Tag: pubmed

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

AIDS Care. 2026 Mar 17:1-12. doi: 10.1080/09540121.2026.2644519. Online ahead of print.

ABSTRACT

Links between hazardous alcohol use and HIV acquisition are well documented, with less known about this relationship among fishermen, a priority group for HIV prevention. We examined associations between hazardous alcohol use and sexual risk behaviors among fishermen in Kenya using 2022 data from 733 fishermen in three Lake Victoria communities. Measures included the AUDIT-C and sexual relationship histories. Logistic regression models assessed associations between hazardous alcohol use and (1) any concurrent sexual relationships, (2) concurrency among non-polygynous men, (3) any higher HIV risk sexual relationships, and (4) higher HIV risk sexual relationships among non-polygynous men in past six months, controlling for covariates and clustering. Among 713 sexually active men. PrEP (8%) and condom use (<5%) were low; 16% reported hazardous alcohol use. Hazardous alcohol use was associated with greater odds of concurrency (aOR = 1.38, 95%CI: 0.96-1.98), though not statistically significant. Among non-polygynous men, hazardous alcohol use was significantly associated with concurrency (aOR = 1.74, 95%CI:1.18-2.56). No association was observed with higher-risk relationships among all men (aOR = 1.72, 95%CI:0.91-3.25) and among non-polygynous men (aOR = 1.67, 95%CI:0.84-3.34). Hazardous alcohol use is linked to sexual behaviors that heighten HIV risk and support integrating alcohol risk reduction into HIV prevention strategies for fishermen in East Africa.

PMID:41844368 | DOI:10.1080/09540121.2026.2644519

Stat Med. 2026 Mar;45(6-7):e70446. doi: 10.1002/sim.70446.

ABSTRACT

In Alzheimer’s disease (AD) research, many observational studies have shown that the effect of sleeping quality, a modifiable risk factor, on cognitive decline is heterogeneous, where some adults experience faster rates of cognitive decline compared to others. However, these effects are likely confounded by unmeasured confounders, and the sensitivity of these effects to unmeasured confounders may be heterogeneous, where one subgroup’s treatment effect is more sensitive than that of another subgroup. Unfortunately, compared to the overall treatment effect, there are limited investigations about the sensitivity of heterogeneous treatment effects to unmeasured confounding. The paper presents and compares methods for sensitivity analysis of heterogeneous effects in observational studies based on Rosenbaum’s model for sensitivity analysis. We show that, unlike the sensitivity analysis of the overall treatment effect, the sensitivity of heterogeneous treatment effects depends on the variation in the effect sizes across subgroups and the correction for multiple testing. The data analysis further supports our findings where the overall effect of sleep disturbances on cognitive decline is significant ( $p$ -value = $5.55\times 10^{–5}$ ). Also, the effect is more severe among males ( $p$ -value = $2.00\times 10^{–4}$ ) and insensitive to a moderate degree of unmeasured confounding. Finally, we offer an easy-to-use R software to carry out the sensitivity analyses for heterogeneous treatment effects.

PMID:41844366 | DOI:10.1002/sim.70446

Cancer Med. 2026 Mar;15(3):e71721. doi: 10.1002/cam4.71721.

ABSTRACT

BACKGROUND: Hepatocellular carcinoma (HCC) survival in the United States varies sharply by neighborhood disadvantage.

AIM: To determine whether residence in persistently impoverished or low-SES census tracts is independently associated with lower all-cause and HCC-specific survival.

METHODS: We identified 51,323 adults with HCC using a population-based retrospective cohort from the Surveillance, Epidemiology, and End Results Research Plus Specialized Database (2006-2020). Two census tract-level socioeconomic exposures were defined: persistent poverty (≥ 20% living below the poverty line for approximately 30 years) and low SES (Yost Index first quintile). Overlap Propensity Score Weighting, combined with marginal structural models, estimated the 1-, 5-, 10-, and 15-year risks of all-cause and HCC-specific mortality.

RESULTS: The median follow-up was 16 months, 6058 (11.8%) lived in persistently impoverished tracts, and 9863 (19.5%) lived in low-SES tracts. After weighting, residents of persistently impoverished areas had a 1-year all-cause mortality risk of 46.0% vs. 40.3% (RD, 5.6%; 95% CI, 4.4% to 6.9%; RR, 1.14; 95% CI, 1.11 to 1.17) and an HCC-specific mortality risk of 33.3% vs. 28.6% (RD, 4.8%; 95% CI, 3.2% to 6.3%; RR, 1.17; 95% CI, 1.11 to 1.22). Living in low-SES tracts raised 1-year all-cause mortality risk to 32.5% vs. 30.1% (RD, 4.8%; 95% CI, 3.6% to 6.0%; RR, 1.12; 95% CI, 1.09 to 1.15) and HCC-specific mortality risk to 32.5% vs. 30.1% (RD, 2.5%; 95% CI, 1.4% to 3.5%; RR, 1.08; 95% CI, 1.05 to 1.12).

CONCLUSIONS: Both persistent neighborhood poverty and contemporary low SES independently contribute to significant increases in mortality risk after HCC diagnosis.

PMID:41844357 | DOI:10.1002/cam4.71721

Vox Sang. 2026 Mar 17. doi: 10.1111/vox.70237. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Transfusion-associated circulatory overload (TACO) is the leading cause of transfusion-related morbidity and mortality. We evaluated the incidence of TACO and its association with new fever (HOT-TACO) at a comprehensive cancer centre.

MATERIALS AND METHODS: Retrospective review of haemovigilance data (July 2019-October 2020) identified 100 possible to definite TACO cases. TACO cases were classified as HOT-TACO or regular TACO, differentiated by an association with new-onset fever. Both groups were assessed by type, age of blood products involved, reaction severity, cancer diagnosis and white blood cells (WBC) counts.

RESULTS: Among 1382 transfusion reactions in a 15-month period, 111 cases of TACO (8%) were diagnosed. A total of 100 adult TACO cases were included in this study; 16% of them were HOT-TACO cases. The median WBC counts pre- and post-transfusion in the HOT-TACO versus regular-TACO group were not statistically different (pre- 5.400 vs. 2.050, p = 0.19; post 4.100 vs. 1.900, p = 0.45). However, the HOT-TACO group had a 2.7-fold higher pre-WBC and a 2.2-fold higher post-WBC when compared with the regular TACO group. There were no significant differences in age of the blood products involved, red blood cell (RBC) age (median 12 days, p = 0.34), platelet age (single donor platelet [SDP]/random donor platelet [RDP] unit) (median 5/5 days, p = 0.32/p = 0.72) or reaction severity between groups.

CONCLUSION: We found an association of TACO and new fever in 16% of cases compared with 32% reported in a non-exclusive oncological setting. Findings are likely related to impaired immune response present in cancer patients associated with immunosuppression. Our findings support that fever should not be used to distinguish transfusion-related acute lung injury (TRALI) from TACO.

PMID:41844335 | DOI:10.1111/vox.70237