Tag: pubmed

Alzheimers Res Ther. 2025 Mar 8;17(1):58. doi: 10.1186/s13195-025-01708-8.

ABSTRACT

BACKGROUND: The influence of duration of type 2 diabetes mellitus (T2DM) on the likelihood of developing new-onset dementia in post-stroke population is not well understood. Therefore, we aimed to clarify the relationship between the duration of T2DM and the risk of developing dementia in the post-stroke population.

METHODS: Leveraging the Korean National Health Insurance Database, this study included 118,790 individuals with a history of stroke but no previous dementia diagnosis. We classified diabetes status into five categories: normoglycemia, impaired fasting glucose (IFG), newly diagnosed T2DM, and established T2DM with durations of less than 5 years and 5 years or more. The primary endpoint was the incidence of all-cause dementia.

RESULTS: Among 118,790 participants (average age 64.26 ± 9.95 years, 48% male), 16.7% developed dementia during an average follow-up of 7.3 ± 2.3 years. Participants with a history of T2DM for less than five years at cohort entry had a 26.7% higher risk of developing all-cause dementia compared to those with normoglycemia. Those with T2DM for five years or longer had a 46.7% increased risk, with an adjusted hazard ratio (aHR) of 1.466 (95% confidence interval [CI], 1.408-1.527). Specifically, the risk of developing Alzheimer’s disease (AD) and vascular dementia (VaD) rose by 43.4% and 51.4%, respectively, for individuals with T2DM lasting more than five years (aHR 1.434, 95% CI 1.366-1.505; aHR 1.514, 95% CI 1.365-1.679, respectively).

CONCLUSIONS: Our findings demonstrated a significant association between an extended duration of T2DM and an increased risk of developing all-cause dementia, including AD and VaD in post-stroke population. These results emphasize proactive dementia prevention approaches in stroke survivors, particularly those with longstanding T2DM.

PMID:40057772 | DOI:10.1186/s13195-025-01708-8

J Health Popul Nutr. 2025 Mar 8;44(1):71. doi: 10.1186/s41043-025-00774-w.

ABSTRACT

BACKGROUND: Like other Sub-Saharan Africa (SSA) countries, Tanzania is undergoing socio-economic changes that impact lifestyles and dietary choices. Traditionally, differences in dietary habits between rural and urban areas in Tanzania and other SSA countries were prominent. However, recent research indicates converging lifestyles and dietary choices associated with increased risk of cardiometabolic diseases. The objective of the current study was hence to investigate differences and similarities in dietary patterns, energy, and food groups intake in urban and rural Tanzania.

METHODS: Dietary habits were assessed by use of a Food Frequency Questionnaire (FFQ) for 442 respondents aged 44-65 years in urban (Ubungo -Dar es Salaam) and rural (Kilindi- Tanga) districts of Tanzania. Dietary patterns were determined using Principal Components Analysis (PCA). Bivariate analyses identified determinants of dietary patterns in urban and rural Tanzania.

RESULTS: Two dietary patterns, a “mixed pattern” characterized by whole grains, potatoes, fruits, vegetables, meat, fried potatoes and tubers, alcohol, sugar-sweetened beverages (SSB), sugar and sweets, and added oils and a “plant-rich pattern” characterized by whole grains, fruits, pulses and peas, seasoning vegetables and salads, SSB, sugar and sweets, and added oils were identified. Urban residents contributed more to the mixed pattern, while rural residents had a higher contribution to the plant-rich pattern. Overall, dietary diversity was greater in urban than rural Tanzania. The estimated median daily energy intake was 2,902 kcal (IQR: 1449.2) with a lower energy intake in rural (2,817 kcal, IQR: 1,274) as compared to urban residents (3,052 kcal, IQR: 1558) (p = 0.021). The percent contribution to the median average daily energy intake for grains, fruits, and milk was higher in rural than urban participants. No differences were observed for meat, poultry and eggs.

CONCLUSION: We identified two distinct dietary patterns: a “mixed pattern” prominent in urban and a “plant-rich pattern” more common in rural. Urban diets were more diverse with slightly higher energy intake. These findings underscore the effects of urbanization on diets and the need for targeted nutritional intervention for both rural and urban populations.

PMID:40057768 | DOI:10.1186/s41043-025-00774-w

Virol J. 2025 Mar 8;22(1):66. doi: 10.1186/s12985-025-02668-z.

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes Coronavirus disease 2019 (COVID-19), which is a huge global health threat. Interleukin27 (IL-27) gene is a cytokine that produces antiviral proteins in an IFN-independent manner and stimulates both pro- and anti-inflammatory responses. Interferon induced transmembrane protein 3 (IFITM3) inhibits SARS-CoV2 infection by blocking SARSCoV-2 spike proteins which facilitate viral entrance and cell-to-cell fusion. The association between genetic variants and COVID-19 in Egyptians is still unclear. Hence, we sought to investigate the impact of the single nucleotide polymorphism of IL-27P28 rs153109 and IFITM3 rs12252 on the susceptibility and severity of SARS-CoV-2 in Egyptian patients.

METHODS: Our study included 242 SARS-CoV-2 patients were recruited from Main University Hospital, Alexandria University, Egypt, and 187 healthy controls. We subdivided the patient group into two subgroups: group A comprised mild/moderate cases (N = 42) (17.4%), and group B included severe/critical cases (N = 200) (82.6%). Genomic DNA was extracted from blood samples using the QIAamp DNA Blood Mini kit, then the PCR products of IL27 and IFITM3 were cut by FastDigest XhoI and MScI, respectively, for detection of SNPs of IL-27P28 rs153109 (-964A/G) and IFITM3 rs12252 (T>C).

RESULTS: The present study found a significant association between IL27 rs153109 (-964A/G) and SARS-CoV-2 infection susceptibility after adjusting for the risk factor (advanced age), IL27 rs153109 (-964A/G) AG genotype (OR = 2.791, 95% CI: 1.237-6.295, P = 0.013), AA genotype (OR = 2.385, 95% CI: 1.075-5.291, P = 0.033), and (AG+AA vs. GG) genotypes (OR = 2.558, 95% CI: 1.186-5.517, P = 0.017). On the other hand, the IFITM3 rs12252(T>C) CT genotype (OR = 1.419, 95% CI: 0.843-2.391, P = 0.188), CC genotype (OR = 2.132, 95% CI: 0.436-10.415, P = 0.350), and (C/T+C/C vs. TT) genotypes (OR = 1.466, 95% CI: 0.884-2.432, P = 0.138) did not show a statistically significant association with either susceptibility or the severity of SARS-CoV-2.

CONCLUSION: IL27P28 rs153109 AG and AA genotypes of IL27 may be associated with the susceptibility of SARS-CoV-2 infection but not the severity. Concerning the IFITM3 rs12252 SNP, we could not confirm its influence on either susceptibility or the severity of SARS-CoV-2 in this Egyptian population.

PMID:40057761 | DOI:10.1186/s12985-025-02668-z

J Health Popul Nutr. 2025 Mar 8;44(1):72. doi: 10.1186/s41043-025-00811-8.

ABSTRACT

BACKGROUND AND OBJECTIVE: Conflicting results exist regarding the associations between dietary acid load (DAL) and cancer risk. This study aimed to investigate the association between DAL and the odds of prostate cancer (PC) in the Iranian population.

METHODS: One hundred and twenty participants (60 controls and 60 newly diagnosed PC patients) engaged in a hospital-based case-control study conducted from April to September 2015. A validated, 160-item semi-quantitative food frequency questionnaire (FFQ) was used to assess usual dietary intakes. DAL was calculated using potential renal acid load (PRAL) and net endogenous acid production (NEAP). Multivariate logistic regression was performed to estimate odds ratios (ORs).

RESULTS: Both PRAL (OR = 5.44; 95% CI = 2.09-14.17) and NEAP (OR = 4.88; 95% CI = 2.22-13.41) were associated with increased odds of PC in the crude model. After adjusting for potential confounders (energy intake, smoking, physical activity, ethnicity, job, education, and medication use), being in the third category of PRAL (OR = 3.42; 95% CI = 1.11-8.65) and NEAP (OR = 3.88; 95% CI = 1.26-9.55) were significantly associated with increased odds of PC.

CONCLUSION: Our findings suggest that dietary acid load may be linked to an increased risk of PC; however, further prospective studies with larger sample sizes and longer durations are necessary to validate these findings.

PMID:40057760 | DOI:10.1186/s41043-025-00811-8

BMC Health Serv Res. 2025 Mar 8;25(1):356. doi: 10.1186/s12913-025-12460-y.

ABSTRACT

BACKGROUND: Effective tuberculosis (TB) management requires timely diagnosis and immediate treatment initiation. The urgency for diagnosing and treating TB is particularly acute among immigrants, who face heightened health risks due to factors such as poverty, hazardous working conditions, and limited healthcare access. The objective of this study was to examine the characteristics of patient and health care delays among migrant and local TB patients in Istanbul and to identify factors associated with delays in the diagnosis and treatment of TB in both migrant and local patients.

METHODS: This cross-sectional study was conducted in six Tuberculosis Control Dispensaries (TCDs) in Istanbul, the city with the highest number of TB cases in Turkey. A total of 211 TB patients, including 140 local residents and 71 migrants, participated. Data were collected through interviews via a structured questionnaire and patient files, following the patients’ consent.

RESULTS: Among migrant patients, the time from the onset of TB-related symptoms to the first contact with a health institution (patient delay) was 4.7 times longer (95% Confidence Interval [CI] = 1.1-20.9) than that in local resident patients. Compared with local patients, migrant patients were predominantly male, younger, had lower education levels, had a history of previous TB, and were less likely to smoke. Additionally, the frequency of working without insurance and unemployment was greater among migrant patients than among those employed with insurance.

CONCLUSION: Our research underscores the importance of focusing on the migrant community to achieve tuberculosis control goals, potentially through interventions to increase knowledge of healthcare system access and the significance of working conditions, including health insurance. While we profiled migrant TB patients, qualitative research is needed to elucidate the underlying reasons for delays in diagnosis and treatment.

PMID:40057758 | DOI:10.1186/s12913-025-12460-y

BMC Med Educ. 2025 Mar 8;25(1):352. doi: 10.1186/s12909-025-06898-1.

ABSTRACT

BACKGROUND: Diabetic ketoacidosis (DKA) is a common emergency associated with significant morbidity and mortality in low resource settings. Prompt diagnosis and correct management improves outcomes. To improve clinician knowledge and confidence in DKA management, we designed a novel curriculum for training local clinicians in a low-resource setting. This curriculum aligned to international guidelines, adapted for local resources. Our aim was to assess if the curriculum improved clinician knowledge and confidence.

METHODS: Participants included physicians and nurses in the Emergency Department (ED) at a tertiary academic center in Nairobi, Kenya. Participants completed pre/post-tests of knowledge, which permitted prospective curriculum evaluation based on the second level Kirkpatrick hierarchy, knowledge retention. The cases focused on local evidence-based DKA management pathways. They were delivered using novel in-person with virtual (recorded) teaching techniques, permitting both conventional and independent learning. Outcome measures related to knowledge improvement were analyzed using independent t-tests; clinician confidence was assessed via self-reported survey and analyzed using descriptive statistics.

RESULTS: 125 clinicians (79.8% nurses and 20.2% physicians) completed pre-training assessment; 104 completed post-training assessment. Prior to training, 53.6% of all trainees reported that they were “highly confident” compared with 61.5% of all trainees post-training (p=0.16). Post-training, there were statistically significant increases in knowledge scores related to DKA diagnosis (14% increase, p=0.03), electrolyte management (41% increase, p<0.0001), fluid administration (28% increase, p=0.01) and insulin administration (24% increase, p=0.01). There was a significant increase in overall clinician knowledge scores with 34.4% (n=43) attaining a knowledge score of 7 or above correct responses out of the 10 cases presented pre-training versus 65.4% n=68 post-training (p<0.0001).

CONCLUSION: Our pretest-posttest results demonstrate that our DKA management course improved clinical knowledge among physicians and nurses working in low-resource ED. Future research is underway to evaluate clinical practice changes and patient care outcomes related to this improved knowledge.

PMID:40057747 | DOI:10.1186/s12909-025-06898-1

BMC Complement Med Ther. 2025 Mar 8;25(1):97. doi: 10.1186/s12906-025-04816-y.

ABSTRACT

BACKGROUND: The use of traditional and complementary medicines (T&CM) among menopausal women has become prevalent due to the concerns on the adverse effects and differing opinions regarding hormone replacement therapy’s (HRT) suitability for long-term following the release of Women’s Health Initiative (WHI) results in 2002. To date, there have been no studies conducted on knowledge, attitude and practice towards T&CM among menopausal women in Malaysia. In addition, many women seek relief from menopausal symptoms by using T&CM despite questionable safety and efficacy. The objective of this study was to determine the knowledge, attitude and practice of menopausal women towards T&CM and its correlation with sociodemographic data in Kuala Lumpur and to assess the prevalence, types and perceived effectiveness of T&CM used by menopausal women in Kuala Lumpur.

METHODS: A cross-sectional study was conducted among menopausal women (n = 390) in Kuala Lumpur in the form of self-administered questionnaire. Data was collected using convenience sampling. The questionnaire was adopted from previous studies and some literature reviews with modifications. It was composed of 4 sections. Statistical analyses were performed using the IBM SPSS Statistics Version 26. Data obtained was analysed using descriptive and inferential analysis such as independent t test, one way ANOVA and chi square test.

RESULTS: The prevalence of T&CM used among menopausal women was found to be 27.2%. Evening primrose oil (53.2%), vitamins and minerals (53.2%) and black cohosh (48%) were most frequently used. Black cohosh and phytoestrogens were perceived as effective in relieving menopausal symptoms by 36.6% and 43.4% of respondents, respectively. Over half of the respondents had poor knowledge (51.3%), negative attitude (56.9%) and poor practice (55.7%) regarding the utilization of T&CM in menopause. There was a significant association between knowledge and attitude (p value < 0.05), as well as between attitude and practice (p value < 0.01). Participants with university level education and high income (> RM10,1000) showed higher knowledge and positive attitude.

CONCLUSIONS: Menopausal women in Kuala Lumpur were found to have a low prevalence rate of T&CM utilization. Respondents’ low understanding and unfavourable views might significantly impact the inadequate usage of T&CM.

PMID:40057740 | DOI:10.1186/s12906-025-04816-y

Crit Care. 2025 Mar 8;29(1):106. doi: 10.1186/s13054-025-05323-9.

ABSTRACT

INTRODUCTION: Albumin kinetics in septic shock have been extensively studied, but clinical recommendations remain weak. An increased transcapillary escape rate (TER) of albumin has been demonstrated, though TER does not account for lymphatic return. Mass balance calculations, considering lymphatic return, have been used to assess net albumin leakage (NAL) in major surgery but not in sepsis.

OBJECTIVES: This study aimed to evaluate NAL in ten ICU patients with suspected sepsis, hypothesizing a net positive leakage. Secondary aims included investigating associations between NAL and fluid overload, glycocalyx shedding products, and cytokines, as well as identifying factors associated with it.

METHODS: This prospective, observational study included ten patients within twelve hours of ICU admission for suspected sepsis at Karolinska University Hospital Huddinge. Albumin, hematocrit, and hemoglobin levels were sampled at 0, 1, 2, 4, 8, and 24 h. NAL was estimated using mass balance calculations, comparing proportional changes in albumin and hemoglobin concentrations over time, adjusted for albumin and hemoglobin infusions and losses. A proportionally greater decrease or smaller increase in albumin compared to hemoglobin indicated NAL, representing the net leakage from the circulation to the interstitium minus lymphatic return.

RESULTS: Over 24 h, patients exhibited a net positive albumin leakage to the interstitium of 8 ± 10 g (p = 0.029). NAL showed no correlation with glycocalyx shedding products or fluid overload but had a weak correlation with interleukin-6 and interleukin-8 in the first 4 h. Albumin infusions appeared to increase net leakage.

CONCLUSION: This study demonstrated a net positive albumin leakage of 8 ± 10 g over 24 h in ICU patients with suspected sepsis, with a weak early correlation to pro-inflammatory cytokines but no significant link to fluid balance or glycocalyx shedding. Notably, albumin infusions were associated with increased net leakage.

PMID:40057738 | DOI:10.1186/s13054-025-05323-9

BMC Public Health. 2025 Mar 8;25(1):926. doi: 10.1186/s12889-025-22090-y.

ABSTRACT

BACKGROUND: People living with HIV (PLHIV) in the southern United States (US) are at high risk for poor outcomes across the HIV care continuum leading to low rates of viral suppression. Understanding structural barriers to care-including transportation vulnerability-is critical to improve HIV outcomes. This study investigated relationships between travel time to HIV care, transportation vulnerability, and HIV care disruptions to inform future transportation interventions for PLHIV residing in South Carolina and other southern US states.

METHODS: A total of 160 PLHIV (N = 160) were recruited from a large immunology center in South Carolina. Participants reported on transportation experiences, transportation vulnerabilities, and residence. Differences in sociodemographic characteristics, transportation vulnerabilities, and HIV care disruptions were compared across travel time groups (< 15, 15-30, and > 30 min from residential location to the HIV clinic) using Mantel-Haenszel Chi-Square tests. Multivariable logistic regression tested our a priori hypothesis that travel time would predict HIV care disruptions.

RESULTS: A majority of participants were aged 45-64 years old (54.4%), single (77.0%), male (63.8%), and Black (77.5%). Nearly 20% of participants lived < 15 min from their HIV clinic, 59.1% lived 15-30 min, and 21.4% lived > 30 min away. PLHIV who had to travel > 30 min to HIV care were more likely than those living < 15 min away to report transportation vulnerability (73.5% vs. 51.6%, p = 0.048), missed HIV care appointments (64.7% vs. 41.9%, p = 0.049), and transportation challenges that prevented them from seeing HIV care providers (67.7% vs. 39.4%; p = 0.014). Adjusted odds ratios (AOR) show that PLHIV who had to travel > 30 min were more likely to experience transportation-related disruptions to HIV care, including being late to appointments (AOR 5.25, 95% CI:1.06-25.92), missing appointments (AOR 3.85, 95% CI:1.04-15.89), and being unable to see HIV providers (AOR 7.06, 95% CI:0.59-14.89).

CONCLUSIONS: In South Carolina-a rural southern state with a disproportionate burden of HIV-long travel time (> 30 min) to HIV care is associated with care disruptions, including more missed visits. Transportation interventions, as well as other efforts to expand rural access to HIV care, are urgently needed to ensure that all PLHIV are able to engage in consistent HIV care in order to reach and maintain viral suppression.

PMID:40057737 | DOI:10.1186/s12889-025-22090-y

Microb Cell Fact. 2025 Mar 8;24(1):58. doi: 10.1186/s12934-025-02671-7.

ABSTRACT

CONTEXT AND GOAL: This study aimed to isolate and optimize a high-yield lipase-producing Pseudomonas aeruginosa strain from biological samples, enhance enzyme production through random mutagenesis, and evaluate its potential anticancer activity. Fifty-one biological samples (blood, urine, sputum, wound pus) were screened, and three isolates demonstrated significant lipase activity. The isolate with the highest activity, identified as P. aeruginosa (GenBank accession number PP436388), was subjected to ethidium bromide-induced mutagenesis, resulting in a two-fold increase in lipase activity (312 U/ml). Lipase production was optimized using submerged fermentation, with critical factors identified statistically as Tween 80, peptone, and substrate concentration. The enzyme was purified via ammonium sulfate precipitation and Sephadex G-100 chromatography, and its molecular weight (53 kDa) was confirmed by SDS-PAGE.

FINDINGS: Optimal conditions for enzyme production included a pH of 9, temperature of 20 °C, and a 24-h incubation period. The partially purified enzyme exhibited high stability at pH values up to 10 and storage temperatures of 4 °C. Anticancer activity was evaluated using the MTT assay, revealing an IC₅₀ of 78.21 U/ml against human hepatocellular carcinoma using HepG-2 cells, with no cytotoxicity observed against Vero cells. Flow cytometry confirmed that the enzyme’s anticancer potential was mediated through apoptosis and necrosis. QRT-PCR data revealed that the expression of the Bcl-2 gene was significantly downregulated by 62% (P < 0.05) following the treatment of HepG-2 cells with the lipase enzyme. These findings suggest that lipase from P. aeruginosa holds promise as a novel therapeutic agent for hepatocellular carcinoma, addressing the limitations of current treatments.

PMID:40057735 | DOI:10.1186/s12934-025-02671-7