Category: Nevin Manimala

Clin Pharmacokinet. 2026 Jan 27. doi: 10.1007/s40262-025-01617-x. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Accurate assessment of the glomerular filtration rate (GFR) is crucial in critically ill children, yet standard estimation formulas (eGFR) perform poorly, especially in the youngest. Iohexol plasma clearance is the reference standard for measured GFR; however, its routine use is limited by logistical constraints. This study aims to develop and internally validate a population pharmacokinetic model of iohexol in critically ill children, to derive a practical model-based GFR estimation formula (eGFR_iohexol), and to compare its predictive performance against established eGFR formulas (eGFR_Schwartz, eGFR_{Smeets/Pierce}).

METHODS: After administration of iohexol, up to six blood samples were drawn from 107 patients over a 6-hour interval. Data from 93 patients were used for model building, and from 31 patients for internal validation. Reference clearances were obtained using the post hoc Bayesian clearance estimates. Predictive performances of eGFR_iohexol, eGFR_Schwartz, and eGFR_{Smeets/Pierce} were compared with reference clearances using bias, imprecision, Total Deviation Index, concordance correlation coefficient, and the percentage of predictions within 10 and 30% error (P10, P30) around reference clearances.

RESULTS: The final model identified body surface area, serum creatinine, cystatin C, postoperative status, and clonidine treatment as significant predictors of iohexol clearance. eGFR_iohexol demonstrated minimal bias (-0.8%) and imprecision (21%) and high accuracy (P30 = 87%), particularly in patients under 2 years of age (P30 = 90 vs 40% for eGFR_Schwartz). Furthermore, eGFR_iohexol also demonstrated superiority over eGFR_{Smeets/Pierce}, which exhibited moderate bias (-5.4%) and reduced accuracy (P30 = 68%).

CONCLUSIONS: A model-derived GFR estimation formula based on iohexol population pharmacokinetic modeling might allow for an accurate bedside assessment of kidney function in critically ill children, outperforming the Schwartz and Smeets/Pierce formulas, particularly in infants. External validation in larger pediatric intensive care unit populations, across the full age and GFR range, is warranted to confirm the generalizability of this equation and its potential for broader clinical application.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT05179564, registered retrospectively on 5 January, 2022.

PMID:41591642 | DOI:10.1007/s40262-025-01617-x

Mol Cell Biochem. 2026 Jan 27. doi: 10.1007/s11010-026-05482-5. Online ahead of print.

ABSTRACT

Despite observed epidemiological associations, the direct causality between chronic kidney disease (CKD) and senile cataract remains unclear. This bidirectional Mendelian randomization (MR) study assessed the causal associations between CKD-including glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (UACR), dialysis, and rapid eGFR decline-and senile cataract. Summary statistics from genome-wide association studies (GWAS) of European ancestry were analyzed. Data for senile cataract comprised 404,086 individuals, while data for CKD and related kidney function traits were sourced from large-scale meta-analyses (sample size up to 1,004,040). Instrumental variables with F-statistics greater than 10 were utilized to estimate causality via inverse-variance weighted (IVW) regression, complemented by weighted median, weighted mode, and MR-Egger methods. Sensitivity analyses included MR-PRESSO for pleiotropy adjustment and Cochran’s Q for heterogeneity assessment. Additionally, a multivariable MR (MVMR) analysis was conducted to adjust for type 2 diabetes (T2D). Univariable MR analyses did not support causal relationships between general CKD, eGFR, UACR, or dialysis and senile cataract. However, in the MVMR analysis adjusting for T2D, a genetically predicted rapid eGFR decline (Rapid3) was significantly associated with an increased risk of senile cataract (OR = 1.089, P = 0.014). Reverse MR analyses indicated no causal effect of senile cataract on CKD or kidney function traits. This study found no evidence for a direct causal link between general CKD and senile cataract. However, the findings suggest that rapid deterioration of kidney function may be a causal risk factor for cataract, independent of shared genetic pathways with T2D. These results underscore the clinical importance of monitoring ocular health in patients experiencing accelerated kidney function loss.

PMID:41591627 | DOI:10.1007/s11010-026-05482-5

Discov Nano. 2026 Jan 27;21(1):17. doi: 10.1186/s11671-026-04447-3.

ABSTRACT

Ultra-wideband (UWB) technology has garnered significant interest from researchers worldwide. Reducing antenna size, guaranteeing radiation stability, attaining impedance matching, and keeping costs down are recent challenges.The adaptability, compactness, and wideband performance of log-periodic sawtooth planar antennas for UWB applications show great potential. There is much potential for improvement, especially in high-gain and multi-band settings, as indicated by the current research and advancements in resonator structures, reconfigurability, and meta surface designs. These advancements guarantee that log-periodic architectures will remain relevant and it targets wideband sub-GHz applications that complement 5G networks, including control, broadcast, and backward-compatibility services. A toothed log-periodic antenna based on graphene is proposed in this study to operate in the 0.1-1.3 GHz frequency range. In proposed method by varying the DC voltage applied to the graphene, the antenna’s bandwidth, radiation pattern, and operating frequency range is dynamically adjusted. The graphene’s chemical potential, surface conductivity, and surface impedance, this voltage control makes it possible to create a reconfigurable antenna design is adjusted. A log-periodic graphene lattice coupled to a 50-ohm feed line makes up the antenna’s radiating element. Simulation and implementation results demonstrate that the antenna generates stable, directional radiation patterns over a wide frequency range from 0.1 to 1.3 GHz when the chemical potential of graphene is set to 1 eV.

PMID:41591626 | DOI:10.1186/s11671-026-04447-3

Clin Rheumatol. 2026 Jan 27. doi: 10.1007/s10067-026-07962-x. Online ahead of print.

ABSTRACT

OBJECTIVE: The study aimed to evaluate Antinuclear antibody detection by indirect immunofluorescence and line immunoassay in patients with suspected autoimmune diseases and to correlate immunofluorescence patterns and autoantibody profiles with their clinical features to improve diagnostic interpretation.

METHODS: A retrospective cross-sectional study was conducted on 1,342 patients clinically suspected of autoimmune diseases over nine months at a tertiary care hospital in North India. All samples were tested using indirect immunofluorescence on HEp-2 cells. Line immunoassay was performed on samples showing nuclear immunofluorescence patterns. Associations between serological findings, demographic variables, clinical features, and final diagnoses were statistically analysed.

RESULTS: Of the 1,342 patients clinically suspected of autoimmune diseases, antinuclear antibodies by indirect immunofluorescence assay were detected in 308 patients (22.95%). Among these positive samples, nuclear patterns were observed in 206 (66.88%) cases and cytoplasmic patterns in 102 (33.11%). The speckled nuclear pattern was the most frequent (151/206; 73.30%), followed by homogeneous (9.22%), nucleolar (8.74%), and centromere (4.85%) patterns. Line immunoassay performed on nuclear pattern-positive samples identified antigen-specific autoantibodies in 67 cases (32.52%), while no autoantibodies were identified in 139 cases (67.48%). The most commonly detected autoantibodies were anti-Ro52, anti-Ro60, and anti-dsDNA. A statistically significant association was observed between indirect immunofluorescence assay patterns and autoantibody profiles (χ2 = 597.587, p < 0.001). Antinuclear antibody positivity showed significant correlation with joint-related symptoms (p < 0.001) and swollen glands (p = 0.004). Distinct immunofluorescence patterns and autoantibody profiles demonstrated disease-specific associations, including centromere pattern with systemic sclerosis and homogeneous and speckled patterns with systemic lupus erythematosus and Sjögren’s disease.

CONCLUSION: A combined diagnostic approach using indirect immunofluorescence for screening and line immunoassay for antigen-specific profiling improves diagnostic accuracy. This strategy is particularly valuable in resource-limited settings, enabling targeted diagnosis and clinical decision-making. Key Points • A dual methodology combining indirect immunofluorescence with Line immunoassay enhances diagnostic specificity in the identification of autoimmune diseases. • Significant associations were identified among Antinuclear antibody patterns, autoantibody profiles, and specific autoimmune diseases. • The study reinforces the utility of integrating indirect immunofluorescence and Line immunoassay in routine autoimmune diagnostics, especially in resource-limited healthcare settings.

PMID:41591621 | DOI:10.1007/s10067-026-07962-x

Int Ophthalmol. 2026 Jan 27;46(1):76. doi: 10.1007/s10792-026-03967-2.

ABSTRACT

INTRODUCTION: Thyroid eye disease (TED) is an autoimmune-mediated inflammatory condition of the orbit leading to hypertrophy and inflammation of the orbital extra-ocular muscles (EOMs). Previous studies have sought to quantify this enlargement, but due to the anatomical proximity and limitations in imaging quality, have measured the superior rectus (SR) and Levator Palpebrae Superioris (LPS) complex together rather than measuring the individual muscles.

METHODOLOGY: Retrospective manual measurements from high-field (3-Tesla) fat-suppressed contrast-enhanced T1-weighted magnetic resonance imaging (MRI) of the orbits were taken from patients diagnosed with TED. To produce a control group, orbital MRIs were measured from patients being investigated for other non-TED related orbital pathology.

RESULTS: 47 patients were included with TED with 78 orbits measured (L: 42 R: 37). In the control group, 111 patients with 163 orbits measured were included. In the TED cohort the mean ratio of LPS to SR size was 1.04 (SD: 0.53) compared to 0.947 (SD 0.33) in the non-TED cohort with no statistically significant difference (p = 0.3381). The LPS in the TED cohort had a mean muscle thickness of 2.4 mm (SD 0.895), which was higher than the non-TED cohort (p < 0.01) which had a mean thickness of 1.56 mm (SD 0.36). This study found LPS enlargement occurred in 48.7% of TED orbits.

CONCLUSION: This study demonstrates that absolute LPS enlargement is a common finding in TED, occurring in nearly half of affected orbits. This is the first study to individually segment and quantify the extent of enlargement of the LPS relative to the SR using modern medical imaging.

PMID:41591619 | DOI:10.1007/s10792-026-03967-2

Int Ophthalmol. 2026 Jan 27;46(1):74. doi: 10.1007/s10792-026-03953-8.

ABSTRACT

BACKGROUND: The primary treatment for managing epilepsy consists of anti-seizure drugs (ASDs). Nevertheless, their prolonged use has been associated with various ocular complications. The structural alterations, such as thinning of the retinal nerve fiber layer (RNFL) and macular edema, have received limited research attention in younger adults undergoing extended ASD treatment.

OBJECTIVE: This study aimed to evaluate the structural and functional changes in the eyes specifically, refractive error, tear film quality, macular health, and RNFL thickness among young adults who are on long-term ASD therapy.

METHODS: A cross-sectional investigation involved 340 subjects aged between 20 and 40, comprising 200 ASD users and 140 healthy controls matched by age. All participant underwent a thorough ocular assessment that included best-corrected visual acuity (BCVA), subjective refraction, intraocular pressure, Schirmer’s I & II tests, tear breakup time (TBUT), slit-lamp examination, fundus photography, and Optical Coherence Tomography (OCT) for analysis of the retinal nerve fibre layer (RNFL) and macula. The statistical evaluation was conducted using the Kruskal-Wallis H test, with significance established at P < 0.05.

RESULTS: Users of ASD exhibited a significantly higher average refractive error (-2.50DS/ ± 1.00DC) compared to controls (-0.75DS/ ± 0.75DC180). Tear metrics were considerably lower, with Schirmer’s I & II and TBUT demonstrating significant disparities in sodium valproate users (P < 0.001). OCT findings indicated early signs of macular edema in 10% of ASD users, particularly among those on sodium valproate and topiramate. RNFL thickness displayed an average reduction of 8.5 µm relative to controls (P = 0.042), with the most pronounced thinning noted in users of lamotrigine and levetiracetam.

CONCLUSION: Prolonged ASD treatment is linked to observable changes in ocular structure, including dry eye disease, myopia, macular edema, and RNFL thinning. These outcomes highlight the necessity for routine ophthalmic evaluation and collaborative care to prevent irreversible visual impairment in individuals with epilepsy.

PMID:41591611 | DOI:10.1007/s10792-026-03953-8

Int Ophthalmol. 2026 Jan 27;46(1):78. doi: 10.1007/s10792-026-03958-3.

ABSTRACT

PURPOSE: This study aims to compare the effects of cooled versus room-temperature irrigation solutions on preoperative and early postoperative choroidal vascularity in patients undergoing pars plana vitrectomy (PPV) for idiopathic epiretinal membrane (ERM) peeling.

METHODS: In this prospective, randomized, comparative study, 54 patients underwent standard 23-G PPV performed by a single surgeon. During the procedure, 27 patients received cooled irrigation solutions (Group 1), while the remaining 27 patients were treated with room-temperature irrigation solutions (Group 2). Central macular thickness (CMT), subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) were measured preoperatively and five to ten minutes postoperatively in both groups. The preoperative-to-postoperative changes within each group and the differences between the two groups were analyzed.

RESULTS: In Group 1, significant differences were observed in both SFCT and CVI values between the preoperative and postoperative measurements (p = 0.002 and p = 0.002, respectively), whereas the mild reduction in CVI in Group 2 (p = 0.012) did not remain statistically significant after Bonferroni correction. However, no statistically significant differences were found in the magnitude or percentage of preoperative-to-postoperative changes between the groups (p > 0.05). A two-way repeated measures ANOVA revealed significant reductions in CMT, SFCT, and CVI following PPV in both groups (p < 0.05).

CONCLUSION: PPV caused an early postoperative decrease in choroidal perfusion, which was significant in the cold irrigation group. However, there was no significant difference between cooled and room-temperature irrigation solutions.

PMID:41591592 | DOI:10.1007/s10792-026-03958-3

Support Care Cancer. 2026 Jan 27;34(2):132. doi: 10.1007/s00520-025-10292-4.

ABSTRACT

PURPOSE: Breast cancer is the most commonly diagnosed cancer among women, and breast cancer survivors face ongoing challenges related to physical, psychological, and social well-being. Social media-based interventions have emerged as potential tools for knowledge dissemination, emotional support, and health management, yet their effectiveness remains under-researched. This review identifies gaps in the current literature and offers recommendations to guide future research and improve social media use in survivorship care.

METHODS: A comprehensive literature search was conducted using PubMed, MEDLINE, Embase, CINAHL, Web of Science, and Google Scholar to identify studies published from database inception through March 2025 that examined the use of social media interventions. Studies were categorized into key themes: knowledge acquisition, social support, psychological health, and physical health outcomes.

RESULTS: Breast cancer survivors may use social media interventions for knowledge acquisition, allowing them to exchange information, engage in peer support, and access expert resources. While these platforms improve understanding of treatment-related concerns, challenges such as misinformation and information overload remain. Social media interventions offer emotional support, fostering peer connections and reducing isolation, often through hashtags that allow individuals to connect, share experiences, and seek emotional support, and allow for anonymous self-expression. However, the emotional amplification of shared suffering may heighten distress. For psychological health, mixed findings suggest that social media has no effect or, in some cases, a negative impact on anxiety and depression experienced by breast cancer survivors. Social media interventions promoting physical activity promise to improve exercise adherence and health outcomes, though long-term effects remain unclear.

CONCLUSION: Social media interventions have the potential to improve knowledge acquisition and support for breast cancer survivors. Future research should focus on randomized controlled trials to better understand the impact of social media interventions on social support and well-being.

PMID:41591579 | DOI:10.1007/s00520-025-10292-4

World J Urol. 2026 Jan 27;44(1):130. doi: 10.1007/s00345-026-06225-3.

ABSTRACT

PURPOSE: Urolithiasis is a common condition in urological practice. Retrograde intrarenal surgery (RIRS) is widely accepted as a safe and effective treatment modality. However, acute ureteral injuries during ureteral access sheath (UAS) placement remain a significant concern. Although beta-adrenergic receptors have been identified in the ureteral wall, studies investigating beta-agonists for ureteral protection are lacking. This study aimed to assess whether short-term preoperative administration of mirabegron, a beta-3 adrenoreceptor agonist, can reduce the incidence of UAS-related ureteral injuries during RIRS.

METHODS: In this prospective non-randomized study, 60 patients undergoing RIRS were enrolled. Allocation was based on clinical indications due to ethical considerations: 30 patients with existing overactive bladder symptoms received preoperative mirabegron, while 30 patients served as controls. Baseline characteristics were comparable between the groups. Ureteral injuries were assessed endoscopically and graded using the Post-Ureteroscopic Lesion Scale (PULS).

RESULTS: The mirabegron group showed a lower incidence of high-grade ureteral injuries compared to the control group, but the difference was not statistically significant (p = 0.123). No adverse events related to mirabegron were reported. Limitations include the lack of randomization, modest sample size, and single-center design.

CONCLUSIONS: Short-term preoperative mirabegron use appears to be safe. While our results suggest a potential trend towards reducing high-grade ureteral injuries, this did not reach statistical significance, likely due to the limited sample size of this preliminary cohort. Further large-scale, multicenter studies with longer follow-up are necessary to confirm these findings.

PMID:41591575 | DOI:10.1007/s00345-026-06225-3

Int J Implant Dent. 2026 Jan 27;12(1):2. doi: 10.1186/s40729-026-00667-5.

ABSTRACT

PURPOSE: In immediate implant placement, both open and closed healing techniques are used, but their comparative esthetic and tissue stability outcomes remain under debate. This study aimed to evaluate and compare these two approaches to support clinical decision-making.

METHODS: In this prospective, randomized controlled trial, 46 patients received a total of 48 implants, assigned to either an open healing group (n = 25) or a closed healing group (n = 23). Clinical and radiological assessments were conducted at three time points: T1 (pre-extraction), T2 (3 months post-op), and T3 (12 months post-op). The primary endpoint was the Pink Esthetic Score (PES), which assesses seven soft tissue parameters. Secondary endpoints included implant survival and volumetric tissue changes. PES was analyzed using a linear mixed-effects model.

RESULTS: The open healing group showed significantly higher PES outcomes compared to the closed healing group (mean difference: -1.49; 95% CI: [-2.36, -0.62]; p = 0.0014). A higher baseline PES was also significantly associated with better esthetic outcomes at follow-up (0.3638, 95% CI: [0.1890, 0.5386], p = 0.0002). Smoking had no significant effect. Volumetric analysis revealed soft tissue volume loss from T1 to T2, with partial recovery by T3. Although the open healing group showed slightly less volume loss, this was not statistically significant. No implant losses occurred in either group.

CONCLUSION: The study demonstrated esthetic advantages of the open healing technique compared to the closed healing technique in immediate implant placement.

PMID:41591574 | DOI:10.1186/s40729-026-00667-5