Tag: pubmed

West Afr J Med. 2025 Dec 30;42(9):739-746.

ABSTRACT

BACKGROUND AND OBJECTIVES: The links between periodontal disease and a number of systemic diseases including respiratory diseases have been widely reported in the literature. The burden and prevalence of periodontal disease and chronic obstructive pulmonary disease (COPD) is increasing globally. Periodontitis is now recognised as an independent risk factor for COPD. In addition, these two chronic diseases have similar pathogenic mechanisms. Despite these facts, the role of prevention of periodontitis in the management of COPD had not been fully explored. The aim of the study was to look at the effect of non-surgical periodontal therapy on the control of symptoms of Chronic Obstructive Pulmonary Disease (COPD) in our resource-limited settings.

METHODS: Sixty-nine COPD patients with concurrent periodontitis, who were at least 40 years old, were recruited from the Chest clinic of a tertiary institution in Ile Ife, Osun State, Nigeria between July 2021 and January 2023. Using GraphPad software, the participants were randomly categorised into two groups (control and intervention). The intervention group received non-surgical periodontal therapy (NSPT) and oral hygiene instructions (OHI) while the control group received oral hygiene instruction (OHI) only after the initial determination of the aMMP-8 assay and oral examinations. However, they had their non-surgical periodontal therapy after the three months follow-up. Clinical parameters such as COPD Assessment Test (CAT) scores, probing pocket depths (PPD), clinical attachment level (CAL) and a biomarker active matrix metalloproteinase-8 (aMMP-8) were recorded at baseline and after 3 months. Independent t-test was used for normally distributed variables for the two groups while Mann-Whitney U test was used for non-normally distributed variables. Paired t-test was used for the intra-group comparisons of the mean values and p value set at <0.05.

RESULTS: A total of 69 participants comprising 35 participants in the intervention group and 34 participants in the control group were enrolled in this study. The intervention group demonstrated statistically significant improvements in the CAT scores from 18.66 to 15.06 (p<0.04), aMMP-8 from 26.28ng/ml to 18.66ng/ml (p<0.001), mean PPD from 2.78mm to 2.64mm (p<0.05) and mean CAL from 4.64mm to 4.50mm (p<0.001) in comparison to the control group ( CAT scores from 18.91 to 17.59 p=0.07, aMMP-8 from 30.80ng/ml to 27.11ng/ml p=0.11, mean PPD from 2.82mm to 2.84mm p=0.37, and mean CAL from 4.88mm to 4.89mm p=0.69).

CONCLUSION: The results of this study emphasize the possible advantages of incorporating periodontal care into strategies for managing COPD.

PMID:42035331

West Afr J Med. 2025 Dec 30;42(9):733-738.

ABSTRACT

BACKGROUND: Tropical Diabetic Hand Syndrome (TDHS) is an acute, rapidly progressive hand infection affecting patients with diabetes mellitus (DM), often following trivial trauma. Unlike those with diabetic foot disease, neuropathy and vasculopathy play a minor role, while poor glycaemic control, delayed presentation, and minor injuries are key risk factors. TDHS is often not recognised in Nigeria despite its potential for disability and mortality. This study reviews the management outcomes of patients presenting with TDHS at a tertiary hospital in Nigeria.

METHODOLOGY: A retrospective review was conducted of all patients with DM managed for TDHS at the Jos University Teaching Hospital from 2015 to 2024. Data were extracted on socio-demographics, type and duration of diabetes, clinical presentation, treatment, and outcomes. Descriptive statistics were applied using SPSS version 25.

RESULTS: Thirteen patients were included: mean age 45.4 ± 11.2 years, with a female predominance (61.5%). Most (92.3%) had type 2 diabetes of a median duration of 6 years, and poor glycaemic control was observed in 86.6%. Abscesses (53.8%) and ulcers (30.8%) were the commonest presentations, predominantly affecting the digits (61.5%). Incision and drainage with dressings (that included the use of povidone iodine) was the main surgical treatment, while flap cover was rarely required. The mean hospital stay was 26.5 ± 23.9 days. Outcomes were favourable in 86.6% (discharged), with one death (7.7%) and one patient leaving against medical advice.

CONCLUSIONS: TDHS remains a preventable but serious complication of diabetes in Nigeria, predominantly affecting middle-aged women with poorly controlled type 2 diabetes. Prompt surgical and medical management yielded favourable outcomes, but prolonged hospitalisation and mortality highlight its burden. Strengthening diabetes care, patient education, and clinician awareness are vital to reducing incidence and improving outcomes.

PMID:42035327

J Health Psychol. 2026 Apr 26:13591053261437920. doi: 10.1177/13591053261437920. Online ahead of print.

ABSTRACT

Latent profile analysis (LPA) is an emerging approach to analyze the Revised Illness Perception Questionnaire (IPQ-R). LPA creates subgroups with similar illness perceptions. We used simulated data sets to provide suggestions and considerations for IPQ-R researchers implementing LPA. We explored 640 simulation parameters, varying sample size, IPQ-R distribution, covariance, and subscale means, simulating 3 distinct latent subgroups. We simulated 1000 samples for each setting via MClust package in R. Caution should be used when N < 100, as LPA only performs adequately (<50% detection). N ⩾ 100 still may not yield ideal performance depending on sample (e.g., subgroup sizes, within-group variance). With more differences between subgroups, LPA is more accurate. However, researchers have little control over mean differences, except indirectly (e.g., diverse sample). Researchers using LPA with IPQ-R data must carefully consider anticipated sample heterogeneity to establish appropriate sample size estimates. Resources provided in this manuscript can support these determinations.

PMID:42035326 | DOI:10.1177/13591053261437920

West Afr J Med. 2025 Dec 30;42(9):718-723.

ABSTRACT

BACKGROUND: Cryptosporidium is a water-borne protozoal parasite that infects humans and causes water-borne diarrhoea outbreaks.

OBJECTIVES: This cross-sectional study determined the prevalence of Cryptosporidium in wells in Ile-Ife, and assessed the risk factors associated with its presence in well water in Ile-Ife.

METHODS: Water samples were collected from 316 wells in the 10 wards that make up Ife East Local Government Area (LGA). A structured questionnaire was used to obtain relevant information on the wells from users. Modified acid-fast staining was used for the phenotypic identification of Cryptosporidium. Nested Polymerase Chain reaction (PCR) amplification of the 18S rRNA gene was carried out on the samples positive by staining. Cryptosporidium was confirmed by PCR and sequenced for species identification. Data was analysed using SPSS (version 21.0). Descriptive and inferential statistics were determined. A p-value of less than 0.05 was considered statistically significant.

RESULTS: The results showed that 11 (3.5%) of the 316 sampled wells were positive for Cryptosporidium by acid-fast staining, however only one was positive for Cryptosporidium by Nested PCR and was confirmed as Cryptosporidium parvum by sequencing. However, none of the risk factors investigated were significantly associated with the presence of Cryptosporidium in the well (p>0.05).

CONCLUSION: The study concluded that Cryptosporidium has low prevalence in wells in Ife East LGA. Cryptosporidium parvum was the species identified in the study area.

PMID:42035313

West Afr J Med. 2025 Dec 30;42(9):708-717.

ABSTRACT

BACKGROUND: Depression among women of reproductive age (WRA) is a major public health challenge because of its impact on mothers, children, and family members.

OBJECTIVE: The study determined the prevalence of depression and its associated factors among women of reproductive age at the three levels of healthcare in Ibadan, Nigeria.

METHODS: This cross-sectional facility-based study was conducted to compare the prevalence and correlates of depression among 991 pregnant, 662 postpartum, and 674 non-pregnant women using the Hospital Anxiety and Depression Scale (HADS). Data were analysed using descriptive statistics, the chi-square test, and binary logistic regression to determine the factors associated with and predictors of depression at p<0.05%.

RESULTS: The mean age of respondents was 29.9±6.3 years. Prevalence of depression was highest among pregnant women (38.5%), followed by non-pregnant (32.9%) and postpartum women (29.6%) (X2=14.93; p-value=0.001). Women whose husbands had primary education or below and those with financial problems were twice as likely to be depressed as those who did not. The presence of family problems and money-related issues were the predictors of depression across the groups.

CONCLUSION: Depression was common in women across the reproductive age lifespan. There is a need for screening for depression during routine health care to identify the women most at risk and for prompt intervention.

PMID:42035309

Ann Pharmacother. 2026 Apr 26:10600280261437728. doi: 10.1177/10600280261437728. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the efficacy and safety of mepolizumab, a humanized monoclonal antibody that targets interleukin-5, a key mediator in eosinophilic inflammation, in reducing moderate-to-severe exacerbations among patients with eosinophilic chronic obstructive pulmonary disease (COPD).

DATA SOURCES: PubMed, Scopus, Web of Science, and Cochrane databases were systematically searched using the terms: “Mepolizumab,” “COPD,” “Chronic Obstructive Pulmonary Disease,” for randomized controlled trials comparing subcutaneous mepolizumab (100 mg every 4 weeks) with placebo in patients with eosinophilic COPD from inception till July 2025.

STUDY SELECTION AND DATA EXTRACTION: Randomized controlled trials comparing subcutaneous mepolizumab with placebo in adults with eosinophilic COPD were included. Two independent reviewers screened studies and extracted data. Finally, 4 studies with a total of 1953 patients were included. Of these, 978 (50.0%) received mepolizumab.

DATA SYNTHESIS: Statistical analysis was performed using R software (version 4.5.0). Mepolizumab significantly prolonged the time to first moderate or severe exacerbation (hazard ratio [HR] = 0.80; 95% confidence interval [CI] 0.69-0.92; P = 0.016) and reduced the rate of moderate-to-severe exacerbations (rate ratio 0.80; 95% CI 0.78-0.83; P < 0.001). The risk of adverse events (AEs) (risk ratio [RR] = 1.00; 95% CI 0.95-1.06; P = 0.962) was similar between groups, while the risk of serious adverse events or death (RR = 0.83; 95% CI 0.72-0.96; P = 0.031) was significantly lower in the mepolizumab group.Relevance to Patient Care and Clinical Practice in Comparison With Existing Drugs:Mepolizumab provides a targeted, biomarker-guided treatment option, potentially reducing exacerbations without the added safety concerns like infections and metabolic complications as seen with existing therapies.

CONCLUSION AND RELEVANCE: Mepolizumab reduces the time to first moderate or severe exacerbation and prolongs symptom-free periods in patients with eosinophilic COPD, without increasing the risk of AEs.

PMID:42035307 | DOI:10.1177/10600280261437728

West Afr J Med. 2025 Dec 30;42(9):701-707.

ABSTRACT

BACKGROUND: Exploring the relationship between refractive error and ocular biometry in young African school children is essential for early detection, prevention, and management of visual impairments.

OBJECTIVES: This study aimed to profile the distribution of ocular biometry parameters and to identify correlates of spherical equivalent refraction (SE) among school children in Nigeria.

METHODS: A cross-sectional study was conducted among 295 secondary school students aged 10-19 years in Ife Central Local Government Area. Ocular measurements, including axial length, corneal radius of curvature, keratometric readings, anterior chamber depth, and horizontal corneal diameter, were obtained using the IOL Master. Refractive error was assessed with an autorefractor, and subjective refraction was also performed on all participants.

RESULTS: Out of the total participants, 109 students (37.0%) had refractive errors, comprising 43.1% males and 56.9% females. Astigmatism was the most common type of refractive error, found in 75 students (68.8%), followed by myopia in 22 (20.2%) and hypermetropia in 12 (11.0%). The median (IQR) axial length was 23.4 (0.8) mm. The average keratometric reading and average corneal radius of curvature were 43.5 ± 1.4 diopters and 7.8 ± 0.2 mm, respectively. The median (IQR) anterior chamber depth, horizontal corneal diameter and spherical equivalent refraction were 3.3 (0.3) mm, 12.2 (0.8) mm and -0.8 (1.3) diopters, respectively. Myopic students had longer axial lengths, deeper anterior chambers, and lower average keratometric readings. Spherical equivalent refraction was significantly negatively correlated with axial length (r = -0.147, p < 0.011), anterior chamber depth (r = -0.130, p < 0.026), and horizontal corneal diameter (r = -0.119, p < 0.042). A positive but non-significant correlation was observed with average keratometric reading (r = 0.009, p = 0.872).

CONCLUSION: Axial length, anterior chamber depth, and horizontal corneal diameter showed significant inverse relationships with spherical equivalent refraction.

PMID:42035305

Global Spine J. 2026 Apr 26:21925682261447886. doi: 10.1177/21925682261447886. Online ahead of print.

ABSTRACT

Study designSystematic review and meta-analysis.ObjectiveTo compare the clinical, radiographic, fusion and complication outcomes between three-level anterior cervical discectomy and fusion (ACDF) and hybrid constructs combining ACDF and cervical disc arthroplasty (CDA).MethodsSystematic search of PubMed, Embase, Scopus, and Web of Science was performed in accordance with PRISMA guidelines. Comparative studies evaluating three-level ACDF and three-level hybrid surgery were included. Primary outcomes included neck disability index(NDI), visual analogue scale(VAS) scores, Japanese Orthopaedic Association (JOA) scores, C2-C7 Cobb angle, C2-7 range of motion (ROM), fusion rates, and complications. Random-effects meta-analyses were performed. Heterogeneity and publication bias were assessed using standard statistical methods.ResultsTwelve studies comprising 1008 patients (553 hybrid and 455 ACDF) met the inclusion criteria. Both surgical strategies demonstrated significant improvements in NDI (P = 0.62), VAS [neck (P = 0.40), arm(P = 0.70)], and JOA (P = 0.97) scores, with no significant between-group differences across clinical outcomes. Hybrid constructs maintained ROM (P = 0.06), and cervical lordosis (P = 0.93) comparable to ACDF. Fusion rates at intended arthrodesis levels were high and similar in both cohorts. There were no significant differences in total, early or late complication rates, although heterogeneity was moderate to high across several outcomes.ConclusionIn three-level cervical degenerative disease, hybrid surgery and ACDF provide equivalent improvements in pain, disability, neurological recovery, alignment, fusion success, and complication profiles. Hybrid constructs demonstrated a trend towards greater preservation cervical range of motion without compromising clinical efficacy or safety. These findings support hybrid surgery as a selective, motion-preserving alternative to three-level ACDF in appropriately chosen patients.Level of evidenceII.

PMID:42035304 | DOI:10.1177/21925682261447886

Eur Heart J Qual Care Clin Outcomes. 2026 Apr 24:qcag074. doi: 10.1093/ehjqcco/qcag074. Online ahead of print.

ABSTRACT

AIMS: The natural history and response to tafamidis treatment in women with wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) remain insufficiently characterised. Current study aimed to explore sex-differences in clinical presentation, natural course and tafamidis treatment efficacy, focusing on women with ATTRwt-CM.

METHODS AND RESULTS: An international, multicentric cohort of ATTRwt-CM subjects was evaluated, including for all-cause mortality. In total 1454 patients were studied (mean age 81±7y), including 307 (21.1%) females. At presentation, females were ∼3 years older than males with slightly worse phenotype, including higher indexed left ventricular wall thickness and National Amyloidosis Centre (NAC) disease stage (p<0.050). Heart failure with preserved ejection fraction and hypertension coincided more often in women (p=0.001). Natural disease course was poor without sex-difference, even when age-corrected (p=0.210). Tafamidis was initiated in 1055 patients, 12% less in females (p<0.001), although reasons for non-initiation and discontinuation did not show heterogeneity by sex (p=0.116 and p=0.304, respectively), indicating structural undertreatment. After 1.9 (0.9-3.3) years of median follow-up, 409 (28.1%) patients died. Tafamidis related to lower mortality in the overall and propensity score-matched cohort (n=742, HR 0.44, 95%CI 0.32-0.61, p<0.001), without sex-difference (female HR 0.76, 95%CI 0.52-1.11, p=0.150) nor sex-based treatment efficacy interaction (p=0.381). NAC disease stages strongly related to mortality under tafamidis treatment (HR 2.13%, 95%, 1.81-2.50, p<0.001), but female sex did not (HR 0.82, 95%CI 0.53-1.27, p=0.365).

CONCLUSIONS: Women with ATTRwt-CM are prone to underdiagnosis and undertreatment, despite similar poor natural course and tafamidis treatment efficacy. Initiatives to increase diagnostic awareness and disease modifying treatment initiation in women are urgently needed.

PMID:42035239 | DOI:10.1093/ehjqcco/qcag074

Am J Hematol. 2026 Apr 25. doi: 10.1002/ajh.70328. Online ahead of print.

ABSTRACT

Venetoclax-based low-intensity regimens have improved the outcomes of older or unfit patients with acute myeloid leukemia (AML). This phase II study investigated the combination of cladribine plus low-dose cytarabine and venetoclax alternating with azacitidine plus venetoclax for older or unfit patients with newly diagnosed AML. A total of 190 patients were included; the median age was 68 years (range, 47-84 years; 13% ≥ 75 years). By the European LeukemiaNet 2022 classification, 16%, 20%, and 64% were stratified as favorable, intermediate, and adverse risk, respectively. The rates of complete remission (CR)/CR with incomplete blood count recovery (CRi) and minimal residual disease (MRD) negative CR/CRi were 84% and 75% overall and 91% and 77% among patients with TP53-wild type AML, respectively. The 4- and 8-week mortality rates were 1% and 3%, respectively. Among responders, 44% proceeded to allogeneic hematopoietic stem cell transplantation. The median overall survival (OS) and event free survival (EFS) were 52 and 50 months, respectively. The 2- and 5-year OS rates were 60% and 45%, respectively. The 2-and 5-year EFS rates were 56% and 43%, respectively. Patients achieving MRD-negative CR had a median OS not reached and a 2-year OS rate of 70%. The median time to absolute neutrophil count recovery (> 1 × 10⁹/L) and platelet count recovery (> 100 × 10⁹/L) after induction was 27 and 24 days, respectively. Overall, the treatment was safe and most grade 3 and 4 adverse events were infectious complications. The combination produced a high rate of remissions, translating into favorable outcomes for older patients with newly diagnosed AML. Trial Registration: ClinicalTrials.gov idetifier: NCT03586609.

PMID:42035228 | DOI:10.1002/ajh.70328