Tag: pubmed

Eur J Orthop Surg Traumatol. 2025 Feb 8;35(1):66. doi: 10.1007/s00590-025-04184-w.

ABSTRACT

PURPOSE: Osteoarticular infections (OAI) are serious clinical conditions with Staphylococcus aureus and Coagulase-negative Staphylococcus (CoNS) responsible for up to two-thirds of cases. This work aimed to compare the epidemiological, clinical, and microbiological characteristics of OAI caused by S. aureus versus CoNS to aid in clinical management and infection control strategies.

METHODS: A single-centre retrospective study was performed at the Centro Hospitalar e Universitário de Coimbra for the period of January 2011 to December 2021. A total of 458 cases of OAI were gathered. Data was retrieved from medical records and statistical analysis was performed with SPSS.

RESULTS: S. aureus accounted for 60.7% of infections, followed by S. epidermidis (29.9%). Independent risk factors for S. aureus infections included being male (p < 0.001; OR = 0.47) and a history of osteomyelitis (p < 0.001; OR = 0.18). In contrast, CoNS infections were associated with older age (p = 0.018), carrying a prosthetic device (p < 0.001; OR = 2.92), and a prior periprosthetic infection (p = 0.023; OR = 1.86). Both groups exhibited significant antimicrobial resistance, with CoNS showing greater resistance to gentamicin, linezolid, teicoplanin and trimethoprim-sulfamethoxazole, while S. aureus was more commonly resistant to clindamycin.

CONCLUSION: Our findings show the distinct characteristics of OAI caused by S. aureus and CoNS, highlighting the need for targeted risk factor management and tailored empiric antibiotic therapy to reduce incidence and improve outcomes.

PMID:39921754 | DOI:10.1007/s00590-025-04184-w

Arch Dermatol Res. 2025 Feb 8;317(1):370. doi: 10.1007/s00403-025-03857-0.

ABSTRACT

Emerging research indicates that gut microbiota and the associated immune responses are crucial in the development of chronic inflammatory skin diseases. This investigation employs Mendelian Randomization (MR) and Bayesian weighting to elucidate the causal links between gut microbiota, immune cells, and psoriasis, with a specific emphasis on CD8 + T cells. We leveraged summary statistics from genome-wide association studies (GWAS) related to gut microbiota, immune cells, and psoriasis. Single nucleotide polymorphisms (SNPs) were chosen as instrumental variables (IVs) to evaluate causal relationships through various MR methods, such as inverse variance weighted (IVW), MR Egger, weighted median, and simple mode. Additionally, Bayesian weighting was used to validate results and account for potential pleiotropy. The IVW analysis revealed significant associations between certain gut microbiota and psoriasis, notably identifying a protective link between Escherichia coli and psoriasis. Further MR analysis demonstrated that Escherichia coli had a causal relationship with CD8 + T cells. Increased levels of CD8 + T cells were associated with a higher risk of psoriasis. BWMR analysis confirmed these findings, showing that CD8 + T cells mediated 10.09% of the protective effect of Escherichia coli on psoriasis. This study underscores the significant role of Escherichia coli and CD8 + T cells in psoriasis, suggesting both protective and exacerbating effects. Understanding these microbiota-immune interactions can lead to the development of more effective, personalized treatments and preventative strategies, ultimately improving patient outcomes and quality of life.

PMID:39921729 | DOI:10.1007/s00403-025-03857-0

Rheumatol Int. 2025 Feb 8;45(3):44. doi: 10.1007/s00296-025-05804-8.

ABSTRACT

Polypharmacy can be associated with poor outcomes in chronic diseases. Our objective is to determine the prevalence of polypharmacy and its association with disease control in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). An observational study was conducted using the SARD database of the CHU de Québec. Participants newly diagnosed with RA or SLE enrolled in the database after 24 months were included. Collected data included number and type of medications, Charlson Comorbidity Index, and medication adherence (proportion of days covered during the first 180 days). Polypharmacy was defined as the simultaneous use ≥5 medications. Multivariable logistic and linear regressions were used to determine the association between polypharmacy and disease control (DAS28CRP, SLEDAI-2 K). The study included 111 participants (RA = 81; SLE = 30). Medication count increased at two years in RA (mean ± SD): 4.6 ± 3.3 to 6.9 ± 3.6; and SLE: 6.5 ± 4.6 to 7.80 ± 4.82. Polypharmacy prevalence increased at two years: RA: from 43 to 74%; SLE: from 47 to 73%. Mean medication adherence exceeded 85%. For RA participants, polypharmacy was associated with a better DAS28CRP score at one year [adjusted odds ratio of achieving a poor outcome: 0.17 (95%CI 0.04-0.71)], but this association was lost at two years [2.88 (0.45-18.29)]. For SLE, polypharmacy was not associated with disease activity based on the SLEDAI-2 K at one year [7.36 (0.26-211.16)] or two years [0.32 (0.05-1.99)]. Overall, polypharmacy is very prevalent in RA and SLE and could be positively associated with the level of disease control in the year after a diagnosis of RA.

PMID:39921727 | DOI:10.1007/s00296-025-05804-8

Arch Dermatol Res. 2025 Feb 8;317(1):377. doi: 10.1007/s00403-025-03899-4.

ABSTRACT

This study aimed to investigated the association between the ratio of neutrophils to lymphocytes (NLR) and cutaneous melanoma (CM) and to determine the association between the NLR and the prevalence of CM. A retrospective observational study involving 62,102 individuals over the age of 18, drawn from the National Health and Nutrition Examination Survey (NHANES), which was carried out over the period from 1999 to 2018. NLR derived from laboratory data, while CM diagnosis was based on participants’ self-reports. The relationship between the NLR and CM was assessed using weighted logistic regression analyses, complemented by restricted cubic spline analyses. The study encompassed a total of 336 adults afflicted with CM and 49,621 adults free from CM. The findings exposed a correlation between the NLR and the occurrence of CM, having an odds ratio (OR) of 1.63 (95% confidence interval [CI]: 1.07 to 2.48; p = 0.022). Moreover, the restricted cubic spline model showed a non-linear pattern between the NLR and CM. Overall, we found that the NLR was positively associated with the prevalence of CM. Our findings highlight that NLR may be a systemic inflammation waring marker for CM in US individuals.

PMID:39921722 | DOI:10.1007/s00403-025-03899-4

Arch Dermatol Res. 2025 Feb 8;317(1):374. doi: 10.1007/s00403-025-03867-y.

ABSTRACT

Skin diseases affect millions of Americans, imposing a large financial burden on the U.S. healthcare system annually. Inpatient dermatology is a subspecialty focused on treating complicated skin diseases in hospitalized patients. Utilization of these services enhances diagnostic accuracy, shorten hospital stays, lower readmission rates, and improve patient outcomes. However, studies have indicated an overall decline in inpatient dermatology consultations and dermatology as primary admitting services. Currently, only two academic hospitals in the United States grant dermatologists admitting privileges, indicating decreased exposure to inpatient dermatology in residency despite the need for more hospital-based dermatologists. Therefore, this narrative review aims to characterize the financial impact and utilization of inpatient dermatology services. Historical and recent data consistently highlight the financial benefit of dermatologic hospitalizations and poor utilization of inpatient dermatology consultations. Teledermatology consultations also improve diagnostic accuracy and expedite interventions to improve patient outcomes. However, challenges like reduced reimbursement, lack of protocols, and limited resident training in inpatient dermatology have discouraged dermatologists from providing inpatient consultations. Policy changes are needed to promote these services that benefit patients as well as health systems.

PMID:39921720 | DOI:10.1007/s00403-025-03867-y

Eur Arch Otorhinolaryngol. 2025 Feb 8. doi: 10.1007/s00405-025-09232-z. Online ahead of print.

ABSTRACT

PURPOSE: Listening effort increases as background noise levels rise, affecting both children and adults. Understanding the impact of increased listening effort and identifying effective methods to estimate it in children is crucial, as higher listening effort can hinder learning. This systematic review and meta-analysis examined the effects of noise on listening effort, as measured using various methods, in children aged 5 to 13 years with normal hearing.

METHODS: Four scientific databases, PubMed, Scopus, Cochrane Library, and Web of Science, were searched to retrieve 23 eligible articles. The methodological quality of the studies was assessed using Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Meta-analysis was performed according to different methods of listening effort [behavioral (single-task paradigm and dual-task paradigm), subjective ratings, and physiological (pupillometry)].

RESULTS: Single-task paradigm and subjective ratings showed a medium effect of noise on listening effort, which was significant. Dual-task paradigm and pupillometry did not show statistically significant effects of noise on listening effort. Further, speech perception tasks show a greater effect of noise on listening effort as compared to listening comprehension.

CONCLUSIONS: Single-task paradigm and subjective rating methods revealed the negative effect of noise on listening effort during spoken language processing in children between 5-13 years of age. Thus, a combination of these two methods might provide useful information regarding the effect of noise on this population. The heterogeneity in the findings could be due to the multidimensional nature of listening effort and lack of construct validity of the methods used to assess listening effort.

PMID:39921717 | DOI:10.1007/s00405-025-09232-z

Eur Radiol. 2025 Feb 8. doi: 10.1007/s00330-025-11398-3. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine whether quantitative parameters derived from dual-energy CT (DECT) could predict prognosis in patients with resectable rectal cancer (RC).

MATERIALS AND METHODS: One hundred and thirty-four patients (recurrence/distant metastasis group, n = 36; non-metastasis/non-recurrence group, n = 98) with RC who underwent radical resection and DECT were retrospectively included. DECT quantitative parameters, including iodine concentration (IC), normalized iodine concentration (NIC), electron density (Rho), effective atomic number (Z_eff), dual-energy index (DEI), the slope of the spectral Hounsfield unit curve (λ_HU) on arterial and venous phase images. Univariate and multivariate Cox proportional hazards models were employed to identify independent risk factors of prognosis. The area under the receiver operating characteristic curve (AUC) was used to assess the performance. Disease-free survival (DFS) curves were constructed using the Kaplan-Meier method.

RESULTS: Patients in the metastasis/recurrence group had higher Rho in arterial phase (A-Rho), NIC in venous phase (V-NIC), Rho in venous phase (V-Rho), Z_eff in venous phase (V-Z_eff), λ_HU in venous phase (V-λ_HU), pT stage, pN stage, serum carcinoembryonic antigen (CEA), carbohydrate antigen-199 levels and more frequent in extramural venous invasion than those in non-metastasis/non-recurrence group (all p < 0.05). V-NIC, V-λ_HU, and CEA were independent risk factors of recurrence/distant metastasis (all p < 0.05). The AUC of combined indicator integrating three independent risk factors achieved the best diagnostic performance (AUC = 0.900). In stratified survival analysis, patients with high V-NIC, V-λ_HU, and CEA had lower 3-year DFS than those with low V-NIC, V-λ_HU, and CEA.

CONCLUSION: Combining V-NIC, V-λ_HU, and CEA could be used to noninvasively predict prognosis in resectable RC.

KEY POINTS: Question TNM staging fails to accurately prognosticate; can quantitative parameters derived from dual-energy CT predict prognosis in patients with resectable rectal cancer? Findings Normalized iodine concentration (V-NIC) and the slope of the spectral Hounsfield unit curve in venous phase (V-λHU), and carcinoembryonic antigen (CEA) are independent risk factors for recurrence/metastasis. Clinical relevance The combined indicator integrating V-NIC, V-λHU, and CEA could predict 3-year disease-free survival in patients with resectable rectal cancer and could aid in postoperative survival risk stratification to guide personalized treatment.

PMID:39921716 | DOI:10.1007/s00330-025-11398-3

Arch Dermatol Res. 2025 Feb 8;317(1):369. doi: 10.1007/s00403-025-03826-7.

ABSTRACT

The diagnostic workup for T3 or greater melanoma includes sentinel lymph node biopsy (SLNB) for staging purposes. However, it is unclear if a negative SLNB in this subset of patients is adequate to rule out distant metastases (DMs) in the absence of imaging. Furthermore, current guidelines for imaging in these cases are ambiguous. Therefore, we aim to report and compare the prevalence of DMs found on imaging in patients with T3 or greater melanoma, stratified by SLNB result. In addition, we aim to qualitatively investigate the effect on time to treatment if imaging is delayed in these patients. This is a retrospective study of 140 patients with T3 or greater melanoma who underwent workup and treatment at our institution from 2009 to 2022. Diagnostic data, primary tumor characteristics, and demographics were collected. Descriptive statistics were applied to describe the cohort with granular detail. An independent Fisher’s exact test was performed to compare the prevalence of DMs detected on imaging stratified by SLNB result. A student’s t test was performed to compare average time to treatment within a subset of patients with negative or non-localizing SLNB to assess for any benefit with staging imaging completed prior to SLNB. The prevalence of DMs detected using advanced imaging in patients with T3 or greater melanoma was similar between groups, where 4 of 33 (12.12%) patients with negative or non-localizing SLNB were found to have DMs compared to 6 of 50 (12%) patients with positive SLNB (two-tailed p = 1). For those who had a negative or non-localizing SLNB and underwent adjuvant therapy, a student’s t-test revealed no significant difference in time to treatment initiation between those who had imaging prior to SLNB (56 days) and those who had imaging after SLNB (86 days) was completed (p = 0.2317). Given the similar prevalence of DMs regardless of SLNB result, patients with T3 or greater melanoma may benefit from more extensive imaging alongside SLNB upon initial diagnosis to prevent potential delays in detection of DMs and prompt initiation of appropriate treatment.

PMID:39921714 | DOI:10.1007/s00403-025-03826-7

Arch Dermatol Res. 2025 Feb 8;317(1):379. doi: 10.1007/s00403-025-03872-1.

ABSTRACT

Hyperpigmentation is a commonly occurring skin problem, it affects people’s quality of life by causing anxiety and depression in them. This systematic review aims to critically evaluate the evidence of the effectiveness of formulations utilized in clinical trials for treating hyperpigmentation (melasma and photoaging). A comprehensive search was conducted using the Scopus, PubMed, Google Scholar, and National Center for Biotechnology Information (NCBI) databases, encompassing literature available up to December 2023. Clinical trials employing various formulations to address skin hyperpigmentation effectively were included and subsequently analysed. Meta-analysis was conducted using IBM SPSS Statistics software (version 29.0.1.0 for window) guidelines. From 102 literatures, 07 clinical studies that follow the inclusion criteria were selected. A total of 337 participants underwent a clinical trial, where 198 participants received the drug and 153 received a placebo. Meta-analysis of 07 clinical studies indicated that employed formulations have a significant effect on treating skin hyperpigmentation {Odds Ratio (OR): 4.260, 95% Confidence Interval (CI) 2.244 to 8.087, Probability value (P) p < 0.001} than placebo. Across 07 clinical trials, heterogeneity was found to be low {Tau-Squared (µ²) = 0.46, Degree of Freedom (df) = 6, p = 0.001, i-Squared (I²) = 0.76}. Formulations assessed in the meta-analysis are Ziziphus jujuba (Z. jujuba) syrup, Amorphophallus konjac (A. konjac) capsules, herbal mixture cream, cysteamine cream, 4-hexyl-1,3-phenylenediol lotion, lignin peroxidase cream, and 0.1% tretinoin cream. 0.1% tretinoin cream shows the lowest effect size while A. konjac capsules show the highest effect size among all the included studies. Formulations used in clinical trials have proven to be effective and safe for controlling skin hyperpigmentation compared to placebo treatments. Among all the formulations, 0.1% tretinoin demonstrates lower efficacy, while A. konjac exhibits the highest efficacy in treating hyperpigmentation. This systematic review will guide researchers and dermatologists in selecting quality products from the available formulations.

PMID:39921709 | DOI:10.1007/s00403-025-03872-1

Scand J Immunol. 2025 Feb;101(2):e13432. doi: 10.1111/sji.13432.

ABSTRACT

Oocyte donation (OD) pregnancies show a higher fetal-maternal incompatibility and a higher risk of developing pre-eclampsia (PE) than autologous pregnancies. As maternal monocytes play a role in the tolerization of the allogeneic fetus, the aim of this study was to analyse monocyte phenotypes in healthy and PE OD pregnancies. We collected maternal peripheral blood at different gestational time points in healthy (n = 10) and PE (n = 5) OD pregnancies. Fetal-maternal human leukocyte antigen (HLA) mismatches were calculated. We used a 35-colour antibody panel for Aurora spectral flow cytometry to analyse the composition and surface marker expression of monocyte subsets. Expression of CD38 on intermediate monocytes significantly increased throughout gestation in healthy OD pregnancies. Compared with the healthy group, the PE group exhibited even higher CD38 expression on monocyte subsets, with statistical significance. Immune inhibiting receptors CD85j (LILRB1) and CD85d (LILRB2), as well as monocyte recruitment regulating molecules CCR2 and CD91, also showed significantly enhanced expression on monocyte subsets during PE. When comparing healthy and PE OD only in pregnancies with high HLA mismatches, the different CD38 and CD85j expression in monocyte subsets was still significant. In conclusion, in healthy OD pregnancies, the upregulated CD38 expression might reflect a proinflammatory condition specifically at the third trimester. In PE OD pregnancies, expression of both inflammatory and immune regulatory markers is increased in maternal peripheral monocyte subsets. The elevated expression of CCR2 and CD91 on these subsets might reflect monocyte chemotaxis and the effect from systemic vascular dysfunction at the late stage of PE.

PMID:39920890 | DOI:10.1111/sji.13432