Tag: pubmed

JAMA Netw Open. 2025 Jun 2;8(6):e2514411. doi: 10.1001/jamanetworkopen.2025.14411.

ABSTRACT

IMPORTANCE: COVID-19 can lead to long-term cardiopulmonary symptoms and is associated with coronary microvascular dysfunction (CMD). However, long-term data on CMD after severe COVID-19 are lacking.

OBJECTIVE: To investigate long-term left ventricular function and the presence of CMD after severe COVID-19.

DESIGN, SETTING, AND PARTICIPANTS: This case-control study was conducted among patients at a single center from the prospective Follow-Up of Patients With Severe COVID-19 (UppCov) study, with follow-up multiparametric perfusion cardiovascular magnetic resonance (CMR) at 10 months after discharge from November 2020 to February 2021. Patients previously hospitalized due to severe COVID-19 (ventilatory support, oxygen flow ≥5 L/min, or both) with or without cardiac involvement (troponin t > 14 ng/L, pulmonary artery pressure >34 mm Hg, or both) were compared with historical sex- and age-matched volunteers without symptomatic ischemic heart disease. Standard contraindications to adenosine CMR were applied. Data were analyzed between March 2023 and March 2025.

EXPOSURE: Hospitalization due to severe COVID-19.

MAIN MEASURES AND OUTCOMES: Comprehensive CMR included native T1, native T2, extracellular volume, adenosine stress and rest perfusion mapping, gadolinium enhancement, and cine imaging. Comorbidities, medications, symptoms at follow-up, and details regarding hospitalization were obtained from patient records.

RESULTS: The study included 37 patients with COVID-19 (mean age, 56 years [95% CI, 53 to 61 years]; 28 male [75.7%]) and 22 healthy volunteers (mean age, 51 years [95% CI, 45 to 57 years]; 12 male [54.4%]). Patients with COVID-19 compared with healthy patients demonstrated reduced mean stress perfusion (2.80 mL/min/g [95% CI, 2.53 to 3.07 mL/min/g] vs 3.43 mL/min/g [95% CI, 3.13 to 3.74 mL/min/g]; P = .003), impaired mean global longitudinal strain (-17% [95% CI, -18% to -16%] vs -19% [-20% to -18%]; P = .003), and impaired mean global circumferential strain (-16% [95% CI, -17% to -15%] vs -19% [-20% to -18%]; P = .001). There were no differences in stress perfusion or myocardial perfusion reserve in the COVID-19 group between patients with vs without cardiovascular risk factors or cardiac symptoms.

CONCLUSIONS AND RELEVANCE: In this study, patients with COVID-19 exhibited long-term reduced stress perfusion indicating CMD, along with declined left ventricular function by global longitudinal strain and global circumferential strain. Lack of variation in stress perfusion between patients with and without cardiovascular risk factors may suggest CMD due to severe COVID-19, warranting further investigation to elucidate mechanisms and guide potential therapies.

PMID:40489109 | DOI:10.1001/jamanetworkopen.2025.14411

Cardiovasc Interv Ther. 2025 Jun 9. doi: 10.1007/s12928-025-01129-2. Online ahead of print.

ABSTRACT

Low-dose prasugrel could provide a better balance between adverse ischemic and bleeding events compared to other P2Y12 receptor inhibitors as part of dual antiplatelet therapy (DAPT) for patients with ischemic heart disease. This study evaluated these risks of adverse events associated with low-dose prasugrel and other P2Y12 receptor inhibitors. A network meta-analysis was conducted, searching for randomized controlled trials (RCTs) comparing clopidogrel (75 mg), low-dose (3.75 mg) and standard-dose (10 mg or 5 mg) prasugrel, or ticagrelor (180 mg). The primary endpoint was major adverse cardiovascular events (MACE), a composite of cardiovascular death, myocardial infarction, or stroke. The secondary endpoint was major bleeding, cardiovascular death, myocardial infarction, and stroke. Across 13 RCTs, neither low-dose prasugrel, standard-dose prasugrel, nor ticagrelor showed a statistically significant difference in MACE compared to clopidogrel [risk ratio (RR): 0.73, 95% confidence interval (CI) 0.49-1.09; RR: 0.86, 95% CI 0.68-1.09; RR: 1.02, 95% CI 0.62-1.67, respectively]. However, the standard dose of prasugrel was associated with a significantly higher risk of bleeding events compared to clopidogrel (RR, 0.72; 95% CI 0.35-1.49; RR, 1.26; 95% CI 1.01-1.58; RR, 1.26; 95% CI 0.82-1.96). The surface under the cumulative ranking curves was highest for low-dose prasugrel for both MACE and bleeding events (17.3 and 64.6 for clopidogrel, 84.5 and 84.9 for low-dose prasugrel, 62.0 and 11.8 for standard-dose prasugrel, and 36.2 and 38.7 for ticagrelor, respectively). Low-dose prasugrel may be a viable option in addition to standard P2Y12 receptor inhibitors.

PMID:40489021 | DOI:10.1007/s12928-025-01129-2

Emerg Radiol. 2025 Jun 9. doi: 10.1007/s10140-025-02353-2. Online ahead of print.

ABSTRACT

PURPOSE: Missed fractures are the primary cause of interpretation errors in emergency radiology, and artificial intelligence has recently shown great promise in radiograph interpretation. This study compared the diagnostic performance of two AI algorithms, BoneView and RBfracture, in detecting traumatic abnormalities (fractures and dislocations) in MSK radiographs.

METHODS: AI algorithms analyzed 998 radiographs (585 normal, 413 abnormal), against the consensus of two MSK specialists. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and interobserver agreement (Cohen’s Kappa) were calculated. 95% confidence intervals (CI) assessed robustness, and McNemar’s tests compared sensitivity and specificity between the AI algorithms.

RESULTS: BoneView demonstrated a sensitivity of 0.893 (95% CI: 0.860-0.920), specificity of 0.885 (95% CI: 0.857-0.909), PPV of 0.846, NPV of 0.922, and accuracy of 0.889. RBfracture demonstrated a sensitivity of 0.872 (95% CI: 0.836-0.901), specificity of 0.892 (95% CI: 0.865-0.915), PPV of 0.851, NPV of 0.908, and accuracy of 0.884. No statistically significant differences were found in sensitivity (p = 0.151) or specificity (p = 0.708). Kappa was 0.81 (95% CI: 0.77-0.84), indicating almost perfect agreement between the two AI algorithms. Performance was similar in adults and children. Both AI algorithms struggled more with subtle abnormalities, which constituted 66% and 70% of false negatives but only 20% and 18% of true positives for the two AI algorithms, respectively (p < 0.001).

CONCLUSIONS: BoneView and RBfracture exhibited high diagnostic performance and almost perfect agreement, with consistent results across adults and children, highlighting the potential of AI in emergency radiograph interpretation.

PMID:40489014 | DOI:10.1007/s10140-025-02353-2

J Med Syst. 2025 Jun 9;49(1):76. doi: 10.1007/s10916-025-02202-2.

ABSTRACT

INTRODUCTION: Understanding user engagement with conversational agents is key to their sustainable use in mobile health and improving patient outcomes. This retrospective study analyzed interactions with a multimodal conversational agent in the Albert Health app to identify usage patterns and barriers to long-term engagement in self-care and chronic disease management.

METHODS: We retrospectively analyzed interactions from 24,537 users of a Turkish-language mobile health app (between January 1, 2022, and December 31, 2023). Interactions with the app’s multimodal conversational agent (voice and text) were categorized by demographics, interaction type, and engagement mode. Descriptive statistics summarized patterns, while Mann-Whitney U, Chi-square, and logistic regression identified group differences and predictors of sustainable engagement.

RESULTS: Most users were female (56%) and aged 30-45 (44%). The majority (92%) used general health programs, with only 8% in disease-specific ones. Common interaction types included health information (32%), small talk (20%), and clinical parameter logging (16%; e.g., blood pressure). Voice use was frequent in fallback (80%; unclear/ out-of-scope input), small talk (64%), and medication tasks (53%), while screen input was more common for clinical logging (61%) and health queries (59%). Engagement peaked in the first week and declined after 10 days. Sustainable engagement was associated with disease-specific program use (OR = 0.67, 95%CI: 0.60-0.74, p < 0.001), greater voice interaction (OR = 1.005, 95%CI: 1.004-1.006, p < 0.001), and a balanced mix of clinical and non-clinical use (OR = 1.56, 95%CI: 1.43-1.70, p < 0.05).

CONCLUSIONS: This study highlights user preferences for voice interaction and health information access when using a multimodal conversational agent. The high rate of single-session users (58%) points to barriers to sustainable engagement, emphasizing the need for better user experience strategies.

PMID:40488988 | DOI:10.1007/s10916-025-02202-2

Pharmacoeconomics. 2025 Jun 9. doi: 10.1007/s40273-025-01510-2. Online ahead of print.

NO ABSTRACT

PMID:40488987 | DOI:10.1007/s40273-025-01510-2

J Endocrinol Invest. 2025 Jun 9. doi: 10.1007/s40618-025-02594-5. Online ahead of print.

ABSTRACT

BACKGROUND: Speckle tracking echocardiography (STE) provides a quantitative assessment of left ventricular systolic performance, including myocardial motion and deformation. Global longitudinal strain (GLS) is a reliable and sensitive indicator of systolic function, with clinical and prognostic value in various settings, including secondary hypertension. There is limited data on GLS evaluation in patients with non-functioning adrenal adenomas (NF), despite emerging evidence suggesting its association with subclinical cardiovascular dysfunction. Investigating the cardiac impact of NF is essential for understanding its role in early cardiac remodeling compared to primary aldosteronism (PA) and essential hypertension (EH).

OBJECTIVE: To retrospectively evaluate the utility of GLS in detecting early cardiac dysfunction in patients with NF, PA, and EH without adrenal adenoma or hyperplasia.

METHODS: This retrospective study included 33 patients with NF, 33 with PA, and 33 with EH, matched by gender and age. Speckle tracking echocardiography was used to assess the GLS of the left ventricle. Data analysis was conducted using IBM SPSS Statistics version 29.0, with a significance threshold set at P < 0.050.

RESULTS: The GLS in NF patients (-20.63 ± 3.10%) was significantly lower than in EH patients (-22.17 ± 3.03%) but higher than in PA patients (-18.55 ± 2.45%), despite NF patients having the lowest prevalence of hypertension and systolic blood pressure. GLS was significantly correlated with cortisol levels, impaired glucose tolerance, and ARR across all patient groups, highlighting the complex interplay between metabolic and hormonal factors in cardiac dysfunction.

CONCLUSION: Cardiac function impairment in NF patients lies between that observed in EH and PA patients, suggesting a nuanced impact of non-functioning adrenal adenomas on cardiac health.

PMID:40488985 | DOI:10.1007/s40618-025-02594-5

Trop Anim Health Prod. 2025 Jun 9;57(5):250. doi: 10.1007/s11250-025-04505-5.

ABSTRACT

This study compared fertility and parturition parameters in Limousin (L) and Charolais (C) heifers to identify the breed most suitable for beef production. A total of 234 L and 76 C Hungarian-origin heifers, aged 9-11 months, were managed under standardized housing and feeding conditions at Dogan Farm. Parturitions were categorized based on the time of day (day: 07:00-19:00; night) and season (cold, cool, hot). Statistical analyses were conducted using ANOVA and Chi-square tests Results showed that C heifers required significantly more inseminations to conceive (C: 3.39 ± 0.22, L: 2.32 ± 0.10, P < 0.0001), indicating lower reproductive efficiency. Additionally, C calves were significantly heavier at birth than L calves (C: 46.1 ± 0.8 kg, L: 40.2 ± 0.3 kg, P < 0.0001), with male calves being generally heavier than females (M: 43.7 ± 0.5 kg, F: 39.5 ± 0.3 kg, P < 0.0001). The incidence of dystocia was higher in C heifers (63.16%) compared to L heifers (41.88%), while L heifers experienced greater parturition ease (58.12% vs. 36.84%; X² = 10.4244, P < 0.0054).

PMID:40488966 | DOI:10.1007/s11250-025-04505-5

Int Ophthalmol. 2025 Jun 9;45(1):235. doi: 10.1007/s10792-025-03613-3.

ABSTRACT

BACKGROUND: Ocular allergy (OA) is a significant public health concern, but its prevalence remains underreported due to underdiagnosis. This study aims to determine the prevalence of OA among adults in Trinidad and Tobago.

METHOD: A descriptive cross-sectional study was conducted using an online questionnaire to assess OA prevalence. Sociodemographic, environmental, and systemic characteristics of participants were also evaluated. Data was analyzed using SPSS with both descriptive and inferential statistical techniques, including bi-variable and multivariable logistic regression.

RESULTS: A total of 591 participants completed the survey with majority (73.6%) as female and aged 18-24 years (50.1%). The overall prevalence of OA was 41.6% (95% CI, 37.2-45.0), with seasonal OA being the most common (80.1%). OA symptoms were most prevalent in spring (62.1%), with light sensitivity reported by 57.7% of participants. Bi-variable analysis identified asthma, allergic rhinitis, pollen allergy, and exposure to environmental factors such as cigarettes and air conditioning as associated with OA. Multivariable analysis confirmed these associations, with significant p-values for asthma (0.017), allergic rhinitis (0.035), pollen allergy (< 0.001), mite allergy (0.038), cigarettes (0.006), air conditioning (< 0.001), and OA awareness (< 0.001).

CONCLUSION: There is a high prevalence of OA among adults in Trinidad and Tobago, with systemic and environmental allergens playing a significant role. Interventions to reduce exposure to allergens, such as using indoor air filters and managing allergic conditions, could help mitigate OA prevalence. Regular assessment of patients with allergic rhinitis and asthma for OA is recommended.

PMID:40488956 | DOI:10.1007/s10792-025-03613-3

Lasers Med Sci. 2025 Jun 9;40(1):264. doi: 10.1007/s10103-025-04512-w.

ABSTRACT

Salivary gland hypofunction (SGH) is associated with an increased risk of tooth decay, oral infections, halitosis, xerostomia, and impaired speaking and swallowing functions, leading to decreased quality of life. Several therapies have been used to increase saliva production, and photobiomodulation therapy (PBMT) has shown promising results in treating SGH. This preliminary study aims to evaluate the efficacy of PBMT in SGH and changes in the quality of life of these patients. Eight patients diagnosed with SGH (salivary flow ≤ 0.2 mL/min) who were on continuous systemic medication underwent ten sessions of PBMT applied to the major salivary glands. A follow-up appointment was performed 45 days after the last session. The effect of PBMT was evaluated in terms of quality of life (XeQoLS) and dysphagia (EAT-10). The Friedman and Wilcoxon tests were used to analyze sialometry and questionnaire data. A p ≤ 0.05 was considered statistically significant. The unstimulated whole saliva flow (UWSF) rate improved in the fifth and tenth PBMT sessions (p = 0.005; p = 0.003, respectively). This improvement was also present 45 days after therapy (p = 0.04), thus demonstrating a long-term effect of PBMT in SGH treatment. Thus, our study demonstrates the efficacy of PBMT in treating salivary gland hypofunction, with a significant and sustained increase in UWSF rate even after the end of treatment. These findings suggest that PBMT may effectively improve saliva production in patients diagnosed with salivary gland hypofunction, including those on continuous systemic medication.

PMID:40488944 | DOI:10.1007/s10103-025-04512-w

J Vector Borne Dis. 2025 Jun 10. doi: 10.4103/jvbd.jvbd_29_25. Online ahead of print.

ABSTRACT

BACKGROUND OBJECTIVES: Dengue fever is a significant public health challenge in India. This threat has been amplified by rapid urbanization. This study analyzes the spatiotemporal patterns of dengue transmission, the influence of climate on dengue transmission, and predict future trends of dengue incidence in Dakshina Kannada from 2024 to 2026.

METHODS: The study used retrospective data from January 1, 2019, to April 30, 2024, and covered 288 locations in the Dakshina Kannada district of Karnataka. Data was collected in Excel and analyzed using Jamovi 2.3.28 for descriptive statistics. Time series analysis was performed in R version 4.4.0, while spatiotemporal clusters were identified using SaTScan V10.1.2 and visualized in QGIS version 3.30.0. Multivariable linear regression was conducted to identify climate factors affecting dengue cases. ARIMA models were employed for predictive forecasting of future dengue cases.

RESULTS: A total of 1,836 recorded dengue cases was retrieved from the Health Management Information System (HMIS) at the district level. The study identified significant spatiotemporal clusters of dengue cases, with the primary cluster occurring from May 1, 2022, to April 30, 2024. Climatic factors, particularly rainfall and temperature, showed significant correlations with dengue incidence. The ARIMA (3,1,1) (1,0,0) [12] model demonstrated robust forecasting capability for dengue cases, indicating a continuing upward trend, which appears to be influenced by seasonal patterns.

INTERPRETATION CONCLUSION: Dengue transmission in Dakshina Kannada is significantly influenced by climatic factors such as temperature, rainfall, and humidity. The ARIMA-based predictive modeling forecasted increased dengue cases in the coming years. These findings show the need for targeted public health interventions in identified hotspot areas, along with continuous climate-based surveillance to support timely and effective dengue control measures.

PMID:40485564 | DOI:10.4103/jvbd.jvbd_29_25