Tag: pubmed

Neurol Ther. 2026 Feb 18. doi: 10.1007/s40120-026-00891-6. Online ahead of print.

ABSTRACT

INTRODUCTION: The spinocerebellar ataxia composite score (SCACOMS) comprises items from the functional Scale for the Assessment and Rating of Ataxia (f-SARA) and the Clinician Global Impression of Change (CGI-C). In the derivation of SCACOMS, weights reflecting 1-year responsiveness were assigned to each item using partial least squares (PLS) regression modeling. The current objective was to incorporate patient-feedback into the SCACOMS item weights, examine corresponding responsiveness of the composite scale, and discuss potential implications for future use.

METHODS: Item weights derived by PLS regression were compared to each item’s relative importance as assigned by 16 patients with SCA during semi-structured interviews. SCACOMS item weights were adjusted using the following combinations: (1) 50/50 weighted combination of PLS and patient weights and (2) reducing the weight of CGI-C to 20% and averaging individual item weights obtained from each perspective. The 1-year mean to standard deviation ratios (MSDRs) for the resulting reweighted scales were compared, with larger MSDRs indicating greatest sensitivity to disease progression.

RESULTS: The PLS-derived SCACOMS had the highest MSDR (0.99). When item weights were averaged across the two sources, the resulting MSDR was 0.91. When the weight of CGI-C was set to 20%, reflecting patient preferences for higher weights on the discrete symptoms, the MSDR was 0.79.

CONCLUSIONS: This study took a novel approach to enhance the face validity of SCACOMS by incorporating patient feedback into the statistically optimized item weights. The result is the merging of objectively derived item weightings (reflecting optimal scale responsiveness) with patient-assigned relevance. While this update may increase the patient centricity of a composite measure, this comes at the expense of reduced sensitivity. This potential trade-off in sensitivity to detect change should be evaluated in the context of the composite measure’s intended use.

PMID:41706362 | DOI:10.1007/s40120-026-00891-6

Sleep Breath. 2026 Feb 18;30(1):55. doi: 10.1007/s11325-026-03591-5.

ABSTRACT

BACKGROUND: Investigation of Restless Legs Syndrome (RLS) in patients with poliomyelitis sequelae (PS) and the effect of RLS on pain, fatigue, sleep and quality of life (QoL).

METHOD: We investigated the presence of RLS in patients with PS who consecutively applied to the neurology outpatient clinic and did not have secondary causes of RLS. Gender, age, side affected by PS, leg muscle strength and length, International RLS Study Group criteria, Pittsburgh Sleep Quality Index questionnaire, Fatigue Severity Scale, SF-36 Form scores were recorded. After receiving a diagnosis of RLS, patients completed the RLS Severity Rating Scale (RLS-SWS) questionnaire.

RESULTS: We identified RLS in 12 (37.5%) of the 32 patients included in the study. There were no differences in demographic characteristics. The leg lengths in the patients with RLS (PwRLS) were significantly shorter (p < 0.001). PwRLS had shorter sleep duration, longer latency, and worse sleep quality and fatigue severity scores (p < 0.001). The pain score was found to be statistically significantly higher in the PwRLS group (p = 0.007). There were no differences in other QoL areas. In the PwRLS study, the RLS-SWS score was positively correlated with sleep latency, sleep quality, and pain and fatigue scores. It was also negatively correlated with sleep duration (p < 0.001).

CONCLUSION: These findings demonstrate that RLS, which has an effective treatment, is a prevalent condition among PS patients that worsens sleep quality and increases pain. Clinicians should screen PS patients who complain of leg pain and/or sleep disturbances for RLS and provide appropriate treatment.

PMID:41706359 | DOI:10.1007/s11325-026-03591-5

J Gambl Stud. 2026 Feb 18. doi: 10.1007/s10899-026-10483-6. Online ahead of print.

NO ABSTRACT

PMID:41706356 | DOI:10.1007/s10899-026-10483-6

Neurosurg Rev. 2026 Feb 18;49(1):232. doi: 10.1007/s10143-026-04139-7.

ABSTRACT

Penetrating traumatic brain injury (pTBI) is a severe subset of cranial trauma associated with high mortality and a substantial burden of intracranial infections. The pTBI infection rates have decreased from approximately 60% in the pre-war era to about 10% today, due to improvements in operative debridement, critical care, and widespread antibiotic availability; however, the independent effect of prophylactic antibiotics remains uncertain, and clinical practice is highly variable. This systematic review and meta-analysis aims to determine whether prophylactic antibiotics truly reduce intracranial infections in pTBI patients. A systematic review and meta-analysis were conducted following PRISMA guidelines. The PubMed, Scopus, and LILACS were rigorously searched. The primary effectiveness outcome analyzed was the risk of central nervous system infection. Secondary outcomes included antibiotic regimens and duration, mortality, and functional outcomes were assessed. Data were analyzed using a random-effects meta-analysis, and statistical heterogeneity was assessed. The study was registered with PROSPERO (CRD420251033854). Eight studies comprising 1372 patients (891 received antibiotic prophylaxis and 481 did not) were included. We found that the administration of prophylactic antibiotics did not significantly reduce the risk of suffering an intracranial infection OR 1.10 (95% CI 0.29-4.22 I² = 48.8%). Furthermore, there was no statistically significant difference between monotherapy and multiple antibiotics, or shorter versus longer courses. Moreover, only one study employed a standardized antibiotic regimen. Prophylactic antibiotic administration in patients with penetrating traumatic brain injury was not associated with a statistically significant reduction in the risk of intracranial infections, as evidenced by substantial heterogeneity in the available literature. However, if prophylaxis is administered, it should be a short-course, monotherapy regimen. These findings highlight the urgent need for high-quality, standardized clinical trials to establish evidence-based guidelines for the use of prophylactic antibiotics in this high-risk population.

PMID:41706320 | DOI:10.1007/s10143-026-04139-7

Child Psychiatry Hum Dev. 2026 Feb 18. doi: 10.1007/s10578-026-01979-8. Online ahead of print.

ABSTRACT

Children and young people living in the Occupied Palestinian Territory (OTP) are repeatedly exposed to potentially traumatic events that can challenge their mental health and school functioning. This study aimed to develop a practical checklist of conflict-related potentially traumatic events of relevance in the school context throughout the OPT. Post-traumatic stress reactions (PTSR) and school functioning assessed the predictive validity of the checklist. Furthermore, we sought to explore the frequency of exposure, PTSR and school functioning between the areas in the OTP and explore how frequency and severity of exposure was associated to PTSR and school functioning. The study was conducted using a mixed method approach between January-June 2019. A qualitative approach with focus group workshops in Gaza city and Ramallah in the West Bank defined the checklist. Quantitative data and statistical analysis validated the checklist and explored the further objectives. The checklist was administered to pupils aged 12-16 (N = 789) recruited from 17 schools in East-Jerusalem, the West Bank and the Gaza Strip, which reported a mean of 5.06 (SD = 2.48) conflict-related potentially traumatic events within the past three months, regardless of where they came from. The predictive validity of the checklist was found to be significant (p < .01), and exposure predicted PTSR and school functioning. Since the checklist consists of only 12 items, it is practical to use for screening and monitoring in a school context. The extent to which the checklist can serve as a multipurpose checklist remains to be tested through practical use, followed by evaluations and further research.

PMID:41706280 | DOI:10.1007/s10578-026-01979-8

Behav Genet. 2026 Feb 18. doi: 10.1007/s10519-026-10256-2. Online ahead of print.

ABSTRACT

Socioeconomic status (SES) predicts age-related changes in health status; however, the source of SES-health associations is heavily debated. Twin studies allow tests of causal hypotheses by modeling within and between twin pair differences in longitudinal latent growth curve models (LGCM) of physical aging, examining level of functioning and rate of change with age. Three longitudinal twin studies of aging (mean age at baseline = 71.36, SD = 10.7) from the Swedish Twin Registry (N = 1369) included up to 27 years of follow-up on a Functional Aging Index (FAI) consisting of lung function, grip strength, walking speed, and self-report sensory functioning. SES indicators included education, financial strain, and occupation-based socioeconomic position. Pair means (between family effect) and within pair differences (within family effect) for SES were included as covariates of both intercept and slopes in a two-slope LGCM (intercept at age 75); models were corrected for sex and parental SES. LGCM results were compared across the full sample, then separately for both monozygotic and dizygotic twin pairs. Results indicated genetic confounding in the associations between multiple SES indicators and the FAI intercept. Additionally, the relationship between education longitudinal change in physical aging up to age 75 was subject to genetic confounding. These patterns were replicated among men. In contrast, findings for women pointed to shared environmental influences rather than genetic confounding, although statistical power was reduced in sex-stratified analyses. Results highlight the importance of considering the timing of socioeconomic exposures and gendered life-course trajectories when examining health inequalities in aging.

PMID:41706277 | DOI:10.1007/s10519-026-10256-2

Ecotoxicology. 2026 Feb 18;35(3):44. doi: 10.1007/s10646-025-03022-3.

NO ABSTRACT

PMID:41706230 | DOI:10.1007/s10646-025-03022-3

Pediatr Surg Int. 2026 Feb 18;42(1):99. doi: 10.1007/s00383-026-06342-5.

NO ABSTRACT

PMID:41706211 | DOI:10.1007/s00383-026-06342-5

Emerg Med Australas. 2026 Feb;38(1):e70237. doi: 10.1111/1742-6723.70237.

ABSTRACT

OBJECTIVE: Overuse of CT Pulmonary Angiography (CTPA) remains a challenge in emergency medicine. Some institutions resort to radiologist vetting to reduce unnecessary imaging. This is a pilot study that aims to investigate the effect of radiology vetting on the CTPA yield.

METHODS AND RESULTS: This is a retrospective study comparing CTPA yields with and without radiology vetting. The results showed that there was no statistically significant difference in CTPA diagnostic yield, 11.4% (CI 9.2-14.0) versus 10.2% (CI 6.8-14.6), p = 0.60.

CONCLUSION: This study showed that removing radiologist approval for CTPA did not appear to reduce diagnostic yield.

PMID:41705429 | DOI:10.1111/1742-6723.70237

Pol Przegl Chir. 2025 Dec 3;98(1):1-8. doi: 10.5604/01.3001.0055.4693.

ABSTRACT

&lt;b&gt;Introduction:&lt;/b&gt; This study characterizes patients with abdominal and/or pelvic trauma admitted to Emergency Departments (EDs) in Poland, focusing on differentiating stable from unstable cases. The objective is to inform of evidence-based guidelines for managing these injuries in both critical and non-critical trauma patients. &lt;br&gt;&lt;br&gt;&lt;b&gt;Aim:&lt;/b&gt; The study aims to characterize patients admitted to randomly selected Hospital Emergency Departments in Poland after abdominal and/or pelvic injury. It aims to provide evidence-based recommendations for managing abdominal and pelvic trauma. &lt;br&gt;&lt;br&gt;&lt;b&gt;Materials and methods:&lt;/b&gt; A retrospective analysis was conducted using anonymized medical records from three randomly selected EDs in Poland, representing Levels I, II, and III of the Polish Trauma Care System. Patients with abdominal and/ or pelvic trauma were identified and categorised by trauma type, injury mechanism, severity, and stability. Data were summarized using descriptive statistics, and relationships between variables were analyzed using the Chi-square or Fisher’s exact test, with α = 0.05 for significance. &lt;br&gt;&lt;br&gt;&lt;b&gt;Results:&lt;/b&gt; Of 93,714 ED patients, 708 met the study criteria, with 215 confirmed cases of abdominal and/or pelvic trauma. Closed (blunt) injuries were predominant (96.3%), especially low-energy injuries among older adults. Mild trauma was most common (64.65%) according to the CRAMS scale, while severe injuries accounted for only 8.84%. A substantial proportion of patients were stable upon ED admission, with 69.3% of abdominal trauma and 100% of pelvic trauma patients exhibiting no signs of organ failure or peritoneal symptoms. The findings indicate a higher-than-expected prevalence of stable trauma cases, underscoring the need for guidelines to manage stable but potentially vulnerable patients. &lt;br&gt;&lt;br&gt;&lt;b&gt;Discussion:&lt;/b&gt; This study offers insights into the demographic and clinical characteristics of patients with abdominal and/or pelvic trauma in EDs, with a particular focus on differentiating stable from unstable trauma patients and addressing distinct clinical needs. By testing key hypotheses on trauma type, severity, and patient stability, the study brings attention to areas in trauma management that may benefit from revised protocols and resource allocation. Our findings underscore the importance of recognizing stable trauma patients as a significant but underrepresented group in trauma literature. Existing studies are often conducted in EDs located within trauma centres, which influences the patient populations represented in the literature. Additionally, a common inclusion criterion in such studies is trauma team activation or the explicit identification of unstable patients with systolic blood pressure below 90 mmHg. Research focusing on stable patients with abdominal and/ or pelvic trauma is rare and typically addresses aspects other than the specific characteristics of this group. However, in our study, a substantial proportion of patients with abdominal and/or pelvic trauma were clinically stable upon ED arrival. This has implications for ED triage, where prioritization often leans towards critically unstable cases, potentially overlooking the nuanced needs of stable patients who may still benefit from close monitoring to prevent deterioration. &lt;br&gt;&lt;br&gt;&lt;b&gt;Conclusions:&lt;/b&gt; This study reveals a significant proportion of stable, low-severity abdominal and pelvic trauma cases in Polish EDs, challenging the traditional focus on high-risk, unstable trauma. Recognizing stable patients’ specific needs could optimize triage and resource allocation, reducing unnecessary admissions while maintaining quality care. Future guidelines should integrate protocols for stable trauma cases to improve ED efficiency and patient outcomes. &lt;br&gt;&lt;br&gt;&lt;b&gt;Significance:&lt;/b&gt; The findings of this study underscore the need for optimized resource allocation within EDs. Given the high proportion of clinically stable, low-severity trauma cases, current triage protocols may require adaptation to ensure efficient patient management. The current study provides evidence supporting the refinement of trauma protocols, particularly for geriatric trauma patients, whose stable presentations can be misleading. Additionally, research suggests that dedicated monitoring processes for stable trauma patients could reduce preventable complications, particularly in cases involving lowenergy blunt trauma. Expanding on existing assessment tools, including modified early warning scores (MEWS) and geriatric trauma triage criteria, could help differentiate stable but at-risk patients from those who can be safely discharged.

PMID:41705379 | DOI:10.5604/01.3001.0055.4693