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{"title":"The methyl-CpG binding domain 2 regulates peptidylarginine deiminase 4 expression and promotes neutrophil extracellular trap formation via the Janus kinase 2 signaling pathway in experimental severe asthma.","authors":"Biao Peng, Mu-Yun Yan, Yun-Rong Chen, Fei Sun, Xu-Dong Xiang, Da Liu","doi":"10.1080/07853890.2025.2458207","DOIUrl":"10.1080/07853890.2025.2458207","url":null,"abstract":"<p><strong>Objective: </strong>The prognosis for severe asthma is poor, and the current treatment options are limited. The methyl-CpG binding domain protein 2 (MBD2) participates in neutrophil-mediated severe asthma through epigenetic regulation. Neutrophil extracellular traps (NETs) play a critical role in the pathogenesis of severe asthma. This study aims to detect if MBD2 can reduce NETs formation and the potential mechanism in severe asthma.</p><p><strong>Methods: </strong>A severe asthma model was established in C57BL/6 wild-type mice exposure to house dust mite (HDM), ovalbumin (OVA), and lipopolysaccharide (LPS). Enzyme-linked immunosorbent assay was used to measure the concentrations of IL-4, IL-17A, and IFN-γ in lung tissues. Flow cytometry was employed to determine the percentages of Th2, Th17, and Treg cells in lung tissues. Quantitative real-time polymerase chain reaction was utilized to assess the mRNA expression levels of MBD2, JAK2, and PAD4. Western blotting and immunofluorescence were conducted to detect the protein of MBD2, JAK2, PAD4, and CitH3. HL-60 cells were differentiated into neutrophil-like cells by culturing in a medium containing dimethyl sulfoxide and then stimulated with LPS. KCC-07, Ruxolitinib, and Cl-amidine were used to inhibit the expressions of MBD2, JAK2, and PAD4, respectively.</p><p><strong>Results: </strong>Severe asthma mice were characterized by pulmonary neutrophilic inflammation and increased formation of neutrophil extracellular traps (NETs). The expression of MBD2, JAK2, and PAD4 was elevated in severe asthma mice. Inhibiting the expression of MBD2, JAK2, and PAD4 reduced NETs formation and decreased airway inflammation scores, total cell counts and neutrophil counts in BALF, and percentage of Th2 and Th17 cell in lung tissues, whereas increasing Treg cell counts. In both severe asthma mice and HL-60-differentiated neutrophil-like cells <i>in vitro</i>, inhibiting MBD2 reduced the mRNA and protein expression of JAK2 and PAD4, and inhibiting JAK2 reduced the expression of PAD4 mRNA and protein.</p><p><strong>Conclusion: </strong>MBD2 regulates PAD4 expression through the JAK2 signaling pathway to promote NETs formation in mice with severe asthma. Further bench-based and bedside-based studies targeting the MBD2, PAD4, and JAK2 signaling pathways will help open new avenues for drug development of severe asthma.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2458207"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic ability for common skin diseases among general practitioners working in community health service centers in Shanghai, China: a cross-sectional study.","authors":"Lei Zhang, Guanghui Wang, Haiying Chen, Xiaoqing Gu, Minjie Jia, Ying Yu, Xiaoxiao Cao, Ruiping Wang","doi":"10.1080/07853890.2024.2442066","DOIUrl":"10.1080/07853890.2024.2442066","url":null,"abstract":"<p><strong>Objective: </strong>Primary care general practitioners (GPs) play a crucial role in common skin diseases (CSDs) diagnosis and treatment for community residents. This study investigates their clinical diagnostic ability for CSDs and influencing factors among GPs in Shanghai.</p><p><strong>Methods: </strong>In 2023, we recruited 5745 GPs in Shanghai, and online survey was conducted among 5745 GPs with written informed consents. Images of ten CSDs was used to evaluate the diagnostic ability among GPs, logistic regression (LR) analysis was applied to explore influencing factors in GPs with a good skin diseases diagnostic ability.</p><p><strong>Results: </strong>The 5745 GPs included 1740 male (30.3%), the age ranged from 25 to 60 years with an average of age of 40.8 years. The total score for GSDs diagnostic ability ranged from 2 to 10, with a median of 7.5. In this study, GPs who have achieved ≥ 9 scores were identified as GPs with good diagnostic ability, with a prevalence of 26.7%. LR analysis indicated that GPs with 11 to 15 and over 15 years of work experience had a higher prevalence of good diagnostic ability compared with those with <5 years, the OR was 1.23 (95% CI: 1.02-1.48) and 1.25 (95% CI: 1.05-1.49) respectively. GPs with advanced studies [OR = 1.61, 95% CI:1.33-1.95] and work experience [OR = 1.39, 95% CI:1.20-1.61] in dermatology had a higher prevalence of good diagnostic ability.</p><p><strong>Conclusion: </strong>The diagnostic ability for CSDs was good among GPs in Shanghai. GPs with more years of work, advanced studies and work experience in dermatology have better diagnostic abilities CSDs.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2442066"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The expression and clinical significance of serum exosomal-long non-coding RNA DLEU1 in patients with cervical cancer.","authors":"Yu Chen, Facai Cui, Xiaoyu Wu, Weifeng Zhao, Qingxin Xia","doi":"10.1080/07853890.2024.2442537","DOIUrl":"10.1080/07853890.2024.2442537","url":null,"abstract":"<p><strong>Background: </strong>Accumulating evidence has demonstrated that the long non-coding RNA (lncRNA) lymphocytic leukaemia deletion gene 1 (DLEU1) is abnormally overexpressed in many cancer types, including cervical cancer (CC). However, the potential clinical significance of DLEU1 in serum exosomes of patients with CC remains unclear.</p><p><strong>Methods: </strong>The expression of serum exosomal DLEU1 was detected by quantitative real-time polymerase chain reaction (qRT-PCR). A receiver operating characteristic (ROC) curve was plotted to evaluate the clinical diagnostic efficacy of DLEU1. The Kaplan-Meier survival curve and Cox proportional hazards model were used to assess the effect of DLEU1 on postoperative recurrence, metastasis and prognosis among patients with CC.</p><p><strong>Results: </strong>Our research showed that DLEU1 expression in the serum exosomes of patients with CC was significantly upregulated compared to that in patients with cervical intraepithelial neoplasia (CIN) and healthy controls (HCs) (both <i>p</i> < .001). DLEU1 relative expression was significantly correlated with tumour size, cervical invasion depth, pathological grade, International Federation of Gynecology and Obstetrics (FIGO) stage and lymph node metastasis among patients with CC (<i>p</i> < .01 all). The combined detection of DLEU1, carbohydrate antigen 125 (CA-125) and squamous cell carcinoma (SCC) exhibited significantly higher diagnostic efficiency (<i>p</i> < .01). Furthermore, the overall survival (OS) and disease-free survival (DFS) of CC patients in the high DLEU1 expression group were markedly lower than those in the low DLEU1 expression group (both <i>p</i> < .01). Cox univariate and multivariate regression analyses indicated that DLEU1 was an independent risk factor for postoperative recurrence and metastasis in CC patients.</p><p><strong>Conclusions: </strong>Our findings suggest that serum exosome DLEU1 has certain clinical value for diagnosing, monitoring recurrence and metastasis, and evaluating CC prognosis.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2442537"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of amniotic fluid on hair follicle growth.","authors":"Gamze Tumentemur, Elif Ganime Aygun, Bulut Yurtsever, Didem Cakirsoy, Ercument Ovali","doi":"10.1080/09546634.2025.2451389","DOIUrl":"https://doi.org/10.1080/09546634.2025.2451389","url":null,"abstract":"<p><p><b>Purpose:</b> Human amniotic fluid stem cells (hAFSCs) have shown significant regenerative potential in treating hair loss, wound healing, and tissue repair. This study aims to evaluate the effects of human amniotic fluid (hAF) on hair follicle (HF) regeneration and immune system modulation.</p><p><p><b>Materials and Methods:</b> The hAF used was pooled, acellular, and gamma-irradiated to standardize its contents and enhance its stability. Both irradiated (FAFI) and non-irradiated (FAF) hAF were assessed for their efficacy and safety in promoting hair growth and modulating immune responses in a rat model of hair loss. The study examined HF regeneration, transition to the anagen phase, and macrophage polarization from the pro-inflammatory M1 phenotype to the anti-inflammatory M2 phenotype.</p><p><p><b>Results:</b> Both FAF and FAFI treatments significantly increased HF density, with FAFI exhibiting enhanced effects. Histological analysis demonstrated improved HF regeneration, increased M2 macrophages, and reduced collagen fiber deposition in treated areas. Gamma irradiation likely improved the efficacy of FAFI by stabilizing active components and inhibiting protease activity.</p><p><p><b>Conclusions:</b> Irradiated hAF is a safe and effective therapeutic candidate for alopecia and HF growth disorders. These findings support further evaluation of hAF in clinical trials to validate its potential for hair regeneration therapies.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":"36 1","pages":"2451389"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and epidemiological characteristics of respiratory syncytial virus, SARS-CoV-2 and influenza paediatric viral respiratory infections in southwest Saudi Arabia.","authors":"Ali Alsuheel Asseri, Saleh M Al-Qahtani, Ibrahim A Alzaydani, Ahmed Al-Jarie, Noha Saad Alyazidi, Ali A Alrmelawi, Alya Musfer Alqahtani, Rahaf S Alsulayyim, Ameerah K Alzailaie, Dhay M Abdullah, Abdelwahid S Ali","doi":"10.1080/07853890.2024.2445791","DOIUrl":"https://doi.org/10.1080/07853890.2024.2445791","url":null,"abstract":"<p><strong>Background: </strong>There is a global consensus that respiratory tract infections are the major causes of morbidity and mortality among children. In this study, we aimed to compare the clinical and epidemiological characteristics of respiratory syncytial virus (RSV), influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among children admitted to hospital with acute respiratory infections. We also opted to identify the predictors of paediatric intensive care unit (PICU) admission.</p><p><strong>Methods: </strong>In this study, a retrospective investigation and analysis of 423 children who were admitted to Abha Maternity and Children Hospital, in the southern region of Saudi Arabia, between January and December 2022 were conducted.</p><p><strong>Results: </strong>The median age of these children was 16.5 months (Q1-Q3: 6-46.3). It was observed that the infectivity levels of RSV, SARS-CoV-2, influenza A and influenza B infections peaked in early to mid-September, mid-July, May and June, and October, respectively. There was a statistically significant difference in the total WBC counts between RSV and influenza B (<i>p</i> = 0.035) and SARS-CoV-2 and influenza B (<i>p</i> = 0.013). Moreover, there was a statistically significant difference in the absolute lymphocyte count between influenza A and RSV (<i>p</i> = 0.002). The median number of days in hospital was 6 days (Q1-Q3: 4-10). Patients with RSV infection required a significantly longer hospital stay, with a median of 8 days (Q1-Q3: 4-10). The factors associated with the likelihood of PICU admission for all study participants were congenital heart disease (odds ratio (OR) = 2.9, 95% confidence intervals (CI) [1.4-6.1]), RSV (OR = 2.3, 95% CI [1.3-4.1]) and age <6 months (OR = 2.0, 95% CI [1.2-3.4]).</p><p><strong>Conclusions: </strong>RSV was identified as the most common pathogen causing acute lower respiratory infections among the studied patients. One of the more significant findings to emerge from this study is the seasonal changes in RSV and influenza infections, which mandates further research.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2445791"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of uric acid on acute coronary syndrome prognosis in elderly patients.","authors":"Yifan Li, Tiantian Sang, Naqiang Lv, Jinxing Liu, Yingzhen Gu, Xiaorong Han, Wei Zhang, Aimin Dang","doi":"10.1080/07853890.2024.2445200","DOIUrl":"https://doi.org/10.1080/07853890.2024.2445200","url":null,"abstract":"<p><strong>Background: </strong>Uric acid (UA) plays an important role in cardiovascular diseases, yet its implications in elderly patients remains incompletely understood. This study aimed to explore the impact of UA on the prognosis in advanced-age patients with acute coronary syndrome (ACS).</p><p><strong>Methods: </strong>We included 526 patients aged 80 and older who were diagnosed with ACS. The UA levels were measured at admission, and patients were divided into four groups based on quartiles of UA levels. Major adverse cardiovascular events (MACE) during follow-up were recorded.</p><p><strong>Results: </strong>The median UA level was 344.09 μmol/L, while the median follow-up duration was 64 months. Kaplan-Meier curves demonstrated a higher cumulative incidence of MACE during long-term follow-up in the Q4 group (Log-rank <i>p</i> < 0.05). Cox regression analysis revealed an independent correlation between UA levels and an increased risk of MACE (HR 1.002, 95%CI 1.000-1.003, <i>p</i> = 0.021). The ROC curve indicated that the optimal UA value for predicting MACE was 324.25 μmol/L. After matching through PSM, the MACE-free survival rate was lower in both hyperuricemia group (UA> 420.00 μmol/L) and high UA group (324.25 μmol/L < UA≤ 420.00 μmol/L) compared to the control group. Both hyperuricemia and high UA levels were independent risk factors for long-term MACE in advanced-age ACS patients, with HR values of 1.546 (1.049-2.280, <i>p</i> = 0.028) and 1.491 (1.011-2.198, <i>p</i> = 0.044), respectively.</p><p><strong>Conclusion: </strong>Elevated UA levels were identified as independent risk factors for MACE in elderly patients with ACS. The optimal predictive value of UA for poor cardiovascular prognosis was significantly lower than the traditional definition of hyperuricemia.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2445200"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic and clinical features of rosacea in North Jordan: a 10-year university hospital retrospective study.","authors":"Diala Alshiyab, Saleh A Ba-Shammakh, Alaa Bani Bakr, Mohammad Abu-Hussein, Abdulqudos Al-Fakih, Sarah Alawneh, Leen Alhuneafat, Leen Heis, Firas Al-Qarqaz","doi":"10.1080/07853890.2024.2445775","DOIUrl":"https://doi.org/10.1080/07853890.2024.2445775","url":null,"abstract":"<p><strong>Background/objectives: </strong>This study aims to investigate the demographic and clinical characteristics of rosacea within the North Jordan population, focusing on Fitzpatrick skin types III and IV. The intent is to address gaps in dermatological research concerning ethnic and racial variations in rosacea's presentation and impact.</p><p><strong>Methods: </strong>We conducted a retrospective cohort analysis at the dermatology department of King Abdullah University Hospital, North Jordan, reviewing medical records of patients diagnosed with rosacea from January 2013 to December 2023. Data collection focused on demographics, rosacea subtypes and environmental factors exacerbating the condition. Statistical analysis utilized Jamovi and GraphPad Prism software.</p><p><strong>Results: </strong>The study included 610 patients, revealing a rosacea prevalence of 1.5% within the hospital's catchment area. Most patients were female (84.4%), with a median age of 44. The majority had Fitzpatrick skin types III and IV. The erythematotelangiectatic subtype was most common (73.6%), followed by papulopustular (23.4%) and phymatous (3%). Environmental triggers like sun exposure and temperature changes were nearly universally reported as exacerbating factors.</p><p><strong>Conclusions: </strong>Rosacea shows significant gender disparities and is influenced by environmental factors. The study underscores the need for targeted research and treatment strategies that consider ethnic and racial variations, along with gender-specific presentations of the disease.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2445775"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of curcumin on methotrexate-induced ovarian damage and follicle reserve in rats: the role of PARP-1 and P53.","authors":"Mete Keçeci, Nesibe Karaoluk","doi":"10.1080/07853890.2024.2446688","DOIUrl":"https://doi.org/10.1080/07853890.2024.2446688","url":null,"abstract":"<p><strong>Background: </strong>Methotrexate (MTX) is an agent used in the treatment of many neoplastic and non-neoplastic diseases and is known to cause oxidative damage in normal tissues. Curcumin (Cur) is a natural polyphenol compound with powerful antioxidant and antiapoptotic effects. In this study we investigate the effects of Cur on MTX-induced ovarian damage.</p><p><strong>Materials and methods: </strong>Thirty-two young adult female Wistar albino rats were divided into four groups: (1) Control (<i>n</i> = 8): only vehicle group, (2) Cur (<i>n</i> = 8): Cur-only group (200 mg/kg/day), (3) MTX (<i>n</i> = 8): MTX-only group (0.35 mg/kg/day), (4) MTX+Cur (<i>n</i> = 8): The group was given MTX (0.35 mg/kg/day) and Cur (200 mg/kg/day) for 28 days. Then, SOD, CAT, MDA, AMH levels were measured using ELISA kits. Follicle count was performed on H&E stained slides. In addition, the expressions of P53 and PARP-1 were analysed by immunohistochemistry.</p><p><strong>Results: </strong>MDA levels were seen to be higher in the MTX group than in the MTX+Cur group (<i>p</i> < 0.05). Cur treatment lowered MDA levels and increased SOD and CAT levels (<i>p</i> < 0.05 for all). In the MTX+Cur group, atretic follicle count decreased (<i>p</i> < 0,05), however, primordial follicle count increased (<i>p</i> < 0,01). Secondary follicle count and AMH levels were higher in MTX-treated groups (<i>p</i> < 0,05 and <i>p</i> < 0,01, respectively). Expressions of p53 and Poly [ADP-ribose] polymerase 1 (PARP-1) increased significantly in the MTX group compared to the other groups (<i>p</i> < 0,05).</p><p><strong>Conclusion: </strong>Cur pretreatment prior to MTX administration may be an effective option in preserving the ovarian follicle pool by regulating P53 and PARP-1 expressions with its antioxidant effect.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2446688"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of contrast-enhanced ultrasound liver imaging reporting and data system for differentiation of patients at risk of hepatocellular carcinoma and liver metastasis.","authors":"Weiqin Huang, Ruoxuan Lin, Zhongshi Du, Zhougui Wu, Xiaohui Ke, Lina Tang","doi":"10.1080/07853890.2024.2442072","DOIUrl":"10.1080/07853890.2024.2442072","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) and metastatic liver tumors (MLT) are the most common malignant liver lesions, each requiring distinct therapeutic approaches. Accurate differentiation between these malignancies is critical for appropriate treatment planning and prognostication. However, there is limited data on the performance of contrast-enhanced ultrasound liver imaging reporting and data system (CEUS-LI-RADS) in this differentiation.</p><p><strong>Objective: </strong>To evaluate the diagnostic efficacy of the CEUS-LI-RADS in distinguishing between HCC and MLT in an expanded population at risk for both tumors.</p><p><strong>Methods: </strong>Between June 2017 and January 2022, 108 patients with HCC and 138 patients with MLT who were pathologically diagnosed, where included in this retrospective study. Two radiologists independently reviewed the CEUS features and liver imaging reporting and data system (LI-RADS) categories of the lesions, and based on their consensus, we calculated the diagnostic performance, including the area under the receiver operating characteristic curve, sensitivity, specificity, and accuracy of the CEUS-LI-RADS criteria.</p><p><strong>Results: </strong>The sensitivity, specificity, and accuracy of CEUS LI-RADS category 5 (CEUS-LR-5) for predicting HCC were 49.1% [95% confidence interval (CI)) 39.3-58.9], 97.1% (95% CI 92.7-99.2), and 76%, respectively, whereas the corresponding values for LI-RADS category M (LR-M) for diagnosing MLT were 89.1% (95%CI 82.7-93.8), 72.2% (95%CI 62.8-80.4), and 81.7%, respectively. Based on current LR-M criteria, a small proportion of HCCs were classified as LR-M due to the presence of early cessation (45-60s). In the analysis of the MLT subgroup, we found that the tumor size affects the distribution of LI-RADS (LR) classification in the subgroup (<i>p</i> = 0.037), and LI-RADS category 3 (LR-3) classification was observed more frequently in tumors of small size (≤3cm) than those of larger size. In addition, LR-3 metastases were more frequently characterized by hypovascular supply.</p><p><strong>Conclusions: </strong>CEUS-LI-RADS demonstrates high specificity in distinguishing HCC from MLT, providing a reliable noninvasive diagnostic tool that can enhance clinical decision-making. These findings are clinically significant as they can improve patient management and treatment outcomes, and they underscore the need for future research to refine and expand the use of CEUS-LI-RADS in diverse clinical settings.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2442072"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for severe postpartum hemorrhage in placenta accreta spectrum patients undergoing prophylactic resuscitative endovascular balloon occlusion of the aorta during cesarean delivery.","authors":"Xiafei Wu, Jie He, Yuxiang Bai, Yanqiong Gan, Hongbing Xu, Hongbo Qi, Xinyang Yu","doi":"10.1080/07853890.2024.2442065","DOIUrl":"10.1080/07853890.2024.2442065","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the risk factors for severe postpartum hemorrhage (SPPH) in patients with placenta accreta spectrum (PAS) undergoing cesarean delivery, despite the prophylactic use of resuscitative endovascular balloon occlusion of the aorta (REBOA).</p><p><strong>Materials and methods: </strong>We conducted a retrospective case-control study on PAS patients who underwent cesarean delivery with prophylactic REBOA at the First Affiliated Hospital of Chongqing Medical University from January 2017 to December 2021. Prophylactic REBOA placement was determined by a prenatal ultrasound scoring system. Patients were divided into those who experienced SPPH (case group) and those who did not (control group), with SPPH defined by one or a combination of the following criteria: intraoperative blood loss ≥1500 mL, transfusion of ≥4 units of packed red blood cells, intraoperative hysterectomy, or sequential uterine artery embolization. Propensity score matching (PSM) was employed to minimize biases, and multivariate logistic regression was used to calculate adjusted odds ratios (aOR) for risk factors.</p><p><strong>Results: </strong>Of the 424 enrolled patients, 102 experienced SPPH (case group), while 322 did not (control group). After PSM, the case group comprised 79 patients, and the control group included 130. After adjusting for confounders, patients with placenta increta (aOR 3, 95% CI 1.49-6.03, <i>p</i> = 0.002), percreta (aOR 21.77, 95% CI 6.57-72.09, <i>p</i> < 0.001), lower hemoglobin levels (aOR 0.98, 95% CI 0.95-1, <i>p</i> = 0.050), and higher D-dimer levels (aOR 1.36, 95% CI 1.12-1.65, <i>p</i> = 0.002) had an elevated risk of SPPH. Threshold effect analysis indicated no significant nonlinear relationship between hemoglobin, D-dimer, and outcomes.</p><p><strong>Conclusions: </strong>PAS patients, particularly those with placenta increta and percreta, lower hemoglobin levels, and elevated D-dimer levels, are at an increased risk of SPPH during cesarean delivery, even with REBOA intervention.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2442065"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}