Tag: nevin manimala

Medicine (Baltimore). 2025 Mar 21;104(12):e41759. doi: 10.1097/MD.0000000000041759.

ABSTRACT

Lower extremity deep venous thrombosis (LEDVT) is a common complication in patients with acute hemorrhagic stroke, leading to increased risk of pulmonary embolism, disability, and mortality. Despite its importance, LEDVT often goes undetected in clinical practice, and early preventive strategies remain insufficient. This study aimed to explore the incidence of LEDVT in acute hemorrhagic stroke patients, identify key risk factors, and discuss potential preventive measures to reduce its occurrence and improve patient outcomes. A retrospective analysis was conducted on 431 acute hemorrhagic stroke patients admitted to The First Affiliated Hospital of Chengdu Medical College between January 2022 and December 2023. Relevant clinical data, including patient demographics, comorbidities, NIHSS score, and treatment history, were collected. LEDVT was diagnosed using standardized ultrasound criteria. Statistical analyses, including univariate and multivariate logistic regression, were performed using SPSS 17.0 to identify independent risk factors associated with LEDVT. The incidence of LEDVT among the 431 acute hemorrhagic stroke patients was 12.1%, with 52 cases identified. Significant risk factors for LEDVT included advanced age, diabetes, infection, prolonged bed rest, high-dose diuretic use, NIHSS score ≥16, and hyperlipidemia (P < .05). Gender, smoking history, and alcohol consumption were not found to be statistically significant. Multivariate logistic regression revealed that advanced age, diabetes, infection, prolonged bed rest, high-dose diuretic use, NIHSS score ≥16, and hyperlipidemia were independent risk factors for LEDVT. LEDVT in acute hemorrhagic stroke patients is influenced by multiple factors, including comorbidities, severity of neurological impairment, and treatment regimens. Dehydration therapy used for managing brain edema and intracranial pressure was also found to be an independent risk factor. Given the significant impact of LEDVT on patient prognosis, early identification of at-risk patients and the implementation of proactive preventive measures-such as pharmacological treatments and physical interventions-are critical in reducing the occurrence of LEDVT, alleviating patient suffering, and improving long-term outcomes. Future studies should focus on refining preventive strategies and exploring more individualized interventions to further reduce the incidence of LEDVT in these patients.

PMID:40128074 | DOI:10.1097/MD.0000000000041759

Medicine (Baltimore). 2025 Mar 21;104(12):e41908. doi: 10.1097/MD.0000000000041908.

ABSTRACT

BACKGROUND: Research shows that traditional Chinese exercises (TCEs) significantly improve anxiety and depression in older adults. However, studies on the effects of different exercise durations, frequencies, and intensities in this population are limited. This systematic review and meta-analysis evaluate the impact of TCEs on anxiety and depression, and explores the optimal exercise parameters, aiming to provide evidence for nonpharmacological treatment options in clinical practice.

METHODS: As of August 2023, we conducted a literature search through 3 English electronic databases to identify relevant studies. We included studies that met our criteria. During the literature inclusion process, we used Review Manager 5.4 to create flow diagrams, assess the risk of bias, and perform statistical analyses.

RESULTS: A total of 31 eligible studies involving 2501 participants were included. Compared with the control group, TCEs showed significant improvements in anxiety (standardized mean differences [SMD] = -0.93, 95% confidence interval [CI]: -1.78 to -0.08, P = .03, I2 = 96%) and depression (SMD = -1.14, 95% CI: -1.82 to -0.47, P = .03, I2 = 96%). Subgroup analyses indicated that an intervention duration of 12 to 16 weeks yielded the largest effect size for anxiety (SMD = -1.36, 95% CI: -2.36 to -0.36, P = .008), while the 24-week group showed the largest effect size for depression (SMD = -0.87, 95% CI: -1.43 to -0.30, P = .002). For intervention frequency, a regimen of 3 to 4 times per week produced the largest effect size for anxiety (SMD = -2.34, 95% CI: -4.69 to 0.02, P = .05), whereas a frequency of 5 to 7 times per week demonstrated the largest effect size for depression (SMD = -1.00, 95% CI: -1.83 to -0.17, P = .02). Regarding single-session exercise duration, a group exercising for 40 to 60 minutes showed the largest effect sizes for anxiety (SMD = -1.38, 95% CI: -2.40 to -0.37, P = .007) and depression (SMD = -0.75, 95% CI: -1.07 to -0.42, P < .00001).

CONCLUSION: The results indicate that TCEs significantly alleviate anxiety and depression in older adults, with intervention frequency, intensity, and duration potentially influencing the outcomes. However, heterogeneity across studies was observed, primarily due to differences in intervention types and control group designs. These findings offer valuable guidance for future research directions.

PMID:40128068 | DOI:10.1097/MD.0000000000041908

Medicine (Baltimore). 2025 Mar 21;104(12):e41931. doi: 10.1097/MD.0000000000041931.

ABSTRACT

The vertebrobasilar artery (VBA) exhibits substantial inter-individual variation that must be considered in diagnosis and surgical planning. We conducted 3-dimensional reconstruction of the bilateral VBA based on head and neck computed tomography angiography (CTA) to assess bilateral, individual, age-dependent, and sex-dependent differences in anatomical parameters. A retrospective study was performed. Individual 3-dimensional models of the VBA and skull were constructed and morphology evaluated based on head and neck CTA data from 199 adults. According to morphological and anatomical variation, the VBA was divided into 3 types: balanced, L, and S. The diameters and lengths of basilar and bilateral vertebral artery (VA) intracranial segments as well as VBA blending length, and bilateral distances of the vertebral arteries moving up the atlas were measured and statistically compared. The L-type was the most common VBA morphology, and anatomic type distribution differed significantly by age (P < .05). VA diameter was 3.34 ± 0.68 mm on the left side and 3.09 ± 0.71 mm on the right side, while bending length was 5.62 ± 3.35 mm on the left and 4.94 ± 3.41 mm on the right side. Balanced basilar arteries measured 3.41 ± 0.61 mm in diameter, 2.83 ± 0.33 cm in length, and 2.55 ± 2.45 mm in bending length. The L-type basilar artery measured 3.48 ± 0.71 mm in diameter, 3.06 ± 0.44 cm in length, and 2.78 ± 0.37 mm in bending length. Finally, S-type basilar arteries measured 3.84 ± 0.86 mm in diameter, 3.38 ± 0.61 cm in length, and 3.67 ± 4.39 mm in bending length. The distance traveled by the VA across the atlas differed significantly between left and right sides as well as between males and females (P < .05). The vertebrobasilar arteries in the general healthy population were successfully fused and 3-dimensionally reconstructed based on the CTA, and an observational study was conducted on their morphological and anatomical characteristics. Three-dimensional reconstruction of the VBA using CTA is feasible for anatomical research and also has diagnostic value for the variations and anatomical parameters of the VBA.

PMID:40128065 | DOI:10.1097/MD.0000000000041931

Medicine (Baltimore). 2025 Mar 21;104(12):e41966. doi: 10.1097/MD.0000000000041966.

ABSTRACT

Disruptor of telomeric silencing 1-like (DOT1L) is a protein involved in epigenetic regulation, as well as in the Wnt and hypoxia signaling pathways. DOT1L has been found to play a role in the pathogenesis of various diseases associated with these pathways. In this study, it was aimed to determine serum DOT1L levels in patients with fibromyalgia (FM) and its association with disease activity. Forty-eight patients diagnosed with FM according to the 2016 American College of Rheumatology criteria and 48 healthy controls were included in the study. Disease activity was measured using clinical questionnaires (Fibromyalgia Impact Questionnaire [FIQ], Visual Analog Scale [VAS], Widespread Pain Index [WPI], Symptom Severity Score [SSS], Pittsburgh Sleep Quality Index [PSQI], Fatigue Severity Scale [FSS], Hospital Anxiety Scale [HAS] and Hospital Depression Scale [HDS]) and DOT1L levels were assessed using Enzyme-Linked ImmunoSorbent Assay in all serum samples. Additionally, routine biochemical analyses were performed. Pain duration, FIQ, VAS, WPI, SSS, PSQI, FSS, HAS, and HDS were found to be statistically significant higher in FM compared to the control group (P = .001). Compared with the control group (0.53 ± 0.12 ng/mL), DOT1L concentrations were significantly higher in patients with FM (1.47 ± 0.13 ng/mL; P = .001). In the FM group, DOT1L levels also showed a positive correlation with the results of the all the clinical questionnaires (P = .001). It was found that the DOT1L measurement value has a statistically significant effect in predicting the difference between the FM and control groups (P = .022). When the cutoff value for DOT1L was set at 0.315 ng/mL, it was found to have 79% sensitivity and 71.7% specificity in detecting FM. This study highlights the potential of DOT1L as a valuable biomarker for FM diagnosis.

PMID:40128062 | DOI:10.1097/MD.0000000000041966

Medicine (Baltimore). 2025 Mar 21;104(12):e41951. doi: 10.1097/MD.0000000000041951.

ABSTRACT

Emerging research indicates a potential pathogenic overlap between primary aldosteronism (PA) and aortic aneurysm (AA)/aortic dissection (AD). Despite case reports suggest a potential link between PA and AA/AD, the causality of this relationship remains unclear. This study is the first to elucidate the causal association between genetically predicted PA and the risk of AA and AD through Mendelian randomization (MR) analysis. Genome-wide significant single nucleotide polymorphisms associated with PA were identified from publicly available genome-wide association study summary statistics. Genetic associations with AA and AD were obtained from the FinnGen database. The inverse-variance weighted (IVW) method, along with complementary MR analysis methods, was employed to generate primary estimates. Sensitivity analyses were performed to ensure the robustness of findings. MR analyses utilizing the IVW method revealed a significant causal association between genetically predicted PA and the risk of AA (OR = 1.038; 95% CI = 1.024-1.053; P < .01), thoracic AA (OR = 1.066; 95% CI = 1.045-1.087; P < .01) and AD (OR = 1.165; 95% CI = 1.113-1.219; P < .01). Conversely, no significant association was observed between PA and abdominal AA (OR = 1.013; 95% CI = 0.993-1.034; P = .210). There was no heterogeneity and horizontal pleiotropy in the MR analyses (P > .05). PA is genetically and causally associated with higher risks of AA and AD. More attention should be paid to the screening and treatment of PA to reduce the incidence of aortic diseases.

PMID:40128053 | DOI:10.1097/MD.0000000000041951

Medicine (Baltimore). 2025 Mar 21;104(12):e41903. doi: 10.1097/MD.0000000000041903.

ABSTRACT

Hand hygiene is an important factor in the prevention of healthcare-associated infections. Studies show healthcare professionals’ hand hygiene practices vary and are not at sufficient levels. This study aimed to examine the effect of the COVID-19 pandemic on the beliefs and practices of nurses working in intensive care units (ICU) towards hand hygiene. This was longitudinal, repeated, and cross-sectional study. The study was conducted in 2 phases between January 2,2020 and March 10,2021 in the intensive care unit of a university hospital in northern Turkey. No sampling method was used. The objective was to reach the entire population. The first phase of this study was completed with 119 (76% of the population) ICU nurses and the second phase with 85 (70% of the population) ICU nurses. The data were collected with the personal information form, hand hygiene belief scale (HHBS), hand hygiene practices inventory (HHPI) and the views of the intensive care nurses related to COVID-19. Descriptive statistics such as mean and standard deviations, frequency, and percentages and analytical statistics such as t-test, Mann-Whitney U test, Kruskal-Wallis test were used for data analysis at the significance level of P < .05. The majority of the nurses who participated in the study were female (75.6%; 69.4%), with a mean age of 30.82 ± 5.51 and 30.58 ± 5.51 years, respectively. There was a significant difference (P < .05) between the median HHBS (P = .002) and HHPI (P = .001) scores before and after COVID-19. All nurses (100%) reported that the pandemic was effective in hand hygiene practices. In this study, it was determined that the hand hygiene beliefs and practices of nurses were high, and the scores of nurses’ hand hygiene beliefs and practices after COVID-19 increased significantly. Healthcare professionals must always adhere to stringent standards of hand hygiene, rather than merely during periods of heightened challenges. To ensure the sustainability of optimal hand hygiene practices, it is recommended that motivational interventions that strengthen beliefs and practices related to hand hygiene should be implemented and that studies should be conducted to evaluate their effectiveness.

PMID:40128050 | DOI:10.1097/MD.0000000000041903

Medicine (Baltimore). 2025 Mar 21;104(12):e41952. doi: 10.1097/MD.0000000000041952.

ABSTRACT

The effectiveness of in-person psychological interventions for chronic pain populations has been widely studied. The current retrospective pilot study evaluates the effectiveness of a 10-week integrative telehealth pain group intervention consisting of cognitive, behavioral, mindfulness, and lifestyle strategies on anxiety, depression, pain catastrophizing, pain interference, and pain intensity. Participants at a large multidisciplinary hospital are referred internally from various medical departments within the hospital. The present study consists of data from 9 group cohorts from October 2020 to June 2022. The study included 86 patients, with 52 completing all 10 weeks of the intervention with post-questionnaire data available. Measures assessing anxiety, depression, pain catastrophizing, pain interference, and pain intensity at baseline and at the completion of the intervention. A series of paired samples t-tests were used to assess change in each outcome measure from baseline to after completion of the program. All the outcome variables including anxiety, depression, pain interference, pain intensity, and pain catastrophizing showed statistically significant reductions after the intervention compared to baseline assessments. There were no significant differences in any of the demographic variables (age, gender, ethnicity, education level) or chronic pain condition between participants who did and did not complete the program. Preliminary data suggest that this 10-week integrative telehealth pain group intervention significantly lowered anxiety, depression, pain catastrophizing, pain interference, and pain intensity from pre- to post-intervention. Larger, randomized controlled studies are needed to validate these results.

PMID:40128049 | DOI:10.1097/MD.0000000000041952

Medicine (Baltimore). 2025 Mar 21;104(12):e41907. doi: 10.1097/MD.0000000000041907.

ABSTRACT

There was currently no bibliometric analysis available regarding to bladder cancer (BCa) imaging. The aim of this study was to conduct a comprehensive bibliometric analysis of relevant literature on the imaging of BCa and elucidate global research hotspots and further trends in this field. All relevant literature on the imaging of BCa published between 1981 and 2023 were retrieved from the Web of Science Core Collection. VOSviewer, Bibliometrix, and Citespace were utilized for bibliometric analysis of publications, countries, authors, institutions, journals, references, and keywords. A total of 4462 articles were retrieved. The research in this field has been increasing consistently since 1981. The United States of America was the most productive country and most productive institutions were from it. Shariat SF was the most productive author with 36 articles and the author with the highest co-citations was Herr HW (472). Journal of Urology was the most productive journal and Frontiers in Oncology, Abdominal Radiology and Cancers exhibited heightened activity in recent years. A study by Siegel RL, published in CA-A Cancer Journal for Clinicians in 2019, had the highest number of co-citations. Further analysis of the keyword analysis and timeline view revealed that “radiomics,” “deep learning,” “multiparametric MRI,” “VI-RADS,” “muscle-invasive bladder cancer,” “immunotherapy,” and “long term outcome” were the most recent hotspots. In totally, in the period of 1981 to 2023 year, the USA occupies a critical position in the field of BCa imaging. It is anticipated that MRI-based imaging-reporting and data system and deep learning will be the research hotspots in the future.

PMID:40128048 | DOI:10.1097/MD.0000000000041907

Medicine (Baltimore). 2025 Mar 21;104(12):e41722. doi: 10.1097/MD.0000000000041722.

ABSTRACT

BACKGROUND: C-reactive rotein (CRP) has been extensively studied as a biomarker that can predict mortality in patients with acute lung disease and our study aimed to elucidate the prognostic value of CRP levels for mortality in patients with various airway diseases, accounting for these differences and potential confounding factors accounts.

METHODS: An extensive literature search was conducted in several databases including PubMed, Embase, Web of Science, Scopus, and ProQuest to ensure the inclusion of up-to-date evidence from studies published between January 2019 and December 2024. Both fixed-effects and random-effects models were used to calculate pooled mean hazard ratios (HR) and odds ratios (OR) for mortality.

RESULTS: For mortality, the fixed effects model revealed a HR of 1.0065 (95% CI: 1.0054-1.0075, P < .0001), indicating a slightly increased risk of death associated with higher CRP levels. However, the random effects model, considering study heterogeneity, suggested an HR of 1.0488 (95% CI: 0.9978-1.1024, P = .0608), with significant heterogeneity (Q = 135.31, P < .0001). The OR analysis under the random effects model showed a more substantial increase in mortality risk with an OR of 1.2033 (95% CI: 1.0635-1.3614, P = .0033). Regarding ICU admissions and ventilation needs, substantial heterogeneity was also observed. The analysis did not find a statistically significant association between elevated CRP levels and ICU admission (OR = 1.1108, 95% CI: 0.9604-1.2847, P = .1568) or the necessity for ventilation (OR = 1.8981, 95% CI: 0.9651-3.7331, P = .0633), although both indicated trends towards increased risk.

CONCLUSION: CRP levels show a potential yet inconsistent association with mortality risk in patients with pulmonary infections. While elevated CRP levels suggest an increased risk of mortality, the results should be interpreted cautiously due to potential overestimation of the effect and the presence of publication bias.

PMID:40128046 | DOI:10.1097/MD.0000000000041722

Medicine (Baltimore). 2025 Mar 21;104(12):e41927. doi: 10.1097/MD.0000000000041927.

ABSTRACT

Brain ultrasonography has emerged as a key tool in neurocritical care. This study aimed to investigate the global research trends and future research directions in the application of brain ultrasonography for craniocerebral diseases using quantification and visualization approaches. Publications on brain ultrasonography published between 2004 and 2024 retrieved from the Web of Science Core Collection database were screened against predetermined inclusion and exclusion criteria and analyzed. The data were processed using VOSviewer and CiteSpace to identify core countries/regions, institutions, authors, journals, collaborations, and research trends. Over the past 2 decades, 1251 articles focusing on brain ultrasonography as the primary subject were published across 455 journals by 5655 authors from 1619 institutions in 84 countries/regions. Publications exhibited a fluctuating and gradually progressive trend, with the number of publications per year peaking between 2019 and 2021. The USA, the United Kingdom, and Germany emerged as leading countries in this field, demonstrating robust cooperation with other countries/regions. Additionally, the University of Leicester and Panerai RB was the most prolific institution and author, respectively. The clinical applications of brain ultrasonography have progressively broadened from neurocritical care to encompass the general intensive care unit and emergency department. Finally, recent scholarly attention has primarily been directed toward the “deep learning framework” and “hypoxic-ischemic brain injury.” Globally, publications focusing on brain ultrasonography displayed a fluctuating and gradually progressive trend over the past 2 decades. Moreover, primary clinical applications and techniques have been constantly expanding. Overall, the findings of our study expanded our understanding of the current status of brain ultrasonography, potentially guiding future development directions in this field.

PMID:40128044 | DOI:10.1097/MD.0000000000041927