Category: Nevin Manimala

Aging Clin Exp Res. 2025 Nov 14;37(1):326. doi: 10.1007/s40520-025-03224-z.

ABSTRACT

BACKGROUND: Ageism and stigma toward individuals with dementia contribute to their social exclusion and negatively impact their well-being. Intergenerational interventions, particularly those based on shared enjoyable experiences, have shown potential in reducing negative stereotypes. This study explored whether a Silent Disco event could challenge ageism and dementia-related stigma by fostering positive intergroup contact.

AIMS: The study assessed the effectiveness of an intergenerational Silent Disco event in reducing ageism and stigma among young adults (21-40 years, M = 32.76 ± 4.70), middle-aged adults (41-60, years M = 51.21 ± 5.88), and young-old adults (61-80 years, M = 66.67 ± 6.10).

METHODS: A 6-item questionnaire with two subscales-“Non-inclusion” and “Unpleasantness of company”-was administered to 115 participants before and after the event to measure negative stereotypes about aging and dementia. Changes in attitudes were analyzed across age groups.

RESULTS: The event reduced stigma-related unpleasantness in the total sample (p = .020) and ageism-related unpleasantness among middle-aged participants (p = .011). However, no statistically significant changes were observed in non-inclusion perceptions for either ageism or stigma.

DISCUSSION: These findings indicate that intergenerational Silent Disco events help reduce specific negative stereotypes-particularly unpleasant perceptions of older adults and people with dementia-with the strongest reduction in ageism-related unpleasantness seen in middle-aged participants. However, the persistence of non-inclusion attitudes highlights the need for broader interventions to address social exclusion.

CONCLUSIONS: Silent Disco events show potential in challenging stereotypes and fostering inclusivity, but additional strategies are needed to promote deeper intergenerational engagement and social inclusion.

PMID:41236675 | DOI:10.1007/s40520-025-03224-z

Geroscience. 2025 Nov 14. doi: 10.1007/s11357-025-02009-6. Online ahead of print.

ABSTRACT

Postoperative delirium is a potentially devastating complication of surgery that commonly affects older adults. Neurofilament light chain (NfL) is a biomarker of neuronal injury with reported associations with the development of postoperative delirium. Previous studies suggest that nighttime dexmedetomidine may help prevent delirium following cardiac surgery. However, the mechanisms involved in the delirium-sparing properties of dexmedetomidine treatment remain unclear. This study investigated circulating NfL levels as an objective molecular biomarker associated with postoperative delirium and investigated whether nighttime dexmedetomidine moderates the association between NfL and delirium severity. Serum collected from participants aged 60 years and older who underwent cardiac surgery in the Minimizing ICU Neurological Dysfunction with Dexmedetomidine Induced Sleep (MINDDS) trial were analyzed for NfL concentrations using single-molecule immunoassays (n = 355 patients with preoperative NfL and delirium severity scores). Delirium assessments were performed using the Confusion Assessment Method (CAM). The primary outcome was the peak CAM-Severity score observed within 3 days after surgery. The analysis investigated the associations between preoperative and postoperative NfL levels and delirium severity, and whether nighttime dexmedetomidine modified these associations. Elevated preoperative NfL was associated with increased delirium incidence (odds ratio = 1.62, 95% confidence interval [1.22-2.14], p = 0.001). A one-standard-deviation increase in preoperative NfL was associated with a 0.32-point increase in CAM-S (95% confidence interval [0.14-0.50], p = 0.001). Dexmedetomidine significantly attenuated the association between preoperative NfL levels and delirium severity suggesting that dexmedetomidine may intervene early in the disease process to mitigate neuronal damage in older adults following surgery. This study provides insight into the use of preoperative NfL levels to predict delirium risk and reveals a novel interaction between dexmedetomidine treatment and delirium severity.

PMID:41236671 | DOI:10.1007/s11357-025-02009-6

Langenbecks Arch Surg. 2025 Nov 14;411(1):12. doi: 10.1007/s00423-025-03890-7.

ABSTRACT

BACKGROUND: Data on multinational 90-day mortality and morbidity rates after surgery for gastric cancer is limited in the literature. This study aimed to understand the 90-day mortality and morbidity outcomes among patients undergoing elective gastric cancer surgery, as in the GASTRODATA Registry, and to identify associated risk factors.

METHODS: We conducted an international prospective study on patients aged ≥ 18 years undergoing elective surgery for gastric cancer with curative intent from January 4 to September 30, 2022. Known metastatic disease, concurrent secondary cancers, gastrointestinal stromal tumour (GIST) and Siewert type I/II oesophagogastric junction malignancies were excluded. Univariate and multivariate logistic regression were used to identify variables associated with the 90-day outcome.

RESULTS: 380 collaborators from 47 countries submitted data on 1538 patients. Median age was 65 years (IQR: 19-94), and 58.5% were males. 90-day morbidity and mortality rates were 38.2% (n = 587) and 2.9% (n = 45), respectively. Pre-operative higher Charlson Comorbidity Index, higher ASA score, pre-operative weight loss > 10%, positive specimen margin, and post-operative pathological IV staging (p value < 0.05) were significantly associated with clinically relevant complications and mortality.

CONCLUSION: Elective gastric cancer surgery has a 90-day morbidity of 38.2% and a 90-day mortality of 2.9% globally. This study provided the most comprehensive international 90-day prospective data to date regarding gastric cancer surgery. Several factors associated with higher morbidity were identified, highlighting the importance of a unified language on surgical morbidity, prehabilitation, and ongoing audits to enhance patient outcomes.

PMID:41236666 | DOI:10.1007/s00423-025-03890-7

Aging Clin Exp Res. 2025 Nov 14;37(1):324. doi: 10.1007/s40520-025-03210-5.

ABSTRACT

BACKGROUND: Declining estrogen in perimenopausal women reduces bone mineral density and increases bone fragility, elevating fall and fracture risk. This presents major challenges for patients and society, yet prior studies lack systematic analysis of this population. This study is the first to utilize mortality and disability-adjusted life years (DALYs) related to falls among perimenopausal women from the Global Burden of Disease (GBD) 2021 database, and to conduct a comprehensive and systematic analysis of the evolving burden of falls in perimenopausal women from 1990 to 2021, as well as to project trends through 2050. This study offers key guidance for optimizing healthcare resource allocation, enhancing patient management, and developing targeted prevention and intervention strategies.

METHODS: This study used GBD 2021 data to systematically analyze fall-related mortality, DALYs, age-standardized rates (ASRs), and estimated annual percentage change (EAPC) among perimenopausal women, examining their associations with the Socio-demographic Index (SDI) at global, regional, and national levels. Joinpoint regression, decomposition, health inequality, and frontier analyses quantified trends, identified factors, and assessed disparities. This study also explored fall risk factors and utilized the Bayesian Age-Period-Cohort (BAPC) model to project global trends in fall burden among perimenopausal women from 2022 to 2050.

RESULTS: Between 1990 and 2021, global mortality attributable to falls among perimenopausal women surged by 116.99% (from 1.67 to 3.63 per 100,000), while DALYs increased by 38.31% (from 116.50 to 188.85 per 100,000). In contrast, age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) declined by 7.00% (EAPC = – 0.30) and 14.62% (EAPC = – 0.56), respectively. Decomposition analysis identified population growth as the predominant contributor to the escalation in mortality (162.91%), while epidemiological changes were the main reason for the reduction (- 63.63%). Marked heterogeneity was observed across SDI strata: low-middle SDI regions exhibited the steepest rise in mortality (138.00%), whereas high-SDI regions achieved the most pronounced reduction in ASMR (- 21.18%). Notably, high-income North America experienced an 106.62% increase in ASMR. The 50-54-year age cohort consistently represented the highest global burden, with low bone mineral density emerging as the principal risk factor. Projections to 2050 suggest ongoing declines in ASMR and ASDR, yet the absolute burden is expected to remain elevated due to persistent demographic expansion.

CONCLUSIONS: Between 1990 and 2021, the global burden of falls among perimenopausal women has exhibited a persistent upward trend, and projections indicate that this burden will likely remain at a high level in the future. This alarming situation underscores the urgent need for targeted interventions. Identifying key risk factors for falls in perimenopausal women is essential for guiding the allocation of public health resources and formulating precise intervention strategies. It is imperative to implement nationwide, cost-effective measures, such as osteoporosis and fall risk screening, the promotion of exercise programs that enhance muscle strength and balance, and, where appropriate, consideration of pharmacological interventions (such as estrogen) to reduce fall risk. This intervention will significantly reduce the risk of falls and associated burdens among perimenopausal women.

PMID:41236661 | DOI:10.1007/s40520-025-03210-5

Eur Radiol. 2025 Nov 14. doi: 10.1007/s00330-025-12132-9. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the completeness and discordance of outside rectal MRI initial staging reports compared to second-opinion reviews, and to assess the potential clinical impact of major discordance on treatment decisions in patients with rectal adenocarcinoma.

MATERIALS AND METHODS: A retrospective analysis of outside rectal MRI reviews submitted for second-opinion interpretation by subspecialized radiologists from June 2014-March 2020 was conducted. Outside and second review reports were compared side-by-side; cases with discordance (and those with major discordance, i.e., may alter treatment, particularly) were identified. Two colorectal surgeons, blinded to report origins, reviewed cases with major discordance to evaluate their theoretical impact on patient management and rated their confidence level of the reports on a five-point Likert scale (1=lowest confidence).

RESULTS: In 461 patients (median age, 57 years [IQR: 49-67]; 274 male), compared to outside reviews, second reviews demonstrated improved report completeness across tumor characteristics, local extent, and nodal/metastatic disease clinical staging categories. The largest reporting gaps were in tumor morphology (66.4%, 306/461 vs. 98.7%, 455/461) and extramural venous invasion (29.1%, 134/461 vs. 93.9%, 433/461). Overall, 53.8% (248/461) of cases showed discordance, with 56.5% (140/248) classified as major. In this subset, second reviews led to fewer cases with insufficient information, e.g., 18.6% (26/140) to 7.1% (10/140) for Surgeon 1, and changes in surgical planning in 38.1-46.3% (43/113 to 44/95) of patients. Surgeons rated reports from second reviews with higher confidence scores (median, 4 vs. 2-3, p < 0.001).

CONCLUSIONS: Second-opinion reviews may impact patient care and improve surgeons’ confidence for treatment planning.

KEY POINTS: Question Do subspecialist radiologist second-opinion reviews improve rectal MRI report completeness and affect treatment decisions in rectal adenocarcinoma staging? Findings While outside reviews often under-reported key imaging findings, second reviews improved report completeness, which led to increased confidence by our surgeons in treatment planning. Clinical relevance These findings underscore the value of expert interpretation and highlight the need for optimized MRI protocols and broader adoption of structured reporting in rectal cancer staging.

PMID:41236658 | DOI:10.1007/s00330-025-12132-9

Eur Radiol. 2025 Nov 14. doi: 10.1007/s00330-025-12135-6. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare the efficacy and safety of ablation therapy in hepatocellular carcinoma (HCC) patients with hepatitis B-related compensated cirrhosis versus those with recompensated cirrhosis.

MATERIALS AND METHODS: In this multicenter, retrospective cohort study, we enrolled hepatitis B-related HCC patients (73 with recompensated cirrhosis and 666 with compensated cirrhosis) who underwent ablation between January 2009 and February 2024. Propensity score matching was performed to balance baseline characteristics, resulting in 73 matched pairs. Recurrence-free survival (RFS), overall survival (OS), and complications were compared.

RESULTS: A total of 739 patients (median age, 59 years [interquartile range, 53-66 years]; 579 men [78.2%]) were enrolled. Following propensity score matching procedures, no significant difference in major complications was observed between patients with recompensated cirrhosis and those with compensated cirrhosis (6.8% vs. 2.7%, p = 0.438). Critically, no postoperative liver failure or decompensation events occurred after ablation therapy in patients with either recompensated cirrhosis or compensated cirrhosis. Moreover, RFS was comparable between patients with recompensated cirrhosis and those with compensated cirrhosis (73.7% vs. 74.0% at 1 year; 43.3% vs. 43.2% at 3 years; 24.8% vs. 36.9% at 5 years; p = 0.699). The overall survival rates at 1, 3, and 5 years were 97.3%, 84.5%, and 73.4% in patients with recompensated cirrhosis, and 98.6%, 92.7%, and 83.7% in patients with compensated cirrhosis, respectively (p = 0.363).

CONCLUSIONS: Ablation therapy is effective and safe in HCC patients with hepatitis B-related recompensated cirrhosis, representing a viable curative option for these patients.

KEY POINTS: Question Is ablation as safe and effective for patients with hepatitis B-related recompensated cirrhosis as it is for those with compensated cirrhosis? Findings The incidence of major complications and long-term survival did not differ statistical significantly between patients with hepatitis B-related recompensated cirrhosis and those with compensated cirrhosis. Clinical relevance Ablation therapy is effective and safe in hepatocellular carcinoma patients with hepatitis B-related recompensated cirrhosis, representing a viable curative option for these patients.

PMID:41236657 | DOI:10.1007/s00330-025-12135-6

Muscle Nerve. 2025 Nov 14. doi: 10.1002/mus.70059. Online ahead of print.

ABSTRACT

INTRODUCTION/AIMS: Neuralgic amyotrophy (NA, Parsonage-Turner syndrome) is a common, multifocal, autoimmune inflammatory disease that predominantly affects proximal nerve segments of the shoulder girdle. Despite the high incidence of 100/100,000, epidemiologic data based on larger cohorts are still lacking. This study aims to address this issue.

METHODS: A retrospective evaluation of billing data from an average of approximately 26,000,000 insured persons of a large German health insurance company was performed from 2013 to 2022. In addition to descriptive statistical methods, regression analyses were carried out.

RESULTS: The incidence and prevalence of NA were 7.7-12.8 and 19.7-21.6 per 100,000 people, respectively. During the study period, a steady decline in incidence and, to a lesser extent, prevalence was observed. The diagnosis was made significantly more frequently in the first quarter of the year than in any other quarter. The prevalence of a simultaneously coded diaphragmatic paresis (indicating the involvement of the phrenic nerve) was 0.45%.

DISCUSSION: Compared with prospectively collected data, the data in this study revealed an approximately 90% lower incidence of NA. It is likely that the majority of cases are not correctly diagnosed and are therefore not captured in the billing data. The involvement of the phrenic nerve in patients with NA also appears not to be recognized in most cases. According to the current pathophysiological model of NA, an immunological trigger is necessary to initiate the disease process. Our data support the accuracy of this model.

PMID:41235535 | DOI:10.1002/mus.70059

Neoplasma. 2025 Oct;72(5):371-378. doi: 10.4149/neo_2025_250730N330.

ABSTRACT

Radiotherapy (RT) plays a central role in the management of glioblastoma, often in combination with other treatment modalities. While RT can enhance both local and systemic tumor control, especially when used alongside immunotherapy, it is also associated with lymphopenia – a reduction in lymphocyte count – which has been linked to poorer treatment outcomes and reduced survival. This retrospective study aimed to examine the relationship between radiation dose delivered to brain vessels and the severity of lymphopenia in patients with newly diagnosed glioblastoma treated at a tertiary cancer center in 2021. Brain vessels were manually contoured using MRI data, and dose-volume analysis was conducted. Lymphopenia severity was graded according to CTCAE v5.0, and statistical analyses were performed to identify any correlations. Among the 28 patients analyzed, 32% developed grade 1-3 lymphopenia. No significant correlation was found between the radiation dose to brain vessels and the degree of lymphopenia. The median volume of irradiated vessels did not differ significantly between patients with and without lymphopenia. In glioblastoma patients, multiple factors contribute to decreased lymphocyte count – e.g., chemotherapy and corticosteroid use. Although no definitive link was identified, the study underscores the importance of preserving lymphocyte counts during glioblastoma treatment and supports the need for further prospective research to explore strategies like lymphocyte-sparing RT and to better understand the mechanisms behind treatment-related lymphopenia.

PMID:41235529 | DOI:10.4149/neo_2025_250730N330

Ter Arkh. 2025 Nov 11;97(10):859-866. doi: 10.26442/00403660.2025.10.203462.

ABSTRACT

BACKGROUND: Despite the variety of antidiabetic therapies, many patients with type 2 diabetes (T2D) do not achieve optimal glycemic control. Therefore, there is a need to develop additional methods for managing T2D, including ones that regulate the gut microbiome.

AIM: To assess the effect of AntiAGE-Biom probiotic on metabolic parameters in T2D patients during 3 months of therapy.

MATERIALS AND METHODS: A randomized, double-blind, placebo-controlled, single-center study included patients with T2D with glycated hemoglobin – HbA_1c<7,5% on stable antidiabetic therapy. Patients were randomized into groups receiving AntiAGE-Biom and placebo. The primary endpoint was the change in HbA_1c from baseline, secondary endpoints included the dynamics in biochemical and anthropometric parameters, body composition, as well as HOMA-IR index.

RESULTS: The study included 40 patients with T2D (n=20 in each group). There was a trend towards a decrease in HbA_1c in AntiAGE-Biom group, that did not reach statistical significance. The use of the probiotic improved the body composition after 3 months: reduced the percentage of fat in men and a subgroup of patients with an initial HbA_1c≥ 6.5%; also increased skeletal muscle mass and lean mass in the trunk segment in men (р<0,05).

CONCLUSION: AntiAGE-Biom probiotic helps to maintain metabolic control and significantly improve body composition in T2D patients with initial HbA_1c<7.5%.

PMID:41235517 | DOI:10.26442/00403660.2025.10.203462