Medical sciences (Basel, Switzerland)最新文献

{"title":"Vitamin D Deficiency and Risk of Surgical Site Infections: A Retrospective Chart Review from a Tertiary Care Center in Qatar.","authors":"Rana Farsakoury, Ahmad Hamdan, Muhammad Naseem Khan, Habib H Farooqui, Sara Al Harami, Susu M Zughaier","doi":"10.3390/medsci13030163","DOIUrl":"10.3390/medsci13030163","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Vitamin D deficiency is common in the Middle East, where it affects about 90% of the population. 25-hydroxyvitamin D [25(OH)D]. plays a key role in immune function and antimicrobial defense. Its deficiency has been implicated in surgical site infections (SSIs) also, which lead to increased healthcare costs and morbidity. Around 60% SSIs are preventable by addressing factors like 25(OH)D levels among others. In Qatar, 55.8% of the population is 25(OH)D deficient, but no direct link has been established between 25(OH)D deficiency and SSI risk. This study aims to investigate the relationship between deficient 25(OH)D levels and SSI development in surgical patients at Hamad Medical Corporation (HMC), Qatar. <b>Methods</b>: A retrospective chart review was conducted on adult patients who underwent surgery at HMC, Qatar, between January 2021 and December 2023, with known 25(OH)D levels measured within three months before surgery. A multivariate logistic regression analysis was conducted to evaluate the relationship between 25(OH)D levels and SSIs. <b>Results</b>: This retrospective chart review included 24,097 patients, with 3818 (15.8%) being 25(OH)D deficient. The mean age of the patients was 45 years, and 55% of them were female. The proportion of SSIs was highest in the 25(OH)D deficient group (2.7%) compared to the insufficient (1.8%) and sufficient (1.9%) groups, with a <i>p</i>-value of <0.01. The mean 25(OH)D level was 23 ng/mL in the SSI group, compared to 25 ng/mL in the no SSI group, with a <i>p</i>-value of <0.01. Multivariate logistic regression analysis identified several independent risk factors for SSIs, including 25(OH)D deficiency, male gender, intermediate and major case levels, longer operative times, lower preoperative serum albumin, and contaminated and dirty wounds, all with <i>p</i>-values of <0.05. <b>Conclusions</b>: Preoperative lower 25(OH)D levels increase the risk of SSIs. This study emphasizes the importance of optimizing 25(OH)D levels before surgery to reduce the occurrence of SSIs.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115260","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":"Looking for Fabry, Finding More: LVH Screening Yields Unexpected Gaucher Diagnosis.","authors":"Sylwia Szczepara, Klaudia Pacia, Katarzyna Trojanowicz, Klaudia Bielecka, Michał Tworek, Zuzanna Sachajko, Katarzyna Holcman, Piotr Podolec, Monika Komar","doi":"10.3390/medsci13030162","DOIUrl":"10.3390/medsci13030162","url":null,"abstract":"<p><strong>Objective: </strong>Fabry disease (FD) is a rare, X-linked lysosomal storage disorder resulting from deficient α-galactosidase A activity, which can manifest as left ventricular hypertrophy (LVH). We aimed to assess the prevalence of FD in an unselected cohort of patients with unexplained LVH.</p><p><strong>Methods and results: </strong>We screened 202 unrelated adults with LVH using enzymatic assays for α-galactosidase A in dried blood spots. Patients with low activity underwent GLA gene sequencing. Echocardiographic parameters were evaluated according to ESC guidelines. FD was diagnosed in 4 women (2%), each carrying distinct pathogenic GLA mutations. All affected individuals showed normal or borderline enzyme activity. Cardiac, renal, or neurological symptoms were observed variably among patients. Echocardiographic findings revealed slightly lower wall thickness and preserved systolic function in FD patients compared to those without FD. Cascade genetic screening identified 16 additional family members with the same mutations. One patient (0.5%) was incidentally diagnosed with Gaucher disease based on syndromic features and enzymatic testing.</p><p><strong>Conclusions: </strong>FD was identified in 2% of patients with unexplained LVH, who were females. Enzyme-based screening followed by targeted genetic testing is a cost-effective strategy for FD detection. Early diagnosis is essential for prompt treatment and family counselling, underscoring the importance of routine FD screening in patients with LVH of unclear aetiology. Our findings support the use of targeted screening for Fabry disease in patients with LVH and systemic features, and highlight the potential to identify other lysosomal disorders in selected cases.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114876","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":"Use of Benzodiazepines in Medical Students: A Comparative Analysis Between Medical and Other University Degrees.","authors":"Paula Fernández de Frutos, Francisco Javier García-Sánchez, Natalia Mudarra-García, Fernando Roque-Rojas, Syed Ihtisham-Kakakhel, Davide Luordo-Tedesco","doi":"10.3390/medsci13030164","DOIUrl":"10.3390/medsci13030164","url":null,"abstract":"<p><strong>Background: </strong>The use of benzodiazepines among university students has been scarcely investigated. This situation raises particular concerns in medical students, due to their exposure to stressful situations and, especially, their familiarity with psychotropic drugs.</p><p><strong>Material and methods: </strong>A descriptive cross-sectional observational study was conducted using an anonymous online survey disseminated among universities in the Community of Madrid during April 2024.</p><p><strong>Results: </strong>25.07% of students stated they had used benzodiazepines at least once, especially from the third academic year onwards. The prevalence was higher among medical students (32.34%). Use was mainly occasional, although 20.21% reported daily use. Among the reasons for use, managing academic stress reached 45.74%. Up to 15.96% of respondents reported a feeling of dependence, and 32.26% noticed concentration difficulties as a side effect of benzodiazepine use.</p><p><strong>Conclusions: </strong>Benzodiazepine use is a relevant phenomenon among university students, with particular incidence in medical degrees. Its onset usually coincides with advanced stages of the degree, which underscores the need for preventive interventions tailored to the academic environment and for the rational use of psychotropic drugs in young populations.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115209","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":"Artificial Intelligence Models for Diagnosis of Periodontitis Using Non-Invasive Biological Markers: A Systematic Review and Meta-Analysis of Patient-Based Studies.","authors":"Carlos M Ardila, Anny M Vivares-Builes, Pradeep Kumar Yadalam","doi":"10.3390/medsci13030159","DOIUrl":"10.3390/medsci13030159","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Early diagnosis of periodontitis remains challenging using traditional clinical methods. This systematic review and meta-analysis evaluated the diagnostic accuracy of artificial intelligence (AI) models trained on non-invasive or minimally invasive biomarkers-including saliva, gingival crevicular fluid (GCF), and immunologic profiles-for diagnosing and classifying periodontitis in human subjects. <b>Methods</b>: A comprehensive search of PubMed/MEDLINE, Scopus, Web of Science, EMBASE, and Cochrane CENTRAL was conducted from database inception to June 2025. Eligible studies used AI or machine learning models with patient-derived biomarker data and reported diagnostic performance metrics. <b>Results</b>: Seven studies were included, employing various AI models such as random forest, artificial neural networks, and gradient boosting. Biomarkers were derived from saliva (n = 4), saliva-derived biomarkers from oral rinse (n = 1), immunologic profiles (n = 1), and tissue-based gene expression (n = 1). Reported area under the receiver operating characteristic (ROC) curve (AUC) ranged from 0.83 to 0.96. Meta-analysis of studies with comparable outcomes showed a pooled sensitivity of 0.89 (95% CI: 0.84-0.93), a specificity of 0.87 (95% CI: 0.80-0.92), and a summary AUC of 0.92. Subgroup analysis revealed that models using salivary biomarkers achieved a higher pooled AUC (0.94) than those using GCF or immunologic markers (AUC: 0.89). Sensitivity analyses excluding studies with unclear bias did not significantly alter pooled estimates, affirming robustness. The overall certainty of evidence was rated as moderate to high. <b>Conclusions</b>: AI-based diagnostic models utilizing salivary, microbiome, or immunologic biomarkers demonstrated quantitatively high accuracy; however, the overall certainty of evidence was rated as moderate to high due to limitations in study design and validation.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115227","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 Systematic Review Exploring the Phytochemical Composition and Anticancer Activities of <i>Acacia catechu</i>.","authors":"Navya Rana, Madhu Bala, Vinod Kumar, Rohitash Yadav, Neeraj Jain, Don Mathew, Khushboo Bisht, Rakesh Kumar, Sunil Kumar","doi":"10.3390/medsci13030161","DOIUrl":"10.3390/medsci13030161","url":null,"abstract":"<p><p><b>Background:</b> <i>Acacia catechu</i> is an important traditional medicinal plant that has been used to manage several ailments. Many in vitro and in vivo studies have demonstrated that it exhibits chemopreventive and antineoplastic effects by modulating diverse signaling pathways and molecular targets involved in cancer progression. This review attempts to systematically investigate the anticancer mechanisms of <i>A. catechu</i>, encompassing antiapoptotic, antioxidant, and antiproliferative activities. <b>Material and Methods:</b> This review was conducted using scientific databases such as Scopus, Web of Science, and Google Scholar, covering the studies from 2000 to 2024. The PRISMA methodology was applied, using the keywords <i>A. catechu</i>, phytoconstituents, and cancer. <b>Results:</b> A total of 39 studies were compiled from various databases that cited the biological use of <i>A. catechu</i>. The plant has an abundance of phenolic compounds, including catechin, epicatechin, epigallocatechin-3-O-gallate, and epicatechin-3-O-gallate, which show strong anticancer activities. The anticancer potential of <i>A. catechu</i> is explained as it regulates several modulators like reactive oxygen species and cytokines, and downregulates oncogenic molecules like c-myc and various signaling pathways, such as c-Jun and NF-κB. <b>Conclusions:</b> Our findings suggest that <i>A. catechu</i> and its bioactive constituents have the potential for cancer prevention and therapy. However, further mechanistic investigations using pure compounds, along with preclinical and clinical trials, are essential to translate this potential into clinical applications.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115157","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":"Rural-Urban Disparities in Treatment and Disease-Specific Survival for Patients with Intrahepatic Cholangiocarcinoma: A Retrospective Cohort Analysis of the 2000 to 2021 SEER Database.","authors":"Odelia H Moon, Mitchell A Taylor, Omar Hamadi, Aditya Sharma, Peter Silberstein","doi":"10.3390/medsci13030158","DOIUrl":"10.3390/medsci13030158","url":null,"abstract":"<p><p><b>Background:</b> Intrahepatic cholangiocarcinoma (ICC) is an aggressive malignancy with very poor survival. Prior research suggests rural-urban disparities on a regional scale. We aimed to elucidate these disparities in treatment and disease-specific survival (DSS) for ICC patients on a national scale using the SEER database. <b>Methods:</b> The SEER database was queried to identify biopsy-confirmed cases of ICC from 2000 to 2021. Differences in clinicopathologic features and treatment between rural and urban patients were assessed using Chi-square and Fischer's exact tests. Disease-specific survival was compared using Kaplan-Meier and log-rank tests as well as multivariable Cox regressions. <b>Results:</b> A total of 14,940 ICC patients were identified. Rural patients were less likely than urban patients to receive chemotherapy (789 of 1588 [49.7%] vs. 7112 of 13,352 [53.3%], <i>p</i> = 0.006) and surgical treatment (305 of 1588 [19.2%] vs. 2922 of 13,352 [21.9%], <i>p</i> = 0.013). Rural patients experienced reduced 5- and 10-year DSS rates (7.0% and 4.0%) compared to urban patients (9.0% and 6.0%, <i>p</i> < 0.001). In multivariable analysis, rural residence independently demonstrated a 17% increased risk of disease-specific mortality compared to their urban counterparts (aHR 1.17, 95% CI 1.03-1.32). <b>Conclusions:</b> This study demonstrates significant rural-urban disparities in ICC treatment and survival throughout the US, independent of other prognostic factors. Further investigation into factors driving these disparities is warranted to improve outcomes for rural ICC patients.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115167","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":"Lavender-Neroli Aromatherapy for Reducing Dental Anxiety and Pain in Children During Anesthesia: A Two-Arm Randomized Controlled Trial.","authors":"Rama Abdalhai, Yasser Alsayed Tolibah, Racha Alkhatib, Chaza Kouchaji, Ziad D Baghdadi","doi":"10.3390/medsci13030166","DOIUrl":"10.3390/medsci13030166","url":null,"abstract":"<p><p><b>Objective.</b> This randomized controlled trial evaluated the efficacy of lavender-neroli oil aromatherapy in managing dental anxiety and pain in children undergoing inferior alveolar nerve block (IANB) anesthesia. <b>Methods.</b> Fifty-four children aged 6-11 years were randomly assigned to either a control group or an aromatherapy group. Children in the control group were asked to wear a regular scented-free nitrous oxide mask. Children in the control group were asked to wear a regular scented-free nitrous oxide mask. Children in the intervention group inhaled lavender-neroli oil via a nitrous oxide nasal mask for 5 min before and during IANB administration. Anxiety and pain levels were assessed pre-and post-treatment using the Facial Image Scale (FIS), Face-Legs-Activity-Cry-Consolability (FLACC) scale, and vital signs (heart rate, blood pressure, oxygen saturation). The collected data were statistically analyzed using SPSS software 20. The Mann-Whitney U test was used for analyzing FIS results, and the independent T test and T Paired test were used for analyzing heart rate, blood pressure, and oxygen saturation results. <b>Results.</b> Results demonstrated significantly lower anxiety, heart rate, blood pressure, and pain scores in the aromatherapy group compared to the control group (<i>p</i> < 0.05), with no significant change in oxygen saturation. <b>Conclusions.</b> Lavender-neroli aromatherapy is a safe, low-cost, and effective adjunct to reduce anxiety and discomfort during pediatric dental anesthesia.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115307","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":"Diagnostic Accuracy of Anthropometric and Metabolic Indicators for Predicting MASLD: Evidence from a Large Cohort of Spanish Workers Using FLI and LAP.","authors":"Juan José Guarro Miguel, Pedro Juan Tárraga López, María Dolores Marzoa Jansana, Ángel Arturo López-González, Pere Riutord Sbert, Carla Busquets-Cortés, José Ignacio Ramirez-Manent","doi":"10.3390/medsci13030160","DOIUrl":"10.3390/medsci13030160","url":null,"abstract":"<p><strong>Background: </strong>Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a major global health concern associated with insulin resistance, metabolic syndrome, and cardiovascular morbidity. Early identification of at-risk individuals through simple, non-invasive methods is essential, particularly in working populations.</p><p><strong>Objectives: </strong>This study aimed to assess and compare the diagnostic accuracy of four widely used anthropometric and metabolic indicators-body mass index (BMI), waist-to-height ratio (WtHR), triglyceride-glucose index (TyG), and waist-triglyceride index (WTI)-in identifying individuals at risk of metabolic-dysfunction-associated steatotic liver disease (MASLD), as determined by the Fatty Liver Index (FLI) and the Lipid Accumulation Product (LAP), within a large sample of Spanish workers.</p><p><strong>Methods: </strong>A cross-sectional analysis was performed on data from 386,924 Spanish employees aged between 18 and 69 years. Standardized anthropometric and laboratory measurements were obtained as part of routine occupational medical examinations conducted from 2021 to 2023. The presence of NAFLD was inferred using two validated surrogate markers: FLI and LAP. Receiver operating characteristic (ROC) curves and area under the curve (AUC) values were used to assess the discriminatory ability of each index, stratified by sex.</p><p><strong>Results: </strong>WTI and TyG demonstrated the highest diagnostic accuracy for both FLI- and LAP-defined NAFLD, with AUC values >0.95 in both sexes. WTI showed the best overall performance, followed closely by TyG. WtHR outperformed BMI but was less accurate than the metabolic indices. Sex-stratified analyses confirmed consistent patterns, with slightly higher AUCs for TyG and WTI in women. BMI consistently yielded the lowest discriminatory performance.</p><p><strong>Conclusions: </strong>WTI and TyG are superior to BMI and WtHR for non-invasive screening of MASLD in occupational settings. Their simplicity, low cost, and strong predictive value support their integration into routine workplace health surveillance. Sex-specific thresholds and prospective validation are warranted to enhance clinical application.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115316","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":"Effect of Lokomat^® Robotic Rehabilitation on Balance, Postural Control, and Functional Independence in Subacute and Chronic Stroke Patients: A Quasi-Experimental Study.","authors":"Marina Esther Cabrera-Brito, María Del Carmen Carcelén-Fraile, Agustín Aibar-Almazán, Fidel Hita-Contreras, Paulino Vico-Rodríguez, Marta Cano-Orihuela, Yolanda Castellote-Caballero","doi":"10.3390/medsci13030157","DOIUrl":"10.3390/medsci13030157","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Balance, postural control, and functional independence are essential components for the autonomy of people with neurological conditions. Robotic technologies such as the Lokomat^® have emerged as promising tools in rehabilitation, but their effectiveness when integrated into functional programs requires further evidence. The objective of this study was to evaluate the impact of an intensive robotic intervention on these three functional variables. <b>Methods</b>: A single-group, quasi-experimental pretest-posttest study was conducted with 136 participants who received a robotic rehabilitation intervention using the Lokomat^® device, and focused on functional tasks over several weeks. Balance (using the Berg scale), postural control (using the PASS), and functional independence (using the Barthel index) were assessed, comparing pre- and post-intervention results using parametric and non-parametric tests. <b>Results</b>: The results showed statistically significant improvements in all three variables after the intervention. The mean Berg score increased from 11.76 to 21.91 points (<i>p</i> < 0.001), postural control increased from 15.53 to 21.90 points (<i>p</i> < 0.001), and the Barthel index increased from 24.71 to 41.76 points (<i>p</i> < 0.001). In all cases, the effect sizes were large (d > 0.90). <b>Conclusions</b>: A rehabilitation program including intensive, task-oriented Lokomat^® training was associated with improvements in balance, postural control, and functional independence. Given the single-group design without a control arm, these findings reflect associations and do not establish causality.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115247","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":"Prevalence of <i>Cryptosporidium</i> Infections in Thailand and Its Association with HIV and Diarrhea: A Systematic Review and Meta-Analysis.","authors":"Manas Kotepui, Aongart Mahittikorn, Jurairat Jongthawin, Chutima Rattanawan, Frederick Ramirez Masangkay","doi":"10.3390/medsci13030156","DOIUrl":"10.3390/medsci13030156","url":null,"abstract":"<p><p><i>Cryptosporidium</i> is a protozoan parasite and a major cause of diarrhea, especially in children and immunocompromised individuals. Despite evidence of its presence in Thailand, comprehensive national data remain limited. This systematic review and meta-analysis aimed to estimate the prevalence of <i>Cryptosporidium</i> infection in Thailand and assess its association with diarrhea, especially among vulnerable populations, to support targeted public health strategies. This systematic review followed the PRISMA guidelines and was registered with PROSPERO (CRD420251015538). A systematic search was conducted in PubMed, Embase, Scopus, Journals@Ovid, Nursing & Allied Health Premium, Google Scholar, and the Thai-Journal Citation Index (TCI) to identify studies on <i>Cryptosporidium</i> infections in humans in Thailand. Quality assessment was independently performed using Joanna Briggs Institute tools. Pooled prevalence and odds ratios (ORs) were estimated using random-effects meta-analyses. Heterogeneity was explored via meta-regression and subgroup analyses, and publication bias was assessed using funnel plots and Egger's test. A total of 38 studies with 24,759 participants were included, mostly conducted in Central Thailand. The pooled prevalence of <i>Cryptosporidium</i> infections was 4.70% (95% CI: 2.68-8.13%), with the highest prevalence observed in Northern Thailand (11.14%) and among HIV-infected individuals (16.33%). Significant predictors of higher prevalence included region, age group, participant type, and diarrheal status. Infection was associated with a non-significant two-fold increased odds of diarrhea (<i>p</i>: 0.39; OR: 2.00; 95% CI: 0.67-5.99), but significantly higher odds of diarrhea among patients with <i>Cryptosporidium</i> infections were seen in the Central region (OR: 3.71; 95% CI: 1.17-11.8). HIV-seropositive individuals had a significantly higher risk of infection (<i>p</i>: 0.006; OR: 8.15; 95% CI: 1.82-36.50). This systematic review and meta-analysis estimated a pooled prevalence of <i>Cryptosporidium</i> infections in Thailand of 4.70%, with the highest rates in Northern Thailand (11.14%) and among HIV-infected individuals (16.33%). Although infection was associated with a two-fold increase in the risk of diarrhea, the association was not statistically significant. Notably, HIV-seropositive individuals had an eight-fold higher risk compared to HIV-seronegative individuals. Future research should expand surveillance in under-represented regions to better understand the epidemiological burden and guide public health interventions.</p>","PeriodicalId":74152,"journal":{"name":"Medical sciences (Basel, Switzerland)","volume":"13 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115047","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}