Search Results (1,650)

Background/Objectives: This study aimed to identify risk factors for postoperative wound infections and healing disorders in patients with brain tumors, based on a large, single-center analysis, and to establish an evidence-based foundation for prevention. Methods: A retrospective analysis was conducted on 1480 patients who underwent intracranial tumor resection in our department over a ten-year period, without the influence of anticoagulant or antiplatelet medication. Potential predictors of wound healing disorders were evaluated, focusing on demographic variables and pre-existing conditions. Results: Among the 1480 patients, postoperative wound infections occurred in 47 cases, corresponding to a cumulative incidence of 3.17%. Platelet count (p = 0.018) and partial thromboplastin time (p = 0.011) emerged as potential risk factors for postoperative wound infections. Length of hospital stay appeared as a distinct outcome-associated marker in cases of postoperative wound infection (p = 0.018). In contrast, demographic characteristics (age, sex, blood type), comorbidities (hypertension, diabetes mellitus, cardiovascular disease, kidney disease, chronic inflammatory conditions), and other surgical or laboratory parameters showed no significant association with wound healing disorders. Conclusions: In patients with brain tumors undergoing surgery without the influence of anticoagulant or antiplatelet therapy, most demographic factors, common comorbidities, and selected laboratory parameters were not associated with an increased risk of postoperative wound infections. Awareness of the identified risk factors may help guide preventive strategies and nursing care. Full article

Background/Objectives: Older adults often face nutrition challenges due to mobility issues, chronic conditions, and limited access to adequate nutrition. Digital and technology-based interventions, including those with nutrition education, nutrition counseling and Medically Tailored Meals [MTMs], can help address these barriers. However, the extent and characteristics of such programs in the United States remain unclear. This scoping review aimed to map the existing evidence on digital and technology-based (“digi-tech”) nutrition interventions for older adults in the United States, with particular attention to the presence, characteristics, and gaps related to MTMs. Methods: This scoping review followed the PRISMA-ScR framework to map existing evidence on technology-enabled nutrition care interventions for older adults aged ≥ 60 years in the United States. Systematic searches were conducted across multiple databases, yielding 18,177 records. Following title and abstract screening, full-text review, and eligibility assessment, 16 intervention studies were included. Study designs comprised randomized controlled trials, quasi-experimental and non-randomized studies, mixed-methods feasibility studies, pilot studies, and one retrospective longitudinal cohort study. Data were extracted on study design, population characteristics, intervention components, technology modalities, outcomes, feasibility, acceptability, and reported barriers. Results: Interventions varied in duration [8 weeks to ≥12 months] and content. Foci ranged from remote nutrition education and mobile app-based tracking to multicomponent interventions integrating exercise, nutrition counseling, health literacy, and meal delivery. Telehealth was the most commonly used technology modality, followed by mobile health applications, wearable devices, and online educational platforms. Most interventions reported high feasibility and acceptability, with improvements in diet quality, adherence to healthy eating patterns, clinical measures such as HbA1c and blood pressure, and functional performance. Common implementation barriers included declining technology use over time, digi-tech literacy, and access to devices or the internet. Notably, no studies evaluated a digi-tech-based MTMs intervention exclusively for older adults in the U.S. Conclusions: Digital and technology-based nutrition interventions show promise for improving dietary and health outcomes in older adults, but there is insufficient empirical evidence. Future research might develop and evaluate hybrid digi-tech intervention models that leverage the potential of digi-tech tools while addressing barriers to technology adoption among older adults. Full article

Background: Conservative treatment of chronic musculoskeletal pain includes exercise, manual therapy, medications, physical agents/modalities, and Therapeutic Patient Education (TPE). Research on TPE has predominantly focused on spinal pain, so we do not know the extent and scope of clinical research in other areas, particularly lower extremities. This review aimed to map current research on this topic. Methods: We searched PubMed, PEDro, CINAHL, PsycINFO, and Cochrane Library up to 1 April 2024. We included RCTs on adults with chronic lower limb musculoskeletal pain, written in English, French, Spanish, or Italian. Results: Fifty-two records concerning knee osteoarthritis (n.33), hip and knee osteoarthritis (n.8), hip osteoarthritis (n.3), chronic knee pain (n.3), patellofemoral pain (n.3), and gluteal tendinopathy (n.2) were included. TPE was delivered through self-management, disease-specific information, pain education, and the management of physical activity, load, diet, stress, and sleep. Interventions were both individual- and group-based; delivery methods included in-person intervention, telephone/video calls, and web tools/apps. TPE combined with exercise seemed to be more effective than exercise alone, information/little education, or usual care. The effects of TPE as a stand-alone intervention appeared uncertain. Conclusions: There is considerable variability in TPE in terms of teaching topics, providers, administration methods, and dosage of interventions. Future studies should investigate the effects of TPE in young adult populations and in ankle conditions. They should also investigate the effects of TPE on pain intensity versus pain interference with activities, by deepening TPE effects on disability and quality of life. Full article

The lack of clinical data for chronic kidney disease (CKD) prediction frequently results in model overfitting and inadequate generalization to novel samples. This research mitigates this constraint by utilizing a Conditional Tabular Generative Adversarial Network (CTGAN) to enhance a constrained CKD dataset sourced from the University of California, Irvine (UCI) Machine Learning Repository. The CTGAN model was trained to produce realistic synthetic samples that preserve the statistical and feature distributions of the original dataset. Multiple machine learning models, such as AdaBoost, Random Forest, Gradient Boosting, and K-Nearest Neighbors (KNN), were assessed on both the original and enhanced datasets with incrementally increasing degrees of synthetic data dilution. AdaBoost attained 100% accuracy on the original dataset, signifying considerable overfitting; however, the model exhibited enhanced generalization and stability with the CTGAN-augmented data. The occurrence of 100% test accuracy in several models should not be interpreted as realistic clinical performance. Instead, it reflects the limited size, clean structure, and highly separable feature distributions of the UCI CKD dataset. Similar behavior has been reported in multiple previous studies using this dataset. Such perfect accuracy is a strong indication of overfitting and limited generalizability, rather than feature or label leakage. This observation directly motivates the need for controlled data augmentation to introduce variability and improve model robustness. The dataset with the greatest dilution, comprising 2000 synthetic cases, attained a test accuracy of 95.27% utilizing a stochastic gradient boosting approach. Ensemble learning techniques, particularly gradient boosting and random forest, regularly surpassed conventional models like KNN in terms of predicted accuracy and resilience. The results demonstrate that CTGAN-based data augmentation introduces critical variability, diminishes model bias, and serves as an effective regularization technique. This method provides a viable alternative for reducing overfitting and improving predictive modeling accuracy in data-deficient medical fields, such as chronic kidney disease diagnosis. Full article

Background: Prior research confirms that social support promotes resilience among medical patients with chronic illness. Beyond emotional benefits, research has increasingly shown the importance of social support on physical health outcomes. Therefore, identifying and evaluating interventions that increase social support among medical patients with chronic conditions is a priority for healthcare. Methods: This meta-analysis summarized data from 39,493 medical patients across 14 non-randomized trials that had been identified by a prior review of the survival benefits of social support interventions. Results: Across four studies reporting hazard ratio data, the results failed to reach statistical significance (HR = 2.10, 95% CI = 0.99 to 4.48, p = 0.0546), and the results of ten studies reporting odds ratio data were of smaller magnitude (OR = 1.27, 95% CI [0.72, 2.23], p > 0.05). Heterogeneity characterized both the odds ratio data (I² = 53%; Q = 18.1, p = 0.03) and hazard ratio data (I² = 89%, Q = 23, p < 0.001). A notable finding was that studies with longer periods of data collection showed longer survival among medical patients receiving social support. Conclusions: Long-term observations may be necessary for the survival benefits of social support interventions to become apparent. Further research with a larger pool of data from long-term follow-up studies will be needed to establish firm conclusions. Full article

The German IQVIA Disease Analyzer (DA) database has become an increasingly important source of real-world evidence for psychiatric research. Over the past decade, and particularly since 2020, DA-based studies have addressed a broad spectrum of psychiatric outcomes including depression, anxiety disorders, schizophrenia, bipolar disorder, dementia, sleep disorders, and the mental health consequences of chronic somatic diseases and of contracting COVID-19. Using large, representative outpatient cohorts, these studies have examined factors associated with the incidence of psychiatric disorders, patterns of psychiatric and somatic comorbidity, treatment trajectories, and long-term outcomes under routine care conditions. The DA database’s longitudinal structure, nationwide coverage, and inclusion of multiple medical specialties enable it to capture psychiatric disorders throughout patient lifetimes and across different clinical contexts. This narrative review summarizes psychiatric research using the DA database that has been published since 2020, focusing on study design, main findings, methodological strengths and limitations, and implications for future psychiatric epidemiology and clinical research. Full article

Background: Patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) or depression both frequently report debilitating exhaustion, yet the two conditions differ in their etiological and diagnostic clarity, and clinical management. This study aimed to examine differences in the use and perceived helpfulness of a broad range of conventional treatments and complementary interventions, including nutritional approaches, between patients with ME/CFS and depression. Methods: A cross-sectional online survey was conducted in 2024. A total of 819 participants self-identified as having either ME/CFS (n = 576) or depression (n = 243). Participants (80% female) reported their use and perceived helpfulness of 52 treatments and interventions, encompassing behavioral therapies, medications, and dietary supplements. Group differences were examined using multivariate analyses of variance and covariance (MANOVA/MANCOVA). Open-ended responses were analyzed descriptively using thematic grouping and frequency counts. Results: Participants with depression most commonly reported the use of psychotherapy (M = 2.49, SD = 1.00) and antidepressant medication (M = 2.44, SD = 2.30), and they rated fewer interventions as helpful compared to participants with ME/CFS. In contrast, participants with ME/CFS reported a significantly broader engagement with diverse intervention modalities, particularly pacing (M = 2.73, SD = 0.80) and dietary supplements (M = 2.43, SD = 1.09), and perceived many of them as helpful. Group differences remained significant after controlling for age, gender, and whether treatment was medically recommended. Supplements targeting energy metabolism (e.g., CoQ10, NADH) were especially favored among ME/CFS participants. Conclusions: Findings suggest that participants with ME/CFS tend to adopt an exploratory and expansive intervention approach, potentially reflecting the lack of standardized guidelines and limited effectiveness of available treatment options. Participants with depression, in contrast, appeared to follow more guideline-concordant, evidence-based treatment pathways. Taken together, the findings point to a need for further development and evaluation of empirically supported, patient-centered treatment and intervention strategies for ME/CFS and suggest differences in clinical care structures between ME/CFS and depression. Full article

Influenza is typically framed as an acute respiratory infection, yet accumulating evidence suggests that—like SARS-CoV-2—it may trigger persistent, multi-organ morbidity consistent with a post-acute infection syndrome (“long flu”). Leveraging the nationwide FinnGen registry infrastructure, we conducted a temporally stratified disease-wide association study (DWAS) to map antecedent risk factors and long-term sequelae following clinically diagnosed influenza and COVID-19. We assembled an exposed cohort comprising 9204 individuals with influenza (ICD-10 J09–J11) and 4258 individuals with COVID-19 (ICD-10 U072) recorded in specialist inpatient/outpatient care between 1998 and 2021, and an unexposed comparator cohort of 420,005 individuals with no recorded influenza or pneumonia (J09–J18) across their available medical history. Across harmonized clinical endpoints, we fitted age- and sex-adjusted Cox proportional hazards models and controlled for multiple testing using a stringent false discovery rate threshold (FDR-adjusted p < 0.001), further interrogating temporal persistence within 1-, 5-, and 15-year windows. The DWAS revealed that both infections are associated with broad, system-spanning disease signatures extending beyond the respiratory tract, including circulatory, neurological, metabolic, musculoskeletal, digestive, mental/behavioural, ocular, and oncologic endpoints. Predisposition analyses demonstrated that infection risk is concentrated in individuals with substantial pre-existing multimorbidity, most prominently cardiovascular disease, alongside cardiometabolic, respiratory, renal, neuropsychiatric, and inflammatory conditions. Post-infection analyses identified a durable burden of incident multi-system morbidity after influenza, with particularly robust and persistent cardiovascular and neurological signatures—encompassing thromboembolic disease and major adverse cardiovascular outcomes, as well as migraine, neurodegenerative disorders, and depression—together with metabolic and renal sequelae that, in subsets, extended across multi-year horizons. Collectively, these longitudinal findings reframe influenza as a systemic event embedded within a chronic disease continuum, motivate recognition of “long flu” as a clinically meaningful post-viral risk landscape, and support intensified prevention and risk-stratified surveillance strategies alongside analogous efforts for long COVID. Full article

The early diagnosis and treatment of civilizational diseases remain a significant challenge worldwide. Although advances in medical technology have led to the introduction of more screening options over time, these measures are still insufficient to effectively reduce mortality from deadly diseases such as lung cancer (LC), cardiovascular diseases (CVD), diabetes, and chronic obstructive pulmonary disease (COPD). These conditions pose a major public health burden, underlying the urgent need for more comprehensive and efficient prevention strategies. Recently, the concept of ‘multiscreening’ has emerged as a promising approach. Multiscreening involves the simultaneous screening for multiple diseases using integrated diagnostic methods, potentially improving early detection rates and optimizing resource utilization. In 2024, Rzyman W. et al. launched the MULTIPREVENT epidemiological study, which aims to develop and validate a low-dose computed tomography (LDCT)-based screening test for civilizational diseases. This study represents a step forward in the pursuit of more effective, minimally invasive diagnostic tools that could facilitate earlier intervention and improve patient outcomes. To better understand the potential of multiscreening approaches and their clinical utility, it is essential to evaluate the existing predictive models used for identifying individuals at high risk for these diseases. This narrative review focuses primarily on lung cancer risk prediction models used in LDCT screening while situating these approaches within the broader conceptual framework of the MULTIPREVENT project, aimed at future integration of multi-disease prevention strategies. With this analysis, we aim to provide insights that will guide the development of more accurate, integrative screening tools that could reduce the global burden of these diseases. Full article

Background/Objectives: Healthy ageing, focused on maintaining daily autonomy and cognitive function despite chronic comorbidities, poses a challenge for public health systems, especially for those aged ≥80, given the expected increase in this population. Promoting a healthy lifestyle in this group is essential to achieving this goal, with primary care services playing a key role in this effort. Therefore, our objective was to profile the participants based on these characteristics. Methods: The study included 222 non-institutionalized, dementia-free individuals (mean age 84.58 ± 3.72 years, 56.3% women) recruited from a primary healthcare service. Data were collected from medical records and interviews, including the cognitive Pfeiffer test, the functional Barthel index (BI), and ad hoc questionnaires (for lifestyle variables). Latent profiling analysis (LPA) was used to classify the participants. Results: The participants reported social support (97.7%), low-risk alcohol consumption (94.6%), adherence to the Mediterranean diet (85.1%), physical activity (74.8%), and never smoking (72.5%). Hypertension (86.5%), cataracts (74.3%), and osteoarticular diseases (68.5%) were the most frequent chronic conditions. Women showed a significantly different distribution of certain variables and a higher number of comorbidities (6.34 ± 2.38) than men (5.58 ± 2.44) (p = 0.019). After LPA, we found that 38.29% of individuals met characteristics compatible with healthy ageing, predominantly male (60%); the association of a high probability of cognitive impairment with a high degree (severe or total), exhibited by the profiles likely >85% women (18.5% of individuals); physical activity, smoking, osteoporosis, anxiety, COPD, chronic kidney disease (CKD), and creatinine blood levels exhibited statistical differences between profiles; and the probability of dependence severity was associated with an increase in age, although cognitive status conservation was associated being male. Conclusions: The studied +80 group seems to follow a healthy lifestyle, as self-reported. Women fare worse than men in resilient ageing. While common factors related to dysfunctionality did not differentiate between profiles, CKD, an increasingly common age-related condition, did. Full article

Background: Hyperbaric oxygen therapy (HBOT) is considered a potential adjunctive modality to enhance tissue regeneration in oral and maxillofacial surgery. By increasing tissue oxygen availability, HBOT may support bone and soft-tissue repair under hypoxic and chronically inflamed conditions. Aim: This narrative review evaluates current experimental and clinical evidence regarding HBOT in high-risk dental indications, including osteoradionecrosis (ORN), medication-related osteonecrosis of the jaw (MRONJ), chronic osteomyelitis, poorly healing postoperative wounds, and procedures in patients with systemic comorbidities. Methods: A structured search of PubMed, Web of Science, and the Cochrane Library identified 123 relevant English-language publications (from 1 January 2000–September 2025) addressing HBOT mechanisms and clinical applications in oral and maxillofacial surgery, including clinical trials, observational studies, preclinical models, and systematic reviews. Results: Available evidence suggests that HBOT may improve healing outcomes and reduce complication rates in early-stage ORN and MRONJ when used as an adjunct to surgery and systemic therapy. However, findings in implantology—particularly in irradiated or diabetic patients—and in periodontal therapy remain limited, heterogeneous, and methodologically inconsistent. Conclusions: HBOT may be considered in selected clinical scenarios, particularly where healing is impaired by hypoxia or systemic disease. Nevertheless, current evidence remains insufficient to support routine use. Standardized, high-quality studies with clearly defined endpoints and uniform therapeutic protocols are needed to determine its clinical effectiveness and optimal indications. Full article

Background/Objectives: Population aging increases the healthcare burden of chronic diseases. We aimed to characterize the sociodemographic and clinical characteristics of Aged Madrid, a cohort comprising 98.6% of the population aged 75 years and older in Madrid, Spain. Methods: Observational study with a five-year retrospective baseline period (2015–2019) to assess baseline vascular and metabolic risk. Data were taken from primary care electronic medical records, hospital discharge summaries, and pharmacy records. Results: 587,603 individuals (mean age: 84 years ± 5.8 years, 61.3% women) were analysed. Obesity affected 31.3% (more frequent in women), while type 2 diabetes occurred in 23.8% (predominantly in men). Hypertension (52.8%), dyslipidaemia (61.6%), and chronic kidney disease (21.7%) were more frequent in women. Atrial fibrillation was the leading cardiovascular condition in women (15.1%), while acute myocardial infarction predominated in men (8.2%). The most prescribed drug classes were antihypertensives (53.8%), statins (44.2%), and oral antidiabetics (26.4%). Among antihypertensives, diuretics (53.9%), ACE inhibitors (27.4%), and ARBs (25.3%) were most used, often in combinations such as diuretics + ACE inhibitors (30.1%). Diabetes treatments favoured metformin and DPP-4 inhibitors; 5.2% received insulin. Conclusions: Sex-based differences emerged in biochemical, anthropometric, and lifestyle variables. Men showed a higher prevalence of cardiovascular diseases and several cardiometabolic risk factors, while women used fewer lipid-lowering and antidiabetic agents. Diuretics were the predominant antihypertensives, and antidiabetic therapy largely followed guideline recommendations. Although 60% of statin users had no prior cardiovascular disease, and their use was concentrated mainly among individuals with major cardiometabolic risk conditions and declined with advancing age, suggesting an age- and risk-sensitive prescribing pattern rather than indiscriminate use. Full article

The global population aged 65 and older is expected to double from 761 million in 2021 to 1.6 billion by 2050. Despite often being treated separately in clinical practice and policy, oral health and mental health are fundamentally interconnected in older adulthood, forming a bidirectional relationship that exacerbates disability, social inequity, and systemic healthcare challenges. This narrative review aims to summarize the two-way relationship between mental and oral health and emphasize their combined impact on systemic health, social engagement, and independence among ageing populations. The bidirectional relationship has profound clinical significance. Untreated oral diseases induce chronic pain and cause social embarrassment, aggravating pre-existing depression and anxiety. Periodontal disease can worsen systemic conditions such as diabetes, cardiovascular disease, and dementia via a shared inflammatory pathway. Conversely, mental health issues—including depression, anxiety, cognitive decline, and the use of psychotropic medications—reduce motivation for oral care, prompt dental neglect, and affect salivary function, deteriorating oral health. Despite clear connections, systemic gaps persist, including fragmented healthcare systems, financial barriers, stigma, lack of awareness, and caregiver burnout. To address these challenges, strategies such as developing integrated care models to unify dental and mental health services, reforming policies to prioritize oral and mental health parity, advocating anti-stigma campaigns to clear the misconceptions, and implementing community-based healthcare programmes to reach underserved older adults are essential. By recognizing oral health as a vital component of mental resilience, societies can transform ageing into an era of empowered well-being, where the mouth–mind connection promotes holistic health rather than functional decline. Full article

Background/Objectives: Preeclampsia is a severe hypertensive disorder that has been linked to increased maternal psychiatric morbidity. However, existing literature remains inconsistent regarding whether this association is independent of underlying medical co-morbidities such as chronic hypertension and diabetes. Our objective was to precisely evaluate the Adjusted Odds Ratio (AOR) of developing Postpartum Depression symptomatology (probable PPD) following a diagnosis of preeclampsia in a prospectively tracked cohort, controlling for essential confounders. Methods: This prospective cohort study included 180 women (33 in the Preeclampsia group, 147 in the Normotensive reference group), with stringent exclusion of women with prior psychiatric history to reduce confounding. PPD was assessed postpartum using the Edinburgh Postnatal Depression Scale (EPDS ≥ 13 cutoff). Multivariable logistic regression was employed to calculate the AOR, adjusting for maternal age, chronic hypertension, and prepregnancy diabetes. Results: The multivariable analysis demonstrated a highly significant and independent association between the primary exposure and the outcome. Preeclampsia was associated with 12.7-fold increased odds of developing PPD (AOR: 12.7; 95% CI: 5.1–31.7; p < 0.001). In contrast, none of the included confounders—chronic hypertension (AOR: 1.96, p = 0.182), prepregnancy diabetes (AOR: 1.8, p = 0.372), or age (AOR: 0.99, p = 0.759)—showed a statistically significant independent association with PPD risk. The model achieved strong explanatory power (Nagelkerke R² = 0.327; Omnibus Test p < 0.001). Conclusions: Preeclampsia represents a powerful and independent determinant of the risk for significant PPD symptomatology, substantially increasing the adjusted odds of the condition. These findings mandate that women with a history of preeclampsia be designated a high-risk group and receive immediate, mandatory, and intensified postpartum mental health surveillance and preferential access to specialized psychological support. Full article

Tai Chi has evolved into a widely used mind–body practice increasingly incorporated into complementary therapy, rehabilitation, and public health. This study provides an updated global bibliometric overview, with VOSviewer mapping publication performance, co-authorship networks, and keyword-based thematic clusters. Articles and reviews with Tai Chi–related terms in the title were retrieved from Scopus, with no restrictions on language or publication year. A total of 2253 publications from 1978 to 2025 were analyzed, revealing steady growth, concentrated largely in the past decade. China led the publication output, while the United States had the highest number of citations, forming a dual-core pattern. The field is largely driven by a small group of authors and regional clusters, and its visibility in mainstream medical journals remains limited. Nine software-generated keyword clusters were manually synthesized into five themes: motor function (balance and fall prevention), musculoskeletal conditions (osteoarthritis, rheumatoid arthritis, fibromyalgia), chronic disease management (cardiovascular disease, stroke, COPD), psychological health (quality of life, depression, anxiety, mindfulness), and cognitive aging (dementia, mild cognitive impairment). Future progress requires greater methodological rigor, including mechanistic inquiry, long-term study designs, and community- or population-level applications, along with stronger international collaboration and deeper integration into clinical and public health practice. Full article