Current Medical Research and Opinion最新文献

{"title":"From insulin resistance to incretin receptor agonism in the prevention of type 2 diabetes mellitus in obese individuals.","authors":"Branislava Teofilović, Jelena Trkulja, Nevena Grujić-Letić, Emilia Gligorić, Djordje Baletic, Ljiljana Tomić, Aleksandra Mesarović, Aleksandar Rašković","doi":"10.1080/03007995.2026.2727202","DOIUrl":"10.1080/03007995.2026.2727202","url":null,"abstract":"<p><p>Type 2 diabetes mellitus (T2DM) represents one of the most significant metabolic challenges of the modern era, with more than 828 million people worldwide living with diabetes. Obesity and insulin resistance are major modifiable contributors to T2DM risk and progression, although the disease is heterogeneous and arises from complex interactions among β-cell dysfunction, hepatic glucose dysregulation, adipose-tissue dysfunction, altered incretin biology, chronic low-grade inflammation, and genetic susceptibility. In individuals with obesity and insulin resistance, progression through prediabetes to overt hyperglycaemia represents an important, although not universal, disease trajectory and provides a clinically relevant window for preventive intervention. This review examines pharmacological strategies relevant to T2DM prevention in individuals without established diabetes who have prediabetes and/or obesity associated with a high risk of progression to T2DM, with particular emphasis on incretin-based obesity pharmacotherapy. Metformin remains the glucose-lowering agent with the most established long-term evidence for diabetes prevention in selected high-risk individuals with prediabetes, acting through multiple hepatic and intestinal mechanisms involving both AMPK-dependent and AMPK-independent pathways. Other established antihyperglycaemic drug classes are discussed primarily to distinguish therapies with evidence for delaying progression to diabetes from agents whose principal role remains the treatment of established T2DM. SGLT2 inhibitors provide substantial cardiovascular and renal protection, although current evidence is insufficient to support their routine use solely for T2DM prevention. GLP-1 receptor agonists and the dual GIP/GLP-1 receptor agonist tirzepatide have substantially advanced obesity pharmacotherapy, producing clinically meaningful weight loss and broader cardiometabolic benefits that may reduce progression to T2DM in high-risk individuals.Next-generation incretin-based therapies, including triple receptor agonists, may further expand therapeutic options but remain an evolving area of investigation. Lifestyle intervention and sustained weight management remain the foundation of T2DM prevention, with pharmacological strategies selected according to individual metabolic risk, obesity-related treatment indications, comorbidities, and the strength of evidence supporting diabetes prevention.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1503-1517"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and clinical distribution of congenital hypothyroidism in Bolu Province, Türkiye: a four-year analysis of the National Newborn Screening Program.","authors":"Semih Bolu, Filiz Bolu, Yasemin Baranoglu Kilinc","doi":"10.1080/03007995.2026.2736327","DOIUrl":"10.1080/03007995.2026.2736327","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to determine the incidence and etiological distribution of congenital hypothyroidism (CH) and evaluate the performance of newborn screening program in Bolu, a province in the Western Black Sea region of Türkiye.</p><p><strong>Methods: </strong>Newborn screening data from 10,854 neonates born between March 2021 and March 2025 were analyzed. Capillary blood samples were collected on days 3-5 and analyzed. Infants with thyroid-stimulating hormone (TSH) levels >20 mIU/L initially or ≥5.5 mIU/L in both initial and repeat samples were recalled for venous confirmation. CH was diagnosed when free thyroxine was <0.7 ng/dL.</p><p><strong>Results: </strong>Recall rate was 6.0%. Nineteen infants had CH (incidence, 1:571), including 13 (68.4%) with transient and 6 (31.6%) with permanent CH. All infants with initial TSH of 5.5-20 mIU/L had transient CH, while all permanent cases had initial TSH >20 mIU/L. A TSH threshold of ≥10 mIU/L reduced the recall rate to 1.1% but missed 5 transient CH cases (sensitivity, 73.7%). Threshold of ≥15 mIU/L reduced the recall rate to 0.3% but resulted in 10 missed transient cases (sensitivity, 47.3%).</p><p><strong>Conclusion: </strong>The incidence of CH and the recall rate in Bolu were higher than those reported in iodine-sufficient countries. Although the high recall rate may be partly attributable to the low TSH cutoff used in the screening program, relatively high proportion of transient CH warrants further investigation of regional iodine status. Increasing the TSH threshold may reduce the recall rate but may also decrease sensitivity and result in missed CH cases, particularly transient CH.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1619-1626"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colorectal cancer screening with multitarget-stool DNA testing: real-world adherence and follow-up colonoscopy in a large urban academic health system.","authors":"Dennis M De Leon Morilla, Shrey Gohil, David Wan, Mohamed Omar, Daniel E Freedberg, Jasmine Sham, Benjamin Lebwohl, Jordan J Karlitz, Mallik Greene","doi":"10.1080/03007995.2026.2727206","DOIUrl":"10.1080/03007995.2026.2727206","url":null,"abstract":"<p><strong>Objective: </strong>This real-world study evaluated adherence to multitarget-stool DNA (mt-sDNA) testing and completion of follow-up colonoscopy (FU-CY) among patients aged 45-75 years in NewYork-Presbyterian, a large urban healthcare system.</p><p><strong>Methods: </strong>This retrospective analysis of tests shipped between 2016 and 2023 linked mt-sDNA data from the Abbott Laboratory Database with Komodo Health administrative claims. Outcomes included mt-sDNA test adherence and completion of FU-CY. Factors associated with these outcomes were evaluated by multivariable logistic regression and Cox proportional hazards regression analyses.</p><p><strong>Results: </strong>Of 7885 mt-sDNA test kits shipped, 70.3% (5543) were completed within 365 days, and 74.5% of patients with positive tests (359/482) completed FU-CY within 365 days; 69.1% completed FU-CY within 180 days. Factors associated with mt-sDNA adherence included traditional Medicare coverage (odds ratio [OR] 2.97; 95% confidence interval [CI] 2.06-4.29; reference: Medicaid), gastroenterologists orders (OR 2.25; 95% CI 1.55-3.26; reference: nurse practitioner/physician assistant), and prior mt-sDNA test return (OR 3.39; 95% CI 2.44-4.72; reference: new patient). Traditional Medicare (hazard ratio [HR] 3.49; 95% CI 1.63-7.44; reference: Medicaid) and email outreach (HR 2.16; 95% CI 1.08-4.32; reference: no digital outreach) were associated with faster FU-CY completion.</p><p><strong>Conclusion: </strong>In this large urban academic health system, mt-sDNA adherence and FU-CY completion were substantial, with relevance to emerging Healthcare Effectiveness Data and Information Set measures assessing colonoscopy follow-up after positive noninvasive colorectal cancer screening tests. Insurance-related differences highlight persistent access-related gaps. Email outreach may represent a modifiable strategy to support timely FU-CY completion.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1545-1560"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Levothyroxine adherence in primary hypothyroidism: clinical impact, measurement challenges, and opportunities for personalized care.","authors":"Salman Razvi","doi":"10.1080/03007995.2026.2740285","DOIUrl":"10.1080/03007995.2026.2740285","url":null,"abstract":"<p><p>Primary hypothyroidism, most commonly caused by Hashimoto's thyroiditis, is a highly prevalent chronic condition typically managed with lifelong levothyroxine therapy. Although treatment is generally straightforward, a substantial proportion of patients do not achieve stable biochemical control or continue to report persistent symptoms. Suboptimal adherence may contribute to these challenges, but should be distinguished from other causes of treatment instability, including administration-related factors, drug and food interactions, and gastrointestinal malabsorption. This narrative review examines current evidence on the prevalence, determinants, clinical consequences and assessment of suboptimal adherence to levothyroxine therapy in primary hypothyroidism. Reported adherence estimates vary substantially according to the populations studied, definitions used and methods of assessment, while biochemical instability alone should not be regarded as evidence of non-adherence. Patient-, treatment- and healthcare system-related factors may all influence medication-taking behaviour. Practical strategies to identify and address suboptimal adherence include patient-centred discussion, education, simplification of administration where appropriate, and targeted use of alternative dosing strategies or formulations. Integrating adherence assessment into routine clinical care may help identify modifiable contributors to unstable treatment and support more individualized levothyroxine management.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1531-1543"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The hidden burden of topical corticosteroid misuse: a systematic review of dermatologic complications.","authors":"Ali Alzahrani","doi":"10.1080/03007995.2026.2734646","DOIUrl":"10.1080/03007995.2026.2734646","url":null,"abstract":"<p><strong>Background: </strong>Topical corticosteroids are widely prescribed for their anti-inflammatory, immunosuppressive, and antiproliferative effects in conditions such as atopic and contact dermatitis. However, their rapid symptomatic relief has contributed to misuse, particularly for cosmetic purposes, leading to multiple adverse effects. This study aimed to evaluate complications associated with topical corticosteroid misuse and the contributing factors.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a systematic search of PubMed, Scopus, and Web of Science was conducted to identify studies published between January 2016 and January 2026. Eligible studies reported primary data on topical corticosteroid misuse and associated factors. Extracted data included study characteristics, patterns of misuse, complications, prevalence of misuse-related adverse effects, and associated factors. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist.</p><p><strong>Results: </strong>Twenty-three studies involving 8,619 participants were included. Misuse was commonly reported for cosmetic indications, including skin lightening, melasma, acne, and skin fairness. Betamethasone, mometasone, and clobetasol were the most frequently misused agents. Most participants experienced at least one adverse effect, including acneiform eruptions, pigmentation disorders, erythema, and worsening dermatophytosis. Factors associated with misuse included female gender, younger age, poor health-seeking behavior, and over-the-counter availability.</p><p><strong>Conclusion: </strong>Topical corticosteroid misuse is an important public health concern, particularly where potent products are readily available without prescription. Reducing misuse requires prescription-based access to potent topical corticosteroids, pharmacist counselling at dispensing, clinician education on appropriate potency and duration, and targeted public education on cosmetic misuse and potential adverse effects.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1519-1529"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different diuretic regimes and long-term outcomes in heart failure with mildly reduced ejection fraction.","authors":"Alexander Schmitt, Michael Behnes, Marielen Reinhardt, Noah Abel, Felix Lau, Kathrin Weidner, Mohammad Abumayyaleh, Michael Hagmann, Ibrahim Akin, Tobias Schupp","doi":"10.1080/03007995.2026.2730837","DOIUrl":"10.1080/03007995.2026.2730837","url":null,"abstract":"<p><strong>Background & objective: </strong>Diuretics are commonly prescribed for patients with heart failure (HF), yet prognostic data in HF with mildly reduced ejection fraction (HFmrEF) remain limited. This study investigates the prognostic impact of thiazide and loop diuretics in HFmrEF.</p><p><strong>Methods: </strong>Consecutive HFmrEF patients hospitalized at the University Medical Centre Mannheim between 2016 and 2022 were retrospectively included (HARMER registry, clinicaltrials.gov identifier: NCT05603390) and stratified by diuretic therapy at discharge: none (N), thiazide-only (T), loop diuretic-only (L), or combined diuretic therapy (T + L). The primary endpoint was all-cause mortality at 30 months (median follow-up), secondary endpoint was HF-related rehospitalization.</p><p><strong>Results: </strong>Among 2,109 HFmrEF patients discharged alive, 43% received no diuretics, 9% thiazides only, 40% loop diuretics only, and 9% combined diuretic therapy. Thiazide-only patients had the lowest of long-term all-cause mortality (11%) compared to no diuretics (20%), while patients with loop (39%), and combined diuretic therapy (48%) had higher long-term mortality rates (log-rank <i>p</i> = 0.001). HF-rehospitalization rates followed a similar pattern (N: 5% and T: 7% vs. L: 21% and L + T: 31%, <i>p</i> = 0.001). After multivariable adjustment, thiazide-only therapy remained associated with lower mortality (HR = 0.515, <i>p</i> = 0.009), while loop and combined diuretic therapy were associated with increased mortality (L: HR = 1.299, <i>p</i> = 0.031; T + L: HR = 1.702, <i>p</i> = 0.001) and HF-rehospitalization (L: HR = 1.998, <i>p</i> = 0.001; T + L: HR = 2.535, <i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>In HFmrEF, thiazide-only therapy was associated with the lowest mortality, while loop and combined diuretic therapy were linked to increased mortality and HF-rehospitalization. Randomized trials investigating long-term diuretic therapy in HFmrEF patients are needed.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1697-1708"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calf blood pressure measurement for detecting elevated arm blood pressure in hemodialysis patients.","authors":"Rodrigo Bezerra, Erico A Oriá, Fernanda S Gorayeb-Polacchini, Flavio Teles, Luís C S Pinto, Ana C N Tome, Marcela P Bidoia, Carolina S Rezende, Edmilson R Marques, Rogerio H Passos, Marcelo Lopes, Bruno Zawadzki, Alexandre B Liborio, Audes D M Feitosa, Cibele I S Rodrigues, Andrei C Sposito, Wilson Nadruz","doi":"10.1080/03007995.2026.2724205","DOIUrl":"10.1080/03007995.2026.2724205","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the relationship between standardized arm and calf blood pressure (BP) measurements obtained in the habitual posture of hemodialysis (HD) and to derive calf BP values corresponding to abnormal arm BP thresholds.</p><p><strong>Methods: </strong>This cross-sectional study included 277 HD participants. Arm and calf BP were measured immediately before dialysis in the habitual HD posture. Linear regression estimated calf values corresponding to arm BP thresholds of 140/90 mmHg and 130/80 mmHg. Receiver operating characteristic (ROC)/Youden analysis identified optimal calf cutoffs. Cutoff-specific sensitivity, specificity, and area under the curve (AUC) were calculated, and agreement was assessed using Bland-Altman analysis.</p><p><strong>Results: </strong>Participants were 55 ± 14 years old, and 64% were male. Mean arm and calf BP were 140 ± 24/83 ± 14 mmHg and 167 ± 29/92 ± 17 mmHg, respectively. Arm-calf correlations ranged from 0.72 to 0.74. Regression-derived calf values corresponding to arm BP 140/90 mmHg and 130/80 mmHg were 167/98 mmHg and 158/89 mmHg, respectively. ROC-optimized calf cutoffs were 171.5/96.7 mmHg for arm BP 140/90 mmHg and 162.2/91.2 mmHg for 130/80 mmHg. For combined SBP-or-DBP classification, the ROC-optimized cutoffs yielded sensitivity/specificity of 79.6%/76.6% and 83.7%/80.8%, with AUCs of 0.781 and 0.823, respectively. Mean calf-arm biases were +26.5 mmHg for SBP and +8.8 mmHg for DBP, with wide limits of agreement indicating substantial individual variability.</p><p><strong>Conclusion: </strong>In conclusion, when upper-arm BP measurement is not feasible in HD patients, ROC-derived calf BP cutoffs of approximately 170/100 mmHg and 160/90 mmHg may help identify contemporaneous arm BP thresholds of 140/90 mmHg and 130/80 mmHg, respectively. However, calf and arm BP are not interchangeable, and these cutoffs should be considered exploratory until externally validated.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1487-1492"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mistakes in the management of irritable bowel syndrome-diarrhoeal subtype and mimics: a narrative review.","authors":"Pavithra Senadheera, Bhagya Silva, Hiruni Jayasena, Madunil Niriella","doi":"10.1080/03007995.2026.2716974","DOIUrl":"10.1080/03007995.2026.2716974","url":null,"abstract":"<p><p>Irritable bowel syndrome with diarrhoea (IBS-D) is one of the most frequently encountered disorders of gut-brain interaction, yet its diagnosis remains challenging owing to the substantial symptom overlap with a wide range of conditions. These mimics, most notably microscopic colitis (MC), bile acid diarrhoea (BAD), small intestinal bacterial overgrowth (SIBO), coeliac disease, exocrine pancreatic insufficiency (EPI), endocrine disorders, lactase deficiency, sucrase-isomaltase deficiency, early inflammatory bowel disease (IBD) and functional diarrhoea (FD) can all present with identical clinical features, leading to diagnostic error, delayed treatment, and inappropriate symptom-based management. This narrative review synthesizes literature from 1997 to 2025, incorporating guideline recommendations (ACG, AGA, BSG, ECCO), RCTs, meta-analyses, systematic reviews, and expert consensus statements. This review highlights the most critical mistakes in diagnosing, evaluating, managing, and monitoring IBS-D and its mimics, with lapses in clinical reasoning and guideline adherence most consequential.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1299-1318"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric profiles and the phenotypic dissociation of imaging steatosis and elevated fibrosis risk in obesity.","authors":"Nuryil Yilmaz, Enis Akca, Zeynep Ekinci, Melik Firat Fidan, Zeynep Pekel, Zelihan Kafadar, Barkin Yigitbasi, Huseyin Dongelli, Metin Ozgen, Demet Yalcin Kehribar","doi":"10.1080/03007995.2026.2719078","DOIUrl":"10.1080/03007995.2026.2719078","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the relationship between psychometric profiles and the phenotypic discordance of ultrasonography (USG)-detected steatosis and Fibrosis-4 (FIB-4) risk in obesity.</p><p><strong>Methods: </strong>This retrospective study included 206 patients with obesity (body mass index [BMI] ≥ 30 kg/m²). We categorized participants into concordant and discordant phenotypes based on USG findings and FIB-4 scores. Psychometric assessments included the Beck Depression Inventory, Eating Attitudes Test-40 (EAT-40), Body Cathexis Scale, and Emotional Eating Scale. Multivariable logistic regression identified independent predictors, adjusting for age, BMI, and glycated hemoglobin (HbA1c).</p><p><strong>Results: </strong>Overall discordance was independently associated with advancing age (<i>p</i> <.05). Isolated USG-detected steatosis with low FIB-4 risk was predicted by higher BMI (OR = 1.067, <i>p</i> = .025), elevated C-reactive protein (OR = 1.084, <i>p</i> = 0.010), and higher EAT-40 scores (OR = 1.037, <i>p</i> = .020). Conversely, elevated FIB-4 with normal USG was associated with older age (OR = 1.095, <i>p</i> <.001) and inversely with BMI (OR = 0.900, <i>p</i> = .040). General psychological measures showed no significant associations.</p><p><strong>Conclusion: </strong>USG and FIB-4 dissociation reflects expected differences in pathological domains as well as the biological heterogeneity of metabolic dysfunction-associated steatotic liver disease (MASLD) rather than diagnostic inconsistency. Disordered eating behaviors were independently associated with isolated USG-detected steatosis phenotypes, whereas fibrosis risk is primarily associated with advancing age. Managing MASLD requires integrating both metabolic and behavioral assessments.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1347-1355"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the fetal Evans Index in pregnancies complicated by fetal growth restriction.","authors":"Aziz Kından, Ahmet Kurt, Özgür Volkan Akbulut, Recep Taha Ağaoğlu, Bahadır Codal, Aykut Kından, Belgin Savran Üçok, Çağlayan Ateş, Mustafa Raşit Özler, Erkan Sağlam, Kadriye Yakut Yücel","doi":"10.1080/03007995.2026.2717002","DOIUrl":"10.1080/03007995.2026.2717002","url":null,"abstract":"<p><strong>Background: </strong>Fetal growth restriction (FGR) can affect fetal brain development despite adaptive circulatory redistribution. The fetal Evans Index (EI)-the ratio of frontal horn width to inner cranial diameter-may capture proportional cranial remodeling in FGR.</p><p><strong>Methods: </strong>In a prospective case-control study of singleton pregnancies ≥32 weeks, FGR was defined by Delphi consensus criteria. EI and frontal proportional ratios were obtained on the standardized axial transventricular plane. We evaluated how well EI distinguished FGR cases from controls and whether its association with NICU admission was independent of conventional fetal growth measurements.</p><p><strong>Results: </strong>The cohort comprised 129 pregnancies (67 FGR, 62 controls). EI was lower in FGR than in controls (0.28 ± 0.02 vs 0.30 ± 0.02; <i>p</i> < 0.001), alongside reduced frontal horn width and a lower FABD/OFD ratio (<i>p</i> < 0.001). EI correlated strongly with frontal horn width (<i>r</i> = 0.752, <i>p</i> < 0.001). EI provided moderate discrimination for FGR (AUC = 0.707, 95% CI 0.617-0.797; cut-off 0.297; sensitivity 78.8%, specificity 51.6%). NICU admission was markedly higher in FGR (44.8% vs 4.8%; <i>p</i> < 0.001). EI ≥ 0.297 was associated with reduced NICU odds in univariate analysis (OR = 0.20, 95% CI 0.07-0.62), but not after adjustment (adjusted OR = 0.38, 95% CI 0.11-1.38); abdominal circumference percentile remained independently associated with NICU admission (adjusted OR = 0.97, 95% CI 0.95-0.99).</p><p><strong>Conclusions: </strong>Late-onset FGR is associated with reduced EI and altered frontal proportional indices, suggesting subtle anterior cerebral remodeling rather than ventriculomegaly. EI may provide complementary neurosonographic information, but its stand-alone diagnostic or prognostic value appears limited.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1379-1389"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}