Category: Nevin Manimala

Diabetes Obes Metab. 2026 Apr 13. doi: 10.1111/dom.70748. Online ahead of print.

ABSTRACT

AIMS: Although pregabalin is a first-line therapy for painful diabetic polyneuropathy (PDPN), its optimal dose-response relationship remains unclear. We conducted a network meta-analysis to evaluate the efficacy and safety of fixed pregabalin dosages in PDPN patients.

MATERIALS AND METHODS: We systematically searched major databases through October 2025 comparing various doses of pregabalin (75, 150, 300, and 600 mg/day) with placebo in adults with PDPN. The outcomes were short- and long-term changes in the average daily pain score, patient/clinician global impression of change, and adverse events (AEs) including dizziness, somnolence, headache, and peripheral oedema.

RESULTS: Twelve RCTs were eligible. In the short term, pregabalin 300 (Standardised Mean Difference [SMD], 1.09; 95% CI, 0.69-1.50) and pregabalin 600 mg/day (SMD, 0.90; 95% CI, 0.24-1.55) produced significant pain reduction compared with placebo. In the long term, both pregabalin 300 (SMD, 0.12; 95% CI, 0.06-0.17) and 600 mg/day (SMD, 0.31; 95% CI, 0.23-0.38) remained effective, whereas pregabalin 75 and 150 mg/day did not demonstrate superiority over placebo. Regarding safety, both pregabalin 300 and 600 mg/day were associated with greater risks of dizziness, somnolence, and peripheral oedema compared with pregabalin 75 mg/day, pregabalin 150 mg/day, and placebo.

CONCLUSION: Pregabalin doses ≤ 150 mg/day demonstrated no clinical benefit over placebo. Conversely, both pregabalin 300 and 600 mg/day showed a pain reduction effect at short- and long-term follow-up. Given that pregabalin 600 mg/day was associated with a higher incidence of AEs, pregabalin 300 mg/day appears to offer a more favourable balance, aligning potent efficacy with a manageable safety profile.

PMID:41969185 | DOI:10.1111/dom.70748

Diabetes Obes Metab. 2026 Apr 13. doi: 10.1111/dom.70747. Online ahead of print.

ABSTRACT

AIMS: To evaluate the accuracy of four general-purpose artificial intelligence (AI) models-ChatGPT (OpenAI), Gemini (Google), Claude (Anthropic) and DeepSeek (DeepSeek AI)-in calculating the carbohydrate content of meals compared with clinicians-calculated reference values.

MATERIALS AND METHODS: The primary endpoint was equivalence between clinicians and AI-generated calculations within an error margin of ±5%. One-hundred twenty-four meals were analysed, equally distributed among breakfast, lunch, dinner and snacks. Carbohydrate contents were jointly determined by two paediatric diabetologists and one clinical nutritionist using the USDA FoodData Central and CREA Italian Food Composition Tables. Each AI model received identical, standardized prompts in English describing the meals. Statistical analyses included the Two One-Sided Tests procedure, the Bland-Altman plots, the Wilcoxon signed-rank and the Spearman correlations.

RESULTS: The clinicians’ median carbohydrate content was 30.32 g. Model medians were 30.75 g (ChatGPT), 30.40 g (Gemini), 29.75 g (DeepSeek) and 29.25 g (Claude). ChatGPT showed the smallest bias, the narrowest limits of agreement, and the highest correlation with clinicians’ calculation. Only ChatGPT met the predefined ±5% equivalence criterion, whereas Gemini and DeepSeek achieved equivalence within a ±10% margin. Claude displayed the largest negative bias and the widest dispersion.

CONCLUSIONS: ChatGPT most accurately approximated clinicians’ carbohydrate calculation among the tested AI models and fulfilled strict clinical equivalence criteria. Although the other models tended to underestimate carbohydrate content, their mean deviations remained within clinically acceptable limits. These findings suggest that AI tools, particularly ChatGPT, may serve as useful adjuncts for carbohydrate counting for people with type 1 diabetes, supporting self-management.

PMID:41969183 | DOI:10.1111/dom.70747

Can J Gastroenterol Hepatol. 2026;2026(1):e1577589. doi: 10.1155/cjgh/1577589.

ABSTRACT

BACKGROUND: Esophageal variceal bleeding (EVB) is a serious complication of cirrhosis and a major cause of upper gastrointestinal hemorrhage, carrying substantial risks of mortality and treatment failure. Prognostic scores are essential for guiding management. This study evaluated and compared the predictive accuracy of the ABC and MAP(ASH) scores with established models in cirrhotic patients with EVB.

METHODS: We retrospectively analyzed 278 cirrhotic patients admitted for EVB at Da Nang Hospital, Vietnam, between January 2022 and January 2025 who underwent endoscopic variceal ligation. Data were collected for ABC, MAP(ASH), AIMS65, and Glasgow-Blatchford scores. Primary outcomes were in-hospital mortality and 5-day treatment failure. Predictive performance was assessed using AUROCs and statistical comparisons.

RESULTS: The ABC score achieved the highest AUROC for predicting in-hospital mortality (0.88), significantly surpassing the MAP(ASH), GBS, and AIMS65 scores (p < 0.001 for all pairwise comparisons). A similar trend was observed for predicting 5-day treatment failure, where the ABC score again demonstrated the highest AUROC (0.79), outperforming both the GBS and AIMS65 scores; however, it showed comparable performance to MAP(ASH) (p = 0.19). In addition, the ABC score’s risk stratification (low, medium, and high) accurately differentiated patients with varying mortality and treatment failure rates.

CONCLUSION: The ABC score is a highly effective and reliable tool for predicting in-hospital mortality and early treatment failure in cirrhotic patients with EVB. While the MAP(ASH) score remains valuable for predicting early treatment failure, the ABC score offers superior overall prognostic accuracy. These findings suggest that the ABC score can guide clinical decisions, particularly in resource-limited settings.

PMID:41969181 | DOI:10.1155/cjgh/1577589

J Ultrasound Med. 2026 Apr 13. doi: 10.1002/jum.70262. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the relationship between intrauterine device (IUD) malposition and patient-reported symptoms, identify risk factors associated with malposition, and assess the reliability of string checks compared with ultrasound findings.

METHODS: A retrospective chart review was conducted at West Virginia University between January 2021 and December 2023. Patients with malpositioned IUDs identified by pelvic ultrasound were included. Data collected included demographics, body mass index (BMI), IUD type, provider type, anatomical abnormalities, symptom profiles, and string check findings. Descriptive statistics were used to summarize the data, and associations with types of IUD malposition were assessed in the statistical analysis.

RESULTS: A total of 175 patients with malpositioned IUDs were identified. Approximately half of the patients were symptomatic (53.1%), most commonly reporting pelvic pain or abnormal uterine bleeding, while 46.9% were asymptomatic. Low intrauterine placement was the most frequent malposition pattern. String visualization was common but did not reliably exclude malposition. No demographic, device, or provider characteristics were significantly associated with specific malposition types.

CONCLUSIONS: Nearly half of patients with malpositioned IUDs were asymptomatic, and visible strings were frequently present, highlighting the limitations of symptom assessment and string checks. Ultrasound plays a central role in evaluating IUD position when clinical concern exists.

PMID:41969178 | DOI:10.1002/jum.70262

J Eur Acad Dermatol Venereol. 2026 Apr 13. doi: 10.1111/jdv.70442. Online ahead of print.

ABSTRACT

BACKGROUND: Dupilumab and tralokinumab for atopic dermatitis (AD) target the type 2 axis through different mechanisms of action, which may lead to variation in effectiveness and safety. Head-to-head trials, however, are lacking.

OBJECTIVES: To compare the real-world effectiveness and safety of dupilumab and tralokinumab in AD.

METHODS: This prospective cohort study enrolled biologic-/Janus kinase inhibitor-naïve AD patients (≥12 years) from the BioDay registry who initiated dupilumab or tralokinumab between November 2021 and September 2024. Visits were scheduled at baseline, 4 weeks and every 3 months up to 52 weeks. Effectiveness outcomes included Eczema Area and Severity Index (EASI), weekly mean pruritus Numeric Rating Scale (NRS), treat-to-target thresholds (EASI ≤ 7; NRS-pruritus ≤ 4, with patients discontinuing treatment considered non-responders) and drug survival. Adverse events (AEs) were assessed at each visit. Inverse probability of treatment weighting (IPTW) was used to balance treatment groups.

RESULTS: In total, 750 patients were included (643 dupilumab; 107 tralokinumab). After IPTW, baseline characteristics were well balanced. During follow-up, dupilumab patients had lower EASI scores than tralokinumab patients, although differences were not consistently statistically significant (p = 0.10). NRS-pruritus scores were significantly lower with dupilumab at all visits (p < 0.0001), mean differences did not exceed the 2-point clinical relevance threshold. The probability of achieving EASI ≤ 7 and NRS-pruritus ≤ 4 was higher with dupilumab (both p < 0.0001), with risk differences of 34.7% and 40.2% at 52 weeks, respectively. After 52 weeks, dupilumab drug survival was 92.6% vs. 70.6% for tralokinumab. Ocular surface disease incidence was similar (HR 1.0, 95% CI 0.6-1.6, p = 0.94) between treatments, leading to discontinuation of dupilumab in n = 23 (3.4/100 PY) and tralokinumab in n = 5 (5.4/100 PY).

CONCLUSIONS: In this real-world comparison, dupilumab provided superior effectiveness compared with tralokinumab. In responders continuing treatment, EASI and NRS-pruritus differences were small. More substantial differences were observed when treatment targets EASI ≤ 7 and NRS-pruritus ≤ 4, and discontinuation rates were taken into account.

PMID:41969170 | DOI:10.1111/jdv.70442

Curr HIV Res. 2026 Apr 7. doi: 10.2174/011570162X435140260327050554. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to determine the prevalence and diversity of dermatoses in HIV infected patients, and to compare alterations of skin lesion characteristics with the past literature.

METHODS: This retrospective, cross-sectional, single-center study was conducted on patients who were admitted to Şanlıurfa Training and Research Hospital between January 2020 and April 2023 with a diagnosis of HIV infection. Patients, whose dermatological examination had been performed, were included in the study.

RESULTS: Out of 144 individuals included in the study, 84.7% of them were male, and the median age was 34.5 (18-75). The prevalence of skin disorders among patients was found to be 57.6%. The most frequently dermatoses were condylomata acuminata (39.8%), telogen effluvium (16.9%), and scabies (9.6%). The frequency of condylomata acuminata and scabies was significantly higher in those with a history of homosexual intercourse. The number of skin findings increased as the CD4 count decreased, but the difference was not statistically significant (p > 0.05).

CONCLUSION: The pattern of HIV/AIDS-related skin disorders has transitioned during ART development; while the findings triggered by immunosuppression decreased, other sexually transmitted infections-related dermatoses and ART-related conditions dominated. Although dermatosis prevalence appears reduced in the ART era, HIV remains linked to a wide range of dermatological manifestations. This study shows that over half of patients still experience skin findings, underscoring the continued importance of dermatological assessment in the comprehensive care of people living with HIV.

PMID:41969168 | DOI:10.2174/011570162X435140260327050554

Chin Clin Oncol. 2026 Mar 30:cco-2025-aw-152. doi: 10.21037/cco-2025-aw-152. Online ahead of print.

ABSTRACT

BACKGROUND: Laparoscopic surgery has been increasingly adopted in the treatment of gastric cancer. Although the safety and efficacy of laparoscopic distal gastrectomy have been well established, evidence regarding laparoscopic total gastrectomy (LTG) remains limited, especially for early-stage disease. This study aimed to compare the short-term surgical outcomes and long-term survival between LTG and open total gastrectomy (OTG) in patients with stage 0-I gastric cancer.

METHODS: A retrospective analysis was conducted on the clinicopathological data of 122 patients with stage 0-I gastric cancer underwent radical LTG or OTG from January 2010 to December 2013. Multivariate regression with a generalized estimation equation (GEE) was used to analyze the differences in total complications, LTG-related complications and OTG-related complications between the laparoscopic and open groups. The inverse probability of treatment weighting (IPTW) Kaplan-Meier survival curve was used to compare the long-term survival of the two groups. The primary outcome was the short-term outcomes and long-term survival of LTG with traditional OTG for stage 0-I gastric cancer.

RESULTS: The incidence of postoperative complications was 16.4% in the LTG group and 18.4% in the OTG group, with no statistically significant difference between the two groups (P>0.05). In the adjusted multivariate GEE regression for OTG-related complications, the risk of OTG-related complications in the laparoscopic group was 0.111 (95% confidence interval: 0.016-0.771, P=0.03). Before and after IPTW adjustment, there was no statistically significant difference in survival between the LTG group and the OTG group (P=0.28 and P=0.34).

CONCLUSIONS: LTG is safe and feasible to apply in stage 0-I gastric cancer. Comparing OTG, LTG with a similar overall complication rate and long-term survival, but reduce the incidence of OTG-related complications and does not increase the risk of LTG-related complications in stage 0-I gastric cancer. However, these findings still need to be confirmed in a large clinical trial.

PMID:41969164 | DOI:10.21037/cco-2025-aw-152

Ann Palliat Med. 2026 Mar 24:apm-2025-1-145. doi: 10.21037/apm-2025-1-145. Online ahead of print.

ABSTRACT

BACKGROUND: Prognostic information is paramount in the decision-making of patients with cancer. Furthermore, the type of information required depends on cancer progression. However, preferences for such information among patients undergoing cancer chemotherapy for the first time have not been well-elucidated. This study aimed to identify patient preferences for prognostic information to improve informational support provided by healthcare providers.

METHODS: This study was conducted as part of a longitudinal study and analyzed data on preferences for prognostic information collected after one course of cancer chemotherapy. A questionnaire was used to assess preferences for prognostic information (life and functional prognoses), knowledge of chemotherapy, anxiety about adverse events (AEs), and information-seeking behaviors. Patient characteristics were collected, and the relationships between variables and preferences for prognostic information were analyzed.

RESULTS: Fifty-four patients participated in the study (mean age: 66.0 years; 55.6% male). Regarding prognosis, 40.7% of patients answered “strongly agree” or “agree” on a six-point scale to the degree to which they wanted to know their life prognoses, whereas 31.5-50.0% wanted to know their functional prognosis. No significant differences were observed in the types of prognostic information; however, each prognostic variable exhibited a positive correlation (r=0.60-0.89, P<0.001). Subgroup analyses were performed according to treatment intent (adjuvant, life-sustaining/palliative). In the life-sustaining/palliative group, a statistically significant association was observed between the propensity to seek information regarding life prognosis and the execution of information-seeking behavior among participants (P=0.04), and correlation analysis revealed a positive correlation between older adult-only households and thinking (r=0.40, P=0.02) and eating prognoses (r=0.38, P=0.03). In the adjuvant group, age exhibited a negative correlation with life prognosis (r=-0.59, P=0.009).

CONCLUSIONS: In Japanese patients undergoing cancer chemotherapy for the first time, both functional and life prognoses are important. Patients who wanted to know about one type of prognosis also tended to want information about another. For patients receiving life-sustaining/palliative care, life prognosis was important, and these patients tended to seek information. Being in an older adults-only household was significantly correlated with the desire for prognostic information, particularly thinking and eating habits. We speculated that this tendency would be observed only in the life-sustaining/palliative group, as these patients were more aware of approaching the end of life. In the adjuvant group, a tendency for decreased prognostic awareness was suggested in older adults, which may reflect a change in treatment values with age, from “life extension” to “functional maintenance”. Healthcare providers should offer individualized informational support that considers each patient’s specific treatment purpose and background rather than a one-size-fits-all approach.

PMID:41969162 | DOI:10.21037/apm-2025-1-145

Am J Biol Anthropol. 2026 Apr;189(4):e70249. doi: 10.1002/ajpa.70249.

ABSTRACT

OBJECTIVES: The objective of this study is to assess temporal change in vertebral size and shape in macaques born on Cayo Santiago from 1951 to 2002 in order to clarify patterns of temporal change identified in the cranium, appendicular skeleton, and body mass.

MATERIALS AND METHODS: We assessed overall size, vertebral body height, and overall shape using a published dataset of 3D coordinate data representing six vertebrae from 132 female and 78 male Rhesus macaques from Cayo Santiago. We performed multiple linear regression with year of birth and age at death as independent variables, and assessed differences between early (1950-1965) and late (1985-2002) cohorts using standard statistical methods.

RESULTS: We found decreases in overall size and vertebral body height over time across vertebrae. Females decreased more than males, resulting in greater sexual dimorphism over time. We found no evidence of vertebral shape change. Incidentally, we found that thoracolumbar vertebral body height is not sexually dimorphic in this group and that males largely maintain vertebral body height over time.

DISCUSSION: Our results are consistent with an overall reduction of the skeleton in this population rather than localized reductions in specific body regions or in soft tissue mass. Females displayed more extreme changes than males, and this pattern may suggest that females are under stronger selection for environmental reasons, possibly due to the physiological demands of pregnancy. Female-male differences may also reflect early female age at first birth, which occurs prior to full skeletal maturation and may directly affect female growth.

PMID:41969161 | DOI:10.1002/ajpa.70249

J Ultrasound Med. 2026 Apr 13. doi: 10.1002/jum.70255. Online ahead of print.

ABSTRACT

BACKGROUND: Ultrasound-guided prostate biopsy is the standard method for the diagnosis of prostate cancer. However, the effect of the optimal puncture approach on diagnostic yield and patient outcomes remains controversial.

OBJECTIVE: To compare the diagnostic effectiveness and clinical outcomes of ultrasound-guided transperineal versus transrectal prostate aspiration biopsy in patients suspected of prostate cancer.

METHODS: A retrospective analysis was conducted on 150 patients who underwent prostate biopsy at our hospital between February 2020 and August 2024. Patients were divided into transperineal (n = 62) and transrectal (n = 88) groups. Key outcomes including cancer detection rate, complications, pain (VAS), and negative emotions were compared, with p < .05 indicating a statistically significant difference.

RESULTS: No significant difference was found between the transperineal and transrectal groups in the detection rates of prostate cancer (51.61% versus 43.18%), chronic prostatitis (12.90% versus 18.18%), or benign prostatic hyperplasia (35.48% versus 38.64%). Transperineal biopsy required longer puncture time (22.92 ± 2.02 min versus 19.70 ± 1.93 min), but resulted in fewer overall complications (20.97% versus 38.64%), lower post-procedure pain scores (VAS: 2.82 ± 1.13 versus 3.68 ± 1.14), and lower anxiety (HAMA: 10.34 ± 1.29 versus 12.55 ± 1.44) and depression scores (HAMD: 10.33 ± 1.68 versus 12.90 ± 1.38).

CONCLUSION: Both ultrasound-guided transperineal and transrectal prostate biopsies are effective diagnostic methods for prostate cancer. Transperineal biopsy offers advantages in reducing postoperative complications, pain, and negative emotional responses, supporting its preferential use in selected patients.

PMID:41969148 | DOI:10.1002/jum.70255