Tag: pubmed

Med Sci Monit. 2026 May 10;32:e951639. doi: 10.12659/MSM.951639.

ABSTRACT

BACKGROUND Patients with multiple sclerosis (MS) present with reduced muscle strength during dynamic and static contractions, with deficits primarily affecting lower limbs. This study aimed to evaluate the functional parameters of lower limbs in patients with MS following an exercise program. MATERIAL AND METHODS We conducted an exploratory individualized 12-week program of self-paced exercises aimed at improving functional parameters of the lower limbs. Foot pressure distribution, balance during a 60-second static trial with eyes open and closed, load on each limb, and center of pressure position were recorded using the Zebris Medical platform and analyzed. RESULTS The study included 24 women with MS (mean age, 36.8 years; mean disease duration, 9.0 years). The differences in body-weight distribution between dominant and nondominant leg were significant at baseline (54.8 vs 45.2 open eyes; 57.2 vs 42.8 closed eyes; P<0.001) and improved after exercises (51.9 vs 48.1 open eyes; 53.0 vs 47.0 closed eyes) but remained significant (P<0.001), resulting in significantly lower asymmetry after exercises (9.7 vs 3.8 open eyes; 14.5 vs 5.9; P<0.001). Numerical improvements were also observed across all balance test parameters; however, statistically significant changes were noted only for two parameters: the x-coordinate of mean center of pressure (17.4 vs 16.3; P=0.005 and 17.4 vs 16.1; P<0.002) and the y-coordinate of mean center of pressure (24.4 vs 22.6; P<0.001 and 24.2 vs 22.3; P<0.001). CONCLUSIONS Regular lower limb self-paced exercises significantly improved limb loading symmetry and selected balance parameters.

PMID:42106907 | DOI:10.12659/MSM.951639

J Crohns Colitis. 2026 May 8;20(5):jjag061. doi: 10.1093/ecco-jcc/jjag061.

ABSTRACT

BACKGROUND & AIMS: Robust evidence for most licensed Crohn’s disease therapies is lacking for perianal fistula outcomes due to a lack of dedicated clinical trials. This study aimed to use a Bayesian framework to determine the efficacy of medical therapies for perianal fistulizing Crohn’s disease (PFCD).

METHODS: A formal prior elicitation exercise was conducted by a group of 11 gastroenterologists and 5 statisticians. Consensus priors were developed leveraging both existing published data and clinical expertise, to determine one-year fistula remission rates for medical treatments with 5 different mechanisms of action (anti-TNF, anti-integrin, anti-IL-12/23, anti-IL-23, and JAK inhibitor). Consensus priors on efficacy of each treatment were determined relative to an elicited consensus prior for placebo control.

RESULTS: Consensus priors were obtained for the likelihood of fistula remission at 1 year. The prior mean, together with a 90% prior credible interval, of the one-year fistula remission rate was 0.22 (0.05, 0.46) for placebo, 0.58 (0.09, 0.96) for intravenous infliximab, 0.39 (0.06, 0.82) for adalimumab, 0.53 (0.09, 0.93) for subcutaneous infliximab, 0.24 (0.03, 0.60) for intravenous vedolizumab, 0.44 (0.05, 0.90) for upadacitinib, 0.34 (0.04, 0.77) for ustekinumab, and 0.36 (0.04, 0.82) for anti-IL-23 specific agents. Oral upadacitinib and subcutaneous infliximab demonstrated the highest probability for efficacy, alongside intravenous infliximab.

CONCLUSIONS: We have conducted the first Bayesian prior elicitation exercise in inflammatory bowel disease. The generated priors could be used to enhance the design and analysis of clinical trials in PFCD by improving estimation of treatment efficacy, minimizing sample sizes, and potentially reducing the need for placebo control arms.

PMID:42106904 | DOI:10.1093/ecco-jcc/jjag061

J Crohns Colitis. 2026 May 8;20(5):jjag046. doi: 10.1093/ecco-jcc/jjag046.

ABSTRACT

BACKGROUND AND AIMS: In women with IBD, there are few options to treat pain during pregnancy and prescribers sometimes rely on opioids. We investigated the prevalence of repeated opioid use during the pregnancy period as well as the impact on birth outcomes.

METHODS: Using the Danish national registries, we identified pregnancies of women with IBD from January 1, 1997, to June 1, 2023. We defined repeated opioid use as at least two opioid prescriptions with a minimum 30-day interval between them. We examined the prevalence in three separate time periods: (1) nine months before conception; (2) throughout pregnancy; and (3) nine months postpartum, and we calculated adverse birth outcomes.

RESULTS: Of 10 904 women with IBD, 237 (2.2%) had repeated use of opioids prior to pregnancy, 220 (2.0%) during pregnancy and 359 (3.3%) postpartum. Women with repeated opioid use prior to pregnancy were significantly more likely to have repeated use during pregnancy (adjusted odds ratio (aOR): 231.50 (95% CI, 159.80-335.36)). Women who had repeated use during pregnancy were significantly more likely to have repeated use during the postpartum period (aOR: 74.98 (95% CI, 53.76-104.57)). Women with repeated use of opioids during pregnancy had statistically significant risks of preterm birth (aOR: 1.87 (95% CI, 1.28-2.74)) and of delivering a small for gestational age infant (aOR: 2.46 (95% CI, 1.41-4.32)).

DISCUSSION: The proportions of women who used repeated opioids prior to pregnancy, during pregnancy, and in the postpartum period were low but consequences for neonates can be severe. Providers should screen for opioid use in this population.

PMID:42106903 | DOI:10.1093/ecco-jcc/jjag046

Biomark Res. 2026 May 9. doi: 10.1186/s40364-026-00927-x. Online ahead of print.

ABSTRACT

BACKGROUND: Niemann-Pick disease, type C1 (NPC1), is a rare, fatal, neurodegenerative lysosomal disorder caused by pathological variants in NPC1. Defects in lysosomal cholesterol transport result in the accumulation of unesterified cholesterol within the endo-lysosomal compartments. Delayed diagnosis, limited treatment options, and phenotypic heterogeneity characterized by a broad range of signs/symptoms underscore the urgent need for effective biomarkers to facilitate diagnosis, monitor disease progression and assess therapeutic response. The goal of this study was to identify serum protein biomarkers for NPC1.

METHODS: Proximal Extension Assays (PEA) were used to determine relative protein expression levels from 68 serum samples from NPC1 individuals and 20 age-appropriate control serum samples. Statistical models identified NPC1 disease-specific effects after adjusting for covariates. Selected proteins were orthogonally validated by ELISA and correlated with assessments of both disease severity (Age of Neurological Onset (ANO) and Annual Severity Increment Score (ASIS)) and disease burden (NPC Neurological Severity Score (NSS).

RESULTS: Quantifiable data was obtained on 2888 proteins, revealing 186 increased (adjusted log₂FC ≥ 1) and 286 decreased (adjusted log₂FC ≤ -1) proteins with adj. p-value < 0.1 when comparing NPC1 individuals not being treated with miglustat versus control serum samples. Using orthogonal assays, we confirmed significant elevations for seven proteins: TREM2, AgRP, CCL18, Cathepsin L, GPNMB, NPY, and HSD17B14, and a significant decrease of BDNF. We further identified 100 proteins whose abundance levels were significantly altered towards normal by miglustat treatment. We found the 17-domain NPC NSS to be correlated with protein levels in the PEA data. Orthogonally validated data correlated with the age of neurological onset. We also identified 25 differentially abundant serum proteins in NPC1 baseline samples which are predominantly expressed in brain regions.

CONCLUSIONS: The statistical analysis pipeline developed in this study is flexible and scalable and supports application to high-dimensional proteomic datasets. This study identified and validated serum proteins with altered expression in individuals with NPC1, responded to miglustat therapy, and correlated with disease severity or burden. These proteins may have clinical utility as biomarkers and provide insights into cellular mechanisms contributing to NPC1 disease pathology.

TRIAL REGISTRATIONS: NCT00344331 (Registration on 2006-06-23).

PMID:42106890 | DOI:10.1186/s40364-026-00927-x

Int J Retina Vitreous. 2026 May 9. doi: 10.1186/s40942-026-00834-1. Online ahead of print.

ABSTRACT

BACKGROUND: To provide population-level estimates of OCT-detected macular pathology in adults living in the Brazilian Amazon region.

METHODS: Population-based, cross-sectional study. Eligible participants were residents aged ≥ 45 years identified through cluster sampling (20 clusters: 14 urban and 6 rural) in Parintins City, Amazonas, Brazil. Ophthalmic examinations included visual acuity testing, biomicroscopy, fundoscopy, and subjective refraction. A subset of eligible participants underwent spectral-domain OCT (SD-OCT; iVue-100, Optovue) using macular mapping protocols. OCT images were graded for predefined abnormalities involving the vitreoretinal interface, inner retina, outer retina/retinal pigment epithelium (RPE)/choroid, and ganglion cell complex (GCC). Generalized estimating equations (GEE) were used to evaluate factors associated with any OCT abnormality. Statistical significance was set at p < 0.05.

RESULTS: Of 2,384 eligible individuals, 2,041 (85.7%) were examined and 588 (28.8%) underwent OCT (1,176 eyes), of which 1,069 eyes (90.9%) were gradable. OCT macular abnormalities were detected in at least one eye in 180 participants (30.6%). Overall, outer retinal layer changes were most frequent, followed by GCC thinning and epiretinal membrane. OCT abnormalities were independently associated with older age and lower educational level. Structural abnormalities were identified in 340 (31.8%) eyes; of these, 208 (19.5%) showed changes also detectable on dilated fundus examination, whereas 132 (12.3%) had a clinically normal funduscopic appearance. Clinically notable lesions were detected in 46 (4.3%) eyes, including signs of late AMD in 27 (2.5%) eyes, diabetic maculopathy in 6 (0.6%), lamellar macular hole in 6 (0.6%), full-thickness macular hole in 3 (0.3%), and central serous chorioretinopathy in 4 (0.4%) eyes. Among 774 eyes clinically normal at fundoscopy, OCT revealed subclinical disease in 127 (16.4%).

CONCLUSIONS: In this underserved Amazonian population, approximately one-third of gradable eyes showed OCT-detected macular abnormalities, many of them subclinical on fundoscopy. Diabetic maculopathy, choroidal neovascular membranes, and late AMD showed very low prevalence and limited epidemiologic weight in this setting. Incorporating OCT into population-based surveys enhances detection and refines burden estimates of subclinical retinal disease and vision-threatening conditions in aging populations.

PMID:42106887 | DOI:10.1186/s40942-026-00834-1

Contracept Reprod Med. 2026 May 9. doi: 10.1186/s40834-026-00458-8. Online ahead of print.

ABSTRACT

BACKGROUND: Young adult women represent a critical population in reproductive health due to their heightened risk of unintended pregnancy and limited socioeconomic opportunities. Contraceptive intention is a key determinant of future contraceptive use; however, limited evidence exists on the factors influencing contraceptive intention among young adult women in Nigeria. This study therefore examined the sociodemographic determinants of contraceptive intention among young adult women in Nigeria, with particular attention to age at first sex and region of residence.

METHODS: This cross-sectional study used data from the 2018 Nigeria Demographic and Health Survey (NDHS). A total of 14,210 women aged 15-24 years who reported their contraceptive intention were included, while current contraceptive users were excluded because the analysis focused specifically on contraceptive intention among women who were not currently using any contraceptive method. Descriptive statistics summarized sample characteristics, while bivariate and multivariable logistic regression analyses identified determinants of contraceptive intention. Results were presented as crude and adjusted odds ratios (CORs and AORs) with 95% confidence intervals (CIs), and statistical significance was set at p < 0.05.

RESULTS: The prevalence of contraceptive intention among young adult women in Nigeria was 47%. Education showed a strong positive association, as women with tertiary education were more than three times as likely to intend to use contraception compared to those with no education (AOR = 3.51; 95% CI: 2.81-4.40; p < 0.001). Married women (AOR = 0.63; 95% CI: 0.54-0.74; p < 0.001) and Muslim women (AOR = 0.52; 95% CI: 0.45-0.60; p < 0.001) had significantly lower odds of intending to use contraception. Wealth status showed a positive gradient, while later sexual debut (≥ 20 years) was associated with higher intention (AOR = 1.35; 95% CI: 1.05-1.73; p = 0.02). Regional differences persisted: women in the North West had higher odds (AOR = 1.59; 95% CI: 1.39-1.83; p < 0.001), while those in the South East, South South, and South West had lower odds of contraceptive intention.

CONCLUSION: Education, marital status, religion, wealth, age at first sex, and regional context are key determinants of contraceptive intention among young adult women in Nigeria. Addressing disparities through youth-centered and culturally sensitive family planning interventions that promote education, reproductive health awareness, and economic empowerment could improve contraceptive uptake and reduce unintended pregnancies. However, the cross-sectional nature of the data limits causal interpretation of the observed associations.

PMID:42106883 | DOI:10.1186/s40834-026-00458-8

Cardiooncology. 2026 May 9. doi: 10.1186/s40959-026-00491-1. Online ahead of print.

ABSTRACT

PURPOSE: Anthracyclines are widely used anticancer agents but are limited by dose-dependent cardiotoxicity. Ivabradine selectively reduces heart rate without negative inotropy and may offer cardio protection in cancer patients, though its efficacy in anthracycline-induced cardiotoxicity (AIC) remains unclear.

METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing ivabradine versus placebo in adult patients receiving anthracycline therapy. PubMed, Cochrane Central, Embase, Web of Science, Google Scholar, Scopus and ClinicalTrials.gov, and reference lists were searched through August 2025. Outcomes included left ventricular ejection fraction (LVEF), heart rate, blood pressure, NT-proBNP, and strain-based parameters. Risk of bias was assessed with the Cochrane RoB 2 tool.

RESULTS: Three RCTs (n = 210) met inclusion criteria. Ivabradine showed no significant effect on LVEF (MD 0.32%, 95% CI – 0.90 to 1.54; p = 0.61) or NT-proBNP. Heart rate reduction was directionally favorable but not statistically significant (MD – 4.11 bpm, 95% CI – 8.69 to 0.46; p = 0.08). Systolic and diastolic blood pressure were unchanged. Strain-based outcomes were inconsistently reported, precluding pooled analysis.

CONCLUSIONS: Given the limited sample size, heterogeneity, and variability in endpoint definitions, current evidence is insufficient to establish a definitive cardioprotective role for ivabradine in AIC. Larger, rigorously designed trials with standardized imaging and biomarker endpoints are needed to determine its role.

PMID:42106880 | DOI:10.1186/s40959-026-00491-1

BMC Psychol. 2026 May 9. doi: 10.1186/s40359-026-04686-0. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to assess the factors associated with marital dissolution among women in Cameroon.

METHODS: The 2018 Cameroon Demographic and Health Survey data was used. A sample of 4,562 women was selected from the domestic violence module. Frequency distributions, Chi-square tests, and Complementary Loglog regressions were used to establish the factors that were associated with marital dissolution among married women in Cameroon.

RESULTS: Over one in ten women (11%) of the ever-married women experienced marital dissolution. Marital dissolution was more among women from older age groups (35-39 and 40-49 years); certain regions e.g. Adamawa (aOR = 1.91; 95% CI: 1.05-3.47), Centre region (aOR = 2.43; 95% CI: 1.38-4.27), Far-north (aOR = 1.82; 95% CI: 1.10-3.00) and North-west (aOR = 2.65; 95% CI: 1.36-5.17); and in urban residence (aOR = 1.57; 95% CI: 1.12-2.19). In addition, MD was higher among women from the poorer wealth quintile (aOR = 1.68; 95% CI: 1.05-2.67); working status (aOR = 1.38; 95% CI: 1.03-1.84); those whose partners had control behavior (aOR 1.78; 95% CI: 1.29-2.47) and those who experienced any form of IPV (aOR = 1.91; 95% CI: 1.42-2.56). Conversely, MD was less among women who had six to nine children (aOR = 0.42; 95% CI: 0.21-0.82), and ten or more children (aOR = 0.24; 95% CI: 0.07-0.81); and those economically empowered (aOR 0.48; 95% CI: 0.33-0.70).

CONCLUSIONS: Marital dissolution in Cameroon was higher among older women, from some regions (Adamawa, Centre, Far North, and North West), urban residents, the poorest wealth quintile, being employed, those with partners’ controlling behaviors, and intimate partner violence. Conversely, MD was lower among women who had a higher number of children ever born and were economically empowered (owned property alone or jointly with their spouses).

PMID:42106874 | DOI:10.1186/s40359-026-04686-0

Syst Rev. 2026 May 9. doi: 10.1186/s13643-025-02975-0. Online ahead of print.

ABSTRACT

BACKGROUND: There are currently two opposing hypotheses regarding the risk factors for acquisition, colonisation and infection with multidrug-resistant Pseudomonas aeruginosa (MDR-PA) in the intensive care unit (ICU). Acquisition could be either endogenous or exogenous or both. It is of great interest to estimate pooled prevalence and describe individual and environmental factors associated with the colonisation and infection with MDR Pseudomonas aeruginosa in intensive care units.

METHODS: This systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol of this review has been registered under CRD42021233832 in the International Prospective Register of Systematic Reviews (PROSPERO) and has been published on Systematic review on November 2022All types of studies carried out in intensive care units (ICUs) were included. MEDLINE (Pubmed), EMBASE (OVID), the Cochrane Library (Wiley), Web of Science, CINAHL (EBSCOHost), LILACS (BIREME), Google Scholar and Open Grey were searched from 1983 to 2023 and the results of electronic searches were uploaded to Rayyan software. The methodological quality of the studies was assessed using the National Heart, Lung, and Blood Institute Critical Appraisal Tools. The I² test was performed to assess the statistical heterogeneity among the included studies. The publication bias was assessed by using the funnel plot and Egger’s test. Descriptive analysis and meta-analysis were performed. Fixed effect model were used to calculate the surveyed prevalence and odds ratio (OR) with their respective 95% confidence intervals (95% CI).

RESULTS: A total of 10,791 articles were identified, of which 13 were retained for descriptive analysis and 8 for meta-analysis. The majority of these 13 studies were conducted in Western countries. Methods were heterogeneous and few studies addressed environmental factors. The pooled prevalence of MDR-PA in the ICU was 4% (95% CI: 0%-11%). Identified risk factors were: length of stay in ICU (> 8 days), mechanical ventilation with OR: 3.19; 95% CI: 2.25-4.53, use of invasive devices with OR: 2.97; 95% CI: 2.40-3.68 (use of central venous catheter with OR: 3.16 95% CI: 1.87-5.33, the use of urinary catheters with OR: 2.65; 95% CI: 2.05-3.44, the use of parenteral nutrition with OR: 2.43; 95% CI: 1.15-5.16 and the use of arterial catheters with OR: 7.00; 95% CI: 2.77-17.68) and the use of antibiotics with OR: 3.69; 95% CI: 3.16-4.27 (carbapenem with OR: 4.12; 95% CI: 3.29-5.16, quinolones with OR: 3.31; 95% CI: 2.45-4.47, bectalactam with OR: 3.58; 95% CI: 2.4-5.24, and aminoglycosides with OR: 3.32; 95% CI: 2.33-4.73) and environmental factors.

CONCLUSION: All this suggest that acquisition or infection by MDR-PA in ICU could be due to endogenous and exogenous transmission. Due to the few numbers of studies analysed, further investigation with more studies is needed to draw definitive conclusions.

SYSTEMATIC REVIEW REGISTRATION: The protocol of this review has been registered under CRD42021233832 in PROSPERO and has been published on Systematic review on November 2022. Eyebe et al. (Syst Rev 11:270, 2022).

PMID:42106844 | DOI:10.1186/s13643-025-02975-0

Scand J Trauma Resusc Emerg Med. 2026 May 9. doi: 10.1186/s13049-026-01618-0. Online ahead of print.

ABSTRACT

BACKGROUND: Eye-related symptoms ranging from mild irritation to acute vision loss can lead to emergency calls. While many cases are benign, others involve chemical exposures or trauma requiring urgent care to prevent permanent damage. Prehospital characteristics, dispatch categorization, and early management of eye-related emergencies remain unexplored. The aim of this study was to provide a systematic description of eye-related emergency calls, including patient characteristics, dispatch categorization, and prehospital management, within the framework of the Danish Index for Emergency Care.

METHODS: We conducted a retrospective cohort study of all emergency calls [1-1-2] in Region Zealand, Denmark, from November 2017 to June 2025, describing eye symptoms. We linked data from the Computer-Aided Dispatch (CAD) system, the Prehospital Patient Records (PPJ), and the Danish National Patient Registry (NPR). Patient demographics, paramedic assessment of primary problem, on-scene symptoms, prehospital treatments and hospital outcomes were analysed using descriptive statistics.

RESULTS: A total of 376 patients were identified calling 1-1-2 and registered with eye related symptoms as the main complaint. Of these, 36 (9.6%) were excluded due to missing patient identifiers or prehospital patient records, leaving 340 in the cohort. Median age was 49.5 years (IQR 29-68), and 62.1% were male. Most calls were categorized as priority B (urgent situation not assessed as acute life-threatening) (70.9%). The leading primary problems were chemical exposures (31.5%), vision loss (25.9%), and ocular trauma (18.2%). Vision disturbance (54.4%) was the most frequently prehospital reported symptom. Prehospital interventions were rarely documented, with irrigation being the most reported procedure (27.1%). Notably, 39 of 340 patients (11.5%) were suspected of stroke prehospitally, and among 283 admitted to hospital, 21 (7.4%) received a confirmed TIA or stroke diagnosis. The median length of stay was 3.7 h (IQR 2.0-7.7). Most frequent discharge diagnoses were injury of the eye and orbit (17.7%), burn and corrosion confined to eye and adnexa (9.9%), and foreign body on external eye (7.8%).

CONCLUSION: Eye-related emergency calls were primarily caused by chemical exposures, vision loss, and trauma, with relatively short hospital stays. Several patients classified as eye-related problems were later diagnosed with stroke, highlighting the need for better dispatcher recognition of visual stroke symptoms.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42106843 | DOI:10.1186/s13049-026-01618-0