Limited data exist on mortality and venous thromboembolism (VTE) risk in hip-fracture patients with recent COVID-19 infection. We aimed to examine (i) the association between vaccination status and mortality risk, (ii) whether infection timing is associated with mortality risk, and (iii) whether recent infection is associated with an increase in postoperative VTE risk.

 Adult Kaiser Permanente Northern California members undergoing hip-fracture surgery (2020-2022) were identified. Patients with varying vaccination statuses and SARS-CoV-2 infection histories within 6 months preoperatively were analyzed. Multivariable regression models were adjusted for demographics, comorbidities, and COVID-19 status to calculate risk ratios. The primary outcome was 90-day mortality; the secondary outcome was 90-day VTE.

 3,674 patients were included. Unvaccinated or partially vaccinated patients with COVID-19 within 6 months preoperatively had a 4.49-fold higher 90-day mortality risk than fully vaccinated patients (95% confidence interval [CI] 3.72-5.42). Among COVID-positive patients, shortening of the interval from infection to surgery from 6 months to 6 weeks was associated with increased 90-day mortality risk of approximately 53% (CI 1.29-1.97). Additionally, more recent infection (within 6 months) was associated with a 3.14-fold higher postoperative VTE risk (CI 1.10-8.98).

 COVID-19 vaccination is associated with a reduction in the mortality risk among hip-fracture patients with recent infection. Shorter infection-to-surgery intervals are associated with increased mortality risk, and recent infection is associated with higher VTE risk.

BackgroundUpper extremity deep-vein thrombosis (UEDVT) is often under-recognized and perceived as less consequential than lower extremity DVT. This study evaluated the risk factors and outcomes of critically ill patients with UEDVT.MethodsWe evaluated patients in the adult ICUs of a tertiary-care hospital who had Doppler ultrasound for suspected acute upper extremity vein thrombosis between January 2022 and December 2023 and documented the presence of UEDVT and superficial-vein thrombosis (UESVT). We compared patients with and without UEDVT, specifically evaluating the incidence of pulmonary embolism and hospital mortality.ResultsAmong 9605 ICU admissions, 501 patients underwent upper extremity ultrasound at a median of 13 days after hospital admission. These patients had a median age of 66 years and were predominantly male (60.3%). 143 patients (28.5%) had UEDVT and 169 (33.7%) UESVT (54 patients had both). UEDVT was significantly associated with central venous catheters, particularly hemodialysis lines. Pulmonary embolism was more common in patients with UEDVT (19.6% versus 10.3%, p=0.005; adjusted odds ratio, 2.08; 95% confidence interval, 1.16-3.71) with a higher rate in patients with multiple versus one affected vein (32.6% versus 13.4%, p=0.007). Hospital mortality was higher in patients with UEDVT (51.7% versus 31.6%, p<0.0001; adjusted odds ratio, 2.05; 95% confidence interval, 1.22-3.45). UESVT was not associated with pulmonary embolism or mortality.ConclusionsUEDVT is an important complication in critically ill patients and may be associated with an increased risk of pulmonary embolism and mortality, underscoring the importance of prevention, early detection, and appropriate therapeutic approach.

The COVID-19 pandemic may have impacted cannabis use among the adolescent population. Therefore, it is important to understand the potential factors linking cannabis use to COVID-19 and vice versa, as well as the consumption patterns following the onset of COVID-19.

This study conducted in Andalusia, Spain. Although, 1,051 adolescents aged 14-18 years were included in this cross-sectional study, of these, the 89 (8.5%) reported testing positive for COVID-19, who were the main target for our analyses. Sociodemographic, psychological, and cannabis use variables, as well as COVID-19 testing positive, isolation and some perceptions about cannabis and COVID-19 were analysed. A binary logistic regression, was conducted to examine the association between COVID-19-related factors and controlled for sociodemographic and psychological variables, assessed estimations with cannabis use.

Adolescents testing positive for COVID-19 are almost 2.89 times more likely to have used cannabis in the last month. Additionally, number of isolations was higher among cannabis users and positive testing. Cannabis users showed a lack of perceived risk that cannabis use could exacerbate COVID-19 and that cannabis' smoke could spread COVID-19. Sharing cannabis among adolescents during the pandemic may increase the risk of COVID-19 transmission.

Informing whether adolescents who use cannabis may be more likely to test positive for COVID-19 can contribute to a better understanding of substance use patterns during a public health emergency. However, given the exploratory and cross-sectional nature of this study, as well as its limited and context-specific sample, the findings should be interpreted with caution. Despite this, we believe that this research may inform future studies exploring the impact of cannabis use among adolescents during public emergency situations in larger samples and other contexts.

Messenger ribonucleic acid vaccines against coronavirus disease 2019 (COVID-19) have been temporally associated with various renal adverse events, including acute tubulointerstitial nephritis (ATIN). Herein, we present the case of a 14-year-old male who developed biopsy-confirmed ATIN following a booster dose of the BNT162b2 (Pfizer-BioNTech) severe acute respiratory syndrome coronavirus 2 vaccine. Ten days after vaccination, the patient presented with fever, fatigue, and nausea and was referred to our hospital because of impaired kidney function. Kidney biopsy demonstrated diffuse tubulointerstitial inflammation consistent with ATIN, and gallium-67 scintigraphy showed diffuse bilateral kidney uptake. The lymphocyte transformation test (LTT) showed a stronger positive response to the BNT162b2 vaccine than to concomitant medications, suggesting a possible association with vaccination. Corticosteroid therapy led to rapid improvement in kidney function and normalization of tubular injury markers. This case demonstrated that ATIN may rarely occur after booster vaccination, and highlights the potential role of the LTT as a useful tool when multiple possible triggers are present.

Cystic fibrosis (CF) and primary ciliary dyskinesia (PCD) are characterized by neutrophilic airway inflammation but differ in clinical features.

We investigated relationships of pulmonary and systemic inflammatory markers with functional and structural lung disease.

Systemic (CRP, IgG, IL-6, and IL-8) and sputum (calprotectin, IL-6, and IL-8) markers were measured at baseline. Relationships were explored with spirometry, lung clearance index and lung computed tomography (CT) scores at baseline and with spirometry 10 years later.

42 patients (21 CF, 21 PCD) of similar age (median CF 27 y [12-59], PCD 27 y [11-62]) and lung function (median ppFEV₁CF 59% [40-99], PCD 67% [30-101]) were enrolled in 2009. Systemic inflammation was significantly higher in CF (Neutrophils, p < 0.05, IL-6 and 8, p < 0.01). Conversely, sputum IL-6 and 8 were higher in PCD (p < 0.01). In CF, sputum IL-6 counter-intuitively correlated with better CT scores (r = -0.51/p < 0.05) at baseline and with better spirometry (r = 0.58, p < 0.05) 10 years later. Conversely, high sputum IL-6 at baseline was associated with worse lung function in PCD (r = 0.81/p = 0.001) after 10 years.

This study emphasizes the differences of functional and structural aspects in both diseases. Markers that predict long-term outcome in PCD and in CF were identified. The most striking and unanticipated finding was that sputum IL-6 correlated with better CT scores and lung function in CF. This paradox merits further research but challenges whether sputum IL-6 in CF is always a bad prognostic indicator.

Sleep-disordered breathing (SDB) is linked to memory decline, but the exact relationship between sleep fragmentation, nocturnal hypoxemia, and cognitive impairment remains unclear.

This study aimed to investigate the associations between micro-arousal burden, nocturnal oxygen desaturation, and memory decline in patients with moderate-to-severe OSA.

Data were retrieved from the clinical and overnight polysomnographic (PSG) records of adult patients evaluated for suspected SDB. The primary clinical endpoint was the presence and severity of memory decline, ascertained via a standardized Subjective Cognitive Decline (SCD) instrument. A multidimensional array of variables was systematically extracted, encompassing baseline demographic characteristics, cardiometabolic comorbidities, and high-resolution sleep architecture metrics, with a distinct emphasis on stage-specific micro-arousal burdens and the morphological profiles of nocturnal oxygen desaturation. Then, independent t tests and x 2 $$ {x}^2 $$ tests were initially utilized to characterize PSG disparities between the memory-normal and memory-decline groups. And interpretable machine learning algorithms, utilizing rigorously partitioned training and validation sets, were deployed to predict cognitive trajectories and elucidate the relative prognostic importance of specific sleep-related parameters.

The final analytical sample comprised 884 participants with complete primary outcome data (memory-normal: N = 408; memory-decline: N = 476). Initial comparative analyses revealed the memory-decline group was older (50.24 vs. 45.95 years, p < 0.001) with a significantly higher prevalence of cardiometabolic comorbidities, including hypertension (47.3% vs. 40.2%, p = 0.035) and diabetes (24.4% vs. 8.8%, p < 0.001). Polysomnographically, this group exhibited a distinct hypopnea-predominant phenotype: despite a comparable overall AHI (45.82 vs. 48.64 events/h, p = 0.099) and global arousal index (26.98 vs. 28.85 events/h, p = 0.172), they demonstrated a significantly higher hypopnea count (122.25 vs. 110.40, p = 0.047) and prolonged awake time with SpO₂ < 95% (33.71 vs. 27.71 min, p = 0.015). Paradoxically, their nadir SpO₂ was elevated (76.68% vs. 74.39%, p = 0.009), maximal obstructive events were shorter (51.42 s vs. 57.49 s, p < 0.001), and obstructive desaturation events were fewer (180.33 vs. 219.70, p = 0.006), indicating a shift toward shallower, persistent desaturation morphologies. Furthermore, interpretable machine learning models, rigorously evaluated on the independent validation set, identified spontaneous NREM micro-arousals, total REM micro-arousals, and obstructive desaturation metrics as the highest-ranking predictive determinants of memory decline.

Memory decline in SDB is more robustly associated with the morphological profile of oxygen exposure rather than absolute event frequencies. A hypopnea-dominant profile with mild, persistent low oxygen levels offers an associative framework for understanding cognitive decline. Future research and clinical interventions should prioritize hypoxic burden as a key factor in phenotype identification and memory decline treatment.

Cystic fibrosis (CF) is a life-limiting genetic disorder caused by deleterious variants in the CFTR gene that results in altered mucus impairing the airway epithelia. Durable correction of these variants in airway cells remains a therapeutic challenge for about 10% of individuals unresponsive to CFTR modulators. A common disease-causing CFTR splice site variant, 3120+1G>A, was corrected in primary CF airway cells using base editor RNAs. Single-cell RNA sequencing revealed a remarkable increase in detectable CFTR transcript in most CF airway epithelial cell types resulting in notable enrichment of CFTR-expressing ionocytes and secretory goblet cells. Progenitor basal cell subtypes were edited, but they decreased as a fraction of total cells and CFTR-expressing cells compared with unedited cells. CRISPR base editors delivered by polymeric nanoparticles (PNPs) facilitated functional rescue of CFTR to clinically meaningful levels in immortalized and primary airway cells. PNPs delivered GFP-encoding RNA to progenitor airway cells in fully differentiated airway cultures. Vitronectin was a major component of the PNP corona that formed in vivo, but preincubation with vitronectin did not enhance delivery. Together, these findings validate a scalable, nonviral platform with compelling translational promise for treating CF and other respiratory diseases involving respiratory epithelial cell dysfunction.

COVID-19 disrupted healthcare systems globally, particularly challenging maternity services which continued to be operated as an essential service. Reconfigurations were implemented to continue providing care in a safe manner and in line with infection control restrictions. This systematic review of women's experiences of maternity care during the COVID-19 pandemic in high-income countries (HICs), aimed to synthesize published literature and inform future responses to global disasters.

Electronic database of Scopus, MEDLINE, EMBASE, CINAHL PsychINFO, and the Cochrane COVID Study Register, were searched from June 2021- June 2024 to identify eligible records. Thematic synthesis was used to synthesise the data.

79 studies were included with data from over 20,000 perinatal women, most were of moderate to high methodological quality. Data synthesis showed 11 themes across five main concepts related to maternity service reconfigurations, namely: (1) Care-seeking and care experience, (2) Virtual care, (3) Self-monitoring, (4) Vaccination, and (5) Ethical future of maternity care.

Women predominantly viewed changes to maternity care negatively. Future strategies to ensure safeguarding of mothers and infants during crises should include enhancing service accessibility, emphasizing women-centered care, and prioritizing support systems for mothers and infants.

https://www.crd.york.ac.uk/PROSPERO/view/CRD42022355948, identifier: CRD42022355948.

While often promoted as a safer alternative to traditional cigarettes, electronic cigarettes (e-cigarettes) are linked to uncertain long-term health effects. Their independent relationship with chronic obstructive pulmonary disease (COPD) remains unclear, mainly due to the confounding effects of traditional cigarette use. This meta-analysis aimed to evaluate the association between current e-cigarette use and the prevalence of COPD. As a key secondary aim, we conducted a subgroup analysis focusing on exclusive e-cigarette users-individuals who currently use e-cigarettes but have never smoked traditional cigarettes-to preliminarily explore the independent association.

A comprehensive literature search was conducted in PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, and Wanfang Database for studies published up to 12 November 2025. Eligible observational studies that assessed the association between e-cigarette use and the prevalence of COPD were included, and pooled estimates were calculated using a random-effects model.

A total of 15 studies were included in the meta-analysis. Current e-cigarette use was associated with a significantly higher odds of having COPD (pooled odds ratio [OR] = 2.03, 95% confidence interval [CI]: 1.61-2.56). Former e-cigarette users also had an elevated association with COPD (OR = 1.82, 95% CI: 1.38-2.41). Subgroup analyses indicated the prevalence of COPD was higher among exclusive e-cigarette users (OR = 2.09, 95% CI: 1.46-3.00), dual users of e-cigarettes and traditional cigarettes (OR = 3.13, 95% CI: 2.01-4.87), and current e-cigarette users with a smoking history (OR = 2.17, 95% CI: 1.41-3.35). Sensitivity analysis supported the robustness of these findings, and no evidence of publication bias was observed.

This meta-analysis suggests that current e-cigarette use is associated with a higher prevalence of COPD. This association remained evident among exclusive e-cigarette users, indicating a potential link independent of traditional smoking history.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251218716, identifier (CRD420251218716).

Recurrent and chronic rhinosinusitis remain challenging conditions with high recurrence rates despite advances in medical and surgical management. Adjunctive therapies ranging from nasal irrigation and physiotherapy to steroid-eluting implants and dental interventions are increasingly used to enhance treatment outcomes. This meta-analysis aimed to evaluate the effectiveness of adjunctive therapies in improving clinical and radiological outcomes in patients with recurrent rhinosinusitis.

A comprehensive literature search was conducted across PubMed, Scopus, ScienceDirect, Google Scholar, and the Consensus Academic Database for studies published between 2015 and 2025. Eligible studies included randomized controlled trials and observational research evaluating adjunctive therapies combined with standard rhinosinusitis treatment. Data extraction and quality assessment followed PRISMA 2020 guidelines using the Cochrane Risk of Bias Tool (RoB 2) and Newcastle Ottawa Scale. Quantitative and qualitative syntheses were performed, with effect sizes expressed as mean differences and 95% confidence intervals.

Nine studies comprising a total of 1,608 patients were included. Adjunctive therapies demonstrated a 30-50% improvement in symptom scores (SNOT-22, RSDI) and a significant reduction in recurrence rates compared to conventional treatment alone. Higher improvement rates were reported in studies evaluating steroid-eluting implants and concurrent dental interventions, which achieved over 90% post-operative success rates. Non-surgical modalities such as nasal irrigation and sinus physiotherapy also yielded meaningful symptomatic relief and improved mucociliary clearance. Heterogeneity was moderate (I ² < 50%), and no significant publication bias was detected in the funnel plot analysis.

Adjunctive therapies significantly improve symptom control, reduce recurrence, and enhance post-operative outcomes in recurrent rhinosinusitis. Integrating these modalities into standard treatment protocols supports a multimodal, patient-centered approach to disease management. Future multicentric randomized controlled trials with standardized intervention protocols are recommended to confirm and refine these findings.