Tag: pubmed

Ir J Med Sci. 2025 Nov 8. doi: 10.1007/s11845-025-04142-9. Online ahead of print.

ABSTRACT

BACKGROUND: Psoriasis vulgaris (PV) is a chronic inflammatory skin disorder in which oxidative stress, redox imbalance, and genetic susceptibility play crucial roles. Glutathione peroxidase-3 (GPx-3), a selenium-dependent antioxidant enzyme, regulates redox homeostasis by detoxifying reactive oxygen species. Variants in the GPx-3 gene may alter antioxidant defense and trace element metabolism, thereby contributing to PV pathogenesis.

AIM: This case-control study investigated the association between the GPx-3 +1494A/G polymorphism and serum trace element levels in PV.

METHODS: A total of 71 patients with PV and 71 age- and sex-matched healthy controls were genotyped using allele-specific polymerase chain reaction (AS-PCR) followed by agarose gel electrophoresis. Serum zinc (Zn), copper (Cu), and iron (Fe) concentrations were measured by atomic absorption spectrometry. Statistical analyses were performed using chi-square (χ²) and Mann-Whitney U tests.

RESULTS: The AG genotype was significantly more prevalent in PV patients than in controls (88.7% vs. 50.6%, p = 0.002). Among AG carriers, PV patients exhibited higher Zn levels (p < 0.001), lower Fe concentrations (p = 0.037), and a reduced Cu/Zn ratio (p = 0.025). Additionally, the AG genotype was associated with increased body mass index (p = 0.049).

CONCLUSION: This study demonstrates a significant association between the GPx-3 +1494A/G polymorphism and serum trace element levels in PV. The AG genotype was more prevalent among patients and accompanied by elevated Zn, reduced Fe and a lower Cu/Zn ratio, suggesting genotype-related alterations in trace element balance. These findings indicate that the +1494A/G variant may contribute to psoriasis susceptibility by modulating oxidative stress and redox homeostasis.

PMID:41205118 | DOI:10.1007/s11845-025-04142-9

Dig Dis Sci. 2025 Nov 8. doi: 10.1007/s10620-025-09538-2. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: Ulcerative proctitis affects approximately 30% of patients with ulcerative colitis. Disease control is essential to maintain quality of life and to prevent disability and disease progression. The aim of this study was to investigate current practice on isolated proctitis management across the globe.

METHODS: Physicians with experience in treating inflammatory bowel diseases (IBD) were invited to participate in an anonymous, multiple-choice survey between January and February 2025.

RESULTS: The survey included 460 physicians from 66 countries. Most participants (87.9%) assessed clinical activity of isolated proctitis within 3 months of treatment initiation, 75.9% used fecal calprotectin, and 67.1% used C-reactive protein to measure disease activity. Endoscopic assessment was performed 3 to 6 months (34.2%) or 6 to 12 months (48.4%) after treatment induction. In this survey, 49% of participants were more reluctant to begin an advanced therapy in patients with isolated proctitis compared to pancolitis or left-sided colitis. About two-thirds of participants were less likely to use biologics in combination with immunosuppressants in isolated proctitis compared to left-sided or pancolitis. Anti-TNF (tumor necrosis factor) was the preferred choice in first-line advanced therapy after failing conventional treatment (48.4%).

CONCLUSION: This study highlighted differences in management of isolated proctitis compared to left-sided colitis or pancolitis. This is likely explained by the fact that isolated proctitis patients were historically excluded from clinical trials; therefore, management relied on extrapolation of data from studies on more extensive disease.

PMID:41205107 | DOI:10.1007/s10620-025-09538-2

Acta Neurochir (Wien). 2025 Nov 8;167(1):290. doi: 10.1007/s00701-025-06686-2.

ABSTRACT

BACKGROUND: Minimally invasive approaches to lumbar spine surgery are increasingly popular. Current guidelines highlight the importance of preoperative HbA1c in optimizing spine surgery outcomes. However, the role of preoperative HbA1c in minimally invasive lumbar spine surgery remains unclear.

OBJECTIVES: We sought to assess the association of HbA1c with readmissions, reoperations, and complications following minimally invasive lumbar spine surgery.

METHODS: We retrospectively reviewed all adult patients at a single institution from 2011 to 2023 who underwent minimally invasive lumbar decompression or decompression with instrumented fusion using CPT and ICD9/10 codes. Multivariate logistic regressions were performed to assess the effect of high HbA1c on readmissions and reoperations.

RESULTS: In total, 1013 [median age 64 (IQR 54-71)] patients met the inclusion criteria. The median preoperative HbA1c was 5.99% (IQR 5.62 – 6.39). Upon multivariate regression analysis adjusting for frailty, socioeconomic status, and other confounders, patients with high HbA1c (> 7.1) had increased odds of unplanned readmission within 90 days (OR 2.02, 95% CI 1.10- 3.56, p = 0.019) and reoperation within 90 days (OR 2.82, 95%CI 1.14-6.31) of the index operation. Patients with high HbA1c also had increased odds of requiring reoperation due to persistent symptoms (OR 2.9, 95%CI 0.91-7.87, p = 0.048). After propensity score matching, patients with high HbA1c also had prolonged hospital lengths of stay (1.32 days vs 1.24 days, p = 0.006), post operative UTI (4.7% vs 0.9%, p = 0.034).

CONCLUSIONS: Our results suggest high preoperative HbA1C may be associated with increased rates of readmission and reoperation following minimally invasive lumbar spine surgery. Preoperative HbA1C control may be indicated for surgical optimization in minimally invasive lumbar spine surgery.

PMID:41205101 | DOI:10.1007/s00701-025-06686-2

Eur Arch Psychiatry Clin Neurosci. 2025 Nov 8. doi: 10.1007/s00406-025-02154-1. Online ahead of print.

ABSTRACT

OBJECTIVE: This study utilized a two-sample Mendelian randomization (MR) approach to investigate the causal relationships between specific sedentary behaviors-namely, driving, watching television, using a mobile phone, and using a computer-and insomnia.

METHODS: We selected independent genome-wide significant SNPs for each exposure and harmonized them with the insomnia GWAS. GWAS summary statistics were obtained from IEU OpenGWAS (UK Biobank). Instrument selection used P < 5 × 10⁻⁸ and LD clumping at r² < 0.001, 10,000 kb. Primary MR estimates were obtained using inverse variance weighting (IVW), with weighted median and MR-Egger as complementary methods. Sensitivity analyses included Cochran’s Q, MR-Egger intercept, MR-PRESSO, and leave-one-out.

RESULTS: After harmonization, the numbers of independent SNPs were: driving (n = 6), television (n = 104), mobile phone (n = 31), and computer (n = 80). IVW MR showed a positive association between television watching and insomnia (OR = 1.20, 95% CI: 1.15-1.26, P < 0.001). Driving showed an inverse association with insomnia (OR = 0.821, 95% CI: 0.72-0.94, P = 0.005). Computer and mobile phone use did not show statistically significant IVW associations with insomnia. Sensitivity analyses did not indicate consistent directional pleiotropy; leave-one-out did not identify any influential SNP.

CONCLUSION: Our MR results indicated that genetic liability to longer television-watching time is associated with an increased risk of insomnia, whereas genetic liability to longer driving time is associated with a decreased risk of insomnia. It is important to approach these results carefully, as the genetic tools employed in this research mainly reflect a behavior’s general duration or tendency, lacking specific contextual information or timing nuances.

PMID:41205073 | DOI:10.1007/s00406-025-02154-1

Obes Surg. 2025 Nov 8. doi: 10.1007/s11695-025-08370-x. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare the severity of binge eating (BE), food addiction (FA), and body image dissatisfaction between candidates to bariatric and long-term post-bariatric patients; and investigate the association between dysfunctional eating behaviors and body mass index (BMI) and body image dissatisfaction after metabolic bariatric surgery.

METHODS: 86 patients seeking metabolic bariatric surgery and 59 patients who underwent Roux-en-Y Bypass Gastric at least two years ago (a mean of 7 years ago) were included. The mental disorders have been investigated through the Diagnostic and Statistical Manual for Mental Disorders – version 5 (DSM-5) criteria. The severity of BE, FA, and body image dissatisfaction were assessed through the Binge Eating Scale (BES), the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), and the Body Shape Questionnaire (BSQ), respectively.

RESULTS: There was no statistically significant difference in the scores of the mYFAS 2.0 (p = 0.929), BES (p = 0.336), and BSQ (p = 0.759) between groups. Among the post-bariatric patients, the mYFAS 2.0 and the BES significantly correlated with the BMI (r = 0.301, p = 0.024 and r = 0.291, p = 0.042, respectively). The BSQ scores were not significantly correlated with BMI (r = 0,207, p = 0,149) but were associated with the mYFAS (0.408, p = 0.004) and the BES (r = 0.526, p < 0.001). The scores of BES significantly predicted the scores of body image dissatisfaction in a linear regression model.

CONCLUSION: Patients who underwent metabolic bariatric surgery a long time ago did not have better food- and eating-related behaviors and were not more satisfied with their body image, despite weighing less. Dysfunctional eating behaviors may impair weight outcomes and body image satisfaction.

PMID:41205055 | DOI:10.1007/s11695-025-08370-x

Clin Oral Investig. 2025 Nov 8;29(12):557. doi: 10.1007/s00784-025-06624-7.

ABSTRACT

BACKGROUND: This study aims to evaluate and compare the effectiveness of 1% melatonin gel combined with demineralized freeze-dried bone allograft (DFDBA) versus DFDBA alone in treating intrabony periodontal defects in Stage II & III periodontitis. Clinical and radiographic outcomes were assessed using cone-beam computed tomography (CBCT), along with analysis of gingival crevicular fluid (GCF) levels of receptor activator of nuclear factor-kappa B ligand (RANKL) and osteoprotegerin (OPG).

METHODOLOGY: A prospective, randomized, controlled, single-blinded clinical trial was conducted on 20 patients with 20 intrabony defects. The control group received DFDBA alone, while the test group received a combination of 1% melatonin gel and DFDBA. Clinical parameters Clinical Attachment Level (CAL) and Probing Pocket Depth (PPD) were evaluated at baseline, 3, and 6 months. Using cone beam computed tomography (CBCT) radiographic parameters linear bone fill and bone volume and GCF biomarkers (RANKL and OPG) were assessed at baseline and 6 months. Plaque Index (PI) and Sulcus Bleeding Index (SBI) were secondary outcomes. CAL change served as the primary outcome variable.

RESULTS: After 6 months, the test group showed a mean CAL gain of 3.10 ± 0.87 mm and the control group 4.00 ± 1.85 mm, which was not statistically significant between the groups; however, intra-group comparison revealed a statistically significant CAL gain from baseline in both groups. Both groups showed improvements in assessed parameters, however, the test group demonstrated significantly greater bone fill (1.88 ± 0.26 mm vs. 1.16 ± 0.38 mm) and bone volume gain (22.67 ± 1.36 mm³ vs. 14.78 ± 0.5 mm³; p< 0.000). Greater reduction in PPD and gain in CAL were noted in the test group. GCF analysis revealed a significant increase in OPG (99.87 ± 15.07) and reduction in RANKL levels (66.13 ± 19.12) in the test group at 6 months (p= 0.000).

CONCLUSION: Melatonin gel as an adjunct to DFDBA enhances clinical, radiographic, and biochemical outcomes in intrabony periodontal defect therapy. Clinical Trials Registry of India (CTRI/2023/07/055039).

PMID:41205053 | DOI:10.1007/s00784-025-06624-7

Int J Comput Assist Radiol Surg. 2025 Nov 8. doi: 10.1007/s11548-025-03545-4. Online ahead of print.

ABSTRACT

PURPOSE: This article reports on the development and feasibility testing of an MR-safe robotic needle driver. The needle driver is pneumatically actuated and designed for automatic insertion and extraction of needles along a straight trajectory within the MRI scanner.

METHOD: All parts use plastic resins and composite materials to ensure MR-safe operation. A needle could be clamped in the needle carriage using a pneumatically operated clamp. The clamp is designed to be easily attached and detached from the needle driver. Clamps with different opening sizes could accommodate a range of needles from 18 to 22 gauge. To mimic the manual procedure of needle insertion, a pneumatically operated rack-and-pinion mechanism simultaneously translates and rotates the needle carriage along a helical slot. Signal-to-noise ratio (SNR) and 2-D geometric distortion were measured to evaluate the MRI compatibility. Targeting was measured with an electromagnetic tracker. We also evaluated the maximum force that could be generated at the tip of the needle with different clamping pressures using a force sensor.

RESULTS: We recorded the maximum percentage change in SNR for multiple configurations of needle drivers as 6.6% and the maximum geometric distortion at 0.24%. The needle driver’s mean positioning accuracy for 105 targets at 50 mm depth was 2.38 ± 1.00 mm in a composite tissue phantom. The angulation error for the straight trajectory was 0.51°, and the mean linear trajectory deviation was statistically negligible. The measured force at the needle tip was 1.17N, 1.6N, and 2.12N at 30, 40, and 50 psi, respectively.

CONCLUSION: This preliminary study showed that the prototype of our robotic needle driver works as intended for the insertion and extraction of the needle. The driver is MR-safe and serves as a suitable platform for MRI-guided interventions.

PMID:41205052 | DOI:10.1007/s11548-025-03545-4

Arch Gynecol Obstet. 2025 Nov 8. doi: 10.1007/s00404-025-08238-6. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the impact of repeated cesarean deliveries on isthmocele formation and to investigate the diagnostic value and clinical presentation of morphometric parameters, including niche depth, width, length, residual myometrial thickness (RMT), adjacent myometrial thickness (AMT), and the depth/AMT ratio.

METHODS: A cross-sectional study was conducted with 116 symptomatic and asymptomatic women aged 18-45 years who had undergone one or more cesarean sections. The presence and dimensions of the isthmocele were assessed via transvaginal ultrasonography using Delphi consensus criteria. Morphometric and obstetric data were analyzed using descriptive statistics, correlation analysis, and binary logistic regression.

RESULTS: Isthmocele was identified in 71.6% of participants, with prevalence rising from 42.9% after the first cesarean to 100% after the fourth. The isthmocele group had significantly higher gravidity, parity, and cesarean numbers (p < 0.001). Niche depth, length, and the depth/AMT ratio were significantly elevated, while RMT was reduced (p < 0.001). The number of cesareans showed a strong negative correlation with RMT (r = -0.499, p < 0.001) and a strong positive correlation with the depth/RMT ratio (r = 0.615, p < 0.001). Multivariate analysis identified having three or more cesareans as an independent predictor of isthmocele (OR = 15.6; 95% CI 3.27-74.4; p < 0.001). Niche length had the highest diagnostic accuracy for symptomatic isthmocele (AUC 0.700; 95% CI 0.589-0.796; cutoff 5 mm).

CONCLUSION: Repeated cesarean deliveries significantly increase both the risk and severity of isthmocele. In women with four cesareans, isthmocele was detected in 100% of cases. A niche length of ≥ 5 mm proved to be the most reliable morphometric marker in identifying symptomatic cases.

IMPLICATIONS FOR CLINICAL PRACTICE: These findings emphasize the importance of routine transvaginal ultrasound screening post-cesarean-especially in women with multiple cesarean sections-and the incorporation of morphometric assessment (including RMT and depth/RMT ratio) into clinical decision-making.

PMID:41205040 | DOI:10.1007/s00404-025-08238-6

Pharmacoecon Open. 2025 Nov 8. doi: 10.1007/s41669-025-00615-w. Online ahead of print.

ABSTRACT

OBJECTIVES: To identify health utility decrements of injection treatment-related attributes among patients with type 2 diabetes mellitus (T2DM) in China.

METHODS: Health states of four attributes (hypoglycemia, dose frequency, flexibility and injection site reaction) were generated using a vignette-based method. Patients with T2DM were recruited from eight cities in China. The sample was broadly consistent with Chinese T2DM population with regard to age and sex distribution. Respondents completed seven time trade-off (TTO) tasks during face-to-face interviews. The ordinary least square (OLS), fixed effects (FE) and random effects (RE) models were used for TTO data. In subgroup analysis, groups were categorized based on whether injection treatment was currently used, number of medications, needle phobia, duration of injectable treatment and travel frequency.

RESULTS: A total of 400 patients (52.75% male, mean [SD] age 50.30 [12.05] years) were included in this study. Severe hypoglycemia had the largest disutility value of all attributes (-0.023, P < 0.001). Three times daily, twice daily and once daily injection (needed to be carried with the patient on short trips) were associated with -0.023 (P < 0.001), -0.018 (P < 0.001) and -0.011 (P = 0.022) disutility values compared with once weekly injection (not required to be carried with the patient on short trips), respectively. The disutility value associated with injection site reaction attribute was -0.013 (P < 0.001). In subgroup analysis, the relative importance of treatment-related attributes was found to depend on patient characteristics.

CONCLUSIONS: This study provides disutility values associated with several injection treatment-related attributes for Chinese patients with T2DM. Hypoglycemia appears to be the most important attribute, followed by dose frequency, flexibility and injection site reaction.

PMID:41205032 | DOI:10.1007/s41669-025-00615-w

Clin Drug Investig. 2025 Nov 8. doi: 10.1007/s40261-025-01497-w. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Anemia is a serious heath concern due to its high prevalence in the global population. Its occurrence in surgical patients varies greatly and correlates with worse outcomes. Higher costs and severe complications could also result from insufficient iron status. An effective way to mitigate the burden of iron deficiency could be the adoption of national patient blood management (PBM) programs. This study aimed to quantify the potential health economic benefits of implementing preoperative anemia management (the first pillar of PBM) with ferric carboxymaltose (FCM) in Romanian hospitals.

METHODS: An already published decision-tree-based health economic model was adapted and populated with Romanian cost and epidemiological data from 2019. Cardiac (coronary artery bypass grafting) and non-cardiac (hip and knee arthroplasty) elective surgery cases were analyzed. Costs of complications per discharged case were assessed on the basis of data from ten local hospitals.

RESULTS: A total of 14,641 cases met the inclusion criteria. On the basis of our sample of ten hospitals, the complication costs per case ranged from €1067.43 (for stroke) to €2896.14 (for sepsis with pneumonia). The health economic model simulated two scenarios. In the first scenario, all cases with anemia received FCM treatment. The total savings at the national level total were at least €1,500,875. In the second scenario half of the cases with anemia received treatment, resulting in savings of €363,779.

CONCLUSIONS: Our results suggest that introducing iron deficiency anemia treatment with FCM in case of elective surgical interventions results in considerable cost reduction for the healthcare system.

PMID:41205029 | DOI:10.1007/s40261-025-01497-w