Tag: nevin manimala

BMC Nephrol. 2026 Jan 16. doi: 10.1186/s12882-025-04690-3. Online ahead of print.

ABSTRACT

BACKGROUND: Abnormal serum potassium levels are common among peritoneal dialysis (PD) patients. Many studies have shown hypokalemia as a risk factor for peritonitis, but most were cross-sectional and observational. We intended to analyze the longitudinal association between serum potassium levels and peritonitis in those undergoing PD.

METHODS: We included 1,288 patients undergoing regular PD at our institution. The endpoint event was peritonitis. Patients were divided into peritonitis and non-peritonitis groups. The relationship between baseline data and the emergence of peritonitis was analyzed through Cox regression analysis. Mixed-effects model was used to analyze the correlation between longitudinal serum potassium and other lab characteristics with peritonitis. Kaplan-Meier survival analysis estimated the median time to peritonitis.Independent samples t-test was used in subgroup analysis to explore the relationship between serum potassium and different pathogenic bacteria. Spearman correlation analysis and scatter plot were used to evaluate the correlation between serum potassium and magnesium. Cochran-Armitage trend chi-square test assessed the trend of peritonitis incidence.

RESULTS: COX regression analysis found higher baseline lymphocyte count and female gender were associated with lower peritonitis risk, while older age and higher baseline uric acid levels were linked to higher risk. A mixed-effects model indicated that the peritonitis group’s serum potassium decreased more rapidly and remained low longer. Kaplan-Meier curves estimated the median time to peritonitis to be 4.09 years. The analysis of subgroups found no significant difference in serum potassium levels between the gram-positive and gram-negative bacteria groups. Spearman correlation analysis showed a very weak positive correlation between potassium and magnesium with poor trend consistency but statistical significance. Peritonitis incidence showed a significant linear downward trend from 2011 to 2023.

CONCLUSIONS: Rapid declines and long-term low levels of serum potassium after PD initiation increase peritonitis risk. Long-term potassium management in PD patients is crucial in clinic practice, with intensified monitoring advised around 4 years into PD treatment.

TRIAL REGISTRATION: 2023BA0125_GC; 2023-10-20.

PMID:41545970 | DOI:10.1186/s12882-025-04690-3

BMC Endocr Disord. 2026 Jan 16. doi: 10.1186/s12902-025-02132-7. Online ahead of print.

NO ABSTRACT

PMID:41545963 | DOI:10.1186/s12902-025-02132-7

BMC Neurol. 2026 Jan 16. doi: 10.1186/s12883-026-04636-8. Online ahead of print.

NO ABSTRACT

PMID:41545942 | DOI:10.1186/s12883-026-04636-8

BMC Anesthesiol. 2026 Jan 17. doi: 10.1186/s12871-026-03628-y. Online ahead of print.

ABSTRACT

BACKGROUND: Intranasal dexmedetomidine is commonly used preoperatively in pediatric anesthesia to reduce agitation and emergence delirium. Esketamine, with sedative and analgesic ef-fects and minimal respiratory depression at clinical doses, is also widely used in chil-dren. However, current evidence remains limited regarding the efficacy and safety of combining intranasal esketamine with dexmedetomidine versus dexmedetomidine alone in improving cooperation during anesthesia induction and reducing postoperative complications.

METHODS: This meta-analysis adhered to PRISMA guidelines and was registered in PROSPERO (CRD420251084757). A systematic search of PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials.gov, and Wanfang was conducted up to May 25, 2025. The primary outcome included the incidence of emergence delirium, emergence time, mask acceptance score (MAS), parental separation anxiety score (PSAS), and the incidence of adverse events, with pooled effect estimate reported as proportions and relative risk (RR) with 95% confidence intervals (CIs). Sensitivity analysis were performed to assess the robustness of the results and to identify sources of heterogeneity.

RESULTS: Six studies involving a total of 515 pediatric patients were included. Compared with dexmedetomidine alone, intranasal esketamine combined with dexmedetomidine significantly reduces the incidence of emergence delirium (RR = 0.27, 95% CI: [0.17-0.44], P < 0.00001, I² = 0%). The incidence of bradycardia is also significantly lower in the combination group (RR = 0.24, 95% CI: [0.08-0.72], P = 0.01). No statistically significant differences are observed between the two groups in terms of emergence time or the incidence of nausea and vomiting. The combination group shows lower parental separation anxiety scores and better mask acceptance scores, indicating improved cooperation during anesthesia induction.

CONCLUSION: Preoperative intranasal administration of esketamine combined with dexmedetomidine significantly reduces the incidence of emergence delirium and bradycardia compared with dexmedetomidine alone.Improved cooperation during anesthesia induction further supports the potential of this combination as a safe and effective alternative to dexmedetomidine monotherapy in pediatric anesthesia.

TRIAL REGISTRATION: Not applicable.

PMID:41545910 | DOI:10.1186/s12871-026-03628-y

J Health Popul Nutr. 2026 Jan 16. doi: 10.1186/s41043-025-01229-y. Online ahead of print.

ABSTRACT

BACKGROUND: Tobacco exposure is a major public health concern and has been implicated in accelerated female reproductive aging. However, most evidence relies on self-reported smoking history, which may introduce bias. Cotinine, a reliable biomarker of nicotine exposure, provides an objective measure to clarify the association between tobacco exposure and reproductive lifespan (RLS).

METHODS: We analyzed 11,944 women from two nationally representative cohorts: NHANES (n = 6,081, U.S., 1999-2018) and KNHANES (n = 5,863, Korea, 2014-2020). Serum cotinine (NHANES) and urinary cotinine (KNHANES) were quantified using standardized laboratory assays. Multivariable linear regression and restricted cubic spline (RCS) models were employed to assess the relationship between cotinine levels and age at menopause, menarche, and RLS, adjusting for demographic, socioeconomic, and metabolic covariates. Subgroup analyses were conducted to explore effect modification.

RESULTS: Higher cotinine levels were significantly associated with earlier menopause (NHANES β = -0.23; KNHANES β = -0.10) and shorter RLS (NHANES β = -0.22; KNHANES β = -0.08). RCS models confirmed linear dose-response associations in both cohorts, with threshold effects observed at higher exposure levels (NHANES ln-cotinine > – 3.47: β = -0.303, 95% CI: -0.386 to – 0.220, P < 0.001). Subgroup analyses indicated stronger associations among younger women, non-diabetic individuals, and lower-income groups, with pronounced differences across racial and educational strata.

CONCLUSIONS: Cotinine, as an objective biomarker of tobacco exposure, was robustly associated with shortened reproductive lifespan across two national cohorts. The associations were linear, with stronger reproductive toxicity at higher exposure levels, particularly among U.S. women. These findings highlight the reproductive risks of smoking and underscore the importance of biomarker-based assessments in reproductive aging research.

PMID:41545908 | DOI:10.1186/s41043-025-01229-y

Acta Obstet Gynecol Scand. 2026 Jan 16. doi: 10.1111/aogs.70141. Online ahead of print.

ABSTRACT

INTRODUCTION: Somatization disorders belong to a category of psychiatric conditions in which psychological distress and impairment are manifested as physical symptoms. Affected patients tend to utilize specialist healthcare services more frequently and have more emergency visits than those without somatization. From a gynecological perspective, it is of relevance to investigate whether any specific somatic symptoms are linked to previous experience of physical, psychological, or sexual violence. The study aimed to explore whether any specific symptoms could be associated with level of somatization among women consulting a gynecologist; whether experience of physical, psychological, or sexual violence could be associated with level of somatization; and whether experience of violence is associated with self-rated state of health.

MATERIAL AND METHODS: A cross-sectional survey was conducted at three gynecological clinics in western Sweden between February and May 2024. A project-specific questionnaire was distributed to women who consulted the clinic and completed in the waiting room. The survey consisted of 13 items, including sociodemographic variables, reasons for the current gynecological consultation, self-rated health, history of physical, psychological or sexual violence, discomfort during gynecological examination, and somatic symptom severity. Data were analyzed using descriptive statistics, chi-square tests, ANOVA, and multivariable linear regression analyses.

RESULTS: Of 2000 questionnaires distributed, 1766 were completed (response rate 88.3%). Among participants, 21.8% reported experience of sexual violence, 16.8% psychological violence, and 13.6% physical violence. Among those reporting any form of violence (n = 653), overlap was common: 236/653 (36.1%) had experienced only sexual violence, while 191/653 (29.2%) had experienced all three types. Somatic symptom severity was significantly associated with both sexual and psychological violence, but not physical violence. Clinical predictors of somatization included abdominal pain, dysmenorrhea, and multiple symptoms including pain. High somatic symptom severity was strongly associated with worse self-rated health. Somatic symptoms and specific consultation reasons, but not violence experiences, were significantly associated with self-rated health.

CONCLUSIONS: Somatization is common among women seeking gynecological care and is associated with a history of sexual and psychological violence. The findings underscore the importance of assessing underlying symptom patterns and the value of trauma-informed assessment to optimize patient management.

PMID:41545902 | DOI:10.1111/aogs.70141

J Orthop Surg Res. 2026 Jan 16. doi: 10.1186/s13018-025-06581-7. Online ahead of print.

ABSTRACT

PURPOSE: The factors that predict delayed union in patients undergoing surgical management of osteoporotic vertebral compression fractures (OVCFs) have not been definitively established. This review aimed to comprehensively identify and analyze these factors to inform clinical practice and improve patient outcomes.

METHODS: Four English and three Chinese databases were systematically searched from inception to July 1, 2025. Stata 16.0 was utilized for data analysis. Predictors of delayed union reported in two or more studies were combined. Sensitivity analyses were performed to ensure stability and reliability. Egger and Begg’s tests were applied to evaluate publication bias.

RESULTS: This review included 14 studies with a total of 2,349 patients and found that the incidence of delayed union after surgical treatment in patients with OVCFs ranged from 7.86 to 50%. Twelve predictors associated with delayed union were included in this meta-analysis. Ten of them had a statistically significant effect on delayed union, covering baseline characteristics, biological and molecular factors, outcome measures, and therapeutic interventions. The most frequently reported predictor was high bone mineral density (OR = 0.173, 95% CI: 0.068 to 0.442, p < 0.001), followed by advanced age (OR = 1.122, 95% CI: 1.046 to 1.203, p < 0.001), combined diabetes (OR = 2.066, 95% CI: 1.697 to 2.514, p < 0.001), Bone Morphogenetic Protein-2/7 (OR = 0.890, 95% CI: 0.792 to 0.999, p = 0.048), and vertebral height restoration rate (OR = 1.848, 95% CI: 1.246-2.742, p = 0.002).

CONCLUSIONS: A total of ten factors were identified as significant predictors of delayed union, encompassing five baseline characteristics, three biological molecular factors, one outcome measure, and one therapeutic intervention. The findings of this study highlight the importance of comprehensive pre- and post- operative evaluations, along with careful surgical techniques, in reducing the risk of delayed union in patients with OVCFs.

PMID:41545892 | DOI:10.1186/s13018-025-06581-7

Eur J Med Res. 2026 Jan 17. doi: 10.1186/s40001-026-03838-7. Online ahead of print.

ABSTRACT

Crohn’s disease (CD) is a chronic inflammatory bowel disease with a complex etiology involving genetic, immune, microbial, and environmental factors. Despite advances in understanding its pathogenesis, accurately predicting CD risk remains challenging, particularly in East Asian populations. In this study, we evaluated the performance of a polygenic risk score (PRS) model to predict CD risk in a Chinese cohort comprising whole-exome sequencing data of 76 CD patients and 552 healthy controls. We calculated PRS by applying causal genetic effect estimated from summary statistics of a public large-scale multi-ethnic genome-wide association study. Our results demonstrated that the PRS model effectively distinguished CD patients from healthy controls, achieving an area under the receiver opperating characteristic curve of 0.75 and an odds ratio of 13 for individuals with a PRS above 2.3. The model also showed consistent performance in independent control data sets of Chinese, East Asian, European, and American ancestries. These findings highlight the potential of PRS derived from multi-ethnic causal effect as a non-invasive tool for CD risk prediction in East Asian populations. However, the moderate predictive accuracy and unexplained variance emphasize the need for larger studies and the integration of additional genetic and environmental factors to refine PRS model further.

PMID:41545884 | DOI:10.1186/s40001-026-03838-7

J Eat Disord. 2026 Jan 16. doi: 10.1186/s40337-025-01512-7. Online ahead of print.

ABSTRACT

This study is the first to comprehensively examine psychometric characteristics of the three main DSM-5 eating disorder (ED) diagnoses (Anorexia Nervosa (AN), Bulimia Nervosa (BN), Binge Eating Disorder (BED)) amongst adult ED patients. Data was collected via an online survey from 126 licensed therapists treating an adult with an ED. Therapists provided an ED DSM-5 diagnosis for a randomly selected patient, as well as endorsed the presence of symptoms from a list of DSM criteria. Criteria endorsement varied across both the entire sample and within diagnoses. Convergence and cohesion also varied within diagnoses. The first factor analysis for DSM-5 ED criteria yielded a five-factor solution for ED criteria accounted for 78.3% of variance: (1) Binge eating, (2) Compensatory and purging behaviors, (3) Shape/weight overvaluation, (4) Drive for thinness, and (5) Absence of binging and purging. Finally, diagnostic efficiency statistics were consistent with this factor model. Overall, our findings support a new, transdiagnostic model with fear of weight gain and weight being main aspects of self-evaluation as common underlying factors amongst all EDs.

PMID:41545883 | DOI:10.1186/s40337-025-01512-7

JAMA Netw Open. 2026 Jan 2;9(1):e2552106. doi: 10.1001/jamanetworkopen.2025.52106.

ABSTRACT

IMPORTANCE: The unexplored quality of evidence supporting online video claims by medical professionals creates a credibility-evidence gap that threatens the principles of evidence-based medicine.

OBJECTIVE: To systematically evaluate the evidence hierarchy supporting medical claims in health care professional-created online videos using a novel evidence classification framework.

DESIGN, SETTING, AND PARTICIPANTS: In this quality improvement study using a cross-sectional analysis, YouTube was searched using cancer- and diabetes-related terms. A total of 309 videos met the inclusion criteria. The video search, data extraction, and archiving were conducted between June 20 and 21, 2025, to create a static dataset. Videos were assessed using the newly developed Evidence-GRADE (E-GRADE [Grading of Recommendations Assessment, Development and Evaluation]) framework, categorizing evidence into 4 levels: grade A (high certainty from systematic reviews and/or guidelines), grade B (moderate certainty from randomized clinical trials, cohort studies, and high-quality observational studies with clear citations), grade C (low certainty from limited observational studies, physiological mechanisms, or case series without critical appraisal), and grade D (very low or no certainty from anecdotal evidence).

EXPOSURE: Videos that had a minimum of 10 000 views, were created by health care professionals, had a minimum duration of 1 minute, and contained specific health claims.

MAIN OUTCOMES AND MEASURES: Primary outcomes included the distribution of evidence grades (A-D) supporting medical claims. Secondary outcomes included correlations between evidence quality and engagement metrics (views and likes) and traditional quality scores (DISCERN, JAMA benchmark criteria, and Global Quality Scale).

RESULTS: Among the 309 videos included, which had a median of 164 454 (IQR, 58 909-477 075) views, most medical claims (193 [62.5%]) were supported by very low or no evidence (grade D), while only 61 claims (19.7%) were supported by high-quality evidence (grade A). Moderate (grade B) and low (grade C) evidence levels were found in 45 (14.6%) and 10 (3.2%) videos, respectively. The correlation with view counts was statistically significant for grade D videos, which were associated with a 34.6% higher view count (incidence rate ratio, 1.35; 95% CI, 1.00-1.81; P = .047) than grade A videos. Traditional quality tools showed only weak correlations (range of coefficients, 0.11-0.23) with evidence levels, thus failing to detect important qualitative differences.

CONCLUSIONS AND RELEVANCE: In this quality improvement study, a substantial credibility-evidence gap was found in physician-generated video-sharing content, where medical authorities often legitimized claims lacking robust empirical support. These findings emphasize the need for evidence-based content guidelines and enhanced science communication training for health care professionals to maintain scientific integrity in digital health information.

PMID:41543855 | DOI:10.1001/jamanetworkopen.2025.52106