Search Results (860)

Reliable preimplantation embryo sexing is relevant in cattle breeding; however, PCR-based Y-marker detection may be sensitive to limited DNA input and sample-type-specific properties of embryo-derived material. In this observational study, we examined assay-output patterns in a low-input multiplex PCR workflow targeting a male-specific Y-chromosome marker (MSY) together with an autosomal internal control targeting cyclin-dependent kinase 1 (CDK1). A total of 141 bovine embryo-derived samples were analyzed across three sample categories: whole embryos, cleavage-stage blastomere biopsies, and blastocyst-stage trophectoderm biopsies. Assay evaluability differed across sample categories, being highest in blastocyst-stage biopsy samples (90.6%, 29/32), intermediate in whole embryos (82.9%, 58/70), and lowest in blastomere-biopsy samples (64.1%, 25/39). Among technically evaluable CDK1-positive samples, apparent MSY-positive classification also differed across categories, with rates of 55.2% (32/58) in whole embryos, 52.0% (13/25) in blastomere-biopsy samples, and 6.9% (2/29) in blastocyst-stage biopsy samples. In a same-lysate repeat-amplification subset, overall evaluability concordance was 92.5% and overall apparent MSY-based classification concordance was 88.2%, although subgroup sizes were limited. Because no independent reference method for true embryo sex was available and sample category was structurally confounded with developmental stage, semen type, sire, and partly PCR-date structure, the findings should be interpreted as assay-output observations rather than measures of biological sex ratio or diagnostic sexing accuracy. Overall, embryo-derived sample categories showed differing assay evaluability and apparent MSY-classification patterns within this low-input PCR setting, supporting the need for sample-type-specific validation when low-cell embryo-derived samples are used. Full article

Background/Objectives: To characterize the zero-shot diagnostic behavior of three commercial multimodal large language models (MLLMs) on cardiopulmonary chest radiograph findings and to assess sex-stratified performance differences. Methods: GPT-5.4, Claude Opus 4.5, and Gemini 2.5 Pro were evaluated in 4500 pathology-specific radiograph evaluations based on frontal chest radiographs from the publicly available CheXpert dataset. Three balanced cohorts of 1500 images each were constructed for cardiomegaly, pulmonary edema, and pleural effusion (375 per sex-by-label subgroup). All models received identical zero-shot prompts requesting binary classification. The primary outcome was area under the receiver operating characteristic curve (AUC-ROC) with 95% bootstrap confidence intervals. Secondary outcomes were sensitivity and specificity. Results: A total of 4500 pathology-specific radiograph evaluations were performed across the three cohorts (2250 male and 2250 female cohort entries; mean age 58.4 ± 18.0 years). GPT-5.4 achieved the highest discrimination (AUC-ROC 0.836–0.883) but showed very low sensitivity (0.043–0.424) with near-perfect specificity (0.977–0.997). Claude Opus 4.5 showed moderate discrimination (AUC-ROC 0.698–0.761) with balanced sensitivity (0.396–0.876) and specificity (0.461–0.863). Gemini 2.5 Pro showed moderate discrimination (AUC-ROC 0.745–0.770) but favored sensitivity (0.673–0.973) at the expense of specificity (0.241–0.804). Sex-stratified analyses showed consistently higher AUC point estimates in male patients for cardiomegaly and pulmonary edema, but smaller and less directional differences for pleural effusion. Conclusions: Commercial MLLMs differ considerably in operating profiles, ranging from ultraconservative to aggressive detection, so that strong aggregate discrimination can mask sensitivity too low for reliable detection. None of the evaluated models are currently suitable for autonomous chest radiograph interpretation. Sex-stratified differences were modest but non-uniform, supporting subgroup-aware reporting rather than reliance on pooled metrics alone. Full article

Background/Objectives: This study aimed to apply morphometric and multivariate analytical techniques to footprint evidence for forensic identity determination, focusing on sex estimation and the reconstruction of body proportions as components of the biological profile. By integrating detailed footprint metrics with body measurements, the research sought to develop discriminant and regression models to evaluate the predictive value of footprint metrics for sex estimation and selected somatic dimensions. Methods: Static bilateral footprints were obtained using charcoal powder impressions and digitized using ImageJ. Eleven footprint parameters (F1–F11) and eleven body measurements (B1–B11) were recorded. Sex-based differences were examined using appropriate parametric or non-parametric tests with effect sizes. Sex estimation was evaluated using discriminant function analysis and internally validated using leave-one-out and stratified 10-fold cross-validation. Regression models for stature and body dimension estimation were assessed with multicollinearity diagnostics and repeated 10-fold cross-validation, including RMSE, MAE, and cross-validated R². Results: The apparent discriminant classification accuracies were 74.0% for the right foot and 71.0% for the left foot. After internal validation, classification performance decreased to approximately 64–67%, indicating moderate discriminative ability. Reduced regression models showed the most stable validated performance for stature and arm span, although cross-validated R² values remained weak. Conclusions: Static footprint morphometry may provide supportive information for sex estimation and selected somatic dimensions in this Turkish adult sample. However, the validated performance indicates that these models should be interpreted as ancillary and exploratory tools rather than standalone forensic identification methods. Full article

Background and Objectives: Eustachian tube (ET) dysfunction links adenoidal disease to persistent middle ear dysfunction in children, yet the independent contribution of ET orifice obstruction grade to audiological outcomes and health-related quality of life remains unquantified after adjustment for anatomical and inflammatory confounders. Because conventional anatomical grading (e.g., the Cassano classification) does not directly characterize the degree of ET orifice compromise, it may underestimate the functional threat to middle ear ventilation; this study is the first to quantify the independent predictive value of endoscopic ET obstruction grade. This study aimed to evaluate ET obstruction grade as an independent determinant of hearing thresholds, middle ear pressure, and quality-of-life impairment in children with chronic adenoiditis and otitis media with effusion. Materials and Methods: A retrospective cohort of 236 children (aged 3–12 years) was analyzed. ET orifice obstruction was graded endoscopically as none, partial, or complete. Primary outcomes included pure tone average (PTA), middle ear pressure (MEP), and OSA-18 total score. Multivariate linear and logistic regression models were fitted, adjusting for age, sex, Cassano grade, neutrophil-to-lymphocyte ratio (NLR), allergic status, and acute otitis media frequency. The modifying role of mucosal appearance (edematous versus fibrotic/remodeling) on quality-of-life outcomes was also assessed. Results: ET obstruction was absent in 42 (17.8%), partial in 114 (48.3%), and complete in 80 (33.9%) children. PTA increased progressively across groups (22.2 ± 5.5 to 36.2 ± 6.7 dB; p < 0.001), as did OSA-18 scores (44.9 ± 7.9 to 80.4 ± 10.3; p < 0.001). In adjusted analysis, each obstruction increment independently predicted a 5.57 dB PTA increase (95% CI 4.37–6.77; p < 0.001), a 14.89-point OSA-18 increase (95% CI 12.87–16.92; p < 0.001), and 5.12-fold higher odds of PTA > 30 dB (95% CI 2.84–9.24; p < 0.001). Persistent middle ear dysfunction at six months occurred in 7.1%, 26.3%, and 61.3% across obstruction grades. Among children with complete obstruction, fibrotic mucosa was associated with higher OSA-18 scores than edematous mucosa (82.3 vs. 76.8; p = 0.02). Conclusions: ET obstruction grade independently determines audiological and quality-of-life outcomes in pediatric chronic adenoiditis. Mucosal remodeling further amplifies quality-of-life burden in complete obstruction. These findings support routine ET endoscopic grading in pediatric otorhinolaryngology risk stratification. Full article

Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) is associated with adverse outcomes in sepsis, but risk stratification within MASLD remains insufficiently defined. We investigated whether an admission liver–metabolic phenotype framework combining cardiometabolic burden with liver injury/fibroinflammatory risk markers identifies clinically relevant organ-support vulnerability in community-acquired sepsis. Methods: This secondary analysis of the prospective SepsisFAT cohort (378 adults with community-acquired sepsis) classified patients into four phenotypes by cardiometabolic burden (≥2 of: diabetes, hypertension, dyslipidemia, BMI ≥ 30 kg/m²) and liver-risk positivity (FIB-4 ≥ 2.67, APRI ≥ 1.0, liver stiffness ≥ 10 kPa, or FAST ≥ 0.55). The primary outcome was acute kidney injury (AKI), while continuous renal replacement therapy (CRRT), other organ-support outcomes and in-hospital mortality were secondary endpoints. Results: Phenotype distribution was Low-risk 137 (36.2%), Cardiometabolic-only 84 (22.2%), Liver-dominant 88 (23.3%), and Mixed liver–cardiometabolic 69 (18.3%). AKI and CRRT increased across phenotypes (13.9% to 40.6% and 5.1% to 26.1%, respectively), and in-hospital mortality was highest in the Mixed phenotype (26.1%). After Firth-penalized adjustment for age, sex, and admission SOFA, the Mixed phenotype remained independently associated with AKI (aOR 2.82, 95% CI 1.37–5.90) and CRRT (aOR 3.87, 1.50–10.80), confirmed in non-renal SOFA and admission eGFR-adjusted sensitivity analyses. Cardiometabolic burden alone did not confer excess organ-support risk. The same gradient persisted within the MASLD subgroup. Conclusions: Admission liver–metabolic phenotyping identified a renal-vulnerable sepsis subgroup not captured by binary MASLD classification alone. These findings support prospective, multicenter external validation of liver–metabolic phenotyping as a pragmatic approach to renal risk stratification in community-acquired sepsis. Full article

Background: Posterior malleolar fractures are commonly assessed using two-dimensional measurements and morphology-based classification systems. However, ankle fracture morphology is inherently three-dimensional, and the reproducibility of CT-based volumetric segmentation for malleolar fracture fragments has not been sufficiently established. Objectives: This study aimed to evaluate the relationship between lateral and posterior malleolar fragment volumes in homogeneous supination–external rotation (SER)-type trimalleolar ankle fractures and to assess the intraobserver and interobserver reproducibility of a manual CT-based three-dimensional volumetric segmentation workflow. Methods: This retrospective musculoskeletal imaging study included 71 patients with SER-type trimalleolar ankle fractures who underwent preoperative computed tomography (CT). Posterior and lateral malleolar fracture fragments were segmented on thin-slice axial CT images using a standardized manual contour-based slice-by-slice workflow. Fragment volumes were calculated using dedicated volumetric imaging software. The association between lateral and posterior malleolar fragment volumes was assessed using Spearman correlation and multivariable linear regression analyses. Measurement reproducibility was evaluated using intraclass correlation coefficients for absolute agreement [ICC(A,1)] and Bland–Altman analyses. Results: The median lateral and posterior malleolar fragment volumes were 8.63 cm³ (interquartile range [IQR], 7.18–10.71) and 2.64 cm³ (IQR, 1.88–4.24), respectively. A weak but statistically significant positive correlation was observed between lateral and posterior malleolar fragment volumes (Spearman rho = 0.313, p = 0.008). In multivariable linear regression analysis, lateral malleolar fragment volume remained independently associated with posterior malleolar fragment volume after adjustment for age, sex, and body mass index (B = 0.316, standardized β = 0.39, p = 0.002). Intraobserver and interobserver reproducibility were excellent for all volumetric measurements, with ICC(A,1) values ranging from 0.996 to 0.999. Bland–Altman analyses demonstrated low mean bias and narrow limits of agreement across all comparisons. Geometric agreement was also excellent, with Dice similarity coefficient values ranging from 0.93 to 0.96 across intraobserver and interobserver segmentation comparisons. Full article

Background: The styloid process exhibits considerable anatomical variability, and its elongation is frequently identified as an incidental finding on panoramic radiographs. However, limited evidence exists regarding its prevalence and possible association with craniofacial skeletal characteristics in adult orthodontic patients. Therefore, the aim of this study was to evaluate the prevalence, morphological characteristics, mineralisation patterns, and possible association of styloid process elongation with skeletal class and facial pattern in an adult orthodontic population. Methods: A retrospective cross-sectional study was conducted on 340 adult orthodontic patients (130 males and 210 females; mean age: 51.55 ± 6.62 years). Panoramic radiographs were used to assess styloid process elongation, defined as ≥30 mm, as well as its morphology and mineralisation patterns according to the Langlais classification. Lateral cephalograms were analysed to determine skeletal class and facial pattern. Statistical analysis included descriptive and inferential methods, with significance set at p < 0.05. Results: Styloid process elongation was identified in 47.65% of patients. Elongated processes showed significantly greater length and side asymmetry (p = 0.001). The most frequent morphology was normal (Type IV), while complete mineralisation (Type D) predominated. No significant associations were found between elongation and age or sex. Furthermore, no statistically significant relationship was observed between elongation and skeletal class (p = 0.479) or facial pattern (p = 0.531). Only a small proportion of patients reported symptoms according to the available clinical records, with no clear association with styloid process elongation. Conclusions: Styloid process elongation is a common incidental finding in adult orthodontic patients and does not appear to be associated with skeletal class or facial pattern. Its recognition on panoramic radiographs may improve the differential diagnosis of orofacial and cervical symptoms. Full article

Introduction: Previous research has suggested thiazolidinediones (TZDs) may be associated with certain solid tumors. We examined incidence rates over time for patients with solid tumors who received TZD treatment for diabetes. Methods: We identified medication use and diagnosis codes that were aggregated to phecode disease classifications derived from the nationwide Veterans Administration Health Record System from 2000 to 2021. We identified 148,139 patients who had ≥2 diabetes diagnoses and had no previous cancer diagnosis. Among these, 8981 subjects had ≥4 years of TZD exposure. We then identified subjects with ≥2 diagnosis codes for solid tumors including bladder (n = 3987), breast (n = 632), colorectal (n = 5139), esophageal (n = 482), glioma (n = 591), lung (n = 5142), melanoma (n = 1896), pancreatic (n = 726), prostate (n = 11,884), renal (n = 3145), testicular (n = 369), and thyroid (n = 513). We used multivariable Cox proportional hazards regressions to measure associations between TZD use and cancer incidence. TZD use was modeled as a time-varying covariate from the first to last prescription of TZD medication, and analyses were adjusted for age at diabetes diagnosis, self-reported race, self-reported ethnicity, sex, body mass index, and cancer site-specific polygenic risk scores. Results: Long-term (≥4 years) exposure to TZDs was significantly associated with increased risk of developing prostate cancer (HR = 1.24, p < 0.001) and decreased risk of developing lung (HR = 0.58, p < 0.001), bladder (HR = 0.51, p < 0.001), and renal cancer (HR = 0.75, p = 0.003). Conclusions: Decreased risk of developing several solid tumors (lung, bladder, and renal) indicate that TZDs may be strong candidates for drug repurposing strategies to manage these types of cancer. These results warrant replication attempts in external datasets. Full article

Purpose: To determine the prevalence and subtype distribution of accessory navicular (AN) on adult ankle MRI and to evaluate MRI factors associated with AN-related bone marrow edema (BME); bilaterality was explored in patients with available contralateral MRI data. Methods: In this retrospective cross-sectional study, consecutive adult patients (≥18 years) who underwent ankle MRI between January 2022 and January 2025 at a single institution in Van, eastern Türkiye, were identified from the institutional archive. Two blinded readers assessed AN presence, classified subtypes using Coughlin criteria, measured maximal ossicle dimension for types 1–2, and recorded BME on fluid-sensitive sequences. Prevalence with 95% CIs was estimated, and multivariable logistic regression assessed factors associated with BME in patients with types 1–2. Results: Among 1988 unique patients (mean age: 42.2 ± 14.2 years; 42.6% male and 57.4% female), AN prevalence was 24.4% (95% CI: 22.6–26.4%), and type 2 predominated (50.2%). In the subgroup of AN-positive patients with available contralateral MRI data, AN was bilateral in 61 of 69 patients (88.4%). Interobserver agreement was excellent for AN detection and subtype classification (κ = 1.00 and κ = 0.98). Among types 1–2 included in the BME analysis (n = 385), BME occurred in 81 patients (21.0%). In the multivariable model, the adjusted ORs for BME were 4.46 for type 2 morphology, 1.24 per 1 mm increase in maximal dimension, 2.08 for female sex, and 0.71 per 10-year increase in age; concomitant os trigonum was not associated with BME. Conclusions: AN was common on ankle MRI, and type 2 was most strongly associated with BME; however, because this was a retrospective, cross-sectional, symptom-blinded study, causality and clinical correlation could not be established. Clinical Significance: Type 2 AN, particularly with a larger ossicle dimension, should prompt careful evaluation for MRI-detected BME, which should be interpreted as an imaging finding requiring clinical correlation. Full article

This pilot study investigated user-preferred ventilated seat intensity levels under simulated hot vehicle cabin cooling conditions to support adaptive seat ventilation systems. Thirty-three participants were exposed to a transient cooling environment in which cabin temperature decreased from approximately 38 °C to 25 °C following air-conditioning activation. Participants selected preferred seat ventilation intensity levels (Low, Medium, or High) while demographic and environmental variables were evaluated. Results indicated that cabin temperature was the strongest predictor of ventilation intensity preference, followed by elapsed cooling time and relative humidity. Age demonstrated a statistically significant effect, whereas height, body weight, BMI, and sex were not statistically significant predictors. An exploratory multinomial logistic regression model demonstrated preliminary predictive feasibility with a cross-validated classification accuracy of 73.2%. The findings suggest that occupant-preferred ventilation intensity levels may be estimated using demographic and environmental variables under transient vehicle cooling conditions. Full article

Background: Abdominal aortic aneurysm (AAA) remains an important cause of cardiovascular mortality in the United States despite advances in screening, surveillance, and aneurysm repair. Contemporary national analyses evaluating long-term AAA mortality trends across demographic and geographic subgroups remain limited, particularly following the COVID-19 pandemic period. Objective: To evaluate temporal trends in AAA-related mortality among U.S. adults aged ≥ 65 years from 1999 to 2024 and characterize demographic and geographic disparities. Methods: A retrospective population-based study was conducted using the CDC WONDER Multiple Cause of Death database. AAA-related deaths were identified using International Classification of Diseases, Tenth Revision (ICD-10) codes I71.3 and I71.4. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated using the 2000 U.S. standard population. Mortality trends were stratified by sex, age, race/ethnicity, census region, and urbanization status. Joinpoint regression analysis was used to estimate annual percent change (APC) and average annual percent change (AAPC). Results: Between 1999 and 2024, a total of 208,476 AAA-related deaths among U.S. adults aged ≥ 65 years were recorded. Overall AAMR declined significantly from 32.61 per 100,000 population in 1999 to 12.17 per 100,000 population in 2024 (AAPC −3.86%; 95% confidence interval [CI]: −4.43 to −3.30; p < 0.001). Mortality rates remained consistently higher among males, adults aged ≥ 85 years, non-Hispanic White individuals, residents of the Midwest, and non-metropolitan populations. Joinpoint analysis demonstrated sustained declines across most demographic groups. Although several subgroups exhibited a temporary plateau in declining mortality trends during the pandemic era, these trend changes did not reach statistical significance. Following 2021, mortality rates resumed a significant downward trend. Conclusions: AAA-related mortality among U.S. adults aged ≥ 65 years declined substantially between 1999 and 2024; however, important demographic and geographic disparities persist. Continued efforts aimed at risk factor reduction, equitable screening access, and preventive vascular care remain essential to further reduce AAA-related mortality among older adults. Full article

Background/Objectives: Odontogenic infections range from localized abscesses to life-threatening deep neck infections and are a frequent cause of emergency admission. We aimed to identify prognostic factors for postoperative complications after their surgical treatment. Methods: We retrospectively analyzed 194 adults (59.3% male) treated at the Department of Cranio-Maxillofacial Surgery in Cracow between 2020 and 2025. The primary outcome was any postoperative complication, graded by the Clavien–Dindo classification and dichotomized into minor (grade I–II) and major (grade ≥ III). Prolonged hospitalization and prolonged irrigation (>7 days) were secondary outcomes. Pre-specified main factors (advanced age, diffuse phlegmonous spread, diabetes mellitus) and covariates (sex, maxillary location, systemic disease) were tested by uni- and multivariable logistic regression. Results: Comorbidities were present in 69.1%. Complications occurred in 49 patients (25.3%): 19 (9.8%) minor and 30 (15.5%) major, including 12 grade IV intensive-care events and two deaths (grade V). In multivariable analysis, diffuse phlegmonous spread independently predicted any complication (adjusted OR 11.7), major complication (OR 23.4), prolonged hospitalization (OR 5.02) and prolonged irrigation (OR 4.39; all p ≤ 0.004). Advancing age independently predicted major complications (OR 1.03 per year, p = 0.037). Both fatal cases shared phlegmon, maxillary location and diabetes. Conclusions: Diffuse phlegmonous spread was the principal prognostic factor across all adverse outcomes, with advancing age additionally predicting major complications. Because intensive-care admission occurred almost exclusively in phlegmon patients, this association is partly definitional. Early identification of diffuse spread and advanced age may support effective triage. Full article

Background/Objectives: Traffic accidents are a significant public health issue. Pedestrians are considered the most vulnerable victims, showing the highest mortality rates. Thus, mortality rate indicators reflect the effectiveness of policies and safety measures applied to urban mobility. Therefore, the study objective is to identify trends in pedestrian mortality to foster an understanding of the local reality and to propose effective interventions for the safety and mobility of this population. Methods: This ecological time-series study used secondary data from the Unified Health System Information System (DATASUS) on all traffic accident-related deaths in Espírito Santo, Brazil, from 2009 to 2020. Data were classified according to the 10th Revision of the International Classification of Diseases (ICD-10). Variables included sex (male; female), age group (in years: 0 to 80+), and victim type (pedestrian). Mortality rates were logarithmically transformed (base 10), and the Prais–Winsten regression model was employed using STATA 13.0. Results: A total of 1969 traffic accident-related deaths were recorded. Males accounted for 75% of deaths, individuals of mixed race (pardo) represented 57%, and 72% were unmarried. A significant reduction in mortality rates was observed across age groups, especially among individuals aged 0–24 years. Mortality trends remained stationary only among individuals aged 80 years and older. Overall, the mortality rate decreased throughout the study period, from 5.51 to 1.69 deaths per 100,000 inhabitants. Conclusion: Pedestrian mortality rates from traffic accidents in Espírito Santo showed a decreasing trend, particularly among children and young people, while remaining stable among the elderly. Full article

Background: Post-COVID-19 conditions (PCCs) present a significant public health challenge due to a vast array of new or persistent health symptoms across subjects. The complex, multi-systemic nature of PCCs makes these conditions difficult to differentiate from other non-COVID-19 related medical conditions. While the Military Health System Data Repository (MDR) provides a robust supply of population-level encounter data, its high-dimensional structure poses challenges for knowledge discovery and outcome research. Objectives: The primary aim of this study was to identify novel manifestations of PCCs among active-duty service members, and model the probabilistic relationships between PCC-related diagnoses. We propose a machine learning workflow as an effective tool for knowledge discovery to statistically validate candidate PCCs from large datasets. Methods: We conducted a retrospective cohort study using MDR records from July 2018 to June 2023. From an initial pool of 311,367 eligible Active-Duty Tricare beneficiaries, we isolated 101,789 COVID-19 infections and matched them 1:1 with uninfected controls (N = 203,578 total) based on age, sex, and propensity for COVID-19. Encounter data was mapped to 392 clinical categories using the Healthcare Cost and Utilization Project (HCUP) Clinical Classification Software Refined (CCSR). Candidate PCC categories were isolated using a cross-validated lasso regression model optimized with a Tree of Parzen Estimators algorithm. A consensus Bayesian Network structure was fitted to model potential probabilistic dependency structures between identified PCCs and prior COVID-19 diagnosis. Finally, conditional Cox proportional hazards models were used to statistically validate selected novel conditions using larger cohorts drawn from the same initial eligible pool by matching cases 1:2 with controls. Results: Feature selection reduced the diagnosis set by 97.96%, isolating 8 clinical categories from the initial 392. The model confirmed known PCCs, such as respiratory symptoms and malaise, and identified two potentially novel candidate PCCs: tinnitus and personality disorders. Survival analysis validated the selection of tinnitus, showing a significant association with COVID-19 (HR: 1.17, 95% CI: 1.12–1.22). No significant association was found between COVID-19 infection and personality disorders (HR: 1.11, 95% CI: 0.97–1.26). Conclusions: This study demonstrates an effective analytical pathway for addressing the limitations of analyzing complex, high-dimensional healthcare billing data. The methodology successfully generated testable hypotheses, identifying tinnitus as a relevant sequela, and is generalizable to future research involving unknown health outcomes related to prior infection. Full article

Objectives: Hypospadias is one of the most common congenital malformations of the male genitourinary system and is frequently accompanied by other congenital anomalies. Whether patients with associated malformations exhibit distinct endocrine characteristics remains unclear. Methods: A retrospective analysis was performed on 323 hypospadias patients who underwent surgery at Capital Medical University Affiliated Capital Children’s Medical Center between January 2020 and September 2024. Data on surgical age, clinical classification, associated malformations, and sex hormone levels were collected. Propensity score matching was used for between-group comparisons. Results: Associated malformations were present in 68 of 323 patients (21.05%), most commonly involving the urogenital system (75.00%). Cryptorchidism was the most common associated anomaly. The surgical age was significantly later in patients with associated malformations (median 3.34 years) compared to those with isolated hypospadias (2.42 years). Following matching, patients with urogenital-related anomalies had significantly elevated FSH and PRL levels (both p < 0.05) compared with isolated hypospadias, whereas no significant hormonal differences were found in those with non-urogenital anomalies. Conclusions: Children with hypospadias and associated urogenital anomalies exhibited subtle differences in endocrine profiles compared with isolated hypospadias. These findings suggest that hypospadias with urogenital anomalies may represent a clinically distinct subgroup and support the need for further prospective studies and long-term endocrine follow-up. Full article