Tag: pubmed

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

ArXiv [Preprint]. 2025 Mar 19:arXiv:2503.15691v1.

ABSTRACT

Rapid technological advances in radiation therapy have significantly improved dose delivery and tumor control for head and neck cancers. However, treatment-related toxicities caused by high-dose exposure to critical structures remain a significant clinical challenge, underscoring the need for accurate prediction of clinical outcomes-encompassing both tumor control and adverse events (AEs). This review critically evaluates the evolution of data-driven approaches in predicting patient outcomes in head and neck cancer patients treated with radiation therapy, from traditional dose-volume constraints to cutting-edge artificial intelligence (AI) and causal inference framework. The integration of linear energy transfer in patient outcomes study, which has uncovered critical mechanisms behind unexpected toxicity, was also introduced for proton therapy. Three transformative methodological advances are reviewed: radiomics, AI-based algorithms, and causal inference frameworks. While radiomics has enabled quantitative characterization of medical images, AI models have demonstrated superior capability than traditional models. However, the field faces significant challenges in translating statistical correlations from real-world data into interventional clinical insights. We highlight that how causal inference methods can bridge this gap by providing a rigorous framework for identifying treatment effects. Looking ahead, we envision that combining these complementary approaches, especially the interventional prediction models, will enable more personalized treatment strategies, ultimately improving both tumor control and quality of life for head and neck cancer patients treated with radiation therapy.

PMID:40166747 | PMC:PMC11957233

ArXiv [Preprint]. 2025 Mar 17:arXiv:2503.13702v1.

ABSTRACT

Even when driven by the same stimulus, neuronal responses are well-known to exhibit a striking level of spiking variability. In-vivo electrophysiological recordings also reveal a surprisingly large degree of variability at the subthreshold level. In prior work, we considered biophysically relevant neuronal models to account for the observed magnitude of membrane voltage fluctuations. We found that accounting for these fluctuations requires weak but nonzero synchrony in the spiking activity, in amount that are consistent with experimentally measured spiking correlations. Here we investigate whether such synchrony can explain additional statistical features of the measured neural activity, including neuronal voltage covariability and voltage skewness. Addressing this question involves conducting a generalized moment analysis of conductance-based neurons in response to input drives modeled as correlated jump processes. Technically, we perform such an analysis using fixed-point techniques from queuing theory that are applicable in the stationary regime of activity. We found that weak but nonzero synchrony can consistently explain the experimentally reported voltage covariance and skewness. This confirms the role of synchrony as a primary driver of cortical variability and supports that physiological neural activity emerges as a population-level phenomenon, especially in the spontaneous regime.

PMID:40166746 | PMC:PMC11957229

ArXiv [Preprint]. 2025 Mar 19:arXiv:2503.15711v1.

ABSTRACT

PURPOSE: Ferumoxytal-enhanced 5D free-running whole heart CMR provides image quality comparable to CTA, but requires hours-long reconstruction time, preventing clinical usage. This study developed a variable projection augmented Lagrangian (VPAL) method for 5D motion-resolved image reconstruction and compared it with alternating direction method of multipliers (ADMM) in five numerical simulations and 15 in-vivo pediatric data set.

APPROACH: Relative error of the reconstructed images against the ground-truth images was assessed in numerical simulations. In-vivo analysis compared reconstruction time, mid-short axis (SA) blood-myocardium sharpness, left ventricular ejection fraction (LVEF), and a radiologist’s image quality ratings between VPAL and ADMM. A paired t-test (p<0.05) was used to determine statistical significance, while linear regression and Bland-Altman analysis for agreement assessments.

RESULTS: VPAL and ADMM had similar relative errors compared to the ground truth, p = 0.07. In in-vivo datasets, VPAL reduced the reconstruction time from 16.3 +/- 3.6 hours (ADMM) to 4.7 +/- 1.1 hours (VPAL), p=1e-10. Blood-myocardium border sharpness in VPAL closely correlates to ADMM , R^2 = 0.97. The LVEFs values measured by VPAL and ADMM reconstructions are largely similar, 56 +/- 6 % in ADMM and 56 +/- 6 % in VPAL, p=0.55. Both VPAL and ADMM reconstructions have good to excellent diagnostic ratings (VPAL vs. ADMM: 3.9 +/- 0.3 vs. 3.8 +/- 0.4 in 2-chamber; 3.9 +/- 0.4 vs. 3.9 +/- in 4-chamber; 3.7 +/- 0.5 vs. 3.7 +/- 0.5 in mid-SA reformatted views.

CONCLUSION: VPAL enables faster reconstruction than ADMM while maintaining equivalent image quality for functional assessments, supporting its potential for clinical use.

PMID:40166739 | PMC:PMC11957230

Toxicol Rep. 2025 Mar 12;14:101993. doi: 10.1016/j.toxrep.2025.101993. eCollection 2025 Jun.

ABSTRACT

BACKGROUND: Bangladesh is heavily impacted by arsenic contamination; however, in-depth research regarding the consequences of arsenic exposure through contaminated food remains in its nascent stage.

OBJECTIVES: Our study aimed to examine the effects of consuming arsenic-contaminated rice and vegetables on Wistar albino rats.

METHODOLOGY: A total of 30 Wistar albino rats were divided into control and experimental groups, receiving diets containing arsenic-contaminated rice and vegetable for 120 days. Arsenic levels in food samples were quantified using FI-HG-AAS. Hematological, biochemical, and histopathological analyses were conducted to assess hepatic and renal toxicity. Statistical analysis was performed using SPSS, ANOVA, DMART with significance set at p < 0.05.

FINDINGS: In hematological studies, hemoglobin was found to be significantly reduced in exposed rats (P < 0.05) to 13.67 ± 0.54 gm/dl for rice diet and 13.77 ± 0.28 gm/dl for edible fern diet compared to control (14.17 ± 0.43 gm/dl for rice diet and 15.27 ± 0.13 gm/dl for edible fern diet), and similar results were also observed for RBC and WBC. Elevated levels of serum ALT, AST, urea and creatinine reflected hepatic and renal dysfunction. In renal and hepatic tissue histopathology, inflammation, degeneration, and fatty changes were observed. This study provides the first direct evidence of systemic toxicity from chronic dietary arsenic exposure in Bangladesh, identifying rice and vegetables as significant, underrecognized sources of arsenic-related health risks.

CONCLUSION: We conclude that eating rice and vegetables that have been exposed to arsenic over an extended period of time might be harmful to the body.

PMID:40166734 | PMC:PMC11957588 | DOI:10.1016/j.toxrep.2025.101993

Clin Cosmet Investig Dermatol. 2025 Mar 27;18:743-753. doi: 10.2147/CCID.S508231. eCollection 2025.

ABSTRACT

PURPOSE: Recent advances in epidemiological and genetic studies have provided some insights regarding the pathophysiology of rosacea, but the majority of its underlying mechanisms are still poorly understood. In particular, more data are needed to fully understand the role of micronutrients in rosacea development. This study aimed to explore the causality of associations between Calcium, Copper, Selenium, Zinc, Iron, Potassium and Magnesium with the risk of rosacea.

PATIENTS AND METHODS: This was a two-sample Mendelian Randomization (MR) study that used data from genome-wide association studies (GWAS) on serum levels of selected micronutrients as exposure and rosacea as the outcome. The analysis primarily employed the Inverse Variance Weighted (IVW) method. Additional methods included weighted median, weighted mode, and MR-Egger regression. Sensitivity analysis included MR-Egger, MR-PRESSO, Cochran’s Q, and leave-one-out methods. A total of 301 Instrumental Variables were selected for analysis.

RESULTS: The genetic prediction indicated a statistically significant association between serum Calcium levels and higher rosacea risk (Odds Ratio (OR) = 2.27, 95% Confidence Interval (CI): 2.02-2.55, P < 0.001), further confirmed by all supplementary MR methods. Significant association was also found between serum Potassium levels and lower rosacea risk (OR = 0.36, 95% CI: 0.14-0.93, P = 0.0354), further confirmed by the weighted-median method. Sensitivity analyses showed that the results were robust and not driven by any single factor, with low probability of horizontal pleiotropy.

CONCLUSION: This study found an evidence of a causal association between genetically predicted serum levels of Calcium and Potassium with the risk of rosacea. The roles of these micronutrients should be further studied in rosacea, especially as a link to neurovascular dysregulation and oxidative stress.

PMID:40166720 | PMC:PMC11956733 | DOI:10.2147/CCID.S508231