Category: Nevin Manimala

J Cardiovasc Med (Hagerstown). 2025 Sep 1;26(9):490-498. doi: 10.2459/JCM.0000000000001766. Epub 2025 Aug 20.

ABSTRACT

AIM: Percutaneous pericardiocentesis represents the sole curative intervention for significant pericardial effusion, especially in cardiac tamponade. While the subxiphoid route is traditionally the most utilized, alternative approaches – such as the apical access – have also been adopted. To date, no studies have directly compared the performance, risk profile, and clinical implications of these techniques. This study aims to evaluate and compare the effectiveness, complication rates, and short- to medium-term outcomes of apical versus subxiphoid pericardiocentesis.

MATERIALS AND METHODS: We performed a retrospective analysis of pericardiocentesis procedures carried out at the Cardiac Intensive Care Unit of the IRCCS San Gerardo dei Tintori Foundation in Monza, Italy, between January 2011 and December 2024. Patients were categorized based on the access site: apical or subxiphoid.

RESULTS: Among 199 procedures, 85 (42.7%) were performed via the subxiphoid route and 114 (57.3%) through apical access. Most interventions addressed acute tamponade or pretamponade states. Imaging guidance was employed in 89.6% of cases. Baseline demographics, comorbidities, and echocardiographic features were comparable between the two groups. The overall success rate was 98.5%, with no significant differences between approaches. Major complications were rare (0.5%), and minor complications occurred in 11.1% of cases, without notable variance between techniques. Patient outcomes – including overall survival, in-hospital survival, and pericardiocentesis-free survival – showed no statistically significant differences (median follow-up: 17.2 months; interquartile range: 3.8-69.2 months).

CONCLUSIONS: Apical access for percutaneous pericardiocentesis demonstrates similar efficacy and safety to the subxiphoid approach, representing a valid alternative in appropriate clinical contexts.

PMID:40977469 | DOI:10.2459/JCM.0000000000001766

Ann Afr Med. 2025 Sep 17. doi: 10.4103/aam.aam_219_25. Online ahead of print.

ABSTRACT

BACKGROUND: Irisin is an adipo-myokine that is released by proteolytic cleavage of the membrane protein, fibronectin type III domain-containing protein 5. Irisin is responsible for the process of browning of white adipose tissue and is known to impact thermogenesis. Owing to the similarities in action between irisin and thyroid hormones, identifying these mutual influences in the body seems to be imperative.

AIM: This study aimed at investigating the association between serum irisin levels and thyroid dysfunction.

METHODOLOGY: This cross-sectional study was conducted in the Department of Endocrinology, Ramaiah Medical College and Hospital, Bengaluru, India, from January 1, 2025, to May 1, 2025, among individuals greater than 18 years old with new-onset hypothyroidism or hyperthyroidism and euthyroid age- and sex-matched control population who consented to the study. Serum irisin levels were assayed and compared between groups (hypothyroid, hyperthyroid, and control). Statistical analysis was performed using SPSS version 22 and Microsoft Excel (2016). An independent t-test was used as a significant test to identify the mean difference between two quantitative variables. Categorical data were represented in frequencies and proportions. Continuous data were expressed as mean and standard deviation. Correlations were performed with the Pearson Correlation coefficient. P <0.05 was considered statistically significant.

RESULTS: The study included 23 euthyroid controls and 48 individuals with thyroid dysfunction (28 hyperthyroid; 20 hypothyroid). A significant difference was noted in serum irisin levels between controls and individuals with thyroid dysfunction (P = 0.03). Further analysis depicted hypothyroid individuals showing a strong positive correlation between irisin and thyroid-stimulating hormone levels (r = 0.382, P = 0.04).

CONCLUSION: This study highlights the positive correlation of irisin levels in hypothyroid individuals, speculating on the possibility of irisin’s role in physiological adaptations in individuals with hypothyroidism.

PMID:40977446 | DOI:10.4103/aam.aam_219_25

Indian J Ophthalmol. 2025 Sep 19. doi: 10.4103/IJO.IJO_926_25. Online ahead of print.

ABSTRACT

PURPOSE: To present results from the Vitreo Retina Society-India (VRSI) 2024 Preference and Trends (PAT) survey focusing on retinal detachment (RD) and myopia management practices among Indian vitreoretinal surgeons.

METHODS: A 62-item questionnaire was distributed to all VRSI members over email. Responses were collected over 6 weeks by google forms. Data were analyzed using descriptive statistics.

RESULTS: A total of 289 members participated in the survey. Prophylactic barrage prerefractive surgery was preferred by 55.21% of the respondents. For phakic retinal detachments, scleral buckling was preferred in the absence of posterior vitreous detachment (PVD) (69.45% single hole, 52% multiple holes), while in pseudophakic, the trend was toward vitrectomy, with an encirclage for inferior breaks (54.38% with no PVD, 52.75% with PVD). For RD with superior breaks with < Grade B PVR, respondents preferred laser to break alone intraoperatively during vitrectomy (65.44%) compared to 360-degree laser and gas tamponade (67.52%), while silicon oil was more preferred tamponade for RD with inferior breaks with > Grade B PVR (99%). Respondents preferred imaging myopic choroidal neovascular membranes with optical coherence tomography and optical coherence tomography angiography (45.42%), initiate treatment with ranibizumab (41.2%), and follow pro-re-nata regimen (61.62%). For myopic macular schisis, vitrectomy was the preferred management for Stage 2C (70%) and Stages 4A and 4C (80%).

CONCLUSIONS: The VRSI-PAT survey highlights current diverse preferences among Indian vitreoretinal surgeons. These survey results will guide fellow practitioners to understand current real-world practice with relation to established literature.

PMID:40977429 | DOI:10.4103/IJO.IJO_926_25

Mov Disord Clin Pract. 2025 Sep 22. doi: 10.1002/mdc3.70370. Online ahead of print.

ABSTRACT

BACKGROUND: Anticholinergic medications and botulinum neurotoxin injections are established treatments for dystonia, yet they carry potential side effects and practical challenges. Deep brain stimulation (DBS) is offered in case of poor response to these approaches.

OBJECTIVES: To assess the need for anticholinergic medications and botulinum neurotoxin injections in adult and pediatric patients at two specialized Canadian centers before and after DBS over the past 10 years.

METHODS: 58 patients were included analyzing data before, 6 and 12 months after DBS. Clinical assessment included the Toronto Western Spasmodic Torticollis Rating Scale and Fahn-Marsden Dystonia Rating Scale. Anticholinergic burden was determined by the Anticholinergic Drug Scale (ADS).

RESULTS: Severity of cervical dystonia and ADS scores reduction were statistically significant after DBS. Anticholinergic medication and Botulinum Neurotoxin injections were discontinued a year after surgery in 28.8% and 72.4% of the patients, respectively.

CONCLUSION: Simplification of anti-dystonia treatments is another added benefit of DBS.

PMID:40977423 | DOI:10.1002/mdc3.70370

Indian J Public Health. 2025 Sep 20. doi: 10.4103/ijph.ijph_935_24. Online ahead of print.

ABSTRACT

BACKGROUND: Breast cancer is the most common cancer among Yemeni women. In this study, we aimed to determine the socioeconomic and lifestyle factors of breast cancer risk and survival among Yemeni women in Thamar.

OBJECTIVES: We assessed the association between socioeconomic status, lifestyle factors, and the risk of developing breast cancer; and compared disease-free survival (DFS) and overall survival between urban and rural breast cancer patients.

MATERIALS AND METHODS: We performed a retrospective, case-control study using data from the Thamar cancer registry and household survey. Cases were women with histologically confirmed breast cancer diagnosed from January 1, 2019 to December 31, 2023, and frequency-matched controls included women without breast cancer. Risk determinants were determined using multivariate logistic regression models and survival outcomes were analyzed using Cox regression.

RESULTS: A total of 115 cases and 119 controls were included in the study. Significant breast cancer-associated factors were illiteracy (adjusted odds ratio [aOR] =5.46, P < 0.001), wood fuel for cooking (aOR =15.8, P < 0.001), low monthly income below 200 USD (aOR =12.1, P < 0.001), and postmenopausal status (aOR =2.54, P = 0.035). The comparison of DFS between urban and rural residents showed no statistically significant difference.

CONCLUSIONS: The study identified illiteracy, wood fuel for cooking, postmenopausal status, and low monthly income as key associated factor for breast cancer among the cases and controls examined. No significant difference in DFS was observed between urban and rural residents.

PMID:40977414 | DOI:10.4103/ijph.ijph_935_24

J Womens Health (Larchmt). 2025 Sep 22. doi: 10.1177/15409996251379401. Online ahead of print.

ABSTRACT

Understanding the public health impact of women’s health research is crucial for improving health outcomes and guiding future research priorities. Bibliometric analysis offers a unique suite of tools to identify opportunities to increase impact and measure the dissemination of women’s health research. Using 2018-2021 mortality data from the National Vital Statistics System, we utilized age-adjusted death rates to identify conditions with the highest relative mortality risk for females versus males. Our analysis showed that breast cancer, Alzheimer’s disease, infections of the kidney, and acute rheumatic fever and chronic rheumatic heart diseases were associated with the highest relative mortality risk for females. Using a systematic keyword search strategy, we identified 219 Centers for Disease Control and Prevention (CDC)-authored publications published between 2018 and 2023 featuring these conditions in a database of CDC-authored publications. For relevant publications on each condition, we evaluated five bibliometric indicators measuring media attention, academic citations, and policy citations. Overall, CDC’s publications on these conditions did not demonstrate a gap in media attention, academic citations, and policy citations compared with other agency publications, underscoring the agency’s effectiveness in disseminating its research on these topics. Assessing bibliometric indicators for published research on conditions with disproportionate relative mortality risk for females can reveal potential gaps in research coverage, highlight research successes, and inform strategic decisions for disseminating women’s health research.

PMID:40977404 | DOI:10.1177/15409996251379401

BJPsych Open. 2025 Sep 22;11(5):e218. doi: 10.1192/bjo.2025.10803.

ABSTRACT

BACKGROUND: To date, little is known about the evidence of a potential risk of psychiatric adverse events following COVID-19 vaccination in large populations with adequate study design.

AIMS: To investigate whether COVID-19 vaccination is associated with increased risk of psychiatric adverse events.

METHOD: We used South Korea’s linkage database to obtain registry data and claims data from 2019 to 2021, and conducted a population-based self-controlled case series study including 11 751 806 individuals. Primary outcomes included anxiety/nervousness, mood disorders, perceptual disturbances/psychoses, aggression/behavioural disturbances, cognitive impairments and sleep disorders within 21 days of COVID-19 vaccination. Secondary outcomes were the stratified primary outcomes according to each individual’s psychiatric history. Conditional Poisson regression was used to estimate incidence rate ratios (IRR) and 95% confidence intervals.

RESULTS: COVID-19 vaccination did not increase the rate of anxiety and nervousness (adjusted IRR 0.95, 95% CI 0.95-0.96), mood disorders (adjusted IRR 0.75, 95% CI 0.75-0.76), perceptual disturbances and psychoses (adjusted IRR 0.72, 95% CI 0.70-0.74), aggression and behavioural disturbances (adjusted IRR 0.93, 95% CI 0.89-0.97), cognitive impairment (adjusted IRR 0.68, 95% CI 0.67-0.69) or sleep disorders (adjusted IRR 0.90, 95% CI 0.89-0.91). Secondary outcomes were consistent with the primary outcome, although the adjusted IRRs for anxiety and nervousness (adjusted IRR 1.17, 95% CI 1.15-1.18) and sleep disorders (adjusted IRR 1.07, 95% CI 1.06-1.09) were statistically significant in individuals with no history of psychiatric disorders. Sensitivity analyses showed consistent results with our main findings.

CONCLUSIONS: Our findings provide short-term safety profiles for COVID-19 vaccines regarding psychiatric adverse events. Continuous monitoring of anxiety/nervousness or sleep disorders after COVID-19 vaccination is required regardless of history of psychiatric comorbidities.

PMID:40977400 | DOI:10.1192/bjo.2025.10803

Sports Health. 2025 Sep 22:19417381251372975. doi: 10.1177/19417381251372975. Online ahead of print.

ABSTRACT

BACKGROUND: Studies of National Collegiate Athletic Association (NCAA) athletes have been concerning for rates of athletes reporting playing while symptomatic with a concussion and of athlete nondisclosure of concussion symptoms.

PURPOSE/HYPOTHESIS: This study’s primary aim was to determine whether application of a brief and validated scale for concussion reporting expectation (CR-E) is an effective screening tool for collegiate athletes. It was hypothesized that 20% of athletes would be considered high risk for nondisclosure of concussion symptoms using this screening tool.

STUDY DESIGN: Cross-sectional.

LEVEL OF EVIDENCE: Level 2B.

METHODS: NCAA Division I athletes (n = 358) from 18 teams who presented for preparticipation physical examinations (PPEs) in the 2023 fall season were queried with the CR-E and concussion history questions. The time to complete the CR-E was recorded, and providers recorded whether the screening results warranted additional concussion counseling or education. We report survey responses for all athletes stratified by sex and sport. Power analysis study population was based on NCAA collegiate athletes.

RESULTS: The CR-E required an average of 2 minutes for athletes to complete during their PPE. Of 238 of 358 athletes who completed the CR-E questionnaire, 2 in 3 were determined to benefit from concussion education. Overall, athletes felt “neutral” about their agreement on a Likert scale to report concussion symptoms in 4 scenarios described on the CR-E. Water polo, volleyball, women’s soccer, gymnastics, and football represented sports with higher rates of counseling, below average agreement to report concussion symptoms for 4 scenarios queried, and most frequent nonreporting histories.

CONCLUSION: The CR-E questionnaire represents an impactful screening tool with high utility and feasibility for collegiate athletes.

CLINICAL RELEVANCE: Our study supports a brief screening tool to guide concussion counseling for athletes. Based on our data, there appears to be room for improvement in athlete concussion education overall.

PMID:40977386 | DOI:10.1177/19417381251372975

Cancer Sci. 2025 Sep 22. doi: 10.1111/cas.70192. Online ahead of print.

ABSTRACT

T-cell receptor (TCR) bispecific proteins represent a pioneering therapeutic modality that harnesses the diverse target recognition capabilities inherent to TCRs while preserving the beneficial characteristics associated with protein therapeutics. However, investigations into TCR bispecific proteins, particularly within the context of lung diseases, remain limited. This study aims to elucidate their potential for the treatment of lung cancer. We employed a humanized murine model to evaluate the efficacy of TCR bispecific proteins in eradicating lung tumors in vivo. Cytotoxic activity was assessed against various lung cancer cell lines, and statistical tests were used to analyze the data. To address concerns regarding toxic side effects from systemic administration, mesenchymal stem cells (MSCs) were explored as vehicles for the targeted delivery of TCR bispecific proteins. Our findings demonstrate that TCR bispecific proteins exhibit substantial cytotoxic activity against a variety of lung cancer cell lines. MSCs, with optimal pulmonary targeting properties, were shown to persist within the lungs for over 7 days. By employing MSCs to locally secrete TCR bispecific proteins, we achieved therapeutic effects comparable to systemic administration without manifestations of immune overactivation in murine subjects. Additionally, we evaluated various cytokine combinations and discovered that the combination of IL-7, IL-21, and TCR bispecific proteins significantly augmented their capacity to eliminate antigen-negative cells in a heterogeneous tumor model. Collectively, our findings suggest that the combinatorial therapy of TCR bispecific proteins and MSCs holds considerable promise for clinical application in the treatment of lung cancer, potentially enhancing therapeutic efficacy while minimizing adverse effects.

PMID:40977380 | DOI:10.1111/cas.70192

Am J Hum Biol. 2025 Sep;37(9):e70149. doi: 10.1002/ajhb.70149.

ABSTRACT

Human biologists seek to understand how cultural, environmental, and biological forces shape observed patterns of human variation. Yet contemporary insights and approaches to observational causal inference remain underutilized in the field. We outline a structured but flexible roadmap for causal inference in human biology that begins with theory development, defines causal questions and estimands, employs directed acyclic graphs (DAGs) to clarify assumptions, and evaluates key identification criteria prior to statistical analysis. We position this framework within a spectrum of causal inference traditions, spanning from interventionist approaches rooted in well-defined, manipulable exposures to realized approaches that engage historically situated and ecologically embedded phenomena. Rather than offering a prescriptive checklist, we frame this toolkit as an opening: a step toward anthropological causal inference that integrates transparency, theoretical and methodological coherence, and the epistemological commitments of the biocultural synthesis in human biology and anthropology.

PMID:40977372 | DOI:10.1002/ajhb.70149