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Rethinking Chronic Wound Treatment: Unlocking the Potential of Combination Products for an Unmet Multifactorial Need: A Review Study. 重新思考慢性伤口治疗:为未满足的多因素需求解锁组合产品的潜力:一项综述研究。
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-02-08 eCollection Date: 2026-02-01 DOI: 10.1002/hsr2.71798
Alberto Nicolás Ramos, Nicolás Cerusico, Romina Chavez-Jara

Background and aims: Chronic wounds, including diabetic foot, venous, and pressure ulcers, remain a major unmet medical challenge due to their prevalence, severity, and the limited efficacy of current treatments. These wounds are inherently multifactorial, requiring simultaneous intervention across all chronicity-inducing factors. Neither medical devices nor single pharmacological agents are sufficient, as they cannot comprehensively address the multiple therapeutic needs. This review aims to propose an integrative therapeutic approach capable of targeting all relevant mechanisms.

Methods: A narrative review of the literature was conducted, analyzing over 100 peer-reviewed articles on chronic wound pathophysiology and therapeutic strategies. Sources were identified through searches in PubMed, Scopus, and Web of Science, complemented by manual reference screening. Studies discussing the mechanisms of wound chronicity, as well as drugs and biologics with potential therapeutic activity, were included.

Results: The analysis revealed that current therapeutic options, including devices, drugs, and biologics, address only isolated aspects of chronic wound pathophysiology. No single agent or device is capable of comprehensively targeting all relevant mechanisms. However, evidence suggests that combining already-approved drugs and/or biologics may provide a synergistic effect, simultaneously targeting inflammation, infection, impaired angiogenesis, oxidative stress, and defective tissue remodeling. Importantly, the use of approved components leverages established pharmacological and safety profiles, potentially streamlining development and regulatory approval.

Conclusion: A topical combination product integrating multiple agents offers a promising strategy to overcome the limitations of current treatments. Advances in the understanding of wound pathophysiology and the availability of diverse active molecules create new opportunities to design effective and holistic therapies. Such combination products could transform the management of chronic wounds and represent the next generation of treatment approaches.

背景和目的:慢性伤口,包括糖尿病足、静脉溃疡和压疮,由于其普遍性、严重性和目前治疗效果有限,仍然是一个主要的未满足的医学挑战。这些伤口本质上是多因素的,需要同时干预所有慢性诱发因素。无论是医疗器械还是单一药物都是不够的,因为它们不能全面解决多种治疗需求。本综述旨在提出一种能够针对所有相关机制的综合治疗方法。方法:回顾性分析100余篇经同行评议的慢性伤口病理生理及治疗策略。通过检索PubMed、Scopus和Web of Science来确定来源,并辅以人工参考文献筛选。包括讨论伤口慢性机制的研究,以及具有潜在治疗活性的药物和生物制剂。结果:分析显示,目前的治疗方案,包括设备,药物和生物制剂,只解决慢性伤口病理生理的孤立方面。没有单一的制剂或设备能够全面针对所有相关机制。然而,有证据表明,联合已批准的药物和/或生物制剂可能提供协同效应,同时针对炎症、感染、血管生成受损、氧化应激和组织重塑缺陷。重要的是,批准成分的使用利用了已建立的药理学和安全性概况,可能简化开发和监管审批。结论:外用多药联合产品是克服目前治疗局限性的一种很有前途的策略。对伤口病理生理学的理解的进步和各种活性分子的可用性为设计有效的整体治疗方法创造了新的机会。这种组合产品可以改变慢性伤口的管理,代表下一代的治疗方法。
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引用次数: 0
Therapeutic Potential of Mesenchymal Stem Cells in Pediatric Kidney Disorders: A Comprehensive Review. 间充质干细胞在儿童肾脏疾病中的治疗潜力:综合综述。
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-02-08 eCollection Date: 2026-02-01 DOI: 10.1002/hsr2.71769
Mahboube Bahroudi, Mastaneh Moghtaderi

Background: Kidney diseases in children present significant health challenges, often leading to complications and reduced quality of life. Mesenchymal stem cell (MSC) therapy shows promise for pediatric kidney disorders. This review evaluates current evidence on MSC applications in pediatric nephrology, focusing on mechanisms, delivery methods, and outcomes.

Methods: We analyzed preclinical and clinical studies of MSC therapy for pediatric acute kidney injury (AKI), chronic kidney disease (CKD), glomerular disorders, and Congenital Anomalies of the Kidney and Urinary Tract (CAKUT), comparing pediatric and adult applications.

Results: MSCs exert therapeutic effects through immunomodulation, tissue regeneration, anti-fibrotic activity, and paracrine mechanisms. Different sources (bone marrow, umbilical cord, adipose) show varying efficacy. Delivery methods significantly impact outcomes: intravenous administration is well-tolerated but limited (2%-5% kidney delivery), while local infusion enhances targeting (10%-20%). Clinical studies show improved renal function: decreased creatinine in AKI, reduced albumin-to-creatinine ratio in CKD, and decreased proteinuria in nephrotic syndrome. Pediatric applications differ from adult ones in disease etiology, physiological considerations, therapeutic goals, and safety requirements.

Conclusion: MSC therapy shows promising potential for pediatric kidney disorders, with preliminary evidence supporting safety and efficacy. Challenges remain in optimizing cell sources, standardizing protocols, and establishing long-term safety. Future research should focus on biomarker identification, pediatric-specific models, and protocol standardization.

背景:儿童肾脏疾病对健康构成重大挑战,常常导致并发症和生活质量下降。间充质干细胞(MSC)治疗显示儿科肾脏疾病的前景。本综述评估了MSC在儿科肾脏病学应用的现有证据,重点是机制、给药方法和结果。方法:我们分析了MSC治疗儿童急性肾损伤(AKI)、慢性肾病(CKD)、肾小球疾病和先天性肾尿路异常(CAKUT)的临床前和临床研究,比较了儿童和成人的应用。结果:间充质干细胞通过免疫调节、组织再生、抗纤维化活性和旁分泌机制发挥治疗作用。不同的来源(骨髓、脐带、脂肪)表现出不同的疗效。给药方式显著影响结果:静脉给药耐受性良好,但有局限性(2%-5%的肾脏给药),而局部输注增强了靶向性(10%-20%)。临床研究显示肾功能改善:AKI患者肌酐降低,CKD患者白蛋白与肌酐比值降低,肾病综合征患者蛋白尿减少。儿童应用不同于成人在疾病病因,生理考虑,治疗目标和安全要求。结论:骨髓间充质干细胞治疗小儿肾脏疾病具有良好的潜力,初步证据支持安全性和有效性。在优化细胞来源、标准化协议和建立长期安全性方面仍然存在挑战。未来的研究应侧重于生物标志物鉴定、儿科特异性模型和方案标准化。
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引用次数: 0
A Bayesian Small Area Estimation Approach for District-Level Fertility and Mortality Estimates in India, 2015-16 to 2019-21. 2015-16至2019-21年印度地区生育率和死亡率估算的贝叶斯小区域估计方法
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-02-08 eCollection Date: 2026-02-01 DOI: 10.1002/hsr2.71789
Laxmi Kant Dwivedi, Somnath Jana, Shekhar Chauhan, Pooja Arora, Priyanka Dixit, Mrigesh Bhatia

Background and aims: Fertility and child mortality are critical public health indicators in India, directly influencing health policy, planning, and intervention effectiveness. The relationship between declining fertility and decreasing child mortality has been widely debated. This study aims to estimate and compare fertility and child mortality rates at the district level using data from the National Family Health Survey (NFHS) rounds 4 and 5, with a focus on understanding regional trends and their implications for health interventions.

Methods: The study investigates four key demographic indicators: Total Fertility Rate (TFR), Neonatal Mortality Rate (NMR), Infant Mortality Rate (IMR), and Under-Five Mortality Rate (U5MR). Fertility and child mortality rates were estimated using Bayesian methods, aligned with Demographic and Health Survey (DHS) standards. Fertility rates were computed in two stages: first, birth history data were transformed into table of birth, followed by the calculation of fertility rates through Poisson regression models at the district level.

Results: Between 2015-16 and 2019-21, the number of districts with a TFR below 1.6 increased from 21 to 166, while number of districts with a TFR between 1.6 and 2.1 remained stable at 328. Additionally, the number of districts with an NMR under 10 per 1,000 live births grew from 79 to 140. The study found a strong association between the reduction in child mortality and the decline in fertility rates.

Conclusion: This study suggests that addressing regional variations in fertility and child mortality rates could enhance the effectiveness of health interventions in India. Policymakers should prioritize expanding access to family planning and maternal-child health services. The availability of district-level data will support more targeted and effective health policies tailored to local needs.

背景和目的:生育率和儿童死亡率是印度重要的公共卫生指标,直接影响卫生政策、规划和干预措施的有效性。生育率下降和儿童死亡率下降之间的关系一直存在广泛的争论。本研究旨在利用国家家庭健康调查(NFHS)第4轮和第5轮的数据估计和比较地区一级的生育率和儿童死亡率,重点了解区域趋势及其对卫生干预措施的影响。方法:研究调查了4个关键人口统计指标:总生育率(TFR)、新生儿死亡率(NMR)、婴儿死亡率(IMR)和五岁以下儿童死亡率(U5MR)。生育率和儿童死亡率采用贝叶斯方法,与人口与健康调查(DHS)的标准保持一致。生育率的计算分两个阶段进行:首先将出生史数据转换为出生表,然后通过泊松回归模型计算各区的生育率。结果:2015-16年至2019-21年,TFR低于1.6的地区从21个增加到166个,TFR在1.6 - 2.1之间的地区保持在328个。此外,每1,000名活产婴儿的核磁共振指数低于10的地区从79个增加到140个。该研究发现,儿童死亡率的降低与生育率的下降之间存在着密切的联系。结论:这项研究表明,解决生育率和儿童死亡率的区域差异可以提高印度卫生干预措施的有效性。决策者应优先考虑扩大获得计划生育和妇幼保健服务的机会。获得地区一级的数据将支持更有针对性和更有效的卫生政策,以适应当地的需要。
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引用次数: 0
Clinical, Pathological, and Imaging Study of Pilomatrixoma: A Retrospective Study 毛基质瘤的临床、病理和影像学研究:回顾性研究
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-02-05 DOI: 10.1002/hsr2.71807
Qi Hao, Cong-Gai Huang, Chao-Ying Wu, Rong Kuang, Meng-Ze Li

Background and Aims

A retrospective analysis was conducted on the clinical, pathological, and imaging features of 471 cases of pilomatrixoma, aiming to enhance clinicians' understanding of pilomatrixoma.

Methods

A total of 471 cases of pilomatrixoma diagnosed and surgically treated in the Affiliated Hospital of Southwest Medical University from August 1999 to July 2024 were retrospectively analyzed. Some cases were also diagnosed through preoperative fine needle aspiration, as well as ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI).

Results

Of these 471 patients, 224 (47.6%) were male, and 247 (52.4%) were female. Their ages ranged from 8 months to 90 years, with an average age of 18.2 years. The highest incidence of pilomatrixoma was observed in patients aged between 0 and 10 years, accounting for 46.5% (219/471). The most common site of pilomatrixoma is the face, followed by the neck. The most common area of the face is the parotid gland region, accounting for 24.8% (61/246) of facial cases. Histology and cytopathology revealed that the tumor cells usually consisted of basaloid cells and eosinophilic shadow cells, and inflammatory cells, foreign body giant cells, and calcifications were seen. Additionally, the ultrasonography showed a mass with calcification, a strong echo band, and parenchyma without calcification. The pilomatrixoma should be considered when the tumor presents as soft-tissue density with varying degrees of calcification, well-defined oval or circular nodules on CT, and characteristic reticular and annular hypersignal on T2WI and T2WI + FS on MRI.

Conclusion

Pilomatrixoma is commonly found on the face and neck of adolescent females. Cytopathology, ultrasound, and imaging features can provide clinical clues, and histopathology can make the final diagnosis. Complete surgical resection is the preferred treatment.

背景与目的回顾性分析471例毛原基质瘤的临床、病理及影像学特点,旨在提高临床医生对毛原基质瘤的认识。方法回顾性分析1999年8月至2024年7月西南医科大学附属医院诊断并手术治疗的471例毛基质瘤病例。部分病例也可通过术前细针穿刺、超声、CT、MRI诊断。结果471例患者中,男性224例(47.6%),女性247例(52.4%)。年龄从8个月到90岁不等,平均年龄18.2岁。毛基质瘤的发病率以0 ~ 10岁的患者最高,占46.5%(219/471)。毛基质瘤最常见的部位是面部,其次是颈部。面部最常见的区域是腮腺区域,占面部病例的24.8%(61/246)。组织学和细胞病理学显示,肿瘤细胞多由基底细胞和嗜酸性阴影细胞组成,可见炎性细胞、异物巨细胞和钙化。超声示肿块伴钙化,回声带强,实质无钙化。当肿瘤表现为软组织密度伴不同程度钙化,CT表现为界限分明的卵圆形或圆形结节,MRI表现为T2WI及T2WI + FS特征性的网状及环状高信号时,应考虑为毛瘤。结论青春期女性头皮屑基质瘤常见于面部和颈部。细胞病理学、超声和影像学特征可提供临床线索,组织病理学可作出最终诊断。完全手术切除是首选的治疗方法。
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引用次数: 0
The Effect of Emotional Self-Regulation Counseling on Anxiety and Fear of Childbirth in First-Time Pregnant Women: A Clinical Trial Study 情绪自我调节咨询对初产妇分娩焦虑和恐惧的影响:一项临床试验研究
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-02-05 DOI: 10.1002/hsr2.71781
Negar Masoumi, Farideh Kazemi, Azita Tiznobaik, Mohammad Ahmadpanah

Background

Pregnancy-related anxiety and fear of childbirth are common in primiparous women and contribute to high cesarean section rates. Few interventions specifically target emotion regulation skills.

Objective

To evaluate the efficacy of a brief, midwife-led, group-based counseling program grounded in Gross's emotion regulation model in reducing pregnancy-related anxiety and fear of childbirth.

Methods

Pragmatic randomized controlled trial in Hamadan, Iran, 2023. Seventy primiparous women (28–33 weeks gestation) were allocated (1:1) to 6 weekly emotion regulation counseling sessions or routine prenatal care. Primary outcomes were post-intervention scores on the Persian Pregnancy-Related Anxiety Questionnaire (PRAQ) and Childbirth Attitudes Questionnaire (CAQ), analyzed by ANCOVA adjusting for baseline scores.

Results

Adjusted mean PRAQ scores were 36.65 (SE 2.74) vs. 66.41 (SE 2.74) (adjusted difference –29.76, 95% CI −37.28 to −22.24, Cohen's d = 1.95, p < 0.001). Adjusted mean CAQ scores were 25.51 (SE 1.07) vs. 35.99 (SE 1.07) (adjusted difference −10.48, 95% CI −13.48 to –7.48, Cohen's d = 1.71, p < 0.001). Effects remained robust after adjustment for insurance status.

Conclusion

This brief emotion regulation intervention produced large reductions in pregnancy-related anxiety and fear of childbirth. Findings are preliminary due to single-center design, lack of blinding, and subjective outcomes. Larger multicenter trials with attention controls and long-term follow-up are needed before routine implementation.

Trial Registration: IRCT20230115054147N1.

背景:与妊娠有关的焦虑和对分娩的恐惧在初产妇女中很常见,并导致剖宫产率高。很少有干预措施专门针对情绪调节技能。目的评价以Gross情绪调节模型为基础的以助产士为主导、以小组为基础的简短咨询方案在减少妊娠相关焦虑和分娩恐惧方面的效果。方法2023年在伊朗哈马丹进行随机对照试验。70例初产妇(孕28-33周)按1:1的比例接受6周情绪调节咨询或常规产前护理。主要结局是干预后波斯妊娠相关焦虑问卷(PRAQ)和分娩态度问卷(CAQ)的得分,通过ANCOVA调整基线得分进行分析。调整后的平均PRAQ评分为36.65 (SE 2.74)比66.41 (SE 2.74)(调整后差异为-29.76,95% CI为- 37.28 ~ - 22.24,Cohen’s d = 1.95, p < 0.001)。校正平均CAQ评分为25.51 (SE 1.07)比35.99 (SE 1.07)(校正差为- 10.48,95% CI为- 13.48至-7.48,Cohen’s d = 1.71, p < 0.001)。在调整保险状况后,效果仍然强劲。结论这种简短的情绪调节干预大大减少了与妊娠有关的焦虑和分娩恐惧。由于单中心设计、缺乏盲法和主观结果,研究结果是初步的。在常规实施之前,需要进行更大规模的多中心试验,包括注意控制和长期随访。试验注册:IRCT20230115054147N1。
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引用次数: 0
Health Workers' Knowledge and Practice of Developmentally Supportive Care for Premature Infants in Four Ugandan Neonatal Units: A Cross-Sectional Study 乌干达四个新生儿单位卫生工作者对早产儿发育支持护理的知识和实践:一项横断面研究
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-02-05 DOI: 10.1002/hsr2.71805
Zelee Hill, Victoria Nakibuuka, Robert Serunjogi, Robert Ssekitoleko, Ritah Nasiima, Sanyu Nalunga-Atuhe, James Nyonyintono, Albert Kamugisha

Background and Aims

Neonatal units can be stressful for pre-term infants at a time of rapid brain growth and plasticity, which may contribute to poorer developmental outcomes. Environmental modification to protect against negative sensory experiences and provide positive caregiver stimuli is the standard of care, but little is known about practices in low-income settings. We aimed to determine knowledge and practice relating to developmentally-supportive-care in Uganda.

Methods

A quantitative survey on knowledge and practice of developmentally-supportive-care was conducted with 135 health workers in four neonatal units. In addition, observations of practices and sound measurements were conducted.

Results

Only 36% of respondents reported that stress, and 21% that parental interaction can affect brain development, and knowledge of stress reduction was limited. 84% of respondents reported actions to protect infants from excessive light in their unit, 33% from excessive sound, and 69% from sleep disruption. The main perceived benefit of family involvement in care was to reduce parental stress levels (67%), with infection risk perceived as the main negative (71%). Workers at the largest volume facility had the lowest knowledge and practice, with wide variations across facilities. All units had sound readings over recommended levels.

Conclusion

Knowledge and practice of DSC in this setting were low and needs to be improved to ensure that pre-terms in this setting both survive and thrive.

背景和目的对于大脑快速发育和可塑性的早产儿来说,新生儿病房可能会给他们带来压力,这可能会导致较差的发育结果。改变环境以防止消极的感官体验并提供积极的照顾者刺激是护理的标准,但对低收入环境的做法知之甚少。我们的目的是确定乌干达与发展支持护理相关的知识和实践。方法对4个新生儿病房135名医护人员的发育支持护理知识和实践情况进行定量调查。此外,还进行了实践观察和声音测量。结果只有36%的受访者表示压力会影响大脑发育,21%的受访者认为父母的互动会影响大脑发育,人们对减压的了解有限。84%的答复者报告采取了保护婴儿免受其单位过度光照的措施,33%的答复者报告采取了保护婴儿免受过度噪音的措施,69%的答复者报告采取了保护婴儿免受睡眠中断的措施。人们认为家庭参与护理的主要好处是降低了父母的压力水平(67%),而感染风险被认为是主要的负面影响(71%)。最大产能工厂的工人知识和实践水平最低,各工厂差异很大。所有设备的声音读数都超过了建议水平。结论该地区对DSC的认识和实践水平较低,需要进一步提高,以确保该地区早产儿的生存和发展。
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引用次数: 0
Explaining Faculty Members' Experiences of Clinical Education During the COVID-19 Pandemic: A Qualitative Study 新冠肺炎大流行期间教师临床教育经历的定性研究
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-02-05 DOI: 10.1002/hsr2.71704
Fazlollah Ahmadi, Mahboobeh Khabaz Mafinejad, Bita Sadeghi, Meysam Heidari, Mehran Tahrekhani, Mohammad Abdi

Background and Aims

Clinical education is a fundamental component of medical training that faced numerous challenges during the COVID-19 pandemic. Understanding faculty members' experiences and strategies can inform plans for enhancing educational quality during future health crises. This study aimed to explore faculty members' experiences in delivering clinical education during the pandemic.

Methods

This qualitative study used a conventional content analysis approach. Data were collected through semi-structured interviews employing purposive sampling. Interviews continued until data saturation was achieved. In total, 14 participants were interviewed. The credibility of the findings was assessed using the criteria proposed by Guba and Lincoln.

Results

The analysis yielded three main themes. The first theme, challenge-based experience, consisted of subcategories including intrapersonal psychological challenges, environmental misinformation, and systemic management deficiencies. The second theme, change-based experience, comprised subcategories such as shifts in protective roles, modifications in clinical education environments, changes in patient collaboration, heightened attention to professionalism, and strengthened role modeling. The third theme, problem-solving-based experience, encompassed subcategories such as an emphasis on feedback, clinical education strategies, educational equity approaches, systemic solutions, exploration of international approaches, and comprehensive assessment strategies.

Conclusion

The study delineates a three-phase adaptation trajectory—through confronting challenges, navigating changes, and implementing problem-solving strategies—that enabled faculty to sustain clinical education during the pandemic. These experiences yield critical, actionable recommendations for future crisis preparedness. We recommend that institutions integrate hybrid clinical training models and develop formal faculty development programs focused on digital pedagogy and crisis management. Embedding these evidence-based strategies into medical education policy is crucial for building a resilient and equitable clinical education system capable of withstanding future disruptions.

背景和目的临床教育是医学培训的基本组成部分,在COVID-19大流行期间面临着许多挑战。了解教师的经验和策略可以为未来健康危机期间提高教育质量的计划提供信息。本研究旨在探讨教师在大流行期间提供临床教育的经验。方法采用常规的含量分析方法进行定性研究。数据收集通过半结构化访谈采用目的抽样。访谈一直持续到数据饱和为止。总共有14名参与者接受了采访。研究结果的可信度是用Guba和Lincoln提出的标准来评估的。结果分析得出三个主要主题。第一个主题是基于挑战的体验,包括个人心理挑战、环境错误信息和系统管理缺陷等子类别。第二个主题是基于变化的经验,包括保护角色的转变、临床教育环境的改变、患者协作的变化、对专业精神的高度关注和角色塑造的加强等子类别。第三个主题,基于问题解决的经验,包含了诸如强调反馈、临床教育策略、教育公平方法、系统解决方案、探索国际方法和综合评估策略等子类别。该研究描绘了一个三阶段的适应轨迹——通过面对挑战、驾驭变化和实施解决问题的策略——使教师能够在大流行期间维持临床教育。这些经验为今后的危机防范提供了关键的、可操作的建议。我们建议机构整合混合临床培训模式,并制定正式的教师发展计划,重点关注数字教学法和危机管理。将这些循证战略纳入医学教育政策对于建立一个能够承受未来干扰的有弹性和公平的临床教育系统至关重要。
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引用次数: 0
Association Between Serum Vitamin D Levels and Mortality in Children Receiving Chronic Dialysis: A Retrospective Cohort Study 接受慢性透析的儿童血清维生素D水平与死亡率之间的关系:一项回顾性队列研究
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-02-03 DOI: 10.1002/hsr2.71804
Sima Shamshiri Khamene, Izat Mohammad Khawajah, Mastaneh Moghtaderi

Background

Vitamin D deficiency is highly prevalent among children on regular dialysis, affecting approximately 90% of patients. This deficiency (serum 25-hydroxyvitamin D < 50 nmol/L or 20 ng/mL) is associated with various complications, including skeletal problems, increased infection risk, arterial stiffness, vascular calcification, and higher cardiovascular mortality. Severe deficiency (< 30 nmol/L) particularly increases mortality risks.

Method

In this cross-sectional retrospective study, we examined 53 pediatric patients (28 boys, 25 girls) undergoing regular dialysis (hemodialysis and peritoneal dialysis) at a children's medical center from 2018 to 2020. The mean age was 8.21 years, with 71.7% aged 2–12 years, 20.8% adolescents, and 7.5% under 2 years. The mean vitamin D level was 23.51 ng/mL.

Results

Results showed that 26.41% of patients died, with mortality analysis revealing a hazard ratio of 3.2 for patients with vitamin D levels below 15 ng/mL. The mortality rate was 64.7% in severe deficiency (< 15 ng/mL), 18.8% in moderate deficiency (15–30 ng/mL), while patients with sufficient levels (> 30 ng/mL) recorded no deaths. Additionally, 11.32% developed skeletal disorders, including two cases of spinal fracture. Vitamin D levels showed significant positive correlations with calcium (r = 0.6) and years under dialysis (r = 0.52) (p > 0.05). Associations were found between vitamin D levels and phosphorus, PTH, and mortality rates. However, no significant relationships were observed with dialysis frequency, age, weight, gender, underlying disease, dialysis type, or hypertension.

Conclusion

In conclusion, children with end-stage renal disease undergoing dialysis face increased risks of vitamin D deficiency due to impaired kidney function. This deficiency significantly impacts survival rates and contributes to poor outcomes. Regular monitoring and management of vitamin D levels are crucial for improving survival in pediatric dialysis patients.

背景:维生素D缺乏症在定期透析的儿童中非常普遍,影响了大约90%的患者。在这项横断面回顾性研究中,我们调查了2018年至2020年在儿童医疗中心接受常规透析(血液透析和腹膜透析)的53名儿童患者(28名男孩,25名女孩)。平均年龄8.21岁,2-12岁占71.7%,青少年占20.8%,2岁以下占7.5%。平均维生素D水平为23.51 ng/mL。结果:结果显示26.41%的患者死亡,死亡率分析显示维生素D水平低于15 ng/mL的患者的风险比为3.2。严重缺乏(30 ng/mL)的死亡率为64.7%,无死亡记录。此外,11.32%的患者出现骨骼疾病,包括2例脊柱骨折。维生素D水平与钙(r = 0.6)和透析时间(r = 0.52)呈显著正相关(p < 0.05)。研究发现,维生素D水平与磷、甲状旁腺素和死亡率之间存在关联。然而,与透析频率、年龄、体重、性别、潜在疾病、透析类型或高血压没有显著关系。结论:接受透析治疗的终末期肾病患儿由于肾功能受损,维生素D缺乏的风险增加。这一缺陷严重影响了生存率,并导致预后不良。定期监测和管理维生素D水平对于提高儿童透析患者的生存率至关重要。
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引用次数: 0
A Comprehensive Review of Acne Treatments: Unpacking the Chemical Structures and Effective Bioactive Compounds 痤疮治疗的综合综述:揭示化学结构和有效的生物活性化合物。
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-02-03 DOI: 10.1002/hsr2.71803
Mobina Tajdari, Setare Abolghasemi, Elham Khanniri, Maryam Bayanati, Rahil Hakimimofrad, Mohammad Mahboubi-Rabbani

Background and Aims

Acne vulgaris is a frequent skin disorder, affecting a large part of the population worldwide, and strongly influencing not only the physical but also the mental aspects of health. The choice of therapy for acne vulgaris is a very difficult one because the multifactorial causality of the disease and interindividual variability in response to treatment should be considered. This article aims to provide a comprehensive review of the drugs used in the treatment of acne vulgaris, along with their chemical structure.

Methods

A comprehensive search of relevant databases (PubMed, Google Scholar, Web of Science, and Scopus) was conducted using keywords such as “acne vulgaris”, “chemical structure”, “mode of action”, and “structure–activity relationship”. We reviewed articles published up to 2025. The authors reviewed articles that discussed the chemical structure and structure–activity relationships of drugs used in the treatment of acne vulgaris. In addition, articles on acne vulgaris pharmacotherapy were also reviewed.

Results

In this review, all the current modalities for the management of acne vulgaris are presented and grouped according to their chemical nature, including topical applications and systemic administration. In this light, we go further into the mechanism of action of each treatment, its efficacy and safety, and possible side effects. New therapeutic agents targeting the skin microbiome, inflammation, and hormonal imbalance are also a focus. We finally propose one step for choosing an optimum therapy based on the subject's constitution, the severity of post-acne scarring, and associated comorbidities.

Conclusion

The present review would benefit general physicians in adapting their management to treat zits and pimples for the improvement of their patients, with particular importance given to the knowledge of the chemical structures of various drugs.

背景与目的:寻常痤疮是一种常见的皮肤疾病,影响着世界上很大一部分人口,不仅对身体健康,而且对心理健康也有很大的影响。寻常痤疮的治疗选择是一个非常困难的,因为疾病的多因素因果关系和个体间对治疗反应的变异性必须考虑。本文旨在对目前治疗寻常性痤疮的药物及其化学结构进行综述。方法:以“痤疮”、“化学结构”、“作用方式”、“构效关系”等关键词,综合检索相关数据库(PubMed、谷歌Scholar、Web of Science、Scopus)。我们回顾了截至2025年发表的文章。本文综述了国内外治疗寻常性痤疮药物的化学结构和构效关系。此外,本文还对寻常痤疮的药物治疗进行了综述。结果:本文综述了目前治疗寻常痤疮的所有方法,并根据其化学性质进行了分类,包括局部应用和全身给药。据此,我们进一步探讨每种治疗的作用机制、疗效和安全性以及可能的副作用。针对皮肤微生物群、炎症和激素失衡的新治疗剂也是一个焦点。我们最后提出了一个步骤,根据受试者的体质,痤疮后疤痕的严重程度和相关的合并症来选择最佳的治疗方法。结论:本综述将有助于普通医生调整治疗丘疹和丘疹的管理方法,以改善患者的病情,特别重视了解各种药物的化学结构。
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引用次数: 0
Effect of Massage With Verbal Contact by Mothers of Premature Infants on Maternal Attachment and Infant's Motor Performance: A Randomized Controlled Trial 早产儿母亲言语接触按摩对母亲依恋和婴儿运动表现的影响:一项随机对照试验。
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-02-03 DOI: 10.1002/hsr2.71697
Ava Monfared, Malek Amini, Jamileh Abolghasemi, Ali Mazouri, Zahra Darabi Boroujeni

Background and Aims

An infant born before 37 weeks of gestation is called a preterm infant. In the Neonatal Intensive Care Unit (NICU), occupational therapists provide essential therapeutic interventions, including those for social-emotional development, the promotion of parent-infant attachment and interactions, and the developmental assessment of preterm infants. This research aimed to explore the effects of maternal massage training combined with verbal contact with preterm infants on maternal attachment and infant motor performance.

Methods

84 preterm infants in the NICU were assigned to intervention and control groups. The infants in the control group underwent standard interventions, while the mothers of the infants in the intervention group gave their babies a massage for 15 min daily over 5 days and talked to their babies during the massage. Maternal Postnatal Attachment Scale (MPAS) and the Test of Infant Motor Performance (TIMP) were utilized for assessment and the data were analyzed using SPSS version 27.

Results

In both groups, MPAS and TIMP post-test scores increased compared to pre-test scores, although the increase in scores was significantly greater in the intervention group than in the control group (95% CI [−6.96, −1.73], p = 0.001% and 95% CI [−0.93, −0.14], p = 0.009, respectively). However, no statistically significant weight gain was observed in either the intervention or control groups (95% CI [−186.14, −129.14], p = 0.720).

Conclusion

Massage along with verbal contact by mothers of premature infants enhances maternal attachment and the infants' motor performance, yet it does not significantly affect the infants' weight gain. Consequently, given the difficulties these babies and their caregivers encounter, massage and verbal contact may serve as a safe and economical approach.

背景和目的:妊娠37周前出生的婴儿称为早产儿。在新生儿重症监护病房(NICU),职业治疗师提供必要的治疗干预,包括社会情感发展,促进亲子依恋和互动,以及早产儿的发育评估。本研究旨在探讨母亲按摩训练结合早产儿言语接触对母亲依恋和婴儿运动表现的影响。方法:将84例新生儿重症监护病房早产儿分为干预组和对照组。对照组婴儿接受标准干预,干预组婴儿的母亲在5天内每天给婴儿按摩15分钟,并在按摩过程中与婴儿交谈。采用母亲产后依恋量表(MPAS)和婴儿运动能力测试(TIMP)进行评估,数据采用SPSS 27版进行分析。结果:两组患者的MPAS和TIMP测试后评分均较测试前评分升高,但干预组的评分升高幅度明显大于对照组(95% CI [-6.96, -1.73], p = 0.001%; 95% CI [-0.93, -0.14], p = 0.009)。然而,干预组和对照组均未观察到有统计学意义的体重增加(95% CI [-186.14, -129.14], p = 0.720)。结论:早产儿母亲在言语接触的同时进行按摩可以增强母亲依恋和婴儿的运动表现,但对婴儿体重的增加没有显著影响。因此,考虑到这些婴儿和他们的照顾者遇到的困难,按摩和口头接触可能是一种安全和经济的方法。
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引用次数: 0
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Health Science Reports
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