Tag: pubmed

JMIR Mhealth Uhealth. 2025 Mar 28;13:e56666. doi: 10.2196/56666.

ABSTRACT

BACKGROUND: Mobile health (mHealth) apps provide innovative solutions for improving treatment adherence, facilitating lifestyle modifications, and optimizing blood pressure control in patients with hypertension. Despite their potential benefits, the adoption and recommendation of mHealth apps by physicians in Germany remain limited. This reluctance may be due to a lack of understanding of the factors influencing physicians’ willingness to incorporate these digital tools into routine clinical practice. Understanding these factors is crucial for fostering greater integration of mHealth apps in hypertension care.

OBJECTIVE: The aim of this study was to explore the relationship between physicians’ information needs and acceptance factors, and how these elements can support the effective integration of mHealth apps into daily medical routines.

METHODS: We conducted a qualitative study involving 24 semistructured telephone interviews with physicians, including 14 cardiologists and 10 general practitioners, who are involved in the treatment of hypertensive patients. Participants were selected through purposive sampling to ensure a diverse range of perspectives. Thematic analysis was conducted using MAXQDA software (Verbi GmbH) to identify key themes and subthemes related to the acceptance and use of mHealth apps.

RESULTS: The analysis revealed significant variability in physicians’ information needs regarding mHealth apps, particularly concerning their functionalities, clinical benefits, and potential impact on patient outcomes. These informational gaps play a critical role in determining whether physicians are willing to recommend mHealth apps to their patients. Key determinants influencing acceptance were identified, including the availability of robust knowledge about the apps, high-quality and reliable data, generational shifts within the medical profession, solid evidence supporting the effectiveness of the mHealth apps, and clearly defined areas of application and responsibilities within the physician-patient relationship. The study found that acceptance of mHealth apps could be significantly increased through targeted educational initiatives, enhanced data quality, and better integration of these tools into existing clinical workflows. Furthermore, younger physicians, more familiar with digital technologies, demonstrated greater openness to using mHealth apps, suggesting that generational changes may drive future increases in adoption.

CONCLUSIONS: The successful integration of mHealth apps into hypertension management requires a multifaceted approach that addresses both the informational and practical concerns of physicians. By disseminating comprehensive knowledge about the variety, functionality, and proven efficacy of hypertension-related mHealth apps, health care providers can be better equipped to use these tools effectively. This approach necessitates the implementation of various knowledge transfer strategies, such as targeted training programs, peer learning opportunities, and active engagement with digital health technologies. As physicians become more informed and confident in the use of mHealth apps, their acceptance and recommendation of these tools are likely to increase, leading to more widespread adoption. Overcoming current barriers related to information deficits and data quality is essential for ensuring that mHealth apps are optimally used in routine hypertension care, ultimately improving patient outcomes and enhancing the overall quality of care.

TRIAL REGISTRATION: German Clinical Trials Register DRKS00029761; https://drks.de/search/de/trial/DRKS00029761.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.3389/fcvm.2022.1089968.

PMID:40153776 | DOI:10.2196/56666

Medicine (Baltimore). 2025 Mar 28;104(13):e41969. doi: 10.1097/MD.0000000000041969.

ABSTRACT

Inflammatory bowel disease (IBD) is a chronic recurrent IBD, whose cause involves the interaction between genetic and environmental factors. Although there is a recognized link between immune response and IBD, the causal relationship between circulating immune cell counts and IBD remains controversial. This study aimed to elucidate the causal relationship between genetically predicted circulating immune cell counts and IBD. We conducted a bidirectional 2-sample Mendelian randomization (MR) study using aggregated statistics from genome-wide association studies. The causal relationship between 5 circulating leukocytes cells (monocytes, lymphocytes, eosinophils, basophils and neutrophils) counts and IBD, including ulcerative colitis (UC) and Crohn disease (CD) was analyzed. Horizontal pleiotropy test and heterogeneity test were used to ensure the stability of the results. Our findings indicated that monocytes, lymphocytes, eosinophils, and basophils count were not significantly associated with IBD, however, elevated circulating neutrophils count was significantly associated with higher risk of IBD [odds ratio (OR) = 1.0017; 95% confidence interval (CI) = 1.0004-1.003; P = .009] and UC [OR = 2.465; 95% CI = 1.236-4.916; P = .01]. In addition, we also found that IBD [OR: 12.07; 95% CI = 1.909-76.316; P = .008] and CD [OR = 1.014; 95% CI = 1.004-1.023; P = .005] were significantly associated with higher circulating neutrophils count in reverse MR. This MR study provides genetic evidence for the causal relationship between the genetically predicted increase in circulating neutrophils count and the risk of IBD (UC and CD). This finding stresses the need for further exploring physiological functions of neutrophils in order to develop effective strategies against IBD.

PMID:40153772 | DOI:10.1097/MD.0000000000041969

Medicine (Baltimore). 2025 Mar 28;104(13):e41948. doi: 10.1097/MD.0000000000041948.

ABSTRACT

After hospitalization caused by COVID-19, a high prevalence of physical deterioration has been observed, hence the importance of having tests to evaluate the functional status of patients and to be able to perform a partition and subsequent referral to the physiotherapy service. This cross-sectional observational study describes the physical status according to the short physical performance battery (SPPB) of patients admitted to the hospital setting for COVID-19 and to identify variables potentially related to this outcome. Thirty-six patients admitted to the hospital setting for COVID-19 in the first wave living in the community. Patients were evaluated with the SPPB, strength test, the International Physical Activity Questionnaire, the 1-minute sit-to stand, spirometry, the Barthel index, the Hospital Anxiety and Depression Scale, and other patient-related data were collected. We performed bivariate and regression analyses. A linear regression was fitted, having SPPB as a dependent variable to ascertain the impact of intensive care unit (ICU) admission on physical performance. Five variables were related to SPPB. There was a significant relationship between admission to the ICU and having a heart disease (P = .015), the level of physical activity (P = .049), number of years smoking (P = .029) and days of hospitalization (P = .005). A total of 22.22% of analyzed patients suffered frailty. SPPB is related to altered respiratory pattern, quadriceps strength, 1-minute sit-to-stand and FEV1, Barthel score, days of hospitalization and FEV/FVC ratio. Lack of association between ICU stay, age or sex with SPPB results differs from the results of other studies.

PMID:40153771 | DOI:10.1097/MD.0000000000041948

Medicine (Baltimore). 2025 Mar 28;104(13):e41941. doi: 10.1097/MD.0000000000041941.

ABSTRACT

Vaccination against human papilloma virus (HPV) play a major role in preventing infection with HPV among heterosexual couples. The aim of this study was to assess public knowledge and attitude towards HPV vaccine in Saudi Arabia. This is an online cross-sectional survey study that was conducted between May and June 2023. This study utilized the convenience sampling technique to recruit the study participants. The study participants were invited to participate in this study through social media platforms (X, Facebook, and WhatsApp). Multiple logistic regression was performed to assess the factors associated with better knowledge level and the findings were presented as odds ratios (OR) with 95% confidence intervals (CI) and corresponding p-values. A total of 819 participants were included in the analysis. A total of 355 participants (43.3%) had a good knowledge score and 464 participants (56.7%) had poor knowledge. The total mean of knowledge score was (3.22 ± 2.44). As the table shown, single participants reported a significant higher knowledge score mean (3.59 ± 2.52) compared to married (2.84 ± 2.32) (P = .0001). Participants aged between 18 to 29 years reported a significant higher knowledge score mean (3.57 ± 2.52) compared to participants aged between 40 and 49 years (2.60 ± 2.21) (P = .0001). Participants who lived in Eastern area had significantly higher odds of knowledge compared to other areas (OR = 2.19, 95% CI = 1.45 – 3.33, P = .001). Participants who worked in medical field had significantly higher odds of having good knowledge compared to other jobs (OR = 3.65, 95% CI = 2.39-5.57, P = .0001). Participants who had 2 sexual partners have you had in the past 2 years had a significant higher odd of having good knowledge (OR = 2.05, 95% CI = 1.02-4.12, P = .04). This study identified that a considerable proportion of the study participants demonstrated poor level of knowledge of HPV vaccine. Participants who lived in Eastern area, those who worked in medical field, and those who had 2 sexual partners have you had in the past 2 years had a significant higher odd of having good knowledge. Future studies should be directed towards developing educational campaign to improve public awareness of HPV.

PMID:40153766 | DOI:10.1097/MD.0000000000041941

Medicine (Baltimore). 2025 Mar 28;104(13):e41950. doi: 10.1097/MD.0000000000041950.

ABSTRACT

Mandibular fractures are one of the most common maxillofacial bone fractures that can occur during many activities in daily life. The aim of this study was to provide data for practitioners and researchers about the variables and outcomes associated with mandibular fractures by examining the relationships between gender, age groups, trauma causes, side, type, and anatomic location of mandibular fractures and concomitant injuries. The demographic and clinical data of the patients were obtained from the hospital information management system of a university hospital. The hospital records for the 10-year period between 2014 and 2023 were examined retrospectively. The mandible fractures were classified according to type, side, and location and compared against gender, age group, and trauma cause. Evaluation was made of 142 patients with traumatic mandibular fracture, comprising 76.8% males and 23.2% females. Of these cases with mandible fracture, 82.4% were aged < 35 years, and 45.1% of the fractures occurred in road traffic accidents. The majority of mandibular fractures were caused by road traffic accidents in males and adults over the age of 18, whereas home, environmental, and leisure accidents were the major cause of mandibular fractures in females and persons under the age of 18. Compound fractures were determined in 59.2% of the cases, single fractures in 80.3%, and parasymphysis and symphysis fractures in 46.2%. The compound and parasymphysis/symphysis region fractures were more common in males, patients aged < 35 years, and those who had undergone any type of trauma. We consider the information obtained through this study could make significant contributions to the data bank for multicenter prospective in-depth epidemiological research in clinical and forensic sciences in the future.

PMID:40153762 | DOI:10.1097/MD.0000000000041950

Medicine (Baltimore). 2025 Mar 28;104(13):e41989. doi: 10.1097/MD.0000000000041989.

ABSTRACT

Chronic kidney disease (CKD) is a growing health concern worldwide. It is crucial to prevent CKD to mitigate its impact and enhance health results. Recognizing and managing the risk factors of chronic kidney disease at an early stage can aid in stopping its advancement. A cross-sectional study was carried out at a hospital from March 1 to April 30, 2023, involving 422 hypertensive patients. The participants were chosen using systematic random sampling. Data on socio-demographic and clinical factors, as well as knowledge and practices, were gathered through interviews, medical record reviews using structured questionnaires. Descriptive statistics were used to determine the frequency and percentage of variables. The data was entered into Epi-data version 4.6 and analyzed using SPSS version 23 (Chicago). Variables with P-values < .25 were considered for multivariable analysis, and those with P-values < .05 were deemed to be factors associated with knowledge and practices. The study found that 42.2% (178) of hypertensive patients had good knowledge about chronic kidney disease, and 43.6% (184) had good practices. Living in urban areas (with an adjusted odds ratio [AOR] of 3.94 at a 95% confidence interval [CI] of 2.42-6.42) and having a family history of kidney disease (AOR 5.59 at a 95% CI of 3.21-9.75) were factors associated with good knowledge. Being a government employee (AOR 7.29, at 95% CI 1.79-29.58) and maintaining a normal body mass index (AOR 8.03, at 95% CI 3.54-18.19) were linked to good practices. Less than half of the study participants had good knowledge and practices toward prevention of chronic kidney disease. Identifying factors that affect knowledge and practices towards the prevention of chronic kidney disease can offer healthcare providers, governmental and nongovernmental organizations (NGOs), and policymakers’ valuable insights for developing strategic interventions and education programs to promote better management of hypertension and CKD.

PMID:40153756 | DOI:10.1097/MD.0000000000041989

Medicine (Baltimore). 2025 Mar 28;104(13):e41970. doi: 10.1097/MD.0000000000041970.

ABSTRACT

This study aims to evaluate the prevalence and factors associated with high blood pressure in secondary school adolescents in the Bamenda municipality, the North West region of Cameroon. A community-based cross-sectional study was conducted over 5 months, involving 720 adolescents aged 10 to 19 years from 13 secondary schools, using a multi-stage sampling approach. Blood pressure was measured using both oscillometric and mercury sphygmomanometer devices. Weight, height, and body mass index (BMI) were also assessed. Participants with high blood pressure values at the first visit underwent repeat screening for over 3 weeks and hypertension defined according to American Academy of Pediatrics guidelines. Logistic regression analyzed factors associated with hypertension, considering P < .05 as statistically significant at 95% Confidence Interval. The prevalence of hypertension was 5% (4% for stage I and 1% for stage II) and that of elevated Blood Pressure was 4.3%. There was an increase in blood pressure with an increase in age. Systolic blood pressure and diastolic blood pressure were significantly positively correlated with BMI. There was a significant association between enrolled in private school (aOR = 0.32; P = .006) and obesity (aOR = 2.94; P = .017) with hypertension in these participants. This study provides valuable insights into the alarming prevalence of hypertension among secondary school adolescents in Bamenda, Cameroon. The identification of key risk factor, obesity, calls for comprehensive strategies to promote healthy lifestyle, regular screening and timely management of high blood pressure in this vulnerable population.

PMID:40153752 | DOI:10.1097/MD.0000000000041970

Medicine (Baltimore). 2025 Mar 28;104(13):e41974. doi: 10.1097/MD.0000000000041974.

ABSTRACT

This study explored connections between women’s reproductive factors and acute ST-segment elevation myocardial infarction (STEMI). A retrospective case-control study was conducted between 2016 and 2017. The study included 110 women diagnosed with STEMI and 110 control participants. Data on reproductive factors were collected through structured questionnaires and analyzed using statistical methods. Findings showed that increased STEMI risk was associated with longer lactation period, a higher number of parities, gravidity, and abortions. No significant relationships were observed for menopausal status, menopausal age, menarche age, reproductive duration, or oral contraceptive use. This study revealed that higher gravidity, parity, history of abortion, and longer breastfeeding duration were linked to an increased risk of STEMI. However, no significant differences were found between the case and control groups regarding menopausal status, age at menopause, age at menarche, reproductive duration, or oral contraceptive use.

PMID:40153750 | DOI:10.1097/MD.0000000000041974

Medicine (Baltimore). 2025 Mar 28;104(13):e41916. doi: 10.1097/MD.0000000000041916.

ABSTRACT

The aim of this study was to examine the relationship between psychological flexibility levels, sociotropy-autonomy personality traits and decision-making styles of individuals with substance use disorder. The study was cross-sectional and correlational. The Data were obtained by face-to-face interviews with 106 patients who were hospitalized in a regional psychiatric hospital Alcohol and Substance Addiction Treatment Center between the dates of June and August 2023 and who agreed to participate in the study after obtaining ethics committee approval. Descriptive information form, sociotropy-autonomy personality traits scale, psychological flexibility scale and Melbourne decision making scale I-II (MDMQ) were used to collect the data. Descriptive statistics and correlation analysis were used to examine the relationship between variables. The patients who participated in the study consisted of 97.2% male and the mean age was 35.30 ± 10.53 years. 31.1% of the individuals stated that they started to use substances in the environment of friends and 65.1% of them stated that they had attempted to quit before. It was observed that the patients had a moderate level of psychological flexibility (116.36 ± 16.49), showed autonomy personality traits (79.77 ± 23.0) and used a Vigilance decision-making style (8.54 + 3.08). A statistically significant negative correlation was found between the mean scores of the psychological flexibility scale and the mean scores of the “buck-passing” subscale of the MDMQ (r=-.303 P = .002). In addition, a statistically significant positive correlation was found between the mean score of the “Sociotropy” subscale of the PES and the mean scores of the Vigilance Decision Making subscale and Hypervigilance Decision Making subscale of the MDMQ (r=.233 P = .016; r=.223 P = .022). There is a relationship between personality traits, psychological flexibility levels and decision-making styles of patients with substance use disorders. While those with low psychological flexibility levels show “buck-passing” decision-making tendencies, those with sociotropy personality traits show “vigilance” and “hypervigilance” decision-making tendencies.

PMID:40153749 | DOI:10.1097/MD.0000000000041916

Dent Med Probl. 2025 Mar 28. doi: 10.17219/dmp/167467. Online ahead of print.

ABSTRACT

BACKGROUND: Chitosan prepared with acetic acid is commonly used as an endodontic irrigant. However, the chitosan solution prepared with distilled water has not been evaluated for endodontic usage.

OBJECTIVES: The present study aimed to compare the effects of ethylenediaminetetraacetic acid (EDTA), fumaric acid, and the chitosan solutions prepared with distilled water (C-DW) and acetic acid (C-AA) on dentin microhardness and dentinal tubule penetration.

MATERIAL AND METHODS: Eighty maxillary central incisors were endodontically instrumented and randomly divided into 2 main groups (n = 40) for the evaluation of dentin microhardness and tubular penetration, with 4 subgroups in each main group (n = 10) according to the final irrigation solutions used (EDTA, fumaric acid, C-DW, and C-AA). The C-AA solution was prepared by diluting medium-molecularweight chitosan in acetic acid. The C-DW solution was prepared with distilled water and chitosan ammonium salts, which were synthesized using trichloroacetic acid and low-molecular-weight chitosan. After irrigation, the roots were sectioned horizontally 2 mm (the apical third) and 5 mm (the middle third) from the apex. The microhardness measurements were taken at depths of 500 μm and 1,000 μm from the canal lumen. The sections were examined for tubular penetration using confocal laser scanning microscopy. The data was analyzed using the analysis of variance (ANOVA), with a significance level set at p < 0.05.

RESULTS: The microhardness values were statistically similar at either depth for each third (p > 0.05), except for the 1,000-μm depth in the apical third, where the use of the C-AA solution resulted in lower microhardness as compared to fumaric acid (p < 0.05). No significant differences were observed in tubular penetration with regard to each third (p > 0.05).

CONCLUSIONS: All solutions showed a similar penetration ability in each third. At the 1,000-μm depth in the apical third, the fumaric acid solution provided a higher microhardness value than the C-AA solution.

PMID:40152894 | DOI:10.17219/dmp/167467