Nevin Manimala

Pak J Pharm Sci. 2026 Jun;39(6):1792-1801. doi: 10.36721/PJPS.2026.39.6.170.1.

ABSTRACT

BACKGROUND: Inpatient care for Alzheimer’s disease (AD), often complicated by comorbidities, frequently involves polypharmacy (≥5 medications). The profile and cognitive consequences of sustained polypharmacy in these elderly inpatients require further investigation.

OBJECTIVES: To investigate the status of polypharmacy in elderly inpatients with AD and its correlation with three-year cognitive outcomes, so as to provide a basis for clinical optimization of medication regimens.

METHODS: This study was a retrospective propensity score matching (PSM) cohort study. 300 AD inpatients who were hospitalized from March 2022 to March 2025 were included. Patients were stratified into polypharmacy and non-polypharmacy groups according to their polypharmacy status. The primary outcome was the incidence of cognitive decline (MMSE decline ≥3 points) at 3 years. Secondary outcomes were the association of CDR progression, rate of decline in MoCA, incidence of falls, all-cause rehospitalization, all-cause mortality and anticholinergic drug burden with cognitive outcomes.

RESULTS: After PSM, baseline characteristics were balanced (p>0.05). At the 3-year follow-up, the polypharmacy group had a significantly higher incidence of cognitive decline than the non-polypharmacy group (64.0% vs. 38.0%; RR=1.68, 95% CI: 1.33-2.13, p<0.001). Polypharmacy was also associated with faster CDR progression, a greater annual rate of MoCA decline and increased risks of falls (RR=1.82, p<0.01) and all-cause rehospitalization (RR=1.67, p<0.001). A high anticholinergic burden (ACB score ≥3) was identified as an independent predictor of cognitive decline (OR=2.5, 95%CI: 1.7-3.7, p<0.001).

CONCLUSIONS: Our findings highlight polypharmacy as a key, modifiable risk for cognitive decline in AD, calling for structured medication management to mitigate this risk.

PMID:42001284 | DOI:10.36721/PJPS.2026.39.6.170.1

J Laparoendosc Adv Surg Tech A. 2026 Apr 19:10926429261445559. doi: 10.1177/10926429261445559. Online ahead of print.

ABSTRACT

BACKGROUND: Laparoscopic surgery (Lap) is widely recognized as the standard minimally invasive method for colorectal surgeries. Although robotic surgery (Rob) has seen increased adoption, its application in inflammatory bowel disease remains uncertain.

METHODS: A systematic search was conducted across PubMed, Scopus, and the Cochrane Central Register of Controlled Trials up to February 2026. Pooled odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity was assessed via the inconsistency (I²) statistic. Trial sequential analysis (TSA) was applied to assess the robustness of the cumulative evidence.

RESULTS: Four observational studies, including 3776 patients, were analyzed; 246 underwent Rob and 3530 underwent Lap. Compared with Lap, Rob was associated with a significantly lower rate of overall postoperative complications (OR: 0.56; 95% CI: 0.31 to 0.99; P = .047). No significant differences were observed between approaches in postoperative ileus (OR: 1.16; 95% CI: 0.67 to 2.01; P = .595), anastomotic leak (OR: 0.92; 95% CI: 0.38 to 2.22; P = .852), surgical site infection (OR: 0.70; 95% CI: 0.36 to 1.36; P = .297), reoperation (OR: 1.00; 95% CI: 0.42 to 2.35; P = .997), or stoma formation (OR: 0.47; 95% CI: 0.18 to 1.25; P = .130). The length of hospital stay was similar between groups (MD: = -0.20 days; 95% CI: = -0.80 to 0.31; P = .37). Operative time was significantly longer in Rob (MD: + 51.8 minutes; 95% CI: 32.0 to 71.6; P < .001). TSA indicated that most outcomes remained underpowered, suggesting a persistent risk of random error.

CONCLUSION: Rob for Crohn’s disease is a safe and feasible minimally invasive approach, with lower overall postoperative complications than Lap. However, Rob was associated with longer operative times, while most perioperative outcomes remain comparable. Further well-designed prospective studies are required to confirm these findings.

PMID:42001279 | DOI:10.1177/10926429261445559

Cell J. 2026 Feb 28;27(1):1-13. doi: 10.22074/cellj.2026.2050175.1770.

ABSTRACT

OBJECTIVE: A paternal high-fat diet (HFD) has been shown to affect the expression of peroxisome proliferator-activated receptors (Ppars), particularly in offspring’s testicle regions. One of its isoforms, Pparγ, participates in spermatogenesis as a transcription factor regulating fatty acid metabolism genes. This study aimed to investigate how paternal dietary intake of trans fatty acids and/or vitamin E influences the expression of Pparγ target genes in the testes of their offspring, with the goal of elucidating potential mechanisms related to altered lipid metabolism and reproductive health.

MATERIALS AND METHODS: In this experimental study, adult male Wistar rats (F0) were fed for 60 days with one of the following four diets: control diets (C), control diets with trans fatty acids (CTH), diets containing vitamin E (E) and diets containing vitamin E and trans fatty acids (ETH). Then the male offspring (F1) were raised on standard chow, and their testicular tissue was later analyzed to assess the impact of paternal diet on gene expression, and the expression of the Pparγ target genes: Elovl2, Muc1, Fads2, Scd1, Glut2 and Lpl were measured quantitatively.

RESULTS: The data revealed that paternal HFD can suppress the expression of Pparγ target genes in the testes of offspring. Fads2, Elovl2 were significantly upregulated in response to paternal vitamin E supplementation. The changes in Lpl gene expression were not statistically significant. Also, co-expression analysis and functional enrichment approach indicated that the genes involved in cellular response to fatty acid, fatty acid metabolic process, lipid storage, and fatty acid biosynthetic process were overexpressed in up/down regulated Pparγ target genes.

CONCLUSION: Our findings demonstrate the metabolic impact of paternal diet on offspring’s, with focus on mechanisms related to altered lipid metabolism and reproductive health.

PMID:42001274 | DOI:10.22074/cellj.2026.2050175.1770

Ann Saudi Med. 2026 Mar-Apr;46(2):137-149. doi: 10.5144/0256-4947.2026.137. Epub 2026 Apr 16.

ABSTRACT

BACKGROUND: Messenger RNA (mRNA)-based influenza vaccines represent a promising advancement in seasonal influenza prevention. However, comprehensive evaluation of their serious safety profile is essential as these vaccines progress toward widespread clinical use. While individual randomized controlled trials (RCTs) have reported low rates of serious adverse outcomes, pooled evidence is limited.

OBJECTIVE: This systematic review and meta-analysis of RCTs aim to assess the risk of serious adverse events (SAEs) and adverse events of special interest (AESIs) associated with mRNA-based seasonal influenza vaccines in adults.

DESIGN: Systematic review and meta-analysis.

SETTING: All RCTs included in the meta-analysis were carried out in the USA.

METHODS: A systematic literature search was done until December 2025. RCTs evaluating mRNA-based influenza vaccines in adults and reporting participant-level data for SAEs and/or AESIs were included. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled.

MAIN OUTCOME MEASURES: Risks of SAEs and AESIs associated with mRNA-based seasonal influenza vaccines in adults, expressed as pooled risk ratios with 95% CIs.

SAMPLE SIZE: Seven RCTs (containing 12 datasets) were included in this meta-analysis. The total number of cases in the intervention and comparator groups were 23,754 and 22,806 respectively.

RESULTS: The pooled analysis demonstrated no increased risk of SAEs (RR=0.90, 95% CI: 0.64-1.27, P=.56) and AESI (RR=0.76, 95% CI: 0.41-1.36, P=.35) among mRNA vaccine recipients compared with controls.

RISK OF BIAS: Based on funnel plots, there is no evidence of systematic asymmetry or absence of smaller studies with null or adverse findings. Risk-of-bias assessment using the Cochrane traffic-light framework indicated low risk across all domains in all included RCTs.

HETEROGENEITY: The heterogeneity was low-to-moderate (τ²=0.08; I²=27.79%; H²=1.38) for SAEs and the Q-test indicated statistically significant heterogeneity (Q=14.46, P=.21). For AESIs, heterogeneity was absent (τ²=0.00; I²=0.00%; H²=1.00), with no evidence of between-study variability by the Q-test (Q=4.70, P=.94).

CONCLUSIONS: Pooled evidence shows that mRNA-based seasonal influenza vaccines are not associated with an increased risk of SAEs or AESIs compared with established influenza vaccines or placebo.

LIMITATIONS: Low absolute number of AESIs limiting detection of extremely rare events, limited long-term follow-up beyond early and intermediate risk windows, and potential differences between trial populations and real-world vaccine recipients.

REGISTRATION: CRD420251271174.

PMID:42001264 | DOI:10.5144/0256-4947.2026.137

J Periodontol. 2026 Apr 19. doi: 10.1002/jper.70136. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to investigate whether healthcare expenditures (HCEs) differed depending on whether the patients left periodontal disease (PD) untreated, despite the need for treatment.

METHODS: This study used public PD screening data from a municipality in Japan to identify adults aged ≥ 40 years who were found to require treatment of PD by dentists at PD screening. The presence or absence of periodontal treatment was determined by a dental visit within 180 days after the date of PD screening based on medical claims data. Annual HCE were calculated from cumulative expenditures over 2 years from the date of the presence or absence of periodontal treatment. A generalized linear model with a gamma distribution and log link function was used to calculate the relative cost ratios (RCRs) and 95% confidence intervals (95% CI), and a two-part model was used to predict annual HCEs and the difference in predicted HCEs based on dental treatment.

RESULTS: Among 652 people (mean age: 62.6 years [1 SD = 9.0], 65.5% women), 9.0% were untreated. After adjusting for the covariates, the RCR for medical, pharmaceutical, and dental costs in the untreated group compared with the treated group were 1.56 (95% CI: 1.02-2.38), 0.95 (95% CI: 0.53-1.70), and 0.14 (95% CI: 0.10-0.19), respectively. The differences in predicted HCEs were $593.5 (95% CI: -280.6, 1467.6) higher for medical, $79.9 (95% CI: -363.6, 523.4) higher for pharmaceutical, and $323.9 (95% CI: -397.3, -250.6) lower for dental.

CONCLUSION: Leaving PD untreated was associated with increased HCEs, particularly medical expenditures.

PLAIN LANGUAGE SUMMARY: This study looked at whether people who were told by a dentist that they needed care for periodontal disease actually received treatment, and how this affected their healthcare costs. The research followed more than 600 adults in Japan for 2 years, comparing the cumulative healthcare costs of those who received dental care with those who did not. The results showed that people who did not treat their periodontal disease ended up spending more on medical care, even though they spent less on dental care. On average, untreated individuals had medical expenses that were around $600 higher than those who received treatment. This suggests that avoiding dental care for periodontal disease might lead to more serious health problems down the line, which can increase overall healthcare costs. Although skipping dental visits may seem like a way to save money, it could actually lead to higher medical bills in the future. These findings highlight the importance of early dental treatment not just for oral health, but also for managing overall healthcare costs and preventing other health complications.

PMID:42001258 | DOI:10.1002/jper.70136

J Health Psychol. 2026 May;31(6):2183-2202. doi: 10.1177/13591053251371792. Epub 2025 Oct 14.

ABSTRACT

The Body Awareness Questionnaire (BAQ) measures attentiveness to normal body processes and is widely used with both healthy and patient samples. Meta-analysis of 10 articles involving 15 studies (4078 participants) examined BAQ reliability. Random-effects models pooled Cronbach’s alpha and test-retest coefficients. Heterogeneity was assessed via I² statistic; publication bias via funnel plots, Egger’s and Begg’s tests, and trim-and-fill method. Pooled Cronbach’s alpha was 0.84 (95% CI: 0.81-0.87), indicating high internal consistency despite substantial heterogeneity (I² = 92.20%). Pooled test-retest reliability was strong at 0.84 (95% CI: 0.78-0.89), though with significant heterogeneity (I² = 95.42%). Egger’s test suggested potential publication bias. Despite heterogeneity and potential bias issues, findings support BAQ’s cross-population applicability.

PMID:42001257 | DOI:10.1177/13591053251371792

J Periodontol. 2026 Apr 18. doi: 10.1002/jper.70121. Online ahead of print.

ABSTRACT

BACKGROUND: Periodontal disease (PD) is associated with type 2 diabetes mellitus (T2DM), while periodontal treatment (PT) improves glycemic control in T2DM patients. Leptin and adiponectin belong to the adipokines family and have almost antagonistic functions in inflammatory processes and insulin sensitivity modulation. Hence, these hormones have been linked with both PD severity and glycemic control. This systematic review aims to assess the effect of PT on serum levels of leptin and adiponectin in patients with T2DM.

METHODS: PubMed, Cochrane Library, and Google Scholar databases and ClinicalTrials.gov website were searched up to January 5th, 2025. Randomized and non-randomized controlled clinical trials (RCTs and CCTs) including patients with T2DM and PD who underwent PT and evaluated serum levels of leptin and adiponectin were included. Assessments of risk of bias and of certainty of evidence were performed.

RESULTS: Seven trials were eligible for qualitative synthesis. A statistically significant increase in serum adiponectin levels was observed across most studies, while no such consistency was observed for leptin. The overall level of certainty of evidence was judged low in the RCTs and very low in the CCTs. Meta-analysis could not be performed due to significant methodological heterogeneity.

CONCLUSIONS: Preliminary findings suggest a potential increase in adiponectin levels in T2DM patients, with possible implications for glycemic control. However, these results should be interpreted with caution due to the small number of studies and important methodological limitations. Well-designed studies with larger sample sizes and adequate adjustment for confounders are necessary to verify this observation.

PLAIN LANGUAGE SUMMARY: People with type 2 diabetes often also have periodontitis, an inflammatory gum disease, which may affect their overall health. The aim of this study was to investigate whether treating periodontitis could help improve certain substances in the blood-called adiponectin and leptin-that are linked to blood sugar control and inflammation. Several studies that tested this in people with both diabetes and periodontitis were included and most of them showed that, after periodontal treatment, levels of adiponectin (which helps reduce inflammation and improve insulin sensitivity) increased. However, results for leptin were less clear. This suggests that taking care of gum health might support better diabetes management. The overall strength of evidence was low due to methodological limitations and heterogeneity among studies. Current findings should be interpreted cautiously, as available data remain preliminary. Still, more high-quality research is needed to fully understand how treating periodontitis may benefit people with diabetes.

PMID:42001255 | DOI:10.1002/jper.70121

JPEN J Parenter Enteral Nutr. 2026 Apr 18. doi: 10.1002/jpen.70091. Online ahead of print.

NO ABSTRACT

PMID:42001253 | DOI:10.1002/jpen.70091

Nurs Open. 2026 Apr;13(4):e70554. doi: 10.1002/nop2.70554.

ABSTRACT

AIM: This study aimed to examine the relationship between nurses’ levels of spiritual well-being and their status of observing patient privacy.

DESIGN: A descriptive and cross-sectional study was conducted.

METHODS AND DATA SOURCE: The sample comprised 199 nurses working in a university hospital. The study data were collected between 1 January and 28 February 2022, using a Descriptive Characteristics Form, the Spiritual Well-Being Scale and the Patient Privacy Scale in Nursing. Ethics committee approval was obtained from a state university’s Scientific Research Ethics Committee.

RESULTS: It was determined that the nurses’ spiritual well-being levels were above the medium level, and the patient’s privacy was high. A statistically significant positive relationship exists between the Spiritual Well-Being Scale and Patient Privacy Scale in Nursing scores. The regression model for the total scale showed an R² of 29.3%. A point increase in the Spiritual Well-Being Scale score causes an increase of 0.424 units in the Patient Privacy Scale in Nursing score.

CONCLUSION: It has been determined that as nurses’ spiritual well-being increases, they pay more attention to patient privacy.

IMPLICATIONS FOR THE NURSING PROFESSION AND PATIENT CARE: This study contributes to the nurses’ understanding of the importance of spiritual values in patient privacy and to pay attention to this issue in patient care.

IMPACT: In this study addressing patient privacy, it was found that nurses’ spiritual well-being is related to patient privacy. The conclusions impact future patients, nurses and managers.

REPORTING METHOD: The study was compliant with the STROBE checklist.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

PMID:42001227 | DOI:10.1002/nop2.70554

Rheumatology (Oxford). 2026 Apr 17:keag208. doi: 10.1093/rheumatology/keag208. Online ahead of print.

NO ABSTRACT

PMID:42001219 | DOI:10.1093/rheumatology/keag208