Male Sex Research Articles

Rifampicin-resistant tuberculosis in Fujian Province, Southeast China: a retrospective analysis of drug resistance screening and treatment outcomes, 2019–2024

BackgroundsRifampicin-resistant tuberculosis (RR-TB) remains a major challenge to global TB control efforts. In Fujian Province, Southeast China, where RR-TB prevalence has been notably high, understanding epidemiological trends and treatment outcomes is crucial for optimizing interventions. This study aimed to analyze RR-TB characteristics, resistance patterns, and treatment outcomes to inform evidence-based control strategies.MethodsAn observational study was conducted utilizing data from China’s National Tuberculosis Information Management System, focusing on bacteriologically confirmed tuberculosis cases reported in Fujian Province during 2019–2024. Epidemiological characteristics, drug resistance and outcomes of RR-TB were described as frequency (n) and percentage (%). Risk factors for unsuccessful outcomes were assessed using univariate and multivariate logistic regression.ResultsA total of 1,368 RR-TB patients were detected, with an overall resistance rate of 3.7%. The RR rate showed a steady decline year by year (χ2 = 76.214, p < 0.001), mainly due to the decrease in new TB cases (χ2 = 60.966, p < 0.001). RR-TB patients exhibited higher co-resistance to isoniazid (71.9% vs. 6.3%, p < 0.001) and ofloxacin (29.8% vs. 1.8%, p < 0.001) compared to rifampicin-sensitive TB. Of 1,056 RR-TB patients initiated on treatment, 720 had outcome data, revealing a low success rate (58.6%) due to high loss to follow-up (31.1%) and mortality (9.3%). Multivariate analysis identified male sex (AOR = 1.67, 95% CI: 1.11–2.52, p = 0.014), age ≥45 years (AOR = 2.27, 95% CI: 1.58–3.26, p < 0.001), high-risk group status (AOR = 1.42, 95% CI: 1.04–1.94, p = 0.026), and occupation as farmer/worker (AOR = 2.17, 95% CI: 1.10–4.26, p = 0.025) as independent risk factors of unsuccessful treatment.ConclusionFujian Province has demonstrated a steady decline in rifampicin resistance rates, primarily driven by reductions in new TB cases. However, treatment inclusion rate and success rate remains suboptimal, highlighting the need for targeted interventions—including enhanced adherence support, intensive follow-up, and adverse event management—particularly for high-risk groups such as older males and manual laborers. These findings can guide tailored strategies to further reduce RR-TB burden in similar settings.

Trends and Risk Factors for the Hospitalization of Older Adults Presenting to Emergency Departments After a Bed-Related Fall: A National Database Analysis

Background/objectives: Falls are a leading cause of traumatic injury and hospitalization for adults over the age of 65. While common, bed-related falls are relatively understudied when compared to ambulatory falls. The aim of this study is to characterize the risk factors for the hospitalization of older adults presenting to U.S. emergency departments (EDs) after a fall from bed. Methods: This was a cross-sectional study using publicly available data from the U.S. Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS) from 2014 to 2023, including all adults over the age of 65 presenting to the NEISS’s participating EDs with bed-related fall injuries. We identified fall injuries using a keyword search of the NEISS narratives and determined how the fall occurred by manually reviewing a randomized 3% sample of the narratives. We summarized demographics and injury patterns with descriptive statistics. We constructed a multivariable logistic regression model to identify risk factors for hospitalization and used Poisson regression to assess temporal trends in fall incidence and hospital admissions. Results: An estimated average of 320,751 bed-related fall injuries presented to EDs annually from 2014 to 2023. ED visits increased by 2.85% per year, while hospital admissions rose by 5.67% per year (p < 0.001). The most common injury patterns were superficial injuries (contusions, abrasions, lacerations, avulsions, and punctures) (28.6%), fractures (21.7%), and internal injuries (including concussions) (21.6%). Most of the falls occurred while transitioning into or out of bed (34.4%) or falling out of bed (56.8%). Hospitalization was required in 34.1% of cases and was associated with male sex, medication use at time of injury, and fracture injuries. Conclusions: Bed-related falls and associated hospitalizations are increasing among older adults. ED providers should understand risk factors for hospitalization in these common injuries such as male sex, medication use at time of injury, and high-risk injury patterns. Additionally, prevention efforts should focus on helping older adults remain safely in bed and then assisting with transitions into or out of bed.

Unrecognized mutations in DPYD* 2 A wild-type rectal cancer patients receiving postoperative 5-FU-based chemotherapy - do they have a clinical impact?

The impact of the unrecognized mutational dihydropyrimidine-dehydrogenase-gene-(DPYD)-status on high-grade CTC-AE-grades ≥ 3 (NCI-Common Terminology Criteria for Adverse Events, vs. 3.0) was assessed in patients with upper rectal cancer (inferior tumor margin ≥ 12cm above the anal verge) treated with upfront surgery and 5-Fluorouracil (5-FU) based adjuvant chemotherapy (CTx). 75 participants of the GAST-05-phase-IIb-trial (ISRCTN35198481) were tested in this single center analysis for DPYD*2A-wildtype (WT) at staging. After surgery, 43 patients (stages II and III, according to the current 8th TNM/UICC-classification, 2017) received FOLFOX-CTx and entered follow-up (median: 101 months). According to recent recommendations of the European Medicines Agency (EMA) and national guidelines, post-hoc genotyping for DPYD*2A (c.1905 + 1G > A; IVS14 + 1G > A; rs3918290), DPYD*13 (c.1679T > G; rs55886062), polymorphism c.2846A > T (rs67376798) and Haplotype B3 (HapB3) (c.1236G > A; c.1129-5923C > G) was performed using cryopreserved blood samples and standardized PCR-techniques. Five patients were found to have a heterozygous (het_) DPYD-HapB3-status. Across all patients, the adherence to CTx-cycles 1 to 4 was 100%, 97.7%, 95.3%, and 93.0%, respectively. Grade ≥ 3 CTC-AEs were observed in 0.9% of both het_HapB3- and WT-patients. The mean administered dose of 5-FU was 68.8% of the target in DPYD-HapB3 carriers, compared to 92.6% in 38 WT patients. Logistic regression analysis revealed that 5-FU dose reductions were significantly associated with DPYD-HapB3 carrier status (odds ratio [OR] 12.55, p = 0.044) and male sex (OR 0.23, p = 0.049). During follow-up het_HapB3-patients had a recurrence rate of 60.0%, compared to 13,6% for WT-patients. The disease-free survival (DFS) for het_HapB3-patients was significantly reduced vs. WT (p = 0.010). Multivariable analysis showed that het_HapB3-patients had an increased risk for reduced DFS (HR 3.774; p = 0.057). Interestingly, 5-FU dose reductions per se were not significantly associated with limited DFS in the total population. DPYD genotyping revealed a het_HapB3 variant in 11.6% of DPYD*2A-WT patients treated with FOLFOX. While not linked to increased toxicity, HapB3 status was associated with reduced DFS, suggesting an impact on treatment efficacy. These results support DPYD genotyping and highlight the need for adequate 5-FU plasma level assessment followed by subtile dose escalation (therapeutic drug monitoring) to personalize 5-FU dosing more precisely, safely and most effective.

Efficacy of Small Incision Cataract Surgery: A Multicenter Retrospective Study of Visual Outcomes in Coastal Ecuador

Cataracts remain one of the leading causes of reversible blindness in low- and middle-income countries such as Ecuador. This study assessed the efficacy of Small Incision Cataract Surgery (SICS) and analyzed sociodemographic and clinical factors associated with postoperative visual outcomes. A retrospective multicenter analysis was conducted across six ophthalmology clinics along the Ecuadorian coast between 2023 and 2024, including 558 patients aged 30 years or older. Postoperative visual acuity, measured using the LogMAR scale, improved significantly (mean improvement of 0.525 LogMAR units in the right eye (OD) and 0.489 LogMAR units in the left eye; p < 0.001). Ages between 60 and 69 years were associated with better outcomes in the right eye, while male sex was a protective factor against poor visual acuity in the left eye. Although diabetes mellitus and hypertension were prevalent, neither condition showed a significant association with postoperative visual outcomes. The findings confirm that SICS is a safe, effective, and cost-efficient surgical approach for restoring vision in resource-limited settings, supporting its inclusion in national public health strategies to reduce avoidable blindness in developing countries.

Association of anemia and cognitive impairment in patients undergoing maintenance hemodialysis: a cross-sectional study.

Cognitive impairment (CI) is common among end-stage renal disease (ESRD) patients undergoing maintenance hemodialysis (MHD), yet its relationship with hemoglobin levels remains underexplored. This study aimed to investigate the association between hemoglobin levels and CI in MHD patients, as well as to identify other contributing factors. A cross-sectional study was conducted with 248 MHD patients (49.60% male, mean age 57.23 ± 13.16 years) from a single hemodialysis center. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) with CI defined as a score < 24. Hemoglobin levels were divided into quartiles (Q1: < 90g/L; Q2: 90-110g/L; Q3: 110-130g/L; Q4: >130g/L). Various independent variables, including age, sex, education level, dialysis duration, comorbidities, and laboratory parameters were analyzed using Spearman correlation test, and univariate and multivariate regression. Of the 248 patients, 33.90% (84 patients) had CI. Higher hemoglobin quartiles (Q3/Q4) were associated with better cognitive function (higher MMSE scores, P < 0.001) and improved performance across cognitive domains. The Spearman and logistic regression analyses revealed the potential associations between cognitive function (MMSE scores) and several factors, including age, education level, dialysis duration, comorbidities, pre-dialysis blood pressure, interdialytic hypotension, albumin, creatinine, uric acid, and hemoglobin (P < 0.05). Age (OR = 1.454, P < 0.001), male sex (OR = 0.171, P = 0.013), pre-dialysis diastolic blood pressure (OR = 0.884, P = 0.024), and uric acid (OR = 0.992, P = 0.007) were significantly linked with the presence of CI in MHD patients. Multivariate regression further confirmed that adequate hemoglobin concentration was an independent related factor against CI in MHD patients (Model 4, Q1 vs. Q3: OR = 15.395, 95% CI = 3.184-74.443, P < 0.001). Anemia is significantly associated with CI in MHD patients, and can still serve as a clinical marker for early detection and intervention in CI. Maintaining adequate hemoglobin levels may be linked with a reduced CI occurrence in hemodialysis patients. These findings highlight the importance of anemia management and tailored interventions to preserve cognitive function health in ESRD patients. Not applicable.

The use of the Odds Ratio Product (ORP) and self-reported data to detect comorbid insomnia and sleep apnea.

To evaluate the utility of the Odds Ratio Product (ORP) in differentiating comorbid insomnia and sleep apnea (COMISA) from obstructive sleep apnea (OSA) and chronic insomnia (CIN). We retrospectively analyzed 9750 patients in four groups: 1) 1152 controls; 2) 2395 with CIN; 3) 2297 with OSA; and 4) 3906 with COMISA. CIN was defined as difficulty initiating/maintaining sleep with daytime fatigue/sleepiness occurring "often"/"always". OSA was defined as an apnea-hypopnea index >5 on polysomnography. ORP, computed every 3seconds from polysomnography, was analyzed alongside sleep metrics, comorbidities, and sleep habits. Associations were assessed using univariate multinomial logistic regression, followed by stepwise regression to identify independent predictors of COMISA versus OSA or CIN. Machine learning models classified COMISA, OSA, and CIN as distinct clinical groups. ORP-derived features showed stronger associations with COMISA than traditional sleep metrics (except N3 latency). Independent objective predictors of COMISA included male sex (OR = 1.31, 95% CI = [1.16, 1.47]), BMI (1.27, [1.25, 1.29]), N3 latency (1.21, [1.13, 1.29]), age (1.17, [1.16, 1.19]), peak ORP during spontaneous arousals (1.12, [1.01, 1.25]), and time in ORP decile 7 (1.10, [1.07, 1.13]). Subjective predictors included depression, hypertension, allergy, headache, sleep aid/alcohol use, sleepiness, and lower sleep duration. Machine learning achieved overall accuracy of 61.2% (p<.05), with sensitivity of 71% for COMISA, 65% for OSA, and 43% for CIN. ORP is a promising objective marker for COMISA, distinguishing it from OSA more effectively than sleep metrics but separating COMISA from CIN poorly.

Week 2 remission with vedolizumab as a predictor of long-term remission in patients with ulcerative colitis: a multicenter, retrospective, observational study.

Vedolizumab (VDZ), a gut-selective monoclonal antibody for ulcerative colitis (UC) treatment, has no established biomarkers or clinical features that predict long-term remission. Week 2 remission, a potential predictor of long-term remission, could inform maintenance treatment strategy. This retrospective, observational chart review included patients with UC in Japan who initiated VDZ between December 2018 and February 2020. Outcome measures included 14- and 54-week remission rates in patients with week 2 and non-week 2 remission (remission by week 14), 54-week remission rates in patients with week 14 remission and primary nonresponse, and predictive factors of week 2 and week 54 remission (logistic regression). Overall, 332 patients with UC (176 biologic-naïve and 156 biologic-non-naïve) were included. Significantly more biologic-naïve than biologic-non-naïve patients achieved week 2 remission (36.9% vs. 28.2%; odds ratio [OR], 1.43; 95% confidence interval [CI], 1.05-1.94; P= 0.0224). Week 54 remission rates were significantly different between week 14 remission and primary nonresponse (both groups: P< 0.0001), and between week 2 and non-week 2 remission (all patients: OR, 2.41; 95% CI, 1.30-4.48; P= 0.0052; biologic-naïve patients: OR, 2.40; 95% CI, 1.10-5.24; P= 0.0280). Week 2 remission predictors were male sex, no anti-tumor necrosis factor alpha exposure, and normal/mild endoscopic findings. Week 54 remission was significantly associated with week 2 remission and no tacrolimus use. Week 2 remission with VDZ is a predictor of week 54 remission in patients with UC. Week 2 may be used as an evaluation point for UC treatment decisions. (Japanese Registry of Clinical Trials: jRCT-1080225363).

Registry of access to chronic dialysis initiation at the Public Health System in Brazil.

We aim to analyze the requests for the initiation of kidney replacement therapy (KRT) in the public health system of the state of São Paulo, Brazil. Initial KRT requests sent to the Regulation Center of the State Department of Health between 01/01/2023 and 12/31/2024 were evaluated. KRT initiation was considered "planned" if it occurred outside the hospital environment or the patient started hemodialysis (HD) with an arteriovenous fistula (AVF). A total of 8451 individuals from 17 healthcare macroregions were included [median interquartile range (IQR)] age: 62 (51-71) years; male sex: 60%; etiology of CKD: 57% hypertension and 21% diabetes). Conservative predialysis treatment of CKD was implemented for 26% of patients in the state, ranging from 4 to 44% in the macroregions. The percentage of patients initiating HD with AVF was 10% (variation in macroregions: 4-25%), and people who initiated KRT in hospital were 70% (37-94%). The initial modality was HD in 95% of the patients (range: 73-100%) (peritoneal dialysis in 5% [(0-27%)], and the median waiting time for a KRT slot vacancy was 12 (IQR: 6-29) days (1 (1-4) to 31 (14-75) in macroregions). Multiple regression analysis revealed that conservative treatment of CKD was independently associated with planned initiation of KRT (odds ratio [OR] [95% confidence interval (CI) = 4.99 (4.48-5.54); p < 0.001]. The results demonstrate the need to adopt actions to implement pre-dialysis care for people with CKD and to mitigate regional inequalities in access to chronic dialysis in this population.

Diabetes-Associated Major Limb Amputation in Solomon Islands: A National, 5-Year Retrospective Study.

Solomon Islands is a Western Pacific nation with one of the highest diabetes prevalences in the world. The delivery of surgical care is challenging given the country's complex geography and limited healthcare resources. This retrospective study aims to quantify diabetes-associated major limb amputation and to describe the characteristics of patients undergoing this procedure. Demographic, clinical, and surgical data were abstracted for patients who underwent major limb amputation secondary to diabetic infection. Summary statistics were gathered from this dataset. Additionally, patients'village names were abstracted, located from publicly available data, and mapped using ArcPro software. The geodesic distance between villages and the surgical centers performing amputation was calculated. Univariate and multivariate modeling was employed to assess the relationship between an a priori set of variables and several outcomes. Over a 5-year period (2018-2023), 401 amputations were performed on 356 patients with diabetic limb infections. Three hundred and five patients had medical records available for abstraction. The median age was 55 (range: 22-84years), and 160 were male (52.5%). Trauma was the most common cause of ulceration (N=135, 44.3%). Delayed presentation was common with 100 patients (32.8%) presenting more than 30days after symptom onset. The mean Wagner score on presentation was 3.6 (STD: 0.8, range: 2-5). Most patients (N=293, 96%) experienced surgical delays. Among all patients who underwent major limb amputation, 38 (10.7%) died prior to discharge. The mean linear distance between patient villages and surgical centers was 53.6km. Greater distance was associated with more delayed presentation (Correlation Coeff: 0.14, p=0.03) and higher Wagner scores (Kruskal-Wallis statistic: 10.7, p=0.01). Multivariable logistic regression indicated that males were more likely to undergo above-knee amputation as compared to females (OR: 2.13, p=0.009). Further multivariable modeling demonstrated that male sex was correlated with higher wait times from presentation to amputation (p=0.035). Major limb amputation is a costly and radical procedure which contributes to severe disability in the local context. Upstream interventions to manage diabetes and facilitate access to surgical care are likely to prevent limb loss.

Risk factors for incident human immunodeficiency virus infection in South African blood donors.

Recruiting blood donors among a population with a high human immunodeficiency virus (HIV) burden requires detailed information on HIV risks. We studied demographic and behavioural risk factors for incident HIV infection among blood donors in South Africa. We conducted a case-control study. Incident HIV was defined as HIV antibody negative and RNA positive, or concordant serology and RNA positive with a limiting antigen avidity assay optical density of <1.5. Cases were matched to infection-negative controls (ratio 1:3) on race, age and geography. Risk factors in the 6 months before donation were ascertained by audio computer-assisted self-interview. Data were fitted using separate multivariable logistic regression models for males and females. From April 2014 to March 2017, we enrolled 323 people with incident HIV and 877 controls. Among women, incident HIV was associated with sex with a person living with HIV (PLWH) or unknown HIV status, multiple male sex partners, never or occasional condom use, anal preparation before sex, first-time donor status and referral to donation by a healthcare worker. Among men, incident HIV was associated with being aged 31-40 years, sex with a PLWH or unknown HIV status, multiple sex partners, more than four lifetime male sex partners, gay/bisexual identity, marriage or stable partnership, lower education, penetrative injury, occasional condom use and first-time or lapsed donor status. Some novel or indirect risks for incident HIV were also observed. We confirmed the known sexual behaviours asked on the donor screening questionnaire. The findings highlight ongoing challenges in donor disclosure during selection and the importance of donor education.

Prognostic Factors Associated with Clinical Improvement Following Energy-Based Device Treatment in Thai Patients with Atrophic Acne Scars: A Retrospective Study.

Acne scarring is a prevalent complication of acne vulgaris, often resulting in significant psychosocial distress. While energy-based devices (EBDs), including fractional laser (FL) and fractional radiofrequency(FRF), are increasingly used for atrophic acne scars, limited data exist on prognostic factors predicting treatment outcomes, particularly in Asian populations. The study aims to identify clinical predictors of graded clinical improvement in patients with atrophic acne scars treated with FL and FRF. This retrospective cohort study was conducted at a university hospital in Bangkok, Thailand, from 2012 to 2023. Clinical improvement was assessed using standardized photographic evaluations and categorized into four levels: < 25%, 25-50%, 51-75%, and > 75% improvement. Univariable and multivariable ordinal logistic regression models were used to determine prognostic factors. Sensitivity analyses were performed to confirm the robustness of the findings. A total of 397 patients were included, of whom 254 received FL and 143 received FRF treatments. Older age (per 5-year increase) (mOR: 1.24; 95% CI: 1.07-1.43), male sex (mOR: 1.29; 95% CI: 1.06-1.57), shorter scar duration (per 5years) (mOR: 0.73; 95% CI: 0.56-0.97), lower Fitzpatrick skin phototypes, and completion of at least three treatment sessions (mOR: 1.33; 95% CI: 1.16-1.53) were independently associated with greater clinical improvement. Sensitivity analyses confirmed the robustness of these associations. Key clinical factors, including patient age, sex, scar duration, skin phototype, and completion of at least three treatment sessions, significantly influence treatment outcomes with EBDs. These findings support the development of personalized treatment strategies to optimize outcomes, particularly in patients with severe scarring. TCTR20240512006.

Measuring hypothyroidism disease control using a TSH-based "time-in-range".

Time-in-range (TIR) using sequential thyroid stimulating hormone (TSH) levels during levothyroxine (LT4) treatment could serve as a measure of chronic disease control in hypothyroidism. Primary objectives: 1) develop a method of estimating TIR, and 2) determine the impact of patient sociodemographic characteristics on TIR. Secondary objective: investigate the relationship between TIR and time to cardiovascular event. The study was conducted using longitudinal clinical data (2016-2022) from a single academic institution. Study participants were ≥18 years old, LT4-treated, and had ≥3 unique TSH levels collected over a minimum of 2 years. For each patient, TIR, time-above-range (TAR), and time-below-range (TBR) were estimated using linear interpolation of log-transformed TSH levels. Fitted linear regression was used to evaluate the relationship between TIR/TAR/TBR and LT4 dose over the study period. Generalized estimating equations (GEE) were used to model annualized TIR/TAR/TBR with sociodemographic and clinical covariates. Survival analysis was used to characterize the relationship between TIR and occurrence of cardiovascular events. A total of 2752 LT4-treated patients had a median TIR of 86% over the study enrollment period (median 3.8 years). For both males and females, LT4 dose was negatively correlated with TIR (R = -0.23 and -0.30, respectively; p <0.001 for both). Male sex and Black race were associated with TIR <75% (OR 1.30, p <0.001; OR 1.37, p <0.001). The association between TAR and cardiovascular events approached significance (OR 1.03 per +10% TAR, p = 0.078). We used TIR estimation to identify differences in disease control between sociodemographic groups and the impact of LT4 dose. In future studies, we aim to better characterize the association between TIR and clinically meaningful outcomes.

Association between working after retirement age and lower depressive symptoms among Korean older adults.

Association between working after retirement age and lower depressive symptoms among Korean older adults.

Outcomes and survival prediction in adults with sickle cell disease treated with extracorporeal membrane oxygenation.

Outcomes and survival prediction in adults with sickle cell disease treated with extracorporeal membrane oxygenation.

Age-stratified differences in coronary artery plaque phenotypes in women and men with non-obstructive coronary artery disease.

Coronary artery disease (CAD) progression and risk of cardiac events differ between women and men during the lifespan. Accordingly, we aimed to explore the impact of sex and age on plaque phenotype in non-obstructive CAD. We included 1189 patients with non-obstructive CAD (48% women) from the Norwegian Registry of Invasive Cardiology and quantitatively assessed each patient's plaque phenotype by coronary CT angiography. Plaque subtypes included calcified (>350 Hounsfield units [HU]), fibrous (131 to 350 HU), fibrofatty (76 to 130 HU) and necrotic core plaques (-30 to 75 HU). The impact of sex on plaque phenotype was assessed after age stratification (≤50, 51-64 and ≥65 years). Total plaque burden adjusted for vessel volume was higher in middle-aged and older women compared with men (all p<0.05). Women had lower proportions of fibrofatty plaques compared with men across all age groups, while middle-aged and older women had higher proportions of calcified and fibrous plaques compared with men. Middle-aged and older men had higher proportions of necrotic core plaques compared with women (all p<0.05). After adjusting for cardiovascular risk factors, female sex remained independently associated with total plaque burden (β=1.0 [0.5 to 1.5], p<0.001), and younger age and male sex with fibrofatty plaque burden (β=-2.8 [-4.4 to -1.2], p<0.001, and β=-3.8 [-4.9 to -2.8], p<0.001, respectively). In non-obstructive CAD, female sex was associated with a higher total plaque burden, whereas male sex and younger age were associated with a higher proportion of vulnerable fibrofatty plaques. Our results highlight important sex differences in plaque phenotypes among patients with non-obstructive CAD during the lifespan, which may impact risk-stratification. NCT04009421.

Functional outcomes of otosclerosis surgery.

Functional outcomes of otosclerosis surgery.

Thermographic abnormalities associate with electrocardiogram/echocardiographic changes and mortality in systemic sclerosis: a retrospective cohort study.

Cardiac involvement is common in systemic sclerosis (SSc) and associated with high mortality, yet challenging to detect. Our aim was to investigate relationships between cardiac involvement, as assessed by electrocardiogram (ECG) and transthoracic echocardiography (TTE), and thermographic abnormalities. A retrospective (2015-2023) study of SSc patients attending a UK referral center. Relevant patient characteristic/demographic data were collected. Logistic regression models were used to evaluate the association between thermographic impairment and ECG/TTE abnormalities. Thermography data were categorized by the presence/absence of 'cold fingers' at baseline (defined as one or more distal digits being more than 1 °C colder than the dorsum-a distal-dorsal difference [DDD]); and impairment with rewarming: 'mild', 'moderate', 'severe'). Kaplan-Meier analysis described differences in survival based on thermographic abnormalities. We included 266 patients (84% female, mean age 57 years). Cardiac abnormalities (≥1) were identified in ∼one-third by ECG (39%) and TTE (34%). Baseline DDD were observed in 83% and severe thermographic impairment of rewarming in 58% of patients. Baseline DDDs were associated with ECG (OR 1.18, p = 0.047) and TTE (OR 1.19, p = 0.008) in univariable analysis, with stronger associations in multivariable analysis for ECG (OR 2.36, p = 0.073) and TTE (OR 9.08, p = 0.05). Cox Proportional Hazard regression analysis revealed higher mortality risk in patients with baseline DDD (HR 6.04), male sex (HR 2.86), older age (HR 1.06), and cardiovascular comorbidities (HR 3.73). Baseline DDD was associated with significantly shorter survival (chi-squared 4.04, p = 0.047). Thermographic abnormalities were associated with cardiac abnormalities and increased mortality in SSc patients.

T and NK lymphoblastic leukemia/lymphoma: Report from the 2023 SH/EAHP Workshop.

The 2023 Society for Hematopathology/European Association for Hematopathology Workshop addressed advancements in the diagnosis and classification of T- and natural killer (NK)-cell lymphomas/leukemias. Session 8 of the workshop collected a diverse set of 38 cases of immature T- and NK-cell lymphoma/leukemias, as well as acute leukemia of ambiguous lineage (ALAL) and other miscellaneous cases, including indolent T-lymphoblastic proliferations. Twenty patients with T-lymphoblastic leukemia/lymphoma (T-LBL/L) and 3 patients with early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) presented at a median age of 21.5 years. Male sex was predominant (70% of all cases), with 40% having a mediastinal mass. Cases (60%) were negative for both CD34 and TdT. In addition, 7 ALAL and 3 mixed phenotype acute leukemia, T/myeloid subtypes were submitted with a median presenting age of 16 (range, 11-56) years, and most patients (67%) frequently showed adenopathy or splenomegaly. A single case of NK acute lymphoblastic leukemia was also submitted. This session highlighted unusual T-LBL/L cases with expression of cytotoxic markers, γ/δ phenotype, a more mature immunophenotype, and ALAL that are challenging to classify. Among T-ALL cases, interesting relapse changes were identified, with 1 patient developing a mature NK-cell phenotype. Patients with ALAL presented in an unusual setting of prior therapy or a germline mutation.

Prognostic and clinicopathological value of fibrinogen-to-albumin ratio in colorectal cancer: a meta-analysis.

The fibrinogen-to-albumin ratio (FAR) has been extensively studied for its potential to predict the prognosis of patients with colorectal cancer (CRC). However, findings have been inconsistent. Therefore, this meta-analysis aims to examine the prognostic value of FAR in CRC. A comprehensive search of PubMed, Web of Science, Cochrane Library, and Embase was conducted up to January 14, 2025. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess the value of FAR for estimating overall survival (OS) and progression-free survival (PFS) in patients with CRC. Additionally, the relationship between FAR and CRC clinicopathological characteristics was explored using pooled odds ratios (ORs) with corresponding 95% CIs. This meta-analysis included 10 studies comprising 4,704 patients. The findings indicated that elevated FAR was significantly associated with worse OS (HR = 1.59, 95% CI = 1.38-1.83, p < 0.001) and PFS (HR = 1.65, 95% CI = 1.44-1.90, p < 0.001) among patients with CRC. Subgroup analyses confirmed that high FAR consistently predicted unfavorable OS and PFS, regardless of study design, histology, treatment, FAR threshold, threshold determination method, or type of survival analysis (all p < 0.05). Moreover, elevated FAR was significantly associated with age ≥60 years (OR = 1.56, 95% CI = 1.31-1.85, p < 0.001), male sex (OR = 1.20, 95% CI = 1.01-1.43, p = 0.042), and poor tumor differentiation (OR = 1.63, 95% CI = 1.26-2.10, p < 0.001). Elevated FAR is strongly associated with poor OS and PFS in patients with CRC, as well as with older age and poor tumor differentiation, suggesting its potential as a prognostic marker.

Mortality and its predictive factors in participants with asthma: a 26-year follow-up.

Mortality and its predictive factors in participants with asthma: a 26-year follow-up.