Tag: pubmed

Int J Gen Med. 2026 Aug 18;19:623797. doi: 10.2147/IJGM.S623797. eCollection 2026.

ABSTRACT

OBJECTIVE: To explore the value of heparin-binding protein (HBP) in the diagnosis of sepsis-associated acute kidney injury (SA-AKI) in patients with sepsis.

METHODS: This retrospective single-center study enrolled 114 patients with sepsis admitted between January 2023 and January 2025. Patients were divided into SA-AKI group (n=76) and non-SA-AKI group (n=38) based on the presence of AKI. Baseline clinical data were collected for both groups. Venous blood samples were obtained at ICU admission (within 30 minutes of arrival, T0) and at 24 h (T24), 48 h (T48), and 72 h (T72) thereafter for measurement of HBP and other infection-related biomarkers. General characteristics and dynamic changes in HBP levels were compared between the two groups. ROC curve analysis was performed to evaluate the diagnosticvalue of each biomarker for SA-AKI.

RESULTS: SOFA score, length of mechanical ventilation, and 28-day mortality were significantly higher in the SA-AKI group than in the non-SA-AKI group (all P < 0.05). HBP levels showed an increasing trend over time in the SA-AKI group, whereas a decreasing trend was observed in the non-SA-AKI group, with statistically significant differences between the two groups at all time points (P < 0.05). Levels of HBP, procalcitonin (PCT), and interleukin-6 (IL-6) were significantly higher in the SA-AKI group compared with the non-SA-AKI group (P < 0.05), while no significant differences were found in white blood cell count or C-reactive protein levels between the two groups. ROC curve analysis demonstrated that HBP, PCT, and IL-6 were effective predictors of SA-AKI, with AUC of 0.869 (95% CI 0.806-0.933, sensitivity 73.7%, specificity 86.8%), 0.777, and 0.738, respectively.

CONCLUSION: HBP demonstrates high early predictive value for SA-AKI in ICU patients with sepsis, with diagnostic performance superior to that of PCTand IL-6. HBP may serve as a promising early biomarker for the diagnosis of SA-AKI.

PMID:42633362 | PMC:PMC13499571 | DOI:10.2147/IJGM.S623797

Int J Nurs Stud Adv. 2026 Aug 6;11:100652. doi: 10.1016/j.ijnsa.2026.100652. eCollection 2026 Dec.

ABSTRACT

BACKGROUND: Personal protective equipment (PPE) restricts heat dissipation from the body, and many healthcare workers experience heat-stress-related physical discomfort, including dizziness, headaches, fatigue, and excessive sweating, during clinical duties. Such thermal strain may compromise not only an individual’s well-being but also work performance and patient safety. Despite these concerns, evidence from routine clinical practice, particularly for PPE commonly used in nursing care, remains limited.

OBJECTIVE: This study aimed to investigate the effects of wearing PPE during simulated nursing care on physiological and psychological responses and to compare gowns and aprons.

METHODS: This study included 11 young women in simulated nursing care wearing PPE in three conditions: control, aprons, and gowns. The ear canal temperature, skin temperature, sweat rate, and subjective responses were evaluated.

RESULTS: Changes in ear canal temperature did not differ significantly among PPE conditions. PPE type and time interactions to changes in forearm skin temperature were observed (F(26,260) = 19.2, p < 0.001, partial η² = 0.66). The forearm skin temperature during nursing care was significantly higher in the gown condition than in the control and apron conditions in multiple comparisons. The sweat rate during simulated nursing care was significantly higher in the gown condition than in the control condition (p < 0.01, r = 0.91). The gown condition was associated with higher thermal sensations (p < 0.05, r = 0.87), more statistically significant thermal discomfort (p < 0.05, r = 0.87), and a stronger sweat sensation (p < 0.05, r = 0.87) than the control condition.

CONCLUSIONS: The simulated nursing care performed while wearing PPE for 20 min in this study did not produce enough heat load to affect the core temperature. However, the thermal sensation and discomfort subjectively increased with the heightened sweat rate in the gown condition. The study findings reinforce the need for evidence-based guidelines aimed at protecting nurses from heat stress associated with the use of protective clothing. Furthermore, this study provides quantitative evidence indicating that PPE type influences the magnitude of these responses, underscoring the necessity of considering PPE type when developing practical recommendations.

REGISTRATION: UMIN Clinical Trials Registry (UMIN000054105), Registered 01/05/2024, first recruitment date 27/05/2024.

PMID:42633357 | PMC:PMC13499407 | DOI:10.1016/j.ijnsa.2026.100652

Cureus. 2026 Jul 23;18(7):e113206. doi: 10.7759/cureus.113206. eCollection 2026 Jul.

ABSTRACT

Background Red blood cell (RBC) alloimmunization is a significant complication among patients with transfusion-dependent thalassemia and sickle cell disease (SCD), potentially leading to difficulties in crossmatching, delayed hemolytic transfusion reactions, and hyperhemolysis. In Bahrain, the prevalence of RBC alloimmunization among patients with hemoglobinopathies had not been previously reported. Objective To determine the prevalence of RBC alloimmunization among patients with transfusion-dependent thalassemia and SCD in Bahrain and to compare findings with published regional and international data. Methods A retrospective, cross-sectional study was conducted at Salmaniya Medical Complex (SMC), Bahrain. A total of 311 transfusion-dependent patients, 203 with SCD and 108 with thalassemia, registered between 2016 and 2025 were included. Clinical and laboratory data were extracted from electronic medical records. Patients with a positive indirect antiglobulin test (IAT) showing a consistent reaction strength of 2+ or greater were considered alloimmunized. Descriptive statistics were used to analyze demographic variables and determine the prevalence of alloimmunization. A chi-square test was used to compare alloimmunization rates between the SCD and thalassemia groups. The rates observed in this study were also compared with those reported in other countries using chi-square analysis. A p-value < 0.05 was considered statistically significant. Results The overall prevalence of RBC alloimmunization was 14.8%. Alloimmunization was significantly more prevalent among patients with SCD, with 41 out of 203 (20.2%) testing positive, compared to only 5 out of 108 (4.6%) patients with thalassemia (p < 0.001). Among the 46 alloimmunized patients, 58.7% were male, and 41.3% were female, reflecting the sex distribution of the study population. Blood group O was the most common (54.3%), and 95.5% of patients were Rh-positive. Conclusion The alloimmunization rates observed in this study are consistent with the rates reported in other Middle Eastern countries. Despite extended phenotypic crossmatching, patients with SCD had a significantly higher alloimmunization rate than patients with thalassemia, likely due to disease-related immune activation and differences in transfusion protocols. Adoption of molecular RBC genotyping and comprehensive antibody identification for all alloimmunized patients is recommended to improve transfusion safety in this population.

PMID:42633355 | PMC:PMC13499651 | DOI:10.7759/cureus.113206

Eur Oral Res. 2026 Aug 11;60(1):344-350. doi: 10.26650/eor.20261863577. eCollection 2026.

ABSTRACT

PURPOSE: The aim of this study is to evaluate in vitro the morphological and physicochemical effects of an experimental epigallocatechin-3-gallate (EGCG) gel and its combination with sodium fluoride (NaF) on the progression of dentin erosion.

MATERIALS AND METHODS: Initial lesions were induced in bovine dentin samples (n=10/group) and divided into: Control (gel without active ingredients), NaF (1.23% NaF), EGCG (10% EGCG), and EGCG+NaF (10% EGCG + 1.23% NaF). Half of the sample was protected and the other half treated and subjected to erosive/abrasive challenges (0.3% citric acid, pH=2.6 and simulated brushing). Volume loss (VL) and surface roughness (Ra) were evaluated by 3D laser confocal microscopy. Dentin composition was analyzed by Raman spectroscopy, considering mineral/matrix ratio (MMR), collagen organization, and crystallinity.

RESULTS: The EGCG+NaF group presented the lowest VL values (p<0.05). The Control group had the highest MMR values, while the EGCG+NaF group presented the lowest (p<0.05). For the Amide I/III ratio, the Control group had the lowest values and the EGCG+NaF group the highest (p<0.05). No statistically significant differences among the groups regarding the crystallographic order (p= 0.668).

CONCLUSION: The combination of EGCG and NaF demonstrates the ability to mitigate volume loss under erosive-abrasive challenges, preserve structural integrity, and enhance collagen cross-linking within the demineralized organic matrix of dentin.

PMID:42633335 | PMC:PMC13499613 | DOI:10.26650/eor.20261863577

Ann Intensive Care. 2026 Aug 4;16:100130. doi: 10.1016/j.aicoj.2026.100130. eCollection 2026.

ABSTRACT

BACKGROUND: Critically ill patients frequently develop intestinal dysbiosis, leading to gastrointestinal (GI) symptoms and infectious complications. No network meta-analysis (NMA) has compared the relative effectiveness of prebiotics, probiotics, and synbiotics for reducing the risk of GI symptoms in critically ill patients.

OBJECTIVE: This study aimed to evaluate their comparative effects in preventing GI symptoms and improving clinical outcomes.

METHODS: MEDLINE, CENTRAL, and Web of Science were searched through June 2025. Eligible randomized controlled trials enrolled critically ill adults and compared prebiotics, probiotics, or synbiotics with controls (placebo or usual care). The primary outcome was GI symptom incidence. Secondary outcomes included mortality, intensive care unit (ICU) length of stay, mechanical ventilation duration, infectious complications, and adverse events. A frequentist random-effects NMA was conducted. Treatment rankings were exploratory, and certainty of evidence was not formally assessed.

RESULTS: Thirty-three randomized controlled trials involving 5,073 patients were included in the analysis of GI symptoms. Compared with control, synbiotics significantly reduced the risk of GI symptoms (risk ratio [RR] 0.52; 95% confidence interval [CI]: 0.35 to 0.77), as did prebiotics (RR 0.66; 95% CI: 0.49 to 0.87). Probiotics produced a similar directional effect, but the difference was not statistically significant (RR 0.81; 95% CI: 0.60 to 1.10). No significant differences were found between the active interventions. Subgroup analyses suggested differences according to the ICU population. Among medical intensive care patients, prebiotics were associated with a lower risk of GI symptoms than control, whereas probiotics and synbiotics were associated with a lower risk among surgical intensive care patients.

CONCLUSIONS: Synbiotics and prebiotics were associated with a significantly lower risk of gastrointestinal symptoms in critically ill patients, whereas probiotics showed a similar but statistically nonsignificant effect. No active intervention was significantly superior to another. The findings suggest that the relative benefits of these interventions may differ between medical and surgical intensive care populations. Nevertheless, the results should be interpreted cautiously because certainty of evidence was not formally assessed.PROSPERO registration number: CRD420251015729; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251015729.

PMID:42633334 | PMC:PMC13499409 | DOI:10.1016/j.aicoj.2026.100130

Intest Fail. 2026 Aug 14;12:100391. doi: 10.1016/j.intf.2026.100391. eCollection 2026 Oct-Dec.

ABSTRACT

BACKGROUND: There has been a shift toward combined liver-intestine and multivisceral transplantation (MVT), whereas isolated intestinal transplantation has taken a backseat, mainly because of its higher rejection rates. Despite this, experimental models tend to focus on intestinal transplantation or isolated liver transplantation, likely because of the technical complexity of MVT. This study aimed to outline a refined surgical protocol for MVT in rats.

MATERIALS AND METHODS: Syngeneic heterotopic MVT was performed in five Sprague-Dawley rat under sevoflurane anesthesia. The grafts included liver, stomach, pancreas, and small bowel tissues. These were anastomosed en bloc, end-to-end, to the infrarenal vena cava and aorta.

RESULTS: A 100% survival rate was achieved. Initially, the clinical discomfort scores increased during the first 48 h but gradually improved by days 6-7, coinciding with weight recovery and normalization of behavior. Histological analysis revealed preserved architecture of the stomach, pancreas, and native organs. The intestinal tissue remained largely unchanged, with mild villous tip edema noted in one case. One grafted liver showed necrosis and hemorrhage, whereas the remaining grafts were viable, with mild congestion in two cases. Biochemical analyses revealed normal levels of total bilirubin, gamma-glutamyl transpeptidase, lipase, urea, and creatinine. Aspartate transaminase, alanine transaminase, alkaline phosphatase, and lactate dehydrogenase levels were elevated, but none reached statistical significance when compared with the pre-transplant values.

CONCLUSIONS: This model offers a dependable and reproducible platform for experimental MVT, providing a well-documented and accessible tool to encourage the incorporation of MVT into current translational and immunological research.

PMID:42633324 | PMC:PMC13499387 | DOI:10.1016/j.intf.2026.100391

Resusc Plus. 2026 Aug 6;31:101436. doi: 10.1016/j.resplu.2026.101436. eCollection 2026 Sep.

ABSTRACT

Infants are particularly vulnerable to cardiorespiratory arrest and choking, emergencies that often occur at home and require immediate intervention. Training parents and caregivers in Basic Life Support (BLS) can improve early emergency response, but access to qualified instructors remains limited. This study evaluated the feasibility of a supervised BLS training model using final-year medical students under direct physician supervision, focusing on long-term knowledge retention.

METHODS: In this prospective quasi-experimental study, 59 caregivers of infants aged 30 days to two years received standardized simulation-based BLS training delivered either by physicians or by final-year medical students under direct physician supervision. Knowledge was assessed before training, immediately afterward, and at 12 months. Participants were recruited from public and private outpatient settings, which were compared as an exploratory proxy for socioeconomic context. Linear mixed-effects models were used to analyze repeated measures, with participant included as a random effect.

RESULTS: In the complete-case analysis (n = 51), knowledge scores increased significantly immediately after training (adjusted mean difference, 8.0 points; 95% CI, 7.1-8.9; p < 0.001) and remained above baseline at 12 months (adjusted mean difference, 5.9 points; 95% CI, 5.0-6.8; p < 0.001). Scores declined between the immediate post-test and 12-month follow-up (mean decrease, 2.1 points; 95% CI, 1.2-3.0; p < 0.001). No statistically significant difference was detected between instructor groups (adjusted mean difference, 0.7 points; 95% CI, -0.1 to 1.5; p = 0.093). Caregivers from the private sector scored higher than those from the public sector (adjusted mean difference, 1.3 points; 95% CI, 0.5-2.1; p = 0.001).

CONCLUSIONS: Physician-supervised medical students may contribute to infant BLS education for caregivers when direct physician supervision and a standardized protocol are maintained. This exploratory finding supports feasibility under supervision, not equivalence. The decline in theoretical knowledge over 12 months highlights the need for planned reinforcement strategies.

PMID:42633318 | PMC:PMC13499414 | DOI:10.1016/j.resplu.2026.101436

Cancer Manag Res. 2026 Aug 18;18:601702. doi: 10.2147/CMAR.S601702. eCollection 2026.

ABSTRACT

BACKGROUND: Plasma cell-free DNA (cfDNA)-based chromosomal instability (CIN) profiling is a non-invasive approach for tumor burden monitoring and treatment response assessment. This pilot study included 50 cancer patients (breast, oral, gastric, lung, and other cancers) to evaluate the clinical utility of the Ultrasensitive Chromosome Aberration Detection (UCAD) method, with exploratory analysis of minimal residual disease (MRD) detection in patients with no evidence of disease on imaging.

METHODS: Fifty patients with histologically confirmed solid tumors who underwent UCAD testing between January 2023 and March 2024 were enrolled. UCAD uses low-depth (1×) whole-genome sequencing of plasma cfDNA to detect genome-wide copy number variations (CNVs). Tumor-derived CNVs are distinguished from germline variation through normalization against healthy donor controls, with statistically significant deviations identified as somatic events reflecting tumor-associated CIN. A tumor fraction index (TFx) is derived as a quantitative metric of the aggregate CNV burden. Patients were stratified by imaging status into no-evidence-of-disease (NED, n=41) and residual lesions (RL, n=9) subgroups. Outcomes included TFx correlation with clinical status and exploratory MRD-recurrence associations within the NED subgroup.

RESULTS: TFx values ranged from 0.021% to 10.12% (median 0.065%) across the cohort. TFx positively correlated with tumor stage (ρ=0.463, P<0.001) and negatively correlated with treatment response (P<0.01). Among 41 NED patients (median follow-up 22 months), elevated TFx (≥0.1%) was observed in patients with subsequent recurrence, including one case with TFx of 0.102% preceding bone metastasis by 3 months. In 9 RL patients, TFx tracked with disease burden and decreased following effective therapy.

CONCLUSION: The findings indicate that the UCAD method showed preliminary feasibility across the evaluated cancer types in this pilot cohort, and the TFx value serves as a quantitative indicator of tumor burden and treatment efficacy, warranting further prospective validation in larger cohorts.

PMID:42633289 | PMC:PMC13499547 | DOI:10.2147/CMAR.S601702

MedComm (2020). 2026 Aug 22;7(9):e70944. doi: 10.1002/mco2.70944. eCollection 2026 Sep.

ABSTRACT

Postoperative delirium (POD) and acute kidney injury (AKI) are serious complications in older patients undergoing surgery, yet predictive model development is often constrained by single-center data limitations and privacy concerns that preclude centralized data sharing. To address these challenges, we retrospectively evaluated a simulated federated learning (FL) framework using multicenter datasets partitioned by hospital source, without sharing raw patient data across centers. A total of 7,216 non-cardiac, non-neurosurgical patients aged 65 years or older were included across five centers, with four contributing training data and one serving as an external validation site. Using a multilayer perceptron architecture, we implemented three federated algorithms and benchmarked them against local learning models (LLMs) and centralized learning models (CLMs). For POD, federated learning models (FLMs) achieved internal area under the curve (AUC) values of 0.725-0.726 and external AUCs of 0.700-0.701. For AKI, internal AUCs reached 0.780 and external AUCs ranged from 0.740 to 0.741. FLM performance was statistically comparable to CLMs (p > 0.05). These findings support federated learning as a feasible privacy-preserving strategy that achieved discrimination comparable to centralized learning for multicenter prediction of postoperative complications in older patients.

PMID:42633270 | PMC:PMC13499364 | DOI:10.1002/mco2.70944

Neurotoxicology. 2026 Aug 22:103551. doi: 10.1016/j.neuro.2026.103551. Online ahead of print.

NO ABSTRACT

PMID:42632804 | DOI:10.1016/j.neuro.2026.103551