Mol4l8 PENTOSAN POLYSULFATE SODIUM ASSOCIATED ADENOMATOUS POLYPOSIS (PPSAP): A NOVEL CLINICAL ENTITY?

Gastrointestinal Endoscopy · 2026-05-01

Mol4l8 PENTOSAN POLYSULFATE SODIUM ASSOCIATED ADENOMATOUS POLYPOSIS (PPSAP): A NOVEL CLINICAL ENTITY?

Gastroenterology · 2026-05-01

Evaluating the clinical utility of multimodal large language models for detecting age-related macular degeneration from retinal imaging

Scientific Reports · 2025-09-26 · 3 citations

This single-center retrospective study evaluated the performance of four multimodal large language models (MLLMs) (ChatGPT-4o, Claude 3.5 Sonnet, Google Gemini 1.5 Pro, Perplexity Sonar Large) in detecting and grading the severity of age-related macular degeneration (AMD) from ultrawide field fundus images. Images from 76 patients (136 eyes; mean age 81.1 years; 69.7% female) seen at the University of California San Diego were graded independently for AMD severity by two junior retinal specialists (and an adjudicating senior retina specialist for disagreements) using the Age-Related Eye Disease Study (AREDS) classification. The cohort included 17 (12.5%) eyes with 'No AMD', 18 (13.2%) with 'Early AMD', 50 (36.8%) with 'Intermediate AMD', and 51 (37.5%) with 'Advanced AMD'. Between December 2024 and February 2025, each MLLM was prompted with single images and standardized queries to assess the primary outcomes of accuracy, sensitivity, and specificity in binary disease classification, disease severity grading, open-ended diagnosis, and multiple-choice diagnosis (with distractor diseases). Secondary outcomes included precision, F1 scores, Cohen's kappa, model performance comparisons, and error analysis. ChatGPT-4o demonstrated the highest accuracy for binary disease classification [mean 0.824 (95% confidence interval (CI)): 0.743, 0.875)], followed by Perplexity Sonar Large [mean 0.815 (95% CI: 0.744, 0.879)], both of which were significantly more accurate (P < 0.00033) Than Gemini 1.5 Pro [mean 0.669 (95% CI: 0.581, 0.743)] and Claude 3.5 Sonnet [mean 0.301 (95% CI: 0.221, 0.375)]. For severity grading, Perplexity Sonar Large was most accurate [mean 0.463 (95% CI: 0.368, 0.537)], though differences among models were not statistically significant. ChatGPT-4o led in open-ended and multiple-choice diagnostic tasks. In summary, while MLLMs show promise for automated AMD detection and grading from fundus images, their current reliability is insufficient for clinical application, highlighting the need for further model development and validation.

E-211 Early, same-hospitalization carotid artery stenting of symptomatic carotid web is necessary, effective, and safe for prevention of 6-months stroke recurrence

2025-07-01

Moderate-to-severe atopic dermatitis and systemic corticosteroids are associated with insulin resistance and metabolic syndrome

JAAD International · 2025-10-25 · 2 citations

E-281 Dotter angioplasty using tenzing (tenzingplasty) for intracranial atherosclerotic disease restores cerebral blood flow and improves neurologic outcomes in symptomatic disease

2025-07-01

997 TIL-guided discovery of TCRs targeting epitopes derived from dark antigens and application to cancer immunotherapies

Regular and Young Investigator Award Abstracts · 2025-11-01

Prevalence, multiterritorial vascular distribution, and burden of subclinical atherosclerosis in psoriasis: The EDSAP study

JAAD International · 2025-12-17 · 2 citations

Background: Psoriasis increases atherosclerosis risk due to inflammation. To date, subclinical atherosclerosis (SA) in psoriasis has only been studied in individual vascular territories by imaging. Objective: To conduct a comprehensive evaluation of multiterritorial SA prevalence in psoriasis by imaging and establish its relationships with cardiovascular (CV) risk scores. Methods: A total of 120 patients with moderate-to-severe psoriasis without CV disease from the Early Detection of Subclinical Atherosclerosis in Psoriasis (EDSAP) cohort underwent vascular ultrasound of carotid/femoral arteries and noncontrast/contrast-coronary computed tomography angiography. SA was defined by the presence of any plaque or a coronary artery calcium score ≥1. Results: The median age was 48.04 (8.25) years, 73% were male, and 77% of participants had SA. Femoral arteries were most affected (57.1%), followed by the coronaries (51.3%) and carotid arteries (49.6%). Femoral plaques exhibited the strongest associations with coronary parameters. CV risk scores underestimated SA, as at least 60% low-risk and 90% moderate-risk patients had SA. Limitations: The main limitation is the small sample size. Conclusions: This study provides the first multiterritorial assessment of SA in psoriasis, revealing a high prevalence of early disease. Femoral arteries were most affected, correlating with coronary atherosclerosis. The high SA detection within low-/intermediate-risk individuals suggests recalibrating CV scores for establishing effective preventive measures.

Subclinical atherosclerosis is increased in moderate‐to‐severe atopic dermatitis

Journal of the European Academy of Dermatology and Venereology · 2025-06-27 · 3 citations

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Impact of combined hormonal contraceptives and metformin on metabolic syndrome in women with hyperandrogenic polycystic ovary syndrome and obesity: The COMET-PCOS randomized clinical trial

PLoS Medicine · 2025-12-08 · 2 citations

BACKGROUND: The risk-to-benefit ratio of using combined oral contraceptive pills (COCPs) and/or metformin for comprehensive management of polycystic ovary syndrome (PCOS) in women with obesity is unclear. As there is a lack of robust evidence on the impact of these first-line medications on cardiovascular disease (CVD) risk, we compared the effect of COCPs, metformin or both on prevalence of metabolic syndrome (MetS) in participants with hyperandrogenic PCOS and hypothesized that COCPs would increase prevalence of MetS while metformin would decrease prevalence of MetS. METHODS AND FINDINGS: We conducted a multicenter, double-blind, double-dummy, randomized trial (COMET-PCOS) in participants between ages ≥18 and ≤40 years and body mass index (BMI) ≥25 kg/m2 and ≤ 48 kg/m2 with hyperandrogenic PCOS (defined by the Rotterdam criteria). Participants were randomized 1:1:1 to 24 weeks of low-dose COCPs (20 μg ethinyl estradiol/0.15 mg desogestrol), metforminXR (2,000 mg), or both (Combined). The primary outcome, assessed by intention-to-treat analysis, was the effect of the different treatment groups on the prevalence of MetS at the end of study. The analytical model included site, race, and the presence or absence of MetS at the screening visit as covariates. The secondary outcomes included changes in each component of MetS (TG, HDL-C, BP, WC, and fasting glucose levels) over the study period. Of the 240 participants randomly assigned, 20 out of 79 in the COCP group, 16 out of 81 in the metformin group, and 17 out of 80 in the combined group dropped out of the study. A total of 169 participants (70.4%) completed the trial between January 2018 and June 2023 (mean age: 29.5 years; mean BMI: 35.6 kg/m2; 70% were White and 23% were Black). The overall prevalence of MetS was 31% at baseline and comparable across groups. At the end of the study, the prevalence of MetS was 26.2% (17/65) in the metformin group, 28.6% (17/59) in the Combined group, and 28.8% (17/59) in COCP group with no significant difference in trend of MetS prevalence between groups (adjusted p = 0.26). Waist circumference (mean change (MC) -2.23 cm; 95% CI [-3.98, -0.49]; p = 0.01), BMI (MC -0.49 kg/m2; 95% CI [-0.88, -0.10]; p = 0.01), and android fat mass measured by DXA (MC -167 g; 95% CI [-264, -71[; p < 0.001) decreased in the COCP group over the study period whilst there was no statistically significant changes in these parameters in the metformin only group when compared to baseline.. In the metformin and Combined groups, the majority of participants (>64%) reported diarrhea, while 24.1% in the COCP group reported uterine bleeding. The main methodologic limitation of the study is the potential lack of power to detect differences in secondary outcomes. CONCLUSIONS: In participants with hyperandrogenic PCOS and overweight/obesity, low-dose COCPs effectively managed PCOS symptoms without increasing prevalence of MetS. Our findings challenge the current practice of using metformin alone or with COCPs for lowering cardiometabolic risk. TRIAL REGISTRATION: ClinicalTrials.Gov Identifier: NCT03229057.