Guidelines on the treatment of hypertensive patients usually refer to 'average' patients. However, in clinical practice, individual patient characteristics may differ substantially from the average. Thus, it seems worthwhile to examine the relationship between comprehensive patient profiles and blood pressure responses. We divided the patient population from the INSIGHT trial into exploration and validation cohorts and constructed composite patient profiles based on predictors of blood pressure control (age, severity of hypertension, comorbidities, and previous treatment status). Next, we tested in the exploration cohort whether blood pressure control rates and adverse effects after 6 months of therapy across these profiles differed from those in the entire patient group. Finally, we explored whether the results from the exploration cohort could be validated using another cohort. Logistic regression analysis showed that the odds of achieving blood pressure control differed substantially between patient profiles but not between treatment modalities. Patients with a less favorable profile (e.g. the combination of age above 60 years, baseline systolic pressure above 160 mmHg, and the presence of diabetes) did less well than patients with a low-risk profile (e.g. absence of organ damage). These results were confirmed in the validation cohort. We conclude that responses to antihypertensive treatment vary in a clinically important manner depending on the composite patient profiles. When found in other trials as well, a priori knowledge about response rates of various patient-profile treatment regimens may help choose the best treatment in individual patients and improve overall blood pressure control rates.

Generalized myasthenia gravis (gMG) is a rare chronic autoimmune disorder of the neuromuscular junction caused by pathogenic autoantibodies directed against a postsynaptic target. The therapeutic landscape of gMG has recently expanded with the introduction of FcRn inhibitors. This study aimed to assess the real-world effectiveness and safety of efgartigimod (EFG) in AChR-positive gMG patients who failed or were intolerant to intravenous immunoglobulin (IVIg). EFG was administered as four consecutive weekly intravenous infusions at 10mg/kg. Treatment efficacy was evaluated using the Myasthenia Gravis Activity of Daily Living (MG-ADL) and Myasthenia Gravis quantitative (QMG) scales at baseline and after 4 weeks. Incidence of adverse events and prednisone use were collected at each time point. Thirteen patients (6 women and 7 men, mean age 52.9 years) received EFG following IVIg therapy. After one treatment cycle, both MG-ADL and QMG scores showed significant clinical improvement. MG-ADL responder rate (MG-ADL reduction > 2) was 84.6% while 69.2% on QMG (QMG reduction > 3). Minimal symptom expression was reached in one patient, accompanied by a mean reduction in daily prednisone dose of 6.9mg. In this real-world cohort, efgartigimod demonstrated a rapid and meaningful clinical benefit with a favorable tolerability profile in patients with AChR-positive gMG after IVIg failure or intolerance. These findings support the potential role of EFG as an effective therapeutic option in this difficult-to-treat population.

Microbiota and esophageal cancer: From dysbiosis to carcinogenesis.

Orbital fractures are common after craniofacial trauma. A rare but severe complication is retrobulbar hematoma (RBH), potentially causing increased intraorbital pressure, optic nerve compression, and irreversible vision loss. Prompt diagnosis and emergency decompression, typically via lateral canthotomy, are critical. Despite its low incidence, the relationship between fracture morphology and RBH remains insufficiently understood. This study investigates the association between orbital floor fracture characteristics and RBH occurrence. In this retrospective single-center study, we analyzed all patients who presented to our department between 2015 and 2025 with CT-confirmed RBH and elevated intraocular pressure (IOP) following orbital trauma. CT-based fracture morphology was assessed and classified by size, fragmentation, and wall involvement. Findings were correlated with clinical parameters, including IOP, initial and postoperative visual acuity, and the need for surgical intervention. Statistical analyses evaluated associations between fracture features and clinical severity. We analyzed 27 patients with RBH following orbital trauma, mainly involving the orbital floor, typically caused by falls or assault. Ipsilateral visual acuity was initially reduced (0.15 (0.00-0.80)), improving after decompression; IOP also decreased significantly. Functional outcomes were associated with fracture pattern and, to a lesser extent, anticoagulation. Several Association of the Study of Internal Fixation (AO) fracture types correlated with clinical outcomes. Receiver operating characteristic analysis showed that orbital floor displacement predicted preoperative visual acuity (AUC=0.75, cut-off 4.7mm), while medial wall displacement poorly predicted IOP or vision initially. Postoperatively, medial wall displacement showed excellent discrimination for IOP normalization (AUC=0.944); however, neither wall predicted visual outcome reliably. The extent and displacement of orbital fractures, along with intraocular pressure, strongly correlated with functional outcomes. Our findings highlight the prognostic value of CT-based fracture assessment in addition to urgent clinical evaluation and suggest that trauma mechanism and patient profile further influence risk and recovery.

Premature ventricular complexes increase with heart rate in patients with mitral valve prolapse.

Immunotherapy and ferroptosis regulation in thyroid cancer: Novel strategies and future perspectives.

The role of serum exosomal miR-23a-3p and miR-375-3p in acute ischemic stroke.

Glycoprotein non-metastatic melanoma protein B promotes pyroptosis of macrophages induced by homocysteine associated with the upregulation of the NOX-2/ NF-κB signaling pathway.

Plasma histone monomers as novel diagnostic markers in adult glioblastoma.

Effects of PCSK9 inhibitors on vascular function, lipid profile, and cardiovascular outcomes in patients with peripheral artery disease: A systematic review and meta-analysis.

APLNR reduction in kidney-muscle crosstalk in renal model recovered by exercise and STAT3 inhibition.

Alglucosidase alfa demonstrates effectiveness and safety in Chinese patients with late-onset Pompe disease: A multi-center prospective study.

Mobility assessment in knee osteoarthritis spans perception (patient-reported outcomes), capacity (in-clinic performance), and performance (free-living behaviour). By integrating all three domains, this study explored emerging pre-operative mobility phenotypes. Fifty-six patients awaiting knee arthroplasty completed patient-reported measures (Oxford Knee Score (OKS), quality of life (EQ-5D)), in-clinic testing with markerless motion capture (60-s preferred-pace and, in a subset, 30-s fast-paced walk and five-repetition sit-to-stand), and seven days of free-living monitoring with shank-mounted inertial sensors (steps, sedentary time, stride time). Hierarchical clustering was applied to standardized features in two models: Model 1 (n=56; in-clinic preferred-pace walk) and Model 2 (n=37; included in-clinic fast-pace walk and sit-to-stand time). Principal component scores (PCs) described knee kinematics. An exploratory tertile transition analysis tracked cross-domain consistency. Both models yielded two phenotypes: a smaller low-functioning group and a larger higher-functioning group. The low-functioning group had higher body mass index and more females, worse self-reported function and quality of life (OKS, EQ-5D), slower in-clinic gait, and lower free-living activity (fewer daily steps, greater sedentary time) with slower gait (longer stride time). The PCs revealed reduced knee flexion magnitude and range of motion, as well as a varus-thrust-like pattern in the low-functioning group. Within the higher-functioning group, only 11-15% of patients remained in the same tertile across domains. The unified mobility assessment identified two distinct pre-operative mobility phenotypes with substantial cross-domain heterogeneity among higher-functioning patients. The implications of this assessment approach may support domain-specific interventions to personalize care and potentially improve recovery after knee arthroplasty.

Lower magnitude of humoral response to recombinant herpes zoster vaccine in immunocompromised Sjögren's disease patients: evidence from a randomized double-blinded placebo-controlled trial.

Immune-related gene expression profiling and alectinib efficacy for patients with ALK-Rearranged non-small cell lung cancer: exploratory analysis of a prospective observational study.

Takotsubo syndrome (TTS), or 'broken heart' syndrome, is an acute, reversible cardiomyopathy classically linked to emotional stress. Although physiological mechanisms have been extensively described, the psychological stress profile of patients with TTS remains incompletely synthesised. This study aimed to systematically review and meta-analyse observational studies examining psychological stress-related factors in patients with TTS compared with cardiac and non-cardiac control groups. We searched PubMed/MEDLINE, Embase, PsycINFO, Scopus, and Web of Science from 1 January 2011 to 31 March 2024 for observational studies of adults with TTS that used validated psychological assessments and included a cardiac or non-cardiac comparison group. Two reviewers independently screened studies, extracted data, and assessed risk of bias with the Newcastle-Ottawa Scale. Random-effects meta-analysis pooled odds ratios (ORs) for study-defined binary psychological endpoints, and comparator-group subgroup analyses were treated as main analyses. Sixteen studies met the inclusion criteria, comprising 1133 patients with TTS and 1396 controls, including 1061 cardiac controls and 335 non-cardiac controls. Across studies, patients with TTS showed higher rates of acute emotional triggers, lifetime mood and anxiety disorders, trauma history, maladaptive personality traits (e.g.,neuroticism and Type D personality), and broader psychological distress, including posttraumatic stress symptoms, sexual distress, and reduced quality of life. The pooled OR for overall psychological morbidity/stress exposure was 6.50 (95% CI: 3.14-13.49), with substantial heterogeneity (I2=84.1%). Comparator-category subgroup analyses showed larger effects against acute coronary syndrome/acute myocardial infarction controls than against healthy volunteers alone. TTS is strongly associated with both acute emotional stressors and chronic psychological vulnerability, supporting models that conceptualise the syndrome as an extreme stress response of the cardiovascular system. These findings reinforce the value of routine psychosocial assessment and stress-focused interventions in the care of patients with TTS.

Medical innovations have extended patient lifespans while also increasing the clinical complexity associated with aging and chronic conditions. As patients live longer, surgeons may encounter an array of perioperative challenges including patients with multiple comorbidities. Consequently, surgical teams must manage bleeding risks while balancing potential thromboembolic complications. This retrospective observational study evaluated trends in perioperative bleeding management and associated surgical care challenges over 22 years, utilizing data from the Premier Perspective Hospital Database. The analysis included 13,358,404 adult surgical patients, examining patient complexity via Charlson Comorbidity Index (CCI), preoperative anticoagulant/antiplatelet usage, and topical hemostatic agent (THA) utilization. Patient complexity, as indicated by CCI, significantly increased annually across all surgical types, with the greatest increase in cardiovascular surgery (0.029/year). Overall preoperative use of anticoagulants and antiplatelets rose by 0.5 % per year, with marked variations across surgical cohorts. Notably, general surgery exhibited the highest annual increase (2.0 %), while knee and hip replacements showed a decline in anticoagulant/antiplatelet use. Overall, use of THA strategies increased by 0.56 % annually, particularly in neurosurgery, spinal, and cardiovascular procedures. Multivariate analysis demonstrated significant associations between patient complexity, anticoagulant/antiplatelet use, and higher use of THA strategies across various surgical disciplines. Elective surgeries were more likely to be associated with THA charges than emergent or urgent procedures. This large retrospective analysis describes evolving patient complexity, antithrombotic medication use, and associated use of THA strategies across surgical specialties over two decades. These findings characterize practice patterns and may inform future hypothesis-driven studies evaluating the clinical role of THAs in different surgical contexts.

Glucagon-like peptide 2 (GLP-2) has therapeutic potential in the treatment of intestinal diseases. Its analogue, teduglutide, is clinically used for the treatment of short bowel syndrome (SBS). Despite the benefit of reduced parenteral support and a consistent safety profile in patients with SBS, teduglutide requires subcutaneous injection once daily. Long-acting GLP-2 analogues and the associated lower injection-frequency compliance are an unmet medical need in drug development. Here, we conjugated the pan-protein binder Coomassie brilliant blue (CBB) to the Lys30 residue of teduglutide to obtain a long-acting analogue 8c that retains potency and selectivity comparable to teduglutide. In the rat subcutaneous pharmacokinetic study, the CBB protracted peptide 8c displays a greatly extended half-life (T1/2: 7.97 vs 0.56 h) in the circulation and a measured release (Tmax: 4 vs 0.33 h) from the subcutaneous depot, which is in line with its enhanced affinity to albumin and special protracting mechanism. The unique pharmacokinetic profile can translate into a significantly enhanced intestinal growth in mice, measured as the 1.25-fold greater weight of the small intestine, 1.75-fold higher villus of jejunum, and 1.1-fold deeper crypt compared to the vehicle control. Its prolonged kinetics and intestinotrophic action would be beneficial for a reduced dosing frequency and better treatment outcome in SBS.

Periodic comprehensive skin examinations of asymptomatic individuals are widely accepted by dermatologists and the public, resulting in deployment of skin cancer (SC) surveillance practices that may include patients at low risk for SC. To define the demographics, SC risk factors, and near-term outcomes of asymptomatic individuals seeking comprehensive skin examinations. This cross-sectional study is a secondary analysis of data collected through a routine, previsit survey completed by patients who visited the Emory Healthcare Dermatology Clinic between March 2021 and October 2022. This study involved new patients who had no specific skin complaints and requested a general skin examination because they had general concerns about SC. Data were analyzed between from July to December 2025. The main objective was to identify patients at higher risk for SC development by evaluating characteristics including demographics and SC risk factors including skin phototype, eye and hair color, and family and personal history of SC. The number needed to examine to diagnose 1 SC was calculated for the entire cohort and for subgroups. A total of 1074 new patients who noted no skin complaints but sought examinations for concerns about SC were identified (mean [SD] age, 50.3 [15.9] years; 643 [59.9%] female). Of these patients, 186 reported a personal history of SC, with the percentage reporting a history of SC increasing with age. Among those reporting SC history, 184 (99.5%) had skin phototypes I through III. Overall, 131 patients (12.2%) underwent 146 skin biopsies, and 38 SCs were diagnosed. Three patients younger than 50 years were diagnosed with SC, and 37 of 38 SCs were diagnosed in patients with skin types I through III. The number needed to be examined to diagnose 1 SC was 181 in patients 50 years or younger and 7 in patients 70 years or older. The number needed to examine for patients with and without a history of SC was 12 and 52, respectively. This study found that populations of new patients without specific skin complaints seeking care for SC surveillance may contain substantial percentages of people at low risk for diagnosis of SC. Implementation of simple triage criteria for asymptomatic patients seeking SC surveillance based on age, skin phototype, and SC history could select for patients at substantially higher risk for SC diagnosis.

The association between individual SVD MRI markers and specific cognitive function remains unclear. This study investigated the association between SVD MRI markers and neuropsychological assessments in patients with amnestic mild cognitive impairment (MCI). Sixty-four patients with amnestic MCI were retrospectively analyzed. Partial correlation and multiple linear regression analyses, adjusted for age, sex, education, and vascular risk, were used to evaluate the associations between individual SVD MRI markers and cognitive scores. Multiple comparisons were handled using FDR correction. Sensitivity analyses were performed to assess the impact of the influential cases identified using scatter plots. The number of lobar CMBs showed a significant positive correlation with time in TMT-A in the total cohort (n = 64, r = 0.275, p = 0.037). This remained significant in the primary analysis (n = 63, r = 0.281, p = 0.034) but was lost in the sensitivity analysis (n = 62, p = 0.862), suggesting the influence of cases with a high lesion burden on the results. Multiple linear regression analyses showed that the number of lobar CMBs contributed to prolonged TMT-A time in the total cohort (n = 64, β = 0.266, p = 0.038) and the primary analysis (n = 63, β = 0.261, p = 0.034), but not in the sensitivity analysis (n = 62, p = 0.862). Our findings suggests that once the accumulation of lobar CMBs exceeds a certain threshold, the impact on the cognitive function (processing speed and psychomotor speed) may accelerate. Further large-scale studies are warranted to validate these findings and clarify the impact of SVD MRI markers on the cognitive profiles of patients with amnestic MCI.