Tag: pubmed

Int Nurs Rev. 2025 Sep;72(3):e70067. doi: 10.1111/inr.70067.

ABSTRACT

AIMS: To assess home disaster preparedness levels of individuals with sickle cell disease to determine education and resource needs and inform policy. To evaluate the association between healthcare provider discussion of preparedness and level of preparedness.

BACKGROUND: Research demonstrates that extreme weather events and public health emergencies result in increased hospital visits for people with sickle cell disease, yet little is known about home disaster preparedness knowledge and actions of these individuals.

METHODS: Cross-sectional study of US adults diagnosed with sickle cell disease. The independent variable was the healthcare provider discussion of household disaster preparedness. The dependent variable was the Household Emergency Preparedness Instrument’s General Preparedness score. Participants self-reported their preparedness actions and disaster supplies through an online survey. Descriptive statistics were analyzed, along with a Welch t test, to examine the associations between the study variables. This study was reported according to the STROBE checklist.

RESULTS: The average General Preparedness score of this sample (N = 32) indicated that the majority of participants were not considered well prepared for disasters. Higher scores were found among participants who had discussions with their healthcare providers about how to prepare for disasters.

DISCUSSION: The sample’s average General Preparedness score was higher than other patient populations assessed with this instrument, possibly due to routine discussions about medical emergency preparedness that individuals with sickle cell disease receive from healthcare providers.

CONCLUSION: Home disaster preparedness levels should be improved to decrease disaster-related morbidity and mortality.

IMPLICATIONS FOR NURSING PRACTICE AND POLICY: Nurses should develop or advocate for home disaster preparedness lessons, community interventions, and public policies to meet the unique needs of community members with sickle cell disease before, during, and after disasters.

PMID:40678875 | DOI:10.1111/inr.70067

Clin Pharmacol Ther. 2025 Jul 18. doi: 10.1002/cpt.70006. Online ahead of print.

ABSTRACT

This study assessed the use of 35 pharmacogenomic (PGx) medications listed in the Royal College of Pathologists of Australasia (RCPA) guideline, estimated the potential costs of subsidizing PGx testing in Australia, and predicted related prescribing changes. Using administrative claims data from the Pharmaceutical Benefits Scheme, accessed via the Australian Bureau of Statistics DataLab, we identified individuals who received any of the 35 medications between January 2021 and December 2023. Incident prescribing rates were calculated for children (0-17), adults (18-64), and older adults (65+). Adults (14.91%) and older adults (14.44%) had the highest rates of PGx medication use, followed by children (3.53%). Commonly prescribed medications included proton pump inhibitors, with frequent associations to genes such as CYP2C19 across all age groups. Estimated costs of PGx testing, assuming 50% and 75% population uptake, were highest for older adults: AUD$1.95 million and AUD$2.93 million, respectively. Predicted prescribing changes, based on literature-reported phenotype frequencies by ancestry, suggested that up to 18.58% of individuals using drugs like clopidogrel or voriconazole may need alternative treatments due to poor metabolism. These findings highlight the clinical potential of integrating PGx testing into routine practice, especially for medications included in international pharmacogenomic guidelines. While implementation would entail significant upfront costs, PGx testing could enhance medication safety and effectiveness and health care cost-efficiency. Future research should focus on scalable strategies for PGx implementation across diverse health care settings to optimize patient care globally.

PMID:40678859 | DOI:10.1002/cpt.70006

Ann Hum Genet. 2025 Jul 17:e70004. doi: 10.1111/ahg.70004. Online ahead of print.

ABSTRACT

BACKGROUND: Alzheimer’s disease (AD) predominantly affects older women, with research suggesting elevated follicle-stimulating hormone (FSH) levels in postmenopausal women correlate with AD risk and cognitive decline. Understanding the causal relationship between FSH and AD is essential.

MATERIALS AND METHODS: We selected single-nucleotide polymorphisms (SNPs) linked to FSH as instrumental variables (IVs) for Mendelian randomization (MR). Statistical methods, including inverse variance weighted (IVW), MR Egger, Weighted Median, Weighted Mode, and Simple Mode, were employed to assess causality and potential pleiotropy. Shared genetic loci between FSH and AD were explored.

RESULTS: We carefully identified and utilized a total of 20 valid SNPs as IVs to assess the potential causal relationship between FSH and AD. Our analysis revealed a significant causal association between genetically determined FSH levels and AD [beta = -0.004; OR = 0.996, 95% confident interval (CI): 0.994-0.999; p = 0.002]. We successfully identified 20 SNPs that correspond to 8 differentially expressed genes (DEGs) between AD and non-demented (ND). These genes have not been previously reported to be linked to either FSH or AD. We conducted an in-depth analysis to explore the potential roles of these genes in the context of FSH and AD.

CONCLUSION: Our MR study revealed that FSH potentially has a causal association with AD. Additionally, FSH might possess distinctive biological mechanisms that influence the development of AD.

PMID:40678826 | DOI:10.1111/ahg.70004

Ther Adv Musculoskelet Dis. 2025 Jul 16;17:1759720X251350087. doi: 10.1177/1759720X251350087. eCollection 2025.

ABSTRACT

BACKGROUND: Treating rheumatic musculoskeletal diseases (RMDs) during pregnancy and breastfeeding presents significant complexities, mainly due to inconsistencies between the clinical guidance documents and the reference safety information, including the summary of product characteristics (SmPC) and the patient information leaflets (PIL).

OBJECTIVES: To assess healthcare professionals’ (HCPs) prescribing behaviors, comfort levels, and challenges when advising patients, focusing on discrepancies between clinical guidance documents and SmPC/PIL.

DESIGN: Online survey entitled PRAISE (Perception of healthcare providers Regarding Antirheumatics in pregnancy and breastfeeding: advice, Information and patient perSpEctives) and disseminated through HCPs groups and social media.

METHODS: A cross-sectional survey was conducted among 414 HCPs globally. Respondents were divided into prescribers (n = 336) and non-prescribers (n = 78) based on their self-reported role in prescribing antirheumatic medications to pregnant or breastfeeding patients with RMDs. The survey covered demographics, clinical experience, confidence in prescribing, use of clinical guidelines, and experiences managing conflicting information between guidelines and SmPC/PIL.

RESULTS: Prescribers were more likely than non-prescribers to feel comfortable discussing medication safety during pregnancy. Most prescribers found clinical guidance documents useful, with 48% rating them as “very useful” and 38% as “extremely useful.” In case of conflicting information between clinical guidance documents and SmPC/PIL, 58% of HCPs reported that it caused confusion and tension in patient-doctor relationships, and almost 20% of them are “likely” or “very likely” to discontinue ongoing treatment. Clear communication and shared decision-making were the most common strategies used to address patient concerns.

CONCLUSION: HCPs often face significant challenges when advising patients with RMDs on the use of medications during pregnancy and breastfeeding. Conflicting information between clinical guidance documents and SmPC/PIL can disrupt patient-doctor relationship and lead to treatment discontinuation, with potential consequences on maternal disease control. Improved alignment between clinical guidance documents and the SmPC/PIL could enhance patient care and prevent confusion among HCPs and patients.

PMID:40678818 | PMC:PMC12267951 | DOI:10.1177/1759720X251350087

Prev Med Rep. 2025 Jun 26;56:103152. doi: 10.1016/j.pmedr.2025.103152. eCollection 2025 Aug.

ABSTRACT

OBJECTIVE: To quantify temporal trends in age-adjusted hypertension prevalence in New York City before and after implementation of a menu labeling regulation requiring sodium warning icons at chain restaurants.

METHODS: Using data from the New York City Community Health Survey, segmented regression models assessed: (1) the average annual percent change (AAPC) of age-adjusted hypertension prevalence during the pre-regulation period (2005-2015), (2) the annual percent change (APC) from 2015 to 2016 (regulation onset association), (3) the AAPC of age-adjusted hypertension prevalence during the regulation period (2016-2020), and (4) the percentage-point difference between the AAPCs of the pre-regulation and regulation periods.

RESULTS: We found a statistically significant average annual percent increase in the age-adjusted hypertension prevalence among the Hispanic population during the pre-regulation period (2005-2015 AAPC: 1.3 %, 95 % CI: 0.3 % to 2.3 %). The regulation’s onset was significantly associated with a 4.2 % (95 % CI: 0.4 % to 8.0 %) increase in the age-adjusted hypertension prevalence among females from 2015 to 2016. During the regulation era, we observed statistically significant average annual percent decreases in age-adjusted hypertension prevalence among Black (2016-2020 AAPC: -1.9 %; 95 % CI: -2.5 % to -1.3 %) and female (2016-2020 AAPC: -3.5 %; 95 % CI: -5.0 % to -2.1 %) subgroups.

CONCLUSIONS: Findings suggest a potential positive impact of the sodium warning regulation on hypertension prevalence. The decreasing trends in hypertension prevalence among female and Black populations suggest that sodium reduction policies may have differential impacts across subgroups. These empirical insights underscore the importance of sustained sodium reduction policies.

PMID:40678813 | PMC:PMC12268849 | DOI:10.1016/j.pmedr.2025.103152

Prev Med Rep. 2025 Jun 27;56:103149. doi: 10.1016/j.pmedr.2025.103149. eCollection 2025 Aug.

ABSTRACT

OBJECTIVE: To analyze the relationship between internalization of appearance ideals, sociocultural pressures, and body dissatisfaction among Brazilian adults.

METHODS: A cross-sectional study was conducted in Mato Grosso do Sul, Brazil, between January and December 2023. Using convenience sampling, data were collected from 290 adults (18-64 years old; median age = 24.0, IQR25 = 21.0, and IQR75 = 34.0; 69.3 % female) through an online self-report questionnaire. The dependent variables included socioeconomic, demographic, and anthropometric data. Sociocultural pressures and the internalization of appearance ideals were measured using the SATAQ-4, with body dissatisfaction as the independent variable. Statistical analyses involved non-parametric tests (Kolmogorov-Smirnov, Mann-Whitney U, Kruskal-Wallis, Dunn’s post hoc tests) and Spearman’s correlation, with a significance level set at p < .05.

RESULTS: Body dissatisfaction was 84.5 % prevalent. Dissatisfaction related to excess weight was associated with pressure from family (p < .001), friends (p = .001), the media (p < .001), and internalization of the thin ideal (p < .001). The median ideal athletic/muscular body was significantly higher in males than in females (p = .015), while median media pressure was higher in females compared to males (p = .001).

CONCLUSIONS: The study highlights the role of sociocultural pressures and appearance ideals in body dissatisfaction, supporting the Tripartite Influence Model.

PMID:40678811 | PMC:PMC12269850 | DOI:10.1016/j.pmedr.2025.103149

Aerosol Sci Technol. 2024 Oct 23. doi: 10.1080/02786826.2024.2403580. Online ahead of print.

ABSTRACT

Exposure to airborne respiratory viruses can be a health hazard in occupational settings. In this study, air sampling was conducted from January to March 2023 in two outpatient medical clinics-one primary care clinic and one clinic dedicated to the diagnosis and treatment of respiratory illnesses-for the purpose of assessing airborne respiratory virus presence. Work involved the operation of a BioSpot-VIVAS^™ as a stationary air sampler and deployment of NIOSH BC-251 bioaerosol samplers as either stationary devices or personal air samplers worn by staff members. Results were correlated with deidentified clinical data from patient testing. Samples from seven days were analyzed for SARS-CoV-2, influenza A H1N1 and H3N2 viruses, and influenza B Victoria- and Yamagata-lineage viruses, with an overall 17.5% (17/97) positivity rate. Airborne viruses predominated in particles of aerodynamic diameters from 1-4 μm and were recovered in similar quantities from both clinics. BC-251 samplers (17.4%, 15/86) and VIVAS (18.2%, 2/11) collected detectable viruses at similar rates, but more numerous BC-251 samplers provided greater insight into virus presence across clinical spaces and job categories. 60% of samples from reception areas contained detectable virus, and exposure to significantly more virus (p = 0.0028) occurred at reception desks as compared to the “mobile” job categories of medical providers and nurses. Overall, this study provides valuable insights into the impacts of hazard mitigation controls tailored to reducing respiratory virus exposure and highlights the need for continued diligence toward exposure risk mitigation in outpatient medical clinics.

PMID:40678809 | PMC:PMC12266680 | DOI:10.1080/02786826.2024.2403580

Clin Kidney J. 2025 Jul 1;18(7):sfaf203. doi: 10.1093/ckj/sfaf203. eCollection 2025 Jul.

ABSTRACT

BACKGROUND: Targeted release formulation (TRF) budesonide (Nefecon), targeting galactose-deficient immunoglobulin A1 (Gd-IgA1) production and IgA immune complex formation, has been approved for IgA nephropathy (IgAN) treatment. In this study we explored whether early changes in these biomarkers can predict the clinical response to Nefecon therapy.

METHODS: Plasma samples from 27 IgAN patients treated with Nefecon and followed at least 6 months were collected during routine visits. We measured the levels of Gd-IgA1 and poly-IgA during the treatment, analysing the association between their baseline levels or changes and proteinuria reduction.

RESULTS: The mean proteinuria level was 1.3 ± 0.8 g/day and the estimated glomerular filtration rate was 47.1 ± 21.7 ml/min/1.73 m² at baseline. During the follow-up, proteinuria slowly decreased, with alterations of -0.12 g/day, -0.42 g/day, -0.58 g/day and -0.86 g/day at 3, 6, 9 and 12 months, respectively. The plasma levels of Gd-IgA1, poly-IgA and total IgA decreased after Nefecon treatment, with an obvious decrease at 2 months in Gd-IgA1 by -1067.3 ng/ml and poly-IgA by -1.18 mg/l. All biomarker reductions were strongly associated with a proteinuria decrease (P < .0001). Importantly, the early reduction in poly-IgA during the first 2 months was associated with a proteinuria reduction at 6 months (R = 0.47, P = .01). Similar trends were observed for Gd-IgA1, though not statistically significant.

CONCLUSIONS: The early changes in Gd-IgA1 or poly-IgA, especially poly-IgA, were associated with future proteinuria reduction, supporting the potential of Gd-IgA1 and poly-IgA as biomarkers for predicting Nefecon response in IgAN.

PMID:40678796 | PMC:PMC12268327 | DOI:10.1093/ckj/sfaf203

Arthroplast Today. 2025 Jul 2;34:101746. doi: 10.1016/j.artd.2025.101746. eCollection 2025 Aug.

ABSTRACT

BACKGROUND: Previous studies have reported initial and proficiency phases of the learning curve among individual surgeons when robotic-assisted total knee arthroplasty (raTKA) into their practices. The purpose of this study was to assess the number of raTKA cases needed to achieve proficiency in the operative time (OT) across a group of surgeons.

METHODS: A retrospective analysis comparing raTKA to manual Total Knee Arthroplasty (mTKA) was performed at a single-site comprised of 6 orthopaedic surgeons. The first 90 patients who underwent raTKA at the institution divided chronologically into 3 groups of 30 each and compared to 30 previous mTKA cases. Tourniquet time was used as the measure for OT, range of motion (ROM) was measured preoperatively and at 2 and 6 weeks postoperative.

RESULTS: Average OT was significantly shorter in the mTKA group in comparison with all the raTKA groups. A statistically significant difference was found in OT when comparing the succeeding raTKA groups (mean time of 97.6, 86.6, and 76.7 min P value<.001). The change in ROM at 6 weeks postoperative was found to be greater in the first raTKA group in comparison to the second raTKA group (mean of 0.9° vs -17.1°; P = .04) and the mTKA group (mean of 0.9° vs -7.9°; P = .04). However, when controlling for preoperative ROM and performing surgeon, there was no difference in ROM at 6 weeks postoperative between defined time periods (P = .78). No difference was found when comparing rate of complications (P value>.05).

CONCLUSIONS: When evaluating the group learning curve, this study showed average shorter operating time with every 30 cases (mean time of 97.6; 86.6- and 76.7-min P value<.001) and no difference in complication rate (P value>.05). These findings suggest continued proficiency over time; however, adoption of the technology is associated with longer OTs.

PMID:40678787 | PMC:PMC12269883 | DOI:10.1016/j.artd.2025.101746

Arthroplast Today. 2025 Jul 2;34:101745. doi: 10.1016/j.artd.2025.101745. eCollection 2025 Aug.

ABSTRACT

BACKGROUND: Impacts of asymptomatic perioperative coronavirus disease 2019 (COVID-19) on total knee (TKA) and hip arthroplasty (THA) outcomes remains unknown.

METHODS: We retrospectively reviewed asymptomatically screened COVID-19 cases undergoing primary TKA or THA between 2020 and 2022. Ninety-day complications, inpatient resources, repeat hospitalizations, and functional outcomes were measured for COVID-19 patients and age- and sex-matched controls. The sample size was determined based on a priori power analysis. Statistics consisted of 2 sample t-tests or Fisher’s exact test based on variable type with α = 0.01 to correct for multiple comparisons.

RESULTS: Of 1914 TKA and 1424 THA patients, 20 and 28 with asymptomatic COVID-19 were compared to 75 and 105 controls, respectively. While there was no statistically significant increase in relative risk for major (TKA P = .04|THA P = .12) or thromboembolic (TKA P = .21|THA P = .04) complications, the COVID-19 group experienced mortality, ischemic stroke, pulmonary embolism, and deep vein thrombosis. There was no significant difference in admission length (TKA P = .29|THA P = .22), physical therapy (TKA P = .36|THA P = .36), labs (TKA P = .57|THA P = .82), nonhome discharge (TKA P = 1|THA P = 1), or mobility (TKA P = .18|THA P = .21).

CONCLUSIONS: The current study suggests that, while perioperative risk of asymptomatic COVID-19 does not meet the threshold for statistical significance, arthroplasty surgeons should be aware of potential mortality and morbidity and engage in shared decision-making regarding deferral of surgery, especially for patients with other comorbidities.

PMID:40678785 | PMC:PMC12269793 | DOI:10.1016/j.artd.2025.101745