Tag: pubmed

BMC Med. 2025 Feb 14;23(1):91. doi: 10.1186/s12916-025-03937-y.

ABSTRACT

BACKGROUND: Women who experience adverse pregnancy outcomes (APOs; gestational hypertension, preeclampsia (PE), gestational diabetes (GD), preterm birth (PTB), small or large for gestational age, miscarriage, multiple miscarriages, stillbirth, and offspring with major congenital anomalies) have increased risk of developing cardiovascular disease (CVD). We aimed to compare cardiometabolic health trajectories across the life course between women with and without APOs.

METHODS: We studied 187,186 women with a registered pregnancy in the UK Clinical Practice Research Datalink (CPRD) GOLD linked to Hospital Episode Statistics. Fractional polynomial multilevel models were used to compare trajectories of cardiometabolic risk factors (body mass index [BMI], blood pressure [BP], cholesterol, and glucose) between women with and without a history of APOs (individual APOs in any pregnancy and number of APOs). We explored two underlying time axes: (1) time relative to first pregnancy (from 10 years before first pregnancy to 15 years after) and (2) age. Models controlled for age at first pregnancy, residential area deprivation, non-singleton pregnancy, parity, smoking status, ethnicity, and medications use.

RESULTS: Women with a history of PE, gestational hypertension, or GD had higher BMI, BP, and glucose 10 years before first pregnancy compared to women without these APOs. These differences persisted 15 years post-first pregnancy. Women with a history of GD had a steeper post-partum rise in glucose. Women who experienced multiple (3 +) miscarriage, stillbirth, and/or medically indicated PTB had higher BP and BMI before and after pregnancy, with BP trajectories converging 15 years after first pregnancy. Women who experienced multiple APOs had the most adverse measurements across all cardiometabolic risk factors, with more unfavourable mean levels with each additional APO. There was little difference in cardiometabolic trajectories between women with and without a history of 1 or 2 miscarriages or congenital anomalies.

CONCLUSIONS: Women with APOs had adverse cardiometabolic profiles before first pregnancy, persisting up to 15 years post-pregnancy. Findings highlight the potential for targeted public health interventions to promote good cardiometabolic health in young adults transitioning from contraceptive use to planning pregnancies. APOs may identify young women who could benefit from monitoring CVD risk factors and interventions to improve cardiometabolic health.

PMID:39948598 | DOI:10.1186/s12916-025-03937-y

BMC Oral Health. 2025 Feb 13;25(1):230. doi: 10.1186/s12903-025-05598-y.

ABSTRACT

BACKGROUND: Periodontitis is a polymicrobial, multifactorial infection that affects the supporting structures of teeth. Melatonin, a biomolecule with anti-inflammatory, antibacterial, and antioxidant properties, has demonstrated promising results in various medical fields, including dentistry.

OBJECTIVE: This study aimed to evaluate the effectiveness of 1% (w/v) melatonin gel as an adjunct to Non-Surgical Periodontal Therapy (NSPT) in improving clinical periodontal parameters, reducing antimicrobial activity against Aggregatibacter actinomycetemcomitans and Prevotella intermedia, and increasing superoxide dismutase (SOD) levels in gingival crevicular fluid (GCF) among patients with stage II periodontitis.

METHODS: A split-mouth randomized controlled trial was conducted on 24 periodontitis patients. Two sites per patient were randomly assigned: the test site underwent scaling and root planing (SRP) followed by intra pocket application of 1% melatonin gel, while the control site received SRP alone. Clinical parameters, including the Plaque Index (PI), Gingival Index (GI), Gingival Bleeding Index (GBI), Periodontal Pocket Depth (PPD), and Clinical Attachment Loss (CAL), were assessed at baseline, 1 month, and 3 months. Subgingival plaque samples and GCF were collected to evaluate microbial and biochemical changes.

RESULTS: Both groups showed statistically significant improvements in clinical parameters from baseline to the 3rd month post-therapy. A quantitative reduction in Aggregatibacter actinomycetemcomitans and Prevotella intermedia was observed at both sites. Additionally, the test site exhibited a greater increase in SOD levels compared to the control site.

CONCLUSION: The adjunctive application of melatonin gel with SRP demonstrated enhanced antioxidant potential and improved clinical outcomes in patients with stage II periodontitis.

TRIAL REGISTRATION TRIAL REGISTRY: ISRCTN. Trial registration number ISRCTN40460432. Date of Registration: 22/10/2024. “Retrospectively registered”.

PMID:39948592 | DOI:10.1186/s12903-025-05598-y

BMC Musculoskelet Disord. 2025 Feb 13;26(1):145. doi: 10.1186/s12891-024-08255-7.

ABSTRACT

BACKGROUND: Medial opening wedge high tibial osteotomy aims to correct coronal plane deformities and redistribute the load in varus-aligned knees. However, changes in the sagittal plane during medial opening wedge high tibial osteotomy can influence the posterior tibial slope, potentially affecting knee biomechanics. The sagittal inclination angle of the osteotomy, which is the angle between the medial joint line and the osteotomy line on lateral view, is a relatively new parameter that has been discussed in the literature, as a factor influencing the posterior tibial slope. The aim of this study is to investigate success rates in achieving the targeted postoperative slope, which is to avoid increasing the slope, with posteriorly inclined sagittal osteotomy.

METHODS: This research was designed as a retrospective single-center case-series study. In order to avoid increasing the posterior tibial slope, our modified surgical technique involves adjusting the sagittal inclination angle to be 10^o posteriorly inclined. This angle was considered to be posteriorly inclined if the anterior portion of the osteotomy was inclined proximally. Pre- and postoperative posterior tibial slope measurements were recorded. Changes in postoperative tibial slope compared to preoperative tibial slope were statistically evaluated using the paired t-test. Changes were categorized as decreases, no change, or increases, and these three groups were compared using the one-sample binomial test.

RESULTS: Ninety-five patients (77 women and 18 men) with a mean age of 52.8 ± 7.0 were included in this study. The preoperative mean posterior tibial slope was measured as 12.5 ± 3.9° and the postoperative mean PTS was 10.6 ± 4.3°. A paired t-test revealed a statistically significant difference of 1.9 ± 3.8° (95% confidence interval: 1.13-2.71; p < .01). In four cases (4.2%), the PTS remained the same, while for 67 patients (70.5%) the PTS decreased and for 24 patients (25.3%) the posterior tibial slope increased. Therefore, a decrease or no change in the posterior tibial slope was achieved in 74.7% of all cases (p < .01).

CONCLUSIONS: Modifying the sagittal inclination angle to achieve a posteriorly inclined osteotomy during medial opening wedge high tibial osteotomy may prevent increasing the posterior tibial slope in the majority of cases.

PMID:39948591 | DOI:10.1186/s12891-024-08255-7

Respir Res. 2025 Feb 13;26(1):53. doi: 10.1186/s12931-025-03129-5.

ABSTRACT

BACKGROUND: Despite its heterogeneity, there is currently limited data in pleural infection phenotyping. Using pleural fluid characteristics, pleural infection can be classified into microbiological-positive pleural infection (MPPI) and microbiological-negative pleural infection (MNPI). This study aimed to evaluate the prognostic significance of microbiological positivity in pleural infection, and to evaluate the performance of RAPID (renal, age, purulence, infection source, dietary factor) score in these subgroups.

METHODS: Consecutive patients hospitalized for pleural infection over a 10-year period in two acute-care hospitals in Hong Kong were evaluated. According to the pleural fluid characteristics, they were classified into MPPI and MNPI, respectively. Survival was evaluated using multivariate Cox regression analysis. Performance of RAPID score to predict mortality at 3-month and 1-year was evaluated using C-statistics.

RESULTS: In total, 381 patients with pleural infection were included. They were classified into MPPI (n = 169) and MNPI (n = 212), respectively. The MPPI group had more elderly home residence and use of large-bore chest tube, and higher Charlson comorbidity index and RAPID score, compared to the MNPI group. Length-of-stay, the need of surgery and intensive care were similar between the two groups. MPPI was associated with significantly increased risk of mortality (adjusted hazard ratio [aHR] 1.46, 95% CI 1.08-1.98). Three-month mortality was significantly higher in MPPI compared to MNPI (24.9% vs. 10.4%, p < 0.001; adjusted odd ratio 2.05, 95% CI 1.11-3.80). The trend continued at 1, 3, 5 and 7 years. RAPID score predicted 3-month and 1-year mortality in both groups (C-statistics, MPPI 0.71, 0.75; MNPI 0.84, 0.81). In the MPPI group, presence of Staphylococcus aureus (aHR 2.26, 95% CI 1.43-3.57) and Gram-negative organisms other than Enterobacteriaceae (aHR 2.00, 95% CI 1.10-3.61) were associated with worse survival, while presence of Streptococcus anginosus group was associated better survival (aHR 0.50, 95% CI 0.32-0.78), when compared to their absence.

CONCLUSIONS: Pleural fluid microbiological positivity is independently associated with increased mortality in patients with pleural infections. This finding should complement the RAPID score in risk stratification and inform future research aimed at improving outcomes in this patient population.

PMID:39948589 | DOI:10.1186/s12931-025-03129-5

BMC Health Serv Res. 2025 Feb 13;25(1):243. doi: 10.1186/s12913-025-12374-9.

ABSTRACT

BACKGROUND: Despite rolling out publicly-funded hepatitis C virus (HCV) treatment across the province of British Columbia (BC), Canada, 35% of people returning positive HCV RNA results in 2020 did not initiate treatment. The HCV epidemic in Canada continues to disproportionately impact people who use drugs and yet, this population has the lowest proportional uptake of HCV treatment. Evidence suggests linkages to healthcare after diagnosis is one of the key factors that impacts uptake of HCV treatment among this priority population. The Hep C Connect pilot project was implemented to characterize HCV testing outcomes and linkage-to-care rates within a low-barrier supervised consumption site (SCS) in Vancouver, BC.

METHODS: All clients (aged ≥ 19 years) attending the Hope to Health SCS in Vancouver, Canada were invited to participate in the pilot study between November 2021 and December 2022. Interviewer-led surveys were conducted and participants were offered same-day HCV point-of-care (POC) antibody (Ab) testing. Participants received a cash honorarium for sharing their time and experiences. Descriptive statistics are shared in order to describe the reach and impact of this pilot project.

RESULTS: The study enrolled 186 participants including 123(66.1%) men and 59(31.7%) women, with a median age of 42 (Q1,Q3- 34,49). Forty-seven (25.3%) participants stated that they use an SCS regularly and 123(66.1%) stated that they get new rigs every day. Notably, 64(34.4%) participants reported not having a primary care provider yet more than three-quarters of the participants (144, 77.4%) reported having been ever tested for HCV. All 186 participants agreed to HCV POC Ab testing with 59.7% returning a positive HCV POC Ab result. Despite good HCV POC Ab uptake and high rates of HCV knowledge, 49(44.1%) of the HCV Ab positive participants chose not to engage in confirmatory ribonucleic acid (RNA) testing.

CONCLUSIONS: The Hep C Connect pilot explored the gaps evident in the HCV cascade-of-care as it pertains to people who use drugs. Findings suggest that, despite high levels of HCV knowledge, the employment of blood draw RNA testing deterred people from engaging in confirmatory testing. Improving the HCV cascade-of-care will require alternative strategies that are more acceptable to this population.

PMID:39948586 | DOI:10.1186/s12913-025-12374-9

Clin Exp Rheumatol. 2025 Feb 12. doi: 10.55563/clinexprheumatol/uol8so. Online ahead of print.

ABSTRACT

OBJECTIVES: The objective of this study was to evaluate the impact of aerobic exercise, resistance exercise combined with aerobic exercise, and yoga exercises combined with aerobic exercise on pain and disease activity in patients with fibromyalgia syndrome (FM).

METHODS: The study population comprised 60 individuals with FM who met the inclusion criteria. The participants were randomly assigned to one of three groups. The first group underwent aerobic exercise (n=20), the second group combined aerobic exercise with yoga (n=20), and the third group engaged in aerobic and resistance exercise (n=20). All exercise interventions were conducted for a total of 12 weeks. Disease activity was evaluated using the Fibromyalgia Impact Questionnaire (FIQ), while pain status was assessed with the Melzack-Melzack Pain Questionnaire (MMPQ). All assessments were conducted before and following the completion of the exercise program. The clinical trial number of this study is NCT06006494.

RESULTS: The measurements of the aerobic exercise and yoga group were significantly lower than those of the aerobic and resistance exercise group. A statistically significant difference was observed between the groups in terms of post-treatment MMPQ scores. The measurements of the aerobic exercise and yoga group were significantly lower than those of the aerobic exercise only and aerobic and resistance exercise groups. No statistically significant difference was observed between the post-treatment MMPQ scores of the aerobic and aerobic resistance exercise groups.

CONCLUSIONS: The combination of aerobic exercise and yoga is more efficacious in the treatment of FM than aerobic exercise alone or a combination of resistance exercises and aerobic exercise.

PMID:39946182 | DOI:10.55563/clinexprheumatol/uol8so

Environ Toxicol Chem. 2025 Jan 6:vgae069. doi: 10.1093/etojnl/vgae069. Online ahead of print.

ABSTRACT

Polycyclic aromatic hydrocarbons (PAHs) are a group of organic compounds that can be toxic to aquatic life at environmentally relevant concentrations. The toxicity of some PAHs increases in the presence of ultraviolet radiation (UVR). The phototoxic target lipid model (PTLM) builds on the narcotic target lipid model and predicts acute phototoxicity by accounting for the light absorbed by PAHs. Given the lack of chronic data for PAHs exposed to UVR, an acute-to-chronic ratio (ACR) was proposed as a means for extending this model for predicting chronic toxicity. No information could be found on ACRs derived for phototoxic chemicals and therefore, this study had two objectives: (a) to generate acute and chronic toxicity data with and without exposure to UVR; and (b) to test the ability of the PTLM to predict chronic toxicity using an ACR. Acute and chronic bioassays were conducted on eight species, with each exposed to three PAHs and two light treatments: with and without UVR. Although there was a general trend of higher ACRs in UVR treatments, there was no statistical difference across all species in the ACR values for UVR treatments. Data generated herein were combined with data collated through a literature search to generate a global ACR of 11.6. Twenty of the 24 predicted phototoxic effect concentration affecting 10% of species (EC10) values calculated using the PTLM and ACR were within a factor of 10 of the observed phototoxic EC10 or lethal concentration affecting 5% of species values. This study demonstrates the capability of ACR to be applied in the context of phototoxicity and therefore proposes an unprecedented methodology to predict the chronic phototoxicity of PAHs.

PMID:39946179 | DOI:10.1093/etojnl/vgae069

Environ Toxicol Chem. 2025 Jan 7:vgae094. doi: 10.1093/etojnl/vgae094. Online ahead of print.

ABSTRACT

The Great Lakes Restoration Initiative aims to protect and restore the nation’s largest freshwater resource, in part, by furthering our understanding of the effects of contaminants of emerging concern (CECs) and chemical mixtures on aquatic and terrestrial organisms. To address this goal, an interagency team conducted field studies at sites along the Maumee River in Ohio, USA, in 2016-2017, monitoring CEC levels along with diverse in vitro and in vivo biological effects in ecologically relevant species (fathead minnows, tree swallows, and golden clams). The objective of the present work was to prioritize the CECs in these studies for further monitoring and assessment by determining if there are patterns in chemical-bioeffect relations across data sets, species, and response types that indicate relatively high or low hazard to aquatic life from CEC exposure. Of the 748 monitored chemicals, 425 were detected and were analyzed for covariance with bioeffects. All 748 chemicals were placed into 10 bins based on their frequencies of monitoring, detection, and covariance with bioeffects across studies and species. We describe how chemicals can be prioritized across bins to aid monitoring and assessment efforts. Our approach using effects-based monitoring data is especially useful for prioritizing chemicals with little or no traditional toxicity testing data. Similar evidence-based prioritizations will allow agencies to more efficiently allocate limited resources to improve the ability to protect aquatic and terrestrial organisms from adverse impacts due to contaminant exposure.

PMID:39946177 | DOI:10.1093/etojnl/vgae094

Ann Work Expo Health. 2025 Feb 13:wxaf005. doi: 10.1093/annweh/wxaf005. Online ahead of print.

ABSTRACT

The construction industry is well-documented as having numerous sources of hazardous noise on the job. Framers who cut and install steel studs on commercial construction sites use a variety of power tools throughout the course of their normal workday and have the potential to be exposed to levels of noise that can lead to occupational noise-induced hearing loss. This study assessed the noise dose of commercial steel stud framers and characterized the noise of common power tools that contribute to their daily noise dose. Occupational exposure limits exist in both required and recommended forms to protect workers; however, large differences in the level of worker protection are apparent between the mandated Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) and the voluntary National Institute for Occupational Safety and Health (NIOSH) recommended exposure limit (REL) for noise exposure. Steel stud framers in this study had a mean OSHA PEL dose of 27.6% and a mean NIOSH REL dose of 340.7% for the same workers. As a comparison, ambient equivalent noise doses at the construction site were 1.4% for PEL criteria and 12.4% for REL criteria. Of task assignments during the workday, workers who were assigned primarily as saw operators had statistically significant higher noise exposures than workers who were assigned as stud installers (P = 0.037). Octave band analysis was conducted for full-day exposures and indicated an upward trend of higher noise exposures at higher frequencies. Overall, among all steel stud framers involved in this study, all workers had noise doses below the OSHA PEL (range 5.8% to 61.4%), and all but 2 workers (n = 35) had noise doses above the NIOSH REL (range 63.9% to 823.2%), indicating exposure to hazardous levels of noise based on more protective RELs.

PMID:39946158 | DOI:10.1093/annweh/wxaf005

JAMA. 2025 Feb 13. doi: 10.1001/jama.2024.28527. Online ahead of print.

ABSTRACT

IMPORTANCE: Abortion bans may lead to births among those who are unable to overcome barriers to abortion. The population-level effects of these policies, particularly their unequal impacts across subpopulations in the US, remain unclear.

OBJECTIVE: To assess heterogeneity in the association of abortion bans with changes in fertility in the US, within and across states.

DESIGN, SETTING, AND PARTICIPANTS: Drawing from birth certificate and US Census Bureau data from 2012 through 2023 for all 50 states and the District of Columbia, this study used a bayesian panel data model to evaluate state-by-subgroup-specific changes in fertility associated with complete or 6-week abortion bans in 14 US states. The average percent and absolute change in the fertility rate among females aged 15 through 44 years was estimated overall and by state, and within and across states by age, race and ethnicity, marital status, education, and insurance payer.

EXPOSURE: Complete or 6-week abortion ban.

MAIN OUTCOME AND MEASURES: Fertility rate (births per 1000 reproductive-aged females) overall and by subgroups.

RESULTS: There were an estimated 1.01 (95% credible interval [CrI], 0.45-1.64) additional births above expectation per 1000 females aged 15 through 44 years (reproductive age) in states following adoption of abortion bans (60.55 observed vs 59.54 expected; 1.70% increase; 95% CrI, 0.75%-2.78%), equivalent to 22 180 excess births, with evidence of variation by state and subgroup. Estimated differences above expectation were largest for racially minoritized individuals (≈2.0%), unmarried individuals (1.79%), individuals younger than 35 years (≈2.0%), Medicaid beneficiaries (2.41%), and those without college degrees (high school diploma, 2.36%; some college, 1.58%), particularly in southern states. Differences in race and ethnicity and education across states explain most of the variability in the state-level association between abortion bans and fertility rates.

CONCLUSION AND RELEVANCE: These findings provide evidence that fertility rates in states with abortion bans were higher than would have been expected in the absence of these policies, with the largest estimated differences among subpopulations experiencing the greatest structural disadvantages and in states with among the worst maternal and child health and well-being outcomes.

PMID:39946144 | DOI:10.1001/jama.2024.28527