Tag: pubmed

MedScience. 2026 Jul 17. doi: 10.1007/s11684-026-1236-9. Online ahead of print.

ABSTRACT

Data on the clinical characteristics and outcomes of patients with pleural infection are limited. This retrospective study aimed to describe the clinical characteristics and outcomes associated with community-acquired pleural infection (CAPI) and hospital-acquired pleural infection (HAPI) in a large Chinese tertiary-care hospital in Beijing over 11 years. The study included 832 patients, of whom 84.9% had HAPI. The most common cause of CAPI was pneumonia and pleurisy, whereas the most common cause of HAPI was trauma or chest surgery. The predisposing factors with statistically significant differences between HAPI and CAPI included the presence of an abdominal indwelling catheter (P = 0.012), thoracic cavity drainage (⩾ 10 days) (P = 0.003), and use of broad-spectrum antibiotics (P = 0.002). Staphylococcus epidermidis (24.76%) and Streptococcus species (27.00%) were the most common Gram-positive bacteria in HAPI and CAPI, respectively, whereas Acinetobacter baumannii (8.61%) and Escherichia coli (4.38%) were the most common Gram-negative pathogens in HAPI and CAPI, respectively. Virtually any Gram-positive bacteria were resistant to linezolid and vancomycin, except Enterococcus faecium displaying resistance to vancomycin (9.88%). The 30-day mortality after the onset of pleural infection was 13.1%. Multivariable logistic regression analysis suggested that intensive care unit (ICU) admission, solid tumors, chronic renal failure, and a decreased serum albumin level were independent risk factors for pleural infection. No statistically significant difference in mortality was observed between patients with CAPI (11.9%) and those with HAPI (13.3%). Differences were noted in clinical characteristics between HAPI and CAPI. The findings might guide empirical treatments and help improve infection control strategies.

PMID:42467364 | DOI:10.1007/s11684-026-1236-9

Health Care Anal. 2026 Jul 17. doi: 10.1007/s10728-026-00587-w. Online ahead of print.

ABSTRACT

This mixed-methods study examines the push-pull factors influencing physician emigration from Turkey and assesses the feasibility of reverse brain drain, framing physician migration as a challenge for health governance rather than merely an individual career choice. Quantitative data from 1331 physicians (700 specialists, 631 interns) across 19 provinces and qualitative interviews with 32 emigrated physicians in four destination countries reveal that violence against healthcare workers (81.6%), low salary (74.3%), and challenging working conditions (59.8%) constitute the primary push factors. A statistically significant negative correlation between job satisfaction and brain drain attitudes (r = – 0.132, p < 0.01) confirms an association but explains only limited variance, indicating that structural and systemic conditions matter beyond individual satisfaction alone in shaping migration orientations. The qualitative findings identify professional burnout, performance system dysfunction, and sociopolitical instability as additional drivers. Only 2 of 32 emigrated physicians were considering return, and no female participant expressed return intention. Drawing on the ethics of health workforce governance, the study argues that when the state fails to protect physicians from violence and provide sustainable professional conditions, the normative responsibility for brain drain shifts from the emigrating individual to the institutional structures that render emigration rational. Policy interventions targeting salary alone are insufficient; comprehensive reforms in professional safety, meritocratic career pathways, workload standards, and sociopolitical stability are required.

PMID:42467353 | DOI:10.1007/s10728-026-00587-w

CNS Drugs. 2026 Jul 17. doi: 10.1007/s40263-026-01316-6. Online ahead of print.

ABSTRACT

BACKGROUND: Plexiform neurofibromas (PN) represent a significant cause of morbidity among patients diagnosed with neurofibromatosis type 1 (NF1). MEK inhibitors continue to be developed as targeted therapies by inhibiting the mitogen-activated protein kinase pathway to treat PN; nonetheless to this day, therapeutic responses have varied across different patient populations and clinical contexts, and the overall efficacy and tolerability of these agents remain incompletely characterized.

OBJECTIVE: We aimed to systematically evaluate the efficacy and safety of MEK inhibitor therapy in patients with NF1-associated PN and to evaluate differences among key subgroups based on the most contemporary metadata.

METHODS: A comprehensive search was performed across electronic databases to identify studies that reported outcomes related to MEK inhibitor therapy in NF1-associated PN. Pooled proportions were calculated using a random-effects meta-analysis with logit transformation. Outcomes assessed included objective response rate, disease control rate, disease progression rate, and grade ≥ 3 adverse events.

RESULTS: A total of 23 studies comprising 769 patients were included. The pooled objective response rate was estimated at 56% (95% confidence interval [CI] 46-65; I² = 79.2%), with significantly higher response rates observed in clinical trials (61%) compared with real-world cohorts (44%) [p = 0.035], while no statistically significant difference was observed between pediatric (58%) versus adult populations (51%) [p = 0.407]. The pooled disease control rate was 96% (95% CI 91-98; I² = 17%) and the pooled disease progression rate was estimated at 2% (95% CI 1-5; I² = 0%), both reflecting on-treatment outcomes. Grade ≥ 3 adverse events occurred in 13% of patients (95% CI 6-25; I² = 51.9%). Subgroup analyses revealed comparable disease control across study settings, with moderate variability in response and toxicity estimates.

CONCLUSIONS: The use of MEK inhibitors is associated with high rates of disease control and minimal tumor progression in patients with NF1-related PN, with consistent effects observed across clinical trial and real-world environments. Although tumor reduction occurs in some patients, the predominant therapeutic benefit appears to be sustained disease stabilization, with response variability noted among different age groups and study designs.

PMID:42467350 | DOI:10.1007/s40263-026-01316-6

Neurol Ther. 2026 Jul 17. doi: 10.1007/s40120-026-00946-8. Online ahead of print.

ABSTRACT

INTRODUCTION: Migraine is a common neurological disorder that can severely diminish quality of life. Quantifying migraine-related changes in a real-world population over time can increase understanding of the natural history of migraine and improve clinical care of individuals with migraine.

METHODS: The Observational survey of the Epidemiology, treatment, and Care Of MigrainE (OVERCOME) is a web-based study that longitudinally assessed migraine-related outcomes in a demographically representative adult population with migraine in the United States. Migraine disease status was classified as “overall improved,” “overall worsened,” or “no net change” based on changes in monthly headache days (MHDs), the Migraine Disability Assessment Scale (MIDAS) score, and the Migraine-Specific Quality-of-Life Questionnaire-Role Function-Restrictive (MSQ-RFR) domain score over 1 year. Migraine-related characteristics and patient-reported outcomes were evaluated for each group.

RESULTS: Among 11,634 individuals with migraine who completed the baseline and 1-year follow-up surveys, 40.4% were classified as having “overall improved,” 24.1% as having “overall worsened,” and 35.5% as having “no net change” migraine status at 1 year. The “overall improved” group reported decreases in MHDs [mean change from baseline (SD), -3.2 (5.0)] and MIDAS score [-15.4 (26.2)] and improvements in MSQ-RFR score [+ 13.7 (21.6)]. Additionally, the impact of migraine on work decreased, there was less stigma, and this group was less likely to overuse acute medications. The “overall worsened” group experienced more MHDs [+ 3.4 (5.7)], increased MIDAS score [+ 18.8 (29.0)], and worsening MSQ-RFR score [-14.1 (21.1)]. Migraine had a greater negative impact on their working lives, and they had a greater need for acute and preventive medications for migraine.

CONCLUSION: MHD, MIDAS score, and MSQ-RFR score together provide a robust characterization of overall change in migraine over time. This study demonstrates the profound effect of improvement or worsening of migraine symptoms on workplace productivity, migraine-related stigma, physical function, and need for treatment.

PMID:42467349 | DOI:10.1007/s40120-026-00946-8

Res Child Adolesc Psychopathol. 2026 Jul 17;54(4):93. doi: 10.1007/s10802-026-01489-0.

ABSTRACT

The Family Stress Model (FSM) is a key framework explaining the relationship between family income and child mental health. However, most studies examining the FSM are cross-sectional and do not clearly distinguish within- from between-person effects, which limits robust inferences about how family income affects child mental health at the within-person level. This study addressed this gap by applying a Random Intercept Cross-Lagged Panel Model to data from the nationally representative UK Millennium Cohort Study, focusing on children aged 3, 5, 7, 11, and 14 (N = 11,845; ~49.9% female). Findings revealed that within-person decreases in family income were associated with subsequent increases in internalizing problems for boys from ages 3 to 5 and for girls from ages 7 to 11. Further, income was associated with externalizing problems indirectly but only among girls and only through maternal, not paternal, distress. Together, these findings suggest that within-person FSM processes operate in gender- and outcome-specific ways within families. Interventions may benefit from considering both child and parent gender, with maternal mental health as a particularly relevant target during economic hardship.

PMID:42467332 | DOI:10.1007/s10802-026-01489-0

J Cancer Res Clin Oncol. 2026 Jul 17;152(7):142. doi: 10.1007/s00432-026-06551-4.

ABSTRACT

PURPOSE: The antibody-drug conjugates (ADCs) sacituzumab govitecan (SG) and datopotamab deruxtecan target trophoblast cell surface antigen 2 (TROP-2) and have shown significant efficacy in HER2-negative metastatic breast cancer (mBC). As TROP-2 may serve as a target across multiple treatment lines, detailed information on TROP-2 expression over time is of great interest.

METHODS: TROP-2 expression was analyzed in breast cancer (BC) samples from patients treated at the University Hospital Würzburg between 2004 and 2025 at clinically indicated biopsy time points (TP), and, in a subset, before and after SG treatment. Expression was assessed immunohistochemically using the H-score (range 0-300).

RESULTS: We evaluated 229 samples from 76 patients. Overall, patient-level TROP-2 expression was high (mean H-score 241.3 ± 73.2) and largely stable over time (TP1: 235.7 ± 60.8, n = 76; TP2: 244.6 ± 77.4, n = 72; TP3: 245.3 ± 84.4, n = 39; TP4: 244.9 ± 95.6, n = 8). However, 21 patients exhibited a decline in TROP-2 expression during disease progression, defined as a decrease of ≥ 50 H-score points between two consecutive TPs. Among 13 patients with paired biopsies obtained pre- and post-SG treatment, the mean TROP-2 H-score decreased from 227.0 ± 74.6 before SG to 202.9 ± 99.4 after SG (mean change – 24.1 ± 86.0; median 1.7, range – 170 to 110; Wilcoxon p = 0.542). TROP-2 H-score decreased in 6/13 patients and increased in 7/13 patients. Exploratory PFS analysis showed no statistically significant difference by post-SG TROP-2 change (log-rank p = 0.526).

CONCLUSION: TROP-2 expression was generally high and relatively stable; however, some patients showed declining levels over time.

PMID:42467304 | DOI:10.1007/s00432-026-06551-4

Eur Arch Paediatr Dent. 2026 Jul 17. doi: 10.1007/s40368-026-01244-5. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the clinical performance of Class II resin composite restorations in primary molars following pulpotomy and to compare them with Class II composite restorations in non-pulpotomised primary molars over 24 months.

METHODS: This prospective within-patient controlled study included healthy children aged 4-8 years with at least one primary molar requiring a Class II resin composite restoration with pulpotomy and one without pulpotomy. Restorations were placed under rubber dam isolation using a fifth-generation adhesive and resin composite. NeoMTA® was used for pulpotomies. Clinical evaluation was performed at 12 and 24 months by a blinded examiner using modified ‘USPHS criteria’. Cross-sectional comparisons were performed using Chi-square or Fisher’s exact tests, whilst longitudinal changes were analysed using the McNemar-Bowker test (p < 0.05).

RESULTS: Forty children (80 teeth) were enrolled initially. At 12 months, 37 children (74 teeth) were evaluated, whilst 32 children (64 teeth) completed the 24-month recall. Most restorations in both groups remained clinically acceptable throughout the study period. Marginal integrity was significantly lower in pulpotomised teeth at 12 months (p = 0.003) and at 24 months (p = 0.011). No statistically significant differences were observed for marginal discoloration, surface texture, wear, postoperative sensitivity, or recurrent caries (p > 0.05). Longitudinal analysis demonstrated significant deterioration in marginal integrity over time in the pulpotomy group (p = 0.041).

CONCLUSIONS: Resin composite restorations in primary molars showed acceptable performance in both groups. However, restorations in pulpotomised teeth demonstrated reduced marginal integrity after 24 months.

PMID:42467298 | DOI:10.1007/s40368-026-01244-5

Neurogenetics. 2026 Jul 17;27(1):50. doi: 10.1007/s10048-026-00918-y.

ABSTRACT

Objective the study investigated the association of rs57095329 polymorphism with Parkinson’s disease (PD) susceptibility, clinical features, and miR-146a expression. Methods in this case-control study (204 PD patients, 218 controls), rs57095329 genotype was performed using TaqMan assays. Serum miR-146a expression levels were detected via RT-qPCR. Statistical evaluation included ROC analysis to assess the diagnostic value of miR-146a, Pearson correlation analysis to examine its association with clinical scores (UPDRS-III, H-Y stage, and MoCA), and logistic regression to identify risk factors associated with PD. Results the dominant model genotypes (AG/GG) and the G allele conferred a reduced risk of PD compared to the AA genotype. This protective relevance was more pronounced in individuals aged ≥ 60 years and those with diabetes. Carriers of the AG/GG genotype presented with lower UPDRS-III scores and H-Y staging, together with higher MoCA scores and upregulated miR-146a levels.Serum miR-146a demonstrated outstanding diagnostic accuracy and correlated inversely with PD severity, and was identified as an independent protective factor for PD. Conclusion the miR-146a rs57095329 polymorphism confers reduced susceptibility to PD, with the G allele exerting a protective effect. Reduced serum miR-146a expression was an independent protective marker and shown promising diagnostic value for PD.

PMID:42467290 | DOI:10.1007/s10048-026-00918-y

J Rehabil Med. 2026 Jul 17;58:jrm46016. doi: 10.2340/jrm.v58.46016.

ABSTRACT

OBJECTIVE: This review explores the use of implementation science theories, models, and frameworks in rehabilitation research by describing study characteristics and assessing how the applied theories, models, and frameworks align with study purposes.

METHODS: In the scoping review, peer-reviewed articles published in English between January 2010 and October 2023 were identified from 5 datbases. Eligible studies applied or were informed by implementation science theories, models, and frameworks in any rehabilitation cotext. Data extraction covered publication characteristics, target populations, setings, study designs, used theories, models, and frameworks, and study purposes. Descriptive statistics and deductive analysis were used to synthesize findings.

RESULTS: Of 2,277 citations, 121 articles met the inclusion criteria. Most of the articles focused on neurological and paediatric rehabilitation, with qualitative and mixed-methods designs predominating. A total of 34 theories, models, and frameworks were identified, mainly determinant frameworks and process models. Theories, models, and frameworks were primarily used to identify barriers and facilitators, evaluate implementation outcomes, and describe implementation processes. However, theories, models, and frameworks selection did not always align with the study purpose.

CONCLUSION: The use of theories, models, and frameworks in rehabilitation research is increasing but remains limited. Their systematic and purposeful application is needed to enhance the usability and transferability of research findings, thereby bridging the research-practice gap, sustaining evidence-based interventions, and informing policy.

PMID:42464854 | DOI:10.2340/jrm.v58.46016

Ginekol Pol. 2026 Jul 17. doi: 10.5603/gpl.104730. Online ahead of print.

ABSTRACT

OBJECTIVES: HPV vaccines have been proven effective against genital warts and various cancers, including cervical, anal, penile, vulvar, vaginal, and oropharyngeal cancers. This study aimed to evaluate the cost-effectiveness of including the 9-valent HPV vaccine in the Turkish National Immunization Program (NIP).

MATERIAL AND METHODS: The Papillomavirus Rapid Interface for Modeling and Economics (PRIME) framework was applied to project the potential financial and societal outcomes of introducing HPV vaccination into Türkiye’s 2024 national immunization schedule. Demographic data were obtained from the Turkish Statistical Institute (TUIK, Turkiye Istatistik Kurumu). The cost of vaccine was gathered from Ministry of Health. Epidemiologic inputs, treatment expenditure data, and additional modeling parameters were derived from previously published research sources. Model outputs included projected vaccination expenses, savings from avoided treatment, net costs, prevented cases and deaths, gained life-years, averted disability-adjusted life-years (DALYs), and estimated incremental cost-effectiveness ratios. Potential variability in model projections was examined through deterministic sensitivity testing.

RESULTS: At the national level, with the 9-valent HPV vaccination of a single age cohort in the base year, an estimated 772 cervical cancer cases and 369 related deaths could be avoided through implementation of the vaccination program. With an estimated US$13,754 per DALY gained, the 9-valent HPV vaccine fell within the acceptable cost-effectiveness threshold, defined as three times the GDP per capita. Sensitivity testing confirmed consistent outcomes across parameter variations, identifying the discount rate as the major driver influencing baseline estimates.

CONCLUSIONS: Findings from this analysis support the inclusion of HPV vaccination within the National Immunization Program (NIP) as a cost-effective public health strategy capable of reducing the burden of cervical cancer. Even when considering only cervical cancer, HPV vaccination proves to be cost-effective; when benefits against genital warts and other HPV-related cancers are included, the overall impact increases significantly.

PMID:42464849 | DOI:10.5603/gpl.104730