Tag: pubmed

Maturitas. 2026 Feb 25;208:108895. doi: 10.1016/j.maturitas.2026.108895. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the controversial association between exogenous hormone use (EHU) and dementia, with a focus on subtype-specific risks.

STUDY DESIGN: This prospective cohort study followed 273,069 women in the UK Biobank over 3,802,608 person-years, identifying 4,710 dementia cases.

MAIN OUTCOME MEASURES: Cox models assessed use of oral contraceptive (OC) and hormone replacement therapy (HRT) in relation to all-cause dementia, Alzheimer’s disease (AD), vascular dementia (VaD), and frontotemporal dementia (FTD) across treatment durations. Subgroup analyses were stratified by age, ethnicity, APOE status, education, income, and reproductive factors. A systematic review was conducted to synthesize existing evidence.

RESULTS: In the cohort study, OC use was associated with reduced risks of all-cause dementia (HR 0.90, 95%CI 0.84-0.95), AD (HR 0.87, 95%CI 0.79-0.95), and VaD (HR 0.81, 95%CI 0.70-0.93), particularly after 4-14 years of use. HRT showed no significant association with increased dementia risk. Synthesized results largely corroborated these findings: OC use was associated with reduced risks of dementia (HR 0.90, 95%CI 0.89-0.92); and although four European studies reported a moderately increased AD risk after post-menopausal HRT use, neither cohort-based studies (HR 0.98, 95%CI 0.90-1.06) nor traditional case-control studies (OR 1.00, 95%CI 0.90-1.11) found an association between HRT and dementia.

CONCLUSIONS: Our combined evidence does not support an increased risk of dementia associated with OC use; similarly, no clear association was observed between HRT and increased dementia risk. Clinical decisions on EHU should be individualized, balancing overall benefits against potential risks.

PMID:41844465 | DOI:10.1016/j.maturitas.2026.108895

J Trace Elem Med Biol. 2026 Mar 11;95:127858. doi: 10.1016/j.jtemb.2026.127858. Online ahead of print.

ABSTRACT

BACKGROUND: Endocrine disrupting metals such as cadmium (Cd), lead (Pb) and mercury (Hg) may have significant influence on fertility issues among otherwise healthy women.

METHODS: In this study, fifty women with preserved ovarian function, undergoing in vitro fertilization (IVF) procedure were tested for heavy metals (Cd, Hg and Pb) in their morning urine samples using inductively coupled plasma mass spectrometry after microwave digestion.

RESULTS: None of the women had measurable lead in the urine samples while cadmium and mercury were quantified in 28% and 60% of the samples, respectively. Serum LH levels were significantly lower (p = 0.046) among women with measurable urinary cadmium values compared to those with cadmium below the limit of quantification (LOQ). The number of immature oocytes retrieved during transvaginal aspiration was significantly higher (p = 0.030) in women with mercury above LOQ in comparison to those below LOQ. The elevation of urinary mercury concentrations was followed by the increment AST and ALT (p = 0.035 and p = 0.001, respectively). Moreover, higher urinary mercury levels were positively associated with fasting and 2 h post-load serum glucose levels during oral glucose tolerance testing (p = 0.035 and p = 0.002, respectively). For the first time, statistically significant (p = 0.009) correlation was obtained between the urinary mercury concentration and serum LDH values. All the associations between mercury and the observed parameters remained significant after adjustments for age, BMI and time attempting to conceive were made.

CONCLUSIONS: Women undergoing IVF have considerable amount of cadmium and mercury in the urine samples, despite the absence of occupational exposure.

PMID:41844457 | DOI:10.1016/j.jtemb.2026.127858

Psychiatry Res. 2026 Mar 9;360:117082. doi: 10.1016/j.psychres.2026.117082. Online ahead of print.

ABSTRACT

OBJECTIVE: Mental health in adolescents has been a growing problem in recent decades. However, comprehensive discussion of the research on the distal and proximal factors related to adolescent mental health were limited and the evidence was lacking. This study aimed to explore the result of adverse childhood experiences and biological rhythms for depressive and anxiety symptoms in adolescents.

METHODS: The data used in this study were obtained from China in 2021 (as baseline) and 2023 (as follow-up). Participants provided self-reported information through an anonymous questionnaire. Logistic regression, cluster analysis, restriction cubic spline plots and receiver operating characteristic curves were used for statistical analysis.

RESULTS: The study involved 2103 teenagers (mean age 15 years old), consisting of 1089 females and 1014 males. Multiple logistic regression results based on this subgroup showed that higher scores on either ACEs or biorhythms were associated with a greater risk of concurrent depressive-anxiety symptoms at baseline and follow-up, the adjusted ORs (95% CI) were 14.46 (7.14-29.26), 12.09 (5.83-22.08), respectively. The area under the receiver operating characteristic curve of the joint predictive effect of the ACEs and biorhythms were 0.664 for depressive symptoms, 0.656 for anxiety symptoms, and 0.667 for co-morbidity.

CONCLUSION: These findings emphasize the necessity of balancing past risk factors with emerging risk factors (biorhythms) in the precaution and management of adolescent depression and anxiety symptoms problems.

PMID:41844454 | DOI:10.1016/j.psychres.2026.117082

Cancer Genet. 2026 Mar 9;304-305:27-33. doi: 10.1016/j.cancergen.2026.03.003. Online ahead of print.

ABSTRACT

BACKGROUND: Hepatoblastoma (HB) is the most common primary liver malignancy in children. Oxidative DNA damage is primarily repaired through the base excision repair (BER) pathway, and genetic polymorphisms in BER-related genes may influence individual susceptibility to HB. However, the contribution of BER gene variants to HB risk remains unclear.

METHODS: A multicenter case-control study including 193 HB patients and 773 cancer-free controls were conducted. Twenty potentially functional single nucleotide polymorphisms (SNPs) in key BER pathway genes were genotyped using TaqMan assays. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models controlling for age and sex. The Benjamini-Hochberg false discovery rate (FDR) procedure was applied to account for multiple testing in the primary analysis. Expression quantitative trait loci (eQTL) analyses were performed using publicly available GTEx data to explore potential regulatory effects.

RESULTS: In unadjusted analyses, several BER SNPs showed nominal associations with HB susceptibility under specific genetic models, including PARP1 rs2666428, APEX1 rs1760944, LIG3 rs4796030, XRCC1 rs25487, and XRCC1 rs915927. However, after Benjamini-Hochberg false discovery rate (FDR) correction across the 20 examined SNPs in the primary (dominant-model) analysis, none of the associations remained statistically significant at an FDR threshold of 0.05. The smallest FDR-adjusted q values were 0.053 (PARP1 rs2666428, APEX1 rs1760944, and XRCC1 rs25487), indicating borderline but non-significant signals. Stratified analyses suggested potential subgroup-specific effects, but these findings were based on limited sample sizes and should be interpreted cautiously. eQTL analyses indicated that selected variants were associated with altered gene expression in normal tissues, providing preliminary functional support.

CONCLUSION: This study provides exploratory evidence suggesting that genetic variation in BER pathway genes may contribute to HB susceptibility in Chinese children. Given the multiple testing burden and modest effect sizes, these findings should be considered hypothesis-generating and require validation in independent cohorts and functional studies.

PMID:41844453 | DOI:10.1016/j.cancergen.2026.03.003

Arch Med Res. 2026 Mar 16;57(5):103407. doi: 10.1016/j.arcmed.2026.103407. Online ahead of print.

ABSTRACT

BACKGROUND: Wilson disease (WD) is a multisystemic disorder caused by a disturbance in copper homeostasis due to pathogenic biallelic variants in the ATP7B gene.

AIM: To identify the pathogenic variants in the ATP7B gene in Mexican individuals with WD and describe their phenotypic presentation.

METHODS: We included 19 individuals from 11 unrelated families with molecularly confirmed WD.

RESULTS: 52.6% of the WD patients were male, and three were asymptomatic at diagnosis. The median age at presentation was 19 years. Of the symptomatic individuals, 84.2% had hepatic manifestations, 62.5% had neurological symptoms, 25.0% had psychiatric manifestations, and 90.9% had Kayser-Fleischer rings. The phenotypic distribution was as follows: combined (52.6%), acute liver failure (26.3%), chronic liver disease (5.3%), and asymptomatic (15.8%). Modified Leipzig scores ranged from 8 to 16. Five patients underwent liver transplantation, and eight patients were treated with copper chelators. Eight different pathogenic variants were identified, including the recurrent c.3207C>A and c.3809A>G, as described in other series.

CONCLUSIONS: We present the first and largest case series of Mexican patients with WD confirmed by molecular testing. All patients exhibited hepatic manifestations. The most frequent phenotypes were combined (52.6%) and acute liver failure (26.3%). A statistically significant difference in the frequency of asymptomatic patients was observed between the homozygous c.3207C>A genotype group and the group with other genotypes (p = 0.036). The modified Leipzig score is a valuable diagnostic tool for WD.

PMID:41844444 | DOI:10.1016/j.arcmed.2026.103407

J Obstet Gynaecol Res. 2026 Mar;52(3):e70250. doi: 10.1111/jog.70250.

ABSTRACT

AIM: To compare outcomes, efficacy, and safety of vNOTES versus conventional laparoscopy and laparoendoscopic single-site surgery salpingectomy for ectopic pregnancy.

METHODS: Electronic databases including PubMed, Medline, Cochrane Library, and Embase were systematically searched. Articles were evaluated according to specified inclusion criteria. Data were extracted and reviewed, with reported duration of procedure and length of patient stay as primary outcomes. Due to heterogeneity of data, analysis was further stratified depending on whether the control groups underwent conventional laparoscopy or laparoendoscopic single-site surgery. Secondary outcomes include success rates, estimated blood loss, Visual Analogue Scores (VAS) for postoperative pain and complications. A formal risk of bias assessment accompanied the included studies.

RESULTS: Twenty-one studies were included within the review with a cumulative total of 405 cases of vNOTES salpingectomy. Studies included randomized control trials (n = 2), cohort control studies (n = 6), case series (n = 12), and case report (n = 1). Meta-analyses of duration of procedure and length of stay were performed across seven papers (stratified according to control groups). This revealed a significant reduction in length of stay but similar duration of surgery under fixed and random effects models (p < 0.05) for vNOTES versus conventional laparoscopic salpingectomy. Patients undergoing vNOTES salpingectomy versus laparoendoscopic single-site surgery had similar duration of surgery and length of stay. Women who had vNOTES demonstrated lower VAS pain scores and reduced analgesia requirements. Up to 4% of cases may need conversion to laparoscopy (these were cases associated with pelvic adhesions or torrential hemorrhage), and documented complications included hemorrhage, post-operative pyrexia, and need for blood transfusion.

CONCLUSIONS: vNOTES salpingectomy for ectopic pregnancy appears to be a safe and feasible procedure, with high levels of patient satisfaction and low pain scores. The heterogeneity of data of the control groups is acknowledged and patients undergoing vNOTES versus conventional laparoscopic salpingectomy had reductions in length of stay but similar duration of surgery, while vNOTES salpingectomy versus laparoendoscopic single-site surgery incurred similar duration of surgery and length of stay. Procedural standardization and larger randomized clinical trials to assess long-term outcomes are crucial if vNOTES salpingectomy should become widely used for surgical treatment of ectopic pregnancy.

PMID:41844421 | DOI:10.1111/jog.70250

Nurs Adm Q. 2026 Apr-Jun 01;50(2):126-132. doi: 10.1097/NAQ.0000000000000717. Epub 2026 Mar 17.

ABSTRACT

BACKGROUND: Discharge delays and emergency department (ED) overcrowding are persistent challenges that negatively affect hospital throughput and patient outcomes. Although discharge lounges (DC Lounges) offer a potential solution, there is limited peer-reviewed literature evaluating their financial return on investment (ROI).

OBJECTIVE: This study examined the operational and fiscal impact of a nurse-led DC Lounge in a large academic medical center, with a focus on cost-savings-based ROI.

METHODS: A quantitative, descriptive design was used to evaluate the first year of DC Lounge implementation at a 700+ bed academic medical center. Data collected included discharge timing, DC Lounge utilization, inpatient bed days saved, and ED hold hours. Financial analysis calculated ROI based solely on cost avoidance.

RESULTS: The DC Lounge reached its financial break-even point in November 2024, saving 88.9 inpatient bed days and achieving an ROI of 1.16. Utilization increased 400% over the first year, while average patient time in the DC Lounge decreased by 19%. Hospital discharges before 2 PM improved.

CONCLUSIONS: This study is among the first to quantify ROI for a DC Lounge, demonstrating its operational and financial viability. Nurse-led coordination and interdisciplinary collaboration were critical to its success.

PMID:41844394 | DOI:10.1097/NAQ.0000000000000717

Nurs Adm Q. 2026 Apr-Jun 01;50(2):77-82. doi: 10.1097/NAQ.0000000000000725. Epub 2026 Mar 13.

ABSTRACT

Clinical nurse peer-to-peer feedback is vital for patient care improvement and achieving Magnet designation, yet evidence is limited about nurses’ perceptions of peer feedback related to autonomous practice, perceived quality, and patient safety. The study aims to understand inpatient clinical nurses’ perception of the peer feedback process related to perceived quality of care, patient safety, and autonomy. In 2021, a descriptive, correlational, cross-sectional study using an online peer feedback survey was conducted on clinical nurses across three inpatient hospitals within a Southern California integrated healthcare system. The data were analyzed using descriptive, comparative, correlational, and regression statistics. N = 457 clinical nurses voluntarily participated. Regression analysis demonstrated that nurses’ comfort in giving and receiving peer feedback contributes to the following dependent variable outcomes: Autonomous practice (R2 = 0.208, F (2,452) = 60.447, p < .001); patient care quality (R2 = 0.130, F (2,453) = 32.515, p < .001); and patient safety (R2= 0.035, F (2,419) = 8.066, p < .001). The study outcomes validate the predictive value of nurses’ perceived comfort in giving and receiving peer feedback on nurse autonomy, quality, and patient safety. The findings reinforce the need for healthcare leaders to strengthen organizational structures and processes supporting peer feedback.

PMID:41844390 | DOI:10.1097/NAQ.0000000000000725

Ren Fail. 2025 Dec;47(1):2564373. doi: 10.1080/0886022X.2025.2564373. Epub 2025 Oct 15.

ABSTRACT

BACKGROUND: Glomerulonephritis-induced chronic kidney disease (CKD) imposes heavy global health and socioeconomic burdens, but regional vs. global data are limited. We assessed its burden, inequalities, projections in China and globally (1990-2021) to inform prevention strategies.

METHODS: Using 2021 Global Burden of Disease data, we analyzed glomerulonephritis-induced CKD indicators: prevalence, incidence, mortality, and disability-adjusted life years. We used advanced methods, including age-period-cohort analysis, decomposition analysis, and Bayesian forecasting to assess temporal trends and health disparities.

RESULTS: From 1990 to 2021, global age-standardized rates (ASRs) of prevalence, incidence, mortality, and DALYs for glomerulonephritis-induced CKD increased. Global age-standardized prevalence (ASPR) rose from 128.55 to 129.94 per 100,000 (1.09%, 95% UI: -0.78% to 2.90%), while China’s ASPR fell from 109.57 to 94.21 (-14.02%, 95% UI: -17.31% to -10.29%). Global slope index of inequality and concentration index decreased. In China, all ASRs decreased. Sex and age disparities were evident, with higher mortality observed among older populations. Decomposition analysis revealed population aging and growth as key contributors to increased mortality. Although a continued reduction in China’s overall disease burden has been projected for 2050, an increasing incidence among individuals over 45 years was observed. Impaired kidney function, hyperglycemia, high body mass index, and hypertension were identified as major risk factors both globally and in China.

CONCLUSION: Glomerulonephritis-induced CKD remains a considerable global burden, particularly in lower Sociodemographic Index countries. Pronounced age and sex disparities underscore urgency of targeted interventions for high-risk populations in China.

PMID:41844386 | DOI:10.1080/0886022X.2025.2564373

Geriatr Gerontol Int. 2026 Mar;26(3):e70449. doi: 10.1111/ggi.70449.

ABSTRACT

OBJECTIVE: Frailty is a recognized syndrome in aging populations, predicting adverse outcomes. The link between its evaluation and adverse effects, particularly under Gobben’s framework, is unclear. This study reviews how multidimensional frailty affects older adults’ health risks.

METHODS: We searched the PubMed, EMBASE, Web of Science, Cochrane Library, CIHNAL, and Chinese databases (WANFANG, CNKI, VIP, and CBM) for relevant studies published from the establishment of the library to January 9, 2026. Statistical synthesis was performed using R software. Employing either fixed-effects or random-effects models based on heterogeneity assessments to evaluate the association between multidimensionally frail older adults and adverse outcomes. Methodological quality, sensitivity analyses, and publication bias were systematically conducted.

RESULTS: A review of 26 studies with 11 186 older adults found that 20.5%-80% exhibited multidimensional frailty, which was associated with increased risks of adverse outcomes, including mortality (HR = 1.61, 95% CI: 1.37-1.89, OR = 2.40, 95% CI: 1.82-3.17), falls (OR = 2.45, 95% CI: 1.29-4.64), and hospitalization (OR = 1.80, 95% CI: 1.29-2.52). However, significant small-study effects were detected for mortality (Egger’s test p < 0.001). After trim-and-fill adjustment, the HR attenuated to 1.27 (95% CI: 1.02-1.59), indicating a weaker but still statistically significant association. The association with readmission was of borderline significance (HR = 1.40, 95% CI: 1.00-1.96, p = 0.05).

CONCLUSION: The research indicates that multidimensional frailty affects older adults, increasing their risk of mortality, falls, hospitalization, and readmission. These results underscore the crucial need for early screening and preventative measures.

PMID:41844382 | DOI:10.1111/ggi.70449