Tag: pubmed

BJUI Compass. 2025 Nov 9;6(11):e70112. doi: 10.1002/bco2.70112. eCollection 2025 Nov.

ABSTRACT

OBJECTIVES: The study aims to review the safety of performing robotic-assisted radical prostatectomy (RARP) in patients with a body mass index (BMI) > 35 kg/m² in a high-volume robotic centre.

MATERIALS AND METHODS: A prospective database of all patients who underwent RARP between December 2015 and October 2024 was reviewed. Propensity score matching was done preoperatively on age, prostate-specific antigen, ISUP grade and T stage. Matched cohort analysis was conducted comparing outcomes in 89 patients with BMI ≥ 35 kg/m² and those with BMI 18-25 kg/m². Outcomes included operational time, estimated blood loss (EBL), positive surgical margins (PSM), complications, length of stay, continence and erectile function at 12 months.

RESULTS: Console time was significantly longer in the high-BMI group (146 ± 48 min vs. 129 ± 44 min, p = 0.02). EBL was also greater (median 350 ml vs. 200 ml, p < 0.001). However, there was no significant difference in hospital stay (median 3 days for both groups, p = 0.86), nerve sparing rates or PSM. Patients in the obese cohort experienced more complications although this was not statistically significant. At 12 months post-operatively, continence was comparable between the groups. Median pad use was 1/day (interquartile range [IQR] 0-2) in the obese cohort versus 0/day (IQR 0-1) in the non-obese cohort (p = 0.09). Pad-free status was achieved in 48.3% compared with 61.8% respectively (p = 0.06). Erectile function recovery found 14.8% regaining function in the obese cohort compared with 18.0% in the non-obese cohort (p = 0.82).

CONCLUSION: This matched cohort analysis demonstrates that obese patients undergoing RARP experience longer operative times and increased EBL. These factors do not adversely impact functional or oncological outcomes. The incidence of post-operative complications remained low and comparable with patients with a normal BMI. With appropriate surgical expertise, high BMI alone should not be considered a contraindication to RARP.

PMID:41221431 | PMC:PMC12597973 | DOI:10.1002/bco2.70112

Clin Optom (Auckl). 2025 Nov 6;17:341-351. doi: 10.2147/OPTO.S551647. eCollection 2025.

ABSTRACT

PURPOSE: Visual skills and Oculomotor function deficits are common in children with Autism Spectrum Disorder (ASD), potentially affecting their development and quality of life. This study aimed to evaluate the effectiveness of vision therapy in visual perceptual skills and oculomotor function in children with ASD.

PATIENTS AND METHODS: This prospective interventional study was conducted using a convenience sampling method between February and May 2025. All children with a prior diagnosis of ASD who met the inclusion criteria were included in the study and underwent 45 sessions of vision therapy guided by the Developmental, Individual-Differences, Relationship-Based (DIR) model. Visual skills and oculomotor functions were assessed before and after vision therapy using the Wachs Analysis of Cognitive Structures (WACS) and the Northeastern State University College of Optometry (NSUCO) Oculomotor test, respectively. The paired t-test with Hedge’s g effect size was used to compare pre and post vision therapy outcomes for normally distributed data, while the Wilcoxon signed-rank test with effect size r was applied for non-normally distributed variables. Analysis of Covariance was used to examine the effect of ASD severity on post-therapy outcomes while controlling for age and gender.

RESULTS: Among the 42 children with ASD enrolled in the study, 36 completed all 45 sessions of vision therapy. Significant post-therapy improvements with large effect size were observed in visual perceptual skills (WACS) and oculomotor functions (NSUCO). Children with mild to moderate ASD showed greater improvements than those with severe ASD. Analysis of covariance revealed a significant effect of ASD severity on post-therapy outcomes: WACS (F(1,32) = 36.80, p < 0.001, R² = 0.55), saccades (F(1,32) = 36.75, p < 0.001, R² = 0.54), and pursuits (F(1,32) = 35.54, p < 0.001, R² = 0.54). Age and gender showed no statistically significant effects on the outcomes.

CONCLUSION: This prospective study provides preliminary evidence that DIR-guided vision therapy, particularly when combined with occupational and behavioral therapy, may enhance visual perceptual and oculomotor functions in children with ASD. However, randomized controlled studies with longer follow-up are needed to confirm these results.

PMID:41221430 | PMC:PMC12599212 | DOI:10.2147/OPTO.S551647

Health Sci Rep. 2025 Nov 9;8(11):e71480. doi: 10.1002/hsr2.71480. eCollection 2025 Nov.

ABSTRACT

BACKGROUND AND AIMS: In low- and middle-income countries, dolutegravir-based antiretroviral therapy regimens are the preferred first-line treatment for adults, adolescents, and children with human immunodeficiency virus (HIV). Dolutegravir exhibits a higher genetic barrier to resistance, improved tolerability, and reduced potential for drug-drug interactions. However, emerging reports suggest a possible association between dolutegravir usage and hyperglycemia. Therefore, this study aims to investigate the hyperglycemia risk in dolutegravir-based antiretroviral therapy among people living with HIV and tuberculosis (TB) in Zimbabwe.

METHODS: An analytical cross-sectional study was conducted on 162 participants aged 18 and older, recruited from April to July 2024 in Harare, Zimbabwe. Participants were divided into three groups based on their HIV and TB status and dolutegravir dosage. Participants’ glycated hemoglobin levels were analyzed to determine the hyperglycaemic risk. A questionnaire was also administered to assess the risk factors associated with hyperglycemia. The R statistical software (version 4.3.2, Vienna, Austria) was used for data analysis. A p-value of < 0.05 was considered to be statistically significant.

RESULTS: The median (interquartile range) ages for these sub-groups were 44 [36-56], 44 (29.3-54.8), and 45 [35-56] years, respectively, and the age range was 20-80 years. The group taking 100 mg of dolutegravir had a 40% prevalence of impaired glucose regulation, and a hyperglycemia prevalence of 31%. In the multivariable logistic regression analysis, taking 100 mg of dolutegravir was associated with a 5.17 (95% Confidence Interval: 1.21-27.82) fold risk of developing hyperglycemia.

CONCLUSION: The study findings indicate that the prevalence of hyperglycemia and impaired glucose regulation is high in patients taking dolutegravir-based antiretroviral therapy in Zimbabwe. People living with both HIV and TB taking a double dose of dolutegravir are at a higher risk of hyperglycemia and impaired glucose regulation than those taking lower doses. This emphasizes the necessity for clinical and public health interventions to mitigate this emerging hyperglycaemic risk.

PMID:41221425 | PMC:PMC12598190 | DOI:10.1002/hsr2.71480

Health Sci Rep. 2025 Nov 9;8(11):e71479. doi: 10.1002/hsr2.71479. eCollection 2025 Nov.

ABSTRACT

INTRODUCTION AND AIMS: Birth injuries contribute to neonatal morbidity and mortality. The incidence rates of birth injuries vary from 1.9 to 53 per 1000 live births. This systematic review and meta-analysis aimed to estimate the pooled prevalence of birth injuries in Ethiopian neonates and to identify key associated risk factors. The study addresses inconsistencies in previous prevalence estimates and fills knowledge gaps regarding important contributing factors that were insufficiently explored in earlier reviews.

METHODS: The study explored various databases to access articles about the prevalence and associated factors of birth injuries among newborns, which are pertinent only to Ethiopia. The Joanna Briggs Institute quality assessment tool was utilized to evaluate the quality of each study. Data analysis was conducted using Microsoft Excel and STATA 17.0 statistical software. A random effects model was employed to estimate the pooled prevalence of birth injuries. Additionally, the Cochrane Q-test statistics and the I² test were applied. Publication bias was assessed using funnel plots and Egger’s statistical tests. Sensitivity analysis was also performed to detect the effects of smaller studies.

RESULT: Six studies involving a total population of 3781 participants were included in the analysis. The pooled prevalence of birth injuries among newborns in Ethiopia was found to be 16.24% (95% CI: 13.34-19.14; I² = 82.67%; p < 0.001). Birth weight greater than 4 kg (adjusted odds ratio [AOR] = 8.88; 95% CI: 1.79-15.98), prolonged labor (AOR = 4.70; 95% CI: 1.90-7.49), vacuum-assisted birth (AOR = 14.92; 95% CI: 6.26 to 36.10), and forceps-assisted birth (AOR = 7.83; 95% CI: 4.71-10.95) were significant predictors.

CONCLUSION AND RECOMMENDATION: The prevalence of birth injuries is notably high. The identified predictors were preventable. Implementation of routine labor and delivery practice audits and enhancing the skills of healthcare providers are recommended to reduce the risk of birth injuries.

PMID:41221423 | PMC:PMC12598101 | DOI:10.1002/hsr2.71479

Health Sci Rep. 2025 Nov 9;8(11):e71490. doi: 10.1002/hsr2.71490. eCollection 2025 Nov.

ABSTRACT

BACKGROUND AND AIMS: Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the retina affecting preterm infants that potentially leads to blindness. Omega-3 long-chain polyunsaturated fatty acids (LCPUFA) have anti-inflammatory and antiangiogenic effects, thereby reducing pathological neovascularization and preventing the incidence of ROP. This study was done to evaluate the effect of available omega-3 LCPUFA supplementation for the prevention of ROP among Bangladeshi infants.

METHODS: This pilot study was conducted in the Neonatology Department of a tertiary care hospital in Bangladesh from November 2022 to March 2024 among preterm neonates < 34 weeks of gestation with birth weight < 1800 g. Initially, 76 preterm neonates were enrolled in this study. Among them, 71 preterm neonates were randomly allocated to the intervention group and the control group. The intervention group received a cap. omega-3 LCPUFA enterally (40 mg/kg/day). It was added to their enteral feeds within 48 h of the first enteral feed and continued from the starting point to 4 weeks. The control group received no supplementation.

RESULTS: The incidence of ROP was almost similar between the omega-3 LCPUFA group and the control group (37.1% in the intervention group vs. 41.6% in the control group, p = 0.69). However, severe ROP incidence was significantly reduced in the omega-3 group. Three patients developed severe ROP in the omega-3 LCPUFA group, in contrast to nine patients in the control group (23.1% vs. 60%, p = 0.049). On logistic regression analysis, while considering risk factors for ROP, omega-3 LCPUFA supplementation was not found to have a significant association with the incidence of ROP.

CONCLUSION: Omega-3 LCPUFA supplementation does not reduce the overall incidence of ROP; however, it may lower the risk of severe ROP. This reduction in severe ROP cases may help decrease the need for invasive treatments and improve long-term visual outcomes in preterm infants. Nonetheless, the study lacks sufficient statistical power to confirm this conclusively.

PMID:41221421 | PMC:PMC12598100 | DOI:10.1002/hsr2.71490

Health Sci Rep. 2025 Nov 9;8(11):e71475. doi: 10.1002/hsr2.71475. eCollection 2025 Nov.

ABSTRACT

BACKGROUND AND AIMS: The burden of chronic kidney disease (CKD) progression remains notably high among patients with CKD, resulting to adverse clinical outcomes. However, there is scarcity of data on CKD progression in patients with cardiorenal anaemia syndrome (CRAS). This study aimed to examine the clinical profile and identity the determinants of CKD progression in patients with CRAS.

METHODS: We conducted a descriptive post-hoc prospective observational study using data from a previously completed prospective cohort study between August 2023 and April 2024 at the cardiology clinic of Benjamin Mkapa Hospital, Dodoma. Adult patients (≥ 18 years) diagnosed with CRAS were included. Baseline demographic and clinical data were analysed. CKD progression was determined based on changes in estimated glomerular filtration rate (eGFR) within 6 months. Determinants of CKD progression were determined and analysed. During exploratory analyses, both descriptive and inferential methods were employed. A statistical significance set at two-sided p-value < 0.05.

RESULTS: A total of 112 patients with CRAS with the mean age of 57.84 (14.53 S.D) years were analysed. At baseline, 54.5% (61/112) were ≤ 60 years, and 56.2% (63/112) being female. The median creatinine was 171 (96-351) mmol/L with a mean _eGFR of 35.2 (14.46 SD) miL/min/1.73 m². Most patients, 60.7% (68/112) were in CKD stage 3, and 51.8% (58/112) presented with moderate to severe increased albuminuria. Over the 6-month follow-up, CKD progression was observed in 53.57% (60/112). Determinants were included advanced age: 3.62 (95% CI, 1.35-9.65; p = 0.010); albuminuria: 2.78 (95% CI, 1.08-7.16; p = 0.034); poor functional cardiac status (NYHA class III/IV): 6.44 (95% CI, 2.04-20.27; p < 0.001) and iron deficiency: 9.11 (95% CI, 2.92-28.47; p < 0.001).

CONCLUSION: There is high burden of CKD progression among patients with CRAS. Therefore, targeted intervention is beneficial to retard CKD progression in this high-risk population.

PMID:41221420 | PMC:PMC12598097 | DOI:10.1002/hsr2.71475

Health Sci Rep. 2025 Nov 10;8(11):e71447. doi: 10.1002/hsr2.71447. eCollection 2025 Nov.

ABSTRACT

BACKGROUND AND AIMS: Childbirth as a physiological phenomenon is painful. Fear and anxiety about labor pain increase the likelihood of women choosing cesarean delivery. Nonpharmacological interventions may enhance maternal comfort during labor. This study investigated the effect of chewing gum on anxiety and labor pain.

METHODS: Studies from 2000 to 2024 were identified through searches of Web of Science, PubMed, Scopus, Google Scholar, and Embase, with no restrictions on language or geographical location. Meta-analysis using Stata v17 employed a random-effects model to calculate standardized mean differences (SMD) with 95% confidence intervals (CIs). Heterogeneity was evaluated using the I ² statistic.

RESULTS: An analysis of five trials (326 women, high to low quality, varying inclusion criteria) showed that chewing gum for 20 min in active and second phases significantly reduced pain and anxiety. Pain scores were lower in the gum-chewing group during the active (SMD: -1.23, 95% CI: -2.30 to -0.16, p < 0.00, I ² = 93.97%) and transition phases (SMD: -1.63, 95% CI: -2.35 to -0.90, p = 0.00, I ² = 85.17%) and anxiety scores were also reduced (SMD: -1.44, 95% CI: -1.03 to 3.92, p < 0.00, I ² = 98.41% and SMD: -0.55, 95% CI: -0.79 to -0.30, p = 0.00, I ² = 0.00%, respectively).

CONCLUSION: Chewing gum use may reduce labor pain and anxiety and shorten labor duration, according to this study. However, more rigorous research is necessary to confirm these findings.

PMID:41221416 | PMC:PMC12598193 | DOI:10.1002/hsr2.71447

J Orthop Surg Res. 2025 Nov 11;20(1):989. doi: 10.1186/s13018-025-06423-6.

ABSTRACT

BACKGROUND: Avascular necrosis (AVN) is a severe complication following pediatric femoral neck fractures (PFNFs). Identifying risk factors for AVN is critical for guiding timely treatment and follow-up. However, prior studies report inconsistent associations. This systematic review and meta-analysis aimed to identify risk factors associated with AVN after PFNFs.

METHODS: A comprehensive literature search was conducted in PubMed, Web of Science, EMBASE, and the Cochrane Library through April 30, 2025. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated to assess the association between potential risk factors and AVN. Leave-one-out sensitivity analyses, meta-regression, and subgroup analyses were performed.

RESULTS: Thirty-four studies comprising 1332 pediatric patients (1340 fractures) were included. Older age (≥ 12 years; RR = 1.40, 95% CI 1.09-1.82), Delbet type I/II fractures (RR = 1.96, 95% CI 1.60-2.39), initial displacement (RR = 2.98, 95% CI 2.04-4.35), and poor reduction quality (RR = 2.43, 95% CI 1.46-4.05) were significantly associated with increased AVN risk. Gender, injury mechanism, time to reduction, and reduction method showed no overall association. Meta-regression identified follow-up duration as a significant moderator. Subgroup analyses of long-term follow-up (≥ 5 years) revealed that delayed reduction increased AVN risk (RR = 2.63, 95% CI 1.35-5.11), while closed reduction and internal fixation (CRIF) reduced risk compared to open reduction (RR = 0.40, 95% CI 0.24-0.65). Subgroup differences between long-term and short-term follow-up were both statistical significant.

CONCLUSIONS: Older age, Delbet type I/II classification, initial displacement, and poor reduction quality are significant predictors of AVN following PFNFs. Early reduction and CRIF may provide superior long-term outcomes. Further high-quality prospective studies with extended follow-up are needed to confirm these findings.

PMID:41220016 | DOI:10.1186/s13018-025-06423-6

Sr Care Pharm. 2025 Nov 1;40(11):472-480. doi: 10.4140/TCP.n.2025.472.

ABSTRACT

Objective To assess the acceptability and perceived utility of the Minnesota Effective Medication Self-Management Toolkit (MEMSMT) four-step approach among participants in the Virginia Commonwealth University (VCU) Mobile Health and Wellness Program (MHWP). Methods Student pharmacist-led focus groups explored medication-related challenges faced by older adults and the perceived utility of the MEMSMT. Participants were recruited from four affordable senior apartment communities served by MHWP. Demographic characteristics of participants were collected and summarized using descriptive statistics. After an explanation of the four-step approach, participants shared their experiences with medication self-management. They then completed the Medication Self-Management Self-Efficacy Checklist and were asked, “Do you believe that the Minnesota Effective Medication Self-Management Toolkit’s four-step approach can help individuals successfully manage their medications?” Comments regarding medication issues were documented and categorized according to the four aspects of self-medication management evaluated by the MEMSMT: indication, effectiveness, safety, and convenience of use. This study was approved as exempt research by Virginia Commonwealth University’s Institutional Review Board (IRB), protocol HM20029554, titled “Effective Medication Self-Management at Low-Income Senior Housing.” Results Five focus groups included 40 participants who took an average of 7.5 ± 5.2 medications daily. Most participants were Black (85%), female (70%), and had low health literacy (44%). The average age of participants was 72.2 years (SD ± 7.1). Examples of medication challenges were categorized as related to indication, effectiveness, safety, or convenience. Based on responses to the Medication Self-Management Self-Efficacy Checklist, participants expressed high confidence in their medication self-management skills. A vast majority of participants (94%) reported that using the MEMSMT four-step approach can help individuals successfully self-manage their medications. Conclusion Participants perceive the four-step process in the MEMSMT as a useful approach to improving medication self-management among residents of low-income senior apartment communities in the Richmond metropolitan area. Further evaluation of the Medication Self-Management Self-Efficacy Checklist is warranted.

PMID:41220009 | DOI:10.4140/TCP.n.2025.472

Arch Public Health. 2025 Nov 12;83(1):271. doi: 10.1186/s13690-025-01762-6.

ABSTRACT

BACKGROUND: Previous studies have demonstrated the importance of obesity and insulin resistance in increasing the risk of cardiovascular and metabolic diseases. However, few studies have demonstrated the association between visceral fat and cardiometabolic multimorbidity (CMM). In addition, the interaction of visceral fat and insulin resistance on CMM and the predictive value of the combination of the two remain incompletely understood.

OBJECTIVE: This study aims to investigate the relationships among novel obesity indices, the TyG index, and the CMM and to evaluate the predictive value of composite indices that combine obesity indices with the TyG index for CMM risk, thereby providing a basis for developing refined and multidimensional intervention strategies.

METHODS: We used data from the China Health and Retirement Longitudinal Study (CHARLS), including baseline information collected in 2011 and follow-up data gathered in 2015 and 2018, which included 9162 participants. The associations between the obesity indices, TyG and CMM were investigated via Cox regression models, Kaplan-Meier curves, the MacKinnon product distribution method, interaction effect analyses, ROC analysis and related indicators (NRI, IDI).

RESULTS: Among the study population, 1530 participants (16.70%) developed CMM. Cox regression analysis indicated significant associations of obesity indices and the TyG index with CMM (P < 0.001). TyG mediated over 20% of the associations between obesity indices and CMM. The interaction effects between obesity indices and TyG on CMM were the most significant. The CVAI showed the best predictive performance among the obesity indices in this study, and the combination of obesity indices and the TyG index showed enhanced prediction performance for CMM (P < 0.001).

CONCLUSION: Our study demonstrated that the composite index constructed by combining novel obesity indices with TyG significantly improved the accuracy of predicting CMM risk in middle-aged and elderly individuals, underscoring the critical role of maintaining a healthy weight and enhancing insulin sensitivity in the prevention of CMM.

PMID:41219986 | DOI:10.1186/s13690-025-01762-6