Tag: pubmed

Clin Anat. 2025 Sep 10. doi: 10.1002/ca.70025. Online ahead of print.

ABSTRACT

This research sought to examine the prevalence and severity of hyperostosis frontalis interna (HFI) in the Chicagoland anatomical body donor population. The study further aimed to elucidate potential demographic risk factors for HFI, including sex, age at death, and structural vulnerability index (SVI), as well as any common comorbidities, as gleaned from death certificates. HFI is an irregular bony overgrowth of the endocranial surface of the frontal bone. It is most often observed in postmenopausal women or in individuals with growth hormone disorders. This work investigated the distribution of HFI in a predominantly geriatric anatomical body donor population (n_total = 235, n_female = 127 n_male = 108; 19-104 years), using a macroscopic classification system that considers both the morphological appearance and the size of the affected area. Relationships between HFI and variables of interest were assessed through various non-parametric statistical tests and binomial logistic regression. While HFI was not associated with age-at-death or SVI, results indicate that there were significant sex differences in both HFI prevalence and severity. Females demonstrated higher rates of HFI across all severity types, whereas in males, HFI lesions were much less common and mostly limited to the earliest stages of disease progression. HFI was also associated with neoplasms as a cause of death. Among cancer deaths, individuals with hormone-sensitive cancers had a higher prevalence of HFI, but this difference was not statistically significant. While the causal pathways of these relationships remain unclear, the association with cancer may potentially explain the reportedly higher HFI prevalence rates in modern compared to past populations. Moreover, this research has bioarcheological and forensic implications as HFI is sometimes used to infer age and sex, given its association with older-aged females.

PMID:40927897 | DOI:10.1002/ca.70025

Am J Biol Anthropol. 2025 Sep;188(1):e70121. doi: 10.1002/ajpa.70121.

ABSTRACT

OBJECTIVES: This study explores cranial morphological variation and population continuity in the Carpathian Basin from the 1st to 13th centuries CE. It focuses on assessing biological differences and similarities across major archaeological periods, with particular emphasis on the Avar, Hungarian Conquest, and Árpádian Age populations.

MATERIALS AND METHODS: A total of 1,597 adult crania (864 males, 733 females) were analyzed using six neurocranial measurements. Morphological distances between populations were calculated using Canberra distance. Canonical Variate Analysis (CVA), Multidimensional Scaling (MDS), and multivariate analysis of variance (MANOVA) were applied to evaluate intergroup differentiation.

RESULTS: The analyses revealed significant morphological variation between most archaeological groups. Avars-especially the Late Avar population-formed distinct morphological patterns, primarily along the first canonical axis influenced by cranial breadth and height. Males showed statistically significant differences between Early and Late Avar groups, whereas the corresponding comparison among females did not reach significance. The strongest separations occurred between Avars and the Gepidic, Sarmatian, and Transition groups, consistent with CVA and MDS findings.

DISCUSSION: The results suggest population continuity in some cases (e.g., Early-Late Avar, Conquest-Árpádian Age), but also highlight evidence of population restructuring, particularly among males. Recent genetic research supports these findings, indicating patrilineal descent and local kinship cohesion within Avar communities. This study underscores the value of the integration of cranial morphometrics with multivariate statistical approaches to reconstruct complex demographic histories in early medieval Central Europe.

PMID:40927894 | DOI:10.1002/ajpa.70121

Health Inf Manag. 2025 Sep 10:18333583251362536. doi: 10.1177/18333583251362536. Online ahead of print.

ABSTRACT

BACKGROUND: The success of disease registry systems (DRSs) depends on developing software that aligns with the registry’s specific needs.

OBJECTIVE: This study focuses on localising the Checklist with Items for Patient Registry sOftware Systems (CIPROS) to facilitate the DRS assessment.

METHOD: This applied and cross-sectional study was carried out in 2023 in six phases. The first phase involved translating the CIPROS checklist. In the second phase, experts validated the face validity of the checklist. The third phase focused on calculating the content validity ratio (CVR) and content validity index (CVI) for each item. In the fourth phase, the items removed earlier were reassessed. In the fifth phase, definitions for each item were proposed. The sixth phase encompassed calculating the reliability of the localised checklist. For the data analysis, descriptive statistics were computed using SPSS software.

RESULTS: The original checklist included 12 aspects and 72 items. After evaluating the CVR and CVI indicators, 40 items were validated. By reassessing the deleted items, the localised checklist was created, composed of 56 items categorised into 11 aspects.

CONCLUSION: The localised tool would support the authorities responsible for DRSs when making software purchasing decisions. Additionally, it would be advantageous for policymakers by helping them establish the criteria for DRS assessment.Implications for health information management practice:Localising the registry assessment tool will facilitate its use; providing descriptions of assessment tool items leads to a uniform understanding and ease of use of the tool.

PMID:40927886 | DOI:10.1177/18333583251362536

Alzheimers Dement. 2025 Sep;21(9):e70675. doi: 10.1002/alz.70675.

ABSTRACT

INTRODUCTION: We developed and validated age-related amyloid beta (Aβ) positron emission tomography (PET) trajectories using a statistical model in cognitively unimpaired (CU) individuals.

METHODS: We analyzed 849 CU Korean and 521 CU non-Hispanic White (NHW) participants after propensity score matching. Aβ PET trajectories were modeled using the generalized additive model for location, scale, and shape (GAMLSS) based on baseline data and validated with longitudinal data. Subgroup analyses examined apolipoprotein E (APOE) ε4 and sex effects.

RESULTS: Age-related centile curves of Aβ PET Centiloid values showed stable distributions in the lower percentiles, increasing with age in the upper percentiles. NHWs exhibited steeper Aβ accumulation trajectories, particularly among APOE ε4 carriers. Calibration with longitudinal data confirmed the reliability of this cross-sectional method.

DISCUSSION: We developed a statistical model of age-related Aβ PET trajectories using baseline data, validated with longitudinal data. NHWs exhibited steeper trajectories than Koreans, suggesting population-specific differences in Aβ accumulation.

HIGHLIGHTS: A generalized additive model for location, scale, and shape model was applied to examine age-related amyloid beta (Aβ) trajectories with baseline data. Trajectories were validated using longitudinal data, confirming model reliability. Non-Hispanic Whites exhibited steeper trajectories than Koreans, especially in apolipoprotein E ε4 carriers. Our approach enables scalable modeling of Aβ dynamics for Alzheimer’s disease prevention strategies. Findings highlight the importance of multi-ethnic research in Aβ accumulation.

PMID:40927871 | DOI:10.1002/alz.70675

Nanotoxicology. 2025 Sep 10:1-14. doi: 10.1080/17435390.2025.2556865. Online ahead of print.

ABSTRACT

The effect of non-functionalized polystyrene nanoparticles (PS-NPs) with diameters of 29, 44, and 72 nm on plasmid DNA integrity and the expression of genes involved in the architecture of chromatin was investigated in human peripheral blood mononuclear cells (PBMCs). The cells were incubated with PS-NPs at concentrations ranging from 0.001 to 100 µg/mL for 24 hours. Gene expression profiling was carried out using quantitative real-time PCR for the following genes: those involved in DNA methylation (DNMT1, DNMT3A), DNA demethylation (TET2, TET3), and chromatin remodeling, including histone methylation (EHMT1, EHMT2) and histone deacetylation (HDAC3, HDAC5). Furthermore, the expression of selected epigenetic markers related to histone acetylation and methylation (H3ac, H3K4me3, H3K9me3) at the protein level was examined using Western blotting. To assess the potential direct interaction of PS-NPs with DNA, a plasmid relaxation assay was performed in an extracellular system. The results demonstrated that PS-NPs do not cleave plasmid DNA directly. The gene expression analysis indicated that PS-NPs did not alter the expression of DNMT1, TET2, TET3, EHMT1, EHMT2, HDAC3, or HDAC5 in PBMCs. However, statistically significant changes in the expression of the DNMT3A gene were observed after exposure to 29 nm nanoparticles (p = 0.016, Kruskal-Wallis test), although post hoc comparisons did not reveal significant differences between individual treatment groups, and no clear dose-dependent trend was evident. PS-NPs induced a statistically significant decrease in post-translational histone modifications, specifically H3ac and H3K4me3. These findings suggest that PS-NPs may influence the epigenetic mechanisms involved in the regulation of chromatin architecture.

PMID:40927865 | DOI:10.1080/17435390.2025.2556865

Circulation. 2025 Sep 10. doi: 10.1161/CIRCULATIONAHA.125.075080. Online ahead of print.

ABSTRACT

BACKGROUND: Limited treatment options exist for infrapopliteal disease in patients with chronic limb-threatening ischemia (CLTI), a condition associated with a high risk of limb loss. Interventional management of diseased infrapopliteal vessels with percutaneous transluminal angioplasty (PTA) is associated with high rates of restenosis and reintervention. In the LIFE-BTK trial, the drug-eluting resorbable scaffold (DRS) demonstrated superior 12-month efficacy compared with PTA in a selected CLTI population with predominantly noncomplex, mildly to moderately calcified lesions. This report presents the 2-year safety and efficacy outcomes of the Esprit below-the-knee (BTK) DRS system in the LIFE-BTK randomized trial comparing DRS with PTA for treatment of infrapopliteal vessels and CLTI.

METHODS: The LIFE-BTK trial was a multicenter, subject-blinded, randomized controlled trial enrolling 261 patients with CLTI who were randomized 2:1 to receive either DRS or PTA. The revised primary efficacy end point was freedom from target limb amputation, target vessel occlusion, clinically driven target lesion revascularization, or binary restenosis. The primary safety end point was freedom from major adverse limb events and perioperative death. Predictors of efficacy and clinically driven target lesion revascularization were analyzed along with subgroup assessments.

RESULTS: At 2 years, the primary efficacy end point was observed in 68.8% of the DRS group versus 45.4% of the PTA group (P=0.0004). Limb salvage rates were 94.7% for DRS and 97.3% for PTA (P=0.34). Binary restenosis occurred in 28.5% of DRS patients versus 48.2% of PTA patients (P=0.005), and clinically driven target lesion revascularization rates were 9.7% versus 18.6%, respectively (P=0.034). The primary safety end point was observed in 91.6% of the DRS group versus 95.6% of the PTA group (P=0.16). Scaffold treatment was an independent predictor of efficacy (odds ratio, 0.27; P=0.0003) and showed a trend toward reduced risk of clinically driven target lesion revascularization, though this did not reach statistical significance. Other predictors included lesion length, Rutherford-Becker class 5, total occlusion, previous amputation, preintervention stenosis, and number of wounds. Subgroup analyses demonstrated consistent efficacy across various patient populations.

CONCLUSIONS: At 2 years, the Esprit BTK DRS demonstrated improved efficacy compared with PTA in maintaining arterial patency, preventing restenosis, and reducing revascularization rates while maintaining a comparable safety profile. These findings support the Esprit BTK scaffold as a promising treatment option for appropriately selected patients with infrapopliteal artery disease and CLTI.

REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04227899.

PMID:40927852 | DOI:10.1161/CIRCULATIONAHA.125.075080

Int J Dermatol. 2025 Sep 10. doi: 10.1111/ijd.70059. Online ahead of print.

ABSTRACT

INTRODUCTION: Cutaneous scalp metastases from breast carcinoma (CMBC) represent an uncommon manifestation of metastatic disease, with heterogeneous clinical presentations, including nodular or infiltrative lesions and scarring alopecia (alopecia neoplastica). The absence of standardized diagnostic criteria, particularly for alopecic phenotypes, poses challenges to early recognition of CMBC, which may represent either the first indication of neoplastic progression or a late recurrence.

MATERIALS AND METHODS: We retrospectively analyzed a multicenter cohort of 15 patients with histologically confirmed CMBC. Demographic, clinical, molecular, and trichoscopic data were collected and correlated with the main clinical phenotypes: patchy alopecia (alopecia neoplastica) versus nodules/plaques. The statistical analyses we performed were the Mann-Whitney test for group comparisons and Fisher’s exact test for categorical variables.

RESULTS: The median age at CMBC diagnosis was 64 years. Alopecia neoplastica was the most frequent phenotype (53.3%). Patients with alopecia neoplastica showed a longer median interval between primary tumor diagnosis and metastasis onset compared to those with nodules/plaques (73.5 months vs. 59.5 months; p = 0.11). Trichoscopic analysis revealed significant differences in the distribution of features between the alopecia neoplastica group and the nodular/plaque group. Statistically significant differences were found among the two groups, including linear-irregular vessels (87.5% vs. 28.6%, p = 0.041), polymorphic vessels (87.5% vs. 28.6%, p = 0.041), pili torti (75% vs. 14.3%, p = 0.041), follicular hyperkeratosis and follicular plugging (87.5% vs. 14.3%, p = 0.01). Overall, the trichoscopic pattern in alopecia neoplastica appeared more variable and heterogeneous compared to that observed in the nodular/plaque phenotype.

CONCLUSION: Alopecia neoplastica, often underestimated in clinical practice, emerges as the predominant CMBC phenotype in our cohort and is associated with a distinct trichoscopic profile. The complexity of the alopecic phenotype may reflect intrinsic biological differences compared to nodular lesions. Larger prospective studies are needed to validate these findings and incorporate trichoscopic profiles into standard diagnostic pathways.

PMID:40927845 | DOI:10.1111/ijd.70059

Dan Med J. 2025 Aug 22;72(9):A01250002. doi: 10.61409/A01250002.

ABSTRACT

INTRODUCTION: In various countries, an increasing proportion of general practitioner (GP) referrals is returned by hospitals. We aimed to uncover the causes and consequences of referral returns from the perspective of GP liaisons.

METHODS: Individual interviews with 20 GP liaison officers from various departments in Southern Denmark, serving 1.2 million citizens, were analysed using systematic text condensation.

RESULTS: The collaboration between general practice and hospital departments was generally viewed as both effective and constructive. Well-argued returns include relevant advice on how to manage the patient and enhance the capabilities of general practice. In contrast, poorly motivated returns harm collaboration and lead to mistrust between GPs, hospitals and patients. Patients with an unclear diagnosis, multimorbidity or social problems do not fit into standard patient pathways, and their referrals are returned more frequently. They may face prolonged diagnostic processes and receive a lower quality of treatment, contributing to health inequalities and the risk of delayed diagnosis or treatment. Furthermore, the return of referrals transfers tasks to general practice.

CONCLUSIONS: Facilitating dialogue-based collaboration between primary and secondary care may improve patient care. However, referral returns may pose risks, particularly for frail or complex patients, and could potentially complicate the collaboration between GPs and hospitals. The underlying reasons and consequences of referral returns are diverse.

FUNDING: Funded by the Quality Improvement Committee Southern Denmark. RIO/SDU 12.228.

TRIAL REGISTRATION: Not relevant.

PMID:40927834 | DOI:10.61409/A01250002

Dan Med J. 2025 Aug 7;72(9):A02250077. doi: 10.61409/A02250077.

ABSTRACT

INTRODUCTION: Erysipelas is a common disease in the emergency department, whereas necrotising soft tissue infections (NSTIs) are rare but more severe. The study aimed to investigate the prevalence, incidence, population-based incidence rate, one-year mortality and clinical presentation of erysipelas and NSTIs, and the aetiology, treatment and recurrence of erysipelas.

METHODS: This was a population-based cohort study including acute non-trauma patients ≥ 18 years old with erysipelas or NSTIs from the Region of Southern Denmark in the period from 1 January 2016 to 19 March 2018.

RESULTS: Among 223,618 acute non-trauma visits, 2,136 had erysipelas (prevalence 1%), and 20 had NSTIs (prevalence 0.01%), 96.7 and 0.89 per 10,000 visits, respectively. The population-based incidence rates were 72.10 per 100,000 person-years for incident cases of erysipelas and 0.94 for NSTIs. One-year mortality was 15% for erysipelas and 25% for NSTIs. Erysipelas and NSTI patients had similar demographics and vital signs. For erysipelas, the predominant pathogen in blood cultures was Streptococcus dysgalactiae, with two-thirds of patients treated with narrow-spectrum penicillin. One-third of the erysipelas patients had a prior hospitalisation for the condition, and 7.7% of incident cases had recurrence within one year. Obesity and liver disease were risk factors for recurrence.

CONCLUSIONS: Erysipelas is a common infection in the emergency department, whereas NSTIs are much rarer but also more severe and, at presentation, not distinctive in clinical parameters, which underlines the importance of clinical judgement.

FUNDING: None.

TRIAL REGISTRATION: Not relevant.

PMID:40927829 | DOI:10.61409/A02250077

Cutan Ocul Toxicol. 2025 Sep 10:1-33. doi: 10.1080/15569527.2025.2554799. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to assess the potential risk of Bullous pemphigoid (BP) associated with antidiabetic agents, antimicrobials, diuretics, immune checkpoint inhibitors, and biological agents.

RESEARCH DESIGN AND METHODS: A retrospective pharmacovigilance data analysis was conducted using the FDA Adverse Event Reporting System (FAERS) between Q1/2004 and Q3/2024. Disproportionality analyses, viz. Proportional Reporting Ratio (PRR), Reporting Odds Ratio (ROR), and Information Component (IC) were performed to identify signals of BP. Additionally, a literature review of case reports of BP was conducted in PubMed, Google Scholar, and Scopus.

RESULTS: Disproportionality analysis identified 61 signals, and the following drugs exhibited the highest number of BP case associations: metformin (596 cases), vildagliptin (406 cases), nivolumab (376 cases), and furosemide (301 cases). Strong statistical correlation for signals was observed for vildagliptin [PRR = 295.8, LB (lower bound) ROR = 287.2, IC₀₂₅ = 7.5], dapsone [PRR = 20.7, LBROR = 14.4, IC₀₂₅ = 3.4], furosemide [PRR = 7.2, LBROR = 6.4, IC₀₂₅ = 2.6], and nivolumab [PRR = 31.5, LBROR = 28.5, IC₀₂₅ = 4.6]. These findings were supported by 106 identified case reports of BP.

CONCLUSION: This study suggests a strong statistical correlation between vildagliptin, dapsone, furosemide, nivolumab, and the development of BP.

PMID:40927818 | DOI:10.1080/15569527.2025.2554799