Tag: pubmed

Eur J Epidemiol. 2025 Jul 2. doi: 10.1007/s10654-025-01263-4. Online ahead of print.

ABSTRACT

Concerns about the safety of titanium dioxide (TiO₂), including potential carcinogenicity, have prompted its ban in foods in the European Union, while remaining allowed as pharmaceutical excipient. We aimed to evaluate whether ingesting increasing quantities of TiO₂ through medicines is associated with higher cancer risk. Data were derived from the French National Health Data System, a nationwide medico-administrative database. A case-control study was nested within two cohorts: users of metformin (all doses) and users of 200 mg acebutolol, both available in TiO₂-containing and TiO₂-free formulations. During 2013-2021, 293,101 cancer cases were identified and matched to 2,930,633 controls. TiO₂ exposure through metformin and acebutolol consumption was calculated based on drug claims from 2006 up to five years before the index date. Conditional logistic regression models estimated linear associations between TiO₂ exposure and cancer risk. RRs of overall cancer per 1000 TiO₂-containing tablets and per 10,000 mg of TiO₂ increments were both 1.00 (95% CI: 0.99-1.01). Analyses by cancer site also yielded RRs very close to 1.00 or slightly different but not statistically significant, except for breast (RR per 10,000 mg: 1.03, 95% CI:1.00-1.07) and lymphoid/hematopoietic (RR per 1000 tablets: 0.97, 95% CI: 0.95-1.00) cancers, which however lost significance after Bonferroni correction. There was a suggestion of non-linear positive association for central nervous system cancers. This first epidemiological study on TiO₂ ingestion and cancer found no meaningful linear association between increasing TiO₂ exposure through medicines and overall or site-specific cancer risk. Non-linear associations cannot be excluded.

PMID:40601245 | DOI:10.1007/s10654-025-01263-4

Cell Biochem Biophys. 2025 Jul 2. doi: 10.1007/s12013-025-01817-z. Online ahead of print.

ABSTRACT

In this study, a series of benzoxazole-linked pyrazole compounds (20a-t) were synthesized and tested for their antiproliferative activity. Their effects on lung cancer (A549) and normal lung (CCD-34Lu) cell lines were evaluated using the MTT assay. Among them, compounds 20m and o showed strong antiproliferative effects, with IC₅₀ values of 7.64 and 15.82 µM, respectively, and selectivity indices of 2.84 and 1.95 in favor of cancer cells. ELISA tests demonstrated that both compounds statistically significantly reduced VEGFR-2 protein levels by 24.8 and 28.7% at their respective IC₅₀ values, indicating potential antiangiogenic properties. Molecular docking studies supported these findings by showing favorable binding of 20m and o to the VEGFR-2 receptor, with binding energies of -7.33 kcal/mol and -7.22 kcal/mol, respectively. Overall, compounds 20m and o stand out as promising candidates for further development as anticancer drugs.

PMID:40601229 | DOI:10.1007/s12013-025-01817-z

Geroscience. 2025 Jul 2. doi: 10.1007/s11357-025-01741-3. Online ahead of print.

ABSTRACT

Canagliflozin (Cana) started at 16 months of age and 16-hydroxy-estradiol (OH_Est) started at 12 months each led to significant increases in lifespan in male UM-HET3 mice but significant decreases in female lifespan. To seek insights into the basis for these sex-specific effects, we performed end-of-life histopathological analyses of control and treated mice for all three interventions testing program sites. There were no significant drug-induced alterations in inferred cause of death, although statistical power was low for such comparisons. Tabulation of incidental lesions (i.e., combining lethal and non-lethal lesions) revealed a complex set of significant and near-significant changes caused by each of the two agents, in some cases absent, or even opposite in direction, in one of the two sexes. The analysis did not, however, reveal a clear pattern that would explain the selective sex-specific effects of either agent on lifespan. It is plausible that the female-specific harm induced by each of these agents could reflect harmful or toxic effects that are not easily detectable by histopathological examination.

PMID:40601216 | DOI:10.1007/s11357-025-01741-3

Ann Intensive Care. 2025 Jul 2;15(1):88. doi: 10.1186/s13613-025-01508-1.

ABSTRACT

BACKGROUND: Post-cardiac arrest (CA) care guidelines (GLs) have been introduced in 2010 and periodically updated every 5 years since then (in 2015 and 2021). However, the impact of these GLs on patients’ outcome remains underexplored. The aim of this study was to comprehensively evaluate and compare the impact of implementation of three consecutive post-CA GLs over 14 years, on patients’ survival and neurological recovery.

METHODS: This retrospective cohort study included adult patients resuscitated from CA and admitted to the intensive care unit (ICU) between 2011 and 2024. Patients were stratified into three cohorts based on the GL in use (GL2010, GL2015, and GL2024). Adherence to GL recommendations was assessed across seven macro-areas: coronary angiography, haemodynamic, ventilation, temperature control, general ICU management, multimodal neuroprognostication, and seizure control. Predictors of survival and favourable neurological outcome at ICU discharge were evaluated using multivariate logistic regression with LASSO selection. Outcome up to 6 months was also evaluated.

RESULTS: A total of 275 patients were included over the 14-year period. Survival to ICU discharge increased from 39.5% in cohort 1 to 53.9% in cohort 3, together with favourable neurological outcome that improved from 30.9 to 42.7%. Adherence to GL recommendations significantly improved across most domains, particularly in haemodynamic management (from 32.0% in cohort 1 to 77.3% in cohort 3), temperature control (from 60.6 to 94.4%), and general ICU management (from 56.3 to 77.6%). Among all interventions, adherence to haemodynamic recommendations was independently associated with improved survival (OR = 2.20, 95% CI: 1.01-4.86).

CONCLUSIONS: Following the implementation of updated post-CA care GLs, adherence to recommendations improved, particularly in haemodynamic management. Although no statistically significant improvements in survival or neurological outcomes were observed, these findings highlight the potential value of sustained GL-based care.

PMID:40601206 | DOI:10.1186/s13613-025-01508-1

J Gen Intern Med. 2025 Jul 2. doi: 10.1007/s11606-025-09701-5. Online ahead of print.

ABSTRACT

BACKGROUND: Transgender and gender diverse (trans) populations are at elevated risk for atherosclerotic cardiovascular disease (ASCVD).

OBJECTIVE: Measure the association of gender identity and gender-affirming hormone therapy (GAHT) with ASCVD outcomes.

DESIGN: Cohort study.

PARTICIPANTS: Over 1 million veterans receiving care in the Veterans Health Administration.

MAIN MEASURES: Gender identity was identified via a validated natural language processing (NLP) algorithm. Incident ASCVD (acute myocardial infarction, ischemic stroke, or revascularization after the baseline date) was identified via International Classification of Diseases diagnosis codes among veterans without prevalent ASCVD. We calculated sample statistics stratified by gender identity and used Cox proportional hazard regression to assess associations of gender identity and GAHT with incident ASCVD.

KEY RESULTS: Among 1,105,082 veterans, 42,149 were classified as trans (8013 transfeminine, 7127 transmasculine, and 27,009 uncategorized trans) while 918,843 were cisgender men and 144,090 were cisgender women. During a median follow-up of 9.39 years, 92,910 veterans had incident ASCVD (2806 among trans veterans). Adjusting for age, race, Hispanic ethnicity, and sexual orientation, trans veterans had 1.52 [1.45, 1.59] and 0.92 [0.89, 0.96] times the hazard of ASCVD compared to cisgender women and cisgender men, respectively. Compared to trans veterans not receiving GAHT, GAHT among trans veterans assigned female at birth was significantly associated a reduced hazard of ASCVD (0.89 [0.80, 0.98]); GAHT was not associated with ASCVD among trans veterans assigned male at birth (0.99 [0.89, 1.09]).

LIMITATIONS: With NLP, there is potential for selection bias as clinicians may preferentially document the gender identity for trans more than cisgender veterans.

CONCLUSIONS: This is one of the first studies to examine the association of both gender identity and GAHT with incident ASCVD in veterans. Future research must comprehensively evaluate ASCVD outcomes and the effects of gender-affirming care (including hormone therapy) in trans populations.

PMID:40601199 | DOI:10.1007/s11606-025-09701-5

Environ Sci Pollut Res Int. 2025 Jul 2. doi: 10.1007/s11356-025-36657-0. Online ahead of print.

ABSTRACT

In this study, different statistical methodologies were combined to assess the relationship between PM₁₀ concentrations and meteorological variables (temperature, relative humidity, wind direction and speed, and atmospheric pressure) and their associations with other pollutants (CO, NO₂, NO, and O₃) recorded during the period 2021-2024 at Mendoza City, Argentina. The results indicate that increased humidity and temperature might reduce PM₁₀ levels by enhancing particle dispersion and deposition. Positive correlations between PM₁₀, NO, and NO₂ suggest a shared origin, likely from vehicle emissions. To further analyze PM₁₀ behavior, prediction models were developed to categorize PM₁₀ levels as “good” (≤ 45 μg/m³) or “bad” (>45 μg/m³) based on a air quality guidelines from WHO. The performance of the random forest (RF) and logistic regression (LR) algorithms were evaluated and compared. Additionally, the influence of atmospheric variables and pollutant concentrations was also assessed to determine their impact on PM₁₀ predictions. RF model demonstrated the highest predictive performance for PM₁₀ level. Results indicate that NOx (NO₂ and NO) significantly contribute to PM₁₀ formation, likely due to shared anthropogenic sources. Temperature, humidity, and wind speed also impact PM₁₀ predictions, though to a lesser extent than pollutant concentrations. The inclusion of these variables highlights the role in the dispersion and transformation of air pollutants. Implementing such models could provide policymakers with real-time data to enhance pollution control and public health protection.

PMID:40601188 | DOI:10.1007/s11356-025-36657-0

Rheumatol Ther. 2025 Jul 2. doi: 10.1007/s40744-025-00780-8. Online ahead of print.

ABSTRACT

INTRODUCTION: The prevalence of knee osteoarthritis (OA) is rising worldwide, leading to disability and a reduced quality of life, particularly in elderly patients. While there are several treatment options, there is little consensus in the scientific community over which methods are most effective. Viscosupplementation with hyaluronic acid (HA) has been found to reduce pain in patients with knee OA over a period of up to 6 months, with little to no side effects. The aim of this prospective open-label, uncontrolled, observational, single-site study was to assess the efficacy and safety of a single hybrid HA injection over a period of 6 months in subpopulations of patients with low to severe symptomatic knee OA in everyday clinical practice.

METHODS: Fifty patients who met the inclusion criteria participated in the study. A single intra-articular ultrasound-guided injection of hybrid HA (Sinovial®) was administered. Patients submitted Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaires at 28, 42, 84, and 168 days post-treatment.

RESULTS: VAS scores measured at rest and when walking indicate an improvement during follow-up, particularly at 28 and 42 days, compared to baseline. Similarly, the most notable improvement of the WOMAC score was observed within the first 42 days after injection. While decrease in pain and joint function improvement were not as pronounced at the end of follow-up, they were still statistically better than at baseline. Overall patient satisfaction was high.

CONCLUSION: Treatment with a single injection of hybrid HA was demonstrated to be safe and effective in patients with varying degrees of knee OA. Patients with medial knee OA responded better to treatment than patients with patellofemoral OA, which provides information on which types of patients are best suited to this intervention.

TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT06652893. Retrospectively registered October 10, 2024.

PMID:40601162 | DOI:10.1007/s40744-025-00780-8

Clin Oral Investig. 2025 Jul 2;29(7):370. doi: 10.1007/s00784-025-06445-8.

ABSTRACT

OBJECTIVES: The consumption of energy drinks with high sugar and acid content is common among adolescents and may contribute to the development of white spot lesions (WSL) during orthodontic treatment. This study aimed to assess the incidence and localization of WSL in adolescents with high energy drink consumption treated with completely customized lingual appliances (CCLAs).

MATERIALS AND METHODS: Eligible for inclusion in this retrospective cohort study were adolescents (< 18 years) who underwent orthodontic treatment with CCLAs, consumed ≥ 2 energy drinks daily, and developed ≥ 1 new labial WSL on a non-bonded surface. High-resolution intraoral photographs before (T0) and after (T1) treatment were evaluated for the presence of WSL (yes/no) on maxillary and mandibular incisors and canines. Differences in WSL rates between labial and lingual surfaces were analyzed using paired t-tests (α = 0.05).

RESULTS: A total of 38 patients (mean age 15.2 ± 1.4 years; 11 females, 27 males) with 912 tooth surfaces were included. At T0, 70 (15.4%) labial surfaces and 5 (1.1%) lingual surfaces showed WSL. At T1, WSL increased to 243 (51.4%) labial surfaces and 45 (9.9%) lingual surfaces. Although the appliance was bonded only to the lingual surface, the incidence of WSL per patient was four times higher on the non-bonded labial surfaces: 4.3 ± 2.1 (36.0%) labial versus 1.1 ± 1.9 (8.8%) lingual. This difference was statistically significant (p < 0.001).

CONCLUSIONS: Orthodontic treatment with CCLAs in adolescents with frequent energy drink consumption was associated with significantly fewer WSL on bonded lingual surfaces compared to non-bonded labial surfaces.

CLINICAL RELEVANCE: Lingual orthodontic appliances are beneficial in patients at high-risk for WSL.

PMID:40601131 | DOI:10.1007/s00784-025-06445-8

Curr Diab Rep. 2025 Jul 2;25(1):40. doi: 10.1007/s11892-025-01598-y.

ABSTRACT

PURPOSE OF REVIEW: Lower extremity amputations (LEAs) are among the most severe complications of diabetes, with approximately 1.5 million procedures performed globally each year. This review explores the impact of social and structural determinants of health on amputation rates in diabetic patients, highlighting disparities driven by systemic factors.

RECENT FINDINGS: Structural determinants such as healthcare policies and economic systems intersect with social factors, including access to care, racial disparities, and socioeconomic status, influencing amputation risk. Black patients with diabetes face up to a fourfold increased risk of major amputation compared to non-Hispanic white patients. Lower socioeconomic status is also strongly linked to higher amputation rates. Geographic and environmental factors, like food deserts and limited access to specialized care, further exacerbate these disparities. Emerging prevention strategies, such as telemedicine and mobile health units, demonstrate promise in improving access to care. Addressing disparities in LEAs requires comprehensive policy changes and targeted interventions. Future directions include leveraging artificial intelligence and precision medicine alongside community-based programs to reduce amputation rates in high-risk diabetic populations.

PMID:40601126 | DOI:10.1007/s11892-025-01598-y

Neurosurg Rev. 2025 Jul 2;48(1):540. doi: 10.1007/s10143-025-03684-x.

ABSTRACT

Cerebral vasospasm (CVS) is a severe complication associated with significant morbidity and in-hospital mortality. While well characterized in aSAH, its occurrence following AVM-related hemorrhage remains less understood. To address this gap, a meta-analysis adhering to PRISMA guidelines was conducted, with two independent authors searching PubMed, Scopus, and Web of Science from inception to July 2024, seeking studies on CVS risk factors following AVM-related hemorrhage. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Dichotomous variables were pooled into an overriding odds ratio (OR) with a 95% confidence interval (CI), while continuous variables were analyzed using the mean difference (MD) with a 95% CI, both using a random-effects model. Out of 2360 screened articles, 4 studies met the inclusion criteria, totaling 7483 AVM-related hemorrhage patients, 958 of whom developed CVS. All studies were rated high quality, according to NOS. A total of 10 extractable demographic, behavioral, clinical, and radiographic variables reported in the literature were assessed. The following CVS risk factors were statistically significant: younger age (MD = -4.99; 95% CI [-9.40 to -0.57]; p = 0.03), female sex (OR = 1.72; 95% CI [1.50-1.98]; p < 0.00001), and intraventricular hemorrhage (OR = 1.24; 95% CI [1.04-1.48]; p = 0.02). Subarachnoid hemorrhage was close to significance (OR = 1.17; 95% CI [1.00-1.36]; p = 0.05). This is the first systematic review and meta-analysis to identify risk factors for CVS in the context of AVM-related hemorrhage. The presented findings may aid clinicians in recognizing high-risk individuals. Further research is warranted to develop a reliable risk scoring system that can predict AVM-associated CVS in clinical settings and to further explore the differences between CVS following aSAH and AVM-related hemorrhage.

PMID:40601117 | DOI:10.1007/s10143-025-03684-x