Category: Nevin Manimala

Eur Radiol. 2025 Jul 29. doi: 10.1007/s00330-025-11868-8. Online ahead of print.

ABSTRACT

Unrecognized and untreated injuries of the posteromedial and posterolateral corners of the knee are more common than previously thought and have been linked to poor outcomes after anterior cruciate ligament reconstruction. Amongst imaging modalities, magnetic resonance is currently referred to as the gold standard for the evaluation of these regions, but has several limitations, in particular in the identification of subacute and chronic lesions. Recent technological advancements and the progressive refinement of linear probes have expanded the potential of High-resolution ultrasound in demonstrating the stabilizers of the posteromedial and posterolateral corners in both normal and pathological cases, and now this modality may be considered as a useful complementary tool for the evaluation of these structures. The aim of this work is twofold: (i) to review, also with the support of dedicated dissections and schematic drawings, the normal anatomy and the biomechanical role of the clinically relevant stabilizers of the posteromedial and posterolateral knee, including the distal expansion of the semimembranosus tendon, the popliteus muscle-tendon unit, and the posterior oblique ligament; (ii) to illustrate the normal ultrasound appearance of these structures and the spectrum of pathological findings that this modality may disclose in patients with anterior cruciate ligament tear. KEY POINTS: Question Injuries of the posteromedial and posterolateral knee worsen the outcome after anterior cruciate ligament reconstruction but are often underdiagnosed on imaging. Findings Ultrasound has potential in diagnosing tears of stabilizers of the posteromedial and posterolateral knee and provides complementary information to MRI about ligament status and continuity. Clinical relevance In subacute and chronic injuries, ultrasound has some advantages over MRI as it can disclose subtle abnormalities that might otherwise be unrecognized, thereby improving diagnostic confidence and patient counselling.

PMID:40728753 | DOI:10.1007/s00330-025-11868-8

Nervenarzt. 2025 Jul 29. doi: 10.1007/s00115-025-01842-6. Online ahead of print.

ABSTRACT

With the introduction of the 11th revision of the World Health Organization International Statistical Classification of Diseases and Related Health Problems (ICD-11), structural and content-related adjustments to the diagnostic guidelines for anxiety disorders were made, which are presented in this review article. Previously classified as “phobic disorders” and “other anxiety disorders” within the group “neurotic, stress-related, and somatoform disorders”, in ICD-11 “anxiety- or fear-related disorders” now constitute a separate group. The core diagnoses of agoraphobia, social anxiety disorder, specific phobia, panic disorder and generalized anxiety disorder are retained, with the modification that agoraphobia and panic disorder can now be diagnosed separately and comorbidly. Within the framework of the lifespan perspective, separation anxiety disorder and selective mutism have been moved to the group “anxiety- or fear-related disorders”. The diagnosis “mixed anxiety and depressive disorder” is now classified as “mixed depressive and anxiety disorder” in the group “affective disorders”. In accordance with the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‑5), it is possible to code isolated panic attacks in addition to other mental or somatic disorders. Overall, ICD-11 follows the DSM‑5 classification of anxiety- and fear-related disorders in many respects. Furthermore, the omission of subcategorizations and a precise minimum number of required symptoms simplify the diagnostic criteria. Future studies will need to address questions regarding the diagnostic accuracy, clinical practicability and further operationalization of the ICD-11 diagnostic criteria for anxiety- or fear-related disorders.

PMID:40728738 | DOI:10.1007/s00115-025-01842-6

J Gambl Stud. 2025 Jul 29. doi: 10.1007/s10899-025-10418-7. Online ahead of print.

ABSTRACT

In literature, there is a lack of multidimensional analyses that examine the co-occurrence of multiple addiction-related behaviors within households. This study aims to fill that gap by identifying the demographic and socioeconomic factors associated with Turkish households in which tobacco use, alcohol consumption, and gambling occur simultaneously, thereby contributing both to academic understanding and to informed policymaking. The study utilizes micro data from the Household Budget Survey conducted by the Turkish Statistical Institute between 2015 and 2019. The probabilities of households engaging in tobacco use, alcohol consumption and gambling behaviors are estimated simultaneously with the Multivariate Probit Model, which also considers correlations among unobservable factors. It has been determined that demographic and socioeconomic factors have separate significant effects on harmful habits. By focusing on the social and cultural dynamics in Türkiye, this study provides insights into harmful habits in households, contains guiding results especially for developing local policies. It has been identified that in Türkiye, deterrent policies for tobacco use should prioritize targeting young, low-educated, high-income males; for alcohol consumption, the focus should be on middle-aged, highly educated, high-income, single males; and for gambling, priority should be given to unemployed, middle-aged, highly educated, high-income, single males.

PMID:40728712 | DOI:10.1007/s10899-025-10418-7

J Endocrinol Invest. 2025 Jul 29. doi: 10.1007/s40618-025-02661-x. Online ahead of print.

ABSTRACT

PURPOSE: Thyroid surgery is performed for various indications, including goiter, suspected or diagnosed malignancy, and hyperthyroidism. While previous studies have focused on postoperative quality of life (QoL) improvements, limited data exist on preoperative QoL in different patient groups. This study aimed to assess the preoperative QoL of patients undergoing thyroid surgery and identify risk factors associated with poor QoL. Additionally, we compared the QoL of patients with thyroid cancer or suspected malignancy to those undergoing surgery for non-cancer-related indications.

METHODS: This prospective study included 204 patients who underwent thyroidectomy or lobectomy at Oulu University Hospital, Finland, between September 2021 and December 2022. Patients completed preoperative QoL assessments using the RAND-36, ThyPRO-39, Beck Depression Inventory (BDI), and Voice Handicap Index (VHI) questionnaires. Patient characteristics and clinical data were collected from medical records. Statistical analyses included Mann-Whitney U tests, Pearson Chi-square tests, and logistic regression to evaluate differences between patient groups and identify factors associated with poor QoL.

RESULTS: Patients undergoing thyroid surgery, regardless of indication, reported lower QoL compared to the general Finnish population. No significant differences were found between cancer and non-cancer patients in overall QoL scores. Poor QoL was significantly associated with younger age (< 65 years), higher BDI and VHI scores, elevated BMI, and frequent dyspnea.

CONCLUSION: Preoperative QoL is significantly lower in patients undergoing thyroid surgery compared to the general population, independent of diagnosis. Contrary to our hypothesis, patients with thyroid cancer did not report worse QoL than those with non-malignant thyroid diseases.

PMID:40728709 | DOI:10.1007/s40618-025-02661-x

J Endocrinol Invest. 2025 Jul 29. doi: 10.1007/s40618-025-02664-8. Online ahead of print.

ABSTRACT

INTRODUCTION: Growth hormone (GH) deficiency (GHD) elevates high-sensitivity C-reactive protein (hs-CRP) levels, an inflammatory marker. While daily GH replacement has been shown to reduce hs-CRP levels, the effects of long-acting GH therapyon hs-CRP remain unclear.

PURPOSE: This pilot study aimed to investigate the association between a once-weekly GH derivative, somapacitan, and hs-CRP in adult patients with GHD.

METHODS: This study prospectively evaluated serum hs-CRP levels and metabolic parameters in adult patients with untreated GHD during a 6-month course of weekly somapacitan therapy.

RESULTS: Among 13 adult patients with GHD (9 men; 10 with adult-onset GHD), serum hs-CRP levels significantly decreased following somapacitan therapy (0.24 [0.07-0.51] to 0.07 [0.06-0.25] mg/dL, P <.001), whereas serum insulin-like growth factor (IGF)-1 levels (80 ± 53 to 148 ± 74 ng/mL, P <.001) and IGF-1 SD scores (- 2.8 ± 2.3 to – 0.4 ± 1.7, P <.001) significantly increased. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels showed slight but statistically insignificant decreases after the treatment. Changes in hs-CRP levels correlated significantly with changes in IGF-1 SD scores (r = -.66, P =.01), AST (r =.67, P =.01), and ALT (r =.74, P =.004). In partial correlation analyses, changes in hs-CRP levels remained significantly associated with ALT changes (r =.59, P =.04), independent of IGF-1 SD score changes.

CONCLUSION: The reduction in hs-CRP levels after somapacitan therapy for GHD suggests that somapacitan has a protective role against inflammation, possibly mediated by the liver.

PMID:40728708 | DOI:10.1007/s40618-025-02664-8

Environ Sci Pollut Res Int. 2025 Jul 29. doi: 10.1007/s11356-025-36759-9. Online ahead of print.

ABSTRACT

Glass waste is generated in large quantities worldwide, yet only a small portion is recycled or reused. To support the circular economy, it is essential to explore alternatives that incorporate this waste into new production chains, such as in civil construction. This study investigates the technical feasibility of replacing sand with glass powder in the production of dry concrete blocks. Four mixtures were tested, with sand replaced by 0%, 25%, 50%, and 75% glass powder (particle size < 600 μm). The obtained blocks were characterized by water absorption and compressive strength. All mixtures met the standard requirement for water absorption (< 10%), with values ranging from 6.0 to 7.5%. In terms of compressive strength, the replacement of sand with glass powder led to a statistically significant improvement (p ≤ 0.05) in all substitution levels. The average compressive strength increased by 32 to 35% compared to the control mix (3.11 MPa at 28 days), with the highest value reaching 4.35 MPa at 56 days for the 50% replacement. Furthermore, only the 50% mix achieved the minimum characteristic compressive strength required by Brazilian standards (fbk ≥ 3 MPa), with 3.62 MPa. The results support the industrial use of glass powder as a sustainable alternative to natural sand, promoting the reuse of long-neck glass bottles and reducing environmental impact.

PMID:40728706 | DOI:10.1007/s11356-025-36759-9

Inflammopharmacology. 2025 Jul 29. doi: 10.1007/s10787-025-01876-x. Online ahead of print.

ABSTRACT

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has prompted global interest in potential adjunctive therapies. N-acetylcysteine (NAC), a mucolytic agent that enhances intracellular glutathione synthesis, has antioxidant properties and may indirectly modulate inflammation through redox regulation. While preclinical and observational data suggest potential mortality benefits, findings from randomized controlled trials (RCTs) have been inconsistent.

OBJECTIVE: To systematically review and synthesize the evidence from RCTs evaluating the effect of NAC on mortality in patients with COVID-19.

METHODS: This systematic review and meta-analysis was conducted according to PRISMA guidelines. Six databases were searched from inception to March 21, 2025. Eligible studies were RCTs comparing NAC to placebo or standard care in adult COVID-19 patients, with mortality as a reported outcome. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane RoB 2 tool. Statistical analyses were performed with a random-effects model to estimate pooled odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS: Ten RCTs comprising 1,424 patients were included. NAC regimens varied by dose and route. The pooled OR for mortality was 0.49 (95% CI: 0.25-0.94; I² = 67%), indicating a 51% reduction in the odds of death among patients receiving NAC. Seven studies had low risk of bias; three had some concerns, primarily due to open-label designs.

CONCLUSION: NAC may reduce mortality in COVID-19 patients, particularly when administered at higher doses or via non-oral routes. Further large-scale RCTs are needed to confirm these findings and establish optimal dosing and administration strategies.

PMID:40728675 | DOI:10.1007/s10787-025-01876-x

Clin Oral Investig. 2025 Jul 29;29(8):392. doi: 10.1007/s00784-025-06465-4.

ABSTRACT

OBJECTIVE: To separately investigate the occurrence of oral candidosis and hyposalivation in Intensive Care Unit (ICU) patients and identify contributing factors.

METHODS: A prospective cohort study was conducted with 100 ICU patients in a hospital in northeastern Brazil. Detailed intraoral examinations were performed daily by calibrated dentists, and sociodemographic and general health-related data were extracted from medical records. Pearson’s Chi-square or Fisher’s exact test assessed variable associations. Survival analysis estimated the onset time of oral candidosis and hyposalivation and their associations with risk factors.

RESULTS: Among the 100 patients, 65% developed hyposalivation, and 11% presented oral candidiasis. The median age was 64 years, with a predominance of males. No significant associations were found between oral candidiasis and demographic or clinical variables. Hyposalivation was significantly linked to underlying renal disease, anemia, and the use of medications such as antibiotics, corticosteroids, anticholinergics, and bronchodilators. Co-occurrence of candidosis and hyposalivation were observed in 7 patients. There was no statistically significant association of the development of oral candidosis or hyposalivation with other oral changes. Anticoagulant use was significantly associated with a higher oral candidiasis-free survival rate. Underlying renal disease, antibiotic treatment, and orotracheal intubation were significantly associated with a reduced survival rate free from hyposalivation.

CONCLUSIONS: Hyposalivation was highly prevalent and may be linked to the development of other oral conditions, such as oral candidosis. Understanding factors that contribute to hyposalivation and oral candidosis is essential for improving ICU healthcare and enhancing patient recovery.

CLINICAL RELEVANCE: Early identification and management of hyposalivation should be prioritized in ICU protocols to enhance patient recovery and oral health care.

PMID:40728670 | DOI:10.1007/s00784-025-06465-4

Eur Spine J. 2025 Jul 29. doi: 10.1007/s00586-025-09190-4. Online ahead of print.

ABSTRACT

PURPOSE: To report the surgical outcomes and complications of the Scoliosis Research Society (SRS)-Schwab grade 6 osteotomy in patients with severe thoracic angular kyphosis (TAK), and to investigate the risk factors of major surgical complications.

METHODS: All patients undergoing SRS-Schwab grade 6 osteotomy for TAK between May 2010 and January 2022 were enrolled. Radiographic changes after surgery were analyzed. Back pain and neurological function were evaluated via Visual analogue scale (VAS) and Japanese Orthopedic Association (JOA) score. Overall complications were classified for each patient using the ISSG-AO Multi-Domain Spinal Deformity Complication Classification System. Univariate and multivariable logistic regression were used to identify the independent risk factors of major surgical complications.

RESULTS: Ninety cases of thoracic tuberculosis complicated with severe angular kyphosis undergoing SRS-Schwab grade 6 osteotomy were analyzed. The mean operating time was 399.8 min, and the mean blood loss was 1627.8 ml. The average segmental kyphosis was significantly corrected from 95.3 ± 25.2° preoperatively to 34.8 ± 16.0° postoperatively. The VAS was statistically decreased from 3.4 ± 2.8 to 1.0 ± 0.9. The JOA score was significantly improved from 6.7 ± 2.6 to 9.4 ± 2.0. The incidences of medical and surgical complication were 23.3% and 62.2% respectively. The most common complications were neurological deficit (36.7%), dural tear (21.1%), and pleural effusion (10%), and 13 patients (14.4%) required a revision. Kyphotic apex at upper-middle thoracic spine (OR = 4.59, 95% CI = 1.43-14.79; p = 0.011) and sagittal-deformity angular ratio (DAR) ≥ 25 (OR = 9.28, 95% CI = 1.80-47.92; p = 0.008) were independent risk factors for major surgical complications.

CONCLUSIONS: Though technical difficulty and high complication rate, SRS-Schwab Grade 6 osteotomy offers a one stage solution with enormous potential to correct rigid kyphosis and improve neurological status.

PMID:40728661 | DOI:10.1007/s00586-025-09190-4

Methods Mol Biol. 2025;2947:139-150. doi: 10.1007/978-1-0716-4662-5_7.

ABSTRACT

In the field of bioinformatics, automated function prediction (AFP) for proteins is a significant issue. We propose a computational framework based on a protein language model to provide accurate functional predictions for proteins. By integrating multiple component methods, our approach effectively improves prediction performance. Additionally, we have developed a user-friendly online platform that allows users to obtain prediction results simply by submitting protein sequences, freely available at https://dmiip.sjtu.edu.cn/ng3.0/?returning=true . We provide a detailed guide on how to use the web server and correctly interpret the prediction results. Finally, through a practical example, we demonstrate the superior performance of NetGO 3.0 in predicting protein functions, further showcasing the potential of this framework for protein functional annotation.

PMID:40728611 | DOI:10.1007/978-1-0716-4662-5_7