Biomedicine hub最新文献

{"title":"Aquaporins in Brain Tumor-Related Edema: A Narrative Review.","authors":"Yusor Al-Nuaimy, Denise Baloi, Clayton Rawson, Jerick Kim, Michael Karsy, Mehrdad Pahlevani","doi":"10.1159/bmh/aboag004","DOIUrl":"https://doi.org/10.1159/bmh/aboag004","url":null,"abstract":"<p><strong>Background: </strong>Brain tumor-related edema is a major contributor to morbidity in patients with intracranial neoplasms, arising from interactions between blood-brain barrier (BBB) dysfunction, tumor biology, and dysregulated water transport. Aquaporins (AQPs), and particularly AQP4, are central to cerebral water homeostasis, and alterations in their expression and spatial polarization within and around brain tumors influence both cytotoxic and vasogenic edema. This narrative review synthesizes contemporary evidence on AQP biology in the tumor-bearing brain and critically appraises the translational maturity of AQP-directed therapy.</p><p><strong>Summary: </strong>AQP4 is the predominant central nervous system AQP, concentrated at astrocytic end-feet and essential for water flux across the BBB and along glymphatic pathways. In high-grade gliomas, AQP4 is upregulated and loses perivascular polarity, a pattern that accompanies extensive vasogenic edema, impaired perivascular clearance, and enhanced tumor cell invasion. Low-grade gliomas and meningiomas show more restricted or vascular-predominant AQP expression, including AQP1 in meningioma vasculature, and comparatively less peritumoral edema. Experimental work demonstrates a bidirectional, context-dependent role for AQP4: it promotes astrocytic swelling when the BBB is intact, yet facilitates reabsorption of extracellular fluid once the barrier is disrupted. This duality has not been resolved in human tumor tissue and constrains any single-direction therapeutic strategy. Candidate interventions, including small-molecule inhibitors (AER-270/AER-271), monoclonal antibodies, SUR1-TRPM4 modulation, RNA interference, and CRISPR/Cas9-based editing, have shown activity in rodent injury models but have not been evaluated in brain tumor populations.</p><p><strong>Key messages: </strong>(1) AQP4 is not uniformly pro-edematous; its net effect depends on BBB integrity, edema phase, and preservation of perivascular polarity, so undifferentiated inhibition risks impairing fluid clearance in precisely the tumors that most need it. (2) The evidence base remains dominated by rodent injury models and small immunohistochemical series rather than human tumor tissue, and no AQP-targeted agent has entered a brain tumor trial. (3) Meaningful progress will require human-tissue studies that quantify AQP4 polarity rather than total expression, prospective imaging biomarkers such as diffusion tensor image analysis along the perivascular space capable of stratifying patients before treatment, and astrocyte-targeted, temporally controlled gene-editing approaches rather than constitutive gene deletion.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"11 1","pages":"184-194"},"PeriodicalIF":0.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13685016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149248318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Pioglitazone in Improving Cognitive Function among Patients with Impaired Cognition as an Add-On Therapy: A Study Protocol.","authors":"Ian Osoro, Caroline Sylvia, Robert S Wilson, M G Rajanandh","doi":"10.1159/000553266","DOIUrl":"10.1159/000553266","url":null,"abstract":"<p><strong>Introduction: </strong>Management strategy to improve cognition is one of the challenges faced by clinicians. Importantly, pioglitazone, a safe and cost-effective medication, has been shown to improve memory dysfunction in both animal and some clinical studies. Thus, the aim of this study was to assess and compare the effect of pioglitazone as an add-on therapy in treating cognitive decline in patients with Parkinson's disease, stroke, and dementia.</p><p><strong>Methods: </strong>This is a randomised double blind controlled trial involving individuals with severe to mild cognitive impairment (MoCA score below 26) associated with either Parkinson's disease, stroke, or dementia. All neurological conditions were clinically diagnosed based on the standard criterions. Participants were randomised 1:1 to orally take 15 mg of pioglitazone once daily for 6 months. A total sample size of 252 participants (42 per group across six groups) was calculated to detect a mean difference of 2 points in MoCA score (SD = 3), with 80% power and 5% significance level, accounting for 15% attrition. The primary outcome measure is the change in MoCA score at 6 months. Secondary outcome measures include the assessment of clinical manifestations, cognitive performance, normal neurological markers, adverse drug reactions, and medication adherence over a follow-up period of 6 months and 12 months.</p><p><strong>Conclusion: </strong>The findings of our study are hypothesis-generating. If positive, this study will support larger multicentre trials to validate efficacy, clarify subgroup responsiveness, and inform future metabolic-targeted therapeutic strategies rather than immediate clinical guideline changes.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"11 1","pages":"160-166"},"PeriodicalIF":0.0,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysphagia and Dysphonia in Parkinson's Disease: Pathophysiological Mechanisms, Treatment Approaches, and Clinical Implications.","authors":"Elizabeth R Hong","doi":"10.1159/000553345","DOIUrl":"10.1159/000553345","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the degeneration of dopamine-producing neurons, leading to a wide range of symptoms that significantly impact patients' quality of life. Among these, dysphagia (difficulty swallowing) and dysphonia (voice impairments) are particularly prevalent, affecting a majority of individuals with PD and contributing to serious health risks and social challenges.</p><p><strong>Summary: </strong>Dysphagia affects up to 80% of individuals with PD, posing risks such as aspiration pneumonia, malnutrition, and dehydration. These clinical manifestations can lead to increased morbidity and mortality, making early detection and intervention essential. Current treatment approaches for dysphagia include compensatory strategies, such as posture adjustments, swallowing exercises, and dietary modifications, as well as pharmacological interventions. However, given the progressive nature of PD, individualized treatment plans are necessary to effectively manage symptoms and prevent life-threatening clinical manifestations. Similarly, dysphonia affects approximately 70-90% of PD patients and results in vocal impairments, including reduced volume, breathy or hoarse speech, and monotone voice, which hinder communication and contribute to social isolation. The loss of vocal strength and clarity can lead to frustration, withdrawal from conversations, and diminished overall well-being. The Lee Silverman Voice Treatment (LSVT) has emerged as one of the most effective therapeutic interventions for dysphonia, aiming to improve vocal loudness and clarity. While LSVT has shown promising results, research on dysphonia remains less extensive than dysphagia, indicating a need for further investigation into optimized treatment strategies.</p><p><strong>Key messages: </strong>Given the profound impact of both dysphagia and dysphonia, a multidisciplinary approach integrating speech-language therapy, medical interventions, and tailored rehabilitation programs is crucial. Addressing these symptoms proactively can help improve communication, reduce health risks, and ultimately enhance the overall quality of life for individuals living with PD.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"11 1","pages":"143-149"},"PeriodicalIF":0.0,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Rurality on Access to Care in Adult Patients with Sinonasal Squamous Cell Carcinoma.","authors":"Emma R Earl, Sam Tenhoeve, Majid Khan, Ashley S Carter, Amarbir Gill, Jeremiah A Alt, Randy L Jensen, Michael Karsy","doi":"10.1159/000552782","DOIUrl":"10.1159/000552782","url":null,"abstract":"<p><strong>Introduction: </strong>Social determinants of health (SDOH) such as uninsured status, race/ethnicity, and low-income status have been identified as risk factors impacting access to care and survival in sinonasal malignancies. Other SDOHs, including rurality and distance to adequate healthcare, have increasingly been shown to be prognosticators and may also play a role in patients with sinonasal malignancies.</p><p><strong>Objective: </strong>The aim of this study was to understand the role of rurality as a prognostic factor in sinonasal malignancy and squamous cell carcinoma (SCC).</p><p><strong>Methods: </strong>A retrospective cohort study of the Utah Cancer Registry database from 1973 to 2019 was performed with patients delineated into Frontier (<6 people/sq mi), Rural (6-99 people/sq mi), and Urban (>100 people/sq mi) populations based on geographic information system mapping.</p><p><strong>Results: </strong>Of the 156 patients with SCC (68.0% male, 96.8% white, 96.2% non-Hispanic), 9 (5.8%) were Frontier, 36 (23.1%) were Rural, and 111 (71.2%) were Urban. Frontier, Rural, and Urban patients resided 109.2 ± 59.4, 55.5 ± 55.7 miles from their treatment facility, with an average of 9.2 ± 10.6 miles, respectively (<i>p</i> < 0.001). As part of treatment, 74.2-80.0% of patients underwent surgery, 35-52.4% had radiation, and 10-23.6% underwent chemotherapy. The Kaplan-Meier survival analysis demonstrated significantly improved survival in Urban patients (median survival 12.3 months) compared with Frontier (10.1 months) and Rural (10.4 months) patients (<i>p</i> = 0.04, log-rank test).</p><p><strong>Conclusion: </strong>Frontier and Rural patients with SCC resided farther from their care facility with worsened survival compared to Urban patients. The presence of a centralized National Cancer Institute designated tertiary care facility in Utah may improve regional patient access to care and survival, which requires future study. These data help compare the treatment infrastructure of rural Utah with other rural US areas.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"11 1","pages":"132-142"},"PeriodicalIF":0.0,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occult Tuberculosis in Dialysis Patients Is Rarely Straightforward: Retrospective Case Series.","authors":"Salah K Essa, Mahmoud Sami Mohammed, Mohamed Salah Essa, Mohamed Sharaf, Mostafa Elshahat Saleh, Mohamed Rabee Mohamed, Reem Imad Mohamed, Ahmad Mansour Almahasneh, Azmi Omar Alharoni","doi":"10.1159/000552714","DOIUrl":"10.1159/000552714","url":null,"abstract":"<p><strong>Introduction: </strong>The diagnosis of tuberculosis (TB) in dialysis patients may be difficult because of the increased frequency of extra-pulmonary presentations, atypical clinical manifestations, and nonspecific symptoms. This study aimed to investigate the spectrum of clinical presentations and outcomes of TB in dialysis patients in a retrospective case series and data analysis over a 14-year period between 2011 and 2024.</p><p><strong>Case presentation: </strong>A total of 6 (3%) patients undergoing hemodialysis were diagnosed with TB from 200 being cared for in Madinat Zayed Hospital Al Dhafra, Abu Dhabi, UAE. Most had extrapulmonary involvement and a delayed diagnosis, and all patients came from countries where TB is endemic. The first-line antituberculous medication proved safe and effective in all cases. Additionally, we report these cases as an important reminder to clinicians to be aware that body fluids may not initially provide positive results for acid-fast bacilli smear, culture or polymerase chain reaction test polymerase chain reaction, additionally, the tuberculin PPD skin test (TST), the classic diagnostic tool for latent TB infection, has several major drawbacks, including poor sensitivity (because of a high prevalence of energy in dialysis patients). Although all patients' microbiology were negative, the diagnostic criteria included lymphocytic exudative fluid upon aspiration, response to empirical antituberculous treatment and in selected patients, tissue diagnosis was obtained.</p><p><strong>Conclusion: </strong>TB should be strongly considered in dialysis patients from endemic regions presenting with unexplained inflammatory syndromes or serosal effusions, even when microbiological tests are negative. Early empirical treatment can be both diagnostic and life-saving.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"11 1","pages":"101-107"},"PeriodicalIF":0.0,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148321628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Exploration of Future Health Professionals' Dementia Knowledge and Perceptions of Dementia-Related Technology Support.","authors":"Helen M Haydon, Melissa Taylor, Annie Banbury, Cindy Jones, Georgina R Chelberg, Louise Horstmanshof, Richard Hicks, Centaine L Snoswell, Melissa Carey","doi":"10.1159/000552620","DOIUrl":"https://doi.org/10.1159/000552620","url":null,"abstract":"<p><strong>Introduction: </strong>This research aimed to explore healthcare professional (HCP) students' dementia knowledge, perceptions of older adults' digital literacy, and perceived usefulness of digital health interventions for people living with dementia and their caregivers.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted to explore HCP student perceptions of cognitive ageing and their understandings of the relationship between technology and healthcare practice. Researchers also explored students' knowledge of dementia and their contemporary educational experiences.</p><p><strong>Results: </strong>Findings revealed a lack of formal education regarding the use of technology in cognitive care associated with ageing populations. Students also reported limited experience with the use of technology in care. However, there was a positive response to the future possibility of introducing technologies into healthcare practice.</p><p><strong>Conclusion: </strong>Considering the prevalence of dementia globally, we should increase knowledge of dementia and associated digital health support so that future HCPs can make informed choices regarding the utility and effectiveness of digital tools.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"11 1","pages":"150-159"},"PeriodicalIF":0.0,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunotherapy in Metastatic Brain Tumors: Mechanisms, Challenges, and Opportunities for Neurosurgical Integration: A 10-Year Narrative Review.","authors":"Henry Freeman, Denise Baloi, Clayton Rawson, Sanehdeep Kaur, Mehrdad Pahlevani, Michael Karsy","doi":"10.1159/000552630","DOIUrl":"10.1159/000552630","url":null,"abstract":"<p><strong>Background: </strong>Brain metastases are the most common intracranial malignancy in adults and represent a major source of neurologic morbidity despite advances in surgery and radiotherapy. Immune checkpoint inhibitors (ICIs) have transformed systemic cancer therapy and are increasingly demonstrating intracranial activity, challenging the long-standing view of the central nervous system as an immune-privileged site.</p><p><strong>Summary: </strong>This narrative review synthesizes mechanistic, translational, and clinical evidence from the past decade examining immunotherapeutic strategies for metastatic brain tumors. We review the neuroimmune microenvironment of brain metastases, including blood-brain and blood-tumor barrier remodeling, myeloid and lymphoid immune niches, and factors that modulate intracranial immune responses. Clinical data supporting the use of ICIs, combination strategies with stereotactic radiosurgery and anti-angiogenic agents, and emerging cellular, viral, and locoregional immunotherapies are discussed, with attention to patterns of intracranial response, resistance, and toxicity. We further examine key challenges unique to the CNS, including corticosteroid-associated immunosuppression and immune-related imaging ambiguity. Throughout, we emphasize the expanding role of neurosurgeons in precision neuro-immuno-oncology through tissue-based discovery, perioperative treatment coordination, steroid-sparing strategies, and development of locoregional delivery platforms.</p><p><strong>Key messages: </strong>Immunotherapy has meaningful intracranial activity in selected patients with brain metastases but remains constrained by CNS-specific biological and clinical barriers. Integrating immunotherapy into neurosurgically centered, tissue-driven care pathways are essential for advancing precision treatment and improving neurologic outcomes.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"11 1","pages":"119-131"},"PeriodicalIF":0.0,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13363142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Outcome and Associated Factors among Chronic Kidney Disease Patients at Zewditu Memorial Hospital and Tikur Anbessa Specialized Hospital: A Retrospective Cross-Sectional Study.","authors":"Teshome Berhe, Zenebe Negash, Gobezie T Tegegne, Alemseged Beyene Berha","doi":"10.1159/000552255","DOIUrl":"10.1159/000552255","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) remains a major treatment challenge in low- and middle-income countries due to limited resources, delayed diagnosis, poor access to essential medicines, and inadequate renal replacement services. Given the limited evidence on CKD management and outcomes in these settings, this study aimed to evaluate the clinical outcomes and associated factors among patients with CKD at Zewditu Memorial Hospital and Tikur Anbessa Specialized Hospital, Ethiopia.</p><p><strong>Methods: </strong>A retrospective cross-sectional study design was employed. All adult patients with CKD attending the renal clinics at both hospitals between March and July 2019 were enrolled. Sociodemographic and clinical characteristics were collected through structured patient interviews and review of medical records. Data were analyzed using Statistical Package for Social Science (SPSS) version 23.</p><p><strong>Results: </strong>Of 300 CKD patients included in the study, nearly half of them had CKD-related complications, and 11% were in end-stage renal disease (ESRD). Among those with complications, 29% had hospitalization prior to data extraction. Most participants (83.7%) adhered to clinician-recommended non-pharmacological interventions. Enalapril and amlodipine were prescribed for 39.0% and 37.3% of patients, respectively, and polypharmacy was observed in 53.3% of patients with stage five CKD.</p><p><strong>Conclusion: </strong>A substantial proportion of patients  with CKD had complications, including hospitalization and ESRD. Polypharmacy was prevalent among patients with advanced CKD, underscoring the need for comprehensive management and close monitoring to improve treatment outcomes.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"11 1","pages":"108-118"},"PeriodicalIF":0.0,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cecoureterocele Presenting as a Urethral Mass in an Infant Female: A Rare Case Report.","authors":"Anant Kumar, Shahrukh Memon, Saurabh Raj, Rudrakshi Mahaldar, Vinod Kumar","doi":"10.1159/000551213","DOIUrl":"10.1159/000551213","url":null,"abstract":"<p><strong>Introduction: </strong>Cecoureterocele is an uncommon variant of ureterocele characterized by submucosal extension of the ureterocele beyond the bladder neck into the urethra. It is usually associated with duplex collecting systems and is more commonly encountered in pediatric female patients. Clinical manifestations range from asymptomatic hydronephrosis to a prolapsing urethral mass, often posing diagnostic dilemmas.</p><p><strong>Case presentation: </strong>We report the case of an 8-month-old female who presented with crying during micturition, a narrow urinary stream, and an intermittent prolapsing mass per urethra. Imaging demonstrated bilateral complete duplex collecting systems with left upper moiety gross hydronephrosis. DMSA scan revealed poor function of the left upper moiety. Cystoscopy identified a left ectopic ureteric orifice inferomedially to the native ureteric orifice with a ureterocele protruding into the urethra. Endoscopic decompression via transurethral incision using a Bugbee electrode resulted in immediate decompression. The infant had an uneventful postoperative recovery, with resolution of symptoms and reduced hydronephrosis at 6-month follow-up.</p><p><strong>Conclusion: </strong>Cecoureterocele, though rare, should be suspected in infants presenting with voiding dysfunction and a urethral mass. Early diagnosis with imaging and minimally invasive decompression via endoscopic incision offers excellent outcomes, preserves renal function, and reduces the need for open surgery.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"11 1","pages":"95-100"},"PeriodicalIF":0.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory and Cardiovascular Readmissions and Prescription Patterns after Spinal Cord Injury: A National Registry-Based Study from Sweden.","authors":"Charlotta Josefson, Katharina Stibrant Sunnerhagen","doi":"10.1159/000551316","DOIUrl":"10.1159/000551316","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal cord injury (SCI) is associated with increased risk of cardiovascular and respiratory morbidity, which are major contributors to rehospitalization and mortality. While overall rehospitalization after SCI is well documented, few studies have focused specifically on early cardiopulmonary readmissions or linked these outcomes with prescription patterns using nationwide registry data.</p><p><strong>Methods: </strong>We linked the Swedish SCI register (SveReh) to the National Patient Register and Prescribed Drug Register. Adults with new-onset SCI admitted for first-time inpatient rehabilitation between 2016 and 2020 were included (<i>n</i> = 1,196). The cohort was followed for 12 months after discharge. Outcomes were cardiovascular (ICD I) and respiratory (ICD J) readmissions. Kaplan-Meier and Cox regression analyses examined predictors (age, neurological level, and pre-SCI drug use). Prescription changes for cardiovascular drugs (ATC C), respiratory drugs (ATC R), and antibiotics (ATC J01) were analyzed 365 days before and after SCI using McNemar's test.</p><p><strong>Results: </strong>Within 12 months, 42 persons (3.5%) were readmitted for cardiovascular and 43 (3.6%) for respiratory causes; >96% remained event-free. Older age predicted both cardiovascular (HR: 1.02 per year, 95% confidence interval [CI]: 1.00-1.05, <i>p</i> = 0.050) and respiratory readmissions (HR: 1.02, 95% CI: 1.00-1.04, <i>p</i> = 0.024). Neurological level was also associated with respiratory readmission, with the highest risk in C1-C4 tetraplegia. Prescription analyses (<i>n</i> = 1,173) showed significant increases in antibiotics (+27.7%), cardiovascular drugs (+7.2%), and respiratory drugs (+3.4%).</p><p><strong>Conclusion: </strong>Cardiovascular and respiratory readmissions within 1 year after SCI were uncommon but strongly influenced by age, and for respiratory causes, by neurological level. Marked increases in antibiotic prescriptions highlight infection burden, while cardiovascular prescribing reflected age-related comorbidity. These findings identify subgroups who may benefit from targeted preventive follow-up.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"11 1","pages":"53-60"},"PeriodicalIF":0.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}