Tag: pubmed

Front Pharmacol. 2026 Mar 23;17:1792080. doi: 10.3389/fphar.2026.1792080. eCollection 2026.

ABSTRACT

INTRODUCTION: The Home Medication Review (HMR) is a structured, patient-centred service provided by pharmacists to facilitate the optimisation of medication therapy, mitigate drug-related issues, and improve health outcomes. Despite the global adoption of HMR, there is a lack of standardisation. To overcome this gap, a detailed HMR checklist was developed to ensure that all key elements of an HMR visit are covered. The aim was to develop and validate a comprehensive checklist to standardise the delivery of HMR and facilitate its widespread implementation in the Indian healthcare system, which can also be adopted internationally with regional modifications.

METHODS: A detailed literature review was conducted to develop a preliminary checklist framework, which was subsequently refined through input from a seven-member advisory board. Content Validity Index (CVI) and modified kappa statistics (k*) were used to evaluate content validity by eleven experts. The checklist was tested for its usability in the home care environment through pharmacist-conducted reviews of medications in a feasibility study involving 20 participants.

RESULTS: The 12-domain, final 65-item HMR Checklist demonstrated high levels of content validity, with an average Cronbach’s alpha (Ave-CVI) of 0.97, indicating high relevance and simplicity. In the case of Universal Agreement-CVI, the values were 0.78 and 0.75. The level of pharmacist compliance during the feasibility tests showed a high level of adherence (93.5% total compliance), with key areas demonstrating adherence at every visit. Further examination of the I-CVI and k* values was very high in all domains, demonstrating good item-level validity. Overall, the feasibility data demonstrated high patient acceptance and easy integration into the workflow.

CONCLUSION: Overall, content validity indices and content validation processes are considered crucial factors in the development of an instrument. The study demonstrates that the HMR Checklist is a reliable, holistic, and practical instrument that can be used to standardise and implement home medication reviews, led by clinical pharmacists. It has a strong potential to enhance medication safety and provides a solid foundation for future large-scale evaluations globally.

PMID:41948732 | PMC:PMC13050876 | DOI:10.3389/fphar.2026.1792080

Front Pharmacol. 2026 Mar 23;17:1670012. doi: 10.3389/fphar.2026.1670012. eCollection 2026.

ABSTRACT

OBJECTIVE: Apatinib combined with S-1 and oxaliplatin (SOX) synergistically improves the prognosis of advanced gastric cancer patients, but its application as an adjuvant regimen has rarely been reported. This study aimed to investigate the efficacy and safety of adjuvant low-dose apatinib combined with SOX versus SOX alone in patients with resectable locally advanced gastric cancer.

METHODS: This cohort study included 110 patients with locally advanced gastric cancer (pTNM stage III) who underwent radical surgery. Among these patients, 70 patients received adjuvant low-dose apatinib (250 mg/day) combined with SOX regimen (named apatinib + SOX group), and 40 patients received adjuvant SOX regimen alone (named SOX group). Disease-free survival (DFS) and adverse events were recorded.

RESULTS: DFS was longer in apatinib + SOX group versus SOX group (P = 0.004). Specifically, the median DFS was not reached, and the 1-year/2-year cumulating DFS rates reached 75.7%/61.4% in apatinib + SOX group, whereas the median DFS was 15.0 (95% confidence interval: 10.0-20.0) months, and the 1-year/2-year accumulating DFS rates were 57.5%/35.0% in SOX group. After adjustment by multivariate Cox regression, apatinib + SOX (versus SOX) was independently related to prolonged DFS (hazard ratio = 0.316, P < 0.001). Moreover, hypertension showed a higher tendency in apatinib + SOX group compared to SOX group (22.9% versus 10.0%, P = 0.093), but did not reach statistical significance. However, incidences of other adverse events were not different between the two groups including: nausea and vomiting (P = 1.000), fatigue (P = 0.709), leukopenia (P = 0.103), pain (P = 0.564), thrombocytopenia (P = 0.113), anorexia (P = 0.564), and anemia (P = 0.686).

CONCLUSION: Low-dose apatinib combined with SOX may be a feasible adjuvant regimen in patients with resectable locally advanced gastric cancer.

PMID:41948723 | PMC:PMC13051217 | DOI:10.3389/fphar.2026.1670012

Front Pharmacol. 2026 Mar 23;17:1789772. doi: 10.3389/fphar.2026.1789772. eCollection 2026.

ABSTRACT

OBJECTIVE: Pomiferin, a prenylated isoflavonoid from Maclura pomifera, shows anticancer and antioxidant potential. However, data vary across cell lines and models. This meta-analysis aims to quantify its IC ₅₀ in different cancer types and systematically synthesise its effects on oxidative stress biomarkers, thereby establishing a quantitative synthesis for its therapeutic profile.

METHODS: A systematic search in PubMed, Scopus, and Web of Science was conducted following PRISMA guidelines. A “mean-only” approach was used to manage within-study dependency and inconsistent variance reporting. Data were analysed with multilevel random-effects models and Cluster-Robust Variance Estimation (CR2).

RESULTS: The pooled geometric mean IC ₅₀ for Pomiferin was 12.6 μM (logIC ₅₀ = 2.53). Meta-regression showed that efficacy varied by tumour type, with Glioma/neurological models having higher IC ₅₀ values (lower efficacy) than others (p = 0.012). Pomiferin increased Catalase activity (p = 0.044) and protein levels (p = 0.033). No statistically significant difference in efficacy was detected between in vitro and in vivo models (p = 0.190); however, current data limitations preclude establishing definitive biological equivalence.

CONCLUSION: This meta-analysis demonstrates that Pomiferin is a context-dependent agent that modulates enzymatic defences, such as CAT, confirming its potential as a therapeutic candidate. It highlights the efficacy limits in resistant types, such as Glioma, and provides a quantitative basis for future research. This study consolidates diverse findings into a robust evidence base, serving as the first comprehensive meta-analysis of Pomiferin’s biological activity and guiding future studies.

PMID:41948722 | PMC:PMC13050899 | DOI:10.3389/fphar.2026.1789772

J Kidney Cancer VHL. 2026 Apr 1;13(1):27-32. doi: 10.15586/jkc.v13i1.421. eCollection 2026.

ABSTRACT

To evaluate whether the length of positive surgical margin carries a risk for recurrence, data of patients that underwent partial nephrectomy (PN) from six centers were evaluated. Fifty-three patints with positive surgical margins (PSMs) (the PSM group) and 438 patients with negative surgical margin (the NSM group) were included in the present study. Pathologic reevaluations were performed, and surgical margins were measured in micrometers. The number of positive margin areas, and the length of the maximum and total positive margins were evaluated. Data were analyzed using SPSS 27 package program. A p-value less than 0.001 was considered statistically significant. Local recurrence occured in 16.98% of patients in the PSM group and 4.24% of patients in the NSM group. (p<0.001). Patients with PSM were at fourfold increased risk for recurrence. Age, gender, tumor location, tumor side and size, and fuhrman grade were not associated with local recurrence of the tumor (p>0.01). However, positive surgical margin was an important risk factor for local recurrence (p<0.01). No relationship was found between positive margin length and local recurrence (p=0.044). Logistic regression analysis did not identify any parameters associated with local recurrence. The presence of a PSM was significantly associated with an increased risk of local recurrence following PN. The number of positive margin foci and total or maximum length of margin involvement were not associated with recurrence. These findings suggest that it is the presence of PSM, rather than its extent, that may be the primary factor influencing oncological risk.

PMID:41948714 | PMC:PMC13051508 | DOI:10.15586/jkc.v13i1.421

Laryngoscope Investig Otolaryngol. 2026 Apr 4;11(2):e70391. doi: 10.1002/lio2.70391. eCollection 2026 Apr.

ABSTRACT

OBJECTIVE: To compare the association of vertigo with rates of frequency-specific hearing recovery in pediatric and adult patients with unilateral idiopathic sudden sensorineural hearing loss (SSNHL).

METHODS: A total of 80 pediatric and 444 adult patients hospitalized with SSNHL were included in this study. Clinical and audiological data were collected, and frequency-specific hearing recovery percentages before and after treatment were compared between pediatric and adult SSNHL patients with and without vertigo.

RESULTS: In pediatric SSNHL patients with vertigo, the median recovery rates at 250-500 Hz, 1000-2000 Hz, and 4000-8000 Hz were 62.5%, 28.2%, and 21.1%, respectively, whereas those without vertigo showed higher median recovery rates of 90.3%, 82.1%, and 56.5%. Similarly, adult SSNHL patients with vertigo exhibited median recovery rates of 53.2%, 33.7%, and 24.6% across the same frequency ranges, compared to 88.9%, 76.6%, and 53.3% in adults without vertigo. In both pediatric and adult cohorts, hearing recovery decreased progressively with increasing frequency. Patients with vertigo exhibited consistently lower recovery across all frequency bands compared to those without vertigo. However, no statistically significant differences in frequency-specific recovery were observed between pediatric and adult SSNHL cohorts.

CONCLUSION: The incidence of vertigo increases with the severity of hearing loss in SSNHL ranging from moderately severe to total deafness. Vertigo is a prognostic factor associated with poorer hearing recovery across all frequencies, underscoring its importance as a critical clinical indicator in the management of SSNHL.

LEVEL OF EVIDENCE: 3.

PMID:41948712 | PMC:PMC13051907 | DOI:10.1002/lio2.70391

Int J Womens Health. 2026 Apr 2;18:585507. doi: 10.2147/IJWH.S585507. eCollection 2026.

ABSTRACT

BACKGROUND: Approximately two million women globally currently live with untreated obstetric fistula, predominantly in sub-Saharan Africa and South Asia, with Nigeria accounting for 40% of cases. Despite the recognition of multiple healthcare barriers, the causal mechanisms through which these barriers affect treatment-seeking behavior remain poorly understood. We conducted a causal mediation analysis to examine potential pathways in the fistula treatment cascade.

METHODS: We analyzed data from 5,496 women who reported fistula symptoms in the 2024 Nigeria Demographic and Health Survey. Using the counterfactual framework for causal mediation, we decomposed the relationship between fistula knowledge (exposure) and treatment-seeking (outcome) into direct and indirect effects operating through three mediator domains: financial, geographic access, and autonomy barriers. We estimated natural direct and indirect effects using Baron and Kenny regression with product-of-coefficients method, inverse probability weighting, and doubly robust estimation. Bootstrap confidence intervals (1,000 replications) and E-value sensitivity analyses were used to assess the robustness of sampling variability and unmeasured confounding.

RESULTS: Among women with fistula, 65.0% sought treatment, 3.3% received surgical repair, and 6.9% achieved resolution leaving 93.1% with unresolved fistula. The largest cascade gap (61.7%) occurred between treatment-seeking and surgery receipt. Geographic access barriers significantly reduced treatment-seeking (OR=0.73; 95% CI: 0.59-0.88; p=0.002), emerged as the only significant mediating pathway (indirect effect β=-0.19; 95% CI: -0.33 to -0.07). Financial barriers (OR=1.11; 95% CI: 0.95-1.31) and autonomy barriers (OR=0.99; 95% CI: 0.84-1.18) were not independently associated with treatment-seeking in adjusted models. The E-value for geographic access barriers was 2.08, indicating moderate robustness to unmeasured confounding.

CONCLUSION: Geographic access barriers emerged as the dominant pathway associated with reduced treatment engagement, findings consistent with these barriers suggesting a critical pathway under stated causal assumptions. Although knowledge was not directly associated with treatment-seeking, mediation models suggested that geographic access barriers were the only pathway consistently linked to care engagement. Financial and autonomy-related barriers were not statistically significant mediators in this analysis, though this may reflect measurement limitations or operation at different cascade stages rather than true irrelevance. The primary cascade bottleneck is surgical access rather than treatment-seeking, suggesting health system capacity constraints. These findings align with a causal interpretation under the stated identification assumptions of the counterfactual framework, though temporal ordering cannot be definitively established from cross-sectional data. Interventions should prioritize mobile surgical outreach, transportation vouchers, and decentralizing fistula repair services.

PMID:41948705 | PMC:PMC13052275 | DOI:10.2147/IJWH.S585507

OTO Open. 2026 Apr 6;10(2):e70222. doi: 10.1002/oto2.70222. eCollection 2026 Apr-Jun.

ABSTRACT

OBJECTIVE: To evaluate the impact of limited English proficiency (LEP) on the presentation, diagnosis, and management of vestibular schwannoma (VS).

STUDY DESIGN: Retrospective matched cohort study.

SETTING: Single tertiary academic center.

METHODS: A retrospective review of patients diagnosed with VS at a tertiary academic center from 2018 to 2023 identified 29 LEP and 1350 non-LEP patients. LEP patients were matched 1:1 to non-LEP patients using propensity scores based on age, sex, insurance, and zip code-based income. Clinical variables included audiometric data, tumor characteristics, time to diagnosis and treatment, and management outcomes.

RESULTS: No significant differences were found in presenting symptoms, tumor characteristics, or treatment recommendations. LEP patients were significantly less likely to undergo word recognition testing (41% vs 97%, P < .001). Among those tested, bilingual LEP patients performed worse than non-LEP counterparts in word recognition testing (44.5% vs 61.9%, P = .1). LEP patients trended toward larger tumor volumes at diagnosis (6072.5 mm³ vs 2114 mm³, P = .059) and longer delays from symptom onset to diagnosis (4949 vs 2609 days), even after outlier removal. LEP patients also had higher loss to follow-up rates (34% vs 14%, P = .123).

CONCLUSION: Though not statistically significant, several trends suggest LEP patients may face potential barriers to timely diagnosis and follow-up for VS. The relative underrepresentation of LEP patients may also reflect underlying disparities. These findings underscore the need for targeted efforts to improve access and outcomes for LEP patients in neurotologic care.

PMID:41948694 | PMC:PMC13052497 | DOI:10.1002/oto2.70222

World J Otorhinolaryngol Head Neck Surg. 2025 Aug 18;12(2):159-167. doi: 10.1002/wjo2.70042. eCollection 2026 Apr.

ABSTRACT

OBJECTIVE: To investigate the influence of hearing loss on the efficacy of personalized and customized music therapy in patients with chronic tinnitus.

METHODS: A total of 147 patients with chronic tinnitus were included in the research; according to the pure-tone average (PTA) test results (PTA at 0.5, 1.0, 2.0, and 4.0 kHz), the patients were classified into three groups: PTA ≤ 25 dB (normal hearing), 25 < PTA ≤ 60 dB (mild to moderate hearing loss), and PTA > 60 dB (severe hearing loss); all patients have received personalized and customized music therapy for 3 months. Electronic questionnaires of Hospital Anxiety and Depression Scale (HADS-A, HADS-D), Tinnitus Handicap Inventory (THI), Insomnia Severity Index Scale (ISI), and Visual Analog Scale (VAS) in the complete follow-up system were used to evaluate the therapeutic effects on the efficacy of music therapy.

RESULTS: The results showed that HADS-A, HADS-D, THI, ISI, and VAS scores after 3 months of therapy were lower than those before treatment in the PTA ≤ 25 dB group (p < 0.001). While HADS-A, THI, ISI, and VAS scores were decreased after 3 months of therapy in the 25 < PTA ≤ 60 dB group (p < 0.001). However, there was no statistically significant difference in HADS-A, HADS-D, THI, ISI, and VAS scores between before and after therapy within 3 months in the PTA > 60 dB group (p > 0.05). Besides, the more severe the hearing loss, the less improvement in tinnitus-related symptoms after music therapy for 3 months.

CONCLUSIONS: Personalized and customized music therapy is effective for chronic tinnitus patients with normal hearing or mild to moderate hearing loss. Hearing loss levels exerted an impact on the efficacy of personalized music therapy; the efficacy of patients with severe hearing loss is worse than that of patients with normal hearing or mild to moderate hearing loss. Appropriate hearing remedial therapy is essential to improve the efficacy of personalized, customized music therapy before receiving music therapy.

PMID:41948685 | PMC:PMC13052217 | DOI:10.1002/wjo2.70042

World J Otorhinolaryngol Head Neck Surg. 2025 Jul 2;12(2):218-227. doi: 10.1002/wjo2.70032. eCollection 2026 Apr.

ABSTRACT

OBJECTIVES: To determine the effect of COVID-19 on voice by evaluating acoustic, aerodynamic, auditory-perceptual, and patient-reported measurements for COVID-19 patients compared to controls.

DATA SOURCES: A systematic review was conducted using PubMed and Embase.

REVIEW METHODS: Studies were reviewed for acoustic, aerodynamic, auditory-perceptual, and patient-reported outcomes.

RESULTS: Seven studies met criteria. There were 790 patients diagnosed with COVID-19 and 484 controls. Acoustic measurements revealed that COVID-19 patients had an increased harmonic-to-noise ratio (HNR) (27.14 vs. 41.37 dB), and increased fundamental frequency (177.66 vs. 172.81 Hz), jitter (0.73 vs. 0.31), and shimmer (4.43 vs. 3.42). Auditory-perceptual measurements indicated that COVID-19 patients had an increased Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) score (11.46 vs. 2.15). COVID-19 patients also had an increased Voice Handicap Index (VHI-10) score (4.89 vs. 1.59). Finally, COVID-19 patients had a statistically significant decrease in maximum phonation time compared to controls (9.94 s vs. 16.32 s, p = 0.01).

CONCLUSIONS: Although maximum phonation time was the only statistically significant measurement, other measurements were worse for COVID-19 patients. The current research suggests negative effects of COVID-19 on the voice; however, this is the first systematic review to summarize its effects with measurable outcomes. More studies with vocal measurements taken at different time points following infection are needed to understand the full long-term effect of COVID-19 on the voice. Additionally, studies evaluating voice quality for mild cases of COVID-19 with comparison to healthy controls are needed to understand its prevalence and effect as the severity of COVID-19 decreases.

PMID:41948684 | PMC:PMC13051893 | DOI:10.1002/wjo2.70032

Health Sci Rep. 2026 Apr 2;9(4):e72268. doi: 10.1002/hsr2.72268. eCollection 2026 Apr.

ABSTRACT

BACKGROUND AND AIMS: Computer vision syndrome (CVS) is a recognised health concern characterized by eye and vision-related symptoms resulting from prolonged use of digital devices. Approximately 60 million people worldwide are affected by CVS, with almost one million new cases reported annually.

METHODS: This cross-sectional study was conducted from September 1 to October 15, 2024, among medical students. A paper questionnaire was distributed to students across all academic years at both public and private universities in Syria. The data were analyzed using descriptive statistics, with categorical variables shown as frequencies and percentages. A Chi-square test was used to explore the association between CVS incidence among medical students in Syrian universities and other relevant factors.

RESULTS: The study included 2,636 medical students from Syrian universities, with a majority (74.54%) enrolled in public institutions. The prevalence of CVS among these students was 47%. The most used electronic devices were smartphones (96%), followed by laptops (32%). The primary reasons for computer use included social media (90%), studying (83%), and watching movies (44%). The most frequently employed preventive measure was taking breaks during usage (60%), while adherence to the 20-20-20 rule was minimal (7%).

CONCLUSION: The prevalence of CVS among medical students is 47%, with 90% of the sample using digital devices for social media and 83% for studying. A significant association exists between the occurrence of CVS and factors such as gender, daily computer usage time, the distance from the screen, sitting posture, and whether the individual wears corrective lenses or glasses. This study underscores the need to educate computer and smartphone users about proper ergonomics, posture, and eye exercises.

PMID:41948655 | PMC:PMC13051820 | DOI:10.1002/hsr2.72268