Tag: pubmed

Nucl Med Commun. 2026 Jul 7. doi: 10.1097/MNM.0000000000002203. Online ahead of print.

ABSTRACT

AIM/INTRODUCTION: Adenosine pharmacological stress is commonly used for the detection of ischemia by myocardial perfusion imaging (MPI) using radiotracers and gated single-photon emission computed tomography/computed tomography (SPECT/CT) imaging. Recently, a phenomenon, splenic switch-off (SSO), has been observed where reduced perfusion to the spleen occurs after adenosine, suggesting an adequate effect of adenosine on the heart. The aim of the study is to evaluate the SSO effect in adenosine stress 99mTc tetrofosmin MPI studies using semiquantitative analysis of SPECT/CT data.

MATERIALS AND METHODS: Seventeen adenosine MPI studies were selected. Each study included stress and rest, which were reoriented in short, horizontal, and vertical long axes. Also, data were reconstructed in the body transaxial, coronal, and sagittal planes. In the resulting images, the spleen was identified on the CT component, and regions of interest were drawn on the spleen, thoracic vertebra, and myocardium. The ratios spleen/vertebra (S/VAd and S/VRst) and myocardium/vertebra (M and M/t) were calculated. Statistical analysis was done using a paired t test.

RESULTS: Mean age was 60.35 years, with 9 males (53%). Mean S/VAd was 0.98 ± 0.38 and S/VRst 1.87 ± 0.87 (t = -3.707, P < 0.01). The mean M/VAd was 2.86 ± 1.65 and M/VRst 3.75 ± 2.41 (t = -1.323, P = 0.204).

CONCLUSION: Using the method outlined, especially the S/V ratio, evaluation of the SSO can be achieved from the acquired data, which shows promise as a marker for adequate effectiveness of adenosine stress in doubtful cases.

PMID:42411251 | DOI:10.1097/MNM.0000000000002203

Nucl Med Commun. 2026 Jul 7. doi: 10.1097/MNM.0000000000002205. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to explore the effects of different breath-holding times (20, 18 and 15 s) on PET/computed tomography (PET/CT) image quality and metabolic parameters of hypermetabolic lung nodules. We hope that our findings will elucidate the clinical feasibility of short-duration breath-hold PET imaging.

RESULTS: Compared to free-breathing PET group, all breath-hold groups showed significantly higher tumour-to-background ratio but lower signal-to-noise ratio (all P < 0.05). Importantly, the 18 s breath-hold group demonstrated overall image quality, fusion scores and contrast-to-noise ratio comparable to those of the 20-s group, without statistically significant differences (all P > 0.05). Moreover, the 18-s group exhibited a more favourable signal-to-noise ratio profile than the 15-s group. Metabolically, all breath-hold scans significantly increased maximum standardized uptake value (SUVmax) and mean SUV while reducing metabolic tumour volume and total lesion glycolysis relative to free-breathing (P < 0.05). Notably, there were no significant differences in key quantitative metrics, including maximum SUV, peak SUV, metabolic tumour volume and total lesion glycolysis, among the three breath-hold groups. The consistency of peak SUV across groups further supports its reliability as a robust parameter under reduced acquisition times.

CONCLUSION: The 18-s breath-hold protocol is a valid clinical alternative to the 20-s acquisition, offering comparable image quality and metabolic data while superior efficiency and patient tolerability, making it an ideal choice for routine practice.

PMID:42411244 | DOI:10.1097/MNM.0000000000002205

Curr Vasc Pharmacol. 2026 Jul 6. doi: 10.2174/0115701611415264260622061654. Online ahead of print.

ABSTRACT

INTRODUCTION: Despite the large use of renin-angiotensin system inhibitors (RASI) in STSegment Elevation Myocardial Infarction (STEMI) patients, few data have been reported on the prognostic impact of chronic RASI at admission in patients suffering from STEMI, especially during the COVID-19 pandemic. Therefore, the current study investigated the prognostic impact of chronic RASI at admission in patients suffering from STEMI, including both SARS-CoV-2 positive and negative individuals, enrolled before and during the COVID-19 pandemic.

METHODS: We included STEMI patients who received primary percutaneous coronary intervention (PPCI) and were enrolled in the ISACS-STEMI COVID-19 registry. In the present sub-analysis, patients were allocated according to chronic RASI therapy at admission. The primary study endpoint was the occurrence of in-hospital mortality. Secondary endpoints were postprocedural TIMI 3 flow and mortality at 1 month.

RESULTS: The overall population was 15,693 patients, including 6,213 patients pretreated with RASI. Several differences in baseline characteristics were observed between the two groups. No difference was observed in the prevalence of SARS-CoV-2 infection. After correction for all baseline confounders, including procedural features, chronic pretreatment with RASI was independently associated with improved postprocedural TIMI 3 flow (OR [95% CI] = 1.14 [1.03-1.35], p = 0.042), lower in-hospital mortality (adjusted OR [95% CI] = 0.64 [0.54-0.75], p < 0.001), and lower 30-day mortality (adjusted OR [95% CI] = 0.62 [0.53-0.73], p < 0.001).

CONCLUSION: This is the largest study investigating the prognostic impact and benefits of chronic RASI pre-treatment in STEMI patients undergoing PPCI, including those treated during the COVID19 pandemic. We found that chronic RASI treatment at hospital admission was associated with significant improvement in reperfusion and reduction in mortality, without any negative effect in SARS-CoV-2 positive patients. Results should be interpreted considering the retrospective, nonrandomized nature of the study.

PMID:42411222 | DOI:10.2174/0115701611415264260622061654

Innate Immun. 2026 Jan-Dec;32:17534259261446053. doi: 10.1177/17534259261446053. Epub 2026 Jul 7.

ABSTRACT

BackgroundConsider this Carrion’s disease (CD) is a biphasic illness-comprising acute and chronic phases-endemic to Peru and caused by Bartonella bacilliformis, a bacterium transmitted by sandflies. Despite its clinical relevance, the mechanisms underlying innate immune activation in response to B. bacilliformis remain poorly understood. Toll-like receptors (TLRs) play a central role in recognizing conserved molecular patterns present in pathogens, thereby initiating innate immune responses. The present study aimed to describe the expression patterns of TLR2 and TLR4, along with cytokine secretion profiles, during peripheral blood mononuclear cells (PBMCs) exposure to B. bacilliformis.MethodsPeripheral blood mononuclear cells (PBMCs) from healthy donors were stimulated with heat-inactivated B. bacilliformis (ATCC 35685 strain), zymosan (TLR2 control), or E. coli LPS (TLR4 control). TLR2 and TLR4 gene expression was quantified by RT-qPCR at 0, 12, 24, 36, and 48 h. Cytokines were measured using a 17-plex panel. Analyses were descriptive, using non-parametric statistics.ResultsResults elicited measurable changes in the transcriptional expression of TLR2 and TLR4 during stimulation, with peak activation typically observed at 12 h, although in one case the maximal response was delayed to 24 h. These expression changes coincided with significant modulation of multiple cytokines, including pro-inflammatory mediators (TNF-α, IL-17, IL-12p70), Th1/Th2 cytokines (IFN-γ, IL-2, IL-5, IL-13), regulatory cytokines (IL-10), and growth factors (GM-CSF, IL-7).ConclusionsThis exploratory study describes the transcriptional expression patterns of TLR2 and TLR4 and the accompanying cytokine responses in PBMCs exposed to B. bacilliformis. These profiles expand current knowledge of the early innate immune signature elicited by this neglected pathogen and provide a foundation for future studies using receptor-specific functional assays. Importantly, these patterns likely reflect early innate immune response signatures rather than definitive evidence of functional receptor activation.

PMID:42411209 | DOI:10.1177/17534259261446053

Addiction. 2026 Jul 7. doi: 10.1111/add.70511. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Data on the presence of new psychoactive substances (NPS) mainly originate from drug-checking, law enforcement and wastewater analysis sources, while data on NPS poisonings are scarce. In Europe, the documented incidence rate of NPS poisonings is highest in the Netherlands. We investigated temporal trends in NPS poisonings reported to the Dutch Poisons Information Center (DPIC) between 2012 and 2025 and compared these trends across NPS categories.

DESIGN: National observational study based on retrospective extraction of recreational drug poisonings (including NPS) from the DPIC database from 2012 to 2025. The DPIC is not accessible to the general public and reporting by healthcare professionals is voluntary.

SETTING/CASES: The DPIC database contains standardized case report forms with anonymous patient data and individually (self-)reported substance exposures (not ICD-coded, not analytically confirmed). All cases concerning human exposures to recreational drugs recorded in the DPIC database were included.

MEASUREMENTS: Primary outcomes were the annual number and annual incidence rate of NPS poisonings reported to the DPIC, relative to the annual number of all recreational drug poisonings. Secondary outcomes were incidence rates of specific (categories of) NPS over time. Predictor was the year of report.

FINDINGS: Between 2012 and 2025, healthcare professionals reported 19 316 recreational drug poisonings, including 4289 NPS-related poisonings, while seeking advice on patient management. The annual number of NPS poisonings increased from 32 in 2012 to 829 in 2025. Between 2012 and 2025 the annual incidence rate of NPS poisonings increased statistically significantly by 19% per year [incidence rate ratio = 1.19; 95% confidence interval (CI) = 1.15-1.23]. A higher incidence rate of NPS poisonings was observed in July and December. Cathinones, phenethylamines and benzodiazepines represented 83% of all NPS poisonings. Benzodiazepines were predominant in 2012 and 2024, phenethylamines from 2013 to 2018 and cathinones from 2019 to 2023 and in 2025. The total number of unique NPS notified to the DPIC increased from 17 in 2012 to 176 in 2025. Poisonings with 3-methylmethcathinone (3-MMC), bromazolam, 4-fluoroamphetamine (4-FA), 4-bromo-2,5-dimethoxyphenethylamine (2C-B) and 4-methylmethcathinone (4-MMC, mephedrone) were reported most frequently (5-22% of 4289 NPS poisonings). Poisonings with arylcyclohexylamines, cannabinoids, opioids, arylalkylamines, tryptamines (indolalkylamines), piperidines and pyrrolidines and other substances were rare (every category <5% of 4289 NPS poisonings). No poisonings with aminoindanes or piperazines were reported from 2012 to 2025.

CONCLUSIONS: The annual incidence rate of new psychoactive substances poisonings reported to the Dutch Poisons Information Center increased by 19% per year between 2012 and 2025. The predominant categories and specific substances involved changed markedly over time.

PMID:42411193 | DOI:10.1111/add.70511

Subst Use Addctn J. 2026 Jul 7:29767342261460762. doi: 10.1177/29767342261460762. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiovascular side effects are commonly reported by men who use anabolic-androgenic steroids (AAS), yet little is known about the factors that increase risk. This study examines data from the 2024 Global Drug Survey (GDS2024) to identify whether route of administration (ROA), image-and performance enhancing drug (IPED) polypharmacy and licit substance use are associated with self-reported cardiovascular-related concerns.

METHODS: The dataset comprised 1167 males (≥16 years) who had used AAS within the previous 12 months. Descriptive statistics summarized demographic and substance use characteristics. Chi-square tests explored associations between self-reported cardiovascular side effects and ROA (oral vs injectable), IPED polypharmacy, and licit substance use respectively. Independent predictors were identified through multivariable binary logistic regression. Associations between substances were investigated using pairwise models. Visualizations included heatmaps, bar charts, forest plots, trend stability, and performance comparisons across models.

RESULTS: Showed that, among AAS consumers, 35.7% reported a self-reported cardiovascular-related concern. Alcohol (79.4%), tobacco (42.0%), and E-cigarette use (40.5%) were prevalent among AAS consumers. Clenbuterol use differed significantly by ROA, reported by 28.4% of oral and 24.3% of injectable AAS consumers. Injectable AAS use was strongly associated with concurrent human hormone growth (HGH) and insulin use. In adjusted models, injectable AAS use showed the strongest association with self-reported cardiovascular-related concerns (OR = 10.57, P < .001), followed by oral AAS use (OR = 1.92, P < .001) and clenbuterol use (OR = 1.44, P = .044). Age, HGH, insulin, alcohol, tobacco, and e-cigarette use were not significantly associated with cardiovascular-related concerns. Pairwise analyses indicated that clenbuterol-containing substance combinations were associated with higher odds of reporting cardiovascular-related concerns, highlighting the relevance of ROA and patterns of concurrent substance use.

CONCLUSIONS: Negative cardiovascular health concerns among AAS consumers are most strongly associated with oral routes and use of substances like clenbuterol.

PMID:42411187 | DOI:10.1177/29767342261460762

Transfusion. 2026 Jul 7. doi: 10.1111/trf.70292. Online ahead of print.

ABSTRACT

BACKGROUND: Understanding patterns in blood availability is key to identifying appropriate interventions to increase blood access, particularly interventions intended for use in blood deserts, defined as areas in which >75% of blood needs are unmet. Blood availability patterns are particularly difficult to understand in the decentralized systems made up primarily of hospital-based blood banks, which are common in low- and middle-income countries. In Liberia, >95% of blood is collected at decentralized hospital-based blood banks.

STUDY DESIGN AND METHODS: A national cross-sectional geospatial analysis of blood bank accessibility in Liberia estimated the population residing within the cumulative travel-time thresholds of blood bank facilities and contextualized these findings using a static national estimate of blood supply. Geographic accessibility to blood banks was estimated in ArcGIS Pro 3.6 using a raster-based travel-time cost-distance approach.

RESULTS: Only 0.22% of people in Liberia live within 30 min of a blood bank; 0.87% live within 60 min.

DISCUSSION: Liberia is a blood desert, and blood-desert specific interventions (e.g., civilian walking blood banks), some of which may focus on hospital-based blood banks, should be considered. Interventions to enhance blood collection at the centralized national level, such as Club 25, are likely also appropriate. This analytic method effectively identified patters in blood availability in the absence of a countrywide blood inventory system. However, factors such as available road and population data, and specific geographic features, could lead the method to over- or underestimate blood availability and should be taken into account when choosing this approach.

PMID:42411176 | DOI:10.1111/trf.70292

J Gastric Cancer. 2026 Jul;26(3):392-407. doi: 10.5230/jgc.2026.26.e26.

ABSTRACT

PURPOSE: Although early-onset gastric cancer (EOGC; diagnosis at age <50 years) exhibits more aggressive clinicopathologic features than typical-onset gastric cancer (TOGC; diagnosis at ≥50 years), its prognostic implications remain unclear.

MATERIALS AND METHODS: Data from 44,262 patients newly diagnosed with gastric cancer between 2012 and 2019 were obtained from the Korean Cancer Public Library Database. Patients were classified as having EOGC or TOGC based on age at diagnosis. All-cause and gastric cancer-specific mortality were evaluated across Surveillance, Epidemiology, and End Results (SEER) summary stages (localized, regional, and distant) using adjusted multivariable Cox proportional hazards models. The interaction between age group and cancer stage was also examined.

RESULTS: EOGC comprised 13.9% of cases. Compared with patients with TOGC, patients with EOGC had fewer comorbidities and were more likely to present with distant-stage disease. Nonetheless, younger patients more frequently received aggressive treatment, whereas treatment rates declined with increasing age. In localized disease, EOGC was associated with significantly lower adjusted mortality (all-cause mortality: adjusted hazard ratio [aHR], 0.52; 95% confidence interval [CI], 0.42-0.66; gastric cancer-specific mortality: aHR, 0.52; 95% CI, 0.37-0.71). In contrast, in regional and distant stages, EOGC was associated with significantly higher mortality (all-cause mortality: aHR, 2.39; 95% CI, 2.20-2.60; gastric cancer-specific mortality: aHR, 1.86; 95% CI, 1.70-2.03). Age and SEER stage showed a significant interaction (P for interaction <0.0001).

CONCLUSIONS: The prognostic effect of younger age in gastric cancer is stage-dependent, conferring a survival advantage in localized disease but poorer outcomes in regional and distant stages.

PMID:42411164 | DOI:10.5230/jgc.2026.26.e26

Paediatr Anaesth. 2026 Jul 7. doi: 10.1002/pan.70257. Online ahead of print.

ABSTRACT

BACKGROUND: Genetic mitochondrial diseases (GMDs) are a large group of genetically and clinically heterogeneous disorders caused by defects in genes encoding mitochondrial components. GMDs are grouped into named syndromes based on clinical presentation, for example, Leigh syndrome (LS). Surgical interventions are often required in GMDs, necessitating the use of general anesthesia (GA). Some GMD animal models show both a marked reduction in anesthetic concentrations necessary for sedation and toxic sequelae resulting from anesthetic exposures. Hypersensitivity to sedation by anesthetic agents, most notably volatile anesthetic agents (VAs), occurs in a subset of GMD patients, and some evidence suggests toxicities are also present. Reported complications of anesthesia in GMD are varied, including minor metabolic changes, acceleration of underlying disease, and death. The potential toxicity of anesthetics in the setting of GMDs has recently been underscored by deaths among pediatric and young adult patients of Venezuelan descent putatively linked to a specific mitochondrial DNA haplotype. Interpretation of clinical findings is limited by the lack of a thorough review of case reports for anesthetic exposures in GMD patients. Here, we provide a comprehensive review of published case reports for GMD patients undergoing anesthetic exposures.

METHODS: Using search terms “anesthesia mitochondrial disease,” “anesthesia mitochondrial disease case report,” and “anesthesia Leigh syndrome” we identified case reports published up to May 2025. Non-English articles were translated and included where possible. Only reports of GMD patients undergoing GA with total intravenous anesthesia (TIVA) or VAs containing outcome information were included, totaling 148 cases from 123 reports. We examined relationships between complications and GA type, clinical diagnosis, perianesthetic drugs, procedure length and type, and general demographics. We performed a narrative review of clinical and pre-clinical literature.

RESULTS: Overall complication rate was significantly higher in VA versus TIVA cases (42% vs. 18%, Fisher’s exact p-value **p = 0.0022), as was rate of severe complications (*p = 0.01). Encephalomyelopathies, including LS, were overrepresented among cases resulting in death. Complication rate has remained relatively stable over time. Sex and age were not associated with significant differences in complication rate. Complication rate varied significantly by procedure type, and severe complications were associated with procedure length. While not statistically significant, older VAs had higher complication rates than newer VAs. Similarly, older neuromuscular blockade agents may be less safe than newer drugs. N₂O and ketamine were notably safe among drugs used in TIVA procedures.

CONCLUSIONS: Available case-report data support the notion that GMD patients are at increased risk of a variety of perianesthetic complications. Clinical symptoms and procedure length appear most strongly predictive of severe complications. Clinical and pre-clinical findings suggest more research is needed to understand the mechanisms of toxicity and more detailed reporting is needed in clinical case reports to identify potential risk factors.

PMID:42411141 | DOI:10.1002/pan.70257

Public Health Nurs. 2026 Jul 7. doi: 10.1111/phn.70149. Online ahead of print.

ABSTRACT

OBJECTIVE: The study examined the effects of a transtheoretical model based training and counseling program on the stages of change, the decisions to avoid partner violence, and the self-efficacy of the victims of intimate partner violence.

METHODS: The study was planned as a single group pre-test post-test quasi-experimental design. Data were collected from 40 women from the Investigation Bureau of Violence Against Women in a courthouse in Turkey between September 2018 and June 2019. Personal questionnaire form, a tool to determine the type of intimate violence, Abused Women’s Change Process Scales, telephone interview form, and semi-structured interview forms were used.

RESULTS: Informative training and a counseling program were offered to the women, who were then followed up for 6 months; the difference between the identified stages of change of the abused women before and after the intervention was found to be statistically significant (p < 0.05). The differences between the mean scores on the pros and cons scales and the Temptations and Confidence Scales before and after the training and counseling program for the victims of intimate partner violence were found to be significant (p < 0.01).

CONCLUSION: Nurses can use sample training and counseling models in institutions where victims of violence apply.

PMID:42411137 | DOI:10.1111/phn.70149