 3.0 ecosystem, these devices align with predictive, preventive, personalized, participatory, and precision (5P) medicine, offering new opportunities for global health equity, chronic disease management, and medical education. This review synthesizes current evidence on the technology, clinical performance, AI applications, and telemedicine integration of digital stethoscopes, highlighting their potential to redefine auscultation in the 21st century.

Purpose : Guidelines adherence and identification factors influencing non-compliance with recommendations in bronchiolitis management.

Methods : A retrospective study of children hospitalized with bronchiolitis from December 1, 2014, to December 31, 2016. Infants aged under 24 months, with an episode of bronchiolitis, were included. Data was analyzed separately for children aged under 12 months with the first episode of dyspnea (strict bronchiolitis) and aged 12 up to 24 months or with the history of previous dyspnea (loose bronchiolitis). There were compared patients treated with the recommendations (adherent group) and not (non-adherent group).

Results: 306 infants were included. 253 patients (82.7%) were treated according to recommendations. 162 (94.2%) of the 172 meeting the “strict bronchiolitis” criteria and 91 (67.9%) of the 134 with “loose bronchiolitis”. In the non-adherent group (n=53, 17.3%) more patients were aged over 12 months (56.6% vs 24.1%), with risk factors (43.4% vs. 30%), previous episodes of bronchiolitis (41.5% vs 15.4%), higher respiratory rate (49 vs 44/min), greater need of oxygen therapy (32% vs 16.6%) and PICU transfer (5.7% vs 0.8%).

Conclusions : Children with bronchiolitis under the age of 12 months with the first episode of dyspnea are more likely to be treated in accordance with the guidelines. The use of additional drugs is due to older age, significant medical history and severe clinical symptoms.

Keywords: Bronchiolitis; Guidelines Compliance; Hospitalized Infants.

Lung infections are a common complication among immunocompromised patients and they have high morbidity and mortality. The continuous use of Tumor Necrosis Factor-alpha (TNF-α) inhibitors in these patients can further worsen the infections, causing lifethreatening pneumonias. We present a 20 year old male with Crohn’s disease administered infliximab while having an active infection of the respiratory system. The infection quickly evolved to bilateral pneumonia. Empirical antimicrobial chemotherapy was initiated with colistin and cefixime and after a 19 day hospitalization the patient was symptomatically better and was discharged. At one-month’s follow up the patient reported total resolution of symptoms and a chest x-ray revealed normal findings in both lung fields. Immunocompromised patients with Crohn’s disease who are administered Tumor Necrosis Factor-alpha inhibitors are more susceptible to infections. In those patients a simple upper respiratory tract infection can quickly evolve to pneumonia, which can present with severe symptomatology and even acute respiratory failure. Clinicians must be aware of and should monitor vigilantly for such potential complications. We recommend the discontinuation of treatment with TNF-a inhibitors in patients who have an active lung infection.