Tag: pubmed

Ann Saudi Med. 2026 Jan-Feb;46(1):20-31. doi: 10.5144/0256-4947.2026.20. Epub 2026 Jan 22.

ABSTRACT

BACKGROUND: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a rare and severe autoimmune disease characterized by pauci-immune necrotizing vasculitis.

OBJECTIVES: The study aims to explore the frequency, clinical characteristics, and management of AAV patients in two tertiary centers in the United Arab Emirates (UAE) over 17 years.

DESIGN: A retrospective observational case series.

SETTING: Two tertiary centers in the UAE.

METHODS: Patients diagnosed with granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), or eosinophilic granulomatosis with polyangiitis (EGPA) from 2008 to 2024 were included. Demographic, clinical, laboratory, histopathological information, treatment, complications, relapses, and mortality were collected. ANCA testing for anti-proteinase 3 (PR3) and anti-myeloperoxidase (MPO) antibodies was performed using enzyme-linked immunosorbent assays. Descriptive statistical analysis was performed to summarize the data.

MAIN OUTCOME MEASURES: Subtype distribution, organ involvement, ANCA positivity, relapse, and mortality rates.

SAMPLE SIZE: Twenty-six patients.

RESULTS: We identified 26 AAV patients with a median age of 52.5 years. The majority were females (58%, n=15), and half were locals. The most common AAV subtype was microscopic polyangiitis (50%, n=13), followed by granulomatosis with polyangiitis (38%, n=10) and eosinophilic granulomatosis with polyangiitis (12%, n=3). ANCAs tested positive in nearly all of these cases. The most common clinical manifestations of AAV were constitutional symptoms with renal and pulmonary involvement. The induction therapy included corticosteroids, rituximab, cyclophosphamide, mycophenolate mofetil, and plasma exchange. The most prescribed maintenance medications were corticosteroids and azathioprine. The overall relapse rate was 31%, and the overall mortality rate was 19% (n=5).

CONCLUSION: In our cohort, MPA was the most common subtype, being predominantly associated with P-ANCA/MPO-ANCA positivity. Notably, few studies from the Gulf region have addressed this topic. It’s unclear whether this finding reflects low occurrence or potential underdiagnosis and, thus, points to unmet needs and a significant gap in the understanding of AAV. Multicenter studies are needed to validate these results and improve AAV management in Middle Eastern populations.

LIMITATIONS: Retrospective design with small number of participants.

PMID:41562166 | DOI:10.5144/0256-4947.2026.20

Ann Saudi Med. 2026 Jan-Feb;46(1):1-8. doi: 10.5144/0256-4947.2026.1. Epub 2026 Jan 22.

ABSTRACT

BACKGROUND: In pediatric surgical practice, physicians may face malpractice claims leading to substantial compensations and even criminal liability.

OBJECTIVES: To examine the legal processes and responsibilities of physicians by reviewing Supreme Court decisions related to malpractice claims involving pediatric surgeons.

DESIGN AND SETTINGS: A retrospective study based on the online archive of Supreme Court decisions.

PATIENTS AND METHODS: A search was conducted using keywords from the Supreme Court decision search engine. Decisions were reached regarding malpractice claims involving pediatric surgery.

MAIN OUTCOMES MEASURES: The medical procedure that was the subject of the malpractice claim, the resulting damage, the expertise of the physicians, and the reasons for the Supreme Court’s reversal and approval were evaluated.

SAMPLE SIZE: 82 Supreme Court decisions.

RESULTS: Among 82 decisions, circumcision (46%; n=38) was the most common. Appendicitis and testicular torsion followed. Total/subtotal penile amputation was present in 40% (n=15) of circumcisions. Half of the appendicitis cases resulted in death, and all testicular torsion cases resulted in organ loss. General surgeons were the most frequent physicians involved in litigation, accounting for 16% of cases (n=13), followed by pediatric surgeons and general practitioners, each accounting for 15% of cases (n=12). Supreme Courts found physicians at fault in 35% of criminal cases and 38% of civil cases. Deficiencies in expert reports were the reason for reversals in 42% of the decisions.

CONCLUSION: Supreme Courts conduct comprehensive evaluations in malpractice cases, considering factors such as indication, authority, fault status, complication management, and causal link. Physicians’ understanding of these issues will significantly contribute to minimizing malpractice claims.

LIMITATIONS: Retrospective study.

PMID:41562164 | DOI:10.5144/0256-4947.2026.1

Ann Saudi Med. 2026 Jan-Feb;46(1):61-74. doi: 10.5144/0256-4947.2026.61. Epub 2026 Jan 22.

ABSTRACT

BACKGROUND: The comparative effectiveness of intercostal tube drainage (ITD) and less invasive methods in initial pneumothorax management remains uncertain.

OBJECTIVES: To compare ITD with other invasive approaches in adults.

DESIGN: A systematic review and meta-analysis based on PRISMA guidelines, covering twelve studies from nine countries (Iran, UK, Netherlands, USA, Belgium, Kuwait, Norway, Pakistan, Switzerland) published between 1994 and 2021.

MATERIALS AND METHODS: A comprehensive search was conducted in PubMed, and Google Scholar. The study encompassed randomized controlled trials (RCTs), prospective and retrospective analyses with adults presenting pneumothorax. Quality assessment was conducted using the Cochrane risk-of-bias (RoB 2) tool for randomized trials and the MINORS tool for non-randomized studies.

MAIN OUTCOME MEASURES: Immediate success rates, hospital stay durations, complication rates, and recurrence rates at 12 months.

SAMPLE SIZE: A total of 1204 patients were included across 12 studies, ten RCTs (n=932), one prospective (n=60) and one retrospective study (n=212).

RESULTS: Meta-analysis showed no statistically significant differences between the ITD and the less invasive techniques in the immediate success rate (OR: 0.88, 95% CI: 0.47-1.65, P=.69). Also, no difference was noticed in the 1-week success rate (OR: 1.01, 95% CI: 0.6-1.5, P=.96) and recurrence (OR: 1.20, 95% CI: 0.80-1.80, P=.38).

RISK OF BIAS: The RoB was low in 82% of studies assessed by RoB 2 and the study evaluated by MINORS demonstrated a moderate RoB.

HETEROGENEITY: A high statistical heterogeneity was observed (I²=77%).

CONCLUSIONS: ITD and other invasive approaches demonstrated comparable effectiveness, with no significant differences in immediate success, 1-week success, or recurrence rates.

LIMITATIONS: The studies varied widely in design, patient groups, and quality. There were also signs of publication bias and a limited number of high-quality RCTs.

PROSPERO REGISTRATION NUMBER: CRD42024517888.

PMID:41562163 | DOI:10.5144/0256-4947.2026.61

Laryngoscope. 2026 Jan 21. doi: 10.1002/lary.70389. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe the prevalence and morphology of vocal fold contralateral reactive lesions in patients with vocal fold polyps or cysts, and to report disease regression following office-based laryngeal surgery (OBLS).

METHODS: Medical records and video recordings of patients with vocal fold polyps or cysts who underwent OBLS between November 2023 and September 2025 were reviewed. Demographic data included age, gender, history of smoking, history of reflux disease, type of vocal fold pathology, and type of office-based laryngeal procedure. Prevalence, morphology, and disease regression of CRLs were assessed by two otolaryngologists who independently reviewed the video recordings of patients included in this study.

RESULTS: Twenty-six males and 19 females were included in the study. The mean age was 48.9 ± 14.9 years. The prevalence of CRLs was 60%. Most of these lesions were fibrous. Eighteen lesions were treated with ILSI, and 8 lesions were treated with the blue laser and steroid injection. Five patients were lost to follow-up. Analysis of 21 CRLs showed complete disease regression in 52.4% of cases, and partial disease regression in 47.6% of cases. There was no statistically significant difference in disease regression between the two treatment subgroups (p = 0.284). There was a statistically significant difference in total disease regression of the primary lesion between those who had partial vs. complete disease regression of their CRL (p < 0.001).

CONCLUSION: CRLs are common in patients with vocal fold polyps and cysts. All lesions regressed partially or completely following OBLS using the blue laser and/or steroid injection.

PMID:41562156 | DOI:10.1002/lary.70389

Hum Vaccin Immunother. 2026 Dec;22(1):2598691. doi: 10.1080/21645515.2025.2598691. Epub 2026 Jan 21.

ABSTRACT

Prophylactic HPV vaccines are effective against cervical cancer and its precursors, but data on their impact on fertility and pregnancy are limited. This registry-based study examined the association between HPV vaccination and childbirth rates. Study population comprised 6200 HPV- and 1667 hepatitis B-virus (HBV) vaccinated women born in 1992-1993 and an age- and community-aligned cohort of 19,473 unvaccinated women born in 1990-1991. Nearly half of the HPV-vaccinated women participated in a cervical screening trial between ages 22 and 28. Childbirth numbers and rates per 10,000 person-years with 95% confidence interval (CI) were compared across the groups. The mean age at first childbirth ranged between 22.9 and 23.4 years among the vaccinated and unvaccinated women. At the age of 28, the cumulative proportion of all childbirths among HPV-vaccinated and screened cohorts was 2277 (36.7%), among HBV-vaccinated 781 (46.9%) and among unvaccinated reference cohorts 8997 (46.2%). Childbirth rates per 10,000 person years were 306 (95% CI 294-319), 390 (95% CI 364-419) and 385 (95% CI 377-393), respectively. HPV-vaccinated and screened women had lower childbirth rates compared to unvaccinated women at young age, possibly due to sexual counseling that HPV-vaccinated participants got in an overlapping cervical screening trial conducted between ages 22 and 28. This may have postponed their family planning to later ages.

PMID:41562152 | DOI:10.1080/21645515.2025.2598691

Knee Surg Sports Traumatol Arthrosc. 2026 Jan 21. doi: 10.1002/ksa.70275. Online ahead of print.

ABSTRACT

PURPOSE: Dynamic tibiofemoral movements following anterior cruciate ligament reconstruction (ACLR) with quadriceps tendon (QT) autografts have not yet been compared to other autografts. We aimed to compare dynamic anterior tibial translation (ATTd) and internal tibial rotation (ITRd) during jump-landing and walking among patients with QT, bone-patellar tendon-bone (BPTB) and hamstrings tendon (HT) autografts at mid-term follow-up. The secondary aim was to compare lower extremity strength among autografts.

METHODS: Patients were included from a previous randomized controlled trial (randomly received primary ACLR with a QT, BPTB or HT autograft), and were prospectively assessed for additional analyses. Primary outcome measures were side-to-side differences in ATTd and ITRd during the side hop, single-leg hop for distance, triple hop for distance, double-leg drop-jump and walking, measured using 3D optoelectronic motion capture, and statistically analyzed using statistical parametric mapping. Moreover, isometric hamstrings and quadriceps strength limb symmetry index (LSI) were assessed using a dynamometer.

RESULTS: Thirty patients were included at 4.7 ± 1.8 years (range: 1.4-7.2) post-ACLR (n = 10 per autograft; age: 31.0 ± 4.8 years). No significant between-group differences were observed for side-to-side difference in ATTd and ITRd during all dynamic tasks (p > 0.05). QT and BPTB autograft groups demonstrated greater isometric hamstrings strength LSI (QT = 98.4% vs. BPTB = 99.3% vs. HT = 79.0%; p = 0.02) and greater hamstrings/quadriceps strength ratio LSI (QT = 102.0% vs. BPTB = 104.6% vs. HT = 79.6%; p = 0.01) compared to the HT autograft, but quadriceps strength was similar among autografts.

CONCLUSIONS: Patients who underwent ACLR with QT autografts demonstrated similar side-to-side differences in ATTd and ITRd compared to patients with BPTB and HT autografts 5 years post-ACLR, without demonstrating graft-harvest-related strength deficits, whereas patients with HT autografts showed persistent hamstrings weakness. Graft selection should consider persistent hamstrings strength deficits in patients with HT autografts, while ATTd and ITRd are not autograft-dependent. These findings support QT autografts as a viable option for ACLR.

LEVEL OF EVIDENCE: Level II.

PMID:41562143 | DOI:10.1002/ksa.70275

Int J Phytoremediation. 2026 Jan 21:1-14. doi: 10.1080/15226514.2026.2617380. Online ahead of print.

ABSTRACT

Significant environmental damage to aquatic ecosystems is caused by heavy metals, and the situation necessitates strategies against the contaminants. The present study was intended to explore Salvinia molesta‘s potential for the phytoremediation of contaminating water to remove three metals: chromium (Cr), nickel (Ni), and cadmium (Cd), with an emphasis on the influence of chemical amendments, ethylene diamine disuccinic acid (EDDS) and sodium dodecyl sulfate (SDS), applied independently. Plants were treated for a period of 60 days with single and combined metal solutions supplemented with EDDS (0.05-0.2%) and SDS (0.5-2%), and responses were measured through morphological factors and biochemical indicators, including bioaccumulation factor (BAF) with translocation factor (TF) used cautiously due to the floating habit of S. molesta. It was observed that S. molesta was capable of substantial heavy metal accumulation, with the highest accumulation recorded under EDDS amended and SDS amended treatments at elevated metal concentrations. EDDS treatments primarily enhanced metal bioavailability and uptake while maintaining plant growth and physiological stability under moderate metal stress, whereas SDS treatments, particularly at higher concentrations, resulted in increased metal accumulation accompanied by reductions in biomass, chlorophyll content and protein levels, indicating stress driven accumulation linked to altered membrane permeability. The application of EDDS or SDS resulted in higher metal uptake compared to untreated controls, with BAF values reaching 3.8 for Cr, 4.2 for Ni, and 3.5 for Cd; however, maximum accumulation under SDS treatments did not consistently correspond to biologically sustainable phytoremediation performance. Statistical analysis showed significant differences (p < 0.05) between treatments and control in metal bioavailability following amendment application, highlighting a dose-dependent tradeoff between metal uptake efficiency and plant health. This study represents the first integrated evaluation of EDDS and SDS under multi-metal (Cr-Ni-Cd) conditions in S. molesta, addressing a major gap in chemical-assisted phytoremediation research. Future work should be aimed at determining the optimum concentrations of these chemical amendments to facilitate the scale-up of phytoremediation projects.

PMID:41562135 | DOI:10.1080/15226514.2026.2617380

Appl Psychol Health Well Being. 2026 Feb;18(1):e70099. doi: 10.1111/aphw.70099.

ABSTRACT

Adolescents across the globe experience increasing demands for care, and the mental health of Polish and Ukrainian youth is especially concerning, due to ongoing war and displacement. This study explores the acceptability, feasibility, and short-term effects of a digital, self-guided single-session intervention (SSI) for improving the mental health of Polish and Ukrainian youth, including Ukrainian refugees in Poland. A non-randomized, open pilot trial was conducted from March to June 2024, involving youth aged 10-18 years from Poland and Ukraine. Participants completed an SSI after cultural adaptations and translation into Polish and Ukrainian. Measures assessed hopelessness, self-hate, agency, perceived control, and acceptability. Statistical analyses included paired t-tests and effect size calculations to examine intervention effects. Among 176 Polish and 139 Ukrainian youth who began the intervention, completion rates were 80.7% and 62.6%, respectively. Polish participants exhibited significant improvements in hopelessness, self-hate, perceived control, and agency, while Ukrainian youth showed moderate improvements in perceived control but limited change in other mental health indicators. Acceptability ratings were high across all youth. Findings suggest SSIs hold potential as a scalable option for mental health care. However, the varied outcomes across the two groups highlight the need for further refinement, especially for displaced youth.

PMID:41562131 | DOI:10.1111/aphw.70099

Circulation. 2026 Jan 21. doi: 10.1161/CIR.0000000000001412. Online ahead of print.

ABSTRACT

BACKGROUND: The American Heart Association annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and cardiovascular-kidney-metabolic syndrome) that contribute to cardiovascular health. The 2026 Heart Disease and Stroke Statistics Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS: The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistics Update with review of published literature through the year before writing. The 2026 Statistics Update is the product of a full year’s worth of effort in 2025 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year’s edition includes a new chapter on cardiovascular-kidney-metabolic syndrome, as well as an expanded chapter on tobacco and nicotine use and exposure.

RESULTS: Each of the chapters in the Statistics Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS: The Statistics Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

PMID:41562125 | DOI:10.1161/CIR.0000000000001412

Pain Rep. 2026 Jan 16;11(1):e1401. doi: 10.1097/PR9.0000000000001401. eCollection 2026 Feb.

ABSTRACT

INTRODUCTION: A history of childhood maltreatment (CM) and trauma-related symptoms has been associated with the development of pain conditions. Individuals raised in Residential Youth Care (RYC) often report significant exposure to CM, high rates of posttraumatic stress disorder (PTSD), and an increased risk for various adverse health outcomes, making them a high-risk group for pain symptoms. Objectives: This study examines the role of CM, trauma, and symptoms of PTSD and dissociation for pain indicators.

METHODS: As part of the 10-year follow-up project, N = 157 individuals (68.15% women) with a history of RYC were recruited. Pain symptoms were assessed using standardized questions from a large-scale population-based study in Norway, recording headache, pain lasting at least 3 months, pain intensity, as well as continuous muscle and joint pain. Childhood maltreatment was measured using the Maltreatment and Abuse Chronology of Exposure scale, and dissociative symptoms through self-report online survey. Trauma load and symptoms of PTSD were evaluated using clinician-administered interviews based on the PTSD Checklist, aligned with Diagnostic and Statistical Manual of Mental Disorders-5 criteria.

RESULTS: We confirmed associations between CM, trauma load and pain intensity, and body pain distribution in a high-risk group, while we did not find associations for headache. Symptoms of PTSD and dissociation predominantly mediated the relationship between CM/trauma load and pain symptoms.

CONCLUSION: A history of CM and trauma-related symptoms are crucial for understanding pain symptoms in individuals transitioning to adulthood after RYC. Posttraumatic stress disorder and dissociation symptoms may contribute to development and exacerbation of pain symptoms and may be a target for intervention.

PMID:41562117 | PMC:PMC12815552 | DOI:10.1097/PR9.0000000000001401