Tag: nevin manimala

JMIR Mhealth Uhealth. 2026 Mar 24;14:e70192. doi: 10.2196/70192.

ABSTRACT

BACKGROUND: Childhood obesity and unhealthy dietary habits remain major public health concerns and are influenced by the surrounding food environment. Food marketing, particularly for ultraprocessed foods (UPFs), shapes children’s food preferences and consumption. However, food environments are complex and constantly changing, making them difficult to map and monitor. Developing approaches that capture these dynamics is essential to understand and address children’s exposure to unhealthy food marketing.

OBJECTIVE: This study aimed to pilot-test a novel tool consisting of a smartphone app and dashboard designed to identify areas where children are exposed to outdoor food advertising. Additionally, the study assessed the prevalence of advertisements for UPFs, health-promoting foods, and offers in the identified areas and explored differences in exposure by city size and socioeconomic status (SES).

METHODS: A cross-sectional study was performed in 2 Swedish counties. Initially, 46 children from 4 schools in areas with varying SES used a smartphone app to take pictures of food advertisements that they encountered in their everyday lives. The app also recorded the GPS locations of where the pictures were taken. Pictures with associated GPS data were automatically uploaded and visualized in a web-based dashboard, allowing for identification of areas where children see many food advertisements, so-called “hotspot areas.” The identified hotspot areas were subsequently visited by 2 researchers (SS and PF), who systematically photographed all food advertisements in the areas. All pictures taken by the researchers were later analyzed based on their content of UPFs, health-promoting foods such as fruits, berries, vegetables, and seafood (FBVS), and price promotions.

RESULTS: Based on 1308 pictures of outdoor food advertisements taken by children using the app, 34 hotspot areas were identified through the dashboard. In these areas, researchers collected 2955 pictures of outdoor food advertisements during the mapping activity. Overall, 77.5% (2291/2955) of advertisements promoted UPFs, with no significant difference between the large and small cities. In Stockholm, a higher proportion of UPFs appeared in the high-SES area compared to the low-SES area, though the proportion was high in both areas. FBVS featured in 20.8% (616/2955) of advertisements, slightly more often in Stockholm and in the high-SES area. Price promotions appeared in 23.6% (697/2955) of advertisements, mainly featured UPFs (518/697, 74.3%) and less often FBVS (142/697, 20.4%). Price promotions for UPFs were somewhat more frequent in Stockholm, and FBVS promotions were more common in the high-SES area.

CONCLUSIONS: Using a novel, child-centered, mobile health tool combining a smartphone app and dashboard, this study identified local food advertising hotspots. Most advertisements in the hotspots promoted UPFs, while a few featured FBVS, a pattern also reflected in price promotions. These trends were consistent across areas, highlighting a food marketing landscape misaligned with dietary guidelines and the need for policy action.

PMID:41876212 | DOI:10.2196/70192

BMJ Support Palliat Care. 2026 Mar 24:spcare-2025-006013. doi: 10.1136/spcare-2025-006013. Online ahead of print.

ABSTRACT

OBJECTIVES: To describe longitudinal changes in quality of life (QOL) and symptoms among patients with acute myeloid leukaemia (AML) receiving real-world early palliative care (EPC) during the first year after diagnosis.

METHODS: This prospective observational study enrolled consecutive adults with AML followed in an outpatient EPC clinic. QOL and symptoms were assessed monthly using the Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu), the Edmonton Symptom Assessment Scale (ESAS) and the Hospital Anxiety and Depression Scale (HADS). Scores were analysed through joint modelling, integrating longitudinal and survival data, and sensitivity analyses.

RESULTS: Thirty-eight patients contributed 169 FACT-Leu, 151 ESAS and 111 HADS questionnaires. From baseline, median FACT-Leu scores improved from 108.7 to 135.7 at 4 months and remained stable through 8 and 12 months (p≤0.011), while ESAS scores decreased from 25.2 to 5.7 by 4 months and remained low through 12 months (p<0.001), indicating sustained symptom improvement. HADS scores showed no statistically significant changes, although a modest anxiety improvement was noted. Trajectories remained consistent across all sensitivity analyses.

CONCLUSIONS: In AML patients receiving EPC in a real-world outpatient setting, QOL and symptom burden showed sustained improvement over time. These descriptive findings highlight the potential effectiveness and clinical relevance of EPC in routine AML care and provide real-world reference data for future controlled studies.

PMID:41876210 | DOI:10.1136/spcare-2025-006013

Mol Oncol. 2026 Mar 24. doi: 10.1002/1878-0261.70242. Online ahead of print.

ABSTRACT

Glioblastoma (GBM) is the most common and aggressive primary brain tumor in adults, with poor prognosis despite multimodal therapy. Chloride cotransporters NKCC1 and KCC2 are key regulators of intracellular chloride levels and thereby determine whether GABA acts inhibitory or excitatory. In GBM, disrupted chloride homeostasis promotes proliferation, migration, and stem-like properties, but its clinical relevance is not fully understood. We analyzed NKCC1 and KCC2 expression in GBM samples, considering clinical parameters, such as age, gender, and MGMT promoter methylation. Statistical analyses included ROC-based cutoff determination, Kaplan-Meier survival analysis, and subgroup. Immunohistochemistry was performed to identify cell types expressing NKCC1. NKCC1 expression was significantly higher in older patients and emerged as a prognostic marker for recurrence-free survival, with lower levels correlating with delayed recurrence, although overall survival was unaffected. NKCC1 was expressed in stem-like, astrocytic, and neuronal progenitor cells, but not in mature neurons. These findings identify NKCC1 as a regulator of GBM progression and recurrence, linking chloride transporter imbalance to GABAergic signaling. Targeting NKCC1 and restoring chloride homeostasis may provide promising new treatment strategies.

PMID:41876207 | DOI:10.1002/1878-0261.70242

Biomedica. 2026 Mar 2;46(1):121-217. doi: 10.7705/biomedica.7946.

ABSTRACT

INTRODUCTION: A second hematopoietic stem cell transplant is required when the first transplant fails, usually due to relapse or graft failure, and is associated with increased morbidity and mortality. Survival rates range from 74 to 82% in non-neoplastic diseases and from 39 to 58% in neoplastic conditions. Evidence on second hematopoietic stem cell transplant in children is limited, particularly in low- and middle-income countries.

OBJECTIVE: To describe the clinical characteristics, complications, and outcomes of children who underwent a second transplant at a high-complexity center between 2012 and 2024.

MATERIALS AND METHODS: Case series study with descriptive and survival analysis using the Kaplan-Meier method in Stata 14™.

RESULTS: A total of 346 allogeneic transplants were performed, of which 20 patients underwent a second transplant. Of these, 17 received a haploidentical donor for their second transplant, and the primary indication was a neoplastic disease in 13 cases. The second transplant was performed due to graft failure in 11 of the 20 patients, and due to relapse in the remaining 9. The mean age was 10.7 ± 5 years, with a male predominance (14 out of 20). Haploidentical transplants accounted for 16 of the 20 cases, and 11 used the same donor. The most common complications were acute graft-versus-host disease in 7 cases, 2 of grade III, cytomegalovirus infection in 10 cases, and graft failure after the second transplant in 4 cases: 3 primary, 1 secondary. Transplant-related mortality was 31%. The 2-year overall survival was 54%, with a median follow-up of 11 months.

CONCLUSIONS: Second hematopoietic stem cell transplant is a viable therapeutic option when no other alternatives are available, particularly in resource-limited settings.

PMID:41875460 | DOI:10.7705/biomedica.7946

Biomedica. 2026 Mar 2;46(1):97-108. doi: 10.7705/biomedica.7551.

ABSTRACT

Introducción. El análisis del flujo vaginal cumple un papel clave en el diagnóstico clínico y en la toma de decisiones médicas. La estandarización del informe es esencial para garantizar la confiabilidad diagnóstica.

OBJETIVO: Evaluar la calidad del informe del frotis vaginal de cinco laboratorios clínicos de la región del Pacífico colombiano. Materiales y métodos. Se trata de un estudio descriptivo y retrospectivo basado en los registros de cinco laboratorios (tres públicos y dos privados) ubicados en tres municipios del Pacífico colombiano. Se utilizó la guía BACOVA ERIGE para evaluar si los componentes analíticos estaban completos o incompletos. Los datos se procesaron con XLSTAT Premium, versión 2024, mediante cálculos de medias, desviaciones estándar, proporciones y razones. Se aplicó la prueba de c2 para comparar el cumplimiento entre laboratorios, y se hicieron análisis de correspondencia múltiple y análisis discriminadores para determinar los patrones del informe y las diferencias entre municipios.

RESULTADOS: Se analizaron 1260 registros de mujeres entre los 18 y los 60 años: el 56,8 % estaban embarazadas y el 57 % se encontraban afiliadas al régimen subsidiado. El cumplimiento de la guía BACOVA ERIGE fue mayor en Ipiales (54,44 %) que en Cali (24,21 %) y Quibdó (21,35 %) (c², p = 0,047). Mediante los análisis de correspondencia múltiple y discriminante, se identificaron tres diferentes patrones de informes por municipio.

CONCLUSIONES: La variabilidad observada en los informes del frotis vaginal pone en evidencia la necesidad de estandarizar los procedimientos posteriores al análisis. La unificación de los criterios técnicos entre laboratorios mejoraría la calidad diagnóstica del desequilibrio de la flora vaginal y fortalecería la toma de decisiones clínicas.

PMID:41875458 | DOI:10.7705/biomedica.7551

Biomedica. 2026 Mar 2;46(1):83-96. doi: 10.7705/biomedica.7730.

ABSTRACT

Introducción. El trasplante de órganos es vital para mejorar la calidad de vida de los pacientes con insuficiencia orgánica, pero la escasez de donantes es un desafío global. En Colombia, la demanda supera la oferta, lo cual aumenta la mortalidad de aquellos pacientes en las listas de espera. Objetivo. Analizar las causas de rechazo de potenciales donantes de órganos, según la evaluación de Fundonar en tres regionales del país durante el año 2022. Materiales y métodos. Se llevó a cabo un estudio transversal descriptivo basado en datos retrospectivos de posibles donantes reportados a la Red de Donación y Trasplantes de Colombia. Se incluyeron 1451 casos evaluados. Las causas para rechazar un donante potencial se agruparon en tres categorías: médicas, médico-legales y logísticas. Se utilizó estadística descriptiva, se evaluó la normalidad de las variables y se compararon los donantes con contraindicaciones en cada regional mediante el análisis de varianza. Se utilizó el software R, versión 4.0.3. Resultados. De los 1451 donantes evaluados, 849 tenían causas para el rechazo. De estos, el 29,8 % presentó falla multiorgánica, el 20,8 % tenía alguna comorbilidad y el 15,3 % no cumplía con los criterios diagnósticos de muerte encefálica. Conclusión. La mayoría de las causas médicas de rechazo podrían reconsiderarse sopesando los riesgos y los beneficios para los receptores. Un enfoque personalizado y multidisciplinario, con criterios basados en la evidencia y decisiones en tiempo real adaptadas a Colombia, podría mejorar las tasas de aprobación de donación de órganos.

PMID:41875457 | DOI:10.7705/biomedica.7730

Biomedica. 2026 Mar 2;46(1):71-82. doi: 10.7705/biomedica.7702.

ABSTRACT

INTRODUCTION: Antibiotic consumption and resistance have increased worldwide. Antibiotic resistance results in longer hospital stays and higher healthcare costs.

OBJECTIVE: To describe the consumption of antibiotics and associated expenses in Colombia.

MATERIALS AND METHODS: A meticulous descriptive cross-sectional study of antibiotic consumption and expenditure in Colombia from 2020 to 2023 was conducted. Between 2020 and 2023, a description of the consumption and expenditure of antibiotics in Colombia was made. Data were obtained from IQVIA™ (IMS Health and Quintiles). The prominent families of antimicrobials used in Colombia were selected. Twelve pharmacological families were classified, including 27 antimicrobials and three β-lactamase inhibitors. The defined daily dose was used to measure antibiotic consumption, identify variations, and evaluate medical prescription practices. The defined daily dose per 1,000 inhabitants per day was estimated to obtain information from the population receiving daily antibiotic treatment. The amount of antibiotics used was estimated in grams and tons per year.

RESULTS: The top 10 most consumed antimicrobials by defined daily dose per 1,000 inhabitants per day in Colombia were amoxicillin, azithromycin, metronidazole, cephalexin, ciprofloxacin, trimethoprim-sulfamethoxazole, ampicillin, sulbactam, clarithromycin, cefazolin, and dicloxacillin. The total consumption of antibiotics was 2,139 tons, which represented an expense of USD$ 708,112,587, for an increase of 17 and 8%, respectively, during the period.

CONCLUSIONS: The progressive increase in consumption and spending on antimicrobials in Colombia requires a set of interventions that include promoting changes in medical prescribing behaviour and a public education campaign that leads to the adoption of a sustainable public health policy.

PMID:41875456 | DOI:10.7705/biomedica.7702

Diving Hyperb Med. 2026 Mar 31;56(1):83-87. doi: 10.28920/dhm56.1.83-87.

ABSTRACT

Closed circuit rebreather (CCR) diving sets use soda lime, a sodium hydroxide-based ‘scrubber’ substance to remove CO₂ from exhaled breathing gas thus prolonging dive time and efficiency. Inadvertent water ingress into the set may result in reaction with the scrubber and a highly alkaline solution known as a ‘caustic cocktail’ may be formed. Ingestion or aspiration of this solution can cause severe chemical burns. Irrigation with freshwater is the mainstay of initial treatment of ‘caustic cocktail’ injuries in CCR divers. Published advice advises divers never to use acidic diluents to irrigate and neutralise a caustic cocktail solution due to concerns over the potentially exothermic nature of the neutralisation reaction. However, there is limited available evidence to support this advice, and it was felt that further research into the best treatment options available for caustic cocktails is required. This study used an in vitro model of an ingested caustic cocktail to investigate pH and temperature changes after adding different diluents (including acidic diluents orange juice or coca cola) to a solution of sodium hydroxide. Acidic diluents reduce pH significantly more than neutral diluents with a respective mean drop in pH of 5.99 compared to 0.78 (P = 0.015). There is no statistically significant difference in temperature change noted between the two types of diluent (P = 0.32) with no exothermia generated. We propose that orange juice or coca cola are more effective irrigation solutions than fresh or seawater, and that advice to divers who use CCRs could change.

PMID:41875445 | DOI:10.28920/dhm56.1.83-87

Diving Hyperb Med. 2026 Mar 31;56(1):48-51. doi: 10.28920/dhm56.1.48-51.

ABSTRACT

INTRODUCTION: This study’s aim was to determine the number of scuba tank fills done in Victoria, Australia from 1 July 2024 to 30 June 2025 to provide an estimate of the number of scuba dives conducted during that period and, from that, estimates of the fatality and decompression illness rates.

METHODS: Suppliers of compressed gas for scuba diving in Victoria were identified through internet searches, industry liaison and the Australasian Diving Safety Foundation records. Those identified were emailed an invitation to participate in the tank fill survey and provided with dedicated spreadsheets. Email reminders were sent to collect monthly data on air, nitrox and ‘other’ fills. Data were compiled and, at the end of the survey period, non-regular participants were approached to provide actual numbers or estimates of the year’s fills.

RESULTS: Overall, 38/40 (95%) identified current suppliers participated in the survey, with 27 submitting regular monthly data and the remainder providing actual or estimated annual fills. There were 46,720 reported fills, including 39,386 air, 6,758 nitrox, and 576 others, with proportions of 84%, 15% and 1%, respectively. During that period, 11 scuba divers were treated for decompression illness (DCI) (eight of whom had dived locally) and there were two fatalities.

CONCLUSIONS: It is estimated that around 50,000 scuba tank fills were provided, equating to approximately 50,000 dives conducted in Victorian waters during from 1 July 2024 to 30 June 2025. During that period, there were eight open circuit divers who had dived in Victoria treated for DCI and two scuba diving fatalities, yielding estimates of 16 DCI cases and four deaths per 100,000 dives.

PMID:41875441 | DOI:10.28920/dhm56.1.48-51

Diving Hyperb Med. 2026 Mar 31;56(1):13-20. doi: 10.28920/dhm56.1.13-20.

ABSTRACT

INTRODUCTION: Acute respiratory symptoms after diving are common among competitive breath-hold divers. These symptoms, including shortness of breath, cough, haemoptysis, and chest discomfort, are often linked to immersion pulmonary oedema (IPO) or pulmonary barotrauma. This study aimed to evaluate the incidence, clinical presentation, and risk factors of IPO using portable ultrasound devices in a depth competition for breath-hold divers in Taiwan.

METHODS: This observational study was conducted during a competition around Liuqiu Island, Taiwan. Twenty-five breath-hold divers participated. Lung ultrasonography was performed pre- and post-diving, along with measurements of basic vital signs. Symptoms and diving history were recorded. The primary outcome measure was B-line score before and after diving.

RESULTS: Following the dive, 7/25 (28%) of divers reported acute respiratory symptoms, 10/25 (40%) showed ultrasound evidence of increased extravascular lung fluid, and 2/25 (8%) met the clinical criteria for IPO, presenting with both symptoms and hypoxaemia (SpO₂ ≤ 95%) alongside positive B-lines. B-line scores significantly increased from a median of 4 (range 1-4) to 7 (range 3-13) (P = 0.048). Male sex, higher body mass index, and elevated pre-dive systolic blood pressure were significantly associated with positive ultrasound findings. Among all factors, only diving depth remained statistically significant associated with increased post-dive B-line scores (regression coefficient = 0.046) (P = 0.007).

CONCLUSIONS: The incidence of post-dive acute respiratory symptoms was 28%, and 8% of participants exhibited clinical features of IPO. Positive lung ultrasound findings were observed in 40% of divers, mostly asymptomatic. Maximum diving depth was significantly associated with increased post-dive B-line scores.

PMID:41875438 | DOI:10.28920/dhm56.1.13-20