Tag: pubmed

Contemp Clin Trials Commun. 2026 Jun 19;52:101660. doi: 10.1016/j.conctc.2026.101660. eCollection 2026 Aug.

ABSTRACT

INTRODUCTION: Obstructive sleep apnea (OSA) is highly prevalent, yet current treatment remains limited. Poor adherence to positive airway pressure (PAP) and barriers associated with injectable therapies can limit potential therapeutic options for moderate-to-severe OSA. The SURMOUNT-OSA trials demonstrated that tirzepatide contributes to OSA severity improvements; however, the injectable mode of administration introduces barriers that may limit accessibility and long-term adherence. Orforglipron, a once daily oral glucagon-like-peptide-1 receptor agonist, may offer a more feasible and accepted therapeutic option. ATTAIN-OSA was developed to evaluate the efficacy and safety of oral orforglipron in adults with moderate-to-severe OSA.

METHODS: ATTAIN-OSA is a master protocol with two multicenter, randomized, double-blind, placebo-controlled Phase 3 trials enrolling adults with moderate-to-severe OSA and obesity or overweight. Study 1 includes participants unable or unwilling to use PAP. Study 2 includes participants who use PAP and complete a protocol-mandated washout before baseline polysomnography. Participants are randomly assigned to placebo or orforglipron capsule formulation at maximum tolerated dose (12, 24, or 36 mg) for 52 weeks following a standardized dose escalation schedule.

RESULTS: The primary endpoint is change in Apnea-Hypopnea Index (AHI) at Week 52. Key secondary endpoints include sleep apnea-specific hypoxic burden, Patient-Reported Outcomes Measurement Information System sleep-related impairment, high-sensitivity C-reactive protein, and body weight, and other AHI-related endpoints. Overall, 712 participants have been randomized to orforglipron or placebo (Study 1, n = 363; Study 2, n = 349).

CONCLUSION: ATTAIN-OSA evaluates if once-daily oral orforglipron can provide an effective and more accessible therapeutic approach to treat moderate-to-severe OSA in adults with obesity or overweight.

TRIAL REGISTRATION: ClinicalTrials.gov, NCT06649045.

PMID:42383207 | PMC:PMC13316212 | DOI:10.1016/j.conctc.2026.101660

ESMO Real World Data Digit Oncol. 2026 Jun 23;13:100721. doi: 10.1016/j.esmorw.2026.100721. eCollection 2026 Sep.

ABSTRACT

BACKGROUND: The costs of cancer therapies are rising rapidly worldwide, with novel therapies such as targeted treatment and immunotherapies being major contributors, but their effectiveness can be low or uncertain due to limited postmarket surveillance. Reliable biomarkers to identify patients highly unlikely to respond to cancer therapies represent an increasingly important clinical and societal need, as they could prevent unnecessary treatments, reduce side effects, and alleviate pressure on health care systems.

MATERIALS AND METHODS: We developed a robust statistical framework for the identification of nonresponse biomarkers for systemic treatments and applied it to whole-genome and transcriptome sequencing data of cancer patients (N = 2594) with advanced disease.

RESULTS: Our approach identified known and potentially novel genomic and transcriptomic biomarkers of nonresponse, such as immune evasion driver events in skin melanoma patients treated with anti-programmed cell death protein 1 checkpoint inhibitors and KRAS ^G12 mutations in metastatic colorectal cancer patients treated with different chemotherapy regimens. Analytical power analysis revealed that for most treatments and/or cancer types, the cohort sizes remain underpowered.

CONCLUSIONS: Systematic identification of nonresponse signals reveals multiple potential biomarkers that will require larger cohort sizes for prospective clinical implementation.

PMID:42383193 | PMC:PMC13316273 | DOI:10.1016/j.esmorw.2026.100721

Med Image Comput Comput Assist Interv. 2022;13436:207-216. doi: 10.1007/978-3-031-16446-0_20. Epub 2022 Sep 17.

ABSTRACT

We propose LiftReg, a 2D/3D deformable registration approach. LiftReg is a deep registration framework which is trained using sets of digitally reconstructed radiographs (DRR) and computed tomography (CT) image pairs. By using simulated training data, LiftReg can use a high-quality CT-CT image similarity measure, which helps the network to learn a high-quality deformation space. To further improve registration quality and to address the inherent depth ambiguities of very limited angle acquisitions, we propose to use features extracted from the backprojected 2D images and a statistical deformation model. We test our approach on the DirLab lung registration dataset and show that it outperforms an existing learning-based pairwise registration approach.

PMID:42383192 | PMC:PMC13316773 | DOI:10.1007/978-3-031-16446-0_20

Eur Urol Open Sci. 2026 Jun 22;90:42-49. doi: 10.1016/j.euros.2026.06.001. eCollection 2026 Aug.

ABSTRACT

BACKGROUND AND OBJECTIVE: Stress urinary incontinence (SUI) remains a debilitating complication after treatment for prostate cancer or benign prostatic obstruction. While artificial urinary sphincter (AUS) implantation is the gold standard, sling procedures are widely adopted for selected patients. We aimed to analyze long-term trends, perioperative outcomes, and explantation patterns of AUS and sling procedures for male SUI in Germany.

METHODS: We performed a population-based study using the German Nationwide Inpatient Sample (GRAND) from 2005 to 2023. Men undergoing AUS or sling implantation were identified through procedure codes. Primary outcomes were in-hospital morbidity, mortality, and length of stay (LOS). Multivariable regression models were adjusted for age, comorbidities, prior radiotherapy, and year of surgery. Reasons for explantation and reimplantation were also assessed.

KEY FINDINGS AND LIMITATIONS: A total of 24 234 men underwent SUI surgery (AUS: 63%, nonadjustable sling: 32%, and adjustable sling: 4.7%). Median age was 72 yr. AUS implantation remained most frequent, although it declined slightly in recent years. Use of nonadjustable sling peaked in 2012 but decreased thereafter, whereas use of adjustable sling procedures increased steadily. Procedure volumes markedly decreased during COVID-19. Perioperative mortality was <0.1% across groups. Nonadjustable slings were associated with a higher risk of acute urinary retention (odds ratio [OR]: 1.1, p = 0.020) but with a lower risk of wound infection (OR: 0.5, p < 0.001) than AUS. No statistically significant differences were observed between adjustable slings and AUS in terms of perioperative morbidity. LOS was longer in AUS (median 6 d) than in slings (median 5 d; p < 0.001). Two-cuff AUS were associated with longer LOS than single-cuff devices. Explantations occurred most often due to infection or mechanical failure for AUS, and for different reasons for slings. Limitations include reliance on administrative coding without functional or long-term patient-reported outcomes.

CONCLUSIONS AND CLINICAL IMPLICATIONS: Male SUI surgery is safe, with AUS remaining the most frequent procedure in Germany. Adjustable slings represent an expanding option for selected patients.

PMID:42383187 | PMC:PMC13316223 | DOI:10.1016/j.euros.2026.06.001

Environ Epidemiol. 2026 Jun 30;10(4):e501. doi: 10.1097/EE9.0000000000000501. eCollection 2026 Aug.

ABSTRACT

BACKGROUND AND OBJECTIVE: Fractional exhaled nitric oxide (FeNO) is a biomarker of type-2 lung inflammation. Standardized measurement is essential for accurate diagnosis and monitoring. We assess seasonality and environmental determinants of FeNO in individuals with and without chronic respiratory diseases in the general population.

METHODS: This is a cross-sectional study on 412 individuals with chronic respiratory diseases (asthma, chronic bronchitis/chronic obstructive pulmonary disease, rhinitis) and 605 individuals without these conditions. Participants, aged 20-65 years, were recruited in the Gene-Environment Interactions in Respiratory Diseases study in Verona, Italy (2008-2014). Geocoded residential addresses were linked to daily PM₁₀ and air temperature at the time of the clinical examination using previously developed spatiotemporal models. Associations with log-FeNO were analyzed using adjusted linear regression, accounting for seasonality and disease status.

RESULTS: FeNO levels were higher in subjects with respiratory diseases during the warm season, even after adjusting for pollen exposures; a milder seasonal pattern was observed in subjects without chronic respiratory diseases (P for interaction = 0.001). A 10 μg/m³ increase in mean PM₁₀ concentration at lag 0-1 (day of FeNO measurement and day before) was associated with a 3% higher FeNO concentration (Ratio of Geometric Means, RGM: 1.03, 95% confidence interval: 1.00, 1.06) after adjusting for seasonality.

CONCLUSION: FeNO is a sensitive biomarker of environmental exposures. Overlooking seasonality and environmental factors might impact clinical decision-making in chronic respiratory diseases.

PMID:42383180 | PMC:PMC13318099 | DOI:10.1097/EE9.0000000000000501

Future Healthc J. 2026 Jun 3;13(3):100542. doi: 10.1016/j.fhj.2026.100542. eCollection 2026 Sep.

ABSTRACT

BACKGROUND: Legislative moves to legalise assisted dying in the UK have renewed discussion on future clinicians’ preparedness for new potential responsibilities. This study examined medical students’ ethical attitudes, legal understanding and curricular exposure.

METHODS: VOICE was a national cross-sectional survey of UK and Ireland medical students in 2025 (n = 896). The questionnaire assessed ethical views, confidence, legal knowledge and teaching exposure. Descriptive statistics, thematic analysis and multivariable logistic regression explored predictors of ethical agreement, curriculum coverage and legal knowledge.

RESULTS: Most students (64.5%) believed that assisted dying can be ethically justified, yet legal knowledge was limited; only 7.6% correctly identified all eligibility criteria. Nearly 70% reported minimal curricular coverage. Formal teaching was associated with higher confidence and greater ethical agreement. Regional variation and concerns about coercion and inequalities were common.

CONCLUSION: Students show broad ethical support but have very limited confidence, legal understanding and curricular preparation, highlighting the need for structured education.

PMID:42383174 | PMC:PMC13315502 | DOI:10.1016/j.fhj.2026.100542

Gynecol Oncol Rep. 2026 Jun 11;66:102135. doi: 10.1016/j.gore.2026.102135. eCollection 2026 Aug.

ABSTRACT

OBJECTIVE: Updated ACOG guidelines recommend a combined approach of transvaginal ultrasound (TVUS) and endometrial sampling for evaluation of most postmenopausal bleeding (PMB). Although prior studies investigating the reliability of TVUS suggest that non-endometrioid endometrial cancer subtypes present with thinner endometrium, some included cases with incomplete endometrial visualization. We therefore evaluated endometrial thickness (ET) by cancer subtype while controlling for incomplete endometrial visualization.

METHODS: We performed a retrospective cohort study of patients with PMB who underwent TVUS followed by tissue-confirmed endometrial cancer at three academic centers (2013-2022). Cancers were classified as endometrioid or non-endometrioid (serous, clear cell, carcinosarcoma, undifferentiated). Fibroid presence, endometrial visualization, and race/ethnicity were recorded. Patients with incomplete endometrial visualization were excluded from endometrial thickness analysis. Appropriate nonparametric statistical comparisons were performed.

RESULTS: Among 171 analysis-eligible patients (121 endometrioid, 50 non-endometrioid), non-endometrioid cancers were more common among non-Hispanic Black (53%) than non-Hispanic White (20%) or Hispanic patients (25%). Patients with non-endometrioid cancers were more likely to have incompletely visualized endometria (34% vs 9.1%, p < 0.01). Among patients with complete visualization, mean ET did not differ between endometrioid and non-endometrioid cancers (16.9 vs 19.5 mm) or by race/ethnicity. ET ≤4 mm occurred in 5.6% of cancers with fully visualized endometria, without differences between subtypes.

CONCLUSION: When endometrium was fully visualized, non-endometrioid cancers did not present with thinner ET than endometrioid cancers, and a 4 mm cutoff may miss 5.6% of cancers. Incomplete visualization, more common in non-endometrioid disease, may lead to additional missed diagnoses, supporting universal endometrial sampling for PMB.

PMID:42383153 | PMC:PMC13315767 | DOI:10.1016/j.gore.2026.102135

Clin Neuropsychiatry. 2026 Jun;23(3):232-242. doi: 10.36131/cnfioritieditore20260302.

ABSTRACT

OBJECTIVE: psoriasis is a chronic immune-mediated disease that significantly impacts patients’ health-related quality of life (HRQOL). While effective treatments exist, the burden of psoriasis on HRQOL and the factors influencing it remain underexplored in Vietnam. To assess HRQOL and its associated factors among patients with psoriasis vulgaris in a tertiary hospital in Vietnam.

METHOD: a cross-sectional study was conducted from March to December 2023, including 149 patients with psoriasis vulgaris. HRQOL was evaluated using the EQ-5D-5L tool, and disease severity was assessed with the Psoriasis Area and Severity Index (PASI). Data analysis included descriptive statistics, chi-square tests, and stepwise multivariate Tobit regression to identify factors associated with the EQ-5D index.

RESULTS: the mean EQ-5D index was 0.85 (SD = 0.17), with patients reporting the fewest problems in mobility (88.6% no issues) and self-care (81.2% no issues). However, pain/discomfort (68.5%) and anxiety/depression (36.2%) were significant concerns. The EQ-5D index declined with increasing PASI scores (mild: 0.87, severe: 0.68, p < 0.01). Factors negatively associated with HRQOL included older age (Coef. = -0.003, p = 0.026), severe redness (Coef. = -0.199, p = 0.001), and pain symptoms (Coef. = -0.108, p = 0.031). Male sex was independently associated with higher HRQOL (Coef. = 0.084, p = 0.015). Fraizeron treatment was positively associated with higher HRQOL (Coef. = 0.164, p = 0.048).

CONCLUSIONS: psoriasis substantially impacts HRQOL, particularly through pain and emotional burden. Older age, severe redness, and pain symptoms were associated with poorer HRQOL, whereas male sex and Fraizeron treatment were associated with higher HRQOL. Comprehensive management strategies addressing both physical symptoms and psychological well-being may help improve HRQOL.

PMID:42383145 | PMC:PMC13316888 | DOI:10.36131/cnfioritieditore20260302

Mayo Clin Proc Innov Qual Outcomes. 2026 Jun 23;10(4):100734. doi: 10.1016/j.mayocpiqo.2026.100734. eCollection 2026 Aug.

ABSTRACT

OBJECTIVE: To address the limited recognition of structural causes of lower-limb pain and the lack of real-world data on entheseal pathology, we evaluated ultrasound-detected entheseal and tendinous abnormalities in an unselected outpatient population, highlighting the underuse of musculoskeletal ultrasound (MSK US) in early diagnostic assessment despite the frequent misclassification of these conditions as nonspecific soft-tissue or degenerative disorders.

PATIENTS AND METHODS: We conducted a retrospective analysis of 667 consecutive adults undergoing standardized MSK US for lower-limb pain in a general ambulatory orthopedic clinic. Fourteen predefined entheseal and tendinous sites across the hip, knee, and ankle-foot regions were evaluated using Outcome Measures in Rheumatology criteria. Prevalence, anatomical distribution, bilaterality, and clinical predictors were assessed using descriptive statistics and multivariable logistic regression.

RESULTS: Ultrasound-confirmed enthesopathy or tendinopathy was present in 152 of 667 patients (22.8%). Lesions most frequently involved the gluteus medius tendon and plantar fascia (5.5% each, n=37), followed by the semimembranosus (2.8%, n=19), patellar (2.6%, n=17), and Achilles tendons (4.2%, n=28). Abnormalities were predominantly unilateral (<10% bilateral). Increasing age was the only independent predictor of entheseal pathology (adjusted OR 1.26 per 10-year increase; 95% CI, 1.08-1.47). Sex, body mass index, diabetes, and rheumatologic disease were not relatively associated with pathology.

CONCLUSION: Entheseal and tendinous abnormalities are common among symptomatic adults in everyday outpatient practice. Systematic integration of MSK US as a first-line assessment tool could improve diagnostic precision and enable targeted management strategies. These findings provide population-relevant evidence to inform musculoskeletal care pathways and health system decision-making.

PMID:42383140 | PMC:PMC13316613 | DOI:10.1016/j.mayocpiqo.2026.100734

Indian J Sex Transm Dis AIDS. 2026 Jan-Jun;47(1):16-21. doi: 10.4103/ijstd.ijstd_94_25. Epub 2026 May 19.

ABSTRACT

BACKGROUND: Syphilis is a sexually transmitted disease that varies in presentation according to the stage of the disease. Susceptibility to penicillin contributed to the near elimination of the disease during the 1990s to 2000 period. Recently, there have been reports of the re-emergence of syphilis from all parts of the world.

AIM: To study the clinical presentation and trends of syphilis.

MATERIALS AND METHODS: A retrospective study was conducted from January 2013 to December 2024. All clinically and/or serologically diagnosed cases of syphilis were included in the study. Medical records of all the patients attending the sexually transmitted infection clinic were analyzed concerning age, sex, clinical presentation, and laboratory investigations. Statistical analysis was done using mean, median, and proportion.

RESULTS: A total of 260 cases with syphilis were enrolled. The male-to-female ratio was 5.53:1. The most common stage of presentation was latent syphilis (45.6%). The most common age group affected was 21-30 years. Out of the total cases, 2.7% of cases were pregnant females, 14.18% were human immunodeficiency virus (HIV) positive, and 95 cases were men who have sex with men cases. Only two cases of congenital syphilis were detected.

CONCLUSION: A resurgence of syphilis cases has been observed in the last 3 years, with latent syphilis contributing to the majority of cases. Possible factors attributed to this surge include promiscuous sexual behavior, HIV coinfection, male having sex with male, and early adolescent sexual exposure. The sudden rise in latent syphilis cases is a warning sign of resurgence in India, as it signifies the persistence of syphilis in the subclinical phase in the community.

PMID:42383134 | PMC:PMC13318344 | DOI:10.4103/ijstd.ijstd_94_25