Category: Nevin Manimala

Clinics (Sao Paulo). 2025 Sep 21;80:100795. doi: 10.1016/j.clinsp.2025.100795. Online ahead of print.

ABSTRACT

BACKGROUND: Myofascial Pain Syndrome (MPS) is regarded as an extremely common clinical disorder, but is not fully understood. Shoulder pain has a lifetime prevalence of up to 66.7% in the general population, and pain due to Myofascial Trigger Points (MTPs) located in the deltoid muscle is fairly common. Analyses of the correlations between innervation patterns and trigger point locations have been successful in other muscular groups.

OBJECTIVE: The objective of this study was to provide a mathematical analysis of the entry points of the axillary nerve into the deltoid muscle and correlate them with the described areas of myofascial pain.

METHOD: Ten cadavers were carefully dissected to measure a series of parameters in each deltoid muscle. The entry points of the axillary nerve into the deltoid muscle were placed in a cartesian graph created by dividing the deltoid muscle into 4-quadrants. Statistical analysis was carried out on the number of points in each quadrant.

RESULTS: Quadrant 1 had the largest number of axillary nerve entry sites, with a mean of 6.85 sites (63%), followed by quadrant 3 with 2.75 sites (25%), quadrant 2 with 1.15 sites (10%), and quadrant 4 with 0.25 sites (2%).

CONCLUSION: In accordance with the clinical literature, the branches of the axillary nerve in the deltoid muscle corresponded to the described areas of the MTPs. Anatomical correlations between MTPs may be useful tools for gaining a better understanding of the physiopathology of these disorders and providing a basis for their treatment.

PMID:40983051 | DOI:10.1016/j.clinsp.2025.100795

Med Image Anal. 2025 Sep 20;107(Pt A):103814. doi: 10.1016/j.media.2025.103814. Online ahead of print.

ABSTRACT

Acquiring high-resolution Magnetic resonance (MR) images is challenging due to constraints such as hardware limitations and acquisition times. Super-resolution (SR) techniques offer a potential solution to enhance MR image quality without changing the magnetic resonance imaging (MRI) hardware. However, typical SR methods are designed for fixed upsampling scales and often produce over-smoothed images that lack fine textures and edge details. To address these issues, we propose a unified diffusion-based framework for arbitrary-scale in-plane MR image SR, dubbed Progressive Reconstruction and Denoising Diffusion Model (PRDDiff). Specifically, the forward diffusion process of PRDDiff gradually masks out high-frequency components and adds Gaussian noise to simulate the downsampling process in MRI. To reverse this process, we propose an Adaptive Resolution Restoration Network (ARRNet), which introduces a current step corresponding to the resolution of input MR image and an ending step corresponding to the target resolution. This design guide the ARRNet to recovering the clean MR image at the target resolution from input MR image. The SR process starts from an MR image at the initial resolution and gradually enhances them to higher resolution by progressively reconstructing high-frequency components and removing the noise based on the recovered MR image from ARRNet. Furthermore, we design a multi-stage SR strategy that incrementally enhances resolution through multiple sequential stages to further improve recovery accuracy. Each stage utilizes a set number of sampling steps from PRDDiff, guided by a specific ending step, to recover details pertinent to the predefined intermediate resolution. We conduct extensive experiments on fastMRI knee dataset, fastMRI brain dataset, our real-collected LR-HR brain dataset, and clinical pediatric cerebral palsy (CP) dataset, including T1-weighted and T2-weighted images for the brain and proton density-weighted images for the knee. The results demonstrate that PRDDiff outperforms previous MR image super-resolution methods in term of reconstruction accuracy, generalization, and downstream lesion segmentation accuracy and CP classification performance. The code is publicly available at https://github.com/Jiazhen-Wang/PRDDiff-main.

PMID:40983006 | DOI:10.1016/j.media.2025.103814

Comput Methods Programs Biomed. 2025 Sep 9;272:109072. doi: 10.1016/j.cmpb.2025.109072. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Coronary Artery Disease (CAD) diagnosis relies heavily on coronary angiography, yet interpretation suffers from variability. Deep learning (DL) offers potential for improvement, particularly in vessel segmentation, a critical step for analysis. This study aims to enhance vessel segmentation accuracy in angiography using a DL framework incorporating advanced preprocessing and texture features.

METHODS: We developed a U-Net architecture integrating Texture Representation of Image (TRI) features (Haralick and Law features) to capture subtle vascular details. Advanced preprocessing (Laplacian Pyramid Restoration, Gaussian Differential Scale-Invariance) was applied to improve image quality. The model was pre-trained on the DRIVE dataset and fine-tuned using 7600 clinical angiography images. Performance was evaluated on a held-out test set (19 patients, ∼1700 images) from the same institution and benchmarked against the public ARCADE dataset. Statistical tests assessed performance improvements. Post-segmentation analysis included branching point detection and vessel diameter visualization using heatmaps.

RESULTS: The proposed method achieved high segmentation performance on the clinical test set (Accuracy: 0.98, Precision: 0.87, Sensitivity: 0.91, F1-score: 0.89, IoU: 0.801, with CIs provided). Ablation studies confirmed statistically significant contributions from both preprocessing and TRI features (p < 0.01 for all metrics). Performance on the ARCADE benchmark was also strong (F1-score: 0.78), considering annotation differences.

CONCLUSIONS: Integrating TRI features and advanced preprocessing with a U-Net architecture significantly improves coronary angiography vessel segmentation. This provides a robust foundation for subsequent quantitative analysis potentially supporting CAD assessment. While limitations exist regarding external validation and direct clinical impact assessment, the enhanced segmentation capability represents a valuable advancement for angiographic image analysis tools.

PMID:40983000 | DOI:10.1016/j.cmpb.2025.109072

J Craniofac Surg. 2025 Sep 22. doi: 10.1097/SCS.0000000000011958. Online ahead of print.

ABSTRACT

BACKGROUND: Rhinoplasty is a frequently performed plastic surgery, but it carries potential short- and long-term complications. Surgeons continuously seek ways to reduce these risks and enhance patient outcomes. Nasal packing is often used postoperatively, but its efficacy in improving recovery remains debated. This study aims to assess the impact of bilateral anterior nasal packing on early postoperative outcomes.

METHODS: In this prospective study, conducted from January to December 2023, 64 rhinoplasty patients were evaluated at Hôtel Dieu de France University Hospital. Twenty patients received short-term nasal packing with paraffin-soaked gauze, while 44 did not. Outcomes were assessed based on periorbital ecchymosis, edema, nasal obstruction, and the occurrence of septal hematomas and epistaxis.

RESULTS: At postoperative day 7, the packing group exhibited significantly more ecchymosis (mean score 3.65 versus 2.47; P = 0.017). However, no significant differences were noted for periorbital edema (P = 0.471) or nasal obstruction (P = 0.172). Postoperative epistaxis and septal hematomas occurred in 10% of patients in the packing group, compared with none in the nonpacking group, though these differences were not statistically significant (P = 0.175).

CONCLUSION: Bilateral anterior nasal packing significantly increases ecchymosis after rhinoplasty without reducing other complications such as edema, nasal obstruction, epistaxis, or septal hematomas. These findings suggest that nasal packing may not be beneficial and should be avoided.

PMID:40982970 | DOI:10.1097/SCS.0000000000011958

Psychiatr Danub. 2025 Sep;37(Suppl 1):99-103.

ABSTRACT

BACKGROUND: This study explores the relationship between cognitive deficits, cognitive reserve (CR), and rehabilitation outcomes in psychiatric offenders and non-offenders. The objective is to analyze how neurocognitive functioning, impulsivity, and CR influence the duration and effectiveness of psychiatric rehabilitation.

METHODS: Fifty-five patients from rehabilitation centers in Southern Italy were assessed using standardized psychiatric and neuropsychological scales. Participants were divided into offenders (n=19) and non-offenders (n=36). Assessments included BPRS, BIS-11, CRIq, T.I.B., and TMT A/B. Statistical analyses involved Pearson’s correlation and t-tests using JASP.

RESULTS: Significant correlations were observed between months of rehabilitation (MoR) and TIQ in non-offenders and CRIq in offenders. A significant correlation between MoR and TMT was observed only in offenders. Offenders with more than 24 months of rehabilitation showed lower impulsivity scores (BIS-11). These findings indicate distinct rehabilitative trajectories and neurocognitive responses in the two groups.

CONCLUSION: Cognitive reserve and neurocognitive assessment can inform individualized rehabilitation strategies in forensic psychiatric populations. Offenders may particularly benefit from longer and more targeted interventions to mitigate impulsivity and enhance cognitive functioning.

PMID:40982968

Psychiatr Danub. 2025 Sep;37(Suppl 1):409-412.

ABSTRACT

BACKGROUND: It is known that youth aged 16 to 23 are more vulnerable to mental distress than other age groups. This vulnerability can be explained by several factors such as the high prevalence of mental illnesses, the changes in the environment, the social expectations and so on. Moreover, in this age group the transition between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) impacts the continuity of care, leading to a negative impact on the prognosis. This article aims to characterize this population based on risk factors, history of care and care plan.

SUBJECTS AND METHOD: We conducted a retrospective study including patients who attended transition psychiatry consultations between October 2020 and December 2023. Data were collected at a secondary care outpatient service.

RESULTS: The sample (n=122) was predominantly female (70.5%, n=86). Referrals were mostly made by psychologists (35.2%, n=43), although many individuals were self-referred (32%, n=39). In most cases, the consultation request came directly from the young person (60.7%, n=74). Regarding previous mental health support, 79.5% (n=97) had already received psychological care at the time of their transition consultation. In terms of risk factors, many participants had been exposed to adverse childhood experiences (ACE): 60% (n=69) reported a first-degree family history of psychiatric disorders, 28% (n=33) had experienced sexual abuse, and 37.3% (n=44) had been exposed to domestic violence. Among those who received follow-up care, 19.7% (n=24) were scheduled for planned inpatient care. Psychotherapeutic follow-up was offered to 79.6% of patients, and psychotropic medication was recommended for 68.9%.

CONCLUSION: This research highlights the major vulnerability of transition-aged youth (TAY) and reinforces the need for specialized care and continuity between CAMHS and AMHS.

PMID:40982949

Psychiatr Danub. 2025 Sep;37(Suppl 1):391-397.

ABSTRACT

BACKGROUND: Food-related problems in Feeding and Eating Disorders (hereafter referred to as eating disorders – EDs) might be considered as the expression of dysfunctional individual and relational patterns based on emotional and behavioral dysregulation. Dysphoria is a transnosographic syndrome found in a multitude of psychiatric disorders including EDs, our cross-sectional study aims to analyze its presence in Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorder (BED) to define its socio-demographic, clinical correlates and phenomenological expression in the three types of EDs.

SUBJECTS AND METHODS: A total of 165 patients were recruited from March 2019 to November 2024. Anamnestic history was collected through a specific form. The Italian version of the Nepean Dysphoria Scale (NDS-I) was used to evaluate Dysphoria. After performing descriptive analyses, one-way ANOVA and Pearson’s r test were performed to respectively assess between-group differences and correlations. Significance was defined as p<0.05.

RESULTS: AN presented the highest degree of Dysphoria than the three, BED the lowest. Older age, physical illnesses and ongoing medical therapy correlated with lower levels of Dysphoria. A Statistically significant positive correlation was found in smoking habits, association with another psychiatric disorder, especially with anxiety disorder, use of benzodiazepines (BDZ) and use of antipsychotics (AP).

CONCLUSIONS: Dysphoria acquires fundamental importance within EDs, possibly having a specific role in the etiology and maintenance of eating behaviors, it might play a core role in this type of mental disorder, with the behavioral aspect aimed at reducing dysphoric anxiety. Understanding these connections could represent a useful tool for the comprehension of EDs, which are increasing and have always represented a great diagnostic and therapeutic challenge.

PMID:40982945

Psychiatr Danub. 2025 Sep;37(Suppl 1):385-390.

ABSTRACT

BACKGROUND: Healthcare workers (HCWs) face significant occupational stressors that increase their risk of psychological symptoms, including anxiety, depression, and burnout. In particular, nurse may experience higher psychological distress due to unique workplace demands. However, direct comparisons between nurses and other HCWs within tertiary care hospitals remain limited. This retrospective study aimed to compare work-related stress levels and mental health outcomes in nurses versus other HCWs seeking psychological or psychiatric support through the Occupational Health Service (OHS) of a tertiary care hospital in central Italy.

SUBJECTS AND METHODS: This is a retrospective cross-sectional study analyzing healthcare workers (HCWs) who accessed psychological or psychiatric support through an Occupational Counseling Service (OCS) over a three-year period. Medical records of 155 HCWs who accessed the OHS from January 2022 to December 2024 were reviewed. Sociodemographic, occupational, clinical, and psychometric data were collected. Subgroup analyses compared nurses (n=79) to other professionals (n=76) regarding psychological distress, psychiatric diagnoses, and treatment. Correlations between personal/family psychiatric history and work-related stress were also assessed.

RESULTS: Nurses exhibited significantly higher levels of depressive symptoms and anxiety compared to other HCWs. A positive personal and/or family history of anxiety and mood disorders was present in 26.5% of the full cohort and correlated significantly with work-related stress and burnout (p<0.001). Burnout and secondary traumatic stress were prevalent across all groups, although compassion satisfaction remained relatively preserved.

CONCLUSIONS: Nurses demonstrated greater vulnerability to affective symptoms and work-related stress compared to other HCWs, underscoring the need for tailored mental health support within occupational health frameworks. Early identification and intervention strategies are crucial to mitigate psychological distress and improve wellbeing among hospital staff.

PMID:40982943

Psychiatr Danub. 2025 Sep;37(Suppl 1):362-367.

ABSTRACT

BACKGROUND: This study aims to analyse certain populations’ sociodemographic factors and to investigate the use of polypharmacy for inpatients assigned to involuntary treatment at the National Center of Mental Health, Riga, Latvia.

METHODS: A retrospective review of clinical data was undertaken in adult inpatients assigned to involuntary psychiatric treatment in the period from December 17th, 2024, till February 4th, 2025. The data about the participants’ sociodemographic factors, hospitalisation duration, diagnosis, and treatment strategies were obtained from the hospital’s databases. Only data from a fixed 30-day window at the time of analysis were considered, irrespective of hospitalization duration, to ensure consistency and avoid bias from ongoing treatment modifications. The Antipsychotic Total Daily Dose Calculator was used to assess polypharmacy load by estimating the BNF (British National Formulary) coefficient relative to the recommended maximum daily dose. All data were collected in MS Excel and analysed using IBM SPSS 29.0.1.0.

RESULTS: The study included 88 inpatients with compulsory medical measures. Results showed a mean age of the participants equal to 41.49±2.41 years, males’ dominance making 86.36% (n=76) of the study group, and schizophrenia (F20, ICD-10) noted as the most dominant diagnostic category. Polypharmacy with more than one antipsychotic medication was observed in 89.77% (n=79) of the inpatients. The most common treatment combination was an antipsychotic with a mood stabilizer, prescribed to 44.32% (n=39) of participants. Treatment was primarily guided by antipsychotics, with haloperidol emerging as the most commonly used drug, representing 72.72% (n=64) of the cases, and mood stabilizers received by 57.95% (n=51) of the inpatients. The analysis revealed that 34.09% (n=30) of participants had a BNF coefficient within the recommended maximum daily dose, while the majority, or 65.9% (n=58), exceeded the recommended threshold.

CONCLUSIONS: This study contributes to existing knowledge of currently available data about polypharmacy in psychiatric practice and certain population groups undergoing involuntary hospitalisation. The results about treatment patterns may support the optimization of treatment practices and warrant closer attention to safety, side effect profiles, and possible long-term outcomes when polypharmacy is used.

PMID:40982939

Psychiatr Danub. 2025 Sep;37(Suppl 1):351-355.

ABSTRACT

BACKGROUND: The rise of synthetic opioids, particularly fentanyl, has intensified the global drug abuse crisis, posing serious challenges to healthcare systems. Nurses and nursing students play a crucial role in prevention, early identification, and emergency management of opioid-related cases. Health Literacy (HL), the ability to access, understand, and use health information, has been proposed as a critical determinant of clinical competence in this context. This study aims to assess the knowledge, awareness, and health literacy of nurses and nursing students in relation to fentanyl and drug abuse, exploring potential associations between HL levels and preparedness to manage substance-related emergencies.

SUBJECTS AND METHODS: A national multicenter cross-sectional study was conducted from October 2024 to January 2025, involving 157 participants (nurses and nursing students) across Italy. A structured questionnaire was administered online, covering four domains: sociodemographic information, health literacy (HL), drug addiction knowledge and specific knowledge of fentanyl. Descriptive and inferential statistics were performed using SPSS.

RESULTS: Participants demonstrated good overall knowledge about fentanyl clinical use and effects. However, misconceptions were identified – particularly regarding lethal dosages and the inability to detect fentanyl with the senses. Notably, HL scores did not consistently correlate with higher knowledge levels; in some cases, participants with lower HL scores showed better understanding of specific topics such as routes of administration and naloxone use. A significant negative correlation was found between HL and knowledge of drug availability (r = -0.35; p < 0.001). No significant differences emerged between students and professionals.

CONCLUSIONS: Findings challenge the assumption that higher HL always predicts better preparedness. Standard HL measures may fail to capture contextual and experiential knowledge essential for managing opioid-related emergencies. Nursing education should incorporate more experiential and clinically focused training on drug abuse, integrating HL as an operational – rather than merely promotional – competency. Further research with larger samples and qualitative methods is recommended.

PMID:40982937