Tag: pubmed

Epilepsia. 2025 Mar 12. doi: 10.1111/epi.18345. Online ahead of print.

ABSTRACT

OBJECTIVE: This study was undertaken to prospectively assess the frequency and type of psychiatric disorders (PDs) in pediatric surgical candidates and evaluate the effects of epilepsy surgery on their psychopathological profile.

METHODS: This is a prospective controlled study. Psychopathology was assessed using both diagnostic interviews and questionnaires completed by clinicians, parents, and whenever possible, patients, at baseline (T0) and 1 year after surgery in operated patients (T1) and 1 year after the first evaluation in a control group of nonoperated patients (T1). A “global assessment measure” was developed to integrate the results of the interviews, and the questionnaires were administered to multiple informants, at both T0 and T1. Descriptive statistics and multivariable analyses were performed for all outcomes. An ordinal logistic regression model was estimated to analyze the correlation between surgical treatment and possible changes in psychopathology at T1.

RESULTS: At T0, 103 children (42 females, mean age at first evaluation = 9.5 ± 3.92 years) with lesional epilepsy were included in the study. Thirty-two patients (31.07%) had at least one PD, and 17 (16.5%) had more than one PD of any type. Sixty-two (60.2%) of 103 patients were enrolled for the T1 phase of the study, of whom 39 underwent epilepsy surgery. The ordinal logistic model revealed that patients who underwent surgery and achieved Engel class I outcome were 17.57 times (p = .047) more likely to experience improvement in their psychopathological profile than those who were not operated on and continued to experience seizures.

SIGNIFICANCE: This prospective controlled study demonstrates a high prevalence of PD in pediatric surgical candidates and a correlation between successful surgery and reduced PD burden. An integrated approach encompassing diagnostic interviews and questionnaires, and accounting for potential disagreement between multiple informants, is essential for carefully assessing psychiatric comorbidities in children with drug-resistant seizures.

PMID:40072310 | DOI:10.1111/epi.18345

Acta Odontol Scand. 2025 Mar 12;84:119-127. doi: 10.2340/aos.v84.43276.

ABSTRACT

The aim was to assess the correlation between periodontal status, whole salivary interleukin-1 beta (IL-1β) levels and oral yeasts carriage (OYC) among individuals with varying ranges of body mass index (BMI). Material and method: The weight, waist circumference (WC), and height of individuals were assessed. Participants were categorized into three groups: Group-1 – normal weight (18.5-24.9 Kg/m2); Group-2 – overweight (25-29.9 Kg/m2); and Group-3 – obese (≥ 30 Kg/m2). Plaque and gingival indices (PI and GI, respectively), probing depth (PD), clinical-attachment-loss (CAL), missing teeth (MT) and marginal-bone-loss (MBL) were assessed. Whole salivary IL-1β levels and OYC were assessed. Group-comparisons were done. P < 0.05 was considered statistically significant. Findings: Twenty-two, 22 and 22 individuals with comparable mean ages were included in groups 1, 2 and 3, respectively. The mean WC and BMI were higher in Group 3 than Groups 1 (P < 0.05) and 2 (P < 0.05). The mean PI, CAL, PD, GI, MT and MBL were higher in Group-3 than groups 1 (P < 0.05) and 2 (P < 0.05). There was no difference in mean PI, CAL, PD, GI, MT and MBL in groups 1 and 2. The salivary flow rate was higher in groups 1 (P < 0.05) and 2 (P < 0.05) than Group-3. The OYC and IL-1β were higher in Group-3 than groups 1 (P < 0.05) and 2 (P < 0.05). There was a correlation between PD and OYC in Group-3 (P < 0.05). Conclusion: Periodontal inflammation is worse, and whole salivary IL-1β levels are elevated in obese than overweight individuals and subjects with normal BMI. There seems to be no association between BMI and OYC.

PMID:40072290 | DOI:10.2340/aos.v84.43276

Nurs Ethics. 2025 Mar 12:9697330251324319. doi: 10.1177/09697330251324319. Online ahead of print.

ABSTRACT

BackgroundNurses working in a clinic must be morally sensitive to identify unethical circumstances and act morally. Educational strategies that can effectively gain this sensitivity are a matter of curiosity.ObjectiveThis study aimed to examine if an interactive ethics training program would benefit (a) moral sensitivity and (b) knowledge.Research DesignThe present study was quasi-experimental based on a control group pretest/posttest.Participants and Research ContextThe study involved 53 nurses from 10 hospitals in Istanbul, Türkiye. The intervention group received the 5-week Interactive Ethics Training Program. Data were collected through the Personal Characteristics Form, Moral Sensitivity Questionnaire, and Nursing Ethics Knowledge Test.Ethical ConsiderationsThe study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Non-Invasive Research Ethics Committee (No. 78/2022) from Istanbul Medipol University.ResultsThere was a statistically significant difference between the two groups in the posttest for moral sensitivity (MD: -10.247; p = .010) and knowledge level (MD: 4178; p = .009).ConclusionAn interactive ethics training program in nursing ethics education positively impacts nurses’ moral sense and knowledge. Improving nurses’ moral awareness can facilitate ethical decision-making. Therefore, it is advised that nurse educators design their curricula based on these results.

PMID:40072238 | DOI:10.1177/09697330251324319

Liver Int. 2025 Apr;45(4):e70059. doi: 10.1111/liv.70059.

ABSTRACT

Metabolic dysfunction-associated steatotic liver disease (MASLD) has become the most common chronic liver disease globally. MASLD is a multisystem disease where metabolic dysfunction plays a key role in the development of MASLD and its most relevant liver-related morbidities and extrahepatic complications, such as cardiovascular disease, chronic kidney disease and certain types of extrahepatic cancers. Among the least examined MASLD-related extrahepatic complications, an ever-increasing number of observational studies have reported a positive association between MASLD and the risk of serious bacterial infections (SBI) requiring hospital admission. This risk remained significant in those studies where statistical analysis was adjusted for age, sex, ethnicity, obesity, type 2 diabetes and other common comorbidities. Notably, the incidence rates of SBI were further increased with more advanced MASLD, especially in patients with MASLD-related cirrhosis, and were also observed for some acute viral infections, including SARS-CoV-2 infection, leading to severe COVID-19. In this narrative review article, we provide an overview of the literature on (a) the recent epidemiological data linking MASLD to the risk of serious bacterial and non-bacterial infections requiring hospital admission, (b) the putative underlying mechanisms through which MASLD may increase the susceptibility to serious infections, both directly and through the immune dysfunction associated with cirrhosis and portal hypertension, and (c) the practical and clinical implications of the increased risk of serious bacterial and non-bacterial infections in the growing global population with MASLD.

PMID:40072231 | DOI:10.1111/liv.70059

Ann Noninvasive Electrocardiol. 2025 Mar;30(2):e70062. doi: 10.1111/anec.70062.

ABSTRACT

INTRODUCTION: Various ventricular repolarization parameters are known to predict ventricular arrhythmias and mortality in various diseases. Although mortality in patients with heart failure with preserved ejection fraction (HFpEF) is similar to that in heart failure with reduced ejection fraction patients, studies on this subject are more limited. Therefore, it is important to evaluate the relationship between ventricular arrhythmias and mortality and ventricular repolarization parameters, especially the frontal plane QRS-T angle, in patients with HFpEF.

METHODS: Electrocardiographic, echocardiographic, and laboratory data of 811 patients were evaluated, and the fQRST angle was calculated on ECG. The occurrence of ventricular tachycardia, ventricular fibrillation, or sudden death within a mean of 48 ± 12 months was recorded. Statistical significance was determined as p < 0.05.

RESULTS: A total of 811 patients were evaluated, 180 patients in the cardiac event group and 631 patients in the no cardiac event group. NT-proBNP, La size, La volume index, Tp-e time, Tp-e/QTc ratio, and fQRS-T angle were statistically significantly higher in the cardiac event group. NT-proBNP level and fQRS-T angle were found to be independent predictors of mortality in multivariate cox analysis. According to ROC analysis, when QRS-T angle has a cut-off value of 58.63, its sensitivity is 81.2, and its specificity is 79.3. Kaplan-Meier analysis also found that when the fQRS-T angle was > 58.63, mortality was higher than at narrower angles.

CONCLUSIONS: According to our study, the fQRS-T angle, which can be easily and inexpensively calculated on ECG, predicts long-term ventricular arrhythmias in patients with HFpEF.

PMID:40072228 | DOI:10.1111/anec.70062

J Vet Pharmacol Ther. 2025 Mar 12. doi: 10.1111/jvp.13506. Online ahead of print.

ABSTRACT

Previous research has shown that azotemic dogs have a lower clearance and higher drug plasma concentrations of ampicillin compared to healthy dogs. The objective of this study was to determine the pharmacokinetics of ampicillin-sulbactam after multiple intravenous doses in hospitalized azotemic and non-azotemic dogs. This prospective study included 29 client-owned dogs; 19 azotemic and 10 non-azotemic. Ampicillin-sulbactam was administered at a combined dose of 22 mg/kg intravenously every 8 h for up to 5 days. Blood samples were obtained at baseline (prior to administration of the first dose of ampicillin-sulbactam), and 1-, 4-, and 8-h post-ampicillin-sulbactam administration each day. Plasma ampicillin was measured using LC-MS and non-compartmental pharmacokinetic modeling and dose interval modeling were performed. Plasma ampicillin exposure (azotemic mean 214.5 ug/mL × h ± 110.8, non-azotemic mean 60.3 ± 35.7; p < 0.0009) and half-life (azotemic mean 3.9 h ± 2.4, non-azotemic mean 1.5 h ± 0.3; p < 0.00001) were statistically greater in azotemic dogs compared to non-azotemic dogs. Single dose interval modeling predicted that 100% of azotemic dogs would have > 50% of the dosing interval with plasma concentrations > MIC (MIC = 2) with q12 h dosing and 79% of azotemic dogs would have > 50% of the dosing interval with plasma concentrations > MIC (MIC = 8) with q12 h dosing. Comparatively, 20% of non-azotemic dogs were predicted to have > 50% of the dosing interval with plasma concentrations > MIC (MIC = 2) with q12 h dosing and 0 non-azotemic dogs would have > 50% of the dosing interval with plasma concentrations > MIC (MIC = 8) with q12 h dosing. This study demonstrated that q12-h dosing of ampicillin-sulbactam in azotemic dogs over multiple days of administration is sufficient to reach the PK-PD target (> 50% of dosing interval > MIC) against susceptible bacteria.

PMID:40072220 | DOI:10.1111/jvp.13506

Radiol Artif Intell. 2025 Mar 12:e240287. doi: 10.1148/ryai.240287. Online ahead of print.

ABSTRACT

“Just Accepted” papers have undergone full peer review and have been accepted for publication in Radiology: Artificial Intelligence. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content. Purpose To test a commercial artificial intelligence (AI) system for breast cancer detection at the BC Cancer Breast Screening Program. Materials and Methods In this retrospective study of 136,700 women (age: µ = 58.8, σ = 9.4, M = 59.0, IQR = 14.0) who underwent digital mammography screening in British Columbia, Canada between February 2019 and January 2020, breast cancer detection performance of a commercial AI algorithm was stratified by demographic, clinical, and imaging features and evaluated using the receiver operating characteristic curve (AUC), and AI performance was compared with radiologists using sensitivity and specificity. Results At 1-year follow-up, the AUC of the AI algorithm was 0.93 (95% CI: 0.92-0.94) for breast cancer detection. Statistically significant differences were found for mammograms across radiologist-assigned BI-RADS breast densities-A: 0.96 (0.94-0.91); B: 0.94 (0.92-0.95); C: 0.93 (0.91-0.95) and D: 0.84 (0.76-0.91) (A_AUC > D_AUC, P = .002; B_AUC > D_AUC, P = .009; C_AUC > D_AUC, P = .02). The AI showed higher performance for mammograms with architectural distortion (0.96, 0.94-0.98) versus without (0.92, 0.90-0.93, P = .003) and lower performance for mammograms with calcification (0.87, 0.85-0.90) versus without (0.92, 0.91-0.94, P < .001). Sensitivity of radiologists (92.6 ± 1.0%) exceeded the AI algorithm (89.4 ± 1.1%; P =.01), but there was no evidence of difference at 2-year follow-up (83.5 ± 1.2% versus 84.3 ± 1.2%; P = .69). Conclusion The tested commercial AI algorithm is generalizable for a large external breast cancer screening cohort from Canada but showed different performance for some subgroups, including architectural distortion or calcification in the image. ©RSNA, 2025.

PMID:40072215 | DOI:10.1148/ryai.240287

Acta Anaesthesiol Scand. 2025 Apr;69(4):e70014. doi: 10.1111/aas.70014.

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) is a serious complication after lung transplantation, but the reported incidence varies in the literature. No data on AKI have been published from the Swedish lung transplantation program.

METHODS: The aim of our study was to investigate the incidence, perioperative risk factors, and effects of early postoperative acute kidney injury (Kidney Disease Improving Global Outcomes [KDIGO] criteria) after lung transplantation. A retrospective, nationwide study of 568 lung-transplanted patients in Sweden between 2011 and 2020 was performed.

RESULTS: The incidence of AKI (any grade) was 42%. Renal replacement therapy was used in 5% of the patients. Preoperative factors independently associated with increased incidence of AKI were higher body mass index (odds ratio [OR]: 1.07, 95% CI: 1.02, 1.12) longer time on transplantation waiting list (OR: 1.05 [1.01, 1.09]), re-transplantation (OR: 2.24 [1.05, 4.80]) and moderate to severe tricuspid regurgitation (OR: 2.61 [1.36, 5.03]). Intraoperative factors independently associated with increased incidence of AKI were use of cardiopulmonary bypass (OR: 2.70 [1.57, 4.63]), increasing number of transfused red blood cell units, and use of immunosuppressive therapy other than routine (OR: 2,56 [1.47, 4.46]). A higher diuresis (OR: 0.70, 95% CI: 0.58-0.85) was associated with less incidence of acute kidney injury. Development of AKI was associated with increased time to extubation (median 30 h, IQR [9, 118] vs. 6 [3, 16]), length of stay in the intensive care unit (9 days [4, 25] vs. 3 [2, 5]) and increased rate of primary graft dysfunction (OR 2.33 [1.66, 3.29]) and 30-day mortality (OR: 10.8 [3.0, 69]).

CONCLUSIONS: Acute kidney injury is common after lung transplantation and affects clinical outcomes negatively. Preoperative factors may be used for risk assessment. The use of cardiopulmonary bypass is a potentially modifiable intraoperative risk factor.

EDITORIAL COMMENT: Acute kidney injury is a common complication after lung transplantation that severely influences patient outcomes. This large study of more than 500 patients treated over a decade identified potentially modifiable factors associated with the development of acute kidney injury.

PMID:40066686 | DOI:10.1111/aas.70014

Ann Ig. 2025 Mar 11. doi: 10.7416/ai.2025.2690. Online ahead of print.

ABSTRACT

BACKGROUND: Seafarers experience unique challenges related to their profession, including risks for mental health. The present study explored the correlates of depression among seafarers in India.

METHODS: Following ethics clearance, this cross-sectional study was conducted at an international shipping company in Mumbai, India. Using time-bound convenience sampling, 105 multi-state seafarers were recruited following verbal consent. The Beck Depression Inventory and Work-Related Quality of Life scale were used to screen for the study outcomes. Data analysis was performed using Jamovi 2.0. Descriptive statistics and Chi-square tests were used to assess associations, and logistic regression was performed to identify correlates of depression.

RESULTS: Of 105 seafarers, the majority (98.1%) were male, most were married (80%), and were aged between 18-35 years (56.2%). About 42.9% had an income of INR 3 lakh (≈$3604) and above monthly. An overwhelming majority had mild mood disturbances, which was found among 90.5% and 8.6% reported depression. Seafarers who engaged in regular physical activity and had higher monthly incomes had higher Work-Related Quality of Life. A significant association was found between depression and isolation (p=0.031) as well as with Work-Related Quality of Life (p=0.012). On logistic regression, we found that the number of hours of work per day, experiencing isolation and Work-Related Quality of Life, significantly predicted depression.

CONCLUSIONS: The existing burden and treatment gap for mental health morbidity among seafarers needs to be addressed. To address early indications of mental health conditions among seafarers, implementing mental health screening and offering counseling services on board may be the way forward.

PMID:40066682 | DOI:10.7416/ai.2025.2690

Epidemiol Prev. 2025 Jan-Feb;49(1):35-43. doi: 10.19191/EP25.1.A788.011.

ABSTRACT

OBJECTIVES: to analyse the prevalence and characteristics of the hikikomori phenomenon in Italy within a representative sample of students aged 15 to 19 years, assessing the factors associated with this behaviour to guide preventive interventions.

DESIGN: cross-sectional study based on anonymous data collected through the ESPAD®Italia (European School Survey Project on Alcohol and other Drugs) survey using a self-administered questionnaire.

SETTING AND PARTICIPANTS: a representative sample of Italian high-school students is selected annually to ensure the comparability of ESPAD®Italia estimates. In this study, the pooled 2021-2023 sample consists of 36,868 students (50.8% male), with an average age of 17.0 years (standard deviation: 1.4).

MAIN OUTCOMES MEASURES: the outcomes analysed are having experienced voluntary social withdrawal for at least six months over a lifetime (Lifetime Hikikomori) and the current behaviour of never leaving the house during the week (Current Withdrawal).

RESULTS: in 2023, 2.0% of students reported having voluntarily isolated themselves for at least six months in their lifetime, with a slightly higher prevalence among girls. Current withdrawal involved 11.3% of students, a significant increase compared to the previous two years. In the pooled 2021-2023 sample, the analysis of independent variables showed that the hikikomori phenomenon is associated with the use of psychotropic drugs, cigarette smoking, having been a victim of cyberbullying, feelings of exclusion, dissatisfaction in friendships, risky behaviours related to internet and video game use, and belonging to non-traditional families. The current withdrawal is directly associated with cigarette smoking, lack of enjoyment in social interactions, overweight/obesity, and belonging to non-traditional families.

CONCLUSIONS: the study provided the first quantitative estimate of voluntary social withdrawal among Italian students aged 15-19 years, confirming that the phenomenon is widespread and concerning, especially among girls. Factors such as the perception of social exclusion, problematic online behaviours and the use of psychotropic drugs are strongly associated with the phenomenon. Future longitudinal research could further explore these relationships and support the development of integrated educational strategies in schools to identify and support at-risk students.

PMID:40066636 | DOI:10.19191/EP25.1.A788.011