Category: Nevin Manimala

Abdom Radiol (NY). 2026 Apr 10. doi: 10.1007/s00261-026-05420-5. Online ahead of print.

ABSTRACT

BACKGROUND: Response evaluation of pancreatic ductal adenocarcinoma (PDAC) with routine contrast-enhanced CT (CECT) using RECIST is currently inadequate for identification of patients benefiting from chemotherapy treatment, as the majority of patients show stable disease. This might lead to inappropriate treatment and potentially diminishes patients’ quality of life. Recent developments in CT perfusion (CTP) show its potential as a biomarker to evaluate therapy response in PDAC.

PURPOSE: To investigate quantitative CT Perfusion as a prognostic biomarker during chemotherapy treatment in patients with PDAC.

MATERIALS AND METHODS: This prospective cohort trial included patients between January 2018 and December 2022 with biopsy-proven PDAC of all stages who underwent CT Perfusion before (i.e. baseline) and after three months of chemotherapy treatment. A previously developed AI-assisted CTP analysis method provided automatic segmentations of tumor and pancreas parenchyma. A trilinear non-parametric CTP contrast-enhancement model described the upslope and the peak of the time intensity curve for both tumor and parenchyma. Perfusion features of baseline and follow-up scans were compared to calculate the percentual difference. The primary endpoint was the association between quantitative CTP parameters and overall survival (OS). Secondary endpoints included comparison with RECIST 1.1 and CA 19-9 response criteria for prognostic stratification. Statistical analysis included Kaplan-Meier curves and log-rank test.

RESULTS: A total of 25 patients were included. Treatment response based on RECIST 1.1 criteria showed two cases with progressive and 23 with stable disease. Patients with increased peak enhancement after chemotherapy demonstrated significantly longer survival compared to those with decreased enhancement (p = 0.02). In contrast, CA19-9 response (≥ 30% decrease) did not significantly differentiate survival (758 days vs 371 days, p = 0.27). Furthermore, CTP found more patients with a higher chance of long survival compared to RECIST (60% vs 25% survival in 24 months). In the subgroup with RECIST stable disease CTP still finds patients with a significantly longer survival (p = 0.02). Combined analysis showed that patients with both CTP increase and CA19-9 response had the best median survival at 758 days (IQR: 561-895).

CONCLUSION: Our study demonstrates that quantitative CTP is associated with better identification of long-term survivors than RECIST, based on increased peak enhancement after chemotherapy. Quantitative CTP may serve as a valuable complement to current treatment assessment methods in patients with PDAC.

PMID:41961316 | DOI:10.1007/s00261-026-05420-5

Drug Saf. 2026 Apr 10. doi: 10.1007/s40264-026-01650-0. Online ahead of print.

ABSTRACT

INTRODUCTION: Giant cell arteritis (GCA) is an immune-mediated vasculitis of large and medium arteries, mainly affecting older adults. Prompted by a consumer concern, a few spontaneous reports after coronavirus disease 2019 (COVID-19) vaccination and Australian regulator signal, we investigated a possible association between GCA and vaccination.

METHODS: This study analysed multiple data sources from January 2021 to September 2024. We reviewed spontaneous GCA reports submitted to the statewide vaccine safety service, Surveillance of Adverse Events following Vaccination in the Community (SAEFVIC), and applied self-controlled case series (SCCS) to two large Australian healthcare datasets [general practice (GP) and linked hospital data]. SCCS used a 1-42-day risk window, stratified by vaccine type, age, and sex. Incident GCA cases were identified via keyword matching and diagnostic codes [Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT)/International Classification of Diseases Tenth Revision, Australian Modification (ICD-10-AM)].

RESULTS: Six cases of GCA were spontaneously reported, four with onset within 42 days postvaccination, all following the adenoviral vectored Vaxzevria® {reporting rate 0.10 [95% confidence interval (CI) 0.03-0.27]}. The proportional reporting ratio signal detection method did not indicate a safety signal. Of 2700 incident cases of GCA identified across primary and hospital care datasets, 293 occurred within 42 days of COVID-19 vaccination. There was no increased risk of GCA following COVID-19 vaccination in either dataset [GP relative incidence (RI): 0.96 (95% CI 0.76, 1.21); hospital RI: 0.79 (95% CI 0.68, 0.91)], including by vaccine type, age, or sex.

CONCLUSIONS: Using three Australian data sources, this study found no increase in GCA presentations within 6 weeks of COVID-19 vaccination. These consumer-stimulated findings support informed decisions, strengthen vaccine safety evidence, and help clinicians counsel patients.

PMID:41961244 | DOI:10.1007/s40264-026-01650-0

Jpn J Ophthalmol. 2026 Apr 10. doi: 10.1007/s10384-026-01340-5. Online ahead of print.

ABSTRACT

PURPOSE: To assess the 6-month efficacy and safety of oxymetazoline hydrochloride ophthalmic solution 0.1% (OMZ 0.1%) versus placebo for acquired blepharoptosis.

STUDY DESIGN: A phase 3, randomized, double-masked, parallel-group, multicenter study conducted in Japan.

METHODS: Patients were randomized 1:1:1 to OMZ 0.1%, once daily (QD) or twice daily (BID), or placebo. Patients received OMZ 0.1% for 6 months. Patients in the placebo group were randomized after 3 months (Treatment Period 1) to OMZ 0.1%, either QD or BID, for the remaining 3 months (Treatment Period 2). The primary efficacy endpoint was the marginal reflex distance-1 (MRD-1) change from baseline to Day 14 (2 hours after the morning drop) with OMZ 0.1% QD or BID versus placebo. Adverse events and adverse drug reactions (ADRs) were recorded.

RESULTS: Overall, baseline MRD-1 (standard deviation) of 336 patients analyzed (n=112 per group) was 1.31 (0.83) mm (Day 0). MRD-1 change from baseline to Day 14 (2 hours after the morning drop) was 1.09 (0.07), 0.93 (0.07), and 0.50 (0.07) mm, with OMZ 0.1% QD, BID, and placebo, respectively. There was a statistically significant difference in the least squares mean (standard error) MRD-1 change versus placebo with OMZ 0.1% QD (0.59 [0.10] mm; 95% CI 0.38, 0.79) and OMZ 0.1% BID (0.43 [0.10] mm; 95% CI 0.23, 0.64) (both p<0.05). All ADRs related to the study drug were mild.

CONCLUSION: Fourteen days of OMZ 0.1% treatment significantly increased MRD-1 versus placebo. There was no loss of effect after 6 months of treatment and no significant safety concerns.

PMID:41961227 | DOI:10.1007/s10384-026-01340-5

Clin Exp Nephrol. 2026 Apr 10. doi: 10.1007/s10157-026-02848-3. Online ahead of print.

ABSTRACT

BACKGROUND: Zinc deficiency is highly prevalent in patients undergoing hemodialysis, and may contribute to cognitive impairment, given its essential role in neurotransmission and neurogenesis. This study aimed to examine the association between serum zinc and cognitive function in this population.

METHODS: This was a cross-sectional study (N = 1207). Cognitive function was assessed by using the Modified Mini-Mental State examination (3MS). The association between serum zinc and 3MS score and its domains were examined by using a linear regression model and ordinal logistic regression model, respectively.

RESULTS: In total patients, 3MS score and serum zins levels were 91 (82-97) points and 68 (61-76) μg/dL, respectively. Serum zinc level was not associated with 3MS score in adjusted model with 16 potential confounders. However, there was a significant interaction between serum zinc and albumin levels (p = 0.019). Therefore, participants were categorized into 2 subgroups by the median serum albumin level (3.7 g/dL) in further analyses. In the lower serum albumin group, the positive association between serum zinc and 3MS was significant after adjustment for 15 potential confounders (p = 0.022). After additional adjustment for both magnesium and phosphate, the association showed a similar positive trend but did not reach statistical significance (p = 0.072). Among the cognitive domains of the 3MS, attention was significantly associated with serum zinc level in participants with lower serum albumin (p = 0.016).

CONCLUSIONS: Lower serum zinc was a novel factor associated with cognitive function, particularly in attention in patients undergoing maintenance hemodialysis with low serum albumin.

PMID:41961222 | DOI:10.1007/s10157-026-02848-3

Thorac Cancer. 2026 Apr;17(7):e70280. doi: 10.1111/1759-7714.70280.

ABSTRACT

OBJECTIVES: To evaluate the prognosis of patients with nonsmall cell lung cancer (NSCLC) who did not undergo surgery after neoadjuvant chemotherapy combined with immunotherapy (NACI). Patients were grouped according to subsequent treatment: radiotherapy (RT) or nonradiotherapy (non-RT), and the prognostic importance of positron emission tomography/computed tomography (PET/CT) was further assessed.

MATERIALS AND METHODS: This retrospective study included NSCLC patients who received NACI between November 2020 and September 2024 at the Cancer Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College. Not all patients underwent surgery and subsequently received either RT or non-RT treatment. Patients were stratified by whether PET/CT was performed and by their SUV-max values before RT or non-RT. Progression-free survival (PFS) and overall survival (OS) were calculated from the start of neoadjuvant therapy using the Kaplan-Meier method.

RESULTS: A total of 73 eligible patients were enrolled: 21 (28.8%) in the non-RT group (nRTG) and 52 (71.2%) in the RT group (RTG). The median follow-up time for all patients in the group was 18 months. The results show no significant difference in PFS (p = 0.653) or OS (p = 0.742) between RTG and nRTG. Among the patients who did not undergo PET/CT examination, the results showed a significant difference in PFS (p = 0.022), but no difference in OS (p = 0.320). Among the patients undergoing PET/CT examinations, in terms of PFS, compared to nRTG + SUV-max ≤ 4 g/mL, there is no significant difference in RTG + SUV-max ≤ 4 g/mL (p = 0.584), and RTG + SUV-max > 4, < 8 g/mL (p = 0.156). However, RTG + SUV-max ≥ 8 shows a statistical difference (p = 0.005).

CONCLUSION: Among NSCLC patients who did not undergo surgery following NACI, no significant differences in OS or PFS were observed between the RTG and nRTG groups. For patients who did not receive PET/CT evaluation, radiotherapy remains a key therapeutic option. In patients with a PET/CT SUVmax ≤ 4, radiotherapy may be safely omitted. In comparison, patients with a PET/CT SUVmax > 4 should be managed with a comprehensive treatment strategy that includes radiotherapy as the main component. PET/CT plays a critical role in guiding subsequent treatment selection.

PMID:41960615 | DOI:10.1111/1759-7714.70280

Pharmacoepidemiol Drug Saf. 2026 Apr;35(4):e70368. doi: 10.1002/pds.70368.

ABSTRACT

PURPOSE: Concurrent use of benzodiazepines and opioids is discouraged due to synergistic adverse effects. However, patients undergoing total hip or knee arthroplasty (THA/TKA) often receive them, particularly in the first 3 postoperative months. We identified factors associated with new outpatient concurrent benzodiazepine-opioid dispensation following THA/TKA.

METHODS: In this nationwide cohort study, we linked the Dutch Arthroplasty Register with the Dutch Foundation for Pharmaceutical Statistics, which provided medication dispensation data. We included all patients undergoing primary elective THA/TKA (2013-2022) who had no preoperative concurrent use in the 6 months pre-procedure. The primary outcome was ≥ 7 days of a new concurrent benzodiazepine-opioid dispensation within 90-day postoperative. Determinants included patient and implant characteristics, and preoperative medication use. Multivariable logistic regression analyses were performed, adjusted for age, sex, and comorbidity.

RESULTS: Among 89 139 THA and 76 710 TKA patients, 3756 (4%) and 5571 (7%), respectively, received new postoperative concurrent benzodiazepine-opioid dispensation within 90-days postoperative. The main factor associated with such dispensation was preoperative benzodiazepine use (THA: OR 23.5 [95% CI: 21.8-25.3], TKA: OR 22.8 [95% CI: 21.3-24.3]), followed by preoperative antidepressant/anxiolytic use (THA: OR 2.9 [95% CI: 2.6-3.1], TKA: OR 2.5 [95% CI: 2.3-2.7]). Other factors included female sex, current smoking, and American Society of Anesthesiologists (ASA) scale III-IV. Preoperative pain scores, preoperative opioid use, and implant characteristics showed little to no association with the outcome.

CONCLUSIONS: Preoperative benzodiazepine use was the main factor associated with new outpatient concurrent benzodiazepine-opioid dispensation after THA/TKA, followed by preoperative antidepressant/anxiolytic use. These results highlighted that careful review of the patient’s medication history when planning postoperative pain management could help prevent unsafe co-prescription.

PMID:41960602 | DOI:10.1002/pds.70368

Health SA. 2026 Mar 13;31:3233. doi: 10.4102/hsag.v31i0.3233. eCollection 2026.

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare systems, posing risks for adolescents living with HIV (ALHIV) in resource-limited, high HIV-prevalence settings. These disruptions threatened antiretroviral therapy (ART) adherence, viral load suppression (VLS) and retention in care (RiC).

AIM: This study aimed to compare treatment outcomes of ALHIV on ART in the Khayelitsha and Eastern Substructure (KESS) before and during the COVID-19 pandemic.

SETTING: The study was performed in KESS, Cape Town, South Africa.

METHODS: A retrospective cohort analysis was conducted among ALHIV aged 10-19 years receiving ART at public health facilities, pre-COVID-19 (before 01 March 2020) and during COVID-19 (01 March 2020-31 December 2021). Sociodemographic, clinical, and treatment data were analysed. Descriptive and inferential statistics compared outcomes and determined factors associated with VLS (< 1000 copies/mL) using SPSS v.30.

RESULTS: Data from 1702 ALHIV (pre-COVID-19) and 2733 ALHIV (during COVID-19) were analysed. Viral load suppression declined from 82.1% to 64.8%, while full VLS (< 50 copies/mL) from 70.8% to 53.7% (p = 0.065). Antiretroviral therapy adherence fell from 96.4% to 70.0% (p < 0.001), and RiC 80.3% to 76.3% (p < 0.001). In multivariate analysis, higher CD4 count, and consistent ART adherence predicted VLS.

CONCLUSION: Antiretroviral therapy adherence and VLS rates among ALHIV declined during COVID-19. Adolescent-centred healthcare delivery models are needed to ensure continuity of HIV treatment during public health emergencies.

CONTRIBUTION: This study provides local evidence on the pandemic’s impact in a high-burden South African context. By quantifying declines in ART adherence, RiC, and VLS, it highlights ALHIV vulnerabilities and the need to strengthen adolescent-responsive, resilient healthcare systems.

PMID:41960585 | PMC:PMC13058524 | DOI:10.4102/hsag.v31i0.3233

Bioinformation. 2026 Jan 31;22(1):385-387. doi: 10.6026/973206300220385. eCollection 2026.

ABSTRACT

Orthodontic appliances influence patients’ oral functions, especially speech and mastication. Therefore, it is of interest to compare speech and mastication difficulties among patients treated with clear aligners and conventional braces. One hundred participants were assessed through a validated questionnaire and performance tests. Clear aligners showed fewer articulation and chewing problems than fixed braces. The differences were statistically significant. Thus, we show clear aligners may provide improved comfort and oral function during orthodontic treatment.

PMID:41960548 | PMC:PMC13058382 | DOI:10.6026/973206300220385

Bioinformation. 2026 Jan 31;22(1):405-408. doi: 10.6026/973206300220405. eCollection 2026.

ABSTRACT

The success of dental implants is influenced by the timing of prosthetic loading. Therefore, it is of interest to compare the clinical and radiological outcomes of immediate loading (IL) versus conventional loading (CL) of dental implants supporting fixed prostheses. Hence, a total of 30 patients were randomly assigned to either IL or CL groups. Clinical parameters such as implant stability (measured by Periotest), peri-implant soft tissue health and radiographic marginal bone loss (MBL) were evaluated over a 12-month period. Results indicated that both groups demonstrated high implant survival rates (96.6% IL vs 100% CL), with no statistically significant differences in MBL at 3, 6 and 12 months (p > 0.05). However, IL provided faster functional rehabilitation and patient satisfaction. Thus, we show the clinical viability of immediate loading protocols in appropriately selected cases, without compromising implant stability or bone levels.

PMID:41960537 | PMC:PMC13058331 | DOI:10.6026/973206300220405

Bioinformation. 2026 Jan 31;22(1):175-179. doi: 10.6026/973206300220175. eCollection 2026.

ABSTRACT

Titanium (Ti) dental implants are considered the gold standard in edentulous rehabilitation. However, the tribocorrosion and subsequent release of titanium ions into the systemic circulation has become an issue of concern. Hence, this prospective longitudinal study used the Inductively Coupled Plasma Mass Spectrometry (ICP-MS) at baseline, 1-week and 6-months post-operative in order to study serum titanium levels in 60 healthy patients that were undertaking the implant surgery. The baseline serum titanium levels were 1.42 ± 0.55 ng/mL with a statistically significant increase of the mean serum titanium levels to 2.15 + 0.82 ng/mL after one week post- operation and a partial stabilization to 1.94 + 0.71 ng/mL at 6 months. Though, the dental implant placement causes a statistically significant increase in the levels of titanium in the systemic compartments, these levels are far below the accepted toxicological limits.

PMID:41960517 | PMC:PMC13058369 | DOI:10.6026/973206300220175