医学最新文献

{"title":"Influence of perineal tears and body image disturbance on postpartum sexual quality of life: a cross-sectional study.","authors":"Deborah Fillion, Alessandro Ferdinando Ruffolo, Nathalie Verlet, Carine Martin, Charles Garabedian, Chrystèle Rubod, Yohan Kerbage, Michel Cosson, Louise Ghesquiere, Romain Corroenne, Marine Lallemant","doi":"10.1080/0167482X.2026.2716382","DOIUrl":"https://doi.org/10.1080/0167482X.2026.2716382","url":null,"abstract":"<p><strong>Background: </strong>Whether perineal injury severity independently determines postpartum sexual quality of life (SQoL) is unclear. This study evaluated perineal tears and body image as determinants of SQoL and sexual resumption timing.</p><p><strong>Methods: </strong>A total of 173 women (2-24 months postpartum, vaginal delivery) completed an online questionnaire including the SQoL-F and Body Image Scale (BIS). Women with perineal tear/episiotomy (PT/E; <i>n</i> = 118) were compared with those with an intact perineum (<i>n</i> = 51) using multivariate regression.</p><p><strong>Results: </strong>SQoL-F scores were similar between groups (71.1 ± 23.3 vs 76.9 ± 24.0; <i>p</i> = 0.10), though PT/E delayed sexual resumption (<i>p</i> = 0.04). On multivariate analysis, SQoL-F was independently associated with dyspareunia (β = -10.96; <i>p</i> < 0.001), body image disturbance (β = -0.93; <i>p</i> < 0.001), and pre-pregnancy sexual satisfaction (β = +4.99; <i>p</i> = 0.001), but not tear type. Delayed resumption was independently associated with OASI (OR = 7.02; <i>p</i> = 0.02), first/second-degree tears (OR = 2.20; <i>p</i> = 0.04), and lower pre-pregnancy relationship satisfaction (OR = 0.50; <i>p</i> = 0.048).</p><p><strong>Conclusions: </strong>Postpartum SQoL is primarily determined by dyspareunia and body image disturbance rather than perineal tear severity. OASI carries a substantial risk of delayed sexual resumption, warranting dedicated postpartum counseling.</p>","PeriodicalId":50072,"journal":{"name":"Journal of Psychosomatic Obstetrics & Gynecology","volume":"48 1","pages":"2716382"},"PeriodicalIF":2.6,"publicationDate":"2027-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Sailing Two Boats\" the fragmented identity of working women and the hidden labor of infertility: a qualitative analysis.","authors":"Swati Dhar, Vidyashree Ganesh Poojari, Prashanth Adiga, Anjali Mundkur, Akash Tomar, Pratap Kumar","doi":"10.1080/0167482X.2026.2742884","DOIUrl":"https://doi.org/10.1080/0167482X.2026.2742884","url":null,"abstract":"<p><strong>Objective: </strong>To explore how professional women undergoing assisted reproductive technology (ART) experience and manage conflicts between treatment demands and professional identity; and to identify ways healthcare professionals can support them.</p><p><strong>Methods: </strong>Following COREQ guidelines, semi-structured, in-depth interviews were conducted with 18 professional women undergoing ART in a tertiary care hospital. Reflexive Thematic Analysis bolstered by interdisciplinary investigator triangulation (clinical and basic science) ensured thematic confirmability.</p><p><strong>Results: </strong>Analysis revealed <i>Gendered Occupational Asymmetry</i> (female occupational burden regardless of clinical aetiology), the <i>Insider Paradox</i> (the role reversal for healthcare professionals) and the <i>Workplace Panopticon</i> (constant self-surveillance to preserve professional authority). Interestingly, work simultaneously often acted as a <i>Sanctuary of Competence</i>, providing psychological respite. Finally, narratives exposed an <i>Existential Rumination</i> (mourning past personal-professional decisions) and permanent temporal career stalling. These themes were further mapped onto a 'A Day in the Life' structural framework to illustrate compounding daily burdens.</p><p><strong>Conclusions: </strong>Current clinical lifestyle directives inadequately account for the rigid psycho-socioeconomic structures governing professional women. Based on identified themes, we propose targeted measures for healthcare professionals to deliver patient-centric care by integrating occupational awareness and identity-sensitive counselling into routine ART practice, thereby potentially reducing distress and improving treatment experience.</p>","PeriodicalId":50072,"journal":{"name":"Journal of Psychosomatic Obstetrics & Gynecology","volume":"48 1","pages":"2742884"},"PeriodicalIF":2.6,"publicationDate":"2027-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting IGD treatment outcomes across interventions using a whole-brain functional connectome biomarker.","authors":"Meiting Wei, Xin Luo, Jiejie Fu, Shuang Li, Haosen Ni, Jiang Liu, Guang-Heng Dong","doi":"10.1080/19585969.2026.2742156","DOIUrl":"10.1080/19585969.2026.2742156","url":null,"abstract":"<p><strong>Background: </strong>Although treatment approaches have been explored in internet gaming disorder (IGD), however, little is known about the specific neural activity that is associated with treatment outcomes. This study aims to establish a treatment-sensitive network that reliably predicts treatment outcomes across different interventions for IGD.</p><p><strong>Methods: </strong>Resting-state fMRI data were collected from 90 individuals with IGD who received one of three different intervention protocols (mindfulness meditation, approach bias modification, or retrieval-aversive conditioning training). Connectome-based predictive modelling (CPM) was used to build a treatment-sensitive network to predict individual symptom reduction, then validated them on the external dataset.</p><p><strong>Results: </strong>The negative (<i>r</i> = 0.401, <i>p</i> <.001) and combined network (<i>r</i> = 0.480, <i>p</i> <.001) can significantly predict a reduction of addiction severity (baseline minus post-test). Specifically, the negative network was primarily centred on the motor, subcortical, and salience networks. The positive network primarily involved cerebellar-related connections. Incorporating these into a combined model significantly improved predictive accuracy, suggesting that cerebellar-related connectivity may contribute to the prediction of intervention-related clinical improvement. Finally, the treatment-sensitive network was validated in a separate data.</p><p><strong>Conclusions: </strong>This study established a treatment-sensitive network based on the whole-brain connectome. These findings provide valuable empirical evidence for identifying biomarkers for IGD treatment and advance personalised therapeutic strategies.</p><p><strong>Clinical trials registration: </strong>The trial protocol was pre-registered with the Chinese Clinical Trial Registry (www.chictr.org.cn; ChiCTR2300077831(MM), ChiCTR2300075869(ApBm), ChiCTR2500095444(R-AC), ChiCTR2400090834(SAE)).</p>","PeriodicalId":54343,"journal":{"name":"Dialogues in Clinical Neuroscience","volume":"29 1","pages":"1-14"},"PeriodicalIF":5.1,"publicationDate":"2027-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From prevalence to prognosis: the clinical relevance of depression and anxiety in COPD.","authors":"Josep Montserrat-Capdevila","doi":"10.1080/02813432.2026.2738628","DOIUrl":"10.1080/02813432.2026.2738628","url":null,"abstract":"","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":"45 1","pages":"2738628"},"PeriodicalIF":1.9,"publicationDate":"2027-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nine minutes is enough: An accelerated fMRI protocol for reliable connectivity mapping in healthy young adults.","authors":"Adrian Falkowski, Krzysztof Szwed","doi":"10.1080/19585969.2026.2710912","DOIUrl":"10.1080/19585969.2026.2710912","url":null,"abstract":"<p><strong>Introduction: </strong>Resting‑state fMRI is widely used to map brain connectivity, yet the field lacks a clear, data‑driven standard for acquisition duration. We compared traditional Single‑Band (SB) imaging with an accelerated Multiband factor 4 (MB4) protocol to identify a time‑efficient approach for capturing stable network topology.</p><p><strong>Methods: </strong>Twenty‑five healthy young adults completed two sessions one month apart, each including counterbalanced 13‑minute SB and MB4 scans. Test-retest reliability was evaluated across multiple durations using Portrait Divergence, a multiscale graph‑theoretic metric. Supplementary analyses compared Portrait Divergence with the field-standard Intraclass Correlation Coefficient, assessed robustness across preprocessing pipelines and parcellation schemes, and examined MB4's ability to capture both cortical and subcortical connectivity.</p><p><strong>Results: </strong>MB4 consistently outperformed SB across all tested durations, with peak topological stability at 9 minutes. Stability declined beyond this point, likely due to cumulative motion artefacts. Supplementary analyses confirmed MB4's robustness across preprocessing strategies and atlas choices and demonstrated effective whole‑brain coverage.</p><p><strong>Conclusions: </strong>In healthy young adults, MB4 captures network topology more effectively than SB and reaches peak stability at 9 minutes before declining, challenging the assumption that longer scans are always better. These findings require validation in clinical, paediatric, and geriatric cohorts.</p>","PeriodicalId":54343,"journal":{"name":"Dialogues in Clinical Neuroscience","volume":"29 1","pages":"24-31"},"PeriodicalIF":5.1,"publicationDate":"2027-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to the letter-to-the-editor \"Percutaneous coronary intervention in nonagenarians\".","authors":"Matti Riihiniemi, Jarkko Piuhola, Matti Niemelä, Juhani Junttila","doi":"10.1080/14017431.2026.2744009","DOIUrl":"https://doi.org/10.1080/14017431.2026.2744009","url":null,"abstract":"","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":"61 1","pages":"2744009"},"PeriodicalIF":1.4,"publicationDate":"2027-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physicians' perspectives of palliative care quality in nursing homes: a cross-sectional study.","authors":"Tuva Sandsdalen, Reidun Hov, Harald Sanaker, Liv Skomakerstuen Ødbehr","doi":"10.1080/02813432.2026.2742320","DOIUrl":"10.1080/02813432.2026.2742320","url":null,"abstract":"<p><strong>Background: </strong>Since physicians have primary responsibility for medical treatment, their perspectives of palliative care quality in nursing homes can provide important knowledge for service evaluation and enhancement in this context. However, few studies exist that include their perspectives.</p><p><strong>Objectives: </strong>The aim was to investigate physicians' perspectives of the quality of palliative care in Norwegian nursing homes.</p><p><strong>Methods: </strong>A cross-sectional study conducted between November 2022 and December 2023, which included 77 nursing home physicians (response rate 43.5%) in Norway. Data were collected using a questionnaire comprising questions about demographic variables and perceptions of quality of care, as measured by the short form of the instrument Quality from the Patients' Perspective for Palliative Care (QPP-PC), adapted for healthcare personnel. Descriptive analyses and Wilcoxon signed rank tests were performed.</p><p><strong>Results: </strong>Nursing home physicians scored subjective importance of the care significantly higher than their perception of the quality of actual care received in the two dimensions; medical-technical competence and sociocultural atmosphere and for nine out of the 24 items and three out of seven additional symptom-specific questions. A need for improvement was identified in care areas such as symptom relief for pain, depression and anxiety, existential care, understanding patients' perspective, waiting time, individualized care, cooperation, and continuity.</p><p><strong>Conclusion: </strong>The results show that provision of high-quality palliative care in nursing homes can be challenging and that the physicians identified several areas for improvement. The results can provide direction for future quality improvement. However, the findings need to be confirmed in a larger sample.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":"45 1","pages":"2742320"},"PeriodicalIF":1.9,"publicationDate":"2027-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond stroke: atrial fibrillation and the broader burden of thromboembolic events in the population-based EpiHealth study.","authors":"Pernilla Höiby, Moncef Zarrouk, Lars Lind, Rani Basna, Marie Claire Overton, Sölve Elmståhl","doi":"10.1080/14017431.2026.2748120","DOIUrl":"10.1080/14017431.2026.2748120","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the distribution and risk of thromboembolic events (TEs) among adults with and without atrial fibrillation (AF), and to assess oral anticoagulant (OAC) use over time.</p><p><strong>Design: </strong>This population-based longitudinal cohort study included EpiHealth participants recruited between April 2011 and December 2016 and followed through linkage to Swedish health data registers from baseline until the first TE, death, or December 31, 2016.</p><p><strong>Results: </strong>At baseline, 873 of 22,616 participants (3.9%) had AF and 297 developed incident AF during follow-up. 484 participants experienced at least one TE during 70,587 person-years. Participants with AF had higher TE incidence (68 events, 5.9%; <i>p</i> < 0.001), predominantly arterial (73.5%), with 94% of arterial events involving the cerebral circulation. Approximately one quarter of TEs among participants with AF occurred outside the cerebral circulation and comprised both venous and non-cerebral arterial events. Although participants with incident AF represented less than one quarter of participants with AF, they accounted for 40% of TEs in the AF group. OAC use increased from 39.0% to 50.4%, with a shift from predominantly warfarin to direct oral anticoagulants. In time-dependent Cox regression adjusted for age, sex, and prior arterial thromboembolism, untreated AF was associated with increased thromboembolic risk compared with no AF (HR 2.53), whereas OAC use was associated with lower risk.</p><p><strong>Conclusions: </strong>AF was associated with substantially increased thromboembolic risk, predominantly arterial in nature. One in five TEs among participants with AF coincided with newly diagnosed AF, suggesting potential opportunities for earlier AF detection and timely initiation of anticoagulant treatment.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2748120"},"PeriodicalIF":1.4,"publicationDate":"2027-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in suicide prevention: promise, peril, and clinical implications for clinical practice.","authors":"Bénédicte Nobile, Philippe Courtet","doi":"10.1080/19585969.2026.2745684","DOIUrl":"10.1080/19585969.2026.2745684","url":null,"abstract":"<p><p>The integration of Artificial Intelligence (AI) into psychiatry is progressing rapidly, with promising yet underexplored applications in suicide prevention. While most existing studies have focused on suicide risk prediction, AI could be applied more broadly across the suicide prevention continuum. This review explores AI's potential in improving the detection of suicidal ideation (SI), enhancing clinician training, and expanding patient access to psychotherapeutic support. Studies suggest that AI models may identify SI more sensitively than clinicians by detecting subtle linguistic or semantic cues. Furthermore, AI-based virtual patients have been shown to improve clinicians' confidence and accuracy in suicide risk assessments, particularly when used alongside traditional training methods. On the patient side, CBT-inspired AI tools offer scalable, on-demand support, but most remain unregulated and clinically unvalidated. Despite their perceived empathy and availability, such tools pose ethical and clinical risks. Many patients use AI tools without professional guidance, a trend clinicians often underestimate. This disconnect calls for urgent regulatory oversight and professional engagement. Without clear clinical validation, AI-based tools may evolve outside medical frameworks, exposing vulnerable individuals to preventable harm. Psychiatry must not only adapt but also lead, ensuring that innovation is harnessed responsibly to serve patients with empathy, safety, and scientific rigor.</p>","PeriodicalId":54343,"journal":{"name":"Dialogues in Clinical Neuroscience","volume":"29 1","pages":"15-23"},"PeriodicalIF":5.1,"publicationDate":"2027-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulatory arrest versus aortic cross-clamping in proximal thoracic aortic aneurysm repair.","authors":"Erik Braatz, Malin Stenman, Julia Al-Mousli, Magnus Dalén, Christian Olsson","doi":"10.1080/14017431.2026.2745873","DOIUrl":"10.1080/14017431.2026.2745873","url":null,"abstract":"<p><strong>Introduction: </strong>Aortic cross‑clamping and mild hypothermic circulatory arrest (MHCA) are commonly used strategies in proximal thoracic aortic aneurysm surgery. This study compared these approaches in elective procedures for patients with a distal ascending aortic diameter of 40-50 mm. The primary outcome was a composite of 30‑day mortality, stroke, or acute kidney injury, with secondary outcomes including long‑term survival and postoperative complications.</p><p><strong>Material and methods: </strong>This single‑center observational cohort included patients treated between 2016 and 2024. Distal ascending aortic diameters were assessed on preoperative computed tomography, and clinical data were obtained from SWEDEHEART. Patients were assigned to aortic cross‑clamp (<i>n</i> = 261) or MHCA (<i>n</i> = 138). Propensity score matching was performed in a 1:1 ratio to balance baseline characteristics.</p><p><strong>Results: </strong>The composite primary outcome occurred in 15 patients (3.8%) and was more common with MHCA than with cross‑clamp (6.5% vs 2.3%, <i>p</i> = 0.035). Two patients (0.5%), both in the MHCA group, died within 30 days. After matching, the odds ratio for the composite endpoint was 2.4 (95% CI, 0.66-11.5), indicating no significant difference. Long‑term survival was similar between groups (log‑rank <i>p</i> = 0.33).</p><p><strong>Conclusions: </strong>Both strategies were associated with low perioperative risk and comparable long‑term survival. These results support flexible operative planning, allowing the distal anastomotic technique to be chosen based on individual anatomy and surgical preference.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":" ","pages":"2745873"},"PeriodicalIF":1.4,"publicationDate":"2027-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}