Tag: pubmed

Prev Med Rep. 2026 Jul 13;69:103571. doi: 10.1016/j.pmedr.2026.103571. eCollection 2026 Sep.

ABSTRACT

OBJECTIVE: To identify the optimal 2-h glucose reduction and baseline level for preventing progression from impaired glucose tolerance to type 2 diabetes using meta-regression.

METHODS: We systematically reviewed randomized clinical trials of lifestyle modifications and/or anti-hyperglycemic medications reporting both 2-h glucose and diabetes prevention in impaired glucose tolerance. PubMed (1997), Cochrane Library (1995), and Ichushi-Web (Japanese medical literature database; 2000) were searched from inception through January 26, 2025. A meta-regression model examined log-transformed hazard ratios for diabetes progression, with 2-h glucose reduction and baseline level as predictors.

RESULTS: From 1372 candidates, 32 studies (n = 33,839 participants) were analyzed. The model indicated linear relationship and the early intervention at a baseline 2-h glucose of 140 mg/dL (7.8 mmol/L) could prevent 44% of diabetes with only a 10 mg/dL (0.56 mmol/L) reduction. Conversely, later interventions at a baseline 2-h glucose of 170-190 mg/dL (9.4-10.6 mmol/L) require larger 2-h glucose reductions of 20-30 mg/dL (1.1-1.7 mmol/L) for similar preventive effects (40-42%); which may necessitate pharmacotherapy.

CONCLUSIONS: This meta-regression analysis demonstrates that early and minimal interventions for impaired glucose tolerance are optimal, suggesting that its timely detection is vital for diabetes prevention.

PMID:42502745 | PMC:PMC13400255 | DOI:10.1016/j.pmedr.2026.103571

Int J Endocrinol Metab. 2026 Jun 22;24(4):e168325. doi: 10.5812/ijem-168325. eCollection 2026 Oct 31.

ABSTRACT

BACKGROUND: Post-transplant diabetes mellitus (PTDM) is a serious complication after heart transplantation, with reported incidence rates ranging from 2% to 53% among solid organ transplant recipients. Comprehensive epidemiological data on prediabetes (Pre-DM) and diabetes mellitus (DM) in heart transplant populations remain limited, particularly in Middle Eastern populations.

OBJECTIVES: This decade-long study investigated the prevalence of DM and Pre-DM among heart transplant recipients and evaluated selected intraoperative risk factors.

METHODS: This retrospective cohort study included 250 heart transplant recipients who received post-transplant care at Dr. Masih Daneshvari Hospital, Tehran, Iran, between 2010 and 2020. Overall, 244 patients were included in the final analysis. Data included anthropometric measurements, cardiovascular parameters, and metabolic profiles. Pre-DM and DM were diagnosed according to the American Diabetes Association criteria. Statistical analyses were performed using SPSS version 26.

RESULTS: The study population comprised 192 males (78.7%) and 52 females (21.3%), with a mean age of 38.46 ± 12.69 years. At transplantation, 36.5% of recipients had established DM, 29.1% had Pre-DM, and 34.4% had normal glucose metabolism. Among patients with DM, 58.4% (52 of 89) were unaware of their diagnosis before transplantation. New-onset PTDM occurred in 6.8% of previously normoglycemic patients by 6 months. The prevalence of hypertension differed markedly by glucose status (P < 0.001): 100% of the normal group had normal blood pressure, 97.2% of patients with Pre-DM had stage 1 hypertension, and 87.6% of patients with DM had stage 2 hypertension. Dyslipidemia, particularly low high-density lipoprotein (HDL), was present in all groups. Pre-transplant hyperglycemia was associated with a numerically higher, but nonsignificant, mortality risk (hazard ratio [HR] = 1.371; 95% CI, 0.891 – 2.132; P = 0.162), which reversed after age adjustment (HR = 0.676; P = 0.083), consistent with negative confounding.

CONCLUSIONS: Pre-transplant metabolic dysfunction was highly prevalent, and 58.4% of diabetic recipients were unaware of their diagnosis. Although the association with mortality was nonsignificant and reversed after adjustment for age, these findings underscore the need for systematic pre-transplant metabolic screening, post-transplant glucose monitoring, and multidisciplinary care in heart transplant recipients.

PMID:42502735 | PMC:PMC13401106 | DOI:10.5812/ijem-168325

J Ophthalmol. 2026 Jul 25;2026:9418834. doi: 10.1155/joph/9418834. eCollection 2026.

ABSTRACT

OBJECTIVE: To investigate the impact of chalazion history on meibomian gland loss and dry eye disease (DED).

METHODS: This study was a retrospective case-control study. Sixty patients with a history of chalazion admitted to a certain hospital from June 2021 to June 2024, who were selected as the previous chalazion group, and another 90 patients with no previous history of chalazion who visited the outpatient clinic consecutively during the same period were selected as the nonchalazion group. Comprehensive ocular surface parameters were compared between groups to evaluate long-term meibomian gland loss and DED. The chalazion group was further divided into MG loss (n = 42) and non-MG loss (n = 18) subgroups based on glandular loss status. Logistic regression analyzed factors influencing meibomian gland loss. The MG loss subgroup was stratified by severity into mild-moderate (< 1/3 or 1/3-2/3 loss) and severe (> 2/3 loss) groups for comparison of parameters of DED (Schirmer’s test, tear break-up time [BUT], and fluorescein staining [FL]). Pearson’s correlation assessed the relationship between meibomian gland loss severity and DED manifestations.

RESULTS: Significant differences were observed between the chalazion and nonchalazion groups in tear meniscus height, BUT, conjunctival redness index, and lipid layer thickness (p < 0.05). The MG loss subgroup indicated statistically significant differences from the non-MG loss subgroup in chalazion recurrence frequency, surgical history, tear meniscus height, BUT, conjunctival redness index, and lipid layer thickness (p < 0.05). All differential indicators demonstrated no collinearity (VIF ≤ 10, tolerance ≥ 0.1). Logistic regression identified chalazion recurrence frequency and surgical history as independent risk factors for meibomian gland loss. Pearson’s analysis revealed negative correlations between meibomian gland loss severity and both Schirmer’s test results (r1 = -0.761) and BUT (r2 = -0.543), and a positive correlation with FL scores (r3 = 0.752) (all p < 0.05).

CONCLUSION: Retrospective analysis revealed that a proportion of patients with meibomian gland loss had prior chalazion history, demonstrating distinct ocular surface characteristics compared to nonchalazion patients. Recurrent chalazion episodes and surgical history were identified as significant contributors to meibomian gland loss, with glandular loss severity showing strong correlations with DED clinical parameters. These findings highlight the substantial impact of recurrent chalazion and surgical interventions on meibomian gland dysfunction and DED development, emphasizing the need for early clinical recognition and proactive management.

PMID:42502732 | PMC:PMC13401330 | DOI:10.1155/joph/9418834

Public Health Pract (Oxf). 2026 Jul 8;12:100824. doi: 10.1016/j.puhip.2026.100824. eCollection 2026 Dec.

ABSTRACT

OBJECTIVES: Despite substantial progress in the fight against HIV/AIDS, the epidemic continues to pose a major global public health challenge, with persistent residential disparities. However, the contributing factor for urban-rural disparities in Ethiopia is limited. Therefore, this study aims to identify inequalities in HIV testing across residences and identify contributing factors in Ethiopia.

STUDY DESIGN: A cross-sectional study design was used to analyse secondary data.

METHODS: We used Individual Recode (IR) dataset, which includes women of reproductive age, and the Male Recode (MR) dataset, which includes men aged 15-59 years, from the 2016 Ethiopian Demographic and Health Survey (EDHS). Descriptive statistics summarised participants’ socioeconomic and demographic characteristics. A multivariate decomposition analysis was employed to assess residential disparities in HIV testing.

RESULT: Overall, 44.9% of participants reported having been tested for HIV. Uptake was substantially higher among urban residents, with 69.3% reporting HIV testing compared with 38.3% of rural residents. The urban-rural gap was explained by both differences in participant characteristics and differences in the effects of those characteristics. Overall, 23.5% of the disparity was attributable to compositional factors, while 76.5% was attributable to coefficient effects. Being married (-12.7%), secondary (12.2%), and higher education (17.3%), and metropolises (3.7%) were the major compositional factors.

CONCLUSION: There was a substantial disparity in HIV testing between urban and rural residents in Ethiopia. The residential difference in HIV testing was largely driven by differences in characteristics such as marital status, education level, and metropolises, which influenced HIV testing. Policy makers should strengthen interventions aiming to increase HIV testing, particularly in rural areas, with a focus on enhancing education and engagement with health services.

PMID:42502692 | PMC:PMC13400955 | DOI:10.1016/j.puhip.2026.100824

Genet Med Open. 2026 May 27;4:104406. doi: 10.1016/j.gimo.2026.104406. eCollection 2026.

ABSTRACT

PURPOSE: Genetic factors play a role in prostate cancer (PCa) development. This real-life, retrospective, multicenter study aimed to identify and characterize the germline genetic testing landscape in men with PCa and to assess the added benefit of next-generation sequencing (NGS) testing compared with testing for founder disease-causing variants.

METHODS: This study included all men who were referred for genetic counseling because of PCa. All patients were offered germline genetic testing. Demographic, clinical, and pathological information was retrieved from their medical records. Variant classification was determined using the American College of Medical Genetics and Genomics guidelines.

RESULTS: Of the 293 men with PCa tested, in 39 (13.3%), a positive genetic finding (pathogenic variant, likely pathogenic, or risk variant) was reported: 18 (6.1%) men had a positive test result for high-penetrance genes (BRCA1, BRCA2, ATM, NF1, and MSH6), and 21 (7.2%) had risk allele variants. One-third (33%) of the disease-causing or likely disease-causing variants identified through NGS in our PCa cohort were unique rather than founder variants. The only significant correlation between positive results and demographic or clinical factors was observed between a positive test result and a family history of cancer.

CONCLUSION: Our findings underscore the importance of NGS genetic investigations in patients with PCa, regardless of ethnicity or disease stage.

PMID:42502690 | PMC:PMC13400249 | DOI:10.1016/j.gimo.2026.104406

Arthroplast Today. 2026 Jul 18;40:102098. doi: 10.1016/j.artd.2026.102098. eCollection 2026 Aug.

ABSTRACT

BACKGROUND: Access to primary total knee arthroplasty (TKA) for morbidly obese (MO) patients is often restricted to reduce complications. We compared complication rates in patients who were MO or non-MO (NMO) at initial presentation based on whether their body mass index (BMI) had decreased by ≥5%, remained stable, or increased by ≥5% at the time of surgery, hypothesizing that preoperative weight loss does not reduce complication rates.

METHODS: Prospectively collected data for 2219 unilateral, primary TKAs were retrospectively reviewed. Cases were performed between 2012 and 2023 at the same academic center by 4 fellowship-trained surgeons using standardized protocols. Twenty-eight percent (n = 627) were MO and 72% (n = 1592) were NMO at initial presentation. Outcomes included intraoperative and 90-day complications and reoperations. Outcome covariates included patient demographics and comorbidities, as well as operative details. Independent samples t-tests and chi-squared tests were used for statistical analysis.

RESULTS: Intraoperative complications (P = .999), medical complications (P ≥ .398), death (P = .299), superficial or deep infection (P = .731), and reoperation on the index joint within 90 days of surgery (P = .801) did not differ in MO patients with a ≥5% decrease vs stable BMI before surgery. These outcomes also did not differ between NMO patients with a ≥5% decrease in BMI and those with stable BMI before surgery (P ≥ .250).

CONCLUSIONS: Findings suggest that withholding surgery from patients who are clinically indicated for TKA pending weight loss may not be necessary to reduce early postoperative complications.

PMID:42502678 | PMC:PMC13400762 | DOI:10.1016/j.artd.2026.102098

Nucl Med Mol Imaging. 2026 Aug;60(4):409-420. doi: 10.1007/s13139-026-01008-5. Epub 2026 Apr 8.

ABSTRACT

BACKGROUND: The reliability of PET radiomic features is fundamentally constrained by inherent stochastic noise originating from Poisson-distributed photon-counting statistics and additional fluctuations introduced by electronic signal processing. To assess its impact, we repeated PET scans under identical acquisition and reconstruction conditions to evaluate the consistency of radiomic feature measurements and quantify the noise-induced variability as a repeatability measure.

MATERIALS AND METHODS: An American College of Radiology-accredited (ACR) phantom was utilized to evaluate measurement variability in PET radiomic features under two scenarios: uniform (Experiment 1) and non-uniform (Experiment 2) radiotracer distributions, employing ¹⁸F-FDG and ⁶⁸Ga-PSMA tracers. A total of 93 radiomic features across six categories were extracted using PyRadiomics. Each experiment was repeated ten times, and measurement variability was quantified using the coefficient of variation (CV). Features were benchmarked and classified into three quality grades of repeatability: Grade A (CV < 10%), Grade B (10% ≤ CV < 20%), and Grade C (CV ≥ 20%).

RESULTS: Experiment 1 identified 22 Grade A and 14 Grade C features, whereas Experiment 2 yielded 30 Grade A and 15 Grade C features. Notably, CV values exhibited substantial variability. In Experiment 1, CV ranged from 0.17% to 205% for ¹⁸F-FDG and from 0.14% to 140% for ⁶⁸Ga-PSMA. Similarly, in Experiment 2, CV spanned from 0.16% to 230% for ¹⁸F-FDG and from 0.23% to 79% for ⁶⁸Ga-PSMA.

CONCLUSION: By isolating inherent stochastic noise, this study applied the coefficient of variation to evaluate measurement variability across repeated PET scans and benchmarked radiomic features into three repeatability quality categories. While some features demonstrated high noise resilience, others showed poor repeatability across repeated scans. These findings highlight the need to establish repeatability standards to guide the development of noise-robust features that support trustworthy imaging biomarkers for clinical applications.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13139-026-01008-5.

PMID:42502658 | PMC:PMC13400607 | DOI:10.1007/s13139-026-01008-5

Nucl Med Mol Imaging. 2026 Aug;60(4):363-370. doi: 10.1007/s13139-026-00992-y. Epub 2026 Feb 20.

ABSTRACT

PURPOSE: Targeted radionuclide therapy (TRT), specifically peptide receptor radionuclide therapy (PRRT) with [¹⁷⁷Lu]Lu-DOTA-TATE is an established treatment for somatostatin receptor-expressing neuroendocrine tumors across different grades; however, its efficacy in other tumors expressing somatostatin receptors remains less defined. This study aimed to evaluate the safety and efficacy of PRRT with [¹⁷⁷Lu]Lu-DOTA-TATE in patients with medullary thyroid cancer (MTC) who presented with progressive recurrence or metastases refractory to standard therapies.

METHODS: Ten patients with MTC (3 females, 7 males; mean age 45.0 ± 13.0 years) underwent slow intravenous injection of [¹⁷⁷Lu]Lu-DOTA-TATE combined with lysine-arginine co-infusion in 2000 mL normal saline. Each patient received a median of 4 cycles (IQR: 3.0-5.3) with a mean activity of 5.5 ± 1.5 GBq per cycle. Post-treatment imaging and serial measurements of calcitonin and carcinoembryonic antigen (CEA) were performed. Hematologic and biochemical toxicities were assessed according to CTCAE criteria.

RESULTS: Calcitonin levels showed a marked numerical decline from 6452.6 ± 8565.7(median:1897.5, interquartile range:127-12993.8) pg/mL to 540.9 ± 632.1 (390, IQR;141.8-723.3) pg/mL, although this change did not reach conventional statistical significance (P = 0.093), while CEA levels decreased significantly from 119.0 ± 186.2 (40, IQR:10.9-199) ng/ml ng/mL to 56.1 ± 67.9 (22, deIQR:5.7-112.3) ng/mL (P = 0.017). Based on calcitonin levels, biochemical response, stable disease, and progression were observed in 4, 4, and 2 patients, respectively; in contrast, CEA showed a biochemical response in 3 patients, with the remaining 7 demonstrating stable disease and no cases of biochemical progression. The median percentage reductions from baseline were clinically meaningful, reaching – 39.3% for calcitonin and – 25.8% for CEA. On imaging assessment, the best overall response comprised partial response in 4 patients, stable disease in 4 patients, and progressive disease in 2 patients. Only grade 1 hematologic toxicity was observed, with no hepatic or renal toxicity detected. White blood cell counts declined from 6144.4 ± 2362.3/µL to 4927.8 ± 1635.3/µL (P = 0.027), while other hematologic, renal, and hepatic parameters remained stable.

CONCLUSION: [¹⁷⁷Lu]Lu -DOTA-TATE PRRT was safe and effective in controlling disease progression and reducing tumor markers in MTC patients unresponsive to conventional therapy, supporting further evaluation in larger studies.

PMID:42502651 | PMC:PMC13400521 | DOI:10.1007/s13139-026-00992-y

Nucl Med Mol Imaging. 2026 Aug;60(4):353-362. doi: 10.1007/s13139-025-00981-7. Epub 2026 Feb 11.

ABSTRACT

OBJECTIVE: Optimized reconstruction algorithms can enhance the image quality and signal-to-noise ratio (SNR) of positron emission tomography (PET) images. This study aimed to compare the impacts of the ordered subset expectation maximization (OSEM) and regularized expectation maximization image reconstruction (HYPER Iterative) algorithms on the image quality and epileptogenic zone (EZ) detection sensitivity in fluorine-18-DPA-714 (¹⁸F-DPA-714) images of drug-resistant focal epilepsy patients.

METHODS: Drug-resistant focal epilepsy patients who underwent presurgical brain ¹⁸F-DPA-714 PET imaging between May 2023 and July 2024 were retrospectively included. PET images were reconstructed using the OSEM (number of iterations ranging from 2 to 6) and HYPER Iterative algorithms [penalization factors (β) of 0.3, 0.5, and 0.8]. Image quality was evaluated by subjective (overall image quality, image noise, and EZ conspicuity) and quantitative assessment [mean standardized uptake value (SUVmean), SUVmax, contrast-to-noise ratio (CNR), SNR, and standardized uptake value ratio (SUVr)]. The sensitivity of detecting EZs in optimal PET images reconstructed by the OSEM and HYPER Iterative algorithms was compared, with histopathology as the gold standard.

RESULTS: Thirty patients were included. The subjective assessment revealed that the HYPER Iterative algorithms outperformed OSEM in overall image quality, with HY0.8 achieving the highest score. Among OSEM algorithms, O5 had the top score and outperformed O6 significantly. Image noises scores were higher in HY0.5 and HY0.8 than in HY0.3 and OSEM algorithms. EZ conspicuity scores were better for HYPER Iteratives, O5, and O6 than for O2 – O4. Quantitative assessment revealed that the SNR was higher in O2, HY0.5, and HY0.8 than in O6, with HY0.8 significantly higher SNR than O5. The SUVr was higher in O6 and HY0.3 compared with O2. No significant differences were observed in SUVmean, SUVmax, mean standardized uptake value of cerebellar gray matter (SUVb) or CNR across all groups. For EZ detection, O5 and HY0.8 were optimal for the OSEM and HYPER Iterative algorithms, respectively. HY0.8 achieved a numerically 13.3% higher sensitivity for EZ detection than O5(80.0% vs. 66.7%), though this difference did not reach statistical significance (p = 0.125).

CONCLUSIONS: The HYPER Iterative algorithm is capable of reducing image noise, enhancing EZ conspicuity, and improving the overall image quality in ¹⁸F-DPA-714 PET for patients with drug-resistant focal epilepsy, further increasing visual interpretability. A penalization factor of 0.8 results in a numerical improvement in the detection sensitivity of EZ, thus facilitating readers’ confidence in detecting EZs.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13139-025-00981-7.

PMID:42502649 | PMC:PMC13400539 | DOI:10.1007/s13139-025-00981-7

Int J Cardiol Heart Vasc. 2026 Jul 17;65:101976. doi: 10.1016/j.ijcha.2026.101976. eCollection 2026 Aug.

ABSTRACT

AIMS: Compared with intravenous iron, oral iron is less expensive, avoids healthcare complexities, and reduces the risk of iron overload. However, conventional oral formulations have not improved clinical outcomes in heart failure (HF) and iron deficiency (ID), largely due to poor absorption. Sucrosomial iron (SI) partially bypasses hepcidin-controlled absorption and showed favorable effects in a small case-control study, warranting further evaluation in a randomized trial.

METHODS: The Effect of Oral sucRosomIal Iron on exerciSE Capacity and Quality of Life in Patients With Heart Failure (RISE-HF; NCT06270498) is a randomized, placebo-controlled, double-blind study enrolling 60 patients with HF with left ventricular ejection fraction <50%, ID (transferrin saturation (TSAT) < 20%), ferritin <400 μg/L and hemoglobin (Hb) 10-16 g/dL. Participants are randomized 1:1 to receive SI (Sideral Forte®: sucrosomial iron 30 mg + 70 mg vitamin C) or placebo for 24 weeks, with daily dose tailored to Hb (2 capsules for Hb 10-13.9 g/dL; 1 capsule for Hb 14-16 g/dL). Co-primary endpoints are changes from baseline to week 12 in exercise capacity, assessed by the 6-min walk test (6MWT) distance, and in quality of life, assessed by the Kansas City Cardiomyopathy Questionnaire-12. Secondary endpoints include changes in individual co-primary endpoints at week 24, effects on iron status and oxidative stress biomarkers, N-terminal pro type-B natriuretic peptide and echocardiographic indices of cardiac function, and gastrointestinal tolerability.

CONCLUSIONS: RISE-HF will determine whether SI can safely improve exercise capacity, quality of life, and iron status in patients with HF and TSAT-defined ID, justifying a larger multicenter trial.

PMID:42502637 | PMC:PMC13400243 | DOI:10.1016/j.ijcha.2026.101976