Category: Nevin Manimala

Eur J Pediatr. 2026 Aug 1;185(8):633. doi: 10.1007/s00431-026-07295-6.

ABSTRACT

Obesity is a chronic relapsing disease leading to weight-related health risks for disorders such as cardiovascular diseases, type 2 diabetes, osteoarthritis, and depression. Many studies focus on these weight-related health risks. However, research on current self-reported social impacts and health complaints is limited. This study aims to investigate self-reported social impact and health complaints, received care aiming at lifestyle change, and perceived effectiveness of this care, by children with obesity and their parents. Secondarily, differences concerning sex, age, obesity-severity and frequency of received care were studied. Questionnaires were collected from children and adolescents aged 0-18 years visiting Obesity Center CGG. Data were analyzed regarding their social impacts, health complaints, received care, and perceived care effectiveness (0-10 scale). Children were categorized into sex, age, BMI, and care categories. Descriptive statistics were performed using chi-square tests and post hoc analyses to examine differences between categories. 86.8% of the patients self-reported experiencing social impact and 92.3% reported health complaints. Most frequently reported social impacts were difficulty to find fitting clothes (70.1%), problems in mobility and sports (63.7%), and bullying (41.6%); most reported health complaints were abdominal pain (38.8%), headache (34.8%), and musculoskeletal pain (34.1%). The dietician (64.1%) was most frequently reported as received care, and effectiveness scores ranged between 0 and 4 out of 10.

CONCLUSIONS: A substantial percentage of patients experience social impacts and health complaints affecting their well-being and quality of life. Low perceived effectiveness of interventions calls for a more innovative and comprehensive care framework incorporating these children’s needs.

WHAT IS KNOWN: • Children with overweight and obesity face a wide range of adverse health consequences and social challenges. • However, the number and types of health issues experienced by children themselves and studying per range of age, BMI-stage or care trajectory have not been systematically investigated.

WHAT IS NEW: • A high percentage of children experience social impacts (87%) and health complaints (70%) aff ecting their well-being and quality of life, and perceived eff ectiveness of lifestyle interventions is low. The main reported healthcomplaints abdominal pain, headache, musculoskeletal pain and snoring loudly were mostly observed in girls withobesity aged 12-18 years, who received three or more care types. • The study demonstrated that perceived treatment effectiveness by children and parents declined with increasingobesity severity.

PMID:42542436 | DOI:10.1007/s00431-026-07295-6

Int J Gynecol Cancer. 2026 Jul 3:104852. doi: 10.1016/j.ijgc.2026.104852. Online ahead of print.

ABSTRACT

OBJECTIVE: Evidence on the clinical utility of baseline human epididymis protein 4 levels and their kinetics in recurrent ovarian cancer remains limited. This study evaluated longitudinal human epididymis protein 4 dynamics in real-world patients treated with platinum-based chemotherapy, aiming to determine the prognostic significance of human epididymis protein 4 kinetic parameters compared with CA125 response and established prognostic factors for progression-free and overall survival.

METHODS: This retrospective analysis included 220 patients with recurrent epithelial ovarian cancer treated with second-line platinum-based chemotherapy between 2000 and 2020. Four mathematical models were tested to describe human epididymis protein 4 kinetics, with model selection based on goodness of fit, visual predictive checks, and prognostic performance. The prognostic value of the most informative human epididymis protein 4 kinetic parameter (the modeled residual human epididymis protein 4 level), was assessed in univariable and multi-variable analyses.

RESULTS: Among the 93 assessable patients, no clear associations were observed between baseline human epididymis protein 4 levels and disease characteristics. Longitudinal human epididymis protein 4 kinetics differed from those of CA125 and showed an initial decline followed by a plateau at approximately 40 days. The best-fitting model was a mono-exponential decline incorporating the modeled residual human epididymis protein 4 parameter, which was subsequently evaluated as a prognostic factor. Baseline human epididymis protein 4 levels lacked prognostic significance for progression-free or overall survival. In contrast, a higher modeled residual human epididymis protein 4 level was significantly associated with shorter progression-free and overall survival in univariable analyses (residual human epididymis protein 4 ≥median vs <median; median progression-free survival: 7.2 vs 12.6 months, p =.002; median overall survival: 16.5 vs 34.9 months; p =.001) and in multi-variable models (overall survival: hazard ratio 2.65; 95% confidence interval 1.23 to 5.71, p =.012) alongside CA125 response.

CONCLUSIONS: In this study, we identified residual HE4 levels in patients treated with second-line platinum-based chemotherapy as an independent dynamic marker of overall survival, with higher levels indicating poorer outcomes and potential chemoresistance.

PMID:42542430 | DOI:10.1016/j.ijgc.2026.104852

Dent Mater. 2026 Aug 1:S0109-5641(26)00397-0. doi: 10.1016/j.dental.2026.07.024. Online ahead of print.

ABSTRACT

OBJECTIVES: To develop remineralizing dental composites incorporating prepolymerized TMPTMA-HEMA particles charged with CaF₂ (THCaF₂).

METHODS: Blends of TMPTMA-HEMA (50/50 wt%), charged with CaF₂ (5, 10, and 15 wt%), were heat-polymerized and crushed to a micrometric scale (THCaF₂). Four dental composites were produced using the same organic matrix (30 wt%) of Bis-GMA/TEGDMA (70/30 wt%). The control composite (C) contained 70 wt% barium borosilicate (BaBSi) fillers, whereas, in CaF5, CaF10, and CaF15, BaBSi fillers were partially replaced by 20 wt% of THCaF₂ particles. The remineralizing potential was evaluated through F⁻ release and the remineralization of caries-like enamel lesions induced by S. mutans biofilm using micro-CT. Physicomechanical properties included degree of conversion (DC%), flexural strength (FS), flexural modulus (FM), water sorption (Wsp), and water solubility (Wsl). Data were analyzed using one-way ANOVA and Tukey’s HSD test (α = 0.05).

RESULTS: All composites containing THCaF₂ released F⁻ ions, whereas only CaF10 and CaF15 induced enamel remineralization. The DC% did not differ among the dental composites (p > 0.05). C showed the highest FS and FM (p < 0.05), whereas the FS and FM of the other composites did not differ from one another (p > 0.05). The lowest Wsp was observed for C (p < 0.05), followed by CaF5, CaF10, and CaF15, which did not differ statistically from one another (p > 0.05). No statistical difference in Wsl was found among the dental composites (p > 0.05).

SIGNIFICANCE: The incorporation of prepolymerized particles charged with CaF₂ (THCaF₂) conferred remineralizing potential to experimental dental composites and represents a promising strategy for developing dental composites capable of preventing enamel demineralization caused by the caries process.

PMID:42542396 | DOI:10.1016/j.dental.2026.07.024

J Rheumatol. 2026 Aug 1:jrheum.2026-0072. doi: 10.3899/jrheum.2026-0072. Online ahead of print.

ABSTRACT

OBJECTIVE: Adverse changes in body composition are increasingly being recognized in Rheumatoid Arthritis (RA) patients. This study aims to explore the relationship between RA’s disease activity, disease impact, and functional disability with bioelectrical phase angle (PhA) and appendicular skeletal muscle mass index (ASMI).

METHODS: RA patients were recruited at a tertiary hospital in Portugal. Disease Activity Score in 28 Joints calculated with erythrocyte sedimentation rate (DAS28-ESR) and CReactive Protein (DAS28-CRP) were used to assess disease activity. The impact of disease and functional status were evaluated using the Rheumatoid Arthritis Impact of Disease (RAID) questionnaire and the Health Assessment Questionnaire (HAQ), respectively. Body composition was measured by bioelectrical impedance analysis (BIA). PhA was stratified into tertiles, and ASMI was classified according to the EWGSOP2 criteria.

RESULTS: 104 patients with RA were included (74.0% female, 60.9 ± 9.6 years old). RAID scores were significantly lower in patients in the highest PhA group (PhA-T3) compared with patients with lower PhA tertiles (PhA-T2 and PhA-T1: p<0.001). HAQ scores were also significantly lower in patients in the highest PhA group (PhA-T3) than in patients in the lower PhA tertiles (PhA-T2: p=0.033; PhA-T1: p<0.001). Median DAS28-ESR and DAS28-CRP were lower among patients with higher PhA, but the difference did not reach statistical significance (p=0.069 and p=0.159). No differences were found between the groups of ASMI for DAS28-ESR (p=0.625), DAS28-CRP (p=0.970), RAID (p=0.300), and HAQ (p=0.514) scores.

CONCLUSION: A lower PhA was associated with increased disease impact and more significant functional disability in RA patients.

PMID:42542378 | DOI:10.3899/jrheum.2026-0072

Soins Gerontol. 2026 Jul-Aug;31(180):36-38. doi: 10.1016/j.sger.2026.06.009. Epub 2026 Jul 20.

ABSTRACT

In Réunion, people aged 75 and older visit hospital emergency rooms more often than their demographic weight would suggest. This finding, based on recent data from the Directorate for Research, Studies, Evaluation, and Statistics (Drees) and viewed within the local context, highlights several organizational weaknesses. The analysis underscores the importance of strengthening preventive care, developing community-based solutions, and improving coordination among healthcare providers to benefit the region’s elderly population.

PMID:42542359 | DOI:10.1016/j.sger.2026.06.009

Soins Gerontol. 2026 Jul-Aug;31(180):10-14. doi: 10.1016/j.sger.2026.06.003. Epub 2026 Jul 20.

ABSTRACT

Residents of long-term care facilities for the elderly have complex medical needs. They are at particularly high risk of being admitted to the emergency room. However, some of these admissions could be prevented. Establishing a clear definition of what constitutes an avoidable admission for this population-and identifying the reasons behind it-allows us to focus our efforts on opportunities for improvement in the five areas listed below.

PMID:42542353 | DOI:10.1016/j.sger.2026.06.003

Enferm Infecc Microbiol Clin (Engl Ed). 2026 Aug-Sep;44(7):503215. doi: 10.1016/j.eimce.2026.503215.

ABSTRACT

INTRODUCTION: Quantitative hepatitis B surface antigen (qHBsAg) is increasingly recognized as a key biomarker for chronic hepatitis B (CHB) management. This study aimed to assess the adoption, practices, and barriers to qHBsAg testing in Spanish clinical microbiology laboratories.

METHODS: A cross-sectional survey was distributed through the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) Viral Hepatitis Study Group (GEHEP). Clinical microbiology laboratory professionals across Spain were invited to complete an anonymous online questionnaire. The survey collected information on qHBsAg implementation, technical practices, barriers, and patient-related data. Descriptive statistics were applied.

RESULTS: Of 118 laboratories invited, 91 responded (77.1%); only 37.4% performed qHBsAg. Among non-performing centers, 86% did not refer samples, mainly due to perceived low clinical demand (57.1%), plus lack of equipment/resources. Implementation correlated with hospital size (p=0.041): 0% (<200 beds), 23.3% (200-500), 44.9% (500-1000), 62.5% (≥1000). Among performing labs, 57.6% quantified after a positive qualitative test, 27.3% on request, and 15.2% as initial screening. Proactive reporting was 69.7%, and 81.8% diluted samples above limits. In the last year, 40.7% of results were <100IU/mL and 27.1% >3000IU/mL; over five years (≈14,500 tests), 29.5% >3000IU/mL and 27.3% <100IU/mL, supporting the clinical relevance of these thresholds.

CONCLUSIONS: qHBsAg testing is not uniformly implemented across Spanish clinical microbiology laboratories and workflows and reporting practices are heterogeneous. Given the descriptive design and potential selection bias, these results should be interpreted as a baseline assessment to inform harmonization efforts and future evaluations linking testing availability to clinical decision-making.

PMID:42542350 | DOI:10.1016/j.eimce.2026.503215

Aerosp Med Hum Perform. 2026 Aug;97(8):618-626. doi: 10.3357/AMHP.6799.2026.

ABSTRACT

INTRODUCTION: The objective of this study was to establish a quantitative relationship between the occurrence of certain auditory impairments in Chinese military pilots and their flight hours. The investigation will determine whether the prevalence of left-ear vulnerability necessitates the implementation of cockpit noise control measures.

METHODS: Cross-sectional pure-tone audiometry (0.125-8 kHz) was performed in 155 active-duty aviators with an average time of 2241 h in 2024. Hearing loss (HL) was defined as pure tone average (4, 6, 8 kHz) ≥25 dB. Asymmetry was tested with paired t-tests.

RESULTS: Prevalence of high-frequency HL rate was 14.2% unilateral and 12.9% bilateral. Aircraft type correlated with threshold differences at 0.125, 2, and 6 kHz in the left ear and at 8 kHz in the right ear. Flight hours showed strong associations with elevated thresholds at 4, 6, and 8 kHz in both ears. A two-way analysis of variance indicated no significant interaction between flight hours and aircraft type on hearing thresholds. An asymmetry existed between the two ears, with left-ear thresholds exceeding the right by 2.9 ± 0.73 dB at 0.25-4 kHz.

DISCUSSION: This study found that age and flight time were statistically significant risk factors for noise-induced HL in military pilots. Early detection strategies are of critical importance for hearing protection. The consistent inferiority of the left ear indicates the necessity of optimizing active noise reduction for the left helmet cup. Hao M, Zheng X, Chen D, Ma X, Yu W, Liu L, Bai Y. A cross-sectional audiometric analysis of noise-induced hearing loss in military aviators. Aerosp Med Hum Perform. 2026; 97(8):618-626.

PMID:42542331 | DOI:10.3357/AMHP.6799.2026

Neurotrauma Rep. 2026 Jul 10;7:2689288X261463039. doi: 10.1177/2689288X261463039. eCollection 2026 Jan-Dec.

ABSTRACT

Females of reproductive age with concussion often report greater symptom severity and duration than age-matched males; the mechanisms underlying female symptomology remain unclear. This study investigated the association between hormone profiles and time to return to learn/work (RTL/W) following concussion. A secondary aim was to explore differences in symptom severity and salivary miR-27a-5p/miR-30a-3p expression between hormone profile groups. Based on an a priori power calculation, 36 females aged 28.8 ± 7.5 (17-44 years) presenting to an emergency department within 72 h of a confirmed concussion were recruited. Participants were classified into three hormone profile groups: n = 20 natural menstrual cycle (NMC); n = 8 progestin-only hormonal contraception (PROG); and n = 8 oral contraception (Oral Contraceptive Pill; OCP). Saliva samples were collected for measurement of miR-27a-5p/miR-30a-3p, and participants completed weekly online surveys reporting symptom scores until achieving RTL/W. The mean initial symptom score was 47.0 ± 23.7 (8-100), and mean time to RTL/W was 27.3 ± 33.1 (2-179 days). Cox hazard regression revealed a statistically significant association of hormone profile with time to RTL/W. PROG (hazard ratio [HR]: 2.5, 95% confidence interval [CI]: 1.0-6.1, p = 0.048) and OCP (HR: 2.7, 95% CI: 1.1-6.4, p = 0.027) were significantly associated with increased likelihood of RTL/W compared with NMC. Initial symptom score was not significantly associated with time to RTL/W (p = 0.628). Exploratory analysis showed no statistically significant mean differences between groups for initial symptom score [F_{(2, 33)} = 1.755, p = 0.189]. Fourteen saliva samples provided complete miR-27a-5p/miR-30a-3p data; mean miR-27a-5p/miR-30a-3p was 0.84 ± 0.06 (0.75-0.92). No statistically significant mean differences in miR-27/miR-30 expression were observed between hormone profile groups (F 2, 11 = 0.519, p = 0.609). Females using PROG or OCP were between 1.0 and 6.7 times more likely to achieve RTL/W than NMC at any given time. Hormone profile, but not initial symptom score, was predictive of time to RTL/W. Salivary miR-27a-5p/miR-30a-3p may be a useful biomarker in females with concussion and warrants further research.

PMID:42539337 | PMC:PMC13422596 | DOI:10.1177/2689288X261463039

Womens Health Rep (New Rochelle). 2026 Jul 1;7:26884844261465278. doi: 10.1177/26884844261465278. eCollection 2026 Jan-Dec.

ABSTRACT

BACKGROUND: Although atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in men and women, there are sex differences in its prevalence and burden. There is limited time to address preventive counseling during in-person office visits. We propose an innovative health care delivery strategy with telehealth group counseling to improve care for women with ASCVD.

METHODS: After institutional review board approval, physicians screened our cardiology practice, and eligible patients were contacted. Women of ≥18 years of age were included, and 13 consented. Group counseling was performed via Zoom in one to five sessions over 12 weeks. Each 60-minute session discussed a secondary prevention topic. Surveys were administered before and after each session. Effectiveness was assessed using unpaired t-tests and qualitative feedback.

RESULTS: The average participant age was 64.5 years. 69.2% of patients were White, while 30.8% were non-White. Hypertension and hyperlipidemia were present in 53.8% and 100% of participants, respectively. 53.8% had Medicare, 7.7% had Medicaid, and 38.5% had commercial insurance. Sessions averaged 7 participants per session, with an average attendance of 2.7 sessions per person. Pre- and postintervention comparisons showed improvement in ease of receiving answers to questions, feeling rushed, and understanding of cardiac problems, though results did not reach statistical significance. Feedback noted satisfaction with format, quality of information, and accessible communication of topics.

CONCLUSION: Telemedicine group health counseling enhanced patient understanding of cardiac problems. However, significance was limited by size. Telemedicine provides an opportunity to optimize preventive care, highlighting the need for larger studies and correlation with clinical outcomes.

PMID:42539330 | PMC:PMC13421926 | DOI:10.1177/26884844261465278