Tag: pubmed

Crit Care Explor. 2025 Jun 4;7(6):e1270. doi: 10.1097/CCE.0000000000001270. eCollection 2025 Jun 1.

ABSTRACT

IMPORTANCE: Epidemiological studies have highlighted disparities in illnesses and outcomes for critically unwell children.

OBJECTIVES: We aimed to describe social characteristics and explore links with the outcome of postoperative complications with children’s heart surgery.

DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of a multicenter observational dataset including those under 17 years old undergoing heart surgery from October 2015 to June 2017 at five U.K. children’s cardiac centers.

MAIN OUTCOMES AND MEASURES: Univariate and multivariable multinomial regression analyses were undertaken for the outcome of predefined postoperative complications.

RESULTS: Of 2898 cases meeting criteria, 2708 had complete data. Two thousand one hundred three (77.66%) had no complications, 369 (13.62%) had a single complication, 56 (2.06%) received Extracorporeal Life Support, and 179 (6.61%) had multiple complications. Children residing in low deprivation neighborhoods were under-represented: lowest quintile 361 (13.33%). Minoritized ethnic group was strongly linked to indices of deprivation: residence in neighborhoods with highest deprivation occurred with Bangladeshi, Black African, and Pakistani ethnicity and lowest deprivation with White ethnicities. Adjusted for clinical risk factors compared with the reference group (White), patients from Asian background had a significantly higher risk of developing single vs. no complications (odds ratio [OR], 1.53; 95% CI, 1.00-2.32) and Black patients had a higher risk of developing multiple vs. no complications (OR, 2.19; 95% CI, 1.09-4.41). Among single complications, Asian children had a higher risk of developing feeding issues (OR, 2.07; 95% CI, 1.13-3.28).

CONCLUSIONS AND RELEVANCE: Ethnicity and socioeconomic deprivation may be linked to greater risk of certain complications after pediatric cardiac surgery. Further exploration of inequities is needed in this population.

PMID:40466039 | DOI:10.1097/CCE.0000000000001270

Crit Care Explor. 2025 Jun 4;7(6):e1271. doi: 10.1097/CCE.0000000000001271. eCollection 2025 Jun 1.

ABSTRACT

OBJECTIVES: To evaluate the safety and efficacy of an early chest tube removal protocol in reducing tube duration without increasing complications following pediatric cardiac surgery.

DESIGN: A single-center, randomized controlled trial.

SETTING: Pediatric cardiac ICU.

PATIENTS: Two hundred fifteen pediatric patients with chest tubes after cardiac surgery.

INTERVENTIONS: Patients were randomized to early removal (drainage threshold < 6 mL/kg over 8 hr) or late removal (24-hr assessment) groups. Primary outcomes included chest tube duration, whereas secondary outcomes encompassed ICU stay, ventilation time, hospital stay, and complication rates.

MEASUREMENTS AND MAIN RESULTS: Median chest tube duration was significantly shorter in the early removal group (3 d) compared with the late removal group (4.9 d; p < 0.0001). Rates of fluid reaccumulation and pneumothorax were low and comparable between groups. Notably, no patients in either group required tube reinsertion. ICU and total hospital stay durations were similar across groups.

CONCLUSIONS: An early chest tube removal protocol following pediatric cardiac surgery suggests a reduction in chest tube duration without increasing the risk of complications. These findings support the adoption of an evidence-based early removal approach to enhance patient comfort and optimize ICU resource utilization in pediatric cardiac surgery patients.

PMID:40466038 | DOI:10.1097/CCE.0000000000001271

J Gerontol A Biol Sci Med Sci. 2025 Jun 4:glaf102. doi: 10.1093/gerona/glaf102. Online ahead of print.

ABSTRACT

BACKGROUND: The relationships of joint exposure to various outdoor and indoor environmental factors with the risk of frailty and mortality remain unclear.

METHODS: Based on the China Health and Retirement Longitudinal Study, we enrolled 13745 participants in the final analysis. The living environmental score incorporated seven factors: ambient fine particulate matter, residential greenness, household fuel use, indoor temperature, water sources, building types, and household cleanliness (ranged from 0 to 8). Frailty was assessed by a 40-item deficit-accumulation frailty index. Cox proportional hazards regressions were used to assess the longitudinal associations of individual and joint exposure to living environmental factors with risk of frailty and mortality.

RESULTS: In this prospective study, 3389 participants developed frailty and 815 died during a 7-year follow-up. A higher living environmental score was linked to reduced risks of frailty (hazard ratio (HR): 0.872, 95% CI: 0.854-0.890) and mortality (HR: 0.893, 95% CI: 0.856-0.932). Population-attributable fraction analyses revealed that 23.5% of frailty and 17.2% of deaths could be attributed to lower living environmental scores. For single factors, solid fuel use and PM2.5 exposure had the greatest attribution to incident frailty and all-cause mortality, respectively. The effects of low living environmental score on all-cause mortality were mediated via frailty.

CONCLUSION: Multiple living environmental risk factors were separately and jointly associated with increased risks of frailty and mortality in an additive manner, emphasizing the importance of comprehensively assessing various environmental factors to promote healthy aging.

PMID:40466023 | DOI:10.1093/gerona/glaf102

JCO Glob Oncol. 2025 Jun;11:e2400535. doi: 10.1200/GO-24-00535. Epub 2025 Jun 4.

ABSTRACT

PURPOSE: Cancer patient navigation (CPN) training programs in the United States do not address the unique challenges of limited-resource settings. This study evaluates knowledge acquisition, utilization, and participant feedback from the Caribbean Cancer Research Institute’s (CCRI) CPN training program, which trained participants from the Caribbean, Botswana, and Kenya between 2018 and 2023.

METHODS: The CCRI conducted in-person CPN training in 2018 and 2019, paused in 2020 because of the COVID-19 pandemic, and transitioned to a virtual format in 2021. The program, delivered annually, expanded its curriculum and included participants from Kenya and Botswana. Knowledge acquisition was assessed through a 60-question pretest and post-test, and a 23-question program evaluation survey measured participant satisfaction. A follow-up eight-question survey assessed knowledge utilization. Summary statistics were used to describe participant demographics and survey responses, whereas paired t-tests were used to compare pretest and post-test scores.

RESULTS: The virtual, self-paced CCRI CPN Training Program covered 11 topics over 12 hours. Between 2018 and 2023, 55 participants enrolled: 80% (n = 44) passed, 18% (n = 10) failed, and 2% (n = 1) did not complete the course. Most participants (95%, n = 52) were from the Caribbean, with 80% (n = 44) from Trinidad and Tobago. Three participants were from Botswana and Kenya. The majority were female (98%, n = 54) and nurses (36%, n = 20), and did not have a personal history of cancer (89%, n = 49). Significant knowledge gains (P < .001) were observed across all years except 2023. Participants expressed high satisfaction and suggested improvements. Twenty-two percent (n = 6 of 27) secured employment as patient navigators in oncology settings.

CONCLUSION: The CCRI CPN training program trained participants across the Caribbean and showed preliminary acceptability in Kenya and Botswana. Strengths include its low-cost, virtual, self-paced format, adaptability to limited-resource settings, and region-specific content. Future efforts will focus on updating training materials and expanding recruitment.

PMID:40466015 | DOI:10.1200/GO-24-00535

Rev Assoc Med Bras (1992). 2025 Jun 2;71(4):e20241894. doi: 10.1590/1806-9282.20241894. eCollection 2025.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the psychometric properties of the Eating Pathology Symptoms Inventory within the Brazilian context. Specifically, it assessed the scale’s efficacy in measuring disordered eating behaviors, with an emphasis on binge eating, and investigated its relationship with food cravings.

METHODS: This cross-sectional study utilized data from a non-probabilistic convenience sample of 1,374 Brazilians. Confirmatory factor analysis and multiple-group confirmatory factor analysis were employed to examine the factor structure and assess invariance across groups with and without binge-eating symptoms. Reliability was evaluated using Cronbach’s alpha and McDonald’s omega, while external validity was assessed through Pearson’s correlations between Eating Pathology Symptoms Inventory and Food Cravings Questionnaire-Trait-reduced scores. Discriminant validity was analyzed using Welch’s t-test.

RESULTS: The confirmatory factor analysis supported the eight-factor model, demonstrating a good fit across the overall sample (Comparative Fit Index=0.936, root mean square error of approximation=0.057). Reliability analysis indicated high internal consistency, with Cronbach’s alpha and McDonald’s omega values ranging from 0.745 to 0.917. Multiple-group confirmatory factor analysis confirmed measurement invariance across groups with and without binge-eating symptoms. The Welch two-sample t-test showed significantly higher Eating Pathology Symptoms Inventory scores in the binge-eating group. Furthermore, Eating Pathology Symptoms Inventory subscales related to binge-eating behaviors exhibited strong correlations with food craving scores, supporting the scale’s external validity.

CONCLUSION: The Eating Pathology Symptoms Inventory demonstrates strong reliability and validity as a tool for assessing eating disorder symptoms in Brazil, with effectiveness in distinguishing binge-eating behaviors.

PMID:40466001 | DOI:10.1590/1806-9282.20241894

Rev Assoc Med Bras (1992). 2025 Jun 2;71(4):e20241760. doi: 10.1590/1806-9282.20241760. eCollection 2025.

ABSTRACT

OBJECTIVE: The aim of this cross-sectional study was to identify genital hygiene behaviors and the influencing factors in a sample of women from the Turkish population.

METHODS: Data collection was conducted through an online survey distributed via WhatsApp and social media groups (n=357). The data were collected using the “Genital Hygiene Behaviors Scale.” Analyses were conducted using the Mann-Whitney U test, Kruskal-Wallis test, Spearman’s correlation, and robust analysis of variance.

RESULTS: The mean age of the women was 31.94±9.7 years; 66.1% were university graduates and 49.6% were married. The mean Genital Hygiene Behaviors Scale total score was 94.93±9.8. genital hygiene behaviors were found to be better among women who were older, who had a higher level of education, were employed, were married, who had received genital hygiene education, and who had a history of genital infections in the past year. Additionally, 38.7% of the women reported abnormal vaginal discharge, and those with abnormal discharge exhibited lower genital hygiene behavior scores. Women who practiced vaginal douching were found to exhibit less adequate genital hygiene behaviors. It was determined that the majority of women with a history of genital infections had not received genital hygiene education and obtained the lowest genital hygiene scores (p<0.05).

CONCLUSION: The findings obtained in the present study indicate that women in socioeconomically disadvantaged groups require more education on this subject and that healthcare professionals should seize every opportunity to provide education.

PMID:40465997 | DOI:10.1590/1806-9282.20241760

Rev Assoc Med Bras (1992). 2025 Jun 2;71(4):e20241739. doi: 10.1590/1806-9282.20241739. eCollection 2025.

ABSTRACT

OBJECTIVE: Temporomandibular disorders associated with myofascial pain syndrome cause pain and disability in daily life. The aim of this study was to investigate the effect of auricular vagus nerve stimulation on pain in women with myofascial pain syndrome-related temporomandibular disorder.

METHODS: A total of 50 women with myofascial pain syndrome-related temporomandibular disorder aged between 18 and 35 years participated in this study. The vagus group (n=25) received auricular vagus nerve stimulation and manual therapy and exercise, and the control group (n=25) received only manual therapy and exercise twice a week for 3 months. The pressure pain threshold was used for the assessment.

RESULTS: In the vagus group, pressure pain threshold on the masseter, temporalis, sternocleidomastoid, digastricus, trapezius, and levator scapula muscles increased statistically significantly after treatment compared to baseline (p<0.05). In the control group, pressure pain threshold on the masseter and levator scapula muscles increased (p<0.05), while no statistically significant difference was found in the pressure pain threshold on the temporalis, sternocleidomastoid, digastricus, and trapezius muscles (p>0.05). When both groups were compared, vagus group was found to be more effective than control group in increasing pressure pain threshold in the masseter, trapezius, and levator scapula muscles (p<0.05).

CONCLUSION: Auricular vagus nerve stimulation was found to be effective in increasing pressure pain threshold in patients with myofascial pain syndrome-related temporomandibular disorder. The clinical trial registration number was NCT05500716.

PMID:40465996 | DOI:10.1590/1806-9282.20241739

Rev Assoc Med Bras (1992). 2025 Jun 2;71(4):e20241627. doi: 10.1590/1806-9282.20241627. eCollection 2025.

ABSTRACT

OBJECTIVE: The aim of this study was to develop and validate the Breast Cancer Myths Scale for women.

METHODS: Confirmatory and exploratory factor analyses were used in this methodological study. The internal consistency was evaluated using the item-total correlation.

RESULTS: The root mean square error of approximation was calculated as 0.072. The final scale version demonstrated excellent internal consistency (Cronbach’s alpha=0.908).

CONCLUSION: The Breast Cancer Myths Scale (single factor, 16 items) is a reliable and valid measure that can be used to evaluate breast cancer myths.

PMID:40465995 | DOI:10.1590/1806-9282.20241627

Rev Assoc Med Bras (1992). 2025 Jun 2;71(4):e20241621. doi: 10.1590/1806-9282.20241621. eCollection 2025.

ABSTRACT

OBJECTIVE: Cardiac implantable electronic devices are widely used today. Therefore, research is ongoing to provide better device implantation in technical terms. The aim of this study was to investigate the relationship between pre-procedural regional right ventricular strain and post-procedural endocardial R-wave amplitude in patients scheduled to receive an implantable cardiac defibrillator.

METHODS: A total of 112 patients who underwent single-chamber implantable cardiac defibrillator implantation were included in the study. Right ventricular strain analysis was performed before the procedure, and the following parameters were recorded: four-chamber strain, free wall strain, septal strain, and apical strain. The relationship between R-wave amplitude, calculated after lead implantation in the apical region, and strain parameters was statistically analyzed.

RESULTS: All strain parameters were statistically significantly better in the group with a high R-wave amplitude. Correlation analysis showed that a higher R-wave amplitude was associated with improved right ventricular four-chamber strain (p<0.001, correlation coefficient=0.436), right ventricular free wall strain (p<0.001, correlation coefficient=0.532), right ventricular septal strain (p<0.001, correlation coefficient=0.394), and right ventricular apical strain (p<0.001, correlation coefficient=0.814). In univariable regression analysis, all strain parameters were identified as dependent predictors; however, in multivariable regression analysis, only right ventricular apical strain (p<0.001) was found to be an independent predictor of high R-wave amplitude.

CONCLUSION: Our study revealed a relationship between the right ventricular apical endocardial R-wave amplitude and all right ventricular strain parameters, especially right ventricular apical strain. We recommend that clinicians perform regional right ventricular strain analysis before implantable cardiac defibrillator implantation in cases where lead positioning is uncertain.

PMID:40465994 | DOI:10.1590/1806-9282.20241621

Rev Assoc Med Bras (1992). 2025 Jun 2;71(4):e20241615. doi: 10.1590/1806-9282.20241615. eCollection 2025.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the risk of obstructive sleep apnea and sleep quality in adolescents with and without polycystic ovary syndrome.

METHODS: A case-control study was conducted on 82 adolescent girls admitted to the pediatric endocrinology clinic of a training and research hospital in Turkey. Data were collected using the Participant Information Form, Stop and Stop-Bang Questionnaire, Cleveland Adolescent Sleepiness Questionnaire, Sleep Quality Scale, and Sleep Variables Questionnaire.

RESULTS: It was determined that the mean Stop and Stop-Bang scores of adolescents in the healthy and polycystic ovary syndrome groups were similar and had a high level of obstructive sleep apnea risk. Daytime sleepiness levels were similar in both groups, but daytime sleepiness mean scores were a little higher in healthy adolescents. In addition, it was determined that the level of sleepiness at school and during transportation was statistically significant and high in the healthy group, and the sleep quality of all adolescents was moderately similar.

CONCLUSION: Our data reveal the importance of a comprehensive assessment of sleep health, including obstructive sleep apnea, as well as duration, timing, and quality in adolescents when considering polycystic ovary syndrome. Healthcare professionals should consider the sleep health of all adolescents presenting to endocrine outpatient clinics.

PMID:40465993 | DOI:10.1590/1806-9282.20241615