Nevin Manimala

J Multidiscip Healthc. 2025 Jun 12;18:3391-3401. doi: 10.2147/JMDH.S515576. eCollection 2025.

ABSTRACT

OBJECTIVE: The study investigated to examine the clinical outcomes of hemiarthroplasties using posterior femoral trochanter osteotomy for the treatment of femoral neck fractures in patients at the sequelae stage of cerebrovascular disease.

METHODS: A retrospective analysis was conducted on the data of 53 patients who had been admitted to the Department of Orthopedics at Yan’an University Affiliated Hospital between May 2020 and May 2023. These patients had been diagnosed with femoral neck fractures and concurrent muscle weakness at the sequelae stage of cerebrovascular disease. The patients were divided into two groups: the osteotomy group (20 cases), which underwent hemiarthroplasties via an L osteotomy of the posterior femoral trochanter, and the conventional group (33 cases), which received hemiarthroplasties through the posterolateral approach of the greater trochanter. The two groups were compared on various parameters, including incision length, operation duration, intraoperative blood loss, postoperative drainage, blood transfusion rates, length of hospitalization, early mobilization post-surgery, hip joint function scores at follow-up visits (3 and 12 months), and the rate of postoperative dislocation of the femoral head.

RESULTS: No significant differences were observed between the two groups regarding incision length (P=0.06), operation duration (P=0.284), intraoperative blood loss (P=0.925), Blood transfusion rate (P=0.489), postoperative drainage (P=0.831) and length of hospital stay (P=0.341). However, the early mobilization time following surgery was shorter in the osteotomy group compared to the conventional group (P<0.001). Additionally, the Harris hip joint function scores for the osteotomy group were significantly higher than those for the conventional group at both the 3- and 12-month postoperative assessments (P=0.003, P=0.004, respectively). The dislocation rate of the femoral head in the osteotomy group was lower than that in the conventional group with no statistical significance difference (P=0.521).

CONCLUSION: The use of hemiarthroplasties via posterior femoral trochanter osteotomy demonstrates favorable clinical outcomes in the treatment of femoral neck fractures.

PMID:40530244 | PMC:PMC12170355 | DOI:10.2147/JMDH.S515576

Clin Interv Aging. 2025 Jun 12;20:825-836. doi: 10.2147/CIA.S519546. eCollection 2025.

ABSTRACT

INTRODUCTION: Cardiovascular diseases (CVD) represents a leading cause of morbidity and mortality worldwide, including China. Accurate prediction of CVD risk and implementation of preventive measures are critical. This study aimed to develop a short-term risk prediction model for CVD events among individuals aged ≥60 years in Shanghai, China.

METHODS: Stratified random sampling recruited elderly individuals. Retrospective data (2016-2022) were analyzed using Lasso-Cox regression, followed by a multivariable Cox regression model. The risk scoring was visualized through a nomogram, and the model performance was assessed using calibration plots and receiver operating characteristic curves.

RESULTS: A total of 9,636 individuals aged ≥60 years were included. The Lasso-Cox regression analysis showed male gender (HR=1.482), older age (HR=1.035), higher body mass index (HR=1.015), lower high-density lipoprotein cholesterol (HR=0.992), higher systolic blood pressure (HR=1.009), lower diastolic blood pressure (HR=0.982), higher fasting plasma glucose (HR=1.068), hypertension (HR=1.904), diabetes (HR=1.128), and lipid-lowering medication (HR=1.384) were related to higher CVD risk. The C-index in the training and validation data was 0.642 and 0.623, respectively. Calibration plots indicated good agreement between predicted and actual probabilities.

CONCLUSION: This short-term predictive model for CVD events among the elderly population exhibits good accuracy but moderate discriminative ability. More studies are warranted to investigate predictors (gender, high-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure, hypertension, and lipid-lowering medication) of CVD incidence for the development of preventive measures.

PMID:40530237 | PMC:PMC12170357 | DOI:10.2147/CIA.S519546

Cureus. 2025 May 18;17(5):e84334. doi: 10.7759/cureus.84334. eCollection 2025 May.

ABSTRACT

Introduction Acetabular and pelvic fractures account for roughly 3% of all skeletal injuries and typically result from high-energy trauma. Surgical fixation is often required to restore pelvic stability and joint congruency. These procedures are technically demanding due to complex pelvic anatomy and limited access. Reconstruction plates are commonly used for their versatility in compression, tension, buttress, and antiglide functions. The Stryker Pelvic PRO Next Generation plating system (Stryker, Portage, MI) offers implants for anterior and posterior fixation, designed to accommodate complex bony morphology. This study evaluates clinical and radiographic outcomes in patients treated with this implant system. We hypothesized that its use would yield rates of bone consolidation, nonunion, and adverse events comparable to the current literature. Methods With institutional review board approval, a retrospective review was conducted at a level I trauma center for patients treated with the Stryker PRO system between January and October 2024. Cases were identified using Current Procedural Terminology codes 27226, 27227, and 27228. Demographics, injury characteristics, surgical details, and outcomes were collected. Radiographic bone consolidation was defined as the presence of bridging callus in three out of four cortices with no visible fracture line or the disappearance of fracture lines, while clinical consolidation was defined as the patient achieving full weight-bearing status without pain. Delayed union was defined as the absence of radiographic healing by three months post-operatively, while nonunion was defined as persistent fracture at six months requiring surgical intervention or documented pain with visible fracture line. Descriptive statistics were performed using IBM SPSS Version 29.0.2.0. Results The study included 20 patients (mean age 44.6, 70% male) with pelvic or acetabular fractures. Most injuries resulted from motor vehicle accidents (70%), with common fracture types including AO 62.A1/62.B1 and posterior wall fractures. Radiographic and clinical consolidation were achieved in 80% of cases each, with 95% overall union. Seven adverse events occurred in five (25%) patients, including infection, heterotopic ossification, osteolysis, and avascular necrosis; 16.6% required reoperation. A total of 28 plates were used, most commonly spring plates (50%); 70% of patients required additional fixation. Conclusion The Stryker PRO implant system demonstrated rates of bone consolidation, nonunion, and adverse events comparable to the current literature.

PMID:40530233 | PMC:PMC12173097 | DOI:10.7759/cureus.84334

Cureus. 2025 May 17;17(5):e84266. doi: 10.7759/cureus.84266. eCollection 2025 May.

ABSTRACT

Background Osteoarthritis of the knee is a prevalent chronic condition, often necessitating total knee arthroplasty (TKA) when conservative treatments fail. Single-stage and double-stage bilateral TKA procedures are both widely performed, and the optimal approach in terms of perioperative complications and functional outcomes remains debated. This study aims to compare single-stage and double-stage bilateral TKA concerning postoperative recovery, complications, and hospitalization parameters. Methods A retrospective study was conducted at R. L. Jalappa Hospital, Tamaka, Kolar, from August 2023 to July 2024, including 38 patients with Kellgren-Lawrence grade 3 or 4 primary osteoarthritis undergoing bilateral TKA. Patients were divided into two cohorts: Group A (n = 19) underwent single-stage TKA, and Group B (n = 19) underwent double-stage TKA (≤12 months apart). Outcomes assessed included pain (Visual Analogue Scale (VAS)), functional recovery (Oxford Knee Score (OKS), Knee Society Score (KSS)), perioperative complications, transfusion rates, and hospitalization duration. Statistical analyses compared both groups. Results The mean age of participants was comparable (65.74 ± 8.13 years in Group A vs. 65.58 ± 10.01 years in Group B). Both groups exhibited similar preoperative VAS (8.53 ± 1.17 vs. 8.47 ± 0.96), OKS (20.32 ± 3.20 vs. 19.74 ± 3.21), and KSS (50.58 ± 5.09 vs. 50.11 ± 5.5). The single-stage group had a significantly shorter hospital stay (6.21 ± 0.85 days vs. 7.74 ± 1.28 days, p = 0.001). Functional scores at six months showed higher OKS in Group A (50.00 ± 3.23) than Group B (47.95 ± 2.697, p = 0.040), while KSS scores were similar. Perioperative complications included deep vein thrombosis (DVT) in three (7.8%) patients, bleeding in one (2.6%) patient, pulmonary embolism (PE) in one (2.6%) patient, wound healing issues in two (5.3%) patients, and urinary complications in two (5.3%) patients, with no significant difference between groups. Conclusion Single-stage bilateral TKA is associated with shortened hospital stay and improved functional outcomes at six months compared to the double-stage approach, without significant differences in perioperative complications. These findings suggest that single-stage TKA may be a preferable option in carefully selected patients.

PMID:40530232 | PMC:PMC12170246 | DOI:10.7759/cureus.84266

World J Surg. 2025 Jun 17. doi: 10.1002/wjs.12649. Online ahead of print.

ABSTRACT

IMPORTANCE: Obesity is a significant factor that increases complication rates in patients undergoing abdominal wall reconstruction (AWR). This has led to caution about performing elective AWR in patients with higher body mass index (BMI). In light of this, our study aims to synthesize the current information on AWR outcomes in patients stratified according to the obesity classification, providing evidence-based insights into the impact of BMI on AWR outcomes.

OBJECTIVE: To compare the clinical outcomes in patients of different BMI groups undergoing AWR.

DATA SOURCES: A systematic literature search of two databases (PubMed and Cochrane CENTRAL) from January 1st, 1966, until July 31, 2024, identified five relevant studies.

STUDY SELECTION: Included in our analysis were original studies that assessed clinical outcomes in patients with a BMI < 35 kg/m² compared to those with a BMI ≥ 35 kg/m² undergoing elective AWR. Studies with a patient population of less than 18 years or oncologic patient population were excluded.

DATA EXTRACTION AND SYNTHESIS: This systematic review and meta-analysis are reported as per the PRISMA statement. As recommended by the Cochrane Collaboration, the Newcastle-Ottawa scale was used to evaluate methodological quality. The Mantel-Haenszel random-effects method was used to calculate the pooled odds ratios (ORs) with their 95% confidence intervals (CIs).

MAIN OUTCOME: The primary outcomes were hernia recurrence, readmission, reoperation, and surgical site infection (SSI).

RESULTS: Out of 4769 classifiable patients that underwent AWR, the majority were obese- CDC Class 1, 2 (2401; 50%) or morbidly obese-Class 3 (1054; 22%). Patients with a BMI < 35 kg/m² compared to a BMI ≥ 35 kg/m² were associated with significantly decreased odds of readmission (OR 0.52, 95% CI 0.38-0.70, I² = 0%, and p < 0.0001), reoperation (OR 0.72, 95% CI 0.55-0.93, I² = 17%, and p = 0.01), and developing SSI (OR 0.62, 95% CI 0.48-0.81, I² = 35%, and p = 0.0005), whereas hernia recurrence (OR 1.03, 95% CI 0.35-3.00, I² = 88%, and p = 0.96) was statistically insignificant.

CONCLUSION AND RELEVANCE: A patient’s BMI should not be the sole determinant when planning elective AWR, as increasing BMI does not impact hernia recurrence rates. However, obese patients should be counseled on the higher risk of developing infections, requiring reoperation, and necessitating readmission due to their weight.

PMID:40528287 | DOI:10.1002/wjs.12649

Ann Med. 2025 Dec;57(1):2514943. doi: 10.1080/07853890.2025.2514943. Epub 2025 Jun 17.

ABSTRACT

OBJECTIVE: This study aims to analyze the clinical characteristics, treatment outcomes, and risk factors associated with respiratory support in infants hospitalized with pertussis.

PATIENTS AND METHODS: We retrospectively analyzed the clinical data of 0-1-year-old pertussis patients admitted to Baoding Hospital of Beijing Children’s Hospital affiliated with Capital Medical University from January 2022 to May 2024. SPSS27.0 statistical software was used to analyze the differences in data among different groups of children with pertussis and to summarize their clinical characteristics. A multiple logistic regression model was used to analyze the clinical risk factors of the respiratory support group.

RESULTS: We enrolled 233 hospitalized children with pertussis. Children requiring respiratory support had lower vaccination rates and higher incidences of cyanosis, wheezing, and RSV infection. Logistic regression identified age, cyanosis after coughing, and IVIG use as independent predictors of respiratory support. Age was an independent protective factor: older children were less likely to require respiratory support (OR = 0.151). Compared with children aged ≥3 months, children aged <3 months had a higher history of contact with cough patients, with symptoms such as cyanosis after coughing, white blood cell counts (WBCs) ≥20 × 10⁹/L, lymphocyte percentage ≥60%, and increased RSV infection incidence. Rates of respiratory support, bronchoscopy treatment, IVIG, tracheal intubation, and exchange transfusion treatment increased (all p < 0.05).

CONCLUSIONS: Younger pertussis patients have more severe clinical manifestations, with significantly increased WBCs, and they are more likely to be infected with other viruses. Age is an independent protective factor, and the younger the patient, the more likely they are to require respiratory support. These findings highlight the need for early recognition and targeted interventions, particularly in younger infants with severe symptoms.

PMID:40528283 | DOI:10.1080/07853890.2025.2514943

Neurorehabil Neural Repair. 2025 Jun 17:15459683251345444. doi: 10.1177/15459683251345444. Online ahead of print.

ABSTRACT

BACKGROUND: Vestibular dysfunction occurs in 30% to 70% of cases with multiple sclerosis (MS).

OBJECTIVE: To compare the clinical and cost-effectiveness of a customized vestibular rehabilitation (VR) program with a generic booklet-based VR intervention in people with MS with clinical signs of vestibulopathy.

METHODS: People with MS and symptoms of vertigo and/or imbalance were screened for vestibulopathy (n = 73). Seventy recruited participants were randomly allocated to a 12-week generic booklet-based home program with telephone support (n = 35) or a 12-week customized VR program (n = 35, 12 face-to-face sessions and a home exercise program). The primary clinical outcome was the Dizziness Handicap Inventory (DHI) at 26 weeks post-randomization. The primary economic endpoint was quality-adjusted life-years (QALYs). Secondary outcomes included vertigo severity, balance, gait, and perceived impact of physical symptoms in MS.

RESULTS: There was no significant between-group difference in the DHI: mean reduction -1.76 (95% confidence interval -10.02, 6.50) at week 26 in favor of the customized group (P = .670). There were significant differences in favor of the customized group for vertigo symptom score, balance confidence, walking, and perceived impact of MS. Primary cost-effectiveness analysis showed customized VR to be less costly and more effective. However, removal of 2 cost outliers in sensitivity analysis resulted in a mean cost-per-QALY of £30 147. Customized VR was also cost-effective from a societal perspective.

DISCUSSION: Impairment level improvements did not translate into functional improvements as measured by the DHI perhaps reflecting that vestibular dysfunction is one of several impairments in MS. The findings indicate the potential cost-effectiveness of the customized program.

CLINICAL TRIAL REGISTRATION: ISRCTN27374299.

PMID:40528281 | DOI:10.1177/15459683251345444

Alzheimers Dement. 2025 Jun;21(6):e70361. doi: 10.1002/alz.70361.

ABSTRACT

INTRODUCTION: Clinical characterization of behavioral variant frontotemporal dementia (bvFTD) and Alzheimer’s disease (AD) is challenging due to overlapping neuropsychiatric symptoms and cognitive profiles between the two conditions.

METHODS: We used clinical network analysis to characterize and compare clinical profiles in AD and bvFTD using initial visit data from the National Alzheimer’s Coordinating Center.

RESULTS: The final matched sample included 890 patients per group (AD: mean age = 63.02, standard deviation [SD] = 9.34, 36.4% female; bvFTD: mean age = 62.87, SD = 9.46, 36.52% female). Both networks were densely connected, reflecting comorbidity between neuropsychiatric symptoms and cognitive scores. Memory performance, hallucinations, and motor disturbance were bridge symptoms in the AD network, whereas elation was the sole bridge symptom in the bvFTD network.

DISCUSSION: Distinct networks highlight unique clinical profiles in AD and bvFTD. Treatment of bridge symptoms may relieve overall symptom burden. Findings can advance clinical characterization of AD and bvFTD, leading to development of targeted interventions.

HIGHLIGHTS: We compared clinical features of Alzheimer’s disease (AD) and behavioral variant frontotemporal dementia (bvFTD). Clinical networks showed comorbidity between neuropsychiatric symptoms and cognitive manifestations. Clinical networks significantly differed between AD and bvFTD, highlighting unique behavioral and cognitive profiles. Distinct symptoms were important for overall symptom comorbidity. Findings can be used to characterize AD and bvFTD and inform targeted treatment.

PMID:40528277 | DOI:10.1002/alz.70361

Antimicrob Resist Infect Control. 2025 Jun 17;14(1):69. doi: 10.1186/s13756-025-01593-8.

ABSTRACT

BACKGROUND: Unstandardised reprocessing procedures for flexible endoscopes can lead to infection outbreaks and threaten the lives of ICU patients. Despite recent updates to technical specification, there was a paucity of studies on the current status of flexible endoscopic reprocessing, particularly concerning flexible bronchoscopes (FB). This study aimed to assess the current practices of reprocessing FBs in ICUs in Hubei Province, China.

METHODS: A cross-sectional study was conducted utilizing convenience sampling from October 11, 2024, to December 6, 2024, in the ICUs of 216 hospitals in Hubei Province, China. A self-developed questionnaire was distributed through an online survey platform to either the person in charge of the ICU or the frontline technicians. The information regarding the reprocessing of FBs was collected, including general characteristics, personnel and training, layout and facilities, reprocessing operations, and reprocessing quality monitoring.

RESULTS: The content validity index of the questionnaire was 0.94. There were 202 valid questionnaires collected with a validity rate of 93.52%, including 158 ICUs in tertiary hospitals and 44 in secondary and primary hospitals. The ICUs of tertiary hospitals were better than the ICUs of secondary and primary hospitals in terms of the number of FBs available, the number of dedicated technicians, the opportunity for training, the availability of some equipment and facilities (ultrasonic cleaners, whole tube irrigators, etc.), and some reprocessing operations (FB sterilisation method and storage cabinet sterilisation frequency) (P < 0.05).

CONCLUSIONS: There were variations in FB reprocessing practices across ICUs in hospitals of all levels in Hubei, along with some common issues. Most ICUs were standardised in personnel training, operation, and recording, and ICUs in tertiary hospitals behaved better than in secondary and primary hospitals. However, there remained a need for improvement in the layout of the reprocessing environment, equipment configuration, and quality monitoring. Future research could apply implementation science to identify barriers and propose strategies to align practice with guidelines.

PMID:40528274 | DOI:10.1186/s13756-025-01593-8

Cancer. 2025 Jun 15;131(12):e35886. doi: 10.1002/cncr.35886.

NO ABSTRACT

PMID:40528271 | DOI:10.1002/cncr.35886