Annals of Medicine and Surgery最新文献

{"title":"Sialadenectomy for management of a large submandibular sialolith using an extraoral approach: a case report.","authors":"Adham Alemdar, Haqi Ismail Ibrahim, Yamen Nohily, Ziad Albash, Abdulkarim Khalil, Wajih Kashkash","doi":"10.1097/MS9.0000000000005600","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005600","url":null,"abstract":"<p><strong>Background: </strong>Submandibular sialolithiasis is a common condition that can cause significant discomfort and complications if left untreated. Treatment strategies depend largely on the size and location of the sialolith, with various surgical and nonsurgical techniques available.</p><p><strong>Case presentation: </strong>This report describes the successful management of a large sialolith in the submandibular gland via sialadenectomy using an extraoral approach. The case highlights the importance of a comprehensive diagnostic and therapeutic strategy for managing large sialoliths and demonstrates the efficacy of sialadenectomy in carefully selected patients.</p><p><strong>Conclusion: </strong>The extraoral approach using a Risdon incision provided excellent exposure of the submandibular gland and enabled safe removal of the large sialolith. Further research is warranted to refine treatment algorithms for sialolithiasis and optimize patient outcomes.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6798-6801"},"PeriodicalIF":1.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The natriuretic peptide blind spot in obesity-related heart failure with preserved ejection fraction.","authors":"Joshua Cho Mbony, Achu Fonkem","doi":"10.1097/MS9.0000000000005620","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005620","url":null,"abstract":"<p><p>Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome in which obesity can influence both disease expression and diagnostic test performance. This editorial examines the clinical implications of low or apparently normal natriuretic peptide concentrations in obesity-related HFpEF. Published clinical and hemodynamic evidence indicates that some affected patients demonstrate pathological elevations in cardiac filling pressures, particularly during exercise, despite natriuretic peptide concentrations below conventional diagnostic thresholds. Although these patients may have less advanced structural disease and lower event rates than those with markedly elevated concentrations, they can still experience substantial functional limitation and worse outcomes than hemodynamically normal individuals. Reliance on fixed biomarker thresholds may therefore delay diagnosis and contribute to underrepresentation of this phenotype in clinical trials. Natriuretic peptides should remain central to HFpEF evaluation but should be interpreted in conjunction with the clinical phenotype, echocardiographic findings, validated probability scores, and selective exercise-based testing.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6225-6228"},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence on \"leptospirosis presenting with fever, jaundice, and generalized lymphadenopathy: a case report with diagnostic challenges\".","authors":"Areeba Amir, Aymar Akilimali","doi":"10.1097/MS9.0000000000005713","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005713","url":null,"abstract":"","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6920-6921"},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short- and long-term outcomes of Deflux injection versus ureteral reimplantation in pediatric vesicoureteral reflux: a narrative review.","authors":"Izhar Ali, Farman Ullah, Javed Miandad, Waqar Hameed Ghazi, Naveed Ahmad Khan, Ijaz Khan, Maryam Rehman, Muhammad Tanveer Sajid, Ramin Khan, Sardar Noman Qayyum, Adnan Ayub, Samim Noori","doi":"10.1097/MS9.0000000000005427","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005427","url":null,"abstract":"<p><p>Vesicoureteral reflux (VUR) is a common urologic disorder associated with recurrent febrile urinary tract infections (UTIs), pyelonephritis, and renal scarring. For children who require intervention, endoscopic injections of dextranomer/hyaluronic acid copolymer (Deflux) and ureteral implantation are the two options. This narrative review employed a structured search of PubMed/MEDLINE, Scopus, and Embase to identify guideline documents, systematic reviews, and original studies with long-term follow-up, comparing these two approaches. The outcomes include radiographic reflux resolution, durability, febrile UTI recurrence, renal outcomes, complications, retreatment, recovery, cost, and quality of life. Evidence states that ureteral reimplantation provides the highest one-procedure radiographic success, and the most durable anatomical correction, especially in high-grade reflux and complex anatomy. Deflux is though less invasive, outpatient alternative with shorter recovery, and low perioperative morbidity, and lower initial treatment burden, but repeat injections, and late radiographic recurrence are more frequent. Both interventions reduce febrile UTI with favorable renal outcomes in most children, if reflux is controlled. Bladder and bowel dysfunction, reflux grade, renal scarring, anatomic complexity, previous treatment, and family preferences should guide the treatment. Deflux is favored over ureteral reimplantation for lower-risk children and families prioritizing minimal invasiveness, whereas ureteral reimplantation remains the more definitive treatment option for high-grade reflux, or where endoscopic therapy failed. Therefore, comparative studies with standardized long-term reporting are needed to refine patient selection.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6566-6575"},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laron syndrome presenting with severe low bone density for age in a 28-year-old woman: a case report.","authors":"Manoj Kumar Chaulagain, Devansh Joshi, Rachana Acharya, Rajendra Tamrakar","doi":"10.1097/MS9.0000000000005570","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005570","url":null,"abstract":"<p><strong>Introduction: </strong>Laron syndrome (LS) is a rare, autosomal recessive disorder of growth hormone insensitivity, characterized by proportional short stature and low concentrations of insulin-like growth factor-1 (IGF-1) despite normal or increased levels of growth hormone.</p><p><strong>Case presentation: </strong>A 28-year-old woman presented with proportional short stature and a markedly low body weight, with a BMI of 14.5 kg/m². Physical examination revealed a characteristic phenotype, including a prominent forehead, saddle-shaped nose and blue-tinted sclera. Investigations revealed low serum IGF-1 levels with elevated levels of growth hormone. Severe vitamin D deficiency and secondary hyperparathyroidism were observed. Differentials of malnutrition and clinical hypothyroidism were systematically ruled out. Management was focused on closed fracture reduction, vitamin D and calcium supplementation, and physical rehabilitation of the patient.</p><p><strong>Clinical discussion: </strong>Based on the phenotypic presentation and endocrine profile of the patient, a clinical diagnosis of LS was formulated. Unlike common LS presentations, this patient was markedly underweight, suggesting ethnic and nutritional variations. The comorbid vitamin D deficiency likely acted as a disease modifier, exacerbating the skeletal complications in an already compromised skeletal system.</p><p><strong>Conclusion: </strong>This case underscores the importance of strong clinical acumen in diagnosing rare growth disorders, especially in resource-limited settings where confirmatory genetic testing is not readily available. It also highlights how secondary bone disturbances can exacerbate the presentation, leading to significant functional impairment.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6792-6797"},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"46,XX pure gonadal dysgenesis presenting with a massive yolk sac tumor: a diagnostic and surgical challenge - a rare case report.","authors":"Aastha Malla, Manvi Mukherjee, Kapil Khanal, Shweta Karna, Nisha Kharel, Neeta Katuwal, Pooja Paudyal, Sagar Mandal","doi":"10.1097/MS9.0000000000005425","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005425","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Pure gonadal dysgenesis (PGD) is a rare condition that presents as phenotypic female individuals with nonfunctional gonads. The development of malignant germ cell tumors like yolk sac tumors (YSTs) in PGD is exceedingly rare, with a less than 5% risk in 46XX PGD and a 30-40% risk in 46XY PGD. We present a case of YST in a 27-year female with PGD.</p><p><strong>Case presentation: </strong>A 27-year-old woman with primary amenorrhea presented with acute lower abdominal pain and a 20 cm adnexal mass. Hormonal assays showed hypergonadotropic hypogonadism. Alpha-fetoprotein (AFP) exceeded 2000 ng/mL. Magnetic resonance imaging (MRI) demonstrated a large abdominopelvic mass and infantile uterus. Karyotype confirmed 46,XX. The patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy followed by bleomycin, etoposide, and cisplatin (BEP) chemotherapy. Post-treatment AFP levels normalized, and six-month imaging showed no residual disease.</p><p><strong>Clinical discussion: </strong>The genetic basis of PGD is complex, involving numerous genes that result in nonfunctional streak gonads. YSTs are aggressive malignancies typically found in dysgenetic gonads, which are prone to neoplastic transformation, though they are rare presentation. Imaging such as ultrasonography and MRI plays a key role in diagnosing both the extent of gonadal dysgenesis and any associated tumors. Surgical pathway is the cornerstone of treatment with BEP regimen as adjuvant chemotherapy.</p><p><strong>Conclusion: </strong>This rare case highlights the importance of considering YST in PGD patients with abdominal masses and elevated tumor markers and demonstrates that prompt surgical and chemotherapeutic intervention yields favorable outcomes.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6757-6762"},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging gene therapies in the treatment of recessive dystrophic epidermolysis bullosa: a systematic review.","authors":"Abolfazl Nikkhoy, Amirhossein Larijani, Erfan Rajabi, Hojat Eftekhari","doi":"10.1097/MS9.0000000000005683","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005683","url":null,"abstract":"<p><strong>Background: </strong>Recessive dystrophic epidermolysis bullosa (RDEB) is a life-limiting collagen type VII alpha-1 (COL7A1)-related disorder characterized by skin fragility, chronic wounds, and early mortality. Gene therapies aim to restore collagen type VII (C7) expression and improve wound healing, but clinical evidence remains limited.</p><p><strong>Objective: </strong>To synthesize current evidence on the safety and effectiveness of gene therapy approaches for RDEB.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched major databases through 7 March 2025 for interventional studies evaluating gene therapies in RDEB. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment. Given the substantial heterogeneity, findings were synthesized narratively without meta-analysis.</p><p><strong>Results: </strong>Five clinical trials met the inclusion criteria and evaluated <i>ex vivo</i> autologous cell-based therapies and <i>in vivo</i> topical vector delivery. Topical herpes simplex virus type 1-based COL7A1 therapy achieved a significantly higher rate of complete wound closure than controls (71% versus 20% at 3 months; <i>P</i> < 0.001). <i>Ex vivo</i> epithelial grafting demonstrated durable clinical benefit during long-term follow-up. Molecular analyses generally showed restoration or increased C7 expression. Patient-reported outcomes improved alongside sustained wound healing. Treatments were generally well tolerated, with predominantly mild adverse events, no treatment-related serious safety signals, and evidence of immunologic tolerance to recombinant C7.</p><p><strong>Conclusion: </strong>Gene therapy for RDEB demonstrates a favorable early safety profile and promising efficacy. However, the small number of heterogeneous early-phase trials and limited follow-up preclude definitive conclusions. Larger, rigorously designed studies with extended follow-up are required to confirm long-term safety and clinical effectiveness.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6718-6729"},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial, sex, and geographic disparities in mortality involving stroke and chronic kidney disease: a CDC WONDER database analysis, 1999-2020.","authors":"Abhishek Kumar Shah, Suhana Chaulagain","doi":"10.1097/MS9.0000000000005695","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005695","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) increases the risk of stroke, and disparities exist in related mortality. Few studies have examined the mortality patterns involving both conditions together. This study evaluates national trends and disparities in stroke- and CKD-related mortality in the United States from 1999 to 2020.</p><p><strong>Methods: </strong>We analyzed death certificate data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database using ICD-10 codes I60-I69 for stroke and N18 for CKD. Age-adjusted mortality rates (AAMRs) per 100 000 population were calculated and stratified by sex, race/ethnicity, age group, census region, and urban-rural classification. Temporal trends were analyzed using Joinpoint regression to estimate annual percent changes with 95% confidence intervals.</p><p><strong>Results: </strong>Between 1999 and 2020, a total of 140 501 stroke- and CKD-related deaths were recorded. The overall AAMR declined from 3.42 in 1999 to 2.71 in 2020. Females had the most deaths, but males had slightly higher AAMRs. The Black population exhibited the highest AAMR. Mortality increased with age and was highest among those aged 85 years or older. Geographic disparities were evident, with the highest rates in the southern states (the Stroke Belt).</p><p><strong>Conclusion: </strong>Mortality from stroke and CKD has declined over two decades, but disparities still persist across race and ethnicity, geography, and sex. Targeted prevention and healthcare access are essential to reduce these disparities.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6730-6740"},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic efficacy and safety of newly approved FDA drug levoketoconazole in cushing syndrome: a systematic review.","authors":"Chiranjeevee R Saravanan, Arvind Dinesh, Elizabeth Gaviria, Vennela Reddy Baddam, Harshit Gaba, Singam Shashank, Jobby John, Nanditha Karra, Omniat Amir Hussin","doi":"10.1097/MS9.0000000000005471","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005471","url":null,"abstract":"<p><strong>Background: </strong>Cushing syndrome is a severe endocrinopathy due to chronic hypercortisolism with etiology that includes the administration of exogenous glucocorticoids, pituitary adenomas, ectopic ACTH-producing tumors, and adrenal tumors. Expressed as central obesity, hypertension, glucose intolerance, and psychiatric symptoms, it greatly affects the QoL and has a high association with morbidity and mortality.</p><p><strong>Aim: </strong>This systematic review summarizes data from clinical trials to compare the effectiveness and safety of a newly approved drug, levoketoconazole, for the treatment of Cushing syndrome.</p><p><strong>Methodology: </strong>An extensive search was conducted in PubMed, Google Scholar, and the Cochrane Library for terms related to the effectiveness and safety of levoketoconazole in Cushing syndrome. Selected studies included phase 2 and phase 3 interventional trials enrolling adult patients (≥18 years) with confirmed endogenous Cushing syndrome (ECS). Outcomes of interest included mean urinary free cortisol (mUFC), clinical signs and symptoms, quality of life measures, and adverse events. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias Tool.</p><p><strong>Results: </strong>Six interventional studies were included. In the SONICS phase 3 trial, 62% of patients achieved normalization of mUFC at the end of the 6-month maintenance phase, with sustained biochemical and clinical benefits during extended evaluation. During the randomized withdrawal phase of the LOGICS trial, loss of mUFC response occurred in 95.5% of patients switched to placebo compared with 40.5% of patients who continued levoketoconazole treatment (<i>P</i> = 0.0002), demonstrating maintenance of biochemical control with active therapy. Common adverse events included nausea, headache, hypokalemia, and fatigue. Serious drug-related adverse events were uncommon but clinically relevant, including hepatotoxicity, QT prolongation, and adrenal insufficiency.</p><p><strong>Conclusion: </strong>Levoketoconazole significantly lowers cortisol levels and alleviates clinical manifestations in patients with Cushing syndrome with reasonable safety. There is a need to perform a periodic checkup of the liver function and adrenal insufficiency. Additional long-term research is needed to strengthen its place in treatment plans.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6576-6584"},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between serum 25-hydroxyvitamin D and osteoarthritis prevalence in US adults: a cross-sectional study using NHANES 2007-2023.","authors":"Ibrahim Khalil, Mohammed Hrebat, Nadjet Laouadi, Ahmed Osman Hassan Ali, Tareq Albaqali, Mahmoud Ali Khazbak, Meera Abu Eisheh, Mahmoud Raed Sarahen, Taher Abuawwad, Farrukh Ameer, Bilal Aqel, Mohammad Hujeirat, Manar Atrash, Noor Nader Rashed, Ahmed Abdelsamad","doi":"10.1097/MS9.0000000000005552","DOIUrl":"https://doi.org/10.1097/MS9.0000000000005552","url":null,"abstract":"<p><p>Osteoarthritis (OA) is a leading cause of chronic disability globally, and the role of vitamin D in OA pathogenesis remains controversial. This cross-sectional study analyzed data from 35 887 US adults aged ≥20 years across seven NHANES cycles (2007-2023), all using standardized LC-MS/MS for serum 25-hydroxyvitamin D [25(OH)D] measurement. Survey-weighted logistic regression, restricted cubic splines (RCS), subgroup analyses with interaction testing, E-value assessment, Baron-Kenny CRP mediation analysis, and temporal trend evaluation were performed. The survey-weighted OA prevalence was 26.2%. In the fully adjusted model, each 10 nmol/L increase in 25(OH)D was associated with 5.3% higher odds of OA (OR = 1.053; 95% CI: 1.037-1.069; <i>P</i> < 0.001). RCS analysis revealed a threshold effect above 50 nmol/L, plateauing at 100-125 nmol/L. Significant effect modification was observed by age (<i>P</i> < 0.001) and BMI (<i>P</i> = 0.004), with the strongest association among obese adults (OR = 1.058). CRP did not mediate the association (-4.7%). The E-value was 1.29. Results were robust across seven sensitivity analyses and consistent across all survey cycles (ORs: 1.032-1.088). Higher serum 25(OH)D was positively associated with OA prevalence in a non-linear fashion, likely reflecting reverse causation or health-seeking behavior (i.e., patients with OA proactively taking vitamin D supplements) rather than a causal harmful effect, consistent with null results from vitamin D supplementation trials for OA.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"88 10","pages":"6349-6358"},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}