CT Imaging Found More Accurate for Assessing Bone Density in Diabetes Patients, claims research

A study published in Skeletal Radiology suggests that CT imaging may offer a more accurate evaluation of bone mineral density (BMD) in individuals with diabetes compared to traditional methods. Among over 1,000 participants, those with diabetes particularly with reduced kidney function showed higher baseline vertebral BMD and significant increases over time. The study was conducted by Elena G. and colleagues.

The longitudinal assessment used 1,046 subjects with vertebral BMD data available from chest CT scans on Exam 5 (2010–2012) and Exam 6 (2016–2018). Diabetes status was defined according to American Diabetes Association guidelines, and subjects with prediabetes (impaired fasting glucose) were excluded to ensure that group comparisons remained clear.

Volumetric BMD estimates were derived from a validated deep learning-based algorithm that segmented the trabecular content of thoracic vertebrae. Researchers applied linear mixed-effects models to estimate the rate of change in BMD over time and tested the interaction between kidney function, as determined by estimated glomerular filtration rate (eGFR), and diabetes status. On the basis of the interaction, the group performed stratified analyses with an eGFR cut-point of 60 mL/min/1.73 m² to separate preserved and impaired renal function.

Key Findings

  • Diabetic participants had greater baseline vertebral BMD than non-diabetic participants:

  • 202 mg/cm³ versus 190 mg/cm³.

  • After a median follow-up of 6.2 years, diabetes participants had an increased BMD at a rate of 0.62 mg/cm³ per year (95% Confidence Interval [CI]: 0.26, 0.98).

  • In those with diabetes and compromised kidney function (eGFR < 60), the rate of increase in BMD was significantly greater (1.52 mg/cm³/year (95% CI: 0.66, 2.39)).

  • By contrast, diabetic patients with maintained kidney function (eGFR ≥ 60) exhibited a less pronounced increase (0.48 mg/cm³/year (95% CI: 0.10, 0.85)).

Overall, this research was able to show that vertebral BMD does actually increase over time in patients with diabetes, specifically in those who have decreased kidney function, displaying a paradox between fracture risk and BMD values in these patients. These findings indicate that standard BMD tests may not accurately be used to determine skeletal health in diabetic patients. Future studies should aim to combine bone quality measures, microstructure analysis, and long-term fracture incidence to design more precise risk stratification instruments specific for the diabetic patient.

Reference:

Ghotbi, E., Hadidchi, R., Hathaway, Q.A. et al. Diabetes and longitudinal changes in deep learning–derived measures of vertebral bone mineral density using conventional CT: the Multi-Ethnic Study of Atherosclerosis. Skeletal Radiol (2025). https://doi.org/10.1007/s00256-025-04995-2

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High metabolic syndrome severity linked to development of CKD

High metabolic syndrome (MetS) severity, expressed by the continuous metabolic syndrome severity score (cMetS-S), is associated with development of chronic kidney disease (CKD), according to a study recently published in Kidney Diseases.

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Missed opportunity common in patients with high-grade serous ovarian cancer

A considerable proportion of patients with high-grade serous cancer (HGSC) have missed opportunities for risk assessment with genetic testing and for surgical prevention, according to a study published online August 13 in JAMA Surgery.

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Household-based screening methods reveal high-risk diabetes patterns across family units

New research presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Vienna, Austria (15–19 September) shows that early detection of individuals at risk of diabetes is possible by analyzing the electronic records of people living within the same household for risk factors.

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Uterine Manipulators may Enhance Laparoscopic Rectal Surgery in Women: Study

A recent study published in BMC Surgery found that using uterine manipulators during laparoscopic rectal resections in women enhances operative exposure without compromising oncological safety or perioperative outcomes. The researchers compared cases where a manipulator was employed to those without, observing that its use provided better visualization and access to the deep pelvis—crucial in women, whose pelvic anatomy and potential uterine mobility can complicate dissection. Despite the improved surgical ergonomics, the study reported no increase in operative times, blood loss, complication rates, or positive margin occurrences. Moreover, functional outcomes post-surgery—including urinary and sexual function—remained equivalent between both groups. This suggests that using uterine manipulators is both safe and beneficial, especially in complex cases such as low rectal tumors or narrow female pelvises. The enhanced exposure facilitated by the manipulator allows for a more precise and controlled dissection, potentially reducing technical difficulty and improving surgeon confidence. Importantly, there was no negative impact on oncological principles: specimen quality, lymph node yield, and circumferential margin status were similar with or without the device. The authors conclude that for difficult pelvic dissections in female patients, uterine manipulator use is a valuable adjunct that doesn’t compromise safety or outcomes. However, they note that surgeon experience and familiarity with the device remain important considerations, and they encourage further randomized studies to quantify benefits on operative ergonomics, long-term outcomes, and patient quality of life.

Reference:
Zhu, Y., Wang, X., Liu, H., & Chen, L. (2025). Uterine manipulators enhance surgical exposure in laparoscopic rectal cancer surgery in women without affecting oncological or perioperative outcomes. BMC Surgery, 25, 189. https://doi.org/10.1186/s12893-025-03078-2 [API]

Keywords: uterine manipulator, laparoscopic rectal surgery, female pelvic anatomy, oncological outcomes, surgical exposure, pelvic dissection, BMC Surgery

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Sleep fragmentation negatively linked to QoL in pediatric nocturnal enuresis

For children with monosymptomatic nocturnal enuresis (MNE), sleep fragmentation is negatively associated with physical and social quality of life, with N2 stage moderating the deleterious effects of fragmentation, according to a study published online May 13 in the International Journal of Environmental Research and Public Health.

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Scientists discover eight new schizophrenia genes

Researchers have discovered eight new genes associated with schizophrenia, in the largest exome-sequencing study of the disorder ever conducted. The breakthrough, made by scientists at the Centre for Neuropsychiatric Genetics and Genomics (CNGG) at Cardiff University, provides new information and improves the understanding and future treatment development for schizophrenia.

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Study explores current state and research innovation in endometrial cancer screening

Endometrial cancer (EC) ranks among the top three gynecologic malignancies globally, with rising incidence in younger populations driven by obesity, metabolic disorders, and lifestyle factors. Despite its prevalence, effective population-level screening remains elusive due to limitations in current methods: transvaginal ultrasound (TVU) exhibits moderate specificity (60–70%), cytology sensitivity is ≤50% in community settings, and histopathology is invasive. This review synthesizes advances in EC screening, highlighting emerging technologies poised to transform early detection.

Current Screening Modalities: Limitations and Gaps

  1. Clinical Symptoms & Imaging:

    • Vaginal bleeding is the primary symptom but lacks specificity due to overlap with benign conditions.

    • TVU detects endometrial thickening (>4 mm in postmenopausal women) but misses 35% of early-stage/hormone-independent tumors (Type II EC). Sensitivity: 80–90%; specificity: 60–70%.

  2. Tumor Markers:

    • CA125 and HE4 correlate with advanced disease but lack utility for early detection. HE4 specificity is compromised by heterogeneity across studies.

  3. Histopathology:

    • Gold standard but invasive, with risks of complications and low patient compliance. Novel samplers (e.g., Pipelle, Tao Brush) enable outpatient cytology yet face challenges in detecting focal lesions.

Innovative Screening Technologies

1. Molecular & Epigenetic Biomarkers

• DNA Methylation Panels (e.g., ADCYAP1, HAND2):

• Phase II trials show 89–94% sensitivity and 91–97% specificity in liquid biopsies.

• Enables non-invasive early detection and monitoring of high-risk groups (e.g., Lynch syndrome).

• Genomic Profiling:

• Mutations in PTEN, TP53, and ARID1A achieve 92.9% sensitivity for hereditary EC.

• Exosomal miRNA:

• Plasma exosomal miR-15a-5p distinguishes EC patients (AUC: 0.823) and correlates with myometrial invasion depth.

2. Liquid Biopsy & Spectroscopy

• Circulating Tumor DNA (ctDNA):

• Combined with tumor-educated platelets, sensitivity reaches 77.8% for early-stage EC. Challenges include standardization and high cost.

• Vibrational Spectroscopy:

• Detects molecular changes in tissues/blood with 87% sensitivity and 78% specificity. Enables rapid intraoperative diagnosis.

3. AI-Driven Platforms

• Risk Prediction Models:

• Integrate demographic, imaging, and biomarker data (e.g., AI-enhanced Risk of Malignancy Index: 94% sensitivity, 75% specificity).

• Cytology Analysis:

• Deep learning algorithms classify benign/malignant cells (95% positive predictive value).

Implementation Strategies

1. Risk Stratification

• High-Risk Groups: Obesity (BMI >30), Lynch syndrome, diabetes, nulliparity, and late menopause (>55 years).

• Lynch Syndrome: Annual TVU + endometrial biopsy from age 30–35.

2. Fertility Preservation

• Early-stage EC: Progestins, levonorgestrel IUDs, or GnRH agonists enable fertility-sparing treatment with 3–6 month follow-ups.

3. Economic & Ethical Considerations

• Cost-Effectiveness: AI and methylation testing reduce long-term costs by minimizing invasive procedures (e.g., Nordic studies show 20% cost reduction over 5 years).

• Ethical Priorities: Minimize invasiveness, address false-positive anxiety, and ensure equitable access.

Future Directions

  1. Multimodal Screening: Combine methylation panels, exosomal miRNAs, and AI for community-level deployment.

  2. Large-Scale Validation: Prospective trials to confirm biomarker efficacy across diverse populations.

  3. Policy Integration: Develop guidelines for risk-stratified screening and subsidize high-accuracy tests (e.g., methylation panels).

Conclusion

Endometrial cancer screening is evolving from symptom-dependent approaches to precision strategies leveraging molecular biomarkers, AI, and non-invasive diagnostics. Key innovations—methylation panels (sensitivity >90%), vibrational spectroscopy, and exosomal miRNAs—offer transformative potential for early detection. Prioritizing risk-adapted frameworks, cost-effective implementation, and ethical deployment will be critical to reducing EC mortality globally.

Reference:

Liu H, Ai H, Liu Y. Exploring the Current State and Research Innovation in Endometrial Cancer Screening. Oncol Adv. 2025;3(1):50-60. doi: 10.14218/OnA.2024.00034.

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Quitting Smoking Boosts Recovery Odds in Substance Use Disorders: JAMA

A new study published in the Journal of American Medical Association revealed that the necessity of including smoking cessation into addiction treatment programs is demonstrated by the 30% increased chance of recovery from non-tobacco addictions among smokers with drug use disorders who stopped cigarettes.

People with other substance use disorders (SUDs) are more likely to smoke cigarettes than people without SUDs. However, SUD treatment centers frequently lack smoking cessation programs. Thus, to validate if switching from present to past smoking is linked to sustained SUD recovery, this study was carried out to evaluate smoking status and SUD recovery across time. 

Using data from the PATH (Population Assessment of Tobacco and Health) research, a nationally representative cohort of US people with a history of SUD participated in this cohort research. In the United States, the PATH Study is a continuous longitudinal cohort study that is nationally representative.

Adults (≥18 years old) in the wave 1 cohort (hired in 2013/2014) who were evaluated yearly for 4 years until wave 4 (2016/2018) were included in the analyses. Sensitivity analysis also evaluated a second nationally representative cohort (2016/2018–2023).

Data analysis was finished between June and September of 2024. Using the Global Appraisal of Individual Needs–Short Screener SUD subscale, the main outcome was SUD recovery, which was defined as either high lifetime SUD symptoms with no past-year symptoms or high lifetime SUD symptoms with any past-year symptoms.

The mean age of 2,652 adults from 2013/2014 to 2016/2018 was 39.4 years (95% CI, 38.7-40.3), and 41.9% of participants (95% CI, 39.4%-44.4%) were female.

13.9% (95% CI, 12.2%-15.6%) of participants were non-Hispanic Black, 63.1% (95% CI, 60.4%-65.7%) were non-Hispanic White, 17.0% (95% CI, 15.3%-18.9%) were Hispanic, and 6.0% (95% CI, 4.9%-7.4%) were another non-Hispanic race (Asian, Native Hawaiian/Other Pacific Islander, Native American/Alaska Native, more than one race).

After controlling for time-varying covariates and between-person variations, there was a positive correlation between SUD recovery and within-person change from current to former smoking: year-to-year change to former cigarette use was linked to a 30% increase in odds of recovery (odds ratio [OR], 1.30; 95% CI, 1.07-1.57). 

Both in the second cohort evaluated from 2016/2018 to 2022/2023 (OR, 1.37; 95% CI, 1.13-1.66) and after trailing predictor by 1 year (OR, 1.43; 95% CI, 1.00-2.05), this connection remained significant.

Overall, recovery from other SUD was linked to a person’s transition from current to past smoking. These findings imply that quitting smoking may be a useful strategy to support SUD recovery and enhance health in adults.

Source:

Parks, M. J., Blanco, C., Creamer, M. R., Kingsbury, J. H., Everard, C. D., Marshall, D., Kimmel, H. L., & Compton, W. M. (2025). Cigarette smoking during recovery from substance use disorders. JAMA Psychiatry (Chicago, Ill.). https://doi.org/10.1001/jamapsychiatry.2025.1976

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Prenatal acetaminophen use may be linked to increased risk of autism and ADHD, reveals Mount Sinai study

Researchers at the Icahn School of Medicine at Mount Sinai have found that prenatal exposure to acetaminophen may increase the risk of neurodevelopmental disorders, including autism spectrum disorder and attention-deficit/hyperactivity disorder (ADHD), in children. The study, published today in BMC Environmental Health, is the first to apply the rigorous Navigation Guide methodology to systematically evaluate the rigor and quality of the scientific literature.

Acetaminophen (often sold under the brand name Tylenol®, and known as paracetamol outside the United States and Canada) is the most commonly used over-the-counter pain and fever medication during pregnancy and is used by more than half of pregnant women worldwide. Until now, acetaminophen has been considered the safest option for managing headache, fever, and other pain. Analysis by the Mount Sinai-led team of 46 studies incorporating data from more than 100,000 participants across multiple countries challenges this perception and underscores the need for both caution and further study.

The Navigation Guide Systematic Review methodology is a gold-standard framework for synthesizing and evaluating environmental health data. This approach allows researchers to assess and rate each study’s risk of bias, such as selective reporting of the outcomes or incomplete data, as well as the strength of the evidence and the quality of the studies individually and collectively.

“Our findings show that higher-quality studies are more likely to show a link between prenatal acetaminophen exposure and increased risks of autism and ADHD,” said Diddier Prada, MD, PhD, Assistant Professor of Population Health Science and Policy, and Environmental Medicine and Climate Science, at the Icahn School of Medicine at Mount Sinai. “Given the widespread use of this medication, even a small increase in risk could have major public health implications.”

The paper also explores biological mechanisms that could explain the association between acetaminophen use and these disorders. Acetaminophen is known to cross the placental barrier and may trigger oxidative stress, disrupt hormones, and cause epigenetic changes that interfere with fetal brain development.

While the study does not show that acetaminophen directly causes neurodevelopmental disorders, the research team’s findings strengthen the evidence for a connection and raise concerns about current clinical practices.

The researchers call for cautious, time-limited use of acetaminophen during pregnancy under medical supervision; updated clinical guidelines to better balance the benefits and risks; and further research to confirm these findings and identify safer alternatives for managing pain and fever in expectant mothers.

“Pregnant women should not stop taking medication without consulting their doctors,” Dr. Prada emphasized. “Untreated pain or fever can also harm the baby. Our study highlights the importance of discussing the safest approach with health care providers and considering non-drug options whenever possible.”

With diagnoses of autism and ADHD increasing worldwide, these findings have significant implications for public health policy, clinical guidelines, and patient education. The study also highlights the urgent need for pharmaceutical innovation to provide safer alternatives for pregnant women.

Reference:

Prada, D., Ritz, B., Bauer, A.Z. et al. Evaluation of the evidence on acetaminophen use and neurodevelopmental disorders using the Navigation Guide methodology. Environ Health 24, 56 (2025). https://doi.org/10.1186/s12940-025-01208-0

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