Tag: pubmed

Environ Epidemiol. 2026 Jun 30;10(4):e501. doi: 10.1097/EE9.0000000000000501. eCollection 2026 Aug.

ABSTRACT

BACKGROUND AND OBJECTIVE: Fractional exhaled nitric oxide (FeNO) is a biomarker of type-2 lung inflammation. Standardized measurement is essential for accurate diagnosis and monitoring. We assess seasonality and environmental determinants of FeNO in individuals with and without chronic respiratory diseases in the general population.

METHODS: This is a cross-sectional study on 412 individuals with chronic respiratory diseases (asthma, chronic bronchitis/chronic obstructive pulmonary disease, rhinitis) and 605 individuals without these conditions. Participants, aged 20-65 years, were recruited in the Gene-Environment Interactions in Respiratory Diseases study in Verona, Italy (2008-2014). Geocoded residential addresses were linked to daily PM₁₀ and air temperature at the time of the clinical examination using previously developed spatiotemporal models. Associations with log-FeNO were analyzed using adjusted linear regression, accounting for seasonality and disease status.

RESULTS: FeNO levels were higher in subjects with respiratory diseases during the warm season, even after adjusting for pollen exposures; a milder seasonal pattern was observed in subjects without chronic respiratory diseases (P for interaction = 0.001). A 10 μg/m³ increase in mean PM₁₀ concentration at lag 0-1 (day of FeNO measurement and day before) was associated with a 3% higher FeNO concentration (Ratio of Geometric Means, RGM: 1.03, 95% confidence interval: 1.00, 1.06) after adjusting for seasonality.

CONCLUSION: FeNO is a sensitive biomarker of environmental exposures. Overlooking seasonality and environmental factors might impact clinical decision-making in chronic respiratory diseases.

PMID:42383180 | PMC:PMC13318099 | DOI:10.1097/EE9.0000000000000501

Future Healthc J. 2026 Jun 3;13(3):100542. doi: 10.1016/j.fhj.2026.100542. eCollection 2026 Sep.

ABSTRACT

BACKGROUND: Legislative moves to legalise assisted dying in the UK have renewed discussion on future clinicians’ preparedness for new potential responsibilities. This study examined medical students’ ethical attitudes, legal understanding and curricular exposure.

METHODS: VOICE was a national cross-sectional survey of UK and Ireland medical students in 2025 (n = 896). The questionnaire assessed ethical views, confidence, legal knowledge and teaching exposure. Descriptive statistics, thematic analysis and multivariable logistic regression explored predictors of ethical agreement, curriculum coverage and legal knowledge.

RESULTS: Most students (64.5%) believed that assisted dying can be ethically justified, yet legal knowledge was limited; only 7.6% correctly identified all eligibility criteria. Nearly 70% reported minimal curricular coverage. Formal teaching was associated with higher confidence and greater ethical agreement. Regional variation and concerns about coercion and inequalities were common.

CONCLUSION: Students show broad ethical support but have very limited confidence, legal understanding and curricular preparation, highlighting the need for structured education.

PMID:42383174 | PMC:PMC13315502 | DOI:10.1016/j.fhj.2026.100542

Gynecol Oncol Rep. 2026 Jun 11;66:102135. doi: 10.1016/j.gore.2026.102135. eCollection 2026 Aug.

ABSTRACT

OBJECTIVE: Updated ACOG guidelines recommend a combined approach of transvaginal ultrasound (TVUS) and endometrial sampling for evaluation of most postmenopausal bleeding (PMB). Although prior studies investigating the reliability of TVUS suggest that non-endometrioid endometrial cancer subtypes present with thinner endometrium, some included cases with incomplete endometrial visualization. We therefore evaluated endometrial thickness (ET) by cancer subtype while controlling for incomplete endometrial visualization.

METHODS: We performed a retrospective cohort study of patients with PMB who underwent TVUS followed by tissue-confirmed endometrial cancer at three academic centers (2013-2022). Cancers were classified as endometrioid or non-endometrioid (serous, clear cell, carcinosarcoma, undifferentiated). Fibroid presence, endometrial visualization, and race/ethnicity were recorded. Patients with incomplete endometrial visualization were excluded from endometrial thickness analysis. Appropriate nonparametric statistical comparisons were performed.

RESULTS: Among 171 analysis-eligible patients (121 endometrioid, 50 non-endometrioid), non-endometrioid cancers were more common among non-Hispanic Black (53%) than non-Hispanic White (20%) or Hispanic patients (25%). Patients with non-endometrioid cancers were more likely to have incompletely visualized endometria (34% vs 9.1%, p < 0.01). Among patients with complete visualization, mean ET did not differ between endometrioid and non-endometrioid cancers (16.9 vs 19.5 mm) or by race/ethnicity. ET ≤4 mm occurred in 5.6% of cancers with fully visualized endometria, without differences between subtypes.

CONCLUSION: When endometrium was fully visualized, non-endometrioid cancers did not present with thinner ET than endometrioid cancers, and a 4 mm cutoff may miss 5.6% of cancers. Incomplete visualization, more common in non-endometrioid disease, may lead to additional missed diagnoses, supporting universal endometrial sampling for PMB.

PMID:42383153 | PMC:PMC13315767 | DOI:10.1016/j.gore.2026.102135

Clin Neuropsychiatry. 2026 Jun;23(3):232-242. doi: 10.36131/cnfioritieditore20260302.

ABSTRACT

OBJECTIVE: psoriasis is a chronic immune-mediated disease that significantly impacts patients’ health-related quality of life (HRQOL). While effective treatments exist, the burden of psoriasis on HRQOL and the factors influencing it remain underexplored in Vietnam. To assess HRQOL and its associated factors among patients with psoriasis vulgaris in a tertiary hospital in Vietnam.

METHOD: a cross-sectional study was conducted from March to December 2023, including 149 patients with psoriasis vulgaris. HRQOL was evaluated using the EQ-5D-5L tool, and disease severity was assessed with the Psoriasis Area and Severity Index (PASI). Data analysis included descriptive statistics, chi-square tests, and stepwise multivariate Tobit regression to identify factors associated with the EQ-5D index.

RESULTS: the mean EQ-5D index was 0.85 (SD = 0.17), with patients reporting the fewest problems in mobility (88.6% no issues) and self-care (81.2% no issues). However, pain/discomfort (68.5%) and anxiety/depression (36.2%) were significant concerns. The EQ-5D index declined with increasing PASI scores (mild: 0.87, severe: 0.68, p < 0.01). Factors negatively associated with HRQOL included older age (Coef. = -0.003, p = 0.026), severe redness (Coef. = -0.199, p = 0.001), and pain symptoms (Coef. = -0.108, p = 0.031). Male sex was independently associated with higher HRQOL (Coef. = 0.084, p = 0.015). Fraizeron treatment was positively associated with higher HRQOL (Coef. = 0.164, p = 0.048).

CONCLUSIONS: psoriasis substantially impacts HRQOL, particularly through pain and emotional burden. Older age, severe redness, and pain symptoms were associated with poorer HRQOL, whereas male sex and Fraizeron treatment were associated with higher HRQOL. Comprehensive management strategies addressing both physical symptoms and psychological well-being may help improve HRQOL.

PMID:42383145 | PMC:PMC13316888 | DOI:10.36131/cnfioritieditore20260302

Mayo Clin Proc Innov Qual Outcomes. 2026 Jun 23;10(4):100734. doi: 10.1016/j.mayocpiqo.2026.100734. eCollection 2026 Aug.

ABSTRACT

OBJECTIVE: To address the limited recognition of structural causes of lower-limb pain and the lack of real-world data on entheseal pathology, we evaluated ultrasound-detected entheseal and tendinous abnormalities in an unselected outpatient population, highlighting the underuse of musculoskeletal ultrasound (MSK US) in early diagnostic assessment despite the frequent misclassification of these conditions as nonspecific soft-tissue or degenerative disorders.

PATIENTS AND METHODS: We conducted a retrospective analysis of 667 consecutive adults undergoing standardized MSK US for lower-limb pain in a general ambulatory orthopedic clinic. Fourteen predefined entheseal and tendinous sites across the hip, knee, and ankle-foot regions were evaluated using Outcome Measures in Rheumatology criteria. Prevalence, anatomical distribution, bilaterality, and clinical predictors were assessed using descriptive statistics and multivariable logistic regression.

RESULTS: Ultrasound-confirmed enthesopathy or tendinopathy was present in 152 of 667 patients (22.8%). Lesions most frequently involved the gluteus medius tendon and plantar fascia (5.5% each, n=37), followed by the semimembranosus (2.8%, n=19), patellar (2.6%, n=17), and Achilles tendons (4.2%, n=28). Abnormalities were predominantly unilateral (<10% bilateral). Increasing age was the only independent predictor of entheseal pathology (adjusted OR 1.26 per 10-year increase; 95% CI, 1.08-1.47). Sex, body mass index, diabetes, and rheumatologic disease were not relatively associated with pathology.

CONCLUSION: Entheseal and tendinous abnormalities are common among symptomatic adults in everyday outpatient practice. Systematic integration of MSK US as a first-line assessment tool could improve diagnostic precision and enable targeted management strategies. These findings provide population-relevant evidence to inform musculoskeletal care pathways and health system decision-making.

PMID:42383140 | PMC:PMC13316613 | DOI:10.1016/j.mayocpiqo.2026.100734

Indian J Sex Transm Dis AIDS. 2026 Jan-Jun;47(1):16-21. doi: 10.4103/ijstd.ijstd_94_25. Epub 2026 May 19.

ABSTRACT

BACKGROUND: Syphilis is a sexually transmitted disease that varies in presentation according to the stage of the disease. Susceptibility to penicillin contributed to the near elimination of the disease during the 1990s to 2000 period. Recently, there have been reports of the re-emergence of syphilis from all parts of the world.

AIM: To study the clinical presentation and trends of syphilis.

MATERIALS AND METHODS: A retrospective study was conducted from January 2013 to December 2024. All clinically and/or serologically diagnosed cases of syphilis were included in the study. Medical records of all the patients attending the sexually transmitted infection clinic were analyzed concerning age, sex, clinical presentation, and laboratory investigations. Statistical analysis was done using mean, median, and proportion.

RESULTS: A total of 260 cases with syphilis were enrolled. The male-to-female ratio was 5.53:1. The most common stage of presentation was latent syphilis (45.6%). The most common age group affected was 21-30 years. Out of the total cases, 2.7% of cases were pregnant females, 14.18% were human immunodeficiency virus (HIV) positive, and 95 cases were men who have sex with men cases. Only two cases of congenital syphilis were detected.

CONCLUSION: A resurgence of syphilis cases has been observed in the last 3 years, with latent syphilis contributing to the majority of cases. Possible factors attributed to this surge include promiscuous sexual behavior, HIV coinfection, male having sex with male, and early adolescent sexual exposure. The sudden rise in latent syphilis cases is a warning sign of resurgence in India, as it signifies the persistence of syphilis in the subclinical phase in the community.

PMID:42383134 | PMC:PMC13318344 | DOI:10.4103/ijstd.ijstd_94_25

Sci Rep. 2026 Jun 30. doi: 10.1038/s41598-026-58207-5. Online ahead of print.

ABSTRACT

Traditional Bayesian network structure learning requires explicit trade-offs among structural complexity, statistical fit, and decision reliability. This study proposes BAPS (Budgeted Acyclicity with Phase-transition Spectral diagnostics), a framework that reformulates structure learning as a budget-controlled optimization problem in which a global edge budget limits the number of selected candidate edges and thereby regulates model capacity. A relaxed QUBO formulation with post-hoc DAG projection explores likelihood-improving structures while recovering feasible directed acyclic graphs; in benchmark experiments, the repair process reduces SHD by 20.6%, 14.9%, and 8.3% on Asia, Insurance, and Barley, indicating improved structural agreement while enforcing feasibility. Spectral diagnostics based on algebraic connectivity serve as descriptive structural indicators for flagging budget regions where repair burden may escalate. A dual-layer credibility framework quantifies uncertainty from parameter and observational sources; credibility interval width contracts by 69-73% under increasing Dirichlet concentration and remains empirically stable in sparse-data conditions where resampling-based methods become unstable due to zero-frequency effects. Across benchmark networks, BAPS achieves the highest BIC gain while maintaining broadly comparable held-out predictive performance relative to established baselines. Overall, BAPS provides a unified framework integrating edge-budget capacity control, structural diagnostics, feasibility repair, and credibility assessment for Bayesian network learning in complex diagnostic environments.

PMID:42380384 | DOI:10.1038/s41598-026-58207-5

Int Microbiol. 2026 Jul 1. doi: 10.1007/s10123-026-00822-3. Online ahead of print.

ABSTRACT

Pseudomonas aeruginosa is a multidrug-resistant pathogen, highly prevalent in ICU patients and is a rising concern globally. Multidrug resistance (MDR) and virulence of P. aeruginosa has been a major reason linked to the high rates of mortality in both developed and non-developed countries. The study focused specifically on main structural outer membrane proteins mainly oprI and oprL due to their significant role on both virulence and MDR by assessing their MDR from the isolates collected from various healthcare settings in Lahore, Pakistan. A total of 65 isolated were collected from different tertiary care hospitals of Lahore, Punjab. All isolates were identified and characterized using conventional methods. MDR patterns were assessed through disk diffusion method in accordance with CLSI 2024 guidelines. Detection of virulence genes (oprI and oprL) was performed using PCR amplification. Statistical and in silico analysis was performed to analyse the prevalence of P. aeruginosa and identification of potential vaccine targets provide alternative treatment strategies against infections caused by it. Out of all 65 isolates, total of 52 isolates was reportedly positive with P. aeruginosa and showed 100% resistance to β-lactams with high susceptibility to cephalosporins and fluoroquinolones. Multidrug resistance was reported in 70% isolates of P. aeruginosa. All isolates (100%) harbored the oprL gene while the oprI gene was detected in 85.5% of isolates. In silico characterization revealed strong binding B and T cell epitopes with 100% conservancy as potential multi-epitope candidates that warrant further in vivo and in vitro validation to overcome deadly infections caused by P. aeruginosa. In conclusion, MDR and virulence gene characterization by both molecular and computational methods will aid in developing multi-epitope vaccine candidate that can be tested in vitro and in vivo to overcome MDR and rising mortality rates in Pakistan.

PMID:42380383 | DOI:10.1007/s10123-026-00822-3

Sci Rep. 2026 Jul 1. doi: 10.1038/s41598-026-58672-y. Online ahead of print.

ABSTRACT

Water immersion is a popular conditioning method; specifically, high-concentration CO₂ hot water immersion (CO₂-HWI) has become more common in recent years. This study aimed to investigate the effectiveness of CO₂-HWI in conditioning for athletes from both physiological and biochemical perspectives. Ten male university baseball players participated in this randomized crossover trial. Each participant completed three 15-min interventions after team training sessions on separate experimental days: CO₂-HWI (CO₂; water temperature, 40 °C; CO₂ concentration, 1000 ppm), tap HWI (TAP; water temperature, 40 °C), and non-water immersion (NON; room temperature, 25 °C; relative humidity 60%). Measurements were taken before and after the intervention, and change scores were calculated. Differences in change scores among the three conditions were analyzed using the Friedman test. From a physiological perspective, systolic blood pressure showed a significant decrease in the CO₂ vs. NON comparison (p < 0.05), whereas most measures (e.g., core and skin temperatures) showed similar changes in the CO₂ and TAP conditions compared with the NON condition (p < 0.05). From a biochemical perspective, salivary cortisol and secretory immunoglobulin A levels did not show significant changes. Meanwhile, salivary human herpesvirus (HHV-) 7 DNA levels showed a significant decrease in the CO₂ vs. NON comparison (p < 0.05), while changes in HHV-6 DNA levels were not statistically significant. In summary, CO₂-HWI demonstrated comparable effectiveness to TAP-HWI from both physiological and biochemical perspectives. Among these findings, CO₂-HWI may contribute to reductions in systolic blood pressure and salivary HHV-7 DNA levels.

PMID:42380375 | DOI:10.1038/s41598-026-58672-y

Eur J Pediatr. 2026 Jun 30;185(7):543. doi: 10.1007/s00431-026-07166-0.

ABSTRACT

To assess clinical value, safety, and applicability of contrast-enhanced ultrasound (CEUS) in neonates, focusing on bedside use in intensive care. This retrospective single-center study included 23 neonates undergoing intravenous CEUS between 2010 and 2024, including seven preterm infants. The liver (n = 18) was the most frequently examined organ, followed by kidneys (n = 2), brain (n = 2), and adrenals (n = 1). Findings were compared with MRI (n = 10), CT (n = 3), or biopsy (n = 8), when available. In nine cases, CEUS findings were consistent with clinical course and treatment response only, without an independent reference standard. Among the 14 cases with available reference diagnostics, CEUS established the diagnosis first in ten (71.4%); histological confirmation was available in eight cases, with concordance in five (62.5%). 13 examinations (56.5%) were performed for bedside problem-solving in the neonatal intensive care unit, and no adverse events were observed.

CONCLUSION: CEUS provided clinically relevant diagnostic information in neonates, including preterm and critically ill infants and was well tolerated. CEUS was particularly valuable in hepatic vascular tumors, where it could provide a definite diagnosis, enabled hemodynamic assessment, supported treatment decisions, and aided identification of potentially life-threatening complications. Bedside use enabled timely diagnosis without sedation, intubation, or patient transport, thereby supporting minimal handling. In selected cases, CEUS may reduce the need for cross-sectional imaging. Despite off-label use, our findings suggest a beneficial role for CEUS in neonatal imaging, predominantly for hepatic indications.

WHAT IS KNOWN: • Contrast-enhanced ultrasound (CEUS) is a radiation-free, bedside-compatible imaging technique with an established safety profile in pediatric patients. • Neonatal CEUS experience is limited to small case series, predominantly reporting cerebral applications.

WHAT IS NEW: • CEUS was feasible and well tolerated in neonates including preterm infants, with no adverse events in 23 examinations. • CEUS yielded clinically relevant diagnostic information across a range of indications, primarily hepatic, encompassing both focal lesions and perfusion assessment, supporting clinical decision-making in neonatal care.

PMID:42380351 | DOI:10.1007/s00431-026-07166-0