Nevin Manimala

Hip Int. 2026 Apr 4:11207000261426459. doi: 10.1177/11207000261426459. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine factors associated with lag screw slide following fixation of intertrochanteric hip fractures with 1 type of cephalomedullary nail.

METHODS: Retrospective review of patients operatively treated for intertrochanteric hip fractures (OTA/AO 31A1 and 31A2) with a single cephalomedullary nail (CMN) at a single academic medical centre between November 2014 and November 2023. CMN lag screw was placed in “dynamic” mode to allow for controlled collapse, or screw “slide.” Screw slide was defined as the difference in lateral prominence of the lag screw at latest follow up compared to its initial position. Patients were grouped based on the amount of screw slide (<5 mm, 5-15 mm, >15 mm) and correlation analysis was performed.

RESULTS: 614 intertrochanteric hip fracture patients were identified (mean age 80.76 years; 72.3% female) with mean 6.2 months follow-up. Mean amount of slide was 3.77 ± 4.79 mm. 66.3% of patients had <5 mm of slide, while 31.3% had 5-15 mm and 2.4% had >15 mm. Univariate analysis demonstrated that slide >15 mm was associated with increased patient BMI (p = <0.001), use of some anti-osteoporotic medications (p = 0.021) and more than 5 mm of immediate postoperative prominence (p = 0.016). Although not statistically significant, patients with >15 mm of slide were only taking vitamin D and calcium whereas those with <15 mm slide more often took bisphosphonates, denosumab and teriparatide (p = 0.163). Multivariate regression demonstrated that only BMI (OR 1.14, 95% CI, 1.04-1.24; p = 0.002) was associated with >15 mm screw slide.

CONCLUSIONS: Excessive lag screw slide (>15 mm) was associated with higher patient BMI. Patients with higher BMIs should be monitored to identify excessive slide. Surgeons should attempt to keep the lag screw as close to the lateral cortex as possible. While the use of anti-osteoporotic therapy was associated with more slide, this was almost exclusively seen in patients only prescribed vitamin D and calcium.

PMID:41934208 | DOI:10.1177/11207000261426459

Womens Health (Lond). 2026 Jan-Dec;22:17455057261437261. doi: 10.1177/17455057261437261. Epub 2026 Apr 4.

ABSTRACT

BACKGROUND: Pregnancy and substance use disorders (SUD) for incarcerated individuals often overlap, but their management varies greatly between jails. A better understanding of pregnancy management across jails is needed to better guide policy and practice recommendations.

OBJECTIVES: To examine the current state of pregnancy management across North Carolina jails, including current practices, challenges, and gaps in pregnancy management in jails.

DESIGN: This is a qualitative analysis within a mixed-methods study assessing the scope of perinatal incarceration and the capacity of North Carolina jails to manage perinatal SUD.

METHODS: We conducted in-depth interviews with North Carolina jail staff using a semi-structured interview guide between October 2022 and September 2023. We used the ideal-type analysis approach to systematically compare pregnancy management and SUD management practices across facilities.

RESULTS: We completed 26 interviews with jail staff. Pregnancy management approaches were unevenly distributed across three ideal types: (1) exclusive use of internal prenatal care resources (n = 2), (2) exclusive use of external prenatal care resources (n = 16), and (3) hybrid use of both internal and external prenatal care resources (n = 8). Within ideal types, SUD management was highly variable.

CONCLUSION: The heavy reliance on external resources for prenatal and SUD care highlights the chronic underfunding and staffing challenges faced by these facilities. There is an urgent need for standardized policies governing prenatal care in jail facilities to help reduce disparities in care quality and ensure that all pregnant individuals receive adequate support, regardless of the jail’s resources. Alternatives to incarceration during pregnancy should be prioritized.

PMID:41934195 | DOI:10.1177/17455057261437261

Gynecol Endocrinol. 2026 Dec 31;42(1):2650027. doi: 10.1080/09513590.2026.2650027. Epub 2026 Apr 4.

ABSTRACT

OBJECTIVES: This retrospective study compares pregnancy outcomes in polycystic ovary syndrome (PCOS) patients across different controlled ovarian stimulation (COS) protocols-specifically GnRH antagonist and GnRH agonist cycles-combined with various frozen embryo transfer(FET) preparation methods, such as hormone replacement therapy (HRT) and ovulatory cycles. Despite the known variations in COS and FET protocols, the optimal combination for improving pregnancy outcomes in this population remains unclear.

METHODS: We analyzed the first FET cycles of 2510 patients with PCOS at our center between January 2017 and September 2024. Baseline characteristics and pregnancy outcomes were compared using the Kruskal‒Wallis test, the chi-square (χ²) statistic, the Bonferroni correction for multiple comparisons, and inverse probability of treatment weighting (IPTW) adjustment.

RESULTS: After IPTW adjustment, no significant differences were observed in live birth rates or other key reproductive outcomes among the four protocol combinations (all P > 0.05). Exploratory analyses revealed nonsignificant trends, suggesting two patterns: 1) GnRH agonist (vs. antagonist) COS protocols were associated with lower point estimates for the risks of preterm PROM and HDP; 2) ovulation (vs. HRT) cycles for FET preparation were similarly associated with lower point estimates for these risks.

CONCLUSIONS: For PCOS patients, live birth success is equivalent regardless of COS/FET protocol combination, supporting flexible treatment personalization. Clinical decision-making involves a critical trade-off: GnRH agonist protocols and ovulation FET cycles may be associated with a trend toward lower obstetric morbidity, potentially linked to the promotion of a more physiological ovulatory milieu. This balance between immediate iatrogenic risk and long-term pregnancy health warrants further study.

PMID:41934169 | DOI:10.1080/09513590.2026.2650027

J Oncol Pharm Pract. 2026 Apr 4:10781552261437734. doi: 10.1177/10781552261437734. Online ahead of print.

ABSTRACT

BackgroundPediatric patients undergoing chemotherapy often need to take multiple medications. Consequently, they may experience drug-related problems (DRPs), including adverse drug reactions, drug interactions, and various medication errors.MethodsA prospective observational study was conducted over three months in the Pediatric Haemato-oncology department of a cancer specialty hospital of Nepal following ethical approval. DRPs were identified from patient medical records and the literature and, recorded according to the Pharmaceutical Care Network Europe V9.1 tool. Data were collected and analyzed using IBM SPSS Statistics V20 and Microsoft Excel 2013 to present the findings.ResultsAmong the 30 enrolled patients, 211 DRPs were identified in 28 patients (93.3%), averaging 7.5 DRPs per patient, all validated through case-by-case review. Treatment safety was the predominant DRP type (n = 131; 62.09%), followed by treatment ineffectiveness (n = 79; 37.44%). Drug selection (n = 116; 51.76%) and dispensing issues (n = 51; 22.77%) were the leading causes, with anti-infective drugs (n = 41; 35%) and antineoplastic agents (n = 24; 20.5%) most frequently implicated.ConclusionDRPs were prevalent among pediatric patients with cancer, with treatment safety being the most significant issue and drug selection being the primary cause. Anti-infective drugs were most frequently involved in DRPs, followed by antineoplastic and immunomodulating agents.

PMID:41934159 | DOI:10.1177/10781552261437734

J Trop Pediatr. 2026 Feb 9;72(2):fmag022. doi: 10.1093/tropej/fmag022.

ABSTRACT

Factors associated with severe dehydration from cholera among children in the community is still not fully understood. We analyzed the characteristics of the pediatric cases who were hospitalized in the community cholera treatment centers in the capital Lusaka between October 2023 and May 2024. Presence of underlying conditions (e.g. human immunodeficiency virus (HIV) infection, severe acute malnutrition), specific catchment areas (e.g. low-income residential areas), and an early phase of the outbreak was associated with increased numbers of severe cases in the community by multivariate analysis. Our study highlighted the importance of mobilization of resources and efforts aimed at enhancing surveillance, risk communication, and case management in the early phase of the outbreak for children living in high-risk areas and those with underlying conditions, in order to reduce severe cases of cholera among children in the community.

PMID:41934155 | DOI:10.1093/tropej/fmag022

J Intensive Care Med. 2026 Apr 4:8850666261424210. doi: 10.1177/08850666261424210. Online ahead of print.

ABSTRACT

PurposeSerratia marcescens is a well-recognized hospital-acquired pathogen frequently implicated in outbreaks in neonatal and pediatric intensive care units. We compared clinical characteristics of infants with Serratia bloodstream infections (BSI) to those with non-Serratia gram-negative BSI.MethodsA retrospective case-control study comparing infants (0-2 y/o) hospitalized at our referral pediatric cardiac intensive care unit (PCICU), who acquired gram-negative blood cultures, during 2012-2022. Patients were categorized into two groups: S. marcescens BSI versus non-Serratia gram-negative BSI. Demographic and clinical data were extracted from our medical databases.ResultsOf 112 patients meeting inclusion criteria, 40 (36%) had Serratia BSI and 72 (64%) non-Serratia gram-negative BSI. Blood stream infection with Serratia occurred later postoperatively (median 15 vs 7 days, p < .01), were associated with less pre-infection inotropic support (median VIS 0 vs 5, p < .01) and higher rates of multisite involvement (35% vs 18%, p = .04). Duration of indwelling vascular catheters at time of infection was longer in the Serratia group (median 10 vs 7 days, p = .03). No associated mortality was attributed to Serratia BSI, as compared to a 5.6% mortality rate in the non-Serratia group.ConclusionsSerratia BSI in the PCICU tends to develop later during hospitalization, involves more multiple infection sites, and is associated with longer vascular catheters dwell durations at the time of infection. Serratia infections appeared sporadically throughout the year without seasonal clustering. This supports the importance of stringent infection control practices and warrants prospective studies on prevention strategies.

PMID:41934153 | DOI:10.1177/08850666261424210

Breast J. 2026;2026(1):e8459253. doi: 10.1155/tbj/8459253.

ABSTRACT

BACKGROUND: Breast conservation surgery (BCS) is considered to be a low-morbidity procedure; however, postoperative complications may adversely affect the quality of life of breast cancer survivors. Social determinants of health have previously been shown to impact postoperative outcomes in various other medical conditions. However, there is a paucity of literature that comprehensively examines the social determinants that impact BCS complications or how race influences specific surgical outcomes. This study thus seeks to address this gap by analyzing the impact of these factors within our diverse patient population in the Bronx.

METHODS: A retrospective chart review was conducted that examined patients who underwent BCS between January 2016 and December 2022 at a single institution. Patient information, such as comorbidities, Distressed Communities Index (DCI), BMI, race, insurance status, age, pathology, surgery details, adjuvant therapy, and complications, was collected. Univariate and multivariate analyses were utilized to determine the relationship between these variables and postoperative complications.

RESULTS: A total of 627 patients were included in the study. Of these patients, 512 (81.5%) were either Hispanic or African American, 46 patients (7.3%) were White, and 69 (11%) belonged to other races. There was a delay in 37 (6.2%) patients receiving adjuvant therapy. Our study found that higher DCI quintile and higher BMI were associated with a statistically significant increase in overall complication rate (p = 0.044, p = 0.05, respectively). Race had an association with persistent pain (p = 0.003). Former smokers (OR = 3.44, 95% CI [1.419, 8.34], p = 0.0062), hypertensive patients (OR = 3.846, 95% CI [1.13, 13.12], p = 0.0314), and patients who received adjuvant chemotherapy (OR = 2.756, 95% CI [1.117, 6.801], p = 0.0278) had higher odds of developing any complication. Patients who developed any complication were more likely to have a delay in adjuvant therapy than patients who did not have complications (OR = 6.452, CI [2.696, 15.44], p < 0.001).

CONCLUSION: BCS is generally a safe procedure with minimal complications; however, patient-specific factors are associated with increased complication rates which can lead to delays in adjuvant therapy. Future studies with larger sample sizes are needed to adequately compare outcomes among minority racial groups to a larger reference population.

PMID:41934150 | DOI:10.1155/tbj/8459253

Int J Gynaecol Obstet. 2026 Apr 4. doi: 10.1002/ijgo.70946. Online ahead of print.

ABSTRACT

OBJECTIVE: The study aimed to investigate familial transmission patterns in women with endometriosis by generating a customized single-nucleotide polymorphism (SNP) array.

METHODS: Patients aged 18-45 who were diagnosed histopathologically with endometriosis were included in the study. Daughters and mothers of these patients were also included, regardless of whether they were diagnosed with endometriosis or not. The control group consisted of female patients of similar ages who were not diagnosed with endometriosis. The first stage of this investigation was the determination of the genes associated with the SNPs through meta-analyses in the field of endometriosis in the literature. The second stage was the creation of a unique SNP array by determining the SNPs in the selected target genes. We specifically evaluated whether SNPs in the WNT4 gene at locus 1p36.12 (rs7521902), the GREB1 gene at locus 2p25.1 (rs13391619), and the FN1 gene at locus 2q35 (rs1250248) were associated with endometriosis risk in the Turkish population.

RESULTS: The study included 91 participants, comprising 66 women diagnosed with endometriosis and 25 healthy controls. The analysis revealed statistically significant associations for the FN1 (rs1250248, G>A) and the GREB1 (rs13391619, T>C) variants among endometriosis patients and their mothers and daughters, indicating a possible familial genetic link.

CONCLUSION: These findings strengthen the evidence for a hereditary component in endometriosis and suggest that SNP-based genetic profiling may support earlier identification of at-risk individuals, enabling more timely surveillance and clinical intervention.

PMID:41934140 | DOI:10.1002/ijgo.70946

Nurs Open. 2026 Apr;13(4):e70520. doi: 10.1002/nop2.70520.

ABSTRACT

AIM: This study aimed to develop and evaluate a hypothetical model based on Lazarus and Folkman’s stress and coping framework to identify the factors and pathways influencing Generation Z new graduate nurses’ intention to stay in the job.

DESIGN: This model validation study employed a cross-sectional path analysis approach using structural equation modelling.

METHODS: The participants were 215 nurses born after 1995 who had < 1 year of nursing experience and were working at three general hospitals located in Seoul, Korea. Structural equation modelling was used to analyse the collected data, and the model was validated through confirmatory factor analysis. Key variables included character strengths and job resources (exogenous) and reality shock, work-life balance and intention to stay (endogenous). Path analysis with phantom variables was conducted to explore mediating effects.

RESULTS: The model showed proper fit indices: χ²/df = 2.34, TLI = 0.90, CFI = 0.91, RMSEA = 0.08, SRMR = 0.06. Character strengths (ß = 0.41, p < 0.001) and reality shock (ß = -0.75, p = 0.002) had significant direct effects, explaining 53.5% of the variance in intention to stay. Reality shock also mediated the relationships between character strengths, job resources and intention to stay, emphasising its pivotal role in retention strategies for Generation-Z nurses. The findings indicate that character strengths and reality shock are important factors in the intention to stay of new graduate nurses in Generation-Z.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

PMID:41934133 | DOI:10.1002/nop2.70520

West J Nurs Res. 2026 Apr 3:1939459261431011. doi: 10.1177/01939459261431011. Online ahead of print.

ABSTRACT

BACKGROUND: The U.S. nursing workforce faces persistent challenges, worsened by a 3.3% decline of nurses and high rates of emotional exhaustion, job dissatisfaction, and moral injury. An aging population drives rising demand for acute and long-term care, requiring proactive pathways for a healthy, competent workforce. This demands precise national and local insights, yet federal and state data sources complicate addressing current and future issues.

OBJECTIVE: We examined registered nurse (RN) workforce data from common federal and state sources, highlighting data set strengths, discrepancies, implications, and use cases.

METHODS: Using Minnesota as an example and California as a contrast, we compared workforce data sources, quantified projected shortages or surpluses, and drew actionable conclusions for nurse leaders and policymakers.

RESULTS: Substantial differences exist in nursing workforce data sets’ completeness and utility. State licensure and survey data provide complete nurse lists and voluntary samples on elements like intent to leave, focusing on supply and characteristics but not growth, demand, or shortages. Bureau of Labor Statistics and similar national data sets support modeling growth and demand but offer little on supply, characteristics, or maldistribution. For example, one source projects 5.6% national RN job growth by 2032, while another forecasts 10% supply and 11% demand growth. These projections are difficult to model due to assumption limitations, capturing long-term trends well but often missing short-term ones.

CONCLUSION: Accurate, complete historical data sets form the foundation for workforce planning and analyzing future trends. We must urgently document and study nursing’s endemic challenges and pursue sustainable solutions, requiring reliable, locally relevant data.

PMID:41934117 | DOI:10.1177/01939459261431011