Tag: pubmed

Eur J Breast Health. 2025 Feb 24. doi: 10.4274/ejbh.galenos.2025.2024-12-9. Online ahead of print.

ABSTRACT

OBJECTIVE: Breast cancer (BC) is a global concern due to its high incidence worldwide. The alarming increase in BC cases highlights the need for careful management of the disease at multiple levels. This study investigated the diagnostic value of hemoglobin, albumin, lymphocyte and platelet counts (HALP score), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) in newly diagnosed BC patients.

MATERIALS AND METHODS: A total of 84 individuals, including 42 healthy volunteers (group I) and 42 patients newly diagnosed with BC (group II), were included. Serum albumin levels were determined using spectrophotometry. The levels of tumor-markers carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA 15-3) in serum were analyzed by electrochemiluminescence immunoassay. Hemogram parameters were analyzed using fluorescence flow cytometry.

RESULTS: The median PLR was significantly lower in group II than group I (p = 0.014). There were no statistical differences in HALP score, NLR, LMR, and prognostic nutrition index between the two groups (p = 0.133, p = 0.993, p = 0.591, and p = 0.294, respectively). The sensitivity and specificity of PLR in predicting BC were 61.90% and 64.29%, respectively, with an area under the curve of 0.665 (p = 0.009, 95% confidence interval: 0.5480 to 0.7819, cut-off value ≤124). PLR, CEA and CA 15-3 were independent risk factors for BC (p<0.05).

CONCLUSION: The findings suggest that PLR may serve as a potential biomarker for the early diagnosis of BC; however, further validation is required. Conversely, the HALP score and other parameters did not demonstrate a significant association with early BC diagnosis. These results warrant corroboration through regional and community-based studies.

PMID:39989379 | DOI:10.4274/ejbh.galenos.2025.2024-12-9

Eur J Psychotraumatol. 2025 Dec;16(1):2465082. doi: 10.1080/20008066.2025.2465082. Epub 2025 Feb 24.

ABSTRACT

Objective: Trauma victimization is common among children, however, a significant proportion of trauma victims go unrecognized unless they are thoroughly assessed, even in child psychiatry clinics. The aim of this study was to evaluate the psychometric properties and diagnostic accuracy of the Turkish version of the UCLA PTSD Reaction Index for DSM-5 (PTSD RI-5) in a clinical sample of trauma-exposed children and adolescents.Method: A total of 208 children and adolescents admitted to the child psychiatry clinic, each of whom had a history of at least one traumatic event, were evaluated with the PTSD RI-5 to investigate trauma history and PTSD symptoms. All participants also completed the Revised Child Anxiety and Depression Scale (RCADS) and 64 participants were assessed with a semi-structured diagnostic interview for PTSD and depression.Results: Internal consistency for the total scale was high (Cronbach’s α = 0.91) and the confirmatory factor analysis (CFA) supported the four-factor structure of the PTSD RI-5 (CFI = 0.915, TLI = 0.902, RMSEA =0.062). ROC analysis showed strong diagnostic accuracy (AUC = 0.94).Conclusion: The Turkish version of the PTSD RI-5 may a reliable and valid tool for diagnosing PTSD in clinical samples and may improve diagnosis and treatment outcomes by identifying unrecognized trauma-related symptoms.

PMID:39989342 | DOI:10.1080/20008066.2025.2465082

Pediatr Transplant. 2025 Mar;29(2):e70048. doi: 10.1111/petr.70048.

ABSTRACT

BACKGROUND: Approximately 50% of patients with chronic kidney disease due to C3 glomerulopathy (C3G) or primary immune-complex membranoproliferative glomerulonephritis (IC-MPGN) will require dialysis and/or kidney transplantation (KTx) within the first 10 years of disease onset. Currently, there are no guidelines regarding the indications for KTx or post-transplant management.

METHODS: We therefore initiated an international online survey via Survey Monkey on C3G and IC-MPGN in children with CKD stage 5. All KTx centers of the European Society for Paediatric Nephrology (ESPN) were invited to participate in the survey, which was conducted from August 23 to November 25, 2023.

RESULTS: Sixty-five (63%) of the centers (n = 103) participated. Twenty-six percent had made at least one decision against living donation for a child with C3G or IC-MPGN. The main reason for 88.2% of these decisions was concern about the recurrence of the underlying disease in any potential transplant. Eighty-eight percent indicated deceased donation as an option; 12% decided not to proceed with transplantation at all. Regarding KTx decision-making or management, none of them referred to an existing recommendation by any national or regional guideline. For the recurrence of C3G or IC-MPGN post-transplant, eculizumab treatment was suggested by 60% of respondents.

CONCLUSION: This survey shows a considerable reluctance of pediatric nephrologists to list patients with CKD stage 5 due to C3G or IC-MPGN for living donor kidney transplantation. This decision is mainly based on the fear of recurrence of the underlying disease combined with the lack of reliable treatment options. This limited access of affected patients to the best treatment option for kidney failure requires further action.

PMID:39989336 | DOI:10.1111/petr.70048

Eur J Psychotraumatol. 2025 Dec;16(1):2457295. doi: 10.1080/20008066.2025.2457295. Epub 2025 Feb 24.

ABSTRACT

Background: Steroid hormone dysregulations have frequently been implicated in posttraumatic stress disorder (PTSD) pathogenesis. However, the translation into naturalistic clinical settings as markers of symptomatology and treatment success remains complex. Particularly, there is little longitudinal data on steroid secretion over the course of interventions.Objective: This study examined the potential of long-term steroid hormone secretion assessed in hair as diagnostic and intervention-related biomarkers among medicated, multimorbid inpatients with PTSD.Method: As part of a secondary analysis of a randomised controlled trial, 54 female inpatients with a primary diagnosis of PTSD received standardised treatment and provided hair samples at pre-treatment, post-treatment, and 3-month follow-up. Cortisol, cortisone, and dehydroepiandrosterone (DHEA) were determined, alongside clinical assessments.Results: Cross-sectional results showed a negative association of pre-treatment DHEA with anxiety symptoms and a trend-level association with lifetime trauma exposure. While inpatients improved in PTSD symptomatology during treatment, neither pre-treatment steroids, nor treatment-induced steroid changes predicted PTSD symptoms at post-treatment or 3-month follow-up.Conclusion: The study highlights the challenges of establishing biomarkers in naturalistic clinical populations. While the association of attenuated DHEA with anxiety symptoms warrants further exploration, our data points towards the potential necessity of patient sub-sample selection to understand, and in the long run clinically target, the endocrine mechanisms in PTSD.

PMID:39989328 | DOI:10.1080/20008066.2025.2457295

Biometrics. 2025 Jan 7;81(1):ujaf015. doi: 10.1093/biomtc/ujaf015.

ABSTRACT

Researchers commonly use difference-in-differences (DiD) designs to evaluate public policy interventions. While methods exist for estimating effects in the context of binary interventions, policies often result in varied exposures across regions implementing the policy. Yet, existing approaches for incorporating continuous exposures face substantial limitations in addressing confounding variables associated with intervention status, exposure levels, and outcome trends. These limitations significantly constrain policymakers’ ability to fully comprehend policy impacts and design future interventions. In this work, we propose new estimators for causal effect curves within the DiD framework, accounting for multiple sources of confounding. Our approach accommodates misspecification of a subset of intervention, exposure, and outcome models while avoiding any parametric assumptions on the effect curve. We present the statistical properties of the proposed methods and illustrate their application through simulations and a study investigating the heterogeneous effects of a nutritional excise tax under different levels of accessibility to cross-border shopping.

PMID:39989323 | DOI:10.1093/biomtc/ujaf015

Biometrics. 2025 Jan 7;81(1):ujaf016. doi: 10.1093/biomtc/ujaf016.

ABSTRACT

Studies have shown that the effect an exposure may have on a disease can vary for different subtypes of the same disease. However, existing approaches to estimate and compare these effects largely overlook causality. In this paper, we study the effect smoking may have on having colorectal cancer subtypes defined by a trait known as microsatellite instability (MSI). We use principal stratification to propose an alternative causal estimand, the Subtype-Free Average Causal Effect (SF-ACE). The SF-ACE is the causal effect of the exposure among those who would be free from other disease subtypes under any exposure level. We study non-parametric identification of the SF-ACE and discuss different monotonicity assumptions, which are more nuanced than in the standard setting. As is often the case with principal stratum effects, the assumptions underlying the identification of the SF-ACE from the data are untestable and can be too strong. Therefore, we also develop sensitivity analysis methods that relax these assumptions. We present 3 different estimators, including a doubly robust estimator, for the SF-ACE. We implement our methodology for data from 2 large cohorts to study the heterogeneity in the causal effect of smoking on colorectal cancer with respect to MSI subtypes.

PMID:39989322 | DOI:10.1093/biomtc/ujaf016

Biometrics. 2025 Jan 7;81(1):ujaf012. doi: 10.1093/biomtc/ujaf012.

ABSTRACT

Dose-finding trials are a key component of the drug development process and rely on a statistical design to help inform dosing decisions. Triallists wishing to choose a design require knowledge of operating characteristics of competing methods. This is often assessed using a large-scale simulation study with multiple designs and configurations investigated, which can be time-consuming and therefore limits the scope of the simulation. We introduce a new approach to the design of simulation studies of dose-finding trials. The approach simulates all potential outcomes that individuals could experience at each dose level in the trial. Datasets are simulated in advance and then applied to each of the competing methods to enable a more efficient head-to-head comparison. Furthermore, individual trial datasets can be interrogated to understand when designs deviate in their decision making. In three case-studies, we show sizeable reductions in Monte Carlo error for comparing a performance metric between two competing designs. Efficiency gains depend on the similarity of the designs. Comparing two Phase I/II design variants, with high correlation of recommending the same optimal biologic dose, we show that the new approach requires a simulation study that is approximately 48 times smaller than the conventional approach. Furthermore, advance-simulated trial datasets can be reused to assess the performance of designs across multiple configurations. We recommend researchers consider this more efficient simulation approach in their dose-finding studies and we have updated the R package escalation to help facilitate implementation.

PMID:39989321 | DOI:10.1093/biomtc/ujaf012

J Laparoendosc Adv Surg Tech A. 2025 Feb 24. doi: 10.1089/lap.2024.0273. Online ahead of print.

ABSTRACT

Background: Incisional hernias (IHs) represent a frequently encountered postoperative complication in patients undergoing liver transplantation. Traditionally, these hernias have been addressed through open surgical techniques. However, laparoscopic repair has been increasingly recognized for its association with a reduced complication rate in the management of ventral hernias. Our objective is to conduct a comparative analysis of the outcomes associated with open versus laparoscopic repair techniques in liver transplant recipients. Methods: We conducted a comprehensive literature review across multiple databases, including PubMed, Cochrane, LILACS, SciELO, and EMBASE, to identify studies that compare the efficacy of open and laparoscopic repair methods for IHs postliver transplantation. For the statistical analysis of gathered data, we used the Review Manager software, version 5.4. To evaluate the variability among the study outcomes, we assessed heterogeneity using the I² statistic. Results: After an initial screening of 334 studies, 6 studies with a combined total of 338 patients fulfilled our inclusion criteria. Our analysis revealed that laparoscopic repair tends to be associated with longer operation times, with a mean difference of 20.30 minutes (confidence interval [CI]: 2.14-38.46; P = .03). We observed no significant differences between laparoscopic and open repair regarding infection rates, recurrence rates, overall surgical complications, or hospital stay duration. Conclusion: Both surgical approaches yield comparable postoperative outcomes. However, laparoscopic repair is associated with an increased operation time duration. To substantiate these findings, further research involving prospective, randomized studies is necessary.

PMID:39989303 | DOI:10.1089/lap.2024.0273

Int J Rheum Dis. 2025 Feb;28(2):e70138. doi: 10.1111/1756-185X.70138.

ABSTRACT

AIM: Rheumatoid arthritis (RA) is an autoimmune disease that is marked by inflammatory response. PNPLA2 (phospholipase patatin-like) which encodes ATGL (adipose triglyceride lipase) also been identified as playing in inflammation. G0S2 (G0/G1) switch gene has been identified as one of the selective inhibitors of ATGL. PNPLA2 and G0S2 may be factors that can help predict the relationship between molecules affecting inflammation, as well as identify inflammatory pathways through genes involved in the metabolic pathway.

METHODS: In the present study, we analyzed the expression levels of PNPLA2 and G0S2 genes as well as their protein concentrations by real-time PCR and immunoassay, respectively on 60 peripheral blood mononuclear cells (PBMC) which are included into 3 different groups of new case patients with RA, chronic patients with RA, and the control individuals. Also, to obtain more accurate information and results, the synovial fluid, triglyceride, cholesterol, and ESR levels were also analyzed. Statistical analysis was then performed with the software SPSS-18.

RESULTS: PNPLA2 gene expression level was significantly increased in the newly diagnosed patients and the chronic RA patients in compared to the control group. Also, the serum levels of ATGL in the newly diagnosed patients and the chronic RA patients were significantly reduced compared to the control group. The gene and protein levels of G0S2 in the newly diagnosed patients elevated compared to other groups, but interestingly this increase in PBMCs was not significant.

CONCLUSIONS: This is predicted that PNPLA2 gene expression in PBMCs is not only regulated by G0S2 gene, but different regulatory factors can also affect the expression level of this gene in the immune cells.

PMID:39989302 | DOI:10.1111/1756-185X.70138

Diabetes Technol Ther. 2025 Feb 24. doi: 10.1089/dia.2025.0033. Online ahead of print.

ABSTRACT

Background: In a prior work, a virtual continuous glucose monitoring (CGM) trace was generated for each of the 1441 participants in the landmark Diabetes Control and Complications trial (DCCT). These new data allow us to compare whether time-in-tight-range (TITR) is a better predictor of diabetic microvascular complications (specifically retinopathy development or progression) than time-in-range (TIR). Methods: Discrete Cox proportional hazard models were used to calculate the hazard ratios (HRs) for the development/progression of retinopathy. Results: For a 1.0 standard deviation (SD) change, the adjusted HR (95% confidence interval) was 2.67 (2.33-3.06) for TIR, 2.74 (2.36-3.18) for TITR, and 2.37 (2.13-2.65) for HbA1c; a similar pattern of results was obtained for a 0.5 SD change. Computing Harrell’s C-statistic showed that a survival model adjusted for TIR, TITR, or HbA1c had similar predictive performance. Conclusion: The associations of TIR and TITR with retinopathy development or progression were similar to HbA1c in the virtual DCCT CGM dataset.

PMID:39989301 | DOI:10.1089/dia.2025.0033