Retropharyngeal abscesses (RPAs) are severe deep neck infections that require rapid intervention to prevent life-threatening complications. This study aimed to evaluate the clinical, laboratory, and radiological risk factors that predict the need for intensive care unit (ICU) admission and surgical drainage in adult patients with RPAs.

A retrospective review was conducted on patients treated for RPAs at our center between January 2013 and December 2023. Of the 64 initial cases, 57 adults were included in the final analysis after excluding pediatric patients and incomplete records. We analyzed the impact of demographics, diabetes mellitus (DM) status, admission laboratory markers (C-reactive protein [CRP], white blood cell [WBC] count), and radiological abscess size on the necessity for ICU admission and surgical intervention. Additionally, Receiver Operating Characteristic (ROC) curves were generated to assess the predictive value of these variables for ICU admission.

The cohort's mean age was 37.7 ± 16.7 years, with 9 patients (15.8%) requiring ICU care. Multivariate logistic regression identified DM (OR = 3.61, 95% CI: 1.31-9.92, p = 0.01), admission CRP level (OR = 1.01, 95% CI: 1.00-1.02, p = 0.03), and maximum abscess diameter (OR = 1.09, 95% CI: 1.02-1.18, p = 0.02) as independent predictors of ICU admission. ROC analysis for CRP yielded an area under the curve (AUC) of 0.87; a 200 mg/L cut-off achieved 100% sensitivity and 80.9% specificity. Maximum abscess diameter demonstrated an AUC of 0.81, with a 30 mm cut-off providing 88.9% sensitivity and 71.4% specificity. None of the evaluated parameters significantly correlated with the need for surgical drainage.

Comorbid DM, elevated CRP levels, and larger abscess dimensions independently predict the need for intensive care in adults with RPAs. The strong discriminative capacity of admission CRP and radiological abscess size highlights their critical utility in early clinical risk stratification and guiding targeted treatment strategies.

Gestational Diabetes Mellitus (GDM) is a growing public health concern in Ethiopia. HbA1c is useful for assessing glycemia but is influenced by physiological changes in pregnancy. To our knowledge, no published trimester-specific HbA1c reference intervals exist for Ethiopian non-diabetic pregnant women. This limits population-specific clinical interpretation.

A facility-based cross-sectional study was conducted from February to July 2025 among 424 non-diabetic pregnant women across all trimesters. Normality of HbA1c distribution was assessed using the Shapiro-Wilk and Kolmogorov-Smirnov tests; outliers were identified using Tukey's fences method. Reference intervals were determined parametrically (mean ±2SD). Differences across trimesters were tested using one-way ANOVA. Because Levene's test indicated a violation of the homogeneity of variances (p < 0.001) and group sizes were unequal, pairwise comparisons were performed using the Games-Howell post hoc test. A p-value < 0.05 was considered statistically significant.

HbA1c showed a normal distribution across all trimesters. Reference intervals were 4.8-5.9% in the first, 4.2-5.8% in the second, and 4.5-5.9% in the third trimester. Mean HbA1c levels differed significantly between trimesters (p < 0.05). Lowest in the second trimester 5.00% (95% CI 4.93-5.07) and highest in the first trimester 5.35% (95% CI: 5.31-5.39). Games-Howell post hoc tests confirmed that all pairwise comparisons were significant (p < 0.05).

Trimester-specific HbA1c reference intervals were defined for non-diabetic pregnant women, demonstrating measurable physiological variation across gestation. The use of locally derived thresholds could improve the accuracy of GDM screening and support more appropriate clinical interpretation.

Smoking and lifestyle‑related diseases increase the risk of cancer incidence and progression, but their impact on castration‑resistant prostate cancer (CRPC) remains unclear. This study examined whether diabetes mellitus (DM), hypertension (HT), and smoking habit (SH) affect the prognosis of CRPC patients treated with enzalutamide (ENZ) or abiraterone plus prednisolone (ABI).

Using data from the ENABLE study for PCa, an investigator‑initiated, multicenter, randomized controlled trial, patients were retrospectively categorized into two groups based on SH. Subsequently, the impact of the absence or presence of either DM or HT and treatment arm (ENZ or ABI) on survival endpoints was investigated.

A total of 178 patients were randomized and treated, of whom 161 had available SH information and were included in the analysis (84 SH- and 77 SH+). No significant differences in survival endpoints were observed between the SH- and SH+ groups. In the SH+ group, prostate cancer-specific survival (PCSS) was significantly worse in the with‑DM/HT group than in the no‑DM/HT group (p = 0.0215). Multivariate Cox analysis confirmed that the presence of DM or HT was an independent predictor of poor PCSS. Furthermore, a significant difference in PCSS between the no‑DM/HT and with‑DM/HT groups was observed in the ENZ arm (p = 0.0201), but not in the ABI arm.

SH does not appear to influence the efficacy of ENZ or ABI therapy for CRPC; however, among SH+ patients, the presence of DM or HT was associated with poorer survival outcomes, particularly in those treated with ENZ.

Type 2 diabetes mellitus (T2DM) significantly amplifies the risk and severity of myocardial ischemia-reperfusion (IR) injury, contributing to the disproportionately high cardiovascular mortality observed in diabetic patients. This study investigated the combined cardioprotective effects of sinomenine and liraglutide in a rat model of T2DM with myocardial IR injury and elucidated the underlying molecular mechanisms. Male Sprague Dawley rats were induced to T2DM with a high-fat diet and low-dose streptozotocin. After the induction of diabetes, the rats underwent 30 min of occlusion of the left anterior descending coronary artery, followed by 24 h of reperfusion. Before the IR procedure, diabetic rats were pretreated with sinomenine and/or liraglutide for 7 days. A comprehensive suite of techniques was employed to evaluate various endpoints, including echocardiographic and hemodynamic profiles, infarct size, histopathological alterations, cardiac troponin I (cTn-I) levels, pyroptosis-related proteins (NLRP3 and cleaved caspase-1), mitophagy-related markers (PINK-1 and Parkin), oxidative stress indicators (MDA, SOD, and GPx), and pro-inflammatory cytokines (IL-18 and IL-1β). The combination of sinomenine and liraglutide significantly improved cardiac function, reduced infarct size, attenuated histopathological damage, and decreased serum cTn-I levels (p < 0.05). It also downregulated the expression of pyroptosis-related proteins, upregulated the expression of mitophagy-related proteins, mitigated oxidative stress, and reduced pro-inflammatory cytokine levels (p < 0.05). The cardioprotective effects of the combined therapy were largely abrogated by pretreatment with mitochondrial division inhibitor 1. The combination of sinomenine and liraglutide showed remarkable cardioprotective effects against IR injury in diabetic rats, which were associated with the the attenuation of NLRP3-driven pyroptosis and the enhancement of PINK-1/Parkin-mediated mitophagy, suggesting a mechanistic link warranting further validation.

To investigate the long-term renal effects of tofogliflozin, with the shortest half-life among sodium-glucose cotransporter 2 inhibitors, in real-world clinical practice.

We retrospectively enrolled patients with type 2 diabetes mellitus treated at three affiliated hospitals between January 2015 and May 2024. The primary outcome was the change in estimated glomerular filtration rate from baseline to 72 months. After inverse probability of treatment weighting, linear mixed-effects models were used to compare estimated glomerular filtration rate changes between the tofogliflozin and non-tofogliflozin groups. As a sensitivity analysis, multiple imputation was performed to address missing baseline urinary albumin-to-creatinine ratio data. Secondary outcomes included estimated glomerular filtration rate slopes, changes in glycated hemoglobin and body weight at 72 months, and changes in urinary albumin-to-creatinine ratio at 48 months.

Among 598 participants (tofogliflozin, n = 245; non-tofogliflozin, n = 353), estimated glomerular filtration rate decline was significantly slower in the tofogliflozin group than in the non-tofogliflozin group (P < 0.001). At 72 months, the least squares mean estimated glomerular filtration rate change was -4.51 and -10.64 mL/min/1.73 m², respectively (between-group difference: 6.14 mL/min/1.73 m²). Significant between-group differences were observed in estimated glomerular filtration rate slope, glycated hemoglobin, and body weight, but not in urinary albumin-to-creatinine ratio. Renal findings were consistent in the multiple imputation sensitivity analysis.

Real-world clinical data over 72 months suggested that tofogliflozin may slow estimated glomerular filtration rate decline.

Atherosclerosis is a systemic vascular disease that can affect visceral arteries, including the superior mesenteric artery (SMA), potentially leading to mesenteric ischemia with high morbidity and mortality rates. Despite its clinical importance, SMA involvement remains under-reported. This study aimed to evaluate the prevalence, morphological characteristics, anatomical distribution, and associated risk factors of SMA atherosclerotic plaques using multidetector computed tomography (MDCT).

This retrospective study was conducted using data collected from a University Hospital in Turkey. This study focused on patients referred to the Department of Radiology and examined imaging data obtained between January 2008 and December 2010. Information was gathered by examining MDCT scans, patient reports, laboratory findings, and medical records of 15,000 patients admitted to our University Hospital over a designated period. The anatomical distribution of the aneurysms within the SMA (proximal, middle, distal, or diffuse) was recorded. The presence of concomitant atherosclerosis in other visceral arteries and cardiovascular risk factors, including hypertension (HT), diabetes mellitus (DM), coronary artery disease (CAD), and abnormal lipid profiles, was evaluated. Statistical analysis was performed using SPSS (Version 10.0), and associations were assessed using Pearson's chi-square test, with a significance level set at p < 0.05.

The prevalence of SMA atherosclerosis was 0.86% in the studied population. Clinical data were available for 102 patients in this study. HT, DM, and CAD were present in 73.5%, 49%, and 44.1% of the patients, respectively. Calcified plaques were the most common type (55.8%), followed by mixed (28.7%) and soft plaques (15.5%).Plaques were predominantly located in the proximal (29.4%) and proximal-middle (22.4%) segments of the SMA, followed by the middle (14.7%), middle-distal (14.7%), distal (4.6%), and diffuse segments (13.9%). All patients demonstrated concomitant abdominal aortic atherosclerosis. Atherosclerotic involvement of other visceral arteries was frequently observed in this study. The renal arteries were the most commonly affected, with bilateral involvement in 49.2% of the patients and unilateral calcified plaques in 23.4% of the patients. Celiac trunk atherosclerosis was detected in 41.8% of patients, splenic artery involvement in 12.4%, and inferior mesenteric artery (IMA) involvement in 27.1%, making it the least affected artery. Lipid profile analysis revealed elevated total cholesterol levels in 38% of the patients and low HDL levels in 25% of the patients although no significant correlation was found between lipid levels and plaque characteristics or distribution.

Contrast-enhanced MDCT is a reliable, noninvasive imaging modality for detecting and characterizing SMA atherosclerosis, allowing for an accurate assessment of plaque morphology, distribution, and associated vascular involvement. Although relatively uncommon, SMA atherosclerosis is strongly associated with systemic atherosclerotic disease and major cardiovascular risk factors. Routine evaluation of mesenteric vessels during abdominal CT examinations may facilitate early diagnosis and improve clinical outcomes by enabling timely management of patients at risk for mesenteric ischemia.

To investigate clinical characteristics, comorbidities, seasonal onset, and antihypertensive medication use among acute primary angle-closure (APAC), chronic primary angle-closure glaucoma (CPACG), and primary angle-closure suspect (PACS) patients.

A retrospective cross-sectional study of 484 Chinese patients was conducted. Baseline demographics, hypertension and diabetes prevalence, antihypertensive medication use, and seasonal onset patterns were compared across primary angle-closure disease (PACD) subtypes. Seasonal variation was assessed using the von Mises distribution, with subgroup analyses stratified by systemic conditions and medication use.

CPACG patients were older (median 71 vs 67y in APAC, P<0.001) with higher hypertension (47.74% vs 31.16%, P=0.003) and diabetes prevalence (20.60% vs 10.05%, P=0.014). Multivariate analysis showed hypertension [odds ratio (OR)=1.85] and diabetes (OR=2.00) were significant predictors of CPACG vs APAC. A modest but significant seasonal peak of APAC onset was identified in early June. Subgroup analyses revealed significant shifts in seasonal patterns according to hypertension (P=0.023), diabetes (P<0.001), and calcium channel blocker (CCB) use (P=0.025). Angiotensin-converting enzyme inhibitors (ACEIs) use was absent in APAC patients but present in CPACG and PACS groups; CCB use was highest in APAC patients, though differences were not statistically significant.

Vascular and metabolic comorbidities are more prevalent in CPACG than APAC, suggesting their role in CPACG pathogenesis. The early-summer peak in disease onset points to possible environmental triggers. Seasonal variation in APAC onset appears to be influenced by systemic vascular conditions and antihypertensive medication use, supporting a multifactorial interaction between environmental, systemic, and pharmacologic factors in APAC.

Verrucous porokeratosis (VP) is a rare variant that typically presents as solitary hyperkeratotic plaques on acral sites, and atypical morphology or unusual location is exceptionally uncommon. We report a rare case of VP on the right lower leg with a striking rupioid (oyster-shell-like) morphology in a patient with long-standing diabetes mellitus and a history of rectal cancer resection and the patient received oral isotretinoin combined with topical corticosteroids and microcirculation-targeting agents, which was well tolerated and led to clinical improvement, which expanding the clinicopathological spectrum of porokeratosis.

Preoperative carbohydrate loading has been known to overcome discomfort and complications associated with cesarean section, but there is a scarcity of evidence on its safety and benefits in patients with gestational diabetes mellitus (GDM). In this study, pregnant women with normoglycemia and GDM were recruited and grouped according to their nutritional choice prior to cesarean delivery. Blood samples and clinical data were collected, and maternal comfort scores based on self-reports and neonatal data recorded. Metabolomic profiling was performed to explore underlying metabolic responses. Results showed perioperative carbohydrate loading significantly reduced thirst, hunger, and anxiety compared with fasting controls in both the normal and GDM groups. The two groups showed no significant differences at any time point in terms of glycemic measures, inflammatory markers, or maternal and neonatal outcomes. Metabolomic analysis revealed distinct but partially overlapping alterations in metabolic pathways at 1 h before surgery between the two groups.

Necrotizing fasciitis (NF) is a rapidly progressive, life-threatening infection, with the lower limbs being a common site. Diabetes mellitus (DM) is a significant risk factor that influences the progression, outcome, and management of NF. Despite its clinical relevance, comparative data on diabetic versus non-diabetic NF outcomes remain limited. This study aimed to compare mortality, amputation rates, and other key outcomes between diabetic and non-diabetic patients with NF.

A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Eligible studies assessed outcomes in diabetic and non-diabetic NF patients. Primary outcome measures included amputation rates, mortality, admission length, debridement frequency, and microbial growth. Secondary outcomes included the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score and unplanned reoperations. Pooled analyses were performed using OpenMeta[Analyst] software, reporting odds ratios (OR) and mean differences (MD) with 95% confidence intervals.

Nine studies comprising 1,890 patients met the inclusion criteria. Diabetic patients had significantly higher rates of amputation (OR 3.77, 95% CI 3.04 to 4.68; p < 0.001) and polymicrobial infections (OR 2.53, 95% CI 1.50 to 4.26; p < 0.001). Mortality was higher among diabetic patients after sensitivity analysis (OR 1.60, 95% CI 1.09 to 2.33; p = 0.02). Length of admission did not differ significantly between groups, whereas the pooled number of debridements was marginally higher in diabetic patients (MD 0.28, 95% CI 0.05 to 0.52; p = 0.02), based on only two studies. Diabetic patients had significantly higher LRINEC scores (MD 2.02, 95% CI 1.33 to 2.72; p < 0.001).

Diabetic patients with NF experience worse clinical outcomes, including increased amputation, mortality, and polymicrobial infection. These findings highlight DM as a key prognostic factor and underscore necessity for aggressive intervention and risk stratification. Further high-quality prospective studies are needed.