Tag: pubmed

J Health Popul Nutr. 2025 Apr 9;44(1):112. doi: 10.1186/s41043-025-00860-z.

ABSTRACT

BACKGROUND: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that increase the risk of cardiovascular diseases (CVD). Patients with inflammatory bowel disease (IBD) may be at higher risk of developing MetS due to chronic inflammation, altered adipokine profiles, and the effects of corticosteroid treatment. However, the prevalence of MetS in IBD patients remains inconsistent across studies. This meta-analysis aims to estimate the prevalence of MetS in IBD patients and compare its occurrence between Crohn’s disease (CD) and ulcerative colitis (UC).

METHODS: A systematic search was conducted across PubMed, Scopus, Embase, and Web of Science from their inception up to January 19, 2025. Eligible observational studies reporting MetS prevalence in IBD patients were included. Meta-analysis was performed using a random-effects model, with heterogeneity assessed via the I² statistic. Comprehensive Meta-Analysis (CMA) software, version 4.0 was used for analysis.

RESULTS: The pooled prevalence of MetS in IBD patients was 21.8% (95% CI: 14.3-31.6%). The prevalence was higher in UC patients (32.7%, 95% CI: 16.0-55.5%) compared to CD patients (14.1%, 95% CI: 8.6-22.3%). Patients with UC had significantly higher odds of MetS than those with CD (OR = 1.38, 95% CI: 1.03-1.85, P = 0.02). Additionally, IBD patients with MetS were significantly older than those without (MD: 9.89, 95% CI: 5.12-14.67, P < 0.01).

CONCLUSION: In summary, this meta-analysis reveals a notable prevalence of MetS among patients with IBD, particularly in those with UC, where the prevalence is higher than in CD. The analysis also shows that IBD patients with MetS tend to be older, suggesting age as a contributing factor. These findings underscore the need for routine metabolic screening in IBD care, especially in UC and elderly patients.

PMID:40205601 | DOI:10.1186/s41043-025-00860-z

J Eat Disord. 2025 Apr 9;13(1):63. doi: 10.1186/s40337-025-01246-6.

ABSTRACT

Eating disorders (EDs) are complex and heterogeneous conditions, which are often not resolved with conventional, manualised treatments. Arguments for the development of holistic, person-centred treatments accounting for individual variability have been mounting amongst researchers, clinicians and people with lived experience alike. This review explores the transformative potential of personalised medicine in ED care, emphasising the integration of precision diagnostics and tailored interventions based on individual genetic, biological, psychological and environmental profiles. Building on advancements in genomics, neurobiology, and computational technologies, it advocates for a shift from categorical diagnostic frameworks to symptom-based and dimensional approaches. The paper summarises emerging evidence supporting precision psychiatry, including the development of biomarkers, patient-reported outcomes, predictive modelling, and staging models, and discusses their application in ED research and clinical care. It highlights the utility of machine learning and idiographic statistical methods in optimising therapeutic outcomes and identifies key challenges, such as ethical considerations, scalability and implementation.

PMID:40205596 | DOI:10.1186/s40337-025-01246-6

BMC Med Educ. 2025 Apr 10;25(1):508. doi: 10.1186/s12909-025-07071-4.

ABSTRACT

BACKGROUND: The shortage of clinical placements and preceptors necessitates innovative approaches to healthcare education. Community health fairs (CHFs) offer a potential solution, but their effectiveness as learning environments is limited. Further, there is lack of recent literature exploring CHFs settings as potential learning environments. This study examined and explored the benefits and challenges of healthcare students and faculty participating in a CHF setting.

METHODS: Using a semi-structured guide developed by the researchers for this study, qualitative conversational interviews were conducted with 14 participants (7 students, 7 faculty) involved in an annual CHF. Prior to the interview, all participants completed a demographic data sheet. All interviews were audio-recorded, transcribed, checked for accuracy, and de-identified, and MAXQDA was used to manage and code the interviews. Two coders analyzed the transcripts, and a third coder served to confirm the qualitative findings, and Clarke and Braun thematic analysis was employed to develop themes. Descriptive statistics were used to describe the sample.

RESULTS: Seven faculty participated in this study; the age range was 34-64 and years in practice ranged from 7 to 23, four participants were advanced practice nurses (28.6%), two mental health providers (14.3%), and one dental provider (7.1%). The student participants consisted of five dental hygiene students (35.7%) and two nursing students (14.3%). Participants were predominantly female (92.9%), with one male participant (7.1%). The average interview lasted 8 min reflecting the dynamic and fast-paced nature of CHFs. Four major themes emerged from the interviews: (1) Skills development and practical experience, (2) Perspective enhancement, (3) Challenges within the Learning environment, and (4) Recommendations for enhancing health fair settings experiences.

CONCLUSIONS: CHFs can serve as valuable active learning environments that promote clinical skill development and broaden perspectives. To improve CHFs experiences, participants discussed increasing collaborations with other healthcare institutions within the state, making the examination rooms more realistic, and increasing privacy for the patients. Participants also recommended pre-training of healthcare volunteers and incorporating technology for teaching patients. More research is needed to evaluate the utility of CHFs as a learning environment. This is urgent since clinical settings are limited and saturated. Further, researchers should continue doing research in this environment since the literature is scant and dated.

PMID:40205592 | DOI:10.1186/s12909-025-07071-4

BMC Nurs. 2025 Apr 9;24(1):396. doi: 10.1186/s12912-025-02778-7.

ABSTRACT

BACKGROUND: Despite their own experience of mental health issues, informal caregivers of individuals with dementia are often overlooked, and there is a limited availability of community services tailored specifically for them. A self-help intervention, bibliotherapy, shows promise as an intervention to enhance the mental well-being of caregivers in resource-constrained settings, and social media has demonstrated its efficacy as a user-friendly platform for delivering health interventions. However, the efficacy of social media-based bibliotherapy remains untested.

AIM: This study aims to test the efficacy of social media-based bibliotherapy on improving the mental health of informal caregivers of people with dementia through a randomized controlled trial.

METHODS: A total of 60 informal caregivers were enrolled in this randomized controlled trial. Participants were randomly assigned to either the social media-based bibliotherapy group, which received eight weekly sessions of bibliotherapy, or the usual care group, which only received routine services from community centers. Outcomes were assessed at baseline and immediately after the intervention. Post-intervention interviews were conducted to explore participants’ experiences with this intervention. Descriptive statistics, t-tests, Mann-Whitney U tests, χ² tests, and generalized estimating equations were used for quantitative data analysis. Content analysis was employed for qualitative data analysis.

RESULTS: The average age of caregivers was 57.41 (SD, 13.63), with a majority being female (79.3%). Baseline characteristics were similar between groups. Both quantitative and qualitative data demonstrated that social media-based bibliotherapy was acceptable for informal caregivers, with WhatsApp being the preferred medium in this study. The recruitment rate, retention rate, and completion rate of weekly tasks all met satisfactory levels. Caregivers found the intervention useful and flexible while experiencing changes in their perceptions towards caregiving responsibilities. The efficacy on mental health (Wald χ² = 8.918, p =.003) and all the subscales of stress (Wald χ² = 4.198, p =.040), anxiety (Wald χ² = 7.667, p =.006), depression (Wald χ² = 9.127, p =.003) was statistically significant. The efficacy on caregiving appraisal was only significant on the perceived caregiving burden subscale (Wald χ² = 4.954, p =.026). However, caregivers expressed changes in caregiving appraisal in qualitative interviews. The efficacy on the mental component scale of health-related quality of life approached significance (Wald χ² = 3.634, p =.057). However, the efficacy on the positive psychological well-being remains insignificant.

CONCLUSIONS: To the best of our knowledge, this is the first attempt to use social media-based bibliotherapy among informal caregivers of individuals with dementia. The utilization of WhatsApp was well received among caregivers, and the positive effects on their mental health was demonstrated.

TRIAL REGISTRATION: The trial has been registered on ClinicalTrial.gov (Ref: NCT06327022).

PMID:40205579 | DOI:10.1186/s12912-025-02778-7

BMC Anesthesiol. 2025 Apr 9;25(1):160. doi: 10.1186/s12871-025-03037-7.

ABSTRACT

BACKGROUND: COVID-19 ranges from asymptomatic cases to severe disease with high mortality. Corticosteroids are crucial in treatment, reducing mortality and morbidity. However, the use of corticosteroids poses additional challenges in maintaining glycemic control in COVID-19 patients This study aims to eva-luate the impact of insulin requirement on mortality and morbidity in non-diabetic ICU patients and investigate its correlation with disease severity.

METHODS: This retrospective cohort study included non-diabetic COVID-19 patients aged ≥ 18 years admitted to the ICU of Prof. Dr. Cemil Taşcıoğlu City Hospital (Turkey) between September 1, 2020, and May 31, 2021. Patients requiring ≥ 24 h of insulin therapy were compared with those who did not need insulin. Data on demographics, severity scores (SOFA, APACHE II, SAPS II), insulin initiation and duration, corticosteroid therapy, mechanical ventilation, antiviral and immunomodulatory treatments, laboratory markers, and infection parameters were analyzed. Mortality and incidence of new-onset diabetes mellitus within the first six months post-discharge were assessed. Statistical analyses were performed using SPSS v22.0, with p < 0.05 considered statistically significant.

RESULTS: Patients with insulin requirements had higher SOFA (p = 0.001), APACHE II (p < 0.001), and SAPS II (p = 0.041) scores, along with increased mechanical ventilation duration (p < 0.001). While corticosteroid type had no effect, > 1 mg/kg/day methylprednisolone or equivalent dexamethasone significantly increased insulin demand (p = 0.002). Among laboratory markers, only peak CRP levels were significantly higher in insulin-requiring patients (p = 0.001). ICU and total hospital stays were significantly longer in the insulin group (p < 0.001). Although in-hospital mortality was similar, 6-month mortality was significantly higher in insulin-requiring patients (p = 0.022). New-onset DM rates were 4.2% in the non-insulin group vs. 31.1% in the insulin group (p = 0.001).

CONCLUSIONS: Insulin requirement in non-diabetic COVID-19 ICU patients is a predictor of 6-month mortality. High-dose corticosteroids exacerbate glycemic dysregulation, increasing insulin needs. SARS-CoV-2-induced beta-cell damage and hyperinflammation-related stress hyperglycemia elevate the risk of post-discharge DM. Close monitoring and diabetes screening are essential in this population.

PMID:40205573 | DOI:10.1186/s12871-025-03037-7

Parasit Vectors. 2025 Apr 9;18(1):136. doi: 10.1186/s13071-025-06777-0.

ABSTRACT

BACKGROUND: Canine vector-borne pathogens (CVBP) are transmitted by arthropod vectors such as ticks, fleas, mosquitoes, and phlebotomine sand flies and are of global veterinary and medical importance. Dogs are important reservoir hosts, which may develop potentially life-threatening clinical signs. The Balkan area harbors diverse vector fauna and associated CVBPs, and data, particularly from the Republic of Kosovo, are scarce. Considering the high number of stray and privately owned dogs primarily kept outside, living in close contact with dogs might promote spillover of zoonotic pathogens to human populations. To combat these diseases, a One Health approach is required. Therefore, our study molecularly analyzed samples of dogs for CVBP.

METHODS: Blood samples of 276 dogs originating from all seven districts of Kosovo collected from 2021 to 2022 were screened using polymerase chain reaction (PCR) and sequencing for a substantial set of pathogens, including Anaplasma spp., Babesia spp., Bartonella spp., Ehrlichia spp., Filarioidea, Hepatozoon spp., Mycoplasma spp., Rickettsia spp., and Trypanosoma spp. Prevalence rates were statistically assessed on the basis of various factors such as sex, breed, age, and district.

RESULTS: In total, 150 (54.3%) dogs tested positive for at least one pathogen, comprising eight species of five genera. The most prevalent pathogens detected were Candidatus Mycoplasma haematoparvum (55; 19.9%), Hepatozoon canis (52; 18.8%), and Mycoplasma haemocanis (49; 17.8%). We also detected double (32; 11.6%) and triple (5; 1.8%) infections, with the latter involving combinations of Mycoplasma spp., Dirofilaria repens, Dirofilaria immitis, H. canis, or Babesia vulpes. In addition, prevalence rates were calculated and mapped by district. Of all included factors, significant prevalence differences were found for purebred/mixed breed dogs as well as between age groups.

CONCLUSIONS: This study provides the first comprehensive polymerase chain reaction (PCR)-based screening and detection of vector-borne pathogens in dogs from Kosovo and highlights the circulation of pathogens with high veterinary importance and zoonotic potential.

PMID:40205569 | DOI:10.1186/s13071-025-06777-0

J Health Popul Nutr. 2025 Apr 9;44(1):111. doi: 10.1186/s41043-025-00771-z.

ABSTRACT

OBJECTIVE: To investigate the clinical efficacy of the combined regimen of four drugs (drospirenone and ethinylestradiol tablets (II), mifepristone, misoprostol, and Xinshenghua granules) for the treatment of incomplete medical abortion (MA).

METHODS: 184 patients diagnosed with incomplete MA were recruited and divided into two groups: the combined medication group (n = 92) and the uterine curettage group (n = 92). Patients in the combined medication group were treated with a combined regimen of four drugs, while those in the uterine curettage group were treated with uterine curettage.

RESULTS: After treatment, the diameter of residue (0.00 VS 4.26 ± 2.34 mm, t=-3.359, P = 0.010), days of vaginal bleeding (9.79 ± 1.76 VS 11.92 ± 1.91 days, t=-4.688, P = 0.010) and return time of menses (28.58 ± 2.67 VS 31.24 ± 2.43 days, t=-4.238, P < 0.001) of the combined medication group were significantly lower than those of the uterine curettage group. The duration of menstruation (6.12 ± 1.12 VS 5.11 ± 0.98 days, t=-2.681, P = 0.007) and the proportion of menstrual volume equal to past menstruation after return of menses were higher in the combined medication group than in the uterine curettage group (80.43% VS 57.61%, χ² = 16.472, P < 0.001). No statistically significant difference was observed between the two groups in terms of serum β-HCG levels after treatment (P > 0.05); the overall response rate was higher in the combined medication group than in the uterine curettage group (97.83% VS 80.43%, χ² = 54.331, P < 0.001). No adverse reaction events occurred during the treatment.

CONCLUSION: The combined regimen of four drugs boasts favorable efficacy for the treatment of incomplete MA, and is equally efficient as compared to uterine curettage.

PMID:40205568 | DOI:10.1186/s41043-025-00771-z

Lipids Health Dis. 2025 Apr 9;24(1):134. doi: 10.1186/s12944-025-02550-5.

ABSTRACT

BACKGROUND: The association between remnant cholesterol (RC) with obesity phenotypes remains unclear.

METHODS: This study designed to evaluate the association between RC and obesity phenotypes using data from the National Health and Nutrition Examination Survey (NHANES). The classification systems for obesity phenotypes encompassed both preclinical/clinical obesity and obesity stages, which were assessed based on two authoritative obesity guidelines: the 2025 clinical obesity guideline, and the 2016 obesity guideline established by the American Association of Clinical Endocrinologists and the American College of Endocrinology (AACE/ACE). Participants were selected according to the diagnostic criteria for obesity proposed in the 2025 clinical obesity guideline and were categorized into tertiles based on their RC levels. Their obesity phenotypes, obesity-related clinical manifestations, obesity-related comorbidities, and characteristics were then described. Logistic regression analyses and restricted cubic spline (RCS) models were used to analyze the relationship between RC and adverse obesity phenotypes. Sensitivity analyses were conducted in patients not receiving lipid-lowering drugs.

RESULTS: This study comprised 3,207 adult participants, revealing distinct prevalence patterns: 47.80% exhibited preclinical obesity and 17.81% showed clinical obesity, while obesity stage stratification demonstrated 0%, 12.76%, and 21.63% prevalence for stage 0, 1, and 2, respectively. Multivariable regression analyses demonstrated dose-response relationship between RC levels and adverse obesity phenotypes, with individuals in the highest RC tertile showing significantly elevated risks of clinical obesity (OR 1.95, 95% CI 1.19-3.19) and obesity stage progression (OR 1.96, 95% CI 1.06-3.62) compared to the lowest tertile reference group. RCS analyses further revealed similar “J”-shaped association between RC levels and adverse obesity phenotypes (P for nonlinearity < 0.001), sharing a common inflection point at 0.51 mmol/L. The sensitivity analyses confirmed the consistency of the results among patients who were not receiving lipid-lowering therapy.

CONCLUSIONS: RC was found to be positively and independently associated with adverse obesity phenotypes, particularly when RC levels exceeded 0.51 mmol/L, demonstrating a similar “J”-shaped association. It is recommended that clinicians monitor RC levels for obese patients as a primary screening indicator for adverse phenotypes of obesity.

PMID:40205563 | DOI:10.1186/s12944-025-02550-5

BMC Endocr Disord. 2025 Apr 9;25(1):96. doi: 10.1186/s12902-025-01922-3.

ABSTRACT

OBJECTIVES: The aim of the study was to determine the correlation between insulin resistance (IR) indexes in children with overweight or obesity.

METHODS: A total of 276 children with overweight or obesity and 100 normal-weight children were enrolled in the study. IR indexes such as homeostasis model assessment insulin resistance (HOMA-IR), quantitative insulin-sensitivity check index (QUICKI), fasting glucose/insulin ratio (FGIR), Triglyceride glucose index (TyG), and lipid-derived ratios were determined.

RESULTS: The mean ages were 13.0 ± 2.6, 13.1 ± 2.7 and 12.72 ± 2.23 (range:6 – 18 years) for children with overweight, obesity and normal-weight, respectively. A statistically significant positive correlation was found between HOMA-IR and TyG index, and a negative correlation between QUICKI, FGIR and TyG index (r = 0.193, P < 0.001; r = – 0.456, P < 0.001 and r = – 0.392, P < 0.001, respevtively). TyG index, triglyceride (TG)/high-density lipoprotein (HDL), total cholesterol (TC)/HDL, and low-density lipoprotein (LDL)/HDL were higher in children with IR than those without IR (P < 0.05). In receiver operating characteristic curves analysis, cut-off points were found to be ≤ 0.31 for QUICKI (94.31% sensitivity and 97.58% specificity), ≤ 6.3 for FGIR (89.1% sensitivity and 93.94% specificity), and > 4.62 for TyG (49.29% sensitivity and 84.85% specificity).

CONCLUSION: HOMA-IR, FGIR, and QUICKI constitute stronger predictors of IR than TyG index in children with overweight and obesity.

PMID:40205558 | DOI:10.1186/s12902-025-01922-3

J Orthop Surg Res. 2025 Apr 9;20(1):352. doi: 10.1186/s13018-025-05779-z.

ABSTRACT

OBJECTIVE: To explore the clinical efficacy and advantages of Arthroscopic-assisted Uni-portal Spinal Surgery (AUSS)-Transforaminal Lumbar Interbody Fusion (TLIF) in the treatment of degenerative lumbar spinal stenosis (LSS).

METHODS: This study included 71 patients with lumbar spinal stenosis who underwent surgical treatment at the Department of Spine Surgery, Second Affiliated Hospital of Xi’an Medical University, between January 2022 and December 2023. Among these, 34 patients underwent AUSS-TLIF surgery, and 37 patients underwent minimally invasive TLIF (MIS-TLIF) surgery. Preoperative and postoperative Visual Analog Scale (VAS) scores for low back and leg pain, Oswestry Disability Index (ODI) scores, intervertebral disc height, anterior-posterior diameter of the canal (APDC), surgical-related parameters (such as operative time, intraoperative blood loss, postoperative drainage, postoperative C-reactive protein levels, and length of hospital stay), and surgical outcomes were compared and analyzed between the AUSS-TLIF and MIS-TLIF groups.

RESULTS: All 71 patients were followed up. There were no significant differences in preoperative VAS scores or ODI index between the AUSS-TLIF and MIS-TLIF groups (P > 0.05). Three days postoperatively, both groups showed significant reductions in back and leg symptoms, with VAS scores significantly lower than preoperatively (P < 0.05). However, the AUSS-TLIF group had lower VAS scores at 3 days and 3 months postoperatively compared to the MIS-TLIF group, with a statistically significant difference (P < 0.05). At 12 months postoperatively, there was no significant difference in VAS scores between the two groups (P > 0.05). Both groups showed significant improvement in lumbar function at 3 and 12 months postoperatively, with ODI scores significantly lower than preoperatively (P < 0.05). However, the AUSS-TLIF group had a significantly lower ODI score at 3 months postoperatively compared to the MIS-TLIF group (P < 0.05), with no significant difference at 12 months (P > 0.05). There were no significant differences in preoperative intervertebral disc height or APDC between the two groups (P > 0.05). CT scans at 12 months postoperatively showed a significant increase in intervertebral disc height and APDC in both groups compared to preoperative values (P < 0.05), with no significant difference between the groups (P > 0.05). The AUSS-TLIF group had lower surgical blood loss, postoperative drainage, and postoperative inflammatory markers compared to the MIS-TLIF group (P < 0.05), but the AUSS-TLIF group had a significantly longer operative time compared to the MIS-TLIF group (P < 0.05).

CONCLUSION: Both AUSS-TLIF and MIS-TLIF achieve good clinical outcomes, but AUSS-TLIF, as an endoscopic surgery with an open surgical concept, offers advantages including greater flexibility, smaller trauma, less blood loss, shorter operative time, and shorter hospital stay. It provides a better perioperative experience for patients.

PMID:40205552 | DOI:10.1186/s13018-025-05779-z