Frontiers in Medicine最新文献

{"title":"Future work self-salience and perceived professional benefits among nursing interns in China: the indirect roles of clinical belongingness and deep acting in a cross-sectional structural equation modeling study.","authors":"Ruoyu Du, Yamei Zhang, Qiuyue Cui, Ying Zhong, Man Zhang, Yuan Ge","doi":"10.3389/fmed.2026.1873837","DOIUrl":"10.3389/fmed.2026.1873837","url":null,"abstract":"<p><strong>Objective: </strong>This study examined whether future work self-salience was associated with perceived professional benefits among nursing interns and whether clinical belongingness and deep acting were involved as independent and serial mediators in this association.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted among 641 nursing interns recruited from six higher education institutions in Guangxi, China (March-April 2026). Measures included future work self-salience (4 items), clinical belongingness (17 items), deep acting (3 items), and perceived professional benefits (29 items). Descriptive statistics, univariate analyses, and correlation analyses were performed. A structural equation model was estimated and a bootstrap procedure with 5,000 resamples tested indirect associations while adjusting for demographic covariates.</p><p><strong>Results: </strong>All study variables were positively correlated (all <i>p</i> < 0.01). The chain mediation model demonstrated good fit (<i>χ</i> ²/df = 2.73, RMSEA = 0.05, GFI = 0.99, AGFI = 0.96, TLI = 0.96, CFI = 0.99, NFI = 0.98). Future work self-salience had a significant direct association with perceived professional benefits (<i>B</i> = 1.146, 95% CI: 0.891-1.401). Significant indirect associations were observed through clinical belongingness (<i>B</i> = 1.251, 95% CI: 0.963-1.553), through deep acting (<i>B</i> = 0.045, 95% CI: 0.005-0.107), and through the sequential pathway of clinical belongingness and deep acting (<i>B</i> = 0.039, 95% CI: 0.009-0.084). The total indirect association accounted for 53.81% of the total association.</p><p><strong>Conclusion: </strong>Future work self-salience was associated with higher perceived professional benefits among nursing interns, both directly and indirectly through clinical belongingness and deep acting. These findings are consistent with the hypothesized serial mediation model, although causal inferences cannot be made due to the cross-sectional design.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1873837"},"PeriodicalIF":3.6,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849815","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":"Visual cueing and adaptive learning for teaching thyroid eye disease diagnostic assessment to ophthalmology residents.","authors":"Jiajun Xie, Ji Shao, Changjun Wang, Xin Shi, Qi Miao, Chee Chew Yip, Juan Ye","doi":"10.3389/fmed.2026.1934529","DOIUrl":"10.3389/fmed.2026.1934529","url":null,"abstract":"<p><strong>Background: </strong>Thyroid eye disease (TED) diagnosis requires residents to interpret subtle clinical and imaging findings for activity and severity assessment. Guided by Cognitive Load Theory, visual cueing may support attention to diagnostically relevant features, whereas adaptive learning may tailor practice to learner performance. This pilot study compared visual cueing, adaptive learning, and traditional static case review for TED diagnostic training.</p><p><strong>Methods: </strong>Forty-five ophthalmology residents were randomised equally to static case review (SCR), an adaptive learning system (ALS), or a visual cueing atlas (VCA). Following a 45-minute intervention, residents completed immediate and two-week delayed tests. The primary outcome was immediate overall diagnostic accuracy. Secondary outcomes were Clinical Activity Score (CAS) accuracy, severity-grading accuracy, delayed-test performance (2 weeks post-intervention), and performance decline from immediate to delayed testing. Educational materials were validated by ten expert ophthalmologists. Item-level content validity indices and the scale-level content validity index were calculated from expert ratings.</p><p><strong>Results: </strong>All residents completed the study. Expert validation showed excellent content validity for the educational materials, with the Item-level Content Validity Index for all components and the overall Scale-level Content Validity Index both reaching 1.00. At the immediate post-test, VCA achieved higher CAS accuracy than SCR (84.7% vs. 64.7%, <i>p</i> < 0.001). ALS and VCA achieved higher severity-grading accuracy than SCR (83.3% and 78.7% vs. 66.7%; <i>p</i> = 0.004 and <i>p</i> = 0.025, respectively), and both achieved higher overall diagnostic accuracy than SCR (66.0% each vs. 51.3%; <i>p</i> = 0.014 and <i>p</i> = 0.008, respectively). At two weeks, ALS showed higher severity-grading accuracy than SCR (74.0% vs. 56.0%, <i>p</i> < 0.001), while both ALS and VCA maintained higher overall diagnostic accuracy than SCR (54.0% and 52.7% vs. 41.3%; <i>p</i> = 0.014 and <i>p</i> = 0.008, respectively).</p><p><strong>Conclusion: </strong>In this pilot study, visual cueing was associated with higher immediate CAS accuracy, whereas adaptive learning was associated with higher severity-grading accuracy on the two-week delayed test, relative to static case review. These approaches may have complementary roles in TED diagnostic education. Larger studies using equivalent instructional exposure, matched assessment forms, and longer follow-up are needed before a staged hybrid approach is recommended.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1934529"},"PeriodicalIF":3.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13509029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826776","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":"Efficacy and safety of traditional Chinese medicine herbal hand-foot bath combined with arnebia oil for chemotherapy-induced hand-foot syndrome refractory to standard treatment: a single-arm prospective interventional pilot study of 30 cases.","authors":"Ying Chen, Yuqi Jin, Linglin Fu, Ping Song, Ziyan Shao, Yinuo Tan","doi":"10.3389/fmed.2026.1900383","DOIUrl":"10.3389/fmed.2026.1900383","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chemotherapy-induced hand-foot syndrome (HFS) is a common dose-limiting cutaneous adverse reaction associated with cytotoxic agents such as capecitabine and small-molecule targeted drugs. Severe HFS may lead to dose reduction or interruption of antitumor treatment, significantly impairing patients' quality of life and treatment compliance. Current standard treatments (urea ointment, vitamin B6, topical corticosteroids, etc.) show limited efficacy for some patients with moderate-to-severe HFS, creating an urgent clinical need for additional supportive interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a single-arm prospective interventional pilot study. It enrolled 30 consecutive patients with solid tumors who received capecitabine-based antitumor therapy or oral targeted therapy, developed HFS ≥ grade 1, and were refractory to standard treatment between November 1, 2025 and April 2026 at the Department of Medical Oncology, The Second Affiliated Hospital of Zhejiang University School of Medicine. All patients received a prespecified combined regimen consisting of self-formulated Yiqi Huoxue Tongluo herbal bath and external arnebia oil. Source-record review showed that the external treatment was initiated during the antitumor drug administration period; for patients receiving capecitabine, treatment generally began on cycle day 2-3 rather than during a scheduled rest period. The primary endpoint was the observed response rate, defined as a reduction in HFS grade by ≥1 grade. Secondary endpoints included complete remission rate, time to improvement, proportion of patients maintaining the original capecitabine dose, two-cycle follow-up recurrence/worsening, and safety. Missing efficacy data were described without imputation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Thirty patients were enrolled, with a mean age of 59.0±12.4 years and 60.0% male. Baseline HFS grade was grade 1 in 2 patients (6.7%), grade 2 in 24 (80.0%), and grade 3 in 4 (13.3%). Twenty-eight patients had complete efficacy evaluation. The observed overall response rate was 85.7% (24/28), complete remission rate was 7.1% (2/28), and the mean reduction in HFS grade was 0.9. The median time to improvement was 7 days (range 3-28 days). In total, 82.1% (23/28) of evaluable patients maintained the original antitumor regimen without capecitabine dose reduction. During two subsequent treatment cycles of follow-up, no recurrence or worsening of HFS was documented; four patients discontinued capecitabine because of disease change, and 25 patients continued the original capecitabine dose. No severe adverse events related to the combined external regimen were observed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Yiqi Huoxue Tongluo herbal bath combined with external arnebia oil showed preliminary signals of effectiveness and favorable safety in chemotherapy-induced HFS refractory to standard treatment. Because this single-arm pilot study lacked a concurrent control group, caus","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1900383"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891362","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":"Clinical characteristics and factors associated with in-hospital mortality in patients with <i>Stenotrophomonas maltophilia</i> infection: a single-center retrospective cohort study.","authors":"Hanli Wang, Min Xing, Haoyu Ji, Yusheng Cheng, Shuhui Hu, Guofeng Wang, Susheng Zhou, Yonghui Han, Bohan Zhang, Lei Zha, Qinghai You","doi":"10.3389/fmed.2026.1902452","DOIUrl":"https://doi.org/10.3389/fmed.2026.1902452","url":null,"abstract":"<p><strong>Background: </strong><i>Stenotrophomonas maltophilia</i> is an intrinsically multidrug-resistant opportunistic pathogen that causes clinically significant infections, particularly in immunocompromised and critically ill patients. The independent contributions of prior antimicrobial exposure and early active therapy to mortality remain uncertain. This study evaluated clinical characteristics, antimicrobial exposure patterns, empirical treatment appropriateness, and mortality-associated factors in patients with clinically confirmed <i>S. maltophilia</i> infection.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included 458 hospitalized patients with confirmed <i>S. maltophilia</i> infection at a tertiary hospital between 1st June 2023 to 31st July 2025. Demographic characteristics, comorbidities, infection-related variables, prior antimicrobial exposure, empirical treatment regimens, laboratory indicators, antimicrobial susceptibility results, and in-hospital outcomes were extracted from electronic medical records. Univariable and multivariable logistic regression analyses were performed to identify factors associated with all-cause in-hospital mortality, with particular attention to prior carbapenem exposure and the appropriateness of initial empirical antimicrobial therapy.</p><p><strong>Results: </strong>Overall in-hospital mortality was 11.8% (54/458). Compared with survivors, non-survivors were older, had a higher Charlson Comorbidity Index (CCI), and more frequently presented with severe clinical features, including septic shock, mechanical ventilation, central venous catheterization, and elevated inflammatory markers. In the multivariable model, older age and higher CCI remained independently associated with mortality, whereas mechanical ventilation showed a strong but statistically non-significant association. Prior carbapenem exposure was common, but mortality was comparable between carbapenem-exposed and unexposed patients. The appropriateness of initial empirical antimicrobial therapy was not independently associated with survival after adjustment for baseline and severity-related factors. Antimicrobial susceptibility testing showed high <i>in vitro</i> activity for minocycline, cefoperazone/sulbactam, doxycycline, and tigecycline.</p><p><strong>Conclusions: </strong>In this cohort of patients with <i>S. maltophilia</i> infection, mortality was associated primarily with host vulnerability and illness severity rather than prior carbapenem exposure or empirical treatment appropriateness alone. Prior carbapenem use may reflect underlying disease complexity rather than act as an independent driver of mortality. These findings suggest that clinical management should emphasize early risk stratification, careful assessment of comorbidity burden, timely supportive care, and antimicrobial selection guided by local susceptibility patterns.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1902452"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896764","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":"Pulmonary neuroendocrine cells in pediatric asthma and bronchopulmonary dysplasia: neuroimmune-developmental mechanisms and translational implications.","authors":"Jianfeng Jiang, Zhiyuan Zhao, Chen Huang, Haizhen Ding","doi":"10.3389/fmed.2026.1898900","DOIUrl":"https://doi.org/10.3389/fmed.2026.1898900","url":null,"abstract":"<p><p>Pediatric asthma, bronchopulmonary dysplasia (BPD), and viral-induced wheeze arise from distinct clinical settings, but all occur in the context of a maturing pediatric lung, where epithelial injury, inflammation, neural inputs, and repair or remodeling programs are closely interconnected. This intersection between pediatric lung maturation and inflammatory injury provides a rationale for focusing on pulmonary neuroendocrine cells (PNECs), developmentally enriched airway epithelial sensor cells that translate environmental and injury-related cues into local neuroimmune, repair, and remodeling responses. In pediatric asthma, PNEC-derived calcitonin gene-related peptide (CGRP) has been implicated in ILC2-associated type 2 inflammation, although CGRP-ILC2 signaling appears context-dependent and should be interpreted alongside epithelial alarmins such as IL-33, IL-25, and TSLP. PNEC-derived γ-aminobutyric acid (GABA) further links neuroendocrine signaling to IL-13-associated mucus remodeling and goblet cell responses. In neonatal lung injury and BPD, gastrin-releasing peptide and bombesin-like peptides have been linked to oxygen-associated stress, inflammatory remodeling, and impaired alveolar or vascular development; recent biomarker studies extend the relevance of this pathway to contemporary preterm lung disease and motivate further mechanistic investigation. Viral-induced wheeze is discussed as a related extension of epithelial alarmin-neuroimmune crosstalk. Overall, this review positions PNECs as cellular nodes linking pediatric lung maturation, environmental sensing, neuroimmune regulation, and epithelial repair or remodeling, with implications for mechanistic phenotyping, biomarker exploration, disease stratification, and future human-centered studies in pediatric respiratory disease.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1898900"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896851","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":"Balanced crystalloid versus saline for resuscitation in adult sepsis: a systematic review and meta-analysis.","authors":"Lipeng Liu, Binrong Cai, Bin He","doi":"10.3389/fmed.2026.1906761","DOIUrl":"https://doi.org/10.3389/fmed.2026.1906761","url":null,"abstract":"<p><strong>Background: </strong>Fluid resuscitation is the cornerstone of sepsis management, however, the choice between balanced crystalloid solutions and normal saline remains debated. This meta-analysis aimed to compare the efficacy of balanced solutions versus saline for fluid resuscitation in adult patients with sepsis.</p><p><strong>Methods: </strong>A systematic literature search was performed in PubMed, Embase, Scopus, and other relevant sources. Retrieved studies were rigorously screened according to predefined inclusion and exclusion criteria. Data from the included studies were extracted for analysis. The primary outcome was defined as mortality rate. Secondary outcomes included acute kidney injury (AKI), hyperchloremia, renal replacement therapy (RRT), ICU-free days, ventilator-free days, vasopressor-free days. The study protocol was registered with PROSPERO (CRD420261368142).</p><p><strong>Results: </strong>A total of eight studies (8,173 patients; 4,056 assigned to balanced solutions, 4,117 to saline) met the inclusion criteria. In the primary analysis restricted to seven randomized controlled trials, balanced solutions were associated with significantly lower mortality than saline (RR 0.92; 95% CI 0.86-0.98; <i>P</i> = 0.01; I² = 37%), and a sensitivity analysis incorporating a <i>post-hoc</i> observational study yielded consistent results (RR 0.91; 95% CI 0.85-0.97). Balanced solutions were also associated with lower incidences of AKI (RR 0.86; 95% CI 0.78-0.96; <i>P</i> = 0.004), hyperchloremia (RR 0.68; 95% CI 0.52-0.90; <i>P</i> = 0.007), and RRT requirement (RR 0.74; 95% CI 0.56-1.00; <i>P</i> = 0.05), and with a greater number of ICU-free, ventilator-free, and vasopressor-free days (all <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>In adult patients with sepsis, treatment with balanced crystalloid solutions for fluid resuscitation significantly reduces mortality (moderate certainty), decreases kidney-related adverse events, and better maintains electrolyte balance, thereby improving patient outcomes. These findings support the preferential use of balanced crystalloids over saline in this population.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420261368142, identifier CRD420261368142.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1906761"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897218","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":"Development and validation of a nomogram for early prediction of sepsis-associated liver injury: a multicenter study.","authors":"Ruimin Tan, Shuwei Zhang, Quansheng Du, Jingmei Wang, Donglin Fu, Yunxing Cao","doi":"10.3389/fmed.2026.1899424","DOIUrl":"https://doi.org/10.3389/fmed.2026.1899424","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sepsis-associated liver injury (SALI) is an important manifestation of sepsis-associated organ dysfunction and is associated with adverse clinical outcomes. However, practical tools for estimating the risk of subsequent SALI in critically ill patients with sepsis remain limited. This study aimed to develop and geographically validate a nomogram based on routinely available clinical variables using multicenter retrospective data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Sepsis patients admitted to the ICUs of Hebei General Hospital and Handan Central Hospital, East District, between March 1, 2021, and June 1, 2024, were retrospectively enrolled. A total of 847 eligible patients from these two centers constituted the model development and internal validation cohort and were randomly divided into a training cohort and a testing cohort at a 6:4 ratio. An independent cohort of 424 sepsis patients admitted to the ICU of Chongqing General Hospital between March 1, 2021, and January 1, 2026, was included for external geographic validation. Demographic characteristics, comorbidities, laboratory parameters, and clinical interventions were collected. Candidate predictors were initially screened using univariable analysis and least absolute shrinkage and selection operator (LASSO) regression, followed by multivariable logistic regression to derive the final prediction model for subsequent in-hospital SALI. A nomogram was constructed using the rms package. Model discrimination was assessed using receiver operating characteristic (ROC) curves and the area under the curve (AUC), calibration was evaluated using calibration plots and quantitative calibration metrics, and potential decision-analytic value was assessed using decision curve analysis (DCA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1,271 patients with sepsis from three centers were included in the final analysis. The development and internal validation cohort comprised 847 patients, of whom 352 developed SALI (41.6%), and was randomly divided into a training cohort of 508 patients and a testing cohort of 339 patients. The independent external geographic validation cohort comprised 424 patients, of whom 183 patients developed SALI (43.2%). After feature selection and multivariable analysis, age, direct bilirubin, aspartate aminotransferase, prothrombin time-international normalized ratio, and vasoactive-drug use were retained as predictors associated with subsequent in-hospital SALI. The nomogram demonstrated favorable discrimination, with AUCs of 0.925 (95% CI, 0.901-0.948), 0.918 (95% CI, 0.888-0.948), and 0.884 (95% CI, 0.849-0.918) in the training, testing, and external geographic validation cohorts, respectively. Calibration was close to the ideal values in the training cohort but deteriorated in the testing and external geographic validation cohorts, particularly in the external cohort, in which the calibration-in-the-large was 0.945 and the calibration slope was 0.600. D","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1899424"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896767","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":"Challenges in managing ruptured ectopic pregnancy complicated by hemorrhagic shock in an Ebola treatment unit in DR Congo: first reported case.","authors":"Prince Imani-Musimwa, Emilie Grant, Daniel Mukadi-Bamuleka, Rigo Fraterne-Muhayangabo, Alfred Ombeni-Musimwa, Zacharie Tsongo-Kibendelwa, Olivier Nyakio-Ngeleza, Richard Kitenge-Omasumbu, Théophile Barhwamire-Kabesha, Dieudonné Sengey-Mushengezi-Amani, Placide Mbala-Kingebeni, Richard Bitwe-Mihanda, Juakali Sihali-Kyolov, Mija Ververs","doi":"10.3389/fmed.2026.1848720","DOIUrl":"https://doi.org/10.3389/fmed.2026.1848720","url":null,"abstract":"<p><strong>Background: </strong>Ectopic pregnancy (EP) is an obstetric emergency; early diagnosis is critical for maternal survival. In resource-limited settings, such as Ebola treatment units (ETU), delayed diagnosis or management of EP often leads to rupture and life-threatening hemorrhagic shock.</p><p><strong>Case presentation: </strong>We report the case of a pregnant woman in her 30s who was admitted to the ETU with suspected Ebola virus disease in the Democratic Republic of Congo (DRC). Her clinical presentation included fever and abdominal pain, which began 4 days before her admission. Thirteen months earlier, she had recovered from an Ebola infection. At admission, she presented with 8 weeks of amenorrhea and discrete pelvic pain. On vaginal examination, we noted a slightly enlarged uterus and palpated a small left adnexal mass. Laboratory exams confirmed malaria and pregnancy. Her EVD test was negative. Due to the absence of an ultrasound machine in the ETU, pelvic ultrasound was impossible. Supportive treatment was initiated. Nineteen hours after admission, the patient developed an acute surgical abdomen, with progressive left-sided pelvic pain, abdominal distension, and diffuse tenderness. A ruptured ectopic pregnancy was suspected and confirmed by diagnostic abdominal puncture, which revealed hemoperitoneum. She developed hemorrhagic shock. However, the ETU lacked an operating room, surgical equipment, and anesthetic drugs. Transfer to another ETU was not feasible due to the absence of a surgical-capable facility, while transfer to a community facility required at least a second negative EVD test 48 h after the first. We used an unused building that was part of the neighboring health center to perform an explorative laparotomy, which revealed an EP in the left tube with ampullary dislocation and active bleeding. We performed a left salpingectomy and homeostatic sutures. The real-time polymerase chain reaction (RT-PCR) tests for EVD performed at 48 and 72 h were negative. She had a normal postoperative course and was discharged from ETU to the community on the 14th day after surgery.</p><p><strong>Conclusion: </strong>Ruptured ectopic pregnancy (REP) remains a life-threatening obstetric emergency that may occur in ETUs, where resources and treatment conditions are limited. To protect maternal health, ETUs should ensure not only proper care for Ebola infection but also adequate capacity for the timely diagnosis and management of obstetric complications.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1848720"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896808","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":"Number of natural teeth and intrinsic capacity among hospitalized older adults in China: a cross-sectional study on the role of social support.","authors":"Xiaoming Zhang, Xinjuan Wu","doi":"10.3389/fmed.2026.1848888","DOIUrl":"https://doi.org/10.3389/fmed.2026.1848888","url":null,"abstract":"<p><strong>Background: </strong>Tooth loss is common in older adults and has been associated with adverse health outcomes, but its relationship with intrinsic capacity (IC), a multidimensional indicator of healthy aging, remains insufficiently understood. Whether social support is involved in this association is also unclear.</p><p><strong>Methods: </strong>This cross-sectional study included 421 hospitalized adults aged 60 years or older who were recruited from Peking Union Medical College Hospital, Beijing, between February and May 2022. The number of natural teeth was assessed by direct visual inspection of the oral cavity by a trained nurse during routine admission assessment. IC was evaluated using six components derived from five World Health Organization domains: locomotion, cognition, vitality, psychological function, hearing, and vision. Participants with impairment in at least one component (IC score ≤ 5 of 6) were classified as having declined IC. Social support was measured using the Multidimensional Scale of Perceived Social Support. Multivariable logistic regression was used to examine the association between natural-tooth count and declined IC. Exploratory structural equation modeling (SEM) was used to assess an indirect statistical pathway involving social support.</p><p><strong>Results: </strong>Among 421 participants (mean age, 71.5 ± 6.3 years; 60.6% male), 66.98% had declined IC. Compared with participants with ≥20 natural teeth, those with < 20 natural teeth had higher odds of declined IC after adjustment for sociodemographic, clinical, and behavioral factors and Charlson Comorbidity Index (OR = 3.11, 95% CI: 1.82-5.32, <i>P</i> < 0.001). When natural-tooth count was modeled continuously, each additional tooth was associated with lower odds of declined IC (OR = 0.96, 95% CI: 0.93-0.98, <i>P</i> = 0.001). In exploratory SEM using the 0-6 IC score, a significant indirect association through social support was observed (β = 0.009, 95% CI: 0.005-0.014, <i>P</i> < 0.001), accounting descriptively for 41.8% of the total statistical association.</p><p><strong>Conclusions: </strong>Fewer natural teeth were associated with declined IC among hospitalized older adults. Social support may be involved in this association, but the cross-sectional design precludes causal interpretation. These findings support incorporating oral health assessment into geriatric care and warrant longitudinal studies to clarify temporal pathways.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1848888"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896846","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":"Correction: Hypertensive disorders in pregnancy and risk of asthma in the offspring: a systematic review and meta-analysis.","authors":"Nancy D Calzada, Carlos A Barba, Carlos Quispe-Vicuña, Raul H Sandoval-Ato, Christian A Rodriguez-Saldaña, Judith Yangali-Vicente, Oriana Rivera-Lozada, Joshuan J Barboza","doi":"10.3389/fmed.2026.1961705","DOIUrl":"https://doi.org/10.3389/fmed.2026.1961705","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fmed.2026.1739697.].</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1961705"},"PeriodicalIF":3.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896756","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}