Tag: nevin manimala

Eur J Med Res. 2026 Mar 4. doi: 10.1186/s40001-026-04021-8. Online ahead of print.

ABSTRACT

BACKGROUND: Clinical observations indicate a correlation between frailty and lower urinary tract symptoms (LUTS) in men. We further investigated this relationship via data from two extensive population-based studies.

METHODS: We performed a cross-sectional study via the National Health and Nutrition Examination Survey (NHANES) and the China Health and Retirement Longitudinal Study (CHARLS). Participants lacking exposure variables, outcome variables, and important covariates were not included. The frailty index (FI) was used to evaluate frailty. In CHARLS, LUTS is defined as a previous diagnosis of benign prostatic hyperplasia. In NHANES, the presence of LUTS was defined as 2 or more symptoms, including hesitancy, incomplete emptying and/or nocturia. After taking into account the covariates (demography, chronic diseases, and unhealthy lifestyles), multivariable logistic regression was employed to examine the association between frailty and LUTS. Furthermore, subgroup analysis was conducted to investigate the influence of covariables on the association between frailty and LUTS. The mediating role of depression was ultimately examined.

RESULTS: Finally, our study included 1735 participants from NHANES and 5008 participants from CHARLS. The NHANES findings indicated a positive connection between frailty and LUTS [OR 1.97, 95% CI (1.53, 2.55)] after controlling for all the variables. The link persisted when FI was set as a categorical variable [Q3, 1.78 (1.05, 3.02); Q4, 2.95 (1.76, 4.93)]. The CHARLS findings indicated a positive connection between frailty and LUTS [1.64 (1.21, 2.23)] after controlling for all variables. The connection persisted when FI was designated as a categorical variable [Q2, 1.73 (1.31, 2.28); Q3, 2.15 (1.64, 2.83); Q4, 3.11 (2.36, 4.09)]. Depression partly mediated the relationship between frailty and LUTS (18.20% in NHANES; 19.63% in CHARLS).

CONCLUSIONS: A high FI was correlated with a greater risk of LUTS in both the US and Chinese men. The relationship between frailty and LUTS was partly explained by depression.

PMID:41776600 | DOI:10.1186/s40001-026-04021-8

BMC Med. 2026 Mar 4. doi: 10.1186/s12916-026-04754-7. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiovascular-kidney-metabolic (CKM) disease and chronic obstructive pulmonary disease (COPD) are associated with major adverse cardiovascular events (MACE). Whether COPD further increases MACE risk within CKM populations, and whether this potential risk is modifiable through inhaled corticosteroids (ICS), is unknown. Within CKM populations, we investigated the relationship between (1) COPD and subsequent MACE, and (2) amongst concurrent CKM-COPD populations, we investigated the relationship between ICS and subsequent MACE.

METHODS: We used Clinical Practice Research Datalink (CPRD) Aurum, Hospital Episode Statistics and Office of National Statistics data, between January 1st, 2010, and March 29th, 2021. We created five discrete cohorts: chronic kidney disease (CKD), type-II diabetes mellitus (T2DM), obesity, MACE history, and older adults (aged ≥ 65 years old [“Age65 + “]). CKD, T2DM, obesity, and Age65 + cohorts were MACE-naïve at the time of inclusion. Aim (1) exposures were (a) COPD, (b) incident COPD, and (c) being at risk of COPD without diagnosis (defined as age ≥ 40 years old, smoking history, no evidence of asthma, and frequent respiratory infections requiring antibiotics). Aim (2) exposure was ICS prescription (control group: long-acting bronchodilators). The outcome was MACE (acute coronary syndrome, arrhythmia, heart failure, ischaemic stroke, or cardiovascular-specific mortality). We implemented Cox proportional hazards models.

RESULTS: COPD was associated with MACE amongst all cohorts, but was comparatively weak in the MACE history cohort (cohort total; adjusted hazard ratio [95% confidence interval]): CKD (N = 573,626; 1.29 [1.26, 1.32]), T2DM (N = 649,506; 1.30 [1.26, 1.35], obesity (N = 225,273; 1.41 [1.34, 1.48]), MACE history (N = 507,889; 1.04 [1.02, 1.06]), and Age65 + (N = 592,123, 1.59 [1.52, 1.66]). Incident COPD was associated with subsequent MACE in CKD only (1.28 [1.13, 1.45]). Being at risk of COPD was associated with subsequent MACE in CKD (1.18 [1.07, 1.30]), MACE history (1.16 [1.08, 1.25]), and Age65 + (1.28 [1.13, 1.46]). ICS prescription was not associated with subsequent MACE in any concurrent CKM-COPD cohort.

CONCLUSIONS: COPD was an independent risk factor for MACE in CKM populations. ICS did not attenuate MACE amongst CKM-COPD groups. Incident COPD was associated with MACE in CKD, and being at risk of COPD was associated with MACE in CKD, MACE history, and Age65 + cohorts.

PMID:41776594 | DOI:10.1186/s12916-026-04754-7

Biol Sex Differ. 2026 Mar 3. doi: 10.1186/s13293-026-00865-1. Online ahead of print.

ABSTRACT

BACKGROUND: Parkinson’s disease (PD) is a neurodegenerative disorder with established sex differences in incidence and progression. Epidemiological evidence suggests nicotine may confer protection against PD, but its mechanisms, particularly regarding sex-specific effects, remain unclear. This study investigated the neuroprotective mechanisms of nicotine in a rotenone-induced PD rat model, with a specific focus on evaluating sex-dependent modulation across behavioral, pathological, and gut-related outcomes.

METHODS: Male and female Sprague-Dawley rats were administered rotenone (2 mg/kg/day, s.c.) for four weeks to induce PD. Nicotine (0.5 mg/kg/day, s.c.) was administered 30 min after rotenone. Motor function was assessed using rotarod and CatWalk XT gait analysis. Neuropathology in the substantia nigra was evaluated via immunofluorescence for α-synuclein and tyrosine hydroxylase (TH). Gut pathology was analyzed through colon histopathology (H&E staining) and ELISA for IL-6 and α-synuclein. Gut microbiota composition was assessed by 16 S rDNA sequencing, and serum metabolomics was performed using UPLC-MS/MS. Data were analyzed by two-way ANOVA with Tukey’s post-hoc test.

RESULTS: Nicotine significantly attenuated rotenone-induced motor impairments: males showed a superior response in balance-related parameters, while females exhibited enhanced efficacy in dynamic gait metrics. Pathologically, nicotine reduced nigral α-synuclein accumulation and TH depletion in both sexes, with males showing greater α-synuclein accumulation following rotenone exposure. Crucially, nicotine exclusively ameliorated colon histopathology, reduced plasma α-synuclein, and suppressed colon IL-6 in females, while attenuating intestinal α-synuclein accumulation in both sexes. Microbiota analysis revealed sex-divergent taxonomic shifts with nicotine treatment. Metabolomics showed significantly more extensive metabolic reprogramming in females, particularly affecting indole derivatives. Pearson correlations revealed significant sex-specific associations between altered serum indole derivatives and gut microbiota genera.

CONCLUSIONS: Nicotine exerts neuroprotection in PD through sex-dependent modulation of multiple pathological pathways, primarily involving the gut-microbiota-metabolite axis. Females benefit from enhanced gastrointestinal protection and metabolic reprogramming, while males show preferential motor balance restoration. These findings underscore the critical importance of sex-stratified therapeutic strategies for PD.

PMID:41776571 | DOI:10.1186/s13293-026-00865-1

J Orthop Surg Res. 2026 Mar 3;21(1):169. doi: 10.1186/s13018-025-06209-w.

ABSTRACT

BACKGROUND: Patient comorbidities and medication intake impact on the mortality rate in revision surgery for periprosthetic joint infection (PJI) of the lower limb. The present study collected data from patients who underwent revision surgery for PJI of total hip arthroplasty (THA) or total knee arthroplasty (TKA). Data regarding comorbidities and medication intake for each patient were collected to investigate whether comorbidities and medication intake influence in-hospital mortality in patients who underwent revision surgery for PJI of a THA or TKA.

METHODS: The present study follows the STROBE Statement. Our institutional databases were searched using the OPS (operation and procedure codes) 5-823 and 5-821 in combination with the ICD (International Statistical Classification of Diseases and Related Health Problems) codes T84.5, T84.7 or T84.8. All patients with hip or knee implant infections who underwent revision surgery were retrospectively retrieved and included in the present study.

RESULTS: Data from 346 patients were collected (181 THAs and 165 TKAs). Patients with renal insufficiency demonstrated a statistically significant greater risk of in-hospital mortality (95% CI 0.0131 to 0.1132), as did patients with a history of malignancy (95% CI 0.1478 to 0.7497), and patients with dementia (95% CI 0.0398 to 0.3791). Nicotine and alcohol abuse, diabetes mellitus, arterial hypertension, hereditary thrombophilia, hereditary haemorrhages, cerebrovascular diseases, coronary heart diseases, chronic obstructive pulmonary disease osteoporosis, liver cirrhosis, rheumatoid arthritis, acute dental infection did not influence in the in-hospital mortality rate in patients who underwent revision surgery for PJI of a THA or TKA. Patient medication therapy did not impact the risk of in-hospital mortality in PJI.

CONCLUSION: Patients undergoing revision surgery for PJI after total hip and knee arthroplasty show an increased in-hospital mortality in the presence of the following comorbidities: dementia, renal insufficiency, and history of malignancy. Based on the present results, further infection prevention and geriatric co-management strategies should be evaluated for patients undergoing revision arthroplasty of the hip and knee for PJI.

PMID:41776540 | DOI:10.1186/s13018-025-06209-w

BMC Oral Health. 2026 Mar 3. doi: 10.1186/s12903-026-07743-7. Online ahead of print.

ABSTRACT

STATEMENT OF THE PROBLEM: The clinical performance of ceramic crowns is influenced by overall marginal adaptation. A recently introduced advanced lithium disilicate ceramic requires further evidence compared to conventional lithium disilicate in terms of vertical marginal fit.

PURPOSE OF THE STUDY: To assess the vertical marginal fit of crowns constructed from advanced and conventional lithium disilicate materials.

MATERIALS AND METHODS: Ten (n = 10) ceramic crowns were constructed and randomly assigned to two groups: Group (T) with CEREC Tessera crowns (n = 5) and Group (E) with IPS e.max CAD crowns (n = 5). Vertical marginal fit was evaluated using a stereomicroscope at 10X magnification both before and after cementation, with twenty equidistant measurement points recorded for each crown. Each crown was cemented to its corresponding natural molar tooth using Totalcem resin cement. Mann-Whitney U test was used to compare the two material groups. Wilcoxon signed-rank test was used to compare between vertical marginal fit before and after cementation (P ≤ 0.05).

RESULTS: The overall vertical marginal fit between the two groups showed no significant difference, whether before or after cementation. However, both groups exhibited a statistically significant decrease in vertical marginal fit after cementation.

CONCLUSION: Advanced lithium disilicate shows advantageous properties concerning mean marginal gap values exhibiting comparable performance to IPS e.max CAD.

CLINICAL IMPLICATIONS: CEREC Tessera demonstrated marginal fit values within clinically acceptable limits, supporting its reliability as a novel chairside material suitable for use in restorative dentistry.

PMID:41776528 | DOI:10.1186/s12903-026-07743-7

BMC Nurs. 2026 Mar 3. doi: 10.1186/s12912-026-04508-z. Online ahead of print.

ABSTRACT

AIM: To determine the association between urinary incontinence and primary caregiver burden (ZBI) in individuals aged ≥ 80, and to assess additional clinical and sociodemographic contributors.

METHODS: In this cross-sectional study at Elazığ City Hospital (Oct-Nov 2025), 311 patient-caregiver dyads were evaluated using interviews and chart review. UI was assessed with ICIQ-SF and burden with the ZBI. We used descriptive statistics, Spearman correlation, and multiple linear regression (outcome: total ZBI).

RESULTS: Mean patient age was 84.6 years; UI prevalence was 53.1% (n = 165). Mean caregiver ZBI = 47.08 ± 19.77. ZBI correlated strongly with ICIQ-SF (r = 0.536; p < 0.001). The regression model explained 31.5% of ZBI variance (F = 19.932, p < 0.001; adj R2 = 0.299); UI (B = 14.776; β = 0.374; p < 0.001) and BMI (B = 1.055; β = 0.194; p < 0.001) were the only significant predictors.

CONCLUSIONS: In geriatric patients, UI independently and substantially increases caregiver burden and may adversely affect quality of care. Prioritized strategies to reduce caregiver burden should include effective UI management, psychosocial support for caregivers, and control of modifiable risk factors such as obesity and falls.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41776504 | DOI:10.1186/s12912-026-04508-z

BMC Pregnancy Childbirth. 2026 Mar 3. doi: 10.1186/s12884-026-08866-z. Online ahead of print.

ABSTRACT

BACKGROUND: Burnout in midwifery is widespread globally, influencing workforce attrition and undermining maternity service provision. Large-scale systematic and structural reforms are necessary but time-consuming. Meanwhile, midwives need immediate support for wellbeing to enable them to make sense of their workplace, workload and their practice. This research aimed to examine the impact of Group Clinical Supervision (GCS) on burnout among midwives.

METHODS: This superiority cluster randomised controlled trial studied registered midwives working at public maternity services in metropolitan New South Wales, Australia. Managers, agency staff and midwifery students were excluded. Sites were randomised electronically; midwives at intervention sites received monthly, hour-long, face-to-face GCS sessions. All participating midwives were surveyed six-monthly between June 2022 and November 2024. The primary outcome was burnout, measured with the Copenhagen Burnout Inventory, including sub-dimensions – personal, work-related and client-related burnout – and analysed using a mixed-effects linear regression model adjusted for covariates. Secondary outcomes were perceptions of workplace culture and the GCS sessions. Only the statistician analysing data was blinded to group allocation.

RESULTS: Twelve maternity services were enrolled, with 980 intervention participants and 1009 controls. Burnout rates were similar for both arms, but following adjustment for covariates, the intervention was associated with a small but statistically significant reduction in overall burnout scores: mean 47.3 for midwives at intervention sites (n = 882) and 50.0 for controls (n = 913), β=-2.7, 95% CI: -4.7 to -0.6] (p = 0.013). Specifically, work-related burnout was 3.0% points lower in the intervention group (p = 0.022), although reductions in client-related and personal burnout were not statistically significant. Most participants perceived their workplace culture positively, although the control group rated their overall workplace culture significantly more highly (p < 0.001). No unintended or harmful events occurred.

CONCLUSION: This study showed that regular GCS can lower overall and work-related burnout in midwives. The overall rate of 51.5% was similar to or lower than other studies, with similarly lower rates among older midwives. There is an urgent need for systemic changes in maternity services, encompassing institutional support strategies to mitigate burnout so that staff can better manage their professional demands.

TRIAL REGISTRATION: 10/05/2021 with Australian New Zealand Clinical Trials Registry – ACTRN12621000545864p.

PMID:41776497 | DOI:10.1186/s12884-026-08866-z

BMC Public Health. 2026 Mar 3. doi: 10.1186/s12889-026-26229-3. Online ahead of print.

ABSTRACT

BACKGROUND: The unmitigated spread of novel infectious pathogens, such as SARS-CoV-2, can result in significant disease burdens and widespread societal impacts. The magnitude, severity, and duration of these events are influenced by factors such as contact patterns and the application and effectiveness of public health control measures. Many non-pharmaceutical interventions (NPIs) were implemented to target these heterogeneous drivers and modifiers of wild-type SARS-CoV-2 transmission in Canada; however, determining and understanding their individual and joint effectiveness on different populations is challenging. In this retrospective study, we delineate the impacts of age-specific NPIs in three urban Canadian regions (Calgary, Greater Vancouver, and the Greater Toronto Area) prior to widespread vaccination availability (March 2020-February 2021) and identify relative age-specific NPI effectiveness on mitigating wild-type SARS-CoV-2 transmission.

METHODS: We developed an age-structured Susceptible-Exposed-Infectious-Recovered (SEIR) deterministic model and stratified our population into two age groups: children and youth (0-19 years) and adults (20+ years). The model incorporated contact mixing rates, wild-type SARS-CoV-2 age-specific susceptibility, and NPI strength. Detailed timelines for each region were compiled, capturing the time-dependent implementation of age-specific and population wide NPIs. Using maximum likelihood estimation, we determined regional baseline transmission probabilities in the absence of widespread NPIs, then estimated the subsequent time-dependent and age-specific NPI strength on transmission reduction. Finally, we considered counterfactual NPI scenarios and compared simulated regional age-specific epidemic trajectories with reported SARS-CoV-2 case data.

RESULTS: The age-specific and sequential time-dependent NPI strength on wild-type SARS-CoV-2 transmission reduction was estimated for each region during March 2020-February 2021. We observed that adult-specific contacts play a large role in transmission, and moderately-strengthened adult-specific NPIs were more effective in reducing transmission across all regions compared to a drastic strengthening of NPIs in children and youth (i.e., closing schools). These results held when varying temporal applications of singular and joint counterfactual NPI scenarios; however, regional contexts and data uncertainties caused varied levels of effectiveness.

CONCLUSIONS: By considering population heterogeneity, our retrospective study provides insight into age-specific NPI effectiveness on wild-type SARS-CoV-2 transmission. These findings and associated model can inform decision-making related to targeted NPI implementation and aid in resource planning and preparedness for future emerging disease outbreaks.

PMID:41776444 | DOI:10.1186/s12889-026-26229-3

BMC Nephrol. 2026 Mar 3. doi: 10.1186/s12882-026-04826-z. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic Kidney Disease (CKD) and epilepsy are common comorbidities in children; their clinical interaction in terms of seizure frequency and severity has been poorly explored. This study investigates the influence of CKD stage and kidney function markers on seizure outcomes in pediatric epilepsy patients.

METHODS: A cross-sectional study was conducted among 250 children aged 2-18 years with biopsy-confirmed CKD and a documented diagnosis of epilepsy. Clinical data were extracted from medical records, including seizure frequency, seizure severity (measured using the National Hospital Seizure Severity Scale, NHS3), serum creatinine, Blood Urea Nitrogen (BUN), and CKD stage. Statistical analyses were performed using SPSS version 26, employing Pearson correlation, one-way ANOVA, and independent samples t-tests to evaluate associations between kidney function, epilepsy etiology, seizure subtype, and seizure outcomes.

RESULTS: Significant positive correlations were observed between BUN and both seizure frequency (r = 0.45, p < 0.01) and seizure severity (r = 0.36, p < 0.01). Serum creatinine was similarly correlated with seizure frequency (r = 0.50, p < 0.01) and seizure severity (r = 0.48, p < 0.01). While seizure severity did not differ significantly across CKD stages, ANOVA revealed a significant effect of epilepsy etiology on seizure severity (F(2,247) = 39.45, p < 0.001), with higher severity in metabolic and genetic etiologies compared to structural ones. Additionally, generalized seizures were associated with greater severity than focal seizures (p < 0.001).

CONCLUSION: Although seizure severity remained relatively constant across CKD stages, impaired renal function-reflected by elevated BUN and serum creatinine-was strongly associated with increased seizure frequency and severity. These findings suggest that metabolic dysfunction plays a more prominent role than CKD stage in determining seizure burden. Regular monitoring of kidney function markers, consideration of epilepsy etiology, and individualized management strategies integrating nephrological and neurological care may improve outcomes for children with CKD and epilepsy.

PMID:41776419 | DOI:10.1186/s12882-026-04826-z

Biol Proced Online. 2026 Mar 3. doi: 10.1186/s12575-025-00267-4. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the regularities and clinical features of sintilimab-related autoimmune myocarditis, and to summarize the differential diagnosis key points between sintilimab-related autoimmune myocarditis and acute myocardial infarction.

METHODS: The case reports about sintilimab-related autoimmune myocarditis were searched on databases from the establishment of the database to April 1st 2024. The relevant medical records were searched on the hospital information system of Beijing Hospital of Traditional Chinese Medicine in the past 3 years. The case reports and medical records were collected for statistical analysis.

RESULT: Twenty three cases were collected including 22 case reports and 1 case record. Most of the sintilimab-related autoimmune myocarditis were in elderly men aged 60-75 years old and occurred between the end of the first dose of treatment to the beginning of the second dose. The symptom was nonspecific such as chest tightness and palpitation, sometimes with symptom of myasthenia as muscle weakness or myositisand as muscle soreness. Elevated cardiac biomarkers and changes in electrocardiogram were common, and decreased left ventricular ejection fraction was rarely seen in echocardiography. 9 cases underwent coronary angiography or computed coronary tomography angiography, and 3 cases underwent cardiovascular magnetic resonance.

CONCLUSION: The manifestations of sintilimab-related autoimmune myocarditis are not specific. The medication history and concomitant symptoms are of warning value. Coronary angiography or coronary computed coronary tomography angiography can be helpful when ruling out acute myocardial infarction. Cardiovascular magnetic resonance and myocardial biopsy can confirm the diagnosis. Cardiac biomarkers and the electrocardiogram can assist in diagnosis and prognosis assessment.

PMID:41776397 | DOI:10.1186/s12575-025-00267-4