Category: Nevin Manimala

Gen Dent. 2025 Sep-Oct;73(5):36-40.

ABSTRACT

Nonodontogenic cysts and pseudocysts pose diagnostic challenges due to their similarity to other maxillofacial lesions in clinical and radiographic appearance. However, these lesions are studied less frequently than odontogenic lesions. This retrospective cross-sectional study aimed to evaluate the frequencies and characteristics of nonodontogenic lesions in an Iranian population over a 20-year period. Archived records of 7036 patients referred to the Department of Oral and Maxillofacial Pathology, Shahid Beheshti University Faculty of Dentistry, Tehran, were reviewed. Data on the age and sex of the patients and the type, clinical and radiographic features, and histopathologic diagnoses of the lesions were collected. Statistical analyses included Fisher exact, Kruskal-Wallis, and chi-square tests, and a value of P < 0.05 was considered statistically significant. Nonodontogenic cysts were found in 0.5% of all referred patients, while pseudocysts were identified in 2.6%. After a review of records, 218 patients with a confirmed diagnosis of oral pseudocysts or nonodontogenic cysts were included in a more detailed analysis. Mucocele was the most common lesion (63.8%), followed by simple bone cyst (13.8%) and nasopalatine duct cyst (11.9%). The mean (SD) age of these patients was 30.5 (15.7) years, and 53.7% of all the lesions occurred in men. Statistically significant relationships were observed between cyst type and sex (P = 0.001; Fisher exact test), age (P < 0.001; Kruskal-Wallis test), and location (P < 0.001; chi-square test). Most pseudocysts occurred on the lower lip, while nonodontogenic cysts and intraosseous pseudocysts were predominantly found in the maxilla and mandible, respectively. The results of this study highlight the varied demographics and clinical and radiographic presentations of nonodontogenic cysts and pseudocysts, emphasizing the need for thorough radiographic and histopathologic analyses to guide appropriate treatment strategies.

PMID:40828556

Gen Dent. 2025 Sep-Oct;73(5):28-34.

ABSTRACT

Periodontitis is an inflammatory destructive condition influenced by obesity and type 2 diabetes mellitus (T2DM). Apelin, a bioactive peptide, is linked to periodontitis, obesity, and T2DM. This study aimed to investigate apelin levels in individuals with periodontitis who are affected by obesity and T2DM. This cross-sectional observational study included 84 participants categorized into 3 main groups of 24 patients based on their periodontal status, body mass index (BMI), and glycated hemoglobin (HbA_1c) levels. Group 1 comprised systemically healthy participants, group 2 comprised individuals with obesity (BMI of 30.0 to 39.0 kg/m2), and group 3 comprised individuals with both obesity and T2DM (HbA_1c of 6.5% to 8.5%). Each group was subcategorized based on the presence or absence of chronic periodontitis (CP), resulting in 6 subgroups with 14 participants each. The clinical parameters assessed included the Sulcus Bleeding Index (SBI), probing depth (PD), clinical attachment loss (CAL), BMI, and HbA_1c level. Apelin levels in serum and saliva were quantified using enzyme-linked immunosorbent assay. Data were analyzed using 1-way analysis of variance and independent samples t test. Pearson correlation coefficients were calculated to assess relationships between different parameters. Within groups, individuals with CP had lower serum and salivary levels of apelin than those without CP, and the differences were statistically significant except in the case of salivary levels in patients with obesity (P < 0.05). Individuals with obesity, as well as those with both T2DM and obesity, had elevated levels of serum apelin compared with systemically healthy individuals. A significant negative correlation was observed between serum apelin and periodontal parameters (SBI, PD, and CAL) in specific subgroups. Apelin could be a valuable biomarker for evaluating periodontal disease affected by obesity and T2DM. However, further longitudinal research with a larger patient sample is needed. Trial registration: Clinical Trials Registry – India No. CTRI/2019/02/017522.

PMID:40828555

Int J Geriatr Psychiatry. 2025 Aug;40(8):e70140. doi: 10.1002/gps.70140.

ABSTRACT

OBJECTIVES: In a sample of community-dwelling older adults, we examined the association of Alzheimer’s Disease and Related Dementias (AD/ADRD) blood-based biomarkers (BBMs) and neuropsychiatric symptoms (NPS) and whether informant type (i.e., spouse vs. child vs. other) modified that association.

METHODS: This study included 430 participants with a cognitively unimpaired or mild cognitive impairment consensus diagnosis from the Wake Forest Alzheimer’s Disease Research Center Clinical Core cohort. Informants reported NPS using the Neuropsychiatric Inventory Questionnaire. AD/ADRD BBMs included the Aβ42/40 ratio, p-tau181, p-tau217, NfL, and GFAP. Generalized linear models were used to examine the associations between AD/ADRD BBMs and NPS. Secondary models adjusted for age, sex, education, race, and cognitive status. Tertiary models adjusted for covariates in secondary models, as well as informant type. Interactions between informant type and AD/ADRD BBMs were examined.

RESULTS: Higher p-tau217 was associated with higher NPS in both unadjusted models and models adjusted for demographics and cognitive status. This association was attenuated and no longer statistically significant after additionally adjusting for informant type. Significant interactions of informant type and p-tau181 or p-tau217 on NPS were demonstrated, where p-tau181 or p-tau217 were more strongly associated with NPS reported by children compared to spouses.

CONCLUSIONS: Informant type modified the association between AD/ADRD BBMs and NPS, with stronger associations observed when symptoms were reported by child informants compared to spouse informants. These findings have important implications for earlier detection of individuals with AD/ADRD pathologies.

PMID:40828547 | DOI:10.1002/gps.70140

J Acquir Immune Defic Syndr. 2025 Aug 19. doi: 10.1097/QAI.0000000000003747. Online ahead of print.

ABSTRACT

BACKGROUND: We assessed an adaptation of a mobile HIV prevention smartphone app, HealthMindr-PrEP, to assess its effectiveness to increase pre-exposure prophylaxis (PrEP) uptake among gay and bisexual men who have sex with men (GBMSM).

SETTING: This study was conducted online among GBMSM living in Ending the HIV Epidemic priority jurisdictions, primarily in the southern United States.

METHODS: We conducted a randomized controlled trial in which participants were randomly assigned to receive the intervention app or an app that only allowed participants to track their study progress. The primary outcome was self-reported PrEP uptake. Cox proportional hazards models were used to compare the rate of PrEP uptake across study arms.

RESULTS: Although no results were statistically significant, the rate of PrEP initiation was higher among participants in the intervention arm compared to the control arm, particularly among participants with PrEP indications at baseline. Among those with PrEP indications at baseline, participants in the intervention arm had a 64% higher rate of PrEP initiation compared to the control arm (hazard ratio = 1.64, 95% CI: 0.89, 3.03). Among those without PrEP indications, the same hazard ratio was 1.05 (95% CI: 0.67, 1.66).

CONCLUSION: Our results suggest that HealthMindr-PrEP increases the rate of PrEP uptake compared to a standard of care control condition; however, we had insufficient statistical power for stratified analyses that demonstrated the strongest effect was among those who had PrEP indications at baseline.

PMID:40828543 | DOI:10.1097/QAI.0000000000003747

JAMA Netw Open. 2025 Aug 1;8(8):e2527464. doi: 10.1001/jamanetworkopen.2025.27464.

ABSTRACT

IMPORTANCE: Genetic testing is the criterion standard for diagnosing neurodevelopmental disorders (NDDs), with chromosomal microarray analysis (CMA) used as a first-line test for autism, intellectual disability, or global developmental delay. Despite advancements in genetic testing technologies and integration into health care systems, data on clinical use remain limited.

OBJECTIVE: To evaluate genetic counseling and testing rates in patients with major NDDs and these individuals’ clinical and sociodemographic characteristics.

DESIGN, SETTING, AND PARTICIPANTS: This longitudinal, retrospective, population-based cohort study analyzed electronic health records of individuals born between 2000 and 2020 and insured by Clalit Health Services, the largest health maintenance organization in Israel. Follow-up extended through December 6, 2023. Patients diagnosed with autism spectrum disorder, intellectual disability or global developmental delay, epilepsy, or cerebral palsy (major NDDs) were included.

EXPOSURE: Neurodevelopmental disorders.

MAIN OUTCOMES AND MEASURES: The outcome was the rate of genetic counseling, CMA testing, and NDD diagnosis measured using descriptive statistics.

RESULTS: Of 2 406 763 individuals born in Israel between 2000 and 2020, 25 403 (1.06%; mean [SD] age at December 6, 2023, 11.9 [4.3] years; 68.7% male) were diagnosed with a major NDD. The cohort was predominantly of middle socioeconomic status (56.5%), and autism was the most common diagnosis (40.6%). Among 18 709 children indicated for CMA (ie, those with autism, intellectual disability or global developmental delay, or multiple diagnoses), 7233 (38.7%) received genetic counseling, and 4592 (24.5%) underwent testing (63.5% of those counseled). Genetic testing rates were higher in children with multiple co-occurring NDDs (1478 of 4005 [36.9%]) compared with those with autism alone (2189 of 10 311 [21.2%]). Genetic counseling rates were lowest for cerebral palsy and epilepsy as guidelines were less established. Genetic evaluation rates increased with more recent birth cohorts. While evaluation rates were similar across subpopulations for children with a diagnosis, initial autism diagnosis rates were 54% to 83% lower in lower socioeconomic status and minority populations, limiting access to counseling and testing.

CONCLUSIONS AND RELEVANCE: A key finding of this cohort study was that more than one-third of patients who received genetic counseling did not undergo testing. Furthermore, low socioeconomic status and minority populations experienced drastic underdiagnosis of autism. These findings underscore the need for national initiatives to improve awareness and access to counseling and testing for all major NDDs and the recognition of autism in minority groups.

PMID:40828538 | DOI:10.1001/jamanetworkopen.2025.27464

Transl Vis Sci Technol. 2025 Aug 1;14(8):25. doi: 10.1167/tvst.14.8.25.

ABSTRACT

PURPOSE: This study presents an artificial intelligence (AI)-based system for measuring eyeball rotation angles, which is a key symptom in assessing eye disease severity. The system aims to accurately segment the optic disc and macula, and compute the eyeball rotation angle based on these features.

METHODS: The system consists of three modules: optic disc segmentation, macular segmentation, and measurement. The optic disc segmentation module utilizes the Efficient-UNet3+ network to address sample imbalance and irregular edge detection of the optic disc. The macular segmentation module uses the Efficient-UNet based on Dual Attention network (DA-EUNet) to enhance macular recognition and boundary feature detection while suppressing irrelevant background interference. The measurement module calculates the eyeball rotation angle by locating the centers of the optic disc and macula and determining the angle between the line connecting these centers and the horizontal vector.

RESULTS: The proposed method demonstrated high accuracy, with a correlation coefficient of 0.94 compared to expert measurements. Statistical analysis revealed no significant difference between the AI-based measurements and expert assessments (P = 0.26).

CONCLUSIONS: This system achieves high accuracy and reliability in clinical diagnostics. The segmentation techniques used significantly improve feature recognition and segmentation performance, enabling accurate measurements of eyeball rotation.

TRANSLATIONAL RELEVANCE: This AI-based system bridges the gap between basic research in medical image processing and clinical care. It provides an automated and reliable tool for ophthalmologists to assess eyeball rotation, which is crucial for diagnosing eye diseases. Eyeball rotation can occur in many eye diseases or systemic diseases, and measuring the eyeball rotation angle has been a challenging issue in clinical practice. By automating this process, the system reduces the clinicians’ workload and enhances diagnostic consistency.

PMID:40828527 | DOI:10.1167/tvst.14.8.25

Invest Ophthalmol Vis Sci. 2025 Aug 1;66(11):44. doi: 10.1167/iovs.66.11.44.

ABSTRACT

PURPOSE: To investigate the diurnal variations of episcleral venous pressure (EVP) and its relationships with IOP, blood pressure, and heart rate in healthy and systemic hypertension subjects.

METHODS: Twenty healthy adults and eight patients taking systemic antihypertensive medications were enrolled. IOP and EVP of both eyes, systolic and diastolic blood pressure (SBP and DBP), and heart rate (HR), were measured at five time points, every two hours from 8 AM to 4 PM. IOP was measured by pneumatonometry, and EVP was assessed using a computer-controlled episcleral venomanometer with video recording and image processing. Changes in measurements at each time point were compared with baseline (8 AM) by using generalized estimating equation models. Correlations between EVP and other variables were determined using linear regression analysis.

RESULTS: EVP and IOP were highest in the early morning (8 AM) and lowest in the late afternoon (4 PM), with statistically significant changes (P < 0.05) across all time points compared to baseline in normotensive subjects. Changes in EVP and IOP were correlated at all time points. In treated systemic hypertensive subjects, similar trends were observed, with significant IOP and EVP correlations at multiple time points. No clear pattern of correlation was noted between EVP, SBP, DBP, and HR in all subjects.

CONCLUSIONS: IOP and EVP follow a diurnal rhythm with the highest values in the early morning, which gradually decrease throughout the day. The relationship between IOP and EVP suggests that reduction of EVP can be an important target for clinical regulation and stability of IOP.

PMID:40828522 | DOI:10.1167/iovs.66.11.44

Int Urol Nephrol. 2025 Aug 19. doi: 10.1007/s11255-025-04724-7. Online ahead of print.

ABSTRACT

BACKGROUND: Lower urinary tract dysfunction (LUTD) is a potential late effect in childhood cancer survivors, often overlooked in survivorship care. Neurotoxic chemotherapy, pelvic tumors, and radiation exposure may contribute to its development.

OBJECTIVES: To determine the prevalence and severity of LUTD in childhood cancer survivors and identify associated risk factors.

METHODS: A prospective observational study was conducted over six months among 92 childhood cancer survivors aged ≥ 5 years to 10 years. Participants were screened using the LUTD Scoring System (DVSS). A score ≥ 9 in males and ≥ 6 in females was considered diagnostic of LUTD. Clinical and treatment-related variables were extracted from medical records and analyzed for associations. Uroflowmetry and ultrasonography were performed in children with abnormal DVSS to further assess voiding pattern and bladder parameters.

RESULTS: LUTD was identified in 20 of 92 participants (21.7%), with a higher prevalence in females (31.6%) compared to males (14.8%), though this difference was not statistically significant (p = 0.073). Significant associations were observed with pelvic tumors (p = 0.002; Φ = 0.394), pelvic irradiation (p < 0.001; Φ = 0.455), Vinca alkaloid use (p = 0.035; Φ = 0.307), and high cumulative alkylating agent dose (> 8000 mg/m²) (p = 0.017; Φ = 0.267). Uroflowmetry confirmed abnormal voiding patterns in 95% of DVSS-positive patients. Most cases were managed conservatively with bladder training, while a subset required anticholinergics or laxatives.

CONCLUSION: LUTD is prevalent among childhood cancer survivors, particularly those exposed to Vinka alkaloids and pelvic-directed therapies. Routine LUTD screening using DVSS should be integrated into long-term follow-up protocols for early detection and intervention.

PMID:40828499 | DOI:10.1007/s11255-025-04724-7

J Nephrol. 2025 Aug 19. doi: 10.1007/s40620-025-02387-2. Online ahead of print.

ABSTRACT

BACKGROUND: Person-centered care and trust in physicians influence medication adherence among dialysis patients. However, the mechanisms linking person-centered care to medication adherence, particularly the mediating effect of trust in physicians, remain unclear. This study investigated the interrelationships between person-centered care, trust in physicians, and medication adherence.

METHODS: Using a multicenter cross-sectional study of Japanese adults receiving outpatient hemodialysis at six dialysis centers, person-centered care was assessed using the 13-item Japanese Primary Care Assessment Tool-Short Form (JPCAT-SF), which included longitudinality and care coordination. Trust in physicians was measured using the five-item Wake Forest Physician Trust Scale. Medication adherence was measured using the 12-item Adherence Starts Knowledge (ASK-12) scale. General linear models examined person-centered care, physician trust, and medication adherence relationships. Mediation analysis determined how much trust in physicians mediated the person-centered care-medication adherence relationship.

RESULTS: A total of 483 patients, with median age and dialysis vintage of 71.9 and 5.7 years, respectively, were included in the analysis. High-quality person-centered care was associated with lower barriers to medication adherence in a dose-response manner across JPCAT-SF quartiles compared to no usual source of care. Trust in physicians partially mediated this relationship in a dose-response pattern, with the proportion of the indirect effect increasing from 16.1% (95% CI 4.5-33.8%) in Q2 to 33.3% (95% CI 17.4-65.5%) in Q4. Similar findings were observed for person-centered care subdomains.

CONCLUSIONS: High-quality person-centered care was associated with medication adherence, with trust in physicians playing a key mediating role. Strategies to enhance medication adherence in hemodialysis patients should incorporate multidimensional person-centered care approaches, building trust and strengthening continuity and care coordination.

PMID:40828491 | DOI:10.1007/s40620-025-02387-2

Neurosurg Rev. 2025 Aug 19;48(1):608. doi: 10.1007/s10143-025-03775-9.

ABSTRACT

PURPOSE: Traumatic vertebral artery injury (TVAI) poses a risk for ischemic stroke, often requiring prompt antithrombotic therapy. However, when concomitant neurosurgical intervention is necessary, concerns regarding perioperative bleeding frequently lead to delays in antithrombotic initiation. This study evaluates the impact of delayed antithrombotic therapy on stroke risk in TVAI patients undergoing neurosurgical interventions.

METHODS: A retrospective review was conducted of a TVAI registry over 7 years (2016-2023) at a level 1 trauma center for patients who were treated with antithrombotics for stroke prevention. Baseline demographics, vertebral artery injury characteristics, concomitant injury characteristics, acute management and outcomes were compared between surgical and non-surgical cohorts. Statistical analyses included Student’s t-test, Chi-square tests, relative risk (RR), and attributable risk (AR).

RESULTS: Among the 121 patients, 44 (36.4%) underwent neurosurgical procedures. The surgical cohort experienced an average 2-day delay in antithrombotic initiation (p < 0.001). The incidence of stroke in the neurosurgical intervention group was 20.5%, which was significantly higher than 5.19% in the control group (p = 0.016), with an associated RR of 3.94 and excess AR of 15.3%. No significant differences in baseline antithrombotic use, injury severity, or mortality were observed between cohorts.

CONCLUSION: Delayed antithrombotic initiation in TVAI patients undergoing neurosurgical intervention is associated with a nearly fourfold increased risk of stroke. Future multi-center studies should explore neurosurgical strategies allowing safer early antithrombotic initiation in this patient population.

CLINICAL TRIAL NUMBER: not applicable.

PMID:40828475 | DOI:10.1007/s10143-025-03775-9