Tag: pubmed

BMC Complement Med Ther. 2025 Feb 8;25(1):44. doi: 10.1186/s12906-025-04785-2.

ABSTRACT

BACKGROUND: Stroke is a leading cause of morbidity and mortality globally, with Nigeria having one of the highest stroke mortality rates in Africa. The burden of stroke is particularly high in middle-aged individuals, who are often the primary breadwinners and caregivers in their families. Despite the high burden of stroke in this community, there is a paucity of studies on the knowledge and perception of stroke management practices among middle-aged residents of Otolo community.

AIM: This study investigated the knowledge and perception of middle-aged residents of Otolo community in Nnewi North Local Government Area to stroke management practices; and to identify certain sociodemographic factors that may influence the knowledge and perception of this residents.

METHOD: A total of 191 middle-aged residents of Otolo community in Nnewi North Local Government Area, participated in this cross-sectional study. A self-reported questionnaire was distributed to the participants in the meeting venues, churches and market places with the help of research assistants after filling the consent forms. The data collection lasted for four weeks and it took the average of 12 min to complete each questionnaire. Analysis of the collected data was done using IBM Statistical Package for Social Sciences (SPSS) version 26.

RESULT: The findings of this study revealed that the study participants had a better knowledge of medical stroke management 36 (19%) than traditional stroke care 19(10%). Majority of the participants had a positive perception of medical stroke care129 (68%) than traditional management practices110 (58%). Age, educational status and occupational status were found to have statistically significant association (p < 0.05) with the participants’ knowledge, while the educational attainment and occupational status were the major demographic variables found to be associated (p > 0.05) with the respondents’ perception of stroke management practice.

CONCLUSION: The middle-aged residents of Otolo community had a fair knowledge of medical management of stroke and a poor knowledge of traditional stroke care. Majority of the study respondents had a more positive perception of medical management of stroke as compared to traditional management. Some of the sociodemographic factors found to impact knowledge and perception of this management practices includes age, educational attainment and occupation.

PMID:39923060 | DOI:10.1186/s12906-025-04785-2

BMC Prim Care. 2025 Feb 8;26(1):31. doi: 10.1186/s12875-025-02734-z.

ABSTRACT

BACKGROUND: Interprofessional relationships between general practitioners (GPs) and dental surgeons with a doctorate in dental surgery are essential for the optimal management of the oral health of patients. The objectives of this study were to describe the factors associated with the referral of patients from GPs to dental surgeons in France, and to improve referral practices by establishing a standardized set of items to be included in a referral letter.

METHODS: A nationwide, observational, survey-based, cross-sectional study was conducted from 9 February 2023 to 6 April 2023. Two 13-item questionnaires were sent to GPs and dental surgeons. Data on practitioner characteristics, frequency, and perceived usefulness of medical correspondence between the two healthcare professionals were collected. Candidate items selected by expert medical opinion for a standardized referral letter template were appraised by the responding oral surgeons.

RESULTS: A group of 245 dental surgeons (mean age: 38.2 ± 11.1 years, 64.5% female) and 235 GPs (mean age: 36.8 ± 9.8 years, 71.9% female) participated in this study. Medical correspondence between GPs and dental surgeons was reported to be insufficient by most dental surgeons (91.4%). Dental surgeons agreed that GP correspondence could decrease the occurrence of adverse events linked with dental care (mean score: 7.36 ± 2.4, for a maximum of 10). Only 20% of GPs indicated that they had regular communication with dental surgeons. The physician characteristics under study were not statistically associated with initiating referrals. The items most frequently selected by dental surgeons for inclusion in a template referral letter were the presence of diabetes (99.6%), of immunosuppression (98.8%), and medication by anticoagulant or antiplatelet agents (98.3%).

CONCLUSIONS: Despite known links between oral and general health, most healthcare professionals did not engage in correspondence or referrals with the other specialty. Standardized referral letters could include the list of items for which interest was confirmed by dental surgeons (including presence of diabetes, immunosuppressants and anticoagulants or antiplatelet agents).

PMID:39923052 | DOI:10.1186/s12875-025-02734-z

BMC Oral Health. 2025 Feb 8;25(1):206. doi: 10.1186/s12903-025-05578-2.

ABSTRACT

PURPOSE: The longevity of zirconia restoration depends upon its esthetic, proper occlusion, marginal adaptation, and restoration retention. This study aimed to investigate the combination of 10-MDP-containing primers between the two commercial systems (Scotchbond Universal Plus Adhesive and Panavia V5) and airborne-particle abrasion on shear bond strength (SBS) between zirconia and resin cement.

METHODS: High translucency zirconia discs were sectioned and sintered according to the manufacturer’s recommendations. The specimens were randomly applied with three different primers (Scotchbond Universal Adhesive, Tooth Primer, and Clearfil Ceramic Primer). Then, each group was bonded with Panavia V5 and RelyX™ Universal resin cements. Airborne-particle abrasion on the zirconia surfaces was also conducted using the manufacturer’s bonding protocol for both resin cements. SBS was analyzed by a two-way ANOVA with Tukey’s adjustment for multiple comparisons (α = 0.05).

RESULTS: Panavia V5 exhibited the highest SBS with Scotchbond Universal Adhesive (9.66±2.00 MPa) and Tooth Primer (8.47±2.08 MPa), respectively. As-sintered zirconia luted with primers and RelyX^TM Universal resin cement exhibited lower SBS than that of Panavia V5. In regard to air-abrasion, air-abraded zirconia luted with Tooth Primer and Panavia V5 exhibited statistically significant higher SBS (29.26±3.26 MPa) than other groups (p<0.0001).

CONCLUSIONS: Combining primers from different adhesive cement systems may significantly enhance the bond strength. Zirconia luted with Scotchbond Universal Adhesive and Panavia V5 achieved the highest bond strength when combined with airborne-particle abrasion.

PMID:39923049 | DOI:10.1186/s12903-025-05578-2

BMC Oral Health. 2025 Feb 8;25(1):207. doi: 10.1186/s12903-025-05552-y.

ABSTRACT

OBJECTIVES: The aim of the study was to compare the efficiency of buccal infiltration versus combination of buccal and palatal infiltration to anesthetize maxillary molars with symptomaticirreversible pulpitis, wither lidocaine or articaine are used.

MATERIAL-METHODS: This randomized clinical study was conducted on 80 patients with symptomatic irreversible pulpitis of the maxillary first and second molars. Eighty patients were divided into 4 groups (n = 20). (1) group buccal infiltration with 1.2 ml 4% articaine containing 1:100,000 epinephrine, (2) group buccal infiltration with 1.2 ml 2% lidocaine containing 80,000 epinephrine, (3) group buccal infiltration with 1.2 ml 4% articaine containing 1:100,000 epinephrine and palatinal infiltration with 0.5 ml 4% articaine containing 1:100,000 epinephrine, 4.group buccal infiltration with 1.2 ml 2% lidocaine containing 80.000 epinephrine and palatinal infiltration with 0.5 ml lidocaine containing 80.000 epinephrine. The pain intensity was measured by the Heft-Parker visual analog scale (VAS) before injection, during access cavity preparation and access palatal canal. The data were analyzed by the chi-square and The Kruskal-Wallis tests.

RESULTS: Within the results of the study, no statistically significant difference was found between 4% articaine containing 1:100,000 epinephrine and 2% lidocaine containing 1:80,000 epinephrine in terms of anesthesia effectiveness (p > 0.05). When palatal infiltration anesthesia was applied in addition to buccal infiltration, the pain during entry into the palatal canals was significantly reduced compared to buccal infiltration anesthesia alone (p < 0.05).

CONCLUSIONS: According to the results of this study, it may be recommended to use palatal infiltration anesthesia in addition to buccal infiltration anesthesia, independent of the anesthetic solution, for an effective pulpal anesthesia in maxillary molars with irreversible pulpitis.

CLINICAL TRIAL REGISTRATION: Registration number is “NCT06342869” and date of registration is 2024-04-02.Retrospectively registered.

PMID:39923048 | DOI:10.1186/s12903-025-05552-y

BMC Womens Health. 2025 Feb 8;25(1):55. doi: 10.1186/s12905-025-03584-8.

ABSTRACT

OBJECTIVE: To systematically evaluate existing developed and validated predictive models for stress urinary incontinence after pelvic floor reconstruction.

METHODS: Relevant literature in PubMed, Embase, Web of Science, Cochrane Library, OVID, China National Knowledge Infrastructure(CNKI), Wan Fang Database, VIP database and Chinese Biomedical Literature Service System (SinoMed) were search from inception to 1 March 2024. Literature screening and data extraction were performed independently by two researchers. The chosen study’s statistics included study design, data sources, outcome definitions, sample size, predictors, model development, and performance. The Predictive Modelling Risk of Bias Assessment Tool (PROBAST) checklist was used to assess risk of bias and applicability.

RESULTS: A total of 7 studies containing 9 predictive models were included. All studies had a high risk of bias, primarily due to retrospective design, small sample sizes, single-center trials, lack of blinding, and missing data reporting. The meta-analysis revealed moderate heterogeneity (I² = 68.8%). The pooled AUC value of the validated models was 0.72 (95% CI: 0.65, 0.79), indicating moderate predictive ability.

CONCLUSION: The prediction models evaluated demonstrated moderate discrimination, but significant bias and methodological flaws. The meta-analysis revealed moderate heterogeneity (I² = 68.8%) among the included studies, reflecting differences in study populations, predictors, and methods, which limits the generalizability of the findings. Despite these challenges, these models highlight the potential to identify high-risk patients for targeted interventions to improve surgical outcomes and reduce postoperative complications. The findings suggest that by integrating these models into clinical decision-making, clinicians can better tailor surgical plans and preoperative counseling, thereby improving patient satisfaction and reducing the incidence of postoperative stress urinary incontinence. Future research should follow TRIPOD and PROBAST principles, focus on addressing sources of heterogeneity, improve model development through robust designs, large sample sizes, comprehensive predictors, and novel modelling approaches, and validate tools that can be effectively integrated into clinical decision-making to manage stress urinary incontinence after pelvic floor reconstruction.

PMID:39923045 | DOI:10.1186/s12905-025-03584-8

Indian J Gastroenterol. 2025 Feb 8. doi: 10.1007/s12664-024-01712-0. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: The epidemiological connections, predisposing factors and clinical outcomes of infections by drug-resistant bacteria in cirrhosis are poorly documented. Thus, this study was conducted to assess the risk factors, complications and patterns of bacterial resistance among these patients.

METHODS: This retrospective observational study was conducted from March 1, 2021, to July 31, 2023, at a tertiary care centre in Uttar Pradesh. Patients of cirrhosis aged ≥ 18 years with microbial infection were included in the study. Samples, as indicated, were sent to the microbiology lab for culture and sensitivity. The patient’s clinical history, details regarding bacterial culture and antibiotic sensitivity results were extracted from the hospital information system (HIS) and entered into an excel sheet. Univariate analysis of the variables was done and the statistical significance of these variables was determined using the p-value. A p-value of < 0.05 was considered significant.

RESULTS: During the study period, 765 patients were diagnosed with cirrhosis, of which 248 (32%) had a positive bacterial culture report. Among them, 206 (83.1%) patients recovered and were discharged in stable condition. Among the cirrhotic patients, the most common infection was spontaneous bacterial peritonitis (49.5%), followed by bacteremia (39.1%), lower respiratory tract infections (6.4%), urinary tract infections (2.9%) and skin and soft tissue infections (2%). Escherichia coli (28%) was the most common gram-negative bacteria. Multidrug-resistant organism infections were seen in 134 (54%) patients. Multidrug-resistant (MDR) infection (31.4%) and extensively drug-resistant (XDR) infection (22.6%) were significantly associated with poor outcomes among these patients. Carbapenem-resistant organisms (22.6%) were the predominant resistant patterns seen among the gram-negative isolates in cirrhosis patients. The mortality rate among these cirrhotic patients with bacterial infection was 16.9%.

CONCLUSIONS: MDR and XDR bacterial infections in cirrhotic patients are an emerging threat that has a detrimental effect on prognosis. Thus, it is critical to assess strategies to prevent the development of antibiotic resistance in cirrhosis.

PMID:39921835 | DOI:10.1007/s12664-024-01712-0

Dermatol Ther (Heidelb). 2025 Feb 8. doi: 10.1007/s13555-025-01350-0. Online ahead of print.

ABSTRACT

INTRODUCTION: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease associated with a high disease burden and substantial impact on patients’ quality of life. Limited therapeutic options are available, with an unmet medical need for earlier diagnosis and treatment and more effective treatment options. Low awareness of HS amongst healthcare professionals (HCPs) leads to delayed diagnosis and a prolonged patient journey to HS-specific treatment. This article aims to describe the design of HELyx, an implementation science study in Germany, which aims to evaluate the effectiveness of an implementation strategy to improve screening and diagnosis of HS among HCPs (dermatologists and non-dermatologists) and timely referral to HS-treating dermatologists.

METHODS: HELyx is a hybrid, effectiveness-implementation science study with a pre-post design involving HCPs and is guided by the Consolidated Framework for Implementation Research. HELyx is being conducted in Germany over four consecutive phases (context analysis, pre-implementation, implementation, and post-implementation) in a sequential manner. A similar implementation science study is also being conducted in the United Arab Emirates (UAE) and Spain. HELyx aims to identify key unmet medical needs in the HS patient journey, to develop and implement a tailored medical education program, and to measure the effectiveness of the implementation.

PLANNED OUTCOMES: The primary endpoint is the change in the proportion of HCPs who used a diagnostic screening tool to identify patients with suspected HS during the 24 weeks of the post-implementation phase (assessed at Week 24) compared to the 24 weeks before implementation (assessed at baseline). Secondary endpoints include assessment of the use of HS disease severity assessment and patient-reported outcome tools and HCP referral behaviours.

PMID:39921830 | DOI:10.1007/s13555-025-01350-0

Tech Coloproctol. 2025 Feb 8;29(1):61. doi: 10.1007/s10151-024-03054-7.

ABSTRACT

BACKGROUND: Crohn’s disease (CD) negatively impacts quality of life, and a high percentage of patients will need surgery. Ileocecal resection (ICR) is the most common abdominal procedure performed in CD. Postoperative complications are frequent, and recurrence is common. The main objectives of this study were to analyze risk factors (RF) for anastomotic leakage (AL) and recurrence after ICR, as well as quality of life (QoL) in CD in a sample of the Spanish population.

METHODS: A prospective, multicenter, observational study was designed, including all types of hospitals in Spain from 2018 to 2021. Demographic and medical-surgical characteristics, postoperative complications, hospital types by annual ICR volume, and quality of life (IBDQ-9) up to 1 year follow-up (OYF) were recorded and analyzed.

RESULTS: A total of 386 ICRs were recorded. At 60 days, there were 134 (36.4%) complications, 46 (11.91%) of which were major. A total of 23 (5.9%) AL were registered, and RF were Montreal A3 [OR 14.2, 95% CI (2.70-126), p = 0.005], Montreal p [OR 7.29, 95% CI (1.14-44.4), p = 0.029], and intensified adalimumab treatment [3.8, 95% CI (1.2-13.1), p = 0.026]. Recurrences at OYF were 67 (19%), and RF were history of neoplasia [OR 7.14, p = 0.01], Montreal B3 [OR 2.12, p = 0.02], and minimally invasive surgery (MIS) [OR 2.63, p = 0.02]. The mean difference in IBDQ-9 from baseline to 60 days was +1.72 (n = 177, p < 0.001) and to OYF +2.12 (n = 140, p < 0.001).

CONCLUSIONS: The AL rate was 5.9%. Montreal A3, perianal disease, and intensified adalimumab were associated with a higher rate of AL. The recurrence rate was 17.6% (OYF). Prior neoplasia, Montreal B3, and MIS were associated with higher risk of recurrence. ICR improves quality of life at 60 days and is maintained 1 year after surgery.

PMID:39921815 | DOI:10.1007/s10151-024-03054-7

Endocrine. 2025 Feb 8. doi: 10.1007/s12020-025-04190-2. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate associations between olfactory function, eating behavior, and characteristics of body composition in adolescents with different body weights.

METHODS: The study included 87 children aged 10-17 years with normal and excess body weight. The study group consisted of overweight and obese adolescents. All children underwent anthropometry with calculation of SDS body mass index (WHO Anthro Plus), body composition was assessed using Inbody 770, diagnosis of olfactory dysfunction was performed using a set of Sniffin Sticks (Odofin, Germany). The Dutch Eating Behavior Questionnaire was used for assessment of eating disorders. IBM SPSS. Statistics v.20 program was used for statistical analysis.

RESULTS: In adolescents with decreased sense of smell, regardless of SDS BMI, restrictive type of eating behavior was more common (p = 0.04). Among girls, hypoosmia was diagnosed in 21.7% (n = 10) of cases, being accompanied by a higher proportion of body fat, higher prevalence of emotionogenic type of eating behavior compared to girls without olfactory impairment, who, on the contrary, more frequently exhibited the restrictive type of eating disorder. Among boys, hypoosmia was found in 39% (n = 16) of cases. There were no statistically significant differences with the normoosmia subgroup in terms of eating behavior type and body composition parameters. Girls with hypoosmia showed positive associations between body fat percentage and discriminatory olfactory test results (r = 0.805; p = 0.020), externalizing type of eating behavior and BMI-FOR-AGE (r = 0.873; p = 0.005), body fat mass (r = 0.764; p = 0.027) and body fat percentage (r = 0.805; p = 0.016). The emotiogenic type of eating behavior showed significant correlations with total body phase angle (r = 0.805; p = 0.029), skeletal muscle mass (r = 0.791; p = 0.034). In boys with hypoosmia, positive associations were found between restrictive type of eating behavior and BMI-FOR-AGE (r = 0.784; p = 0.002), visceral fat area (r = 0.701; p = 0.008), body fat mass (r = 0.660; p = 0.014) and body fat percentage (r = 0.742; p = 0.004).

CONCLUSION: The results of this study suggest that hypoosmia is associated with changes in eating behavior and body composition in adolescents with different body weight, yet the direction of such casual relationship remains unclear.

PMID:39921810 | DOI:10.1007/s12020-025-04190-2

Musculoskelet Surg. 2025 Feb 8. doi: 10.1007/s12306-025-00889-7. Online ahead of print.

ABSTRACT

PURPOSE: Osteoarthritis (OA) is a prevalent, debilitating ailment among the elderly. Humans need a correct sagittal spino-pelvis-lower extremity alignment to stand upright. Pathology in trunk or lower extremity section might disrupt this harmony, causing compensatory alterations in other segments. The aim of the present study was to evaluate spino-pelvis-lower extremity alignment and association among the various spino-pelvic, knee, and ankle radiological angles in patients with knee osteoarthritis (OA).

MATERIALS AND METHODS: This prospective study enrolled 70 adults over 50 years of age of either sex who complained of knee pain and met the American College of Rheumatology criteria for symptomatic OA of at least one knee. The radiological assessment comprised anteroposterior and lateral lower extremity full-length scans, as well as the Kellgren-Lawrence radiographic classification of OA. We measured hip, knee, ankle, and spino-pelvic angles using Horos software. We calculated descriptive statistics and linear correlation between continuous variables.

RESULTS: There was a significant association (p < 0.05) between age and the majority of the spino-pelvic, knee, and ankle angles and between age and severity of OA. Significant variables linked with ‘SFA’ include HKAA (p = 0.008), mLDFA (p < 0.001), TJLA, FS-TS, Cond-Plateau, and femoral bowing (p = 0.007). We found significant associations between ‘PFA’ and mMPTA (p = 0.005), Cond-Plateau (p = 0.005), Tibial Bowing (p = 0.003), and ‘LL’ with HKAA, mLDFA, FS-TS, and Cond-Plate. SSA was significantly associated with mLDFA, mMPTA, TJLA, Cond-Plateau, and HKAA; while, FI’ was significantly associated with FS-TS, femoral bowing, and tibial bowing (p < 0.001). The variables ‘SS’ was substantially linked with TTA (p = 0.008), TT (p = 0.004), PP (< 0.001), GP (p < 0.001), and GT (p = 0.010). ‘PI’ was substantially linked to TT (p = 0.001), GP (p = 0.005), and GT (p = 0.042), and ‘PT’ to TT (p < 0.001) and GT (p = 0.012). ‘SFA’ and ‘PFA’ only correlated with TT (p = 0.012 and 0.010). Lower limb angles were significantly associated with TT, PP, GP, GT, mLDFA, and mMPTA (p = 0.031, p = 0.026, p = 0.009, p = 0.009, TT, GP, GT, p < 0.001). GP was the sole significant association for ‘TJLA’ (p = 0.016). ‘FS-TS’ substantially correlated with PP (p = 0.015), GP (p < 0.001), and GT (p < 0.001). “Femoral Bowing” was significantly linked to PP (p = 0.017), GP (p = 0.007), and GT (p < 0.001), and “Cond-Plateau” was significantly linked to GP (p = 0.002) and GT. “Tibial Bowing” was significantly linked to TTA (p < 0.001), TAS (p = 0.003), LDTA (p = 0.002), TC (p < 0.001), GP (p = 0.007), and GT (p < 0.001). Age, gender, BMI, and the severity of knee OA significantly influenced the association among these various angles.

CONCLUSION: Osteoarthritis of the knee disrupts the harmonious alignment of the spine and pelvis with the lower limbs, resulting in compensatory changes in the ankle and spine. The severity of knee osteoarthritis and the patient’s gender, age, and BMI impact compensatory adaptations.

TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION: CTRI/2021/08/036088 [Registered on: 31/08/2021] – Trial Registered Prospectively.

PMID:39921806 | DOI:10.1007/s12306-025-00889-7