Tag: pubmed

Sci Rep. 2025 Apr 20;15(1):13627. doi: 10.1038/s41598-025-97025-z.

ABSTRACT

Sickness absence (SA) changed in various occupations during the COVID-19 pandemic. The aim was to investigate the prevalence of all-cause sickness absence (SA) during the COVID-19 pandemic in relation to in the preceding years, as well as factors associated with all-cause SA and SA due to COVID-19 and COVID-like diagnoses during the COVID-19 pandemic among blue-collar workers in the retail and wholesale industry. A population-based longitudinal cohort study using microdata linked from nationwide registers in Sweden. All 297 378 blue-collar employees aged 18-67 years in wholesale and retail in 2019 were followed during 2016-2021 regarding SA in spells > 14 days. Yearly prevalence rates were calculated for all-cause SA in sociodemographic and occupational groups. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for all-cause SA and SA due to COVID-19 or COVID-like diagnoses in 2020 and 2021. The annual prevalences of SA were 7.5-8% in 2016-2018, 10% in 2020, and 9% in 2021. The prevalence of SA due to COVID-19 or COVID-like diagnoses was 2.1% in 2020 and 1.6% in 2021. The OR was higher in the older age groups (OR age 55-64 = 2.38, 95% CI 2.20-2.57 compared to age 25-34). There were few significant occupational differences, however, warehouse and terminal staff had a higher OR (1.37, 1.27-1.48) than sales assistants, daily goods. While SA rates increased during the COVID-19 pandemic, the distribution of SA between sociodemographic or occupational groups did not change markedly. The distribution of SA due to COVID-19 and COVID-like diagnoses was similar to all-cause SA.

PMID:40254621 | DOI:10.1038/s41598-025-97025-z

BMC Urol. 2025 Apr 21;25(1):96. doi: 10.1186/s12894-025-01781-z.

ABSTRACT

PURPOSE: Nephrectomy for inflammatory renal conditions (IRCs) presents comparable challenges irrespective of the surgical approach. This meta-analysis evaluates whether laparoscopic nephrectomy (LN) is safer than open nephrectomy (ON) for managing IRCs, including xanthogranulomatous pyelonephritis (XGP), pyonephrosis, and renal tuberculosis.

METHODS: Following PRISMA/Cochrane guidelines, we systematically reviewed studies comparing LN and ON in adults with IRCs. Inclusion required direct LN vs. ON comparisons and perioperative outcomes. Exclusions included pediatric cohorts and studies conflating converted LN cases with ON groups.

RESULTS: From 16 identified studies, 13 met the inclusion criteria, encompassing 868 patients undergoing nephrectomy for IRCs. Of these, 398 (45.9%) underwent ON, and 470 (54.1%) underwent LN. Compared to ON, LN demonstrated a statistically significant (28%) reduction in overall-complications (RR = 0.72, 95% CI [0.6-0.86]; p = 0.0004; low-heterogeneity) and non-significant reduction in high-grade complications (RR = 0.65, 95% CI [0.4-1.06]; p = 0.09; low-heterogeneity), with moderate certainty of evidence. LN was also associated with 53% fewer blood transfusions (post-sensitivity analysis (RR = 0.47, p < 0.0001; low certainty), significant blood loss reduction in XGP-patients (after subgroup analyses MD = -130.8 mL; 95% CI [-203.35 to -58.21]; low certainty), and shorter hospital stays (PMD = -3.04 days; p < 0.00001; very low certainty), albeit with longer operative times (PMD = + 39.05 min; p = 0.03; very low certainty).

CONCLUSION: LN is a safer alternative to ON for IRCs, offering fewer complications, shorter hospitalization, and reduced transfusions despite prolonged operative times. Surgeon expertise and patient-specific selection are critical to optimizing outcomes.

PMID:40254599 | DOI:10.1186/s12894-025-01781-z

BMC Oral Health. 2025 Apr 20;25(1):605. doi: 10.1186/s12903-025-05939-x.

ABSTRACT

OBJECTIVES: More time is often needed for adult orthodontic patients compared with juvenile counterparts due to lower tissue vitality. In some cases, the prolonged orthodontic treatment may cause a series of problems, such as enamel demineralization, dental caries, periodontitis and root resorption. Therefore, we aimed to accelerate tooth movement to avoid various adverse reactions by 3D-printing assisted micro-osteoperforations (MOPs) in difficult orthodontics cases.

METHODS: Twenty-eight adult patients (28.3 ± 3.4 years) with slow tooth movement after extraction of bilateral maxillary first premolars were included. The scheme of 3D-printing assisted MOPs was designed to perform bone punctures in the mesial and distal sides of canines.

RESULTS: The average speed of the retraction of canines was 1.02 ± 0.41 mm per month after MOPs and significantly faster than that before the MOPs, 0.34 ± 0.16 mm per month (P < 0.05). Moreover, the evaluation of side effects including root resorption, periodontal damage did not reach statistical difference and pain level was acceptable generally.

CONCLUSION: MOPs assisted by 3D-printing could significantly accelerate tooth movement while achieving greater precision, without notably increasing side effects.

TRIAL REGISTRATION: ChiCTR2100044685, date of registration: 25/03/2021.

PMID:40254596 | DOI:10.1186/s12903-025-05939-x

BMC Emerg Med. 2025 Apr 20;25(1):69. doi: 10.1186/s12873-025-01191-2.

ABSTRACT

BACKGROUND: Cancer-related emergencies are a significant challenge for healthcare systems globally, including Jordan. Effective triage is critical in ensuring timely and accurate prioritization of care, especially for surgical cancer patients requiring urgent intervention. However, under-triage-misclassification of high-acuity patients into lower urgency categories-can lead to significant delays and worsened outcomes. Despite the recognized importance of accurate triage, limited research has evaluated its impact on cancer patients in Jordan, particularly those requiring surgical care.

OBJECTIVES: This study aimed to evaluate the timeliness and prioritization of care for cancer patients admitted through the emergency department (ED) in Jordan. The specific objectives were to examine the association between under-triage and treatment delays and assess its impact on key outcomes, including time to physician assessment, time to treatment, and hospital length of stay.

METHODS: A retrospective cohort design was used to analyze data from 481 cancer patients admitted through the ED in four governmental hospitals across Jordan. Two cohorts were established: surgical cancer patients requiring emergency interventions and non-surgical cancer patients presenting with other oncological emergencies. Triage accuracy was assessed using the Canadian Triage and Acuity Scale (CTAS), and under-triage was identified when patients requiring high urgency care (CTAS I-III) were misclassified into lower urgency categories (CTAS IV-V). Data were collected from electronic health records and analyzed using multiple linear regression to evaluate the association between under-triage and treatment outcomes.

RESULTS: The majority of patients were elderly, with a mean age of 62.6 years (± 10.7), and a significant proportion presented with advanced-stage cancer (83.4% in stages III and IV). Surgical patients frequently exhibited severe symptoms such as acute pain (51.6%) and respiratory discomfort (41.1%). Under-triage rates were 44.1% for surgical patients and 39.4% for non-surgical patients. Among surgical patients, under-triage significantly delayed time to physician assessment (β = 34.9 min, p < 0.001) and time to treatment (β = 68.0 min, p < 0.001). For non-surgical patients, under-triage delays were even greater, with prolonged physician assessment times (β = 48.6 min, p < 0.001) and ED length of stay (β = 7.3 h, p < 0.001). Both cohorts experienced significant increases in hospital length of stay (surgical: β = 3.2 days, p = 0.008; non-surgical: β = 3.2 days, p < 0.001).

CONCLUSION: Under-triage in Jordanian EDs is strongly associated with significant delays in care for both surgical and non-surgical cancer patients, highlighting systemic gaps in acuity recognition and triage processes. These findings underscore the need for targeted interventions to improve triage accuracy, particularly through oncology-specific training and the integration of evidence-based tools like SIRS criteria. Enhancing ED processes for cancer patients is crucial to reducing delays, optimizing resource allocation, and improving clinical outcomes in this vulnerable population.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40254595 | DOI:10.1186/s12873-025-01191-2

Rehabilitacion (Madr). 2025 Apr 19;59(2):100907. doi: 10.1016/j.rh.2025.100907. Online ahead of print.

ABSTRACT

Virtual reality (VR) is emerging technologies in the field of rehabilitation of post-stroke patients. The aim of this study was to systematically explore the effects of VR rehabilitation program on functional capacity of stroke patients. We conducted a systematic review and meta-analysis. The searches were carried out in the PubMed/Medline, Web of Science, PEDro and OTSeeker to October 2024. Methodological quality was assessed using the Downs and Black scale and the Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to assess risk of bias. A total of 4 studies met the inclusion criteria. The type of VR intervention varied among studies using Wii Fit, ARMEO Spring 1.1, Rehabilitation Gaming System and ArmAble™. The meta-analysis indicated that the VR group showed statistically significant improvement in functional ability versus control group. The methodological quality mean was moderate quality level. VR interventions seem to be a promising therapeutic system for functional capacity rehabilitation in people with post-stroke.

PMID:40253724 | DOI:10.1016/j.rh.2025.100907

J Community Health Nurs. 2025 Apr 20:1-18. doi: 10.1080/07370016.2025.2487702. Online ahead of print.

ABSTRACT

PURPOSE: To understand the impact of post-acute sequelae of COVID-19 (PASC) on quality of life (QOL) in a Midwestern community sample.

DESIGN: Anonymous online cross-sectional community survey.

METHODS: Survey responses collected July 2023-October 2024 were examined from 1,564 individuals reporting prior COVID-19 positive test or diagnosis. Logistic regressions and sensitivity analyses using subset of data were conducted to identify symptoms significantly associated with perceived Current QOL (determined by “Taking everything in your life into account, please rate your current overall QOL”) and Deteriorated QOL (i.e., Current QOL rated lower than QOL prior to SARS CoV-2 infection).

FINDINGS: Current QOL was predicted by pre-infection QOL and more frequent experiences of work/school difficulties, challenges with shopping/cleaning/driving/meal-prep, anxiety, depression, fatigue/tiredness, light headedness/fainting/rapid heartbeat episodes, and diminished activity/exercise tolerance (C-statistic = 0.84). Compared to the full dataset’s primary analyses, sensitivity analysis revealed all identified predictors except three physical symptoms remained significant Current QOL predictors. Deteriorated QOL after SARS-CoV-2 infection was predicted by pre-infection QOL, and more frequent experiences of work/school difficulties, diminished activity/exercise tolerance, anxiety, depression, trouble completing daily activities, fatigue/tiredness, and slow mental processing (C-statistic = 0.85). In contrast, sensitivity analysis revealed frequency of SARS-CoV-2 infection, pre-infection QOL, and more frequent challenges with shopping/cleaning/driving/meal-prep were the only significant predictors of Deteriorated QOL.

CONCLUSIONS: PASC negatively impacted QOL. Pre-infection QOL may influence perceived post-infection QOL.

CLINICAL EVIDENCE: Results make a compelling case for community nurses to identify PASC, rule-out underlying medical causes, and refer patients for interdisciplinary post-COVID rehabilitation to improve health outcomes and QOL.

PMID:40253714 | DOI:10.1080/07370016.2025.2487702

Scand J Clin Lab Invest. 2025 Apr 20:1-6. doi: 10.1080/00365513.2025.2494261. Online ahead of print.

ABSTRACT

This study evaluates the utility of leftover EDTA whole blood from a diagnostic biobank for determining concentrations of ferritin, cobalamin, homocysteine, hCG, and thyroid-related hormones and antibodies (TSH, fT4, fT3, TRAb, and anti-TPO). Twenty participants were included. Pre-analytical bias in their blood samples was assessed as per European Federation of Clinical Chemistry and Laboratory Medicine Milano performance specifications. We evaluated the stability of EDTA whole blood stored at various intervals (days 0, 1, 6, and 13), and compared plasma derived from these samples with serum samples. Bland Altman plots and Paired t-test were used to identify statistically significant differences. We found good quantitative agreement, with biases within set performance specifications for cobalamin (14%), fT4 (3.5%), fT3 (3.6%), TSH (15%), and ferritin (7.4%). The calculated biases for serum vs. EDTA plasma day 6 were as follows: cobalamin 1.9%, fT4 2.6%, fT3 0.4%, TSH -2.1%, and ferritin -4.5%. The biases for homocysteine exceeded limits in all comparisons, except serum vs. EDTA plasma on day 0 and between EDTA plasma from day 0 and day 1. The calculated bias of 41% exceeded the set limit of 13% when comparing serum with EDTA plasma day 6. For hCG, anti-TPO, and TRAb, limited measurable levels restricted bias calculations. As per the diagnostic biobank protocols, EDTA blood stored for up to 6 days provides plasma suitable for analyzing cobalamin, fT4, fT3, TSH, and ferritin. Our study confirms previous findings that homocysteine has poor stability in whole blood.

PMID:40253713 | DOI:10.1080/00365513.2025.2494261

Aging Ment Health. 2025 Apr 20:1-9. doi: 10.1080/13607863.2025.2468893. Online ahead of print.

ABSTRACT

OBJECTIVES: This study presents findings from IDEA Café, for older adults aged 50 and older living with early dementia, dementia, Alzheimer’s Disease or cognitive impairment (ED/CI) with no informal caregiver or care partner. IDEA Café is a group adaptation of Innovations in Dementia Empowerment and Action (IDEA) (built upon the foundation of RDAD). It was tested with sexual and gender minority (SGM) older adults, as an underserved population.

METHOD: Employing a two-group randomized controlled pilot trial, thirty participants were randomly assigned to IDEA Café (n = 15) or routine medical care (RMC; n = 15). Feasibility and acceptability were assessed. We conducted pre- and post-treatment assessments of primary and secondary outcomes.

RESULTS: IDEA Café was feasible (attendance, participation), acceptable (helpfulness of the program), and met enrollment goals, with 85% of participants reporting treatment as helpful. The treatment group showed significant improvement in physical functioning (p = 0.04), depressive symptomology (p = 0.03), quality of life (p = 0.04), and a reduction in microaggressions (p = 0.05) and social exclusion (p = 0.03). The RMC showed no statistical change from pretest to posttest.

CONCLUSION: A future randomized controlled trial is needed to test the efficacy and sustainability of the intervention and to bring the intervention to scale.

PMID:40253707 | DOI:10.1080/13607863.2025.2468893

Age Ageing. 2025 Mar 28;54(4):afaf106. doi: 10.1093/ageing/afaf106.

ABSTRACT

BACKGROUND: Orthogeriatric care has been shown to effectively reduce mortality and morbidity and has a potential impact on health-related quality of life (HRQoL). This systematic review and meta-analysis summarises the effects of orthogeriatric care on HRQoL in hip fracture patients.

METHODS: The review protocol was registered in International Prospective Register of Systematic Reviews (PROSPERO): CRD42021206280. We searched Medline and EMBASE from inception to January 2024 without language restrictions. We included randomised and non-randomised controlled trials comparing HRQoL in older hip fracture patients receiving orthogeriatric care to other fracture care. Study quality was evaluated using the Revised Cochrane Risk-of-Bias (RoB) tool or the Newcastle-Ottawa Scale (NOS). Pooled standardised mean differences (SMDs) were calculated using random-effects models. We reported according to the Preferred Reporting Items of Systematic reviews and Meta-Analyses guidelines.

RESULTS: Eight studies involving 2411 patients were included, all employing various orthogeriatric care models with moderate to good methodological quality, based on the RoB tool and NOS. However, substantial clinical heterogeneity was present due to variations in study design, number and execution of intervention components, outcome measures and patient populations. Despite this variability, meta-analysis showed that in-hospital orthogeriatric care, compared to usual care, led to a small but statistically significant improvement in overall HRQoL (SMD 0.18, 95% CI 0.06-0.30) with moderate heterogeneity (I2 = 47%).

CONCLUSION: In-hospital orthogeriatric care has a small but significant effect on HRQoL. This study highlights the need for clear descriptions of orthogeriatric care models, their implementation, fidelity and contextual factors. High-quality future research is essential to advance clinical practice, refine care models, address methodological limitations and prioritise patient-centred short- and long-term HRQoL outcomes.

PMID:40253688 | DOI:10.1093/ageing/afaf106

Age Ageing. 2025 Mar 28;54(4):afaf096. doi: 10.1093/ageing/afaf096.

ABSTRACT

BACKGROUND: Hospital-based Special Care Units (SCU) for dementia show promise as effective models of care. However, limited research describes hospital-wide benefits.

OBJECTIVE: To describe patient-level outcomes and hospital service-level outcomes of a SCU.

DESIGN: Pre-post analyses of SCU-patient data and hospital service-unit incident report data.

SETTING, PARTICIPANTS: 2-years of SCU-patient admissions and 4-years of hospital incident-reports from four medical wards (2-years pre-post SCU).

METHODS: Admission and discharge severity of SCU-patients’ behaviour was prospectively measured by specialist SCU nurses. One-year hospitalisation rates, length-of-stay, diagnosis and patient demographics were retrospectively obtained from medical records. Hospital service-unit data included 4 years of monthly incident report rates for falls, pressure injury and occupational violence (OV) across four medical wards. Analysis of count data used Poisson and Negative Binomial Regression models.

RESULTS: 121 SCU admissions involved 107 unique patients. Median SCU LoS was 23 days (interquartile range [IQR], 13-50), and stabilisation of behaviour severity took 11 days (IQR 6-12). Barriers to discharge related to substitute decision-making and care facility availability. After SCU discharge, yearly hospitalisation rates for ‘all-reasons’ decreased by 68% (Incident Rate Ratio [IRR], 0.32, 95% CI, 0.23-0.43), and 83% for behaviour-related admissions (IRR 0.17, 95% CI, 0.11-0.28). For hospital service-unit outcomes, falls-per-month decreased by 21% (IRR 0.79, 95% CI 0.64-0.99) after SCU implementation and OV by 26% (IRR, 0.74, 95% CI 0.59-0.94).

CONCLUSIONS: A hospital-based SCU reduced hospital health service demand through decreased SCU-patient readmissions and was associated with decreased falls and OV rates across hospital medical wards.

PMID:40253685 | DOI:10.1093/ageing/afaf096