Tag: pubmed

Updates Surg. 2025 Jan 30. doi: 10.1007/s13304-025-02086-4. Online ahead of print.

ABSTRACT

BACKGROUND: Primary hyperparathyroidism (PHPT) due to a parathyroid adenoma stands as one of the most prevalent endocrinological disorders, with focused parathyroidectomy being the established therapeutic strategy.

AIM: This study aims to investigate whether the volume of the pathological gland influences perioperative outcomes and postoperative morbidity.

METHODS: A retrospective analysis was conducted on data from 141 patients who underwent focused parathyroidectomy for PHPT at the University Hospital of Basel between 2007 and 2022.

RESULTS: A total of 141 patients underwent surgery, with a mean age of 57.2 years and prevalence of women (64.5%).The volume of the lesion was divided into three groups (low < 1 ml, middle 1-1.99 ml, large > 2 ml) based on pathological specimen analysis. Preoperative calcium and parathyroid hormone (PTH) values were significantly higher in the large volume group compared to the low volume group (p < 0.05), while phosphate and vitamin D values were significantly lower (p < 0.05). A comparison of adenoma volume in symptomatic patients with asymptomatic patients revealed no statistically significant difference (p = 0.845) and the volume of the gland of any group did not influence the length of the operation (p = 0.173) and the perioperative morbidity (p = 0.108).

CONCLUSION: Compared to a volume of less than 1 ml, a parathyroid gland volume greater than 2 ml was associated with higher preoperative PTH and calcium levels and lower phosphate and vitamin D levels. The volume of the parathyroid gland does not seem to impact the clinical manifestations, or the incidence of perioperative complications.

PMID:39883321 | DOI:10.1007/s13304-025-02086-4

Adv Ther. 2025 Jan 30. doi: 10.1007/s12325-024-03099-y. Online ahead of print.

ABSTRACT

INTRODUCTION: Atrial fibrillation (AF), a common heart rhythm abnormality, is linked to a higher risk of stroke. Traditionally, warfarin has been the primary anticoagulation treatment for reducing the stroke risk. The new standard of treatment by direct oral anticoagulants (DOACs) offers greater benefits including improved efficacy and fewer adverse effects with reduced monitoring. This study aims to evaluate the risk of stroke/systemic embolism (SE) and major bleeding (MB) among patients with AF who switched from warfarin to DOACs.

METHODS: This study utilized Medicare data to conduct a retrospective analysis of patients with non-valvular atrial fibrillation (NVAF) who switched from warfarin to DOACs between January 1, 2012, and December 31, 2019. Patients with NVAF aged 65 and older who switched from warfarin and had continuous health plan enrollment were included. Descriptive statistics, propensity score matching (PSM), and Cox proportional hazard (PH) models were utilized to compare the outcomes and assess risks of SE and MB across the DOAC cohorts.

RESULTS: Among 1,843,495 patients with NVAF on warfarin, 171,700 switched to DOACs within 90 days of discontinuation (apixaban: 90,850; rivaroxaban: 67,698; dabigatran: 12,900). The mean follow-up period across DOAC cohorts ranged from 552 to 628 days. After PSM, apixaban showed significantly lower rates of stroke/SE compared to dabigatran (2.99% vs. 3.98%, p < 0.0001) and rivaroxaban (3.08% vs. 3.80%, p < 0.0001). MB rates were also lower with apixaban versus dabigatran (4.29% vs. 5.57%, p < 0.0001) and rivaroxaban (4.07% vs. 6.35%, p < 0.0001). Cox PH models confirmed these findings, with apixaban demonstrating lower risks of stroke/SE [hazard ratio (HR) 0.83, 95% confidence interval (CI) 0.72-0.96 vs. dabigatran; HR 0.91, 95% CI 0.85-0.96 vs. rivaroxaban] and MB (HR 0.79, 95% CI 0.71-0.89 vs. dabigatran; HR 0.68, 95% CI 0.65-0.72 vs. rivaroxaban).

CONCLUSION: The risk of stroke/SE and MB varies significantly among patients with NVAF switching from warfarin to different DOACs, with apixaban presenting the lowest risk compared to dabigatran and rivaroxaban.

PMID:39883308 | DOI:10.1007/s12325-024-03099-y

J Assist Reprod Genet. 2025 Jan 30. doi: 10.1007/s10815-024-03374-5. Online ahead of print.

ABSTRACT

The objective of this study is to explore the impact of the use of granulocyte-macrophage colony-stimulating factor (GM-CSF) in female undergoing assisted reproductive technology (ART) on reproductive outcomes. A literature search was performed using electronic databases (PubMed, EMBASE, Web of Science, CNKI, Wanfang data, Geen Medical, and Cochrane Library). Risk ratio (RR), odds ratio (OR), and mean difference (MD) with 95% confidence intervals (CI) for various outcomes were presented. The publication bias and heterogeneity were determined using funnel plot symmetry and I² test separately. The combined results of the RCT studies did not reveal statistical differences between the GM-CSF group and the control group for any outcome indicators. However, our pooling of results showed that after meta-analysis of non-RCT studies, GM-CSF had a positive effect on implantation rate (OR 1.90; 95% CI 1.11-3.24), clinical pregnancy rate (OR 1.54; 95% CI 1.21-1.95), live birth rate (OR 1.43; 95% CI 1.04-1.98), and available embryo rate (OR 1.27; 95% CI 1.10-1.46). In conclusion, these results suggest that for a subset of women undergoing ART, GM-CSF may favorably affect CPR, LBR, IR, and available embryo rate (AER). TRIAL REGISTRATION: PROSPERO registration number CRD42022322778.

PMID:39883302 | DOI:10.1007/s10815-024-03374-5

Diabetes Ther. 2025 Jan 30. doi: 10.1007/s13300-025-01696-w. Online ahead of print.

ABSTRACT

INTRODUCTION: Scientific publications have shown sodium-glucose co-transporter-2 (SGLT2) inhibitors to have several beneficial effects in patients with complex type 2 diabetes mellitus (T2DM). However, sodium-glucose co-transporter-1 (SGLT-1) inhibitor is still under investigation in clinical trials. Recently, a dual inhibitor of sodium-glucose co-transporter (SGLT1/2), sotagliflozin, has been approved for use in patients with T2DM. In this analysis, we aimed to systematically compare the cardiovascular outcomes in patients with complex T2DM who were treated with the newly approved dual (SGLT 1 and 2) inhibitor sotagliflozin.

METHODS: Electronic databases, including Embase, MEDLINE, http://www.

CLINICALTRIALS: gov , Web of Science, Google Scholar, the Cochrane database, and reference lists of relevant publications, were searched for publications comparing the novel SGLT1/2 inhibitor versus placebo for the treatment of patients with complex T2DM. The primary endpoint, including total number of deaths from cardiovascular causes, hospitalization for heart failure, and urgent visits for heart failure, death from cardiovascular causes, cardiac mortality, hospitalization for heart failure, non-fatal myocardial infarction, and total number of cardiac events, were considered as the endpoints in this analysis. The RevMan software version 5.4 was used to carry out the statistical analysis. Risk ratios (RR) with 95% confidence intervals (CI) were used to represent the data following analysis.

RESULTS: A total of 13,054 participants enrolled between 2017 and 2020 were included in this analysis, with 6734 participants assigned to sotagliflozin and 6320 assigned to placebo. The results of this analysis showed that the primary endpoint was significantly in favor of sotagliflozin with (RR: 0.73, 95% CI 0.67-0.80; P = 0.00001). Hospitalization for heart failure (RR: 0.67, 95% CI 0.60-0.75; P = 0.00001) and the total number of cardiac events (RR: 0.73, 95% CI 0.67-0.79; P = 0.00001) were also significantly lower with sotagliflozin when compared to placebo in these patients with complex T2DM. However, the risk for cardiovascular mortality and non-fatal myocardial infarction were not significantly different with (RR: 0.91, 95% CI 0.76-1.09; P = 0.31) and (RR: 0.92, 95% CI 0.27-3.12; P = 0.89), respectively.

CONCLUSIONS: Cardiovascular outcomes, including the total number of adverse cardiac events and hospitalization for heart failure, were significantly reduced with the newly approved SGLT1/2 inhibitor sotagliflozin apparently showing its cardiovascular efficacy in patients with complex T2DM. Future trials with larger sample sizes and a longer follow-up time could possibly confirm this hypothesis.

PMID:39883288 | DOI:10.1007/s13300-025-01696-w

Invest New Drugs. 2025 Jan 30. doi: 10.1007/s10637-025-01506-x. Online ahead of print.

ABSTRACT

BACKGROUND: Immune checkpoint inhibitors (ICIs) combined with anti-vascular endothelial growth factor (VEGF) have been the standard first-line treatment of hepatocellular carcinoma (HCC). However, the efficacy of this combination in post-line treatment is still unknown. This study aimed to evaluate the efficacy and safety of the combination of anti-PD-L1 envafolimab and novel humanized anti-VEGF suvemcitug as second-line treatment for patients with HCC.

METHODS: This open-label, prospective phase II clinical study (NCT05148195) comprised safety run-in stage and dose expansion stage of HCC cohort. Eligible patients were aged ≥ 18 years and had undergone at least a prior line of treatment. Patients received fixed-dose envafolimab and suvemcitug until termination of disease progression, unacceptable toxicities, or withdrawal. The primary endpoint of safety run-in stage was recommended dose (RD), and dose expansion stage was objective response rate (ORR).

RESULTS: As of August 10, 2023, no dose-limiting toxicity was observed in six patients in the safety-run-in stage, and 2 mg/kg dose every 3 weeks was declared the RD of suvemcitug. Among 20 patients with HCC, the median age was 54.5 (range, 42-70) years. Of these patients, 20 (100.0%) received ≥ one prior line treatment, with 20 (100%) received tyrosine kinase inhibitor (TKI) treatment and 8 (40.0%) received prior ICI treatment. The ORR was 10.0% (95% confidence interval (CI), 1.2-31.7), DCR was 65.0% (95% CI, 40.8-84.6), and DoR was not reached (NR). With a median follow-up of 13.9 months, the median progression-free survival (PFS) and median overall survival (OS) were 4.3 months (95% CI, 1.4-8.1) and 10.7 months (95% CI, 6.0-not evaluable [NE]), respectively. Treatment-related adverse events (TRAEs) of grade ≥ 3 occurred in 40% patients, with proteinuria (20.0%, 4/20) being the most frequent. The ORR of no lung metastasis, prior first-line treatment and IO naïve treatment subgroup was 16.7%.

CONCLUSIONS: The combination of envafolimab and suvemcitug showed a tolerable safety profile and promising antitumor activity in HCC patients who failed later-line treatment.

PMID:39883265 | DOI:10.1007/s10637-025-01506-x

Lasers Med Sci. 2025 Jan 30;40(1):54. doi: 10.1007/s10103-025-04296-z.

ABSTRACT

To investigate the efficacy and safety of picosecond (PS) and nanosecond (NS) 1064-nm neodymium-doped yttrium aluminum garnet (Nd: YAG) laser in treating Café-au-lait macules (CALMs). We retrospectively analyzed the medical records of patients with CALMs, who were treated with PS or NS 1064-nm lasers from January 2020 to January 2022. The efficacy was determined based on the before and after pictures by two independent investigators. The incidence of adverse events and recurrence were explored after treatments. A total of 116 patients (83 in the PS group and 33 in the NS group) were recruited. For subjects in the PS group, after 1-9 sessions, the lesion clearance was poor in 15 patients (18.1%), fair in 29 (34.9%), good in 14 (16.9%), and excellent in 25 (30.1%). In the NS group, after 1-7 sessions, the lesion clearance was poor, fair, good, and excellent in 7 (21.2%), 8 (24.2%), 13 (39.4%), and 5 (15.2%) patients, respectively. There was no statistically significant difference in efficacy between the two lasers (p > 0.05). The incidence of complications (hyperpigmentation, hypopigmentation) in the PS group (16.9%) was numerically lower than in the NS group (24.2%) (p = 0.136). Among patients who responded well to the treatment, 10.3% of patients in the PS group experienced relapse, compared with 22.2% in the NS group (p = 0.926). The PS 1064-nm laser provided comparable efficacy and potentially fewer complications compared with the NS laser in treating CALMs.

PMID:39883241 | DOI:10.1007/s10103-025-04296-z

Parasitol Res. 2025 Jan 30;124(2):15. doi: 10.1007/s00436-024-08447-z.

ABSTRACT

Biting midges of genus Leptoconops Skuse 1889 are small blood-feeding insects recognized as highly irritating diurnal pests in certain regions around the globe. In Europe, their presence is poorly documented, except in France and Italy. Following reports of human discomfort in a tourist area of Menorca, Balearic Islands (Spain), a small-scale study was conducted to identify the biting species and assess their preferred biting sites using a human-landing assay along a habitat gradient in a coastal dune area. Leptoconops irritans (Noé, 1905) was identified based on morphological features and DNA barcoding. This species reached high densities (average rates of 3.3 landings/min), particularly near coastal dune vegetation. No statistically significant differences were found among the four main body sites for landings of L. irritans (F_3,6.023 = 1.80, p = 0.250): head (n = 91, 53.8%), lower extremities (n = 39, 23.1%), upper extremities (n = 37, 21.9%), and other covered areas (n = 2, 1.2%). Landing preferences varied among the three volunteers, and bites progressed differently. This study represents the second documented case of Leptoconops midges causing human discomfort in Spain. We hope this research will stimulate further interest in this understudied genus, which has been largely overlooked across much of Europe.

PMID:39883237 | DOI:10.1007/s00436-024-08447-z

J Mater Sci Mater Med. 2025 Jan 30;36(1):16. doi: 10.1007/s10856-024-06839-2.

ABSTRACT

The objective of this study is to fabricate and develop hydroxypropyl methylcellulose (HPMC) hydrogel (HG)-based composite bone cements with incorporation of hydroxyapatite (HA), beta-tricalcium phosphate (β-TCP), and with/without polymethylmethacrylate (PMMA) for vertebroplasty. For animal study, twenty female Wister rats (250-300 g, 12 weeks of age) were divided into four groups including a two non-ovariectomy (NOVX) groups and two ovariectomy (OVX)-induced osteoporosis groups. Two prepared biocomposites including HG/β-TCP/HA and HG/β-TCP/HA/PMMA were injected into the tibial defects of both OVX and NOVX rats for evaluating in vivo osteogenesis after 12 weeks. Micro-computed tomography and histological analysis using hematoxylin and eosin (H&E) and Masson’s trichrome stains of the two composite cements implanted into the tibial defects of OVX and NOVX rats revealed enhanced bone regeneration potential. However, no statistically significant differences were noted among the groups based on new bone formation, demonstrating that the injected composite cements showed similar osteogenesis effects in both OVX and NOVX rats. These findings suggest that the newly developed composite bone cement composed of HG, β-TCP, HA and/or PMMA may be a promising and professional tool for treating osteoporotic and non-osteoporotic vertebral fractures.

PMID:39883233 | DOI:10.1007/s10856-024-06839-2

Neurosurg Rev. 2025 Jan 30;48(1):107. doi: 10.1007/s10143-025-03259-w.

ABSTRACT

Pineal gland lesions pose a significant surgical challenge due to the deep-seated nature of the pineal gland, as well as the limited field of view, and the complex vascular anatomy. The mainstay of surgical treatment, when necessary, is always histopathological clarity and gross total resection (GTR). We evaluate the surgical outcomes for pineal gland lesions, shedding light on functional outcomes, histological findings, and surgical complications. We analyzed patients with pineal gland lesions who underwent surgical treatment in our institution between September 2013 and May 2022. Patient demographics, clinical symptoms, surgical approaches, resection extent, surgery-related complications, and histopathological diagnosis were studied. Pre- and postoperative functional outcomes were assessed using the modified Rankin Scale (mRS) and were compared using the Student´s t-test. 32 patients (13 males, 19 females) were included. The mean age was 39 years old. We adopted the infratentorial supracerebellar approach (ITSC) in a semi-sitting position. 2 of these patients received preoperatively an endoscopic third ventriculocisternostomy (ETV) combined with endoscopic biopsy. The mean operating time for the ITSC approach was 170 min, whereas 53 min for the ETV with endoscopic biopsy. The mean length of stay was 13 days. The most common histopathological diagnosis was pineal cysts (38%). Surgical mortality was 0%, and morbidity was 28%. GTR was possible in 72% of patients treated using the ITSC approach. There was a functional outcome improvement, with a statistical significance measured via the Student´s t-test (p = 0.047). The ITSC approach remains safe and feasible when performed by an experienced surgical team, yielding a histopathological diagnosis and improvement of functional status.

PMID:39883229 | DOI:10.1007/s10143-025-03259-w

Rheumatol Int. 2025 Jan 30;45(2):39. doi: 10.1007/s00296-025-05791-w.

ABSTRACT

This systematic review aims to summarise the association between skin disease and quality of life (QoL) in people with psoriatic arthritis (PsA) and identify areas for future research and management. This review was registered on PROSPERO (CRD42024500994). Databases were searched for articles in English published until 7th January 2025. All study types were included except editorials, conference abstracts and reviews. Data gathered included demographics, treatment, type and severity of skin disease and QoL. Data were analysed using descriptive statistics and summarised using vote-counting. 2338 articles were retrieved with 18 ultimately included (10 cross-sectional; 7 observational cohort; 1 randomised controlled trial). A pooled total of 16,960 patients with PsA were included, with 48.1% male and mean age of 47.6 years (SD 5.78). Tools for assessing psoriasis included the Psoriasis-Area-Severity-Index (PASI, n = 9), Body-Surface-Area (BSA, n = 7), with four using others, and several using a combination. PASI scores ranged from 2.6 (mild) to 9.88 (moderate); BSA was reported as ≥ 3%, 5-10%, or ≥ 10%. QoL was assessed using Dermatology-Life-Quality-Index (DLQI; n = 10); EuroQol-5 Dimension (EQ-5D; n = 3); 36-Item-Short-Form-Survey (SF-36; n = 3); and four studies used other measures. 13 studies reported an association between worse skin disease and poorer QoL in PsA. Three studies reported no association between severity of skin disease and quality of life, while two were undecided. This review highlights that there is an association between dermatological symptoms and QoL in PsA patients, even in milder disease, indicating the importance of multidiscplinary management to facilitate greater QoL and patient outcomes.

PMID:39883198 | DOI:10.1007/s00296-025-05791-w