Tag: pubmed

Aesthetic Plast Surg. 2026 Apr 2. doi: 10.1007/s00266-026-05802-6. Online ahead of print.

ABSTRACT

BACKGROUND: Trapezius hypertrophy is a significant aesthetic concern among women. Botulinum toxin has emerged as a potential treatment option for this condition. In this study, we conducted a prospective, randomized, double-blind trial to evaluate the effectiveness and safety of letibotulinumtoxinA specifically for women.

METHODS: We conducted a prospective study between July 2022 and June 2023, recruiting 20 patients seeking treatment for trapezius hypertrophy. LetibotulinumtoxinA (Botulax®) was used as the neurotoxin. The patients were randomized into group A (n = 10, 40 units) and group B (n = 10, 80 units). Each group received different doses of toxin at 10 injection points along the trapezius muscle.

RESULTS: We analyzed the contour changes in two groups and calculated the average area before and after treatment. After 12 weeks post-treatment, both groups demonstrated a decrease in the trapezius area with statistically significant differences (p = 0.011, p = 0.005). The median satisfactory score was 4, indicating a moderate level of satisfaction in both groups. No statistically significant differences or complications were observed between the groups.

CONCLUSION: LetibotulinumtoxinA for trapezius hypertrophy demonstrated efficacy with no differences between two experimental groups. Aesthetic concerns were addressed, enhancing shoulder and neck appearance with a high degree of satisfaction.

LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:41927997 | DOI:10.1007/s00266-026-05802-6

Eur Radiol. 2026 Apr 2. doi: 10.1007/s00330-026-12520-9. Online ahead of print.

NO ABSTRACT

PMID:41927981 | DOI:10.1007/s00330-026-12520-9

Eur Radiol. 2026 Apr 2. doi: 10.1007/s00330-026-12494-8. Online ahead of print.

ABSTRACT

OBJECTIVES: Sentinel lymph node (SLN) biopsy remains the standard for axillary staging in early-stage breast cancer, though ongoing clinical investigations are exploring the omission of axillary procedures in specific subgroups. This study assessed whether axillary ultrasonography (US) and MRI can predict SLN involvement and developed a predictive tool to identify patients who may safely forgo axillary surgery.

MATERIALS AND METHODS: We retrospectively analyzed 8114 patients with cT1-T2N0 invasive breast cancer across three cancer centers in China. All patients underwent preoperative axillary US and/or MRI. Multivariate logistic regression identified independent predictors of SLN metastases, which were used to construct a predictive model. The model was validated using a 70:30 training-validation split and visualized through a nomogram. Subgroup analyses evaluated the risk of SLN involvement among patients with negative imaging findings.

RESULTS: SLN metastases were observed in 2545 patients (31.37%), with clinical T2 stage, lymphovascular invasion, Ki-67 ≥ 20%, ER + /HER2- subtype, and positive findings on US or MRI independently associated with SLN involvement (p < 0.001). Among 2282 patients with negative US and MRI findings, the SLN metastasis rate was 16.39%. The multivariable predictive model integrating imaging findings with clinicopathologic variables demonstrated good performance, with an AUC of 0.775 (95% CI: 0.750-0.801) in the training set and 0.759 (95% CI: 0.740-0.778) in the validation set. Notably, omission of axillary surgery would miss nodal metastases in 17.4% of patients eligible for CDK4/6 inhibitors.

CONCLUSION: Preoperative US and MRI are valuable for identifying low-risk patients. The prediction model may help select early-stage breast cancer patients for whom axillary surgery can be safely omitted while minimizing undertreatment risks for adjuvant therapies.

KEY POINTS: Question Can preoperative axillary ultrasound and MRI reliably stratify lymph node metastasis risk in patients with early-stage breast cancer? Findings A multivariate nomogram developed from 8,114 patients showed consistent predictive accuracy for axillary metastasis (AUC: 0.775 in training; 0.759 in validation cohort). Clinical relevance This model supports individualized axillary management by identifying patients who may safely avoid axillary surgery while preserving accurate nodal risk stratification for adjuvant systemic therapy and radiotherapy decision-making.

PMID:41927980 | DOI:10.1007/s00330-026-12494-8

Eur Radiol. 2026 Apr 2. doi: 10.1007/s00330-026-12493-9. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the association between the cancer detectability by artificial intelligence (AI) and long-term survival outcomes in invasive breast cancer.

MATERIALS AND METHODS: This retrospective study analyzed consecutive women diagnosed with invasive breast cancer who underwent preoperative mammography between January and December 2013. Mammograms were analyzed using FDA-cleared AI software (Lunit INSIGHT MMG v1.1.8.2). Cancers were classified as AI-detected if correctly localized by AI, and AI-undetected if AI missed or mislocalized. Propensity score matching was performed using 29 clinical, pathological, and treatment-related covariates. Recurrence-free survival (RFS) and overall survival (OS) were compared using Kaplan-Meier estimates and Cox proportional hazards models.

RESULTS: Among 879 women (mean age ± standard deviation, 50.3 ± 10.2 years), AI correctly identified cancers in 83%. Before matching, the AI-detected group had higher recurrence (11% vs 5%; p = 0.02) and mortality rates (7% vs 1%; p = 0.003). Distant recurrence was also more prevalent in AI-detected cases (p = 0.04). After matching, no differences were observed in RFS (HR, 1.7 [95% CI: 0.8, 3.9]; p = 0.20) or OS (HR, 4.1 [95% CI: 0.5, 38.1]; p = 0.21). AI detectability was not associated with RFS (HR, 1.9 [95% CI: 0.9, 3.8]; p = 0.07) or OS (HR, 5.5 [95% CI: 0.8, 40.7]; p = 0.09) in multivariable analysis.

CONCLUSION: AI-detected breast cancers showed higher recurrence and mortality rates in the unadjusted analysis. However, after adjusting for confounders, AI detectability was not associated with RFS or OS, suggesting that AI may preferentially detect tumors with aggressive characteristics.

KEY POINTS: Question AI-based software for mammography interpretation is increasingly being integrated into practice, but the long-term prognostic implications of breast cancers detected or undetected by AI remain unclear. Findings In this retrospective study, AI detectability was not associated with recurrence-free (HR, 1.7; p = 0.20) or overall survival (HR, 4.1; p = 0.21) after propensity score matching. Clinical relevance AI may be more likely to detect biologically aggressive tumors, rather than directly influencing survival.

PMID:41927979 | DOI:10.1007/s00330-026-12493-9

Int J Obes (Lond). 2026 Apr 2. doi: 10.1038/s41366-026-02072-9. Online ahead of print.

ABSTRACT

PATHWEIGH is the first intervention scaled to 274,182 patients to mitigate population weight gain. In a stepped-wedge cluster-randomized pragmatic trial in Colorado, USA, 56 primary care clinics were randomly assigned to three clusters with staggered start dates for a one-way crossover from usual care to the intervention phase. The intervention (PATHWEIGH) included: health system primary care leadership endorsement, an electronic health record (EHR)-driven care process designed to prioritize, facilitate and expedite weight management, and implementation strategies to support use of the care process and educate clinicians on obesity treatment. The objective of the current analysis was to identify mediators and moderators associated with successful population-level weight management in primary care. The majority of subgroups (moderators) benefited from the intervention because they either lost more weight, gained less weight or switched from weight gain to weight loss compared to usual care. Patient and/or provider use of an EHR component of the intervention mediated 37% of additional patient weight loss and use of an anti-obesity medication mediated 4% over 18 months (p < 0.001 for all comparisons). Altogether, the intervention had favorable effects on patient weight across the subgroups, particularly when a patient or provider used ≥1 EHR component of PATHWEIGH.

PMID:41927969 | DOI:10.1038/s41366-026-02072-9

Commun Med (Lond). 2026 Apr 2. doi: 10.1038/s43856-026-01528-3. Online ahead of print.

ABSTRACT

BACKGROUND: Growing evidence implicates early metabolic dysfunctions in retinal ganglion cells (RGCs) as a contributor to both high- and normal-tension glaucoma, yet no approved therapy directly protects RGCs to preserve vision. We aimed at identifying a safe, druggable neuroprotective strategy that restores RGC metabolic homeostasis for glaucoma therapy.

METHODS: Using a live-cell mitochondrial screen in human embryonic stem cell-derived retinal ganglion cells (H7; female donor), we identified the clinically tested 5-HT1A antagonist WAY-100635 (WAY) as a neuroprotective agent. Mechanisms are probed by pharmacologic competition with agonist 8-OH-DPAT, cAMP assays, and PGC-1α dependent mitochondrial-biogenesis tests. RGC metabolism and survival are assessed by Seahorse and apoptosis assays. In vivo efficacy is evaluated in acute optic-nerve crush (ONC) and microbead-induced ocular-hypertension glaucoma models using histology, brain MRI, visual-acuity, contrast sensitivity testing, and flash VEPs to quantify cortical responses in wild-type C57BL/6 J male mice. Statistics used two-tailed Student’s t-tests or ANOVA, as appropriate.

RESULTS: Here we show that WAY elicits a reversible cAMP surge that drives PGC-1α dependent mitochondrial biogenesis and reduces apoptosis in hRGCs. In glaucoma-associated OPTN^E50K hRGCs, it restores mitochondrial fitness, attenuates excitotoxicity, and shifts metabolism toward aerobic glycolysis, while in progenitors, WAY enhances cristae maturation, oxidative phosphorylation, accelerating RGC specification. Systemic dosing in ONC mice preserves RGC somata, retinal function (PhNR), and optic-pathway integrity. WAY-treated glaucoma mice show preserved visual acuity and fVEP propagation to cortex, halting glaucoma progression.

CONCLUSIONS: A clinically tested 5-HT1A antagonist WAY restores RGC metabolic homeostasis and preserves visual-pathway function across acute and chronic injury models, without detected systemic toxicity, supporting development of a neuroprotective candidate for glaucoma and potentially for other mitochondrial optic neuropathies.

PMID:41927968 | DOI:10.1038/s43856-026-01528-3

Ann Surg Oncol. 2026 Apr 2. doi: 10.1245/s10434-026-19458-8. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to compare the perioperative and oncologic outcomes between robotic and open retroperitoneal lymph node dissection in patients with testicular cancer.

METHODS: The study was conducted in accordance with the PRISMA guidelines, and quality assessment was performed following the AMSTAR criteria. A systematic search was performed in Embase, PubMed, and Web of Science databases, with the search period up to July 2025. Statistical analysis was performed using Stata 17 software.

RESULTS: The current results showed that compared with open retroperitoneal lymph node dissection (O-RLND), robotic retroperitoneal lymph node dissection (R-RPLND) had a shorter hospital length of stay (effect, – 3.68; 95 % confidence interval [CI], – 4.16 to – 3.21; P < 0.05), less estimated blood loss (effect, – 296.09; 95 % CI, – 416.62 to – 175.55; P < 0.05), and a lower overall complication rate (relative risk, 0.66; 95 % CI, 0.49-0.89; P < 0.05). Lymph node production and recurrence rate did not differ significantly between the two.

CONCLUSION: Robotic retroperitoneal lymph node dissection appears to be safer than O-RLND and has a faster postoperative recovery. Oncologic outcomes did not differ significantly, but more research is needed to explore further.

PMID:41927958 | DOI:10.1245/s10434-026-19458-8

AAPS J. 2026 Apr 3;28(3):85. doi: 10.1208/s12248-026-01213-2.

ABSTRACT

This study presents a workflow for virtual bioequivalence (VBE) assessment of 3-month paliperidone palmitate (PP) long-acting injectable (LAI) suspensions using a novel physiologically-based pharmacokinetic (PBPK) model. The mechanistic absorption and PBPK model was implemented in the Simcyp® Simulator and calibrated against individual concentration-time profiles derived from a published and validated population pharmacokinetic model. The model was able to accurately simulate drug concentration profiles after PP administration. Across 1000 subjects, four model-predicted bioequivalence (BE) metrics, including C_max,ss and AUC_tau,ss, differed by at most 10% from validation data. The initial mean drug particle radius was assessed as the critical formulation attribute in the VBE analysis. We conducted extensive VBE simulations to evaluate the required sample size of parallel trial designs for a given statistical power. The statistical power of two-one-sided t tests (TOST) to declare BE was estimated from the passing rate of Monte Carlo simulated VBE trials. Power calculations using the validated model indicated that a VBE trial with a minimum of 160 subjects per arm is required to achieve at least 80% power for declaring BE when the formulations are identical in terms of mean particle size. If the mean drug particle radius between test and reference formulations differs by 20%, the required sample size for BE demonstration approximately doubles to maintain the same power. This suggests that particle size affects formulation variability. The power calculations demonstrated that BE assessments were very sensitive to formulation differences in drug particle radius and to the parametrization of the model. These findings emphasize the critical need for rigorous model validation to ensure reliable VBE assessments.

PMID:41927954 | DOI:10.1208/s12248-026-01213-2

Sci Rep. 2026 Apr 2. doi: 10.1038/s41598-026-46698-1. Online ahead of print.

ABSTRACT

Necrotising enterocolitis (NEC) is a devastating gastrointestinal disease of premature infants, in which hypoxia-induced apoptosis plays a critical role in intestinal epithelial injury. The balance between pro-apoptotic and anti-apoptotic proteins, particularly Bax and Bcl-2, as well as the hypoxia-responsive transcription factor HIF-1α, are key determinant of epithelial survival. Sildenafil citrate, a phosphodiesterase-5 inhibitor, has been shown to improve microcirculation and exert anti-apoptotic effects through nitric oxide-cGMP signalling, but its role in NEC-related intestinal injury remains poorly understood. This study aimed to evaluate the protective effects of sildenafil on apoptosis in a hypoxia-ischemia-induced NEC-like intestinal injury model. A total of 75 Wistar rat pups were randomly assigned to six groups: control, NEC, vehicle (saline+DMSO), and sildenafil-treated groups (1, 5, and 10 mg/kg/day). Sildenafil was administered intraperitoneally for 4 days before NEC induction. NEC was induced by hypoxia (100% nitrogen for 60 s, twice daily for 48 h) and followed by cold stress (10 min at 4 °C). Intestinal tissues were collected for histopathological scoring, caspase-3 immunohistochemistry, and quantitative RT-PCR analysis of HIF-1α, Bax, and Bcl-2 expression. Data were analysed using ANOVA and Kruskal-Wallis tests, with p ≤ 0.05 considered statistically significant. Pups subjected to hypoxia-induced intestinal ischemia exhibited severe villous damage, elevated histological injury scores, and marked upregulation of HIF-1α and Bax, along with downregulation of Bcl-2. Caspase-3 immunoreactivity strongly correlated with histological injury (Spearman’s ρ = 0.795, p < 0.001). Sildenafil pretreatment reduced histological damage and apoptosis in a dose-dependent manner. The Sil_10 group showed the lowest injury score (1.06 ± 0.4, p < 0.0001 vs. NEC), significantly reduced Caspase-3 labelling, suppressed Bax and HIF-1α expression, and increased Bcl-2 levels, resulting in a markedly reduced Bax/Bcl-2 ratio compared with NEC (p < 0.0001). Sildenafil attenuates hypoxia-induced, ischemia-dominant NEC-like intestinal injury by modulating apoptotic and hypoxia-related pathways, lowering HIF-1α expression, reducing Bax/Bcl-2 ratio, and preserving epithelial integrity. These findings provide novel histological and molecular evidence for the anti-apoptotic effects of sildenafil in experimental NEC, highlighting HIF-1α modulation as a potential therapeutic strategy.

PMID:41927903 | DOI:10.1038/s41598-026-46698-1

Sci Rep. 2026 Apr 2. doi: 10.1038/s41598-026-47139-9. Online ahead of print.

NO ABSTRACT

PMID:41927879 | DOI:10.1038/s41598-026-47139-9