Tag: pubmed

Crit Care. 2026 Jan 23. doi: 10.1186/s13054-026-05858-5. Online ahead of print.

ABSTRACT

BACKGROUND: Optimal pain and sedation management in intensive care unit (ICU) remains challenging. While opioids and benzodiazepines are widely used, their adverse effects highlight the need for alternative or adjunctive strategies. Ketamine, with its analgesic and opioid-sparing has been proposed as an adjuvant. However, current evidence regarding its efficacy in ICU patients, particularly within the surgical population, remains inconclusive. We evaluated whether continuous low-dose ketamine infusion in postoperative surgical ICU patients reduces opioid consumption and improves pain intensity, and whether it affects opioid-related adverse events and key ICU recovery outcomes.

METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing continuous postoperative ketamine infusion versus non-ketamine based infusion for analgesia & sedation in patients admitted to the surgical ICU. Literature searches were performed in PubMed, Cochrane Central, and ClinicalTrials.gov from inception until July 2025. The primary endpoints were cumulative opioid consumption in the first 24-48 h (standardized to IV morphine equivalents where applicable) and rest pain intensity at prespecified early postoperative timepoints. Secondary endpoints included PONV, psychotomimetic events (e.g., hallucinations), and ICU recovery outcomes (e.g., ICU length of stay and duration of mechanical ventilation) when reported. We performed random-effects meta-analyses and assessed certainty using GRADE.

RESULTS: Nine RCTs comprising 666 patients were included. Ketamine significantly reduced opioid consumption at 24 h in adults (mean difference [MD] – 5.77 mg morphine equivalents; 95% CI – 6.32 to – 5.23; p < 0.0001), although the reduction at 48 h and in pediatric subgroups was not statistically significant. Pain scores at 12, 24, and 48 h were comparable between the groups. Ketamine did not significantly shorten the mechanical ventilation time (MD – 0.84 h; 95% CI – 1.93 to 0.24) or ICU length of stay (MD – 0.97 h; 95% CI – 1.95 to 0.02). However, ketamine use was associated with a lower incidence of PONV (RR 0.59; 95% CI 0.36-0.98; p = 0.0399). Psychotomimetic adverse events were infrequent and not significantly increased. GRADE evidence was moderate for opioids in adults at 24 h and low to very low for the remaining outcomes.

CONCLUSIONS: In postoperative surgical ICU patients, continuous low-dose ketamine infusion provides modest opioid sparing and is associated with lower PONV, without clear improvements in pain scores or ICU recovery outcomes. Large-scale trials with different dosing protocols are needed to explore the optimal role of ketamine beyond analgesia and PONV reduction.

PMID:41578281 | DOI:10.1186/s13054-026-05858-5

BMC Public Health. 2026 Jan 23. doi: 10.1186/s12889-025-26157-8. Online ahead of print.

ABSTRACT

BACKGROUND: HIV has been reported a disproportionately increase among young students worldwide including China. Considering newly enrolled university students experienced living away from home, the absence of family control and the changes from a relatively closed environment to an open environment, HIV related knowledge, attitudes and practices (KAP) for this group may change after enrollment in universities. Thus, we aim to explore the changes of HIV related knowledge, attitudes and practices in newly enrolled students in universities.

METHOD: This prospective-based investigations were carried out among students when they enrolled in the university and 3 months after enrollment. All the newly enrolled students in the university were invited to participate in the investigation. HIV related knowledge was measured using the 8-item HIV Knowledge Questionnaire. Changes regarding HIV related knowledge, attitudes, sexual behaviors and social network self-efficacy were analyzed, and statistical differences were examined using Mcnemar and Wilcoxon signed-rank test.

RESULTS: Among the participants, 56.2% (431) were male students with 43.8% (336) were female students. The average HIV related knowledge score was 7.55 ± 0.73 at the enrolment and it increased to 7.64 ± 0.65 after 3 months of enrollment (p < 0.001). Regarding the HIV related attitudes, most items showed no significant difference between enrolment and after 3 months of enrolment (p > 0.05). However, more students thought they had traditional sexual beliefs after 3 months of enrollment compared with that at the enrollment (42.5% vs. 32.8%). Regarding the HIV related practice, the romantic love experiences increased from 23.2%(178/767) at enrollment to 30.0%(230/767) after 3 months of enrollment(p < 0.001), and the percentage of having sexual intercourse increased from 1.2%(9/767) to 2.0%(15/767) although it did not show significant difference with the P value of 0.07. In addition, condom using, sexual partner and internet dating did not show statistical difference between enrollment and after 3 months of enrollment (p > 0.05). The total score of social networking self-efficacy decreased from 80.31 to 79.25 from enrollment to 3 months after enrolment(p = 0.002) with decreased dimension of self-disclosure (p = 0.002) and self-control (p < 0.001).

CONCLUSION: This prospective study highlights that newly enrolled university students experienced an increase in HIV-related knowledge and a rise in romantic relationship within the first three months. However, this was not accompanied by a positive shift in attitudes or safer practices. This knowledge-behavior gap, coupled with declining social self-efficacy, highlights the urgent need for early, skills-based HIV interventions that go beyond mere knowledge dissemination to effectively address behavioral risks during this transitional period.

PMID:41578249 | DOI:10.1186/s12889-025-26157-8

BMC Pediatr. 2026 Jan 23. doi: 10.1186/s12887-026-06536-9. Online ahead of print.

ABSTRACT

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is integral to the management of pediatric hematologic malignancies and non-malignant disease, but infection is a significant cause of morbidity and mortality. The purpose of this study is to assess the application of antimicrobial agents in pediatric HSCT.

METHODS: This multicenter retrospective observational cohort study was conducted across 21 hospitals in China. We included pediatric patients who underwent HSCT and received antimicrobial treatment between January 2023 and April 2024. The study collected and analyzed data on patients’ disease types, antibiotic use, antifungal drug use, and treatment durations, with subgroup analysis based on age. Statistical analysis was performed using Python 3.13.

RESULTS: We included a total of 186 patients with 73 patients in the tumor group and 113 patients in the non-tumor group. The most frequent disease in the tumor group was acute lymphoblastic leukemia (37 patients, 50.68%), and the most frequent disease in the non-tumor group was mucopolysaccharidosis (48 patients, 42.48%). The antibiotic piperacillin-tazobactam (136 prescriptions, 63.85%) and antifungal agents fluconazole (118 prescriptions) and voriconazole (72 prescriptions, 36.36%) were the most frequently applied antibiotics and antifungal agents, respectively. In patients receiving antibacterial therapy, the median treatment period was 10 days, and the majority of patients were found to have treatment periods of between 7 and 14 days. This corresponded to a non-significant trend toward longer treatment in school-age children compared with infants (10 vs. 8 days).

CONCLUSION: In pediatric HSCT recipients, antibacterial and antifungal therapy is predominantly broad-spectrum with moderate durations; school-age children have slightly longer courses without significant differences.

PMID:41578231 | DOI:10.1186/s12887-026-06536-9

BMC Infect Dis. 2026 Jan 23. doi: 10.1186/s12879-026-12521-5. Online ahead of print.

NO ABSTRACT

PMID:41578214 | DOI:10.1186/s12879-026-12521-5

BMC Med Res Methodol. 2026 Jan 23. doi: 10.1186/s12874-026-02771-x. Online ahead of print.

NO ABSTRACT

PMID:41578196 | DOI:10.1186/s12874-026-02771-x

BMC Med Res Methodol. 2026 Jan 24. doi: 10.1186/s12874-025-02760-6. Online ahead of print.

NO ABSTRACT

PMID:41578192 | DOI:10.1186/s12874-025-02760-6

Ann Clin Transl Neurol. 2026 Jan 23. doi: 10.1002/acn3.70313. Online ahead of print.

ABSTRACT

BACKGROUND: SOX1 antibody-positive paraneoplastic neurological syndromes (PNS) exhibit significant population-specific clinical heterogeneity. While Western cohorts predominantly manifest Lambert-Eaton myasthenic syndrome (65%-80%), comprehensive clinical characterization and treatment response data in Asian populations remain critically limited.

METHODS: We conducted a single-center retrospective case series analyzing 13 consecutive patients with SOX1 antibody-positive PNS treated at Guangdong Sanjiu Brain Hospital from January 2019 to December 2024. SOX1 antibodies were confirmed using commercial immunoblot assay. Primary endpoints included treatment response (≥ 1-point improvement on modified Rankin Scale [mRS]) and functional recovery (mRS ≤ 2). Statistical analyses employed Fisher’s exact tests and Mann-Whitney U tests.

RESULTS: Among 13 patients (median age 61 years [IQR 56-67], 53.8% female), neuropsychiatric presentations predominated, including seizures (46.2%) and psychiatric symptoms (30.8%), with combined neuropsychiatric manifestations occurring in 53.8% of patients. Co-existing neuronal antibodies were identified in 15.4% of cases (GABAB receptor, LGI1). Malignancy was confirmed in 30.8% of patients. Immunotherapy recipients (n = 7) demonstrated significantly superior functional outcomes compared to non-treated patients: median 3-month mRS 0 (IQR 0-0) versus 3 (IQR 3-3), p = 0.03. Treatment response rates were 85.7% versus 33.3% (p = 0.103).

CONCLUSIONS: Chinese patients with SOX1 antibody-positive PNS demonstrate a neuropsychiatric-predominant phenotype (53.8%), contrasting markedly with Western cohorts. Early immunotherapy administration was associated with superior functional outcomes (median 3-month mRS: 0 vs. 3, p = 0.03). These findings support comprehensive neuronal antibody profiling and early immunotherapy consideration in patients presenting with neuropsychiatric manifestations.

PMID:41578161 | DOI:10.1002/acn3.70313

World J Biol Psychiatry. 2026 Jan 23:1-9. doi: 10.1080/15622975.2026.2617200. Online ahead of print.

ABSTRACT

INTRODUCTION: Suicidal behaviour, including completed suicide and attempted suicide, is affected by genetic factors, involving serotonergic system genes. TPH2 gene encodes tryptophan hydroxylase 2, rate-limiting brain serotonin synthetising enzyme whose pre-mRNAs are edited by ADAR enzymes, including ADARB1. TPH2 rs4290270 and ADARB1 rs9983925/rs4819035 variants have been previously implicated in suicide attempt in Serbian psychiatric patients. Our aim was to investigate whether these variants could also contribute to genetic predisposition for a more extreme phenotype-completed suicide differentiated by violent and non-violent method-in a Slovenian cohort.

METHODS: Genotyping of TPH2 rs4290270 and ADARB1 rs9983925/rs4819035 was performed on sample including 333 suicide completers (305 violent and 28 non-violent), and 357 non-suicidal autopsy controls from Slovenia. Statistical analyses were performed in PLINK ver. 1.9.

RESULTS: TPH2 rs4290270 AA genotype increased the risk of completed suicide compared to controls (p = 0.032/0.031^corrected), mainly driven by violent suicide (p = 0.045/0.044^corrected). Preliminary, ADARB1 rs4819035 GT and GG genotypes increased the risk of non-violent completed suicide compared to controls (p = 0.015/0.011^corrected), and to violent completed suicide (p = 0.026/0.022^corrected).

CONCLUSION: TPH2 and ADARB1 genetic variants shape different genetic backgrounds in different types of suicidal behaviour, completed and attempted suicide. Preliminary, these variants might also differentiate between various methods of completed suicide, violent and non-violent.

PMID:41578154 | DOI:10.1080/15622975.2026.2617200

Scand J Caring Sci. 2026 Mar;40(1):e70190. doi: 10.1111/scs.70190.

ABSTRACT

AIMS AND OBJECTIVES: Patients’ perspectives on quality of care are vital, and cross-country comparisons of inpatient settings can provide valuable insights. This study aims to describe and compare Norwegian and Swedish patients’ perceptions of the quality of their inpatient mental healthcare. It also explores how admission status (voluntary vs. involuntary), demographics and clinical characteristics are associated with these perceptions.

ETHICAL ISSUES AND APPROVAL: The study adhered to the Declaration of Helsinki and received approval from the Regional Ethical Committees in both countries.

RESEARCH METHODS: A cross-sectional, descriptive-comparative design was applied. Adult inpatients meeting inclusion criteria were recruited from 21 mental health hospital wards in Norway and Sweden using convenience sampling. Data were collected using the validated Quality in Psychiatric Care-Inpatient (QPC-IP) instrument. Of 354 returned questionnaires, 40 were excluded due to missing data, leaving 155 Norwegian and 159 Swedish for analysis. Descriptive statistics and inferential analyses were conducted to examine differences (p ≤ 0.05).

OUTCOME MEASURES: Perceived quality of mental healthcare, measured with the QPC-IP.

RESULTS: Norwegian patients reported significantly higher perceived quality of care than Swedish patients across all QPC-IP dimensions: Encounter, Participation, Discharge, Support, Secluded Environment and Secure Environment. Significant interactions between country and admission status were observed on the Support and Discharge dimensions, with involuntarily admitted Swedish patients reporting the lowest quality of care.

STUDY LIMITATIONS: Although the study included multiple hospitals in both countries, the sample size was relatively small. While not designed to yield generalisable results, the limited sample may still restrict transferability. Data was collected during different time periods, which may have introduced time-related variation.

CONCLUSIONS: The findings reveal significant differences in perceived quality of mental healthcare between the two settings, underscoring the need to explore factors contributing to these disparities.

PMID:41578152 | DOI:10.1111/scs.70190

Nat Commun. 2026 Jan 23. doi: 10.1038/s41467-026-68707-7. Online ahead of print.

ABSTRACT

Brain age prediction has been widely utilized to assess functional connectivity (FC) development, but conventional global brain age indices are limited in capturing spatial heterogeneity across the cortex. This study introduces a regional brain development index to characterize fine-grained FC maturation across cortical regions. We examined its spatial variability and stratified individuals into subtypes with distinct region-wise FC developmental patterns. Using data from the Philadelphia Neurodevelopmental Cohort (ages 8-23 years), we identified three distinct subtypes and found that individuals with advanced FC developmental pattern aligning with the sensorimotor-association axis exhibited superior cognitive performance. Robustness was confirmed through replication in the Human Connectome Project Development cohort. Further analyses revealed associations between FC development and gene expression linked to neural differentiation, synaptogenesis, and myelination. These findings suggest that spatial heterogeneity in FC development reflects cortical microstructure and hierarchical organization, underscoring its critical role in neurocognitive maturation during youth.

PMID:41578132 | DOI:10.1038/s41467-026-68707-7