Journal of Clinical Medicine最新文献

{"title":"Characteristics of Older Adults with Favorable Locomotive Syndrome and Frailty Outcomes Following Locomotion Training: A Preliminary Pre-Post Study.","authors":"Ikki Yoshida, Yohei Sawaya, Tamaki Hirose, Yuta Hanawa, Hiroto Ito, Reina Ohkubo, Ryo Sato, Tomohiko Urano","doi":"10.3390/jcm15197748","DOIUrl":"10.3390/jcm15197748","url":null,"abstract":"<p><p><b>Background/Objectives:</b> We evaluated changes in locomotive syndrome (LS) and frailty following locomotion training (LT) in community-dwelling older adults and explored their characteristics with favorable outcomes for each condition. <b>Methods:</b> In this pre-post intervention study, 37 community-dwelling older adults (mean age, 77.6 ± 6.0 years) who participated in a community-based preventive care program completed a 126-day home-based LT program of single-leg standing, squats, and heel raises. Before and after the intervention, LS was assessed using the LS risk test and frailty with the Japanese version of the Cardiovascular Health Study (J-CHS) criteria and Questionnaire for Medical Checkup of Old-Old (QMCOO); changes in LS and frailty were analyzed, and the baseline characteristics of participants with favorable outcomes were explored. <b>Results:</b> The LT was performed as prescribed or partially on 84.8% of days. Following the intervention, the LS stage (<i>p</i> = 0.016), J-CHS score (<i>p</i> = 0.014), and usual walking speed (<i>p</i> < 0.001) significantly improved. The QMCOO total score did not change significantly. Individual-level LS stage improved by at least one stage in 20.6% of participants with baseline LS. In participants with baseline pre-frailty/frailty, 43.5% (J-CHS) and 31.3% (QMCOO) improved by at least one category. LS favorable status was not associated with baseline frailty measures. In both J-CHS and QMCOO assessments, the robust maintenance/improvement groups were younger and had better baseline two-step test values and GLFS-25 scores. The QMCOO robust maintenance/improvement group had a better LS stage. <b>Conclusions:</b> Following LT, LS stage and J-CHS total score improved significantly, with favorable individual-level outcomes in LS and frailty. Participants with favorable frailty outcomes had better baseline LS measures, whereas participants with favorable LS outcomes did not differ in baseline frailty measures. Large controlled studies are warranted.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194109","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":"Longitudinal Changes in the Digitized Archimedes Spiral Drawing Test Following iTBS of the Left DLPFC in Parkinson's Disease: An Exploratory Feasibility Study.","authors":"Alexander Zakharov, Mariya Sergeeva, Yuliya Komarova, Natalia Romanchuk, Vladimir Khorev, Igor Shirolapov","doi":"10.3390/jcm15197754","DOIUrl":"10.3390/jcm15197754","url":null,"abstract":"<p><p><b>Background:</b> The Digitized Archimedes Spiral Drawing Test (DAST) provides objective assessment of fine motor function, but its utility as a biomarker for neuromodulatory interventions in Parkinson's disease (PD) remains underexplored. <b>Objective:</b> To explore longitudinal changes in a comprehensive set of DAST parameters following a course of intermittent theta-burst stimulation (iTBS) of the left dorsolateral prefrontal cortex (DLPFC) in PD patients as a feasibility study. <b>Methods:</b> Twenty-seven participants (17 PD patients, 10 healthy controls) underwent DAST testing at baseline and at 1.5 and 6 months; the immediate post-course assessment was performed only in the PD group, whereas the controls received a single sham session. Forty kinematic, temporal, spatial and tremor-related metrics were extracted. Clinical assessment was performed using MDS-UPDRS. Linear mixed models, ANCOVA, and Friedman tests were applied for statistical analysis. <b>Results:</b> Temporal and kinematic parameters showed modest changes over the study period, including mean velocity (<i>p</i> = 0.0437), trial duration (<i>p</i> = 0.0437), and mean number of movements (<i>p</i> = 0.0485). In contrast, spatial parameters (total error and length-normalized error) showed no significant change over the study period but maintained stable between-group differences across all stages (<i>p</i> = 0.0251 and <i>p</i> = 0.0123 at 6 months). Age and sex significantly influenced several DAST metrics: age affected mean error for spiral types 2, 3, and 4 (<i>p</i> = 0.008-0.047), while sex influenced dominant tremor frequency, tremor power ratio (<i>p</i> = 0.005-0.007), and mean error for spiral types 3 and 4 (<i>p</i> = 0.023-0.039). The DAST showed limited ability to differentiate adjacent PD stages: only mean velocity of spiral type 2 differed between Hoehn and Yahr stages 2 and 3 at baseline (<i>p</i> = 0.0176), with no significant differences between subgroups at 6 months. <b>Conclusions:</b> The changes over the study period were observed in kinematic and temporal DAST measures, but not in spatial parameters. These preliminary findings may suggest a possible dissociation between parameters predominantly reflecting motor planning and those reflecting trajectory execution. It may be tentatively hypothesized that DLPFC stimulation primarily modulates motor planning processes and movement execution strategies, whereas trajectory implementation and spatial coordination appear to be mediated by other cortico-subcortical structures. DAST shows potential as an objective tool for monitoring motor changes in PD; nevertheless, its responsiveness should be further evaluated in larger studies.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193760","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":"Effect of Overweight/Obesity on Traumatic Dental Injuries in Children and Adolescents: A Systematic Review with Meta-Analysis.","authors":"Anika Islam, Spyridon N Papageorgiou, Blend Hamza, Marc Schätzle","doi":"10.3390/jcm15197749","DOIUrl":"10.3390/jcm15197749","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Overweight and obesity are growing global pediatric health concerns, but their association with the occurrence of traumatic dental injuries (TDIs) is unclear. The aim of this systematic review was to critically appraise evidence on the prevalence of TDIs in children and adolescents according to their weight. <b>Methods</b>: Systematic literature searches without restrictions were undertaken in six databases from inception up to August 2026 for studies reporting on the association between overweight/obesity and TDIs among children. After duplicate study selection, data extraction, and risk of bias assessment with a custom tool based on the Joanna Briggs Institute's tool for case-control studies, random-effects meta-analyses were performed, followed by subgroup, meta-regression, and sensitivity analyses. <b>Results</b>: Twenty-six studies covering a total of 23,772 patients (54.5% male; average age 10.1 years) were included. Increased patient weight (overweight/obesity) was significantly associated with higher odds of TDIs in children (Odds Ratio [OR] 1.48; 95% CI 1.22 to 1.80; <i>p</i> < 0.001). TDIs were significantly associated with obesity (OR 1.45; 95% CI 1.10 to 1.96; <i>p</i> = 0.01) but not with overweight (OR 1.13; 95% CI 0.79 to 1.62; <i>p</i> = 0.45). No significant effects were seen for age, sex, dentition, confounder adjustment, study design, and study sample size, while differences were seen according to the TDI diagnostic criteria used. The certainty in existing evidence was very low due to methodological limitations of existing studies and between-study heterogeneity. <b>Conclusions</b>: Obesity seems to be associated with increased odds of TDIs in children and adolescents, whereas overweight alone shows no significant association. However, due to the very low certainty in the evidence, these results should be interpreted cautiously and warrant further high-quality research.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194363","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":"Transcatheter Valve-in-Band Implantation in a Swine Model of Failed Mitral Repair: A Technical Note and Proof of Feasibility.","authors":"Julia E Katter, Jonathan Martinez Rivera, Meghan A Matlack, Daniel A Anderson, Emily K Leva, Allison M Tomasino, Henry J Tannous","doi":"10.3390/jcm15197733","DOIUrl":"10.3390/jcm15197733","url":null,"abstract":"<p><p>Surgical mitral valve repair is the gold standard for severe primary mitral regurgitation (MR), yet when repairs fail, open reintervention carries substantial perioperative risk. Following band annuloplasty, minimally invasive options, such as transcatheter mitral valve replacement (TMVR), remain largely unexplored due to a hypothetical concern around the lack of circumferential radial support. Although transapical transcatheter mitral valve-in-band (ViB) replacement has been reported in a single human case, we report the first controlled large-animal model of ViB. A 68 kg, 20-month-old female Yucatan mini pig underwent placement of a 28 mm mitral annuloplasty band, oversized to create MR, via clamshell sternotomy under cardiopulmonary bypass; a simulated dilated left atrium enabled transcatheter access. A 23 mm Edwards SAPIEN 3 Ultra valve was deployed within the band using the Commander delivery system under fluoroscopic guidance. The valve achieved stable fixation without embolization, paravalvular leak (PVL), or left ventricular outflow tract (LVOT) obstruction with resolution of MR on echocardiography. The stable position was consistent with a contribution from the native anterior leaflet and annulus, although radial forces were not directly measured. The animal tolerated the procedure without complications. This first-in-animal study suggests the acute technical feasibility of TMVR within a mitral annuloplasty band and supports further investigation of percutaneous band modification strategies to optimize ViB outcomes.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194416","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":"Skeletal Muscle Mass as a Potential Mediator of the Physical Activity-Left Atrial Function Relationship: A Community-Based Cross-Sectional Study.","authors":"Yue Zhong, Kai Li, Lijun Zeng, Xue Yang, Changwei Cai, Bin Yu, Shujuan Yang, Qingyu Dou","doi":"10.3390/jcm15197744","DOIUrl":"10.3390/jcm15197744","url":null,"abstract":"<p><p><b>Objectives:</b> Left atrial (LA) strain reflects early cardiac dysfunction preceding structural remodeling and clinical disease. Data on the association between physical activity (PA) and LA function are limited. In this study, we aim to explore the association of PA with LA strain, and to test the indirect effect of skeletal muscle mass in the PA-LA association. <b>Methods:</b> Data from the Healthy Lifestyle Promotion Cohort involving 407 participants were analyzed. Multivariate linear regression models were used to estimate the associations of leisure-time PA with LA function, and indirect associations through skeletal muscle mass were determined using a regression-based mediation analysis. <b>Results:</b> PA was significantly associated with LA reservoir strain (β = 2.907, <i>p</i> < 0.001) and with pump strain (β = -1.674, <i>p</i> < 0.001). PA had a significant effect on the skeletal muscle mass index (SMI) (β = 0.230, <i>p</i> < 0.001), while the SMI had a significant impact on LA reservoir strain (β = 2.619, 95% CI 1.425-3.813, <i>p</i> < 0.001) and pump strain (β = -2.621, 95% CI -3.472--1.771, <i>p</i> < 0.001). The SMI partially mediated the effect of PA on LA reservoir strain by 21% (95% CI: 9-38%, <i>p</i> < 0.001) and LA pump strain by 36% (95% CI: 20-59%, <i>p</i> < 0.001). Subgroup analysis revealed that this statistical mediation effect of the SMI demonstrated a stronger trend in women compared to men and in participants ≥60 years old compared to their younger counterparts. <b>Conclusions:</b> The SMI partially mediates the association between PA and LA function in the community-dwelling Chinese participants. Sustaining a higher level of leisure-time PA was associated with better LA function. These possible beneficial effects may be partially explained through favorable changes in the SMI.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194427","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":"Congenital/Inherited CD59 Deficiency: A Systematic Review.","authors":"Lama Alwahiby, Lanah Alsuhim, Manal Alzahrani, Jalnar Albaloshi, Cristina Skrypnyk, Kannan Sridharan","doi":"10.3390/jcm15197751","DOIUrl":"10.3390/jcm15197751","url":null,"abstract":"<p><p><b>Background:</b> Inherited CD59 deficiency is a rare autosomal recessive complement-mediated disorder caused by biallelic loss-of-function variants in the <i>CD59</i> gene. It typically presents in infancy with Coombs-negative hemolytic anemia, relapsing demyelinating polyneuropathy, and recurrent ischemic strokes. Diagnosis is often delayed due to overlapping with more common neurological and hematological disorders. The present study was carried out to systematically review the literature on congenital CD59 deficiency, focusing on genotype-phenotype correlations, geographic distribution, clinical presentation, diagnostic approaches, and treatment outcomes. <b>Methods:</b> Eligible studies included case reports and case series of genetically or functionally confirmed inherited CD59 deficiency. Demographic, molecular, clinical, and therapeutic data were extracted and analyzed descriptively. <b>Results:</b> 20 reports included. Evidence remains mainly limited to case reports and small case series. The disorder demonstrates a severe and heterogeneous phenotype with predominant neuromuscular involvement, frequently associated with hematologic and cerebrovascular manifestations. Most reported cases originate from regions with high consanguinity, particularly the Middle East and Asia, suggesting possible founder effects and underrecognized prevalence. Exploratory analysis suggested a possible relationship between predicted variant functional impact and clinical severity. However, given the small and heterogeneous evidence base, this finding should be considered hypothesis-generating. Responses to conventional immunomodulatory therapies are variable and often transient. Eculizumab has shown clinical benefit in some patients, although treatment responses remain inconsistent. <b>Conclusions:</b> Congenital CD59 deficiency is a severe and underrecognized complement-mediated disorder with major diagnostic and therapeutic challenges. Current evidence remains insufficient to establish definitive genotype-phenotype correlations or standardized management strategies. Increased clinical awareness, early integration of functional and genetic testing, and further studies are needed to improve diagnosis and optimize treatment outcomes.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194208","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":"Gingival Crevicular Fluid Levels of Parathyroid Hormone-Related Protein, RANK Ligand, and Osteoprotegerin in Periodontal Health, Gingivitis, and Periodontitis: A Cross-Sectional Study.","authors":"Bilge Meracı Yıldıran, Nuray Ercan, Esra Ateş Yıldırım, Zeynep Akgül, Özgür Mehmet Yis","doi":"10.3390/jcm15197752","DOIUrl":"10.3390/jcm15197752","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Parathyroid hormone-related protein (PTHrP) modulates the receptor activator of nuclear factor kappa B ligand (RANKL)/osteoprotegerin (OPG) system in periodontal cells in vitro but has not been measured in gingival crevicular fluid (GCF). This study compared GCF PTHrP, RANKL, and OPG across periodontal health, gingivitis, and periodontitis. <b>Methods</b>: This cross-sectional study included 81 participants with periodontal health, gingivitis, or stage III grade B periodontitis (<i>n</i> = 27 each). GCF was collected from two interproximal sites per participant. PTHrP, RANKL, and OPG were quantified by ELISA and expressed as total amount per site and concentration. Group comparisons were repeated with adjustment for age and sex. <b>Results</b>: PTHrP total amount differed between all three groups, with values of 4.26 ± 2.96, 12.45 ± 5.77, and 19.67 ± 4.59 pg/site in periodontal health, gingivitis, and periodontitis, respectively (<i>p</i> < 0.001). RANKL total amount did not differ among groups (median: 51.40, 51.40, and 51.78 pg/site; <i>p</i> = 0.977). OPG total amount was lower (median: 53.36, 46.70, and 46.70 pg/site; <i>p</i> < 0.001) and the RANKL/OPG ratio higher (median: 0.98, 1.10, and 1.14; <i>p</i> < 0.001) in both disease groups than in periodontal health. After adjustment, PTHrP and OPG differences persisted, whereas no pairwise difference in the RANKL/OPG ratio remained significant. PTHrP correlated negatively with OPG (<i>r</i> = -0.530) and positively with the RANKL/OPG ratio (<i>r</i> = 0.481; both adjusted <i>p</i> < 0.001). <b>Conclusions</b>: GCF PTHrP total amount differed between periodontal health, gingivitis, and periodontitis, with the highest values in periodontitis. These cross-sectional findings identify an association between GCF PTHrP and periodontal status but do not establish a causal role for PTHrP in periodontal tissue breakdown.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194322","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":"Clozapine and Solid Cancer Risk in Lithuania: A Population-Based Cohort Study.","authors":"Mingaile Drevinskaite, Arunas Germanavicius, Giedre Smailyte","doi":"10.3390/jcm15197739","DOIUrl":"10.3390/jcm15197739","url":null,"abstract":"<p><p><b>Background</b>: People with schizophrenia may experience altered cancer risk because of lifestyle-, healthcare access-, and treatment-related factors. Evidence on the solid cancer risk associated with clozapine remains limited. We aimed to assess solid cancer incidence among clozapine users in Lithuania between 2013 and 2021. <b>Methods</b>: We conducted a retrospective population-based cohort study linking National Health Insurance Fund records with the Lithuanian Cancer Registry. Patients with schizophrenia treated with clozapine during 2013-2021 were followed from the first recorded clozapine prescription until death, emigration, or 31 December 2021. Standardized incidence ratios (SIR) for cancers were calculated as the ratio of observed cancer cases in the clozapine user cohort to the expected number of cancers in the general Lithuanian population. <b>Results</b>: The cohort included 3473 clozapine users and 91 incident cancers. Overall cancer incidence was lower than expected in males. Among men with at least 3 years of clozapine exposure, prostate cancer incidence was reduced (SIR 0.47, 95% CI 0.22-0.98). Among women with at least 3 years of exposure, corpus uteri cancer incidence was increased (SIR 2.42, 95% CI 1.21-4.83). <b>Conclusions</b>: Current evidence on solid cancer incidence among clozapine users remains limited. Prolonged exposure may be associated with cancer-specific rather than uniform changes in risk. These exploratory findings should be interpreted cautiously and support continued attention to cancer surveillance and further large-scale pharmacoepidemiological studies with longer follow-up.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193884","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 Myopic Normal Tension Glaucoma Treatment Study (MYNT-GTS): Protocol and Baseline Characteristics of a Randomized Controlled Trial.","authors":"Eun Ji Lee, Joon Mo Kim, Jiwoong Lee, Sangwoo Moon, Sang Woo Park, Mi Sun Sung, Ji-Ah Kim, Gyu-Nam Kim, Jong Chul Han, Ji Eun Song, Kyoung Min Lee, Tae-Woo Kim","doi":"10.3390/jcm15197734","DOIUrl":"10.3390/jcm15197734","url":null,"abstract":"<p><p><b>Background/Objectives</b>: To describe the study protocol and baseline characteristics of participants in the Myopic Normal-Tension Glaucoma Treatment Study (MYNT-GTS), which is a randomized controlled trial evaluating the effect of intraocular pressure (IOP)-lowering treatment on glaucoma progression in eyes with myopic normal-tension glaucoma (NTG). <b>Methods</b>: A prospective, multicenter, randomized controlled clinical trial and baseline cross-sectional analysis. The study enrolled 473 treatment-naïve NTG eyes with myopia (spherical equivalent ≤ -1.0 diopters or axial length [AXL] > 24.0 mm) aged 20-60 years from 9 tertiary referral centers in South Korea. Participants were randomized at a 1:1 ratio into a treated group and an untreated group managed by active surveillance, and stratified by age, baseline IOP, AXL, and visual field (VF) mean deviation (MD). Treatment was initiated or intensified when predefined structural or functional progression was detected. Comprehensive examinations including quantitative assessments of the optic nerve head structure and microvasculature, medication adherence, and quality of life were performed every 4 months during the first year and every 6 months thereafter. Glaucoma progression was assessed from the rate of circumpapillary retinal nerve fiber layer (RNFL) thinning, and the rate of VF deterioration was assessed from the MD or visual field index (VFI). <b>Results</b>: The 473 enrolled participants comprised 239 assigned to the treated group and 234 to the untreated group. Most of the baseline variables did not differ significantly between the groups, including age (43.1 ± 9.1 vs. 43.9 ± 9.1 years [mean ± standard deviation], <i>p</i> = 0.33), baseline IOP (14.9 ± 2.6 vs. 14.7 ± 2.5 mmHg, <i>p</i> = 0.26), AXL (26.31 ± 1.37 vs. 26.32 ± 1.34 mm, <i>p</i> = 0.94), global RNFL thickness (79.5 ± 11.4 vs. 80.5 ± 13.2 μm, <i>p</i> = 0.38), and VF MD (-2.71 ± 2.58 vs. -2.32 ± 2.52 dB, <i>p</i> = 0.10). <b>Conclusions</b>: The vast majority of the analyzed variables did not differ significantly between the treated and untreated groups at baseline, supporting the validity of the subsequent comparisons. As the first prospective, multicenter randomized controlled trial dedicated to myopic NTG, the MYNT-GTS should clarify the efficacy of IOP-lowering treatment and inform the individualized management of myopic NTG. <b>Trial Registration</b>: Clinical Research Information Service (CRIS), Republic of Korea, KCT0005225.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194222","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":"Association Between Periodontal Status and Undiagnosed Diabetes in Adults Without Diagnosed Chronic Diseases: The Korea National Health and Nutrition Examination Survey 2013-2015.","authors":"Young Sang Lyu, So Yeong Kim, Sang Hee Jeong, Youngmin Yoon, Sang Yong Kim, Jin Hwa Kim","doi":"10.3390/jcm15197747","DOIUrl":"10.3390/jcm15197747","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Periodontitis and diabetes are closely linked; however, whether periodontal findings are associated with previously unrecognized dysglycemia in adults without known chronic diseases remains unclear. We examined the association between periodontal status and undiagnosed prediabetes and diabetes in this population. <b>Methods:</b> We analyzed data from 7635 adults (3218 men and 4417 women) aged ≥19 years without self-reported physician-diagnosed chronic diseases who participated in the Korea National Health and Nutrition Examination Survey 2013-2015. Glycemic status was classified as normal, undiagnosed prediabetes, or undiagnosed diabetes based on a single measurement of fasting plasma glucose and glycated hemoglobin. Periodontal status was determined with the Community Periodontal Index (CPI) and grouped as CPI 0-2, CPI 3, or CPI 4. Survey-weighted multivariable logistic regression analyses were performed in men and women separately, and effect modification by sex was formally tested. <b>Results:</b> Undiagnosed prediabetes and diabetes were present in 42.0% and 5.0% of men and in 31.7% and 2.9% of women (weighted estimates). After multivariable adjustment, CPI 3 (odds ratio [OR] 3.594, 95% confidence interval [CI] 1.553-8.316) and CPI 4 (OR 5.837, 95% CI 2.341-14.555) were associated with higher odds of undiagnosed diabetes in men, whereas no significant association was observed in women (<i>p</i> for sex interaction = 0.004). Periodontal status was not associated with undiagnosed prediabetes in either sex. <b>Conclusions:</b> In this cross-sectional analysis, CPI-defined periodontitis was associated with higher odds of undiagnosed diabetes in men. These findings do not establish causality or the diagnostic performance of periodontal examination as a screening test; rather, periodontal findings may help identify individuals in whom standard diabetes risk assessment or medical referral could be considered.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193772","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}