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Is the Treatment of Coronary Artery Disease Following the Recommendations Set Out in the Proposed Guidelines and in the SYNTAX Study?

Braz J Cardiovasc Surg. 2025 Aug 7;40(5):e20240248. doi: 10.21470/1678-9741-2024-0248.

ABSTRACT

INTRODUCTION: Coronary artery disease (CAD) is the main cause of death among cardiovascular diseases. Current guidelines aim to guide clinical practice in choosing the best treatment, based on the best scientific evidence. The SYnergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX) score uses anatomical and clinical factors, helping to assess the complexity of coronary lesions.

OBJECTIVE: To verify whether the treatment used in CAD complied with the recommendations set out in the guidelines and in the SYNTAX study.

METHODS: Single-center, cross-sectional, observational, descriptive, and retrospective study, which analyzed medical records over a three-year period. Patients diagnosed with CAD who had obstructive disease in at least two vessels were selected. The exams were evaluated by a specialist who was unaware of the report and the treatment used for each patient. SYNTAX 1 and 2 scores were calculated, and the recommended treatment was compared to the established treatment.

RESULTS: Two hundred and ten patients were distributed, according to SYNTAX Score 1, into the groups low (Group A), intermediate (Group B), and high risk (Group C). Of 155 patients in Groups B and C, 105 (67.7%) were treated with percutaneous coronary intervention (PCI), vs. 24 (15.5%) with CABG. When calculating the SYNTAX Score 2 of the 101 patients with recommended treatment for CABG, 71 (70.3%) received PCI, compared to 18 (17.8%) treated with CABG. All patients recommended for preferential treatment for PCI had the recommendation respected.

CONCLUSION: The treatment offered was not supported by current guidelines and recommendations. Expanding the sample size may determine the current situation of the treatment of CAD in Brazil.

PMID:40773620 | DOI:10.21470/1678-9741-2024-0248

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Open-Label Study: Over-the-Counter Oat Flour/Oat Oil/ Oat Extract-containing Lotion With Avenanthramides for Sensitive Skin and Psoriasis

J Drugs Dermatol. 2025 Aug 1;24(8):782-786. doi: 10.36849/JDD.9238.

ABSTRACT

BACKGROUND: Psoriasis is a common skin condition that affects the physical and emotional well-being of patients. Moisturizers have been shown to significantly improve skin condition and quality of life in this patient population. Skin afflictions such as atopic dermatitis and pruritis share etiological similarities with psoriasis, and oatmeal (Avena sativa)-containing lotion has proven effective in treating the symptoms of those conditions. However, data on the use of an over-the-counter oatmeal-containing lotion alone to treat the symptoms of psoriasis are limited.

METHODS: An open-label clinical study of 60 adult subjects with sensitive skin and mild to moderate psoriasis was completed. Subjects applied a topical lotion containing oat flour, oat oil, and oat extract with avenanthramides (the oatmeal-containing lotion) on the entire body, with a focus on dry patches, at least once daily for 4 weeks as the sole intervention to manage their symptoms. The primary objective of the study was to assess the efficacy and tolerability of the oatmeal-containing lotion in patients with psoriasis. Product satisfaction was also measured after 4 weeks of use.

RESULTS: After 4 weeks of treatment, subjects reported statistically significant improvements in all self-assessment parameters of skin condition, with no adverse effects reported. Overall, subjects expressed high satisfaction with the product.

CONCLUSIONS: This study provides evidence supporting the efficacy and tolerability of a topical, over-the-counter lotion containing oat flour, oat oil and oat extract with avenanthramides as the sole intervention for managing the symptoms of sensitive skin and mild to moderate psoriasis.

PMID:40773617 | DOI:10.36849/JDD.9238

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Study of Adjuvant Sensitive-Skin Cleansing and Moisturizing Regimen in Plaque Psoriasis

J Drugs Dermatol. 2025 Aug 1;24(8):739-743. doi: 10.36849/JDD.9163.

ABSTRACT

BACKGROUND: Epidermal barrier dysfunction is a key feature of plaque psoriasis. Skincare improves epidermal barrier function and is an increasingly recommended part of psoriasis management.

METHODS: This multicenter, blinded study of adults (N=46) with psoriasis evaluated the use of a gentle skincare regimen (cleanser, moisturizer, and optional moisturizer with SPF 35) as an adjunct to medical therapy during an 8-week period. Efficacy was assessed via clinical grading of body surface area (BSA), target lesion severity score (TLSS), physician global assessment (PGA), and bioinstrumentation for skin hydration and texture. Standard safety and tolerability assessments were performed, and subjects completed satisfaction and the Dermatology Life Quality Index (DLQI) questionnaires.

RESULTS: There was a statistically significant decrease in BSA by week 8 from 9.3 to 5.1 (P<0.05). Significant improvements in TLSS (10.9 to 3.5, P<0.05) and PGA (2.7 to 1.4, P<0.05) occurred by week 8, with improvements noted at each study time point (P<0.05 vs baseline). Bioinstrumentation showed reduced scaling and improved skin smoothness (P<0.05 at all timepoints vs baseline). DLQI results improved from 9.2 at baseline (a moderate effect of disease) to 2.9 at week 8 (small effect, P<0.05). There was a significant reduction in dryness, itching, and burning/stinging throughout the study (P<0.05 at all timepoints). Four adverse events occurred in 4 subjects (itching and burning/stinging) and resolved by the end of the study.

CONCLUSIONS: This study highlighted the benefit of skincare in conjunction with prescription products for plaque psoriasis. The skincare regimen supported the skin barrier and improved patient outcomes.

PMID:40773615 | DOI:10.36849/JDD.9163

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Two-Year Treatment Persistence of Guselkumab vs Other Biologics in Plaque Psoriasis Patients

J Drugs Dermatol. 2025 Aug 1;24(8):762-768.

ABSTRACT

OBJECTIVE: The study objective was to compare long-term treatment persistence between patients initiating guselkumab vs 3 commonly prescribed biologics in the United States.

METHODS: Adult plaque psoriasis patients enrolled in the CorEvitas Psoriasis Registry initiating guselkumab, adalimumab, secukinumab, or ixekizumab (July 2017 – January 2022) were divided into biologic-naïve and biologic-experienced cohorts. The primary outcome measure was average 2-year treatment persistence, estimated as restricted mean survival time (RMST), comparing guselkumab with adalimumab, secukinumab, and ixekizumab. Standardized mortality ratio weighting was used to adjust for confounding.

RESULTS: 1,007 biologic-naïve and 1,584 biologic-experienced treatment initiations were included. For biologic-naïve initiators, the weighted-average treatment persistence for guselkumab was 20.3 months (95% CI: 19.4, 21.3), 14.6 months (13.5, 15.7) for adalimumab; 17.5 months (16.5, 18.6) for secukinumab, and 18.9 months (17.8, 20.1) for ixekizumab. The RMST difference for guselkumab was 24.9 weeks (95% CI: 18.4, 31.3) vs adalimumab, 12.1 weeks (5.9, 18.2) vs secukinumab and 6.0 weeks (0.4, 12.4) vs ixekizumab. For biologic-experienced initiators, the weighted-average treatment persistence for guselkumab was 17.6 months (95% CI: 16.9, 18.4), 13.5 months (11.6, 15.5) for adalimumab, 16.5 months (15.7, 17.3) for secukinumab, and 16.9 months (16.1, 17.8) for ixekizumab. The RMST difference for guselkumab was 17.7 weeks (95% CI: 8.7, 26.7) vs adalimumab, 5.0 weeks (0.2, 9.1) vs secukinumab and 2.9 weeks (-1.9, 7.7) vs ixekizumab.

CONCLUSIONS: In both biologic-naïve and biologic-experienced cohorts in this real-world study, average treatment persistence was significantly longer for guselkumab compared to adalimumab and secukinumab and numerically longer compared to ixekizumab.

PMID:40773600

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Streamlining Psoriatic Arthritis Screening and Management Using the IDEOM Clinical Framework: A Quality Improvement Initiative

J Drugs Dermatol. 2025 Aug 1;24(8):777-781. doi: 10.36849/JDD.9210.

ABSTRACT

BACKGROUND: Psoriatic arthritis (PsA) is undiagnosed in up to 41% of cases, risking irreversible joint damage if untreated. This quality improvement initiative facilitates PsA screening, assessment, and rheumatology referral to improve patient outcomes.

METHODS: Our clinical framework integrated the Psoriasis Epidemiology Screening Tool (PEST) and the 12-item Psoriatic Arthritis Impact of Disease questionnaire (PsAID-12) into the electronic medical record system in 26 dermatology clinics. Psoriasis (PsO) patients underwent PsA screening via the PEST. Those scoring ≥3 or already diagnosed with PsA1 completed the PsAID-12, which guides management. PsAID-12 score >4 indicates an unacceptable symptom state, prompting treatment changes or rheumatology referral.2 Providers received results in real-time for review.

RESULTS: Over 27 months, 7,692 PsO patients were seen by dermatology providers. Of the 6,473 PsO patients without a PsA diagnosis, 37.2% completed the PEST; 12.5% scored ≥3 and completed the PsAID-12. 75.7% of patients who took the PsAID-12 scored ≤4, indicating effective management. Of the 24.3% of patients scoring >4, 24.7% were referred to rheumatology, and 44.4% subsequently received a diagnosis of PsA. When comparing the 493 patients who took the PsAID-12 at least twice, an average baseline PsAID-12 score of 2.80 was seen compared to an average most recent score of 2.53, indicating a significant reduction (P<0.0001).

CONCLUSION: Our study demonstrates the feasibility of IDEOM’s clinical framework in optimizing PsA screening, assessment, and quality of care.

PMID:40773599 | DOI:10.36849/JDD.9210

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The 988 Suicide and Crisis Lifeline: Evaluating college student knowledge and utilization of crisis services

J Am Coll Health. 2025 Aug 7:1-8. doi: 10.1080/07448481.2025.2542413. Online ahead of print.

ABSTRACT

OBJECTIVE: This study describes the prevalence of and relationships between suicide risk, substance use, and help-seeking intentions among college students, as well as knowledge and utilization of the 988 Suicide and Crisis Lifeline.

PARTICIPANTS: The sample included 1,345 racially diverse college students from a large, urban university in the Southeastern United States.

METHODS: SPSS was used to test correlational relationships between help-seeking intentions and suicide or substance use. Descriptive statistics revealed current rates of suicide risk, substance use, and help-seeking intentions.

RESULTS: Help-seeking intentions was negatively correlated with suicide risk, suicide behavior, and substance use frequency. Only 20 participants reported using the 988 Lifeline, while 56.6% of participants were unaware of the service. During a crisis, 21.9% of participants reported they would not contact any services.

CONCLUSIONS: These findings suggest the need for crisis training across services and social supports, and greater public awareness of mental health and crisis services.

PMID:40773536 | DOI:10.1080/07448481.2025.2542413

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Lipid Profile and Apolipoprotein B Serum Levels in the Vietnamese Population With Newly Diagnosed Elevated Low-Density Lipoprotein Cholesterol and Association With the Single-Nucleotide Variant rs676210: Cross-Sectional Study

JMIR Cardio. 2025 Aug 7;9:e76850. doi: 10.2196/76850.

ABSTRACT

BACKGROUND: Apolipoprotein B (APOB) rs676210 polymorphism has been associated with altered lipid metabolism and cardiovascular risk in various populations; however, data from Vietnamese populations remain limited.

OBJECTIVE: This study aimed to investigate the association of the APOB rs676210 variant with lipid profiles among Vietnamese individuals newly diagnosed with elevated low-density lipoprotein cholesterol (LDL-C).

METHODS: A cross-sectional study was conducted among 69 Vietnamese adults newly diagnosed with elevated LDL-C (≥130 mg/dL) at a tertiary hospital in Southern Vietnam. Participants were genotyped for APOB rs676210 using real-time polymerase chain reaction (PCR) with allele-specific probes. Lipid profile components, including LDL-C, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, and ApoB, were compared across genotype groups (AA vs GA/GG) and alleles (A vs G). Statistical analyses involved t tests, chi-square tests, and multivariable linear regression adjusted for age, sex, the BMI, and diabetes. P<.05 was considered statistically significant.

RESULTS: Of the 69 participants, 32 (46.4%) carried the AA genotype, while 37 (53.6%) carried the GA or the GG genotype. The AA genotype was associated with significantly higher LDL-C (mean 5.19, SD 0.95, vs mean 4.37, SD 0.97, mmol/L; P<.001), non-HDL-C (mean 5.94, SD 1.08, vs mean 5.31, SD 1.22 mmol/L; P=.03), and ApoB (mean 149.5, SD 26.3, vs mean 136.9, SD 15.2, mg/dL; P=.02) and lower HDL-C (mean 1.26, SD 0.31, vs mean 1.44, SD 0.39, mmol/L; P=.03) compared to the GA/GG genotype. Allele-based analysis showed that carriers of the A allele (98/138, 71%) also had higher LDL-C (mean 4.91, SD 1.02, vs mean 4.36, SD 0.97, mmol/L; P=.004) and ApoB (mean 145.6, SD 23.2, vs mean 135.9, SD 16.0, mg/dL; P=.02) than G allele carriers (40/138, 29%). These associations remained significant after multivariate adjustment.

CONCLUSIONS: APOB rs676210 polymorphism is associated with significant differences in lipid profiles among Vietnamese adults with elevated LDL-C. Specifically, the A allele and the AA genotype confer a more atherogenic profile, suggesting potential utility as a genetic marker in lipid screening and personalized cardiovascular risk management in this population.

PMID:40773287 | DOI:10.2196/76850

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Evaluation of keratoconus and its impact on vision-related quality of life

Optom Vis Sci. 2025 Aug 8. doi: 10.1097/OPX.0000000000002284. Online ahead of print.

ABSTRACT

SIGNIFICANCE: This study adds to the understanding of how different factors affect quality of life in people with keratoconus.

PURPOSE: To evaluate how various demographic factors, clinical characteristics, and treatment modalities influence quality of life in people with keratoconus.

METHODS: This prospective survey study recruited adult participants (18 years and older) with a history of keratoconus. Demographic information, clinical characteristics, visual and surgical treatment history, and responses to the National Eye Institute 25-Item Visual Functioning Questionnaire (NEI-VFQ-25) were collected.

RESULTS: Between June 2022 and June 2023, 40 participants completed the study. The mean age was 40.9 ± 15.1 years, and 70.0% were male. All participants wore contact lenses (52.5% scleral lenses, 45.0% corneal lenses, and 2.5% soft lenses), and 17.5% had a history of corneal crosslinking. Compared to scleral lens wear, corneal lens wear was associated with worse quality of life on the NEI-VFQ-25 overall composite (p=0.015), general vision (p=0.02), and mental health (p=0.052) domains. History of corneal crosslinking was associated with worse quality of life in the NEI-VFQ-25 overall composite (p=0.002), mental health (p=0.010), role difficulty (p=0.045), and dependency (p=0.021) domains. The five lowest-scoring NEI-VFQ-25 domains in this sample were general health, general vision, ocular pain, mental health, and role difficulties.

CONCLUSIONS: Factors such as the type of contact lens wear may influence an individual’s quality of life. In categories like mental health, general vision, and the overall composite score, scleral lens wearers reported better quality of life. Similarly, surgical treatment history may influence quality of life. Specifically, those with a history of corneal crosslinking reported worse quality of life scores in the categories of mental health, role difficulty, dependency, and the overall composite score. Although these factors were found to be statistically significant, not all reached clinical significance. To determine whether the relationships found in this study are repeatable across different populations, additional studies must be performed. Additionally, eye care providers must consider how different treatment options impact not only a patient’s vision and ocular health but also their quality of life.

PMID:40773279 | DOI:10.1097/OPX.0000000000002284

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Proteomic prediction of aortic disease: from statistical association to biological insight

Int J Surg. 2025 Aug 7. doi: 10.1097/JS9.0000000000003175. Online ahead of print.

NO ABSTRACT

PMID:40773259 | DOI:10.1097/JS9.0000000000003175

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Tracing SARS-CoV-2 clusters across local scales using genomic data

Proc Natl Acad Sci U S A. 2025 Aug 12;122(32):e2501435122. doi: 10.1073/pnas.2501435122. Epub 2025 Aug 7.

ABSTRACT

A quantitative understanding of local transmission dynamics is essential for designing effective prevention strategies. In this study, we developed a computational workflow to identify viral introductions and trace locally circulating clusters. We analyzed over 26,000 SARS-CoV-2 genomes and their associated metadata, collected between January and October 2021, to explore introduction and local dispersal patterns in Greater Houston, a major metropolitan area known for its demographic diversity. Our analysis identified more than 1,000 independent introduction events, resulting in clusters of varying sizes. The majority of introductions originated from domestic sources, while international introductions occurred earlier and were associated with larger cluster sizes. An analysis of locally circulating clusters revealed age-structured transmission dynamics. Geographic reconstruction of cluster spread identified Harris County as the primary viral source for surrounding areas. The outbreak in the source population was characterized by 1) a smaller proportion of new cases associated with external viral imports and 2) longer persistence times of circulating lineages. Overall, our high-resolution spatiotemporal reconstruction of the epidemic provides essential insights into the local-scale transmission landscape, supporting outbreak-specific, regional response strategies and public health planning.

PMID:40773234 | DOI:10.1073/pnas.2501435122