Tag: nevin manimala

J Formos Med Assoc. 2026 Jan 2:S0929-6646(25)00699-0. doi: 10.1016/j.jfma.2025.12.042. Online ahead of print.

ABSTRACT

PURPOSE: Studies exploring changes in fibrosis markers and their predictive performance for histological fibrosis staging after hepatitis C virus (HCV) eradication are limited. The aim of this study was to examine the predictive performance of and exclusionary and confirmatory thresholds for the ELF test, FIB-4 index, APRI, M2BPGi, liver stiffness measurement (LSM) through acoustic radiation force impulse elastography, and the collagen proportionate area (CPA) for each METAVIR fibrosis stage after treatment.

METHODS: We examined 280 and 207 patients (3.1 ± 0.3 years) before and after HCV eradication, respectively, of whom 197 underwent paired liver biopsies. Statistical analysis assessed fibrosis markers’ predictive performance using AUROC and ROC curves, and their optimal thresholds.

RESULTS: The median ELF, FIB-4, APRI, M2BPGi, LSM, and CPA values for each METAVIR stage and the exclusionary and confirmatory thresholds for dichotomized METAVIR stages decreased after HCV eradication. The areas under the receiver operating characteristic curve (AUROCs) derived for ELF, FIB-4, APRI, M2BPGi, LSM, and CPA for predicting advanced fibrosis (F3-F4) were 0.803, 0.826, 0.784, 0.750, 0.863, and 0.920, respectively, before viral eradication and 0.710, 0.791, 0.766, 0.699, 0.810, and 0.901, respectively, after viral eradication. CPA had the highest AUROCs for predicting significant (F2-F4) and advanced fibrosis (F3-F4) before and after HCV eradication. Most of the fibrosis markers decreased significantly after viral eradication, regardless of METAVIR fibrosis stage changes.

CONCLUSIONS: Noninvasive fibrosis markers can be used at a low threshold to determine the stage of liver fibrosis, although their predictive performance decreases after HCV eradication.

PMID:41484047 | DOI:10.1016/j.jfma.2025.12.042

Dig Liver Dis. 2026 Jan 2:S1590-8658(25)01228-9. doi: 10.1016/j.dld.2025.12.002. Online ahead of print.

ABSTRACT

BACKGROUND: Autoimmune atrophic gastritis (AAG) is an immune-mediated disorder affecting the gastric oxyntic mucosa. Two pathogenetic models are proposed: a pure autoimmune disorder or gastric autoimmunity triggered by Helicobacter pylori (Hp)-infection. In AAG, histological diagnosis of Hp may be challenging and serology can help assess exposure to Hp-infection. This study aimed to determine seroreactivity to Hp-antigens in AAG patients by using Hp-multiplex serology assay.

METHODS: A single-centre case-control study on 178 adults: 75 patients with serological and histological AAG diagnosis, 25 controls with histologically Hp-positive-non-atrophic gastritis (Ctr-NAG-Hp+) and 78 subjects with a healthy stomach (Ctr-HS). Sera were analysed using Hp-multiplex serology assay allowing simultaneous detection of antibodies to 13 Hp-proteins. Overall positivity cutoff: seroreactivity to more than 3 Hp-antigens.

RESULTS: The number of seroreactive Hp-antigens was higher in AAG than in Ctr-HS(mean±SEM 2.2±0.3 vs 1.4±0.22,p=0.02) and lower than in Ctr-NAG-Hp+ patients (mean±SEM 5.4±0.5,p<0.001).Overall Hp-seropositivity in AAG was two-fold higher than in Ctr-HS but not statistically significant (21.1% vs 10.3%,p=0.06) and lower than in Ctr-NAG-Hp+(80%,p<0.0001). Complete absence of seroreactivity was similar in AAG and Ctr-HS (29.3% vs 38.5%, p=0.23) and significantly higher than in Ctr-NAG-Hp+ (4%, p=0.009). Main immunogenic Hp-proteins were HP0010(GroEL),HP1098(HcpC),HP0695(HyuA),HP0875(Catalase),HP1564,HP0547(CagA) and HP0243(NapA) with seroreactivity in >50% of AAG patients.

CONCLUSIONS: By Hp-multiplex serology, 30% of histologically Hp-negative AAG pts had no seroreactivity, likely belonging to the pure AAG type. Conversely, 20% of AAG pts showed Hp exposure, indicating that infection might have triggered gastric autoimmunity. The remaining AAG patients showed seroreactivity below cut-off for seropositivity and thus not definitively categorisable by this approach.

PMID:41484031 | DOI:10.1016/j.dld.2025.12.002

Nutr Metab Cardiovasc Dis. 2025 Dec 2:104483. doi: 10.1016/j.numecd.2025.104483. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Combined therapy, sodium-glucose cotransporter 2 inhibitors (SGLT2i), and glucagon-like peptide-1 receptor agonists (GLP1ra) reduce all-cause mortality in patients with diabetes. We aimed to analyse the differential behaviour of combined therapy between women and men regarding all-cause mortality.

METHODS AND RESULTS: This is a retrospective observational cohort study. Using “Big data” according to electronic medical records in the Santiago-Barbanza health area, which covers 450,000 patients. Out of 15,118 patients, 41 % were women. The median follow-up was 33 months. Women were older (71 [62-78] vs. 67 [59-75], p: <0.001) and with a higher incidence of obesity (53 % vs. 41 %, p: <0.001), meanwhile, men presented more coronary artery disease (CAD) (19 % vs. 9 %, p: <0.001). The multinomial propensity score and multivariate Cox regression were used for statistical analysis. All-cause mortality was compared between combined vs. monotherapy in women or men. Men had a higher risk of all-cause mortality than women in this population (HR [95 % CI] 1.50 [1.28-1.75]). Combined regarding monotherapy (GLP1ra (HR [95 % CI] 0.19 [0.14-0.27]), or SGLT2i (HR [95 % CI] 0.30 [0.23-0.40]), and treatment duration (HR [95 % CI] 0.95 [0.94-0.96] were associated with lower risk of all-cause mortality; with higher benefit in women (GLP1ra (HR [95 % CI] 0.14 [0.08-0.27]), or SGLT2i (HR [95 % CI] 0.18 [0.11-0.30]) regarding men (HR [95 % CI] 0.25 [0.16-0.40] for GLP1ra, and HR [95 % CI] 0.41 [0.29-0.58] for SGLT2i).

CONCLUSIONS: Combined therapy vs. monotherapy was associated with a lower risk of all-cause mortality in patients regardless of sex. Nevertheless, a higher benefit was observed in women regarding men.

PMID:41484025 | DOI:10.1016/j.numecd.2025.104483

Nutr Metab Cardiovasc Dis. 2025 Dec 2:104487. doi: 10.1016/j.numecd.2025.104487. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: The Mediterranean diet (MD) has been associated with better glycaemic control in children with type 1 diabetes mellitus (T1DM) and favourable microbiome profiles in healthy individuals. However, it remains unclear whether MD adherence is associated with glycaemic control via microbiome. This study examined the relationships among MD adherence, gut microbiome, and glycaemic control in adults with T1DM and assessed the microbiome’s ability to predict clinical and dietary outcomes.

METHODS AND RESULTS: In a cross-sectional study of 253 adults with T1DM, dietary intake was assessed using the EPIC food frequency questionnaire, and MD adherence was measured using the rMED score. Participants were stratified by adherence level (low, medium, high). Glycaemic control was evaluated using HbA1c and CGM metrics. Shotgun metagenomic sequencing of stool samples (n = 103) assessed the gut microbiome. Statistical analyses included ANOVA, PERMANOVA, LEfSe, and machine learning modeling. Higher MD adherence was associated with lower HbA1c levels (7.1 % vs 7.7 %; p < 0.001), greater time in range (67.0 % vs 59.4 %; p-trend = 0.03), and higher HDL cholesterol (1.62 vs 1.39 mmol/L; p = 0.01). High MD adherence was linked to a greater abundance of bacterial species such as Faecalibacterium prausnitzii. Both high MD adherence and lower HbA1c were associated with distinct microbiome functional pathways. Microbiome-based machine learning models predicted dietary patterns and clinical metrics.

CONCLUSIONS: In adults with T1DM, greater MD adherence is associated with better glycaemic control and a favourable gut microbiome. Specific microbial pathways may underlie these associations. Integrating diet and microbiome data supports personalized care. The study was registered at ClinicalTrials.gov with the identifier NCT05936242.

PMID:41484024 | DOI:10.1016/j.numecd.2025.104487

Acad Radiol. 2026 Jan 2:S1076-6332(25)01133-X. doi: 10.1016/j.acra.2025.11.047. Online ahead of print.

ABSTRACT

BACKGROUND: Deep learning image reconstruction (DLIR) has gained recognition as a promising technique to improve image quality in low-dose CT imaging. However, its performance in dual-energy CT portal venography (DE-CTPV), particularly under reduced contrast medium volume and radiation dose (dual-low dose) conditions, remains underexplored.

OBJECTIVE: This study aims to compare the performance of DLIR and adaptive statistical iterative reconstruction (ASIR-V) in DE-CTPV, with a focus on image quality across multiple vascular segments of the portal venous (PV) system under dual-low dose protocols.

METHODS: Patients undergoing DE-CTPV were reconstructed using DLIR medium (DLIR-M) and high strength (DLIR-H) and ASIR-V (50%). Image quality was assessed both subjectively and objectively in the main portal vein (MPV), left and right portal veins (LPV, RPV), splenic vein (SV), and superior mesenteric vein (SMV). Objective metrics, including image noise, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR), were calculated. Additionally, radiation dose parameters (CTDI_vol, DLP, ED) and contrast medium volume were compared with data from previous studies.

RESULTS: In this study, the mean CTDI_vol, DLP, and ED were 9.79 ± 2.13 mGy, 326.26 ± 84.58 mGy·cm, and 4.89 ± 1.27 mSv, respectively. The mean contrast medium volume was 79.5 ± 11.4 mL. DLIR-H significantly enhanced image quality across all vascular segments, achieving substantial reductions in image noise and notable increases in CNR and SNR (P < 0.05). It also received the highest subjective ratings for overall image quality, image noise, vascular edge sharpness, and diagnostic confidence compared to ASIR-V 50%. The use of 55 keV virtual monoenergetic imaging (VMI) further enhanced iodine contrast effectiveness, while DLIR effectively reduced noise, ensuring clearer and more consistent vascular delineation across all assessed vascular segments.

CONCLUSION: DLIR substantially improves image quality in DE-CTPV compared with ASIR-V 50%, even when utilizing dual-low dose protocol. By providing consistent, high-quality imaging across multiple portal venous segments, DLIR may offers a safer and more reliable approach for preoperative evaluation and postoperative monitoring in liver transplantation.

PMID:41484021 | DOI:10.1016/j.acra.2025.11.047

Pain Manag Nurs. 2026 Jan 2:S1524-9042(25)00345-5. doi: 10.1016/j.pmn.2025.12.007. Online ahead of print.

ABSTRACT

INTRODUCTION: Chronic overlapping pain conditions (COPCs) are a group of pain conditions that often co-occur and present with challenging nociplastic pain. Individuals with COPCs describe clinician skepticism and prolonged diagnosis, leading to periods of inadequate pain treatment. The lack of methods to identify nociplastic pain in electronic health records (EHRs) limits large-scale studies of nociplastic pain trajectories and phenotyping that could improve treatment.

OBJECTIVE: To develop and validate the Centralized Pain Score (CPS) as a method for identifying nociplastic pain in EHR data.

METHODS: In a large deidentified EHR database, the CPS, which sums central sensitization-weighted COPC ICD codes across individual records, was examined. Descriptive statistics were calculated for three groups: a General Population Group (N = 55,340), a group clinically determined to have nociplastic pain (Nociplastic Pain Group, N = 100), and an Age- and Sex-Matched Group (N = 500). T-tests were used to compare differences in CPS between pairs of these three groups. A post hoc content analysis of clinical documentation was conducted to examine the nomenclature of nociplastic pain.

RESULTS: The Nociplastic Pain Group demonstrated a CPS 8.6-fold higher (mean = 3.7, standard deviation [SD] = 2.9) than the General Population (mean = 0.43, SD = 1.0, p < .001) and 7.9-fold higher than the Age- and Sex-Matched Group (CPS mean = 0.47, SD = 1.1, p < .001). Nociplastic pain was most commonly documented as “central pain syndrome.”

DISCUSSION: Clinicians are documenting nociplastic pain and recommending interventions targeting centralized mechanisms. The CPS appears to capture nociplastic pain. The term central pain syndrome was not intended for nociplastic pain, but it is frequently used.

CONCLUSION: Using the CPS to examine nociplastic pain could improve early detection of nociplastic pain conditions.

PMID:41484019 | DOI:10.1016/j.pmn.2025.12.007

Oral Surg Oral Med Oral Pathol Oral Radiol. 2025 Dec 9:S2212-4403(25)01349-5. doi: 10.1016/j.oooo.2025.11.016. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate oral clinical and cytological changes in patients on HIV pre-exposure prophylaxis (PrEP).

STUDY DESIGN: Clinical evaluations and epithelial cell smears were done on ventral tongue, buccal, and labial mucosa before treatment (T0), after 30 (T30), and 120 days (T120) of PrEP use. Clinical changes were assessed using questionnaires and oral examinations, and a descriptive analysis was performed. Cellular changes were observed through liquid-based exfoliative cytology, and the Wilcoxon and McNemar tests were applied.

RESULTS: Sixty-three patients (60 males, 3 females; mean age 29.65) were included; 36 returned at T30 and 20 at T120. Most frequent complaints were dry mouth and increased fluid intake. Wilcoxon test showed no systematic observer error (P > .05). Karyomegaly increased significantly in all sites at T30 and in ventral tongue and buccal mucosa at T30 and T120 (P < .05). Keratinization increased significantly in buccal mucosa at T30 and ventral tongue at T30 and T120 (P < .05).

CONCLUSION: Our findings indicate an increase in oral epithelial changes during the first 30 and 120 days of PrEP use. Although these changes are nonspecific, continuous oral health monitoring may support early detection of alterations and adherence among patients on HIV PrEP.

PMID:41484006 | DOI:10.1016/j.oooo.2025.11.016

J Neurovirol. 2026 Jan 2. doi: 10.1007/s13365-025-01295-2. Online ahead of print.

ABSTRACT

BACKGROUND: HIV-associated neurocognitive impairment (HAND) is a common complication of HIV-1 infection, which can be exacerbated by exposure to cigarette smoke (CS). Tight junction proteins (TJPs) of the blood-brain barrier (BBB) play a crucial role in maintaining BBB integrity and preventing the entry of circulating toxic factors, including those resulting from HIV-1 infection, into the central nervous system. Both CS exposure and HIV-1 infection can independently disrupt TJPs and compromise BBB integrity; however, the combined or individual effects of these factors on BBB TJPs remain poorly understood.

METHODS: An in vitro BBB comprised of Sprague-Dawley rat brain microvascular endothelial cell (RBMVEC) transwell cultures was exposed to wild-type (WT) and HIV-1 transgenic (TG) rat sera, alone or in combination with cigarette smoke extract (CSE) and analyzed for trans-endothelial electrical resistance (TEER) and paracellular permeability to 10 kDa fluorescein isothiocyanate (FITC)-dextran. Immunofluorescence staining was performed to assess the effects of treatment on the cellular localization and expression of the TJPs, “zonula occludens-1 (ZO-1) and claudin-5.

RESULTS: Pretreatment TEER measures were significantly higher for cultures treated with WT serum alone compared to those treated with TG serum or with CSE. Compared to pretreatment, TEER measures were significantly reduced by treatment with WT serum alone, CSE alone, WT serum + CSE, and TG serum + CSE. TG serum alone or TG serum + CSE resulted in statistically significant increased permeability compared to WT serum. All treatments decreased TJP staining intensity, and, in some cases, altered TJP localization. These effects were most prominent following incubation with either CSE alone, TG serum alone, or TG serum + CSE.

CONCLUSIONS: CSE and TG serum induced separate and additive toxic effects on BBB function and integrity, which may underlie mechanisms that are associated with more severe HAND among HIV+ cigarette smokers.

PMID:41483449 | DOI:10.1007/s13365-025-01295-2

Curr Rev Musculoskelet Med. 2026 Jan 2;19(1):10. doi: 10.1007/s12178-025-10003-w.

ABSTRACT

PURPOSE OF REVIEW: Ponte osteotomy (PO) is frequently used in corrective surgery, yet its specific effect on vertebral rotation correction remains unclear. This study systematically reviewed the literature to compare PO with alternative techniques in patients with idiopathic scoliosis. Following PRISMA methodology, MEDLINE, Embase, and Web of Science were searched for comparative studies assessing axial rotation outcomes in idiopathic scoliosis treated with or without PO. The primary outcome was vertebral rotation correction.

RECENT FINDINGS: Six studies were included, encompassing a total of 439 patients with mean ages ranging from 13.5 ± 2.8 to 17.5 ± 3.7 years. Most study populations were predominantly female in four studies, predominantly male in one, and evenly distributed in one. Two studies showed a meaningful improvement in postoperative thoracic rotation in the PO group compared to inferior facetectomy (IF). Other studies found PO to be superior to IF and posterior spinal fusion (PSF), although these differences were not statistically significant, except for one study that reported a statistically significant advantage of PO over PSF. No meaningful superiority was observed when comparing PO with skip pedicle screw fixation. Overall, intraoperative and postoperative complication rates were similar between PO and non-PO groups, although one study reported a higher rate of intraoperative neuromonitoring changes and reoperations in the PO group. Most studies to date have found that PO is associated with superior vertebral rotation outcomes compared to IF and PSF, with only half showing statistical significance. PO is also linked to longer operative time and greater blood loss, warranting further high-quality studies to clarify its risk-benefit profile.

PMID:41483443 | DOI:10.1007/s12178-025-10003-w

Qual Life Res. 2026 Jan 3;35(1):22. doi: 10.1007/s11136-025-04102-x.

NO ABSTRACT

PMID:41483427 | DOI:10.1007/s11136-025-04102-x