Tag: pubmed

Childs Nerv Syst. 2025 Nov 13;41(1):352. doi: 10.1007/s00381-025-07039-1.

ABSTRACT

PURPOSE: This study investigates normocephalic craniosynostosis (NC), a condition characterised by the premature fusion of cranial sutures without visible cranial deformities, which may be associated with significant neurodevelopmental risks.

METHODS: A case-control study was conducted involving patients aged 1 to 20 years with incidental diagnoses via CT scans. We collected comprehensive data from electronic medical records, including demographics, CT characteristics, neurological symptoms, and comorbidities.

RESULTS: The study included 42 NC cases and 41 controls with patent cranial sutures. The average cephalic index was 81.7% in NC cases and 81.2% in controls, with no significant difference (p = 0.44). The mean age at scanning was similar between groups (11.7 years for NC versus 11.3 years for controls, p = 0.29). Notably, a marked male predominance was observed among NC cases (83.3% versus 56.1% in controls, p = 0.01). Additionally, a history of abnormal neurological issues was more common in the NC group (35.7%) compared to 19.5% in controls. A family history of abnormal neurodevelopment was noted in 4.8% of NC cases and was absent in controls; however, the difference was not statistically significant (p = 0.08).

CONCLUSIONS: These findings underscore the possible pathological implications of NC, emphasising the need for enhanced clinical vigilance and thorough monitoring. A multidisciplinary approach is crucial in evaluating and managing these patients to ensure optimal care and enhance understanding of NC, despite the absence of external cranial deformities.

PMID:41231404 | DOI:10.1007/s00381-025-07039-1

Environ Monit Assess. 2025 Nov 13;197(12):1335. doi: 10.1007/s10661-025-14664-5.

ABSTRACT

The Bay of Cartagena, located in the Colombian Caribbean, suffers from significant pollution caused by urban, industrial, commercial, tourism, maritime, and port activities. Studies conducted since the 1970s have documented contamination by heavy metals such as Cu, Cr, Ni, and Zn, which are essential for living organisms due to their role in metabolic functions, but at excessive concentrations, they become toxic. From 2015 to 2019, within the framework of REDCAM, the metals Cr, Cd, Pb, Cu, Ni, and Zn were monitored in the Bay of Cartagena, finding that only 25% of the collected data were at quantifiable concentrations and the remaining 75% were below the laboratory’s quantification limits, which has hindered the determination of whether the contaminants are present or absent, leading to the reporting of censored data. This study aimed to propose an alternative analysis for these censored data using the regression on order statistics (ROS) model and to perform a temporal comparison of heavy metal concentrations in the Bay of Cartagena, thereby providing a more accurate assessment of its metal contamination status.

PMID:41231397 | DOI:10.1007/s10661-025-14664-5

J Adhes Dent. 2025 Nov 13;27:221-230. doi: 10.3290/j.jad.c_2336.

ABSTRACT

PURPOSE: To evaluate bonding to dentin contaminated with primers/etchants used for adjacent ceramic repair.

MATERIALS AND METHODS: Mid-coronal dentin of sound human third molars was exposed and allocated to 10 experimental groups. The universal adhesive (UA) Single Bond Universal (‘SBU,’ 3M Oral Care), applied either in etch-and-rinse (E&R) or self-etch (SE) bonding mode, and the considered gold-standard SE adhesive Clearfil SE Bond X (‘CSE,’ Kuraray Noritake) were bonded to dentin contaminated with either Monobond Etch & Prime (‘MEP,’ Ivoclar) or IPS Ceramic Etching Gel (‘HF,’ Ivoclar) following 10 scenarios: phosphoric acid (PA)+SBUE&R (uncontaminated E&R UA control), HF+PA+SBUE&R, MEP+PA+SBUE&R, PA+MEP+SBUE&R, SBUSE (uncontaminated SE UA control), HF+SBUSE, MEP+SBUSE, CSESE (uncontaminated SE control), HF+CSESE, MEP+CSESE. Upon adhesive and composite application, the specimens were stored in artificial saliva at 37°C. After 1 week, all specimens were sectioned into resin-bonded dentin sticks, which were randomly distributed over two groups to be subjected to a microtensile bond-strength test immediately at 1 week or upon aging by storage in artificial saliva for 6 months. Statistics involved linear mixed-effects modeling with Bonferroni correction (P 0.05).

RESULTS: E&R bonding to dentin contaminated with MEP or HF did not significantly differ from bonding to non-contaminated dentin (controls). However, SE bonding to MEP- and HF-contaminated dentin was significantly less effective than to non-contaminated dentin (controls). Aging for 6 months did not reduce E&R bonding as compared to the 1-week data, while SE bonding was significantly less effective upon 6-month aging. E&R bonding was affected more when dentin was contaminated with MEP before phosphoric acid (PA) etching than when dentin was contaminated with MEP after PA etching.

CONCLUSIONS: Dentin contamination with MEP and HF impacted self-etch (SE) bonding but not etch&rinse (E&R) bonding.

PMID:41231395 | DOI:10.3290/j.jad.c_2336

Int Urol Nephrol. 2025 Nov 13. doi: 10.1007/s11255-025-04906-3. Online ahead of print.

ABSTRACT

PURPOSE: Signet ring cell carcinoma (SRCC) of the urachus is a rare and aggressive histologic variant with limited guidance on optimal treatment. This study aimed to characterize the clinicopathological features, treatment patterns, and survival outcomes of urachal SRCC using a large national dataset and to assess the impact of surgical and systemic therapies on prognosis.

METHODS: We queried the National Cancer Database (NCDB) for patients diagnosed with urachal SRCC between 2004 and 2020. Clinical and pathological staging, surgical approach (partial vs. radical cystectomy), chemotherapy use, and overall survival were analyzed. Kaplan-Meier survival curves and statistical comparisons were used to evaluate treatment outcomes.

RESULTS: A total of 60 patients with SRCC of the urachus were identified. A substantial proportion presented with advanced or unstaged disease (43.3% cTX, 38.4% pTX). Partial cystectomy was performed more often than radical cystectomy (56.7% vs. 31.6%). Chemotherapy was administered in 38.4% of patients, most commonly as multi-agent regimens. Median overall survival was approximately 30 months. No significant survival benefit was observed with chemotherapy administration.

CONCLUSION: Urachal SRCC is associated with poor survival and considerable heterogeneity in staging and management. Our findings suggest limited observed benefit of systemic therapy in this cohort, underscoring the need for further prospective studies.

PMID:41231381 | DOI:10.1007/s11255-025-04906-3

Bioelectromagnetics. 2025 Dec;46(8):e70033. doi: 10.1002/bem.70033.

ABSTRACT

This paper presents a comprehensive measurement-based assessment of radio-frequency (RF) electromagnetic field (EMF) exposure level in a French city. Three types of assessment methods are used to collect measurement data: drive test (DT), spot measurements, and sensor networks. The DT measurements were conducted by a portable spectrum analyzer, i.e., Tektronix RSA 306B, connected to a 3-axis antenna mounted on the roof of the vehicle. DT system continuously recorded frequency-dependent electric field (E-field) values on a pre-defined outdoor route. The spot measurements were done in the same region, covered by DT, with both broadband and frequency-selective systems. Additionally, 19 sensors were installed on streetlamps in the same part of the city to measure the broadband E-field level. The overall statistical analysis on raw data shows good agreement on RF-EMF exposure level from three types of measurements. Then a distance-based moving average method was carried out to remove the random noise in the DT data, where the optimized window size is explored using Kolmogorov-Smirnov test. The smoothed DT data show a good correlation with nearby spot measurement values, as well as with base station antenna (BSA) density. Specific fifth-generation (5G) spot measurements, performed with and without traffic-attracting downloads, demonstrate the impact of beamforming on exposure levels in 5G new radio (NR) bands. Then spot measurements were used to build the exposure map using the kriging method, where the kriging prediction from the trained model is further compared with DT. Furthermore, the temporal variations observed in the sensor network were analyzed in relation to distance from the nearest BSA, revealing an inverse proportional relationship between E-field level and proximity to the nearest BSA. This study shows good reliability in assessing the RF-EMF exposure level using different systems. The advantages and limitations of different systems are also demonstrated by performing the intercomparison between data sets.

PMID:41230687 | DOI:10.1002/bem.70033

J Pediatr Orthop. 2025 Nov 13. doi: 10.1097/BPO.0000000000003160. Online ahead of print.

ABSTRACT

BACKGROUND: Pediatric medial malleolus fractures pose a risk for physeal bar formation and growth disturbances. This study aimed to determine the rate of physeal bar formation following Salter-Harris (SH) III or IV medial malleolus fractures and identify patient, fracture, and management factors predictive of bar formation. A secondary objective was to evaluate the rate of additional surgeries required in the event of physeal bar formation.

METHODS: A retrospective review was performed of 161 patients (age 16 y or younger) with isolated medial malleolus or bimalleolar fractures. Fifty-six skeletally immature patients (39% female) with SH III or IV medial malleolus fractures and ≥6 months of radiographic follow-up met the inclusion criteria. Demographics, injury mechanism, fracture management, and secondary surgeries were recorded. Radiographs were analyzed for fracture displacement, SH classification, coronal plane physeal involvement, anterior and lateral distal tibial angles, postreduction displacement, and physeal bar formation. Wilcoxon rank sum tests assessed statistical significance (α<0.05).

RESULTS: Thirty-five isolated medial malleolus and 21 bimalleolar ankle fractures were identified (SH III=40, SH IV=16). Initial treatment was operative in 34 patients (60.7%), with greater fracture displacement (4.9 vs. 2.4 mm) and coronal plane physeal involvement (21.5% vs. 16.4%) being significant predictors of surgical management. Physeal bars developed in 17 patients (30.4%), with a mean diagnosis time of 8.4 months. Patients with bar formation also presented with significantly greater fracture displacement (5.4 vs. 3.3 mm) and coronal plane physeal involvement (23.6% vs. 17.8%). No difference in bar formation rates was observed among other patient or fracture characteristics. Eight of 17 physeal bar patients (47%) required at least one secondary surgery, including bar resection (n=4), epiphysiodesis (n=7), and/or osteotomies (n=3).

CONCLUSIONS: Pediatric physeal medial malleolus fractures carry a high risk for bar formation. Greater fracture displacement and coronal plane physeal involvement were significant predictors of initial surgical management and bar formation. Close radiographic monitoring of these high-risk fractures for at least 1 year following injury and attentive patient counseling on the risk of secondary surgery is recommended for timely identification and intervention.

LEVEL OF EVIDENCE: Level IV-case series.

PMID:41230683 | DOI:10.1097/BPO.0000000000003160

Addiction. 2025 Nov 13. doi: 10.1111/add.70233. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: In recent years, the potency of natural cannabis products (herb and resin) has increased with a higher delta- 9-tetrahydrocannabinol (Δ9-THC) content, but there are limited data on trends on clinical presentation and severity of toxicity in cannabis users consulting the emergency department (ED) for acute intoxication. This study aimed to analyse the evolution over time of clinical findings and severity of presentations in a large series of patients presenting to European EDs with acute toxicity after lone cannabis use.

DESIGN: Secondary analysis of data included in the Euro-DEN Registry from 1 October 2013 to 31 December 2022.

SETTING: 40 EDs in 25 European countries.

PARTICIPANTS/CASES: ED presentations reporting lone cannabis use. Presentations reporting concomitant use of, or having positive toxicological tests for, ethanol or other drugs were excluded. 3839 ED presentations reporting lone cannabis use were analysed (median age 25 years, interquartile range= 20-33; 71% male).

MEASUREMENTS: Temporal trends of 14 pre-defined clinical signs/symptoms and 4 markers of severity, which included the need for ambulance transfer to the ED, hospitalisation, intensive care unit admission (ICU) and death.

FINDINGS: The most frequent clinical features were anxiety (35%), agitation (22%), decreased alertness (drowsiness or coma, 21%) and vomiting (20%), while seizures, arrythmias and hyperthermia were observed in <3% of cases. Statistically significant changes over time were only found in the frequency of hypotension [adjusted odds ratio (OR) = 1.239 per every subsequent year, 95% confidence interval (CI) = 1.107-1.386], hypertensive crisis (OR = 1.168, 95% CI = 1.070-1.274) and palpitations (OR = 0.922, 95% CI = 0.883-0.962). Nonlinear analyses detected statistically significant mid-period increases for anxiety, agitation and arrhythmias that subsided by the end of the study, and showed increases in chest pain and decreases in seizures that became statistically significant in the latter half of the period. Regarding episode severity, 76% of cases were brought to the ED by ambulance, 13% required hospitalisation, 1% were admitted to the ICU and 0.1% died. No statistically significant changes were observed over time in either the linear or the nonlinear models.

CONCLUSION: Very few changes in the clinical features of patients presenting to European emergency departments with lone acute cannabis toxicity were identified over 2013 to 2022, suggesting that despite the increase in potency of cannabis in Europe over this period, the severity of acute intoxication has remained unchanged.

PMID:41230681 | DOI:10.1111/add.70233

Eur J Psychotraumatol. 2025 Dec;16(1):2580210. doi: 10.1080/20008066.2025.2580210. Epub 2025 Nov 13.

ABSTRACT

Background: Complex post-traumatic stress disorder (cPTSD) was recently included in the ICD-11, extending the PTSD symptom profile to encompass disturbances in self-organization (DSO). Trauma-focused Dialectical Behavior Therapy (DBT-PTSD) is an effective psychotherapeutic treatment, particularly among women. However, empirical data on DBT-PTSD’s gender-specific effectiveness in naturalistic settings remains limited.Objective: The present study examined whether DBT-PTSD is similarly effective in reducing symptoms of cPTSD among women, men, and gender minority (GM) individuals under routine clinical conditions.Method: This observational single-center study included 215 patients (women = 78.1%, men = 18.6%, GM = 3.3%; 44.6+/-11.5 years) with cPTSD treated with DBT-PTSD at a psychosomatic inpatient clinic in Austria. Primary outcome was mean change in symptom severity assessed by the International Trauma Questionnaire (ITQ) before (T1) and after treatment (T2) and secondary assessment included anxiety and depression, somatization, dissociation, assessment of functioning, personality traits, emotion regulation, locus of control and borderline symptomatology. Repeated measures ANOVAs were used to evaluate treatment outcomes. Baseline predictors (T1) for ITQ score at T2 were identified by machine learning models and validated with mixed linear models.Results: While DBT-PTSD overall led to significant reductions in cPTSD symptoms with large effect size (p < .001, η² = 0.17), no significant difference was observed between men and women neither for the ITQ (p = .90, η² < 0.01), nor for any of the secondary outcomes (p = .08-.86; η² ≤ 0.01). Secondary outcomes showed statistically significant improvements in depression, anxiety, somatization emotion regulation and the locus of control (p < .001-.012). Higher negative affectivity was associated with worse outcomes in both men and women, while higher antagonism was associated with better outcomes in women and worse outcomes in men.Conclusions: DBT-PTSD is effective in reducing cPTSD symptoms among men and women in real-world clinical settings. However, larger samples of men are needed to validate the findings of this study.

PMID:41230649 | DOI:10.1080/20008066.2025.2580210

Leuk Lymphoma. 2025 Nov 13:1-9. doi: 10.1080/10428194.2025.2582732. Online ahead of print.

ABSTRACT

Adult histiocytic disorders are rare, and limited data exists on spectrum, clinical presentation and real-world management strategies. Here, we present Canadian single-center experience spanning over 23 years. Ninety-six patients were identified, with Langerhans Cell Histiocytosis (LCH; n = 60), Erdheim-Chester disease (ECD; n = 11); Rosai-Dorfman disease (RDD; n = 19) constituting the majority. At a median follow-up of 38 months, median OS of our cohort was not reached with encouraging 5-year OS of 96.3%, 79.5% and 86% amongst LCH, ECD and RDD patients respectively. Although, 5-year PFS rates were higher for LCH and RDD compared to ECD patients (61.7% vs 47% vs 24.2%; p = 0.320), these were not statistically significant. LCH patients with RO involvement had inferior 2-year PFS compared to those without (33.3% vs 75.8%; p = 0.042). A high incidence of concomitant hematological malignancies, (n = 3/11 in ECD and n = 3/60 in LCH) in our cohort warrants the need for further translational studies to explore possible association.

PMID:41230646 | DOI:10.1080/10428194.2025.2582732

Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2025 Sep 10;42(9):1069-1077. doi: 10.3760/cma.j.cn511374-20250303-00120.

ABSTRACT

OBJECTIVE: To explore the impact of age on the genetic variant spectrum and prognosis of patients with previously untreated Diffuse large B-cell lymphoma (DLBCL).

METHODS: A retrospective analysis was conducted on the clinical data and follow-up information of 254 previously untreated DLBCL patients from 14 hospitals in the Jiangsu Cooperative Lymphoma Group (JCLG) enrolled from July 2018 and July 2023. Following extraction of DNA from tumor tissue samples, next-generation sequencing (NGS) technique was employed to analyze the genetic variant spectrum of the DLBCL patients, with an evaluation of the relationship between age and genetic variants as well as prognosis. This study was approved by the Medical Ethics Committee of the Affiliated Hospital of Nantong University (Ethics No.: 2023-K048-01).

RESULTS: The median age of the 254 DLBCL patients was 62 years old, with 55% of patients aged 60 years or above. Clinical evaluation showed that younger (< 60 years) patients had higher complete response (CR) (70% vs. 59%), and objective response rate (ORR) (88% vs. 79%) than older patients, though the difference between the two groups was not statistically. Survival analysis indicated that both the five-year overall survival (OS) (82.7% vs. 71.7%, P = 0.006) and progression-free survival (PFS) (70.6% vs. 50.2%, P < 0.05) rates were significantly higher in younger patients. NGS showed that 99.6% of the patients harbored genetic variants, with PIM1, KMT2D, TP53, MYD88, and CD79B being the most common genes. Age significantly affected the variant frequency of certain genes, with MYC variants serving an adverse prognostic factor for OS in younger patients (P = 0.002), while TP53 (P = 0.024) and BCL2 (P = 0.002) variants significantly impacted OS in older patients. Prognostic analysis identified age ≥ 60 years (HR = 3.439, 95%CI: 1.318~9.874), presence of B symptoms (HR = 2.871, 95%CI = 1.133~7.307), and elevated lactate dehydrogenase (HR = 3.528, 95%CI = 1.231~10.66) as independent adverse prognostic factors.

CONCLUSION: Age, genetic variants, and clinical factors may significantly affect the prognosis of the DLBCL patients. Younger patients have better survival compared to older patients. Variants of the MYC, BCL2, and TP53 genes are closely associated with poor prognosis.

PMID:41230584 | DOI:10.3760/cma.j.cn511374-20250303-00120