Category: Nevin Manimala

Int Urol Nephrol. 2025 Feb 7. doi: 10.1007/s11255-025-04397-2. Online ahead of print.

ABSTRACT

PURPOSE: Differences in metabolic profiles were used to search for urinary metabolic markers in patients with tubular dysfunction after percutaneous coronary intervention (PCI).

METHODS: In this study, 50 patients with renal tubule dysfunction 6 h after PCI were collected and urine samples before PCI were used as control group and 6 h after PCI were used as observation group. The urine samples were processed by high-speed centrifugation, filtered by microporous membrane, and the superclear was obtained for LC-MS detection and analysis, and their metabolic profiles and related data were obtained.

RESULTS: Compared with the control group, α1-MG, NAG and Cys-C in the urine of the observation group were significantly increased, and the difference was statistically significant (P < 0.05). After the urine samples were processed by LC-MS technology, SIMCA realized the visual visualization of the score plots of PCA, OPLS-DA and other models, and then verified by statistical methods, it was found that there were different metabolites in the urine of patients before and after PCI. The HMDB database was used to search for differential metabolites and 16 different metabolites such as L-ornithine, oleic acid amide, D-histidine, p-hydroxyphenyllactic acid, acetylmethionine, N-(2-furanyl) glycine, cholesterol laurate, cholic acid, 1-methylguanine, L-hydrochloric acid, homovanillic acid, alpha-keto-isocaproic acid, 3-β-hydroxy-D5-cholenoic acid, adenine, palmitic acid, pentadecanoic acid. Pathway Analysis in MetaboAnalyst5.0 was used to analyze the metabolic pathways of 16 different metabolites. Finally, a total of 11 metabolic pathways were matched. Finally, we believe that the biosynthetic pathway of arginine and the metabolic pathway of alanine, aspartate and glutamate are most relevant to tubular dysfunction after percutaneous coronary intervention (PCI).

CONCLUSION: In this study, LC-MS technology was used to analyze urine samples from CIN patients and patients with coronary heart disease before and after PCI and a total of 16 different metabolites were screened out, which may serve as potential biomarkers to help diagnose renal tubular dysfunction. There are 11 metabolic pathways in the body involved in the occurrence and development of renal tubular dysfunction after angiography and the biosynthesis pathway of arginine and the metabolic pathway of alanine, aspartate and glutamate may play the most important role in the occurrence and development of renal tubular dysfunction.

PMID:39918700 | DOI:10.1007/s11255-025-04397-2

Eur J Orthop Surg Traumatol. 2025 Feb 7;35(1):65. doi: 10.1007/s00590-025-04187-7.

ABSTRACT

PURPOSE: Scoliosis, if left untreated, can lead to severe curvatures exceeding 90°, causing devastating functional impairments. Various surgical methods exist, but the optimal approach is still debated. One-stage posterior spinal fusion (PSF)-only surgery is gaining favor for its comparable outcomes and reduced morbidity. This study, focusing on radiographic and surgical outcomes, evaluates the efficacy and safety of one-stage PSF for scoliosis curves over 90° in pediatric patients.

METHODS: Thirty-five pediatric patients with scoliosis (Cobb angle ≥ 90°) who underwent one-stage posterior spinal fusion (PSF)-only surgery from January 2020 to December 2023 were included. Patients with idiopathic, neuromuscular, or syndromic scoliosis were included. The primary outcome was the correction rate (CR) of scoliosis curves. Secondary outcomes included major postoperative complications, surgery duration, blood loss, and hospital stay length. Preoperative and postoperative radiographic and clinical data were analyzed.

RESULTS: The mean CR for major and minor curves was 65.2 ± 10.5% and 57.9 ± 12.8%, respectively. The mean preoperative and postoperative Cobb angle of major and minor curves was 102.6° and 35.6°, 68.6° and 28.8°, respectively. There were 13 recorded complications, with only one being life-threatening. Mean blood loss was 787 ± 437 ml. Total surgical time was roughly 5 h per case. The mean length of hospital stay (LOS) was 9 days.

CONCLUSIONS: PSF-only surgery for severe scoliosis over 90° is effective and safe. It supports using posterior-only methods as a viable alternative to combined approaches, suitable for patients with even more severe curves when their condition allows.

PMID:39918694 | DOI:10.1007/s00590-025-04187-7

Neurosurg Rev. 2025 Feb 7;48(1):216. doi: 10.1007/s10143-025-03334-2.

ABSTRACT

Microscopic microvascular decompression(M-MVD) is considered the gold standard treatment for primary trigeminal neuralgia and presents excellent long-term pain control rates. Despite the effectiveness of M-MVD, the use of endoscopy in these procedures has proven to be a promising approach. To evaluate the safety and efficacy of purely endoscopic microvascular decompression (E-MVD). A systematic review of the literature was performed using the PubMed, Scopus, Embase, and Cochrane databases. The primary outcome was satisfactory pain relief in short-term (0-30 days), mid-term (mean follow-up >/= 12 months) and long-term (mean follow-up >/= 24 months). Secondary outcomes were CSF leak, facial weakness, hearing loss, facial numbness, the rate of intraoperative identification of the offending vessel(s), mortality, length of stay and operative time. Inclusion criteria were studies including only patient submitted to E-MVD. Exclusion were secondary trigeminal neuralgia and mean follow-up < 12 months. Statistical analysis was performed using RStudio 2024.04.1 + 748. Heterogeneity was assessed using I² statistics. Sensitivity analysis was performed with leave-one-out test. Thirteen articles met the inclusion criteria, comprising a total of 1336 patients. Patients submitted to E-MVD had mean satisfactory pain relief rates of 92.93% (95% CI: 89.52-96.34% I2 = 86%), 88.54% (95% CI: 83.73-93.54% I2 = 87%) and 83.38% (95% CI: 76.58-90.17% I2 = 83%) in the short-term, mid-term and long-term follow-ups, respectively. Furthermore, the incidence of postoperative complications was low, including CSF leak (1.29% (95% CI: 0.32-2.26% I2 = 20%)), facial weakness (0.50% (95% CI: 0.00-1.79% I2 = 60%)), hearing loss (0.81% (95% CI: 0.05-1.57% I2 = 7%)) and facial numbness (3.84% (95% CI: 1.95-6.20% I2 = 54%)). There was no mortality related to the procedure (0% (95% CI: 0-0%; I2 = 0%)). The offending vessel(s) were identified in 99.57% of the cases (95% CI: 98.17-100.00% I2 = 67%)). Our meta-analysis revealed that E-MVD is a safe and effective procedure for the treatment of primary trigeminal neuralgia. Further studies are necessary to compare its usefulness to the traditional M-MVD approach.

PMID:39918650 | DOI:10.1007/s10143-025-03334-2

Lasers Med Sci. 2025 Feb 7;40(1):76. doi: 10.1007/s10103-025-04321-1.

ABSTRACT

This study aims to evaluate the efficacy of photodynamic therapy (PDT) using a 405 nm laser and two photosensitizers derived from silver nanoparticles, red onion extract, and shallot peel extract, comparing their effectiveness against Candida albicans. Candida albicans causes candidiasis, which requires effective, chemical-free treatment methods. PDT offers promise in this regard. The samples were divided into four groups: B1 (silver nanoparticles from red onion extract at concentrations of 1 mM, 1.5 mM, and 2 mM), A1 and A2 (fungus samples irradiated with a 405 nm laser at varying times and concentrations), and B2 (silver nanoparticles from shallot peel extract at the same concentrations). After each photosensitizer exposure, the fungi were subjected to radiation for 90-180 s. Following incubation, optical density (OD) was measured, and Tukey’s Post Hoc Test (p < 0.05) and Two-Way ANOVA were used for statistical analysis. Silver nanoparticles from shallot and red onion peel extracts and 405 nm laser radiation dramatically decreased the viability of Candida albicans compared to controls. After 180 s of radiation, red onion extract nanoparticles showed reductions of 50.92% to 64.55%, and shallot peel extract nanoparticles showed reductions of 47.37% to 70.71%. Using an energy density of 3.44 J/cm², red onion and shallot peel extract nanoparticles effectively deactivated C. albicans, with red onion extract achieving up to 70.71% ± 1.99% reduction. The study highlights the potential of PDT with silver nanoparticles as an alternative treatment for Candida infections.

PMID:39918643 | DOI:10.1007/s10103-025-04321-1

Skeletal Radiol. 2025 Feb 7. doi: 10.1007/s00256-025-04890-w. Online ahead of print.

ABSTRACT

OBJECTIVE: Baker’s cyst, or popliteal cyst, is a common knee condition associated with osteoarthritis and rheumatoid arthritis. While previous studies have explored the cyst’s relationship with soft tissue abnormalities, the connection between popliteal cysts and medial knee bone morphology remains unclear. This study aims to assess the association between anatomical bone structures of the medial knee joint and popliteal cyst presence using magnetic resonance imaging (MRI).

METHODS: A retrospective analysis was conducted on 100 patients who underwent MRI for knee pain between June and December 2021. Group 1 (n = 50) consisted of patients with Baker’s cysts, and group 2 (n = 50) included those without cysts. MRI measurements included medial condyle width, condyle length, distal and posterior articular diameters, medial tibial plateau depth, and tibial slope. Cyst dimensions and volume were measured. Statistical analyses, including Pearson correlation and chi-square tests, were performed, with significance set at p < 0.05.

RESULTS: No significant differences in medial knee bone morphology were found between groups (p > 0.05). However, popliteal cyst size was positively correlated with age (p = 0.016, r = 0.339 and p = 0.020, r = 0.328, respectively). Higher Kellgren-Lawrence grades were also associated with cyst presence (p = 0.001). Gender correlated with knee measurements, showing smaller knee dimensions in women (p < 0.001).

CONCLUSION: This study found no direct association between medial knee bone morphology and the presence of popliteal cysts. However, cyst size increased with age and degenerative changes, suggesting that inflammation and joint degeneration may play a significant role in cyst development. Further studies with larger cohorts are required to validate these findings.

PMID:39918639 | DOI:10.1007/s00256-025-04890-w

Head Neck Pathol. 2025 Feb 7;19(1):20. doi: 10.1007/s12105-025-01753-7.

ABSTRACT

PURPOSE: Extranodal extension (ENE) increases the risk of recurrence and death in head and neck squamous cell carcinoma (HNSCC) patients and is an indication for treatment escalation. Histopathology forms the mainstay of diagnosing ENE. There is substantial variation in the diagnosis of ENE and related terminology. Harmonising the diagnostic criteria for ENE was identified as a priority by the Head and Neck Consensus Language for Ease of Reproducibility (HN CLEAR) Steering Committee and its global stakeholders.

METHODS: An international working group including 16 head and neck pathologists from eight countries across five continents evaluated whole slide images of haematoxylin and eosin-stained sections depicting potential diagnostic problems through nine virtual meetings to develop consensus guidelines.

RESULTS: ENE should be diagnosed only when viable carcinoma extends through the primary lymph node (LN) capsule and directly interacts with the extranodal host environment with or without desmoplastic stromal response. Identifying the original LN capsule and reconstruction of its contour can assist in the detection and assessment of ENE. The term matting is recommended for confluence of two or more nodes due to histologically identifiable tumour extending from one LN to another. Matting constitutes major form of ENE. On the other hand, the terms fusion/adhesion/confluence/conglomeration and other synonyms of adhesion should be limited to confluence due to fibrosis or inflammation without histologically identifiable tumour between involved lymph nodes. Tumour extension along narrow needle tracks or spillage of cyst contents following an FNA do not constitute ENE.

CONCLUSIONS: The consensus recommendations encompassing the definition of ENE, macroscopic and histologic examination of lymph nodes (LN) and practical guidelines for handling challenging cases are provided.

PMID:39918634 | DOI:10.1007/s12105-025-01753-7

Dysphagia. 2025 Feb 7. doi: 10.1007/s00455-025-10804-8. Online ahead of print.

ABSTRACT

Post-stroke dysphagia is a common and debilitating complication affecting millions of people worldwide, often leading to malnutrition, pneumonia, and reduced quality of life. This study, an interim analysis of the Korean Study Cohort for Functional and Rehabilitation, aimed to identify long-term changes and predictive factors associated with post-stroke dysphagia at 3 years after stroke. A total of 4735 patients with acute first-ever stroke, including both ischemic and hemorrhagic subgroups, were followed, and dysphagia was assessed using the ASHA-NOMS scale. All the patients were then followed up for up to 36 months. The results showed significant improvements in dysphagia up to 12 months after stroke in the total and hemorrhagic stroke group, and the decline in swallowing function after 24 months in the total stroke and ischemic stroke groups was a novel finding. The hemorrhagic stroke group showed worsening dysphagia after 30 months. It is unclear whether patients who experienced worsening of swallowing function had other conditions, including new strokes, that might have contributed to this decline. Male gender, age at stroke, K-FAST at 7 days, ASHA-NOMS scale, mRS score at 3 months, and early comprehensive rehabilitation were identified as predictors of a decrease in the ASHA-NOMS score after 24 months. Additionally, the K-MBI score at 3 months post-stroke was found to be a significant factor influencing long-term improvements in swallowing function. These findings suggest that patients should be closely monitored for dysphagia beyond 24 months after stroke onset, as swallowing function may decline over time. During follow-up, it is essential to carefully consider the multiple factors associated with this decline.

PMID:39918632 | DOI:10.1007/s00455-025-10804-8

Eur J Trauma Emerg Surg. 2025 Feb 7;51(1):99. doi: 10.1007/s00068-024-02723-4.

ABSTRACT

BACKGROUND: Epidural hematomas (EDH) are associated with a high rate of mortality and morbidity. Good clinical outcome depends on initial Glasgow Coma Scale (GCS), pupillary abnormalities, hematoma volume, age and time to surgery. The latter is mostly influenced by distance to the next level-1-trauma center.

OBJECTIVE: The aim of this study was to evaluate the surgical care and the influence of a potential interhospital transport of patients with acute EDH.

MATERIAL & METHODS: A retrospective analysis of data from 2009 to 2020 was carried out. All patients who underwent surgical evacuation of an EDH were included. Time and distance to surgery, pupillary abnormalities, initial GCS, age at surgery, direct or indirect transport, outcome (GOS) and comorbidities were collected. The effect on outcome was analyzed by multivariate analysis.

RESULTS: One hundred and thirty-one patients (106 men, 25 women) with EDH were surgical treated at our department. 54% were transported directly to our hospital. Median time to surgery was 4 h (2-336 h) and mean distance was 50 km (road kilometers). There was no difference in surgical treatment between admission patterns. Secondarily transferred patients have been operated at least as fast than primary hospital admissions (median 10 h vs. 11 h, respectively). Direct or indirect transport of patients had no statistically significant influence on outcome (p = 0.72), like sex (p = 0.33) and time to surgery (p = 0.75).

CONCLUSION: Interhospital transport did not cause a significant delay of surgical treatment and outcome was comparable between direct and indirect transport to specialized neurosurgical care. Direct transport was more common on severe TBI and in patients with pupillary abnormalities, but secondary transport also allowed for adequate care.

PMID:39918624 | DOI:10.1007/s00068-024-02723-4

Addiction. 2025 Feb 6. doi: 10.1111/add.16772. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Mechanisms of varenicline preloading in promoting smoking abstinence have not been evaluated. Based on an extinction of reinforcement framework, we tested the hypothesis that pre-quit reductions in smoking rate mediate the effect of extended preloading on abstinence. We also tested alternative indicators of change in smoking reinforcement, as well as smoking aversion, nausea and abstinence self-efficacy as candidate mediators.

DESIGN, PARTICIPANTS AND INTERVENTION: Randomized, double-blind, placebo-controlled trial (NCT03262662) comparing extended (4-week varenicline) to standard (3 weeks of placebo, 1-week varenicline) preloading, preceding 11 weeks of open-label varenicline, in 320 adults (56% female). The primary outcome was self-reported continuous smoking abstinence during the last 4 weeks of treatment, with cotinine bio-verification at end of treatment (EOT).

SETTING: University at Buffalo, State University of New York, USA (part of the trial was conducted at participants’ homes due to the COVID-19 pandemic).

MEASUREMENTS: Candidate mediators, including smoking rate and subjective effects of smoking (reward, satisfaction, aversion), self-reported craving, withdrawal, nausea and abstinence self-efficacy, were assessed daily during the pre-quit period with ecological momentary assessment. At two laboratory visits participants completed a choice task to assess smoking reinforcement.

FINDINGS: There was a statistically significant indirect effect of extended preloading on greater EOT abstinence rates through pre-quit declines in smoking rate [a*b = 0.284, 95% confidence interval (0.072,0.616)] and percent reduction in smoking across the pre-quit period [a*b = 0.225, (0.080,0.437)]. There were also statistically significant indirect effects through reductions in pre-quit craving [a*b = 0.150, (0.01,0.420)] and increases in pre-quit self-efficacy [a*b = 0.157, (0.038,0.375)]. Sex-specific analyses suggested these mediated effects were consistently limited to females. No other candidate mediators yielded statistically significant indirect effects.

CONCLUSIONS: Extended varenicline preloading mediated smoking abstinence through reduced pre-quit smoking and craving among female smokers seeking to quit; increased pre-quit abstinence self-efficacy was also a significant mediator.

PMID:39915904 | DOI:10.1111/add.16772

Stat Med. 2025 Feb 28;44(5):e70001. doi: 10.1002/sim.70001.

ABSTRACT

A surrogate marker is a biological measurement in a clinical trial that aims to replace the primary outcome in evaluating the treatment effect, and can be measured earlier, with less cost, or with less patient burden. In theory, once a surrogate is validated, future studies can evaluate treatment efficacy using only the surrogate. While there are many methods to evaluate a surrogate, these methods rarely account for heterogeneity in surrogacy, that is, when a surrogate is valid for only certain people. We propose a general framework for the assessment of complex heterogeneity in the strength of a surrogate marker, as well as corresponding parametric and semiparametric estimation procedures. Our framework defines the proportion of the treatment effect on the primary outcome that is explained by the treatment effect on the surrogate, as a function of multiple baseline covariates, W $$ mathbf{W} $$ . We additionally propose a formal test of heterogeneity and a method to identify a region of the covariate space where the surrogate is sufficiently strong. We examine the performance of our methods via a simulation study featuring varying levels of heterogeneity and use our methods to examine potential heterogeneity in the strength of a surrogate in an AIDS clinical trial.

PMID:39915898 | DOI:10.1002/sim.70001