Critical factors for successful outcomes of endoscopic dacryocystrhinostomy.

It is not yet clear whether baseline severity is associated with the effects of psychotherapies. We examined baseline severity at the study level in a large sample of randomized controlled trials comparing psychotherapies against a control condition for the treatment of depression. We used an existing large database of randomized trials comparing psychotherapies for depression with control groups (www.metapsy.org). We converted baseline severity scores across different depression measures into a common metric. We ran bivariable and multivariable meta-regression analyses to examine the association of effect sizes with baseline severity. We also examined response rates in treatment and control conditions. We included 387 randomized trials (463 comparisons; 47,315 patients). The pooled effect size of the psychotherapies was g=0.77 (95% CI, 0.70; 0.84). In the main analyses, we found a highly significant association between the effect size and baseline severity (bivariable coefficient: 0.024 (SE=0.006; p<0.0001), multivariable coefficient: 0.022 (SE=0.007; p=0.002)). This was confirmed in some but not all sensitivity analyses. Absolute response rates in the control conditions remained stable across different levels of baseline severity (bivariable metaregression analyses: p=0.545), or showed a negative association (multivariable analyses: p=0.002). In the therapy conditions the response rates were significantly larger with increasing levels of baseline severity (bivariable: p≤0.0001; multivariable: p=0.006). The effects of psychotherapies are probably associated with baseline severity. Response rates in control conditions remained relatively stable across different levels of baseline severity, while in the treatment conditions the response rates increased with increasing levels of baseline severity.

Effect of a preoperative coating agent on postoperative skin tears in pancreatectomy.

Efficacy of radiotherapy to metastatic lesion in de novo metastatic nasopharyngeal carcinoma patients: A multicenter, propensity score matching study.

The Frailty Index (FI) is a well-established predictor of accelerated biological aging and a reliable tool for estimating all-cause and cardiovascular disease (CVD) mortality in older adults in the United States. However, its predictive value remains unclear in other U.S. population subgroups. This study aimed to examine the association between FI levels and both all-cause and CVD mortality among patients diagnosed with Cardiovascular-Kidney-Metabolic Syndrome (CKM syndrome). This study utilized the data from the National Health and Nutrition Examination Survey (NHANES 2011-2018), which included 7049 participants with complete information for CKM staging (stages 0-4). We employed multivariate Cox proportional hazards models in conjunction with restricted cubic splines (RCS) to account for potential non-linear relationships in the data. Additionally, segmented Cox proportional hazards models were used to examine the association between FI levels and both all-cause and CVD mortality in the CKM syndrome population. Subgroup analyses stratified by demographic and clinical factors, along with interaction tests, were performed to evaluate the consistency of these associations. After adjusting for potential confounding variables, a nonlinear association was observed between the FI and CKM syndrome. Multivariable Cox regression analysis based on nationally representative data demonstrated that higher FI levels were significantly associated with increased risks of both all-cause and CVD mortality among patients with CKM syndrome. Multivariable analysis indicated a robust association between higher FI levels and the presence of CKM syndrome. Among patients diagnosed with CKM syndrome, each 10-unit increase in the FI was associated with a 54% higher risk of CVD mortality (HR = 1.54, 95% CI: 1.24-1.91; P < 0.001) and a 55% higher risk of all-cause mortality (HR = 1.55; 95% CI: 1.38-1.73, P < 0.0001). Stratified analyses revealed no significant interaction effects between the FI and demographic or clinical factors on mortality outcomes. The results highlight a robust and statistically significant association between FI and increased risk of both all-cause and CVD mortality among individuals with KM syndrome. Notably, FI may serve as a valuable marker for CKM stage stratification and for identifying high-risk patients.

While body mass index (BMI) is the most used measure of adiposity, it does not account for fat distribution. Novel indices, such as A Body Shape Index (ABSI) and Body Roundness Index (BRI), may better reflect cardiometabolic risk. However, their association with subclinical cardiac damage, particularly left ventricular hypertrophy (LVH), remains unclear. The aim of this study was to evaluate the association between novel adiposity indices (ABSI and BRI) and left ventricular mass (LVM) assessed by echocardiography in a large cohort of patients with hypertensive. We conducted a cross-sectional study including 724 hypertensive adults who underwent standardized anthropometric and echocardiographic assessments. Adiposity indices (BMI, waist circumference, ABSI, and BRI) were calculated, and left ventricular mass was indexed to body surface area and height2.7. Correlations and multivariate analyses were performed, and receiver operating characteristic (ROC) curves were used to assess diagnostic performance. All adiposity indices were significantly higher in individuals with LVH. BRI showed the strongest correlation with LVMH2.7 (r=0.423), particularly in women. In multivariate analysis, BRI remained significantly associated with LVMH2.7 in both sexes, while ABSI was not independently associated in men. ROC curve analysis demonstrated that BRI had the highest diagnostic accuracy for identifying LVH, outperforming BMI and ABSI, especially when LVH was defined using LVMH2.7. BRI outperformed traditional and novel adiposity indices in identifying LVH in hypertensive patients, particularly when LVM was indexed to height2.7. Given its superior diagnostic performance, BRI may represent a valuable tool in cardiovascular risk stratification, though further studies are warranted.

Ewing sarcoma (ES) is the most prevalent malignant thoracic tumor in childhood and young adults. This study reports the outcome of a national cohort treated in an international prospective trial for a localized rib ES, with a long follow-up. All the patients treated in a prospective trial (December 1999-April 2013) were included. Data were collected from a prospective database and supplemented by a retrospective review of the patients' files. Local control alone rate, progression-free survival (PFS), and overall survival (OS) were assessed. Multivariate analyses were conducted to adjust for classical prognosis factors. Eighty-two patients, median age 13.6 years, were included. All received induction chemotherapy. Surgery was completed (R0) in 88%. Overall, 66% had good histological response (GR). Radiotherapy (RT) was performed on the primary tumor in 28%, on the hemithorax in 13%, or on both in 32%. With a median follow-up of 12 years, 28 patients (34%) relapsed. Five-year local control rate was 95% (95%CI [89%-95%]), 5-year PFS was 73% (95%CI [62%-81%]), and 5-year OS was 79% (95%CI [69%-87%]). In multivariate analysis, pleural effusion was significantly associated with poor PFS (p=0.049). In the case of R0 and GR (n=41), no significant difference in PFS/OS (p=0.16/p=0.36) was reported according to adjuvant local RT. Overall, 38% of scoliosis and 7.3% of secondary cancer were reported. A multidisciplinary approach in high-risk patients can provide good local control in rib ES. In patients who have undergone R0 surgery and are GR, omitting adjuvant RT of the surgical bed may be discussed.

The mortality rate after endovascular treatment (EVT) in patients with acute basilar artery occlusion (ABAO) remains high. This study aimed to analyze the clinical factors associated with 90-day mortality following EVT. We retrospectively analyzed patients with ABAO who underwent EVT within 24 hours of symptom onset in the Department of Neurology, Baotou Central Hospital, Inner Mongolia, China, between April 2017 and September 2023. A favorable functional outcome was defined as a modified Rankin Scale (mRS) score of 0-3 at 90-day follow-up, whereas poor outcome was defined as an mRS score of 4-6. Mortality was defined as an mRS score of 6 at 90 days. Univariate and multivariate analyses were performed to identify predictors of mortality. A total of 96 patients were included. Early reperfusion (modified Thrombolysis in Cerebral Infarction ≥ 2b) was achieved in 87 patients (90.6%). Fifty patients (52.1%) achieved a favorable outcome, while the overall mortality rate was 30.2%. Univariate analysis showed that baseline Glasgow Coma Scale, baseline National Institutes of Health Stroke Scale score, posterior circulation Alberta Stroke Program Early Computed Tomography Score, symptomatic intracranial hemorrhage, successful reperfusion, and onset-to-puncture time (OPT) were associated with mortality. In multivariable analysis (model 3, including percutaneous transluminal angioplasty (PTA) and stenting as salvage therapy), OPT (odds ratio [OR] 1.004; 95% confidence interval [CI] 1.002-1.007; P=0.002), successful reperfusion (modified Thrombolysis in Cerebral Infarction ≥ 2b) (OR 0.058; 95% CI 0.004-0.804; P=0.034), and PTA as salvage therapy (OR 9.202; 95% CI 1.783-47.505; P=0.008) were identified as independent predictors of 90-day mortality. Prolonged OPT and the use of PTA as salvage therapy may lead to an increased 90-day mortality. In contrast, early successful reperfusion significantly reduces 90-day mortality in ABAO patients treated with EVT. Therefore, early reperfusion remains critical. Meanwhile, efforts should be made to shorten the OPT and to reduce the use of PTA as a salvage therapy for ABAO.

HALP score as an independent prognostic biomarker for recurrence and progression in non-muscle-invasive bladder cancer: A retrospective cohort study.

Acute-phase Geriatric Nutritional Risk Index is associated with swallowing function after convalescent rehabilitation in older patients with ischemic stroke: A retrospective cohort study.

Exploring the formation pathways of characteristic volatile organic compounds after walnut roasting based on HS-SPME-GC-MS and multivariate statistical analysis.

Introduction: Prostate Cancer (PCa) and Benign Prostatic Hyperplasia (BPH) often present with overlapping clinical symptoms, complicating accurate diagnosis. Although ProstateSpecific Antigen (PSA) and PSA Density (PSAD) are widely used diagnostic tools, their limited specificity underscores the need for novel biomarkers. Histone Deacetylase 1 (HDAC1), an epigenetic regulator implicated in tumour progression, may serve as a non-invasive biomarker for PCa detection and risk stratification. Aim: To compare the diagnostic value of serum HDAC1, PSA, and PSAD in differentiating PCa from BPH, and to assess their association with the Gleason score. Materials and Methods: The present study was conducted at KAHER’s Jawaharlal Nehru Medical College and KLE Dr. Prabhakar Kore Hospital and Medical Research Center, Belagavi, Karnataka, India, from December 2022 to November 2024. A total of 130 male patients aged over 40 years were included, comprising 65 patients with PCa and 65 with BPH. Serum HDAC1 levels were quantified using a high-sensitivity EnzymeLinked Immunosorbent Assay (ELISA). The correlation between serum HDAC1 levels and the Gleason score was assessed using Spearman’s rank correlation coefficient (ρ). Multivariate logistic regression analysis was performed to identify independent predictors of PCa. Data analysis was conducted using the Mann-Whitney U test, Receiver Operating Characteristic (ROC) analysis, logistic regression, and Spearman correlation, using the Statistical Package for the Social Sciences (SPSS) version 25.0. Results: Serum HDAC1 levels were significantly elevated in patients with PCa compared with those with BPH (p&lt;0.001). Compared with PSA (AUC=0.789) and PSAD (AUC=0.697), HDAC1 demonstrated superior diagnostic performance (AUC=0.922). Multivariate logistic regression analysis identified HDAC1 as an independent predictor of PCa (Odds Ratio (OR)=6.624, p&lt;0.001). HDAC1 also showed a strong positive correlation with the Gleason score (ρ=0.649, p&lt;0.001). ROC analysis further confirmed the ability of HDAC1 to distinguish high-grade (Gleason ≥7) from low-grade (≤6) PCa (AUC=0.803). Conclusion: Serum HDAC1 is a promising non-invasive biomarker with high sensitivity and specificity for distinguishing PCa from BPH and predicting tumour aggressiveness. Its integration into clinical diagnostic algorithms may enhance early detection and reduce reliance on invasive procedures.

Comparison of the efficacy of lidocaine and bupivacaine in GON blockade for prophylaxis of chronic migraine.

Evaluation of Chemotherapy Efficacy in Primary Gastric Diffuse Large B-cell Lymphoma on a Point-based Scoring System: A Multicenter Study.

Retrospective Cohort Study: Supraceliac Cross Clamping Does Not Affect Early Outcomes After Juxtarenal Aneurysm Repair.

Disease clearance may represent the ultimate treatment target in ulcerative colitis, but is seldom achieved in clinical practice. A treatment escalation strategy based on fecal calprotectin may potentially improve these results. Case cohort study including 108 ulcerative colitis patients with severe endoscopic activity at baseline (Mayo endoscopic subscore = 3) and a follow-up endoscopy with histologic assessment. For each elevated fecal calprotectin (≥250 μg/g) between endoscopic evaluations, we identified any adjustment of medical treatment performed. The ratio of treatment escalation per elevated fecal calprotectin (Te/eFc) was correlated with disease clearance rates at the follow-up endoscopic evaluation. In addition, we compared the rates of negative outcomes (clinical relapse, treatment discontinuation, surgery, and colorectal cancer) in patients with and without disease clearance. Thirty-three (30.5%) patients reached disease clearance over a median follow-up of 21.5 months [interquartile range (IQR): 15-40 months]. Quartile analysis demonstrated that a ratio Te/eFc greater than 50% resulted in higher rates of disease clearance compared with a ratio Te/eFc less than or equal to 50% (51.5 vs. 20.0%; P = 0.001). In multivariate analysis, a ratio Te/eFc greater than 50% was independently associated with disease clearance (odds ratio: 4.47, 95% confidence interval: 1.79-11.15, P = 0.001). Patients with disease clearance presented lower chances of reaching any negative outcome (37.5 vs. 67.1%; P = 0.006). A Te/eFc greater than 50% improved the chances of obtaining disease clearance in ulcerative colitis. Disease clearance is associated with better long-term outcomes.

BRCA1/2, PALB2 mutations and first-line CDK4/6 inhibitor efficacy in HR+ metastatic breast cancer.

Combined anterior cruciate ligament and anterolateral ligament reconstruction using an adjustable-loop device provides similar short-term clinical outcomes compared with isolated reconstruction.

Association of denosumab treatment with survival and skeletal-related events in Asian men with mCRPC: A real-world observational study.

Tumour budding (TB) is a noteworthy morphologic indicator for tumour microenvironment (TME) especially because it is detectable with routine haematoxylin and eosin (H&E) staining. Its prognostic relevance has been demonstrated across various cancers, but its significance in pretreatment biopsy specimens of cervical cancer is unknown. This is the first study to investigate the prognostic value of TB in pretreatment cervical biopsy. Additional TME features identifiable with H&E such as cell nest size (CNS) were evaluated. A retrospective review was conducted on the 2018 International Federation of Gynaecology and Obstetrics (FIGO) stage IIVA cervical cancer patients (N = 182) who had completed standard treatment. In multivariate analysis, TB (hazard ratio [HR], 2.06) and CNS (HR, 2.16) independently predicted overall survival. While TB (AUC, 0.7065) slightly outperformed CNS (AUC, 0.6975) in discriminating overall survival, the combination of TB and CNS demonstrated the highest performance (AUC, 0.7192) in time-dependent receiver operating characteristic analysis. This study is the first to suggest TB inpretreatment biopsy specimens as a reliable morphologic prognosticator in cervical cancer. TME features may enhance precision oncology by offering insights into the individual tumour biology. The fact that these morphologic features are available from routine H&E slides, reserving immunohistochemistry or molecular analysis for indeterminate cases, is of particular value in low-resource settings where the burden of cervical cancer is most significant.