Tag: pubmed

Indian J Orthop. 2025 Jun 29;59(9):1462-1468. doi: 10.1007/s43465-025-01464-9. eCollection 2025 Sep.

ABSTRACT

INTRODUCTION: Conventionally, radiographs have been used to assess the severity of knee osteoarthritis (OA), but they fail to measure soft tissue changes responsible for generating symptoms. In recent literature, there is discordance between clinical symptoms and X-ray findings in knee OA. Therefore, we used MRI in our study to assess the correlation between patient-reported outcome measures as assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and MRI findings as assessed by the Whole-Organ Magnetic Resonance Imaging Score (WORMS) score in knee OA. The study was done after approval from The Institutional Human Ethics Committee.

METHODS: The sample size was calculated as 34. Eight women and 26 men who fulfilled the inclusion and exclusion criteria were included in the study. The knee with a higher Kellgren and Lawrence (KL) grade underwent MRI. The WOMAC score was used to assess pain, morning stiffness and physical function and the MRI findings were evaluated using the WORMS score. Spearman’s rank correlation coefficient was used for correlation analysis.

RESULTS: The mean age was 53.5 ± 8.08 years, BMI 29.35 ± 4.51 kg/m², disease duration 2.57 ± 1.91 years, VAS score 5.08 ± 1.50, total WOMAC score 41.50 ± 10.80, and total WORMS score 64.78 ± 26.49. Statistical analysis revealed a positive correlation between WOMAC score and WORMS score (Spearman’s rho value-0.645, p-value- < 0.05, Confidence Interval- 95%), and between WORMS score and KL grade (Spearman’s rho value-0.637, p-value- < 0.05, Confidence Interval- 95%). There was no correlation between the WOMAC score and KL grade, highlighting the limitation of radiographs in reflecting symptom severity.

CONCLUSION: Conventional radiography is a good screening tool for knee osteoarthritis but cannot detect structural changes causing symptoms, leading to symptom-radiograph discordance. MRI better identifies these changes, as our study shows, and is useful when symptoms and radiographs misalign or conservative treatment fails. Future research should identify WORMS subgroups that better correlate with symptoms for improved diagnosis and management.

PMID:41054741 | PMC:PMC12496301 | DOI:10.1007/s43465-025-01464-9

F S Rep. 2025 Jun 28;6(3):299-308. doi: 10.1016/j.xfre.2025.06.009. eCollection 2025 Sep.

ABSTRACT

OBJECTIVE: To investigate clinical characteristics and in vitro fertilization (IVF) outcomes in patients after radical abdominal trachelectomy (RAT) for early-stage cervical cancer.

DESIGN: A retrospective cohort study of patients who underwent IVF after RAT between January 2009 and December 2022, with comparison to age-matched controls.

SUBJECTS: Forty-one patients who underwent RAT for early-stage cervical cancer and subsequently sought IVF, compared with 82 age-matched controls.

EXPOSURE: Radical abdominal trachelectomy as a fertility-sparing surgery for early-stage cervical cancer, followed by IVF.

MAIN OUTCOME MEASURES: Embryological outcomes, clinical pregnancy rates, live birth rates, and factors influencing IVF success, including age at first oocyte retrieval, ovarian response parameters, number of oocytes retrieved, presence of cervical stenosis, and endometrial thickness at embryo transfer (ET) were compared between the RAT and control groups.

RESULTS: The RAT group had similar anti-mullerian hormone levels and embryological outcomes compared with controls. In the RAT group, clinical pregnancy and live birth rates were 68.3% (28/41) and 58.5% (24/41) per patient and 20.8% (37/178) and 15.7% (28/178) per ET, respectively. These rates were comparable to those in the control group, which were 62.2% (51/82) and 50.0% (41/82) per patient and 25.4% (80/314) and 16.6% (52/314) per ET, respectively. In the RAT group, live birth outcomes were associated with younger age at first oocyte retrieval, higher number of oocytes retrieved, fewer cases of cervical stenosis, and greater endometrial thickness at ET. An endometrial thickness of 9.2 mm was identified as the optimal statistical boundary for predicting both clinical pregnancy and live birth.

CONCLUSION: The live birth rate in the RAT group was comparable to that in the age-matched control group, indicating that RAT does not negatively impact assisted reproductive technologies outcomes. Age at first oocyte retrieval, number of oocytes retrieved, presence of cervical stenosis, and endometrial thickness at ET may influence IVF outcomes after RAT.

PMID:41054736 | PMC:PMC12496419 | DOI:10.1016/j.xfre.2025.06.009

F S Rep. 2025 Jul 1;6(3):328-334. doi: 10.1016/j.xfre.2025.06.011. eCollection 2025 Sep.

ABSTRACT

OBJECTIVE: To compare the outcomes of oocyte cryopreservation in transgender patients with and without prior testosterone use.

DESIGN: Retrospective cohort study.

SUBJECTS: Transmasculine/non-binary patients assigned female at birth who were referred for fertility preservation from January 2012 to March 2024 at a multicenter health maintenance organization.

EXPOSURE: Gender-affirming hormone therapy with testosterone.

MAIN OUTCOME MEASURES: The primary outcome measure was the number of mature oocytes collected. Secondary outcomes included the total number of oocytes, percentage of mature to total oocytes, total dose of gonadotropins used, baseline antimüllerian hormone, baseline antral follicle count, and baseline endometrial thickness.

RESULTS: Data from 50 transgender oocyte cryopreservation cycles were analyzed in the time period studied. A total of 34 subjects (68%) had no exposure to testosterone, whereas prior testosterone use was reported in 16 subjects (32%). The mean duration of testosterone was 4.1 ± 2.6 years. Testosterone was discontinued 3 weeks to 3 months before cycle start. There were no significant differences in baseline demographics, such as age and body mass index, between the two patient groups. The total number of oocytes retrieved was statistically the same between transgender patients with prior testosterone use (17.3 ± 10.1) and those without (21.3 ± 10.1). Additionally, there were no differences in the number of mature oocytes (12.0 ± 7.5 vs. 16.1 ± 9.1) or ratio of mature/total oocytes between the two groups (72.3% ± 18.3% vs. 70.9% ± 22.4%). Secondary outcomes such as baseline antral follicle count, baseline antimüllerian hormone, total dose of gonadotropins used, and baseline endometrial thickness demonstrated no significant difference between the two study groups.

CONCLUSION: Our study suggests that prior testosterone use does not appear to impact oocyte cryopreservation outcomes in transgender patients. As a growing number of transgender patients seek fertility care, there is a need for evidence-based research that can guide clinical practice and empower this population to realize their aspirations for parenthood.

PMID:41054727 | PMC:PMC12496435 | DOI:10.1016/j.xfre.2025.06.011

F S Rep. 2025 May 9;6(3):270-279. doi: 10.1016/j.xfre.2025.05.002. eCollection 2025 Sep.

ABSTRACT

OBJECTIVE: To examine the utility of semen parameters and sperm mitochondrial DNA copy number (mtDNAcn) to predict couples’ time to pregnancy (TTP).

DESIGN: This study assessed the predictive power of sperm mtDNAcn and 34 semen parameters. Two composite semen quality indices (SQIs) were developed; an unweighted ranked-sperm quality index (ranked-SQI) derived from only semen parameters and a weighted sperm quality index generated using machine learning via elastic net (ElNet-SQI). Discrete-time proportional hazard models, logistic regression, and receiver operating characteristic (ROC) analyses were used to evaluate the predictive ability of achieving pregnancy at 3, 6, and 12 months, and the overall TTP.

SUBJECTS: The participants included 281 men from the Longitudinal Investigation of Fertility and the Environment study, a large preconception general population cohort designed to explore factors affecting conception.

EXPOSURE: Sperm mtDNAcn, 34 semen parameters, unweighted ranked-SQI, and a machine learning-based weighted SQI were evaluated for the ability to predict pregnancy.

MAIN OUTCOMES MEASURES: The main outcome measures were the overall time taken to achieve pregnancy and the likelihood of achieving pregnancy within 3, 6, or 12 months of trying to conceive.

RESULTS: For individual semen measures, sperm mtDNAcn was most predictive of pregnancy at 12 menstrual cycles in ROC analyses (area under the curve [AUC], 0.68; 95% confidence interval [CI], 0.58-0.78). Among multiparameter biomarkers, ElNet-SQI (comprised of 8 semen parameters and mtDNAcn), demonstrated the highest AUC, 0.73; 95% CI, 0.61-0.84) for pregnancy status at 12 cycles. Furthermore, ElNet-SQI was the most strongly associated with TTP than any other individual or combinations of semen parameters (fecundability odds ratio [FOR], 1.30; 95% CI, 1.14-1.45; P=6.0∗10^-5).

CONCLUSION: Sperm mtDNAcn is associated with multiple conventional and detailed semen parameters. Moreover, a composite machine learning ElNet-SQI that included mtDNAcn and several semen parameters had the highest predictive ability of pregnancy. These results indicate that sperm mtDNAcn can serve as a biomarker of overall sperm fitness and likelihood of reproductive success.

PMID:41054723 | PMC:PMC12496432 | DOI:10.1016/j.xfre.2025.05.002

Reprod Health. 2025 Oct 6;22(1):184. doi: 10.1186/s12978-025-02070-6.

ABSTRACT

BACKGROUND: This study explores the awareness and predictors of knowledge regarding sexually transmitted diseases among early adolescents (ages 11-15) in the Koforidua Municipality.

METHODS: The study was designed as convergent parallel mixed-methods research hinged on an analytical cross-sectional and descriptive phenomenological design. In all, 373 adolescents were surveyed, obtaining varied insights across different demographic groups, with an additional 10 interviews conducted for qualitative analysis. Quantitative data were analyzed using descriptive statistics and multilevel logistic regression, while the qualitative data were thematically analyzed.

RESULTS: Two-thirds (67.3%) of early adolescents reported awareness of STDs. 134(53.4%) out of the 251 early adolescents who were aware of STDs opted to test for them. HIV (M = 1.33, SD = 0.699), and Gonorrhea (M = 1.55, SD = 0.827) were the most commonly recognized infections but misconceptions about Syphilis (M = 1.94, SD = 0.929), Chlamydia (M = 2.49, SD = 0.778), Genital wart (M = 2.35, SD = 0.854) and Hepatitis (M = 2.36, SD = 0.755) as types of STDs were dominant. Early adolescents in Junior High School -JHS1 (AOR 0.307 (95.0% CI 0.111-0.847 p = 0.023), JHS 2 (AOR 0.201 (95.0% CI 0.070-0.579 p = 0.003), JHS 3 (AOR 0.134 (95.0% CI 0.043-0.414 p = 0.00) were less likely to know STDs compared to those in primary six. Early adolescents who had never dated (AOR 0.705 (95.0% CI 0.423-1.173 p = 0.014) were also less likely to know about STDs compared to those who had ever dated.

CONCLUSION: The findings highlight the need for the Ghana Education Service to integrate comprehensive sexual health education into primary and junior high school curricula to improve STD knowledge among early adolescents.

PMID:41053753 | DOI:10.1186/s12978-025-02070-6

Malar J. 2025 Oct 6;24(1):318. doi: 10.1186/s12936-025-05433-3.

ABSTRACT

BACKGROUND: Effective malaria control in under-five children depends on caregivers seeking timely medical care. However, despite available healthcare services, many caregivers do not utilize health facilities, undermining malaria control efforts. This study assessed care-seeking behaviour of caregivers for suspected malaria in under-five children and associated factors in a southwest state of Nigeria.

METHODS: A cross-sectional analytical study was conducted in Ondo State, Southwestern Nigeria. The study areas were Ifedore, Ondo East, and Idanre Local Government Areas (LGAs) randomly selected from the eighteen LGAs in Ondo state. A multistage sampling technique was used to select participants and data was collected using a structured questionnaire. Descriptive and inferential statistics were applied to analyse the data, with logistic regression identifying significant predictors of care-seeking behaviour of caregivers of under-five children at p-value < 0.05.

RESULTS: The study included 301 caregivers of under-five children, predominantly aged 26-45 years (69.4%), males were 50.8% compared to females (49.2%) and 66.1% residing in rural areas. While 84.4% of caregivers identified infected mosquito bites as the cause of malaria, and 98.3% recognized fever as a main symptom, only 51.2% demonstrated good overall knowledge of malaria and symptoms in under-five children. Although 94.0% of caregivers suspected malaria in their under-five children within 12 months prior to the study, however, only 9.3% visited a health facility for treatment of their under-five children. In contrast, 37.4% purchased drugs from patent medicine vendors and pharmacies, while 25.2% used herbs for home management. Bivariate analysis showed significant associations between health facility visits and being a female caregiver (p = 0.009), urban residence (p = 0.002), residing within 5 km of a facility (p = 0.021), and good malaria knowledge (p = 0.033). Multivariate logistic regression indicated that female caregivers (aOR = 3.32, 95% CI 1.29-8.54), urban residents (aOR = 4.25, 95% CI 1.72-10.48), residing within 5 km of a health facility (aOR = 3.38, 95% CI 1.03-11.07), and those with good malaria knowledge (aOR = 4.16, 95% CI 1.61-10.77) were significant predictors of visiting a health facility for malaria care for under-five children with suspected malaria by caregivers.

CONCLUSION: The study revealed low utilization of health facilities by caregivers seeking malaria treatment for under-five children with suspected malaria. Therefore, targeted community awareness campaigns are recommended to encourage caregivers to seek prompt, facility-based malaria care for under five children. Furthermore, in hard-to-reach or underserved rural areas with limited access to healthcare services, training and sensitization programmes for caregivers on appropriate home-based management of malaria including the use of pre-packaged artemisinin-based combination therapies are recommended.

PMID:41053751 | DOI:10.1186/s12936-025-05433-3

Lipids Health Dis. 2025 Oct 6;24(1):309. doi: 10.1186/s12944-025-02732-1.

ABSTRACT

BACKGROUND: The triglyceride-glucose index (TyG) and C-reactive protein (CRP) are key biomarkers on clinical diagnosis, each related to lung dysfunction. However, the relationship of both indexes with the risk of chronic obstructive pulmonary disease (COPD) is still unclear. This study purposes to focus on the individual and joint associations of TyG and CRP levels with COPD risk.

METHODS: This cohort study utilized baseline TyG and CRP data from the UK Biobank. Hazard ratios (HRs) and 95% confidence intervals (CIs) for COPD risk associated with TyG and CRP levels were calculated through Cox regression models. Receiver operating characteristic (ROC) curves were conducted to determine the optimal cut-off values for TyG and CRP, which were combined into a joint variable. Kaplan-Meier (KM) method was utilized to analyze cumulative hazard, while joint analysis was employed for evaluating the joint risk. Stratified and sensitivity analyses were also performed to assess the associations within subgroups, and mediation effect of TyG on COPD risk via CRP levels was assessed.

RESULTS: This study enrolled 385,523 individuals, with 10,515 COPD cases were recorded in follow-up. Compared to the lowest quintile, individuals with higher TyG and CRP had increased risk of COPD (all HRs > 1.00). The optimal cut-off values of TyG and CRP were 7.14 and 1.88 mg/L, and we found that the simultaneous elevation of both TyG and CRP significantly increased the risk of COPD. Moreover, the joint effect was stronger in participants younger than 60 years old, males, smokers or passive smokers, those with body mass index (BMI) < 25.0 kg/m², and those without baseline diabetes, asthma, or a family history of respiratory diseases (P _{for interaction} < 0.05). Moreover, the effect of TyG on COPD was significantly mediated by CRP, explaining almost 15.6% of this influence.

CONCLUSIONS: These results underscored the individual and joint effects of TyG and CRP upon COPD risk, indicating their usefulness as biomarkers for early risk assessment.

PMID:41053749 | DOI:10.1186/s12944-025-02732-1

BMC Health Serv Res. 2025 Oct 6;25(1):1308. doi: 10.1186/s12913-025-13151-4.

ABSTRACT

BACKGROUND: This study describes and compares the utilisation rates of specialist mental health and addiction (MH) services between different refugee groups and the New Zealand (NZ) resident population.

METHODS: Using linked data in Statistics NZ’s Integrated Data Infrastructure, we identified 23,709 individuals with an asylum seeker or refugee visa who stayed in NZ for at least 6 months. Logistic regression models compared the use of MH services between different refugee groups (quota refugees, convention refugees, family reunification, and asylum seekers). We conducted cox regression hazard models to investigate the time to the first service use between refugee groups and a sample of NZ resident population, including NZ-born and overseas-born individuals.

RESULTS: Adjusting for age, sex, ethnicity, neighbourhood deprivation, and time spent in NZ, we found that asylum seekers, family, and convention refugees were less likely to utilise MH services than quota refugees. The following groups had higher odds of utilising MH services: females compared with males (OR = 1.46, 95%CI = 1.35, 1.59) and those living in more deprived neighbourhoods compared with less deprived areas (OR = 1.27; 95%CI = 1.18, 1.38). Quota refuges were more likely to use MH services compared to the NZ-born group (HR = 1.94, 95%CI = 1.86, 2.03). Convention, family and asylum seekers were less likely to utilise MH services than the NZ-born population (HR = 0.82; [95% CI = 0.76, 0.89], HR = 0.54; [95% CI = 0.46, 0.64], and HR = 0.71, [95%=0.59, 0.86], respectively). We found that quota refugees’ primary source of MH service use was NGOs whereas for other refugee sub-groups, it has been District Health Boards.

CONCLUSION: The use of MH services differed between refugee groups. Quota refugees were more likely to utilise services, mainly from NGOs, with women and those who lived in the most deprived areas more likely to use MH services. These results have policy implications, such as improving early service accessibility for all refugee sub-groups.

PMID:41053745 | DOI:10.1186/s12913-025-13151-4

BMC Surg. 2025 Oct 6;25(1):453. doi: 10.1186/s12893-025-03201-3.

ABSTRACT

BACKGROUND: This study aims to evaluate the feasibility and safety of two intestinal fecal diversion methods using novel stents to prevent anastomotic leakage after surgery for middle and lower rectal cancer, and to compare their advantages and disadvantages for clinical application.

METHODS: A retrospective analysis was conducted on 101 patients who underwent laparoscopic radical resection(LAR) for rectal cancer at Yongchuan Hospital from June 2021 to March 2024. Patients were divided into three groups: 26 in the ileum group (using terminal ileal stents) ,54 in the in situ group (using rectal in situ covered stents) and 21 in the control group. Preoperative, surgical, and postoperative data were compared among the three groups.

RESULTS: No significant differences were found in baseline characteristics, surgical data, or the occurrence of postoperative anastomotic leakage or other complications. The in situ group showed no statistically significant differences from the control group in the postoperative hospital stay(12.6 ± 3.7 vs. 11.4 ± 2.9days, p > 0.05 ), total cost of hospitalization (48903.58 ± 7094.14 vs. 82205.77 ± 12222.41yuan, p > 0.05). Moreover, the ileum group in these comparisons performed worse than the control group. After incorporating data related to stoma closure surgery, the in situ group and ileum group showed significant advantages in overall hospitalization costs(59085.88 ± 7460.79 vs. 48903.58 ± 7094.14 vs. 81418.32 ± 11186.78yuan, p < 0.05), and the in-situ group also had shorter overall hospital stay(17.6 ± 5.0 vs. 22.2 ± 4.0days, p < 0.05).

CONCLUSIONS: Both fecal diversion methods showed acceptable rates of postoperative anastomotic leakage and can avoid a second stoma closure surgery. The in situ covered stent method seemed better as it not only saved hospitalization time and costs but also made postoperative management simpler and more efficient.

PMID:41053739 | DOI:10.1186/s12893-025-03201-3

Cardiovasc Diabetol. 2025 Oct 6;24(1):385. doi: 10.1186/s12933-025-02915-1.

ABSTRACT

BACKGROUND: Cardiovascular outcome trials have shown that glucagon-like peptide 1 receptor agonists (GLP1-RAs) reduce cardiovascular event rates more effectively than placebo and in patients with type 2 diabetes at increased cardiovascular risk. However, the generalizability of these findings to real-world settings remains uncertain.

AIM: This study aimed to evaluate the real-world cardiovascular effectiveness of sustained GLP1-RA use compared to dipeptidyl peptidase 4 inhibitor (DPP-4i) over 3.5 years.

METHODS: Using Danish nationwide registries, we emulated a target trial to assess the real-world effectiveness of GLP1-RAs in a population of individuals with type 2 diabetes mirroring the inclusion and exclusion criteria from the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trial. The study period was 2012-2022. Outcomes included the composite of myocardial infarction, stroke, and cardiovascular mortality (3P-MACE), as well as each component individually, alongside all-cause mortality, heart failure, angina pectoris, and revascularization. Longitudinal Targeted Minimum Loss-based Estimation, a method that adjusts for both baseline and time-varying confounding, was used to estimate absolute risks of cardiovascular outcomes under sustained use of GLP1-RA and DPP 4i (active comparator), adjusting for baseline and time-varying confounding.

RESULTS: We included 6,681 people initiating GLP1-RA and 19,072 initiating DPP-4i. Accounting for baseline and time-varying confounding, sustained GLP1-RA use showed a 2.5% (95% CI 0.8-4.1%) risk reduction of 3P-MACEover 3.5 years. Risk reductions for cardiovascular mortality, all-cause mortality, heart failure, and unstable angina pectoris were 2.3% (95% CI 1.4-3.1%), 2.5% (95% CI 0.7-4.3%), 0.9% (95% CI 0.01-1.8%), and 0.7% (95% CI 0.01-1.3%), respectively. No significant differences were observed for myocardial infarction, stroke, or revascularization with risk differences of 0.1% (95% CI -1.0 to 0.8%), 0.8% (95% CI -0.2 to 1.7%), and 0.2% (95% CI -0.7-1.1%), respectively.

CONCLUSIONS: This real-world study confirms the cardiovascular benefits of GLP1-RAs over DPP-4is, particularly for reducing cardiovascular and all-cause mortality under continuous treatment exposure in patients with type 2 diabetes at increased cardiovascular risk.

PMID:41053738 | DOI:10.1186/s12933-025-02915-1