Tag: pubmed

J Assist Reprod Genet. 2025 Sep 20. doi: 10.1007/s10815-025-03675-3. Online ahead of print.

ABSTRACT

PURPOSE: To investigate whether re-biopsy and re-vitrification affect embryo developmental potential and clinical outcomes.

METHODS: Embryos that underwent preimplantation genetic testing for aneuploidy (PGT-A) and single embryo transfer between December 2017 and April 2024 were studied. All embryos were categorized into three groups: fresh biopsy and vitrification (BV group; n = 346); thawed, biopsied, and subsequently vitrified (VBV group; n = 12); fresh biopsied, vitrified, further thawed and biopsied again due to inconclusive results from the previous biopsy (BVBV group; n = 19). The live birth rate and miscarriage rate will be evaluated after embryo transfer in each group.

RESULTS: Live birth rate (LBR) was not statistically significant among the BV group (50.00%), VBV group [41.67%; adjusted relative risks (aRR) 0.96; 95% confidence interval (95% CI): 0.81-1.14], and BVBV group (42.11%; aRR 0.97, 95% CI: 0.83-1.13). The miscarriage rate was not statistically significant: BV group (11.27%); VBV group (25%; aRR 1.09, 95% CI: 0.95-1.25), and BVBV group (5.26%; aRR 0.97, 95% CI: 0.91-1.02).

CONCLUSIONS: The differences in LBR and miscarriage rates among the groups were not statistically significant. However, the limited sample sizes of the VBV and BVBV groups cannot rule out the possibility of moderate differences. Some embryos can be successfully salvaged, leading to live births. To minimize inconclusive results, the laboratory should refine the procedural details.

PMID:40974472 | DOI:10.1007/s10815-025-03675-3

Eur J Pediatr. 2025 Sep 20;184(10):627. doi: 10.1007/s00431-025-06416-x.

ABSTRACT

Tenosynovial giant cell tumour (TGCT) is a benign fibrohistiocytic proliferation that can lead to intraarticular inflammation causing secondary degenerative arthropathy. Surgery is the preferred treatment to avoid complications. Paediatric TGCT is rarely reported, mostly in case studies. This revision presents the largest paediatric series. This observational study involved 24 paediatric patients reported between 1998 and 2023 with confirmed histological diagnosis of TGCT. Descriptive statistics were used for analysis. Twenty-four patients (mean age 12.25 years, SD 3.78; 1:1 gender ratio) were included with the anatomopathological diagnosis of TGCT. The knee was the most affected joint (75%), with localized nodular presentation (66.7%). Initial symptoms were mechanical pain in all patients, joint effusion in 79.1%, and limp in 25%. Mean duration of symptom duration before diagnosis was 9 months (range 4-15). Magnetic Resonance Imaging (MRI) findings were consistent with TGCT in all cases, and alter confirmed by arthroscopic biopsy. Radiographs showed soft tissue changes in five patients. Treatment included arthroscopic synovectomy (70.8%) or open surgery (29.2%). Over a mean follow-up of 98 months (range 6-288), six recurrences occurred, all with diffuse presentation at the knee.

CONCLUSION: MRI is the preferred method for diagnosis and follow-up. Surgery is the main treatment, with low recurrence if nodular lesions are accurately removed. Outcomes and recurrence depend on diffuse presentation. We recommend open surgery for recurrences and local adjuvant treatment.

WHAT IS KNOWN: • Tenosynovial Giant Cell Tumour (TGCT) is an uncommon benign synovial lesion usually described as isolated case reports in children. • MRI is the preferred imaging technique due its superior tissue contrast and ability to differentiate diffuse and localized forms.

WHAT IS NEW: • We present the largest known pediatric series of TGCT including 24 histolgically confirmed cases and with outcome data. • The study provides insight into recurrence patterns and supports a tailored surgical approach based on lesion type.

PMID:40974423 | DOI:10.1007/s00431-025-06416-x

Int Arch Occup Environ Health. 2025 Sep 20. doi: 10.1007/s00420-025-02170-7. Online ahead of print.

ABSTRACT

PURPOSE: After vision, hearing is the most important sensory mechanism for obtaining essential and critical information during flight operations. Pilots are at risk of hearing loss due to exposure to excessive noise which usually causes permanent and incurable hearing damage. This study investigated the hearing status of Iranian pilots and explored the relationship between the severity of their impairment, age, work experience and flight hours.

METHODS: In this cross-sectional study, eligible pilots were selected. Demographic information, job characteristics, flight hours and auditory complaints were collected. Subsequently, the pilots underwent hearing tests (Pure tone Audiometry) and the hearing threshold was measured at different frequencies.

RESULTS: the study involved 100 pilots (57 fixed-wing pilots and 43 helicopter pilots) with the mean age of 47.77 ± 7.53 years (28-64 years). The average and standard deviation of work experience in all the studied subjects was equal to 24.84 ± 8.44 years. 55 pilots had no auditory impairments, while 45 were diagnosed with some form of hearing impairment. The findings indicate that older age, longer work experience, and more flight hours are significantly associated with greater hearing impairments. Individuals with any level of hearing impairment (slight to mild) had higher age, more work experience, and flight hours compared to those with normal hearing. Helicopter pilots exhibited higher hearing loss severity across frequencies compared to fixed-wing pilots, with statistically significant differences at 2000 Hz for the left ear and 1000, 2000, and 3000 Hz for the right ear. The comparison between the two ears showed that the hearing threshold in any of the flight devices (fixed wing or helicopter), in any of the investigated frequencies, has no significant difference between the left and right ears.

CONCLUSION: Exposure to loud noise during flights can significantly impact the hearing of pilots. The severity of hearing loss in helicopter pilots is higher across all frequencies compared to fixed-wing pilots. Increased age, work experience, and flight hours are significantly associated with higher severity of hearing loss in both ears. Regular auditory assessments for pilots, especially helicopter pilots, are essential for early detection and monitoring of noise-induced hearing loss.

PMID:40974421 | DOI:10.1007/s00420-025-02170-7

Lasers Med Sci. 2025 Sep 20;40(1):376. doi: 10.1007/s10103-025-04650-1.

ABSTRACT

The introduction of diode semiconductor lasers operating in the infrared spectrum has significantly advanced dental practice, elevating it to a new level of clinical efficiency. These technologies enable treatment methods that markedly reduce patient recovery time. Laser wavelengths of 810 ± 10 nm and 980 ± 10 nm are widely utilized in laser surgery and photobiomodulation. Of growing interest is the potential use of laser irradiation at a wavelength of 445 nm for photobiomodulation of oral mucosal tissues in cases of periodontal diseases and stomatitis. Using laser Doppler flowmetry, we demonstrated the effectiveness of non-ablative blue laser application to the gingival area in 20 healthy volunteers aged 22.9 ± 0.8 years. A statistical analysis was conducted to assess gingival microcirculation parameters, including peripheral blood flow, peripheral lymphatic flow, tissue fluorescence amplitude at 460 nm (NADH coenzyme), and at 515 nm (FAD coenzyme). Oxidative metabolism index was calculated using a specific formula. Following a 1-minute low-level laser irradiation session, a statistically significant average increase of 3.07 perfusion units in microcirculation was observed. Lymphatic perfusion values decreased by an average of 0.04 perfusion units. The oxidative metabolism index increased by an average of 0.16 perfusion units post-procedure. The observed enhancement in blood flow velocity and oxidative metabolism index in gingival tissues after exposure to 445 nm wavelength laser irradiation at 0.1 W confirms the therapeutic potential of blue laser technology.

PMID:40974420 | DOI:10.1007/s10103-025-04650-1

Support Care Cancer. 2025 Sep 20;33(10):867. doi: 10.1007/s00520-025-09922-8.

ABSTRACT

PURPOSE: Second opinions are increasingly sought by patients, particularly in complex and life-altering conditions such as gastrointestinal (GI) cancers, to ensure confidence in their diagnosis and treatment plans or to seek therapeutic trials.

METHODS: This retrospective study analyzed second-opinion requests handled by the GI oncology team in our institution between January and March 2024, examining the types of questions raised, patient characteristics, and their impact on clinical decision-making.

RESULTS: Of 261 eligible patients, 259 were included in this analysis. Most patients had metastatic disease (86%), and 51% had received at least two lines of prior treatment. Requests were predominantly submitted by oncologists (63%), with a significant proportion (41%) coming from outside academic centers. General practitioners (GPs) accounted for 37% of the submissions, often with incomplete records (86% completeness vs. 99% for oncologists; p < 0.01). The median age at diagnosis was 60 years, with younger patients being more frequently referred by oncologists (57.0 vs. 62.5 years, p < 0.001). The most common diagnoses were pancreatic (29%) and colorectal (27%) cancers. Second-opinion requests focused on therapeutic management (73%) and access to clinical trials (60%). Therapeutic decisions were in line with the standard of care in 93% of the cases, while 15% received alternative recommendations, such as intrahepatic arterial infusion or targeted therapies. However, participation in therapeutic trials (1.2%) and molecular screening (2.7%) was seldom offered to patients, highlighting the need for better tools to access trials. Importantly, palliative care decisions were upheld in 95% of the specific requests.

CONCLUSION: This study demonstrates the potential value of structured second-opinion pathways in ensuring adherence to evidence-based care and addressing patient concerns. However, improving GP support, reducing referral delays, and optimizing access to trials remain critical for improving outcomes in patients with advanced GI cancer.

PMID:40974415 | DOI:10.1007/s00520-025-09922-8

Environ Monit Assess. 2025 Sep 20;197(10):1127. doi: 10.1007/s10661-025-14541-1.

ABSTRACT

Climate change has emerged as one of the most pressing issues of the twenty-first century. Its induced disasters have posed significant threats to social, economic and environmental systems on the planet earth. Thus, the understanding of implications of climate change is crucial for developing effective mitigation and adaptation strategies. Climate change-induced flood has caused significant economic and environmental losses. This review paper synthesises the state of knowledge on flood susceptibility, vulnerability and risk for identifying research gaps and recommending future research. We collected the articles on the research domains through Web of Science and Scopus search engines to create a coherent database for analysis. A total of 156 research articles were Analysed after the exclusion criteria for the state of research. A bibliometric and systematic analyses were carried out for examining the trend in the publication, frequency of keywords, scale and distribution of studies during 1990-2023. The major emphasis of the review was on conceptualisation, approaches and methods used for analysing flood susceptibility, vulnerability and risk. The findings of this study revealed that most of the reviewed research papers were focused on flood susceptibility, risk and vulnerability while less attempts have been made on flood perception, flood resilience and flood management. The effectiveness of flood resilience, community-based initiatives and policy frameworks for sustainable flood management has been explored for the holistic and interdisciplinary approach. This paper emphasises the necessity of collaboration between policymakers, scientists and local communities to develop adaptive and resilient flood management strategies for future research direction. The insights of this study may help to build more resilient communities in the face of increasing flood-related challenges.

PMID:40974414 | DOI:10.1007/s10661-025-14541-1

Neuroradiology. 2025 Sep 20. doi: 10.1007/s00234-025-03776-x. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to evaluate the effectiveness of the Fast 3D wheel (Fast 3Dw) technique in cerebral magnetic resonance angiography (MRA) and compare it with the conventional parallel imaging (PI) technique. The primary objective was to determine whether Fast 3Dw could reduce the examination time while maintaining image quality and diagnostic accuracy in patients with cerebral aneurysms.

METHODS: This retrospective study included 50 patients with unruptured cerebral aneurysms who underwent 3D time-of-flight MRA using either PI or Fast 3Dw techniques on a 3T magnetic resonance imaging scanner. The image quality was quantitatively assessed using the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), aneurysm diameter, and vessel diameter. Qualitative image assessments included vascular clarity, artifacts, and diagnostic confidence level and were evaluated using a 5-point scale. Statistical comparisons were performed using t-tests, Wilcoxon signed-rank tests, and weighted kappa statistics.

RESULTS: The mean examination time for Fast 3Dw (171.5 ± 4.9 s) was significantly shorter than that for PI (383.8 ± 13.2 s; p < 0.05). Fast 3Dw exhibited a significantly higher SNR (50.0 ± 14.2) than PI (46.6 ± 12.9; p < 0.05), while CNR showed no significant difference between the two techniques. No significant differences in aneurysm diameters and vessel diameters were observed between the two methods. Qualitative evaluations demonstrated no significant differences in vascular clarity, artifacts, and diagnostic confidence levels between the two methods.

CONCLUSION: The Fast 3Dw technique significantly reduces examination time while maintaining image quality and diagnostic accuracy in cerebral MRA compared to PI. This method may be a viable alternative for routine cerebral MRA in clinical practice.

PMID:40974398 | DOI:10.1007/s00234-025-03776-x

Neurosurg Rev. 2025 Sep 20;48(1):659. doi: 10.1007/s10143-025-03832-3.

ABSTRACT

Background Despite the increasing number of decompressive craniectomy (DC) in neurotrauma, the optimal timing for elective cranioplasty (CP) is still debated. Little is known about the CP complications related to surgery, implant material, and post-traumatic hydrocephalus. Objectives To explore the correlation between CP timing, implant material, and the incidence of postoperative complications in patients undergoing CP after DC for severe head injuries. Materials and methods A retrospective multicenter study was conducted from January 2010 to December 2021 across 9 European neurosurgical centers. A cohort of 4007 patients who underwent CP following DC for severe head injury was analyzed. Timing was categorized as: ultra-early (< 30 days), early (31-90 days), late (> 90 days). Complications were defined according to Clavien-Dindo classification, requiring revision surgery and/or hospital readmissions. Results Among the 4007 patients, 352 (8.8%) had ultra-early CP, 1627 (40.5%), and 2028 (51.7%) had early and late CP respectively. Cerebrospinal fluid (CSF) derangement was more frequently associated with large defects and the incidence of Sinking Skin Flap Syndrome (SSFS). SSFS was more frequently diagnosed in patients undergoing late surgery whereas hydrocephalus and epilepsy were less frequently encountered in the ultra-early and early groups (p < 0,05). The overall complication rate was 24.6% (985 patients) including internal hydrocephalus (20%), infection (18%), external hydrocephalus (15%), epilepsy (15%), acute extradural (14%) or subdural hematomas (10%), and subdural hygroma (8%). CP stabilized CSF derangement in 80% of cases, which did not progress into overt hydrocephalus, whereas 17% with definite diagnosis of post-traumatic hydrocephalus required a Ventriculo-Peritoneal shunt (VPS). Simultaneous CP and VPS led to infections in all cases, regardless of implant material. Conclusion Surgery timing has a greater impact on CP complications than implant material. CSF derangement represents the single most relevant factor influencing the clinical course of patients undergoing CP.

PMID:40974389 | DOI:10.1007/s10143-025-03832-3

Environ Monit Assess. 2025 Sep 20;197(10):1128. doi: 10.1007/s10661-025-14594-2.

ABSTRACT

Liverpool, a city with an industrial legacy and among the most socioeconomically deprived local authorities in the UK, faces a significant health challenge: the combined impact of air pollution and deprivation on children’s respiratory health. This study deploys a dense network of 52 air quality sensors, one of the most comprehensive in the UK, to monitor particulate matter in 2023. PM2.5 levels ranged from 4.78 to 18.15 µg/m³ (median 7.15 µg/m³), and PM10 from 11.21 to 43.14 µg/m³ (median 17.30 µg/m³), frequently exceeding WHO thresholds. High concentrations were found in northern wards with high deprivation. Hospital admission rates for under-18 s ranged from 0.2 to 2%, exceeding national averages. Linear regression showed Index of Multiple Deprivation (IMD) scores explained 16.1% of the variance in hospital admissions (R² = 0.1608, β = 0.023 to 0.025, p < 0.02), more than PM2.5 (6.6%) or PM10 (4.7%). Interaction terms suggested amplified pollution effects in deprived areas. Liverpool offers a valuable case study for understanding the intersection of environmental and social determinants of health as seen in many urban UK settings. Socioeconomic deprivation emerged as both a mediator, through factors like healthcare access, and a confounder in the pollution-health relationship. These findings underscore the need for targeted emission reductions and investment in disadvantaged communities. Future research with extended data could confirm these patterns and support broader policy action.

PMID:40974382 | DOI:10.1007/s10661-025-14594-2

Aliment Pharmacol Ther. 2025 Sep 20. doi: 10.1111/apt.70383. Online ahead of print.

ABSTRACT

BACKGROUND: Severe alcohol-associated hepatitis (sAH) is a life-threatening condition. Despite advances in clinical management, prognosis remains poor and long-term effectiveness of available therapies is uncertain. We conducted a systematic review and meta-analysis to evaluate short-term mortality (28, 60, and 90-day) trends in sAH over the past five decades.

METHODS: We searched PubMed, EMBASE, and Scopus from database inception to February 2024 for studies reporting 28, 60, and 90-day mortality in patients with sAH. Pooled mortality estimates were calculated using a random-effects meta-regression model. We assessed heterogeneity using the I² statistic and explored sources of heterogeneity through subgroup and meta-regression analyses. Separate Bayesian mixed-effects binomial models were used to estimate the posterior distribution of mortality probability, updated sequentially across calendar time.

RESULTS: 34 studies comprising 1586 patients with sAH were included. Pooled mortality rates were 26.8% (95% CI: 21.0%-33.5%) at 28 days, 35.1% (95% CI: 28.3%-42.5%) at 60 days, and 43.7% (95% CI: 34.6%-53.3%) at 90 days. Mortality increased steadily with follow-up time. Substantial heterogeneity was observed, as expected in pooled proportion meta-analysis (I² > 80%). Although cumulative Bayesian analysis showed that average 28-day mortality declined from over 50% in the 1970s to ~25% after 2000, a formal decade-based analysis indicated no statistically credible improvement in short-term mortality was detected overall in the past four decades. In multivariable models adjusting for follow-up time, the Model for End-Stage Liver Disease (MELD) score was significantly associated with mortality.

CONCLUSIONS: Short-term mortality in sAH remains high and has not improved in recent decades. These findings highlight the urgent need for effective therapies, improved patient selection for early liver transplantation, and better prognostic tools to guide clinical decision-making.

PMID:40974371 | DOI:10.1111/apt.70383