Tag: pubmed

Eur J Orthop Surg Traumatol. 2025 Oct 10;35(1):430. doi: 10.1007/s00590-025-04558-0.

ABSTRACT

PURPOSE: Tibial plateau fractures can result in significant morbidity, and complications following surgical fixation may negatively impact recovery. We aimed to evaluate whether such complications influence patient-reported outcomes at 6 months postoperatively.

METHODS: We conducted a retrospective cohort study at a single level I trauma center from 2022 to 2024. Adult patients who sustained a tibial plateau fracture (AO/OTA 41) treated with open reduction internal fixation (ORIF) were eligible for inclusion if they had completed Patient-Reported Outcomes Measurement Information System (PROMIS) surveys at 6 months postoperatively and had clinical follow-up confirming radiographic healing. Patients were excluded if they were under 18 years of age, lacked adequate medical record documentation, were managed non-operatively or with closed reduction percutaneous fixation, or did not complete PROMIS surveys at the 6-month time point. The primary outcomes were PROMIS scores assessing physical function (PF), pain interference (PI), global physical health (GPH), global mental health (GMH), anxiety, and depression. Secondary outcomes included percent of normal function and Brief Resilience Scale (BRS) scores. These outcomes were compared between patients who experienced complications and those who did not.

RESULTS: A total of 106 patients were included (mean age 50.4 years; mean follow-up 261.5 days). Complications occurred in 25.5% of patients, including fracture-related infection (FRI, 10.4%), DVT/PE (7.5%), and reoperation within 6 months (11.3%). Patients with FRI had significantly lower PROMIS-PF scores at 6 months compared to those without FRI (31.5 vs. 37.4, p = 0.015), exceeding the MCID. Other PROMIS domains were not significantly different. Patients undergoing early reoperation prior to 6 months, or reoperation to promote bone healing at any timepoint, demonstrated lower PF scores, though these differences were not statistically significant.

CONCLUSION: In this cohort of patients with tibial plateau fractures, FRI was associated with significantly worse physical function at 6-months as measured by the PROMIS-PF score. This difference was also clinically significant, exceeding the MCID.

PMID:41073836 | DOI:10.1007/s00590-025-04558-0

Geroscience. 2025 Oct 10. doi: 10.1007/s11357-025-01889-y. Online ahead of print.

ABSTRACT

Sarcopenia is a major contributor to frailty and functional decline among older adults. Combining exercise with nutritional strategies such as creatine monohydrate (CRE) and β-hydroxy-β-methylbutyrate (HMB) supplementation may help to preserve strength and independence. To evaluate the effects of 6-week CRE + HMB supplementation combined with an integral physical conditioning (IPC) program on functional strength and body composition in physically active older adults. In a randomized, double-blind, placebo-controlled crossover trial, 30 older adults (20 men, 10 women; ≥ 60 years) completed two 6-week intervention periods (CRE + HMB or placebo) separated by a 3-week washout. The IPC program performed in both conditions consisted of four supervised weekly sessions combining strength, power, multicomponent circuits, high-intensity interval and moderate intensity continuous training), performed at 40-100% training heart rate (THR) and 20-90% one-repetition maximum (1RM) and structured as warm-up, main part and cooldown. Functional strength and body composition (bioelectrical impedance analysis) were assessed pre- and post-intervention, respectively. Significant time × group interactions were observed for fat mass, fat-free mass, total muscle mass, skeletal muscle mass, appendicular skeletal muscle mass, muscle mass index, skeletal muscle index and ALM/BMI (all p < 0.05). The CRE + HMB group showed reductions in fat mass and body fat percentage, with slight numerical increases in muscle parameters, whereas the placebo group exhibited opposite trends. However, within-group changes were not statistically significant. In contrast, CRE + HMB significantly improved multiple functional strength outcomes, including leg/back strength, arm flexion strength, upper-body endurance (dumbbell flexion, push-ups, isometric hold) and core endurance (crunches). Regression analyses suggested that these improvements were largely independent of changes in muscle mass, supporting a potential neuromuscular mechanism. Six weeks of CRE + HMB supplementation combined with IPC enhanced functional strength and endurance in active older adults, largely independent of changes in muscle mass. This combined approach represents a promising strategy for preserving functional capacity and promoting healthy ageing.

PMID:41073834 | DOI:10.1007/s11357-025-01889-y

Support Care Cancer. 2025 Oct 11;33(11):930. doi: 10.1007/s00520-025-09917-5.

ABSTRACT

PURPOSE: The clinical management of patients with cancer by oncologists and nurses needs to differentiate between maladaptive emotions that do require professional mental health care and adaptive emotions that do not require such care. Previous qualitative research identified six symptoms as potential indicators of maladaptive emotions. These included lingering, increasing or extreme emotions, emotions that interfere with daily life or with treatment, and unexplained somatic symptoms. The present study tested the validity of these symptoms as indicators of maladaptive emotions in patients with cancer.

METHODS: Patients with a solid malignancy were assessed 3 to 7 months after the start of chemo- or immunotherapy. Patients were categorized as experiencing either adaptive or maladaptive emotions, using two reference standards: (a) a psychiatric diagnostic assessment or (b) patient’s subjective need for professional mental health care. Oncologists and nurses assessed the presence of the six symptoms, using a checklist. A total count was made of the number of symptoms that were rated as present.

RESULTS: As hypothesized, the total symptom count was statistically significantly greater in patients with maladaptive emotions than in patients with adaptive emotions. This was consistently observed for the ratings by oncologists as well as nurses, and for both reference standards.

CONCLUSION: The current study confirmed six symptoms assessed by oncologists and nurses as valid indicators of maladaptive emotions in patients with cancer. We recommend assessing these symptoms in the broader context of managing emotional well-being of patients with cancer.

PMID:41073816 | DOI:10.1007/s00520-025-09917-5

Support Care Cancer. 2025 Oct 10;33(11):927. doi: 10.1007/s00520-025-10012-y.

ABSTRACT

PURPOSE: To investigate the current status of CRF and identify its influencing factors in patients undergoing chemotherapy for gastric cancer.

METHODS: A total of 525 patients receiving chemotherapy for gastric cancer were recruited from a tertiary general hospital in China. Data were collected using a set of standardized questionnaires. Stepwise multiple linear regression was applied to determine the impact of variables that were statistically significant (P < 0.05) in independent sample t tests, one-way ANOVA, and correlation analyses on fatigue levels. All statistical tests were two-sided, with a significance level set at α = 0.05.

RESULTS: The median (interquartile range) scores for total CRF, physical fatigue, emotional fatigue, and cognitive fatigue were 21.00 (15.00-27.00), 8.00 (4.00-12.00), 9.00 (7.00-11.00), and 4.00 (1.00-6.00), respectively. Overall, 57.2% of patients experienced moderate to severe fatigue. Multivariate analysis showed that female gender, nutritional risk status, poor sleep status, depression, and pain were significantly associated with higher CRF in patients undergoing chemotherapy for gastric cancer, together explaining 31.6% of the total variance.

CONCLUSION: CRF is highly prevalent among patients with gastric cancer and is influenced by multiple factors. These findings provide scientific evidence for the early identification of high-risk groups and the development of personalized intervention programs.

PMID:41073814 | DOI:10.1007/s00520-025-10012-y

Eye (Lond). 2025 Oct 10. doi: 10.1038/s41433-025-04035-2. Online ahead of print.

ABSTRACT

OBJECTIVE: The clinical evidence linking medications to retinal detachment (RD) remains limited. This study utilises real-world data from the U.S. FDA Adverse Event Reporting System (FAERS) to identify drugs associated with RD and characterise their classifications.

METHODS: A disproportionality analysis was performed on over 17 million FAERS reports. Drugs with statistically significant disproportionate RD reporting were identified and categorised by therapeutic class, signal strength, latency period, subgroup factors (e.g., off-label use, age, gender, subtypes, regions), and sensitivity analysis.

RESULTS: Thirty drugs showed significant associations with RD, including ophthalmic agents, anticancer therapies, corticosteroids, and erectile dysfunction medications. Signal strength varied: pilocarpine, encorafenib, and ocriplasmin exhibited the highest signal strength, while prednisolone and bevacizumab showed lower strength. Latency periods differed significantly: erectile dysfunction drugs had the longest median latency (365 days), whereas anticancer drugs had the shortest (14 days). Subgroup analyses revealed elevated RD signal strength with off-label use and distinct susceptibility patterns: younger adults (<65) and males had higher signal strength for specific drug classes (e.g., ophthalmic agents), while older adults (>65) were more susceptible to RD with corticosteroids. Subtype analysis highlighted drug-specific associations with exudative, tractional, and rhegmatogenous RD. Sensitivity analysis restricted to healthcare professional reports further confirmed the robustness of the findings.

CONCLUSIONS: This study provides a stratified list of medications with disproportionate reporting signals for RD. Further high-quality epidemiological and mechanistic studies are warranted to validate the potential causality associations between these medications and RD. Assessment of drug-related retinal detachment using real-world large-scale data.

PMID:41073807 | DOI:10.1038/s41433-025-04035-2

Neuropsychopharmacology. 2025 Oct 10. doi: 10.1038/s41386-025-02257-2. Online ahead of print.

ABSTRACT

There is active scientific debate about the nature of addiction as a mental disorder, but with comparatively little discussion of nosology itself. To contribute to the ongoing dialogue, this review provides a concise history of the formal medical diagnoses used to define addiction clinically and vanguard contemporary perspectives. The history of addiction as a medical diagnosis starts at the beginning of the 20th century in the first International Classification of Diseases (ICD) and was present in 1953 in the first edition of the Diagnostic and Statistical Manual (DSM). Across iterations of both systems, the evolving nosology can be broadly divided into three epochs, an early primeval period (1900-1948), reflecting coarse definitions subsumed within personality disorder; a phenomenological period (1948-1980), reflecting descriptive definitions; and an empirically-informed period (1980 to the present), comprising operational definitions of polythetic syndromes, increasingly informed by empirical findings. Contemporary priorities suggest an emerging fourth epoch, prioritizing a diagnostic nomological network of objective etiologically-informed tests via, for example, the Research Domain Criteria (RDoC) and Addictions Neuroclinical Assessment (ANA) frameworks. Both RDoC and ANA focus on using objective mechanistic indicators to decrease subjectivity in diagnosis and increase alignment between etiology and diagnosis. Next-generation diagnostic approaches are anticipated to enhance incisiveness in psychiatric diagnosis and in turn improve clinical outcomes. Tracing the vicissitudes of addiction nosology over the past century reveals an evolution that is both more humane and scientific, from moral weakness and personality defect toward diagnostic definitions and practices that are grounded in empirical evidence.

PMID:41073802 | DOI:10.1038/s41386-025-02257-2

Mol Syst Biol. 2025 Oct 10. doi: 10.1038/s44320-025-00160-y. Online ahead of print.

ABSTRACT

Deciphering patient-specific mechanisms of cancer cell reprogramming remains a crucial challenge in systems oncology, as it is key to improving patient diagnosis and treatment. For this reason, comprehensive and patient-specific multi-omic characterization of tumor specimens has become increasingly common in clinical practice. Here, we developed PatientProfiler, a computational workflow that integrates proteogenomic data with curated causal interaction networks to generate mechanistic models of signal transduction for individual patients. PatientProfiler allows multi-omic data analysis and standardization, generation of patient-specific mechanistic models of signal transduction, and extraction of network-based prognostic biomarkers. We successfully benchmarked the tool on proteogenomic and clinical data derived from 122 biopsies of treatment-naïve breast cancer, available through the CPTAC portal. We identified patient-specific mechanistic models that recapitulate oncogenic signaling pathways. In-depth topological exploration of these networks revealed seven subgroups of patients, associated with unique transcriptomic signatures and distinct prognostic values. We identified well-known Basal-like 1 and 2 subtypes, while also highlighting distinct mechanistic drivers such as the MYC-CDK4/6 axis or NF-kappaB-mediated inflammatory programs. Beyond breast cancer, PatientProfiler offers a generalizable framework to transform cohort-level multi-omic data into interpretable mechanistic models, making it applicable across diverse cancer types and other complex diseases.

PMID:41073799 | DOI:10.1038/s44320-025-00160-y

Oral Maxillofac Surg. 2025 Oct 11;29(1):171. doi: 10.1007/s10006-025-01470-z.

ABSTRACT

PURPOSE: To assess postoperative fracture reduction and visualization of titanium-based and bioresorbable osteosynthesis materials in maxillofacial trauma surgery using ultra-high-resolution photon-counting detector computed tomography (PCD-CT) compared with cone-beam computed tomography (CBCT).

METHODS: Fractures were induced in six cadaveric pig mandibles at the angle, body, and parasymphysis and were stabilized using various titanium and bioresorbable plate systems. Specimens were scanned with CBCT and dose-matched PCD-CT in the ultra-high resolution mode, applying standard and low-dose protocols. Two observers assessed fracture reduction and implant delineation using a 5-point visual analog scale. Fracture gap and osteosynthesis materials were quantitatively measured and compared to ground-truth values. Descriptive statistics and inter-reader agreement (weighted κ) were calculated.

RESULTS: PCD-CT enabled excellent assessment of fracture reduction and visualization of osteosynthesis materials, with perfect inter-observer agreement (Median = 5, IQR, 5-5; κ = 1.0, p < 0.001), whereas low-dose CBCT showed reduced image quality and lower reproducibility (Median = 4, IQR, 4-4; κ = 0.92; p < 0.001). Bioresorbable plates were not directly visible using either scanner, but the associated screw drill holes were reliably delineated. PCD-CT achieved the smallest measurement deviations of fracture gap and osteosynthesis materials compared with ground truth, and with superior reproducibility (κ = 0.74-0.84; ICC = 0.95-0.99; all p < 0.001), outperforming CBCT across most parameters.

CONCLUSIONS: Ultra-high resolution PCD-CT combines superior visualization and precise measurements compared with CBCT even at low radiation dose. With further clinical validation, these findings highlight PCD-CT’s strong potential for perioperative imaging in maxillofacial trauma, particularly benefiting younger patients who require repeated scans.

PMID:41073793 | DOI:10.1007/s10006-025-01470-z

Nat Genet. 2025 Oct 10. doi: 10.1038/s41588-025-02399-5. Online ahead of print.

NO ABSTRACT

PMID:41073789 | DOI:10.1038/s41588-025-02399-5

Lasers Med Sci. 2025 Oct 11;40(1):425. doi: 10.1007/s10103-025-04696-1.

ABSTRACT

Rosacea is a common, chronic inflammatory skin condition lacking specific treatment. This study investigates the efficacy of various photoelectric therapies in treating rosacea. 90 rosacea patients who visited the dermatology outpatient clinic of the hospital from August 2022 to November 2023 were analyzed (retrospective registration 20240425). The patients were categorized into three groups based on different treatment methods: the control group received oral hydroxychloroquine sulfate and topical recombinant bovine basic fibroblast growth factor; observation group 1 underwent intense pulsed light therapy in addition to the control group’s treatment; observation group 2 received light-emitting diode therapy on top of the control group’s regimen. The therapeutic effect was evaluated by physicians’ subjective evaluation and patients’ pruritus symptoms. The effective rates of observation group 1, observation group 2, and the control group were 73.3%, 66.7%, and 40%, respectively, with statistical significance (P < 0.05). There was no significant difference between observation group 1 and observation group 2 (P < 0.05). Additionally, there were no significant adverse reactions in any of the three groups. The comparison between observation group 1 and observation group 2 revealed that the two combined treatment methods achieved similar and positive therapeutic effects across various clinical manifestations. The effectiveness of both observation groups was found to be superior to that of drug therapy alone.

PMID:41073773 | DOI:10.1007/s10103-025-04696-1