Tag: nevin manimala

J Alzheimers Dis. 2025 Sep 22:13872877251378759. doi: 10.1177/13872877251378759. Online ahead of print.

ABSTRACT

BackgroundDiabetes has been linked to increased prevalence of dementia, but the link between diabetic retinopathy (DR) and Alzheimer’s disease (AD) remains unclear.ObjectiveThis study aimed to evaluate potential associations between DR and AD-related protein biomarkers in plasma and ocular fluid.MethodsA prospective, cross-sectional study collected human blood, vitreous, aqueous, and tear samples and measured amyloid-β (Aβ₄₀, Aβ₄₂), total-tau (t-tau), phosphorylated-tau (ptau181), glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL) by digital immunoassays.ResultsThe study included 79 eyes (79 patients) [41 females (59.4%); mean (SD) age 57.1 (12.2) years] of which DR was present in 44 (55.7%). All six biomarkers were significantly higher in plasma in participants with DR compared to those without DR [Aβ₄₀ p = 0.002, Aβ₄₂ p = 0.002, t-tau = 0.013, ptau181 p = 0.005, GFAP p = 0.010, and NfL p < 0.001]. Within vitreous, DR participants had significantly elevated t-tau (p = 0.002), ptau181 (p = 0.049), and NfL (p = 0.006); and within aqueous, higher NfL (p = < 0.001). Neuropsychological testing scores were lower in participants with DR than those without but did not reach statistical significance (Montreal-Cognitive-Assessment: p = 0.070; Mini-Mental-State-Exam: p = 0.057).ConclusionsThis study showed significant increases of AD associated protein biomarkers in plasma, vitreous, and aqueous in patients with DR. These results support a potential biological link between DR and AD pathology and suggest that DR, which tends to occur in younger individuals, may be a predictive factor for AD.

PMID:40982223 | DOI:10.1177/13872877251378759

J Urban Health. 2025 Sep 22. doi: 10.1007/s11524-025-01013-7. Online ahead of print.

ABSTRACT

While both individual- and neighborhood-level factors play a role in the progression from gestational diabetes mellitus (GDM) to type 2 diabetes mellitus (T2DM), few studies have simultaneously examined these two sets of factors. In this retrospective cohort study of 3567 women with a history of GDM, we used multilevel survival analysis to quantify T2DM risk associated with patient-level and neighborhood-level factors. During a mean follow-up of 2.2 years, 195 women (5.5%) developed T2DM. Statistically significant risk factors of T2DM progression included Black or Asian race, preeclampsia, family history of diabetes, and overweight or obesity. Importantly, residing in neighborhoods with a top tertile social deprivation index was also associated with increased risk (HR = 1.78, 95% CI: 1.01-3.14). In addition, after accounting for other factors, the residual clustering associated with neighborhoods conferred a 19% higher risk. Interventions addressing both individual- and neighborhood-level factors, including socioeconomic disparities, are critical to reducing the risk of T2DM in women with GDM.

PMID:40982206 | DOI:10.1007/s11524-025-01013-7

Obes Surg. 2025 Sep 22. doi: 10.1007/s11695-025-08274-w. Online ahead of print.

ABSTRACT

Metabolic-associated steatotic liver disease (MASLD) and its complications represent a growing global health challenge. Both Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) have demonstrated long-term benefits for liver health and are currently recommended by international guidelines for patients with MASLD who meet surgical criteria. However, few randomized controlled trials (RCTs) have directly compared the hepatic effects of these commonly performed bariatric procedures in this population. A systematic search of PubMed, EMBASE, and Cochrane CENTRAL was conducted to identify RCTs evaluating RYGB and SG in patients with obesity and MASLD, with a minimum follow-up of 12 months. The primary outcome was the change in hepatic fibrosis, assessed by the number of patients with advanced fibrosis postoperatively. Secondary outcomes included changes in liver enzymes and body mass index (BMI). Meta-analyses were performed using Review Manager 5.4 and RStudio 4.1.2. Three RCTs comprising 322 patients (160 undergoing RYGB, 162 undergoing SG) were included. Both procedures significantly reduced the number of patients with advanced fibrosis: SG (OR = 4.10; 95% CI: 2.18-7.69; p < 0.0001) and RYGB (OR = 12.78; 95% CI: 5.21-31.37; p < 0.00001). While RYGB showed a higher overall odds of fibrosis improvement compared to SG (OR = 1.63; 95% CI: 0.94-2.81), this difference was not statistically significant (p = 0.08). No significant differences were found between groups in liver enzyme reductions. Both RYGB and SG significantly improved hepatic fibrosis in patients with MASLD, with RYGB demonstrating a stronger, albeit non-statistically significant, trend toward fibrosis resolution. Both procedures also reduced liver enzyme levels, reinforcing the role of metabolic surgery in improving liver-related outcomes in this population.

PMID:40982201 | DOI:10.1007/s11695-025-08274-w

Clin Transl Oncol. 2025 Sep 22. doi: 10.1007/s12094-025-04023-8. Online ahead of print.

ABSTRACT

BACKGROUND: Breast cancer remains a major global health concern due to its heterogeneous nature influenced by genetic, biological, and environmental factors. Serum biomarkers offer promises for improving diagnostic precision and monitoring treatment response.

OBJECTIVE: To evaluate the diagnostic and prognostic significance of serum biomarkers including CA-125, CA-19-9, and CA-15-3 in breast cancer patients and to explore associations with clinical and biochemical parameters.

METHODS: A retrospective, single-center study was conducted in the Hail region, involving 187 breast cancer patients. Data were extracted from electronic health records. Statistical analyses, including ANOVA and regression models, assessed the relationships between serum biomarkers and clinical variables, such as age, cancer stage, obesity, and laboratory parameters. Serum biomarkers CA-125, CA-19-9, and CA-15-3 were quantified using electro-chemi-luminescence immunoassay (ECLIA) assay with Elecsys kits Roche Diagnostics, with detection limits of ~ 1.0 U/ml and inter-assay variability < 7%.

RESULTS: The highest incidence was observed in women aged 46-55 (26.7%) with obesity present in 50% of cases. Advanced stages (2 and 3) comprised 82.6% of diagnoses. CA-125 levels were elevated in middle-aged patients, while CA-19-9 was higher in younger individuals. CA-15-3 showed increased levels in early-stage cancer, suggesting its utility for early detection. Obesity was linked to increased CA-125 and decreased CA-19-9 levels. Laboratory findings revealed hypocalcemia, elevated bilirubin, high GGT, and increased HbA1c, indicating potential risks of bone metastases, hepatic dysfunction, and poor glycemic control.

CONCLUSION: Serum biomarkers demonstrate significant diagnostic and prognostic potential in breast cancer management. Findings support the importance of early detection, obesity management, and integrated monitoring to enhance outcomes and reduce relapse risk.

PMID:40982199 | DOI:10.1007/s12094-025-04023-8

Pharmaceut Med. 2025 Sep 22. doi: 10.1007/s40290-025-00586-7. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Regulatory agencies and policy makers increasingly recognize real-world evidence (RWE) as a valuable complement to randomized controlled trials (RCTs) in oncology, yet data on how US physicians who treat cancer use and perceive RWE remain limited. The study aimed to assess attitudes toward RWE among US physicians who treat cancer, including their confidence in interpreting it and reliance across clinical decision contexts.

METHODS: A cross-sectional national survey was administered in November 2024 to licensed US physicians who treat cancer, recruited from the American Society of Clinical Oncology (ASCO) member directory, using a random sample stratified by state population. Inclusion criteria were active US medical licensure and current involvement in oncology patient care. The survey instrument included sections on demographics and practice characteristics; RWE familiarity and usage frequency; comparative reliance on RWE versus RCTs in treatment selection, dosing, and outcome prediction (scales ranging from 0 to 10: 0 = complete reliance on RCT data, 10 = complete reliance on RWE); perceived barriers to adoption (4-point scale); and potential facilitators (4-point scale). Categorical data were summarized as counts and percentages, and continuous variables were summarized as means and standard deviations (SD). Chi-squared tests were used to compare categorical variables across groups, paired t tests were used to assess differences in mean reliance scores, and Spearman’s rho was used to evaluate correlations. Statistical significance was set at p < 0.05.

RESULTS: In total, 128 completed surveys were received. Overall, 94% of respondents (n = 120) were at least “somewhat familiar” with RWE, 14% (n = 18) used it “often,” and 3% (n = 4) reported daily use. 49% (n = 63) felt confident interpreting RWE studies, with late-career physicians (> 20 years of experience) less confident than their early and mid-career peers. Reliance on RWE was lower for treatment selection (mean 3.0, SD 1.7) than for dosing (mean 3.7, SD 2.0) or outcome prediction (mean 3.8, SD 2.0) (p < 0.001). Top barriers included reconciling conflicting RWE versus RCT data, data completeness, and bias. Key facilitators included improved analytical standards, guideline integration, and additional training.

CONCLUSIONS: While awareness of RWE is high among US physicians who treat cancer, they apply it selectively on the basis of clinical context, showing notably lower reliance for treatment selection. Addressing concerns about methodological rigor, data quality, and interpretive skills may strengthen RWE’s integration into oncology care.

PMID:40982185 | DOI:10.1007/s40290-025-00586-7

Acta Anaesthesiol Scand. 2025 Oct;69(9):e70124. doi: 10.1111/aas.70124.

ABSTRACT

BACKGROUND: Antibiotics are widely used in intensive care units (ICUs), yet detailed nationwide data on ICU-specific consumption are limited. In 2012, the Danish Health Authority introduced a policy framework to promote prudent antibiotic use. We evaluated national trends in antibiotic consumption across Danish ICUs from 2013 to 2023 considering this initiative.

METHODS: We conducted a nationwide observational study including all adult ICUs across 29 public hospitals in Denmark. All ICU admissions from January 1, 2013, to December 31, 2023, were included, covering 1,121,639 ICU patient days. Antibiotic consumption was assessed using defined daily doses (DDD) derived from national sales data. No interventions were implemented.

RESULTS: During the study period, a total of 1,624,281 DDD of intravenous antibiotics were administered. Overall antibiotic consumption declined from 1705 to 1348 DDD per 1000 patient days, representing a 21% relative reduction. Marked decreases were observed for fluoroquinolones (-80%), first- and second-generation cephalosporins (-61%), and carbapenems (-34%). Conversely, consumption of penicillins with beta-lactamase inhibitors increased by 139%. Run chart analyses indicated these trends were non-random. Importantly, no deterioration in clinical outcomes was observed. Antibiotic consumption varied widely across ICUs and regions. According to both WHO’s AWaRe framework and a modified national classification, ‘Watch’ antibiotics accounted for the largest share of consumption.

CONCLUSION: In this nationwide study of Danish ICUs, antibiotic consumption decreased substantially over an 11-year period-driven by reductions in broad-spectrum classes-without evidence of worsening clinical outcomes. These data document a sustained decline in broad-spectrum antibiotic use in Danish intensive-care practice and may provide a benchmark for other high-income healthcare systems.

EDITORIAL COMMENT: This inventory of antibiotics consumption in Danish intensive care units demonstrates a recent reduction in broad-spectrum antibiotic ordering which differs from the well-known increase of antibiotics used in health care in general.

PMID:40982183 | DOI:10.1111/aas.70124

Acta Neurol Belg. 2025 Sep 22. doi: 10.1007/s13760-025-02892-y. Online ahead of print.

ABSTRACT

BACKGROUND: Idiopathic Intracranial Hypertension (IIH) has been associated with comorbid sleep disorders. Although emerging evidence suggests a link between IIH and sleep disorders, yet this association remains underexplored. This case -control study aims to evaluate the prevalence of sleep-related abnormalities in patients with IIH using validated screening and severity assessment tools.

METHODS: 120 newly diagnosed, drug naive IIH patients and 40 age and gender matched controls were enrolled. Baseline characteristics and clinical parameters were evaluated. Headache severity was assessed using MIDAS and HIT6 questionnaires. Sleep disturbances were assessed using the Pittsburg Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), restless leg syndrome (RLS) scale, Berlin Questionnaire, and STOP-BANG questionnaire. Statistical analysis was conducted using SPSS v27.

RESULTS: The mean age of patients was 34.92 (9.42) years. IIH cases were predominately female (85%). Cases had significantly higher BMI (85% were overweight and obese). Poor sleep quality (PSQI ≥ 5) was significantly more common in IIH patients (46.67%) than controls (15%) (p < 0.001). High OSA risk was also more prevalent in IIH patients based on Berlin and STOP-BANG scores (p = 0.013 and p = 0.044 respectively). Although rates of Daytime sleepiness, RLS and Insomnia were higher in the IIH group, these differences were not statistically significant.

CONCLUSION: Patients with IIH exhibit significantly higher rates of sleep disturbances, particularly poor sleep quality, and increased risk of OSA based on screening tools, which were also associated with higher BMI and psychiatric comorbidities. These findings underscore the importance of routine sleep screening in IIH patients.

PMID:40982163 | DOI:10.1007/s13760-025-02892-y

Mol Biol Rep. 2025 Sep 22;52(1):941. doi: 10.1007/s11033-025-11059-0.

ABSTRACT

BACKGROUND: Mutations in NKG2D gene increase the risk of cancer, including chronic myeloid leukemia (CML). The Mutational landscape of exon 8 of NKG2D gene remains poorly characterized, especially in CML.

PURPOSE: Exploring the mutations in exon 8 of NKG2D gene of CML patients, examine its interactions with other genes, and evaluate associated biochemical, hematological and clinical-pathological parameters.

METHODOLOGY: Blood samples from CML patients and healthy controls were collected for molecular, biochemical and hematological assessments. Mutations in exon 8 of NKG2D gene were detected using Sanger sequencing. NKG2D gene interactions were predicted via GeneMANIA database.

RESULTS: in exon 8 of the NKG2D gene, mutations (substitution and deletion) were detected in 88% of CML patients, with 50% carrying multiple variants. Nine single nucleotide polymorphisms (SNPs) were identified, including eight substitutions and one deletion. The most frequent substitution was G > GC and six variants were novel. Homozygous 414G > C had the highest mutation score. GeneMANIA analysis revealed strong interactions between NKG2D and 20 other genes, notably HCST gene, with co-expression and pathway interactions involving thirteen and eleven genes, respectively. LDH levels were significantly higher in patients, while uric acid levels showed no significant difference. CML patients also had higher MID% and lower RBC count, hemoglobin and hematocrit levels. In addition, there were no statistically significant correlations between mutation burden and biochemical/hematological parameters.

CONCLUSION: NKG2D exon 8 mutations are highly prevalent among CML patients, with multiple or novel variants identified. A strong interaction profile of NKG2D with immune-related genes, indicating possible roles in leukemogenesis.

PMID:40982140 | DOI:10.1007/s11033-025-11059-0

Rheumatol Int. 2025 Sep 22;45(10):231. doi: 10.1007/s00296-025-05983-4.

ABSTRACT

Takayasu arteritis is a rare inflammatory disease that primarily affects medium- and large-sized arteries, particularly the aorta and its branches. The Hata classification defines six angiographic types based on the involved aortic segments. Clinical symptoms May vary depending on the distribution of arterial involvement. This systematic review and meta-analysis aimed to estimate the pooled prevalence of each angiographic type and evaluate their associations with clinical Manifestations.A systematic search of electronic databases was conducted to identify studies reporting angiographic classifications and clinical symptoms in patients with Takayasu arteritis. Pooled prevalence estimates were calculated using R software, including subgroup analyses by geographic area and imaging modality. Meta-regression was used to assess associations between angiographic types and specific clinical features.Type V was the most common angiographic subtype, with a pooled prevalence of 43.49%, while type III was the least common, 5.32%. Subgroup analyses showed statistically significant differences only for type IIb, based on modality types. Meta-regression revealed significant correlations between angiographic types and clinical symptoms, with Type V exhibiting the greatest severity, and types IIb and III the lowest.This meta-analysis highlights the varying distribution of angiographic types of Takayasu arteritis and their significant associations with clinical symptoms, which may guide prognostic and management strategies.

PMID:40982119 | DOI:10.1007/s00296-025-05983-4

Eur J Trauma Emerg Surg. 2025 Sep 22;51(1):294. doi: 10.1007/s00068-025-02967-8.

ABSTRACT

PURPOSE: The aim of the study is to introduce our experiences and surgical tips of free vascularized fibular grafting (FVFG) for the treatment of osteonecrosis of the femoral head (ONFH), and explore the clinical effect of the procedure.

METHODS: Between March 2016 and September 2022, the clinical data of 23 patients (26 hips) with ONFH were respectively analyzed. The involved hips were classified as stages III (23.1%), IIIA (57.7%), and IIIB (19.2%) according to the Association Research Circulation Osseous (ARCO) classification. The mean preoperative Harris Hip Score (HHS) was 60.9 ± 9.0. All patients were implemented the FVFG. The fibular bone flap was harvested 10 cm distal to the tip of the fibular head. Regular postoperative follow-up was performed to assess the union of the fibula flap and development of ONFH, and to examine the hip function. Statistically differences were analyzed between the preoperative and postoperative HSS (P < 0.05).

RESULTS: All patients were followed up for 13 to 93 months, and the HHS was 90. 9 ± 4. 5 at the last follow-up, indicating a statistically significant improvement compared to that preoperatively (P < 0.001). Postoperative X-rays, CT and MRI revealed no displacement of the fibular bone flap, and all the bone flap healed well without evidence of ONFH progression.

CONCLUSIONS: The treatment of ONFH with FVFG can significantly improve the hip joint function of patients. Incorporating these surgical tips and our experiences may contribute to improved procedural accuracy, enhanced effectiveness, potential cost-efficiency, and broader applicability for dissemination.

PMID:40982114 | DOI:10.1007/s00068-025-02967-8