Frontiers in Medicine最新文献

{"title":"Kidney biopsy in the diagnosis of immunoglobulin A nephropathy.","authors":"Kirk N Campbell, Anthony Chang, Marina Vivarelli","doi":"10.3389/fmed.2026.1882638","DOIUrl":"10.3389/fmed.2026.1882638","url":null,"abstract":"<p><p>Immunoglobulin A nephropathy (IgAN) is a kidney disease characterized by deposition of galactose-deficient IgA1-containing immune complexes in the glomerular mesangium. It is the most common primary glomerular disease worldwide, affecting approximately 2.5 persons per 100,000 population annually. A definitive IgAN diagnosis requires a kidney biopsy. However, non-specific clinical signs, limited disease awareness, and lack of validated biomarkers can delay nephrology referral from primary care providers, prolonging time to diagnosis and negatively impacting patient outcomes. In this perspective, we aim to raise awareness of the importance of timely kidney biopsy in IgAN. To do so, we first outline the key clinical features of IgAN and kidney biopsy indications that should prompt nephrology referral. Subsequently, we highlight the diagnostic and prognostic significance of kidney biopsy findings, examine barriers to kidney biopsy completion, and provide our outlook on the ways in which kidney biopsy may be useful for IgAN management in the future.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1882638"},"PeriodicalIF":3.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13683010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-hospital events and resource utilization associated with percutaneous-based vs. open lumbar fusion, stratified by admission status: a national inpatient sample analysis.","authors":"Hao Yang, Jianlong Li, Yu Sun","doi":"10.3389/fmed.2026.1906068","DOIUrl":"10.3389/fmed.2026.1906068","url":null,"abstract":"<p><p>Minimally invasive surgery (MIS) may be associated with a more favorable short-term inpatient profile after lumbar fusion, but whether these associations differ by admission status remains unclear. In this retrospective observational analysis of repeated cross-sectional 2016-2022 National Inpatient Sample (NIS) discharge data, hospitalizations of adults undergoing lumbar fusion were identified and stratified as elective or non-elective. The exposure was defined by the International Classification of Diseases, Tenth Revision, Procedure Coding System-coded approach as percutaneous-based (percutaneous/percutaneous-endoscopic) vs. open fusion. Survey-weighted multivariable logistic regression accounted for the NIS's complex design and adjusted for demographics, hospital characteristics, fusion extent, indication/case-mix, and individual Elixhauser comorbidities; formal approach-by-admission interactions were tested. A total of 174,704 hospitalizations met the inclusion criteria. In elective admissions, percutaneous-based fusion was associated with lower odds of blood product transfusion (aOR 0.448, 95% CI 0.311-0.644), acute posthemorrhagic anemia (aOR 0.591, 95% CI 0.475-0.736), and prolonged length of stay (aOR 0.774, 95% CI 0.656-0.914). In non-elective admissions, it was associated with lower odds of acute posthemorrhagic anemia (aOR 0.669, 95% CI 0.491-0.912) and non-home discharge (aOR 0.666, 95% CI 0.502-0.883). Significant approach-by-admission interactions were observed for blood product transfusion (<i>P</i> = 0.037) and non-home discharge (<i>P</i> = 0.022). These findings indicate that the short-term association profile of percutaneous-based vs. open lumbar fusion differs across admission settings and specific in-hospital measures.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1906068"},"PeriodicalIF":3.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13683617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Mycobacterium mageritense</i> submandibular lymphadenitis in children: diagnostic challenges and the role of metagenomic next-generation sequencing: two case reports and literature review.","authors":"Li Li, Zhijie Xing, Liyan Liu, Xiao Mu, Yunpeng Zhai, Shengwei Luan, Jian Li, Qingwei Guo","doi":"10.3389/fmed.2026.1936269","DOIUrl":"10.3389/fmed.2026.1936269","url":null,"abstract":"<p><p><i>Mycobacterium mageritense</i> is an extremely rare, rapidly growing nontuberculous mycobacterium (NTM). Pediatric cases are rarely reported worldwide, and the non-specific clinical manifestations, low sensitivity of conventional microbiological tests, and limited specimen volume from children often lead to diagnostic delays. We describe the clinical data of two immunocompetent children with submandibular lymphadenitis caused by <i>Mycobacterium mageritense</i>, both diagnosed by metagenomic next-generation sequencing (mNGS). We also systematically reviewed the relevant literature and performed a pooled analysis of 36 eligible cases (the two new paediatric cases from the present study included). Case 1 involved a 6-year-old girl with dental caries and acute fever who was initially misdiagnosed with common bacterial infection and received ineffective empirical antibiotics for over two weeks; mNGS of aspirated pus confirmed the diagnosis. Case 2 involved a 9-year-old girl with dental caries who presented only with submandibular lymphadenopathy and normal laboratory findings, with a diagnostic delay of up to two months; mNGS of lymph node tissue identified the pathogen. Literature-pooled analysis of 36 patients revealed a mean diagnostic delay of 4.69 months (median 2.00 months, IQR: 0.81-5.75 months). Conventional culture had low sensitivity, often requiring prolonged incubation (≥96 h) or special media to obtain positive results. Initial misdiagnosis occurred in 17.6% of cases. Patients diagnosed by NGS achieved more rapid and accurate pathogen identification. This report suggests that mNGS, as a culture-independent, unbiased pan-pathogen detection technique, shows clear advantages in identifying rare and fastidious pathogens such as M. mageritense. For pediatric patients with dental caries, fever, and cervical lymphadenopathy unresponsive to conventional therapy, clinicians should suspect <i>Mycobacterium mageritense</i> infection, and mNGS is an effective tool for its rapid and accurate diagnosis.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1936269"},"PeriodicalIF":3.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13683177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Delayed-onset and recurrent infectious endophthalmitis after intravitreal dexamethasone implant.","authors":"Xinyue Yang, Mengfan Li, Yiwei Zhu, Xiuli Tao, Yan Cheng","doi":"10.3389/fmed.2026.1962200","DOIUrl":"10.3389/fmed.2026.1962200","url":null,"abstract":"<p><strong>Purpose: </strong>To report a rare case of delayed-onset infectious endophthalmitis occurring 33 days after an intravitreal dexamethasone implant (Ozurdex®), with recurrence 20 days after complete pars plana vitrectomy and implant removal.</p><p><strong>Methods: </strong>Case report with clinical findings, diagnostic workup, management, and literature review.</p><p><strong>Results: </strong>A 51-year-old male with recurrent anterior uveitis received a dexamethasone implant for refractory cystoid macular edema. Thirty-three days post-injection, he developed acute hypopyon and severe vitritis. Emergent 25-gauge pars plana vitrectomy with implant removal was performed. Aqueous humor metagenomic next-generation sequencing (mNGS) confirmed Staphylococcus epidermidis (24,904 reads; 99.96% relative abundance), with no resistance genes detected. Postoperatively, inflammation initially resolved; however, hypopyon recurred 20 days after vitrectomy. A 6-day course of intravenous vancomycin achieved complete resolution. At final follow-up, best-corrected visual acuity improved to 20/33, with no further recurrence.</p><p><strong>Conclusion: </strong>Endophthalmitis following corticosteroid implants may present with delayed-onset and can recur even after complete surgical removal. Systemic antimicrobial therapy may play a crucial role in eradicating residual infection in such challenging cases.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1962200"},"PeriodicalIF":3.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13683054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VoiceLove for patient-family communication in the ICU: a usability study of a novel voice messaging app.","authors":"Soibhan Kelley, Leanne M Boehm, Mariu Duggan, Jason M Slagle, Carrie Reale, Russ Beebe, E Wesley Ely, Christina Boncyk","doi":"10.3389/fmed.2026.1838229","DOIUrl":"10.3389/fmed.2026.1838229","url":null,"abstract":"<p><strong>Background: </strong>Family engagement has been associated with improved outcomes following critical illness, but communication barriers challenge family engagement. Traditional video or phone call strategies to navigate communication barriers are time-, resource-, and labor-intensive for hospital staff, often limiting their use. VoiceLove is a Health Insurance Portability and Accountability Act (HIPAA)-compliant mobile phone app that enables family members to send real-time voice messages to intensive care unit (ICU) patients without relying on the clinical team to coordinate calls. We conducted iterative usability testing of VoiceLove to optimize use for patients, families, and their clinical teams in the adult ICU.</p><p><strong>Methods: </strong>We completed 2 rounds of usability testing of the VoiceLove app in a simulated environment. Usability was assessed through System Usability Scale (SUS) scores and task success rates. Semi-structured interviews were used to identify themes, concerns, and design priorities.</p><p><strong>Results: </strong>Mean SUS scores for rounds 1 and 2 of testing were 77.5 (SD 11.1) and 75.9 (SD 26.8), respectively. The app concept was overall viewed favorably as a tool with the potential to provide comfort and streamline communication. Key usability issues included navigation, clarity of labels, and accessibility, which were addressed through iterative app improvements. Implementation concerns included nursing workload, family cognitive burden, and interplay with complex family dynamics.</p><p><strong>Conclusion: </strong>A diverse group of ICU stakeholders found the VoiceLove app demonstratedpotential to improve communication with critically ill patients inherently disadvantaged in their ability to communicate. Further testing in a real-world setting is needed to assess the impact of VoiceLove implementation on clinical team work load and family dynamics.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1838229"},"PeriodicalIF":3.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13683571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond tessellation: AI-derived choroidal vessel density on multi-channel cSLO as a surrogate biomarker for OCT choroidal parameters.","authors":"Yuou Yao, Xi Wang, Tengfei Long, Chaohong Li, Saiguang Ling, Enzhong Jin, Yaoyao Sun, Shirong Su, Jianyu Xiong, Jiyang Tang, Xiang Meng, Yi Cai, Qiaozhu Zeng, Heng Li, Heng Miao","doi":"10.3389/fmed.2026.1884151","DOIUrl":"10.3389/fmed.2026.1884151","url":null,"abstract":"<p><strong>Purpose: </strong>To develop an AI-based method for quantifying choroidal vessel density (CVD) from ultra-widefield confocal scanning laser ophthalmoscopy (UWF-cSLO) and to validate this metric against swept-source optical coherence tomography (SS-OCT) choroidal parameters.</p><p><strong>Methods: </strong>In this retrospective cross-sectional study, 633 eyes from 354 participants underwent simultaneous UWF-cSLO and SS-OCT imaging on an integrated platform, ensuring precise spatial co-registration. A TransUNet deep-learning model segmented choroidal vessels from red-channel (R; 665 nm) and infrared-channel (IR; 785 nm) images, yielding channel-specific metrics (R-CVD and IR-CVD) and a combined metric (IR + R CVD). Eight SS-OCT parameters-including choroidal thickness (CT), choroidal vascularity index (CVI), luminal area, stromal area (SA), total choroidal area (TCA), and vessel volume index (VVI)-served as reference measures. Associations were evaluated using Spearman correlations with participant-level clustered bootstrap confidence intervals, multivariable generalised estimating equations (GEE) adjusted for age and sex, and receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Segmentation accuracy exceeded 0.95 (Dice coefficient) in both channels. R-CVD exhibited the strongest inverse correlations with structural and volumetric OCT parameters (SA: <i>ρ</i> = -0.619; CT: <i>ρ</i> = -0.615; TCA: <i>ρ</i> = -0.615; all <i>q</i> < 0.001), whereas IR + R CVD correlated most closely with proportion-based indices (VVI: <i>ρ</i> = -0.34; CVI: <i>ρ</i> = -0.29). These channel-dependent patterns persisted after adjustment for age and sex in multivariable GEE models. On ROC analysis, R-CVD discriminated thin from thick choroids with an area under the curve (AUC) of 0.789 (sensitivity 72.5%; specificity 74.8%), whereas IR-CVD alone showed near-chance performance (AUC 0.517).</p><p><strong>Conclusions: </strong>AI-derived CVD from UWF-cSLO correlates strongly with SS-OCT choroidal parameters in a wavelength-dependent manner and may serve as an accessible surrogate for choroidal structural assessment in settings without OCT.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1884151"},"PeriodicalIF":3.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13683970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual-phase CTA filling pattern is associated with reperfusion-related complications after mechanical thrombectomy in late-window anterior circulation stroke.","authors":"Truong Van Le, Khanh T Ngoc Thach, Tuyen Trong Nguyen, Ha Hai T Dinh","doi":"10.3389/fmed.2026.1934591","DOIUrl":"10.3389/fmed.2026.1934591","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate whether pre-treatment dual-phase computed tomography angiography (CTA) filling patterns are independently associated with reperfusion-related complications after late-window mechanical thrombectomy and whether they provide incremental prognostic value beyond conventional clinical and imaging variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a prospective single-center cohort study including 80 consecutive patients with anterior circulation large-vessel occlusion who underwent mechanical thrombectomy within 6-24 h after stroke onset or last known well. Dual-phase CTA filling patterns were classified as good early filling, delayed filling, or persistent poor filling; delayed and persistent poor filling were combined for the primary analyses. The primary outcome was a composite of reperfusion-related complications within 72 h, including hemorrhagic transformation ≥HI2, malignant cerebral edema, or early neurological deterioration. Secondary outcomes were 90-day functional independence and all-cause mortality. Independent predictors were identified using Firth penalized logistic regression. Incremental model performance was evaluated using receiver operating characteristic analysis, bootstrap internal validation, reclassification metrics, and decision-curve analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Reperfusion-related complications occurred in 28 patients (35%) and were significantly more frequent in patients with delayed or poor filling than in those with good early filling (56% vs. 20%; &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Delayed or poor filling independently predicted reperfusion-related complications after adjustment for age, baseline NIHSS score, and ASPECTS (adjusted OR 3.97, 95% CI 1.22-14.10; &lt;i&gt;p&lt;/i&gt; = 0.022). Older age was also independently associated with increased risk (adjusted OR 2.14 per 10-year increase, 95% CI 1.24-4.12; &lt;i&gt;p&lt;/i&gt; = 0.005), whereas higher ASPECTS was protective (adjusted OR 0.35 per point, 95% CI 0.18-0.61; &lt;i&gt;p&lt;/i&gt; &lt; 0.001). The full model incorporating dual-phase CTA achieved excellent discrimination (AUC 0.895; optimism-corrected AUC 0.867). Addition of the dual-phase CTA filling pattern improved patient risk reclassification, although the increase in discrimination beyond the clinical-plus-ASPECTS model was not statistically significant. Patients with delayed or poor filling had substantially worse 90-day outcomes, including lower functional independence (24% vs. 70%) and higher mortality (38% vs. 4%) (both &lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Delayed or persistent poor filling on dual-phase CTA is an independent imaging marker of reperfusion-related complications following late-window mechanical thrombectomy. Although its incremental contribution to model discrimination was modest, dual-phase CTA may improve early risk stratification and help identify patients who may benefit from intensified post-procedural monitoring. External validation is warranted before rou","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1934591"},"PeriodicalIF":3.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13683744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding people's experiences of practising Tai Chi for health and wellbeing: a protocol for a qualitative systematic review.","authors":"Hanjiang Liu, Weiting Liu, Youchang Zeng, Wurong Guo, Shun Chen, Lianyu Zou, Yanting Ding, Guoping Ye","doi":"10.3389/fmed.2026.1962809","DOIUrl":"10.3389/fmed.2026.1962809","url":null,"abstract":"<p><strong>Background: </strong>Tai Chi is a traditional Chinese mind-body practice that is widely used for health promotion, rehabilitation, symptom management, and overall wellbeing. Although numerous systematic reviews have demonstrated its potential effectiveness across a range of physical and psychological outcomes, quantitative evidence alone cannot explain how individuals experience Tai Chi, why they initiate or sustain practice, or how the practice is integrated into everyday life. Existing qualitative studies have provided valuable insights into participants' experiences; however, these findings remain dispersed across different populations, health conditions, and practice settings. To date, no qualitative evidence synthesis has comprehensively integrated people's experiences of practising Tai Chi across health-related contexts.</p><p><strong>Methods: </strong>This review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for qualitative evidence synthesis using the meta-aggregation approach. A comprehensive search will be undertaken in MEDLINE, Embase, CINAHL, PsycINFO, AMED, Scopus, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, Google Scholar, and ProQuest Dissertations & Theses Global from database inception to the final search date. Qualitative studies exploring people's experiences of practising Tai Chi for health and wellbeing will be eligible for inclusion. Two independent reviewers will undertake study selection, methodological quality appraisal, and data extraction. Methodological quality will be assessed using the JBI Critical Appraisal Checklist for Qualitative Research, and confidence in the synthesised findings will be evaluated using the ConQual approach.</p><p><strong>Discussion: </strong>This review will provide the first comprehensive qualitative evidence synthesis of people's experiences of practising Tai Chi across diverse populations and health-related contexts. The review is expected to generate evidence that informs the person-centred design, implementation, and future evaluation of Tai Chi programmes, while identifying priorities for future research.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/, PROSPERO CRD420261473258.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1962809"},"PeriodicalIF":3.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13683576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic role of granulocyte-colony stimulating factor and aspirin in unexplained recurrent pregnancy loss: a retrospective study.","authors":"Xia Huang, Qiongxiu Luo, Yuehua Luo, Yue Xiao","doi":"10.3389/fmed.2026.1857890","DOIUrl":"10.3389/fmed.2026.1857890","url":null,"abstract":"<p><strong>Background: </strong>Recurrent pregnancy loss (RPL), the loss of two or more clinically confirmed pregnancies, is observed in approximately 1%-5% of couples trying to conceive. Immune dysfunction is increasingly recognized as a contributing factor. This study evaluated pregnancy outcomes among women with unexplained RPL treated with combined recombinant human granulocyte-colony stimulating factor (rhG-CSF) and low-dose aspirin, while acknowledging that the evidence base for rhG-CSF in unexplained RPL remains uncertain.</p><p><strong>Methods: </strong>In this retrospective study, 300 women aged 18-45 years with at least two consecutive unexplained pregnancy losses were treated with subcutaneous rhG-CSF and low-dose aspirin. Eligible women had documented ovulation, no major uterine abnormality, and no male-factor infertility. Source records were reviewed for mode of conception; all 300 index pregnancies were documented as spontaneous conceptions, and no pregnancies achieved by assisted reproductive technology (ART) were included. rhG-CSF was initiated on the sixth day after ovulation and continued until menstruation or completion of 9 gestational weeks; aspirin 75 mg/day was initiated at the same post-ovulatory time point and continued until 36 gestational weeks unless pregnancy loss or a safety indication required discontinuation. Clinical pregnancy, live birth, miscarriage, stillbirth, neonatal outcomes, and adverse events were assessed. Maternal age was treated as a clinically relevant covariate. Analyses were conducted using IBM SPSS version 27.</p><p><strong>Results: </strong>Live birth at or after 20 weeks of gestation occurred in 211/300 women (70.3%) according to the institutional obstetric registry definition used in the source records. All index pregnancies were verified as spontaneous conceptions, with no ART pregnancies included. Clinical pregnancy, defined as an intrauterine gestational sac with fetal cardiac activity at 6-7 gestational weeks, was observed in 99.3% of participants. In the age-adjusted model, a higher pretreatment systolic/diastolic ratio remained associated with lower odds of live birth (adjusted OR = 0.34, 95% CI 0.22-0.52, <i>p</i> < 0.001), while increasing maternal age was also associated with lower live-birth odds (adjusted OR per year = 0.94, 95% CI 0.89-0.99, <i>p</i> = 0.031). The miscarriage rate was 29.7%, median neonatal birth weight was 3,012 g, and congenital anomalies were documented in 12.6% of recorded neonatal outcomes.</p><p><strong>Conclusion: </strong>In this retrospective cohort, combined rhG-CSF and aspirin therapy was associated with improved uterine Doppler indices and a 70.3% live-birth rate among women with unexplained RPL. Because the study lacked an untreated control group and rhG-CSF use for unexplained RPL remains off-label with conflicting trial evidence, these findings should be interpreted cautiously and confirmed in adequately powered controlled studies.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1857890"},"PeriodicalIF":3.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13683567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of axial length measurement and other biometric parameters using three different generations of biometers.","authors":"Ferdinando Cione, Domenico Mucci, Isabella Pellegrino, Francesco Maria Capuano, Maddalena De Bernardo, Nicola Rosa","doi":"10.3389/fmed.2026.1943418","DOIUrl":"10.3389/fmed.2026.1943418","url":null,"abstract":"<p><strong>Purpose: </strong>To compare biometric measurements obtained with partial coherence interferometry (IOLMaster 500, IOLM), optical low-coherence reflectometry (Lenstar 900, LS900), and swept-source optical coherence tomography (Eyestar 900, ES900).</p><p><strong>Methods: </strong>In this prospective, observational study, axial length (AL), anterior chamber depth (ACD), aqueous depth (AD), lens thickness (LT), and central corneal thickness (CCT) were measured with the three devices. Exclusion criteria were ocular disease, previous ocular surgery, and contact lens use within 72 h. Normality was assessed using the exact Kolmogorov-Smirnov test. Comparisons were performed with paired T-tests and repeated-measures ANOVA with Bonferroni correction. Agreement was evaluated using Bland-Altman plots, and correlation was evaluated using Pearson correlation (<i>r</i>), and intraclass correlation coefficients (ICC). Subgroup analysis by eye side was conducted.</p><p><strong>Results: </strong>Two-hundred-six eyes of 103 healthy subjects (38 females) were recruited at Public hospital \"San Giovanni di Dio e Ruggi d'Aragona\", Salerno, Italy. All devices showed excellent correlation for AL and ACD (<i>r</i> ≥ 0.947, ICC≥0.939; <i>p</i> < 0.001). AL and ACD were comparable between LS900 and IOLM (<i>Δ</i>AL = +0.00 ± 0.09 mm; <i>Δ</i>ACD = +0.01 ± 0.10 mm; <i>p</i> > 0.050). ES900 measured longer AL and deeper ACD than LS900 (<i>Δ</i>AL = +0.03 ± 0.10 mm; <i>Δ</i>ACD = +0.04 ± 0.11 mm; <i>p</i> ≤ 0.031) and IOLM (<i>Δ</i>AL = +0.03 ± 0.08 mm; <i>Δ</i>ACD = +0.04 ± 0.11 mm; <i>p</i> ≤ 0.013). Strong correlation was observed between ES900 and LS900 for CCT, AD, and LT (<i>r</i> ≥ 0.979, ICC≥0.961; <i>p</i> < 0.001). ES900 measured thicker CCT, deeper AD, and thinner LT (<i>p</i> < 0.017).</p><p><strong>Conclusion: </strong>Despite excellent correlation, ES900 provided systematically higher AL and ACD values and different anterior segment measurements. Therefore, caution should be taken when using these devices interchangeably, especially in longitudinal studies and follow-up evaluations; device-specific interpretation is recommended to optimize refractive outcomes in cataract surgery.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1943418"},"PeriodicalIF":3.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13683111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}