Nevin Manimala

Jpn J Ophthalmol. 2025 May 5. doi: 10.1007/s10384-025-01208-0. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the clinical features and prognostic factors of patients with thyroid eye disease (TED) combined with myasthenia gravis (MG) at a tertiary comprehensive hospital in China during a 10-year period.

STUDY DESIGN: retrospective study.

METHODS: A case series of patients diagnosed with TED combined with MG was conducted at a tertiary general hospital over 10 years. Medical records of general conditions, clinical presentation, imaging and laboratory tests, treatment modalities, and prognostic outcomes were reviewed.

RESULTS: Twenty-three patients with TED combined with MG were found throughout the study period. The mean age was 42.57 ± 14.89 years with 10 men and 13 women. Ocular motility disorders (82.61%), diplopia (73.91%), and ptosis (73.91%) were the primary clinical manifestations, and ocular motility disorders with limited movement in all directions were common (17 eyes) (50.00%). Active (69.57%) and moderate-to-severe (82.61%) TED was common, and hyperthyroidism was the most common complication of thyroid disease (57.17%). Ocular MG was the predominant subtype of MG (86.96%). Chest CT or pathologic examination identified thymic hyperplasia in 4 patients (17.39%) and thymoma in 1 patient (4.35%). A statistically significant association was observed between smoking and an unfavorable prognosis of TED combined with MG (P<0.05).

CONCLUSIONS: MG should be taken into account in patients with TED who exhibit the following: unilateral or bilateral ptosis, ptosis in one eye and upper eyelid retraction in the other, obvious eye movement disorders without or with mild involvement of the extraocular muscles on imaging, and symptoms of morning and evening fluctuations. Ophthalmologists should refer these patients to the Department of Neurology to avoid misdiagnosis or underdiagnosis. The co-occurrence of TED and MG is rare clinically, mostly affecting young and middle-aged women, with ocular MG and hyperthyroidism as the main clinical subtype, and thymic hyperplasia or thymoma in a small percentage. Smoking is an independent risk factor for poor prognosis of TED combined with MG.

PMID:40323520 | DOI:10.1007/s10384-025-01208-0

Naunyn Schmiedebergs Arch Pharmacol. 2025 May 5. doi: 10.1007/s00210-025-04223-7. Online ahead of print.

ABSTRACT

The research aims at identifying the risk of adverse events, including acute myocardial infarction (AMI) readmission, heart failure (HF) readmission, and cardiovascular (CV) death induced by sacubitril/valsartan in patients with end-stage renal disease (ESRD) and HF. This data came from the Taiwan National Health Insurance Research Database (NHIRD). Propensity scoring (PS) matching was used. Cox proportional hazard model was applied to calculate the hazard ratio (HR) and 95% confidence interval (CI) for adverse events among the study groups. After propensity score matching, among HF + ESRD patients, 854 received sacubitril/valsartan, and the other 854 patients did not. Compared to patients who did not receive sacubitril/valsartan, patients with sacubitril/valsartan were more likely to suffer AMI readmission (aHR = 1.85, 95% CI = 1.42-2.41), HF readmission (aHR = 2.21, 95% CI = 1.93-2.55), and CV death (aHR = 1.65, 95% CI = 1.28-2.12) after matching. Patients who received sacubitril/valsartan for less than 75 days had a greater risk of AMI readmission (aHR = 2.83, 95% CI = 2.27-3.53), HF readmission (aHR = 5.36, 95% CI = 4.75-6.06), and CV death (aHR = 2.27, 95% CI = 1.81-2.85) than non-sacubitril/valsartan cohorts. However, when the patients received sacubitril/valsartan for ≥ 185 days, they had a trend toward a lower risk of AMI readmission (aHR = 0.66, 95% CI = 0.41-1.04), HF readmission (aHR = 0.84, 95% CI = 0.68-1.03), and CV death (aHR = 0.83, 95% CI = 0.55-1.24) than the non-sacubitril/valsartan cohort, although it did not reach statistical significance. This study highlights significant risks associated with sacubitril/valsartan, particularly in the short term, and the protective effect of prolonged use of sacubitril/valsartan in HF + ESRD patients.

PMID:40323509 | DOI:10.1007/s00210-025-04223-7

Fam Cancer. 2025 May 5;24(2):44. doi: 10.1007/s10689-025-00466-8.

ABSTRACT

Germline (likely-)pathogenic variants (PV) in CDH1 predispose carriers to hereditary diffuse gastric cancer and lobular breast cancer. Previous studies from the United States suggest CDH1 variant carriers have an increased risk for adenomas or sessile serrated lesions (SSL), yet data linking CDH1 PVs and colorectal neoplasia are scarce. We aimed to investigate colonoscopy findings in CDH1 PVs. Adults carrying a PV/LPV in CDH1 with ≥ 1 colonoscopy between 01/01/2004-12/31/2023 were included. Patients were sourced from the David G. Jagelman Inherited Colorectal Cancer Registries at Cleveland Clinic and the German Consortium for Familial Intestinal Cancer. 103 CDH1 PV carriers were included. Most were female (66%) and white (93.1%). The median age at first colonoscopy was 47 years. The adenoma detection rate (ADR) was 29.4% (95% CI:19.9-41.1%) in the German cohort and 48.6% (95% CI: 33.0-64.4%) in the Cleveland cohort (p = 0.055) and significantly correlated with age (< 45 years, 13.6% (95% CI: 6.40-26.7%); 45-49 years, 52.4% (95% CI: 32.4-71.7%); ≥50 years, 52.6% (95% CI: 37.3-67.5%); p < 0.001). The ADR in Cleveland was higher than the U.S. average ADR but the difference was not statistically significant (48.6% vs. 35.6%, p = 0.08), and the ADR in the German cohort (29.4%) was similar to the national German average risk screening cohort (31.3% in men, p = 0.84; 20.1% in women, p = 0.08). In our screening cohort with CDH1 PV carriers, we demonstrated an ADR of 13.5% in individuals under 45 years, similar to the ADR in patients aged 25-40 years with a family history of CRC. Overall, SSL detection rate was 9.7%. Colorectal cancer was diagnosed in 3 patients (3.2%), 2/3 with an early age of onset before the age of 50 years. This first international study provides preliminary evidence of a higher ADR in U.S. CDH1 PV carriers compared to the general population, with a high number of adenomas detected before the age of 50. This may indicate an increased CRC risk that should be explored in larger studies.

PMID:40323501 | DOI:10.1007/s10689-025-00466-8

Eur Rev Med Pharmacol Sci. 2025 Apr;29(4):199-210. doi: 10.26355/eurrev_202504_37167.

ABSTRACT

OBJECTIVE: Rapid and accurate pathogen identification is critical for the effective management of native septic arthritis (NSA) and periprosthetic joint infections (PJIs), enabling timely, targeted antimicrobial therapy and improving patient outcomes. This study aimed to evaluate the diagnostic performance and clinical relevance of the BIOFIRE Joint Infection Panel (BJIP) in NSA and PJI. MATERIALS AND METHODS: A prospective investigation was conducted, including samples from patients with suspected NSA and PJI. The diagnostic performance and turnaround time of BJIP were compared to conventional culture methods, with an additional analysis of BJIP’s clinical impact. RESULTS: A total of 80 patients were included. The BJIP displayed a higher sensitivity (67%) compared to conventional culture (47%), albeit without any statistical significance (p = 0.078), and a specificity of 94%. Total percent agreement was estimated at 66% ( = 0.36). The combination of BJIP and culture significantly improved sensitivity (74%) compared to conventional culture alone (p = 0.0001) or BJIP alone (p = 0.03). BJIP sensitivity was 57% in NSA and 72% in PJI, with a higher sensitivity observed in late acute PJI (90%) compared to early acute (60%) and chronic PJI (33%). However, this difference was not statistically significant (p = 0.122). Among patients with prior antibiotic therapy, BJIP exhibited significantly higher sensitivity than conventional culture (68% vs. 35%, p = 0.006). BJIP also reduced the turnaround time for pathogen detection by 83 hours. Retrospective analysis suggested a BJIP-based clinical management improvement among 31% of infected and 50% of uninfected individuals. CONCLUSIONS: Our study demonstrated a high sensitivity and specificity of BJIP in diagnosing joint infections. The combination of BJIP and conventional culture emerged as an optimal diagnostic approach. BJIP outperformed conventional culture among patients with prior antibiotic treatment, substantially reduced the turnaround time for pathogen identification, and showed potential for improving clinical management.

GRAPHICAL ABSTRACT: https://www.europeanreview.org/wp/wp-content/uploads/Graphical-abstract-1.png.

PMID:40322824 | DOI:10.26355/eurrev_202504_37167

Eur Rev Med Pharmacol Sci. 2025 Apr;29(4):174-179. doi: 10.26355/eurrev_202504_37162.

ABSTRACT

OBJECTIVE: Nerve growth factor (NGF) and glial cell line-derived neurotrophic factor (GDNF) are proteins that support the growth and survival of neurons, and they have also been demonstrated to have potential effects on immune modulation and inflammatory diseases. This study aims to evaluate serum levels of nerve growth factor NGF and GDNF in patients with Behçet’s disease and to explore their potential roles in disease pathogenesis and activity. MATERIALS AND METHODS: Serum NGF and GDNF levels were measured in 34 Behçet’s disease patients and 37 healthy controls using enzyme-linked immunosorbent assay (ELISA). Patients were classified as having active or inactive Behçet’s disease. Statistical analyses were performed to assess differences in neurotrophic factor levels between groups and their associations with clinical parameters. RESULTS: Serum NGF and GDNF levels were significantly lower in Behçet’s disease patients compared to healthy controls (p=0.015 and p=0.022, respectively). Active BD patients exhibited higher NGF and GDNF levels than those with inactive disease (p<0.001 for both). Neurological involvement and other clinical manifestations, such as arthritis and uveitis, did not significantly influence NGF and GDNF levels (p>0.05). Furthermore, no correlations were found between neurotrophic factor levels and laboratory parameters, including ESR and CRP. CONCLUSIONS: NGF and GDNF levels are altered in Behçet’s disease, with significant variations based on disease activity. Elevated levels in active Behçet’s disease may reflect their involvement in inflammatory processes, while reduced levels in inactive disease could indicate immune dysregulation. Further longitudinal studies are warranted to elucidate their mechanistic contributions to Behçet’s disease pathogenesis.

GRAPHICAL ABSTRACT: https://www.europeanreview.org/wp/wp-content/uploads/Graphical-Abstract-1-1.png.

PMID:40322820 | DOI:10.26355/eurrev_202504_37162

Pol Merkur Lekarski. 2025;53(2):250-255. doi: 10.36740/Merkur202502114.

ABSTRACT

OBJECTIVE: Aim: The aim is to investigate the mental health indicators of cadets during their stressful academic training under martial law.

PATIENTS AND METHODS: Materials and Methods: The research, which was conducted in the academic year 2023-2024, involved 253 male cadets of the 1st-4th training years at the National Academy of Internal Affairs (Kyiv, Ukraine). Research methods: theoretical analysis and generalization of literary sources, mental health testing, and methods of mathematical statistics. Seven psycho-diagnostic methods were used to test the cadets’ mental health.

RESULTS: Results: The results obtained indicate a pronounced negative impact of stressors of academic activities under martial law on the cadets’ mental health and, in particular, on the level of manifestation of stress disorders, a tendency to develop stress, reduced stress resistance, increased nervous and emotional stress, anxiety, and deterioration of the emotional state. The most pronounced negative changes in these indicators of mental health were found in cadets who have not developed skills to cope with stress during academic activities and the use of effective means of stress prevention and restoration of psycho-emotional state (junior cadets).

CONCLUSION: Conclusions: The research demonstrates the urgent need to develop cadets’ stress resistance during academic training to ensure the effectiveness of their educational activities under martial law and further service activities, as well as to develop skills in the use of available means to prevent stressful phenomena in the process of education during the war.

PMID:40322809 | DOI:10.36740/Merkur202502114

Pol Merkur Lekarski. 2025;53(2):229-238. doi: 10.36740/Merkur202502112.

ABSTRACT

OBJECTIVE: Aim: This study investigates dehumanization and attitudes toward LGBTQ+ individuals among primary healthcare nurses in Greece, exploring the influence of personality traits, empathy, and LGBTQ+ health knowledge.

PATIENTS AND METHODS: Materials and Methods: A cross-sectional design was used with 114 public-sector primary healthcare nurses completing self-report questionnaires between July and October 2023. Instruments included a culturally adapted dehumanization scale, the Ten-Item Personality Inventory, and the Toronto Empathy Questionnaire. Statistical analysis included Mann-Whitney and Kruskal-Wallis tests, Spearman’s correlations, and linear regression.

RESULTS: Results: The sample was predominantly female (74.6%), heterosexual (93.9%), and Christian Orthodox (93%). Only 8.8% had attended LGBTQ+ healthcare courses, and 33.3% had cared for LGBTQ+ patients. Mechanistic dehumanization showed limited associations with personality traits, while animalistic dehumanization was negatively correlated with willingness to care (r = -0.441, p < 0.001) and comfort with LGBTQ+ care (r = -0.391, p < 0.001). Empathy and openness to experience influenced attitudes and willingness to care. Higher empathy unexpectedly reduced willingness to care, while emotional stability and conscientiousness predicted dehumanization.

CONCLUSION: Conclusions: Findings highlight a moderate dehumanization trend among nurses, affecting LGBTQ+ patients’ care quality. Educational initiatives targeting LGBTQ+ health knowledge, empathy training, and the influence of personality traits are critical to fostering inclusive care and reducing dehumanization in healthcare settings.

PMID:40322807 | DOI:10.36740/Merkur202502112

Pol Merkur Lekarski. 2025;53(2):203-211. doi: 10.36740/Merkur202502108.

ABSTRACT

OBJECTIVE: Aim: This preclinical study was oriented towards evaluating the efficiency of newly developed antibiotics against a selection of multi-drug-resistant Staphylococcus aureus strains, with the broader aim of finding a potent candidate to counteract the increasing resistance issue.

PATIENTS AND METHODS: Materials and Methods: The study utilized four distinct strains of multi-drug-resistant Staphylococcus aureus (SA-1 to SA-4) and three novel antibiotics (NA-1 to NA-3) under controlled laboratory conditions. The bacterial strains were cultured in vitro, and a series of tests including drug susceptibility testing and the determination of minimum inhibitory concentrations (MIC) were conducted. Statistical analysis was carried out using two-way ANOVA and Bonferroni post-hoc tests to analyze the significance of the observed results.

RESULTS: Results: Our data showcased variations in the growth characteristics and resistance profiles of the different strains, helping in identifying the most potent antibiotic among the tested compounds. Notably, antibiotic NA-1 manifested the lowest MIC values against the strains SA-1 and SA-3, indicating a higher potency (p < 0.01). Moreover, NA-1 exhibited significantly lower MIC₅₀ and MIC₉₀ values (0.56 μg/mL and 0.95 μg/mL, respectively), suggesting that it had the best inhibitory power amongst the antibiotics tested against a majority of the strains (p < 0.05).

CONCLUSION: Conclusions: The findings from this preclinical in-vitro study accentuate the potential of novel antibiotic NA-1 as a promising candidate in combatting multidrug- resistant Staphylococcus aureus strains. However, further research, including in-vivo studies, is requisite to substantiate the efficacy of this antibiotic in a clinical setting.

PMID:40322803 | DOI:10.36740/Merkur202502108

Pol Merkur Lekarski. 2025;53(2):157-165. doi: 10.36740/Merkur202502102.

ABSTRACT

OBJECTIVE: Aim: The purpose of the study was to prove the effectiveness of platelet-rich plasma (PRP) application in the treatment of post-immobilization extra-articular contractures of the mandible by modeling the specified pathology and conducting morphological analysis of experimental material.

PATIENTS AND METHODS: Materials and Methods: The study involved an experiment conducted on 60 male WAG rats aged 9-11 months. Four groups were formed. Group 1 included 6 intact rats that were not subjected to any interventions and were withdrawn from the experiment one month after its initiation. Group 2 included 18 rats with a mandibular fracture in the angle region which was treated over the course of one month using an immobilizing muzzle. After removal of the muzzle, extra-articular mandibular contracture was diagnosed. All rats were withdrawn from the experiment one month after its initiation. Group 3 included 18 rats with mandibular fractures that were treated over the course of one month using an immobilizing muzzle. After removal of the muzzle, post-immobilization extra-articular mandibular contracture was diagnosed. Following this diagnosis, 6 rats were withdrawn from the experiment. The other rats received PRP injections into the contracture area every three days for 15 days. After completion of the treatment, these rats were also withdrawn from the experiment. Group 4 included 18 rats with a mandibular fracture. After modeling a mandibular fracture, PRP was injected into the soft tissues surrounding the fracture through the available holes in the immobilizing muzzle every five days for one month. After a month, the immobilizing muzzle was removed from the rats, among which 6 rats were randomly selected and withdrawn from the experiment. The other rats continued to be injected with PRP every three days for 15 days, after which the animals were withdrawn from the experiment. The material for morphological examination consisted of masseter muscle samples. Histological, histochemical, immunohistochemical, morphometric and statistical methods were used.

RESULTS: Results: The comprehensive morphological study showed that PRP in the masseter muscle had antifibrotic and anti-inflammatory effects, reduced the severity of alterative changes in muscle fibers and increased their regenerative potential, reduced the severity of hemodynamic disorders, and increased the number of vessels. The therapeutic effect of PRP was more pronounced in cases where it was applied both during the treatment of mandibular fracture using an immobilizing muzzle for one month and for an additional 15 days after its removal, compared to animals in which PRP was applied only during the 15 days following muzzle removal.

CONCLUSION: Conclusions: The comprehensive morphological study of experimental material conducted by the authors confirmed the effectiveness of platelet-rich plasma in the treatment of post-immobilization extra-articular contractures of the mandible, thereby expanding the available arsenal of treatment methods for this pathology.

PMID:40322797 | DOI:10.36740/Merkur202502102

Nat Ment Health. 2025 Feb;3(2):253-265. doi: 10.1038/s44220-024-00353-8. Epub 2025 Jan 8.

ABSTRACT

Alcohol use disorder (AUD) is highly heritable and burdensome worldwide. Genome-wide association studies (GWASs) can provide new evidence regarding the aetiology of AUD. We report a multi-ancestry GWAS focusing on a narrow AUD phenotype, using novel statistical tools in a total sample of 1,041,450 individuals [102,079 cases; European, 75,583; African, 20,689 (mostly African-American); Hispanic American, 3,449; East Asian, 2,254; South Asian, 104; descent]. Cross-ancestry functional analyses were performed with European and African samples. Thirty-seven genome-wide significant loci (105 variants) were identified, of which seven were novel for AUD and six for other alcohol phenotypes. Loci were mapped to genes, which show altered expression in brain regions relevant for AUD (striatum, hypothalamus, and prefrontal cortex) and encode potential drug targets (GABAergic, dopaminergic and serotonergic neurons). African-specific analysis yielded a unique pattern of immune-related gene sets. Polygenic overlap and positive genetic correlations showed extensive shared genetic architecture between AUD and both mental and general medical phenotypes, suggesting they are not only complications of alcohol use but also share genetic liability with AUD. Leveraging a cross-ancestry approach allowed identification of novel genetic loci for AUD and underscores the value of multi-ancestry genetic studies. These findings advance our understanding of AUD risk and clinically-relevant comorbidities.

PMID:40322774 | PMC:PMC12048032 | DOI:10.1038/s44220-024-00353-8