Tag: pubmed

Emerg Radiol. 2025 Jul 18. doi: 10.1007/s10140-025-02366-x. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to evaluate and compare the diagnostic performance and image quality of deep learning reconstruction (DLR) with hybrid iterative reconstruction (Hybrid IR) and filtered back projection (FBP) in contrast-enhanced CT venography for deep vein thrombosis (DVT).

METHODS: A retrospective analysis was conducted on 51 patients who underwent lower limb CT venography, including 20 with DVT lesions and 31 without DVT lesions. CT images were reconstructed using DLR, Hybrid IR, and FBP. Quantitative image quality metrics, such as contrast-to-noise ratio (CNR) and image noise, were measured. Three radiologists independently assessed DVT lesion detection, depiction of DVT lesions and normal structures, subjective image noise, artifacts, and overall image quality using scoring systems. Diagnostic performance was evaluated using sensitivity and area under the receiver operating characteristic curve (AUC). The paired t-test and Wilcoxon signed-rank test compared the results for continuous variables and ordinal scales, respectively, between DLR and Hybrid IR as well as between DLR and FBP.

RESULTS: DLR significantly improved CNR and reduced image noise compared to Hybrid IR and FBP (p < 0.001). AUC and sensitivity for DVT detection were not statistically different across reconstruction methods. Two readers reported improved lesion visualization with DLR. DLR was also rated superior in image quality, normal structure depiction, and noise suppression by all readers (p < 0.001).

CONCLUSIONS: DLR enhances image quality and anatomical clarity in CT venography. These findings support the utility of DLR in improving diagnostic confidence and image interpretability in DVT assessment.

PMID:40679754 | DOI:10.1007/s10140-025-02366-x

Infection. 2025 Jul 18. doi: 10.1007/s15010-025-02606-9. Online ahead of print.

ABSTRACT

PURPOSE: Sepsis survivors suffer from frequent rehospitalizations, of which a certain proportion is considered preventable by timely and adequate management in the outpatient setting (= ambulatory care sensitive conditions, ACSC). We aimed to assess the frequency of and risk factors for ACSC and infection-associated ACSC rehospitalization among sepsis survivors.

METHODS: Population-based, retrospective cohort study among using nationwide health claims data of the “AOK- die Gesundheitskasse”. Sepsis patients with inpatient treatment in 2016-2019 were identified using ICD-codes. Among sepsis hospital survivors, ACSC and infection-related ACSC were identified. Patient-related risk factors for ACSC were assessed by a multiple logistic regression analysis.

RESULTS: We included 347,826 sepsis patients and 234,874 sepsis hospital survivors. A total of 53.2% and 21.3% of sepsis survivors had at least one ACSC and infection-related ACSC rehospitalizations in the 12-months post-discharge, respectively. ACSC rehospitalizations often occurred closely after discharge and more frequently affected older, male, care dependent patients as well as those living in rural areas.

CONCLUSION: ACSC are common among sepsis survivors. This underlines to need for structured aftercare programs and interventions in these patients, particularly for ACSC risk groups which comprise older, male, care dependent patients in rural areas.

PMID:40679743 | DOI:10.1007/s15010-025-02606-9

Obes Surg. 2025 Jul 18. doi: 10.1007/s11695-025-08077-z. Online ahead of print.

ABSTRACT

Bariatric surgery is effective for treating obesity and its comorbidities, but the optimal technique remains debated. This meta-analysis compared one-anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) in comorbidity remission and postoperative outcomes. We analyzed 12 trials, assessing T2DM, hypertension, and sleep apnea remission, as well as postoperative complications. Statistical analyses included risk differences (RD) and risk ratios (RR). OAGB was non-inferior to RYGB for T2DM remission (RD -1%; 95% CI -10% to 8%) but had higher risks of bile reflux (RR 7.62; 95% CI 1.97-29.46) and de novo GERD (RR 5.10; 95% CI 1.44-18.00). While OAGB is effective for T2DM remission, RYGB is superior in reducing bile reflux and GERD, highlighting the need for individualized surgical approaches.

PMID:40679731 | DOI:10.1007/s11695-025-08077-z

J Epidemiol Glob Health. 2025 Jul 18;15(1):99. doi: 10.1007/s44197-025-00445-3.

ABSTRACT

BACKGROUND: The pediatric intensive care unit (PICU) plays a crucial role in managing critically ill children requiring advanced airway, respiratory, and hemodynamic support. Reducing the mortality rate is one of the primary objectives in every ICU. However, data regarding mortality and associated risk factors from low-resource countries remain insufficient. The aim of our study was to describe the mortality pattern, and to evaluate risk factors associated with mortality in the PICU at Mukalla Maternity and Childhood Hospital.

METHODS: This retrospective study analyzed the admission records for children aged over 1 month to 15 years from the PICU over four years (1st January 2021 to 31st December 2024). The information retrieved included gender, age, place of residence, body weight, nutritional status, vaccination status, clinical presentations on admission, temperature, level of consciousness, presence of co-morbidities, the lag time between illness onset and hospital admission, date of admission, date of discharge, referring source, readmission frequency, diagnosis, need for mechanical ventilation, and condition at discharge (survived /deceased).

RESULTS: Out of the 790 patients admitted to the PICU, 716 were included in the study. The three most common disease categories among admissions were respiratory diseases (29.5%), central nervous system diseases (27.1%), and gastrointestinal diseases (11%). The overall mortality rate was 38.1%. Among deceased patients, 57.9% were severely undernourished, 38.5% were unvaccinated, and 63.4% had associated co-morbidities. The most common causes of death were pneumonia (26%), meningoencephalitis (17.2%), and sepsis/septic shock (9.2%). Independent risk factors of PICU mortality included length of PICU stay [AOR 0.129, p < 0.001], need for mechanical ventilation [AOR 68.6, p < 0.001], cardiovascular diseases [AOR 3.1, p = 0.003], hypothermia [AOR 7.1, p = 0.014], convulsions [AOR 0.375, p = 0.001], disturbance of consciousness [AOR 2.1, p = 0.002], and hepatosplenomegaly [AOR 15.7, p = 0.024].

CONCLUSION: The mortality in our PICU is high and is associated with several independent factors. Recognizing these risk factors will facilitate the identification of critical cases, enable the prioritization of resources, and support the implementation of essential modifications.

PMID:40679717 | DOI:10.1007/s44197-025-00445-3

Breast Cancer Res Treat. 2025 Jul 18. doi: 10.1007/s10549-025-07781-9. Online ahead of print.

ABSTRACT

PURPOSE: Previous studies have demonstrated that ductal carcinoma in situ (DCIS) component often exhibits higher HER2 expression than the invasive component when assessed by immunohistochemistry, while some other studies showed concordant HER2 expression between these two components. In this study, we used our high-sensitivity HER2 (HS-HER2) quantitative immunofluorescence assay to compare HER2 expression in IDC and co-existing DCIS and correlate with clinicopathologic characteristics.

METHODS: We included 36 IDC + DCIS cases from the Yale Pathology department. DCIS was classified according to the three-tier nuclear grading system: low (grade 1), intermediate (grade 2), and high (grade 3) nuclear grade. Invasive carcinoma was graded according to the modified Bloom-Richardson histologic grading system. Cases were divided into two groups: low to intermediate-grade DCIS (G1-2) with co-existing invasive carcinoma (n = 26) and high-grade DCIS (G3) with co-existing invasive carcinoma (n = 10). Separate regions of interest for IDC and DCIS were annotated by two board-certified pathologists. Serial sections of FFPE tumor specimens were used to accurately measure the HER2 protein expression by the HS-HER2 assay in attomole/mm² unit and the acquisition by QuPath v.04 with the Qymia extension.

RESULTS: Low to intermediate-grade DCIS expressed higher HER2 levels (4295 ± 449 amol/mm²) than co-existing invasive carcinoma (2880 ± 413 amol/mm²). Similarly, high-grade DCIS expressed higher HER2 levels (4953 ± 700 amol/mm²) than co-existing invasive carcinoma (3560 ± 688 amol/mm²). Neither of these trends toward lower expression levels in the IDC were statistically significant. Additionally, no significant statistic difference was noted between low to intermediate-grade DCIS versus high-grade DCIS or between their corresponding co-existing invasive carcinomas in this cohort.

CONCLUSION: Using the HS-HER2 assay, our results demonstrated comparable HER2 expression levels in DCIS and paired invasive carcinoma regardless of histopathological grade or HER2 immunohistochemical score. These findings contributed to a more nuanced understanding of HER2 biology in early breast carcinogenesis and may inform future biomarker-driven therapeutic strategies.

PMID:40679712 | DOI:10.1007/s10549-025-07781-9

Sleep Breath. 2025 Jul 18;29(4):248. doi: 10.1007/s11325-025-03389-x.

ABSTRACT

BACKGROUND: The increasing use of e-cigarettes and the decline in sleep duration among young people are growing public health concerns. While cigarette smoking has been linked to shorter sleep duration, less is known about the effects of e-cigarettes. This study explores the association between exclusive e-cigarette use and sleep duration among US young adults aged 18-24 who only use e-cigarettes.

METHODS: We analyzed data from 26,943 young adults in the 2022 Behavioral Risk Factor Surveillance System survey. Sleep duration was categorized as short (< 7 h/24 hours), normal (7-9 h), or long (> 9 h). We excluded participants using any tobacco/nicotine products other than e-cigarettes and restricted the sample to 4,553 young adults with complete data. Logistic regression models assessed e-cigarette use status (i.e., current use, past use, and non-use) in relation to sleep duration, adjusting for demographics, current substance use, lifestyle factors, and health conditions.

RESULTS: Overall, 31.9% of young adults experienced short sleep duration, 63.2% reported normal sleep, and 4.9% had long sleep. Current e-cigarette users had a higher prevalence of short sleep duration (44.6%) than past users (33.0%) and non-users (27.4%; p-value < 0.001). Weighted analyses indicated that current e-cigarette use was significantly associated with short sleep duration (adjusted OR = 1.82; 95%CI: 1.30-2.54), but no significant associations were found with long sleep duration (all p-values > 0.05).

CONCLUSIONS: Current exclusive e-cigarette use is associated with short sleep duration among US young adults. Efforts to reduce e-cigarette use in this population may contribute to improved sleep health.

PMID:40679707 | DOI:10.1007/s11325-025-03389-x

Trop Anim Health Prod. 2025 Jul 18;57(7):307. doi: 10.1007/s11250-025-04550-0.

ABSTRACT

This study investigated the effects of Lactobacillus plantarum (LAC) and its cell-free supernatant (CFS) on vaginal health and reproductive performance in ewes. The ewes were synchronized using fluorogestone acetate (FGA) or medroxyprogesterone acetate (MPA) impregnated intravaginal sponges. A total of 196 Merino ewes were randomly assigned to four groups in a 2 × 2 factorial design. Intravaginal sponges remained for 14 days, and vaginal discharge, sponge weight change, estrus response, and pregnancy rates were evaluated. No adverse health effects were observed following intravaginal probiotic treatment. There was a tendency (p = 0.07) for higher sponge loss in the FGA group (13.2%) compared to the MPA group (5.7%). On the day of sponge removal, 90.8% of ewes exhibited vaginal discharge. Although not statistically significant, mean vaginal discharge scores were lower in LAC-treated groups compared to CFS-treated groups. While L. plantarum had no significant effect on vaginal discharge scores in the MPA group (40.7% in MPA + LAC vs. 41.7% in MPA + CFS for score 2; p > 0.05), it significantly reduced purulent/hemorrhagic discharge in the FGA group (29.7% in FGA + LAC vs. 47.6% in FGA + CFS; p < 0.05). Estrus initiation occurred significantly earlier in the FGA group (36.8 ± 1.9 h) compared to the MPA group (49.1 ± 1.2 h; p < 0.01), although neither the probiotic treatment nor its interaction with progestagen type significantly influenced estrus timing. Pregnancy rates were significantly higher in the FGA + LAC (71.7%) and FGA + CFS (75.6%) groups compared to the MPA + LAC (49.0%) and MPA + CFS (50.0%) groups (p < 0.01). Our findings suggest that FGA-based synchronization improves pregnancy rates, while treatment with L. plantarum may enhance vaginal health, providing a potential non-antibiotic approach for reproductive management.

PMID:40679696 | DOI:10.1007/s11250-025-04550-0

Eur J Pediatr. 2025 Jul 18;184(8):489. doi: 10.1007/s00431-025-06313-3.

ABSTRACT

Serial lung recruitment assessment in neonates with moderate-to-severe neonatal acute respiratory distress syndrome (NARDS) is crucial. However, current methods involve ionizing radiation or invasiveness, which limits their serial use in neonates. This study evaluated the feasibility of rib-indexed quantitative lung ultrasound (LUS) as a radiation-free alternative for monitoring lung aeration in neonates with moderate-to-severe NARDS on surfactant therapy combined with prone position. A prospective observational study enrolled 35 term neonates with moderate-to-severe NARDS. Lung recruitment was assessed via anterior-posterior approach rib-indexed quantitative LUS and posteroanterior chest X-ray (CXR) before and 6 h after combined surfactant therapy and prone position. Following the intervention, it demonstrated a significant reduction in the LUS aeration score, from a pre-intervention median of 18 points (IQR 16, 22) to a post-intervention median of 15 points (IQR 12, 20) (P < 0.001). In contrast, the decrease in the CXR score (pre-intervention median 3 (IQR 3, 4) vs. post-intervention median 2 (IQR 2, 3)) did not reach statistical significance (P = 0.059). Posterior approach rib-indexed quantitative LUS showed high concordance with posteroanterior CXR in determining the rib level of the pulmonary-diaphragmatic interface (ICC > 0.95, kappa > 0.94, P < 0.001). No adverse events occurred during the LUS assessments.Conclusion: Posterior approach rib-indexed quantitative LUS is a reliable and non-invasive modality for real-time lung recruitment assessment in neonates with NARDS. It significantly detected improved lung aeration following surfactant therapy combined with prone position, whereas CXR failed to demonstrate a statistically significant improvement. Posterior approach rib-indexed quantitative LUS can also determine the rib level of the pulmonary-diaphragmatic interface, similarly to posteroanterior CXR. The superior sensitivity and safety of rib-indexed quantitative LUS offer a clinically valuable and innovative alternative for dynamic monitoring of lung recruitment in neonatal critical care. Future multi-centre studies should integrate CT validation to confirm broader applicability.Trial registration: The trial was prospectively registered with the Chinese Clinical Trial Registry (ChiCTR2300074652) on August 11, 2023.

PMID:40679694 | DOI:10.1007/s00431-025-06313-3

Trop Anim Health Prod. 2025 Jul 18;57(7):304. doi: 10.1007/s11250-025-04553-x.

NO ABSTRACT

PMID:40679686 | DOI:10.1007/s11250-025-04553-x

J Robot Surg. 2025 Jul 18;19(1):403. doi: 10.1007/s11701-025-02557-1.

ABSTRACT

Robotic surgery is increasingly prevalent in thoracic surgery. Studies of specific kinematic data on outcomes are missing. The object of this study was to examine correlations between years in practice, robotic experience, and kinematic (motion) data on complications and readmissions. Kinematic data from the first lymph node dissection of anatomic robotic lung resections were combined with data from a prospectively maintained single institution database. Kinematic data included arm movement speed, economy of motion, and camera movement. Lobectomies and segmentectomies were matched and propensity-score weighted with inverse-probability treatment weights. Pearson’s correlations, between years in practice, robotic experience, and kinematic data; and logistic regression; between years in practice and robotic experience on complications and readmissions were done. Lobectomies, 42, and segmentectomies, 31, from 2022 to 2023 were included. After matching, lymph nodes sampled were greater with lobectomies than segmentectomies, but other data were well matched; nodes sampled with lobes 13.4 vs 7.6 with segments, p < 0.001. Years in practice and robotic experience were not correlated with complications or readmissions. Significant correlations were noted between kinematic data and robotic experience. Length of stay had a negative correlation with robotic experience, -0.16, p < 0.001. No odds ratios were significant. In this small series, decreased length of stay was correlated with increased robotic experience which was a stronger outcome determinant than practice years. The complications and readmissions were not correlated with either measure. Increasing robotic experience may help optimize patient care but additional data are needed to establish usefulness of specific kinematic data.

PMID:40679677 | DOI:10.1007/s11701-025-02557-1