Annals of medicine最新文献

{"title":"Rapid initiation of antiretrovirals at a syringe services program for people with HIV who inject drugs.","authors":"Marina Plesons, William Yang, Griffin M Sansbury, Edward Suarez, Chevel Collington, Elisha Ekowo, Katrina Ciraldo, Teresa Chueng, David P Serota, David W Forrest, Tyler S Bartholomew, Hansel E Tookes","doi":"10.1080/07853890.2025.2461670","DOIUrl":"10.1080/07853890.2025.2461670","url":null,"abstract":"<p><strong>Background: </strong>People who inject drugs (PWID) living with HIV are less likely to receive care at early disease stages and have low rates of viral suppression. This study examined the feasibility and acceptability of rapid antiretroviral therapy (ART) initiation among PWID with HIV at a syringe services program (SSP) and assessed retention in care after transition to a traditional HIV clinic.</p><p><strong>Patients/materials and methods: </strong>A mixed-methods single-arm pilot study was conducted at an SSP in Miami, Florida. Participants with HIV viral load >200 copies/mL were immediately connected with an HIV care provider and received HIV care and peer navigation at the SSP for 6 months, then were transitioned to a traditional HIV clinic. Demographic data were abstracted from the SSP's administrative records. Laboratory assessments and qualitative interviews were conducted at 1, 3, 6, 9, and 12 months.</p><p><strong>Results: </strong>Sixty-nine percent, 70%, and 69% of participants were virally suppressed (<200 copies/mL) at 1, 3, and 6 months, respectively. Following transition to a traditional HIV clinic, viral suppression remained high at 74% and 79% at 9 and 12 months, respectively. Themes were identified on: 1) barriers to care in traditional HIV clinics, 2) the SSP as a 'safe haven', 3) benefits of the rapid ART initiation program, 4) acceptability of telehealth, and 5) persistent barriers to engaging in HIV care.</p><p><strong>Conclusion: </strong>Rapid ART initiation for PWID at an SSP was acceptable and feasible and showed preliminary effectiveness in achieving HIV viral suppression and sustaining it after transition to a traditional HIV clinic.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2461670"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384210","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":"Correlational study on idiopathic neonatal hyperbilirubinemia and closure time of ductus venosus.","authors":"Lu Cai, Zhengying Li, Zhijun Zhang, Wei Wang, Yiyi Cao, Tao Xie, Hui Wang","doi":"10.1080/07853890.2025.2468266","DOIUrl":"10.1080/07853890.2025.2468266","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the correlation between idiopathic neonatal hyperbilirubinemia and ductus venosus closure time and to examine prenatal factors influencing DV closure in neonates.</p><p><strong>Methods: </strong>A total of 103 full-term hyperbilirubinemic neonates born between September 2022 and September 2023 were selected as the hyperbilirubinemia group, while 169 full-term healthy neonates were chosen as the control group. Neonates with other perinatal or maternal abnormalities were excluded. Ultrasonographic examinations monitored ductus venosus closure time. ductus venosus blood flow, umbilical vein blood flow, ductus venosus shunt fraction, middle cerebral artery pulsitility index, and estimated fetal weight at term were retrospectively analyzed to compare differences between the two groups. The correlation between neonatal serum total bilirubin and ductus venosus closure time, as well as prenatal influences on ductus venosus closure time in neonates, were evaluated.</p><p><strong>Results: </strong>The hyperbilirubinemia group had significantly longer ductus venosus closure time than the control group (<i>p</i> < 0.05). A positive association was found between ductus venosus closure and elevated neonatal serum total bilirubin. Prenatal factors influencing ductus venosus closure time included ductus venosus shunt fraction and fetal weight, where lower fetal weight and higher ductus venosus shunt fraction were associated with a delayed ductus venosus closure in neonates.</p><p><strong>Conclusion: </strong>Ductus venosus closure time is positively correlated with idiopathic neonatal hyperbilirubinemia, suggesting a potential role in its development. Fetal weight and the ductus venosus shunt fraction during the fetal period appear to influence the timing of ductus venosus closure in neonates.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2468266"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451224","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":"Comparison of combined suprascapular and axillary nerve pulsed radiofrequency and nerve block for the treatment of primary frozen shoulder: a prospective cohort study.","authors":"Yue Wu, Jiangyou Huang, Weibo Zhang, Suming Tian, Gang Chen","doi":"10.1080/07853890.2025.2456692","DOIUrl":"10.1080/07853890.2025.2456692","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the effects of pulsed radiofrequency (PRF) and block of the suprascapular nerve (SSN) and axillary nerve (AN) in patients with primary frozen shoulder (FS).</p><p><strong>Methods: </strong>Patients with primary FS received PRF (Group P) or block (Group B). Shoulder pain during rest, activity and sleep was measured by a numerical rating scale (NRS), the Shoulder Pain and Disability Index (SPADI) was used to assess shoulder function and disability, and the passive range of motion (PROM) of the shoulder joint was measured by a digital inclinometer. Assessments were made at baseline and 2 weeks and 1, 3, and 6 months after the procedure.</p><p><strong>Results: </strong>Of the 74 patients, 63 were eventually included, and a total of 3 patients were lost to follow-up. Finally, 60 patients (30 in each group) completed the final analysis. There was a significant improvement in all outcome measures from baseline to 6 months after the procedure. Compared with those in group B, the NRS scores during activity and sleep in group P decreased more at 6 months after the procedure (<i>p</i> = 0.005 and 0.028). SPADI total scores were lower at 3 and 6 months after the procedure (<i>p</i> = 0.021 and 0.001). At different time after the procedure, most of the parameters of PROM improved more in group P than those in group B (flexion at 3 and 6 months, <i>p</i> = 0.042 and <0.001; abduction at 3 and 6 monthse, <i>p</i> = 0.001 and 0.001; extension at 3 and 6 months, <i>p</i> = 0.038 and 0.007, internal rotation at 6 months, <i>p</i> = 0.015; external rotation at 1, 3, and 6 months, <i>p</i> = 0.002, 0.002, and 0.001, respectively).</p><p><strong>Conclusions: </strong>In patients with primary FS who completed both manipulation under anesthesia and intra-articular injections, PRF with SSN and AN appears to provide better pain relief, better PROM recovery, and more shoulder function improvement than nerve block treatment.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2456692"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190336","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":"Persistence of scrub typhus IgM and IgG antibodies among patients from Karnataka, India.","authors":"Kiran Chunduru, Manoj A R, Subhadra Poornima, Nagalakshmi Narasimhaswamy, Indira Bairy, Mridula M, Manjunatha Hande H, Shamee Shastry, Ramakrishna Devaki, George M Varghese, Kavitha Saravu","doi":"10.1080/07853890.2025.2468258","DOIUrl":"10.1080/07853890.2025.2468258","url":null,"abstract":"<p><strong>Background: </strong>The longevity of scrub typhus IgM and IgG are not clear. A region-specific diagnostic cut-off for enzyme-linked immunosorbent assay (ELISA) is a necessity for improved diagnosis.</p><p><strong>Objectives: </strong>To determine a region-specific optical density (OD) value cut-off for scrub typhus IgM and IgG ELISA and to study the persistence of these antibodies.</p><p><strong>Methods: </strong>A prospective cohort study was conducted among patients diagnosed with scrub typhus admitted to Kasturba Hospital, Manipal, Karnataka, India from August 2019 to April 2023. An equal number of scrub typhus patients and healthy volunteers were enrolled to determine region-specific scrub typhus IgM and IgG ELISA OD value cut-off. A receiver operating characteristic (ROC) curve analysis was performed to determine the OD value cut-off with an optimal combination of sensitivity and specificity. The patients were followed up prospectively at varying time points up to 18 months and scrub typhus IgM and IgG ELISA were performed in all the collected samples.</p><p><strong>Results: </strong>The ROC curve analysis of scrub typhus IgM revealed an optimal OD value cut-off of 1.309 with a sensitivity and specificity of 98.7% (95% CI: 93.1%-100%). The ROC curve analysis of scrub typhus IgG revealed an optimal OD value cut-off of 0.9 with a sensitivity of 71.7% (95% CI: 60.5%-81.4%) and specificity of 93.5% (95% CI: 85.7%-97.9%). At 18 months of follow-up, scrub typhus IgM (OD value > 1.309) and IgG (OD value > 0.9) were above the newly derived diagnostic cut-off in 17 (32%) and 40 (75.4%) patients, respectively.</p><p><strong>Conclusion: </strong>Scrub typhus IgM and IgG antibodies were persistent above the newly derived regional diagnostic cut-off for up to 18 months.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2468258"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545021","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":"Sodium butyrate alleviates DSS-induced inflammatory bowel disease by inhibiting ferroptosis and modulating ERK/STAT3 signaling and intestinal flora.","authors":"Yingyin Liu, Nachuan Chen, Huaxing He, Lulin Liu, Suxia Sun","doi":"10.1080/07853890.2025.2470958","DOIUrl":"10.1080/07853890.2025.2470958","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), can seriously impact patients' quality of life. Sodium butyrate (NaB), a product of dietary fiber fermentation, has been shown to alleviate IBD symptoms. Some studies have shown that it is related to ferroptosis. However, the precise mechanism linking NaB, IBD, and ferroptosis is not clear.</p><p><strong>Objective: </strong>This study aimed to demonstrate that NaB suppresses ferroptosis, thereby alleviating inflammatory bowel disease (IBD) through modulation of the extracellular regulated protein kinases/signal transducer and activator of transcription 3 (ERK/STAT3) signaling pathway and intestinal flora.</p><p><strong>Methods: </strong>An IBD model was established using 2.5% (<i>w/v</i>) dextran sulfate sodium (DSS). Mice were orally administered low-dose NaB, high-dose NaB , or 5-aminosalicylic acid (5-ASA). Ferroptosis-related molecules were measured using specific kits, and western blotting (WB) and real-time polymerase chain reaction (RT-qPCR) were used to determine the levels of the target molecules.</p><p><strong>Results: </strong>NaB alleviated symptoms in IBD mice, including reduced weight loss, prolonged colon length, reduced disease activity index (DAI), and reduced spleen index and mRNA expression of inflammatory factors. Additionally, NaB reduced the content of Fe²⁺ and myeloperoxidase (MPO) and increased the content of GSH and the activity of superoxide dismutase (SOD), which reflected NaB-inhibited ferroptosis. Moreover, western blotting showed that NaB enhanced STAT3 and ERK phosphorylation. In addition, NaB regulates the composition and functions of flora related to IBD.</p><p><strong>Conclusion: </strong>NaB alleviates IBD by inhibiting ferroptosis and modulating ERK/STAT3 signaling and the intestinal flora.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2470958"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545022","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":"Role of iron in brain development, aging, and neurodegenerative diseases.","authors":"Qiqi Gao, Yiyang Zhou, Yu Chen, Wei Hu, Wenwen Jin, Chunting Zhou, Hao Yuan, Jianshun Li, Zhenlang Lin, Wei Lin","doi":"10.1080/07853890.2025.2472871","DOIUrl":"10.1080/07853890.2025.2472871","url":null,"abstract":"<p><p>It is now understood that iron crosses the blood-brain barrier <i>via</i> a complex metabolic regulatory network and participates in diverse critical biological processes within the central nervous system, including oxygen transport, energy metabolism, and the synthesis and catabolism of myelin and neurotransmitters. During brain development, iron is distributed throughout the brain, playing a pivotal role in key processes such as neuronal development, myelination, and neurotransmitter synthesis. In physiological aging, iron can selectively accumulate in specific brain regions, impacting cognitive function and leading to intracellular redox imbalance, mitochondrial dysfunction, and lipid peroxidation, thereby accelerating aging and associated pathologies. Furthermore, brain iron accumulation may be a primary contributor to neurodegenerative diseases such as Alzheimer's and Parkinson's diseases. Comprehending the role of iron in brain development, aging, and neurodegenerative diseases, utilizing iron-sensitive Magnetic Resonance Imaging (MRI) technology for timely detection or prediction of abnormal neurological states, and implementing appropriate interventions may be instrumental in preserving normal central nervous system function.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2472871"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560196","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":"Clinical and microbiological characteristics and prognosis of invasive infection caused by <i>Klebsiella pneumoniae</i> in the community.","authors":"Hongkui Sun, Hanlin Zhang, Wenqing Lai, Li Lei, Jianwei Li, Miaolian Chen, Haijun Li, Zhanyuan Zhao","doi":"10.1080/07853890.2025.2450526","DOIUrl":"10.1080/07853890.2025.2450526","url":null,"abstract":"<p><strong>Background: </strong>The incidence of invasive infection of <i>Klebsiella pneumoniae</i> (Kp) in the community is increasing every year, and the high disability and mortality rates associated with them pose great challenges in clinical practice. This study aimed to explore the clinical and microbiological characteristics of Kp invasive infection in the community.</p><p><strong>Method: </strong>This study investigated the data of 291 patients with Kp infection in the community in three hospitals (Zhongshan City, Guangdong Province) from January 2020 to August 2023. The risk factors for invasive infection and death due to Kp infection were determined through multivariate logistic regression models and Cox models.</p><p><strong>Result: </strong>The mortality rate of community-acquired <i>Klebsiella pneumoniae</i> (cKp) invasive infections markedly exceeded that for non-invasive infections (47.6% vs 25.9%) (<i>p</i> = 0.001). Multivariate logistic regression analysis identified high viscosity type (OR:2.26, <i>p</i> = 0.031) and shock (OR:3.42, <i>p</i> = 0.001) as significant risk factors for invasive infection. Among patients who succumbed to invasive infections, multivariate Cox regression analysis revealed that elevated CK-MB (OR: 1.01, <i>p</i> = 0.040), increased IL-6 levels (OR: 1.00, <i>p</i> = 0.023), and high SOFA scores (OR: 1.16, <i>p</i> = 0.017) were linked to increased mortality risk. This study found that co-infection of the liver, lungs, and bloodstream was most prevalent in invasive infections. Notably, co-infection involving the lungs, bloodstream, and brain was associated with the highest mortality rate (100%, 6/6). No significant differences were found between patients with or without invasive infections, as well as between surviving and non-surviving patients (all <i>p</i> ≥ 0.05).</p><p><strong>Conclusion: </strong>Patients with cKp invasive infections exhibit more severe inflammatory responses and a poorer prognosis, necessitating vigilant attention from clinicians. The treatment of cKp invasive infections remains inconclusive between \"heavy-handed strikes\" and \"sensitivity is sufficient\". Focusing solely on the liver and lungs while neglecting infection sites outside of these organs can lead to catastrophic results, which should be avoided during treatment.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2450526"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967508","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":"Haematologic outcomes and associated clinical characteristics among patients receiving Olaparib therapy in the UAE: a retrospective chart review.","authors":"Lina Wahba, Said Nabil, Saba Kendakji, Mariam Ibrahim, Sham ZainAlAbdin, Salahdein Aburuz, Amal Akour","doi":"10.1080/07853890.2024.2440631","DOIUrl":"10.1080/07853890.2024.2440631","url":null,"abstract":"<p><strong>Background: </strong>Poly ADP ribose polymerase (PARP) inhibitors, such as Olaparib (Lynparza^®), are pivotal in treating certain cancers, particularly those linked to BReast CAncer gene (BRCA) mutations. Despite its established efficacy, Olaparib use is associated with various adverse events (AEs), notably haematologic toxicities, such as anaemia. This retrospective chart review study aimed to examine haematologic outcomes and associated factors in patients treated with Olaparib at a tertiary hospital in the UAE.</p><p><strong>Methods: </strong>We reviewed the medical charts of patients prescribed Olaparib and focused on haematologic indices at a baseline of 1-month, 3-month and 6-month follow-up periods. Data were analysed to determine the AEs frequency, transfusions need and potential associated patients' clinical characteristics.</p><p><strong>Results: </strong>This study included all patients who received Olaparib (<i>n</i> = 66). Most patients were females (<i>n</i> = 61; 92.4%) and the vast majority were non-smokers (97%) and free of hepatic disease. Themean age of the patients was 57.03-year-old (SD) = 12.06 years), and body mass index (BMI) was 28.16 (SD = 6.40) kg/m². A high rate of anaemia (70.8%) was detected among the patients during their Olaparib therapy. Approximately, one-third of the patients developed neutropenia and thrombocytopenia. Transfusion was needed in almost half of the patients. Glomerular filtration rate (GFR) and neutropenia were significantly correlated with moderate-severe anaemia (OR = 0.097, 95% CI: 0.011-0.88, <i>p</i> value = .038) and (OR = 9.04, 95% CI: 1.024-79.78, <i>p</i> value = .048), respectively.</p><p><strong>Conclusions: </strong>Our findings highlight the side effects of Olaparib therapy in terms of haematology which could be avoided. Further studies are needed to better understand the therapeutic management of Olaparib and the mitigation of haematologic complications.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2440631"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824851","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":"Clinical course and potential associated factors of progressive calcinosis cutis in early systemic sclerosis: a cohort study.","authors":"Vassana Kanjanajarurat, Prathana Chowchuen, Chingching Foocharoen, Punthip Thammaroj","doi":"10.1080/07853890.2025.2455535","DOIUrl":"10.1080/07853890.2025.2455535","url":null,"abstract":"<p><strong>Background: </strong>Calcinosis cutis of hands can progress and impair hand function in systemic sclerosis (SSc). Understanding the natural disease and comprehensive management is crucial.</p><p><strong>Objective: </strong>To examine clinical course and identify risk factors associated with progressive calcinosis cutis in early SSc.</p><p><strong>Methods: </strong>Dual time-point hand radiography was performed at initial and after diagnosis at median interval (range 2.9 ± 0.4 years) in 53 recruited patients with early SSc. Progressive calcinosis cutis defined as the worsening of severity according to simple soring scoring system (no, mild, moderate, severe) comparing to previous hand radiography. Odds ratio (OR) and their 95%CI were used to evaluate associated factors and calcinosis cutis progression.</p><p><strong>Results: </strong>A total of 35 cases (155 per 100 person-year), showed progressive calcinosis cutis with the incidence of 22.6 per 100-person-years (95%CI 16.2-31.4). The most common area of progressive calcinosis cutis was at right distal phalanx, 12 of 35 (22.6%). Although statistically not significant by logistic regression analysis, elderly patients, Raynaud's phenomenon, ischemic ulcer, telangiectasia, and salt-pepper tended to be more frequent in progressive calcinosis cutis than those who had no progression. Around one-quarter of those who had no calcinosis cutis experienced worsening across more than one level of severity.</p><p><strong>Conclusion: </strong>Progression of calcinosis cutis in early SSc increased over time, particularly within 3 years after the first evaluation. Elderly patients and those with vasculopathy were found more frequently. Further study with a larger cohort is needed to support these findings.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2455535"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025985","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":"Handgrip strength measurement protocols in individuals with Down syndrome: a systematic review and meta-regression.","authors":"Geiziane L R Melo, Rafaela C Espírito Santo, Viney P Dubey, Cesar Agostinis-Sobrinho","doi":"10.1080/07853890.2025.2453077","DOIUrl":"10.1080/07853890.2025.2453077","url":null,"abstract":"<p><strong>Background: </strong>Handgrip strength (HGS) serves as a robust predictor of overall strength across various populations, including individuals with Down Syndrome (DS).</p><p><strong>Objective: </strong>To analyze the HGS measurement protocols used in studies involving individuals with DS.</p><p><strong>Methods: </strong>Primary sources were sourced from six databases: PubMed, Scopus, Ovid, Embase, ERIC, and Web of Science, spanning from inception to 23rd December 2023. Inclusion criteria focused on individuals with DS, compared with control groups, and examined HGS measurement protocols and outcomes. Meta-regression was utilized to assess bias associated with HGS values concerning different measurement protocols.</p><p><strong>Results: </strong>Out of 29 studies involving 1816 participants, most controlled for body position (65%), arm position (82%), elbow position (82%), wrist position (62%), handgrip duration (55%), hand adjustment to dynamometer (62%), verbal encouragement (75%), and familiarization (44.8%). The number of reported variables in the HGS protocol was significantly associated with an increase in HGS, with a mean estimate of 20.59 units (SE = 2.59, <i>p</i> < 0.0001, 95% CI [15.49-25.68]), though there was notable heterogeneity (<i>I</i>² = 94.33%). The spline regression analysis showed that the model explained 82.66% of the variation in HGS, with adults having 47.61 units higher HGS than children (<i>p</i> = 0.0009), while obesity was linked to a decrease of 15.68 units (<i>p</i> = 0.0675). Sample size and group had no significant effects.</p><p><strong>Conclusion: </strong>Overall, protocols for assessing HGS in DS studies are comprehensive yet heterogeneous. Higher HGS values correlated with adherence to standard protocols.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2453077"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018279","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}