Tag: pubmed

Georgian Med News. 2025 May;(362):122-128.

ABSTRACT

BACKGROUND: The intermediate type of diabetes, known as latent autoimmune diabetes in adults (LADA), has traits in common with both type 1 and type 2 diabetic mellitus (T2DM). Initial insulin independence leads to misdiagnosis of type 2 diabetes.

AIM: This study sought to ascertain the prevalence and features of LADA in patients with type 2 diabetes in Port Sudan, Sudan.

METHODS: A comparative cross-sectional study was conducted from April 2020 to January 2024 at the Osman Degna Hospital and Ahmed Hassan Diabetic Center, Port Sudan. A total of 250 T2DM patients were recruited: 150 insulin-requiring patients after years of diagnosis (study group) and 100 non-insulin-requiring patients (control group). Structured interviews were used to gather demographic and clinical information, and a fully automated chemiluminescence immunoassay (CLIA) was used to quantify the blood levels of C-peptide, GAD-65A (glutamic acid decarboxylase 65 autoantibody), and IA-2A (Insulinoma-Associated Protein 2 Autoantibody) autoantibodies. SPSS version 26 was used for statistical analysis, and p<0.05 was chosen as the significance level.

RESULTS: 10.7% of patients with type 2 diabetes had LADA. Compared to the non-LADA group (1.47±0.04 ng/ml, p<0.0001), the C-peptide levels in the LADA group were significantly lower (0.50±0.18 ng/ml). Compared to non-LADA patients, GAD-65A and IA-2A autoantibody titers were higher in LADA patients (p<0.0001). Patients with LADA had lower waist circumferences (79.62±15.42 cm vs. 92.55±17.24 cm, p<0.0001) and BMIs (Body Mass Index) (21.02±4.21 kg/m2 vs. 24.02±3.48 kg/m2, p<0.0001). Furthermore, 68.75% of patients with LADA had a first-degree family history of diabetes, compared to 50% of non-LADA patients.

CONCLUSION: LADA is underdiagnosed, with a prevalence of 10.7% among T2DM Sudanese patients. GAD-65A autoantibodies are the most sensitive biomarker. For prompt diagnosis and treatment, early screening is recommended.

PMID:40737658

Georgian Med News. 2025 May;(362):92-97.

ABSTRACT

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder associated with long-term complications. Metformin, the first-line therapy for T2DM, has been implicated in nutrient malabsorption, particularly vitamin B12, potentially leading to hyperhomocysteinemia and related metabolic dysfunction.

OBJECTIVES: This study examines how serum levels of vitamin B12, folic acid, homocysteine, and glycemic control markers are affected in patients with type 2 diabetes by metformin and other oral antidiabetic medications (OADs).

METHODS: A total of 330 participants were recruited and split into four groups: 30 healthy controls, 100 newly diagnosed T2DM patients not taking any medication, 100 T2DM patients taking other OADs, and 100 T2DM patients taking metformin. Vitamin B12, folic acid, homocysteine, fasting blood glucose (FBG), HbA1c, and creatinine were measured using CMIA and enzymatic techniques in fasting blood samples. Kruskal-Wallis, independent t-tests, and Pearson’s correlation were all used in the statistical analysis.

RESULT: Compared to other groups, Group A (metformin users) had significantly higher homocysteine levels and significantly lower levels of folic acid and vitamin B12 (p<0.001). Age (r=-0.30), HbA1c (r=-0.54), homocysteine (r=-0.64), and FBG (r=-0.46) all showed a significant negative correlation with vitamin B12. Patients who took more than 1000 mg of metformin per day for more than five years had significantly lower vitamin B12 levels (p<0.001). Weight, creatinine, and BMI did not significantly differ between groups.

CONCLUSION: In patients with type 2 diabetes, prolonged high-dose metformin use is linked to worsened glycemic control, increased homocysteine, and vitamin B12 deficiency. For patients receiving long-term metformin therapy, routine vitamin B12 monitoring is advised to reduce the risk of complications from deficiencies.

PMID:40737654

Georgian Med News. 2025 May;(362):86-91.

ABSTRACT

OBJECTIVE: Medical statistics is a core competency for medical students, yet factors influencing learning outcomes remain understudied, particularly in resource-limited settings. This study examines how gender, learning attitudes, and teaching evaluations jointly shape learning outcomes in medical statistics education.

METHODS: A cross-sectional study design was employed to conduct a questionnaire survey and performance analysis among 243 medical students at a medical college in Anhui Province. Single-factor analysis, Pearson correlation, and multiple linear regression models were used to examine the effects of gender, learning attitude, and teaching evaluations on performance.

RESULTS: The mean learning outcome score was 72.39±12.96. Female students demonstrated significantly better outcomes than males (74.23 vs. 60.67, p < 0.001). The total learning attitude score positively correlated with learning outcomes (r=0.192), with value judgment (r=0.208) and effort level (r=0.204) being significant contributors (both p<0.05). Multivariate regression identified female gender (β=0.349, 95% CI: 8.72-17.61), favorable course evaluations (β=0.137), and positive learning attitudes (β=0.147) as independent predictors of improved learning outcomes.

CONCLUSION: Gender differences, learning attitudes, and teaching evaluations collectively influence learning outcomes in medical statistics. Targeted interventions for male students and enhanced emphasis on course value recognition may improve educational effectiveness.

PMID:40737653

Georgian Med News. 2025 May;(362):73-79.

ABSTRACT

Low back and neck pain are widespread issues with significant social and economic implications, often resulting from disc degeneration. While disc and vertebral degeneration are interconnected, variations in degeneration patterns between the cervical and lumbosacral regions remain underexplored. Understanding these differences is crucial for diagnosing and treating spinal disorders effectively. This study aims to compare the onset and progression of disc degeneration in the cervical and lumbosacral regions and perform an intra-patient analysis to assess region-specific degeneration patterns within the same individuals. We conducted a comprehensive MRI analysis of 150 patients, categorized into three groups: cervical spine MRI, lumbosacral spine MRI, and combined cervical/lumbosacral MRI. Disc degeneration was graded using the Pfirrmann classification, endplate degeneration with the Modic classification, osteophytes and hemangiomas were also assessed. Statistical analyses included tests of normality, Spearman’s rank correlation, logistic regression, and descriptive statistics to examine degeneration patterns and correlations between Pfirrmann grades and Modic changes. Cervical and lumbar regions both showed moderate to advanced degeneration (Pfirrmann grades 2-4), but severe degeneration (grade 5) was more prevalent at lower lumbar levels (L4/L5, L5/S1) compared to the cervical spine. Modic changes were more frequent in the lumbar spine, particularly at L4/L5 and L5/S1. Intra-patient analysis revealed stronger correlations between degeneration at adjacent lumbar levels compared to cervical levels, indicating more widespread and severe degeneration in the lumbar region. Logistic regression demonstrated a significant association between hemangiomas and higher Pfirrmann grades in the lumbar spine. The findings suggest distinct patterns of disc degeneration between the cervical and lumbar spine, with more severe and widespread degeneration in the lumbar region. This observation underscores the possible association of hemangiomas with spinal degeneration, suggesting a potential role in the degenerative process.

PMID:40737651

Georgian Med News. 2025 May;(362):37-45.

ABSTRACT

Research Rationale: Quality of life (QoL) is a critical public health concern, extending beyond clinical outcomes to encompass a wide range of social, psychological, and environmental factors. While the majority of QoL studies have focused on individuals with specific health conditions, it is now well-recognized that QoL is also significantly influenced by a variety of non-medical determinants.

STUDY OBJECTIVE: Тo evaluate the associations between socio-demographic characteristics, lifestyle factors, and quality of life among the adult population.

MATERIAL AND METHODS: Thе study was conducted as part of a scientific research project and included 180 male and female participants aged 16 to 60 years. Quality of life was assessed using a modified version of the Short Form-36 Health Survey (SF-36). Socio-demographic and lifestyle data were collected using a specially designed questionnaire. Statistical analysis was performed using SPSS version 22.0. To determine the significance of differences between two groups, the nonparametric Mann-Whitney U test was employed; for comparisons among three or more groups, the Kruskal-Wallis H test was used, followed by Dunn’s post hoc test for pairwise comparisons.

RESULTS: The findings indicate that women reported lower QoL than men, and QОL declined with age. Lower QОL scores were significantly associated with severe stress exposure, lack of cold exposure practices, physical inactivity, absence of regular vacations, poor housing conditions, high levels of morbidity among family members, low or below-average financial status, widowhood, and inadequate nutrition (p<0.05). A tendency toward increased psychological vulnerability was observed. The most affected QОL domains, in descending order, were: mental health, vitality, general health, role emotional functioning, social functioning, role physical functioning, physical functioning, and bodily pain (p<0.05).

CONCLUSIONS: The study highlights that socio-demographic disparities can introduce bias in population-based research and reduce the generalizability of findings. These factors should be carefully considered by public health and social care professionals to ensure accurate and equitable assessments.

PMID:40737646

Curr Med Sci. 2025 Jul 30. doi: 10.1007/s11596-025-00095-3. Online ahead of print.

ABSTRACT

OBJECTIVE: This is a self-controlled multicenter retrospective study based on the clinical efficacy and complications of physiological reconstruction in the treatment of moderate and severe pelvic organ prolapse.

METHODS: From December 2014 to August 2021, 517 women were included and registered for physiological reconstruction at four Chinese urogynecology institutions. We enrolled 364 women with POP-Q stage ≥ 3. The degree of POP was quantified via a POP-Q system. The surgical purpose of physiological reconstruction is to repair the vagina, levator ani muscle, perineum, and urogenital hiatus and adopt a repair method in accordance with the axial direction of physiology. All 330 evaluable participants were followed for 2 years. The evaluation indices included the PFDI-20, PGI-I, PFIQ-7, PISQ-12, PGI-I, and PGI-S. All complications were coded according to the category-time-site system proposed by the International Urogynecological Association (IUGA) and International Continence Society (ICS).

RESULTS: Compared with the preoperative POP-Q scores, statistically significant improvements were observed at the 6-month, 1-year and 2-year time points (P < 0.001). Statistically significant improvements in quality of life were observed across all time points.

CONCLUSIONS: Physiologic reconstructive surgical techniques combined with modified anterior pelvic floor mesh implantation could help restore the physiologic axis and vaginal shape, which may be the most important factors in maintaining the functional position of pelvic floor organs and is the most effective method for repairing the pelvic fascia tendon arch. This surgical method is safe, feasible, and effective in patients with severe prolapse.

PMID:40736934 | DOI:10.1007/s11596-025-00095-3

J Cancer Surviv. 2025 Jul 30. doi: 10.1007/s11764-025-01782-9. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Allostatic load (AL) significantly impacts patient outcomes. This study aimed to explore the association between AL levels and time to deterioration (TTD) of health-related quality of life (HRQoL) in non-small cell lung cancer (NSCLC) patients.

METHODS: A prospective study (May 2017-September 2022) included 362 NSCLC patients from The First Affiliated Hospital of Fujian Medical University. HRQoL was assessed using EORTC QLQ-C30 and EORTC QLQ-LC13 questionnaires, and AL-related biomarkers were collected. Univariate and multivariate Cox regression analyses evaluated the impact of AL on HRQoL TTD.

RESULTS: TTD events were most common in global health status (QL), physical functioning (PF), and dyspnea (LC-DY). Lower AL levels delayed TTD in emotional functioning (EF) (HR = 2.041, 95% CI: 1.404-2.969, P < 0.001), cognitive functioning (CF) (HR = 1.613, 95% CI: 1.082-2.403, P = 0.019), insomnia (SL) (HR = 1.553, 95% CI: 1.064-2.266, P = 0.022), constipation (CO) (HR = 2.114, 95% CI: 1.179-3.791, P = 0.012), and hemoptysis (LC-HA) (HR = 2.316, 95% CI: 1.037-5.172, P = 0.041). Multivariate analysis confirmed these findings, except for insomnia, which lost significance.

CONCLUSIONS: Lower AL levels delayed TTD in EF, CF, CO, and LC-HA, highlighting AL’s role in preserving HRQoL in NSCLC patients.

IMPLICATIONS FOR CANCER SURVIVORS: HRQoL is critical for cancer survivors. This study underscores the importance of AL to improve HRQoL outcomes in NSCLC patients.

PMID:40736930 | DOI:10.1007/s11764-025-01782-9

Updates Surg. 2025 Jul 30. doi: 10.1007/s13304-025-02328-5. Online ahead of print.

ABSTRACT

This study aims to compare postoperative outcomes of video-assisted thoracoscopic surgery (VATS) and thoracotomy in elderly patients undergoing segmentectomy or lobectomy for primary non-small cell lung cancer (NSCLC). A retrospective analysis was conducted on 129 patients aged 70 years or older who underwent anatomical lung resection (segmentectomy or lobectomy) for NSCLC between January 2016 and June 2021. Patients were divided into two groups based on surgical approach: VATS and thoracotomy. Demographics, tumor characteristics, postoperative complications, chest drainage duration, hospital stay, and short- and mid-term mortality rates were analyzed and compared. The mean age of patients was 73.5 ± 3.2 years, with 55% undergoing surgery via VATS. The VATS group had significantly shorter chest drainage duration (median 4 vs. 6 days, p < 0.001) and hospital stay (median 6 vs. 7 days, p < 0.001). Minor complications were more common in the thoracotomy group (p = 0.022), while no significant differences were found in major complications (p = 0.888). Thirty-day, ninety-day, one-year, and in-hospital mortality rates showed no statistically significant differences between groups. Both VATS and thoracotomy are viable surgical options for elderly NSCLC patients, with similar mortality and major morbidity rates. However, VATS provides advantages in terms of reduced chest drainage duration and shorter hospitalization. Surgical approach should be individualized, taking into account patient characteristics and surgical risk.

PMID:40736929 | DOI:10.1007/s13304-025-02328-5

Coron Artery Dis. 2025 Jul 31. doi: 10.1097/MCA.0000000000001558. Online ahead of print.

ABSTRACT

BACKGROUND: Carotid artery stenosis is a significant predictor of perioperative stroke risk in patients undergoing coronary artery bypass grafting (CABG). Identifying noninvasive, simple, and clinically relevant biomarkers for risk stratification is crucial in this population. The CALLY index, a composite marker reflecting systemic inflammation and nutritional status, has shown prognostic value in various diseases. However, its relationship with carotid artery stenosis in patients undergoing isolated CABG remains unclear. This study aimed to evaluate the relationship between carotid artery stenosis and the CALLY index in patients undergoing isolated CABG.

METHODS: This retrospective, single-center study included 820 patients who underwent isolated CABG and preoperative carotid Doppler ultrasonography between January 2020 and December 2024. The degree of carotid artery stenosis was classified into three groups (<50, 50-70, >70%). CALLY index values were calculated using lymphocyte count, albumin, and C-reactive protein (CRP) levels. Statistical analyses included Kruskal-Wallis H and Spearman’s rank correlation tests.

RESULTS: The CALLY index was significantly lower in patients with higher degrees of carotid artery stenosis (P < 0.001). A strong negative correlation was found between the CALLY index and carotid stenosis severity (Spearman’s rho = -0.831, P < 0.001).

CONCLUSION: Low CALLY index values are significantly associated with the presence and severity of carotid artery stenosis in patients undergoing isolated CABG. The CALLY index may serve as a simple and practical biomarker for preoperative risk assessment, aiding in the identification of high-risk patients and potentially improving surgical outcomes.

PMID:40736922 | DOI:10.1097/MCA.0000000000001558

J Vector Borne Dis. 2025 Jul 30. doi: 10.4103/jvbd.jvbd_16_25. Online ahead of print.

ABSTRACT

BACKGROUND OBJECTIVES: The proportion of asymptomatic malaria is no doubt one of the factors determining the dynamics of its transmission and burden in endemic areas. This research focused on screening for Plasmodium parasitemia and analysing the relationship between proportions of malaria cases among asymptomatic and symptomatic persons in Lokoja, Northcentral Nigeria.

METHODS: Cross-sectional survey and experimental designs were adopted. A semi-structured interview guide was used to collect data on socio-demography and clinical status of the participants. Blood samples were randomly collected from 328 consenting participants during high transmission season (April – October) of malaria within a three-year period (2018-2021), and screened for Plasmodium species by light microscopy (LM). Statistical analyses of related parameters were performed using the Statistical Package for the Social Sciences (SPSS) version 25 software.

RESULTS: A total of 12.4% (25/202) and 85.7% (108/126) asymptomatic and symptomatic individuals were recorded respectively. There was no significant difference (p > 0.05) between the mean distributions of malaria cases among the asymptomatic and those of symptomatic persons. All cases identified were uncomplicated and falciparum-specific; and a 40.5% (133/328) prevalence of P. falciparum malaria with hyperparasitemia was observed in the area. The implications of these findings were discussed in relation to previous rates and other nearby endemic settings.

INTERPRETATION CONCLUSION: As a matter of success towards malaria elimination, a renewed call is made for regular monitoring of malaria prevalence using more efficient means of diagnosis and consideration of control strategies such as regular mass antimalarial administration, particularly targeting the often-neglected asymptomatic reservoir subset.

PMID:40736912 | DOI:10.4103/jvbd.jvbd_16_25