Postgraduate medicine最新文献

{"title":"Autonomic modulation following fecal microbiota transplantation in chronic insomnia.","authors":"Teng Gao, Mingming Zheng, Feng Geng, Yixiao Fu, Yongfeng Yang, Xinrong Li, Yongxiang Wang, Daomin Zhu, Zhe Wang, Lin Lu","doi":"10.1080/00325481.2026.2664261","DOIUrl":"10.1080/00325481.2026.2664261","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether fecal microbiota transplantation (FMT) modulates autonomic function in chronic insomnia disorder and whether autonomic rebalancing mediates sleep improvement.</p><p><strong>Methods: </strong>This prespecified exploratory analysis was embedded within a multicenter, double-blind, randomized, placebo-controlled trial of FMT for chronic insomnia. The original trial was designed to evaluate the efficacy and safety of the FMT-based treatment protocol, with polysomnography-measured sleep efficiency at 1 month as the primary endpoint. Eighty adults were randomly assigned to receive either FMT (<i>n</i> = 40) or placebo capsules (<i>n</i> = 40). Overnight polysomnography was conducted at baseline and 1 month, and heart rate variability indices were derived to quantify autonomic regulation. Sleep outcomes included PSG-derived metrics and validated subjective questionnaires. Associations between changes in autonomic parameters and sleep outcomes were examined using correlation analyses. Mediation analysis was performed to evaluate whether autonomic changes statistically mediated FMT-associated improvements in sleep. Gut microbiota composition was profiled using 16S rRNA gene sequencing.</p><p><strong>Results: </strong>In the original trial, the FMT-based treatment met its prespecified primary endpoint, with significantly improved polysomnography-measured sleep efficiency at 1 month. In this exploratory analysis, FMT significantly reduced the LF/HF ratio (-0.10; 95% CI, -0.18 to -0.02; <i>p</i> = 0.010). A reduction in LF/HF was associated with longer TST (β = -0.41; <i>p</i> = 0.004). Mediation analysis showed that LF/HF accounted for 49.7% of the FMT effect on TST (ACME = 19.44 min; <i>p</i> = 0.018). FMT induced microbial compositional remodeling associated with the nocturnal LF/HF ratio, including enrichment of Lachnospira eligens, Christensenellaceae R-7 group, Ruminococcaceae, and Coprococcus, and depletion of Prevotella copri, Streptococcus, and Faecalibacterium.</p><p><strong>Conclusions: </strong>These findings provide clinical exploratory evidence for autonomic system as a potential pathway through which microbiota-targeted interventions may alleviate insomnia. Further studies are needed to determine the durability and clinical significance of these findings.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov: NCT05917379 (June 23, 2023).</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"417-429"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Readmission and mortality outcomes with subsequent follow-up hemoglobin checks in general medical patients with hospital-acquired anemia.","authors":"Brianna L Konwinski, Ananya Vinay, Christopher L Boswell, Brad A Bohn, Donna M Miller, Alyssa Wallace, Gregory M Garrison, Nathaniel E Miller","doi":"10.1080/00325481.2026.2670028","DOIUrl":"10.1080/00325481.2026.2670028","url":null,"abstract":"<p><strong>Introduction: </strong>Hospital-acquired anemia is associated with increased readmissions and 30-day mortality. We evaluated whether anemia severity is associated with readmission and mortality 1-year post-hospitalization, and whether a recheck of hemoglobin and/or hematocrit level within 30 days of discharge is associated with reduced readmission and mortality rates.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 1734 patients at the Mayo Clinic Hospital Inpatient services from 2020 to 2023. The association between readmission and death within 1 year, and hemoglobin recheck within 30 days, or anemic category, was assessed using multivariable Cox regression while controlling for patient characteristics.</p><p><strong>Results: </strong>There were 1734 patients meeting inclusion criteria (mean age 61.5 years). Prior to discharge, 89.4% of the patients remained anemic, categorized as mild (53%), moderate (39.1%), or severe (7.8%) anemia. Only 526 (30.3%) had a hemoglobin recheck within 30 days of discharge. Anemia severity at discharge was not associated with readmission or mortality. Age, length of stay, and a higher hemoglobin level prior to discharge were significantly associated with readmission and mortality risk. A hemoglobin recheck within 30 days post-discharge was associated with a higher risk of 30-day readmission and subsequent mortality (HR = 5.97, <i>p</i> < 0.001; HR = 1.69, <i>p</i> = 0.006).</p><p><strong>Conclusion: </strong>Patients with more severe hospital-acquired anemia did not have increased readmission and mortality during 1-year post-hospitalization. Anemia rechecking was associated with increased mortality but likely confounded by underlying co-morbidities and other clinical factors. Future studies could compare readmission and mortality in different discharge destinations.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"430-436"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception and reality: assessing the accuracy of self-assessed dysphonia and dysphagia risk in people with cardiovascular disease.","authors":"Maria Pagano, Anna Anselmo, Giuseppe Micali, Fabio Mauro Giambò, Antonio Duca, Francesco Speciale, Piercataldo D'Aleo, Daniela Costanzo, Bianca Pellizzeri, Alessia Bramanti, Marina Garofano, Placido Bramanti, Francesco Corallo, Irene Cappadona","doi":"10.1080/00325481.2026.2672789","DOIUrl":"10.1080/00325481.2026.2672789","url":null,"abstract":"<p><strong>Background/objectives: </strong>Cardiovascular disease (CVD) is a chronic condition influenced by aging and lifestyle, and its effects extend to systems involved in voice and swallowing. Age-related changes in these functions are common, and when worsened by CVD, they can lead to isolation, malnutrition, and complications such as aspiration pneumonia. This study investigated how individuals with CVD perceive their risk of dysphonia and dysphagia compared with clinician-administered screening-based assessments.</p><p><strong>Methods: </strong>Seventy-three participants (mean age 65.2 years; 86.3% male) completed structured screening tools and self-report questionnaires. Dysphonia was evaluated using the GIRBAS scale and Voice Handicap Index-30, while dysphagia was assessed with the Swallowing Disturbance Questionnaire and Eating Assessment Tool-10. Spearman correlation analyses examined associations between perceived and assessed scores, and Wilcoxon signed-rank tests compared their differences.</p><p><strong>Results: </strong>There was a moderate to strong correlation for dysphonia (ρ = 0.68, <i>p</i> < 0.01), with participants tending to overestimate voice problems. For dysphagia, correlation was moderate (ρ = 0.52, <i>p</i> < 0.01), and significant underestimation of swallowing difficulties was observed.</p><p><strong>Conclusions: </strong>Routine monitoring of voice and swallowing should be included in prevention and rehabilitation programs for individuals with CVD. Increasing public awareness may support earlier detection and reduce related complications.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"437-442"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time of first diagnosis in liver cirrhosis: what has changed over time from etiology to stage of disease?","authors":"Zülal İstemihan, Ahmet Oğuz Çelik, Arzu Taş, Dilek Deniz, Çağrı Muratoğlu, Kanan Nuriyev, Sezen Genç Uluçeçen, Aynura Rustamzade, Gizem Dağcı, Mehmet Akif Yağlı, Bilger Çavuş, Aslı Çifcibaşı Örmeci, Filiz Akyüz, Kadir Demir, Fatih Beşışık, Sabahattin Kaymakoğlu","doi":"10.1080/00325481.2026.2672786","DOIUrl":"10.1080/00325481.2026.2672786","url":null,"abstract":"<p><strong>Objectives: </strong>It was aimed to investigate the characteristics of cirrhosis etiology, stage at diagnosis, diagnostic methods, and complications with a 1-decade interval.</p><p><strong>Methods: </strong>The clinical and demographic characteristics of patients with cirrhosis at the time of diagnosis at a tertiary university hospital between 2005-2009 (first period) and 2019-2023 (second period) were retrospectively investigated.</p><p><strong>Results: </strong>In total, 1311 patients were diagnosed with cirrhosis, of which 857 (65.4%) were men. Seven hundred and ninety-eight (60.9%) were diagnosed in the first period. Six hundred and ninety (52.6%) patients were decompensated at diagnosis. Child Turcotte Pugh score was more common in the second period. MELD-Na score was higher in the first period (<i>p</i> = 0.026). The presentation rate with decompensation was higher in the first period (<i>p</i> = 0.009). In the first period, 211 (26.4%), and in the second period, 134 (26.1%) patients were diagnosed in the emergency department. The others were diagnosed in the outpatient clinic. There was no difference in the conditions for diagnosing between periods (<i>p</i> = 0.898). The causes of cirrhosis were, in order, 22.6% HBV, 19.7% MASLD, 18.9% cryptogenic, 13.1% ALD, 10.1% HCV, 7.7% autoimmune liver diseases, 4% HDV, 2.1% other causes, and 1.8% genetic diseases. In the second period, the frequency of cirrhosis caused by viral etiologies decreased (<i>p</i> < 0.05), and the frequency of MASLD and ALD increased (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Over the past decade, viral factors in the etiology of cirrhosis have gradually decreased, MASLD and ALD have progressively increased. While patients were detected more in compensated states, a significant portion of patients are still diagnosed in the decompensated stage and in emergency clinics.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"479-486"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term (74-month) efficacy and safety of ivosidenib and azacitidine in an elderly patient with mutated <i>IDH1</i> acute myeloid leukemia: insights from a case report.","authors":"Tomasz Wróbel, Elzbieta Kalicińska","doi":"10.1080/00325481.2026.2668750","DOIUrl":"10.1080/00325481.2026.2668750","url":null,"abstract":"<p><strong>Introduction: </strong>Older patients with acute myeloid leukemia (AML) who are unfit for intensive chemotherapy (IC) are more likely to have poor outcomes. Ivosidenib is a first-in-class, oral, targeted small-molecule inhibitor of mutated isocitrate dehydrogenase (mIDH1) approved for use with azacitidine, following the AGILE trial (NCT03173248), for the treatment of mIDH1 AML in patients who are unfit for IC.</p><p><strong>Case report: </strong>We report the case of a woman diagnosed in 2019, aged 81 years, with mIDH1 AML and deemed unfit for IC due to age and comorbidities. The patient was enrolled in the AGILE trial and treated with ivosidenib and azacitidine. The patient responded well to treatment with a 1% blast count (complete response) after three cycles. At 74 months, aged 88 years, the patient was still receiving treatment with reduced doses of ivosidenib and azacitidine. The treatment was well tolerated, and the patient remained in good physical condition throughout. Mutational testing was performed throughout the trial according to protocol, with four pathogenic alterations identified at baseline (IDH1, DNMT3A splice, U2AF1, and RUNX1). Linear phylogeny was observed with the parent U2AF1 clone acquiring IDH1 followed by RUNX1. During treatment, the IDH1 and RUNX1 mutations were cleared. At a follow-up assessment, IDH1 and RUNX1 were still not detected, but ASXL1 had emerged.</p><p><strong>Conclusion: </strong>The exceptional 74-month long response of this patient demonstrates that a long-term response is possible for a patient unfit for IC with mIDH1 AML treated with ivosidenib and azacitidine. Further insights into the impact of the mutational status of patients and/or the clonal hierarchy are warranted.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"387-390"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147871093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between TLR2 expression and common carotid artery bifurcation angle in carotid atherosclerotic plaque: a cross-sectional study.","authors":"Yuan Liang, Yanfang Si, Jun Wang, Xingjian Fang, Guangliang Diao, Yan Chang, Yumei Tang, Cunping Yin","doi":"10.1080/00325481.2026.2672783","DOIUrl":"10.1080/00325481.2026.2672783","url":null,"abstract":"<p><strong>Objective: </strong>During eversion carotid endarterectomy (CEA), optimizing the bifurcation angle can reduce hemodynamic disturbances and postoperative restenosis risk. However, determining the precise degree of bifurcation angle modification during eversion CEA remains an unresolved issue. This study aims to investigate the correlation between TLR2 expression in carotid artery plaque and the carotid bifurcation angle.</p><p><strong>Methods: </strong>In this cross-sectional study, 128 patients were enrolled. For all subjects before surgery, carotid bifurcation angle were measured with picture archiving and communication system. After surgery, the expression of inflammation factor TLR2, NF-κB, and MYD88 in the plaque specimens was analyzed using RT-qPCR.</p><p><strong>Results: </strong>Relative higher bifurcation angles were positively correlated with increased TLR2. A univariate analysis displayed a significant positive correlation between bifurcation angles and TLR2 expression (<i>p</i> = 0.004). In multivariate piecewise linear regression and restricted cubic spline, the levels of TLR2 increased with the elevation of bifurcation angles when bifurcation angles was more than 49.1.</p><p><strong>Conclusion: </strong>This study demonstrated that TLR2 expression in carotid atherosclerotic plaque exhibited a significant positive correlation with the carotid bifurcation angle. When the bifurcation angle exceeded 49.1°, TLR2 expression increased sharply, suggesting a therapeutic potential of angle-optimized eCEA, particularly in patients with wider bifurcation angles.</p><p><strong>Clinical trial registration: </strong>https://www.chictr.org.cn/index.html identifier: ChiCTR2500102233.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"487-493"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safeguarding Quality in Health and Medical Science Information Today.","authors":"Scott C Ratzan, Rebecca K Ivic, Kenneth H Rabin, Ruth M Parker, Sara Rubinelli, Rafael Obregon, Lawrence O Gostin, Michael G Baker, Samantha Thomas, Don Nutbeam, Ilona Kickbusch, J Gregory Payne, Vivianne Ihekweazu, Kirsten J McCaffery, Richard L Street, Sir Cary Cooper","doi":"10.1080/00325481.2026.2655398","DOIUrl":"https://doi.org/10.1080/00325481.2026.2655398","url":null,"abstract":"","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"1-3"},"PeriodicalIF":2.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute kidney injury in heart failure hospitalization: a national study of outcomes and healthcare utilization.","authors":"Brent Tai, Chijioke Okonkwo","doi":"10.1080/00325481.2026.2658370","DOIUrl":"10.1080/00325481.2026.2658370","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common complication among patients hospitalized with acute heart failure and is associated with worse clinical outcomes. However, contemporary national data examining its epidemiology and association with outcomes across heart failure phenotypes and chronic kidney disease (CKD) stages remain limited. We evaluated the prevalence of AKI and its association with mortality, critical care interventions, and healthcare utilization in a nationally representative cohort.</p><p><strong>Methods: </strong>We conducted a retrospective study using the 2022 Healthcare Cost and Utilization Project National Inpatient Sample. Adult hospitalizations for acute heart failure were identified using ICD-10-CM codes, and AKI was defined using diagnosis codes. Survey-weighted multivariable logistic regression models were used to identify factors associated with AKI and evaluate its association with in-hospital outcomes. Multicollinearity was assessed using variance inflation factors.</p><p><strong>Results: </strong>Among 1,126,036 hospitalizations, AKI occurred in 35.2%. AKI was associated with higher in-hospital mortality (adjusted odds ratio [aOR] 3.69; 95% CI 3.60-3.77), corresponding to adjusted mortality of 10.2% vs 3.4% (absolute difference 6.8% points). AKI was also associated with higher odds of mechanical ventilation (aOR 3.86), vasopressor use (aOR 3.66), and acute kidney replacement therapy (aOR 16.17) (all <i>p</i> < 0.001). In addition, AKI was associated with greater healthcare utilization, including prolonged length of stay (aOR 1.77; 40.0% vs 22.1%) and increased likelihood of discharge to skilled nursing or rehabilitation facilities (aOR 1.43).</p><p><strong>Conclusions: </strong>AKI is common among acute heart failure hospitalizations and is associated with higher mortality, greater use of critical care interventions, and increased healthcare utilization. These findings reinforce prior evidence that AKI identifies a high-risk population. Given the observational design, results should be interpreted as associations rather than causal effects. Further studies using laboratory-based definitions and longitudinal outcomes are needed to better characterize the long-term implications of AKI.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"283-292"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological characteristics of pure red cell aplasia induced by immune checkpoint inhibitors in cancer patients.","authors":"Jian Xiao, Licheng Li, Yuxiang Luo, Zhi Xia, Min Fang","doi":"10.1080/00325481.2026.2662039","DOIUrl":"10.1080/00325481.2026.2662039","url":null,"abstract":"<p><strong>Background: </strong>This study aims to elucidate the clinical features of pure red cell aplasia (PRCA) induced by immune checkpoint inhibitors (ICIs), with the goal of providing guidance for the prevention, diagnosis, and clinical management of this complication.</p><p><strong>Methods: </strong>We systematically searched multiple databases, including PubMed, Embase, EBSCO, Scopus, Web of Science, and Google Scholar, and integrated case reports related to ICI-induced PRCA for retrospective analysis. The search period spanned from the initiation of relevant research up to 11 July 2025.</p><p><strong>Results: </strong>This study included 32 patients with PRCA induced by ICIs, with a median age of 57.5 years (25-84 years). The median time to PRCA onset was 3 months (0.7-36 months) after ICI initiation, and the median treatment duration was 4 cycles (1-52 cycles). The main clinical manifestations were anemia and fatigue, with diagnosis confirmed by hematologic laboratory tests and bone marrow biopsy. Upon discontinuation of ICIs, along with transfusion support, systemic glucocorticoid therapy, and, when necessary, intravenous immunoglobulin or other immunosuppressants, the condition of ICI-associated PRCA patients showed significant improvement.</p><p><strong>Conclusion: </strong>PRCA induced by ICIs is a rare immune-related adverse event that typically occurs around 3 months after treatment. Early identification and appropriate intervention can lead to favorable outcomes.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"370-376"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of social determinants of health in predicting pediatric anemia in primary care clinics.","authors":"Julia Hoffman, Molly Posa, Jaclyn Otero, Xiaofei Chi, Cynthia Garvan, Colton Kelly, John Jones, Maria Kelly","doi":"10.1080/00325481.2026.2661421","DOIUrl":"10.1080/00325481.2026.2661421","url":null,"abstract":"<p><strong>Background: </strong>Social determinants of health (SDOH) influence access to nutrition, healthcare, and living conditions and may contribute to pediatric anemia. Anemia in children is particularly concerning because delayed identification can lead to developmental and long-term health consequences. Despite their potential impact, SDOH are not explicitly recognized as risk factors in current AAP anemia screening guidelines. Identifying whether SDOH predict anemia risk may facilitate earlier detection and treatment.</p><p><strong>Objective: </strong>To determine whether specific SDOH domains predict an increased risk of anemia in pediatric patients in primary care settings.</p><p><strong>Methods: </strong>Pediatric patients (<18 years) presenting for routine or acute primary care visits and their caregivers were recruited. Caregivers completed a validated SDOH screener, and tcHgb measurements were obtained. A retrospective chart review provided demographic and clinical data. Associations between tcHgb and numeric variables were assessed using Spearman correlations; categorical variables were analyzed with Kruskal-Wallis or Wilcoxon rank sum tests. Regression analysis evaluated tcHgb as the outcome with SDOH risk as the predictor, adjusting for age, sex, race, and insurance type. Analyses were conducted using SAS v9.4.</p><p><strong>Results: </strong>Among 248 families, 186 children (75%) had at least one identified social need. The most common were financial strain (31.85%), food insecurity (25.00%), cognitive disabilities (21.77%), language and literacy barriers (21.05%), and mental health concerns (18.11%). Mean (SD) tcHgb was 12.7 (1.2) g/dL, with a median of 2.0 [0.5, 3.0] positive SDOH domains when present. TcHgb was not associated with age, BMI, or sex but differed by insurance type. Each additional SDOH concern was associated with a 0.29 g/dL decrease in tcHgb (<i>p</i> < .0001).</p><p><strong>Conclusion: </strong>SDOH risk factors are significantly associated with lower hemoglobin levels in pediatric patients, with cumulative social needs conferring increased anemia risk. Incorporating SDOH screening into pediatric primary care may improve early identification and outcomes for children at risk of anemia.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"309-314"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}