Category: Nevin Manimala

Aesthetic Plast Surg. 2025 Sep 4. doi: 10.1007/s00266-025-05189-w. Online ahead of print.

ABSTRACT

INTRODUCTION: This meta-analysis evaluates the impact of ethnicity-conscious rhinoplasty on patient satisfaction and complication rates. Traditional rhinoplasty techniques often overlook ethnic anatomical differences, leading to suboptimal aesthetic outcomes and higher revision rates. In contrast, individualised approaches aim to optimise both form and function by tailoring procedures to specific anatomical and cultural contexts.

METHODS: A systematic search of PubMed, PROSPERO, DynaMed, EMBASE, and the Cochrane Library was conducted in April 2025. Seventeen comparative clinical studies (2003-2023) were included in a PRISMA-compliant meta-analysis (PROSPERO ID: CRD420251045319). Primary outcomes were patient-reported satisfaction, complication rates, and revision frequency. Secondary analyses assessed effectiveness of specific surgical techniques across major ethnic groups: Hispanic/Mestizo, African-American, Middle Eastern, Indian-American, Asian, and Caucasian. Statistical analyses used RevMan 5.4 with random-effects modelling and I² for heterogeneity. Study quality was evaluated using the Newcastle-Ottawa scale and AHRQ criteria.

RESULTS: Ethnicity-conscious rhinoplasty was associated with significantly greater patient satisfaction (SMD = 0.68 [95% CI 0.63-0.73]; p < 0.001). The highest satisfaction was observed in multi-ethnic (SMD = 0.76), African-American (0.71), and Middle Eastern (0.63) groups. Indian (0.58) and Asian (0.55) patients also showed favourable outcomes, while Caucasian patients had the lowest satisfaction (0.21). Tailored approaches resulted in lower complication (8.7%) and revision (5.3%) rates compared to conventional methods (17.4% and 12.1%). Heterogeneity was minimal (I² = 0%), with no evidence of publication bias.

CONCLUSION: Ethnicity-conscious rhinoplasty enhances patient satisfaction and safety across diverse populations. These findings support the need for culturally and anatomically informed surgical planning in modern aesthetic practice.

LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:40906288 | DOI:10.1007/s00266-025-05189-w

Aesthetic Plast Surg. 2025 Sep 4. doi: 10.1007/s00266-025-05185-0. Online ahead of print.

ABSTRACT

BACKGROUND: No studies in Japan have investigated delayed-onset inflammatory nodules as an adverse event following hyaluronic acid (HA) injections. Our institution, located in a rural area with no nearby aesthetic clinics, allows for comprehensive follow-up of HA-treated patients. This study analyzed complications from 673 cases over 6 years, focusing on delayed-onset inflammatory nodules.

METHODS: A retrospective review of medical records was conducted for patients treated with AbbVie-Allergan HA products between January 2018 and December 2023. Adverse events were categorized as acute complications or delayed-onset inflammatory nodules. Statistical analysis assessed product type, time to onset, patient history, and treatment approaches.

RESULTS: One acute allergic reaction and seven cases (1.07%) of delayed-onset inflammatory nodules were identified. Volbella was involved in 4 cases, Volift in 1 case, Voluma in 1 case, and Ultra Plus in 1 case. Statistical analysis revealed a significantly higher incidence with Volbella (p = 0.0484). The average onset was 144 days, with no seasonal pattern. Among affected patients, three had a history of non-HA-related allergies, and one had a preceding infection. Treatments included oral antibiotics (2 cases), oral antihistamines (5 cases), topical steroids (3 cases), hyaluronidase injections (4 cases), oral steroids (2 cases), and surgical intervention (1 case).

CONCLUSIONS: Delayed-onset inflammatory nodules occurred in approximately 1% of cases, with Volbella showing the highest incidence. Patients with allergies or prior infections may have an increased risk. Comprehensive informed consent should emphasize potential delayed complications to ensure patient understanding.

LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:40906285 | DOI:10.1007/s00266-025-05185-0

Knee Surg Sports Traumatol Arthrosc. 2025 Sep 4. doi: 10.1002/ksa.70052. Online ahead of print.

ABSTRACT

PURPOSE: To compare graft synovialization and tear rates between autograft and allograft anterior cruciate ligament (ACL) reconstruction based upon second-look arthroscopy (SLA), along with joint stability, subjective and objective clinical outcomes.

METHODS: A systematic search of PubMed, Embase and the Cochrane Library was conducted on 7 March 2025, to identify studies reporting graft synovial coverage and tear rates on SLA following primary ACL reconstruction. Meta-analyses were conducted using a random-effects model with logit transformation. Study weights were calculated via the inverse variance method. Heterogeneity was assessed using Cochran’s Q and the I² statistic. Forest plots were created to display individual and pooled estimates with 95% confidence intervals.

RESULTS: A total of 26 clinical studies comprising 2891 patients were included in this systematic review. Of these, 2164 patients underwent ACL reconstruction with autografts and 727 with allografts. SLA was performed in 2009 patients, including 1570 in the autograft group (78.1%) and 481 in the allograft group (23.9%). Good synovial coverage (>50% of the graft) was observed in 1303 autograft cases (83%) and 341 allograft cases (70.9%) (p < 0.001). Poor synovial coverage (<50%) was seen in 146 autografts (9.3%) and 93 allografts (19.3%) (p < 0.001). Torn grafts were found in 125 autografts (8%) and 25 allografts (10%) (n.s.). No significant differences in synovial coverage or graft tear rates were observed when comparing single bundle versus double bundle ACL reconstructions. Mean anterior tibial translation was significantly lower in the autograft group compared to the allograft group (1.23 ± 0.68 vs. 2.00 ± 0.38 mm; p < 0.001). No significant differences were noted in postoperative Lachman (n.s.) and pivot shift tests (n.s.), or in subjective outcomes based on Lysholm (p = 0.05) and Tegner scores (n.s.). However, significantly more patients in the autograft group achieved normal (A) or nearly normal (B) International Knee Documentation Committee (IKDC) objective scores (p = 0.02), whereas higher rates of abnormal or severely abnormal (grades C and D) IKDC scores were observed in the allograft group (p < 0.001). Remnant-preserving ACL reconstruction resulted in significantly better synovial coverage, fewer graft tears and improved knee stability compared to conventional ACL reconstruction (all p < 0.001), with no difference in cyclops lesion incidence (n.s.).

CONCLUSIONS: Autograft ACL reconstruction showed superior synovial coverage, lower retear and failure rates, reduced anterior tibial translation and better IKDC objective scores compared to allografts. Remnant-preserving techniques further enhanced synovial coverage, lowered graft tear rates and improved joint stability. No significant differences in synovial coverage, graft tears or failure rates were observed between single bundle and double bundle ACL reconstruction.

LEVEL OF EVIDENCE: Level IV, systematic review and meta-analysis.

PMID:40905314 | DOI:10.1002/ksa.70052

Knee Surg Sports Traumatol Arthrosc. 2025 Sep 4. doi: 10.1002/ksa.70025. Online ahead of print.

ABSTRACT

PURPOSE: This study aims to characterize the mechanism of multi-ligament knee injury (MLKI) sustained during a National Football League (NFL) game through video analysis.

METHODS: A retrospective video analysis of official NFL game footage spanning 1997-2022 was performed. Players with MLKIs were identified from publicly available injury surveillance data. Player and game demographic information was collected. Athletes were categorized based on ligament injury patterns. Videos including MLKI were analyzed to categorize injuries based on non-contact, indirect or direct contact mechanisms and determine the hip, knee and ankle position at the time of injury. Differences across MLKI groups were identified by Fisher’s exact test.

RESULTS: Thirty-five MLKIs were identified. MLKIs most commonly occurred from direct contact to the limb (80%), with the second most common injury mechanism being indirect contact (14.3%). The most common MLKI was injury to the anterior cruciate ligament (ACL) and medial collateral ligament (MCL) (65%), while the second most common was the ACL and lateral collateral ligament (LCL) (15%). Direct contact MLKI most often resulted in a valgus and external rotational force about a flexed knee (58%). There were statistically significant differences when comparing the direction of contact, hip and knee position between injury MLKI groups. Combined ACL and MCL injury commonly occurs with knee flexion, valgus and external rotation. Combined ACL/posterior cruciate ligament (PCL) or ACL/LCL injuries occurred most commonly with varus and internal rotational forces on an extended knee. Multiligament injuries involving three ligaments occurred only from direct contact mechanisms.

CONCLUSION: Various injury mechanisms and characteristics result in different types of MLKI in NFL athletes, though the vast majority of MLKIs occur from direct contact forces to the knee. Combined ACL and MCL injury occurred most frequently, resembling the mechanism and lower extremity position for isolated ACL injury, though it frequently occurs due to direct contact with the knee.

LEVEL OF EVIDENCE: Level IV.

PMID:40905306 | DOI:10.1002/ksa.70025

Parasitology. 2025 Sep 4:1-6. doi: 10.1017/S0031182025100632. Online ahead of print.

ABSTRACT

Rosacea is a chronic inflammatory skin disease affecting approximately 5.4% of the world population. Among its pathogenic factors is infestation by Demodex spp. Standardized skin surface biopsy (SSSB) and direct microscopic examination (DME) are widely used methods to measure Demodex spp density (Dd); however, there is no agreement on the method of choice, nor the prevalence of infestation in rosacea patients. This study compared both techniques in rosacea patients. A prospective study was conducted with 61 patients diagnosed with rosacea by dermatologists from two dermatology centres. Dd was evaluated using SSSB and DME in each patient. Results, median sampling time and reported pain were analyzed using appropriate statistical methods. The median Dd was significantly higher with SSSB (11 mites/cm²) compared to DME (1 mites/cm²; P < 0.001). Infestation (>5 mites/cm²) was detected in 64% of patients with SSSB and in 28% with DME (P < 0.001). The median sampling time was longer for SSSB (60 s) than for DME (30 s; P < 0.001). Both methods were associated with mild pain, slightly lower with DME (P = 0.033). SSSB proved more effective than DME for detecting Demodex spp. in rosacea, identifying a greater total number of mites and a higher percentage of infestation. Up to 64% of rosacea patients showed infestation with Demodex spp. using the SSSB technique. The results reinforce the use of SSSB as the standard technique for diagnosing Demodex spp. infestation in rosacea patients.

PMID:40905295 | DOI:10.1017/S0031182025100632

Reprod Domest Anim. 2025 Sep;60(9):e70118. doi: 10.1111/rda.70118.

ABSTRACT

This experiment evaluated the effects of increasing MitoQ concentrations in semen extender on post-thaw quality of Holstein bull sperm, including motility, membrane integrity, antioxidant status and viability. Semen samples were collected, pooled and diluted with extender containing 0 (control), 5, 50, 500 and 1000 nM of MitoQ and frozen through the standard procedure. An increase in MitoQ supplementation positively influenced total and progressive motility, as well as average path velocity; however, these effects were not statistically significant until the concentration reached 50 nM. The highest MitoQ level (1000 nM) showed no difference from the control group. Supplementation of semen extender with 50 and 500 nM of MitoQ significantly increased sperm membrane integrity and mitochondrial activity. Sperm viability improved significantly in concentrations of 5, 50 and 500 nM of MitoQ compared to control, whereas 1000 nM of MitoQ did not show any difference from the control group. Moreover, MitoQ significantly reduced MDA level regardless of its concentration. The concentrations of 50 and 500 nM of MitoQ significantly reduced ROS concentration. It can be concluded that 50 and 500 nM of MitoQ in extender can improve sperm quality parameters in bull semen.

PMID:40905291 | DOI:10.1111/rda.70118

J Asthma. 2025 Sep 4:1-18. doi: 10.1080/02770903.2025.2552748. Online ahead of print.

ABSTRACT

BACKGROUND: Pediatric asthma (PA) is the prevailing chronic respiratory ailment in childhood. A better understanding of plasma metabolites is the goal for elucidating the molecular pathological mechanisms of PA and investigating novel therapeutic approaches.

METHODS: Data for PA from Genome-Wide Association Studies (GWAS) was derived from the IEU-OpenGWAS project, featuring a collection of 1400 plasma metabolites. The inverse-variance weighting (IVW) method assessed causal relationships between plasma metabolites and PA, with measures taken to mitigate horizontal pleiotropy and heterogeneity. To select instrumental variables, a genome-wide significance threshold (p <5 × 10-8) was applied to ensure robust genetic instruments. A Bonferroni correction controlled for multiple testing, with statistical significance defined as p <3.57 × 10-5) (0.05/1400). To further substantiate outcomes, a reverse Mendelian randomization analysis was conducted.

RESULTS: Research found 91 plasma metabolites linked to PA, ten of which showed significant associations. Of note, 20:4n6 levels (IVW: OR (95% CI) = 1.062 (1.030 to 1.094) and G/C16 (IVW: OR (95% CI) = 0.886 (0.832 to 0.943) were identified as pivotal exposure factors for PA.

CONCLUSIONS: This study highlights 10 plasma metabolites that may have significant associations with PA incidence, with 20:4n6 levels and G/C16 potentially serving as valuable biomarkers for the early detection and management of PA.

PMID:40905282 | DOI:10.1080/02770903.2025.2552748

Reprod Domest Anim. 2025 Sep;60(9):e70119. doi: 10.1111/rda.70119.

ABSTRACT

Cryopreservation of ram sperm is a cornerstone in reproductive biotechnology but is often accompanied by oxidative damage that compromises post-thaw sperm quality. Curcumin, a natural polyphenol with potent antioxidant properties, may offer protection against cryo-induced injuries. This study evaluated the effects of curcumin supplementation at two concentrations (10% and 20%) in semen extenders on the functional and molecular characteristics of ram spermatozoa. A total of 14 ejaculates were collected from healthy adult rams and randomly allocated into three groups: control (no curcumin), C1 (10% curcumin) and C2 (20% curcumin). Semen samples were cryopreserved using a Tris-based extender, and post-thaw evaluations included total motility, viability (eosin-nigrosin), morphology (head, midpiece, tail abnormalities), membrane integrity (HOST), chromatin integrity (toluidine blue) and PRDX5 gene expression via qPCR. Curcumin supplementation, particularly in the C2 group, significantly improved total motility and viability (p < 0.01), while reducing head and tail morphological abnormalities and chromatin damage (p < 0.05), compared to the control. No significant difference was observed in PRDX5 gene expression among groups (p > 0.05). These improvements are likely attributed to curcumin’s antioxidant activity, including ROS scavenging and membrane stabilisation. Curcumin supplementation in semen extenders enhances post-thaw sperm quality in rams by improving functional parameters and maintaining chromatin integrity, without modulating PRDX5 gene expression. These findings support the potential of curcumin as a safe and effective cryoprotective additive in ovine artificial insemination and genetic conservation protocols. Further research combining transcriptomic and proteomic analyses (or approaches), along with validation of post-thaw sperm fertility, is needed to clarify curcumin’s effects and its potential in livestock breeding.

PMID:40905281 | DOI:10.1111/rda.70119

Knee Surg Sports Traumatol Arthrosc. 2025 Sep 4. doi: 10.1002/ksa.70059. Online ahead of print.

ABSTRACT

PURPOSE: To determine the long-term risk of osteoarthritis following combined anterior cruciate ligament reconstruction (ACLR) and lateral extra-articular procedures (LEAP).

METHODS: A comprehensive search of multiple databases (EMBASE, OVID Medline, PubMed, Cochrane, and Scopus) was independently conducted by two reviewers according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies reporting on the rates of osteoarthritis following primary, arthroscopic ACLR combined with LEAP and a minimum 5-year follow-up were eligible for inclusion. The primary outcome was the prevalence of moderate to severe radiographic arthritis defined as International Knee Documentation Committee (IKDC) grades C or D, Ahlback grades 1-5, or Kellgren-Lawrence grades 3 or 4. A comparative meta-analysis of ACLR with and without LEAP was also performed.

RESULTS: A total of eight studies were included, comprising 849 patients who underwent ACLR with LEAP, and 164 who underwent isolated ACLR. Cumulative meta-analysis showed a 4% prevalence of moderate to severe osteoarthritis across all studies after ACLR with LEAP. Subgroup analysis demonstrated a prevalence of 3% in the 5-to-10-year follow-up group and 6% in the 10+ year follow-up group. In the three comparative cohort studies, meta-analysis revealed no statistically significant difference in moderate to severe osteoarthritis rates between ACLR with LEAP and ACLR alone.

CONCLUSION: This study demonstrates that long-term prevalence of moderate to severe osteoarthritis following combined ACLR with LEAP is low, and that the addition of LEAP does not increase the incidence compared to ACLR alone. These findings support the use of LEAP in selected patients, without concern for increased long-term joint degeneration.

LEVEL OF EVIDENCE: Level III, meta-analysis and systematic review.

PMID:40905276 | DOI:10.1002/ksa.70059

Infect Control Hosp Epidemiol. 2025 Sep 4:1-7. doi: 10.1017/ice.2025.10232. Online ahead of print.

ABSTRACT

BACKGROUND: Species of the Burkholderia (B.) cepacia complex (Bcc) have been implicated in multiple nosocomial outbreaks linked to contaminated water-based products, including liquid soaps, mouthwash, and other non-alcoholic aqueous solutions.

OBJECTIVE: We describe two substantial healthcare-associated outbreaks of Bcc (B. cepacia and B. contaminans) in the United Kingdom and Ireland associated with contaminated products. We highlight the challenges during investigation and mitigation, and provide recommendations.

METHODS: A multidisciplinary, multi-stakeholder investigation across both outbreaks was adopted, involving interviews, trawling questionnaires, and targeted product sampling.

RESULTS: There were 153 and 66 confirmed cases in the B. cepacia and B. contaminans outbreaks, respectively. Cases predominantly comprised hospitalized individuals, and 70% of isolates were recovered from an invasive site. The outbreak strain of B. cepacia was isolated from non-sterile ultrasound gel. An analytical study suggested the B. contaminans cluster was also linked to ultrasound gel; however, a disinfectant wipe product was subsequently identified as the source (0-3 single nucleotide polymorphism differences between case and wipe isolates).

OUTBREAK CONTROL MEASURES: The affected disinfectant wipes were withdrawn. The ultrasound gel was not recalled but health system procurement was suspended, rapid clinical guidance was produced and a National Patient Safety Alert was issued. Inter-organizational partnership was required to mitigate risks.

CONCLUSION: Identifying the source of outbreaks associated with contaminated products can be challenging, requiring complex multi-stakeholder interventions. We recommend a low threshold for investigation of Bcc clusters, adopting a multidisciplinary approach to investigation and mitigation, implementing interventions focusing on practice, and prompt product removal to protect patients.

PMID:40905274 | DOI:10.1017/ice.2025.10232