Tag: pubmed

J Endocrinol Invest. 2026 May 4. doi: 10.1007/s40618-026-02899-z. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to investigate the associations between composite inflammatory indicators and the presence of osteoporosis (OP) and sarcopenia in patients with type 2 diabetes mellitus (T2DM), and to explore the potential mediating role of inflammation in the relationship between sarcopenia and OP.

METHODS: In this cross-sectional study, 756 adults with T2DM were enrolled. Osteoporosis was defined as a Bone Mineral Density (BMD) T-score ≤ -2.5 at the hip or lumbar spine. Sarcopenia was diagnosed according to Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Composite inflammatory indicators, including systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), pan-immune inflammation value (PIV), platelet-to-lymphocyte ratio (PLR), advanced lung cancer inflammation index (ALI), neutrophil-to-albumin percentage ratio (NPAR), platelet-to-neutrophil ratio (PNR), and neutrophil-lymphocyte-platelet ratio (NLPR) were calculated from routine blood parameters. Associations between composite inflammatory indicators and OP as well as sarcopenia were assessed using restricted cubic splines (RCS) and multivariate logistic regression analysis. The ability of composite inflammatory indicators to identify sarcopenia was evaluated using receiver operating characteristic (ROC) curves. Mediation analysis to assess the indirect effect of inflammation on the sarcopenia and osteoporosis relationship.

RESULTS: In this study, the prevalence of osteoporosis was 31.1%, and the prevalence of sarcopenia was 34.0%. RCS analysis revealed that ALI exhibited a linear negative correlation with osteoporosis, and SII, SIRI, NLR, PIV, PLR, NLPR, NPAR exhibited linear positive correlations with sarcopenia (all P for nonlinearity > 0.05). PNR and ALI demonstrated a negative nonlinear association with sarcopenia (all P for nonlinearity < 0.05). Logistic regression analysis indicated that sarcopenia was positively associated with osteoporosis (P< 0.05). However, ALI (aOR 0.99, 95% CI 0.98-1.00) showed inverse association with osteoporosis (P < 0.05). Logistic regression analysis also indicated that osteoporosis was positively associated with sarcopenia (P < 0.05). The multivariable regression analysis showed hs-CRR (aOR 1.03, 95% CI 1.01-1.05), SII (aOR 1.00, 95% CI 1.00-1.00), SIRI (aOR 1.46, 95% CI 1.13-1.93), PIV (aOR 1.00, 95% CI 1.00-1.00), NPAR (aOR 1.11, 95% CI 1.04-1.19), and NLR (aOR 1.20, 95% CI 1.05-1.38) showed positive associations with sarcopenia. Conversely, ALI (aOR 0.98, 95% CI 0.97-0.99) exhibited a inverse association with sarcopenia (P < 0.05). The area under the ROC curve (AUC) for ALI in identifying sarcopenia was 0.68. Mediation analysis showed that ALI mediated the statistical association between sarcopenia and osteoporosis with proportions (%) of 19.58.

CONCLUSION: Sarcopenia is positively associated with osteoporosis in patients with T2DM, and this relationship is partially mediated by systemic inflammation, as captured by the ALI. The ALI may serve as a useful and accessible clinical indicator to identify T2DM patients at higher risk for sarcopenia and osteoporosis, who may benefit from targeted screening and multimodal interventions.

PMID:42081166 | DOI:10.1007/s40618-026-02899-z

Acta Biotheor. 2026 May 4;74(3):14. doi: 10.1007/s10441-026-09523-w.

NO ABSTRACT

PMID:42081161 | DOI:10.1007/s10441-026-09523-w

Support Care Cancer. 2026 May 4;34(5):489. doi: 10.1007/s00520-026-10748-1.

ABSTRACT

PURPOSE: To evaluate the impact of telemedicine adoption and pandemic-related fear on treatment adherence, healthcare utilization, and supportive care processes among patients undergoing cancer therapy during the COVID-19 pandemic.

METHODS: In this prospective cohort study, we followed 149 cancer patients over two years to evaluate telemedicine utilization, treatment modifications, and COVID-19-related fear. We employed validated psychometric tools, including the COVID-19 Fear Scale.

RESULTS: Telemedicine adoption (24.8% of patients) was associated with fewer hospital visits (7.3 ± 3.2 vs 9.4 ± 4.1, p = 0.004) and reduced emergency room utilization (16.2% vs 46.4%, p < 0.001). Treatment modifications occurred in 55.9% of patients, predicted by COVID-19 infection (OR = 2.8, 95% CI:1.7-4.6) and neutropenia (OR = 2.1, 95% CI:1.3-3.4). High fear scores were linked to increased mortality (8.1% vs 2.7%, p = 0.032), disease progression (37.8% vs 21.4%, p = 0.018), lower treatment adherence (75.7% vs 87.5%, p = 0.041), and higher hospitalization rates (51.3% vs 24.1%, p < 0.001).

CONCLUSION: This study demonstrates that telemedicine can reduce acute care utilization while treatment modifications and high pandemic-related fear significantly worsen cancer outcomes. These findings highlight the need for oncology teams to proactively integrate remote care strategies and targeted psychological support to maintain treatment adherence and mitigate adverse outcomes during health crises.

PMID:42081154 | DOI:10.1007/s00520-026-10748-1

J Mol Histol. 2026 May 4;57(3):157. doi: 10.1007/s10735-026-10819-x.

ABSTRACT

A histological safety profile is essential for non-antibiotic microbial interventions in aquaculture. This study assessed the multi-organ histological biocompatibility of a novel actinobacterial strain, Agrococcus sp. RKDAS_1, in Nile tilapia (Oreochromis niloticus) under controlled conditions. Juvenile tilapia were fed diets with varying concentrations of RKDAS_1 (10⁵, 10⁷, and 10⁹ CFU g^{– 1} feed) for 60 days. Tissues from the gill, intestine, liver, and heart were analysed through standard histological methods, employing semiquantitative scoring and intestinal morphometry. Across all examined organs, RKDAS_1 supplementation did not induce inflammatory responses, degenerative lesions, or structural disruptions, which are indicative of tissue-level toxicity. Gill architecture was intact, with normal hepatocyte arrangements and no necrosis or fibrosis, while cardiac tissues showed a normal structure. Intestinal morphology maintained epithelial integrity, displaying dose-related variations in villus height and goblet cell density. Intermediate-dose live hepatic sections showed reduced cytoplasmic vacuolation compared to controls, though the difference was not statistically significant. The semi-quantitative histopathological evaluation showed that the tissue structure remained intact across different treatments. The results collectively suggest that Agrococcus sp. RKDAS_1 did not cause any noticeable histopathological damage, indicating enhanced biocompatibility. The findings suggest that Agrococcus sp. RKDAS_1 is compatible with biological tissues without causing significant damage. However, these conclusions are restricted to structural analysis and do not ensure functional improvements or overall safety beyond tissue examination. The findings provide a critical starting point for future research, which will delve into molecular, immunological, and long-term exposure studies. These investigations aim to evaluate the biotherapeutic potential of RKDAS_1 thoroughly.

PMID:42081141 | DOI:10.1007/s10735-026-10819-x

Pediatr Surg Int. 2026 May 4;42(1):213. doi: 10.1007/s00383-026-06455-x.

ABSTRACT

PURPOSE: Implementation of Enhanced Recovery After Surgery (ERAS) protocols in paediatric surgery remains limited, despite proven benefits in adults. The barriers to implementation and protocol modifications requires comprehensive detailing in paediatrics. We aimed to determine the practicality and safety of ERAS in paediatric laparoscopies at a tertiary-care center, addressing the context-specific barriers.

METHODS: This was a prospective, single-arm, preliminary study. One hundred thirty-six children, aged 2-14 years, undergoing laparoscopy were enrolled. ERAS elements were implemented perioperatively. The outcomes analysed included protocol compliance, length of hospital stay (LOS), 30-day complications, readmission and mortality rates. The challenges to implementation were noted.

RESULTS: Overall protocol compliance was 82.5 ± 12.4%. There was a significant correlation between adherence to components and LOS (r=-0.642 ; p < 0.01). Time to start liquids/solids and drain removal showed a significant correlation with LOS. No complications and 30-day readmissions were directly attributable to the fast-track concepts. There was no mortality. Key challenges included infrastructure, parental anxiety regarding early discharge and persistently motivating stakeholders to adhere the protocol.

CONCLUSION: Implementing paediatric ERAS protocol is safe and feasible within a tertiary health-setting. A high degree of multidisciplinary commitment can successfully overcome the unique logistic and cultural barriers with an accelerated convalescence.

PMID:42081132 | DOI:10.1007/s00383-026-06455-x

J Alzheimers Dis. 2026 May 4:13872877261445578. doi: 10.1177/13872877261445578. Online ahead of print.

ABSTRACT

BackgroundDementia contributes to morbidity and mortality in aging populations, with infectious diseases as frequent terminal events. In Brazil, data on causes of death in dementia and hospital-based end-of-life care are limited.ObjectiveTo describe causes of death, clinical characteristics, and pharmacological treatment patterns during the last month of life among patients with dementia hospitalized in a geriatric hospital in São Paulo, Brazil.MethodsThis retrospective observational study included all patients with clinically diagnosed dementia who died between 2015 and 2023 in a specialized geriatric hospital. Demographic, clinical, and pharmacological data were extracted from electronic medical records. Causes of death were classified using ICD-10 codes. Associations between dementia subtypes and infection-related deaths were evaluated using logistic regression adjusted for age, sex, and comorbidities. Statistical analyses were performed using R, with p < 0.05 considered significant.ResultsA total of 122 patients were included (mean age 83.6 ± 7.4 years; 61.5% female). Alzheimer’s disease was the most frequent subtype (52.5%), followed by vascular (26.2%) and mixed dementia (21.3%). Infectious diseases accounted for 67.2% of deaths, mainly pneumonia (48.3%) and sepsis (18.9%). Antibiotics were prescribed in 76.2% of cases, and antipsychotics in 58.1%. Palliative care measures were documented in 41.0% of cases.ConclusionsInfectious diseases were the most frequent causes of death among hospitalized patients with dementia, with high antibiotic use and limited palliative care documentation. These findings indicate the need for integrated end-of-life protocols and improved recognition of palliative needs.

PMID:42081122 | DOI:10.1177/13872877261445578

J Alzheimers Dis. 2026 May 4:13872877261441774. doi: 10.1177/13872877261441774. Online ahead of print.

ABSTRACT

BackgroundAlzheimer’s disease and other dementias (ADODs) are increasing rapidly with population aging, yet region-specific projections for the Western Pacific remain limited.ObjectiveTo project ADOD disability-adjusted life-years (DALYs) and deaths in the Western Pacific to 2050 and evaluate how modifying key risk factors could inform policy and planning.MethodsUsing the Global Burden of Disease 2021 scenario framework, we modeled ADOD burden for 37 Western Pacific countries/areas (2023-2050), stratified by age and sex. Primary outcomes were all-age DALY and death rates per 100,000. Projections included a reference and four counterfactual scenarios. Uncertainty was estimated using 1000 Monte Carlo draws, summarized with 95% uncertainty intervals (UIs).ResultsRegional DALY rates rise from 777.6 (95% UI 375.5-1714.8) in 2023 to 1980.9 (964.7-4176.9) in 2050 (+154.7%), while death rates increase from 41.1 (10.5-110.2) to 119.7 (30.5-302.8) (+191.3%). Female rates exceed male rates throughout, widening absolute sex gaps. By 2050, ages 80-94 account for ∼62% of DALYs and ∼69% of deaths; ≥95 contribute ∼10% and ∼17%. Japan remains highest, while the Republic of Korea approaches comparable levels. China and Singapore show the steepest absolute increases. Scenario curves remain similar until the 2040s; small differences by 2050 reflect survival-driven cohort expansion at high-risk ages.ConclusionsDemographic aging will dominate Western Pacific dementia burden through mid-century. Prevention remains critical to delay onset, compress disability, and improve overall healthy aging, but demographic aging will still drive substantial growth in service needs. Health systems must scale dementia-capable primary care, long-term and palliative services, caregiver support, and gender-responsive planning.

PMID:42081116 | DOI:10.1177/13872877261441774

Top Stroke Rehabil. 2026 May 4:1-11. doi: 10.1080/10749357.2026.2664222. Online ahead of print.

ABSTRACT

BACKGROUND: Spasticity is a common condition among stroke survivors, and previous studies have explored the effects of whole-body vibration therapy for its benefits. However, the findings regarding lower limb spasticity remain inconsistent. Thus, the aim of this study was to determine the effect of eight-week whole-body vibration exercise on lower limb spasticity for stroke survivors.

METHODS: This is a single-blind randomized controlled trial. The 40 participants were eligible to participate the study and were allocated randomly to either an intervention group or control group. The intervention group implemented as 40 min of conventional therapy sessions and whole-body vibration training daily, five times a week for eight weeks; the control group implemented the same movements on a vibration platform without vibration with daily habitual living styles. The measurements were assessed at baseline, week four, and week eight. Primary outcomes were measured using the Modified Ashworth Scale and surface electromyography to measure spasticity. The Fugl-Meyer assessment was measured as a secondary outcome.

RESULTS: In the intervention group, spasticity of the triceps surae decreased by a mean of 0.45 points on the Modified Ashworth Scale from baseline to mid-intervention, and the same mean reduction was maintained at post-intervention. However, the statistical between-group differences were not observed at either mid-intervention or post-intervention. No significant between-group or within-group differences were observed in surface electromyography outcomes or Fugl-Meyer Assessment scores in either the intervention or control group.

CONCLUSION: Whole-body vibration therapy may contribute to improvements in lower-limb spasticity in stroke survivors and demonstrates some moderate effect sizes. These findings suggest that whole-body vibration may have potential benefits as a long-term adjunct therapy in stroke rehabilitation.Trial registrationThe registration number is ChiCTR1900026439.

PMID:42077180 | DOI:10.1080/10749357.2026.2664222

Am J Sports Med. 2026 May 4:3635465261439048. doi: 10.1177/03635465261439048. Online ahead of print.

ABSTRACT

BACKGROUND: Hip arthroscopy for femoroacetabular impingement (FAI) in professional athletes is associated with significant improvements in postoperative pain and function and a return-to-sport (RTS) rate >80%. However, RTS rate after hip arthroscopy for FAI in professional athletes with borderline dysplasia is unknown.

PURPOSE: To assess RTS rates exclusively in professional athletes with borderline dysplasia after hip arthroscopy for treatment of FAI.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: A total of 40 professional and Olympic athletes (42 hips) with borderline dysplasia (lateral center edge angle [LCEA] 18°-25°) underwent hip arthroscopy for FAI between 2005 and 2022. RTS was defined as competing in a single professional game at an equal level after surgery. Data were retrospectively obtained for each athlete from publicly available sport-specific data sources.

RESULTS: The study included 42 hips. Patients undergoing primary hip arthroscopy demonstrated a 79% RTS rate, whereas patients undergoing revision hip arthroscopy demonstrated a 25% RTS rate (P = .006). Among athletes who successfully returned, RTS occurred at a median of 7.5 months (range, 3.1-24.3 months) after surgery. The mean age at the time of surgery was 28.9 years (range, 18-53.5 years). In total, 21 hips (50%) had an Outerbridge grade 3 or 4 defect at the time of surgery, and 10 (24%) underwent a microfracture procedure. Older age (P = .041) and history of previous hip arthroscopy (P = .008) were associated with a lower likelihood of return to professional sport. No statistically significant association was found between femoral version, LCEA, alpha angle, the presence of Outerbridge grade 3 or 4 defect, or minimum joint space and RTS.

CONCLUSION: In the primary setting, professional athletes with borderline hip dysplasia who underwent hip arthroscopy for FAI demonstrated a 79% RTS rate. The mean time to return was 7.5 months, with older age and a history of prior hip arthroscopy predictive of a lower likelihood of RTS (25% RTS among revision cases). Hip arthroscopy for FAI in professional athletes with borderline dysplasia was effective for returning the majority of these athletes to their preoperative level, especially in the primary setting.

PMID:42077177 | DOI:10.1177/03635465261439048

Clin Nurs Res. 2026 May 4:10547738261441460. doi: 10.1177/10547738261441460. Online ahead of print.

ABSTRACT

Inadequate nutritional knowledge among hemodialysis (HD) patients can lead to poor fluid and dietary adherence, increasing the risk of complications. This study aimed to evaluate the effects of a nurse-led, animated video-based nutrition education program on dietary knowledge and fluid-diet adherence in individuals receiving HD. This experimental study employed a pretest-posttest control group design and included 107 HD patients, 48 in the intervention group and 59 in the control group. Data were collected using a patient information form, a nutritional knowledge survey, and the Dialysis Diet and Fluid Non-Adherence Questionnaire. Descriptive statistics and initial data entry were conducted using SPSS 24.0. The difference-in-differences (DiD) analysis was performed in Stata 18.0. The intervention group received nurse-led nutrition education supported by a 10-min animated video. Measurements were taken at baseline and 12 weeks after the intervention. There were no significant differences between groups in baseline nutritional knowledge or fluid-diet adherence scores. However, at week 12, the intervention group demonstrated a significant increase in nutritional knowledge and a decrease in fluid-diet nonadherence compared to the control group (p < .05). A DiD analysis revealed that the educational intervention resulted in a 4.4-point increase in knowledge scores, which was statistically significant (p < .05). Nurse-led animated video education significantly improved nutritional knowledge and fluid-diet adherence among HD patients. This approach may be an effective tool for supporting patient education and self-management of chronic kidney disease.

PMID:42077174 | DOI:10.1177/10547738261441460