We sought to compare the MiniMed™ 770G to the 780G insulin pump for glycemic control and quality of life in Japanese adults with T1D over a one-year period.

Thirty-six adults with T1D who switched from the MiniMed™ 770G to the 780G system were analyzed over 48 weeks using continuous glucose monitoring data, retrospectively. The percentages of time within the target glucose range (70-180 mg/dL), time above 180 mg/dL, and time below 70 mg/dL were compared before and after switching. Quality of life (QOL) scores were also evaluated in 39 patients using a validated questionnaire, prospectively.

After switching to the MiniMed™ 780G, the time within the target glucose range significantly increased from 71.6 ± 12.4% to 76.1 ± 10.2% (P < 0.01), while the time above 180 mg/dL decreased from 25.2 ± 13.4% to 21.0 ± 11.0% (P < 0.01). The time below 70 mg/dL did not differ significantly overall, but nocturnal hypoglycemia decreased from 4.9% to 2.7% (P = 0.02). Glycated hemoglobin improved from 7.2 ± 0.8% to 7.0 ± 0.7% (P < 0.01). Although the total QOL score did not change significantly, the subscales reflecting anxiety and treatment satisfaction improved significantly.

Switching from the MiniMed™ 770G to the 780G system in Japanese adults with T1D improved both glycemic control and treatment-related QOL, supporting the clinical usefulness of the 780G in real-world clinical practice. This study provides the first one-year real-world evidence of MiniMed™ 780G use in Japan.

Endocrine and metabolic diseases are known to be common late effects in childhood cancer survivors (CCS). We assessed the prevalence of these diseases in a large German CCS cohort, and a matched comparison population, using health claims data.

The cohort study was based on record linkage between the nationwide German Childhood Cancer Registry and claims data from 13 major German statutory health insurances.

The monitored insurance period covered the years 2017-2021. We assessed the frequencies of endocrine and metabolic diseases among 11 863 five-year CCS, diagnosed 1991-2021, with continuous insurance coverage and a matched comparison group of 35 589 insured persons without a history of childhood cancer. We present prevalence and prevalence ratios (PR) with corresponding 95% confidence intervals (95% CI).

At least one endocrine or metabolic disease was recorded in 31.3% of survivors (n = 3716) and in 16.4% of the comparison group (n = 5819, PR = 1.9; 95% CI: 1.8-2.0). The frequency of diseases was higher among females than among males in both groups. The PR was 2.4 (95% CI: 2.3-2.5) for males and 1.6 (95% CI: 1.5-1.7) for females. The frequency of at least one disease increased with increasing attained age. The disease with the highest frequency among CCS was hypothyroidism (15.85%), and the highest PR was estimated for patients with primary thyroid cancer (43.5; 95% CI: 24.2-78.1).

Our study highlights the increased vulnerability of CCS to endocrine and metabolic diseases compared to the general population and underscores the need for risk-adapted surveillance during the whole survivorship trajectory.

Endovascular thrombectomy (EVT) is an effective treatment of acute ischemic stroke caused by large-vessel occlusion (AIS-LVO) of the anterior circulation, and technical success is essential to maximize outcomes. Increased EVT pass counts have been associated with reduced procedural efficacy and worse patient outcomes. We examined the impact of pre-EVT cerebral perfusion imaging parameters on clinical outcomes in patients with high EVT pass numbers.

We performed a multicenter retrospective analysis of patients with AIS-LVO who had pretreatment CTA and CTP imaging and a pass count ≥3. Baseline NCCT imaging was analyzed according to ASPECTS. Ischemic core was defined as relative CBF <30% on CTP. Collateral blood flow was evaluated using the modified Tan scoring system on CTA, hypoperfusion intensity ratio (time-to-maximum >10 seconds/>6-second volumetric ratio) on CTP, and venous outflow (VO) on CTA. The primary outcome was favorable clinical outcomes (mRS 0-2) at 90 days.

One hundred seventy-eight patients met the inclusion criteria and were dichotomized into favorable (mRS 0-2, 29%) and unfavorable outcome (mRS 3-6, 71%) groups. Patients with favorable outcomes had lower blood glucose levels (mean, 115 mg/dL; interquartile range [IQR], 102-128 versus 126 mg/dL [IQR, 103-156; P = .03) and lower baseline NIHSS scores (median, 9; IQR, 6.5-13.5 versus 17; IQR, 13-20; P < .001) compared with those with unfavorable outcomes. On pre-EVT imaging, favorable patients had smaller ischemic core volumes (median, 2 mL; IQR, 0-14 versus 16 mL; IQR, 0-39; P < .001), higher ASPECTS (median, 9; IQR, 7-10 versus 7; IQR, 6-9; P = .001), a higher frequency of favorable CTA collaterals (87% versus 57%, P < .001), a more favorable hypoperfusion intensity ratio (median, 0.3; IQR, 0.2-0.5 versus 0.5; IQR, 0.4-0.6; P < .001), and higher rates of favorable VO (73% versus 15%; P < .001). In a regression analysis, favorable outcome was independently associated with lower-presentation NIHSS (OR, 0.84; 95% CI, 0.76-0.93; P < .001), successful reperfusion (modified TICI score 2b-3; OR, 4.95; 95% CI, 1.18-20.72; P = .03), and favorable VO (OR, 12.35; 95% CI, 4.23-36.10; P < .001).

In Patients with AIS-LVO treated with EVT that involved ≥3 passes, lower presentation NIHSS, successful reperfusion, and favorable VO were associated with an increased likelihood of a favorable outcome.

The World Health Organization recommends a minimum intake of 400 g or five servings of Fruits and Vegetables (FVs) per day for the prevention of chronic diseases.

The present study aims to describe the prevalence and factors associated with inadequate FVs intake in a sample of Angolan adults who participated in the CardioBengo study.

It is a subset analysis of CardioBengo, a community-based cross-sectional observational study conducted in the Dande Municipality, Bengo Province, Angola.

The sample included 2161 individuals aged 18 to 84, with 64.1% being women. 57.2% of participants was below high school, and only 3.1% attended higher education. 61.7% were married, 48.3% had a monthly income below 150 USD. The prevalence of insufficient FVs consumption in the sample was 86.2%. It was observed that female gender, low education level, and the age group of 20-29 years were associated with inadequate FVs intake (p = 0.010, p = 0.001, and p = 0.006, respectively).

There was no association between FVs consumption and cardiovascular risk factors. A prevalence of FVs consumption well below current recommendations was identified. The identified risk factors can serve as a strategy to increase FVs consumption in this population.

The obligate intracellular parasite, Leishmania, causes leishmaniasis as an infectious disease. The parasite is transmitted through female sandfly bites and infects the host mononuclear phagocytes, leading to severe skin lesions and fatal systemic infection. The quick diagnosis and effective treatment can prevent the development scars and chronic or uncontrollable disease forms. The current chemical and physical treatments have limitations; hence, the use of plant compounds and their derivatives is a new proposed treatment method. Therefore, in this review, the recent advances in combination therapy of cutaneous leishmaniasis were investigated. The information was obtained from all articles published in PubMed, SciELO, ScienceDirect, Scopus, Google Scholar, and Web of Science databases (1998-2022). Search terms used were "Combination Therapy" AND "Cutaneous Leishmaniasis." The data showed increased synergistic efficacy or shortening the course of treatment and few adverse effects in the combined treatment of (CL), in vitro and in vivo. Expanding the combination therapy in clinical trials could open a new insight in treatment strategies of CL.

Menopausal symptoms can disrupt the lives of women at the peak of their careers and family life. Currently, the most effective treatment for these symptoms is menopausal hormone therapy (MHT). The presence of cardiovascular and metabolic diseases does not preclude the use of MHT to relieve menopausal symptoms and improve quality of life. However, physicians' concerns about causing more harm than good often hinder the use of this type of hormone therapy. Caution is especially important when it comes to women with comorbidities. Moreover, it should be acknowledged that high-quality studies on the safety of MHT for major chronic noncommunicable diseases and common comorbid conditions are insufficient. This consensus document analyzes all currently available data from clinical trials of various designs and develops a set of eligibility criteria for prescribing MHT to women with comorbid cardiovascular and metabolic diseases. Based on this document, physicians of various specialties who consult with women in menopause will receive an accessible algorithm that will allow them to avoid potentially dangerous situations and appropriately prescribe HRT in clinical practice.

Oral insulin delivery represents a transformative approach to diabetes management, offering improved patient compliance and physiological insulin delivery patterns compared to subcutaneous injection. However, multiple gastrointestinal barriers, including enzymatic degradation, mucus entrapment, epithelial impermeability, and first-pass metabolism, have limited oral bioavailability to below 1% for unmodified insulin. This review comprehensively examines contemporary strategies to overcome these barriers. We analyze structural modifications of insulin, including PEGylation, lipidation, cyclization, and glycoengineering, which enhance stability while maintaining biological activity. The analysis extends to sophisticated formulation technologies incorporating nanocarriers (polymer-based, lipid-based, inorganic nanocarriers, and metal organic frameworks), biomimetic systems, and stimuli-responsive mechanisms for protection and delivery. A central focus is on absorption-enhancing strategies, which range from chemical permeation enhancers to precise biological mechanisms like receptor-mediated transcytosis and other active transport pathways. Emerging tools such as microbiome-based carriers and smart devices are also discussed. Despite significant progress in preclinical models, challenges remain in manufacturing scalability, inter-patient variability, long-term safety, and regulatory approval. Future directions emphasize hybrid delivery systems, digital health integration, and personalized formulations. Realizing clinically viable oral insulin requires continued multidisciplinary collaboration addressing biological, technological, and translational barriers to transform diabetes care.

Granuloma annulare (GA) is a benign inflammatory dermatosis characterized by dermal granuloma formation. While its etiology is unclear, GA has been linked to systemic comorbidities. Localized GA typically responds to corticosteroids, but generalized GA often follows a more refractory course. Pentoxifylline has emerged as a potential steroid-sparing agent, though data are limited.

A retrospective chart review was conducted on 102 patients diagnosed with GA at a single academic dermatology clinic in rural Appalachia. Demographic data, disease subtype, treatment history, and comorbidities were recorded. Comorbidity prevalence was compared with state and national averages. Statistical analysis assessed associations between disease extent, treatment response, and comorbidity burden.

The cohort was 79% female with a mean age of 46 years; 19% of cases were pediatric. Generalized GA accounted for 46% of cases and showed elevated rates of type 2 diabetes (36%), hypothyroidism (26%), and autoimmune disease (15%). Patients with &ge;3 comorbidities were more likely to have prolonged disease (&gt;2 years). Generalized GA required more treatment attempts (P&lt;0.001) and had higher failure rates than localized disease. Pentoxifylline achieved a 64% response rate in generalized GA, outperforming hydroxychloroquine and topical corticosteroids.

Generalized GA is more treatment-resistant and associated with a greater comorbidity burden. Pentoxifylline demonstrated favorable efficacy and may serve as a first-line systemic agent in refractory cases. Further multi-center studies are needed to validate these findings and guide evidence-based management of GA. &nbsp.

Insulin resistance (IR) is a central pathophysiological feature of type 2 diabetes mellitus (T2DM) and is closely associated with chronic low-grade inflammation. Simple systemic inflammatory markers derived from routine laboratory testing may reflect this inflammatory-metabolic state; however, their clinical relevance in relation to IR remains incompletely defined.

In this retrospective cross-sectional study, 2,177 patients with T2DM and 327 age- and sex-matched healthy controls were included. Insulin resistance was assessed using the homeostasis model assessment index (HOMA-IR), and patients with T2DM were classified as insulin-resistant or non-insulin-resistant based on established criteria. Systemic inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), high-sensitivity C-reactive protein (hs-CRP), and white blood cell count (WBC), were analysed. Associations with IR were examined using correlation analysis and multivariable logistic regression. Receiver operating characteristic (ROC) curve analysis was performed to evaluate discriminative performance.

Levels of NLR, hs-CRP, and WBC were significantly higher in patients with T2DM than in healthy controls and were further elevated in insulin-resistant patients. All three markers were positively correlated with HOMA-IR, with NLR showing the strongest association (r = 0.280, p < 0.001). In multivariable logistic regression analysis, NLR remained independently associated with insulin resistance after adjustment for body mass index, glycated haemoglobin, and triglyceride levels. ROC analysis demonstrated that NLR had the highest area under the curve (AUC = 0.670), indicating modest discriminative ability, with higher sensitivity but lower specificity compared with hs-CRP and WBC.

Systemic inflammatory markers, particularly NLR, are significantly associated with insulin resistance in patients with T2DM. Although the discriminative performance of NLR was modest, its simplicity, low cost, and availability from routine complete blood counts support its potential role as a complementary marker associated with IR rather than a standalone diagnostic tool. Prospective studies are needed to clarify temporal relationships and validate these findings across diverse populations.

Type 2 diabetes mellitus (T2DM) presents a growing health burden globally and in Bangladesh, where control rates remain suboptimal. Fixed-dose combinations (FDCs) integrating agents with complementary mechanisms, such as empagliflozin and linagliptin, may enhance glycemic control, reduce cardiovascular risk factors, and improve adherence. This study aimed to evaluate the real-world effectiveness and safety of empagliflozin-linagliptin FDC over 24 weeks in adult T2DM patients in Bangladesh.

This prospective, multi-center, open-label, real-world observational cohort study was conducted across 10 outpatient centers in routine clinical practice in Bangladesh and enrolled 321 adults with T2DM who were either treatment-naïve or inadequately controlled on oral antidiabetic drugs. Participants received once daily empagliflozin 10 mg or 25 mg, plus linagliptin 5 mg. Clinical visits were conducted at baseline, week 6, week 12, and week 24. Primary endpoints comprised changes in HbA1c and fasting plasma glucose (FPG). Secondary measures included proportions achieving HbA1c <7%, and changes in weight, blood pressure, lipid profile, renal function, and liver enzymes. Safety was assessed via recorded adverse events and treatment discontinuation rates.

At 24 weeks, mean HbA1c decreased significantly from 9.82 ± 1.01% to 6.29 ± 0.76% (mean change: -3.55%, n = 303, p<0.001). FPG dropped from 13.27 ± 2.66 mmol/L to 6.31 ± 0.70 mmol/L (mean change: -6.96 mmol/L, n = 321, p < 0.001), and 225 (74.3%) attained HbA1c <7%. There were significant reductions in mean weight (-7.17 kg), systolic blood pressure (-14.97 mmHg), and diastolic blood pressure (-2.84 mmHg) (n = 321, p < 0.001 for all). Among subsets, total cholesterol, low-density lipoprotein (LDL), triglycerides, serum creatinine, and serum glutamic pyruvic transaminase (SGPT) levels improved, with estimated glomerular filtration rate (eGFR) increasing significantly (p < 0.05). No serious adverse events or study withdrawals occurred; minor adverse events (AEs) included transient hypoglycemia in one participant (<1%), anorexia or nausea in 10 (≤3.1%), urinary tract infections in two (~0.6%), dysuria in two (<1%), and dizziness in two (<1%).

In this real-world observational cohort of Bangladeshi adults with T2DM, treatment with the empagliflozin-linagliptin FDC was associated with improvements in glycemic control, cardiometabolic benefits, and renal improvements over 24 weeks, with a favorable short-term safety profile. These findings indicate that the FDC was associated with significant improvements in this real-world cohort, providing supportive evidence for its utility.