Category: Nevin Manimala

Indian J Gastroenterol. 2025 Feb 8. doi: 10.1007/s12664-024-01712-0. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: The epidemiological connections, predisposing factors and clinical outcomes of infections by drug-resistant bacteria in cirrhosis are poorly documented. Thus, this study was conducted to assess the risk factors, complications and patterns of bacterial resistance among these patients.

METHODS: This retrospective observational study was conducted from March 1, 2021, to July 31, 2023, at a tertiary care centre in Uttar Pradesh. Patients of cirrhosis aged ≥ 18 years with microbial infection were included in the study. Samples, as indicated, were sent to the microbiology lab for culture and sensitivity. The patient’s clinical history, details regarding bacterial culture and antibiotic sensitivity results were extracted from the hospital information system (HIS) and entered into an excel sheet. Univariate analysis of the variables was done and the statistical significance of these variables was determined using the p-value. A p-value of < 0.05 was considered significant.

RESULTS: During the study period, 765 patients were diagnosed with cirrhosis, of which 248 (32%) had a positive bacterial culture report. Among them, 206 (83.1%) patients recovered and were discharged in stable condition. Among the cirrhotic patients, the most common infection was spontaneous bacterial peritonitis (49.5%), followed by bacteremia (39.1%), lower respiratory tract infections (6.4%), urinary tract infections (2.9%) and skin and soft tissue infections (2%). Escherichia coli (28%) was the most common gram-negative bacteria. Multidrug-resistant organism infections were seen in 134 (54%) patients. Multidrug-resistant (MDR) infection (31.4%) and extensively drug-resistant (XDR) infection (22.6%) were significantly associated with poor outcomes among these patients. Carbapenem-resistant organisms (22.6%) were the predominant resistant patterns seen among the gram-negative isolates in cirrhosis patients. The mortality rate among these cirrhotic patients with bacterial infection was 16.9%.

CONCLUSIONS: MDR and XDR bacterial infections in cirrhotic patients are an emerging threat that has a detrimental effect on prognosis. Thus, it is critical to assess strategies to prevent the development of antibiotic resistance in cirrhosis.

PMID:39921835 | DOI:10.1007/s12664-024-01712-0

Dermatol Ther (Heidelb). 2025 Feb 8. doi: 10.1007/s13555-025-01350-0. Online ahead of print.

ABSTRACT

INTRODUCTION: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease associated with a high disease burden and substantial impact on patients’ quality of life. Limited therapeutic options are available, with an unmet medical need for earlier diagnosis and treatment and more effective treatment options. Low awareness of HS amongst healthcare professionals (HCPs) leads to delayed diagnosis and a prolonged patient journey to HS-specific treatment. This article aims to describe the design of HELyx, an implementation science study in Germany, which aims to evaluate the effectiveness of an implementation strategy to improve screening and diagnosis of HS among HCPs (dermatologists and non-dermatologists) and timely referral to HS-treating dermatologists.

METHODS: HELyx is a hybrid, effectiveness-implementation science study with a pre-post design involving HCPs and is guided by the Consolidated Framework for Implementation Research. HELyx is being conducted in Germany over four consecutive phases (context analysis, pre-implementation, implementation, and post-implementation) in a sequential manner. A similar implementation science study is also being conducted in the United Arab Emirates (UAE) and Spain. HELyx aims to identify key unmet medical needs in the HS patient journey, to develop and implement a tailored medical education program, and to measure the effectiveness of the implementation.

PLANNED OUTCOMES: The primary endpoint is the change in the proportion of HCPs who used a diagnostic screening tool to identify patients with suspected HS during the 24 weeks of the post-implementation phase (assessed at Week 24) compared to the 24 weeks before implementation (assessed at baseline). Secondary endpoints include assessment of the use of HS disease severity assessment and patient-reported outcome tools and HCP referral behaviours.

PMID:39921830 | DOI:10.1007/s13555-025-01350-0

Tech Coloproctol. 2025 Feb 8;29(1):61. doi: 10.1007/s10151-024-03054-7.

ABSTRACT

BACKGROUND: Crohn’s disease (CD) negatively impacts quality of life, and a high percentage of patients will need surgery. Ileocecal resection (ICR) is the most common abdominal procedure performed in CD. Postoperative complications are frequent, and recurrence is common. The main objectives of this study were to analyze risk factors (RF) for anastomotic leakage (AL) and recurrence after ICR, as well as quality of life (QoL) in CD in a sample of the Spanish population.

METHODS: A prospective, multicenter, observational study was designed, including all types of hospitals in Spain from 2018 to 2021. Demographic and medical-surgical characteristics, postoperative complications, hospital types by annual ICR volume, and quality of life (IBDQ-9) up to 1 year follow-up (OYF) were recorded and analyzed.

RESULTS: A total of 386 ICRs were recorded. At 60 days, there were 134 (36.4%) complications, 46 (11.91%) of which were major. A total of 23 (5.9%) AL were registered, and RF were Montreal A3 [OR 14.2, 95% CI (2.70-126), p = 0.005], Montreal p [OR 7.29, 95% CI (1.14-44.4), p = 0.029], and intensified adalimumab treatment [3.8, 95% CI (1.2-13.1), p = 0.026]. Recurrences at OYF were 67 (19%), and RF were history of neoplasia [OR 7.14, p = 0.01], Montreal B3 [OR 2.12, p = 0.02], and minimally invasive surgery (MIS) [OR 2.63, p = 0.02]. The mean difference in IBDQ-9 from baseline to 60 days was +1.72 (n = 177, p < 0.001) and to OYF +2.12 (n = 140, p < 0.001).

CONCLUSIONS: The AL rate was 5.9%. Montreal A3, perianal disease, and intensified adalimumab were associated with a higher rate of AL. The recurrence rate was 17.6% (OYF). Prior neoplasia, Montreal B3, and MIS were associated with higher risk of recurrence. ICR improves quality of life at 60 days and is maintained 1 year after surgery.

PMID:39921815 | DOI:10.1007/s10151-024-03054-7

Endocrine. 2025 Feb 8. doi: 10.1007/s12020-025-04190-2. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate associations between olfactory function, eating behavior, and characteristics of body composition in adolescents with different body weights.

METHODS: The study included 87 children aged 10-17 years with normal and excess body weight. The study group consisted of overweight and obese adolescents. All children underwent anthropometry with calculation of SDS body mass index (WHO Anthro Plus), body composition was assessed using Inbody 770, diagnosis of olfactory dysfunction was performed using a set of Sniffin Sticks (Odofin, Germany). The Dutch Eating Behavior Questionnaire was used for assessment of eating disorders. IBM SPSS. Statistics v.20 program was used for statistical analysis.

RESULTS: In adolescents with decreased sense of smell, regardless of SDS BMI, restrictive type of eating behavior was more common (p = 0.04). Among girls, hypoosmia was diagnosed in 21.7% (n = 10) of cases, being accompanied by a higher proportion of body fat, higher prevalence of emotionogenic type of eating behavior compared to girls without olfactory impairment, who, on the contrary, more frequently exhibited the restrictive type of eating disorder. Among boys, hypoosmia was found in 39% (n = 16) of cases. There were no statistically significant differences with the normoosmia subgroup in terms of eating behavior type and body composition parameters. Girls with hypoosmia showed positive associations between body fat percentage and discriminatory olfactory test results (r = 0.805; p = 0.020), externalizing type of eating behavior and BMI-FOR-AGE (r = 0.873; p = 0.005), body fat mass (r = 0.764; p = 0.027) and body fat percentage (r = 0.805; p = 0.016). The emotiogenic type of eating behavior showed significant correlations with total body phase angle (r = 0.805; p = 0.029), skeletal muscle mass (r = 0.791; p = 0.034). In boys with hypoosmia, positive associations were found between restrictive type of eating behavior and BMI-FOR-AGE (r = 0.784; p = 0.002), visceral fat area (r = 0.701; p = 0.008), body fat mass (r = 0.660; p = 0.014) and body fat percentage (r = 0.742; p = 0.004).

CONCLUSION: The results of this study suggest that hypoosmia is associated with changes in eating behavior and body composition in adolescents with different body weight, yet the direction of such casual relationship remains unclear.

PMID:39921810 | DOI:10.1007/s12020-025-04190-2

Musculoskelet Surg. 2025 Feb 8. doi: 10.1007/s12306-025-00889-7. Online ahead of print.

ABSTRACT

PURPOSE: Osteoarthritis (OA) is a prevalent, debilitating ailment among the elderly. Humans need a correct sagittal spino-pelvis-lower extremity alignment to stand upright. Pathology in trunk or lower extremity section might disrupt this harmony, causing compensatory alterations in other segments. The aim of the present study was to evaluate spino-pelvis-lower extremity alignment and association among the various spino-pelvic, knee, and ankle radiological angles in patients with knee osteoarthritis (OA).

MATERIALS AND METHODS: This prospective study enrolled 70 adults over 50 years of age of either sex who complained of knee pain and met the American College of Rheumatology criteria for symptomatic OA of at least one knee. The radiological assessment comprised anteroposterior and lateral lower extremity full-length scans, as well as the Kellgren-Lawrence radiographic classification of OA. We measured hip, knee, ankle, and spino-pelvic angles using Horos software. We calculated descriptive statistics and linear correlation between continuous variables.

RESULTS: There was a significant association (p < 0.05) between age and the majority of the spino-pelvic, knee, and ankle angles and between age and severity of OA. Significant variables linked with ‘SFA’ include HKAA (p = 0.008), mLDFA (p < 0.001), TJLA, FS-TS, Cond-Plateau, and femoral bowing (p = 0.007). We found significant associations between ‘PFA’ and mMPTA (p = 0.005), Cond-Plateau (p = 0.005), Tibial Bowing (p = 0.003), and ‘LL’ with HKAA, mLDFA, FS-TS, and Cond-Plate. SSA was significantly associated with mLDFA, mMPTA, TJLA, Cond-Plateau, and HKAA; while, FI’ was significantly associated with FS-TS, femoral bowing, and tibial bowing (p < 0.001). The variables ‘SS’ was substantially linked with TTA (p = 0.008), TT (p = 0.004), PP (< 0.001), GP (p < 0.001), and GT (p = 0.010). ‘PI’ was substantially linked to TT (p = 0.001), GP (p = 0.005), and GT (p = 0.042), and ‘PT’ to TT (p < 0.001) and GT (p = 0.012). ‘SFA’ and ‘PFA’ only correlated with TT (p = 0.012 and 0.010). Lower limb angles were significantly associated with TT, PP, GP, GT, mLDFA, and mMPTA (p = 0.031, p = 0.026, p = 0.009, p = 0.009, TT, GP, GT, p < 0.001). GP was the sole significant association for ‘TJLA’ (p = 0.016). ‘FS-TS’ substantially correlated with PP (p = 0.015), GP (p < 0.001), and GT (p < 0.001). “Femoral Bowing” was significantly linked to PP (p = 0.017), GP (p = 0.007), and GT (p < 0.001), and “Cond-Plateau” was significantly linked to GP (p = 0.002) and GT. “Tibial Bowing” was significantly linked to TTA (p < 0.001), TAS (p = 0.003), LDTA (p = 0.002), TC (p < 0.001), GP (p = 0.007), and GT (p < 0.001). Age, gender, BMI, and the severity of knee OA significantly influenced the association among these various angles.

CONCLUSION: Osteoarthritis of the knee disrupts the harmonious alignment of the spine and pelvis with the lower limbs, resulting in compensatory changes in the ankle and spine. The severity of knee osteoarthritis and the patient’s gender, age, and BMI impact compensatory adaptations.

TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION: CTRI/2021/08/036088 [Registered on: 31/08/2021] – Trial Registered Prospectively.

PMID:39921806 | DOI:10.1007/s12306-025-00889-7

Clin Exp Med. 2025 Feb 8;25(1):51. doi: 10.1007/s10238-025-01576-4.

ABSTRACT

Hepatocellular carcinoma (HCC) is the most common primary liver cancer. Sorafenib is the first FDA-approved systemic therapy for advanced HCC. This study investigates the influence of IL-23R (rs7517847) and ATG-10 (rs10514231) genetic polymorphisms on Sorafenib response, survival outcomes, average tolerable dose, and adverse events. This prospective open-label cohort study included 100 HCC patients, assessing IL-23R and ATG-10 genotypes via real-time polymerase chain reaction (RT-PCR). Patient’s responses were evaluated using modified RECIST criteria. Statistical analyses evaluated the association of genetic variants with response, progression-free survival (PFS), overall survival (OS), average tolerable Sorafenib dose, and adverse events. IL-23R TT carriers had the highest Sorafenib response rate (80%) compared to GT (13.3%) and GG (6.7%) (P = 0.021), while ATG-10 TT carriers had a 13.9-fold increased response likelihood (P = 0.001). The T allele in ATG-10 significantly predicted longer PFS (P = 0.025) and OS (P = 0.011), suggesting a potential prognostic role. IL-23R GG carriers received significantly higher Sorafenib doses than TT (P = 0.0174) and GT (P = 0.0227), whereas ATG-10 had no effect on dosage. However, its CT genotype was significantly associated with a higher risk of Hand-Foot Syndrome (P = 0.012), and independent of dose (P = 0.0018). IL-23R and ATG-10 polymorphisms influence Sorafenib response, survival, and tolerability in HCC patients. Genetic screening may improve personalized treatment strategies by optimizing Sorafenib efficacy and minimizing toxicity.This trial was registered on clinicaltrials.gov with registration number NCT06030895, registered on “September 11th, 2023,” retrospectively.

PMID:39921803 | DOI:10.1007/s10238-025-01576-4

Environ Geochem Health. 2025 Feb 8;47(3):69. doi: 10.1007/s10653-025-02375-2.

ABSTRACT

This study evaluated the Air Pollution Prevention and Control Action Plan (APPCAP) in China using 2000-2023 data. The average annual PM_2.5 concentration dropped from 46.11 ± 16.18 µg/m³ to 31.75 ± 14.22 µg/m³ (P < 0.05) after APPCAP, with components showing a similar decline. Temporal analysis via Mann-Kendall test indicated a decreasing trend (Z < 0, P < 0.05), seasonally peaking in winter and lowest in summer. Spatially, APPCAP reduced concentration distribution, with key regions improving but areas like Shandong and Henan still facing severe pollution. The main PM_2.5 driver shifted from human (e.g., population density) to meteorological (e.g., temperature) factors post-APPCAP, and anthropogenic influence varied across regions. In summary, APPCAP has curbed PM_2.5 pollution, yet SO₄^2-, NO₃^–, and NH₄⁺ remain relatively high, and the increasing human impact in central and southeastern China demands attention in future policies.

PMID:39921792 | DOI:10.1007/s10653-025-02375-2

J Patient Rep Outcomes. 2025 Feb 8;9(1):16. doi: 10.1186/s41687-025-00848-7.

ABSTRACT

PURPOSE: Diabetes Mellitus (DM) management is increasingly focusing on patient-centered care, making patient-reported experience measures (PREMs) critical for understanding the subjective aspects of diabetes treatment and self-management. These measures differ based on cultural contexts and individual perspectives, leading different countries to the development of country-specific tools to assess care quality from the patient’s viewpoint. This review aimed to identify available instruments for assessing patient-reported experiences in individuals with diabetes and examine the different domains, items, and the validity and reliability of these instruments.

METHODS: Following PRISMA-ScR guidelines, databases including PubMed, Embase, CINAHL, Cochrane, and Scopus were searched for English-language articles without year limitations. This scoping review focused on PREMs that evaluate the quality of diabetes care among adolescent and adult patients with type 1 and type 2 DM. Studies that used patient expectation questionnaires, involved individuals not receiving care, or focused on patient-reported outcomes rather than experiences were excluded.

RESULTS: Eight articles from six countries representing different healthcare settings were included, mostly from developed countries. A variety of methodologies were used to develop these PREM instruments, with unique domains and items. Content analysis revealed five commonly measured domains: (1) care planning, (2) patient education, (3) professionalism, (4) quality of care, and (5) hospital care and transition, reflecting diverse patient experiences across healthcare services.

CONCLUSIONS: This scoping review identifies a limited number of tools for evaluating PREMs in diabetes care, highlighting variability in their development and domain coverage. Five core domains are proposed across different settings, with an emphasis on culturally adapted measures to enhance the accuracy of patient experience capture in diverse populations.

PMID:39921791 | DOI:10.1186/s41687-025-00848-7

Biochem Genet. 2025 Feb 8. doi: 10.1007/s10528-025-11048-9. Online ahead of print.

ABSTRACT

Dyslipidaemia, characterised by abnormal lipid levels in the blood, is an important risk factor for cardiovascular disease. In this case-control study, the association between single-nucleotide polymorphisms in ERBB2 and ERBB3 genes and the risk of dyslipidaemia in a population from Northern Anhui, China was evaluated. Particularly, we analysed samples from 543 patients with dyslipidaemia and 648 healthy controls for five potentially functional polymorphisms using TaqMan assays. Multivariate logistic regression was used to assess the relationship between genotype and dyslipidaemia, adjusting for confounding variables. The ERBB2 rs2517955 and rs1058808 single-nucleotide polymorphisms were significantly associated with dyslipidaemia. The rs2517955 variant showed a protective effect against dyslipidaemia in males, individuals aged 55 years or younger, and those without diabetes. Similarly, the rs1058808 variant decreased the risk of dyslipidaemia in these stratified groups. Conversely, ERBB3 rs2292238 was associated with an increased risk of dyslipidaemia in patients with diabetes. Compared with the corresponding wild-type alleles, variant alleles of rs2517955 and rs1058808 were associated with a reduced risk of decreased high-density lipoprotein cholesterol levels. Additionally, ERBB2 rs2517955 variants were significantly linked to total cholesterol levels, whereas ERBB3 rs3741499 and rs877636 variants were significantly associated with low-density lipoprotein cholesterol levels. Our findings suggest that ERBB2 and ERBB3 polymorphisms are closely associated with the risk of dyslipidaemia in the Chinese population. These results provide valuable insights for further genetic studies of dyslipidaemia and the identification of potential therapeutic targets.

PMID:39921768 | DOI:10.1007/s10528-025-11048-9

Support Care Cancer. 2025 Feb 8;33(3):167. doi: 10.1007/s00520-025-09235-w.

ABSTRACT

AIM: The aim of our study is to evaluate the relationship between sarcopenia, overall survival (OS), and chemotherapy toxicity in patients with unresectable/metastatic soft tissue sarcoma (STS) treated with adriamycin and ifosfamide.

METHODS: Patients with unresectable/metastatic STS over the age of 18, diagnosed between 2015 and 2023, were included in the study. The study was conducted retrospectively in a single center. Total muscle volume at the lumbar 3 (L3) vertebra level was measured from the patient’s computer tomography (CT) images. The skeletal muscle index (SMI) was calculated for each patient. Additionally, the prognostic nutritional index (PNI) was calculated for each patient using blood values.

RESULTS: Fifty-eight patients were included in the study. The median age of the patients was 51 years, Thirty-six (62.1%) were female and 22 (37.9%) were male. The SMI median was 49 cm²/m² in male patients. ROC analysis demonstrated a statistically significant prediction of OS when the SMI index was < 49.2 cm²/m². In female patients, the median SMI was 40 cm²/m². ROC analysis demonstrated a statistically significant prediction of OS when the SMI index was < 40.3 cm²/m². Median OS in the SMI < 49 cm²/m² male group was 9 months (95% CI 7.99-10.08). In the SMI ≥ 49 cm²/m² male group, the median OS was 30.2 months (95% CI 0.0-66.66). OS was statistically significant between the two groups (p = 0.003). The median OS in the SMI < 40 cm²/m² female group was 20.5 months (95% CI 7.69-33.30). In the SMI ≥ 40 cm²/m² female group, the median OS was 59.1 months (95% CI 21.36-96.98). OS was statistically significant between the two groups (p = 0.025). The relationship of SMI, as well as PNI, age, and Eastern Cooperative Oncology Group performance status (ECOG PS) with OS, was assessed. The relationship between SMI and chemotherapy toxicity was also evaluated. Chemotherapy-related toxicity was found to be significantly higher in sarcopenic patients (male SMI < 49 cm²/m², female SMI < 40 cm²/m²) (p = 0.025).

CONCLUSIONS: A significant relationship was found between SMI and OS, but no significant relationship was found between PNI and OS. A significant relationship was also detected between SMI and treatment toxicity. Our study reveals that evaluating ECOG PS and sarcopenia in addition to grade and histological subtype when making treatment decisions will be associated with longer survival and less toxicity.

PMID:39921759 | DOI:10.1007/s00520-025-09235-w