Tag: pubmed

Int J Urol. 2026 Aug;33(8):e70602. doi: 10.1111/iju.70602.

ABSTRACT

BACKGROUND: Salvage radical prostatectomy (sRP) is a potentially curative treatment for localized recurrence after radiation therapy for prostate cancer; however, nationwide real-world perioperative outcomes remain unclear.

METHODS: We conducted a retrospective descriptive study using the Japanese National Clinical Database (NCD). Patients who underwent sRP after radiation therapy were identified, and perioperative, functional, and pathological outcomes were summarized descriptively according to surgical approach and prior radiation modality without comparative statistical analysis.

RESULTS: A total of 162 patients were included. The median age was 71 years, and high-risk features were common (Gleason score ≥ 8, 49.4%; pathological stage ≥ pT3, 45.7%). Robot-assisted surgery was performed in 88.3% of cases. The median operative time was 254.5 min, and estimated blood loss was 101 mL. Blood transfusion was required in 4.3% of patients. Major complications (Clavien-Dindo grade ≥ III) occurred in 4.9%, with one postoperative death (0.6%). Operative time and blood loss tended to be higher in patients with prior BT than EBRT, whereas major complication rates were comparable. Positive surgical margins were observed in 24.1%, and extraprostatic extension in 36.4%. Early continence recovery was limited, with 27.2% of patients using 0-1 pad/day at 1 month.

CONCLUSIONS: This nationwide NCD study provides contemporary real-world data regarding perioperative outcomes after salvage radical prostatectomy in Japan. Although perioperative morbidity appeared acceptable in appropriately selected patients, these findings should be interpreted descriptively because formal comparative analyses were not performed.

PMID:42603088 | DOI:10.1111/iju.70602

Int Arch Otorhinolaryngol. 2026 Aug 14;30(3):1-11. doi: 10.1055/a-2852-9524. eCollection 2026 Jul.

ABSTRACT

INTRODUCTION: In some patients with conductive or mixed hearing loss, or single-sided deafness, bone conduction implants (BCIs) offer an effective treatment; and scar appearance is a relevant factor in the overall outcome.

OBJECTIVE: To compare scar appearance and alopecia between linear and curved scalp incisions in patients undergoing transcutaneous BCIs surgery.

METHODS: An observational, cross-sectional study was conducted at a tertiary referral center in patients who underwent transcutaneous BCI. Postoperative follow-up period was between 6m to 3y. Scar evaluation was performed using the Patient and Observer Scar Assessment Scale (POSAS) and the Vancouver Scar Scale (VSS). Alopecia was defined as absence of hair follicles within 2 mm of the incision line. Statistical comparisons between linear and curved incisions groups were conducted, as well as multivariate analysis with logistic regression models.

RESULTS: Eighty-four cases were analyzed: 28 underwent linear incisions and 56 underwent curved incisions. Patients reported significantly better scar appearance with linear incisions in POSAS, p = 0.035. Alopecia occurred less frequently among patients who received the Bonebridge implant (OR = 0.113; 95% CI: 0.027-0.478; p = 0.003). No statistically significant differences were found in observer assessment of POSAS or VSS scores.

CONCLUSION: Linear incisions may offer advantages in scar appearance with transcutaneous BCIs. Certain scar characteristics may also be influenced by the type of device and the surgical approach required for its placement, making it challenging to isolate this effect from that attributed solely to type of incision. These results highlight the need to consider both cosmetic factors and auditory outcomes in surgical planning.

PMID:42603080 | PMC:PMC13476099 | DOI:10.1055/a-2852-9524

O G Open. 2026 Aug 13;3(4):e196. doi: 10.1097/og9.0000000000000196. eCollection 2026 Aug.

ABSTRACT

OBJECTIVE: To describe the cervical cancer screening preferences of transgender and gender-diverse individuals presenting for care at the study institution.

METHODS: We administered a cross-sectional survey to a convenience sample of 50 patients 18-65 years of age assigned female at birth and self-identifying as transgender or gender-diverse (TGD) from a single academic endocrinology clinic. The 30-item survey, adapted from previous research in this population, included gender-neutral language and various multimedia. We used descriptive statistics to characterize preferences for cervical cancer screening in the form of a ranked list, as well as responses regarding comfort with self-swabs and past experiences with screening. We also performed a post hoc content analysis of free-text responses related to respondent cervical cancer screening preferences.

RESULTS: We enrolled 51 patients, and 50 completed the survey (98% response rate). Overall, 56.0% of respondents chose human papillomavirus (HPV) self-swab as their first-choice cervical cancer screening preference, followed by provider-collected HPV swab (18.0%), decline screening (14.0%), and Pap test (12.0%). Themes identified from free-text responses around cervical cancer screening included fear of provoking gender dysphoria, value of preventive health care, appreciation of privacy with self-swabs, and desire for gender-diverse-competent health care teams.

CONCLUSION: In this sample of TGD patients, the majority of respondents preferred self-collected HPV tests for cervical cancer screening, and some respondents preferred to forego screening altogether. Participants emphasized the importance of preventive health care and clinician competency in transgender health and trauma-informed care.

PMID:42603067 | PMC:PMC13475924 | DOI:10.1097/og9.0000000000000196

Ann Pediatr Cardiol. 2026 Jul-Aug;19(4):389-395. doi: 10.4103/apc.apc_153_25. Epub 2026 Jul 31.

ABSTRACT

INTRODUCTION: Total anomalous pulmonary venous drainage (TAPVD) constitutes approximately 1.5% of all congenital heart defects. Surgical correction has traditionally been performed using the conventional technique; however, the sutureless approach has emerged as a recent alternative. This study aims to compare the surgical outcomes of the two techniques and to identify the variables influencing them.

SUBJECTS AND METHODS: This was a retrospective study over a 17-year period from 2007 to 2024. There were 55 patients of TAPVD: supracardiac ( n = 32), intracardiac ( n = 18), infracardiac ( n = 3), and mixed ( n = 2).

RESULTS: The median age of surgical intervention was 43 days (interquartile range [IQR]: 30-120), and the median weight was 3.40 kg (IQR: 3.00-4.30). Prematurity was present in 3 (5.5%) patients, 11 (19.6%) had preoperative pulmonary vein obstruction, 2 (3.6%) had atrial septal defect obstruction, and 23 (41.1%) had preoperative pulmonary hypertension. Twelve (21.4%) patients required preoperative intubation, 4 (7.1%) required inhaled nitric oxide, and 7 (12.5%) had hemodynamic instability/cardiopulmonary resuscitation (CPR). Surgical correction (supracardiac and infracardiac) was by conventional repair in 20 patients and sutureless in 15 patients. When comparing sutureless and conventional TAPVD repair techniques, no statistically significant differences were observed in rates of pulmonary hypertension crisis, hospital stay duration, noninvasive ventilation duration, postoperative infections, or chest re-exploration rates. Similarly, the incidence of pulmonary venous obstruction (PVO) and early mortality was comparable between the two groups. The predictors of early mortality were seen in patients with preoperative pulmonary hypertension (odds ratio [OR]: 5.63, P = 0.048), preoperative intubation (OR: 9.29, P = 0.008), and preoperative CPR (OR: 36.67, P ≤ 0.001). Incidence of postoperative low cardiac output syndrome was strongly associated with preoperative pulmonary hypertension (OR: 3.90, P = 0.02), while predictors of postoperative extracorporeal membrane oxygenation predominant in patients with preoperative PVO (OR: 24.57, P = 0.007), associated pulmonary abnormality (OR: 4.57, P = 0.031), and preoperative intubation (OR: 3.88, P = 0.05).

CONCLUSIONS: Early postoperative outcomes were found to be closely associated with the patients’ preoperative clinical status. Overall, in our cohort, no difference was seen between the conventional and sutureless technique of TAPVD repair. These findings may be influenced by the study’s limited sample size, potentially reducing its statistical power.

PMID:42603057 | PMC:PMC13475845 | DOI:10.4103/apc.apc_153_25

Ann Pediatr Cardiol. 2026 Jul-Aug;19(4):379-388. doi: 10.4103/apc.apc_235_25. Epub 2026 Jul 31.

ABSTRACT

BACKGROUND: Congenital heart disease (CHD) is a leading noninfectious cause of mortality during childhood and adolescence, particularly in developing countries where timely diagnosis and treatment are limited. Despite its public health significance, data on mortality trends and their predictors in resource-limited settings remain scarce. This study aimed to assess mortality trends and identify predictors among children with CHD in a resource-limited setting.

MATERIALS AND METHODS: We conducted a retrospective follow-up study on 6228 children and adolescents with CHD who received care at the Cardiac Center of Ethiopia, either as outpatients or inpatients, with follow-up between 2015 and 2024. Data were collected through medical record reviews and phone interviews with caregivers from January 1 to August 1, 2025. Joinpoint was used to assess trends in CHD-related mortality by calculating the annual percent change (APC), and the average APC (AAPC) was used to evaluate overall mortality trends. Predictors of CHD-related mortality were identified using a Cox proportional hazards model.

RESULTS: The median age of patients was 0.7 years (interquartile range, 0.3-3.8 years), with a female-to-male ratio of 1.42:1. During follow-up, 827 patients (13.3%) died. The overall AAPC in mortality per 1000 CHD cases was -8.19% (95% confidence interval [CI]: -11.2–5.47, P < 0.001), indicating a statistically significant annual decline. A marked decrease occurred between 2019 and 2022 (APC: -40.94%; 95% CI: -47.41–27.50; P = 0.04). Malnutrition increased mortality risk by 2.9-fold (adjusted hazard ratio [AHR]: 2.9; 95% CI: 1.9-3.9; P < 0.001), pulmonary hypertension (PH) by 3.5-fold (AHR: 3.5; 95% CI: 2.2-6.6; P < 0.001), and the presence of syndromic associations (with or without extracardiac anomalies) by 30% (AHR: 1.3; 95% CI: 1.1-2.2; P = 0.04). Conversely, undergoing surgery or an interventional procedure reduced mortality risk by 80% (AHR: 0.2; 95% CI: 0.1-0.8; P < 0.001).

CONCLUSION: Mortality among children and adolescents with CHD in Ethiopia has shown a significant decline in recent years. However, malnutrition, PH, syndromic associations, and lack of surgical or interventional care remain key predictors of poor outcomes. Strengthening timely access to interventions, enhancing nutritional and multidisciplinary support, and prioritizing early identification of high-risk patients are essential to further reduce CHD-related mortality in resource-limited settings.

PMID:42603051 | PMC:PMC13475836 | DOI:10.4103/apc.apc_235_25

Cureus. 2026 Jul 15;18(7):e112736. doi: 10.7759/cureus.112736. eCollection 2026 Jul.

ABSTRACT

Background Developmental defects of enamel (DDE) are disturbances that occur during amelogenesis and may affect the quantity or quality of enamel. These defects may predispose affected teeth to dental sensitivity, caries, and esthetic concerns. Limited epidemiological data are available regarding the prevalence of DDE among Kashmiri children. Objective This study aims to evaluate the prevalence and distribution of DDE among children aged 3-12 years in the Kashmiri population using the modified DDE Index. Methods A hospital-based cross-sectional epidemiological study was conducted among children aged 3-12 years attending the outpatient department (OPD) of Pediatric and Preventive Dentistry at Government Dental College and Hospital, Srinagar, India. A total of 10,070 children were examined over a period of seven months. The modified DDE Index was used to assess enamel defects in both primary and permanent dentition. Buccal/labial, lingual/palatal, and occlusal/incisal surfaces were examined. Demographic variables, including age group as well as dentition type (primary and permanent), were recorded to evaluate their association with the prevalence and distribution of enamel defects. Data were analyzed using Python version 3.8 (Python Software Foundation, Fredericksburg, VA), and a chi-square test was applied for statistical analysis. Chi-square test of independence demonstrated a statistically significant association between DDE prevalence and dentition type (primary and permanent dentition) (p = 0.0001). Results Among the 10,070 children examined, 1,208 children demonstrated DDE involving 3,308 teeth. The prevalence of DDE was highest in the 9-12-year age group (2570, 77.69%), followed by the 6-9-year age group (696, 21.03%) and the 3-6-year age group (42, 1.2%). Permanent incisors were the most commonly affected teeth (2162, 65.35%), followed by permanent molars (754, 22.79%). Demarcated opacities (DEO) were the most prevalent enamel defect (816, 49.28%), followed by hypoplasia (408, 24.64%) and diffuse opacities (DIO) (324, 19.57%). Chi-square analysis demonstrated a statistically significant association between age groups (3-6, 6-9, and 9-12 years) and the distribution of DDE (p < 0.05). It also revealed a statistically significant variation in the distribution of developmental enamel defects between primary and permanent dentition and across different categories of permanent teeth, including molars, canines, premolars, and incisors (χ² = 361.92, p < 0.0001). Conclusion DDE was predominantly observed in permanent incisors and molars among Kashmiri children, with DEO being the most common defect type. The findings highlight the need for preventive and early intervention strategies to reduce the burden of DDE in pediatric populations.

PMID:42603046 | PMC:PMC13475951 | DOI:10.7759/cureus.112736

Orthop Rev (Pavia). 2026 Aug 12;18:165086. doi: 10.52965/001c.165086. eCollection 2026.

ABSTRACT

BACKGROUND: Pregnancy-associated low back and pelvic pain is a common musculoskeletal condition associated with substantial pain, impaired mobility, and functional limitation during pregnancy. Pharmacologic pain management is constrained by maternal and fetal safety considerations, increasing reliance on conservative musculoskeletal interventions.

METHODS: A systematic review and meta-analysis of randomized controlled trials was conducted in accordance with PRISMA 2020. PubMed/MEDLINE, Scopus, and Web of Science were searched from database inception through February 2026. Eligible studies included pregnant women with pregnancy-associated low back pain, pelvic girdle pain, or mixed lumbopelvic pain syndromes receiving conservative musculoskeletal interventions. Primary outcomes were pain intensity and functional disability assessed using validated instruments. Random-effects meta-analysis using standardized mean differences with Hedges g correction and 95% confidence intervals was performed.

RESULTS: Six randomized controlled trials met inclusion criteria for qualitative synthesis, of which four studies involving 254 participants contributed directly extractable data for the primary quantitative meta-analyses. Conservative musculoskeletal interventions were associated with significant reductions in pain intensity (SMD -0.85, 95% CI -1.18 to -0.53; P < 0.001; I² = 34%) and functional disability (SMD -0.84, 95% CI -1.31 to -0.37; P < 0.001; I² = 66%). Subgroup analysis demonstrated numerically larger pain effects for device-assisted interventions, followed by acupuncture-based and manual or manipulative approaches, although subgroup differences were not statistically significant (P = 0.26). One trial was judged at high risk of bias, while the remaining studies were classified as having some concerns.

CONCLUSIONS: Conservative musculoskeletal interventions were associated with improvements in pain intensity and functional disability among women with pregnancy-associated low back and pelvic pain. However, limited trial numbers, methodological heterogeneity, and risk of bias constrain treatment-specific conclusions. Larger, adequately powered, methodologically rigorous randomized controlled trials are needed to inform higher-confidence clinical recommendations.

PMID:42603043 | PMC:PMC13475796 | DOI:10.52965/001c.165086

Cureus. 2026 Jul 15;18(7):e112727. doi: 10.7759/cureus.112727. eCollection 2026 Jul.

ABSTRACT

Background Fine-needle aspiration cytology (FNAC) and fine-needle non-aspiration cytology (FNNAC) are commonly used techniques for the evaluation of thyroid lesions. Differences in smear quality, cellular preservation, and diagnostic performance between these methods remain a subject of interest. Our study compared FNAC and FNNAC in thyroid lesions using histopathological examination as the reference standard. Methodology A cross-sectional observational study was conducted among 110 patients with clinically palpable thyroid swellings, of whom 75 patients who underwent thyroid surgery with available histopathological examination were included in the final analysis. Both FNAC and FNNAC were performed on the same lesion during the same sitting. Smears were assessed for adequacy, cellular preservation, and diagnostic categorization using the Bethesda System for Reporting Thyroid Cytopathology. Histopathological examination served as the reference standard for cytohistological correlation and assessment of diagnostic performance. Results The mean age of participants was 42.88 ± 13.59 years. Superior smear quality was observed in 55 (73.3%) FNAC samples and 59 (78.7%) FNNAC samples. Bethesda Category II lesions constituted the majority of cases with both techniques. FNNAC reduced the proportion of indeterminate lesions and identified a higher proportion of malignant lesions. Histopathology revealed 53 (70.7%) benign and 22 (29.3%) malignant lesions. FNNAC demonstrated a stronger correlation with histopathological diagnosis and showed better preservation of cellular architecture with less blood contamination. Diagnostic accuracy was numerically higher with FNNAC (63, 84.0%) than with FNAC (58, 77.3%), with corresponding sensitivities of 11 (50.0%) and 9 (40.9%), respectively; however, the difference in diagnostic accuracy was not statistically significant (McNemar’s test, p = 0.228). Conclusions Both FNAC and FNNAC are effective techniques for the cytological evaluation of thyroid lesions. FNNAC demonstrated higher smear quality, improved cellular preservation, higher specificity, and numerically higher overall diagnostic accuracy than FNAC. Although the difference in diagnostic accuracy was not statistically significant, FNNAC may serve as a valuable alternative or complementary technique for improving smear quality in thyroid cytology.

PMID:42603037 | PMC:PMC13475714 | DOI:10.7759/cureus.112727

Dement Neuropsychol. 2026 Aug 14;20:e20250349. doi: 10.1590/1980-5764-DN-2025-0349. eCollection 2026.

ABSTRACT

Early detection of possible cognitive decline (PwCD) is crucial for preserving function and independence in aging.

OBJECTIVE: To examine whether dual-task and functional assessment tools can help detect cognitive impairment in older adults without prior diagnosis of neurocognitive disorders.

METHODS: A cross-sectional study was conducted with healthy older adults (≥60 years). The following exclusion criteria were adopted: neurological diseases with motor deficits, severe functional limitations, mobility aid use, and inability to walk six meters unaided. Assessments included the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Clock Drawing Test (CDT), Verbal Fluency (VF), Pfeffer Functional Activities Questionnaire, Timed Up and Go (TUG), Sit-to-Stand Test (STS), Berg Balance Scale (BBS), Step Test, and dual-task TUG (TUGdt) using animal naming (TUGdt-NA) and serial subtraction (TUGdt-S7). Statistical analyses included t-tests, Mann-Whitney U, ꭓ² tests, and logistic regression (p≤0.05).

RESULTS: Among 144 participants, 89 were classified as healthy and 55 as PwCD. Most were female (90.9%), black (57.7%), with an average of 11.04 years of education. Groups did not differ in age, gender, or comorbidities. The PwCD group had lower education (p=0.01), more black individuals (p=0.03), and scored significantly worse on all cognitive tests (p<0.0001) and TUGdt (NA: p=0.040; S7: time p=0.027; accuracy p<0.001). No differences were found in STS, Step Test, BBS, or total Pfeffer scores; however, the PwCD group showed greater instrumental activities of daily living (IADL) impairment.

CONCLUSION: The ability to perform dual tasks appears to be associated with functional capacity.

PMID:42603030 | PMC:PMC13475946 | DOI:10.1590/1980-5764-DN-2025-0349

Ann Pediatr Cardiol. 2026 Jul-Aug;19(4):364-373. doi: 10.4103/apc.apc_22_26. Epub 2026 Jul 31.

ABSTRACT

BACKGROUND: Friedreich’s ataxia (FA) is a hereditary neuromuscular disorder with cardiac involvement as the leading cause of death. This study examines the progression of cardiac magnetic resonance imaging (CMR) biomarkers in FA-associated cardiomyopathy and their relationships with clinical outcomes.

MATERIALS AND METHODS: This retrospective, single-center study included FA patients with at least one CMR. CMR assessment included segmental late gadolinium enhancement (LGE), left ventricle (LV) ejection fraction (EF), LV wall thickness, native T1 mapping, and extracellular volume (ECV) fraction. Linear mixed-effects regression models were used to assess CMR parameters in relation to each other and time.

RESULTS: Fifteen patients (mean age: 22.7 ± 7.6 years) and 37 CMRs were evaluated over an average of 11.0 ± 5.0 years from neuromuscular symptom onset. LV thickness was most notable along the septum, while LGE was localized to the LV free wall. Native T1 and ECV were globally elevated. Six (40%) patients demonstrated LGE, and those negative at baseline remained negative. LGE increased by 0.5 segments per year ( P = 0.25), and LVEF declined by 0.73%/year ( P = 0.06); however, neither reached statistical significance. LV thickness, native T1, and ECV did not change significantly. Maximal LV thickness correlated with cardiac symptoms ( P = 0.04) and cardiac medications ( P = 0.024).

CONCLUSIONS: In this exploratory study, CMR demonstrated patterns of septal hypertrophy, lateral wall fibrosis, and trends toward declining ventricular function. Findings were largely nonsignificant and should be considered hypothesis-generating. Larger, multicenter studies are needed to clarify the role of CMR in disease progression and clinical management.

PMID:42603024 | PMC:PMC13475841 | DOI:10.4103/apc.apc_22_26