Turku University Hospital (Finnish: Turun yliopistollinen keskussairaala, TYKS, Swedish: Åbo universitetscentralsjukhus, ÅUCS) is a hospital in Turku, Finland.
A subset of individuals experience prolonged neurological and psychiatric symptoms following SARS-CoV-2 infection, a condition referred to as long COVID (LC). Limited evidence implicates ongoing neuroinflammatory processes as a driver of LC. This study investigates neuroinflammation in LC using translocator protein positron emission tomography (TSPO PET). 14 LC, 11 healthy control (HC) and 13 multiple sclerosis (MS) participants were included in the study. They underwent [11C]PK11195 TSPO PET and 3T magnetic resonance imaging (MRI) to evaluate glial activation, white matter (WM) pathology and brain volumetrics. Serum neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) were measured as markers of neuronal and glial damage. LC participants completed neurological examinations and mental health assessments. TSPO availability, measured as distribution volume ratio (DVR), was not elevated in LC compared to HCs but was significantly lower in LC compared to MS (WM DVR 1.03 vs. 1.06; p = 0.007). Individuals imaged within 16 months of SARS-CoV-2 infection showed higher WM DVR compared to those with a longer disease duration (1.05 vs. 1.02; p = 0.04). Moreover, lower quality of life was associated with higher DVRs in the hippocampus, amygdala and thalamus (ρ = − 0.83- − 0.70), and depression and anxiety correlated positively with DVRs in the hippocampus and amygdala (ρ = 0.75–0.97). LC TSPO availability did not differ from HCs in any studied brain area. However, lower WM TSPO availability in individuals with longer LC duration suggests COVID-19-associated neuroinflammation may subside with time, while the association between limbic TSPO availability and LC severity may imply a role for limbic activity in LC symptomology.
In chronic pancreatitis (CP), a symptomatic benign biliary stricture (BBS) evolves as an adverse event in 3–30
AIMS:The role of adult HDL-C in atherosclerotic cardiovascular disease (ASCVD) faces challenges from Mendelian randomizations and drug trials. However, the association between childhood HDL-C and its changes and adult ASCVD remains undefined. This study aimed to determine this association. METHODS AND RESULTS:Participants: Children in the International Childhood Cardiovascular Cohort (i3C) Consortium with childhood HDL-C and adult ASCVD follow-up. Age- and sex-standardized HDL-C z-scores were calculated for childhood (3-19 years), early childhood (3-11 years), and adolescence (12-19 years); low HDL-C defined as <1.03 mmol/L; participants classified as consistently normal, low to normal, normal to low, and consistently low based on HDL-C status at early childhood and adolescence. ASCVD events: Identified using self-reports adjudicated by medical records or death registries. Analysis: Cox proportional hazards models quantified the associations between childhood HDL-C and adult ASCVD. The study included 38 589 participants (49.7% males, mean age in 2016: 46.4 years) with 779 ASCVD and 784 imputed ASCVD events. After adjusting for sex, cohort, age, and HDL-C measurement year, higher HDL-C z-scores in childhood, early childhood, and adolescence were associated with lower adult ASCVD risk [hazard ratio (HR): 0.81-0.82], with the lowest risk at HDL-C > 1.50 mmol/L. Normal to low [HR 1.38, 95% confidence intervaI (CI) 1.04-1.82] and consistently low (HR 1.94, 95% CI 1.45-2.63) childhood HDL-C increased adult ASCVD risk compared to consistently normal HDL-C. Adjusting for body mass index and triglycerides weakened these associations. CONCLUSION:Childhood and adolescent HDL-C were prospectively and inversely associated with adult ASCVD, suggesting that low HDL-C could be a risk marker of adult ASCVD. Future replications, mechanistic studies, and Mendelian randomizations on childhood HDL-C may clarify its causal effects on adult ASCVD. LAY SUMMARY:We examined the association between childhood HDL-C measurement and adult atherosclerotic cardiovascular disease (ASCVD) at follow-up in data from the International Childhood Cardiovascular Cohort (i3C) Consortium.Higher HDL-C levels in childhood were associated with lower risk of a ASCVD event, irrespective of age (early childhood vs. adolescence). The lowest risk was observed at HDL-C concentrations of around and above 1.50 mmol/L (58 mg/dL). A decrease in HDL-C from early childhood to adolescence was associated with an increased risk of adult ASCVD.When additionally adjusted for body mass index z-score, attenuated associations were noted. Adding triglycerides to models attenuated associations towards null.
To present and contextualise the 2025 revision of the European Training Requirements (ETR) for the Specialty of Geriatric Medicine, developed under the auspices of the European Union of Medical Specialists-Geriatric Medicine Section (UEMS-GMS), and to summarise its main innovations in structure, content, and pedagogical approach. The 2025 ETR strengthens the 2020 version by further developing Entrustable Professional Activities (EPAs) to harmonise postgraduate geriatric training across Europe. It updates and expands the content and recommends the knowledge-based European Geriatric Medicine Specialty Exam (EGeMSE) as part of the certification standards. The 2025 ETR reflects the continued evolution of European geriatric medicine education, uniting scientific progress and competency-based pedagogy within a coherent, evidence-informed framework that promotes excellence, mobility, and comparability of specialist training across Europe. It establishes a forward-looking standard designed to remain fit for purpose over the next 5 years. To describe the process, content, and significance of the 2025 revision of the European Training Requirements (ETR) for the Specialty of Geriatric Medicine, developed under the auspices of the European Union of Medical Specialists-Geriatric Medicine Section (UEMS-GMS). The revision aims to update European postgraduate training standards to reflect current scientific, clinical, and educational advances. The revision followed the official UEMS procedure for ETR development and was conducted by the UEMS-GMS ETR Review Committee between September 2024 and October 2025. Building on the 2019 European Postgraduate Curriculum in Geriatric Medicine and the 2020 ETR, the committee incorporated stakeholder feedback, expert consultation, and international endorsement. The final document was reviewed and formally approved by the UEMS-GMS and endorsed by the European Geriatric Medicine Society (EuGMS), the European Academy for Medicine of Ageing (EAMA), the International Association of Gerontology and Geriatrics (IAGG), and the European Interdisciplinary Council on Ageing (EICA). The 2025 ETR retains the established UEMS three-part structure (for trainees, trainers, and training institutions) whilst introducing a modernised, competency-based education framework. The updated syllabus expands and refines theoretical content to reflect the latest scientific, clinical, and pedagogical advances. The revised ETR further elaborates the use of Entrustable Professional Activities (EPAs) as core instruments for assessing competence. Assessment standards now feature an expanded toolkit, incorporating the knowledge-based European Geriatric Medicine Specialty Exam (EGeMSE). The 2025 ETR for Geriatric Medicine represents a further step toward harmonised, competency-based specialist training across Europe and beyond. Reflecting global public health priorities, including the UN Decade of Healthy Ageing (2021–2030), the revision reinforces educational excellence and the delivery of high-quality, integrated, person-centred care for older adults. It also supports the continued development of the specialty of Geriatric Medicine in countries where it is not yet established or remains emerging. LINK to ETR 2025: https://www.uems.eu/european-training-requirements (Geriatric Medicine, 2025/29).
Longitudinal, nationwide register study. To identify independent predictors of clinical outcomes at 12 months for patients undergoing primary anterior cervical discectomy and fusion (ACDF) for degenerative cervical spine disease (DCSD). ACDF is an established surgical treatment for DCSD. Identifying factors that predict successful surgical outcomes can improve patient selection and inform decision-making. This study utilized data from the Finnish National Spine Register (FinSpine), covering all Finnish centers that perform ACDF surgery. Patients undergoing primary ACDF surgery for DCSD between June 2016 and February 2024 without prior cervical spine surgery were included (n=5517). Patients were grouped based on the patient symptom status (“improved” vs. “indifferent or worse”) at 12 months postsurgery. Predictive factors were identified using classification tree analysis followed by binary logistic regression. At 12 months, 76.8% (n=1799) of patients reported symptom improvement, while 23.2% (n=542) reported that symptoms were indifferent or worse. Loss to follow-up for the outcome variable was 57.6% at 12 months. The following factors were associated with better outcomes: shorter preoperative pain duration (≤1 yr, OR=1.95, P<0.001), lower preoperative Neck Disability Index (NDI) scores (≤42, OR=1.37, P=0.012), and nonsmoking (OR=1.37, P=0.030). The initial diagnosis also influenced outcomes: patients treated for herniated disks and nerve root stenosis were more likely to report improvement compared to those with central canal stenosis or myelopathy (P<0.001). Gender, age, BMI, working status, regular use of pain medication, perioperative complications, muscle weakness, levels fused, and use of plate versus stand-alone cage were not independently predictive of outcomes. Shorter preoperative pain duration, lower NDI scores, and nonsmoking status were significant predictors of good outcomes at 12 months after ACDF surgery for DCSD. These findings can help to guide preoperative patient counseling and enhance evidence-based decision-making for treating DCSD.
