Nevin Manimala

Pain Res Manag. 2026;2026(1):e5531157. doi: 10.1155/prm/5531157.

ABSTRACT

BACKGROUND: Patient-controlled analgesia (PCA) pumps have emerged as the prevalent modality for managing postoperative pain. Opioids, although widely utilized as analgesic agents in these pumps, are often accompanied by undesirable side effects that can compromise patient comfort and hinder the widespread adoption of PCA therapy.

METHODS: We conducted a retrospective study involving 392 patients undergoing lumbar spine surgery who were prescribed PCA pumps for pain relief. Over the initial 1-3 days postsurgery, comprehensive data encompassing resting and activity-related pain levels, Ramsay sedation scores, activity status, and flatus passage were carefully recorded and analyzed.

RESULTS: Interestingly, patients who received a supplemental dose of nalmefene in their PCA pumps exhibited a notable increase in resting pain intensity on the second postoperative day. However, the incidence of postoperative nausea and vomiting (PONV) was notably reduced (15.5% in the sufentanil + nalmefene group vs 25.5% in the sufentanil group). Notably, no statistically significant variations were discerned between the two groups in Ramsay sedation scores, postoperative activity capabilities, flatus passage, or inflammatory biomarker levels.

CONCLUSION: The integration of nalmefene into PCA pumps presents a promising strategy for mitigating the occurrence of PONV, albeit with the caveat of potentially compromising opioid-mediated analgesia, necessitating further research and exploration. The delicate balance between enhancing patient comfort and preserving effective pain control remains a critical area of investigation in the field of postoperative pain management.

PMID:42179138 | DOI:10.1155/prm/5531157

Mediators Inflamm. 2026;2026(1):e3674573. doi: 10.1155/mi/3674573.

ABSTRACT

BACKGROUND: Despite extensive evidence supporting the American Heart Association (AHA)’s life’s essential 8 (LE8) framework for cardiovascular health (CVH) assessment, the underlying biological mechanisms linking LE8 to mortality outcomes in high-risk populations remain unexplored. This study aimed to investigate the association between LE8 scores and mortality risk among individuals with diabetes, hypertension, and their coexistence, and explored whether inflammation and biological aging statistically mediate these relationships.

METHODS: We conducted a large-scale longitudinal analysis using National Health and Nutrition Examination Survey (NHANES) data (2005-2018), including 4939 individuals with diabetes, 13,298 with hypertension, and 3303 with both conditions. LE8 scores were calculated from eight CVH metrics, with mortality ascertained through the National Death Index (NDI). Mediation analyses examined the roles of inflammation markers (neutrophil-to-lymphocyte ratio [NLR] and pan-immune-inflammation value [PIV]) and phenotypic age acceleration (PhenoAgeAccel).

RESULTS: Higher LE8 scores were significantly associated with reduced all-cause mortality and heart disease mortality across all groups (p < 0.001). Stratified analyses showed stronger associations among younger individuals (≤60 years) and those with higher socioeconomic status. In mediation analyses, inflammatory markers and PhenoAgeAccel statistically explained a meaningful proportion of the LE8-mortality associations, with different patterns across disease groups. For all-cause mortality, in diabetes, NLR and PIV accounted for larger proportions of the association (NLR: 31.6%; PIV: 26.9%), whereas in hypertension, PhenoAgeAccel accounted for a larger proportion (56.3%). Among individuals with both conditions, PhenoAgeAccel (26.1%) and NLR (5.3%) contributed to the association. Similar patterns were observed for heart disease mortality.

CONCLUSION: Higher LE8 scores are associated with reduced mortality risk in individuals with diabetes and/or hypertension, with inflammation and biological aging statistically mediating these associations in an exploratory manner. These findings suggest potential statistical mediators that may inform future mechanistic research and therapeutic targets, but causal interpretation requires further longitudinal studies.

PMID:42179110 | DOI:10.1155/mi/3674573

Public Health Nurs. 2026 May 25. doi: 10.1111/phn.70135. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the Disaster Safe Educational Unit (SPAB), internationally known as the Comprehensive School Safety (CSS) program, in DKI Jakarta, Indonesia focusing on disaster preparedness across different types of educational units.

METHODS: This study employed an evaluative mixed-methods design combining quantitative and qualitative approaches. Quantitative data were analyzed using cross-tabulation and Chi-Square tests in IBM SPSS Statistics version 22. Semi-structured qualitative interviews with experts were conducted to support data triangulation.

SAMPLE: The study included 3672 schools in DKI Jakarta Province, Indonesia surveyed using an online instrument adapted from the National Disaster Management Agency (BNPB) monitoring framework, covering three implementation pillars: disaster-safe facilities, disaster management in schools, and disaster risk reduction education.

RESULTS: The findings indicate that while progress has been made in providing disaster-safe facilities, preparedness in disaster management and disaster risk reduction education remains limited. Notably, preschools were identified as a high-priority risk group due to regulatory exclusions and resource constraints. Key challenges include a lack of teaching materials, limited resources, and insufficient expertise.

CONCLUSION: Although institutional support for the SPAB is high, implementation capacity across schools remains insufficient. This study highlights the need for inclusive regulatory reinforcement, targeted capacity building for early childhood education, and the formal integration of SPAB into school budgeting to ensure resilient learning environments.

PMID:42179070 | DOI:10.1111/phn.70135

Stress Health. 2026 Jun;42(3):e70184. doi: 10.1002/smi.70184.

ABSTRACT

Dermatological conditions are a major contributor to global nonfatal disease burden. Evidence suggests that psychological stress and trauma, including adverse childhood experiences (ACEs), stressful life events (SLEs), and post-traumatic stress disorder (PTSD), may affect the onset and severity of inflammatory and stress-responsive skin diseases, though findings remain fragmented. This systematic review aimed to synthesise evidence on associations between stress- and trauma-related exposures and dermatological conditions across the lifespan, focusing on timing, chronicity, and cumulative stress. The review followed PRISMA 2020 guidelines. Searches were conducted in Scopus, PubMed, and PsycINFO (from January 2000 to November 2025). Eligible studies were peer-reviewed empirical investigations of stress- or trauma-related exposures and dermatological outcomes in children or adults. Risk of bias was assessed using the Newcastle-Ottawa Scale and Joanna Briggs Institute checklists; only low- and moderate-risk studies were included. Thirty studies met inclusion criteria. Stress- and trauma-related exposures were associated with increased risk, earlier onset, or greater severity of conditions, particularly psoriasis, atopic dermatitis, alopecia areata, and chronic urticaria. Associations were strongest for early-life adversity and cumulative stress. Results support an association between trauma-related exposures and dermatological outcomes. Longitudinal studies are needed to clarify temporal relationships and inform psychosocial assessment.

PMID:42179055 | DOI:10.1002/smi.70184

Cancer Control. 2026 Jan-Dec;33:10732748261455722. doi: 10.1177/10732748261455722. Epub 2026 May 25.

ABSTRACT

IntroductionEvidence indicates that being married may influence prognosis in various malignancies; however, whether this association extends to small intestinal stromal tumors (SISTs) remains unclear. To address this gap, we analyzed population-based data to determine the prognostic significance of marital status for SIST patients.MethodsThis population-based, retrospective cohort study leveraged data from the Surveillance, Epidemiology, and End Results (SEER) database for the period 2000 to 2019. We classified patients as either married or unmarried according to their recorded marital status. To minimize bias from confounders, we performed 1:1 propensity score matching (PSM). Survival outcomes, including overall survival (OS) and cancer-specific survival (CSS), were estimated via the Kaplan-Meier method and Cox proportional hazards models.ResultsOur analysis included 3315 SIST patients, of whom 2132 were married and 1183 were unmarried. Compared with unmarried individuals, married patients experienced significantly better OS and CSS (both P<0.05). Multivariable analysis identified marital status as an independent predictor for both endpoints, with adjusted HRs of 1.35 (95% CI: 1.20-1.52) for OS and 1.27 (95% CI: 1.10-1.48) for CSS. Following PSM, the survival advantage for married patients persisted (P<0.05 for both OS and CSS). Notably, the 5-year OS and CSS rates favored the married cohort over the unmarried cohort (75.2% vs. 64.0%, P <0.001; 83.7% vs. 76.1%, P = 0.001, respectively). Subgroup analyses further revealed that the survival benefit associated with marriage was particularly evident among elderly, female, Caucasian, and surgically treated patients.ConclusionsMarital status independently predicts prognosis in small intestinal stromal tumors (SISTs), with married patients exhibiting superior outcomes.

PMID:42179050 | DOI:10.1177/10732748261455722

Behav Sleep Med. 2026 May 25:1-10. doi: 10.1080/15402002.2026.2679677. Online ahead of print.

ABSTRACT

OBJECTIVE: In recent times, Fear of Missing Out (FoMO) has emerged as a significant psychological construct adversely impacting the well-being and emotional health of social media users. Among the many psychological and physiological impacts of FoMO, its relation with sleep is frequently examined, considering its influence on disruption of sleep. This study intended to explore the association between FoMO, Psychological Capital (PsyCap), and sleep quality among college students and to determine whether PsyCap moderates the relationship between FoMO and sleep quality.

METHOD: A total of 110 college students aged between 18 and 25 participated in the study. Standardized self-report measures, including the Fear of Missing Out Scale (FoMOs), Psychological Capital Questionnaire (PCQ-24), and Pittsburgh Sleep Quality Index (PSQI), were employed to assess FoMO, PsyCap, and sleep quality. Descriptive statistics, Pearson correlations, independent sample t-tests, and moderation analysis using the Hayes PROCESS macro (Model 1) were executed.

RESULTS: Findings demonstrated that FoMO was positively correlated with poor sleep quality. PsyCap, on the other hand, was negatively correlated to FoMO and poor sleep quality. Further, it was observed that FoMO significantly correlates with poorer sleep in those students with low PsyCap levels.

CONCLUSION: PsyCap appears to play a moderating role against the effects of FoMO on sleep. The study highlights the need to conduct PsyCap-based interventions for enhancing the sleep quality and overall well-being among young adults.

PMID:42179046 | DOI:10.1080/15402002.2026.2679677

Int J Urol. 2026 May;33(5):e70527. doi: 10.1111/iju.70527.

ABSTRACT

OBJECTIVES: Desmopressin is an established treatment for nocturia due to nocturnal polyuria. In Japan, low-dose formulations (25 and 50 μg) were approved only for men in 2019. However, age- and dose-specific prescribing patterns in real-world practice remain unclear. Using nationwide aggregated claims data, we analyzed age-stratified prescribing trends and dose selection patterns.

METHODS: Publicly available NDB Open Data (fiscal years 2020-2023) were used. Outpatient prescriptions for desmopressin orally disintegrating tablets (25 and 50 μg) were extracted by sex and 5-year age categories. Population-adjusted prescription rates per 1000 persons and 95% confidence intervals (CIs) were calculated. Temporal trends were evaluated using Poisson regression models with log-population offset.

RESULTS: In men, the population-adjusted prescription rate increased from 21.5 per 1000 persons in 2020 to 84.6 in 2023 (p for trend < 0.001). More than 90% of prescriptions were issued to individuals aged ≥ 65 years. Overall, use of the 25 and 50 μg formulations was balanced; however, the proportion of the 25 μg formulation increased with advancing age, and the 25 μg/50 μg ratio reached 1.37 among those aged ≥ 90 years. Prescriptions in women also increased, with predominance of the 25 μg formulation.

CONCLUSIONS: Desmopressin prescribing has increased nationwide in Japan, particularly among older men. Increased selection of the lower-dose formulation in older patients may reflect safety considerations. Off-label use in women is increasing, indicating the need for further safety evaluation and appropriate prescribing guidelines.

PMID:42179007 | DOI:10.1111/iju.70527

Orbit. 2026 May 25:1-8. doi: 10.1080/01676830.2026.2651956. Online ahead of print.

ABSTRACT

PURPOSE: To describe large-scale epidemiological patterns of chalazia and assess treatment outcomes.

METHODS: We conducted a retrospective cohort study using the Clalit Health Services electronic medical record database, analyzing demographic data, medical history, treatments, procedures, and outcomes between January 2003 and December 2022.

RESULTS: A total of 611,993 chalazion diagnoses were recorded in 412,365 patients. Invasive procedures were required in 56,840 cases (9.3%). After topical therapy, 11.2% of cases progressed to surgical management (18.3% with neomycin/polymyxin-B/dexamethasone, 9.7% with chloramphenicol, 13.9% with tobramycin, and 7.1% with azithromycin). Those treated only with lubricants required intervention in 6.0% of cases. Differences across treatments were statistically significant (p < 0.01). Invasive intervention was age-dependent: 1.8% in patients <18 years, 8.1% in those 18-45, and 13.7% in those> 45 (p < 0.0001). Chalazion incidence correlated strongly with mean monthly temperature (r = 0.71, p < 0.001), with higher prevalence above 21°C (specificity 0.91, sensitivity 0.79, AUC 0.90).

CONCLUSIONS: Most chalazia resolve with conservative management. Age and climate significantly influence both incidence and treatment outcomes. These findings underscore the role of environmental and demographic factors in a chalazion’s clinical course and may guide more tailored management strategies.

PMID:42178961 | DOI:10.1080/01676830.2026.2651956

Pol Przegl Chir. 2025 Dec 15;98(2):1-7. doi: 10.5604/01.3001.0055.5120.

ABSTRACT

&lt;b&gt;Introduction:&lt;/b&gt; Crohn’s disease (CD) is a chronic inflammatory bowel disease frequently necessitating surgical intervention, particularly ileocecal resection (ICR), due to complications unresponsive to medical therapy. Postoperative complications remain a significant concern, highlighting the need for reliable preoperative biomarkers to improve risk stratification.&lt;b&gt;Aim:&lt;/b&gt; This study aimed to evaluate the utility of selected serologic inflammatory markers in predicting postoperative complications and their severity in CD patients undergoing ICR.&lt;b&gt;Materials and methods:&lt;/b&gt; A retrospective analysis was conducted on 110 patients who underwent ICR for CD-related complications between 2015 and 2024. Preoperative blood parameters, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), and C-reactive protein (CRP), were analyzed in relation to postoperative complications classified by Clavien-Dindo grading and the Comprehensive Complication Index (CCI).&lt;b&gt;Results:&lt;/b&gt; Postoperative complications occurred in 46 patients (41.8%), with surgical site infection being the most common. Severe complications (Clavien-Dindo grade IV) were observed in 5 patients, with no mortality recorded. While no statistically significant associations were found between Clavien-Dindo grade and white blood cells (WBC), platelets (PLT), NLR, MPV, or CRP levels, CRP demonstrated a significant positive correlation with CCI score (p &lt; 0.05), suggesting its potential as a predictive marker for overall complication burden.&lt;b&gt;Conclusions:&lt;/b&gt; Elevated preoperative CRP levels may serve as a useful predictor of postoperative complication severity in CD patients undergoing ICR. Although other markers, such as NLR and MPV, showed trends toward association, statistical significance was not reached. Comprehensive preoperative assessment incorporating inflammatory biomarkers could enhance surgical planning and improve outcomes in this high-risk population.

PMID:42178956 | DOI:10.5604/01.3001.0055.5120

Pol Przegl Chir. 2025 Dec 15;98(2):26-36. doi: 10.5604/01.3001.0055.5118.

ABSTRACT

&lt;b&gt;Introduction:&lt;/b&gt; Vitamin D plays a key role in immune regulation, inflammation control, and musculoskeletal health. Patients with burn injuries are particularly vulnerable to its deficiency. Despite its importance, current clinical guidelines do not provide a clear consensus on how vitamin D should be managed in this population. &lt;br&gt;&lt;br&gt;&lt;b&gt;Aim:&lt;/b&gt; This meta-analysis aimed to assess the clinical impact of adequate vitamin D levels or supplementation compared to vitamin D deficiency or no supplementation in patients with burns. &lt;br&gt;&lt;br&gt;&lt;b&gt;Materials and methods:&lt;/b&gt; A systematic literature search was conducted in PubMed, Scopus, and Web of Science databases for studies reporting clinical outcomes in these 2 patient groups. The primary outcomes included duration of hospitalization, length of stay in burn intensive care units, mortality, and the incidence of sepsis and intubation. Subgroup analyses were performed for randomized and non-randomized studies. Statistical analysis was conducted using Cochrane’s Review Manager. &lt;br&gt;&lt;br&gt;&lt;b&gt;Results:&lt;/b&gt; Patients with sufficient vitamin D levels or those who received supplementation had significantly shorter overall hospitalization and burn intensive care unit stays. Although the difference in mortality was not statistically significant, intubation and sepsis occurred more frequently in patients with vitamin D deficiency or no supplementation. Subgroup analyses confirmed that both randomized and non-randomized studies showed a significantly reduced hospital stay in patients with adequate vitamin D status. &lt;br&gt;&lt;br&gt;&lt;b&gt;Discussion:&lt;/b&gt; The findings suggest that vitamin D management may improve clinical outcomes in burn patients and should be considered in future guidelines. &lt;br&gt;&lt;br&gt;&lt;b&gt;Conclusions:&lt;/b&gt; Further prospective studies with larger patient populations are necessary to establish standardized treatment protocols.

PMID:42178955 | DOI:10.5604/01.3001.0055.5118