Tag: pubmed

Cardiovasc Diabetol. 2026 Jan 18. doi: 10.1186/s12933-025-03074-z. Online ahead of print.

NO ABSTRACT

PMID:41549299 | DOI:10.1186/s12933-025-03074-z

Eur J Med Res. 2026 Jan 19. doi: 10.1186/s40001-026-03857-4. Online ahead of print.

ABSTRACT

BACKGROUND: Sepsis is a life-threatening condition that requires rapid and accurate identification of causative pathogens to guide timely antimicrobial therapy. Blood culture is the current diagnostic standard, but it suffers from low sensitivity and long turnaround times. Droplet digital polymerase chain reaction (ddPCR) has emerged as a promising molecular tool that may overcome these limitations. This study aimed to evaluate the diagnostic utility of ddPCR compared with conventional blood culture in patients with sepsis.

METHODS: We performed a retrospective study of 115 patients admitted with sepsis to Tianjin First Central Hospital between October 2024 and June 2025. All patients underwent both blood culture and ddPCR testing on admission. Clinical characteristics, laboratory parameters, and infection outcomes were collected. Diagnostic performance, including sensitivity, specificity, positive predictive value, and negative predictive value, was calculated using blood culture as the reference standard. Concordance between ddPCR, blood culture, and non-blood specimen cultures was analyzed. Statistical analysis was performed using descriptive statistics and agreement measures.

RESULTS: Blood culture identified pathogens in 27.8% of patients, whereas ddPCR detected organisms in 53%. ddPCR revealed a broader microbial spectrum, particularly Gram-negative bacteria such as Escherichia coli and Klebsiella pneumoniae, and identified mixed infections frequently missed by culture. Within its detection panel, ddPCR demonstrated a sensitivity of 81.3% and specificity of 56.6%, with a high negative predictive value of 88.7%. ddPCR findings showed strong agreement with non-blood culture results in cases where blood cultures were negative, underscoring its clinical relevance. Early in the study, false-positive Candida results were observed but eliminated after stricter aseptic protocols were implemented.

CONCLUSIONS: Droplet digital polymerase chain reaction significantly outperformed blood culture in pathogen detection for sepsis, especially for Gram-negative and polymicrobial infections. Its high negative predictive value supports its use as a complementary tool to exclude bloodstream infections and guide early antimicrobial de-escalation. While positive findings must be interpreted with clinical context to avoid overtreatment, ddPCR offers substantial potential to accelerate pathogen identification, improve antimicrobial stewardship, and enhance outcomes in septic patients.

PMID:41549293 | DOI:10.1186/s40001-026-03857-4

J Orthop Surg Res. 2026 Jan 18. doi: 10.1186/s13018-026-06662-1. Online ahead of print.

ABSTRACT

BACKGROUND: The unique vulnerability of the neonatal joint to septic arthritis poses a substantial risk for lifelong musculoskeletal disability. Precise estimates of long-term functional outcomes are crucial for prognostication and clinical decision-making, yet robust pooled data remain scarce. This systematic review and meta-analysis was therefore conducted to determine the aggregate rate of favorable prognosis in neonates following septic arthritis.

METHODS: We queried four major databases (PubMed, Embase, Cochrane Library, and Web of Science) from inception until September 2025 to identify studies reporting Prognostic outcomes of neonatal septic arthritis. The primary outcome was the pooled rate of favorable prognosis, defined as normal/near-normal joint function, synthesized under a random-effects model. Heterogeneity was quantified (I² statistic), and we explored its sources via pre-specified subgroup analyses and sensitivity analyses.

RESULTS: Thirteen studies (258 patients) were included. The pooled rate of favorable prognosis was 69.7% (95% CI: 60.5-77.7). Significant heterogeneity (I² = 40.9%) was observed. Subgroup analyses identified longer follow-up (> 2 years), non-hip joint involvement, and prompt intervention (≤ 7 days) as significant positive predictors of outcome.

CONCLUSION: Approximately one-third of infants with neonatal septic arthritis experience adverse sequelae. Prognosis is significantly influenced by follow-up duration, anatomic site of involvement (particularly the hip), and the timeliness of intervention. These findings highlight the paramount importance of early diagnosis and urgent treatment, providing crucial evidence for family counseling and structuring long-term follow-up protocols.

PMID:41549270 | DOI:10.1186/s13018-026-06662-1

BMC Anesthesiol. 2026 Jan 19. doi: 10.1186/s12871-026-03621-5. Online ahead of print.

ABSTRACT

BACKGROUND: Total knee arthroplasty (TKA) is an effective treatment for end-stage knee osteoarthritis, but postoperative pain and delayed recovery remain challenges. This study aimed to evaluate the effects of hypobaric unilateral fine-needle spinal anesthesia combined with multimodal analgesia (MMA) on postoperative recovery in TKA patients.

METHODS: A randomized controlled triple-blind trial enrolled 118 patients scheduled for TKA between January 2022 and June 2023. Patients were divided into three groups: hypobaric fine-needle spinal anesthesia (Group A, n=40), isobaric fine-needle spinal anesthesia (Group B, n=39), and hypobaric spinal-epidural combined anesthesia (Group C, n=39). Outcomes included puncture success rates, puncture time, maximum active knee flexion angle, breakthrough analgesia frequency, statistical test and complications.

RESULTS: No significant differences were observed in puncture success rates. However, Group C had a significantly longer puncture time than Groups A and B. Group B showed a lower maximum active knee flexion angle on postoperative day 1 compared to Groups A and C. Group C had a higher incidence of low back pain and headache within 7 days. Postoperative pain scores (NRS) were significantly lower in Group A at all time points.

CONCLUSIONS: Hypobaric fine-needle spinal anesthesia (Group A) demonstrated superior performance in puncture time, postoperative mobility, and complication rates, making it a preferred anesthetic strategy for TKA.

TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2500100428). Registered on 9 April 2025. Retrospectively registered.

PMID:41549267 | DOI:10.1186/s12871-026-03621-5

BMC Geriatr. 2026 Jan 19. doi: 10.1186/s12877-026-06982-1. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: This study examined whether different levels of cognitive impairment influence postural control (PC) in physically independent older women, using complementary time domain and time-frequency analyses. Understanding these associations may help identify early markers of cognitive vulnerability and guide preventive strategies aimed at reducing fall risk in aging.

METHODS: A cross-sectional sample of 129 women aged ≥ 60 years (mean age 69), physically independent and not engaged in structured exercise for at least three months, was categorized into three groups according to Montreal Cognitive Assessment (MoCA) scores: normal cognition (NC), mild cognitive impairment (MCI), and advanced cognitive impairment (ACI). PC was assessed through time domain variables, mean sway velocity (anteroposterior and mediolateral) and the area of the center of pressure (A-COP), and through time-frequency parameters categorized into low (0.05-0.5 Hz; visual-vestibular contribution), medium (0.5-1.5 Hz; cerebellar modulation), and high (1.5-10 Hz; proprioceptive contribution) frequency bands. Confirmatory analyses for the primary conditions (BSEO and BIUS) were performed using ANCOVA adjusted for age, body mass index (BMI), Charlson Comorbidity Index (CCI), and Falls Efficacy Scale (FES) scores. Exploratory outcomes were analyzed with one-way ANOVA, followed by Sidak-adjusted post hoc tests. Effect sizes were estimated using partial eta squared.

RESULTS: Time domain analyses showed that women with better cognitive performance demonstrated better postural control, reflected by lower sway velocity, particularly in the BSEO and BIUS conditions. Exploratory analyses also identified group differences in the BIVR condition. Although the time-frequency analyses did not reveal statistically significant differences between groups, the descriptive patterns suggested that lower-frequency components were more evident during less demanding tasks, whereas medium and high frequency components appeared more prominent in more challenging conditions. Effect-size estimates supported the clinical relevance of time domain differences between cognitive groups.

CONCLUSION: Cognitive status influences postural control in physically independent older women. Time domain measures, particularly sway velocity, were sensitive to poorer balance among those with cognitive impairment, while time-frequency parameters did not differentiate cognitive groups. These findings highlight the importance of incorporating cognitive screening into balance assessment and fall-prevention strategies in aging populations.

PMID:41549246 | DOI:10.1186/s12877-026-06982-1

Ir J Med Sci. 2026 Jan 19. doi: 10.1007/s11845-025-04276-w. Online ahead of print.

ABSTRACT

OBJECTIVE: The Figure-8 Walk Test (F8WT) is a standardized clinical assessment used to evaluate walking performance, including straight walking and maneuvering around obstacles, as required in daily life. The aim of this study was to establish reference values for the F8WT in healthy adults.

METHODS: A total of 1,145 healthy Turkish adults participated in this cross-sectional study. Individuals aged ≥ 18 years who were able to walk independently without assistive devices were included. Participants with a history of neurological, musculoskeletal, or cardiopulmonary disorders affecting gait, recent lower extremity injury or surgery, or cognitive impairment were excluded. The F8WT was administered, and anthropometric as well as sociodemographic parameters were recorded.

RESULTS: The 25th, 25th-75th, and > 75th percentiles were classified as low, average, and high fall risk for both men and women based on F8WT performance. For men, < 3.06 s indicated low fall risk, 3.06-9.34 s indicated average fall risk, and 9.34-22.31 s indicated high fall risk. For women, < 2.41 s indicated low fall risk, 2.41-8.43 s indicated average fall risk, and 8.43-16.06 s indicated high fall risk. Statistically significant differences were observed between men and women in terms of age, height, body weight, and body mass index (BMI) (p < 0.01). In the overall sample, F8WT performance was significantly correlated with age (r = 0.575, p < 0.001), height (r = -0.145, p < 0.001), weight (r = 0.242, p < 0.001), and BMI (r = 0.359, p < 0.001).

CONCLUSION: This study provides reference values for the F8WT according to age and sex in healthy adults. Women demonstrated shorter F8WT completion times than men, and test duration increased with advancing age.

CLINICAL TRIAL NUMBER: NCT06314347.

PMID:41549207 | DOI:10.1007/s11845-025-04276-w

Environ Geochem Health. 2026 Jan 19;48(2):102. doi: 10.1007/s10653-026-02995-2.

ABSTRACT

The study examined natural radionuclide levels in edible muscles of cephalopod species consumed in Kerala. Uranium (²³⁸U) concentrations ranged from 1.14 ± 0.06 to 1.72 ± 0.07 Bq kg^-1, while thorium (²³²Th) levels were between 0.08 ± 0.02 and 0.66 ± 0.04 Bq kg^-1. Polonium (²¹⁰Po) showed higher concentrations, ranging from 4.7 ± 0.9 to 27.2 ± 3.3 Bq kg^-1, and lead (²¹⁰Pb) levels varied from 3.8 ± 0.9 to 24.6 ± 6.8 Bq kg^-1. Squids, being pelagic, accumulated higher amounts of ²³⁸U and ²¹⁰Po, whereas cuttlefishes, being benthic, showed greater levels of ²³²Th and ²¹⁰Pb. Statistical analysis revealed significant differences in radionuclide concentrations among and within cephalopod species, influenced by habitat and taxonomy (p < 0.05). The annual committed effective dose (ACED) for coastal residents consuming these cephalopods was assessed. ²¹⁰Po was the main contributor to radiation dose, comprising over 80% of the total dose from all radioisotopes analyzed. Despite this significant contribution, the study concluded that health risks from consuming these cephalopods were within acceptable safety limits.

PMID:41549201 | DOI:10.1007/s10653-026-02995-2

Int J Cardiovasc Imaging. 2026 Jan 19. doi: 10.1007/s10554-026-03615-x. Online ahead of print.

ABSTRACT

This study evaluated the predictive value of combining clinical characteristics, serum biomarkers, and radiomic features for poor prognosis in patients with acute pulmonary embolism (APE). Clinical data, serum biomarker data (e.g., inflammatory and coagulation biomarkers), and computed tomography pulmonary angiography (CTPA) image from patients with APE were retrospectively collected from the First Affiliated Hospital of Hebei Northern University, First Hospital of Zhangjiakou, and Second Affiliated Hospital of Hebei Northern University. Patients were divided into good and poor prognosis groups. Data from the first two hospitals were randomly split into a training cohort (166) and internal validation cohort (72) using a 7:3 ratio; data from the third hospital formed the external validation cohort (37). Using 3D Slicer software, thrombus regions were outlined to extract radiomic features were constructed using R software. Model performance was assessed via receiver operating characteristic (ROC) curve, calibration, and decision curves analysis, and the Delong test. Six statistically significant radiomic features and independent clinical risk factors, including white blood cell count, neutrophile percentage, lymphocyte percentage, respiratory rate, pulse, syncope, smoking history, and RV / LV ratio, were identified (P < 0.05). The combined model outperformed individual models in the training (AUC = 0.85) (P < 0.05), internal validation (AUC = 0.86), and external validation cohorts (AUC = 0.88) (P < 0.05), demonstrating high clinical utility. The combined model effectively predicts early poor prognosis in APE, offering a robust tool for clinical evaluation and intervention planning.

PMID:41549198 | DOI:10.1007/s10554-026-03615-x

Drugs. 2026 Jan 19. doi: 10.1007/s40265-025-02274-x. Online ahead of print.

ABSTRACT

BACKGROUND: Elevated lipoprotein(a) [Lp(a)] is a genetically determined, causal risk factor for atherosclerotic cardiovascular disease, but effective therapies remain limited. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are primarily used to lower low-density lipoprotein cholesterol (LDL-C), yet their effects on Lp(a) have been inconsistently reported. This umbrella review synthesizes meta-analytic evidence on PCSK9 inhibitors and Lp(a).

METHODS: We systematically searched PubMed, Embase, Web of Science, and Cochrane Library through April 2025 for meta-analyses of randomized controlled trials (RCTs) comparing PCSK9 inhibitors (alirocumab, evolocumab, inclisiran) with placebo or standard therapy. The primary outcome was mean percentage change in Lp(a). Methodological quality was assessed using the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), and evidence certainty was graded with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Overlap of primary trials was quantified using the Corrected Covered Area (CCA), and sensitivity analyses were performed to account for overlapping evidence.

RESULTS: Twenty-one meta-analyses (116 RCTs; 231,796 participants) were included. The PCSK9 inhibitors consistently reduced Lp(a): evolocumab (29.68-46.68%; high certainty), alirocumab (18.55-26.46%; high certainty), and inclisiran (18.00%; high certainty). Higher biweekly doses yielded larger decreases (e.g., alirocumab 150 mg: 24.6%; evolocumab 140 mg: 26.8%, high certainty). Reductions were dose-dependent and broadly consistent across populations, comparators, follow-up durations, and baseline Lp(a). The Lp(a) reductions correlated modestly with LDL-C (β = 0.28; 95% CI 0.07-0.49) and apolipoprotein B (apoB) (β = 0.33; 95% CI 0.03-0.63). Concomitant reductions in LDL-C, apoB, and major adverse cardiovascular events were supported by high and moderate certainty evidence. Safety was favorable, with injection-site reactions being the most common adverse event. Sensitivity analyses confirmed robustness of findings after accounting for overlapping trials.

CONCLUSIONS: The PCSK9 inhibitors, particularly evolocumab 140 mg every 2 weeks, significantly lower Lp(a) alongside LDL-C and apoB. These findings highlight the consistent Lp(a)-lowering effect of PCSK9 inhibitors. However, the observed cardiovascular benefits are largely attributable to concomitant LDL-C reduction, and the incremental contribution of Lp(a) lowering remains uncertain. Confirmation from outcome trials specifically designed to target Lp(a) is required.

REGISTRATION: PROSPERO CRD420251048597.

PMID:41549171 | DOI:10.1007/s40265-025-02274-x

Int J Legal Med. 2026 Jan 19. doi: 10.1007/s00414-025-03713-w. Online ahead of print.

ABSTRACT

Postmortem interval (PMI) estimation is mandatory in any forensic investigation. Although it remains a very challenging task, particularly in skeletonized human remains. Luminol chemiluminescence has been explored as a tool for PMI estimation, however, its application requires further experimental validation to ensure accuracy and reproducibility. The present research aims to increase the objectivity of PMI estimation by quantifying the light emission from the luminol chemiluminescence reaction. For this purpose, a sample of clavicles collected from 24 adult individuals of both sexes, with known PMI ranging from 7 to approximately 500 years, was selected. After being reduced to powder, the samples were analyzed on a CCD camera with an image intensifier, and the reaction Ipeak was measured. The results obtained revealed a clear inverse relationship between PMI and Ipeak values. A segmented regression analysis identified a statistically supported threshold at approximately 30 years postmortem, distinguishing a variable early postmortem phase from a long-term phase characterized by consistently low and minimally variable chemiluminescence intensities. This pilot study supports the validity of quantifying the luminol chemiluminescence reaction as a feasible and informative presumptive screening tool for PMI estimation, with potential applicability in distinguishing remains of forensic interest from those of archaeological relevance.

PMID:41549170 | DOI:10.1007/s00414-025-03713-w