Nevin Manimala

Support Care Cancer. 2025 May 10;33(6):466. doi: 10.1007/s00520-025-09517-3.

ABSTRACT

PURPOSE: This study evaluated how frequently patients with early onset colorectal cancer received fertility counseling and whether patient characteristics affected the likelihood of receiving such counseling.

METHODS: We conducted a single-center retrospective review of all new patients seen by medical oncology for colorectal cancer who were age 55 years or younger for men and 50 years or younger for women. Associations between patient demographics and clinical characteristics with receipt of fertility counseling were explored using univariate analyses and multivariable logistical regression analyses.

RESULTS: A total of 194 patients were included, of whom 15.5% received fertility counseling. Using multivariate analysis, we found that age < 40 (OR 15.587, p < 0.0001, 95% CI 4.841-50.191) and female sex (OR 3.979, p = 0.0292, 95% CI 1.150-13.770) were correlated with increased likelihood of fertility counseling. Patients living in areas of higher household income were more likely to receive fertility counseling, with a statistically significant difference between the 3rd and 1st quartiles of income (p = 0.0369, 95% CI 1.161-115.940).

CONCLUSION: A majority of patients with EOCRC did not receive fertility counseling despite the known toxicities of CRC treatment modalities on fertility. Older age, male sex, and residence in areas of lower income were associated with decreased likelihood of receiving fertility counseling.

PMID:40347312 | DOI:10.1007/s00520-025-09517-3

CNS Drugs. 2025 May 10. doi: 10.1007/s40263-025-01188-2. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Baclofen, a traditional treatment for spasticity, is gaining interest for its use in alcohol use disorder (AUD). To assist clinicians in using baclofen for effective and safe treatment of AUD, we investigated the optimal target dosage of baclofen through a systematic review and dose-response meta-analysis.

METHODS: We searched Cochrane, EMBASE, MEDLINE via PubMed, PsycINFO, ClinicalTrials.gov, and the International Clinical Trials Registry Platform for randomized controlled trials on 1 and 2 April 2024. Inclusion criteria were patients aged ≥ 18 years diagnosed with AUD according to Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV, DSM-IV-TR, or International Classification of Diseases (ICD)-10, and treated with baclofen monotherapy. Continuous outcomes-percent days abstinent, drinks per drinking day, heavy drinking days (HDDs), craving, and anxiety-were analyzed as mean or standardized mean differences. Binary outcomes-relapse and dropout, including due to adverse events-were analyzed as odds ratios. Each outcome was assessed using the Cochrane Risk of Bias 2.0 tool. A one-stage random-effects dose-response meta-analysis was performed using restricted cubic splines with fixed knots at 10%, 50%, and 90% percentiles.

RESULTS: A total of 14 trials (1344 patients) were included. Increasing the dose of baclofen up to 50-60 mg/day was associated with a higher percent days abstinent and reduced craving. However, a higher baclofen dose increases the risk of dropout due to adverse events. Commonly observed adverse events were drowsiness, sedation, somnolence and fatigue. Baclofen up to 50-60 mg/day did not significantly affect drinks per drinking day, HDDs, anxiety, relapse or dropout. Doses > 60 mg/day lacked reliable evaluation due to limited data and study heterogeneity.

CONCLUSIONS: Baclofen up to 50-60 mg/day may increase percent days abstinent and reduce craving, but may increase dropout due to adverse events. Clinicians should carefully consider individual patient factors when prescribing baclofen to patients with AUD.

PMID:40347309 | DOI:10.1007/s40263-025-01188-2

J Gastrointest Cancer. 2025 May 10;56(1):114. doi: 10.1007/s12029-025-01243-7.

ABSTRACT

PURPOSE: We previously identified examination time and 2-year interval as effective quality indicators for detecting upper gastrointestinal cancer during screening esophagogastroduodenoscopy (EGD). We evaluated the significance of biennial endoscopy in detecting pharyngeal and esophageal cancer.

METHODS: Individuals who underwent multiple EGD examinations as health checkups at our center between August 2012 and January 2022 were included. Endoscopists were categorized into two groups based on their mean examination time for normal EGD findings, using a threshold of 5 min. The associations between cancer detection rate and these indicators were analyzed using multivariable analyses.

RESULTS: Twelve endoscopists performed more than 1000 examinations each, for a total of 28,842 examinations, detecting all (6 pharyngeal and 26 esophageal) cancers. Intervals between endoscopies were classified into three groups: ≤ 1 year (Group 1), 1 to ≤ 2 years (Group 2), and > 2 years (Group 3). This cancer detection rate did not differ significantly between Groups 1 and 2 (p = 0.761) but was significantly higher in Group 3 than in Group 2 (OR = 4.356, 95% CI = 1.161-16.333, p = 0.029). When Groups 1 and 2 were combined (≤ 2 years) and compared with Group 3, an interval of > 2 years was significantly associated with a higher detection rate, including cases not curable by endoscopic resection (OR, 4.710; 95% CI, 1.806-12.282; p = 0.002). Examination time was not associated with the cancer detection rate (p = 0.944).

CONCLUSIONS: These findings support the significance of biennial endoscopy in detecting pharyngeal and esophageal cancer as well.

PMID:40347302 | DOI:10.1007/s12029-025-01243-7

Cell Tissue Bank. 2025 May 10;26(2):23. doi: 10.1007/s10561-025-10172-5.

ABSTRACT

Tibial reconstruction for major bone loss is a challenging surgical situation. For more than 30 years, massive bone allografts entered our therapeutic arsenal as a major tool to reconstruct large bone defect. Despite allograft is valued for its convenience, it is still burdened by a high complication rate. This retrospective monocentric study focuses on the clinical outcomes of massive tibial allografts and their outcome’s prediction. Between 1987 and 2022, the files of 148 massive tibial allografts were retrospectively reviewed (registration number B403201523492). Survival curves were calculated based on the allograft success or failure. Survival curves without revision surgery were calculated following the same design. Finally, multiple logistic regression models were set up to point out variables that influence the allograft survival. After 30 years, 87.2% of the patient retained limb function. However, 55% of the allograft failed and had to be removed (mean survival time is 20.06 ± 2.07 years (CI 16.0-24.1)). The estimate mean survival time is 10.26 ± 1.60 years (CI 7.1-13.4) with less than 20% survival for the allografts without revision surgery after 30 years. Tumor and septic indications worsen the prognosis as well as the number of revision surgeries and the osteochondral allograft type. In contrast, PSI use or traumatological indications improve the allograft survival. Despite remaining an excellent surgical reconstructive option, massive tibial allografts show a high revision surgery rate. Thanks to our multiple logistic regression models, we can start to predict and improve the final outcomes of these complex allograft reconstruction.

PMID:40347297 | DOI:10.1007/s10561-025-10172-5

Eur Spine J. 2025 May 10. doi: 10.1007/s00586-025-08806-z. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to compare the clinical outcomes and sexual function of male and female patients who underwent IELD and MD due to LDH.

METHODS: The retrospective study included 72 sexually active patients aged 24-50 years. Patients were divided into four groups based on genders and surgical techniques. Visual Analogue Scale (VAS) (leg pain/LBP) and Oswestry Disability Index (ODI) tests were performed. International Index of Erectile Function-5 (IIEF-5) to evaluate the sexual functions of male patients; Female sexual function tests (FSFI) were used to evaluate the sexual functions of female patients, and the Hospital Anxiety Depression Score (HADS) test was used to evaluate the hospital anxiety and depression levels of all patients.

RESULTS: Mean age of the patients 39.8 ± 5.6. In all patients, a statistically significant improvement in three parameters (VAS-Leg, VAS-LBP, ODI) was observed in the post-operative period. However of note, the MD group had a statistically higher post-operative VAS-LBP pain score when compared with the IELD group (p = 0.001; p < 0.01). Both surgical interventions proved effective in increasing IIEF-5 scores, with the IELD group having statistically higher scores in the postoperative period. However, there was no such difference in FSFI scores in female patients with either procedure.

CONCLUSION: The results showed that both IELD and MD improved sexual function in patients with LDH, but IELD had a greater positive effect in male patients compared to MD. It was also found that IELD caused less LBP and more improvement in anxiety levels compared to MD.

PMID:40347289 | DOI:10.1007/s00586-025-08806-z

Pediatr Cardiol. 2025 May 10. doi: 10.1007/s00246-025-03885-7. Online ahead of print.

ABSTRACT

Homografts conduits has been the gold standard for right ventricle to pulmonary artery (RV-PA) conduit. Several different types of xenograft valved conduits have been used as an alternative to homografts, due to their limited availability. In this single center, retrospective study, we analyzed the outcomes of patients with bovine jugular vein conduit (Contegra) and porcine valved conduit (Biointegral) in terms of survival and reintervention rate. Between 2012 and 2023, 44 children underwent surgical repair with RV-PA conduits using Contegra (n = 20) or Biointegral (n = 24). Patients with truncus arteriosus and patients who underwent unifocalization and Ross procedures were excluded. The operations in which other RV-PA conduits such as homografts, Gore-Tex grafts with PTFE handmade valved were used, were also excluded from the study. The median age of the patients was 19 (3-60) months and 84% of the patients (n = 37) had a history of previous intervention. Hospital mortality was 4.5% (n = 2). The median length of stay in intensive care unit and hospital was 5 (2-63) and 19 (2-145) days, respectively. 36 of the patients (82%) were followed for a median of 68 (4.8-143.7) months. There was one late death in Contegra group and five late deaths in Biointegral group. Survival analysis revealed that 1, 5, and 10-year survival rates were 100%, 90%, and 90% in Contegra group and 81%, 76.2%, and 33.9% (p = 0.047) in Biointegral group, respectively. During follow-up period, 11 patients (30.5%) needed reintervention (n = 3 in Contegra; n = 8 in Biointegral group). Freedom from reintervention rates were 100%, 94.1%, and 47.1% at 1, 5, and 10 years in Contegra group and 100% and 63.3% at 1 and 5 years in Biointegral group, respectively (p = 0.024). In this study, the outcomes of Contegra conduits were statistically significantly better than Biointegral conduits. Contegra is still the most valuable alternative to homografts. We believe that the choice of conduit in the first surgery is an important decision that directly affects survival and re-intervention rates.

PMID:40347272 | DOI:10.1007/s00246-025-03885-7

Graefes Arch Clin Exp Ophthalmol. 2025 May 10. doi: 10.1007/s00417-025-06852-3. Online ahead of print.

ABSTRACT

PURPOSE: To investigate distribution differences of parafoveal cone photoreceptors between dominant and non-dominant eyes using the adaptive optics scanning laser ophthalmoscope (AO-SLO) system.

METHODS: This retrospective study included 156 eyes from 78 healthy subjects, all of whom had best-corrected visual acuity of 20/20 or better in both eyes and underwent ophthalmological examinations. The dominant eye was determined using the hole-in-the-card test. Retinal cone photoreceptor observations were performed at an eccentricity of 3.0° from the foveal center using the AO-SLO system. Quantitative distribution parameters, including cone density, spacing, regularity, and dispersion of both dominant and non-dominant eyes, were analyzed and compared.

RESULTS: Dominant eyes exhibited higher cone photoreceptors density at a 3.0° horizontal eccentricity from the fovea [22,896 (20,954, 25,179) cells/mm²] than non-dominant eyes [22,621 (20,147, 24,253) cells/mm²] (p = 0.03). Correspondingly, the spacing of cone photoreceptors in dominant eyes [5.41 (5.09, 5.68) µm] was smaller than that in non-dominant eyes [5.47 (5.23, 5.72) µm] (p = 0.041). The interocular difference in cone regularity between dominant [96.53 (95.07, 97.46)%] and non-dominant [96.68 (95.49, 97.57)%] eyes was statistically significant (p = 0.04). However, there was no significant interocular difference in cone dispersion, which could reflect distribution uniformity (p = 0.795).

CONCLUSION: Our findings reveal that the dominant eye exhibits higher cone density in the parafoveal region with narrower spacing but a less regular arrangement than the non-dominant eye. These cytological features provide new evidence linking cone photoreceptor distribution to ocular dominance, which may account for the electrophysiological asymmetry observed between the two eyes.

KEY MESSAGES: What is known? • The adaptive optics scanning laser ophthalmoscope can correct aberrations caused by irregularities in the eye’s optics, allowing for the direct and noninvasive observation of retinal microstructures in vivo. What is new? • Our study reveals that parafoveal cone photoreceptors in dominant eyes exhibit significantly higher density, narrower spacing, and a less regular arrangement compared to those in non-dominant eyes in vivo. • The cytological asymmetry between photoreceptor cells in dominant and non-dominant eyes may serve as a potential basis for the electrophysiological differences observed between the two.

PMID:40347260 | DOI:10.1007/s00417-025-06852-3

Abdom Radiol (NY). 2025 May 10. doi: 10.1007/s00261-025-04981-1. Online ahead of print.

ABSTRACT

OBJECTIVE: Microsatellite instability (MSI) is a novel predictive biomarker for chemotherapy and immunotherapy response, as well as prognostic indicator in colorectal cancer (CRC). The current standard for MSI identification is polymerase chain reaction (PCR) testing or the immunohistochemical analysis of tumor biopsy samples. However, tumor heterogeneity and procedure complications pose challenges to these techniques. CT and MRI-based radiomics models offer a promising non-invasive approach for this purpose.

MATERIALS AND METHODS: A systematic search of PubMed, Embase, Cochrane Library and Scopus was conducted to identify studies evaluating the diagnostic performance of CT and MRI-based radiomics models for detecting MSI status in CRC. Pooled area under the curve (AUC), sensitivity, and specificity were calculated in RStudio using a random-effects model. Forest plots and a summary ROC curve were generated. Heterogeneity was assessed using I² statistics and explored through sensitivity analyses, threshold effect assessment, subgroup analyses and meta-regression.

RESULTS: 17 studies with a total of 6,045 subjects were included in the analysis. All studies extracted radiomic features from CT or MRI images of CRC patients with confirmed MSI status to train machine learning models. The pooled AUC was 0.815 (95% CI: 0.784-0.840) for CT-based studies and 0.900 (95% CI: 0.819-0.943) for MRI-based studies. Significant heterogeneity was identified and addressed through extensive analysis.

CONCLUSION: Radiomics models represent a novel and promising tool for predicting MSI status in CRC patients. These findings may serve as a foundation for future studies aimed at developing and validating improved models, ultimately enhancing the diagnosis, treatment, and prognosis of colorectal cancer.

PMID:40347255 | DOI:10.1007/s00261-025-04981-1

Int Urogynecol J. 2025 May 10. doi: 10.1007/s00192-025-06130-0. Online ahead of print.

ABSTRACT

INTRODUCTION AND HYPOTHESIS: Urinary incontinence can occur during university years, just as at other stages of life. The aim of this study was to determine the prevalence of urinary incontinence and related factors in university students.

METHODS: The cross-sectional research involved 293 students enrolled in the faculty of health sciences at a public institution. Data were collected using an information form, the International Consultation on Incontinence Questionnaire Short Form, the King’s Health Survey, the Physical Activity Scale- 2, and the Childhood Trauma Scale. Descriptive statistics, the Mann-Whitney U test for pairwise group comparisons, the Kruskal-Wallis test for three or more group comparisons, and the Spearman correlation test were used to analyze data that did not follow a normal distribution.

RESULTS: The students’ average age was 20.94 ± 1.70 years; 79.2% of them were female. It is observed that 98.6% of the students who were enrolled were single. 15.7% of the students reported that they frequently experienced urinary tract infections. 30% of the students had urinary incontinence problems; 21.1% were affected mildly, 8.2% moderately and 0.7% severely. It was found that the impact of urinary incontinence on quality of life varied based on students’ personal characteristics and urinary problems. Various associations were identified between age, urinary incontinence symptoms, quality of life, physical activity levels, and childhood trauma.

CONCLUSIONS: Preventive interventions should be implemented to address urinary incontinence among university students, as it is a public health concern. To avert the onset of urinary incontinence, it is advisable to identify students experiencing this condition, assist them in enhancing their quality of life by addressing relevant factors, promote and motivate them toward physical activity, and implement preventive measures such as exercise programs and counseling.

PMID:40347245 | DOI:10.1007/s00192-025-06130-0

Knee Surg Relat Res. 2025 May 9;37(1):21. doi: 10.1186/s43019-025-00274-5.

ABSTRACT

BACKGROUND: This study aims to evaluate research trends, key contributors, and thematic focuses in research of the anterolateral ligament (ALL) of the knee. It seeks to identify future direction for studies related to long-term clinical outcomes regarding ALL’s role in rotational stability, especially in the context of anterior cruciate ligament (ACL) injuries.

METHODS: A bibliometric analysis was conducted using the Web of Science (WoS) database, covering publications from 2012 to 2024 with the search term “anterolateral ligament”. A total of 942 studies were identified. Descriptive statistics summarized publication trends, authorship, institutional contributions, and citation metrics. VOSviewer software was used to analyze co-authorship network analysis, keyword co-occurrence mapping, and total citation analysis. Yearly publication and citation trends were analyzed using WoS data. Studies addressing the ALL in other body regions were excluded. Additionally, only authors with at least one publication and one citation were considered, and documents with more than 25 authors were excluded. A total citation analysis was conducted, and 24 relevant keywords with more than 5 occurrences were identified using VOSviewer.

RESULTS: Among 942 publications, 707 were original articles. Research output peaked in 2017 (125 articles). Sonnery-Cottet was the leading author (75 publications), while Universidade De São-Paulo emerged as the top institution (57 publications). Key journals included Arthroscopy: Journal of Arthroscopic and Related Surgery (143 articles) and The American Journal of Sports Medicine (131 articles). Keywords such as “anterior cruciate ligament”, “reconstruction”, and “rotational stability” dominated, reflecting a focus on ACL injury management. The top ten cited studies accrued 3,86 citations, with Claes et al.’s anatomical study leading (621 citations). Of the 942 ALL-related articles in WoS, 381 focused on anatomy (11,278 citations) while 814 addressed reconstruction (17,048 citations). Keyword trends shifted from anatomical to clinical terms, with anatomy declining and stability, injury, and outcomes gaining prominence from 2021 to 2024.

CONCLUSIONS: This bibliometric analysis underscores the growing interest in ALL research, peaking between 2016 and 2017. While foundational studies on ALL anatomy and biomechanics appear saturated, future research should prioritize clinical outcomes in terms of failure rate, reoperation, the long-term efficacy of ACL-ALL reconstruction, and advancements in imaging techniques.

PMID:40346719 | DOI:10.1186/s43019-025-00274-5