Colorectal Dis. 2025 Nov;27(11):e70309. doi: 10.1111/codi.70309.
NO ABSTRACT
PMID:41239745 | DOI:10.1111/codi.70309
Tag: nevin manimala
Medicine (Baltimore). 2025 Nov 14;104(46):e45738. doi: 10.1097/MD.0000000000045738.
ABSTRACT
This study aimed to investigate the clinical improvement of the incremental dosage regimen in allergic rhinitis (AR) patients with low response to sublingual immunotherapy (SLIT). This retrospective study included 65 AR patients with low response to dust mite SLIT after 6-month treatment. Patients were divided into regular-dose (RD) group (n = 23) and high-dose (HD) group (n = 42). The RD group maintained the previous standard dose, while the HD group received the higher tolerated dose and further categorized into 2 subgroups based on increased doses. Total nasal symptoms score (TNSS), total medication score (TMS), combined symptom and medication score (CSMS), and visual analog scale were compared at baseline, 6 months, and 1 year. Safety was assessed by reported adverse events (AEs).There were no significant differences between RD and HD groups at baseline and 6 months. However, patients in the HD group showed significantly lower TNSS, TMS, CSMS, and visual analog scale at 1 year compared to the RD group (all P <.01). Continued improvements in TNSS, TMS, and CSMS were only found in the HD group from 6-month to 1-year treatment (all P <.01). Moreover, there was no statistical difference between HD subgroups at any follow-up points. In addition, a higher proportion of patients in the HD group discontinued medication. No difference was observed in AEs between RD and HD groups. Dose increment after 6-month SLIT treatment could significantly enhance efficacy in low-response AR patients over a 1-year course without raising the risk of AEs.
PMID:41239732 | DOI:10.1097/MD.0000000000045738
Medicine (Baltimore). 2025 Nov 14;104(46):e45928. doi: 10.1097/MD.0000000000045928.
ABSTRACT
Chat Generative Pretrained Transformer (ChatGPT), a large language model developed by OpenAI, has shown potential in healthcare communication and patient education. However, its performance in specialized medical domains, such as pituitary adenomas (PAs), remains unclear. Therefore, this study aimed to evaluate the reliability and consistency of ChatGPT in answering PA-related questions. We hypothesized that ChatGPT would demonstrate high reliability in responding to general patient-oriented queries but lower reliability for specialized clinical questions. A total of 256 PA-related questions were collected from patients and families, clinical practice guidelines, and medical question banks. Each question was input into ChatGPT (GPT-4, March 2025 version), and the generated responses were independently reviewed by 2 senior neurosurgeons. Any discrepancies in their assessments were resolved by a third neurosurgeon with over 30 years of clinical experience. Responses were categorized as completely correct, partially correct but usable, partially correct, or incorrect. Responses rated as completely correct or partially correct but usable were considered reliable. Consistency was assessed based on the stability of response quality across similar question types. Comparisons were made by question type (general vs professional) and source using univariate analysis. Among the 256 responses, 143 (55.8%) were completely correct, 68 (26.6%) were partially correct but usable, 19 (7.4%) were partially correct, and 26 (10.2%) were incorrect. Overall, 82.4% of the responses were considered reliable, and 68.4% demonstrated consistency. Reliability was significantly higher for general questions than for professional ones (95.0% vs 78.6%, OR = 5.182, 95% CI: 1.545-17.378, P = .003), and for guideline-derived questions compared to question bank-derived ones (100.0% vs 75.7%, OR = 1.321, 95% CI: 1.214-1.437, P = .017). Differences in consistency across subgroups were not statistically significant. ChatGPT exhibits high reliability and moderate consistency in answering PA-related questions, especially for general and guideline-based content. It may serve as a supplementary source of patient information but should not replace professional medical consultation, particularly in complex or surgical contexts. As this study was conducted in an artificial testing environment without validation in real patient consultations, the generalizability of the findings remains limited.
PMID:41239728 | DOI:10.1097/MD.0000000000045928
Medicine (Baltimore). 2025 Nov 14;104(46):e45886. doi: 10.1097/MD.0000000000045886.
ABSTRACT
Depressive symptoms are common in the nursing profession. A normal body mass index (BMI) is an important indicator of individuals’ health. However, few studies have examined the relationship between depressive symptoms and BMI in nurses. The aim of the present study was to investigate the association between them in Chinese nurses. A total of 1866 nurses from 12 tertiary hospitals participated in a survey conducted in Shandong, China. BMI was calculated by measuring participants’ height and weight. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale. The relationship between BMI and depressive symptoms was analyzed using a multivariate logistic regression analysis. The depressive symptom prevalence in Chinese nurses was 47.8%. The results of the multivariate logistic regression analysis revealed that compared with participants whose BMI was in the normal range, those who were underweight (odds ratio = 1.670, 95% confidence interval: 1.161-2.403) or obese (odds ratio = 1.540, 95% confidence interval: 1.003-2.365) were positively associated with depressive symptoms, and those who were overweight were not significantly associated with depressive symptoms. Our findings indicated a high depressive symptom prevalence in Chinese nurses. Nurses who were obese or underweight were more likely to have depressive symptoms than those with a normal BMI. Age, educational background, professional title, monthly income, and department were factors that influenced depressive symptoms. Hospital administrators should take effective measures to encourage nurses to maintain a normal BMI status or be overweight and focus on the role of influencing factors that are conducive to improving nurses’ depressive symptoms.
PMID:41239726 | DOI:10.1097/MD.0000000000045886
Medicine (Baltimore). 2025 Nov 14;104(46):e45808. doi: 10.1097/MD.0000000000045808.
ABSTRACT
This retrospective study investigates the impact of early postoperative shoulder functional exercise timing on drainage duration and subcutaneous seroma formation in overweight women undergoing modified radical mastectomy (MRM) for breast cancer. A total of 194 overweight breast cancer patients (BMI > 24) who underwent MRM between January 2023 and December 2024 were included. Patients were divided into a study group (n = 101, shoulder exercise initiated on postoperative day 7) and a control group (n = 93, exercise started on day 3). Key outcomes included postoperative drainage volume, drainage tube retention duration, and incidence of subcutaneous seroma. Additional visual analyses and subgroup analyses by BMI were performed. A multivariable logistic regression model was constructed to identify independent predictors of seroma formation. The study group exhibited significantly lower postoperative drainage volume (229.5 ± 82.2 vs 581.3 ± 115.7 mL, P < .001), shorter drainage tube retention duration (6.8 ± 0.8 vs 8.3 ± 0.7 days, P < .001), and a lower incidence of subcutaneous seroma (11.9% vs 30.1%, χ2 = 8.850, P = .003). Visual comparisons confirmed more favorable distribution patterns in the study group. BMI subgroup analysis revealed that patients with BMI ≥ 27.0 kg/m2 had worse outcomes, and benefited more from delayed exercise. Multivariate analysis identified early exercise initiation (odds ratio (OR) = 4.14, P = .004), higher BMI (OR = 1.20, P = .031), and advanced tumor stage (OR = 1.92, P = .015) as independent risk factors for seroma. Delaying shoulder functional exercise initiation to postoperative day 7 significantly reduces drainage volume, shortens drainage tube retention, and lowers the risk of seroma in overweight women following mastectomy. These benefits are particularly pronounced in patients with higher BMI. Adjusting rehabilitation protocols based on body habitus may improve postoperative recovery and warrants broader clinical adoption.
PMID:41239724 | DOI:10.1097/MD.0000000000045808
Medicine (Baltimore). 2025 Nov 14;104(46):e45821. doi: 10.1097/MD.0000000000045821.
ABSTRACT
Cervical tension elastography represents a novel noninvasive approach for assessing cervical stiffness and predicting the outcomes of labor induction. However, its additive value along with cervical length (CL) measurement is unknown. This study aimed to evaluate the predictive value of cervical tension elastography, particularly stiffness ratio and CL, for successful labor induction in nulliparous women during late pregnancy. This prospective study was conducted at 2 healthcare centers, Eskişehir City Hospital and Hitit University Erol Olçok Education and Research Hospital, from May 2024 to June 2024. A total of 50 nulliparous women were included in the study, of whom 43 had vaginal delivery and 7 underwent cesarean section. Cervical stiffness ratio and CL were measured using cervical tension elastography before induction. The statistical analysis was performed using IBM SPSS (Chicago) version 24.0. Continuous variables were analyzed using t-tests or nonparametric tests, and chi-square tests were used for categorical variables. Receiver operating characteristic analysis was also conducted to assess predictive values. Among the participants, 14% (7/50) experienced induction of labor failure, which aligned with global rates (17.3%-36.8%). CL and stiffness ratio, assessed via strain elastography, showed no significant predictive value for induction of labor success (P > .05). Receiver operating characteristic analysis demonstrated poor discrimination, with area under the curve values of 0.58 for CL and 0.55 for stiffness ratio. When measured in conjunction with CL, the cervical stiffness ratio was not found to improve the predictability of labor induction. Larger studies are required to validate these preliminary findings in more diverse populations.
PMID:41239722 | DOI:10.1097/MD.0000000000045821
Eur J Med Res. 2025 Nov 14;30(1):1120. doi: 10.1186/s40001-025-03388-4.
ABSTRACT
BACKGROUND: Metabolic disorders represented by insulin resistance (IR) are at risk of chronic kidney disease (CKD). Estimated glucose disposal rate (eGDR) reflects IR. The relationship between eGDR and CKD was unclear. This study aimed at discussing the association between eGDR and the prevalence of CKD in general population and the mortality of CKD patients, and compare it with other IR indicators.
METHODS: The data from the National Health and Nutrition Examination Survey (NHANES) were used to conduct a cross-sectional study with linked mortality follow-up. The association between eGDR and CKD prevalence was determined using logistic regression, restricted cubic spline (RCS) analysis and stratified analysis. Receiver-operating characteristic (ROC) curves, weighted quantile sum (WQS) model, random forest and extreme gradient boost (XGBoost) machine learning models were performed to explore the importance of IR indicators components and CKD risk factors. The association between eGDR and mortality was analyzed by sub-distribution hazard model in CKD patients.
RESULTS: Among 29,621 participants finally included, the median eGDR was 8.64 mg/kg/min and the CKD prevalence was 12.47%. Logistic regression and stratified analysis showed eGDR was associated with CKD prevalence independently, especially in people aged 40-60 years, with overweight or impaired glucose tolerance. RCS curve indicated the association between decreased eGDR and increased CKD risk was a U-shaped curve. ROC analysis showed eGDR assessed the CKD prevalence better. WQS model implied blood glucose control level was the main influencing factor in IR components. In machine learning models, the weights of age, eGDR, uric acid and heart failure were high. During 71 months follow-up, the all-cause mortality was 23.33% and cardiovascular disease (CVD) mortality was 8.9%. Sub-distribution hazard model showed eGDR independently predicted all-cause mortality rather CVD mortality in CKD patients after adjusting for confounding factors.
CONCLUSIONS: eGDR was a better indicator to assess CKD risk in general population and could predict all-cause mortality rather CVD mortality in CKD patients.
PMID:41239541 | DOI:10.1186/s40001-025-03388-4
Trop Med Health. 2025 Nov 14;53(1):163. doi: 10.1186/s41182-025-00812-7.
ABSTRACT
BACKGROUND: Diarrhea is a common cause of morbidity and mortality, and its incidence worldwide has changed little over the past four decades. Therefore, to estimate the disease burden of diarrhea, this study aimed to assess the prevalence, risk factor, and determinants of health-seeking behavior in people with diarrhea in Chongqing.
METHODS: This cross-sectional study was conducted in Chongqing, China, between May and June 2024. An online questionnaire was used to survey respondents’ demographic information, experience of diarrhea symptoms, and treatment-seeking behaviors in the past 6 months (from October 2023 to April 2024). Descriptive statistics, univariate and multivariate logistic regression analyses were used to summarize the data and identify the possible determinants of medical treatment-seeking behaviors.
RESULTS: Among 27,150 respondents, 7.98% were young children (≤ 5 years). Diarrhea prevalence was 25.38% overall, and higher among children ≤ 5 years (29.5%) and adults ≥ 60 years (26.7%). Only 23.23% (1601/6891) of diarrhea cases sought medical care, primarily due to perceived mild severity or treatment unnecessary. Higher odds of healthcare-seeking behaviors were observed in children aged ≤ 5 years, rural residents, and those with higher household incomes (particularly ≥ 12,000 yuan). Proximity to primary healthcare facilities (< 1 km), poorer self-rated health, fewer diarrhea episodes, more severe symptoms, longer duration of illness (especially ≥ 7 days), and greater perceived impact of diarrhea were also positively associated with healthcare-seeking behaviors. The main reasons individuals with diarrhea did not seek medical care were that they felt their condition was not serious and that a visit to a medical facility was unnecessary (71.40%).
CONCLUSION: Diarrhea is highly prevalent in Chongqing, especially among young children and the elderly, coupled with a low rate of medical seeking. The findings underscore the influence of socioeconomic, geographic, clinical severity, and perceptual factors on healthcare-seeking behavior. Targeted interventions should focus on high-risk groups and improving accessibility and awareness to encourage appropriate care for diarrhea.
PMID:41239540 | DOI:10.1186/s41182-025-00812-7
Eur J Med Res. 2025 Nov 14;30(1):1127. doi: 10.1186/s40001-025-03381-x.
ABSTRACT
OBJECTIVE: To investigate the potential links between soluble transferrin receptor (sTfR), the monocyte/HDL cholesterol ratio (MHR), and heart failure with preserved ejection fraction (HFpEF), in order to provide new biomarkers for clinical evaluation of HFpEF and new ideas for disease treatment.
METHOD: 66 patients diagnosed with HFpEF who visited the cardiology department of Cangzhou Central Hospital from January 2023 to October 2023 were selected as the study group, and 70 healthy participants from concurrent physical examinations at the hospital’s examination center were designated as controls. Record demographic data, hematological/biochemical parameters (including sTfR, MHR), and echocardiographic measures of cardiac structure and function. Compare these indices between groups to assess for statistically significant differences. Conduct a multi-factor analysis of the risk factors obtained from the single factor analysis above to explore the independent risk factors of HFpEF. Conduct subgroup analysis on the research group to explore the correlation between sTfR and cardiac structure, function, and activity tolerance in HFpEF patients. Follow up with the patients in the research group for 1 year and analyze their prognosis.
RESULT: Female representation (69.7% vs 51.4%), left atrial diameter (37.52 ± 3.57 mm vs 35.04 ± 2.83 mm), and sTfR [3.29 (2.76, 3.57) mg/L vs 2.43 (2.08, 2.78) mg/L] were significantly greater in the study group compared to the control group across both cohorts (P < 0.05); There were no significant intergroup differences in terms of age, demographic and clinical histories (smoking, alcohol use, hypertension, diabetes), blood lipid profile, hepatic and renal function, other biochemical parameters, or MHR (P > 0.05 for all). Multivariable analysis identified sTfR (OR 1.293, P = 0.012) and LAD (OR 15.229, P < 0.01) as independent risk factors for HFpEF. Their predictive performance, assessed by ROC curve analysis, yielded AUC values of 0.835 for sTfR and 0.609 for LAD. The corresponding optimal diagnostic thresholds for predicting HFpEF were 3.05 mg/L and 37.5 mm, respectively. Subgroup analysis revealed significantly higher BNP and LAD, but lower 6MWT, in patients with high versus low sTfR expression (all P < 0.05). Over the 1-year follow-up, cumulative event-free survival did not differ significantly between patients with high versus low sTfR expression (median 11.17 vs. 11.65 months; Log-Rank χ2 = 0.174, P = 0.676).
CONCLUSION: Serum sTfR correlates with HFpEF severity and prognosis, offering a potential biomarker for disease assessment and outcome prediction.
PMID:41239525 | DOI:10.1186/s40001-025-03381-x
Perioper Med (Lond). 2025 Nov 14;14(1):126. doi: 10.1186/s13741-025-00618-5.
ABSTRACT
BACKGROUND: Peritoneal symptoms, including visceral pain, abdominal discomfort, and vagal responses (e.g., nausea, bradycardia), are common during abdominal surgeries under spinal anesthesia. This study compared intrathecal dexmedetomidine and fentanyl for their effectiveness in controlling these symptoms during appendectomy.
METHODS: This randomized, double-blinded clinical trial included 150 patients of the American Society of Anesthesiologists I, II physical status scheduled for emergency open appendectomy. Participants were randomly assigned to receive either intrathecal dexmedetomidine (5 μg, Group D) or fentanyl (25 μg, Group F), both combined with 0.5% hyperbaric bupivacaine.
RESULTS: Dexmedetomidine significantly reduced the incidence of peritoneal symptoms compared to fentanyl: abdominal discomfort (9.5% vs. 33.3%), visceral pain (10.8% vs. 53.3%), nausea (9.5% vs. 34.7%), and vomiting (6.8% vs.34.7%) (P < 0.001). The time to first rescue analgesia was significantly longer in the dexmedetomidine group (396 vs. 243 min; P < 0.001). Bradycardia was more frequent in group D (25.7% vs. 1.3%, P < .001); no cases of respiratory depression were observed. Hypotension occurred slightly more frequently in group D, whereas shivering was more prevalent in group F; however, neither difference reached statistical significance. The VAS was significantly higher in group F than in group D at four and six hours postoperatively (P < 0.001).
CONCLUSIONS: Dexmedetomidine provides superior peritoneal symptom control and prolonged analgesia compared to fentanyl as an intrathecal adjuvant in spinal anesthesia for appendectomy. Despite a higher incidence of bradycardia, its opioid-sparing benefits and overall safety make it a valuable alternative, particularly for procedures involving significant visceral manipulation.
PMID:41239518 | DOI:10.1186/s13741-025-00618-5