Tag: pubmed

J Clin Ultrasound. 2026 Mar 17. doi: 10.1002/jcu.70229. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Ultrasonography is routinely used after pediatric kidney transplantation, but the prevalence and longitudinal pattern, and prognostic value of abnormal findings are not well defined. We described the frequency and temporal trends of post-transplant ultrasound abnormalities in children and evaluated their association with graft outcomes.

METHODS: We retrospectively included patients (< 18 years) who underwent kidney transplantation at Children’s Medical Center Hospital between 2018 and 2024. Sonographic features (parenchymal changes, peritransplant collections, urinary tract abnormalities, and Doppler indices) were recorded within six predefined follow-up windows. We used descriptive statistics and Kaplan-Meier survival curves stratified by the presence of any abnormal ultrasound finding at each window. Analyses were performed in R (version 4.3).

RESULTS: Sixty-three patients (mean age 12.0 ± 3.9 years) were included. Abnormal findings were present in 43%-56% of scans across follow-up windows. Peritransplant collections (33.9%) and hematomas (24.6%) were common early findings, whereas hydronephrosis and increased echogenicity became more frequent over time. Resistive index elevation (> 0.8) was uncommon (< 3.5%). Three-year graft survival was 55.7%. Any abnormality on baseline ultrasound was associated with lower 36 month survival (40.9% vs. 73.1%, log-rank p = 0.025), while abnormalities detected at later windows were not associated with survival differences.

CONCLUSION: Abnormal ultrasound findings were common after pediatric kidney transplantation, particularly in the early postoperative period. Baseline abnormalities were associated with poorer long-term graft survival, which may reflect perioperative complications or early allograft injury. This supports the clinical value of baseline ultrasound for early risk stratification and guiding the follow-up intensity.

PMID:41844519 | DOI:10.1002/jcu.70229

Clin Oncol (R Coll Radiol). 2026 Jan 27;53:104059. doi: 10.1016/j.clon.2026.104059. Online ahead of print.

ABSTRACT

AIMS: Healthcare systems data (HSD) can potentially improve the efficiency and costs of clinical trials (CTs) and reduce the burden of follow-up. To be used in CTs, HSD need to be accessible, accurate and complete. We compared data from trial-specific case-report forms (CRFs) with relevant HSD to assess whether HSD could replace hospital-based follow-up within an ongoing CT.

MATERIALS AND METHODS: Add-Aspirin (NCT02804815) is a multicentre, randomised, basket trial evaluating aspirin after potentially curative cancer therapy in four tumour types. The primary outcome measure is disease-free survival. HSD obtained from the English National Cancer Registration and Analysis Service (NCRAS) included initial cancer diagnosis and staging, recurrence, specific adverse events, and mortality for English participants during the first 3 years of the trial and was compared to CRF data collected at participating centres. Tabulations and descriptive statistics were used to assess agreement and explore differences between the datasets.

RESULTS: HSD was obtained for 3188/3538 (90%) of English participants. Tumour staging for all four tumour groups generally had good concordance, though this was variable (ranging from 85% (Cohen’s weighted kappa = 0.32) to 99% (kappa = 0.84)) and was lower with neoadjuvant therapy and/or radical radiotherapy. HSD identified all CRF-reported deaths and some further deaths not in the trial database due to loss to follow-up or lag time in data submission. Cancer registry recurrence data captured <50% of recurrences. However, most recurrences could be identified by utilising a combination of NCRAS datasets, including treatment and hospital events. Specific trial-defined adverse events were challenging to identify within HSD.

CONCLUSION: In this example, we found that HSD could not replace CRFs for later trial follow-up as anticipated, because at that time it could not capture all key outcomes accurately . Focussed, hospital-based follow-up was continued for a further 5 years. Selective use of HSD to improve trial efficiency retains potential.

TRIAL REGISTRATION NUMBER: NCT02804815.

PMID:41844499 | DOI:10.1016/j.clon.2026.104059

Gynecol Oncol. 2026 Mar 16;207:66-73. doi: 10.1016/j.ygyno.2026.02.035. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the long-term survival outcomes of robotic-assisted versus traditional laparoscopic surgery for treatment of stage I endometrial cancer.

METHODS: We performed a retrospective cohort study using the National Cancer Database, including patients with stage I endometrial cancer diagnosed from 2010 to 2017 (with follow-up through 2020) who underwent treatment with either robotic-assisted or traditional laparoscopic surgery. Demographics, clinical characteristics, and outcomes were summarized using descriptive statistics. Overall survival (OS) was compared using a Cox proportional hazard model, adjusting for demographic and clinical factors; hazard ratios and 95% confidence intervals reported.

RESULTS: A total of 127,342 patients with stage I endometrial cancer who underwent minimally invasive surgery were included. The median follow-up among those still known to be alive was 69.7 months. Almost three-quarters (74.5%) received robotic-assisted surgery, while 25.5% received traditional laparoscopic surgery. Demographic and clinical factors were similar between groups. No differences in OS were observed by surgery modality (5-year OS: 91.7% for robotic vs. 91.4% for traditional laparoscopic surgery) and this remained after adjustment for demographic and clinical factors (HR = 1.00, 95% CI 0.96-1.04).

CONCLUSIONS: There was no difference in OS for patients with stage I endometrial cancer treated with robotic-assisted versus traditional laparoscopic surgery. These data demonstrate excellent survival outcomes in this cohort and do not favor a robotic-assisted or traditional laparoscopic approach. However, the full extent of a route-of-surgery decision may not be detected given the potential for late recurrences and deaths, highlighting the need for large, prospective studies with long duration of follow-up.

PMID:41844495 | DOI:10.1016/j.ygyno.2026.02.035

JACC Adv. 2026 Mar 16;5(4):102653. doi: 10.1016/j.jacadv.2026.102653. Online ahead of print.

ABSTRACT

BACKGROUND: Peripartum cardiomyopathy (PPCM) is a leading cause of heart failure in pregnancy and contributes significantly to maternal morbidity and mortality. Black women are disproportionately affected and experience worse outcomes compared with other groups.

OBJECTIVES: This study aimed to quantify differences in risk factors and outcomes between Black and White women in the United States diagnosed with PPCM.

METHODS: We conducted a systematic review and meta-analysis of observational studies published after 2002 including U.S. women with PPCM and race-stratified risk factors and outcomes. Investigated outcomes included mortality, major adverse cardiac events, and recovery of left ventricular ejection fraction. Random-effects meta-analysis estimated the pooled prevalence of risk factors and outcomes. Logistic regression, forest plots, and I² statistics were utilized for analysis.

RESULTS: Compared with controls, cases had higher rates of obesity, preeclampsia, hypertension, diabetes, multiple gestations, and tobacco use. Compared to White cases, Black cases had higher prevalence of diabetes (14% vs 5%; P = 0.027) and utilization of public payer (72% vs 30%; P < 0.001). At presentation, mean left ventricular ejection fraction was 26% in Black women and 29% in White women. White women experienced higher rates of recovery in ejection fraction (63% vs 40%; P < 0.0001). Mortality rates were higher among Black women (8% vs 2%; P = 0.013).

CONCLUSIONS: Black women with PPCM experienced lower recovery and higher mortality rates compared with White women. With the exception of a significant difference in payer status, modest differences in previously identified risk factors were observed between racial groups to account for worse outcomes (Disparities in risk factors and outcomes between Black and White US women with peripartum cardiomyopathy: A systematic review and meta-analysis; CRD42023439228).

PMID:41844488 | DOI:10.1016/j.jacadv.2026.102653

Maturitas. 2026 Feb 25;208:108895. doi: 10.1016/j.maturitas.2026.108895. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the controversial association between exogenous hormone use (EHU) and dementia, with a focus on subtype-specific risks.

STUDY DESIGN: This prospective cohort study followed 273,069 women in the UK Biobank over 3,802,608 person-years, identifying 4,710 dementia cases.

MAIN OUTCOME MEASURES: Cox models assessed use of oral contraceptive (OC) and hormone replacement therapy (HRT) in relation to all-cause dementia, Alzheimer’s disease (AD), vascular dementia (VaD), and frontotemporal dementia (FTD) across treatment durations. Subgroup analyses were stratified by age, ethnicity, APOE status, education, income, and reproductive factors. A systematic review was conducted to synthesize existing evidence.

RESULTS: In the cohort study, OC use was associated with reduced risks of all-cause dementia (HR 0.90, 95%CI 0.84-0.95), AD (HR 0.87, 95%CI 0.79-0.95), and VaD (HR 0.81, 95%CI 0.70-0.93), particularly after 4-14 years of use. HRT showed no significant association with increased dementia risk. Synthesized results largely corroborated these findings: OC use was associated with reduced risks of dementia (HR 0.90, 95%CI 0.89-0.92); and although four European studies reported a moderately increased AD risk after post-menopausal HRT use, neither cohort-based studies (HR 0.98, 95%CI 0.90-1.06) nor traditional case-control studies (OR 1.00, 95%CI 0.90-1.11) found an association between HRT and dementia.

CONCLUSIONS: Our combined evidence does not support an increased risk of dementia associated with OC use; similarly, no clear association was observed between HRT and increased dementia risk. Clinical decisions on EHU should be individualized, balancing overall benefits against potential risks.

PMID:41844465 | DOI:10.1016/j.maturitas.2026.108895

J Trace Elem Med Biol. 2026 Mar 11;95:127858. doi: 10.1016/j.jtemb.2026.127858. Online ahead of print.

ABSTRACT

BACKGROUND: Endocrine disrupting metals such as cadmium (Cd), lead (Pb) and mercury (Hg) may have significant influence on fertility issues among otherwise healthy women.

METHODS: In this study, fifty women with preserved ovarian function, undergoing in vitro fertilization (IVF) procedure were tested for heavy metals (Cd, Hg and Pb) in their morning urine samples using inductively coupled plasma mass spectrometry after microwave digestion.

RESULTS: None of the women had measurable lead in the urine samples while cadmium and mercury were quantified in 28% and 60% of the samples, respectively. Serum LH levels were significantly lower (p = 0.046) among women with measurable urinary cadmium values compared to those with cadmium below the limit of quantification (LOQ). The number of immature oocytes retrieved during transvaginal aspiration was significantly higher (p = 0.030) in women with mercury above LOQ in comparison to those below LOQ. The elevation of urinary mercury concentrations was followed by the increment AST and ALT (p = 0.035 and p = 0.001, respectively). Moreover, higher urinary mercury levels were positively associated with fasting and 2 h post-load serum glucose levels during oral glucose tolerance testing (p = 0.035 and p = 0.002, respectively). For the first time, statistically significant (p = 0.009) correlation was obtained between the urinary mercury concentration and serum LDH values. All the associations between mercury and the observed parameters remained significant after adjustments for age, BMI and time attempting to conceive were made.

CONCLUSIONS: Women undergoing IVF have considerable amount of cadmium and mercury in the urine samples, despite the absence of occupational exposure.

PMID:41844457 | DOI:10.1016/j.jtemb.2026.127858

Psychiatry Res. 2026 Mar 9;360:117082. doi: 10.1016/j.psychres.2026.117082. Online ahead of print.

ABSTRACT

OBJECTIVE: Mental health in adolescents has been a growing problem in recent decades. However, comprehensive discussion of the research on the distal and proximal factors related to adolescent mental health were limited and the evidence was lacking. This study aimed to explore the result of adverse childhood experiences and biological rhythms for depressive and anxiety symptoms in adolescents.

METHODS: The data used in this study were obtained from China in 2021 (as baseline) and 2023 (as follow-up). Participants provided self-reported information through an anonymous questionnaire. Logistic regression, cluster analysis, restriction cubic spline plots and receiver operating characteristic curves were used for statistical analysis.

RESULTS: The study involved 2103 teenagers (mean age 15 years old), consisting of 1089 females and 1014 males. Multiple logistic regression results based on this subgroup showed that higher scores on either ACEs or biorhythms were associated with a greater risk of concurrent depressive-anxiety symptoms at baseline and follow-up, the adjusted ORs (95% CI) were 14.46 (7.14-29.26), 12.09 (5.83-22.08), respectively. The area under the receiver operating characteristic curve of the joint predictive effect of the ACEs and biorhythms were 0.664 for depressive symptoms, 0.656 for anxiety symptoms, and 0.667 for co-morbidity.

CONCLUSION: These findings emphasize the necessity of balancing past risk factors with emerging risk factors (biorhythms) in the precaution and management of adolescent depression and anxiety symptoms problems.

PMID:41844454 | DOI:10.1016/j.psychres.2026.117082

Cancer Genet. 2026 Mar 9;304-305:27-33. doi: 10.1016/j.cancergen.2026.03.003. Online ahead of print.

ABSTRACT

BACKGROUND: Hepatoblastoma (HB) is the most common primary liver malignancy in children. Oxidative DNA damage is primarily repaired through the base excision repair (BER) pathway, and genetic polymorphisms in BER-related genes may influence individual susceptibility to HB. However, the contribution of BER gene variants to HB risk remains unclear.

METHODS: A multicenter case-control study including 193 HB patients and 773 cancer-free controls were conducted. Twenty potentially functional single nucleotide polymorphisms (SNPs) in key BER pathway genes were genotyped using TaqMan assays. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models controlling for age and sex. The Benjamini-Hochberg false discovery rate (FDR) procedure was applied to account for multiple testing in the primary analysis. Expression quantitative trait loci (eQTL) analyses were performed using publicly available GTEx data to explore potential regulatory effects.

RESULTS: In unadjusted analyses, several BER SNPs showed nominal associations with HB susceptibility under specific genetic models, including PARP1 rs2666428, APEX1 rs1760944, LIG3 rs4796030, XRCC1 rs25487, and XRCC1 rs915927. However, after Benjamini-Hochberg false discovery rate (FDR) correction across the 20 examined SNPs in the primary (dominant-model) analysis, none of the associations remained statistically significant at an FDR threshold of 0.05. The smallest FDR-adjusted q values were 0.053 (PARP1 rs2666428, APEX1 rs1760944, and XRCC1 rs25487), indicating borderline but non-significant signals. Stratified analyses suggested potential subgroup-specific effects, but these findings were based on limited sample sizes and should be interpreted cautiously. eQTL analyses indicated that selected variants were associated with altered gene expression in normal tissues, providing preliminary functional support.

CONCLUSION: This study provides exploratory evidence suggesting that genetic variation in BER pathway genes may contribute to HB susceptibility in Chinese children. Given the multiple testing burden and modest effect sizes, these findings should be considered hypothesis-generating and require validation in independent cohorts and functional studies.

PMID:41844453 | DOI:10.1016/j.cancergen.2026.03.003

Arch Med Res. 2026 Mar 16;57(5):103407. doi: 10.1016/j.arcmed.2026.103407. Online ahead of print.

ABSTRACT

BACKGROUND: Wilson disease (WD) is a multisystemic disorder caused by a disturbance in copper homeostasis due to pathogenic biallelic variants in the ATP7B gene.

AIM: To identify the pathogenic variants in the ATP7B gene in Mexican individuals with WD and describe their phenotypic presentation.

METHODS: We included 19 individuals from 11 unrelated families with molecularly confirmed WD.

RESULTS: 52.6% of the WD patients were male, and three were asymptomatic at diagnosis. The median age at presentation was 19 years. Of the symptomatic individuals, 84.2% had hepatic manifestations, 62.5% had neurological symptoms, 25.0% had psychiatric manifestations, and 90.9% had Kayser-Fleischer rings. The phenotypic distribution was as follows: combined (52.6%), acute liver failure (26.3%), chronic liver disease (5.3%), and asymptomatic (15.8%). Modified Leipzig scores ranged from 8 to 16. Five patients underwent liver transplantation, and eight patients were treated with copper chelators. Eight different pathogenic variants were identified, including the recurrent c.3207C>A and c.3809A>G, as described in other series.

CONCLUSIONS: We present the first and largest case series of Mexican patients with WD confirmed by molecular testing. All patients exhibited hepatic manifestations. The most frequent phenotypes were combined (52.6%) and acute liver failure (26.3%). A statistically significant difference in the frequency of asymptomatic patients was observed between the homozygous c.3207C>A genotype group and the group with other genotypes (p = 0.036). The modified Leipzig score is a valuable diagnostic tool for WD.

PMID:41844444 | DOI:10.1016/j.arcmed.2026.103407

J Obstet Gynaecol Res. 2026 Mar;52(3):e70250. doi: 10.1111/jog.70250.

ABSTRACT

AIM: To compare outcomes, efficacy, and safety of vNOTES versus conventional laparoscopy and laparoendoscopic single-site surgery salpingectomy for ectopic pregnancy.

METHODS: Electronic databases including PubMed, Medline, Cochrane Library, and Embase were systematically searched. Articles were evaluated according to specified inclusion criteria. Data were extracted and reviewed, with reported duration of procedure and length of patient stay as primary outcomes. Due to heterogeneity of data, analysis was further stratified depending on whether the control groups underwent conventional laparoscopy or laparoendoscopic single-site surgery. Secondary outcomes include success rates, estimated blood loss, Visual Analogue Scores (VAS) for postoperative pain and complications. A formal risk of bias assessment accompanied the included studies.

RESULTS: Twenty-one studies were included within the review with a cumulative total of 405 cases of vNOTES salpingectomy. Studies included randomized control trials (n = 2), cohort control studies (n = 6), case series (n = 12), and case report (n = 1). Meta-analyses of duration of procedure and length of stay were performed across seven papers (stratified according to control groups). This revealed a significant reduction in length of stay but similar duration of surgery under fixed and random effects models (p < 0.05) for vNOTES versus conventional laparoscopic salpingectomy. Patients undergoing vNOTES salpingectomy versus laparoendoscopic single-site surgery had similar duration of surgery and length of stay. Women who had vNOTES demonstrated lower VAS pain scores and reduced analgesia requirements. Up to 4% of cases may need conversion to laparoscopy (these were cases associated with pelvic adhesions or torrential hemorrhage), and documented complications included hemorrhage, post-operative pyrexia, and need for blood transfusion.

CONCLUSIONS: vNOTES salpingectomy for ectopic pregnancy appears to be a safe and feasible procedure, with high levels of patient satisfaction and low pain scores. The heterogeneity of data of the control groups is acknowledged and patients undergoing vNOTES versus conventional laparoscopic salpingectomy had reductions in length of stay but similar duration of surgery, while vNOTES salpingectomy versus laparoendoscopic single-site surgery incurred similar duration of surgery and length of stay. Procedural standardization and larger randomized clinical trials to assess long-term outcomes are crucial if vNOTES salpingectomy should become widely used for surgical treatment of ectopic pregnancy.

PMID:41844421 | DOI:10.1111/jog.70250