Tag: pubmed

Clin Exp Rheumatol. 2025 May 31. doi: 10.55563/clinexprheumatol/b90gug. Online ahead of print.

ABSTRACT

OBJECTIVES: Ultrasound (US) detection of peritenon extensor tendon inflammation (PTI) was found highly specific for spondyloarthropathies (SpA), including psoriatic arthritis (PsA). However, this finding has not been extensively investigated. This study aimed to investigate the value of PTI at metacarpophalangeal (MCP) joint level in the differential diagnosis between rheumatoid arthritis (RA) and PsA, and analyse the differences between early (less than 1 year of disease duration) and established (more than 1 year of disease duration) disease groups.

METHODS: Consecutive RA and PsA patients with clinical involvement of at least one MCP joint were enrolled. The 2nd to the 5th MCP joints of both hands were scanned on the dorsal aspect to detect intra-articular and peri-tendinous inflammatory findings using both B-mode and power Doppler (PD) mode.

RESULTS: The study included a total of 69 patients, 37 patients with RA and 32 patients with PsA. PTI was found in a significantly higher number of patients with PsA rather than in RA patients. Conversely, there was no statistical difference in terms of PTI prevalence between RA and PsA patients in the early disease groups. On the other hand, no statistically significant difference was found in terms of synovitis prevalence between RA and PsA patients.

CONCLUSIONS: PTI was found more frequently in PsA rather than in RA patients. Nevertheless, since no statistically significant difference was found between RA and PsA patients with less than 1 year of disease duration, PTI may represent an inflammatory feature of the early phases of both the diseases.

PMID:40470548 | DOI:10.55563/clinexprheumatol/b90gug

JMIR Public Health Surveill. 2025 Jun 4;11:e67725. doi: 10.2196/67725.

ABSTRACT

BACKGROUND: Nonpharmaceutical interventions (NPIs) are effective tools for pandemic containment but often impose significant socioeconomic consequences that intensify over time. Public support and compliance to NPIs are crucial to ensure their effectiveness.

OBJECTIVES: This study aimed to elicit preferences of a Singaporean population for the reintroduction of NPIs in response to the emergence of a new SARS-CoV-2 variant during the COVID-19 endemic phase.

METHODS: A web-based discrete choice experiment (DCE) was conducted. DCE attributes reflected key NPIs implemented in Singapore during the COVID-19 pandemic from 2020 to 2022, including mask wearing, dining restrictions, suspension of vocalization activities and large-scale events, quarantine after international travel, and mandatory vaccine boosters. Participants were recruited from a demographically representative online panel. Statistical analysis was performed using a mixed-logit model and mixed-mixed multinomial logit model.

RESULTS: A total of 1552 participants were included in the analysis. Overall preferences from the mixed-logit model showed that mask wearing was valued, both in public and indoors. Dining restrictions allowing groups of up to 5 people were preferred, but stricter dining restrictions allowing up to 2 people or no dining out were not favored. Prohibiting large-scale events was not preferred. Participants accepted quarantine at home but opposed quarantine in government facilities. Two classes emerged from the mixed-mixed logit model: class 1 (“Prefer NPIs”) and class 2 (“Prefer No NPIs”). While class 1 (39%) was only opposed to a complete prohibition on dining in at food and beverage establishments, no NPIs were preferred by class 2 (61%). Both classes were not opposed to mandatory mask wearing, dining restrictions allowing groups of up to 5 people, and mandatory vaccine boosters. Sex, age, education, employment status, the number of COVID-19 vaccine shots received, and risk attitude were associated with individuals’ likelihood of belonging to a specific preference group.

CONCLUSIONS: Following the emergence of a new SARS-CoV-2 variant after a prolonged period of restrictions, less disruptive NPIs such as mask wearing indoors were valued by the public and should be swiftly reinstated. Adaptive strategies should be adopted for more contentious NPIs, such as strict dining restrictions and quarantine policies. Public preferences should be considered in the design and selection of NPIs for future pandemic containment strategies to enhance compliance and effectiveness.

PMID:40470547 | DOI:10.2196/67725

High Alt Med Biol. 2025 Jun 5. doi: 10.1089/ham.2025.0028. Online ahead of print.

ABSTRACT

Berendsen, Remco R., Dirk C A.A. de Vries, Alea Steger, Nadine Herold, Feico J.J. Halbertsma, Adriaan F. Norbart, Hannes Gatterer, and Bengt Kayser. Lack of altitude medicine knowledge among mountaineers in the Italian Alps. High Alt Med Biol. 00:00-00, 2025. Introduction: In 2022, expert consensus defined a set of minimum altitude medicine knowledge statements for laypersons traveling to high altitudes (STAK: strengthening altitude knowledge). We used these statements to assess knowledge among mountaineers in the Italian Alps. Methods: Mountaineers in a hut (3,647 m) completed an online STAK-based questionnaire, also indicating their confidence after each answer. A score of ≥19/28 was used as a statistical threshold, exceeding chance alone. Logistic regression assessed the link between confidence and correctness; multivariate regression explored demographic, educational, and behavioral predictors of achieving an above-threshold score. Results: Of 576 participants, 412 (72%) were included in the final analysis and 115 (28%) scored ≥19. Among them, 59% of medical professionals, 36% of mountain guides, and 23% of general participants reached the threshold; the medical professionals scored significantly higher than the general participants (p < 0.001). Both being a mountain guide (odds ratios [OR]: 2.3, 95% confidence intervals [CI]: 1.0-5.0, p < 0.05) and being a medical professional (OR: 4.5, 95% CI: 2.1-10.0, p < 0.001) were associated with higher scores. Conclusion: Using STAK as a benchmark, we found a substantial lack of altitude medicine knowledge in mountaineers, even among guides and medical professionals. These findings suggest a potential for targeted educational interventions.

PMID:40470536 | DOI:10.1089/ham.2025.0028

Lancet Reg Health West Pac. 2025 May 8;58:101571. doi: 10.1016/j.lanwpc.2025.101571. eCollection 2025 May.

ABSTRACT

BACKGROUND: Hong Kong has one of the longest life expectancies in the world but was heavily impacted by COVID-19 in 2022. We aimed to estimate patterns in mortality rates and changes in life expectancy in Hong Kong during the COVID-19 pandemic.

METHODS: We constructed sex-specific life tables from 1998 to 2023 using parametric bootstrapping to account for statistical uncertainty in mortality rates. We used Arriaga’s decomposition method to estimate age- and cause-specific contributions to overall changes in life expectancy for 2020-2023, with 2019 as the reference year. We also estimated cause-specific mortality rates.

FINDINGS: Hong Kong reported 50,666 deaths in 2020, 51,354 in 2021, 63,692 in 2022, and 54,731 in 2023. Estimates of life expectancy in males and females in 2020 and 2021 were similar to the pre-pandemic trend from 1998 to 2019 but declined significantly in 2022. Compared to the pre-pandemic trend, the 2022 values of 80.4 years for males and 86.4 years for females corresponded to reductions by 2.22 (95% CI: 2.08, 2.36) years in males and 2.30 (95% CI: 2.17, 2.43) years in females. The loss in life expectancy in 2022 was mainly attributed to increased respiratory mortality rates, with a negative contribution to life expectancy of 1.47 and 1.26 years for males and females respectively. In 2023 life expectancy increased by 0.60 (95% CI: 0.46, 0.75) years in males and by 1.10 (95% CI: 0.95, 1.26) years in females.

INTERPRETATION: In 2022 a very high respiratory mortality rate in older adults in Hong Kong during the COVID-19 pandemic was associated with a reduction in life expectancy by more than 2 years. In 2023 life expectancy increased towards the pre-pandemic trend.

FUNDING: Health and Medical Research Fund, Hong Kong.

PMID:40470520 | PMC:PMC12134540 | DOI:10.1016/j.lanwpc.2025.101571

Orthop J Sports Med. 2025 Jun 3;13(6):23259671251327684. doi: 10.1177/23259671251327684. eCollection 2025 Jun.

ABSTRACT

BACKGROUND: Burnout has been associated with decreased quality of patient care and results in an estimated cost of roughly $5 billion per year. With a growing awareness of burnout prevalence in high-level athletes, the physicians working with the athletic departments of the National Collegiate Athletic Association (NCAA) institutions can be forgotten.

PURPOSE: To assess the prevalence of burnout among physicians of the NCAA teams and assess predictors that may lead to burnout.

STUDY DESIGN: Cross-sectional study.

METHODS: A cross-sectional survey using the Professional Fulfillment Index scale with demographic data was sent to multiple Division I NCAA conferences. Eligible participants included any physicians who care directly for Division I NCAA teams. Each item was assessed on a 5-point Likert scale, and comparisons were made between those who did and did not achieve burnout. Linear and logistic regression models were used to assess predictors of burnout score and achievement of burnout, respectively.

RESULTS: Of the 89 completed responses, 79 (79/89; 89%) participants qualified as having achieved burnout. No significant differences were identified in burnout achievement based on patient demographics. Specifically, there was no difference in burnout achievement based on specialty (P = .16), taking call (P = .05), or years in practice (P = .12). A linear regression model showed that the only significant predictor of burnout score was specialty, with family medicine-sports medicine and Other both associated with greater burnout scores (P < .001 and P = .002, respectively) compared with orthopaedics.

CONCLUSION: The prevalence of burnout in NCAA physicians is extremely high, even compared with the rate of other physicians, and the lack of predictive factors shows this issue to be multifactorial. Further studies need to be conducted with larger sample sizes, as well as isolating historical factors of burnout, to better improve the health of this unique physician population.

PMID:40470518 | PMC:PMC12134507 | DOI:10.1177/23259671251327684

Orthop J Sports Med. 2025 Jun 2;13(6):23259671251327600. doi: 10.1177/23259671251327600. eCollection 2025 Jun.

ABSTRACT

BACKGROUND: Anterior cruciate ligament (ACL) injuries are common in sports. These injuries often present with ≥1 meniscal tears, which may affect pre- and postoperative patient outcomes.

PURPOSE: To compare patient-reported outcome measures (PROMs) between isolated ACL reconstruction (ACLR) and ACLR with concomitant meniscal surgery, such as meniscal repair or arthroscopic partial meniscectomy, over 2 years to aid in preoperative counselling and rehabilitation.

STUDY DESIGN: Cohort study; Level of evidence 3.

METHODS: This retrospective study included 415 consecutive patients who underwent ACLR at a tertiary referral hospital between January 2009 and December 2022. PROMs-including the Knee injury and Osteoarthritis Outcomes Score (KOOS) and the Lysholm score-were assessed preoperatively and at the 2-year follow-up between the isolated ACLR group and the ACLR with meniscal surgery group using the Mann-Whitney U test. A Wilcoxon signed-rank test within groups was used to assess preoperative to the 2-year follow-up improvements. Also, 95% CIs were utilized to provide the likely values of the true population mean. Two-tailed significance tests were used, and the statistical significance level was set at P < .05.

RESULTS: The patients in the 2 groups (isolated ACLR group, n = 205 and ACLR with meniscal surgery group, n = 210) had similar baseline characteristics for age, sex, and body mass index (P > .05). The meniscal surgery group showed significantly worse Lysholm scores (71.1 [95% CI, 68.8-73.5] vs 74.9 [95% CI, 72.6-77.1]; P = .017) and KOOS domain scores preoperatively compared with the isolated ACLR group: KOOS Symptoms, 72.4 (95% CI, 69.9-75) versus 77.3 (95% CI, 75-80) (P = .011); KOOS Activities of Daily Living, 81.4 (95% CI, 79-83.7) versus 85.6 (95% CI, 83.6-87.6) (P = .006); KOOS Pain, 76.3 (95% CI, 73.9-78.8) versus 81(95% CI, 78.7-83.2) (P = .006); and KOOS Quality of Life, 39.4 (95% CI, 36.4-42.5) versus 43.9 (95% CI, 41-46.9) (P = .028). However, the KOOS Sport and Recreation domain had a lower and insignificant mean (35.6 [95% CI, 31.7-39.4] vs 39.9 [95% CI, 36.2-43.6]; P = .061). Both groups significantly improved across all PROMs at the 2-year follow-up (P < .001). When compared with the isolated ACLR group, the meniscal surgery group had lower postoperative scores for Lysholm scores (93.8 [95% CI, 92.6-95] vs 95.3 [95% CI, 94.3-96.4]; P = .017), the KOOS Sport and Recreation Function (87.5 [95% CI, 85.1-90] vs 89.6 [95% CI, 87-92.2]; P = .025), and the KOOS Pain (97 [95% CI, 96-98] vs 96.7 [95% CI, 95.9-97.6]; P = .010), with insignificant differences in other KOOS domains (P > .05).

CONCLUSION: The study demonstrated that patients undergoing ACLR with concurrent meniscal surgery initially showed slightly poorer functional scores compared with those who underwent isolated ACLR. Both groups showed significant postoperative improvements. However, patients requiring surgical intervention for concurrent meniscal injuries can expect poorer functional outcomes than those requiring isolated ACLR, even after 2 years. These data may be important when counselling patients presenting with ACL tears who need to receive surgical treatment.

PMID:40470515 | PMC:PMC12130643 | DOI:10.1177/23259671251327600

Biologics. 2025 May 31;19:351-363. doi: 10.2147/BTT.S530354. eCollection 2025.

ABSTRACT

Guselkumab, a selective interleukin-23 (IL-23) inhibitor, has emerged as a promising biologic therapy for the management of patients with moderate-to-severe Crohn’s disease (CD) and has been recently approved for its treatment. Unlike conventional therapies, guselkumab offers a different mechanism of action by selectively inhibiting IL-23, a key cytokine implicated in the pathogenesis of CD. IL-23 drives intestinal inflammation through activation of the Th17 cell pathway and other immune processes, positioning IL-23 inhibition as a critical therapeutic approach. In randomized Phase III clinical trials, guselkumab proved to be effective in inducing clinical and endoscopic remission both in patients naive to biologics and in patients already exposed to advanced therapies. Furthermore, no safety issues were found, supporting the well-characterized safety in other indications and its use in clinical practice also in IBD. Moreover, guselkumab has been approved for other immunomediated inflammatory disease moderate to severe plaque psoriasis, psoriatic arthritis and ulcerative colitis. This review summarizes the available evidence on efficacy and safety of guselkumab in patients with moderate to severe CD, focusing on its positioning in the treatment algorithm.

PMID:40470513 | PMC:PMC12136076 | DOI:10.2147/BTT.S530354

Front Neurol. 2025 May 21;16:1601778. doi: 10.3389/fneur.2025.1601778. eCollection 2025.

ABSTRACT

BACKGROUND: Parkinsonism is a progressive neurodegenerative disorder characterized by motor and non-motor impairments, significantly impacting quality of life (QoL). Transcranial direct current stimulation (tDCS) has shown promise in improving motor and cognitive functions when combined with physical therapy. This study aimed to explore the association between tDCS exposure and disability levels, as well as its impact on self-reported QoL in individuals with Parkinsonism undergoing physical therapy.

METHODS: This cross-sectional study enrolled 51 participants diagnosed with Parkinsonism from a tertiary care hospital’s neurology outpatient clinic. Based on clinical records of tDCS sessions, participants were stratified into tDCS-exposed and non-exposed groups. Disability was assessed using the World Health Organization Disability Assessment Schedule, and QoL was measured using the Parkinson’s Disease Questionnaire (PDQ-39). Statistical analyses included t-tests for comparing means and Pearson correlation coefficients for assessing relationships between tDCS exposure, disability, and QoL.

RESULTS: The tDCS-exposed group demonstrated lower mean disability scores (WHODAS 2.0: 42.50 ± 8.12) and better quality of life scores (PDQ-39: 35.10 ± 6.45) compared to the non-exposed group (WHODAS 2.0: 45.30 ± 9.21; PDQ-39: 40.15 ± 7.32); however, these differences were not statistically significant (disability: p = 0.131; QoL: p = 0.236). Subgroup analyses revealed statistically significant improvements among participants under 65 years of age (disability mean difference = -3.3, 95% CI: -6.17 to -0.43, p = 0.023) and those in Hoehn and Yahr stages 1-2 (QoL mean difference = -3.7, 95% CI: -6.16 to -1.24, p = 0.004). Additionally, a moderate negative correlation was observed between tDCS session frequency and disability scores (r = -0.60, 95% CI: -0.78 to -0.30, p = 0.04), and a weak negative correlation with quality of life scores (r = -0.43, 95% CI: -0.66 to -0.11, p = 0.039).

CONCLUSION: These findings suggest possible associations between tDCS exposure and clinical outcomes in individuals with Parkinsonism; however, due to the cross-sectional design and underpowered subgroup analyses, results should be interpreted with caution and viewed as hypothesis-generating.

PMID:40470495 | PMC:PMC12133549 | DOI:10.3389/fneur.2025.1601778

Front Neurol. 2025 May 21;16:1562079. doi: 10.3389/fneur.2025.1562079. eCollection 2025.

ABSTRACT

BACKGROUND: Epilepsy affects approximately 70 million people globally, with a prevalence in Mexico of 10.8 to 20 cases per thousand. Antiseizure Medications (ASM) are the first line of treatment for people with epilepsy (PWE), aiming to achieve early seizure control while minimizing adverse effects that could impact quality of life.

MATERIALS AND METHODS: This retrospective cohort study analyzed data from 2020 to 2024 collected from medical records, clinical histories, and electronic systems, using REDCAP^® and SPSSV21^®. It included all epilepsy patients treated at the National Institute of Neurology and Neurosurgery “MVS” in Mexico City. Descriptive statistics were reported as means ± standard deviations for quantitative variables and percentages for categorical variables. Bivariate analysis used the Q Cochran test for dichotomous variables and the chi-square or Fisher’s exact test for qualitative variables.

RESULTS: Of 1,192 prescriptions, third-generation ASMs accounted for the majority (53.7%), led by levetiracetam (24.1%), lamotrigine (14%), and lacosamide (6%). Second-generation ASMs comprised 42.4%, including valproate (21.5%), carbamazepine (11.3%), and clonazepam (5.5%). First-generation ASMs were less frequently prescribed (3.9%), primarily phenytoin (2.3%), primidone (1.0%), and phenobarbital (0.3%). Third-generation ASMs were the most prescribed for focal seizures (38.6%), generalized seizures (13.3%), and seizures of unknown (1.9%) or unclassified types (2.1%).

DISCUSSION: Compared to a 2012 study in the same population, which showed second-generation ASM as dominant, this study highlights a significant shift toward third-generation ASM, now representing over half of prescriptions. While valproate and carbamazepine remain versatile second-generation options, newer ASMs, such as levetiracetam, are increasingly favored.

CONCLUSION: These findings demonstrate a preference for second- and third-generation ASMs in tertiary hospitals in Latin America, which is concordant with global trends. First-generation ASMs are still prescribed but at lower rates. These results provide insights into changing prescription practices and access to newer medications, informing future research and hospital policies.

PMID:40470492 | PMC:PMC12135803 | DOI:10.3389/fneur.2025.1562079

Front Neurol. 2025 May 21;16:1499407. doi: 10.3389/fneur.2025.1499407. eCollection 2025.

ABSTRACT

OBJECTIVE: Quantitative evaluation of the effect of exercise intervention in amyotrophic lateral sclerosis (ALS).

METHODS: The CNKI, WOS, PubMed, and Scopus databases were searched by computer, and randomized controlled trials (RCTs) of exercise intervention in ALS were screened out according to the inclusion and exclusion criteria of the PICOS principle. Stata 12.0 software was used for statistical analysis.

RESULTS: A total of 12 RCTs including 430 participants were included. Meta-analysis results show that exercise intervention can significantly improve the overall function, walking test (WT) distance and maximum expiratory pressure (MEP) of ALS patients (p < 0.05). However, exercise interventions did not show significant effects on fatigue, maximum inspiratory pressure (MIP), forced vital capacity (FVC), and peak expiratory flow (PEF) in ALS patients (p > 0.05). Subgroup analysis showed that resistance exercise is the most effective intervention for improving the function of ALS patients, while aerobic exercise is the most effective intervention for improving FVC in ALS patients.

CONCLUSION: Exercise intervention in ALS has a positive effect, but due to the small number of included studies and possible heterogeneity, risk of bias and sensitivity issues, further research is needed.

PMID:40470490 | PMC:PMC12133518 | DOI:10.3389/fneur.2025.1499407