Tag: pubmed

Oral Radiol. 2026 Jun 22. doi: 10.1007/s11282-026-00942-6. Online ahead of print.

ABSTRACT

OBJECTIVE: Pleomorphic adenoma (PA) is the most common benign parotid tumour. Magnetic resonance imaging (MRI) and fine-needle aspiration cytology (FNAC) are routinely used during preoperative work up. However, there is insufficient evidence to support the use of MRI alone to diagnose a PA. This paper aims to evaluate the diagnostic performance of MRI and FNAC in the diagnosis of PA and develop an MRI assessment tool to potentially reduce an invasive biopsy.

METHODS: A retrospective cohort study was conducted in 155 patients with histopathologically confirmed parotid tumours with preoperative MRI and/or FNAC between 2015 and 2020. Two experienced head and neck radiologists, both with over 20 years’ experience, blinded to final histopathology, evaluated 100 MRIs. Diagnostic values for detecting PA with MRI and FNAC were evaluated. An MRI assessment tool was developed based on clinical criteria and MRI characteristics typical for a PA.

RESULTS: The sensitivity, specificity, positive predictive value (PPV), negative predictive value, (NPV) and diagnostic accuracy for predicting PA were 93%, 97%, 96%, 94% and 95% (Area under ROC curve (AUC) 0.95) for FNAC and 95%, 90%, 86%, 96% and 92% (AUC 0.93) for MRI respectively. There was no statistically significant difference between MRI and FNAC for diagnosing PA with regards to sensitivity (p = 0.628), specificity (p = 0.162) or overall accuracy (p = 0.361).

CONCLUSION: MRI is a noninvasive imaging technique that can predict PA with similar sensitivity, specificity and diagnostic accuracy compared with FNAC. The PA MRI assessment tool aims to assist in surgical management decisions, while potentially reducing the need for an invasive biopsy.

PMID:42329557 | DOI:10.1007/s11282-026-00942-6

Saudi Dent J. 2026 Jun 22;38(7):91. doi: 10.1007/s44445-026-00201-8.

ABSTRACT

Endodontically treated teeth often have compromised tooth structure, which increases their susceptibility to fracture. This in vitro study compared the fracture resistance of endodontically treated mandibular premolars restored using the sandwich technique, Nayyar core composite, and semi-direct composite onlay. Seventy-six extracted mandibular premolars were randomly allocated into four groups (n = 19): intact teeth (control), conventional sandwich technique, Nayyar core composite, and semi-direct composite onlay. All groups except the control teeth group underwent standardized root canal treatment and obturation, followed by composite restoration according to the group allocation. Specimens were loaded axially in a universal testing machine until fracture. Fracture resistance was recorded in kilonewtons (kN). Data were analyzed using one-way ANOVA and Dunnett T3 post-hoc tests (p < 0.05). Mean fracture resistance was highest in the intact control group (8.70 ± 4.09 kN), followed by the sandwich technique (7.50 ± 1.55 kN), Nayyar core composite (6.10 ± 1.61 kN), and semi-direct composite onlay (4.94 ± 3.16 kN). The overall difference among the groups was statistically significant (p = 0.001). Post-hoc analysis showed significant differences between the control and semi-direct onlay groups (p = 0.019) and between the sandwich technique and semi-direct onlay groups (p = 0.022). Within the limitations of this in vitro study, the sandwich technique demonstrated the highest fracture resistance when compared with Nayyar core composite restoration and semi-direct composite onlay in endodontically treated mandibular premolars with conservative access preparation and intact marginal ridges.

PMID:42329556 | DOI:10.1007/s44445-026-00201-8

Esophagus. 2026 Jun 22. doi: 10.1007/s10388-026-01223-1. Online ahead of print.

ABSTRACT

BACKGROUND: Risk assessment is essential for planning esophagectomy in patients with esophageal or gastro-esophageal junction (GEJ) cancers. However, previous reports using only preoperative variables (preoperative risk models) have poorly predicted postoperative anastomotic leakage. This study aimed to develop a novel risk model for anastomotic leakage using a combination of preoperative, intraoperative, and postoperative variables (perioperative risk model).

METHODS: Clinical data of 20,113 patients with esophageal or GEJ cancer who underwent esophagectomy followed by reconstruction between 2016 and 2019 were retrieved from the National Clinical Database (NCD), a Japanese web-based nationwide registry. Preoperative and perioperative risk models for anastomotic leakage were developed using only preoperative variable and a combination of preoperative, intraoperative, and postoperative variables within 72 h, respectively. The performance of the perioperative risk model was validated using NCD data of 5,147 esophagectomies registered in 2020.

RESULTS: In the overall population, 11,360 (45.0%) patients were aged ≥ 75 years, and 81.3% were male. Preoperative variables were comparable between the development and external validation cohorts. Anastomotic leakage was observed in 13.7% and 14.4% of the development and validation cohorts, respectively, and in 13.9% of all patients. The optimism-corrected C-statistics was higher in the perioperative risk model (0.610; 95% CI, 0.599-0.621) than in the preoperative risk model (0.565; 95% CI, 0.554-0.577). In the validation analysis, the C-statistics was 0.602 (95% CI, 0.580-0.623) for predicting anastomotic leakage.

CONCLUSION: Postoperative risk assessment using perioperative variables, including operative factors and early postoperative events, may help surgeons predict anastomotic leakage and improve patient management after esophagectomy.

PMID:42329555 | DOI:10.1007/s10388-026-01223-1

J Cardiovasc Transl Res. 2026 Jun 22;19(1):75. doi: 10.1007/s12265-026-10804-5.

ABSTRACT

Left ventricular thrombus (LVT) in ischemic heart failure carries embolic risk; tools to anticipate persistence are limited. We studied 190 consecutive patients with imaging-confirmed LVT managed with guideline-concordant anticoagulation and serial echocardiography. The primary outcome was 6-month non-regression; 1-year MACE was secondary. We combined classical statistics with explainable machine learning. CatBoost yielded the best discrimination for non-regression (CV-AUC 0.76; test accuracy 0.79). SHAP highlighted left atrial diameter, pulmonary artery pressure, platelet count, and LV end-diastolic diameter as leading predictors. For 1-year outcomes, thrombus size and CHA2DS2-VA were independently associated with MACE (logistic AUC 0.71), whereas “regression vs persistence” alone was not. Baseline remodeling and coagulability markers, captured by an interpretable ML model, stratify early risk of LVT persistence and complement clinical decision-making for imaging follow-up and anticoagulation intensity.

PMID:42329547 | DOI:10.1007/s12265-026-10804-5

Cogn Process. 2026 Jun 22. doi: 10.1007/s10339-026-01367-z. Online ahead of print.

ABSTRACT

Responsible forgetting refers to an adaptive process whereby individuals intentionally forget information that does not need to be remembered. This study examined whether responsible forgetting is influenced by the forgetfulness of a partner in collaborative recall. Participants imagined preparing for a camping trip with a hypothetical friend. Each camping item was paired with a cue (You or Friend) indicating whether the participant or friend was responsible for remembering it. Participants in the forgetful condition were told that their friend was forgetful, whereas no information was provided about the friend in the control condition. Results demonstrated that the interaction effect between partner unreliability and memory-responsibility cue on recall performance was statistically significant (OR = 0.39, 95% CI [0.17, 0.90]). Participants in the forgetful condition recalled more friend-assigned items than those in the control condition. These findings indicate that responsible forgetting is flexibly moderated depending on the situation, such as a partner’s forgetfulness.

PMID:42329544 | DOI:10.1007/s10339-026-01367-z

Geroscience. 2026 Jun 22. doi: 10.1007/s11357-026-02374-w. Online ahead of print.

ABSTRACT

Aging-related metabolic dysregulation and vascular vulnerability contribute substantially to stroke susceptibility, yet subtype-specific metabolic signatures remain incompletely characterized. Employing a nested case-control design within the Taizhou Longitudinal Study, we quantified 296 lipoprotein parameters and 54 metabolites in 1208 stroke-control pairs using nuclear magnetic resonance. Logistic regression estimated subtype-specific associations, and machine learning constructed prediction models for ischemic stroke (IS) and intracerebral hemorrhage (ICH). Distinct metabolic profiles were observed across stroke subtypes. Triglyceride-enriched lipoproteins and several low-molecular-weight metabolites were positively associated with both IS and ICH, whereas apolipoprotein A-related components showed inverse associations, with generally stronger effects observed for IS than for ICH. Age-stratified and interaction analyses revealed age-dependent heterogeneity, especially among histidine and lipoprotein composition measures. To further characterize systemic metabolic vulnerability, we constructed a weighted metabolic risk score (MRS), which was associated with age and statistically accounted for part of the age-stroke association (average causal mediation effects: 0.020 for IS; 0.025 for ICH). MRSs were also positively correlated with age and inflammatory markers, particularly for IS (both P < 0.001). Metabolite-based models improved risk discrimination beyond traditional risk factors for both IS and ICH. These findings identify subtype-specific metabolic signatures of stroke and suggest that circulating metabolomic profiles reflect age-associated metabolic alterations relevant to stroke susceptibility beyond traditional cardiometabolic risk factors.

PMID:42329535 | DOI:10.1007/s11357-026-02374-w

Minim Invasive Ther Allied Technol. 2026 Jun 22:1-9. doi: 10.1080/13645706.2026.2686989. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to investigate and compare the postoperative effects of vaginal natural orifice transluminal endoscopic surgery (vNOTES) and conventional laparoscopy on patients’ sexual function, quality of life, and self-esteem for benign indications.

METHODS: Data from patients who underwent hysterectomies and tubal surgeries using either vNOTES or conventional laparoscopy between January 2022 and August 2023 were analyzed and compared. The primary outcomes were sexual function, quality of life, and self-esteem, assessed both preoperatively and at 3 months post-surgery. Other outcomes of interest, such as surgical success, duration of surgery, complication rates, and postoperative pain, were also included.

RESULTS: Among the women included in the study, 105 (34.8%) underwent total laparoscopic hysterectomy (TLH), 63 (20.9%) underwent vNOTES hysterectomy (VH), 53 (17.5%) underwent laparoscopic tubal surgery (LTS), and 81 (26.8%) underwent vNOTES tubal surgery (VTS). Postoperative Short Form-12 (SF-12) Physical Component Summary (PCS) scores improved significantly in the hysterectomy groups (TLH: 41.16 ± 4.85; VH: 39.68 ± 4.73; p = 0.001). Similarly, Mental Component Summary (MCS) scores also improved postoperatively (TLH: 42.54 ± 5.05; VH: 39.68 ± 4.26; p = 0.001). In the tubal surgery groups, postoperative PCS scores were 42.87 ± 3.38 for LTS and 41.6 ± 3.25 for VTS, with significant improvements observed in both LTS (p = 0.033) and VTS (p = 0.002). However, postoperative MCS changes were not statistically significant for either LTS (p = 0.808) or VTS (p = 0.072). Postoperative Female Sexual Function Index (FSFI) scores increased significantly in both hysterectomy groups (TLH: 20.73 ± 6.26; VH: 21.52 ± 5.23; p = 0.001). Preoperative FSFI scores were similar between the LTS (23.67 ± 6.88) and VTS (23.75 ± 3.26) groups (p = 0.741). Postoperatively, mean FSFI scores increased to 26.98 ± 5.35 in the LTS group and 29.95 ± 4.31 in the VTS group, demonstrating significant improvement (p = 0.001). On the Rosenberg Self-Esteem Scale, only the VH group showed a significant postoperative improvement (p = 0.001).

CONCLUSIONS: The vNOTES procedures yielded results comparable to those of the control group while demonstrating notable improvements in patient-centered outcomes, including sexual function, quality of life, and self-esteem, alongside favorable perioperative surgical outcomes.

PMID:42325077 | DOI:10.1080/13645706.2026.2686989

Natl Med J India. 2026 Jul-Aug;39(4):257-260. doi: 10.25259/NMJI_383_2024.

ABSTRACT

Background Workplace violence is a critical occupational hazard faced by healthcare professionals worldwide, adversely affecting their mental well-being and the quality of healthcare. Assessing the situation and how junior doctors deal with it is critical. We assessed the prevalence of workplace violence against junior doctors in a tertiary care hospital in Manipur and explored coping strategies amongst those who experienced it. Methods A mixed-method study was conducted from October to November 2023 amongst junior doctors. Data were collected using a self-administered questionnaire and in-depth interviews were conducted amongst those who had experienced workplace violence. Descriptive statistics and Chi-square test were used. p<0.05 was considered statistically significant. Thematic analysis was done to identify codes, categories and themes. Results Of the 124 participants, 55 (44.4%) had experienced workplace violence. Verbal violence was the most common. It was significantly higher among non-academic junior residents (p=0.005) than among interns and those working shifts (p=0.017). Thematic analysis also showed that perpetrators of violence were mainly patients or their relatives and were caused by miscommunication or lack of supplies. During such incidents, they attempted to avoid the situation or sought help from colleagues, and seeking support and disengagement were crucial in coping with the crisis. Conclusion Nearly half the junior doctors experienced workplace violence. A positive work environment for junior doctors with measures to prevent workplace violence is needed. Effective coping mechanisms are crucial during and after a crisis to navigate the incident and its aftermath.

PMID:42325045 | DOI:10.25259/NMJI_383_2024

Natl Med J India. 2026 Jul-Aug;39(4):235-238. doi: 10.25259/NMJI_536_2024.

ABSTRACT

Background Diabetic foot ulcers are an important problem for people with diabetes mellitus. We aimed to determine the mortality rate in patients with diabetic foot ulcers and assess the relationship between mortality, the Wagner classification of diabetic foot, and biochemical parameters, such as glucose, haemoglobin A1c (HbA1c), and lipid profile. Methods We included patients with diabetic foot ulcers treated at a training and research hospital from April 2019 to June 2022. We compared patients who died during this period and those who were alive to determine the mortality rate and assess predictive factors for mortality. Results We included 170 patients in the study; their mortality rate was 29.4%. The Wagner classification did not reveal a statistically significant difference in mortality (p=0.334). However, a statistically significant association was found between mortality and the duration of diabetes (p=0.036), uric acid levels and creatinine values (p<0.05). Although the median HbA1c levels were higher in those who were alive compared with the deceased, this did not affect mortality. Conclusion The Wagner classification for diabetic foot ulcers did not show any correlation with mortality. Instead, blood glucose, creatinine, and aspartate aminotransferase values predicted mortality in people with diabetic foot.

PMID:42325033 | DOI:10.25259/NMJI_536_2024

Natl Med J India. 2026 Jul-Aug;39(4):218-223. doi: 10.25259/NMJI_617_2023.

ABSTRACT

Background Hypertension is a major global threat associated with adverse cardiovascular events, especially in the Asian population. Ambulatory blood pressure monitoring (ABPM) is a valuable tool in diagnosis and management of hypertension and is predictive of future cardiovascular events. We assessed the feasibility of ABPM and generated preliminary normative data specific to the Indian population. Methods The circadian profile of 24-hour blood pressure (BP) in 53 healthy subjects was studied in their natural settings. Various circadian parameters like midline estimating statistic of rhythms (MESOR), 24-hour average BP, awake hours average BP, sleep hours average BP, % dip in systolic BP, and morning surge in BP were studied. Results BP and heart rate followed a sinusoidal pattern, with almost all the subjects having significant Cosinor rhythm. ABPM was generally well-tolerated, with no major discomfort, limited restrictions on daily activities, and the values of ABPM parameters in this population matched those of other populations. Conclusion ABPM is feasible and acceptable in India and follows a sinusoidal pattern in healthy young adults, similar to other populations.

PMID:42325022 | DOI:10.25259/NMJI_617_2023