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{"title":"The role of astrocytes in ischemic stroke: A bibliometric analysis (2015-2025).","authors":"ZiYan Lin, You Zhang, MinZhi Li, BaiZhi Lin, Huan Liang, LiZhen Yi, Si Yuan, Zenghui Yue","doi":"10.1097/MD.0000000000051006","DOIUrl":"10.1097/MD.0000000000051006","url":null,"abstract":"<p><strong>Background: </strong>Astrocytes, the most abundant glial cells in the central nervous system, play essential roles in maintaining neuronal homeostasis, regulating neurovascular function, and modulating inflammatory responses after ischemic stroke. Although increasing evidence indicates that astrocytes contribute to both neuroprotection and injury progression, the global research landscape and emerging trends in astrocyte-related ischemic stroke research remain unclear. This study aimed to systematically characterize the development, hotspots, and future directions of this field using bibliometric analysis.</p><p><strong>Methods: </strong>Publications related to astrocytes and ischemic stroke were retrieved from the Web of Science Core Collection database between January 1, 2015 and July 1, 2026. A total of 2690 publications were included for analysis. VOSviewer, CiteSpace, and the R package bibliometrix were used to evaluate publication trends, international and institutional collaborations, journal and author contributions, co-citation networks, keyword co-occurrence, and emerging research themes.</p><p><strong>Results: </strong>The annual publication output showed a continuous increasing trend, indicating growing interest in astrocyte-related ischemic stroke research. A total of 72 countries/regions contributed to this field, with China (1372 publications, 34.73%) and the United States (461 publications, 20.49%) being the leading contributors. Shanghai Jiao Tong University was the most productive institution (149 publications). The most active journals included International Journal of Molecular Sciences, Molecular Neurobiology, and Journal of Neuroinflammation, while Stroke, Journal of Cerebral Blood Flow & Metabolism, and Journal of Neuroscience showed strong co-citation influence. Citation and keyword analyses revealed that major research themes focused on astrocyte activation, oxidative stress, neuroprotection, blood-brain barrier regulation, neurovascular interactions, microglia-associated inflammation, energy metabolism, NLRP3 inflammasome, pyroptosis, epigenetic regulation, and endoplasmic reticulum stress.</p><p><strong>Conclusion: </strong>This bibliometric analysis provides a comprehensive overview of global research trends in astrocyte-related ischemic stroke. The field has evolved from investigating general astrocytic responses toward exploring molecular mechanisms, cellular interactions, and targeted regulatory strategies. Future studies should further elucidate astrocyte heterogeneity, metabolic and inflammatory regulation, and neurovascular unit interactions to facilitate the development of astrocyte-targeted therapeutic approaches.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 43","pages":"e51006"},"PeriodicalIF":2.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149270380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of sexual mindfulness in enhancing sexual well-being among breast cancer survivors: A randomized clinical trial.","authors":"Asefeh Shirdashtzadeh Kerdabadi, Zeinab Tavakol, Fereshteh Rasti Borujeni, Hadi Raeisi Shahraki, Zahra Davoodi","doi":"10.1097/MD.0000000000051237","DOIUrl":"10.1097/MD.0000000000051237","url":null,"abstract":"<p><strong>Background: </strong>Patients with a wide range of sexual disorders are vulnerable to negative sexual well-being due to complications from breast cancer treatment. This study aimed to investigate the impact of sexual mindfulness-based training on the sexual well-being of women with breast cancer.</p><p><strong>Methods: </strong>This randomized clinical trial was conducted in 2024 and involved a statistical population of women with breast cancer who had consulted comprehensive health service centers in Shahrekord, Iran. Among the referring women, 36 people were selected by convenience sampling. To investigate depression in the participants, the short-form Beck Depression Questionnaire was used, and 4 patients were excluded from the study due to severe depression. Then, the participants were randomly assigned to 2 study groups of 16 patients.Sexual mindfulness training was conducted in 8 sessions (90 minutes, once a week) for the intervention group at the reproductive and sexual health clinic in Shahrekord. Meanwhile, the control group was not subjected to planned intervention or training. A sexual well-being questionnaire was used to collect data for repeated measures analysis. Both groups were asked to complete the sexual well-being questionnaire before, immediately after, and 3 months after the intervention. Data were analyzed through independent samples T-test, analysis of covariance, and repeated measures analysis.</p><p><strong>Results: </strong>The findings showed that there was no significant difference in sexual well-being between the intervention and control groups before the intervention (P = .29). Immediately after the intervention, sexual well-being significantly increased in the intervention group, from 39.33 ± 25.56 to 56.17 ± 22.29 (P < .001); however, the corresponding between-group comparison was not statistically significant (P = .11). Three months after the intervention, sexual well-being was significantly higher in the intervention group (66.42 ± 13.79) than in the control group (51.92 ± 20.62; P < .001).</p><p><strong>Conclusion: </strong>Sexual Mindfulness can be considered a therapeutic method in palliative care to improve sexual well-being in breast cancer patients.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 43","pages":"e51237"},"PeriodicalIF":2.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149270431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pan-immune-inflammation value and sleep disturbances in rheumatoid arthritis: A population-based NHANES study.","authors":"Yuting Xiao, Jiayou Zhang, Shaoling Han, Lijuan Chen, Junhui Liu, Jing Wu, Jing Su","doi":"10.1097/MD.0000000000051348","DOIUrl":"10.1097/MD.0000000000051348","url":null,"abstract":"<p><p>The present study sought to assess the individual and synergistic effects of pan-immunoinflammatory value (PIV) and trouble sleeping on rheumatoid arthritis (RA). We used data from the National Health and Nutrition Examination Survey from 2005 to 2020. PIV was computed as: (neutrophil count × platelet count × monocyte count) /lymphocyte count. Trouble sleeping was assessed using a single self-reported question (National Health and Nutrition Examination Survey item SLQ050), while RA case ascertainment relied on self-reported diagnosis by a physician. The associations between PIV and sleep-related RA susceptibility were interrogated through multivariable logistic regression models, with restricted cubic splines deployed to unmask potential nonlinear relationships. Effect modification was further evaluated via stratified analyses across demographic and clinical subgroups. The analytical cohort comprised 27,398 participants (2032 RA cases). In fully adjusted models, elevated PIV demonstrated a 14.9% increased RA risk in the highest versus lowest PIV quartile (Q4 vs Q1) (OR = 1.149, 95% CI:1.007-1.312), while trouble sleeping independently conferred 59.8% higher odds (OR = 1.598, 95% CI:1.449-1.761). Interaction analysis revealed that the association between PIV and RA was modulated by trouble sleeping. This study explores the association between elevated PIV, trouble sleeping, and RA. However, due to the cross-sectional nature of the data, causality cannot be inferred. The findings suggest a correlation between PIV and trouble sleeping with RA risk, but further longitudinal studies are required to establish causal relationships.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 43","pages":"e51348"},"PeriodicalIF":2.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149270454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is intra-articular injection of high-concentration ozone (O2-O3) more effective in treating knee osteoarthritis?: A multicenter cohort study.","authors":"Ridvan Isik, Burak Yildiz, Sena Unver, Savas Sencan, Serdar Kokar, Osman Hakan Gunduz, Emre Uzun, Kemal Nas","doi":"10.1097/MD.0000000000051297","DOIUrl":"10.1097/MD.0000000000051297","url":null,"abstract":"<p><p>Knee osteoarthritis is a prevalent joint disorder globally, resulting in pain and disability, with various treatment options available. Intra-articular ozone (O2-O3) administrations are an efficient therapeutic approach commonly employed in this condition. With this study, we aimed to compare the effect of varying ozone concentrations on treatment outcomes. This multicenter retrospective cohort study was conducted at 2 distinct university hospitals between May 2023 and September 2024. Medical records of patients who underwent intra-articular knee ozone injections were retrospectively reviewed and divided into 2 groups as 15 μg/mL (group A) and 25 μg/mL ozone (group B). Participants' pain scores were measured by Numeric Rating Scale, functional status by Western Ontario and McMaster Universities Osteoarthritis Index and quality of life by 12-item Short Form Health Survey before and at 1 and 3 months following ozone therapy. A total of 190 patients were screened; 159 patients (105 females, 54 males) were included in the study, with 77 patients in group A and 82 patients in group B. Both groups demonstrated significant improvements in all outcomes during follow-up. After adjustment for multiple comparisons, between-group differences in Numeric Rating Scale scores were not statistically significant at either 1 or 3 months. Group B had significantly better Western Ontario and McMaster Universities Osteoarthritis Index, 12-item Short Form Health Survey physical component summary, and 12-item Short Form Health Survey mental component summary scores at both follow-up assessments (all Holm-adjusted P < .001). The 25 μg/mL concentration was associated with more favorable short-term functional and quality-of-life outcomes and a trend toward greater pain improvement. These findings should be considered exploratory and require confirmation in prospective randomized studies.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 43","pages":"e51297"},"PeriodicalIF":2.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149270294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of regional disparities in access to rehabilitation services on mortality among stroke patients: A Korean nationwide population-based retrospective cohort study.","authors":"Dong-Yup Yoo, Chang-Yoon Baek, Jung-Kyu Choi","doi":"10.1097/MD.0000000000051192","DOIUrl":"10.1097/MD.0000000000051192","url":null,"abstract":"<p><p>This study aimed to analyze physical therapy (PT) and occupational therapy (OT) claims data to determine whether access barriers to rehabilitation services due to regional factors affect PT and OT accessibility. Furthermore, we investigated the mortality rate of stroke patients by region in South Korea using the National Health Insurance Service-National Sample Cohort database. This is a register-based, retrospective cohort study. Using data from the National Health Insurance Service database, we included patients who were newly diagnosed with stroke between 2005 and 2017. Of the 19,067 patients diagnosed with stroke, 2263 who died within 6 months were excluded. The final sample included 16,804 patients (51.3% men and 48.7% women). Residential regions were categorized into Capital, Capital area, Metropolitan, and Rural area. After adjusting for covariates, a logistic regression model was used to analyze the accessibility of rehabilitation services by residential region. The Kaplan-Meier method was employed to compare the survival rates of rehabilitation patients across different residential regions. A Cox proportional hazards model was used to estimate the independent contribution of each factor to mortality risk (hazard ratios [HRs] and 95% confidence interval [CIs]). Significant differences in mortality were observed according to sociodemographic factors and Charlson Comorbidity Index scores. Accessibility in Capital area and Metropolitan cities was comparable to the Capital. However, patients living in a rural area had significantly lower access to rehabilitation compared to those in the Capital (PT: OR = 0.889, 95% CIs: 0.809-0.987, P = .029; OT: OR = 0.802, 95% CIs: 0.726-0.886, P = .001). Notably, among those receiving inpatient rehabilitation, rural area residency was associated with a higher risk of death compared to the Capital (HRs = 1.288; 95% CIs, 1.015-1.635; P = .037). In contrast, no significant disparity was found in the outpatient group (HRs = 1.011; 95% CIs, 0.917-1.115; P = .820). Stroke patients living in rural area were less likely to receive rehabilitation services than those in the capital. This regional disparity in access, particularly in inpatient rehabilitation, is associated with an increased risk of long-term mortality after stroke. These findings suggest that improving inpatient rehabilitation infrastructure in rural area is critical to reducing survival gaps.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 43","pages":"e51192"},"PeriodicalIF":2.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149270335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline peak expiratory flow and incident hip fracture in older Chinese adults: A prospective CHARLS cohort study.","authors":"Wei Chen, Zongfeng Chen, Yan Wang, Wanfei Wu, Yufeng Zhao, Jun Fei","doi":"10.1097/MD.0000000000051167","DOIUrl":"10.1097/MD.0000000000051167","url":null,"abstract":"<p><p>Peak expiratory flow (PEF), a simple measure of respiratory function, may be linked to skeletal health through shared pathways related to physiological reserve and functional capacity. However, the long-term association between PEF and incident hip fracture in community-dwelling older adults remains unclear. We conducted a longitudinal analysis of participants aged ≥60 years from the China Health and Retirement Longitudinal Study, using 2013 as baseline and follow-up waves in 2015, 2018, and 2020 (up to ~7 years). Baseline PEF was defined as the maximum of 3 attempts, and incident hip fracture was identified as self-reported hip fracture first reported during follow-up. Associations were evaluated using Cox proportional hazards models stratified by self-rated health, with multiple imputation for missing covariates. PEF was modeled per 1-standard deviation increase and by quartiles. A prespecified conceptual framework distinguished likely confounders from potentially pathway-related variables. Supplementary discrimination analyses used C-index and time-dependent area under the receiver operating characteristic curve. Among 5789 participants, incident hip fractures occurred in 98 (6.5%), 76 (5.1%), 51 (3.7%), and 46 (3.2%) individuals from the lowest to highest PEF quartile (P < .001). Per 1-standard deviation higher PEF, hazard ratios were 0.70 (95% CI: 0.62-0.80) in the crude model, 0.79 (0.68-0.91) in the primary confounder-adjusted model, and 0.87 (0.74-1.02) in the broader model. For quartiles, Q4 versus Q1 hazard ratios were 0.46 (0.32-0.65), 0.63 (0.43-0.93), and 0.80 (0.53-1.20), respectively. Restricted cubic splines showed no evidence of nonlinearity (P = .866). Supplementary discrimination analyses showed higher C-index and time-dependent area under the receiver operating characteristic curves for the broader model than for the unadjusted and primary confounder-adjusted models. Higher baseline PEF was associated with lower incident hip fracture risk in crude and partially adjusted analyses, but the association was attenuated after broader adjustment. Baseline PEF appears to have limited stand-alone prognostic value and may be better viewed as a pragmatic signal prompting broader geriatric assessment rather than as a stand-alone fracture risk tool.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 43","pages":"e51167"},"PeriodicalIF":2.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149270219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inspiratory muscle strength and skeletal muscle mass are associated with postoperative functional exercise capacity after lung cancer surgery: A retrospective cohort study.","authors":"Hanee Rim, Soo Ho Lee, Joon-Sung Kim, Bo Young Hong, Yeun Jie Yoo, Sun Im, Mi-Jeong Yoon","doi":"10.1097/MD.0000000000051190","DOIUrl":"10.1097/MD.0000000000051190","url":null,"abstract":"<p><p>Although surgical resection is the cornerstone of curative treatment for early-stage lung cancer, patients often experience postoperative declines in physical fitness and skeletal muscle mass, resulting in reduced exercise capacity, which is associated with prognosis. This study aimed to identify clinical factors associated with postoperative functional exercise capacity, as measured by the incremental shuttle walk test, in patients undergoing lung cancer surgery. This retrospective study included 62 subjects (mean age, 67 ± 8.7 years; 24 women and 38 men) who underwent lung cancer surgery and completed a postoperative assessment at 3 months. Functional exercise capacity was assessed using the incremental shuttle walking distance (ISWD) as the primary outcome. Correlation and regression analyses were conducted to examine the associations between ISWD and concurrent measures of forced expiratory volume in 1 second, forced vital capacity, maximal inspiratory pressure (MIP), maximal expiratory pressure, and skeletal muscle index (SMI). At 3 months postoperatively, ISWD was negatively correlated with age (r = -0.354, P = .005) and positively correlated with SMI (r = 0.253, P = .048) and predicted MIP (%; r = 0.293, P = .02), whereas other pulmonary function parameters were not significantly associated with ISWD. In regression models adjusted for 1-month ISWD, age, and sex, both predicted MIP (%; β = 0.290, P = .03; ΔR2 = 0.079) and SMI (β = 0.340, P = .03; ΔR2 = 0.075) were independently associated with 3-month ISWD. Subjects with low SMI demonstrated significantly lower 3-month ISWD than those with normal SMI (P = .02). Skeletal muscle mass and inspiratory muscle strength were associated with functional exercise capacity assessed using the incremental shuttle walk test at 3 months after lung cancer surgery. These findings suggest that assessment of muscle-related factors may improve the evaluation of postoperative functional recovery and help identify potential targets for rehabilitation.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 43","pages":"e51190"},"PeriodicalIF":2.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149270269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological analysis of tooth and gingival procedures in England and Wales: An ecological study.","authors":"Abdullah S Bin Rahmah, Abdallah Y Naser, Mohammed I Alsaif","doi":"10.1097/MD.0000000000051312","DOIUrl":"10.1097/MD.0000000000051312","url":null,"abstract":"<p><p>Oral health affects a person's general health and tooth decay leads to pain that affects the whole body. There are limited studies that examined oral procedures globally and specifically in the United Kingdom. Therefore, the aim of this study was to analyze tooth and gingiva procedure patterns across England and Wales in the past decade. In this ecological study, we utilized the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. F08-F20 code data were used to extract relevant data. A 37.8% decline in the tooth and gingiva procedure rate, from 404.10 (95% confidence interval [CI]: 402.46-405.73) in 2014 to 251.33 (95% CI: 250.08-252.59) in 2023 per 1,00,000 persons per year, was observed during the study period. The most frequently performed tooth and gingiva procedures were \"surgical removal of tooth\" and \"simple extraction of tooth,\" representing 47.0% and 39.1% of episodes, respectively. Females accounted for 55.0% of these episodes (9,22,485 procedures), an average of 1,02,498 procedures annually. The rate of tooth and gingiva procedures decreased by 39.0% among females (from 439.31 [95% CI: 436.92-441.70] in 2014 to 267.97 [95% CI: 266.15-269.79] in 2023 per 1,00,000 persons per year) and by 36.4% among males (from 367.47 [95% CI: 365.25-369.69] in 2014 to 233.85 [95% CI: 232.11-235.58] in 2023 per 1,00,000 persons per year). The 15 to 59 age group accounted for most tooth and gingiva procedure episodes (59.3%), followed by the below-15 age group with 27.9%. Tooth and gingiva procedure trends were declining in the past decade in England and Wales. Factors such as the impact of the COVID-19 pandemic and demographic inequalities in access to these services could have contributed to these declines. Furthermore, there were distinctions in tooth and gingiva procedure trends, where females had higher rates than males for 8 of 12 procedure types, and children under 15 years had the highest rates for 7 of 12 procedure types, while the 15 to 59 age group accounted for the largest share of episodes.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 43","pages":"e51312"},"PeriodicalIF":2.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149270303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Executive dysfunction in COPD: prevalence and clinical correlates of cognitive impairment: A cross-sectional case-control study.","authors":"Hüsniye Aylin Dikbaş, Ruhsel Cörüt, Ali Muhtaroğlu","doi":"10.1097/MD.0000000000051215","DOIUrl":"10.1097/MD.0000000000051215","url":null,"abstract":"<p><p>Cognitive impairment in chronic obstructive pulmonary disease (COPD) is increasingly recognized, but its clinical correlates remain unclear. This study aimed to assess the prevalence of mild cognitive impairment and dementia in COPD and identify associated clinical factors. In this cross-sectional case-control study, 86 patients with COPD and 61 age- and sex-matched controls aged ≥60 years were evaluated. Cognitive status was assessed using the Mini-Mental State Examination, Montreal Cognitive Assessment, and domain-specific cognitive tests, including the Stroop test. Clinical variables, including spirometric measures, resting oxygen saturation, dyspnea severity, and C-reactive protein, were recorded. Multivariable analysis was performed to evaluate factors associated with Stroop word-reading time. The overall distribution of cognitive status did not differ significantly between groups (P = .228). Mild cognitive impairment was numerically more frequent in the COPD group than in controls (30.2% vs 18.0%), whereas dementia rates were similar. Stroop word-reading time was significantly longer in the COPD group (P < .001). Within the COPD group, poorer cognitive performance was associated with lower resting oxygen saturation and greater dyspnea severity. In multivariable analysis, COPD status remained independently associated with longer Stroop word-reading time after adjustment for age, sex, smoking, C-reactive protein, and body mass index (B = 5.09, P = .004). Although the overall distribution of cognitive status and global cognitive screening scores did not differ significantly between groups, patients with COPD showed longer Stroop word-reading time. Lower resting oxygen saturation and greater dyspnea were associated with poorer cognitive performance within the COPD group. These findings suggest that domain-specific cognitive assessment may provide additional information beyond global cognitive screening; however, prospective studies are needed to confirm the clinical utility of these findings.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 43","pages":"e51215"},"PeriodicalIF":2.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149270316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fasting before contrast-enhanced CT in the emergency department and risk of aspiration pneumonia: An 8-year cohort study.","authors":"Yunseo Choi, Ju Young Jeong, Seonok Kim, Pyeong Hwa Kim, Kye Jin Park, Hyo Jung Park, Choong Wook Lee, Chong Hyun Suh","doi":"10.1097/MD.0000000000051273","DOIUrl":"10.1097/MD.0000000000051273","url":null,"abstract":"<p><p>We aimed to assess the necessity of preparative fasting for contrast-enhanced abdominopelvic computed tomography (CT) in the emergency department to prevent emetic complications including aspiration pneumonia. This retrospective, observational, single-center study included patients who underwent contrast-enhanced abdominopelvic CT in the emergency department from January 2015 to December 2022. In a predefined subgroup of 5170 examinations performed between January and June 2022, fasting status was inferred from CT-based stomach content assessment. Patients were categorized into fasting and non-fasting groups based on a collapsed stomach or stomach distension with fluid and food materials. Risk factors of iodinated contrast media-related adverse drug reactions (ADRs) were analyzed with inverse probability of treatment weighting to adjust for confounding factors. Among 81,886 examinations, 806 acute ADRs (0.98%) were reported. The incidences of nausea, vomiting, and nausea or vomiting were 0.25%, 0.21%, and 0.32%, respectively. No cases of aspiration pneumonia were noted. Among 5170 examinations, symptoms of ADR were analyzed, revealing an overall ADR incidence of 0.52% in the fasting group and 0.96% in the non-fasting group (odds ratio [OR] 1.85; 95% confidence interval [CI]: 0.90-3.82; P = .097). The incidence of nausea or vomiting was 0.18% and 0.44% in the fasting and non-fasting groups, respectively (OR 2.41; 95% CI: 0.78-7.50; P = .128). The result was consistent in inverse probability of treatment weighting, overall ADR incidence of 0.52% in the fasting group and 0.92% in the non-fasting group (OR 1.77; 95% CI: 0.85-3.68; P = .125). No statistically significant difference in iodinated contrast media-related ADR was observed between the fasting and non-fasting groups, and no cases of aspiration pneumonia were identified.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 43","pages":"e51273"},"PeriodicalIF":2.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149270362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}