Tenofovir alafenamide (TAF) exhibits antiviral efficacy comparable to tenofovir disoproxil fumarate (TDF). Nonetheless, concerns persist regarding TAF's impact on the lipid profile and potential atherosclerotic cardiovascular disease (ASCVD) risk. This study evaluated long-term ASCVD risk in patients with chronic hepatitis B (CHB) treated with TAF or TDF using Korean National Health Insurance Service claims data. We retrospectively analyzed treatment-naïve patients with CHB who received TAF or TDF between 2017 and 2022. Cumulative ASCVD incidence was estimated using the Kaplan-Meier method and compared using the log-rank test. Propensity score (PS) matching and Cox regression were used to minimize confounding and identify ASCVD risk factors, respectively. Among 44,714 patients with CHB, 16,120 (36.1%) received TAF, whereas 28,594 (63.9%) received TDF. Over a median follow-up period of 3.0 years, ASCVD occurred in 817 patients (630 TDF-treated and 187 TAF-treated), with an annual incidence of 6.18/1000 patient-years (PYs). TAF was associated with lower ASCVD risk than TDF (4.60 vs. 6.88/1000 PYs; p < 0.001), a trend maintained after PS matching (4.67 vs. 6.67/1000 PYs; hazard ratio 0.70; p < 0.001) among 15,169 matched pairs. Older age, male sex, hypertension, current smoking, and aspartate aminotransferase ≥ 40 U/L were risk factors for ASCVD development. Despite concerns about lipid metabolism, TAF did not increase ASCVD risk compared with TDF, offering reassurance for clinicians selecting antiviral therapies for patients with CHB.

COVID-19 has had a significant impact on the scientific field. The multitude of effects this virus has on different organ systems is a continuously expanding range of study. The purpose of this study is to differentiate between the cardiac effects of the three different waves of COVID identified between March 2020- July 2022 using echocardiographic results and the cardiac biomarkers troponin and B-type natriuretic peptide (BNP). By using this information, we can evaluate cardiac impact from COVID-19, which may lead to effects on overall survival.

Information was gathered through eight acute care facilities as part of a multi-center retrospective observational cohort study of patients hospitalized with confirmed SARS-CoV-2, who experienced a cardiovascular event and received an echocardiogram during admission between March 2020 and July 2022. A total of 222 participants were included and divided into 3 waves based on the highest SARS-CoV-2 strain prevalence at the time in Louisville, KY, USA. This consisted of 56 patients in the Original wave 1 (March-July 2020), 143 during the Delta wave 2 (September 2020-March 2021), and 23 during the Omicron wave 3 (January 2022-July 2022).

There were statistically significant differences in cardiac functions as indicated by echocardiogram and cardiac biomarkers. The Original wave not only showed the highest intensive care unit (ICU) admission rate of 73.2 %, but it also had a notable left ventricular diastolic dysfunction and the highest BNP levels. The Delta wave had the highest troponin value of 3.1 ng/mL. The left atrial volume of patients in the Omicron wave was significantly lower than in the Original and Delta waves. However, the tricuspid annular place systolic excursion for patients in the Omicron wave was significantly higher than the other two waves. In survival time models correlated with echocardiograph parameters, the Original wave showed significant correlations between left ventricular ejection fraction, left ventricular volume, right ventricular diameter, and survival. Delta wave showed significant correlation between ascending aortic size, right ventricular systolic pressure, right atrial pressure, and survival. the Omicron wave displayed significant correlation between peak troponin levels and survival.

COVID-19 variants showed statistically significant impacts on cardiac function and biomarkers. There were significant correaltions between these echocardiographic parameters and biomarkers with survival. These cardiac differences can be used to determine overall severity of disease and provide insight into the level of clinical care indicated in COVID patients.

Frailty is highly prevalent in patients with atrial fibrillation (AF) and is associated with adverse outcomes compared with non-frail individuals. This study aimed to explore whether the effects of ablation versus drug therapy on clinical outcomes and quality of life (QoL) differ according to frailty status in patients with AF.

This is a post hoc analysis of the Catheter Ablation versus Antiarrhythmic Drug Therapy for Atrial Fibrillation (CABANA) trial. The frailty index (FI) was calculated using 30 items, with an FI ≥ 0.21 defined as frailty. The primary endpoint was a composite of death, disabling stroke, serious bleeding, or cardiac arrest. The secondary outcomes included all-cause death and heart failure (HF) hospitalization. QoL was assessed periodically over 60 months using the Mayo AF-Specific Symptom Inventory (MAFSI).

In this study, a total of 2189 and 2070 patients were included in the intention-to-treat (ITT) and per-protocol (PP) populations, respectively. Over a median follow-up of 1440 (IQR, 900-2880) days, 184 patients experienced the primary endpoint, 122 died, and 174 experienced HF hospitalizations. Compared with drug therapy, catheter ablation did not significantly reduce the risk of clinical outcomes, with no significant difference observed across frailty strata. Regarding QoL, patients with AF and frailty in the ablation group experienced significant improvement compared with those in the drug group: a mean difference among all follow-ups of - 1.58 (- 2.11 to - 1.06; P < 0.001) in the MAFSI frequency score and - 1.26 (- 1.69 to - 0.84, P < 0.001) in the MAFSI severity score. However, patients with AF and without frailty in the ablation group showed no significant QoL improvement compared with those in the drug group.

There is no significant difference in the effectiveness of reducing clinical outcomes of catheter ablation according to frailty status in patients with AF compared with drug therapy, while patients with AF and frailty could derive a higher QoL improvements from catheter ablation therapy. These findings highlight the potential role of catheter ablation in improving QoL for patients with AF and frailty.

To assess the outcome of endovascular revascularisation in patients with diabetes presenting with ischaemic foot ulcers.

This prospective observational study was conducted at the foot clinic of a tertiary care diabetes unit from August 2019 to September 2020. The Wound, Ischemia, and foot Infection (WIfI) classification method was used for wound classification. Foot ulcers were classified as ischaemic based on wound features, pedal pulses, ankle-brachial pressure index (ABPI) and arterial doppler ultrasound. Patients with diabetes with ischaemic foot ulcers were evaluated and treated according to the standard protocols. Patients undergoing endovascular revascularisation procedures were followed for 14 months post-procedure for the outcome measurement. The primary outcome of successful endovascular intervention was wound healing, either primarily or with a minor (below the malleoli) amputation.

A total of 95 patients were included (70% males) with a mean age of 61.78±11.03 years and a mean duration of diabetes of 16.99±10.4 years. Almost 85% of patients had foot infections with varying severity. Endovascular revascularisation procedure was successful in 90% of the study population and almost 75% of the patients achieved wound healing. The mean ABPI significantly improved from 0.82±0.78 to 1.00±0.46 (p=0.024). On angiography, it was observed that infrapopliteal vascular involvement, either alone or in combination with infrainguinal vessels, was observed in almost 70% of patients and the majority (85%) of them had a diffuse pattern of atherosclerosis.

The findings of this study demonstrated that successful endovascular revascularisation had a significant impact on wound healing and salvaging limbs in ischaemic diabetic foot ulcers.

The aim of the present study was to examine whether age and sex affected the prevalence and severity of periodontal conditions in patients attending an academic dental clinic.

Electronic health record (EHR) data on the demographic characteristics and periodontal conditions of patients presented for a comprehensive periodontal evaluation were extracted from the institutional dental EHR database. Retrospective analysis of independent associations of age, sex, and other subject characteristics with periodontal conditions was determined using multinomial logistic regression. The null hypothesis stating that age and sex were not associated with the increased prevalence and/or severity of periodontal conditions was tested at a significance level α < 0.05.

A total of 5027 subjects met the inclusion criteria. Clinical gingival health (CGH), gingivitis, and periodontitis were diagnosed in 4.2%, 5.2%, and 55.8% of patients, respectively. Severe periodontitis was diagnosed in 84.6% of the 4302 patients with periodontitis and was significantly associated with each year of age increase (odds ratio [OR] 1.13; 95% confidence interval [CI] 1.11, 1.15) and male sex (OR 2.02; 95% CI 1.30, 3.15). The combined effect of a 15-year age increase and male sex was reflected in the increased odds of severe periodontitis (OR 12.63; 95% CI 9.57, 16.67). The combined effect of older age and male sex is shown by the increased odds of severe periodontitis (OR 12.63; 95% CI 9.57, 16.67). Similar associations were found between age, male sex, and total periodontitis, but not CGH and gingivitis.

Increasing age and male sex significantly correlated with increased odds of total and severe periodontitis.

Periodontitis, or inflammatory gum disease, affects many adults in the United States and worldwide. Various factors, such as smoking and diabetes mellitus, increase the risk of periodontitis and the severity of its symptoms. To determine if periodontitis occurs more commonly and is more severe according to patient age and sex, the study used health records from almost 8,000 patients attending dental clinics at the University of Texas School of Dentistry (Houston, TX) from 2007 to 2020. The results demonstrated that adult patients who were older or males had periodontitis more often than those who were younger or female, respectively. Periodontitis was also more severe in older or male patients. These results show that older adults and males can be considered vulnerable individuals when it comes to diagnosing periodontitis. Therefore, dentists should pay more attention to these patients, and individualized treatment methods need to be considered for providing dental care to the gums of these patients.

Diabetic kidney disease (DKD) is a severe complication of diabetes mellitus and the leading cause of chronic kidney disease worldwide. Among the many drivers of tubular injury, lipid accumulation and inflammation are emerging as major contributors to kidney disease progression, but the molecular link between lipid metabolism and inflammatory signaling remains to be determined.

Kidney biopsies from patients with DKD across pathologic classes were labelled for lipid droplets and analyzed by Nile Red spectroscopy. Digital spatial profiling and single-cell spatial transcriptomics were performed on samples from 14 patients representing different DKD classes. RNA scope and immunofluorescence microscopy were used for data validation and characterization.

Lipid droplets (LD) were increasingly abundant in advanced stages of DKD, primarily accumulating in the proximal tubules. Single-cell spatial transcriptomics identified several genes-DUSP5, AZU1, COL9A1, HSPB1, and IGFBP7-as highly upregulated in DKD. Remarkably, IL32, which encodes a LD-associated cytokine, was highly enriched in injured proximal tubules. Immunofluorescence confirmed IL-32 localization to LDs predominantly within KIM1 positive tubules in moderate to advanced DKD. Furthermore, injured IL-32 expressing tubules were in close proximity to infiltrating neutrophils and macrophages, immune effectors of non-resolving inflammation and kidney disease progression.

IL-32 is a LD-associated cytokine upregulated during tubular injury that represents a potential link between lipid dysregulation, inflammation and progression in human DKD.

The most important factors for a successful colon capsule endoscopy (CCE) study are the quality of bowel preparation and the capsule excretion during battery life. Incomplete conventional colonoscopy is one of the main indications for CCE. The aim of this study was to analyze clinical and demographic factors for incomplete CCE after an incomplete conventional colonoscopy.

A retrospective single-center study was conducted including patients who underwent CCE after an incomplete colonoscopy (IC). Complete CCE was defined as capsule excretion or visualization of hemorrhoidal pedicles within battery time. Demographic (gender and age) and clinical data (obesity, smoking history, diabetes mellitus, hypothyroidism, constipation, depression, psychotropic medication use and history of abdominal or pelvic surgery) were collected.

A total of 197 patients were included (mean age 67 ± 10 years; 71.6% female). Complete CCE was achieved in 133 (67.5%) of cases. Adequate bowel preparation was observed in 145 (73.6%) of cases. The most common causes of incomplete conventional colonoscopy were colonic fixed angulation (56.3%) and irreducible loop (42.1%), with no significant difference in capsule completion between these groups (p = 0.770). Obesity (OR 5.328; 95% CI 1.735-16.369; p = 0.003) and constipation (OR 2.999; 95% CI 1.264-7.114; p = 0.013) were independently associated with incomplete CCE.

Obesity and constipation are risk factors for incomplete CCE. Adjustments or intensification of bowel preparation protocols may improve completion rates in these patients.

Type 2 diabetes mellitus (T2DM) is a global disease threatening human health. Regulating blood glucose homeostasis is a key strategy for the treatment of T2DM. In recent years, animal skin-derived hypoglycemic peptides (ASHP) have been proven to effectively regulate blood glucose homeostasis in T2DM, demonstrating significant application potential. Low-value animal skins are the main by-products of food processing, and sustainable development highlights the importance of their high-value utilization. This review summarizes the recent advances in ASHP preparation. It discusses the structure-activity relationships between ASHP and blood glucose regulatory target enzymes, and analyzes the multi-level regulatory mechanism of ASHP on blood glucose homeostasis in T2DM. Unique Gly-Pro-Y sequence structure of animal skin collagen is the key factor that makes it suitable for preparing highly active ASHP. After high-temperature hot water extraction of collagen from animal skin, combining with physical pretreatment techniques can significantly improve the hydrolysis efficiency of collagen. Selecting appropriate enzymes for specific animal skin is crucial for preparing highly active hypoglycemic peptides. Artificial intelligence prediction combined with peptide sequence structural characterization analysis is a crucial strategy for screening highly active ASHP. Competitive inhibitory type of ASHP with the Gly-Pro-Y sequence structure exhibit potent inhibitory activity against α-glucosidase and dipeptidyl peptidase-IV, thereby demonstrating excellent hypoglycemic activity. ASHP can regulate blood glucose homeostasis in T2DM through multiple pathways, among which improving insulin resistance plays a key role. This review provides prospective insights into the high-value utilization of animal skins and the effective prevention and control of T2DM.

To systematically summarize and evaluate the current evidence regarding sex-based differences in healthcare utilization (HCRU), direct costs, and indirect socioeconomic burden in patients with pituitary adenomas.

A systematic literature search of PubMed, EMBASE, and Web of Science identified studies reporting HCRU and/or cost data with sex-stratified analyses. Studies focusing on drug-specific cost-effectiveness, case reports, and scenario-based models were excluded. Eight studies met the inclusion criteria, including non-functioning pituitary adenoma, prolactinoma, acromegaly, Cushing's disease (CD), and perioperative pituitary tumor cohorts from Europe and the United States. Findings were synthesized narratively due to methodological heterogeneity and the scarcity of sex-specific cost estimates.

Total and surgical costs did not differ between men and women across most settings in Europe. Only one U.S. acromegaly cohort showed lower adjusted annual costs in women, and one Chinese perioperative patient cohort reported lower inpatient charges among women. In contrast, sex-based differences in HCRU were consistent and clinically relevant: women with acromegaly demonstrated longer diagnostic delays, more pre-diagnostic visits, higher specialist engagement, and more treatment modifications. Perioperatively, sex was not a predictor of length of stay or cost, but several cohorts reported higher rates of cerebrospinal fluid leak, arginine-vasopressin deficiency, and late hyponatremia in women. The most pronounced disparity was observed in indirect socioeconomic burden, with women more frequently experiencing reduced work capacity, early retirement, psychosocial distress, and poorer quality-of-life in acromegaly and CD.

Although sex-based differences in overall healthcare costs are limited, women face a disproportionately complex and burdensome care trajectory. Standardized, value-based care pathways may help mitigate these disparities, underscoring the need for prospective, sex-stratified studies.