Tag: pubmed

Support Care Cancer. 2026 May 1;34(5):482. doi: 10.1007/s00520-026-10694-y.

ABSTRACT

PURPOSE: To investigate and compare the prevalence and experience of dental caries in childhood cancer survivors (CCS) with that in healthy controls.

METHODS: A total of 113 CCS (0-18 years) who completed cancer treatment between 2017 and 2021 at Haukeland University Hospital were invited. Two healthy controls per CCS were randomly selected from the Norwegian National Population Register and matched by age and sex. Decayed, missing, and filled teeth (DMFT/dmft) and surfaces (DMFS/dmfs) were used as indices of dental caries experience. The difference in the number of affected teeth/surfaces per patient between CCS and controls was assessed via Poisson regression, with a significance level of 0.05.

RESULTS: A total of 97 CCS (85.8%) provided consent and completed the clinical examinations. The mean age among CCS was 10.4 years. Among both the CCS (34/97) and healthy controls (68/194), 35.1% had d_3-5mft and/or D_3-5MFT > 0. The mean d_3-5mft and/or D_3-5MFT was 1.15 in CCS and 0.96 in controls. A significantly greater degree of caries experience (d_3-5mfs and/or D_3-5MFS, p < 0.001; d_3-5mft and/or D_3-5MFT, p = 0.002) was observed in the CCS group than in the healthy control group for mixed dentition. No significant associations were found for the other dentitions or for d_1-5mfs and/or D_1-5MFS or d_1-5mft and/or D_1-5MFT.

CONCLUSIONS: This study compared caries experience in CCS and matched healthy controls and found no overall differences at the tooth level, indicating that awareness and follow-up of oral health in paediatric cancer patients may play a role in limiting caries development and disease burden.

PMID:42062554 | DOI:10.1007/s00520-026-10694-y

J Hum Hypertens. 2026 Apr 30. doi: 10.1038/s41371-026-01151-8. Online ahead of print.

ABSTRACT

Primary healthcare (PHC) physicians play a pivotal role in the diagnosis and management of hypertension. While guidelines suggest that blood pressure (BP) should be measured in every patient visit at PHC units, the few studies conducted among PHC physicians report a low ratio of BP measurements in PHC settings. Data on PHC physicians’ practices concerning BP measurement in Greece are lacking. This study aimed to investigate the practices of PHC physicians regarding BP measurement in Greece. A cross-sectional web-based survey was conducted among PHC physicians across Greece. A total of 284 PHC physicians completed the questionnaire and 282 responses were included in the analysis, 42.9% male, 92.9% General Practitioners, 89.4% working in the public sector, with a median of 25 (17 – 30) daily patient visits. PHC physicians reported measuring BP in 33.3% (20-50%) of their patients and recommending home BP measurements in 31.1% (SD: 24.3%) of them. Among those who measured BP, 22.3% measured it once, 44.7% measured it twice, and only 21.3% measured it three times, while 54.6% used an electronic upper arm BP monitor. The main barriers reported were high daily patient volume (60.5%), together with limited time available with patients (69.5%), while only 1.3% declared insufficient training. This is the first study in Greece investigating the practices of PHC physicians regarding BP measurements. Our findings underscore the need for targeted interventions to improve BP monitoring practices. Education and motivation of physicians and other primary care team members would be fundamental in addressing the challenge of implementing BP measurement recommendations in clinical practice.

PMID:42062548 | DOI:10.1038/s41371-026-01151-8

Eur J Clin Pharmacol. 2026 May 1;82(5):138. doi: 10.1007/s00228-026-04052-4.

ABSTRACT

PURPOSE: Drug supply shortages are a recurring issue in developed countries, with consequences for patients even before the COVID-19 pandemic. Questions arise regarding the effectiveness and tolerability of alternative treatments chosen by physicians due to these shortages.

METHODS: To answer these questions, a survey for practicing physicians was distributed to medical associations in Germany and Austria and conducted from November 2022 to January 2024. 895 physicians responded to the survey. The survey targeted 20 drugs with known supply shortages, namely amoxicillin, amoxicillin/clavulanic acid, penicillin V (phenoxymethylpenicillin), cefuroxime, cefaclor, erythromycin, cotrimoxazole, ibuprofen, paracetamol, urapidil, metoprolol, amlodipine, candesartan, tamoxifen, methotrexate, fluoxetine, lorazepam, human insulin, salbutamol and prednisolone.

RESULTS: Physicians most frequently chose a different antibacterial drug (> 60% of the physicians), while for analgesics, they more often used a different dosage form of the same drug (> 33%). For antihypertensive drugs, physicians more often chose a different dosage of the same drug. In many cases, alternative antibiotics were chosen that carried a greater risk of antimicrobial resistance than the antibiotic originally intended. The treatment success for replacing antibacterials and analgesics with a different drug was rated with 4-5 on a predefined scale of 1 (very poor) to 6 (very good) in comparison to the original drug. Using the same drug in a different dosage/dosage form was also around 4-5/6 effective.

CONCLUSIONS: Supply shortages can foster antimicrobial resistance through the use of antibacterials with a higher potential for resistance. The success of alternative treatments was not always considered to be very good in comparison to the original medication.

PMID:42062544 | DOI:10.1007/s00228-026-04052-4

Eur J Clin Nutr. 2026 Apr 30. doi: 10.1038/s41430-026-01758-7. Online ahead of print.

ABSTRACT

BACKGROUND: Over time, amyotrophic lateral sclerosis (ALS) has been considered an accelerated model of sarcopenia. However, muscle mass is rarely assessed in ALS patients. The aim of this study was to explore the agreement between bioelectrical impedance analysis (BIA)-measured and calf circumference (CC)-derived appendicular skeletal muscle mass index (ASMMI) in ALS patients.

METHODS: Body composition was assessed using anthropometric measures and BIA. Pearson analyses were used to assess correlations and Kappa (κ) statistics were used to evaluate agreement between BIA-measured and CC-derived ASMMI. CC predictive ability was assessed through the area under the receiver operating characteristic curve.

RESULTS: A total of 61 ALS patients were included. The CC-ASMM was highly correlated with the BIA-ASMM (r = 0.830, p < 0.001) and CC-ASMMI was moderately correlated with BIA-ASMMI (r = 0.62, p < 0.001). Low CC-derived and BIA-derived ASMMI presented a moderate degree of agreement in the overall sample (k = 0.546, 95% CI 0.325-0.767) and in men (k = 0.432, 95% CI 0.056-0.809), while a substantial agreement was observed in women (k = 0.613, 95% CI 0.344-0.883). The optimal cut-off values for CC in identifying low ASMMI from the ROC analysis, were 34 cm for both sexes with an area under the curve (AUC) of 0.818 for men (sensitivity 80%, specificity 78.3%) and of 0.841 (sensitivity 83.3%, specificity 72.7%) for women.

CONCLUSION: Our preliminary study showed a good predictive ability of the CC, an anthropometric parameter significantly associated with sarcopenia, in reflecting the ASMM. The best performance was found for a CC cut-off point of ≤34 cm in both sexes.

PMID:42062527 | DOI:10.1038/s41430-026-01758-7

Pediatr Res. 2026 Apr 30. doi: 10.1038/s41390-026-05022-3. Online ahead of print.

ABSTRACT

BACKGROUND: To assess rates and factors for disability at 3 following hypoxic-ischemic encephalopathy (HIE).

METHODS: Newborns more than 34 weeks with HIE Sarnat grades I to III, mostly treated by hypothermia were included in the population-based cohort LyTONEPAL and followed at 3. Mild, moderate, or severe neurodevelopment was defined on motor, sensorial impairment, epilepsy and neurodevelopmental delay. Main measurement was relative risk ratio (aRRR) and 95% CI of disability, adjusted for birth circumstances and neonatal complications, estimated on complete and imputed cases.

RESULTS: 647 out of 794 newborns survived, and 463 were assessed. Severe, moderate or mild neurodevelopmental impairment was observed in 10.5% (95% CI 7.6-14.1), 11.8% (95% CI 8.7-15.6) and 22.0% (95% CI 17.9-26.6), respectively. Moderate to severe outcome was increased with an abnormal examination at discharge (aRRR=4.22, 95% CI 1.74-10.25) and hypoglycemia (aRR=8.54, 95%CI 1.88-38.73.05) while hypothermia decreased it (aRRR=0.36 95% CI 0.13-0.99). Mild outcome was associated with neonatal infection (aRRR 3.73, 95% CI 1.55-8.98-8.36), while higher gestational age seemed protective (aRRR 0.83, 95% CI 0.69-1.00).

CONCLUSION: Four in 10 HIE had neurodevelopmental sequelae, half of which were mild. A more immature brain or exposure to neonatal infection seemed to worsen prognosis, irrespective of disease severity.

TRIAL REGISTRATION: Clinical trials registry, NCT02676063, ClinicalTrials.gov.

IMPACT: Follow-up at 3 in a 647 children with HIE Sarnat grades I to III, mostly treated by hypothermia showed impairment of motor, sensorial and learning skills in 44.4%, of which 10.5% and 11.8% were moderate and severe respectively. 45.7% of children have at least one rehabilitation treatment, including 26% of children with favorable outcome. Neonatal infection increased the risk of unfavorable evolution, while more advanced gestational age and hypothermia were protective. In addition to clinical or MRI severity, our data suggest to integrate gestational age and neonatal infection into early prognostic assessment, and extending HIE follow-up to school age.

PMID:42062519 | DOI:10.1038/s41390-026-05022-3

Ultrasound Obstet Gynecol. 2026 Apr 30. doi: 10.1002/uog.70219. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare gestational age (GA) dating models for pregnancies conceived via assisted reproductive technology (ART), assess whether 14 or 15 days more accurately reflects the median follicular-phase duration in ART pregnancies and evaluate whether the gestational timelines of ART pregnancies are comparable with that of spontaneously conceived pregnancies.

METHODS: We employed population data from the Medical Birth Registry of Norway (2015-2021), including 163 544 children conceived spontaneously, 2067 conceived via fresh embryo transfer (ET) and 2080 conceived via frozen ET. Among ART pregnancies, we compared two GA dating methods: a population-based ultrasound model (GA_US) and an ART-based formula based on the known oocyte fertilization date. Statistical agreement was evaluated by calculating individual pairwise differences in GA estimates. Bias and precision in the estimated date of delivery (EDD) were assessed by constructing cumulative birth distribution (Kaplan-Meier) curves for fresh and frozen ET pregnancies separately, employing time-to-event analysis to account for nonspontaneous births.

RESULTS: The absolute individual GA differences between ultrasound and ART-based dating, considering a 14-day median follicular-phase duration, were ≤ 1 day for 969/2067 (46.9%) fresh ET pregnancies and for 874/2080 (42.0%) frozen ET pregnancies. An approximate systematic difference of 1 day was observed, which we corrected by employing a 15-day median follicular-phase duration in the ART-based formula (GA_ART,15). There was a median pairwise difference between GA_US and GA_ART,15 of -0.4 (95% CI, -0.5 to -0.3) days in fresh ET pregnancies and -0.2 (95% CI, -0.4 to -0.1) days in frozen ET pregnancies. Both models demonstrated equivalent precision in the EDD. Measured using the ultrasound model, frozen ET pregnancies had a median pregnancy duration of 286.1 (95% CI, 285.5-286.7) days, which was 3.2 (95% CI, 2.4-3.9) days longer than that in fresh ET pregnancies, and 2.6 (95% CI, 2.0-3.2) days longer than that in spontaneously conceived pregnancies.

CONCLUSIONS: We found close statistical agreement between ultrasound and ART-based dating models for both GA and EDD. However, 15 (not 14) days of follicular-phase duration should be utilized in the ART-based formula to avoid systematic bias in ART-based GA estimates. Fresh and frozen ET pregnancies had different birth distributions and median pregnancy durations, underscoring that they are not comparable with spontaneously conceived pregnancies and they should be evaluated separately. © 2026 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

PMID:42060947 | DOI:10.1002/uog.70219

Int J Neurosci. 2026 Apr 30:1-17. doi: 10.1080/00207454.2026.2664786. Online ahead of print.

ABSTRACT

OBJECTIVES: The relationship between epilepsy and neurodegeneration has recently been a subject of debate, particularly regarding whether neurodegeneration is a cause or a consequence of epilepsy. Given that the retina is an extension of the brain and closely connected to it, retinal layer thickness can serve as a biological marker of neurodegeneration. The aim of this work was to measure retinal nerve fiber layer (RNFL) thickness in patients with epilepsy in comparison to healthy controls, and to study the impact of epilepsy duration and seizure frequency on RNFL thickness in those patients.

METHODS: This case-control study was conducted on 53 patients matched clinical definition of epilepsy established by the International League Against Epilepsy (ILAE) 2017, and 50 healthy controls. Cognitive assessment using Montreal cognitive assessment scale (MOCA), and measurement of RNFL thickness using Spectral domain Optical Coherence Tomography (SD-OCT), were done to all included patients and controls.

RESULTS: The peripapillary RNFL thickness (superior, inferior & average) were all significantly reduced in both eyes in epileptic patients compared to healthy controls (P-value <0.05). There was a statistically significant difference between epileptic patients and controls regarding MOCA score. There was no statistically significant impact of seizure control, history of status epilepticus, anti-epileptic drugs, seizure frequency, or disease duration on RNFL thickness.

CONCLUSION: There was a statistically significant reduction of the retinal nerve fiber layer thickness in epileptic patients in comparison to healthy controls. Epileptic patients had significant impairment in cognitive functions in comparison to healthy controls.

PMID:42060940 | DOI:10.1080/00207454.2026.2664786

JMIR Serious Games. 2026 Apr 30;14:e93412. doi: 10.2196/93412.

ABSTRACT

BACKGROUND: Internet gaming disorder (IGD) is increasingly prevalent among adolescents. Although socially prescribed perfectionism (SPP) and resilience are both related to IGD, longitudinal evidence on their temporal relationships and underlying mechanisms remains limited.

OBJECTIVE: This study aimed to examine the longitudinal associations among SPP, resilience, and IGD in Chinese adolescents; test the mediating role of resilience; and explore potential sex differences.

METHODS: A 3-wave prospective longitudinal study was conducted among students from 4 middle schools in Zhejiang Province, China. Adolescents who had played online games in the past 12 months were recruited using convenience sampling. Data were collected at 6-month intervals: time 1 (T1; March 2024), time 2 (T2; September 2024), and time 3 (T3; March 2025). A total of 1332 Chinese adolescents (875/1332, 65.7% male; mean age 13.61, SD 0.70 years) participated in the baseline survey. SPP, resilience, and IGD were assessed using the Hewitt-Flett Multidimensional Perfectionism Scale-Short Form, the 10-item Connor-Davidson Resilience Scale, and the 9-item Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) IGD Checklist, respectively. Cross-lagged panel model (CLPM) and multigroup analyses across sex were conducted.

RESULTS: All statistical tests were 2-tailed with α=.05. The CLPM demonstrated good fit to the data (χ²38=163.34; comparative fit index [CFI]=0.945; Tucker-Lewis index [TLI]=0.932; root mean square error of approximation [RMSEA]=0.054; standardized root mean square residual [SRMR]=0.047). Higher SPP predicted later IGD (T1→T2: β=0.10, 95% CI 0.04 to 0.16, P<.001; T2→T3: β=0.09, 95% CI 0.03 to 0.15, P=.004) and lower resilience (T1→T2: β=-0.09, 95% CI -0.16 to -0.02, P=.007; T2→T3: β=-0.12, 95% CI -0.18 to -0.06, P<.001). In contrast, SPP was not significantly predicted by prior IGD nor resilience. Higher resilience predicted lower subsequent IGD (T1→T2: β=-0.09, 95% CI -0.15 to -0.03, P=.001; T2→T3: β=-0.09, 95% CI -0.15 to -0.03, P=.001), whereas higher IGD predicted lower subsequent resilience (T1→T2: β=-0.19, 95% CI -0.27 to -0.11, P<.001; T2→T3: β=-0.09, 95% CI -0.15 to -0.03, P=.003). Bootstrapped mediation analysis showed a significant indirect effect of SPP at T1 on IGD at T3 via resilience at T2 (β=0.008, 95% CI 0.004 to 0.012, P=.005). However, multigroup analyses revealed no significant sex differences.

CONCLUSIONS: This study provides novel insights into the longitudinal associations among SPP, resilience, and IGD in adolescents. Unlike previous research based mainly on cross-sectional data, this 3-wave CLPM study clarifies the temporal relationships among these variables and shows that resilience mediates the association between SPP and subsequent IGD. These findings advance the field by identifying a temporal psychological pathway underlying adolescent IGD. They also have practical implications for early screening and for developing resilience-focused interventions for adolescents at risk of IGD.

PMID:42060935 | DOI:10.2196/93412

JMIR Public Health Surveill. 2026 Apr 30;12:e89295. doi: 10.2196/89295.

ABSTRACT

BACKGROUND: Hypertensive disorders of pregnancy (HDP) may cause lasting vascular, cardiac, and renal damage, potentially increasing the risk of postpartum cardiovascular disease.

OBJECTIVE: This study aimed to examine the association between gestational blood pressure (BP) trajectories in HDP and the risk of unrecovered BP at 6 weeks post partum.

METHODS: A total of 3162 women with HDP were obtained from the antenatal care and the postpartum follow-up information system, between January 1, 2018, and December 31, 2024. Of the 3162 women included, 1674 had gestational hypertension, 607 had preeclampsia, 246 had chronic hypertension with superimposed preeclampsia, and 635 had chronic hypertension. Group-based trajectory modeling was used to fit systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) trajectories during pregnancy. Modified Poisson regression was used to assess the association between gestational BP trajectories and the risk of unrecovered BP at 6 weeks post partum.

RESULTS: Trajectories of SBP, DBP, and MAP during pregnancy were significantly associated with unrecovered BP at 6 weeks post partum. For gestational hypertension, those with the high-consistent rise (adjusted relative risk [aRR] 2.493, 95% CI 1.093-5.689) and high-late surge SBP trajectories (aRR 4.535, 95% CI 1.884-10.917) were associated with a significantly increased risk of BP nonrecovery at 6 weeks post partum. Similar associations were observed for DBP and MAP. For chronic hypertension with superimposed preeclampsia, women with high-late surge in SBP (aRR 2.792, 95% CI 1.081-7.214), DBP (aRR 4.043, 95% CI 1.327-12.324), or MAP (aRR 4.018, 95% CI 1.462-11.045) had a significantly increased risk of BP nonrecovery at 6 weeks post partum. Among women with chronic hypertension, those with the high-consistent rise trajectories of SBP (aRR 2.557, 95% CI 1.256-5.207), DBP (aRR 3.862, 95% CI 1.673-8.913), and MAP (aRR 3.714, 95% CI 1.682-8.201) had a significantly increased risk of BP nonrecovery at 6 weeks post partum. Among women with preeclampsia, only high-consistent rise SBP trajectory remained significantly associated with unrecovered BP post partum (aRR 3.355, 95% CI 1.140-9.873). The high-consistent rise and high-late surge trajectories of SBP, DBP, and MAP in gestational hypertension started at similar initial levels and crossed at approximately 22 weeks of gestation.

CONCLUSIONS: The gestational BP trajectories in women with HDP are positively associated with the risk of unrecovered BP at 6 weeks post partum. Early identification of women at high risk for poor postpartum BP recovery through BP trajectory analysis may have important clinical implications for improving long-term cardiovascular outcomes in this population.

PMID:42060921 | DOI:10.2196/89295

J Med Internet Res. 2026 Apr 30;28:e76236. doi: 10.2196/76236.

ABSTRACT

BACKGROUND: Digital oral health builds on the broader framework of eHealth, leveraging digital technologies to improve patient care, increase access to dental services, and enhance oral health outcomes. However, health care organizations and institutions encounter challenges in implementing digital oral health interventions across various levels. Addressing these challenges requires a comprehensive understanding of the barriers and facilitators that influence its successful adoption.

OBJECTIVE: This study aimed to explore the facilitators of and barriers to the implementation of digital oral health programs from the perspective of chief dental officers from countries across the World Health Organization (WHO) regions.

METHODS: This study is part of a broader investigation into global readiness for digital oral health. Participants were the 144 chief dental officers or designated oral health officials within ministries of health across the 6 WHO regions. An explanatory sequential mixed methods design was used across 2 phases. In the quantitative phase, an online survey was administered using the WHO’s global survey on eHealth instrument. Some items were modified slightly to be applied to the field of dentistry. Descriptive statistics were used to present the quantitative data. In the qualitative phase, data were collected through virtual interviews, using an interview guide developed based on preliminary findings from the quantitative phase, the technology acceptance model, and the eHealth readiness assessment tool. The qualitative data were analyzed using thematic analysis.

RESULTS: The survey response rate was 70.1% (101/144). The qualitative phase involved in-depth interviews with 15 participants. The findings were integrated under 2 broad themes of facilitators and barriers. Perceived facilitators included the existence of national policies and guidelines on eHealth. Approximately 63.9% (53/83) of the respondents indicated the presence of a national oral health policy in their countries. Capacity building, motivation of health care providers and academic leadership, digital health training for students or professionals, and WHO support to implement the mOral Health program were the other facilitators. The strongest barriers were a lack of funding to develop and support digital health programs, lack of norms and standards to guarantee application interoperability, and lack of equipment and/or connectivity. Approximately 45.1% (37/82) of the participants reported having government-sponsored mobile health programs, while 31.7% (26/82) reported having no financial support for the implementation of national digital oral health programs. Furthermore, lack of evidence on the effectiveness and cost-effectiveness of programs was highlighted as a barrier by 73.8% (59/80) and 73% (57/78) of the participants, respectively.

CONCLUSIONS: The results of this study enabled the identification of key barriers to and enablers of the implementation of digital oral health programs in WHO member countries. Supportive governmental policies and adequate funding and investment in digital infrastructure and technologies are essential to mitigate digital oral health-related challenges.

PMID:42060912 | DOI:10.2196/76236