Tag: pubmed

Wiad Lek. 2026;79(4):755-762. doi: 10.36740/WLek/216923.

ABSTRACT

OBJECTIVE: Aim: To investigate the clinical and laboratory features of breast cancer with the progression of the tumour process, after complex treatment, depending on the stage of the disease and the molecular type of the tumour, and to determine the prognostic value of each factor.

PATIENTS AND METHODS: Materials and Methods: A retrospective analysis of 701 outpatient records of patients with breast cancer in the long term, after complex treatment, was performed. Patients, depending on the presence of verified breast cancer progression, were divided into two groups – 472 (67.3%) patients ‘without tumour progression’ and 229 (32.7%) patients ‘with tumour progression’. The informativeness of the studied indicators and diagnostic coefficients was determined using the Kullback method. The results were statistically processed using Microsoft Excel spreadsheets and the PAST statistical processing software package.

RESULTS: Results: Breast cancer progression occurs more often at stage III of the disease, in Lum.-B, Her/2new+, and Triple-negative tumour types. The progression of breast cancer is characterized by a relatively more extended history of the disease, a larger size of the primary tumour, and a higher percentage of comorbidities. The study of the informativeness of the studied indicators and diagnostic coefficients made it possible to form a table of prognosis of possible progression of breast cancer after complex treatment.

CONCLUSION: Conclusions: The prognostic model of breast cancer progression enables to obtain the prediction of the absence of tumour progression, uncertain prognosis, and the appearance of the latter, with the sensitivity (Se=75%) and specificity (Sp=75%) of this model.

PMID:42139613 | DOI:10.36740/WLek/216923

Wiad Lek. 2026;79(4):745-754. doi: 10.36740/WLek/216921.

ABSTRACT

OBJECTIVE: Aim: The aim of the study is to determine the effectiveness of psychological preparation methods for future specialists in the security and defense sector in extreme conditions, specifically evaluating emotional and cognitive reactions to stress factors, and exploring the potential of human resources in these conditions to enhance the effectiveness of professional activities.

PATIENTS AND METHODS: Materials and Methods: The study involved cadets from Dnipro State University of Internal Affairs, divided into two groups: Group 1 (control, n=120, mean age 18.86±1.25) received standard training, while Group 2 (experimental, n=120, mean age 18.73±1.19) underwent 10 months of specialized training for extreme conditions.

RESULTS: Results: A special training program with crisis models, such as “Technogenic disaster in a combat zone,” led to a statistically significant difference between the control and experimental groups (p<0.05) after using the Stress Resistance Scale. The Cattell test (16 RF) showed that the experimental group had a higher emotional stability score compared to the control group. Emotional stability test results revealed lower anxiety levels in the experimental group (p<0.01). A framework for “Human Potential Development through Assessment and Adaptation” was developed, focusing on emotional and cognitive reactions. Practical recommendations were provided to improve training programs and enhance psychological resilience for future specialists in the security and defense sector.

CONCLUSION: Conclusions: Improving special training programs for future specialists in the security and defense sector should integrate physical, cognitive, and psychological aspects, considering individual traits. A systemic approach, including psychological preparation and stress management skills, will enhance psychological resilience, essential for success in extreme conditions.

PMID:42139612 | DOI:10.36740/WLek/216921

Wiad Lek. 2026;79(4):690-699. doi: 10.36740/WLek/218738.

ABSTRACT

OBJECTIVE: Aim: To demonstrate the effects of hydrogen-rich water (HRW) on hydration by examining hematocrit, blood viscosity, and urine osmolality.

PATIENTS AND METHODS: Materials and Methods: Hydrogen Evodrop rich water (HEW), produced from a patented device with hydrogen concentration therein 900-1200 ppb or 0.9-1.2 ppm, ORP ranging from -450 to -580 mV, and pH=7.1-7.3. Blood viscosity, hematocrit and urine osmolality had been determined in 10 volunteers (five women and five men) during the 21-day period of HEW intake, under standard dietary conditions.

RESULTS: Results: No evidence of erythrocyte agglutination or morphological abnormalities was observed. Urine osmolality in both men and women decreased after HEW consumption, likely due to improved hydration. However, osmolality before the consumption was higher in men compared to women. Both men and women exhibited statistically significant changes in hematocrit and blood viscosity parameters after consuming HEW, which decreased. This suggests improved hydration and reduced blood viscosity.

CONCLUSION: Conclusions: These results suggest that measurable hydration effects in the human body may be achieved through regular intake of HEW. The findings of the research support the benefit of the use of HEW in promoting body hydration. The analysis suggests that hematocrit is more closely associated with other factors, such as hydration status and plasma volume following HEW consumption. HEW consumption consistently affected urine osmolality, which may reflect in overall hydration status. Overall, HEW intake produced consistent changes in key hematological and renal hydration markers, indicating favorable effects on blood fluidity and water balance.

PMID:42139605 | DOI:10.36740/WLek/218738

JBRA Assist Reprod. 2026 May 15. doi: 10.5935/1518-0557.20250185. Online ahead of print.

ABSTRACT

OBJECTIVE: Platelet-rich plasma (PRP) is currently utilized in several clinical fields, including infertility treatment. This study aimed to evaluate the effectiveness of intraovarian PRP injections in improving reproductive outcomes in women who have previously experienced unsuccessful IVF cycles.

METHODS: In this Open-label Single-Arm Longitudinal clinical trial study, a number of 15 infertile patients, POSEIDON groups 1 and 3 (poor ovarian reserve), with no history of hematological, immunological, hormonal disorders, chromosomal and genetic abnormalities, and kidney failure were investigated. PRP was prepared using a standardized protocol and administered at a dose of 2.5 cc per ovary. Key reproductive parameters, including follicle development, oocyte quality, embryo formation, and endometrial thickness were measured before PRP treatment, immediately after treatment, and three months post-treatment. After collecting and sorting, the data was analyzed using SPSS Ver.26 statistical software.

RESULTS: Nearly 27% of the participants achieved pregnancy, despite previous IVF failures. The findings revealed significant improvements in the median number of follicles larger than 17 millimeters, the number of oocytes, fertilizable oocytes, and endometrial thickness following PRP treatment (p<0.05). The number of embryos formed, as well as the frequency of A or B grade embryos, also increased significantly at three months post-PRP (p<0.001).

CONCLUSIONS: Intraovarian PRP injections show potential as an effective treatment for improving reproductive outcomes in women with a history of IVF failures. However, further research with larger sample sizes, control groups, and extended follow-up periods is needed to validate these findings and establish PRP as a standard therapy in reproductive medicine.

PMID:42139603 | DOI:10.5935/1518-0557.20250185

Ophthalmic Surg Lasers Imaging Retina. 2026 May;57(5):310-318. doi: 10.3928/23258160-20260320-01. Epub 2026 Apr 21.

ABSTRACT

BACKGROUND AND OBJECTIVE: This study reports outcomes of secondary intraocular lens (IOL) surgeries from a vitreoretinal service.

PATIENTS AND METHODS: A retrospective cohort study was performed of consecutive patients undergoing secondary IOL implantation between January 2017 and September 2024 by five vitreoretinal surgeons at a single tertiary academic center. Eyes were categorized by secondary IOL type: sulcus IOL, scleral fixated IOL (SFIOL, eg, Yamane technique), scleral sutured IOL (SSIOL, eg, Akreos lens), and anterior chamber IOL (ACIOL). Primary outcomes include intraoperatively identified retinal breaks and postoperative retinal detachments. Secondary outcomes include anesthesia type, case duration, and rates of lens repositioning or exchange due to rotation, dislocation, or other complication, endolaser for retinal tufts/tags, rescued IOL, iridotomy, combination silicone oil removal, air or gas used, and fibrin sealant use. Comparisons between categorical variables were made using the chi-square test of independence or the likelihood ratio if chi-square assumptions were not met. Comparisons between continuous variables were analyzed using Mann-Whitney U or Kruskal-Wallis ANOVA. Equal variances were not assumed. P values < .05 were considered statistically significant, with Bonferroni correction applied for multiple comparisons.

RESULTS: A total of 138 eyes from 136 patients were included in the study (42 ACIOL, 27 sulcus IOL, 43 SFIOL, 26 SSIOL). Retinal tears or holes were intraoperatively identified in nine (6.5%) eyes. Of those, two (1.4%) also had focal retinal detachments (RD). Retinal tags and other suspicious areas of retina were prophylactically lasered in nine (6.5%) cases, and 16 (11.6%) eyes received endolaser retinopexy. Postoperative RD occurred in three cases (2.2%). Eyes with a history of RD or PPV were associated with a lower rate of intraoperatively identified retinal breaks (P = .01 and 0.008, respectively). Rates of iridotomy differed significantly between IOL types (P < .001). ACIOLs were associated with worse vision at POM3 and higher rates of postoperative CME (P = .002). SSIOLs were associated with higher rates of vitreous hemorrhage (P < .001). Among SFIOL cases, three (7.0%) developed severe IOL rotation, and all required repeat IOL surgery.

CONCLUSIONS: Secondary IOL surgery performed by vitreoretinal surgeons was associated with a lower rate of intraoperative retinal breaks and postoperative RD compared to previous reports. There was a trend towards lower rates of intraoperatively identified retinal breaks in eyes with prior RD or PPV. Some IOL types were associated with higher rates of postoperative complications such as CME and vitreous hemorrhage.

PMID:42139587 | DOI:10.3928/23258160-20260320-01

Int J Urol. 2026 May;33(5):e70473. doi: 10.1111/iju.70473.

ABSTRACT

OBJECTIVE: Pelvic organ prolapse (POP) is a common pelvic floor disorder in postmenopausal women, yet no biomarkers currently exist to predict its development. This study aimed to investigate the relationship between sex hormone levels, particularly androgens, and the severity of POP in postmenopausal women.

METHODS: We conducted a prospective observational study including 109 postmenopausal women with POP and 66 age-matched women without POP (control group) at Saga University Hospital. POP severity was classified using the Pelvic Organ Prolapse Quantification (POP-Q) system. Salivary free testosterone and 17β-estradiol were measured, along with serum dehydroepiandrosterone sulfate (DHEA-S), using enzyme-linked immunosorbent assays. Clinical characteristics and lower urinary tract symptoms were also assessed. Statistical comparisons were performed using t-tests, Chi-square tests, and Pearson correlation analysis.

RESULTS: The POP group had significantly higher BMI and parity and reported more severe lower urinary tract symptoms than the control group. Salivary free testosterone levels were significantly decreased, and serum DHEA-S levels were significantly increased in the POP group (p = 0.0157 and p = 0.0082, respectively), while estradiol levels showed no significant difference. Advanced POP (stages III-IV) was associated with further reductions in free testosterone. DHEA-S levels were unexpectedly higher in POP stages II and III compared to controls.

CONCLUSION: Reduced levels of circulating androgens, particularly Salivary free testosterone, may be associated with POP development and severity. Salivary free testosterone could serve as a non-invasive biomarker for POP risk stratification. Further longitudinal and multi-institutional studies are needed to clarify the role of androgens in POP pathophysiology.

PMID:42138067 | DOI:10.1111/iju.70473

J Dent Educ. 2026 May 15. doi: 10.1002/jdd.70238. Online ahead of print.

ABSTRACT

PURPOSE: This study evaluated the effectiveness of combining a digital real-time evaluation system and virtual simulation system in enhancing tooth preparation skills for preclinical training.

METHODS: A total of 32 students from the Class of 2020 were trained using the traditional phantom head simulator. In contrast, 28 students from the Class of 2021 and 32 students from the Class of 2022 completed the training and the first ceramic crown preparation test and were assigned to Groups A or B, receiving training either with the digital real-time evaluation system or with the virtual simulation system, respectively. After completing the second incisor crown preparation test, training tasks were exchanged for a month, concluding with a final incisor crown preparation test and questionnaire. Students from the Class of 2022 completed a multidomain well-being survey to evaluate their perceived stress levels and overall well-being.

RESULTS: The 2021 and 2022 cohorts scored significantly higher than the 2020 cohort in the final test. Groups A and B (the 2021 and 2022 cohorts) showed statistically significant sequential improvement across the three tests. However, no significant difference was observed between the performance of Group A and Group B in any individual test (p > 0.05). Students expressed stronger support for the implementation of the digital real-time evaluation system relative to the virtual simulation system.

CONCLUSIONS: The combination of the digital real-time evaluation system with virtual simulation system enhances the manual dexterity of dental students in ceramic crown preparation. The sequence in which these two digital methods are implemented does not influence the effectiveness of preclinical tooth preparation training, suggesting that this combined approach may serve as a flexible and effective strategy for preclinical education. A positive association was observed between students’ final test scores in tooth preparation and their emotional well-being.

PMID:42138060 | DOI:10.1002/jdd.70238

Psychol Med. 2026 May 15;56:e154. doi: 10.1017/S0033291726103663.

ABSTRACT

The nosological status and psychopathology of delusional disorder have been a subject of debate since Kraepelin distinguished it from schizophrenia and affective psychoses. Contemporary diagnostic manuals define delusional disorder primarily by the presence of delusions, offering limited guidance for its differentiation from schizophrenia. Notably, DSM-5 introduced a major, seemingly unexplained change by allowing bizarre delusions in delusional disorder, contrary to ICD-11, prior DSM editions, and classical descriptions. This narrative review revisits the seminal works of six classical authors (Kraepelin, Jaspers, Kretschmer, Sérieux and Capgras, and De Clérambault), who shaped the concept of delusional disorder (paranoia), and their detailed clinical cases of the disorder. All considered delusional disorder to be an independent psychotic disorder, characterized by chronic, systematized, nonbizarre delusions, preservation of personality, and minimal hallucinations, with a largely intact experiential framework outside of the delusional theme. Additional features such as delusional misinterpretations, illusions, and false memories were also emphasized in the classical literature. We examined these authors’ clinical cases of delusional disorder for the presence of delusional features characteristic of schizophrenia (delusional mood, first-rank symptoms, autistic-solipsistic delusions, and double bookkeeping), which index alterations in the structure of experience rather than mere delusional content. Such delusions were rarely found in the classical clinical cases of delusional disorder. Our findings highlight psychopathological distinctions between delusional disorder and schizophrenia, suggesting that schizophrenia involves a qualitative alteration of the experiential framework that is absent in delusional disorder. These findings raise concerns about the validity of the DSM-5 change, allowing bizarre delusions in delusional disorder.

PMID:42138058 | DOI:10.1017/S0033291726103663

Otolaryngol Pol. 2025 Nov 25;79(6):9-14. doi: 10.5604/01.3001.0055.3301.

ABSTRACT

&lt;b&gt;Introduction:&lt;/b&gt; Postural stability depends on the integration of various neural circuits, including somatosensory, motor, visual, vestibular, and cognitive systems, which enable flexible posture and gait control. However, the understanding of vestibular otolith function and its brain connections remains limited.&lt;b&gt;Aim:&lt;/b&gt; To elucidate the anomalies of cervical vestibular-evoked myogenic potentials (cVEMPs) and their clinical correlation with symptoms associated with brainstem involvement in individuals with Parkinson’s disease (PD).&lt;b&gt;Methods:&lt;/b&gt; This prospective, observational, case-control study consisted of 62 subjects: 31 idiopathic PD patients (cases) and 31 healthy volunteers (controls). Each participant underwent an otological examination, hearing evaluation, cVEMP test, and pull test. We also recorded the affected side, previous frequent falls, and illnesses duration.&lt;b&gt;Results:&lt;/b&gt; The mean Revised Movement Disorder Society Unified Parkinson’s Disease Rating Scale Section III score was 14.10 8.42, and the mean scale of Hoehn and Yahr was 1.77 0.62. A statistically significant difference (P &lt; 0.001) was found between the two groups in cVEMP identification, with presence of response in almost two thirds of Parkinson’s disease patients. In the case group, there was a considerable delay in the mean P13 and N23 latencies (P &lt; 0.001) and a significant reduction in the mean P13-N23 amplitude (P = 0.001).&lt;b&gt;Conclusions:&lt;/b&gt; cVEMP is a quick, easy, and noninvasive method to investigate brainstem dysfunction and the pathophysiological dynamics of the saccular section of the otolith and its central connection in patients with PD.

PMID:42138044 | DOI:10.5604/01.3001.0055.3301

J Eval Clin Pract. 2026 Jun;32(4):e70444. doi: 10.1111/jep.70444.

ABSTRACT

RATIONALE: Acutely hospitalised patients may be medically ready for discharge but face psychosocial and other non-medical barriers to returning home. This increases their length of stay and may lead to exposure to hospital associated risks such as hospital-acquired infections. To address these non-medical delays, a transdisciplinary allied health service (the Flying Squad, n = 1.9 Full Time Equivalent professionals) was established at The Royal Melbourne Hospital.

AIMS AND OBJECTIVES: To evaluate the feasibility (demand, implementation, practicality, acceptability and limited efficacy) of this service.

METHOD: A single-site observational study was conducted to determine the demand (number of referrals and patient characteristics including indicators of complexity via the Blaylock Risk Assessment Screening Score; BRASS), implementation (timing of referrals and home visits completed), practicality (case examples, adverse events), acceptability (compliments and complaints) and limited efficacy (estimated number of hospital days saved through the Flying Squad intervention [anticipated minus actual length of stay], discharge destination, hospital length of stay and 28-day readmissions).

RESULTS: Over 12 months, 147 participants were seen by the Flying Squad professionals (median age 64 years [Interquartile Range 51-78 years], 61% male, on day 14 [Interquartile age 7-24] of their hospital admission). Median BRASS scores were 14 (Interquartile Range 9-19] indicating “at risk of requiring extended discharge planning”. Fifty-four home visits were completed for 34 (23%) participants, and one adverse event was reported (fall with no injuries during a home visit). The service won two hospital Awards for Excellence. The median length of hospital stay was 26 [13-45] days; 80 (54%) participants were discharged directly home, and 13 (9%) were readmitted after 28 days. It was estimated that the Flying Squad saved 756 hospital days over 12 months.

CONCLUSION: The Flying Squad was a feasible service that may assist with addressing non-medical barriers to discharge.

PMID:42138035 | DOI:10.1111/jep.70444