Medicina (Kaunas, Lithuania)最新文献

{"title":"Integrative Molecular Profiling and Single-Cell Characterization of <i>LHFPL5</i> Reveal Cancer-Specific Regulatory Features in Clear Cell Renal Cell Carcinoma and Lung Adenocarcinoma.","authors":"Hakeemah H Al-Nakhle, Zinab O Doha","doi":"10.3390/medicina62101971","DOIUrl":"https://doi.org/10.3390/medicina62101971","url":null,"abstract":"<p><p><i>Background and Objectives</i>: <i>LHFPL5</i> encodes a four-pass transmembrane protein essential for cochlear mechanotransduction, but its molecular behavior in cancer remains poorly defined. We characterized the genomic, epigenetic, transcriptomic, immune, and cellular context of <i>LHFPL5</i> in clear cell renal cell carcinoma (KIRC) and lung adenocarcinoma (LUAD), along with its associations with clinical outcomes. <i>Materials and Methods</i>: Retrospective analyses integrated TCGA RNA sequencing, clinical, DNA methylation, copy number, tumor purity, and immune deconvolution data. Transcriptome-wide associations and Hallmark enrichment defined <i>LHFPL5</i>-associated programs. Continuous-expression Cox models estimated hazard ratios (HRs) per standard-deviation increase, adjusted for age, sex, and pathological stage. GEO cohorts assessed external reproducibility, matched TCGA expression pipelines assessed processing sensitivity, and three non-TCGA single-cell datasets examined cellular localization. <i>Results</i>: <i>LHFPL5</i> showed distinct molecular contexts in KIRC and LUAD. In KIRC, higher expression remained associated with poorer overall survival after clinical adjustment (528 patients; 174 deaths; HR = 1.36, 95% CI 1.21-1.53; <i>p</i> = 2.42 × 10^-7), while subtype and immune fractions showed limited statistical overlap with the association. In LUAD, expression covaried with copy-number state and showed a weak inverse relationship with first-exon methylation. Proliferation-related transcriptional programs were associated with survival, although enrichment support depended on the multiple-testing procedure. The primary STAR-derived LUAD analysis was null (485 patients; 177 deaths; HR = 1.02, 95% CI 0.89-1.18; <i>p</i> = 0.770), and survival inference varied with RNA processing. External adjusted replication was inconclusive. Single-cell detection was sparse in KIRC and one LUAD dataset; another LUAD cohort showed more frequent epithelial detection without resolved malignant-cell identity. <i>Conclusions</i>: <i>LHFPL5</i> exhibits cancer-specific molecular architecture. LUAD showed copy-number, methylation, and proliferation-related associations, whereas KIRC showed a distinct molecular context with an independent survival signal. These findings support context-dependent <i>LHFPL5</i> regulation and prioritize genomic, epigenetic, and transcriptional mechanisms for functional investigation.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149280924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic Carbetocin Versus Oxytocin and Blood Loss After Vaginal Delivery: Agent Selection and Confounding by Indication in a Retrospective Cohort Study.","authors":"Wing Lam Tsui, Dah-Ching Ding","doi":"10.3390/medicina62101967","DOIUrl":"https://doi.org/10.3390/medicina62101967","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Carbetocin is increasingly used for postpartum hemorrhage (PPH) prophylaxis, but its selection in routine practice may bias comparisons with oxytocin. This observational study examined the association between the agent received and blood loss after vaginal delivery. <i>Materials and Methods</i>: This retrospective cohort included 559 women delivering vaginally in 2022-2023 who received carbetocin 100 μg intravenously (<i>n</i> = 474) or oxytocin 10 IU by infusion (<i>n</i> = 85). Gravimetric blood loss was analyzed using linear (primary), robust and median (co-primary) regression, and propensity score methods. <i>Results</i>: Carbetocin recipients more often underwent induction (63.3% vs. 43.5%), vacuum extraction (26.8% vs. 15.3%), and epidural analgesia (76.2% vs. 29.4%). Blood loss was higher with carbetocin before adjustment (223.7 vs. 180.0 mL, <i>p</i> = 0.003) but not after adjustment (β 12.72 mL, 95% CI -50.19 to 75.64, <i>p</i> = 0.691; robust <i>p</i> = 0.479; median <i>p</i> = 0.354). Propensity score results conflicted: inverse probability weighting showed higher blood loss with carbetocin (47.84 mL, <i>p</i> = 0.002), whereas matching and trimmed weighting did not. PPH occurred in 2.7% vs. 0% (<i>p</i> = 0.234). <i>Conclusions</i>: Carbetocin was preferentially used in higher-risk labors, indicating confounding by indication. Adjusted blood loss did not differ significantly, although a modest increase could not be excluded. The study was severely underpowered for PPH.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149281014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crestal Versus Lateral Window Approaches for Maxillary Sinus Floor Augmentation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Heera Lee, Sung-Bin Lee, Na Jin Kim, Ji-Eun Lee, Jun-Beom Park","doi":"10.3390/medicina62101973","DOIUrl":"https://doi.org/10.3390/medicina62101973","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Evidence directly comparing crestal and lateral approaches for maxillary sinus floor augmentation remains uncertain. We compared their outcomes and assessed certainty of evidence. <i>Materials and Methods</i>: Randomized trials directly comparing both approaches were included. MEDLINE/PubMed, Embase, and the Cochrane Library were searched from inception to 30 July 2026, supplemented by non-systematic Google Scholar searches. Risk of bias and evidence certainty were assessed using RoB 2 and GRADE. Outcomes were pooled as risk ratios (RRs), mean differences (MDs), or standardized mean differences (SMDs), with 95% confidence intervals (CIs). The protocol was registered in PROSPERO (CRD420261447905). <i>Results</i>: Thirteen randomized trials (17 reports) were included. No statistically significant differences were found for implant failure (RR 0.50, 95% CI 0.10-2.61), membrane perforation (RR 0.63, 95% CI 0.29-1.38), marginal bone loss at 12 months (MD -0.08 mm, 95% CI -0.31-0.15), vertical bone gain at 12 months (MD -0.81 mm, 95% CI -1.94-0.33) or 6 months (MD -1.07 mm, 95% CI -2.50-0.36), or postoperative pain (SMD -1.56, 95% CI -3.31-0.20). Certainty was low to very low. <i>Conclusions</i>: Current evidence does not establish superiority of either approach. Selection should reflect residual bone height, sinus anatomy, treatment objectives, and operator experience.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149280752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of VE1 Immunohistochemistry for BRAF p.V600E in Colorectal Carcinoma: A Systematic Review.","authors":"Ovidiu-Ioan Șușu, Marian Botoncea, Gabriel Serac, Marius-Alexandru Beleaua, Tamás-Csaba Sipos, Oana Alexandra Tăurean, Dragoș Călin Molnar, Remus-Sebastian Șipoș, Zsuzsánna Pap","doi":"10.3390/medicina62101974","DOIUrl":"https://doi.org/10.3390/medicina62101974","url":null,"abstract":"<p><p><i>Background and Objectives</i>: BRAF p.V600E status has diagnostic, prognostic, and therapeutic relevance in colorectal carcinoma. Molecular assays remain the reference methods, whereas mutation-specific BRAF (VE1 clone) immunohistochemistry offers a rapid tissue-based alternative. We evaluated VE1-molecular concordance and factors affecting diagnostic performance. <i>Materials and Methods</i>: PubMed/MEDLINE, Scopus, and Web of Science were searched in August 2025 and updated on 27 July 2026 for English-language original studies published from 2014 through the update date. Eligible reports applied VE1 and a recognized molecular reference method to the same colorectal carcinoma specimens or a defined overlapping cohort. Study selection and data extraction were performed by one reviewer and independently verified by a second reviewer. Risk of bias and applicability were assessed at the estimate level with QUADAS-3. Because of substantial clinical and methodological heterogeneity, no meta-analysis was performed, and the findings were synthesized descriptively. <i>Results</i>: Of 704 database records, 358 unique records were screened; 38 full-text reports were assessed and 28 were included. Twenty-three reports or defined subcohorts provided complete or clearly reconstructible 2 × 2 comparisons. Sensitivity ranged from 74.6% to 100% and specificity from 66.7% to 100%. Most optimized protocols exceeded 90% for both measures, whereas selected sampling, weak or focal staining, post hoc thresholds, protocol effects, and selective molecular verification reduced reliability. <i>Conclusions</i>: VE1 immunohistochemistry may provide a rapid, locally validated triage method for detecting BRAF p.V600E in colorectal carcinoma. However, substantial heterogeneity and recurrent risk-of-bias concerns limit the generalizability of the available estimates and do not support universal substitution for molecular testing. Equivocal, technically inadequate, or clinically discordant results require molecular clarification.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149280773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Upright Cardiovascular-Autonomic Characteristics, Temporal Gait Measures, and Mediolateral Plantar Center-of-Force Measures in Adults with Developmental Disabilities: An Exploratory Cross-Sectional Study.","authors":"Ji-Hyun Nam, Han Suk Lee","doi":"10.3390/medicina62101968","DOIUrl":"https://doi.org/10.3390/medicina62101968","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Adults with developmental disabilities may show altered gait and autonomic regulation, but their relationship during upright function remains unclear. This study examined associations between upright cardiovascular-autonomic characteristics, temporal gait measures, and mediolateral plantar center-of-force (COF) measures and secondarily compared intellectual disability (ID) and autism spectrum disorder (ASD) groups. <i>Materials and Methods</i>: This cross-sectional study included 24 adults. Measures were the change in heart rate from supine to standing (ΔHR), standing root mean square of successive differences (RMSSD), standard deviation of normal-to-normal intervals (SDNN), and normalized high-frequency power [HF (nu)]. F-Scan 3-Box outputs from three 6-meter walks provided eight gait measures, including trial-to-trial coefficients of variation (CV) and symmetry index (SI) of temporal variables. Thirty-two primary partial rank correlations were adjusted for age, sex, and body mass index (BMI), with Benjamini-Hochberg false discovery rate (BH-FDR) correction. <i>Results</i>: Standing HF (nu) and stride time SI showed a nominally significant negative association (partial ρ = -0.663, unadjusted <i>p</i> = 0.0071; 95% CI [-0.877, -0.227]), but this association did not remain significant after BH-FDR correction (q = 0.228). No primary association survived FDR correction. Additional adjustment for diagnosis yielded ρ = -0.672 (unadjusted <i>p</i> = 0.0085). Standing RMSSD and stance time CV were not significantly associated (ρ = -0.527, <i>p</i> = 0.053). No primary gait measure differed significantly between ASD and ID. <i>Conclusions</i>: The observed standing HF (nu)-stride time SI association is exploratory and did not survive correction for multiple testing. The findings do not establish stronger temporal than spatial associations, clinical benefit, or a causal mechanism. Larger studies with detailed heart rate variability (HRV) and gait-event measurements are needed.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149280777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ROS-NLRP3 Inflammasome Axis in Obesity: A Critical Review of Oxidative Stress-Driven Inflammation and Emerging Therapeutic Strategies.","authors":"Sungeun Ahn, SangMin Park, Shakina Yesmin Simu","doi":"10.3390/medicina62101969","DOIUrl":"https://doi.org/10.3390/medicina62101969","url":null,"abstract":"<p><p><i>Background and Objectives:</i> Obesity is a chronic, low-grade inflammatory state. Oxidative stress and reactive oxygen species (ROS) are increasingly recognized as not just passive byproducts but also signaling contributors to metabolic dysfunction in obesity. Among the inflammatory effectors that interact with ROS, the NOD-, LRR-, and pyrin domain-containing protein 3 (NLRP3) inflammasome has emerged as an important node linking metabolic stress to interleukin (IL)-1β/IL-18-mediated inflammation and insulin resistance. This review critically examines the ROS-NLRP3 axis as a mechanistic framework for obesity progression, weighing supporting against contradictory evidence and defining translational opportunities. <i>Materials and Methods:</i> A narrative concept-driven review was conducted by searching PubMed, Scopus, and Web of Science throughout August 2026, prioritizing mechanistic, human, and interventional studies of ROS, mitochondrial ROS (mtROS), NLRP3 activation, and obesity, with deliberate inclusion of discordant findings. <i>Results:</i> ROS-dependent NF-κB signaling contributes to NLRP3 priming, whereas mtROS, oxidized mitochondrial DNA, and thioredoxin-interacting protein (TXNIP) are consistently implicated in NLRP3 activation and caspase-1-dependent maturation of IL-1β and IL-18, which are associated with adipose tissue inflammation and impaired insulin signaling. However, loss-of-function studies have yielded inconsistent metabolic protection; human evidence is largely observational, and NLRP3 inhibitors, such as MCC950, carry organ-specific toxicities, indicating context dependence rather than a simple linear pathway. Upstream (mitochondria-targeted antioxidants, TXNIP blockade), core (selective NLRP3 inhibitors), and downstream (IL-1β/IL-18 blockade) strategies are supported mainly by preclinical or early clinical data; for metformin, SGLT2 inhibitors, and GLP-1 receptor agonists, ROS/NLRP3 modulation is a potentially relevant contributory mechanism. <i>Conclusions:</i> The ROS-NLRP3 axis provides a useful mechanistic framework for obesity-associated inflammation, but human causal evidence is limited, and its contribution is tissue-, stage-, and context-dependent; therefore, human-validated, mechanism-based studies are needed.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149281020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remission Trajectories During Low-Intensity Cognitive Behavioural Therapy for Obsessive-Compulsive Disorder: A 2-Year Naturalistic Follow-Up Study.","authors":"Keiichiro Mukai, Naomi Matsuura, Yukihiko Hosoi, Masahiko Sakurai, Kyosuke Yamanishi, Hisato Matsunaga","doi":"10.3390/medicina62101970","DOIUrl":"https://doi.org/10.3390/medicina62101970","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Cognitive-behavioural therapy (CBT) for obsessive-compulsive disorder (OCD) has primarily been evaluated in short-term, high-intensity treatment protocols. However, remission trajectories during low-intensity CBT (LiCBT) delivered in routine clinical practice remain insufficiently characterised. The aim of this study was to examine 2-year remission trajectories among patients with OCD receiving LiCBT in routine outpatient care. <i>Materials and Methods</i>: This study was a secondary analysis of an ongoing prospective cohort of patients with OCD treated at Hyogo Medical University Hospital, Japan. Patients who had received inpatient treatment or high-intensity CBT were excluded. Symptom severity was assessed using the Yale-Brown Obsessive-Compulsive Scale at baseline, 1 year, and 2 years. Patients were retrospectively classified into early remission, delayed remission, and non-remission groups according to remission timing. <i>Results</i>: Of 62 eligible patients, 47 completed the 2-year follow-up and were included in the remission trajectory analyses. Remission was achieved in 18 patients at 1 year and in an additional 10 patients at 2 years. At baseline, Y-BOCS scores were significantly lower in the early remission group than in the non-remission group, whereas by the 1-year follow-up, Y-BOCS scores differed significantly across all three groups. The delayed remission group did not meet the remission criteria at 1 year and subsequently achieved remission by 2 years. <i>Conclusions</i>: In this naturalistic multimodal treatment setting that included LiCBT, remission followed heterogeneous temporal trajectories rather than a single uniform course. The findings suggest that remission should not be evaluated solely within the first year of treatment and highlight the clinical importance of longitudinal assessment in routine outpatient care.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149280957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Sodium-Glucose Cotransporter Type 2 Inhibitors on Residual Kidney Function in Patients Undergoing Incremental Hemodialysis: A Two-Center, Retrospective, Exploratory Cohort Study.","authors":"José C De La Flor, Elena Jiménez Mayor, Avinash Chandu Nanwani, Celia Rodríguez Tudero, Francisco Valga, Esperanza Moral Berrio, Javier Deira, Jesús Hernández Vaquero, Gabriel de Arriba","doi":"10.3390/medicina62101972","DOIUrl":"https://doi.org/10.3390/medicina62101972","url":null,"abstract":"<p><p><i>Background and Objectives</i>: The preservation of residual kidney function (RKF) is a major determinant of outcome in patients undergoing incremental hemodialysis (iHD). While sodium-glucose cotransporter-2 (SGLT-2) inhibitors have established nephroprotective benefits in non-dialysis chronic kidney disease (CKD), evidence regarding their role in preserving RKF after the initiation of hemodialysis remains limited. The primary objective of this study was to explore the impact of SGLT-2 inhibitors on the preservation of RKF in incident patients undergoing iHD over a 12-month follow-up. <i>Materials and Methods</i>: This study involved a two-center retrospective exploratory observational longitudinal study over 12 months of follow-up, including 32 incident iHD patients (one or two sessions per week, 1WHD or 2WHD). Participants were divided into a study group (SGLT-2iG, n = 15) receiving SGLT-2 inhibitors and a control group (non-SGLT-2iG, n = 17). RKF parameters, including 24 h (h) urine output (UO), urea clearance (KrU), and creatinine clearance (CrCl), were monitored quarterly. <i>Results</i>: Over 12 months, 24 h UO increased significantly within the SGLT-2iG (+573.3 mL; <i>p</i> < 0.001) and did not change significantly within controls (-202.9 mL, <i>p</i> = 0.34). KrU and CrCl showed only non-significant within-group trends (upward in the SGLT-2iG, downward in controls). Between-group differences were not formally tested and are described descriptively. A total of 80% of patients in SGLT-2iG maintained a 1WHD regimen at 12 months, compared with 46.7% in the non-SGLT-2iG. Safety was favorable, with no cases of ketoacidosis or severe infections and a trend toward fewer cardiovascular events in the SGLT-2iG (6.7% vs. 35.3%). <i>Conclusions</i>: In this two-center, real-world cohort, SGLT-2 inhibitor use in incident iHD patients was associated with a within-group increase in 24 h UO and non-significant trends toward preservation of KrU and CrCl over 12 months, together with an apparently favorable safety profile. Given the observational design and small sample, these hypothesis-generating findings should be interpreted with caution and warrant confirmation in dedicated randomized controlled trials.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149280803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Composite Haematological and Nutritional Indices Show No Evidence of Improved Long-Term Mortality Discrimination Beyond Their Own Components in Non-ST-Segment Elevation Myocardial Infarction.","authors":"Emrah Bozbeyoğlu, Aylin Sungur, Fatma Can, Barış Şimşek, Duygu Genç Albayrak, Funda Özlem Pamuk, Can Yücel Karabay","doi":"10.3390/medicina62101965","DOIUrl":"https://doi.org/10.3390/medicina62101965","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Composite indices from routine inflammatory, haematological and nutritional measurements are widely reported as prognostic markers after acute coronary syndromes, but whether they add information beyond their components is uncertain. <i>Materials and Methods</i>: In 30-day survivors of non-ST-segment elevation myocardial infarction (NSTEMI) undergoing coronary angiography at a single centre, thirteen composite indices and six prespecified components were evaluated for five-year all-cause mortality using ROC analysis, Cox regression and the change in Harrell's C-index (ΔC) over a study clinical model. Each index was also compared with a freely weighted model of its own constituents and with a reference model adding CRP and albumin. <i>Results</i>: Among 561 patients (median follow-up 5.48 years), 94 died, 86 within five years. Composite-index AUCs ranged from 0.616 to 0.689; none exceeded CRP alone after multiplicity correction. Eight indices were nominally associated with mortality after adjustment (hazard ratios 1.26-1.38 per 1 SD), but every bootstrap confidence interval for ΔC over the clinical model included zero. Fixed indices and freely weighted constituents performed similarly (cross-validated ΔC -0.0089 to +0.0053), with one small exploratory difference favouring the fixed MLR ratio. Adding CRP and albumin raised the C-index from 0.7720 to 0.7826; over this reference, no estimable composite showed evidence of association (all <i>p</i> ≥ 0.19). <i>Conclusions</i>: In 30-day survivors of NSTEMI, composite indices showed no evidence of improved long-term mortality discrimination over a study-specific clinical model and contained no information beyond their measured constituents. Their independent associations may largely reflect information already present in the components. Small gains cannot be excluded; the findings do not establish equivalence.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149280739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of 24-2 and 24-2C Visual Field Testing in Eyes with Ocular Hypertension.","authors":"Berire Şeyma Durmuş Ece, Kaan Özkan, Halime Kübra Şahin, Musab Özdere","doi":"10.3390/medicina62101962","DOIUrl":"https://doi.org/10.3390/medicina62101962","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Ocular hypertension (OHT) is associated with a variable risk of progression to primary open-angle glaucoma, and early detection of functional abnormalities is important during follow-up. The 24-2C visual field pattern was designed to improve central sampling by adding 10 test locations to the conventional 24-2 grid. This study aimed to compare central visual field findings obtained with the 24-2 and 24-2C protocols in patients with OHT. <i>Materials and Methods</i>: This prospective, single-center, paired comparative study included 60 eyes of 60 patients with OHT. Each eye underwent 24-2 and 24-2C testing using the SITA Faster strategy during the same visit, with randomized test order. Global indices, test duration, the number of abnormal points within the central 10°, central mean sensitivity, and the presence of abnormal central clusters were compared between protocols. Peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell complex (mGCC) thicknesses were measured using spectral-domain optical coherence tomography, and structure-function relationships were explored. <i>Results</i>: Mean deviation, pattern standard deviation, visual field index, false-positive rate, and central mean sensitivity did not differ significantly between protocols. Test duration was longer with 24-2C than with 24-2 (167.4 ± 39.2 vs. 141.6 ± 31.9 s; <i>p</i> < 0.001). The number of abnormal points at <i>p</i> < 0.05 within the central 10° was higher with 24-2C (3.81 ± 3.6 vs. 2.35 ± 2.4; <i>p</i> = 0.006). Abnormal central clusters were detected in 19 eyes (31.7%) with 24-2C and 9 eyes (15.0%) with 24-2 (<i>p</i> = 0.031). Among eyes classified as normal on 24-2, 14 of 51 (27.5%) showed a central cluster on 24-2C. No significant correlations were found between central functional parameters and average RNFL or mGCC thicknesses. <i>Conclusions</i>: 24-2C detected more central abnormalities than 24-2 in eyes with OHT, while global visual field indices remained similar. Longitudinal studies are needed to establish the reproducibility and prognostic relevance of these additional findings.</p>","PeriodicalId":520709,"journal":{"name":"Medicina (Kaunas, Lithuania)","volume":"62 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149280511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}