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Impact of Hospitalization on Continuation of SGLT2 Inhibitors and GLP-1 Receptor Agonists for Comorbidities in Patients with Type 2 Diabetes

Innov Pharm. 2025 Jan 14;15(4). doi: 10.24926/iip.v15i4.6432. eCollection 2024.

ABSTRACT

Purpose: In the treatment of type 2 diabetes mellitus (T2DM), select sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists are recommended based on comorbidities such as chronic kidney disease (CKD), heart failure (HF), and atherosclerotic cardiovascular disease (ASCVD). Because guidelines typically recommend insulin for inpatient treatment of T2DM, there is potential that these therapies may be negatively impacted by hospitalization. This study aimed to assess the effect of hospitalization on outpatient T2DM therapy. Methods: In this retrospective study, patients were included if they had a diagnosis of T2DM plus a comorbidity (CKD, HF, ASCVD) for which they were prescribed an SGLT2 inhibitor or GLP-1 receptor agonist and had a recent hospitalization and follow-up appointment at an outpatient clinic. Electronic medical records were reviewed to determine if these therapies were continued during transitions of care. Data was analyzed with basic descriptive statistics. Results: Thirty-six patients on SGLT2 inhibitor therapy met inclusion criteria. Four (11%) patients were never restarted on therapy outpatient following hospitalization, three of which did not have an appropriate reason for discontinuation. Twenty-two patients on GLP-1 receptor agonist therapy met inclusion criteria. Four (18%) were never restarted on therapy outpatient following hospitalization, two of which did not have an appropriate reason for discontinuation. Conclusion: Five out of 58 patients (8.6%) included in the study experienced an inappropriate discontinuation of therapy throughout the transitions of care process. While most patients had their T2DM medication restarted, this study shows hospitalization can impact guideline-directed outpatient therapy.

PMID:40401295 | PMC:PMC12090087 | DOI:10.24926/iip.v15i4.6432

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Awareness on antibiotic prescription for endodontic cases among Dentists and Endodontists in Saudi Arabia

Bioinformation. 2024 Mar 31;20(3):282-291. doi: 10.6026/973206300200282. eCollection 2024.

ABSTRACT

The knowledge of Dentists and Endodontists in Saudi Arabia regarding antibiotic prescriptions during and after endodontic treatment is of interest. A self-designed questionnaire survey was utilized to assess the knowledge of dentists across various cities in Saudi Arabia concerning antibiotic usage guidelines for endodontic purposes. A total of 391 participants were included in the study and the questionnaire was distributed through social platforms like WhatsApp, Instagram, Facebook Messenger and email. Results revealed that over 80% of participants acknowledged the need for antibiotics in cases of acute apical abscess with cellulitis, with amoxicillin being the most recommended antibiotic by dentists. Interestingly, there was no statistically significant difference in knowledge based on experience or graduation group. In conclusion, while participants demonstrated adequate knowledge about antibiotic prescriptions in endodontic cases, continued awareness of updated guidelines, including the WHO’s Essential Medicines List (EML), guidelines by the European Society of Endodontology (ESE) and American Association Endodontists (AAE) is essential for optimal clinical practice.

PMID:40401285 | PMC:PMC12093258 | DOI:10.6026/973206300200282

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Imaging and clinical efficacy analysis of minimally invasive reduction and crossbar external fixation in the treatment of Sanders Ⅱ and Ⅲ calcaneal fractures

Front Surg. 2025 May 7;12:1550024. doi: 10.3389/fsurg.2025.1550024. eCollection 2025.

ABSTRACT

OBJECTIVE: To evaluate the clinical efficacy of percutaneous minimally invasive reduction combined with crossbar external fixation in the treatment of Sanders type II and III calcaneal fractures.

METHODS: A retrospective analysis was performed on 65 patients with Sanders type II and III calcaneal fractures who were treated at Zhongshan Hospital affiliated with Dalian University between February 2019 and June 2021. Among them, 48 were males and 17 were females, with a mean age of 42.3 ± 10.2 years. There were 45 cases of Sanders type II fractures and 20 cases of type III fractures. Patients were divided into three groups based on the surgical methods: Group A (n = 25, minimally invasive reduction with crossbar external fixation), Group B (n = 21, minimally invasive locking plate fixation via the sinus tarsi approach), and Group C (n = 19, locking plate fixation via the lateral L-shaped incision). The following parameters were recorded and compared among the groups: preoperative waiting time, operative duration, intraoperative blood loss, incision length, and postoperative complications. Imaging parameters assessed included calcaneal length, width, height, Böhler angle, Gissane angle, and varus angle. Clinical outcomes were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Visual Analogue Scale (VAS), Short Form Health Survey (SF-36), and Maryland Foot and Ankle Score.

RESULTS: Baseline characteristics showed no significant differences among the groups (P > 0.05). All patients were followed up for an average duration of 15.6 ± 1.2 months. Group A demonstrated significantly shorter preoperative waiting times, operative durations, lower intraoperative blood loss, and shorter incision lengths compared with groups B and C (P < 0.05). Furthermore, VAS scores 3 days postoperatively were significantly lower in group A compared to groups B and C (P < 0.05), whereas no significant difference was observed between groups B and C. The incidence of postoperative complications was significantly lower in groups A and B compared with group C (P < 0.05), with no significant difference observed between groups A and B. In addition, complications observed in the study included pinhole infections, cyanosis of the skin at the edge of the incision, nerve damage, and skin necrosis. Statistically, the complication rate was significantly lower in the group with the percutaneous minimally invasive approach than in the group with the traditional L-shaped approach. Imaging assessments at 2 weeks and 12 months postoperatively revealed no significant differences among the three groups in Böhler angle, Gissane angle, calcaneal varus angle, and calcaneal dimensions (P > 0.05). All imaging parameters significantly improved postoperatively within each group (P < 0.05). At the final follow-up, clinical outcomes (AOFAS, SF-36, Maryland scores) showed no significant differences among groups (P > 0.05).

CONCLUSION: The Percutaneous minimally invasive reduction combined with crossbar external fixation provides effective fixation with minimal trauma, shorter hospital stays, and lower complication rates, representing a viable treatment strategy for Sanders type II and III calcaneal fractures.

PMID:40401282 | PMC:PMC12092454 | DOI:10.3389/fsurg.2025.1550024

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Association of nocturnal blood pressure and left ventricular hypertrophy in Iranian hypertensive patients

Am J Cardiovasc Dis. 2025 Apr 25;15(2):108-114. doi: 10.62347/HQQX9117. eCollection 2025.

ABSTRACT

OBJECTIVES: Hypertension is a prevalent risk factor for cardiovascular mortality and morbidity, often leading to left ventricular hypertrophy (LVH). As ambulatory blood pressure monitoring (ABPM) gains prominence in hypertension management, it is crucial to explore its association with LVH occurrence to enhance clinical understanding and treatment strategies. This study aims to investigate the correlation between nocturnal blood pressure patterns and presence of LVH in hypertensive patients, offering insights into optimizing hypertension management strategies.

METHODS: Fifty-four patients with confirmed hypertension were included in this study. All participants underwent transthoracic echocardiography within two days of admission and 48-hour ABPM within one week of admission. Based on the presence of LVH, patients were categorized into LVH and non-LVH groups. Nocturnal systolic/diastolic BP were compared between the two groups using the appropriate statistical tests.

RESULTS: Among the 54 hypertensive patients, those with LVH (n = 22) demonstrated a significantly higher nocturnal average SBP (124.04 ± 11.92 mmHg) and DBP (76.24 ± 9.76) compared to those without LVH (n = 32, SBP = 116.78 ± 13.92 mmHg, DBP = 72.45 ± 9.76, P < 0.001).

CONCLUSION: This research shows a significant association between nocturnal BP patterns and the presence of LVH in hypertensive individuals. Nocturnal SBP and DBP were identified as independent risk factors for LVH. Further research, particularly on the timing of antihypertensive medication, is warranted to confirm causal relationships and improve management strategies.

PMID:40401275 | PMC:PMC12089019 | DOI:10.62347/HQQX9117

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Influence of Maternal Education and Household Wealth on Double Burden of Malnutrition in South and Southeast Asia

Matern Child Nutr. 2025 May 21:e70049. doi: 10.1111/mcn.70049. Online ahead of print.

ABSTRACT

The double burden of malnutrition (DBM), defined by the coexistence of undernutrition and overnutrition within households, poses significant public health challenges in South and Southeast Asia. While previous studies have examined the individual effects of maternal education and household wealth on DBM, findings remain inconsistent, and little is known about how these factors interact across different contexts. To address this gap, we used nationally representative Demographic and Health Survey (DHS) data from Bangladesh (2017-2018), Cambodia (2022), Nepal (2022) and Timor-Leste (2016) to analyse the interaction between maternal education and household wealth in shaping DBM risk. These countries were selected due to their ongoing nutritional transition, which has contributed to the increasing prevalence of DBM. For the analysis, we used DHS data, which employs a standardised multistage cluster sampling method and probabilistic methods to ensure representativeness. In this study, we selected mother-child pairs from the DHS survey, focusing on children aged 0-59 months and nonpregnant mothers at the time of the survey. We included those pairs for which both the mother and child had valid weight and height measurements. Maternal education and household wealth were identified as the primary exposures. To examine their interaction and the impact of other covariates on DBM, we employed multivariable logistic regression models. Our study found that DBM prevalence was higher in urban and wealthier households, with the highest rates observed in Timor-Leste and Cambodia. Multivariable logistic regression indicated that lower maternal education increased DBM risk, especially in affluent households (OR 2.07-3.29). Conversely, higher maternal education was associated with lower DBM prevalence. Additionally, breastfeeding and antenatal care visits emerged as protective factors. These findings indicate the necessity for specific interventions aimed at enhancing maternal education and promoting healthy dietary practices, particularly in rich households. Additionally, reinforcing breastfeeding practices and increasing antenatal care visits are essential strategies to mitigate the risks associated with DBM.

PMID:40400047 | DOI:10.1111/mcn.70049

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Comparative analysis of conventional and IRMS techniques for honey adulteration detection in accordance with ISIRI standards

BMC Res Notes. 2025 May 21;18(1):226. doi: 10.1186/s13104-025-07287-z.

ABSTRACT

OBJECTIVE: This study assesses the comparative performance of Isotope Ratio Mass Spectrometry (IRMS) and conventional techniques in detecting honey adulteration. Standard analytical methods, in accordance with ISIRI guidelines, were evaluated alongside δ13C isotopic analysis via IRMS across a dataset of 20 honey samples. Conventional analytical techniques were employed to evaluate parameters such as pre-hydrolysis reducing sugars, sucrose content, the fructose-to-glucose ratio, proline, and hydroxymethylfurfural (HMF). The advanced IRMS technique was utilized to determine δ13C values for glucose with high accuracy and sensitivity. The carbohydrate profile of honey, including glucose, fructose, disaccharides, and trisaccharides, was analyzed using LC/IRMS. A comparative assessment of both methods was conducted on twenty honey samples, following ISIRI guidelines.

RESULTS: While conventional methods met ISIRI criteria in 18 out of 20 samples, IRMS produced contrasting findings-only 2 samples were identified as genuine and free from adulteration. Statistical evaluation using Prism software revealed a significant discrepancy between the two techniques, with a p-value < 0.05, indicating stronger confidence in IRMS results. The findings highlight the necessity of reconsidering current protocols for honey adulteration detection in order to preserve the purity and credibility of this high-value natural product.

PMID:40400041 | DOI:10.1186/s13104-025-07287-z

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Newborn blood pressure dynamics during immediate postnatal transition – a retrospective analysis

Ital J Pediatr. 2025 May 21;51(1):149. doi: 10.1186/s13052-025-02001-y.

ABSTRACT

BACKGROUND: The transition from intrauterine to extrauterine life presents challenges for neonates, who are at increased risk of cardio-respiratory instability. Although electrocardiogram monitoring is recommended for neonatal resuscitation after birth, its ability to assess cardiovascular function is limited. Measuring arterial blood pressure (ABP) is feasible in neonates during the immediate transition period, though its interpretation is complex. This study analyses ABP values during the immediate transition in preterm neonates.

METHODS: Data from neonates born at the Medical University of Graz between 2009 and 2023 were analysed. All preterm neonates who survived without intraventricular haemorrhage grade II or higher, and who had ABP measured non-invasively at 15 min after birth, were eligible for inclusion. Statistical analyses were employed to evaluate ABP values for each gestational week, ranging from 23 to 36 weeks of gestation.

RESULTS: Out of 305 eligible neonates, 267 preterm neonates met the inclusion criteria. The median (IQR) systolic ABP ranged from 46 (43-51) to 64 (56-68) mmHg showing a gradual increase with advancing gestational age. The mean ABP ranged from 30 (27-36) to 45 (37-47) mmHg, also exhibiting a gradual increase with higher gestational age. Similarly, the diastolic ABP ranged from 22 (19-29) to 34 (29-41) mmHg, again showing a gradual increase with advancing gestational age.

CONCLUSION: The findings indicate that ABP values during the immediate transition may be higher than those described after immediate transition in large cohort studies. Moreover, the gradual increase in ABP in preterm neonates with advancing gestational age underscores the necessity for tailored approaches to neonatal cardiovascular management during immediate transition.

PMID:40400033 | DOI:10.1186/s13052-025-02001-y

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Insomnia and depressive symptoms mediate childhood abuse and psychotic experience of male juvenile offenders: a chain mediation model

BMC Psychol. 2025 May 21;13(1):539. doi: 10.1186/s40359-025-02722-z.

ABSTRACT

BACKGROUND: Male juvenile offenders, a high-risk group with elevated recidivism and violent crime rates, face significant mental health problems, particularly with a high prevalence of psychotic experiences. Childhood abuse is known to play a key role in such experiences. Evidence suggests that insomnia and depressive symptoms may mediate the relationship between childhood abuse and psychotic experiences. This study explores how childhood abuse relates to psychotic experiences in male juvenile offenders, with a focus on the mediating roles of insomnia and depressive symptoms.

METHODS: This is a convenience sampling survey, a total of 500 juvenile male offenders in a correctional facility in southwestern China were recruited. Assessment tools included the Childhood Trauma Screener (CTS) for childhood abuse, the Athens Insomnia Scale (AIS-8) for insomnia, the Patient Health Questionnaire-2 (PHQ-2) for depressive symptoms, and the Community Assessment of Psychic Experiences-8 (CAPE-8) for psychotic experiences. Data were analyzed using descriptive statistics, hierarchical regression, and SEM with SPSS 26.0 and Mplus 8.0.

RESULTS: 475 valid samples were analyzed for demographic variables such as family structure, residence, education, and substance use. Correlation analysis revealed significant positive associations between childhood abuse, insomnia, depressive symptoms, and psychotic experiences, with the strongest correlations observed between insomnia and depressive symptoms (r = 0.44) and between depressive symptoms and psychotic experiences (r = 0.44). Hierarchical regression and structural equation modeling confirmed that childhood abuse significantly predicts psychotic experiences (β = 0.22, p < 0.001), with insomnia (β = 0.42, p < 0.001) and depressive symptoms (β = 0.44, p < 0.001) serving as partial mediators. Mediation analysis indicated that insomnia and depressive symptoms jointly accounted for 28.40% of the variance in psychotic experiences, supporting the proposed chain mediation effect. These findings highlight the interactive mediating roles of insomnia and depressive symptoms in the relationship between childhood abuse and psychotic experiences among male adolescent offenders.

CONCLUSIONS: Insomnia and depressive symptoms mediate the childhood abuse and psychotic experiences among male juvenile offenders. This finding provides valuable insights for mental health interventions aimed at reducing recidivism in this population. Specifically, the results highlight the importance of implementing mental health interventions targeting insomnia and depression within the correctional system, which not only helps improve the mental health of juvenile offenders but also effectively reduces the risk of recidivism.

PMID:40400021 | DOI:10.1186/s40359-025-02722-z

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Factors contributing to non-compliance with on-demand treatment guidelines in hereditary angioedema

Allergy Asthma Clin Immunol. 2025 May 21;21(1):25. doi: 10.1186/s13223-025-00969-0.

ABSTRACT

BACKGROUND: Hereditary angioedema (HAE) is a rare genetic disorder characterized by painful and potentially life-threatening tissue swelling due to a deficiency or dysfunction of the C1 esterase inhibitor protein. Despite the availability of comprehensive on-demand treatment guidelines, compliance to guideline recommendations remains suboptimal, resulting in persisting unmet need.

METHODS: This observational, online survey was conducted between September 6, 2022, and October 19, 2022 to understand the behaviors and perspectives of individuals in the US with hereditary angioedema (HAE). Participants were recruited by the US Hereditary Angioedema Association and were eligible if they were US residents with clinician-diagnosed HAE type I or II and had experienced at least one HAE attack. The survey included multiple-choice, rank-order, and scale-based responses using a 5-point Likert scale for agreement and an 11-point Likert scale for anxiety. Statistical analysis was performed using Microsoft Excel, summarizing continuous variables as means, medians, and ranges, and categorical variables as frequency distributions and percentages.

RESULTS: A total of 107 out of 155 participants completed the survey (mean age = 41 years; 80.4% female). Half of the respondents used both prophylaxis and on-demand therapy, while the other half used on-demand therapy only. Icatibant was the most commonly used on-demand treatment (78.5%). The survey revealed that 57% of respondents did not treat all HAE attacks, and only 14% treated attacks immediately. Delays in treatment were common, with a mean time to treatment of 2.4 h, and younger patients were less likely to carry on-demand treatment. Reasons for delaying treatment included the perceived severity of the attack, lack of on-demand treatment availability, and pain associated with treatment. Additionally, 32.7% of respondents experienced the return of an HAE attack after initial treatment, with those delaying treatment more likely to experience recurrence. The survey also found that delayed treatment led to more severe attacks and longer recovery times, impacting work, social activities, and overall quality of life.

CONCLUSIONS: Although guidelines recommend early treatment of HAE attacks, many respondents do not treat immediately. This finding underscores the importance of incorporating open patient-physician communication to improve guideline compliance and the management of HAE.

PMID:40400016 | DOI:10.1186/s13223-025-00969-0

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Distribution of age at natural menopause, age at menarche, menstrual cycle length, height and BMI in BRCA1 and BRCA2 pathogenic variant carriers and non-carriers: results from EMBRACE

Breast Cancer Res. 2025 May 21;27(1):87. doi: 10.1186/s13058-025-02030-9.

ABSTRACT

BACKGROUND: Carriers of germline pathogenic variants (PVs) in the BRCA1 and BRCA2 genes are at higher risk of developing breast and ovarian cancer than the general population. It is unclear if these PVs influence other breast or ovarian cancer risk factors, including age at menopause (ANM), age at menarche (AAM), menstrual cycle length, BMI or height. There is a biological rationale for associations between BRCA1 and BRCA2 PVs and reproductive traits, for example involving DNA damage and repair mechanisms. The evidence for or against such associations is limited.

METHODS: We used data on 3,046 BRCA1 and 3,264 BRCA2 PV carriers, and 2,857 non-carrier female relatives of PV carriers from the Epidemiological Study of Familial Breast Cancer (EMBRACE). Associations between ANM and PV carrier status was evaluated using linear regression models allowing for censoring. AAM, menstrual cycle length, BMI, and height in carriers and non-carriers were compared using linear and multinomial logistic regression. Analyses were adjusted for potential confounders, and weighted analyses carried out to account for non-random sampling with respect to cancer status.

RESULTS: No statistically significant difference in ANM between carriers and non-carriers was observed in analyses accounting for censoring. Linear regression effect sizes for ANM were -0.002 (95%CI: -0.401, 0.397) and -0.172 (95%CI: -0.531, 0.188), for BRCA1 and BRCA2 PV carriers respectively, compared with non-carrier women. The distributions of AAM, menstrual cycle length and BMI were similar between PV carriers and non-carriers, but BRCA1 PV carriers were slightly taller on average than non-carriers (0.5 cm difference, p = 0.003).

CONCLUSION: Information on the distribution of cancer risk factors in PV carriers is needed for incorporating these factors into multifactorial cancer risk prediction algorithms. Contrary to previous reports, we found no evidence that BRCA1 or BRCA2 PV are associated with hormonal or anthropometric factors, except for a weak association with height. We highlight methodological considerations and data limitations inherent in studies aiming to address this question.

PMID:40399999 | DOI:10.1186/s13058-025-02030-9