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Prognostic analysis of children with tetralogy of Fallot through a small incision in the right axilla

Front Cardiovasc Med. 2025 Jun 30;12:1457554. doi: 10.3389/fcvm.2025.1457554. eCollection 2025.

ABSTRACT

OBJECTIVE: Compare the clinical efficacy of a minimally invasive small incision in the right axilla vs. traditional median sternotomy in the surgical treatment of tetralogy of Fallot (TOF).

METHODS: A retrospective analysis was conducted on 330 infants and young children under the age of 3 who underwent radical surgery for tetralogy of Fallot between March 2022 and March 2024. Patients were categorized into two groups based on the surgical approach. To ensure the consistency of preoperative baseline data (weight, gender, age, O2 saturation, main pulmonary artery and pulmonary branches diameter, McGoon ratio) between the two groups, the propensity score matching method was applied for 1:1 matching, resulting in two cohorts of 228 cases. The minimally invasive group (n = 114) received surgery through a small incision in the right axilla, while the median sternotomy group (n = 114) underwent surgery via median sternotomy. Clinical parameters including demographic data (weight, gender, age, O2 saturation, main pulmonary artery and pulmonary branches diameter, McGoon ratio), cardiopulmonary bypass metrics (duration of bypass, aortic cross-clamp time), duration of mechanical ventilation, intensive care unit (ICU) stay, postoperative chest drainage volume within 24 h, pulmonary valve regurgitation, and complications (reintubation, peritoneal dialysis, reoperation, extracorporeal membrane oxygenation (ECMO) use, infection, and mortality) were collected for comparison between groups.

RESULTS: No statistically significant differences were observed between the two groups in 24 h chest drainage volume, mortality, reintubation, reoperation, ECMO use, and infection. However, the minimally invasive group showed significantly shorter ventilator duration and ICU stay and a reduced rate of peritoneal dialysis (all p < 0.05).

CONCLUSION: In infants and children under 3 years old with TOF, surgical correction via a right axillary small incision achieves equivalent clinical outcomes to traditional median sternotomy, without increasing postoperative mortality or complication rates. In addition, the minimally invasive approach offers benefits of reduced surgical trauma and enhanced postoperative recovery.

PMID:40662136 | PMC:PMC12256465 | DOI:10.3389/fcvm.2025.1457554

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Regulatory T Cell Dysregulation in Vitiligo: A Meta-Analysis and Systematic Review of Immune Mechanisms and Therapeutic Perspectives

Int J Dermatol. 2025 Jul 14. doi: 10.1111/ijd.17959. Online ahead of print.

ABSTRACT

Vitiligo is an autoimmune disorder marked by the progressive loss of skin melanocytes, increasingly linked to immune dysregulation as a key driver of disease onset and progression. Regulatory T (Treg) cells are essential for maintaining immune homeostasis by suppressing autoreactive immune responses. Mounting evidence implicates functional and numerical alterations in Treg cells in the pathogenesis of vitiligo. This study reviews findings on lesional and circulating Treg cells in vitiligo patients compared to healthy controls (HCs), examining Treg cell frequency, their ability to suppress CD4+ and CD8+ T cell activity, levels of the immunoregulatory cytokines interleukin-10 (IL-10) and transforming growth factor-β (TGF-β), expression of the key suppressive marker FOXP3, as well as levels of the pro-inflammatory cytokines interleukin-17 (IL-17) and interleukin-22 (IL-22). A comprehensive systematic search was performed across Embase, MEDLINE/PubMed, and Scopus databases to identify eligible studies. A total of 21 studies comprising 1016 vitiligo patients and 846 HCs were included in the review. The analysis revealed a significant reduction in peripheral Treg cell counts (p = 0.01), impaired overall suppressive capacity of CD4+ and CD8+ T cells (p = 0.01), reduced levels of IL-10 (p = 0.02), increased levels of IL-17 (p ≤ 0.01) and IL-22 (p ≤ 0.01) in the blood of vitiligo patients compared to HCs. No statistically significant difference was observed in circulating TGF-β levels (p = 0.1). Most studies reported reduced FOXP3 expression in both skin and blood of vitiligo patients. Current evidence suggests vitiligo involves both reduced numbers and impaired function of Treg cells, supporting further study of Treg pathways as targets for immunomodulatory therapy.

PMID:40660423 | DOI:10.1111/ijd.17959

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Combined effects of dietary inflammatory index and vigorous physical activity on abdominal adipose tissue: analysis of NHANES 2011-2018

J Health Popul Nutr. 2025 Jul 14;44(1):254. doi: 10.1186/s41043-025-00991-3.

ABSTRACT

BACKGROUND: The accumulation of abdominal visceral (VAT) and subcutaneous adipose tissue (SAT) has been closely correlated with an array of metabolic disorders and chronic inflammation. This study elucidated the joint effects of a dietary inflammatory index (DII) and vigorous intensity physical activity (PA) on VAT and SAT.

METHODS: The study enrolled 3,444 adults sourced from the National Health and Nutrition Examination Survey (NHANES). The NHANES is designed with a sophisticated, multistage probability sampling methodology and is specifically tailored to comprehensively assess the health and nutritional conditions of the non-institutionalized population. Utilizing the initial 24 h dietary recall data from the NHANES database, our analysis incorporated 28 distinct food parameters for calculating the DII score. Multiple linear regression models are used to calculate the β value and 95% confidence interval of independent and dependent variables.

RESULTS: Compared with the pro-inflammatory diet group, VAT and SAT in the anti-inflammatory diet group were lower [-21.60 (-32.63, -10.58, P < 0.01) and – 85.67 (-108.80, -62.55, P < 0.01)]. The VAT and SAT in the sufficient vigorous intensity PA group were lower than those in the insufficient vigorous intensity PA group [-27.13 (-38.40, -15.86), P < 0.01; -57.05 (-80.82, -33.27), P < 0.01]. There was a linear positive association between DII with VAT (P < 0.01, P for nonlinearity = 0.13) and SAT (P < 0.01, P for nonlinearity = 0.06). Additionally, there were significant L-shaped relationships between vigorous intensity PA with VAT and SAT (all log-likelihood ratio P < 0.05).

CONCLUSION: A lifestyle of anti-inflammatory diet incorporated with sufficient vigorous intensity PA was associated with lower VAT and SAT. Notably, the increase of vigorous intensity PA is associated with the decrease of VAT and SAT in the L-shaped relationships, suggesting that the vigorous intensity PA with at least 75 min per week may be related to greater benefits of VAT.

PMID:40660417 | DOI:10.1186/s41043-025-00991-3

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The chemosynthetic biofilm microbiome of deep-sea hydrothermal vents across space and time

Environ Microbiome. 2025 Jul 14;20(1):88. doi: 10.1186/s40793-025-00738-x.

ABSTRACT

Microbial biofilms colonize mineral and biological substrates exposed to fluid circulation at deep-sea hydrothermal vents, providing a biologically active interface along redox boundaries. Since many biofilms at deep-sea vents are associated with invertebrates, microbial distribution and abundance are not only constrained by local fluid geochemistry, but also through host-microbe interactions. This study examined the spatial distribution and diversity of established microbial biofilm communities collected from three distinct biological regimes characteristic of the East Pacific Rise (9°50 N, 104°17 W) vent system, as well as newly established biofilms on experimental microbial colonization devices. Transcripts from 16S rRNA-based amplicon sequencing revealed that Campylobacterota of the Sulfurimonas and Sulfurovum genera dominated newly-formed biofilms across all biological regimes. Statistical analyses using environmental chemistry data from each sampling site suggest that community composition is significantly impacted by biofilm age, temperature and sulfide concentration ranges, and to a lesser extent, locality. Further, metatranscriptomic analyses were used to investigate changes in community gene expression between seafloor and subseafloor biofilms. Our findings revealed differences in the type and abundance of transcripts related to respiratory pathways, carbon fixation and reactive oxygen species (ROS) detoxification. Overall, this study provides a novel conceptual framework for evaluating biofilm structure and function at deep-sea vents by showing a transition from a niche-specific pioneer microbial community in newly-formed biofilms, to a complex population of increased diversity in established biofilms and by identifying key changes in gene expression in taxonomically similar biofilms during the transition from the shallow subseafloor to the seafloor.

PMID:40660416 | DOI:10.1186/s40793-025-00738-x

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Trends in enhanced recovery after surgery (ERAS) in thoracic surgery from a bibliometric insight

Hereditas. 2025 Jul 14;162(1):131. doi: 10.1186/s41065-025-00501-9.

ABSTRACT

BACKGROUND: In thoracic surgery, the concept of Enhanced Recovery After Surgery (ERAS) has been extensively implemented. Although numerous studies have investigated ERAS in thoracic surgery, bibliometric analyses remain limited. In this study, the developmental trajectory, current research status, and prospective trends of ERAS in thoracic surgery were systematically analyzed through bibliometric and visual analysis techniques.

METHODS: Literature pertaining to ERAS in thoracic surgery was retrieved from the Web of Science Core Collection (WoSCC). Microsoft Excel 2019, R software (version 4.1.0), the Bibliometric Online Analysis Platform, VOSviewer (version 1.6.18), and Citespace (version 6.3.R1) were utilized for statistical analysis, bibliometric evaluation, and data visualization.

RESULTS: A total of 617 publications were retrieved over the past decade. The number of publications has generally demonstrated an upward trend from 2015 to 2024. China and Sichuan University ranked as the leading country and institution, respectively, in terms of publication volume. The Journal of Thoracic Disease was identified as the leading journal in both publication count and citation frequency. Henrik Kehlet was recognized as the most prolific and highly co-cited author. Current research hotspots include “video-assisted thoracic surgery,” “pain management,” and “multicenter clinical trials.”

CONCLUSION: ERAS-related research in thoracic surgery has been increasing steadily, highlighting it as a rapidly evolving and promising field. The ERAS concept plays a critical role in all perioperative phases-preoperative, intraoperative, and postoperative-and requires further in-depth investigation. Many existing ERAS studies in thoracic surgery lack high-quality evidence, underscoring the urgent need for rigorously designed research with robust methodological standards.

PMID:40660412 | DOI:10.1186/s41065-025-00501-9

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Chronic lung diseases (Asthma and COPD) among middle-aged and older populations in India: social, individual, and household determinants and their associations with geriatric syndromes

Arch Public Health. 2025 Jul 14;83(1):186. doi: 10.1186/s13690-025-01675-4.

ABSTRACT

BACKGROUND: India’s ageing population presents new health challenges, particularly the rising burden of lung diseases like Asthma and COPD among middle-aged and older adults. These conditions weaken individuals and heighten the risk of geriatric complications. Understanding their interplay with socio-economic, demographic, and household factors is essential for informed public health interventions.

OBJECTIVES AND METHODS: This study investigates the growing burden of Asthma and COPD among Indian individuals aged 45 years and above using LASI Wave 1 data. Unadjusted prevalence was calculated across predictor variables. Poisson regression identified factors associated with Asthma and COPD, while logistic regression examined their unadjusted and adjusted associations with geriatric syndromes.

RESULTS: The study reveals that the prevalence of Asthma and COPD among individuals aged 45 years and above is 4.38% and 2.1%. It reveals distinct yet overlapping risk patterns for both Asthma and COPD. For both diseases, the risk increases significantly with age, particularly for those aged 60 years and above, and is higher among wealthier individuals and those belonging to SC, OBC, or non-classified social groups. Women are less likely to suffer from both diseases, while discontinued smoking elevates the risk for both. Employment status influences both conditions differently, those currently working are less likely to have COPD and Asthma. Household factors such as the absence of a separate kitchen increase the risk for both diseases. Cooking on open fires and exposure to passive smoking significantly heighten the risk of COPD. Regional variations persist, with lower risk in the North-East and elevated risks in the South. Both diseases show significant association with geriatric syndromes such as ADL (1.418 for Asthma and 1.424 for COPD), IADL (1.587 for Asthma and 1.542 for COPD), and Falls ((1.172 for Asthma and 1.320 for COPD)), after adjusting for various individual and household determinants.

CONCLUSION: The study reveals complex relationships between social, individual and household factors, chronic lung diseases (Asthma and COPD), and age-related complications in India’s older population.It highlights the need for targeted treatments addressing both lung diseases and geriatric complications, guiding policymakers in framing healthcare policies to promote healthy aging in India’s diverse older population.

PMID:40660407 | DOI:10.1186/s13690-025-01675-4

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Tumor markers level profile in dermatomyositis, systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis and ovarian cancer

Eur J Med Res. 2025 Jul 14;30(1):618. doi: 10.1186/s40001-025-02892-x.

ABSTRACT

BACKGROUND: Autoimmune diseases (AID) have been showed to be susceptibility to malignancy. This study aimed to analyzed the profile of serum tumor markers in four common autoimmune disease.

METHODS: Patients with dermatomyositis (DM, n = 132), Systemic sclerosis (SSc, n = 77), Systemic lupus erythematosus (SLE, n = 191), Rheumatoid arthritis (RA, n = 160) and ovarian cancer (n = 250) were included in this study. Twelve tumor markers (CA724, AFP, FRT, NSE, CA19-9, CA125, CYFRA21-1, CA153, β-HCG and HE4) levels and abnormal rate in these patients were retrospective statistics. The tumor markers profiles were compared among the different AID.

RESULTS: Compared with ovarian cancer (OV) patients, there were no significant differences for the levels and abnormal rates of CYFRA21-1/HE4/CA50/FRT in AID patients. The levels and abnormal rates of CA724/FRT/CA125/NSE were higher in OV patients than that in AID patients. 75% AID patients have at least one elevated tumor marker. 69.46% AID patients have 2-5 elevated tumor markers. All the 12 tumor markers were negative in 16.67, 19.74, 27.23 and 32.70% of DM, SSc, SLE and RA patients. Except CA50, the levels of the other eleven tumor markers were significantly different between DM/SSc/SLE/RA. Except AFP/β-HCG/SCC, the abnormal rate of the other tumor markers were significantly different between these AID.

CONCLUSIONS: The increased levels of tumor makers were common in four major AID, and the profile of tumor makers were significantly different among these AID.

PMID:40660406 | DOI:10.1186/s40001-025-02892-x

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Effect of intravenous and intra-cuff magnesium sulphate on post-extubation tracheal morbidity: a randomised single-blind study

J Anesth Analg Crit Care. 2025 Jul 14;5(1):43. doi: 10.1186/s44158-025-00246-x.

ABSTRACT

BACKGROUND: Post-extubation sore throat (PEST), cough, and hoarseness are common complications of tracheal intubation. Several agents and techniques have been postulated to reduce their occurrence.

AIM: This study sought to compare the effects of intravenous and intra-cuff magnesium sulphate on the incidence and severity of PEST, cough and hoarseness of voice.

MATERIALS AND METHODS: This was a randomised single-blind study involving 90 surgical patients requiring endotracheal intubation. Patients were randomised into 3 groups: A (control), B (intra-cuff magnesium sulphate) and C (intravenous magnesium sulphate). Participants in Group A had the endotracheal tube cuff (ETTc) inflated with air to a pressure of 25 cmH2O whilst those in Group B had the ETTc inflated with 2 g of magnesium sulphate solution and the pressure adjusted to 25 cmH2O with top-ups of 0.9% normal saline. Participants in Group C had the ETTc filled with air to a pressure of 25 cmH2O and received 2 g of intravenous magnesium sulphate in 20 ml of 0.9% normal saline perfused over 10 min immediately prior to the induction of general anaesthesia. The occurrence of PEST, cough and hoarseness of voice were recorded at 0, 4, 8, 12 and 24 h after surgery.

RESULTS: The incidence of PEST on swallowing in the intra-cuff magnesium sulphate group compared to the intravenous magnesium sulphate group at 4, 8, and 12 h post-operatively were 51.7% vs 12.5%, 51.7% vs 18.8% and 51.7% vs 21.9% respectively. Compared to intra-cuff magnesium sulphate, intravenous magnesium sulphate significantly reduced the incidence and severity of PEST during swallowing at 4, 8, and 12 h. The incidence of PEST at rest in the intra-cuff magnesium sulphate group compared to the intravenous magnesium sulphate group at 0, 4, 8, 12 and 24 h post-operatively were 13.8% vs 9.4%, 20.7% vs 6.3%, 17.2% vs 6.3%, 13.8% vs 3.1% and 13.8% vs 3.1% respectively. Compared to intra-cuff magnesium sulphate, intravenous magnesium sulphate reduced the incidence of PEST at rest, though this was not statistically significant over first 24 h postoperative period. Intravenous magnesium sulphate had significantly lower PEST severity scores at rest at 12 h only compared to intra-cuff magnesium sulphate. There was no statistically significant difference in the incidence and severity of cough and hoarseness between the study groups.

CONCLUSION: Intravenous magnesium sulphate given at induction was found to be better compared to intra-cuff magnesium sulphate in lowering the incidence and severity of post-extubation sore throat on swallowing but not at rest. However, it does not significantly reduce the incidence or severity of post-extubation cough or hoarseness.

TRIAL REGISTRATION: PACTR202211634990263.

PMID:40660404 | DOI:10.1186/s44158-025-00246-x

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The impact of abrocitinib treatment on lesion area and pruritus in patients with atopic dermatitis: a systematic review and meta-analysis

Eur J Med Res. 2025 Jul 14;30(1):617. doi: 10.1186/s40001-025-02873-0.

ABSTRACT

BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense itching and lesions that significantly impact patients’ quality of life. Abrocitinib, a selective Janus kinase 1 (JAK1) inhibitor, has shown promise in treating AD by targeting inflammatory pathways linked to disease symptoms. This systematic review and meta-analysis evaluates the effectiveness of abrocitinib in reducing lesion severity and pruritus in AD patients.

METHODS: A systematic search of PubMed, Embase, Web of Science, and Cochrane Library was conducted on September 19, 2024, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies were randomized controlled trials assessing abrocitinib’s effects on lesion area and pruritus in AD patients. Data extraction and quality assessment were performed using the Cochrane risk of bias tool. Statistical analyses, including meta-regression and subgroup analysis, were conducted using Stata. Funnel plots were examined to assess publication bias.

RESULTS: Five studies met inclusion criteria, with sample sizes ranging from 267 to 837 participants. Abrocitinib significantly improved Investigator’s Global Assessment (IGA) and Eczema Area and Severity Index (EASI-75) scores, as well as pruritus scores on the Pruritus Patient Numeric Rating Scale (PP-NRS), compared to placebo (all P < 0.001). A dose-response effect was observed, with higher efficacy at the 200 mg dose. The incidence of treatment-emergent adverse events (TEAEs) was higher in the intervention group, particularly at 200 mg, though no significant difference was noted in serious adverse events (SAEs) between groups.

CONCLUSIONS: Abrocitinib is effective in reducing lesion severity and pruritus in AD, with dose-dependent improvements. Despite a higher incidence of manageable TEAEs at 200 mg, no significant increase in SAEs was observed, supporting abrocitinib’s safety and efficacy as a treatment for moderate to severe AD.

REGISTRATION: CRD420251056272.

PMID:40660399 | DOI:10.1186/s40001-025-02873-0

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Role of placental extracts in enhancing periodontal flap surgery healing: insights from periostin biomarker analysis

Eur J Med Res. 2025 Jul 14;30(1):623. doi: 10.1186/s40001-025-02891-y.

ABSTRACT

BACKGROUND: The elimination of the causative agent and the facilitation of tissue regeneration are the fundamental objectives of periodontal therapy. Various adjunctive agents have been investigated to optimize treatment outcomes with surgical interventions. Periostin is a matricellular protein predominantly expressed in periodontal tissues, playing a key role in tissue remodeling, inflammation, and wound healing. The human placental extract has been used in periodontal surgery and compared with open flap debridement alone, with gingival crevicular fluid (GCF) periostin levels assessed to gauge periodontal wound healing.

METHODS: Sixteen systemically healthy patients diagnosed with Stage III Grade C periodontitis were enrolled in the study. Participants were randomly assigned to either the test group (n = 8) or the control group (n = 8), with a total of nine males and seven females distributed across the groups. The test group underwent open flap debridement (OFD), followed by applying human placental extract gel absorbed into a gelatin sponge, while the control group received only OFD. Clinical parameters were assessed at baseline and 3 month post-treatment. GCF periostin levels were measured at baseline, 6 weeks, and 3 months.

RESULTS: The test group demonstrated a mean probing pocket depth (PPD) reduction of 4.75 ± 1.28 mm, compared to 3.12 ± 1.12 mm in the control group, with the difference being statistically significant. The relative attachment level (RAL) gain was 4.37 ± 1.18 mm in the test group and 2.75 ± 0.70 mm in the control group; however, this difference was not statistically significant. At 3 months, the mean healing index score was 4.50 ± 0.53 in the test group and 3.62 ± 0.51 in the control group, with a statistically significant intergroup difference. The Plaque Index (PI), Gingival Index (GI), and Gingival Bleeding Index (BI) showed moderate reductions at 3 months; however, intergroup differences were not statistically significant, except for BI, where the difference at 3 months was -0.180.

CONCLUSIONS: The adjunctive use of placental extract gel in surgical periodontal therapy demonstrated beneficial effects on healing outcomes. In addition, periostin shows promise as a biomarker for periodontal wound healing.

PMID:40660386 | DOI:10.1186/s40001-025-02891-y