Tag: pubmed

Int Urol Nephrol. 2025 Jul 21. doi: 10.1007/s11255-025-04671-3. Online ahead of print.

ABSTRACT

BACKGROUND: Overactive bladder (OAB) is a common condition in children, affecting 5-12% of children between the ages of 5 and 10 years. It is characterized by urinary urgency, frequency, and nocturia, often leading to incontinence. OAB significantly impacts a child’s emotional and social development, causing anxiety, low self-esteem, and social withdrawal. Oxybutynin is the standard treatment for overactive bladder in children, but side effects like dry mouth, constipation, and cognitive issues can make it difficult for patients to stick with the therapy.

METHODS: This study systematically reviewed and analyzed existing research to evaluate and compare the effectiveness and safety of transcutaneous electrical nerve stimulation (TENS) versus oxybutynin for treating overactive bladder in children. We performed an electronic search of PubMed, Cochrane, and other databases up to April 2023 to identify randomized controlled trials (RCTs) that reported outcomes related to symptom improvement and adverse effects in children with OAB. We included studies based on the PICO criteria: pediatric patients (under 18 years), OAB treatment (TENS or Oxybutynin), and outcomes such as urinary urgency and incontinence. The risk ratios were calculated to compare the two treatments, and heterogeneity was assessed using the I² statistics.

RESULTS: The search found six relevant studies and three of these were suitable for the meta-analysis. The results showed that TENS was much more effective than oxybutynin in improving symptoms, with a risk ratio of 1.93 (95% CI 1.35-2.74). TENS also caused fewer side effects compared to oxybutynin, with a risk ratio of 0.09 (95% CI 0.03-0.30). There was no variation between the studies (I² = 0), indicating that the results were consistent across all trials.

CONCLUSION: TENS has been shown to be both more effective and safer than oxybutynin for treating overactive bladder in children. It leads to greater improvement in symptoms and is linked to fewer side effects. These results indicate that TENS may be a better option, especially for children who have difficulty tolerating medication due to adverse reactions.

PMID:40690105 | DOI:10.1007/s11255-025-04671-3

Forensic Sci Med Pathol. 2025 Jul 21. doi: 10.1007/s12024-025-01045-0. Online ahead of print.

ABSTRACT

A diagnosis of atherosclerotic cardiovascular disease is critical importance in forensic medicine, particularly because severe atherosclerosis is known to be associated with a high risk of sudden death. In South Korea, the assessment of coronary atherosclerosis during autopsy largely depends on the forensic pathologist’s visual measurements, which may limit diagnostic accuracy. The objective of this study was to develop a deep learning algorithm for rapid and precise assessment of coronary atherosclerosis and to identify factors influencing the model’s prediction of atherosclerosis severity. A total of 3,717 digital photographs were retrospectively extracted from a database of 1,920 forensic autopsies, with one image each selected for the left anterior descending coronary artery and the right coronary artery. The deep learning algorithm developed in this study demonstrated a high level of agreement (0.988, 95% CI: 0.985-0.990) and absolute agreement (0.986, 95% CI: 0.978-0.991) between predicted and ground truth atherosclerosis values on the test set. The model demonstrated strong overall performance on the test set, achieving a weighted F1-score of 0.904. However, the class-wise F1-scores were 0.957 for mild, 0.785 for moderate, and 0.876 for severe grades, indicating that performance was lowest for the moderate grade. Additionally, decomposition, stent implantation, and thrombi did not have a statistically significant impact on coronary atherosclerosis assessment except for calcification. Although enhancing model performance for moderate grades remains a challenge, this study’s findings demonstrate the potential of artificial intelligence as a practical tool for assessing coronary atherosclerosis in autopsy photographs.

PMID:40690102 | DOI:10.1007/s12024-025-01045-0

Invest New Drugs. 2025 Jul 21. doi: 10.1007/s10637-025-01565-0. Online ahead of print.

ABSTRACT

INTRODUCTION: No correlation between the dose, adverse events, and efficacy was detected in clinical trials of anti-PD-1 antibodies across a range of solid and hematological malignancies. Given that dose reduction with potentially comparable clinical efficacy may improve access to treatment, particularly in low-income regions, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of low-dose PD-1 inhibitor monotherapy in relapsed/refractory (r/r) classic Hodgkin lymphoma (cHL).

MATERIALS AND METHODS: Relevant reports were identified through PUBMED, MEDLINE, Cochrane, ScienceDirect databases, and major international conference proceedings, from inception till December 1, 2024. The risk of bias was assessed independently by two authors using the Joanna Briggs’s critical appraisal checklist for studies reporting prevalence data. Heterogeneity was assessed using Cochran’s Q test, with statistical significance defined as p < 0.05; I² statistic was used to quantify heterogeneity. Random effects models (Der-Simonian method) was used to pool results from primary studies in the presence of significant heterogeneity.

RESULTS: After screening, 13 reports including 148 patients were included in the systematic review. After exclusion of duplicated reports, studies with less than 5 patients, and studies with unextractable data, five studies with a total of 84 patients were included in the meta-analysis. The pooled objective response rate (ORR) with low-dose PD-1 inhibition in r/r cHL, as determined by meta-analysis, was 87% (95% CI, 71.9%-100%), with a corresponding complete response (CR) rate of 53.9% (95% CI, 34.7%-73.1%). The ORR with low-dose nivolumab was 83.8% (95% CI, 64.2%-100%), with a CR rate of 43.3% (95% CI, 29.7%-56.9%). The pooled rate of any-grade adverse events after low-dose PD-1 inhibition was 55.7% (95% CI, 36.1%-75.3%), with a grade 3-4 adverse event rate of 7.5% (95% CI, 1.7%-13.3%).

CONCLUSIONS: This systematic review and meta-analysis demonstrated the high efficacy and acceptable toxicity of low-dose PD-1 inhibition in r/r cHL.

PMID:40690099 | DOI:10.1007/s10637-025-01565-0

Acta Parasitol. 2025 Jul 21;70(4):163. doi: 10.1007/s11686-025-01099-8.

ABSTRACT

BACKGROUND: Cyclospora cayetanensis is a coccidian protozoan parasite belonging to the phylum Apicomplexa. This systematic review and meta-analysis aimed to assess the prevalence and risk factors of C. cayetanensis in patients with Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS).

METHODS: A literature search was performed in international databases for studies published until October 18, 2024, focusing on cross-sectional and case-control studies. Data from eligible studies were analyzed using Comprehensive Meta-Analysis (CMA) software, employing random-effects models for pooled estimates and weighted odds ratios (ORs), along with heterogeneity assessment via I² statistic.

RESULTS: This systematic review analyzed 73 studies, including 48 cross-sectional and 25 case-control involving 13,986 HIV/AIDS patients and 3,559 non-HIV/AIDS controls across 22 countries, mainly in Asia and Africa. The global prevalence of C. cayetanensis infection was 4% in HIV/AIDS patients (95% CI: 2.9-5.4%) versus 1.8% in controls (95% CI: 1.1-3.2%), resulting in an OR of 3.5 (95% CI: 2.04-6.06), indicating HIV/AIDS patients were significantly more likely to be infected. Sensitivity analysis indicated that none of the studies significantly affected the pooled estimates and weighted ORs. The prevalence of infection showed no significant association with quantitative variables such as publication year, sample size, and Human Development Index (HDI). Moreover, the pooled prevalence of C. cayetanensis infection was estimated across various subgroups, including publication year, World Health Organization (WHO) region, country, continent, country income level, HDI value, and sample size.

CONCLUSION: The findings confirm the opportunistic nature of C. cayetanensis infection and highlight the need for increased awareness and diagnosis of this infection in HIV/AIDS patients. Monitoring this opportunistic infection is vital for patient management, particularly in resource-limited areas.

PMID:40690092 | DOI:10.1007/s11686-025-01099-8

Eat Weight Disord. 2025 Jul 21;30(1):56. doi: 10.1007/s40519-025-01767-8.

ABSTRACT

PURPOSE: The present study reports on the psychometric properties of the Dutch translation of the clinical impairment assessment (CIA) questionnaire in female patients with eating disorders. The aim of this study was to determine the factor structure of the CIA as there are conflicting studies supporting a three-factor, bifactor, and single-factor model with a general factor and three specific factors.

METHODS: The CIA was translated and administered to 321 female patients with various eating disorders receiving treatment in a specialized eating disorder center. Its factor structure, internal consistency, convergent validity, and sensitivity to change were investigated.

RESULTS: Confirmatory factor analyses showed the best fit was a bifactor model with one strong general factor and three less strong specific factors for personal, social, and cognitive impairment. Furthermore, good internal consistency (Cronbach’s α = 0.91), good convergent validity between CIA global score and eating disorder examination questionnaire global score (r = 0.58; p < 0.001) and good sensitivity to change (t (115) = 13.76, p < 0.001) were found.

CONCLUSIONS: The Dutch CIA is a reliable and valid instrument to measure impairment secondary to eating disorder symptoms, but interpretations made from subscales scores should be used with caution.

LEVEL OF EVIDENCE: Level III, validation study.

PMID:40690077 | DOI:10.1007/s40519-025-01767-8

Arch Orthop Trauma Surg. 2025 Jul 21;145(1):382. doi: 10.1007/s00402-025-05993-8.

ABSTRACT

BACKGROUND: Hip fractures have a significant impact on morbidity and mortality in older adults, often leading to loss of function and an increased healthcare burden. The role of geriatric co-management in improving postoperative outcomes remains controversial. This meta-analysis evaluates the impact of geriatric care on functional recovery, complications, length of hospital stay, and one-year mortality in older patients with hip fractures.

METHODS: A meta-analysis was conducted according to PRISMA guidelines. Randomized controlled trials (RCTs) and prospective cohort studies comparing standard orthopedic care with geriatric co-management were included. The primary outcomes examined were one-year mortality, functional independence (Barthel ADL scores, independent walking), length of hospital stay and postoperative complications (delirium, infections, falls).

RESULTS: Six RCTs with 1,780 patients (894 geriatric care, 886 standard care) were analyzed. Geriatric care was associated with improved ADL scores (Cohen’s d = 0.066, 95% CI 0.027-0.105) and a 19% higher rate of independent walking (RR = 1.19, 95% CI 1.092-1.288). The length of hospital stay was reduced by 1.39 days (95% CI – 1.98 to – 0.80). Complication rates decreased slightly (- 3.60%), but no significant reduction in one-year mortality was observed (- 2.26%). Heterogeneity was high for functional outcomes (I² = 99.91%) and LOS (I² = 99.99%).

CONCLUSIONS: Geriatric care improves short-term functional outcomes, reduces complications and shortens hospital stay in elderly patients with hip fractures. However, its impact on one-year mortality is limited. Standardized geriatric care models and further research on long-term recovery strategies are needed to optimize outcomes.

PMID:40690069 | DOI:10.1007/s00402-025-05993-8

Int Ophthalmol. 2025 Jul 21;45(1):301. doi: 10.1007/s10792-025-03669-1.

ABSTRACT

PURPOSE: To investigate the effect of posterior corneal surface abnormalities following deep anterior lamellar keratoplasty (DALK) on visual outcomes and high order aberrations (HOA).

METHODS: A retrospective cohort study was conducted on DALK cases. Patients were divided into two groups: Group A with posterior corneal surface abnormalities (interface haze, pre-Descemet’s scarring, central Descemet’s membrane (DM) perforation, and central DM folds) and Group B (control group) with regular posterior surface. Visual acuity, refractive outcomes, contrast sensitivity, and HOA were assessed in both groups.

RESULTS: This study included 84 eyes of 78 patients. Group A included 42 eyes of 38 patients and an equal number of control eyes were randomly included in group B. Group A exhibited significantly lower corrected distance visual acuity (CDVA) compared to Group B (Mean LogMAR 0.45 ± 0.25 in group A vs 0.31 ± 0.21 in group B, P = 0.012). Subgroup analysis revealed the lowest visual acuity in eyes with multiple posterior surface abnormalities, although the difference was not statistically significant. The mean topographic astigmatism was significantly higher in group A than in group B (4.47 ± 2.36 diopters vs 3.11 ± 2.16 diopters, respectively, P = 0.001). No significant differences were found between the 2 groups regarding total eye or corneal HOA. Contrast sensitivity was significantly lower in Group A at lower spatial frequencies (P = 0.013 and P = 0.004 at 3 and 6 cycles per degree, respectively), particularly in eyes with large DM perforations.

CONCLUSION: Posterior corneal surface abnormalities after DALK can negatively impact visual outcomes, especially contrast sensitivity.

PMID:40690055 | DOI:10.1007/s10792-025-03669-1

Support Care Cancer. 2025 Jul 21;33(8):708. doi: 10.1007/s00520-025-09717-x.

ABSTRACT

OBJECTIVE: To explore the determinants of loneliness among patients undergoing peripheral blood stem cell transplantation (PBSCT) and to identify factors that influence their loneliness levels, with the aim of developing targeted nursing strategies and interventions.

METHODS: A total of 300 PBSCT patients were recruited through convenience sampling. Data were collected using a general information questionnaire, the UCLA Loneliness Scale (UCLA), the Functional Assessment of Cancer Therapy-General (FACT-G), and the Perceived Social Support Scale (PSSS). Statistical analyses were performed to assess loneliness levels and identify associated factors.

RESULTS: The average UCLA loneliness score among patients was 52.97 ± 12.35, indicating moderate to high levels of loneliness. Pearson correlation analysis revealed a significant negative relationship between loneliness and perceived social support as well as other measured dimensions (all P < 0.01). Multiple linear regression analysis identified marital status, employment status, presence of comorbidities, and perceived social support as significant predictors of loneliness (R² = 0.300, adjusted R² = 0.238, F = 17.874, P < 0.001), with social support and health status being the strongest contributors.

CONCLUSION: Loneliness in PBSCT patients is influenced by various factors, with social support and health status playing critical roles. To mitigate loneliness and enhance patients’ quality of life, healthcare teams should prioritize strengthening social support networks and addressing health-related challenges. Regular psychological assessments and timely interventions are essential for reducing loneliness and facilitating recovery in transplant patients.

PMID:40690046 | DOI:10.1007/s00520-025-09717-x

Cancer Med. 2025 Jul;14(14):e71053. doi: 10.1002/cam4.71053.

ABSTRACT

INTRODUCTION: Objective was to describe the association between baseline characteristics and the number of Symptom Screening in Pediatrics Tool (SSPedi) assessments completed over an 8-week period.

METHODS: This was a sub-analysis of a cluster randomized controlled trial among 10 sites that were randomized to the intervention group. Participants were English- or Spanish-speaking pediatric patients 8-18 years of age newly diagnosed with cancer. Participants were prompted to complete SSPedi three times weekly for 8 weeks. The outcome was the number of SSPedi assessments completed during the 8-week period. Factors associated with the number of assessments were determined using mixed effects Poisson regression.

RESULTS: At the 10 intervention sites, 216 patients were included in the analysis. Among these participants, 129 (59.7%) were male, 112 (51.9%) were white, and 83 (38.4%) were Hispanic. The number of SSPedi assessments was significantly higher for participants 11-14 years (rate ratio (RR) 1.13, 95% confidence interval (CI) 1.02-1.25) and 15-18 years (RR 1.15, 95% CI 1.04-1.27) compared to 8-10 years. Participants completed more SSPedi assessments if they were Asian compared to white (RR 1.27, 95% CI 1.10-1.46), non-Hispanic compared to Hispanic (RR 1.15, 95% CI 1.04-1.28) and from families with a household income ≥$60,000 (RR 1.12, 95% CI 1.03-1.21). Participants completed fewer SSPedi assessments if they had solid tumors compared to leukemia (RR 0.91, 95% CI 0.84-0.99).

CONCLUSION: Adherence to three-times weekly SSPedi varied by age, race, ethnicity, cancer diagnosis, and family income. This information may facilitate interventions to support routine symptom screening in clinical practice.

TRIAL REGISTRATION: NCT04614662.

PMID:40686265 | DOI:10.1002/cam4.71053

Cancer Med. 2025 Jul;14(14):e71052. doi: 10.1002/cam4.71052.

ABSTRACT

PURPOSE: We aimed to analyse trends in incidence, mortality and 5-year relative survival of malignant and benign/borderline brain and central nervous system (CNS) tumours between 1980 and 2021 in the Canton of Zurich, Switzerland, stratified by sex, age group, behaviour and histological subtypes.

METHODS: We used incidence data from the Cancer Registry of Zurich, Zug, Schaffhausen and Schwyz, including primary benign/borderline and malignant tumours diagnosed between 1980 and 2021 in the Canton of Zurich in patients aged ≥ 15 years (N = 10,226). Mortality data were provided by the Swiss Federal Statistical Office (N = 3514). We calculated age-standardised incidence and mortality rates per 100,000 person-years and used Joinpoint to analyse trends.

RESULTS: The age-standardised incidence rate of malignant tumours was stable over time (around 7.7-8.2 per 100,000 person-years in men and 4.6-5.2 in women), while the rate of benign/borderline tumours increased from 3.8 in 1980-1990 to 10.8 in 2011-2021 in men and from 5.7 to 19.1 in women. The age-standardised mortality rate remained stable over time for malignant tumours (around 5.5-6.1 in men and 3.5-4.0 in women) but significantly decreased for benign/borderline tumours (from 1.0 to 0.5 in men and from 1.2 to 0.5 in women). Age-standardised 5-year relative survival increased from around 80% in 1980-1989 up to > 90% in 2011-2017 for benign/borderline tumours and from < 20% to around 30% for malignant tumours. There was a small survival advantage in women compared to men.

CONCLUSIONS: We observed an increase in incidence and a decrease in mortality rates for benign/borderline tumours, while both rates remained stable for malignant tumours. Five-year relative survival improved over time. The increasing incidence rates in benign/borderline tumours may be due to improved diagnostic techniques and an increasing use of CT scans, as reported in other countries. The increase in relative survival may reflect earlier detection and better treatment options.

PMID:40686230 | DOI:10.1002/cam4.71052