Bilateral hearing loss prevalent in children with Down syndrome: Study

A new study published in the journal of Nature Scientific Reports showed that 4.1% of children with Down syndrome had sensorineural hearing loss (SNHL), whereas almost half (48.8%) had conductive hearing loss (CHL).

Hearing loss in DS patients can be caused by a number of circumstances. Otitis medium with effusion (OME) is the most frequent cause of CHL and a very common disease in children with DS. Due to the difficulty of diagnosing hearing impairment, parents and professionals face difficulties. To determine the prevalence of OME, permanent, and transitory hearing loss in children with DS who are receiving care at Mansoura University Children’s Hospital, Sohier Yahia and team carried out this study.

A total of 170 juvenile individuals with genetically proven DS are the subjects of this descriptive cross-sectional research. From October 2021 to October 2022, patients were gathered from the Mansoura University Children’s Hospital’s genetic outpatient clinic. A lateral X-ray of the nasopharynx with the mouth open and the neck extended was performed on all babies and children after a thorough history was taken.

After examination, any accumulated cerumen in the ears was removed. The tympanic membrane was examined otoscopically to determine whether middle ear pathology was present. Tympanometry was used to evaluate otitis media with effusion and eustachian tube dysfunction. Pure tone audiometry (PTA) and auditory brain stem response (ABR), among other appropriate hearing tests, were employed.

Of the children with DS in the study, 4.1% had sensorineural hearing loss and 48.8% had conductive hearing loss. Bilateral affection was observed in 86.5% of hearing-impaired individuals. 59.1% of individuals with CHL and 71.4% of patients with SNHL had minor hearing loss. Of the total CHL patients, 45.8% had stagnant HL, 15.7% had a regress from moderate to mild HL, and 38.6% had normalized HL.

All 7 afflicted individuals had persistent SNHL, with 4 showing a stable course and three showing a progressive one. In babies and children with DS, CHL was frequently linked to OME, adenoid hypertrophy, and upper respiratory tract infections (URTI). The majority of kids with DS have modest, bilateral hearing loss. The majority of HL is conductive. Overall, every newborn and youngster with Down syndrome should have their hearing evaluated. Even with a standard newborn hearing screening test, patients with DS should be monitored.

Source:

Yahia, S., Metawea, M., Megahed, A., ELshawaf, W., Wahba, Y., & Mahmoud, R. (2025). The prevalence of hearing impairment in infants and children with down syndrome a cross sectional study in a Tertiary Care Center. Scientific Reports, 15(1), 7570. https://doi.org/10.1038/s41598-025-90500-7

Powered by WPeMatico

Maternal cannabis use triples risk of disruptive behaviour in children: Study

Children exposed to their mother’s cannabis use during pregnancy and after birth are three times more likely to develop behavioural problems, new Curtin University research has found.

Published in Psychiatry Research, the study analysed data from more than 222,600 Australian mothers and children, revealing maternal cannabis use disorder (CUD) during pregnancy and the postnatal period significantly increased the risk of childhood disruptive behavioural disorders.

Lead researcher Abay Tadesse, from Curtin’s School of Population Health, said the findings highlighted the need for interventions targeting cannabis use among reproductive-age women.

“We found children of mothers with cannabis use disorder were at a significantly higher risk of developing behavioural issues such as oppositional defiant disorder (ODD) and conduct disorder (CD),” Mr Tadesse said.

“Our research showed maternal cannabis use during pregnancy increased the risk of disruptive behavioural disorders by 3.56 times, while postnatal use increased the risk by 2.95 times.

“With an estimated one in five Australian pregnant women using cannabis and disruptive behavioural disorders on the rise, our findings underscore the growing public health concern around cannabis use.”

Professor Rosa Alati, the Head of Curtin’s School of Population Health, said the study highlighted the lasting impact of maternal cannabis use on children’s mental health.

“Cannabinoid ingredients can cross the placenta and enter breast milk, potentially affecting brain development. This research provides critical evidence to help shape health policies aimed at minimising harm,” Professor Alati said.

“While intervention strategies are essential, further genetic research is also needed to better understand the link between maternal cannabis use and childhood behavioural disorders.”

This study identifies maternal cannabis use as a significant risk factor for childhood disruptive behavioural disorders, acknowledging that these associations are also likely to be influenced by a range of genetic, environmental and social factors.

Reference:

Abay Woday Tadesse, Berihun Assefa Dachew, Getinet Ayano, Kim Betts, Rosa Alati, Maternal cannabis use disorder and offspring behavioral outcomes: findings from a linked data cohort study, Psychiatry Research, https://doi.org/10.1016/j.psychres.2025.116404.

Powered by WPeMatico

Diabetes drug could help cancer patients make better recovery, suggests study

A common type of diabetes medication could help cancer patients make a better long-term recovery, according to new research from the University of East Anglia.

Many cancer patients go on to develop heart failure-because of the cancer itself and also due to chemotherapy. This can lead to a reduced quality of life, multiple admissions to hospital or even death.

But a new study published today shows that a type of diabetes medication, called an SGLT2 inhibitor, may help protect the heart during and after cancer treatment.

This is the first time that any medication has been shown to be beneficial in reducing heart failure or heart failure hospitalisation in cancer patients and survivors.

The medication appears to lower the risk of heart failure and unplanned hospital visits related to heart failure by more than 50 per cent.

And the benefits were found to be particularly promising for breast cancer patients receiving a common chemotherapy type called anthracycline chemotherapy, which can affect heart health.

Lead researcher Prof Vassilios Vassiliou, from UEA’s Norwich Medical School and Consultant Cardiologist at the Norfolk and Norwich University Hospital, said: “Cancer is currently one of the leading causes of premature death worldwide​.

“Chemotherapy has played an instrumental role in improving patient outcomes. But up to 20 per cent of cancer patients who have had chemotherapy go on to develop heart problems, with up to 10 per cent having heart failure.

“We know that a type of diabetes medication called SGLT2 inhibitors are recognised for their cardiovascular benefits. They can improve the symptoms of heart failure such as breathlessness and tiredness, and also reduce people’s risk of becoming frail.

“We wanted to see whether SGLT2 inhibitors could help protect the heart during and after cancer treatment.”

Analysing 13 studies with a total of 88,273 cancer patients and survivors, the team found that hospital admissions for heart failure were reduced by half.

The effect was especially striking in breast cancer patients undergoing anthracycline chemotherapy, offering a promising breakthrough in patient care

The number of new heart failure cases appeared to fall by more than two-thirds (71 per cent), suggesting these pills might help protect the heart during and after cancer treatment, though the research team say that more research is needed to confirm these findings. 

Prof Vassiliou said: “What we found is that SGLT2 inhibitors may help protect the heart during and after cancer treatment.

“These medications significantly lowered the risk of heart failure and reduced hospital visits related to heart failure.

“The benefits are particularly promising for breast cancer patients receiving a common type of chemotherapy called anthracycline chemotherapy,” he added.

“We hope that this type of medication could in future be used as routine for cancer patients.”

Reference:

U Bhalraam, Rathna B Veerni, Sophie Paddock, James Meng, Massimo Piepoli, Teresa López-Fernández, Vasiliki Tsampasian, Vassilios S Vassiliou, Impact of sodium–glucose cotransporter-2 inhibitors on heart failure outcomes in cancer patients and survivors: a systematic review and meta-analysis, European Journal of Preventive Cardiology, 2025;, zwaf026, https://doi.org/10.1093/eurjpc/zwaf026.

Powered by WPeMatico

SGLT2 Inhibitors May Lower Risk of Atopic Dermatitis in Diabetics: Study

Researchers have identified in a new study that sodium-glucose cotransporter-2 inhibitors (SGLT2i) could diminish the risk for the development of atopic dermatitis (AD) in patients with type 2 diabetes. Atopic dermatitis, characterized as a metabolic inflammatory skin condition, is recognized to have associations with the metabolic syndrome. Given SGLT2i’s ability to promote glucose and sodium excretion through urine, their impact on skin conditions has gained interest. The study was published in The British Journal of Dermatology by Yuan-Liang and colleagues.

This nationwide, active-comparator cohort study used data from the Taiwan National Health Insurance Database. Adult type 2 diabetes patients who started either SGLT2i or DPP4i between May 2016 and December 2018 were included, as long as they had no previous prescriptions for these drugs in the 12 months prior to recruitment. The study group consisted of 148,354 SGLT2i users, and the comparator group consisted of 322,703 DPP4i users. The main outcome was AD incidence, which was measured with Cox proportional hazards regression models. To control for confounders, inverse probability of treatment weighting (IPTW) was used to balance variables like baseline parameters, medical history, and prior medication use. Other analyses, such as sensitivity tests, subgroup analysis, and gender analysis, were also carried out for cross-validation.

Key Findings

  • Reduced Rate of AD: The incidence of AD in SGLT2i users was 9.742 per 1,000 person-years and in DPP4i users was 12.070 per 1,000 person-years.

  • Substantial Risk Reduction: SGLT2i users, after IPTW adjustment, presented with a 16% lower risk of AD compared to DPP4i users (HR = 0.847).

  • Persistent Protective Effect: All SGLT2i classes experienced a persistent reduced risk for AD.

  • Dose-Dependent Benefit: The highest dose of SGLT2i was linked with the lowest AD risk (IPTW-adjusted HR = 0.647), which lends support to a hypothetical dose-response relationship.

  • Gender Differences: Male SGLT2i users exhibited a greater protective effect against AD (IPTW-adjusted HR = 0.750) compared to female users.

The research implies several mechanisms through which SGLT2i could decrease AD risk. Through glucose excretion, these drugs could decrease systemic inflammation, a central mechanism in AD pathogenesis. The sodium loss caused by SGLT2i could have immunomodulatory effects, perhaps affecting skin barrier function and inflammatory processes.

The study authors concluded that SGLT2i markedly decreases AD risk in patients with diabetes versus DPP4i, and the highest efficacy is achieved at higher doses. These findings confirm that SGLT2i can be utilized not only to manage diabetes but also as a measure to prevent AD, especially in men. More research should investigate the mechanisms and long-term skin effects of SGLT2i.

Reference:

Wen, Y.-L., Hsu, W.-T., Chen, Y.-H., Kao, H.-H., Liao, C.-C., To, S.-Y., Yang, H.-W., & Kao, L.-T. (2025). Sodium-glucose cotransporter 2 inhibitors and inverse risk of new-onset atopic dermatitis in diabetic population: A nationwide, active-comparator study. The British Journal of Dermatology. https://doi.org/10.1093/bjd/ljaf086

Powered by WPeMatico

Levels of select vitamins & minerals in pregnancy may be linked to lower midlife BP risk: Study

Women with higher levels of essential minerals circulating in their blood during pregnancy, particularly copper and manganese, along with vitamin B12, had a lower risk of developing high blood pressure in middle age, about 20 years later, according to research presented at the American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Scientific Sessions 2025. The meeting will be held in New Orleans, March 6-9, 2025, and offers the latest science on population-based health and wellness and implications for lifestyle. According to the study authors, it is the first to explore the associations of pregnancy metal levels with women’s midlife blood pressure and hypertension risk, and the full manuscript is simultaneously published today in the American Heart Association’s peer-reviewed journal Hypertension.

Manganese, selenium, magnesium and copper are among the essential metals important for a healthy body because their anti-oxidation and anti-inflammatory properties may help protect against cardiovascular disease. Previous researchhas found that higher levels of manganese were associated with a lower risk of preeclampsia (high blood pressure during pregnancy). However, it is not known whether higher levels of essential metals during pregnancy may influence the risk of developing high blood pressure later in life. Additionally, chronic exposure to the non-essential metals lead, cadmium and arsenic is associated with an increased risk of cardiovascular disease, according to the Association’s 2023 scientific statement “Contaminant Metals as Cardiovascular Risk Factors.“

“People are constantly exposed to heavy metals and trace elements, and much research has shown that exposure to those metals and elements may have an impact on cardiovascular health, especially hypertension,” said lead study author Mingyu Zhang, Ph.D., M.H.S., an epidemiologist and instructor in medicine at Beth Israel Deaconess Medical Center and Harvard Medical School, both in Boston. “In our study, we wanted to examine how levels of essential metals and elements during pregnancy may affect blood pressure and hypertension risk in midlife.”

The researchers analyzed data from Project Viva, an ongoing, long-term study that began in 1999 of women and their children who live in eastern Massachusetts. Nearly 500 women enrolled in the study during early pregnancy, between 1999 and 2002. Researchers measured concentrations of non-essential metals (arsenic, barium, cadmium, cesium, mercury and lead), essential minerals (copper, magnesium, manganese, selenium and zinc), folate and vitamin B12 in blood samples collected during study enrollment.

After nearly twenty years of follow-up, researchers conducted a “midlife” study visit between 2017 and 2021 with the same study participants, who were now at a median age of 51.2 years. Researchers measured blood pressure to assess potential associations of individual metals with blood pressure and high blood pressure risk. Participants were categorized as having high blood pressure if blood pressure measures were greater than 130/80 mm Hg or if participants confirmed taking anti-hypertensive medication. In addition, the potential collective effects of all eleven metals and two micronutrients on blood pressure were analyzed.

The study found:

  • After researchers adjusted for sociodemographic factors, as levels of copper and manganese doubled in the blood during pregnancy, the risk of high blood pressure in midlife was 25% and 20% lower, respectively.
  • As blood levels of vitamin B12 doubled during pregnancy, women had an average 3.64 mm Hg lower systolic blood pressure and 2.52 mm Hg lower diastolic blood pressure almost two decades later. About 95% of the study participants had vitamin B12 levels within the normal range, the researchers noted.
  • Blood levels of the mixture of copper, manganese, selenium and zinc were also associated with lower blood pressure in a relationship that increased with dose. Nonessential metals did not have a significant impact on blood pressure.

“Circulating levels of these metals and minerals in blood were measured, however, the sources of exposure, such as food or dietary supplements, were not quantified so these findings should not be interpreted as recommendations,” Zhang said. “Optimizing these essential metals, minerals and vitamins, particularly copper, manganese and vitamin B12, during pregnancy may offer protective benefits against hypertension in midlife, an especially critical time period for women’s future cardiovascular risk in later life.”

“More research including clinical trials is needed to determine the optimal dietary intake of these minerals and micronutrients,” he added. The researchers hope to ultimately identify women at high risk for developing high blood pressure later in life and intervene during pregnancy, either with enhanced nutrition or supplements.

Study details, background and design:

  • The analysis included 493 women enrolled in Project Viva, a prospective study examining the effects of environmental and lifestyle factors during pregnancy on the short and long-term health of women and their children.
  • Project Viva enrolled women in early pregnancy between 1999 and 2002. The women had a median age of 32.9 years at enrollment. Participants were followed for 18.1 years, through 2021.
  • 72% of participants self-identified as white women; 11% were self-identified as Black women; and 17% self-identified as Hispanic or Latina, Asian or Pacific Islander, American Indian or Alaskan Native, or selected “Other” race, more than one race or “do not know.”
  • Blood samples were collected at study enrollment and stored in freezers for subsequent analyses. The researchers accessed blood samples and analyzed them for this study in 2018. Folate and vitamin B12 were also measured in blood plasma samples during pregnancy.
  • Blood pressure was measured in study participants during a “midlife” (median age of 51 years) study visit between 2017 and 2021. During this visit, trained research assistants measured participants’ blood pressure up to five times, at one-minute intervals. Blood pressure measurements were then averaged.
  • The analyses were adjusted for maternal age at study enrollment, pre-pregnancy body mass index, race and ethnicity, education, household income, parity (the number of pregnancies carried to term), use of anti-hypertensive medication, DASH diet score in early pregnancy and multivitamin intake.

The study’s limitations include that it was an observational study, meaning other confounding factors that were not measured in the study may have affected the results; the researchers only included a subset of the original Project Viva participants; and there were demographic differences between participants included and excluded. In addition, the researchers did not have measurements for metal levels between delivery and midlife; and participants were predominantly white women who resided in Eastern Massachusetts, which may limit the generalizability of the study’s findings.

Reference:

Levels of select vitamins & minerals in pregnancy may be linked to lower midlife BP risk, American Heart Association, Meeting: AHA Epidemiology Lifestyle Scientific Sessions 2025.

Powered by WPeMatico

Collagenase Injection More Effective Than Needle Fasciotomy for Primary Dupuytren Contracture: study

Collagenase Clostridium histolyticum (CCH) and percutaneous needle fasciotomy (PNF) are two treatment options for Dupuytren disease. Ingi Thor Hauksson et al conducted a study was to compare these 2 methods in terms of clinical and patient reported outcomes. It was performed at Akershus University Hospital, Lørenskog, Norway

Eighty patients (median age, 72 years; 83% male) with a single-digit primary metacarpophalangeal (MCP) joint contracture of more than 30degree were randomized to either CCH or PNF and followed for 5 years.

Collagenase (0.58 mg) was injected into the palpable cord in the proximal zone 2 of the involved digit, followed by an extension manipulation 24 hours later under use of a local finger anesthetic block. PNF was performed according to the Lermusiaux multiple perforation technique.

The primary outcome was the difference in flexion-contracture reduction at the MCP joint from baseline to 2 years, with additional analysis examining the effect of the primary endpoint variable up to 5 years. Secondary outcomes included complications, grip strength, scores on the visual analogue scale (VAS) for pain, the shortened version of the Disabilities of the Arm, Shoulder and Hand, the brief Michigan Hand Questionnaire, Unit´e Rhumatologique des Affections de la Main, and a VAS for treatment satisfaction as well as recurrence and retreatments.

The main findings of the study were:

• The mean MCP joint contracture was 48deg at baseline and 2deg at 5 years in the CCH group, and 50deg at baseline and 7deg at 5 years in the PNF group.

• The reduction in MCP contracture at 2 years was larger in the CCH group than in the PNF group, with a mean difference between the groups of 12deg (95% confidence interval [CI], 1.5deg to 22.3deg; p = 0.026).

• At 5 years, this mean difference was reduced to 6deg (-1.5deg to 12.8deg; p = 0.1).

• There was no difference between the groups in any patient reported outcome scores or grip strength beyond 4 weeks, with the exception of the brief Michigan Hand Questionnaire at 5 years.

• Ten (25%) of the patients in the PNF group compared with no patient in the CCH group had recurrence (contracture of more than 30) at the MCP joint at 2 years.

• At 5 years, 17 (42.5%) of 40 patients in the PNF group had been retreated compared with 4 (10%) of 40 in the CCH group (p < 0.001).

• The CCH group experienced more transient complications (stiffness and

• hematoma) during the first week and were more satisfied (VAS satisfaction) from 1 year to the 5-year follow-up.

The authors concluded that – “Our study supports the use of CCH as a more durable treatment for primary Dupuytren disease MCP joint contracture. It reduced the need for further treatment for a large proportion of patients for at least 5 years. However, PNF treatment is a safe and effective initial option, which delays more costly treatments (CCH) or invasive surgical procedures.”

Level of Evidence: Therapeutic Level I.

Further reading:

Collagenase Clostridium histolyticum Versus Needle Fasciotomy for Primary Metacarpophalangeal Dupuytren Contracture Five-Year Results from a Randomized Controlled Trial Ingi Thor Hauksson et alJBJS Open Access 2024:e24.00038. http://dx.doi.org/10.2106/JBJS.OA.24.00038

Powered by WPeMatico

Enhancing Adherence to Perioperative Antibiotic Prophylaxis Guidelines: Key Step for Prevention of Surgical Site Infections

Recent qualitative study aimed to explore factors influencing perioperative antibiotic administration and assess the potential impact of a clinical decision support tool on improving adherence to Infectious Disease Society of America (IDSA) guidelines for surgical antibiotic prophylaxis. The researchers conducted semistructured interviews with a diverse group of perioperative personnel, including anesthesiologists, surgeons, nurses, residents, and pharmacists across the Yale-New Haven Health System. After 3 pilot interviews, 9 sessions were conducted with a total of 17 participants. Several key themes emerged from the interviews: 1. Limited familiarity with IDSA antibiotic guidelines – There was significant uncertainty regarding the existence and content of IDSA guidelines, with practitioners often relying on Surgical Care Improvement Project (SCIP) guidance instead. 2. Lack of standardization and optimization of the antibiotic decision-making process – While electronic health record resources and pharmacy consultation were available, access and usability were variable, leading to inconsistent workflows. 3. Challenges with managing beta-lactam allergies and optimizing vancomycin timing – Practitioners expressed uncertainty about appropriate antibiotic choices for patients with allergies and difficulty ensuring optimal timing of vancomycin administration. 4. Perceived benefit of a clinical decision support tool – Interviewees felt that a well-designed tool integrated into the electronic health record could enhance workflow and promote better adherence to perioperative antibiotic guidelines. The interviews provided important insights into the barriers to guideline adherence and potential opportunities for improvement through the development of a tailored clinical decision support tool. Key recommendations included improved visibility and accessibility of guidelines, better integration of pharmacy input, and more reliable processes for managing antibiotic administration, especially for challenging scenarios like vancomycin timing and antibiotic allergies.

Key Points

1. The study aimed to explore factors influencing perioperative antibiotic administration and assess the potential impact of a clinical decision support tool on improving adherence to Infectious Disease Society of America (IDSA) guidelines for surgical antibiotic prophylaxis.

2. The researchers conducted semistructured interviews with a diverse group of perioperative personnel, including anesthesiologists, surgeons, nurses, residents, and pharmacists across the Yale-New Haven Health System, and identified several key themes: – Limited familiarity with IDSA antibiotic guidelines, with practitioners often relying on Surgical Care Improvement Project (SCIP) guidance instead. – Lack of standardization and optimization of the antibiotic decision-making process, with variable access and usability of electronic health record resources and pharmacy consultation. – Challenges with managing beta-lactam allergies and optimizing vancomycin timing, leading to uncertainty about appropriate antibiotic choices and difficulty ensuring optimal timing of vancomycin administration. – Perceived benefit of a well-designed clinical decision support tool integrated into the electronic health record, which could enhance workflow and promote better adherence to perioperative antibiotic guidelines.

3. The interviews provided insights into the barriers to guideline adherence and potential opportunities for improvement, including improved visibility and accessibility of guidelines, better integration of pharmacy input, and more reliable processes for managing antibiotic administration, especially for challenging scenarios like vancomycin timing and antibiotic allergies.

4. The study highlighted the need for a tailored clinical decision support tool to address the identified barriers and improve adherence to perioperative antibiotic guidelines.

5. The findings suggest that a well-designed clinical decision support tool integrated into the electronic health record could enhance workflow and promote better adherence to IDSA guidelines for surgical antibiotic prophylaxis.

6. The study emphasizes the importance of addressing the identified barriers, such as limited familiarity with guidelines, lack of standardization in the antibiotic decision-making process, and challenges with managing complex scenarios, in order to improve adherence to perioperative antibiotic guidelines.

Reference –

Amit Bardia et al. (2024). Individual And System Level Factors Contributing To Guideline Non-Adherent Surgical Antibiotic Prophylaxis At A Tertiary Health Care System: A Qualitative Analysis.. *Anesthesiology*. https://doi.org/10.1097/ALN.0000000000005302.

Powered by WPeMatico

Lesion size critical predictor of clinically significant prostate cancer within PI-RADS 4 category: Study

A new study published in the journal of Research and Reports in Urology showed that lesion size was a crucial predictor of clinically significant prostate cancer (CSPCa) in the PI-RADS 4 category.

When diagnosing prostate cancer (PCa), magnetic resonance imaging (MRI) is a crucial diagnostic technique. The frequency of CSPCa with PI-RADS 4 is 33–41%, whereas PI-RADS 5 is 62–79%, per the most recent guidelines. The PI-RADS v2.1 score corresponds with clinically significant prostate cancer. Despite just being 15 mm apart, there is a noticeable variation in risk between both groups.

To assist with risk stratification and patient counseling in the pre-biopsy scenario, this study by Ali Hooshyari and team attempts to identify a size threshold linked with CSPCa within the PI-RADS 4 group. This threshold may be employed in conjunction with other prostatic characteristics, such as PSA density. In the event of a negative biopsy, this may also help with surveillance of smaller PI-RADS 4 lesions and prevent needless repeat biopsies unless prompted by a size threshold.

The data from a total of 407 individuals who had transperineal prostate biopsies (TPPBs) between April 2022 and November 2023 were used in a retrospective analysis. For analysis, a subset of patients with PI-RADS 4 was included. The result was a ROC-AUC.

The findings of this study found that the PSA density was 0.20 (interquartile range 0.13–0.28) and the median age was 67 (interquartile range: 61–71). There was a link between the PI-RADS score and CSPCa: 10% for PI-RADS 1 and 2, 20% for PI-RADS 3, 60% for PI-RADS 4, and 80% for PI-RADS 5 (Pearson correlation = 0.51, p < 0.001).

The results showed that the Receiver Operating Characteristic Area Under the Curve (ROC-AUC) was 0.664 [0.579–0.7499]. 8.5 mm was the ideal cut-off point. CSPCa risk was 2.31 times greater in those with lesions bigger than 8.5 mm. When PI-RADS 4 lesions reach the statistically significant size threshold of 8.5 mm, the probability of CSPCa is 2.31 [1.31–4.07] times greater than for lesions that fall below this threshold. Therefore, the size of a PI-RADS 4 lesion is important and may actually be used to predict the likelihood of a positive biopsy for CSPCa.

Overall, the study emphasized the significance of considering PI-RADS 4 lesions in size-specific groups. This is a helpful tool for increasing the precision of patient counseling and optimizing follow-up or monitoring tactics when paired with PSA density.

Source:

Hooshyari, A., Scholtz, D., Maoate, K., Robertson, S., Vermeulen, L., De Andrade, L. G. M., Kawano, P., Gilling, P., Fraundorfer, M., & Vasconcelos Ordones, F. (2025). Does size matter? A retrospective study analysing the size of PI-RADS 4 lesions and its associated prostate cancer positivity with transperineal prostate biopsy. Research and Reports in Urology, 17, 49–57. https://doi.org/10.2147/rru.s499930

Powered by WPeMatico

Unusual Presentation of Lateral Periodontal Cyst in Molar Region of Elderly Patient

USA: In a recent case report, the researchers have reported a rare presentation of a lateral periodontal cyst (LPC) in the interdental molar region in a 68-year-old patient, highlighting the need for careful diagnosis and timely management of such lesions in older individuals.

The case report was described in the Gerodontology Journal by John K. Brooks, Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, Maryland, USA, and colleagues.

LPC is a developmental odontogenic cyst that typically occurs along the lateral roots of mandibular canines and premolars. However, its presence in the molar region is highly uncommon, and reports of such cases in geriatric patients are even rarer. This case sheds light on an unusual location of LPC and reinforces the importance of considering it in differential diagnoses for cystic lesions in the posterior mandible.

The lesion was incidentally detected during routine extraoral and intraoral radiographic examinations. Initially, the researchers suspected it to be an infected odontogenic keratocyst or unicystic ameloblastoma due to its radiographic features. Given the potential for more aggressive pathologies, further investigation was necessary to determine the exact nature of the lesion.

Histopathological analysis of the excised specimen confirmed the diagnosis of an LPC, revealing a thin cuboidal epithelial lining with focal nodular thickenings and an underlying fibrovascular connective tissue wall. The patient underwent surgical removal of the lesion, and follow-up at six months showed no recurrence, with evidence of radiographic bone regeneration.

This case highlights the importance of considering LPC in the differential diagnosis of odontogenic cysts, even in atypical locations such as the inter-molar region. Preoperative cone beam computed tomography (CBCT) can be a valuable tool in optimizing surgical planning by providing detailed imaging of the lesion’s extent and relationship with surrounding structures.

Early identification and excision of cystic lesions, particularly in older patients, prevent complications such as infection, bone loss, or potential malignancy. The case emphasizes the need for dental professionals to remain vigilant when evaluating radiolucent lesions in geriatric patients, ensuring timely intervention to reduce postoperative complications and promote better outcomes.

“LPC should be considered in the differential diagnosis of developmental odontogenic cysts in the inter-molar region. A preoperative cone beam computed tomography scan can aid in optimizing the surgical approach,” the researchers wrote.

“Early removal of suspected cystic lesions, especially in older patients with infection, may help minimize postoperative complications and exclude the possibility of malignancy,” they concluded.

Reference:

Brooks, J. K., Portillo, N., Bhatti, A. K., Parsa, A., & Basile, J. R. (2025). Lateral periodontal cyst in an interdental molar site: Novel presentation in a geriatric patient. Gerodontology, 42(1), 124-128. https://doi.org/10.1111/ger.12759

Powered by WPeMatico

First-Trimester Ultrasound Effective for Screening for Fetal CHD, suggests study

Researchers have found in a new study that first-trimester ultrasound screening enables early prenatal diagnosis and consultation for fetal congenital heart disease (CHD). Further the standardized screening strategy used in the study demonstrated a high detection rate, supporting its effectiveness. However, while this approach is recommended for early diagnosis, it should not replace second-trimester fetal echocardiography.

A study was done to assess the performance of a standardized first-trimester ultrasound screening strategy for fetal congenital heart disease (CHD). This was a large retrospective study involving 74 839 consecutive mixed-risk pregnancies (77 396 fetuses). Routine ultrasound scans at 11 + 0 to 13 + 6 weeks’ gestation were performed in a single center from January 2015 to June 2023. All fetuses were examined using a predefined standardized ultrasound scanning strategy with adjustment of imaging parameters, which included assessment of the fetal heart. The ultrasound results (e.g. extracardiac congenital malformations), ultrasound markers (e.g. nuchal translucency thickening, reversed a-wave in the ductus venosus and tricuspid regurgitation), follow-up, genetic tests and diagnostic results were recorded and analyzed. RESULTS: In total, there were 831 cases of CHD, with an incidence of 1.07% (831/77 396). In the first-trimester scan, 590 fetuses were diagnosed with CHD, but four were confirmed as normal in later examinations. In addition, 245 cases were missed. The detection rate was 70.52%, with a sensitivity, specificity, false-positive rate and false-negative rate of 70.52%, 99.99%, 0.01% and 29.48%, respectively. In fetuses with negative ultrasound markers and no extracardiac malformations, the detection rate of CHD was 45.79% (185/404). There were 281 cases that underwent karyotyping and chromosomal microarray (245 fetuses) or whole-exome sequencing (36 fetuses). In total, 38.79% (109/281) had a positive genetic test result. There were 273/831 CHD cases associated with extracardiac malformations. The abnormal image patterns and abnormal features of each view in the scanning strategy were summarized. Ultrasound screening for fetal CHD in the first trimester of pregnancy enables earlier prenatal diagnosis and consultation. The standardized ultrasound screening strategy used in this study had a high detection rate for fetal CHD in the first trimester. Our proposed fetal heart screening strategy shows promising effectiveness for early diagnosis of CHD and we recommend its use. It is important to note, however, that first-trimester ultrasound screening for fetal CHD should not replace fetal echocardiography in the second trimester. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.

Reference:

Yang, S, et al. “Evaluation of First-trimester Ultrasound Screening Strategy for Fetal Congenital Heart Disease.” Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2025.

Keywords:

First-Trimester, Ultrasound, Effective, Screening, Fetal, CHD, suggests, study, Ultrasound in Obstetrics & Gynecology, Yang, S

Powered by WPeMatico