Tag: pubmed

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2024 Sept 28;49(9):1421-1430. doi: 10.11817/j.issn.1672-7347.2024.230603.

ABSTRACT

OBJECTIVES: The early imaging features of spinal tumors and spinal infections are similar, and the lack of specific early diagnostic indicators can lead to misdiagnosis or missed diagnosis. Although serum tumor markers have been widely used in early cancer screening, spinal tumors are mostly metastatic, lacking specific markers, and some patients with spinal tumors may even test negative for tumor markers. Therefore, the role of tumor markers in the early differential diagnosis of spinal tumors remains unclear. This study aims to investigate the value of tumor markers in the early differential diagnosis of spinal tumors and spinal infection.

METHODS: We retrospectively analyzed the clinical data of 221 patients with spinal bone destruction admitted to Xiangya Hospital of Central South University between April 2017 and October 2022. Peripheral blood levels of 10 tumor markers were measured upon admission, including carcinoembryonic antigen (CEA), alpha fetoprotein (AFP), neuron-specific enolase (NSE), cytokeratin 19 fragment antigen 21-1 (cyfra21-1), carbohydrate antigen 199 (CA199), carbohydrate antigen 125 (CA125), carbohydrate antigen 72-4 (CA72-4), pepsinogen I (PGI), pepsinogen II (PGII), and the PGI/PGII ratio (PGR). Univariate Logistic analysis was used to screen relevant variables, and the correlation between tumor markers was analyzed. Multivariate Logistic regression was then employed to identify risk and protective factors. The optimal cut-off values were calculated using the receiver operating characteristic (ROC) curve and Youden index, and a differential diagnosis model for early spinal tumors and spinal infections was constructed based on the selected indicators. Diagnostic performance was then evaluated.

RESULTS: According to the pathological diagnosis, 91 patients had spinal tumors, and 130 patients had spinal infections. The levels of CEA, AFP, NSE, cyfra21-1, CA199, and CA72-4 were higher in the spinal tumor group than those in the spinal infection group, while PGR was lower, with statistically significant differences (all P<0.05). Univariate Logistic analysis showed significant differences in CEA, AFP, NSE, cyfra21-1, CA199, CA125, CA72-4, and PGR (all P<0.05). Correlation analysis indicated a strong positive correlation between CEA and cyfra21-1, CA199, and CA125, as well as a strong negative correlation of PGII with PGI and PGR. Multivariate Logistic analysis identified AFP and cyfra21-1 as risk factors (P<0.01) and PGR as a protective factor (P<0.05). When the standard cut-off values (AFP<20 ng/mL, cyfra21-1< 3.3 ng/mL, and PGR>3) were applied, AFP had a sensitivity of 3.3% and accuracy of 60.2%, cyfra21-1 had a sensitivity of 20.9% and accuracy of 66.1%, and PGR had a sensitivity of 2.2% and accuracy of 59.3%. The AUC of the early spinal tumor diagnosis model was 0.623. Using the optimal cut-off values (AFP<1.625 ng/mL, cyfra21-1<1.175 ng/mL, and PGR>11.05) from the ROC curve, AFP had a sensitivity of 69.2% and accuracy of 64.7%, cyfra21-1 had a sensitivity of 68.1% and accuracy of 70.1%, and PGR had a sensitivity of 62.6% and accuracy of 57.5%, with the model’s AUC at 0.772.

CONCLUSIONS: A comparative analysis of 10 serum tumor markers reveals that AFP, cyfra21-1, and PGR are significantly associated with spinal tumors. The diagnostic model constructed based on these 3 markers shows promising predictive performance and may be helpful to the differentiation for the early clinical diagnosis of spinal tumors and spinal infection.

PMID:39931772 | DOI:10.11817/j.issn.1672-7347.2024.230603

Health Promot J Austr. 2025 Apr;36(2):e70020. doi: 10.1002/hpja.70020.

ABSTRACT

ISSUE ADDRESSED: Type 2 diabetes (T2D) prevalence in Thailand is rapidly increasing, with significant challenges in achieving optimal glycemic control. There is a need for accessible interventions to help improve glycaemic control in people with type 2 diabetes in Thailand. This study evaluates a web application designed to enhance self-management in individuals with uncontrolled T2D. Pre- and post-intervention results indicate a statistically significant reduction in fasting blood glucose. Despite the inability to effectively utilise the web application for controlling blood sugar levels, the study suggests its suitability and potential for benefiting diabetes patient care.

BACKGROUND: Diabetes is a rapidly growing global health concern, with an estimated 537 million people affected worldwide in 2021, a number projected to rise to 783 million by 2045. In Thailand, diabetes cases have increased significantly, with over 3.3 million individuals affected in 2022. Effective diabetes management requires strict adherence to self-care behaviors, including diet, exercise, medication adherence, and glucose monitoring. However, many patients struggle with self-management, leading to severe complications. The integration of a web application in diabetes care has shown potential for enhancing patient engagement and glycemic control. This study explores the role of a web application in improving diabetes self-management and health outcomes.

METHOD: The quasi-experimental single-group research, assessing pre- and post-intervention outcomes, aims to investigate the feasibility of using a web application for diabetes patient care in controlling blood sugar levels. The study employs a web application focusing on dietary behaviour adjustment, physical activity and exercise among 80 diabetes patients selected through simple randomisation. Additionally, 10 nurses responsible for healthcare promotion at five hospitals oversee and empower patients’ behaviours over two months. The research concentrates on exploring the feasibility of the web application and includes (I) the application’s suitability and (II) the patient’s blood sugar levels. The research collected quantitative and qualitative data from November 2022 to May 2023. Tools used for data collection include the feasibility assessment and application suitability.

RESULTS: The research findings indicate that the primary assessment regarding the feasibility of using the web application for diabetes patient care in controlling blood sugar levels shows overall high feasibility. The overall assessment also falls within a high range. Comparing the average levels of fasting blood sugar (FBS) before and after using the web application showed a statistically significant decrease (p-value = 0.023). When comparing the average FBS levels before and after using the web application among diabetes patients, the average FBS decreased significantly from 157.07 ± 47.248 mg/dL to 150.00 ± 43.325 mg/dL (p = 0.023). However, the HbA1c levels showed no statistically significant change (9.17% ± 1.76 to 9.12% ± 1.82, p = 0.38). SO WHAT?: These outcomes may positively contribute to early effective interventions and as well as appropriate responses to diabetes mellitus. Further supported for the health care professionals the use of a web application for diabetes patient care in patients with poorly controlled blood sugar. Specifically, for patients with smartphones, this intervention could help address their issues and provide tools for better self-regulation of their eating habits, physical activities and overall well-being. This can lead to better blood sugar control efficacy.

PMID:39931764 | DOI:10.1002/hpja.70020

J Ultrasound Med. 2025 Feb 11. doi: 10.1002/jum.16660. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to compare changes in ultrasonic Doppler parameters, particularly the peak ratio (PR) of the ophthalmic artery (OA) and optic nerve sheath diameter (ONSD), in pregnancies complicated by fetal growth restriction (FGR). Furthermore, it sought to evaluate differences in these parameters across various subgroups and analyze the cut-off value of PR for predicting delivery within 1 week in pregnancies complicated by FGR.

METHODS: A total of 62 pregnant women in the mid-to-late stages of gestation were enrolled, comprising 31 participants in the FGR group and 31 in the control group. The general conditions, pregnancy outcomes, Doppler parameters of the OA, and ONSD were compared between the two groups. Comparative analysis was performed to investigate differences in OA Doppler parameters and ONSD across FGR subgroups. The predictive value of PR for delivery within 1 week was assessed using the area under the receiver operating characteristic curve.

RESULTS: The PR of the OA was significantly elevated in the FGR group compared to the control group, demonstrating a statistically significant difference. The threshold PR value for predicting delivery within 1 week was 0.565, with a sensitivity of 0.88 and a specificity of 0.58.

CONCLUSIONS: The PR value of the OA in pregnant women with FGR is significantly increased and may serve as a reliable predictor for pregnancies complicated by FGR.

PMID:39931757 | DOI:10.1002/jum.16660

Front Sports Act Living. 2025 Jan 27;7:1500723. doi: 10.3389/fspor.2025.1500723. eCollection 2025.

ABSTRACT

The study examined the effect of a 5-week Comprehensive School Physical Activity Program (CSPAP) on overhand throw skills and perceived motor competence in students from low socio-economic backgrounds. Participants were children recruited from a Title 1 school in the Southwest U.S. Students were assigned to either CSPAP condition (n = 60, 26 boys, 34 girls; Mgrade = 4.27, SD = .43) or a control condition (n = 20, 7 boys, 13 girls; Mgrade = 4.00, SD = .35). Overhand throwing and perceived motor competence were assessed at baseline and post-intervention using the Test of Gross Motor Development-2nd Edition and Perceived Motor Competence for Children (PMC-C). The Analysis of Covariance test showed that students who participated in the CSPAP performed statistically significant improvements in the overhand throw compared to control students in the post-test p < .001, with a moderate effect size. However, there was no significant difference in the PMC-C score after the 5-week intervention between the CSPAP students and control students. CSPAP can improve overhand throwing in students from low-income families, but new strategies are needed to enhance perceived motor competence in after-school contexts.

PMID:39931734 | PMC:PMC11808130 | DOI:10.3389/fspor.2025.1500723

Med Trop Sante Int. 2024 Aug 5;4(3):mtsi.v4i3.2024.557. doi: 10.48327/mtsi.v4i3.2024.557. eCollection 2024 Sep 30.

ABSTRACT

INTRODUCTION: Scabies is an often-neglected skin parasitosis which can affect patients’ quality of life, and its treatment may be delayed in some poor African countries due to a lack of trained healthcare personnel or a lack of financial resources. The aim of this study was to describe the treatment-seeking paths of patients seen in dermatological consultations in Lomé for scabies, the direct costs of treatment and the impact of this condition on the quality of life of patients suffering from it.

PATIENTS AND METHOD: This was a descriptive and analytical study of patients diagnosed with scabies in one of Lomé’s dermatology departments from January 1 to December 31, 2021. The variables studied were sociodemographic; the patient’s therapeutic course prior to the dermatology consultation; the direct cost of the present consultation and the patient’s quality of life. The Dermatology Life Quality Index (DLQI) was used. Statistical analysis was performed with EPI Info software version 7.2.5.0.

RESULTS: A total of 157 patients were selected, including 114 cases of clinical scabies. The median age of patients was 26 years, and 29.3% were under 15 years of age. The sex-ratio M/F = 1.03. Out of them, 139 patients had one or more courses of treatment prior to the dermatological consultation, including self-medication (80.9%), consultations with non-dermatological healthcare personnel (62.4%). The average cost to the patient and family of drugs prescribed during the dermatological consultation was 19,817 CFA francs (30.2 €). The mean DQLI score for adults was 7.4, and 34.9% had moderate impairment of quality of life. The mean CDQLI score for children was 7.2, and 71.4 % had moderate impairment of quality of life.

CONCLUSION: Scabies is a parasitosis that impair patients’ life quality. In the absence of subsidized treatment and financial resources for patients, treatment remains limited, which could contribute to the spread of the disease.

PMID:39931727 | PMC:PMC11809070 | DOI:10.48327/mtsi.v4i3.2024.557

Med Trop Sante Int. 2024 Jul 3;4(3):mtsi.v4i3.2024.431. doi: 10.48327/mtsi.v4i3.2024.431. eCollection 2024 Sep 30.

ABSTRACT

BACKGROUND: Vaccination adherence among populations is a complex process involving, on the one hand, the expected benefit of a vaccine, and on the other, the perceived risk. To develop an evidence-based communication strategy aimed at improving vaccination coverage in Niger, we conducted a mixed socio-anthropological study of the perceptions among the population on the benefit and the risk of the childhood (Expanded Program on Immunization, EPI) and the Covid-19 vaccines. While the vaccine coverage for some of the EPI vaccines is above 80%, only 33% of the children are fully vaccinated, according to the national vaccination schedule. The first objective of our study was to understand the perceptions that might explain this drop off.The second objective was to identify the drivers of the low adherence to the Covid-19 vaccination, 22% of the illegible population being vaccinated.

MATERIALS AND METHODS: In March 2023, we interviewed 509 people for the quantitative study and 40 people through focus groups and individual interviews for the qualitative one, in Niamey (80% of the interviewees) and two villages.

RESULTS: 96.9% of the interviewees think that childhood vaccines are “a good thing,” even though 30.6% know that they might have negative side effects. While 87.8% think that it is “easy” or “very easy” to get children vaccinated, 21.4% point out as “annoying” the lack of amiability by the health care workers and 16.9% the waiting time. The qualitative study showed that these two complaints drive some women not to complete the vaccination schedule. We might also hypothesize that, given the perceived lack of amiability, some women don’t get enough information on the side effects and their management. Surprisingly, 73.3% of the interviewees think that vaccines against the disease are a good thing, and 83% of those who have heard messages promoting the vaccination approve them. This apparent contradiction with the low vaccine uptake is explained by a very low perception of the Covid-19 risks. More than half of the population surveyed believe that the disease is not present in the country, a very large majority believe that only ill people can transmit the disease, while only 12.8% think they know anybody who has ever been sick with Covid-19. According to our results, the circulating rumors on the vaccines don’t play a significant role in the low adherence to Covid-19 uptake, nor in the insufficient completeness of the EPI vaccination schedule.

CONCLUSION: The communication efforts on EPI vaccination should focus on the explanation of the side effects and their management, as well as improving the organization of the vaccination sessions. The communication on Covid-19 vaccination should focus on the reality of the disease in the country and the groups at risk for severe forms.

PMID:39931726 | PMC:PMC11809066 | DOI:10.48327/mtsi.v4i3.2024.431

Clin Cosmet Investig Dermatol. 2025 Feb 6;18:345-353. doi: 10.2147/CCID.S502333. eCollection 2025.

ABSTRACT

BACKGROUND: Psoriasis is an immune-mediated skin disease with a chronic relapsing-remitting course. Hyperglycemia has been shown to correlate with psoriasis severity. However, whether it could trigger psoriasis flares is not known.

OBJECTIVE: To investigate the association between hyperglycemia and psoriasis exacerbation.

METHODS: We conducted a retrospective cohort study at a university-affiliated hospital in Bangkok, Thailand, between 2008 and 2022 to examine the effects of elevated HbA1c on psoriasis flares. Patients with psoriasis vulgaris and either type 2 diabetes mellitus (T2DM) or impaired fasting glucose (IFG) who had at least 2 HbA1c values were identified. Statistical analyses were performed using mixed-effects logistic regression.

RESULTS: A total of 201 psoriasis patients (95 with severe psoriasis and 106 with mild psoriasis) with 1,717 follow-up visits were included in the analysis. In patients with severe psoriasis, HbA1c ≥ 7% (adjusted odds ratio (OR): 1.905 (95% confidence interval: 1.328-2.731)) and alcohol consumption status (adjusted OR: 3.328 (1.235-8.965)) were identified as independent prognostic factors for psoriasis flares. Meanwhile, in mild psoriasis patients, none of the variables were independently associated with psoriasis flares.

CONCLUSION: Hyperglycemia and alcohol consumption were associated with exacerbation in patients with severe psoriasis who had T2DM/IFG.

PMID:39931717 | PMC:PMC11809405 | DOI:10.2147/CCID.S502333

Circ Rep. 2025 Jan 21;7(2):76-85. doi: 10.1253/circrep.CR-24-0152. eCollection 2025 Feb 10.

ABSTRACT

BACKGROUND: This study assessed the prognostic value of submaximal cardiopulmonary exercise testing (CPET) in cardiac amyloidosis and explored CPET as an alternative to the 6-min walk test (6MWT).

METHODS AND RESULTS: In this single-center prospective observational study, 160 patients with cardiac amyloidosis (87% male; mean age 78±7 years) were evaluated. A total of 145 performed maximum symptom limited CPET. The V̇E/V̇CO₂ slope was 39±8, submaximal power output (SPO) was 24.75±11.50 W, and V̇O₂ at anaerobic threshold (AT) was 8.13±2.29 mL/min/kg. During follow up, 34 (21.25%) patients died, and another 34 (21.25%) experienced heart failure (HF)-related hospitalization, with 15 (9.38%) patients experiencing both events. Univariate analysis showed that V̇E/V̇CO₂ slope (hazard ratio [HR] 0.89; 95% confidence interval [CI] 0.86-0.93; P<0.001) and SPO (HR 0.91; 95% CI 0.87-0.96; P<0.001) were predictors of mortality. In multivariate analysis, V̇E/V̇CO₂ slope remained a significant predictor (HR 0.92; 95% CI 0.88-0.97; P<0.001) for both all-cause mortality and HF-related hospitalization independently. A SPO cut-off of <28 W predicted a worse outcome for both measures independently. Moderate correlations for V̇E/V̇CO₂ slope (-0.56 [CI -0.67, -0.42]) and SPO (0.55 [CI 0.42, 0.67]) with 6MWT distance have been found.

CONCLUSIONS: These findings highlight CPET parameters, particularly V̇E/V̇CO₂ slope and SPO with a cut-off <28 W, as predictors of survival and HF-related hospitalization in cardiac amyloidosis.

PMID:39931706 | PMC:PMC11807689 | DOI:10.1253/circrep.CR-24-0152

Clin Ophthalmol. 2025 Feb 6;19:407-416. doi: 10.2147/OPTH.S489669. eCollection 2025.

ABSTRACT

PURPOSE: Report the clinical effects and discomfort of using 0.1% hyaluronic acid (HA [Kynex 1^®, Alcon, Seoul, S. Korea]) and 0.3% HA (Kynex 3^®, Alcon, Seoul, S. Korea) to treat dry eye disease (DED).

METHODS: This study was designed as a prospective, crossover, randomized, and double-blind study. Patients aged >19 years with DED level 2 or higher, corneal staining score > 1, and tear break-up time (TBUT) < 10s were included. Sixty patients were randomly assigned to two groups. Patients in group 1 were instilled with 0.1% HA for four weeks and then 0.3% HA for the next four weeks. Group 2 patients were instilled with the eye drops in the reverse order of group 1. Patients were evaluated using a corneal staining score, TBUT, and the Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire at baseline, four weeks, and eight weeks.

RESULTS: In both groups, 0.3% HA showed an increasing trend in TBUT, although the difference was not statistically significant. Changes in the Schirmer test were greater in group 2, but this difference was also not statistically significant. The corneal staining score improved in both groups, with no statistically significant difference. While 0.3% HA was more effective than 0.1% HA according to the absolute value, this difference was not statistically significant. There was no difference between the two groups in the SPEED questionnaire evaluation that assessed aspects of discomfort, such as blurred vision, foreign body sensation, and burning sensation.

CONCLUSION: 0.3% HA was more effective for treating DED, although the difference was not statistically significant. In terms of discomfort, 0.3% HA showed no difference compared to 0.1% HA. Using both 0.1% HA and 0.3% HA in a tailored treatment approach can improve patient comfort and treatment outcomes.

PMID:39931678 | PMC:PMC11809210 | DOI:10.2147/OPTH.S489669

Diabetes Obes Metab. 2025 Feb 10. doi: 10.1111/dom.16238. Online ahead of print.

ABSTRACT

AIMS: The associations of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and outcomes among patients with obesity according to the presence of cardiovascular risk factors (metabolically healthy obesity (MHO) or metabolically unhealthy obesity (MUHO)) remain unclear. We examined the associations of GLP-1RAs with mortality and adverse cardiovascular events in patients with MHO and MUHO.

METHODS: The TriNetX network was utilized to select a cohort of patients with MHO or MUHO, and use or non-use of GLP-1RAs with propensity score matching (1:1). Cardiovascular events were identified during follow-up.

RESULTS: A total of 2 983 151 patients with obesity (512 434 with MHO and 2 470 717 with MUHO) were included in the study. Among these, 416 713 (13.9%) were GLP-1RA users. After propensity score matching, GLP-1RA use in MUHO was associated with a significantly lower risk of mortality (HR 0.580 [95% CI, 0.566-0.595]), ischemic stroke (HR 0.921 [0.890-0.953]), AF (HR 0.913 [0.888-0.938]) and hospitalization for HF (HR 0.925 [0.900-0.949]) during follow-up compared with non-use of GLP-1RA. Patients with MHO had a markedly lower risk of clinical events than those with MUHO. A trend towards a lower risk of cardiovascular events associated with GLP-1RA was seen among patients with MHO. There was no statistical interaction in the risk of cardiovascular outcomes with GLP-1RA use for MHO and MUHO patients.

CONCLUSIONS: The use of GLP-1RAs was associated with lower rates of cardiovascular events than no use in patients with MUHO. Similar but non-statistically significant trends were seen in patients with MHO.

PMID:39930557 | DOI:10.1111/dom.16238