Frontiers in Medicine最新文献

{"title":"The association between lipid accumulation product and osteoporosis in American adults: analysis from NHANES dataset.","authors":"Huawen Pan, Xiao Long, Ping Wu, Yongchun Xiao, Huanran Liao, Li Wan, Jianxian Luo, Zhisheng Ji","doi":"10.3389/fmed.2025.1513375","DOIUrl":"10.3389/fmed.2025.1513375","url":null,"abstract":"<p><strong>Background: </strong>The Lipid Accumulation Product (LAP), a novel indicator of fat accumulation, reflects the distribution and metabolic status of body fat. This study aims to evaluate the relationship between adult Americans' prevalence of osteoporosis and LAP.</p><p><strong>Methods: </strong>This study used data from the NHANES cycles 2007-2010, 2013-2014, and 2017-2018, including 4,200 adults aged 50 and above. LAP was calculated using waist circumference and triglyceride levels, whereas osteoporosis was identified using information from dual-energy X-ray absorptiometry (DXA) assessments of bone mineral density (BMD). Restricted cubic spline (RCS) analysis was evaluated the relationship between LAP and osteoporosis. Additionally, subgroup analyses were conducted to assess the impact of demographic characteristics and health status on the relationship between LAP and osteoporosis.</p><p><strong>Results: </strong>LAP and osteoporosis were shown to be significantly inversely correlated in the study. In the unadjusted model, the prevalence of osteoporosis and Log LAP showed a significant negative connection (OR = 0.62, 95% CI = 0.52-0.74). Osteoporosis prevalence decreased by 45% in the fully adjusted model for every unit rise in Log LAP (OR = 0.54, 95% CI = 0.44-0.66). RCS analysis revealed a nonlinear association between LAP and osteoporosis prevalence (<i>P</i>-non-linear = 0.0025), showing an L-shaped negative correlation. Subgroup studies showed that, regardless of age, sex, ethnicity, or health condition, there was a constant negative connection between LAP and osteoporosis.</p><p><strong>Conclusion: </strong>According to this study, there is a substantial negative relationship between adult prevalence of osteoporosis in America and LAP. LAP is an easy-to-use and practical indication that may be very helpful in osteoporosis prevention and early detection.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1513375"},"PeriodicalIF":3.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771897","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: Cholecystitis and gastric perforation caused by a fishbone and treated by laparoscopic surgery.","authors":"Xuemin Li, Junfeng Cheng, Yonghang Wang, Zhijun Chen, Zewei Chen, Chao Ren","doi":"10.3389/fmed.2025.1523249","DOIUrl":"10.3389/fmed.2025.1523249","url":null,"abstract":"<p><p>Rare cases of swallowed fish bones leading to cholecystitis and gastric perforation have been reported. Here, we present the case of a 71-year-old male patient who experienced 10 days of right upper quadrant pain after eating fish. Laparoscopic repair of gastric perforation and cholecystectomy was performed and successfully removed a fishbone of 3 cm in length from the region between the gallbladder cavity and the gastric antrum. The patient was 10 days after surgery and recovered well. No sign of recurrence was observed at the 3-month follow-up.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1523249"},"PeriodicalIF":3.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771635","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":"Development and validation of a 14-CpG DNA methylation signature and drug targets for prognostic prediction in breast cancer.","authors":"Bao-Xing Tian, Zhi-Xi Yu, Xia Qiu, Li-Ping Chen, Yu-Lian Zhuang, Qian Chen, Yan-Hua Gu, Meng-Jie Hou, Yi-Fan Gu","doi":"10.3389/fmed.2025.1548726","DOIUrl":"10.3389/fmed.2025.1548726","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer (BC) is the most prevalent cancer among women and a leading cause of cancer-related deaths worldwide. Emerging evidence suggests that DNA methylation, a well-studied epigenetic modification, regulates various cellular processes critical for cancer development and progression and holds promise as a biomarker for cancer diagnosis and prognosis, potentially enhancing the efficacy of precision therapies.</p><p><strong>Methods: </strong>We developed a robust prognostic model for BC based on DNA methylation and clinical data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO). We analyzed the association of the model with clinicopathological features, survival outcomes, and chemotherapy drug sensitivity.</p><p><strong>Results: </strong>A set of 216 differentially methylated CpGs was identified by intersecting three datasets (TCGA, GSE22249, and GSE66695). Using univariate Cox proportional hazard and LASSO Cox regression analyses, we constructed a 14-CpG model significantly associated with progression-free interval (PFI), disease-specific survival (DSS), and overall survival (OS) in BC patients. Kaplan-Meier (KM) survival analysis, receiver operating characteristic (ROC) analysis, and nomogram validation confirmed the clinical value of the signature. The Cox analysis showed a significant association between the signature and PFI and DSS in BC patients. KM analysis effectively distinguished high-risk from low-risk patients, while ROC analysis demonstrated high sensitivity and specificity in predicting BC prognosis. A nomogram based on the signature effectively predicted 5- and 10-year PFI and DSS. Additionally, combining our model with clinical risk factors suggested that patients in the I-II & M⁺ subgroup could benefit from adjuvant chemotherapy regarding PFI, DSS, and OS. Gene Ontology (GO) functional enrichment and KEGG pathway analyses indicated that the top 3,000 differentially expressed genes (DEGs) were enriched in pathways related to DNA replication and repair and cell cycle regulation. Patients in the high-risk group might benefit from drugs targeting DNA replication and repair processes in tumor cells.</p><p><strong>Conclusion: </strong>The 14-CpG model serves as a useful biomarker for predicting prognosis in BC patients. When combined with TNM staging, it offers a potential strategy for individualized clinical decision-making, guiding personalized therapeutic regimen selection for clinicians.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1548726"},"PeriodicalIF":3.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771942","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":"Experimental and theoretical studies on structural changes in the microtubule affinity-regulating kinase 4 (MARK4) protein induced by <i>N</i>-hetarenes: a new class of therapeutic candidates for Alzheimer's disease.","authors":"Ashanul Haque, Khalaf M Alenezi, Mohd Saeed Maulana Abdul Rasheed, Md Ataur Rahman, Saleha Anwar, Shahzaib Ahamad, Dinesh Gupta","doi":"10.3389/fmed.2025.1529845","DOIUrl":"10.3389/fmed.2025.1529845","url":null,"abstract":"<p><strong>Introduction: </strong>Alzheimer's disease (AD) is a neurodegenerative disorder that progressively affects the cognitive function and memory of the affected person. Unfortunately, only a handful of effective prevention or treatment options are available today. Microtubule affinity-regulating kinase 4 (MARK4) is a serine/threonine protein that plays a critical role in regulating microtubule dynamics and facilitating cell division. The dysregulated expression of MARK4 has been associated with a range of diseases, including AD.</p><p><strong>Methods: </strong>In this study, we synthesized a series of <i>N</i>-hetarenes via Pd(0)-catalyzed Suzuki-Miyaura cross coupling reaction. All compounds were characterized using multi-spectroscopic techniques and evaluated for their activity against the MARK4 enzyme through ATPase inhibition assays. The experimental data was further supported by computational and quantum chemical calculations. We also computed the drug-likeness, bioavailability, and toxicity (ADME/T) profiles of the compounds.</p><p><strong>Results: </strong>Six new 4-(6-(arylpyrimidin-4-yl)piperazine-1-carboximidamides <b>5-10</b> were prepared in good yields. ATPase inhibition assay conducted on these compounds demonstrated IC₅₀ values in micromolar range (5.35 ± 0.22 to 16.53 ± 1.71 μM). Among the tested compounds, 4-(6-(<i>p</i>-tolyl)pyrimidin-4-yl)piperazine-1-carboximidamide (<b>5</b>; IC₅₀ = 5.35 ± 0.22 μM) and 4-(6-(benzo[<i>b</i>]thiophen-2-yl)pyrimidin-4-yl)piperazine-1-carboximidamide (<b>9</b>; IC₅₀ = 6.68 ± 0.80 μM) showed the best activity. The binding constant (<i>K</i>), as determined by the fluorescence quenching assay was estimated to be 1.5 ± 0.51 × 10⁵ M^-1 for <b>5</b> and 1.14 ± 0.26 × 10⁵ M^-1 for <b>9</b>. The results of molecular docking and MD simulation studies against MARK4 (PDB: 5ES1) indicated that compounds were able to bind the ATP binding pocket of the MARK4, leading to its stabilization. Additionally, ADME/T analysis revealed a high degree of drug-likeness of the compounds.</p><p><strong>Conclusion: </strong>We demonstrated that 4-(6-(arylpyrimidin-4-yl)piperazine-1-carboximidamides) are a promising class of <i>N</i>-hetarenes for developing next-generation anti-AD drugs. The reported class of compounds inhibited MARK4 activity in-vitro at micromolar concentration by targeting the ATP-binding pocket. These findings provide valuable insights for future drug design.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1529845"},"PeriodicalIF":3.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771952","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":"Myocarditis associated with <i>Salmonella enterica</i> serovar Weltevreden gastroenteritis in medical practitioner; case report from South India.","authors":"Mahadevaiah Neelambike Sumana, Morubagal Raghavendra Rao, Vidyavathi B Chitharagi, Badveti Satyasai, Supreeta R Shettar, Veerabhadra G S Swamy, Chinchana S Eshwarappa, Yogeesh D Maheshwarappa","doi":"10.3389/fmed.2025.1513974","DOIUrl":"10.3389/fmed.2025.1513974","url":null,"abstract":"<p><p><i>Salmonella enterica</i> serovar Weltevreden, a non-typhoidal serovar, has emerged as a significant foodborne pathogen, particularly in Southeast Asian countries. While it is commonly associated with gastroenteritis and foodborne outbreaks, it can also lead to invasive infections in immunocompromised adults and neonates. This case report presents a rare instance of myocarditis associated with <i>Salmonella</i> Weltevreden gastroenteritis in a 43-year-old healthy male physician from South India. The patient had a month-long history of intermittent fever, which worsened 2 days before admission, along with myalgia and headache. A day after the admission the patient developed diarrhea. Upon investigation, stool culture revealed <i>Salmonella enterica</i> serovar Weltevreden. Notably, the patient had a genetic predisposition to inflammatory bowel disease and reported recent use of nonsteroidal anti-inflammatory drugs, which may have increased his susceptibility to non-typhoidal <i>Salmonella</i> infection. The patient also developed myocarditis, making this the first reported case of Weltevreden-associated myocarditis in the region. Antimicrobial susceptibility testing indicated ciprofloxacin susceptibility, an increasingly rare finding, as most reported serovar Weltevreden cases exhibit ciprofloxacin resistance. The patient recovered following treatment with ciprofloxacin and was discharged with instructions for follow-up. This case highlights the need for heightened awareness of the potential for non-typhoidal <i>Salmonella</i> infections to cause systemic manifestations, even in individuals without major underlying comorbidities. Continuous monitoring of antimicrobial resistance patterns and strict food safety measures are essential to control outbreaks of these emerging pathogens.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1513974"},"PeriodicalIF":3.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771959","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":"Construction of a predictive model for the efficacy of anti-VEGF therapy in macular edema patients based on OCT imaging: a retrospective study.","authors":"Tingting Song, Boyang Zang, Chui Kong, Xifang Zhang, Huihui Luo, Wenbin Wei, Zheqing Li","doi":"10.3389/fmed.2025.1505530","DOIUrl":"10.3389/fmed.2025.1505530","url":null,"abstract":"<p><strong>Background: </strong>Macular edema (ME) is an ophthalmic disease that poses a serious threat to human vision. Anti-vascular endothelial growth factor (anti-VEGF) therapy has become the first-line treatment for ME due to its safety and high efficacy. However, there are still cases of refractory macular edema and non-responding patients. Therefore, it is crucial to develop automated and efficient methods for predicting therapeutic outcomes.</p><p><strong>Methods: </strong>We have developed a predictive model for the surgical efficacy in ME patients based on deep learning and optical coherence tomography (OCT) imaging, aimed at predicting the treatment outcomes at different time points. This model innovatively introduces group convolution and multiple convolutional kernels to handle multidimensional features based on traditional attention mechanisms for visual recognition tasks, while utilizing spatial pyramid pooling (SPP) to combine and extract the most useful features. Additionally, the model uses ResNet50 as a pre-trained model, integrating multiple knowledge through model fusion.</p><p><strong>Results: </strong>Our proposed model demonstrated the best performance across various experiments. In the ablation study, the model achieved an F1 score of 0.9937, an MCC of 0.7653, an AUC of 0.9928, and an ACC of 0.9877 in the test conducted on the first day after surgery. In comparison experiments, the ACC of our model was 0.9930 and 0.9915 in the first and the third months post-surgery, respectively, with AUC values of 0.9998 and 0.9996, significantly outperforming other models. In conclusion, our model consistently exhibited superior performance in predicting outcomes at various time points, validating its excellence in processing OCT images and predicting postoperative efficacy.</p><p><strong>Conclusion: </strong>Through precise prediction of the response to anti-VEGF therapy in ME patients, deep learning technology provides a revolutionary tool for the treatment of ophthalmic diseases, significantly enhancing treatment outcomes and improving patients' quality of life.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1505530"},"PeriodicalIF":3.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771752","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":"Auricular acupoint therapy for functional gastrointestinal disorders: a systematic review and meta-analysis of randomized clinical trials.","authors":"Meng-Yuan Shen, Ze-Jiong Li, Shu-Han Wang, Tian-Chen Lin, Qin-Yi Lou, Shan Liu, Dan-Dan Feng, Dong-Dong Yang, Chen-Juan Wang, Zhe-Kai Ying, Rong Zhou, Jian-Nong Wu","doi":"10.3389/fmed.2025.1513272","DOIUrl":"10.3389/fmed.2025.1513272","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to conduct a systematic review and meta-analysis of randomized controlled trials to evaluate the efficacy and safety of auricular acupoint therapy (AAT) for functional gastrointestinal disorders (FGIDs).</p><p><strong>Methods: </strong>We conducted a thorough search across eight databases, including PubMed, EMBASE, Web of Science, the Cochrane Library, CNKI, Wanfang, VIP, and CBM. The search covered the period from the inception of each database up to June 30, 2024. The authors independently reviewed all the references, evaluated the risk of bias, and extracted the data. GRADEpro software was utilized to calculate overall strength of evidence. A random effects or fixed effects model was selected on the basis of the <i>p</i>-value and <i>I²</i> . RevMan 5.3, Stata/MP 18.0, R 4.3.1 and R Studio 2023.09.0 were used for data processing. TSA 0.9.5.10 beta software was used to evaluate data stability.</p><p><strong>Results: </strong>The review included 19 randomized controlled trials with a total of 1,681 patients (895 in the treatment group and 886 in the control group). The treatment duration ranged from 2-12 weeks. The meta-analysis revealed that, compared with the control, AAT was significantly more effective at treating FGIDs (RR: 1.35; 95% CI: 1.21-1.51; <i>p</i> < 0.001), reducing the symptom score (MD: -1.94; 95% CI: -3.06 to -0.85; <i>p</i> < 0.001; five trials), improving the SAS score (MD: -12.47; 95% CI: -13.92 to -11.01; <i>p</i> < 0.001; five trials), and improving the SDS score (MD: -4.97; 95% CI: -9.23 to -0.72; <i>p</i> = 0.02; six trials). A total of two articles mentioned relatively significant adverse reactions (MD: 2.98; 95% CI: 0.51-17.26; <i>p</i> = 0.009). Sensitivity and trial sequential analyses confirmed the stability of these results.</p><p><strong>Discussion: </strong>While our meta-analysis suggests that AAT may offer benefits for FGIDs, these results must be interpreted with caution due to methodological limitations in the included trials. Further investigations in high-quality trials are warranted.</p><p><strong>Systematic review registration: </strong>https://clinicaltrials.gov/, identifier CRD42024558786.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1513272"},"PeriodicalIF":3.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771970","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":"The strong correlation between visual function improvement and retinal microcirculation enhancement in glaucoma.","authors":"Ting Wang, Qiying Ling, Boyu Shen, Xu Jia","doi":"10.3389/fmed.2025.1537741","DOIUrl":"10.3389/fmed.2025.1537741","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the alterations in retinal vessel density (VD) among glaucomatous patients following effective intraocular pressure (IOP) reduction and to explore the relationship between retinal VD, visual function, and optic nerve structure.</p><p><strong>Methods: </strong>Participants diagnosed with primary open-angle glaucoma (POAG) and chronic primary angle-closure glaucoma (CPACG) were included. We measured peripapillary and macular VD, retinal nerve fiber layer (RNFL) thickness, foveal avascular zone (FAZ), and visual field (VF) parameters before treatment, and at 1 week, 1 month, 3 months, and 6 months post-treatment. The data were analyzed using ANOVA and Pearson correlation analysis.</p><p><strong>Results: </strong>A total of 20 patients were included. Significant improvements in peripapillary VD were observed in the superior and nasal sectors at 1 week, superior and temporal sectors at 1 month, and in the superior, inferior, and temporal sectors at 3 months, with sustained improvements in the superior, nasal, and temporal sectors at 6 months. Recovery of macular VD was noted across all sectors at 1 week, predominantly in the superior parafovea at 1 month, and in the superior, inferior parafovea, and inferior perifovea by 3 months, with further improvement in the inferior parafovea and perifovea at 6 months. The FAZ area significantly narrowed within the first 3 months. The mean deviation (MD) value demonstrated an increase at 1 week, 3 months, and 6 months. Notably, changes in peripapillary VD in the superior and inferior sectors exhibited a strong correlation with MD values, while correlations in the nasal and temporal sectors were moderate. Conversely, the correlation between IOP changes and MD was weak.</p><p><strong>Discussion: </strong>Effective IOP reduction was beneficial for the recovery of both peripapillary and macular microcirculation, leading to improvements in visual function, suggesting that actively improving retinal microcirculation while reducing IOP may contribute to partial recovery of visual function for patients with chronic glaucoma.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1537741"},"PeriodicalIF":3.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771949","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":"Application of the metagenomic next-generation sequencing technology to identify the causes of pleural effusion.","authors":"Zhiyun Yan, Cheng Sun, Wanna Tang, Weitao Cao, Jin Lv, Zhike Liang, Shuquan Wei, Weinong Zhong, Ziwen Zhao, Zhuxiang Zhao, Yujun Li","doi":"10.3389/fmed.2025.1525100","DOIUrl":"10.3389/fmed.2025.1525100","url":null,"abstract":"<p><strong>Background: </strong>Pleural effusion (PE), frequently encountered in clinical practice, can arise from a variety of underlying conditions. Accurate differential diagnosis of PE is crucial, as treatment and prognosis are heavily dependent on the underlying etiology. However, diagnosing the cause of PE remains challenging, relying on mycobacteriological methods that lack sensitivity and are time-consuming, or on histological examinations that require invasive biopsies. The recent advancements in metagenomic next-generation sequencing (mNGS) have shown promising applications in the diagnosis of infectious diseases. Despite this, there is limited research on the utility of mNGS as a comprehensive diagnostic tool for simultaneously identifying the causes of PE, particularly in cases of tuberculosis or malignancy.</p><p><strong>Methods: </strong>This study aimed to assess the efficacy of mNGS in detecting tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE). A total of 35 patients with PE were included, and their PE samples were analyzed using mNGS.</p><p><strong>Results: </strong>Among the participants, 8 were ultimately diagnosed with TPE, and 10 were diagnosed with MPE, with lung adenocarcinoma being the most prevalent pathological type (50%, 5/10), according to established diagnostic criteria. Additionally, 7 patients were diagnosed with non-infectious PE. However, mNGS identified only 2 cases of TPE and 8 cases of MPE. The sensitivity of mNGS for detecting <i>Mycobacterium tuberculosis</i> was 25% (2/8), while the specificity was 100%. For tumor detection, mNGS demonstrated a sensitivity of 80%, a specificity of 92.6%, and an AUC of 0.882.</p><p><strong>Conclusion: </strong>mNGS is effective in distinguishing MPE from non-MPE, but is not suitable for diagnosing TPE.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1525100"},"PeriodicalIF":3.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771969","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":"Blastemal predominant WT1 negative Wilms tumour of the young adult: a unique case report and review of the literature.","authors":"Jozef Škarda, Michal Grepl, Valeria Skopelidou, Vladimír Židlík, Pavel Hurník, Daniela Skanderová, Michael Michal, Michal Michal, Pavla Hanzlíková, Jana Vaculová, Marcel Mitták","doi":"10.3389/fmed.2025.1507011","DOIUrl":"10.3389/fmed.2025.1507011","url":null,"abstract":"<p><p>Wilms tumour is a common juvenile cancer of the kidney, and its occurrence in adolescence or adulthood is extremely rare, accounting for around 1% of all adult kidney malignancies. Histopathologically, three tissue patterns can be identified, including blastemal, epithelial, and stromal components, while the overall microscopic appearance of an adult-type tumour does not differ from that of its juvenile counterpart. The blastemal predominant Wilms tumours are the most aggressive and have the worst prognosis. The samples must be histopathologically verified before the definitive diagnosis can be made, and immunohistochemistry examination is critical. Wilms tumours are often positive for keratin, vimentin, desmin, actin, and WT1, which distinguishes this type of tumour from other malignancies. WT1 positivity is indicative of the blastemal component of the tumorous tissue and may be completely absent in the mature epithelial and stromal parts. Only three WT1 negative adult-type Wilms tumours have been reported in the literature to this date. However, none of the patients had a blastemal predominant tumour. That is why we would like to present a highly interesting and diagnostically challenging case of a young man who was diagnosed with a tumorous lesion of the left kidney parenchyma. Genetic analysis did not reveal any known fusion genes associated with round cell sarcomas, ruling out this differential diagnosis. This article also includes a literature review on published articles on WT1 negative Wilms tumour in adults and other concerns related to this topic. The main goal of this publication was to emphasise that, while it is a rare entity in general, similar problematic cases can occur in practise, and thus it is important to be aware of this type of tumour when making a differential diagnosis in cases with similar clinical and histopathological features.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1507011"},"PeriodicalIF":3.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771899","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}