Nevin Manimala

Medicine (Baltimore). 2025 May 16;104(20):e42469. doi: 10.1097/MD.0000000000042469.

ABSTRACT

This study aimed to quantify the lumbar skeletal muscle index (SMI) to predict the incidence and risk of lower back pain and to develop preventive strategies to reduce the incidence of sarcopenia and lower back pain. A total of 29 patients with low back pain in our hospital between September 2022 and March 2024 were enrolled, and lumbar computed tomography data were collected, including age, sex, and visual analog scale (VAS) score for low back pain. This study included 29 patients with an average age of (53.72 ± 18.82) years and an average height of (1.65 ± 0.43) m. The degree of lower back pain was evaluated using the visual analog scoring method, with an average score of (5.14 ± 1.382). Using AutoCAD drawing software, the total cross-sectional area of the skeletal muscles at the level of the lumbar vertebrae was calculated, with an average area of (105.63 ± 27.73) cm2. The SMI at the level of the lumbar vertebrae 3 was calculated as the ratio of the total cross-sectional area of the skeletal muscles at the level of the lumbar vertebrae to height2, (38.27 ± 8.07). Statistical analysis showed a significant negative correlation (P < .01) between SMI, age, and VAS score in patients with sarcopenia, whereas there was no significant difference in SMI between the sexes in patients with sarcopenia(P > .05). There was a significant negative correlation between SMI and age as well as VAS score, indicating that lower back pain is caused by a decrease in SMI. As people age, their muscle mass and strength gradually decreases.

PMID:40388778 | DOI:10.1097/MD.0000000000042469

Medicine (Baltimore). 2025 May 16;104(20):e42489. doi: 10.1097/MD.0000000000042489.

ABSTRACT

Medical staff hold dual roles as advocates and potential blood donors, yet systemic barriers within high-pressure clinical environments hinder their participation. Understanding their motivations and challenges is critical for strengthening blood supply systems. This cross-sectional study aimed to identify determinants of donation willingness and policy expectations among medical staff to inform evidence-based interventions. A structured questionnaire, developed via Delphi methodology with hematologists, policy experts, and psychologists, was administered to medical staff at a tertiary Grade A hospital in Chongqing, China. Stratified random sampling ensured representation across demographics. Data were collected via an encrypted online platform (SoJump.com) and analyzed using SPSS 22.0 and GraphPad Prism 6. Among 1096 participants, the observation group (non-donors, n = 460, 41.97%) exhibited statistically significant demographic divergences from the control group across gender, age, educational attainment and professional category (all P < .05). Multivariate logistic regression identified these variables as independent predictors of donation status (P < .05). Despite 83.26% of the observation group endorsing blood donation and 69.34% comprehending deferral criteria, key participation barriers included occupational workload saturation (59.13%), inadequate promotional mechanisms (49.57%), adverse physiological reactions (43.04%), and insufficient motivation (26.52%). For intervention optimization, respondents in the observation group prioritized structured promotional mechanisms (80.22%), establishing policy guidance protocols (53.26%), and systematizing regular donor recruitment activities (46.74%). Young, male, and highly educated medical staff exhibited higher donation rates. Structural reforms to alleviate occupational burdens, optimize donor recruitment paradigms, and institutionalize periodic mobilization are imperative to align clinical demand with donor supply.

PMID:40388772 | DOI:10.1097/MD.0000000000042489

Medicine (Baltimore). 2025 May 16;104(20):e42532. doi: 10.1097/MD.0000000000042532.

ABSTRACT

Although observational studies have suggested associations between personality disorders and schizophrenia, the causality of these relationships remains unclear. Determining whether personality disorders causally contribute to schizophrenia could inform early identification and preventive efforts. We performed two-sample Mendelian randomization (MR) analysis using large-scale Genome-wide Association Study data from populations of European ancestry. Because no single nucleotide polymorphism for personality disorders reached the conventional genome-wide significance threshold (P < 5 × 10-8), we sequentially relaxed the criteria (P < 5 × 10-7, P < 5 × 10-6, P < 5 × 10-5) until at least 10 instrumental variables were obtained. Ultimately, 11-95 single nucleotide polymorphism met the relaxed threshold (P < 5 × 10-5), all with F-statistics > 10, thus ensuring robust instrumental variables. The inverse variance weighted method served as our primary MR approach, supplemented by MR-Egger, weighted median, and MR Robust Adjusted Profile Score analyses, to minimize confounding, reverse causation, and weak instrument bias. Inverse variance weighted analysis revealed a significant causal association between genetically predicted personality disorders and schizophrenia (odds ratios = 1.190, 95% confidence intervals: 1.122-1.261, P = 5.51 × 10-9). Additionally, when examining a combined group of specific personality disorders, a similar causal effect was observed (odds ratios = 1.180, 95% confidence intervals: 1.033-1.345, P = .015). The sensitivity analyses showed no evidence of horizontal pleiotropy, thus supporting the robustness of these findings. Our study provides the first genetic evidence that personality disorders may have a causal influence on schizophrenia risk. These results highlight the importance of early screening and targeted interventions in individuals with personality disorders. Future research should expand to more diverse populations, employ dimensional diagnostic frameworks, and investigate the underlying biological and developmental pathways to refine the preventative and therapeutic strategies.

PMID:40388757 | DOI:10.1097/MD.0000000000042532

Medicine (Baltimore). 2025 May 16;104(20):e42526. doi: 10.1097/MD.0000000000042526.

ABSTRACT

Physical strength alone is not enough in today’s sports’ society, where athletes’ performance is geared around winning; the body’s demand for mental training is growing every day. The aim of this study is to examine the mental endurance, mental training and emotional intelligence levels of elite level individual athletes; to evaluate the relationships between these psychological variables in a multifactorial structure and to determine whether these variables show significant differences according to demographic characteristics such as gender, age, education level and duration of sportsmanship. This will offer useful strategies to maximize the performance of elite athletes. In this cross-sectional study, a quantitative research method was applied using the survey model. A total of 242 elite Turkish athletes competing in individual sports branches in the Turkish National Teams in 2023 to 2024 participated in the study. Athletes’ data was gathered and examined between January 02 and March 02, 2024. The data were collected using the Sport Mental Endurance Inventory, Sport Mental Training Inventory, and Sport Emotional Intelligence Scale. Nonparametric tests were applied for statistical analysis. The findings of this study showed that there were significant differences in mental endurance, mental training, and emotional intelligence levels according to gender, age, and sport branch variables. It was found that male athletes aged between 26 to 33 years had higher levels of mental endurance and emotional intelligence. In addition, it was determined that female athletes aged 21 years and over had higher levels of mental training and emotional intelligence. High positive correlations were found between mental endurance and emotional intelligence and between mental training and emotional intelligence. The development of mental endurance and emotional intelligence is of great importance for elite athletes to improve their success and performance. These findings suggest that mental endurance and emotional intelligence levels of athletes may differ according to demographic characteristics such as gender, age, and sport branches. These factors may have significant effects on athletes’ performances.

PMID:40388754 | DOI:10.1097/MD.0000000000042526

Medicine (Baltimore). 2025 May 16;104(20):e42510. doi: 10.1097/MD.0000000000042510.

ABSTRACT

The aim of this study was to investigate the safety and efficacy of the double mini-incision approach, and to clarify its surgical details. We retrospectively enrolled 82 patients with primary carpal tunnel syndrome. Among them, 30 patients with conventional approach were enrolled in group A, and the other 52 patients with double mini-incision approach were enrolled in group B. Objective tests were performed on patients, and basic information and subjective evaluation of patients were collected. The surgical effects and complications of the 2 approaches were compared. In addition, the surgical details of double mini-incision were further explored. The incision length of group B (26.1 ± 6.1 mm) was significantly shorter than that of group A (45.7 ± 5.9 mm, P ＜ .001). Patients in group B (93.7 ± 5.4) had significantly higher satisfaction with incision appearance than those in group A (84.3 ± 6.1, P ＜ .001). At the 12-month follow-up, no statistically significant difference in clinical outcomes were observed between the 2 groups (P > .05). However, there were 2 cases with wound pain and 1 case with pillar pain in group A, but none in group B. Two patients in group B who underwent the distal incision 1st were transferred to the conventional approach because of the epineurium and perineurium injury. The double mini-incision approach offers a sufficient range of release and surgical field, resulting in favorable surgical outcomes. The proximal incision made 1st helps to reduce the risk of nerve injury.

PMID:40388748 | DOI:10.1097/MD.0000000000042510

Medicine (Baltimore). 2025 May 16;104(20):e42473. doi: 10.1097/MD.0000000000042473.

ABSTRACT

Patients with coronary heart disease may have a higher risk of medication discrepancy during hospital-family transition period because of the complexity of their diseases, the diversity of medicines brought out of hospital and the sensitivity of medicine taking time. This study aims to analyze the influencing factors of medication discrepancy in patients with coronary heart disease during hospital-family transition period. Patients admitted to the department of cardiovascular medicine from July 1, 2023 to June 30, 2024 in a hospital in Ningbo City, Zhejiang Province, China. Electronic medical record system and patients themselves before discharge collected the baseline data of patients with coronary heart disease. Within 2 weeks after discharge, the patients were investigated by telephone follow-up with the medication discrepancy tool. Logistic regression was used to determine the influencing factors of patients’ medication discrepancy. The incidence of medication discrepancy in 107 patients within 2 weeks after discharge was 23.4%. The main discrepancy type is “medication omission.” The causes of patient-induced medication discrepancy are relatively high, and the most common reason is “forgetting to take medicine.” Logistic regression analysis showed that aspirin medication history and family APGAR index were the influencing factors of medication discrepancy. The incidence of medication discrepancy in patients with coronary heart disease in hospital-family transition period is high, among which omission is the most common. Aspirin medication history and family function are the key to identify patients’ medication discrepancy. Medical staff should pay attention to the management of medication discrepancy in patients with coronary heart disease.

PMID:40388747 | DOI:10.1097/MD.0000000000042473

Medicine (Baltimore). 2025 May 16;104(20):e42501. doi: 10.1097/MD.0000000000042501.

ABSTRACT

To clarify the patterns, reasons, and patient characteristics associated with emergency visits in the final 30 days of life for patients receiving home care in Japan. We conducted a retrospective analysis of emergency visits made by home care physicians to patients who died while receiving home care in 2018. Data on patient characteristics and emergency visits during the final 30 days of life were extracted from medical records. Poisson regression analysis was used to identify factors associated with emergency visit frequency. Among 83 end-of-life patients (median age 84 years, 49.4% male), a total of 86 emergency visits were recorded. These visits occurred most frequently in the days immediately preceding death, with 40.7% occurring within 5 days before death. Visits were more common during afternoons (37.2%) and weekends (39.6%). The primary reasons for visits included respiratory distress (20.9%), clinical assessment (14.0%), and neurological symptoms (12.8%). While some visits resulted in medication prescriptions (26.7%) or laboratory tests (22.1%), 36.1% involved observation only. Multivariable analysis revealed that longer duration of home care was associated with increased emergency visit frequency (31-365 days: relative risk [RR] 2.30, 95% confidence interval [CI]: 1.16-4.54; >365 days: RR 3.00, 95% CI: 1.56-5.78), while younger age was associated with increased visits (≤79 years: RR 2.04, 95% CI: 1.19-3.47). Emergency home visits in the terminal phase often clustered near death and frequently resulted in observation only, suggesting that some visits may be driven more by caregiver anxiety than medical urgency. Additionally, care level appeared to play a limited role during this period. These findings highlight the need for proactive symptom management, caregiver support, and scalable approaches such as telehealth to optimize end-of-life care.

PMID:40388741 | DOI:10.1097/MD.0000000000042501

Medicine (Baltimore). 2025 May 16;104(20):e42522. doi: 10.1097/MD.0000000000042522.

ABSTRACT

May measurement month (MMM) is a global blood pressure (BP) screening campaign that aims to emphasize the importance of BP measurement and identify those who require intervention/follow-up for elevated BP. The objective of this regional analysis in Newfoundland and Labrador (NL), Canada, was to examine the proportion of individuals screened with elevated BP, including those with and without a history of hypertension (HTN). This cross-sectional study was completed in accordance with the global MMM protocol. All consenting adults ≥18 years old were eligible to take part. Data collection took place in 28 community pharmacies across the province of NL. Descriptive statistics were analyzed and associations between elevated BP and covariates of interest were determined using logistic regression. A total of 384 participants took part in this study, with a mean age of 54.4 years (standard deviation 18.2); 66.1% (n = 254) of participants were female and 41.4% (n = 159) had known HTN. A complete set of 3 BP readings were recorded for a total of 375 participants and therefore, these participants were included in the analysis. Elevated BP was observed in 21.9% (n = 82) of participants, including 13.5% of those who had no history of HTN (i.e., 30 of 222). Known HTN and diabetes were statistically significant predictors of elevated BP in the multivariate regression model. Regional implementation of the MMM campaign in NL helped to identify a relatively large proportion of individuals with elevated BP, including those with no history of HTN. Targeted measures are needed to achieve BP targets among individuals with hypertension and diabetes in the province.

PMID:40388740 | DOI:10.1097/MD.0000000000042522

Medicine (Baltimore). 2025 May 16;104(20):e42423. doi: 10.1097/MD.0000000000042423.

ABSTRACT

Post-traumatic stress disorder (PTSD) and Attention deficit and hyperactivity disorder (ADHD) are common mental illnesses. Observational studies have indicated that these conditions often co-occur with gastrointestinal diseases. However, the causal relationship between PTSD and ADHD with gastrointestinal diseases remain unclear. We conducted Mendelian randomization (MR) analysis to investigate these associations. We selected genetic instrument data with genome-wide significance levels for PTSD and ADHD from the psychiatric genomics consortium open genome-wide association study platform. Summary statistics for the 24 gastrointestinal diseases were obtained from the FinnGen study. We used the “TwoSampleMR” package in R to perform a 2-sample MR analysis and conducted sensitivity analysis of the results. We found that genetic susceptibility to PTSD was associated with 1 gastrointestinal disease, specifically pancreatic cancer (P = .003; odds ratios [OR] = 1.295; 95% CI, 1.094-1.531). Genetic susceptibility to ADHD was associated with 4 gastrointestinal diseases: gastroesophageal reflux (P = .014; OR = 1.100; 95% CI, 1.020-1.186), gastric ulcer (P = .004; OR = 1.208; 95% CI, 1.061-1.376), duodenal ulcer (P = .020; OR = 1.206; 95% CI, 1.029-1.413), and chronic gastritis (P = .021; OR = 1.122; 95% CI, 1.018-1.237). This study provides MR evidence supporting causal relationship between PTSD and ADHD with specific gastrointestinal diseases.

PMID:40388735 | DOI:10.1097/MD.0000000000042423

Medicine (Baltimore). 2025 May 16;104(20):e42484. doi: 10.1097/MD.0000000000042484.

ABSTRACT

Previous studies have confirmed that hyperthyroidism is one of the common causes of secondary osteoporosis and can aggravate the disease severity in patients with osteoporosis. This study is mainly based on the Taiwan National Health Insurance Database and through big data analysis shows that combining traditional Chinese medicine (TCM) treatment can help the health of patients with hyperthyroidism and osteoporosis. There were 4980 patients who received TCM treatment and 19,920 controls who did not receive TCM treatment selected from Taiwan National Health Insurance Database in a 4:1 ratio of gender, age, and index year. Cox proportional hazards analyzes were performed to compare fracture, inpatient, and all-cause mortality over an average follow-up period of 15 years. A total of 4745/5823/3487 enrolled subjects (19.06%/23.39%/14.00%) suffered fractures/hospitalization/all-cause death which TCM group was 452/987/511 (15.10%/19.82%/10.26%); control group was 3993/4836/2976 (20.05%/24.28%/14.94%). Cox proportional hazards regression analysis showed that subjects in the TCM group had lower fractures, hospital mortality, and all-cause mortality (adjusted HR = 0.563; 95% confidence intervals [CI] = 0.392-0.680, P < .001; adjusted HR = 0.614; 95% CI = 0.474-0.714, P < .001; adjusted HR = 0.691; 95% CI = 0.569-0.792, P < .001). Kaplan-Meier analysis showed that the cumulative risk of fracture, hospitalization and death were lower in TCM group with significant differences (all log-rank P < .001). The analysis of this study shows that patients with hyperthyroidism and osteoporosis even with comorbidity of atrial fibrillation, atrial flutter, or heart failure combined with TCM treatment are associated with a lower risk of fractures, hospitalization, or all-cause death, providing clinicians with a treatment option.

PMID:40388732 | DOI:10.1097/MD.0000000000042484