Search Results (4,331)

This study investigated the impact of maternal psychological factors—specifically anxiety and depression—on breastfeeding outcomes in women with high-risk and low-risk pregnancies. A total of 157 postpartum women were assessed using the State-Trait Anxiety Inventory (STAI) and the Edinburgh Postnatal Depression Scale (EPDS) at multiple time points: 3–4 days, 3 months, and 6 months postpartum. Breastfeeding duration and exclusivity were the primary outcomes. Correlation analyses showed significant negative associations between STAI scores and breastfeeding duration in both groups, with stronger effects in the low-risk group (e.g., r = −0.546, p < 0.001 at 3 months). Similarly, EPDS scores were inversely correlated with breastfeeding duration, particularly at 3 and 6 months postpartum (r = −0.272, p < 0.001 and r = −0.248, p = 0.001, respectively, in the high-risk group). Logistic regression identified EPDS scores at 3 months (p = 0.046, Exp(B) = 0.844) and STAI scores at 3–4 days postpartum (p = 0.006, Exp(B) = 0.861) as significant predictors of early breastfeeding cessation. The model explained 64.9% of the variance in the low-risk group. These findings highlight the significant influence of postpartum anxiety and depressive symptoms on breastfeeding outcomes and suggest that early screening and support for these specific psychological factors may enhance breastfeeding duration and exclusivity, particularly after high-risk pregnancies. Full article

Urinary tract infections (UTIs) are among the most common pathologies, with a high incidence in women and hospitalized patients. Their diagnosis is based on the presence of clinical symptoms and signs in addition to the detection of microorganisms in urine trough urine cultures, a time-consuming and resource-intensive test. The goal was to optimize UTI detection through artificial intelligence (machine learning) using non-microbiological laboratory parameters, thereby reducing unnecessary cultures and expediting diagnosis. A total of 4283 urine cultures from patients with suspected UTIs were analyzed in the Microbiology Laboratory of the University Hospital Virgen de las Nieves (Granada, Spain) between 2016 and 2020. Various machine learning algorithms were applied to predict positive urine cultures and the type of isolated microorganism. Random Forest demonstrated the best performance, achieving an accuracy (percentage of correct positive and negative classifications) of 82.2% and an area under the ROC curve of 87.1%. Moreover, the Tree algorithm successfully predicted the presence of Gram-negative bacilli in urine cultures with an accuracy of 79.0%. Among the most relevant predictive variables were the presence of leukocytes and nitrites in the urine dipstick test, along with elevated white cells count, monocyte count, lymphocyte percentage in blood and creatinine levels. The integration of AI algorithms and non-microbiological parameters within the diagnostic and management pathways of UTI holds considerable promise. However, further validation with clinical data is required for integration into hospital practice. Full article

Background and Objectives: Sciatica is a common condition associated with significant pain and reduced quality of life (QoL). However, its impact and associated determinants remain underexplored in Saudi Arabia. Therefore, this study aimed to examine determinants of quality of life among Saudi adults with sciatica. Materials and Methods: A cross-sectional study was conducted in Saudi Arabia between February and March 2024 using an online Arabic questionnaire disseminated via social media. Participants (n = 927) aged ≥18 years completed a 50-item questionnaire covering sociodemographic characteristics, clinical history, lifestyle factors, and the Short Form-12 (SF-12) QoL scale. Results: Of the 927 adults (mean age 30 ± 11 years), 76% (n = 706) were female and 24% (n = 221) male; 10% (n = 92) reported sciatica. Overall, 57% (n = 531) reported good QoL. Multivariate analysis revealed that increasing age (Odds ratio (OR) = 1.04; 95% CI: 1.01–1.07), urban residence (OR = 1.49; 95% CI: 1.11–2.00), and higher income (>15,000 Saudi Arabia Riyal (SAR); OR = 1.53; 95% CI: 1.03–2.27) were associated with better QoL. Conversely, diabetes (OR = 0.42; 95% CI: 0.22–0.79), arthritis (OR = 0.52; 95% CI: 0.32–0.83), and sciatica duration >1 year (OR = 0.29; 95% CI: 0.12–0.69) were associated with poorer QoL. Gender, body mass index (BMI), smoking, and physical activity showed no significant associations. Conclusions: Sciatica, prolonged symptom duration, and comorbidities such as diabetes and arthritis negatively affect QoL in Saudi adults, whereas socioeconomic and demographic factors contribute positively. The results underscore the importance of early intervention and tailored support for sciatica patients with long-standing symptoms or specific comorbidities to improve health outcomes. Longitudinal studies are warranted to assess causality and the impact of interventions. Full article

Celiac disease (CeD) is an autoimmune disorder where adherence to a lifelong gluten-free diet (GFD) is the only available treatment. While this approach is rather effective, some patients experience ongoing symptoms, and this factor, along with the rigidity of the GFD, may predispose some to disordered eating behaviors, including Avoidant/Restrictive Food Intake Disorder (ARFID). ARFID is characterized by persistent food avoidance that is not driven by body image concerns, resulting in nutritional, psychological, and social impairment. This scoping literature review explores the emerging intersection between ARFID and CeD, examining prevalence, pathophysiology, clinical features, complications, and management strategies. Recent studies report that 14–57% of individuals with CeD may meet the criteria for ARFID, depending on the population and screening tools used. Factors contributing to ARFID in CeD may include ongoing gastrointestinal symptoms, anxiety over gluten exposure, negative conditioned responses to food, social challenges related to GFD adherence, and psychiatric co-morbidities. ARFID in CeD is associated with worsened nutritional deficiencies, anxiety, depression, and impaired social functioning, making the diagnosis of ARFID challenging due to symptom overlap with CeD and other psychiatric conditions. Management requires a multidisciplinary approach, including medical, nutritional, and psychological interventions. Routine screening, early intervention, and integrated care models may improve outcomes and quality of life. Full article

Background/Objectives: There is a growing need for programs addressing perinatal mental health, particularly for new mothers. Postpartum depression (PPD) may occur during pregnancy or within the first year postpartum, with both short- and long-term negative consequences for both mothers and their infants. This study describes the cultural adaptation, implementation, and one-year follow-up of the Mom-to-Mom (M2M) program for minority Bedouin women in Southern Israel. Methods: We conducted a community-based intervention (M2M) emphasizing cultural adaptation. Outreach efforts were conducted in collaboration with healthcare professionals to encourage referral to the M2M program. A total of 111 mothers completed a self-administered questionnaire that included socio-demographic characteristics and PPD symptoms (PPDs) at two time points: prior to the intervention (Time-1) and one year after participating in the program (Time-2). PPD was measured using the Edinburgh Postnatal Depression Scale (EPDS), using a score cutoff of ≥10. Results: There was a significant decrease in PPDs (EPDS ≥ 13) between Time-1 and Time-2 after one year of follow-up in the M2M program (from 45% to 19.8%). Of the participants, 75% were referred to the program by healthcare professionals. Among those with EPDS ≥ 10, 30% were referred to mental health services. This program provided education, professional support, and led to the establishment of the first M2M center within a Bedouin community, located in the Negev (Naqab). Conclusions: The results emphasize the importance of culturally sensitive approaches to increase awareness, early diagnosis, and professional support in addressing PPD, tailored to a cultural context. Culturally adapted programs can be effective in minority populations and contribute to reducing disparities in maternal mental health care. Full article

Background/Objectives: Schizophrenia is associated with cognitive deficits that may compromise everyday functioning, including driving. This review systematically examined recent original research (2015–2025) on driving performance in individuals with schizophrenia with a focus on neuropsychological factors, applying a narrative synthesis given the heterogeneity of designs and outcomes, while no quantitative meta-analysis was feasible. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a structured search of PubMed and Scopus was conducted on 4 May 2025. The inclusion criteria were original studies involving individuals diagnosed with schizophrenia, published between 2015 and 2025. Studies on animals, other psychiatric or neurological conditions, and healthy populations were also excluded. Critical appraisal was performed using the Joanna Briggs Institute (JBI) tools. Extracted data included sample demographics, cognitive deficits, neuropsychological assessments, brain imaging, and the main findings. A narrative synthesis was then performed. Results: Six high-quality studies met the inclusion criteria. Findings were grouped into three categories: (1) driving behavior: fitness to drive varied widely across individuals, (2) cognitive deficits and brain activity: poorer driving-related performance was consistently associated with specific impairments in cognition and brain structure, and (3) medication effects: individuals taking certain atypical antipsychotics demonstrated better driving performance compared to those on other types of medication, while extrapyramidal symptoms negatively influenced driving fitness. Conclusions: Driving in schizophrenia is shaped by cognitive, clinical, and pharmacological factors. These findings highlight the clinical relevance of individualized evaluations, integration into personalized care and targeted rehabilitation to promote driving autonomy and community inclusion. This area remains under-researched, as only six studies met the inclusion criteria, which restricts the robustness and generalizability of the conclusions. Funding: This review received no funding from any external sources. Registration: The review protocol was submitted to PROSPERO (International Prospective Register of Systematic Reviews) under registration number CRD420251060580. Full article

Background/Objectives: Attention-deficit/hyperactivity disorder (ADHD) is increasingly recognized for its impact on social functioning, including deficits in social cognition and empathy. Emerging neurobiological evidence highlights the potential role of oxytocin in these impairments. However, the influence of pharmacotherapy, particularly methylphenidate (MPH) and atomoxetine (ATX), on these domains remains underexplored. This study aimed to examine the effects of MPH and ATX on social cognition, empathy, and serum oxytocin levels in children with ADHD. Methods: This study included 152 children aged 6–12 years diagnosed solely with ADHD. The patient group consisted of 102 children, comprising n = 52 receiving MPH and n = 50 receiving ATX for at least 3 months. The control group comprised 50 newly diagnosed, untreated children. A sociodemographic form, the Social Skills Rating Scale (SRSS), the Reading the Mind in the Eyes Test (RMET), the Bryant Empathy Index (BEI), and the Swanson, Nolan, and Pelham Questionnaire (SNAP-IV) were applied. Serum oxytocin levels were measured via venous blood samples. Results: Medicated children exhibited significantly elevated SRSS scores, irrespective of the pharmacotherapy administered. RMET scores were significantly higher in the ATX group. No significant differences were found between the three groups in terms of empathy scores and serum oxytocin levels. A significant negative correlation was identified between ADHD symptom severity and RMET and SRSS-Total scores. Regular medication use was a significant predictor of SRSS scores, while empathy and serum oxytocin levels were nonsignificant predictors. Conclusions: Pharmacotherapy may enhance social cognition among children with ADHD. Longitudinal studies are warranted to assess the long-term effects of medication on social cognition and empathy. Full article

Background/Objectives: Influenza continues to cause high morbidity and mortality rates worldwide, inflicting a major burden on the public health system. There is little data available on the 2024–2025 seasonal outbreak. Moreover, biomarkers for rapidly identifying subjects at higher risk for severe forms are needed. Methods: We retrospectively collected hospitalization data for influenza in Cannes, France, during the 2024–2025 seasonal outbreak. Severe forms were defined as cases either requiring admission to the Intensive Care Unit (ICU) or resulting in death. They were compared to uncomplicated forms. Main demographic, clinical, radiological, and laboratory characteristics were collected for each patient. Results: From October 2024 to May 2025, 59 patients were admitted to either the Infectious Diseases Department or the ICU (56% male, age 72 years, 27% vaccinated, influenza type A 93%, symptom duration 3.5 days prior to hospitalization, 31% admissions to ICU, 14% deaths). Vaccination status did not differ between severe and uncomplicated forms. In the univariate analysis, severe forms had higher neutrophil/lymphocyte and platelet/lymphocyte ratios upon admission and included more cases of acute hepatitis, pneumonia, and oseltamivir use than uncomplicated forms. A neutrophil/lymphocyte ratio > 15 was independently associated with severity (OR_adj 8.79, 95% CI: 1.34–57.6, p = 0.023), with 40.9% sensitivity, 94.6% specificity, 81.8% positive predictive value, and 72.3% negative predictive value for predicting a severe form. Conclusions: The N/L ratio was an easy-to-perform predictive marker for influenza severity during the 2024–2025 seasonal outbreak, warranting further prospective studies Full article

Background/Objectives: Cardiorespiratory fitness (CRF) represents a strong and consistent predictor of mortality among adults. It is ideally expressed as the maximum or peak rate of oxygen consumption per kilogram of body mass (VO_2max) determined by the cardiopulmonary exercise test (CPX). Variance in CRF is mainly attributable to genetics and physical training; nevertheless, strong behavioral and socioeconomic confounders need to be considered. Among those, psychosocial stress may play an important role. Some papers show an association between low CRF and chronic stress conditions; nevertheless, CRF is generally estimated by indirect assessment and not directly measured by CPX. Methods: CRF was directly assessed by performing a CPX in 145 consecutive subjects (56 male, 89 female) (age 19–65 years) who attended our Exercise Medicine unit for health check-ups. Weekly total volume of physical activity (PA) was evaluated using a validated questionnaire (IPAQ); perceptions of stress, fatigue, and somatic symptoms were assessed using a self-administered questionnaire. Results: VO_2max was negatively correlated with perception of stress (p = 0.03), fatigue (p < 0.001), and somatic symptoms (p < 0.001); as expected, it was positively correlated with the weekly volume of PA (p < 0.001). This link was further evidenced by the observation that subjects who did not meet the PA goals as indicated by WHO guidelines presented a higher perception of stress, fatigue, and symptoms, as compared to physically active subjects. Conclusions: This direct link might, on the one hand, corroborate the role of exercise as a tool to manage stress and, on the other hand, focus on the role of stress as a possible determinant of CRF. Full article

Background: Borderline Personality Disorder (BPD) often emerges during adolescence and young adulthood, a period marked by heightened vulnerability to impulsivity and affective dysregulation. While impulsivity is a core feature of BPD, its multidimensional expression in this age group remains insufficiently documented. This study examined impulsivity traits in young adults with BPD, their associations with depressive and anxiety symptoms, and their links to risk behaviors. Methods: A total of 160 participants aged 16–25 were recruited in Belgium between 2021 and 2023: 44 with BPD from inpatient and outpatient psychiatric services and 116 healthy controls from schools and universities. Assessments included the short UPPS-P, Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory (STAI-T), and the Diagnostic Interview for Borderlines–Revised (DIB-R). Logistic regressions with robust errors and Kendall’s tau-b correlations were used. Results: Compared with controls, individuals with BPD scored higher on all UPPS-p subscales except Sensation Seeking (e.g., Negative Urgency: 14 vs. 10, p < 0.001). Logistic regression identified Negative Urgency (OR = 5.31, 95% CI: 2.07–13.62, p = 0.001) and Positive Urgency (OR = 3.26, 95% CI: 1.37–7.75, p = 0.007) as independent predictors of BPD. Within the BPD group, depressive and anxiety symptoms correlated with several UPPS-P dimensions, notably Negative Urgency and Lack of Perseverance. Suicide attempts were associated with the DIB-R total score, BDI-II, and STAI-T, while substance use was linked to the DIB-R impulsivity subscale and STAI-T. Conclusions: Emotional impulsivity—particularly Negative Urgency—emerges as a central feature of BPD in emerging adulthood. Its interplay with depressive and anxiety symptoms, and its associations with suicidal and addictive behaviors, support a dual-level conceptualization of impulsivity as both a dispositional trait and a state-dependent clinical risk factor. Full article

Background: A large number of substance use disorders are increasingly associated with complex clinical presentations and unknown mental and medical risks, presenting a growing challenge for mental health worldwide. Research exploring the interplay between substance use and psychiatric disorders remains limited in Eastern Europe. Objectives: We investigated the demographic and clinical features of 203 patients admitted to a major Romanian psychiatric hospital, aiming to clarify the patterns of dual diagnosis and symptomatology within this vulnerable population. Results: Cannabis, novel psychoactive substances and unknown substances were the most commonly used drugs. Psychiatric comorbidity was rather the rule than the exception within our group. Cluster analysis revealed three distinct symptom profiles: manic/psychotic, negative affective and disorganized. While individual drug type did not independently predict symptom severity or readmission risk, a significant interaction effect between drug use and psychiatric comorbidity influenced symptom cluster membership. Conclusions: These findings highlight the complexity and heterogeneity of dual diagnoses and underline the importance of an integrated, multidisciplinary approach in addiction medicine. Full article

COVID-19 signs and symptoms varied among patients, with the most common being fever, fatigue, sore throat, cough, anorexia, and shortness of breath. (1) Background: This study aimed to assess effort, dyspnea, and cooperation scores in patients with mild and moderate post-COVID-19 forms, both at baseline and after completing a structured physical recovery program. (2) Methods: Our study included 160 post-COVID-19 patients who had experienced mild or moderate disease. (3) Results: Effort and dyspnea scores were significantly lower (p < 0.01), while cooperation scores were significantly higher after the rehabilitation program. Both men and women demonstrated significant increases in cooperation scores after recovery. Additionally, both groups showed statistically significant reductions in effort and dyspnea scores (p < 0.001). Among patients aged under and over 60 years, effort and dyspnea scores decreased after rehabilitation, and cooperation scores increased significantly (p < 0.001). No statistically significant differences were observed between genders in any of the three scores. Similarly, no significant differences by age were found in cooperation or dyspnea scores. A significant negative correlation was observed between cooperation and effort scores: patients with higher cooperation scores tended to report lower effort scores, and vice versa (p < 0.001, R = −0.571). (4) Conclusions: The improved cooperation demonstrated by patients during the physical recovery program was significantly associated with reductions in perceived effort and dyspnea, indicating a positive impact on post-COVID-19 rehabilitation outcomes. Full article

Background: Preschool bedroom television placement represents an established risk factor for negative psychological and behavioral outcomes in adolescence. Girls and boys have different risk factors for developmental psychopathology. It is unclear if childhood sport participation can act as a protective factor for the potential maladaptive behaviors associated with having a bedroom television in early childhood. Methods: This study aims to evaluate the impact of having a bedroom television in early childhood on later externalizing behaviors while examining the potential beneficial role of extracurricular sport participation in middle childhood using the Quebec Longitudinal Study of Child Development (Canada). We examine subsequent teacher-reported psycho-social outcomes by the end of sixth grade. Linear regression is used to examine the interaction between child-reported bedroom television placement (age 4 years) and parent-reported childhood sport participation trajectories (ages 6 to 10 years) in predicting behavioral outcomes at age 12 years. Results: For boys, extracurricular sport amplified the relationship between having a preschool bedroom television and subsequent physical aggression (b = 0.95, SE = 0.32, p < 0.001) and ADHD symptoms (b = 0.59, SE = 0.30, p ≤ 0.05), beyond individual and family characteristics. No interaction results were found for girls; however, consistent sport participation between ages 6 and 10 years resulted in a decrease in ADHD symptoms in girls (b = −0.329, SE = 0.102, p ≤ 0.001). Conclusion: Unexpectedly, for boys exposed to early bedroom television, consistently participating in extracurricular sport in childhood exacerbated long-term behavioral risks. Social unpreparedness from bedroom television placement countered the intended benefits of sport. This private access to screens might influence sedentary, unsupervised, isolated activity that increases the chances of viewing violence and reduces opportunities for social interaction. Full article

Background/Objectives: This study was designed to investigate the potential clinical, biochemical, haematological, and pathological associations of carpal tunnel syndrome through a multidisciplinary approach encompassing the fields of internal medicine, gastroenterology, and neurology. Methods: The study group (CTS-positive) comprised 265 patients who presented with dyspeptic complaints and underwent upper gastrointestinal endoscopy, gastric antrum biopsy, electromyography, and comprehensive biochemical and haematological analyses. A control group of 265 patients with similar symptoms but without CTS was selected for comparison. A comparative analysis was conducted on clinical findings, gastric biopsy results, and biochemical and haematological parameters. Results: There were no significant differences in age, gender distribution, or gastric biopsy findings (Helicobacter pylori, intestinal metaplasia, atrophy, and dysplasia) between the CTS-positive and CTS-negative groups. However, significant biochemical differences were identified, including elevated calcium and reduced magnesium levels in CTS-positive patients. Haematological evaluations revealed higher lymphocyte, eosinophil, basophil, erythrocyte, haemoglobin, and haematocrit levels, along with reduced neutrophil-to-lymphocyte ratios and red blood cell distribution widths in the CTS-positive group. Further analysis in the form of correlation and logistic regression analyses provided further confirmation of the association of elevated calcium, haemoglobin, and lymphocyte levels with increased risk of CTS. Conclusions: This multidisciplinary study identifies significant associations between CTS and specific biochemical and haematological parameters, notably calcium-magnesium imbalance and erythrocyte indices. These findings suggest underlying biological interactions that may guide future diagnostic and therapeutic strategies for patients with carpal tunnel syndrome. Full article

Background: This study was a cross-sectional online survey aimed at examining health-related quality of life and the effect of different symptoms and lifestyle factors on health-related quality of life in a sample of women with endometriosis in Hungary. Methodology: A cross-sectional online survey was carried out in a sample of women with endometriosis. Self-edited and Hungarian versions of validated questionnaires were used to assess health-related quality of life (Sf-36-Health Survey—SF-36), pain (Numeric Rating Scale-NRS), effect of pelvic pain on everyday life (Pelvic Pain Impact Questionnaire—PPIQ), perceived stress levels (Perceived Stress Scale—PSS), and physical activity (Global Physical Activity Questionnaire—GPAQ). Data analysis was conducted using IBM SPSS Statistics 28.0, and the level of significance was set at p < 0.05. Multivariate linear regression analysis was performed to examine the effect of different lifestyle factors, pain-related, and physical symptoms on the participants’ health-related quality of life (HrQoL). Results: The health-related quality of life of Hungarian women with endometriosis in our sample was significantly lower than the latest Hungarian normative values. Multiple linear regression analyses revealed that psychological, pain-related, and lifestyle factors significantly predicted HrQoL across SF-36 subscales in women with endometriosis (all models, p < 0.001; Adjusted R² = 0.274–0.654). Pain self-efficacy (PSEQ) was a consistent positive predictor that was significantly associated with better scores in five SF-36 domains, including physical and social functioning. Perceived stress (PSS) is a strong negative predictor that particularly affects emotional well-being, energy/fatigue, and social functioning. Pain interference (PPIQ) was linked to poorer HrQoL in seven out of eight SF-36 domains, while average pain intensity (NRS) negatively predicted Physical Functioning and General Health. Vigorous physical activity was positively associated with Social Functioning, whereas moderate activity had no significant effect. Among the demographic factors, only age was negatively associated with Physical Functioning; BMI and education were not significant predictors. Conclusions: Psychological, lifestyle, and symptom-related factors play key roles in health-related quality of life among women with endometriosis. Self-efficacy was a strong positive predictor, whereas perceived stress and pain interference were linked to poorer outcomes. High-intensity physical activity supported better social functioning. These findings highlight the need for multidisciplinary interventions targeting psychological support, pain management, and physical activity to improve quality of life in this population. Full article