Tag: pubmed

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Apr;39(4):319-323. doi: 10.13201/j.issn.2096-7993.2025.04.005.

ABSTRACT

Objective:To evaluate the utility of the Rapid Axial Roll Test （RART）, Supine Roll Test （SRT）, and Lying-Down Test （LDT） in determining the affected semicircular canal in cases of horizontal semicircular canal benign paroxysmal positional vertigo （HSC-BPPV）. Methods:A total of 330 patients diagnosed with HSCBPPV from September 2022 to September 2023 were collected and divided into three groups based on the different positional tests received: ①SRT Group, ②LDT+SRT Group, ③RART+SRT Group. The trial was divided into two stages: LDT/RART for patients in the first stage, and SRT for patients in the second stage. The elicitation rate of nystagmus among the three groups was compared to evaluate the accuracy in determining the affected semicircular canal in HSCBPPV. Results:Nystagmus was elicited in 84.55% （279/330） of the patients by positional tests. The elicitation rate of nystagmus in the RART+SRT/LDT group was 94.55% （104/110）, in the LDT+SRT group it was 84.11% （90/107）, and in the SRT group it was 69.91% （79/113）. The differences among the three groups were statistically significant （χ²= 23.88, P<0.001）. In the ② and ③ groups, there was a statistically significant difference in the elicitation rate of nystagmus between stage Ⅰ （patients with LDT or RART） （χ²=43.842, P<0.001）. SRT was performed in the stage Ⅱ, and there was a statistically significant difference in nystagmus extraction rate between the two groups （χ² =4.690, P=0.030）. The difference in the proportion of agreement between stage Ⅰ（LDT or RART） and stageⅡ （SRT） in determining the affected side of the semicircular canal was also statistically significant （χ² =40.502, P<0.001）. For patients with a consistent diagnosis of the affected semicircular canal, the difference in cure rate was not significant （P=0.149）. The Kappa statistic indicated substantial agreement between RART and SRT in terms of eliciting nystagmus （agreement 96.36%, Kappa = 0.730, P<0.001）. Conclusion:RART and SRT show a high degree of agreement regarding the elicitation rate of nystagmus. RART is simple and safe, and it can effectively induce the characteristic nystagmus of HSC-BPPV, accurately identify the responsible semicircular canal and provide a more optimized examination protocol for clinical practice in HSCBPPV.

PMID:40166872 | DOI:10.13201/j.issn.2096-7993.2025.04.005

Physiother Res Int. 2025 Apr;30(2):e70056. doi: 10.1002/pri.70056.

ABSTRACT

BACKGROUND: A frequent sequela of stroke is upper limb (UL) impairment. Accurate UL function prognosis is crucial for targeted rehabilitation.

OBJECTIVE: To determine the accuracy of physiotherapists’ predictions of UL function and investigate whether prediction accuracy is affected by physiotherapists’ seniority within rehabilitation and/or their level of education. Physiotherapist predictions were compared with a prediction algorithm.

METHODS: Data from 81 patients were included. Two weeks post-stroke, physiotherapists predicted UL function based on clinical reasoning. ARAT scores (poor, limited, good, or excellent) at 3 months post-stroke served to determine prediction accuracy. Prediction accuracy was calculated as correct classification rate (CCR). Logistic regression was used to explore the effect of seniority and education. McNemar’s test was applied to compare physiotherapist predictions to an algorithm applied 2 weeks post-stroke to the same patients.

RESULTS: The overall correct classification rate (CCR) of physiotherapist predictions was 41% (95% CI: 30-51). Predictions were most accurate for the excellent (75%) and poor (71%) categories, but lower for limited (22%) and good (30%). No association was observed between prediction accuracy and physiotherapist seniority or education. There was a tendency, but not a statistically significant superiority, in the prediction accuracy of the algorithm compared to the physiotherapist predictions (Odds ratio 2 [95% CI: 0.96-4.39], McNemar p = 0.0455, exact McNemar p = 0.0652).

TRIAL REGISTRATION: Project number: 628213.

PMID:40166834 | DOI:10.1002/pri.70056

Brain. 2025 Apr 1:awaf111. doi: 10.1093/brain/awaf111. Online ahead of print.

ABSTRACT

RAB3A encodes a small GTP-binding protein that is abundant in brain synaptic vesicles and crucial for the release of neurotransmitters and synaptic plasticity. Here we identified RAB3A as a candidate gene for autosomal dominant cerebellar ataxia by two independent approaches: linkage in a large dominant ataxia family and, in parallel, an untargeted computational genetic association approach, analyzing the 100,000 Genomes Project datasets. To further validate the role of RAB3A in ataxia, we next screened large rare disease databases for rare heterozygous RAB3A variants in probands with ataxia features. In total, we identified 18 individuals from 10 unrelated families all sharing a cerebellar ataxia phenotype. Notably, 9 out of 10 families carried a recurrent variant in RAB3A, p.Arg83Trp, including one de novo occurrence. In addition, our screening revealed three families with a neurodevelopmental phenotype and three unique RAB3A variants, which were either de novo or loss-of-function variants. In line with the different RAB3A variant types, protein domains, and predicted functional consequences, a comprehensive set of complementary methods was used to functionally characterize the identified variants. As expected, GTPase-activating protein (GAP)-dependent GTP hydrolysis was reduced for those two missense variants located in the GAP binding domain of RAB3A (Arg83Trp, Tyr91Cys). In a Drosophila Rab3 loss-of-function model, these two missense variants also failed to rescue a synaptic phenotype. Overexpression of Rab3 variants in Drosophila wildtype background did not cause an obvious phenotype, making a dominant negative effect of these variants unlikely. Lastly, exploring interactors of RAB3A variants by using co-immunoprecipitation and mass spectrometry showed differential changes in variant-specific interactions with known RAB3A key regulatory and effector proteins. In sum, our results establish RAB3A as a neurological disease gene. It represents an autosomal dominant gene for cerebellar ataxia with different variants associated with disease, including the frequent reoccurring variant p.Arg83Trp. Our study sheds light on the variant-specific interactome of RAB3A. Finally, we suggest an association of RAB3A with a neurodevelopmental phenotype, as reported for variants in several RAB3A interaction partners and as seen in Rab3A-deficent mice, although this possible association warrants further investigation by future studies.

PMID:40166812 | DOI:10.1093/brain/awaf111

Parasite Epidemiol Control. 2025 Mar 13;29:e00422. doi: 10.1016/j.parepi.2025.e00422. eCollection 2025 May.

ABSTRACT

BACKGROUND: Malaria and schistosomiasis are two parasite illnesses that share transmission sites in distinct tropical climates. Malaria-schistosomiasis coinfection is widespread in Africa. Also, malaria and Schistosoma mansoni coinfection cause exacerbation of health consequences and co-morbidities. However, there is limited pooled data on the prevalence of malaria and Schistosoma mansoni coinfection in sub-Saharan Africa.

OBJECTIVE: This systemic review and meta-analysis aimed to assess the prevalence of malaria and Schistosoma mansoni coinfection in sub-Saharan Africa.

METHOD: Systematic search on PubMed, Scopus, Google Scholar, and Science Direct was used to identify relevant studies following reviews and meta-analysis guidelines. A total of eighteen relevant articles on the prevalence of malaria and Schistosoma mansoni coinfection were identified for final systematic review and meta-analysis. Extracted data was analyzed using STATA software version 17.0. The absence or presence of publication bias was assessed using Egger’s test. Heterogeneity across studies was checked by I² statistics; if the I² value was ≥50 %, significant heterogeneity was considered and subgroup analysis was done.

RESULTS: A total of 18 studies were included for this systematic review and meta-analysis. From this meta-analysis, the pooled prevalence of malaria and Schistosoma mansoni coinfection was 17.39 % (95 % CI: 5.94-28.84). There was significant heterogeneity in prevalence of coinfection, with I² values greater than or equal to 99.97 % at P = 0.00. The subgroup analysis based on year of publication showed that the pooled prevalence of malaria and Schistosoma mansoni coinfection in studies conducted 2014-2018 was 20.73 % (95 % CI: 0.66-40.80), while it was 14.68 % (95 % CI: 1.02-28.34) in studies conducted 2019-2024. On the other hand, subgroup analysis on diagnostic techniques showed significant differences in the pooled prevalence of malaria and Schistosoma mansoni coinfection.

CONCLUSIONS: This systematic review and meta-analysis showed that malaria and Schistosoma mansoni coinfection are prevalent in sub-Saharan Africa.This highlights the region’s major challenges in controlling malaria and Schistosoma mansoni coinfections.To ensure the efficiency of coinfections control and treatment, regular monitoring, identification, and reduction of the prevalence of malaria and Schistosoma mansoni coinfection must be maintained. Furthermore, cooperative efforts at local, countrywide, and global levels are necessary to address the multifaceted factors causal to malaria-S.mansoni coinfection.

PMID:40166801 | PMC:PMC11957671 | DOI:10.1016/j.parepi.2025.e00422

Cureus. 2025 Mar 1;17(3):e79869. doi: 10.7759/cureus.79869. eCollection 2025 Mar.

ABSTRACT

Lower back pain (LBP) poses a significant challenge for cricketers of all standards, often leading to rehabilitation periods exceeding eight months and potential termination of the playing season. Despite the identification of modifiable risk factors and interventions in previous studies, a comprehensive review of the past decade is absent. With the introduction of shorter formats like Twenty20 (T20) and the rise of franchise cricket, an updated evaluation of risk factors and interventions for preventing and treating LBP in cricketers is needed. This study critically assesses and summarises current understanding in this area, incorporating previous recommendations and considering the evolving cricket landscape. A systematic review was conducted using databases such as SportsDiscus, MEDLINE, CINAHL, ISI Web of Knowledge, and Cochrane Library. Key terms related to LBP in cricketers were utilised. The Down and Black quality assessment tool, in addition to van Tulder’s criteria for levels of evidence, was applied. The quantitative analysis involved meta-analyses conducted using IBM SPSS Statistics for Windows, Version 29 (Released 2023; IBM Corp., Armonk, New York). Sixteen studies, of which 15 were of high quality, investigated risk factors associated with LBP. One low-quality randomised controlled trial examined LBP treatment. The meta-analysis revealed significant associations between LBP and increased workload, decreased bone mineral density, and poor lumbo-pelvic control through increased side flexion during the bowling action. Strong evidence supported the association between the presence of bone marrow oedema (BMO) and LBP. Bone marrow oedema on magnetic resonance imaging (MRI) provides an early indicator before the development of stress fractures, serving as a valid and reliable screening tool. Workload monitoring plays a crucial role in identifying high-risk bowlers. However, further research is needed to establish causal relationships among several other risk factors outlined. Additionally, addressing the scarcity of high-quality interventional studies is of utmost importance.

PMID:40166796 | PMC:PMC11955932 | DOI:10.7759/cureus.79869

Cureus. 2025 Mar 31;17(3):e81500. doi: 10.7759/cureus.81500. eCollection 2025 Mar.

ABSTRACT

INTRODUCTION: This study aims to explore if laparoscopic surgery impacts liver function tests (LFTs). This study compares LFT changes following elective biliary and non-biliary laparoscopic procedures to determine if the laparoscopic approach itself, rather than underlying biliary pathology, contributes to these alterations.

METHODS: This prospective, observational study (July 2023 to June 2024) included 116 American Society of Anesthetists (ASA) grades I and II patients undergoing laparoscopic procedures with normal preoperative LFTs. Exclusion criteria included pre-existing liver disease or conversion to open surgery. The LFTs (aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and bilirubin) were measured preoperatively, at 24 hours, and 72 hours postoperatively. Statistical analysis included Friedman ANOVA, t-tests, and repeated measures ANOVA to compare LFT changes between groups and assess the effect of surgical duration.

RESULTS: A total of 90 patients underwent a biliary procedure, while 26 patients had a non-biliary procedure. Significant postoperative changes in LFTs were observed, with total bilirubin (TB), AST, ALT, ALP, and GGT significantly increasing at 24 hours (p<0.001) before declining at 72 hours. Preoperative TB and GGT were higher in the biliary group (p=0.034 and p=0.023, respectively). The AST was significantly higher at 24 hours for biliary procedures (p <0.001), with a similar level at baseline. Procedure duration showed a significant association with GGT levels at 24 hours only (p=0.031).

CONCLUSION: Laparoscopic surgery results in transient derangement of LFTs, peaking at 24 hours postoperatively, irrespective of biliary or non-biliary indication. These findings underscore the importance of recognizing this transient effect and suggest routine intervention based solely on these changes may be unwarranted.

PMID:40166793 | PMC:PMC11956381 | DOI:10.7759/cureus.81500

Cureus. 2025 Mar 1;17(3):e79867. doi: 10.7759/cureus.79867. eCollection 2025 Mar.

ABSTRACT

Background The prevalence of HIV among pregnant women remains a significant public health concern in Pakistan. Understanding the risk factors associated with HIV infection in this population is crucial for developing effective interventions and reducing the incidence of mother-to-child transmission (MTCT) of the virus. Aim This study aimed to assess the frequency of HIV infection among pregnant women attending a tertiary care hospital in Islamabad, Pakistan, and to identify the associated risk factors. Methods A cross-sectional study was conducted involving 130 pregnant women who presented with one or more HIV risk factors. Ethical approval and informed consent were obtained prior to the study. Participants underwent HIV testing, and data on demographics and HIV-related knowledge were collected. Statistical analysis was performed using IBM SPSS Statistics, utilizing descriptive statistics and chi-square tests to determine associations between HIV infection and various risk factors, with a significance threshold set at p < 0.05. Results Out of the 130 participants, 128 (98.5%) tested negative for HIV and 2 (1.5%) tested positive. The study revealed a low prevalence of unprotected sexual intercourse and a limited history of sexually transmitted infections (5.3%). Additionally, 97.7% of women reported limited knowledge about HIV transmission, and a small percentage reported barriers to accessing healthcare services, including HIV counseling. Conclusion The study found a low frequency of HIV among pregnant women in the sample population; however, it highlighted a significant lack of awareness regarding HIV transmission and related health services. Increased educational initiatives and accessible healthcare resources are recommended to enhance knowledge and reduce the risk of HIV among pregnant women, thereby minimizing the potential for MTCT.

PMID:40166790 | PMC:PMC11955858 | DOI:10.7759/cureus.79867

Cureus. 2025 Mar 1;17(3):e79872. doi: 10.7759/cureus.79872. eCollection 2025 Mar.

ABSTRACT

This study aimed to devise a dynamic method to diagnose occlusive hydrocephalus by transcranial ultrasound. By using transcranial B-mode ultrasound and speckle tracking software, we registered cardiac-related pulsations of the lateral walls of the third ventricle. We determined the measurement location with the least variance in 24 participants using a mixed-effect model. In six patients, we used this optimized measuring procedure to obtain deformation curves before and after surgical therapy of occlusive (i.e., obstructive) internal hydrocephalus. Speckle tracking points at the lateral change of contrast delineating the wall of the third ventricle at the level of the thalami accounted for the least variance in normal subjects. Using this refined method, all normal participants showed transient lateral distension of the third ventricle. In all patients, the deformation curves before surgery clearly differed from the normal collective and showed mostly a transient reduction of ventricle diameter. In two hydrocephalus patients with operative restoration of normal cerebrospinal fluid (CSF) pathways, the curves after surgery resembled the normal collective. The complete remission of those changes in some patients suggested restoration of near-normal CSF dynamics.

PMID:40166781 | PMC:PMC11956120 | DOI:10.7759/cureus.79872

Cureus. 2025 Mar 1;17(3):e79879. doi: 10.7759/cureus.79879. eCollection 2025 Mar.

ABSTRACT

BACKGROUND: Pulsed radiofrequency (PRF) has evolved as a promising neuromodulative technique in chronic pain. Although it was initially used to treat spinal ganglia, it seems that it might also positively affect peripheral nerves. However, clinical evidence of its effect on peripheral nerves remains scarce.

METHODS: In this retrospective study, we included patients with therapy-refractory chronic pain who received PRF treatment of peripheral nerves during an 11-month period in the pain center of a tertiary hospital in Zurich, Switzerland. A total of 17 treatments were analyzed. Pain scores, Global Impression of Change (GIC) scores, reduction of medication, and time to next infiltration up to three months after PRF were documented. Nine different peripheral nerves were treated.

RESULTS: Pain scores were statistically lower at two weeks, one month, and three months after therapy. Overall, eight (47%) and five (29%) patients reported at least a 50% decrease in pain at one and three months, respectively. Of all patients, 12 (71%) reported an improvement in GIC at one and three months, while 10 (67%) could reduce or cease pain medications. PRF resulted in 14 (82%) patients not requiring a new infiltration for at least three months. However, in the presence of a psychiatric diagnosis, results were poorer.

CONCLUSIONS: Using PRF on peripheral nerves provided promising clinical results in terms of pain and impact of change in therapy-refractory cases. PRF might be a useful tool in pain medicine when the effects of nerve blocks are not sustainable. Further research is warranted.

PMID:40166778 | PMC:PMC11956847 | DOI:10.7759/cureus.79879

Clin Interv Aging. 2025 Mar 25;20:349-367. doi: 10.2147/CIA.S490166. eCollection 2025.

ABSTRACT

OBJECTIVE: This study aims to assess the current utilization status of transitional care service among older adults with chronic diseases and identify factors influencing their use.

METHODS: Utilizing Andersen’s Behavioral Model, a cross-sectional survey was conducted in a specific region from October 2023 to December 2023 using convenience sampling. The survey aimed to analyze the impact of predisposing factors, enabling factors, and need factors on the utilization of transitional care services by older adults with chronic diseases.

RESULTS: Disease guidance had the highest utilization rate at 61.92% among various types of professional guidance on transitional care, while other professional guidance and services had utilization rates below 50%. Regarding predisposing factors, older adults with chronic diseases who were unmarried, employed part-time or full-time, or previously unemployed indicated lower utilization of transitional care services. In terms of enabling factors, those with a primary caregiver, high monthly family income, and medical insurance were more likely to use transitional care. With respect to need factors, older adults with a higher number of chronic diseases and impaired activities of daily living were less likely to use transitional care services.

CONCLUSION: Older adults with chronic diseases tend to underutilize transitional care services. Based on Andersen’s Behavioral Model, factors influencing the utilization of these services include marital status, employment status, previous occupation, primary caregiver presence, monthly family income, method of medical expense payment, number of chronic diseases, and Activities of Daily Living score.

PMID:40166759 | PMC:PMC11955712 | DOI:10.2147/CIA.S490166