Nevin Manimala

J Psoriasis Psoriatic Arthritis. 2025 Jun 2:24755303251345804. doi: 10.1177/24755303251345804. Online ahead of print.

ABSTRACT

Biologic dosing frequency is a key concern among psoriasis (PsO) patients and physicians, yet dosing optimization remains a challenge. This study evaluates patient dosing preferences for IL-17 and IL-23 inhibitors, risankizumab (RZB) every 12 weeks, guselkumab (GUS) every 8 weeks, and ixekizumab (IXE) every 4 weeks, in managing PsO. This phone survey study evaluated 87 adults on RZB (n = 29), GUS (n = 35), or IXE (n = 23) from 2019 onward at two clinical sites. Patients were assessed for baseline PsO bothersome severity, current dosing frequency satisfaction, frequency of PsO flares, and preferred dosing frequency. Most patients were males (57.5%) with an average age of 54.1 years and an average treatment duration of 19.0 months. At baseline before treatment, 87% were ‘very bothered’ by their PsO. After treatment, 86% were either ‘3-somewhat’ or ‘4-very satisfied’ with their current dosing schedule, with no significant differences between each drug (P = 0.7). Across all biologics the majority of participants (62% with RZB, 57% with GUS, and 48% with IXE) preferred maintaining their current dosing frequency. No statistically significant differences were observed in dosing frequency preference between treatment groups, suggesting dosing schedule is not a primary concern for most patients. This aligns with previous research demonstrating effective disease control is the most important factor for patient satisfaction; however, tailoring dosing regimens to individual patient needs can also strengthen long-term adherence, as demonstrated in recent studies.

PMID:40476147 | PMC:PMC12133784 | DOI:10.1177/24755303251345804

Cureus. 2025 May 6;17(5):e83583. doi: 10.7759/cureus.83583. eCollection 2025 May.

ABSTRACT

BACKGROUND: Atrial fibrillation (AF) is a common complication following coronary artery bypass grafting (CABG) and is associated with increased morbidity and prolonged hospital stay. This study aimed to determine the frequency of new-onset atrial fibrillation (NOAF) in post-CABG patients and assess its association with demographic and clinical variables, including comorbidities.

METHODS: This descriptive observational study was conducted in the Cardiac ICU of Rehman Medical Institute (RMI) over six months. A total of 101 post-CABG patients admitted to the ICU were included and monitored for the development of AF. Patients with congenital anomalies, a prior history of arrhythmias, or those who did not provide consent were excluded. Data were collected prospectively, including patient demographics, comorbidities, and antiarrhythmic management. Statistical analysis was performed using SPSS version 26 (Armonk, NY: IBM Corp.), with quantitative variables presented as means±standard deviations and qualitative variables as frequencies and percentages.

RESULTS: The frequency of NOAF in post-CABG patients was found to be 13.86% (n=14). The mean age of the study population was 59.62 years (SD=9.81), with a male predominance (69 males, 32 females). Hypertension (HTN) and coronary artery disease (CAD) were the most common comorbidities, affecting 29.7% (n=30) and 20.8% (n=21) of patients, respectively. A trend was observed suggesting that patients with multiple comorbidities had an increased likelihood of developing AF, although this finding was descriptive and not statistically significant. Antiarrhythmic medications were administered in all AF cases, with a variable response.

CONCLUSION: The incidence of NOAF in post-CABG patients remains significant based on previous researches. Age and pre-existing comorbidities, particularly hypertension and CAD, appear to contribute to AF development. Developing preoperative and intraoperative risk assessment tools may help identify patients at higher risk for post-CABG atrial fibrillation. Future interventional studies can evaluate strategies such as fluid management, early beta-blockers, or anti-inflammatory therapies to reduce the incidence of AF.

PMID:40476136 | PMC:PMC12140130 | DOI:10.7759/cureus.83583

Cureus. 2025 May 6;17(5):e83569. doi: 10.7759/cureus.83569. eCollection 2025 May.

ABSTRACT

BACKGROUND: Circulatory system diseases are leading causes of emergency department (ED) visits in the United States. Understanding trends in these visits is crucial for healthcare planning.

OBJECTIVE: This study aimed to identify the most frequent primary circulatory system diagnoses presenting to EDs, examine temporal trends in ED visit rates from 2016 to 2022, and assess disparities by patient age, sex, race/ethnicity, insurance status, and geographic region.

MATERIALS AND METHODS: A cross-sectional analysis of the National Hospital Ambulatory Medical Care Survey (NHAMCS) data (2016-2022) identified ED visits with a primary circulatory disease diagnosis using International Classification of Diseases (ICD) codes. Weighted estimates ensured national representativeness. Descriptive statistics and inferential statistics were used to assess trends. Analyses were performed in STATA 17 (StataCorp., College Station, TX, USA) (p<0.05).

RESULTS: Overall ED visit rates for circulatory diseases rose from 15 per 1,000 in 2016 to 17 per 1,000 in 2019 (p<0.01), declined to 16 per 1,000 in 2020 (p<0.05 vs. 2019), and stabilized at 17 per 1,000 in 2021-2022 (no significant change, p=0.12). Essential hypertension (14%), hypertensive heart or kidney disease (13%), acute myocardial infarction (11%), atrial fibrillation/flutter (10%), and ischemic stroke (8%) represented the five most common primary diagnoses, accounting for over 56% of circulatory presentations. Older adults (65+) exhibited the highest visit rates (peaking at 55 per 1,000 in 2022), males had slightly higher rates than females (18 vs. 16 per 1,000 in 2022), and non-Hispanic Black individuals had persistently elevated rates (28 per 1,000 in 2022) compared to non-Hispanic White individuals (17 per 1,000) and Hispanic individuals (12 per 1,000) (all p<0.05). The Midwest and Northeast regions reported the highest rates, whereas the West had the lowest, underscoring geographic variation in circulatory disease burden. Medicare beneficiaries had the highest utilization (44 per 1,000 in 2022), highlighting insurance-related disparities.

CONCLUSIONS: In this nationally representative analysis, primary ED presentations for circulatory diseases were dominated by hypertension-related conditions and acute ischemic events. Stabilization of rates post-2020, particularly among older and Medicare-insured patients, indicates potential targets for intervention. Strengthening primary care access and preventive programs, especially for older adults and non-Hispanic Black individuals, may reduce ED reliance and improve equity in cardiovascular care.

PMID:40476134 | PMC:PMC12139463 | DOI:10.7759/cureus.83569

Cureus. 2025 May 6;17(5):e83560. doi: 10.7759/cureus.83560. eCollection 2025 May.

ABSTRACT

Context Hip range of motion plays a crucial role in the functional health of runners. Osteopathic manipulative treatment has historically been used to maintain or restore a joint’s range of motion; therefore, this study investigates how the Spencer technique impacts femoroacetabular active range of motion in runners. Objective This study investigated the impact that the bilateral Spencer technique has on all planes of hip motion. Methods Forty participants were randomly divided into treatment and control groups, with the treatment group receiving twice-weekly bilateral Spencer technique for four weeks and the control group receiving no treatment. Both groups were instructed to train as they normally would for the four weeks leading up to a five-kilometer (5K) race. Measurements of hip flexion, extension, internal rotation, external rotation, abduction, and adduction were taken to assess the percent change in range of motion over the course of training, as well as before and after the race, for all planes of motion in treatment vs control groups. Results The only significant difference in average percent change in range of motion for control (n=19) vs treatment groups (n=20) across both treatment and race periods was found for abduction wherein the control group experienced an average change of +7.09% (standard deviation of 17.38%) and the treatment group experienced an average change of -5.58% (standard deviation of 17.48%) for a difference of 12.67% (p=0.03). All other findings for all other motions across both training and race periods showed no statistically significant difference (p>0.05). Conclusion This study found that four weeks of twice-weekly treatment with the Spencer technique of the hip had no statistically significant impact on change in hip flexion, extension, internal rotation, external rotation, abduction, and adduction across the four weeks when compared to control. When analyzing the impact of this treatment on the change of these motions across a 5K race occurring at the end of the four weeks, this study found that the Spencer technique of the hip had a statistically significant negative impact on abduction, compared to the control. These findings bring into question the role that the Spencer technique of the hip may have for healthy individuals training for athletic competition and open the door for future research to analyze the effect that this osteopathic technique has on motion in a setting that better controls for differences in training habits.

PMID:40476131 | PMC:PMC12140400 | DOI:10.7759/cureus.83560

J Physiol Anthropol. 2025 Jun 5;44(1):16. doi: 10.1186/s40101-025-00396-5.

ABSTRACT

BACKGROUND: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that increase the risk of cardiovascular disease and type 2 diabetes. High-sensitivity C-reactive protein (hs-CRP) is a biomarker of systemic inflammation, but its relationship with MetS and its components remains unclear. This study investigates the association between hs-CRP and MetS in a representative Korean population.

METHODS: Using data from the 2022 Korea National Health and Nutrition Examination Survey (KNHANES), we analyzed 4,823 adults. MetS was defined according to revised NCEP-ATP III criteria. Multivariate analyses were conducted, adjusting for confounders such as sex, age, income, education, smoking, alcohol consumption, physical activity, and waist circumference.

RESULTS: Among the study population, 1,784 participants (37.0%) were diagnosed with MetS. hs-CRP levels were significantly higher in individuals with MetS (1.06 mg/L vs. 0.79 mg/L, p < 0.001) and increased with the number of MetS components (p for trend < 0.001). Significant associations were observed between hs-CRP and all MetS components. However, after adjusting for waist circumference, these associations lost statistical significance.

CONCLUSION: This study confirms a strong association between hs-CRP and MetS, primarily influenced by central obesity. The findings highlight abdominal obesity as a key contributor to systemic inflammation in MetS. Further longitudinal studies are needed to explore the causal relationship and underlying mechanisms.

PMID:40474309 | DOI:10.1186/s40101-025-00396-5

BMC Nutr. 2025 Jun 5;11(1):112. doi: 10.1186/s40795-025-01099-x.

NO ABSTRACT

PMID:40474304 | DOI:10.1186/s40795-025-01099-x

BMC Psychol. 2025 Jun 5;13(1):615. doi: 10.1186/s40359-025-02927-2.

ABSTRACT

BACKGROUND: One of the problems of infertility is damage to the genital self-image, which is one of the essential components of sexual health and is associated with sexual satisfaction and all dimensions of sexual function. Recently, narrative therapy has been used to treat a wide range of sexual disorders and marital incompatibility. The present study aimed to determine the effect of online narrative therapy on the genital self-image and sexual satisfaction of infertile women.

METHODS: This randomized controlled trial was conducted with 64 women with infertility, who were selected through the convenience sampling method from gynaecologists with infertility fellowship and family physician clinics. Genital self-image score and sexual satisfaction of the participants were evaluated using the Female Genital Self-Image Scale (FGSIS) and the Hudson sexual satisfaction questionnaire, respectively. The participants were randomly assigned to two narrative therapy and control groups of 32 women using the RANDBETWEEN software. The intervention group received five sessions of weekly 90-minute online narrative therapy sessions using the WhatsApp platform, and the control group received routine care. The data of the two groups, before the intervention, immediately after, and 45 days after the completion of the intervention, were collected and assessed. SPSS version 22 software and statistical tests such as Mann-Whitney U, Friedman, Bonferroni test, and repeated measures ANOVA were used for data analysis.

RESULTS: The Mann-Whitney U test showed that the mean score of the genital self-image in infertile women in the intervention and control groups showed no significant differences before the intervention (p = 0.312). The study results immediately and 45 days after the intervention demonstrated significant differences regarding the mean score of genital self-image compared to the control group (p < 0.001). In addition, according to the Bonferroni test, the mean sexual satisfaction score immediately and 45 days after the intervention had a significant difference from before the intervention (p < 0.001).

CONCLUSIONS: Online narrative therapy can be a suitable approach to improving genital self-image score and sexual satisfaction in infertile women.

TRIAL REGISTRATION: The protocol of this research was registered in the Iranian Registry of Clinical Trials (IRCT20161126031117N11) on 15/11/2021.

PMID:40474302 | DOI:10.1186/s40359-025-02927-2

Orphanet J Rare Dis. 2025 Jun 5;20(1):277. doi: 10.1186/s13023-025-03805-1.

ABSTRACT

Rare diseases present critical challenges to healthcare systems, patients, and caregivers due to their low prevalence and unique characteristics. Designing clinical trials and developing statistical methodologies for evaluating interventions in rare diseases face several challenges. The “EBStatMax” project, part of the European Joint Programme on Rare Diseases’ Demonstration Projects, aimed to address one of these challenges, namely: designing and analyzing longitudinal cross-over data in rare diseases, like Epidermolysis bullosa simplex (EBS). Although the main findings of the project have been published elsewhere, this manuscript reflects on additional hurdles encountered during the project, particularly regarding outcomes and methodological considerations. It explores issues surrounding outcome measurement, statistical methodology, and clinical considerations, emphasizing their broader relevance to methodological advancements in rare disease research beyond this specific case. This manuscript highlights the critical role of international collaboration in rare disease research to enhance evidence quality and aims to inspire further advancements in the field.

PMID:40474287 | DOI:10.1186/s13023-025-03805-1

Scand J Trauma Resusc Emerg Med. 2025 Jun 5;33(1):102. doi: 10.1186/s13049-025-01399-y.

ABSTRACT

BACKGROUND: Severe pelvic injuries with ISS > 15 is associated with a high degree of morbidity and mortality. We aimed to describe the demography, emergency interventions and outcome of patients with these injuries and analyze changes in practice occurring in this timeframe.

METHODS: Stavanger University Hospital (SUH) is located in South-Western Norway. All patients registered in the Stavanger University Hospital Trauma registry between 2004-2022 with a pelvic injury and concomitant ISS > 15 were included in this study.

RESULTS: In total 2283 patients with a pelvic injury were included in the trauma registry between 2004-2022. There were 160 patients with an ISS > 15, with 115 (72%) men and 45 (28%) women. Median age of men was 45 years, while women were slightly older at 52 years of age. The 30-day mortality in men (25/115) and women (10/45) was identical at 22%. Emergency intervention was performed in 33/160 (20.1%%) patients. In 27 patients a laparotomy, an EPP or an angioembolization was the primary hemostatic emergency procedure. All but one pelvic packing were done in the years 2010-2014, with one packing also performed in 2021. A significant decline both in number of patients receiving crystalloids and the amount of crystalloids administered, both prehospitally and in the ER were seen when comparing period 1-3. The mortality in the EPP group was very high at 6/8 (75%) while only 1/9 in the laparotomy group succumbed and 2/10 (20%) in the AE group. These discrepancies may be related to the high median ISS of 50 in the pelvic packing group, vs 40 in the angioembolization group vs 38 in the laparotomy group, reflected by a statistically significant difference in probability of survival (TRISS score) between emergency intervention groups (p < 0.001).

CONCLUSION: Severe pelvic injuries are quite rare, with about 1 incident per month. About 2/3 are men and transport related injuries are the most common mechanism of injury. Patients in need of emergency intervention are characterized by a high median ISS and concomitant high mortality. A significant decline in emergency interventions were seen over time, which may be related to declining infusions of crystalloids and better transfusion protocols.

PMID:40474283 | DOI:10.1186/s13049-025-01399-y

J Health Popul Nutr. 2025 Jun 5;44(1):190. doi: 10.1186/s41043-025-00785-7.

ABSTRACT

BACKGROUND: In this study, it was aimed to investigate whether engagement in healthy aging differs according to gender and whether the factors affecting the participation of men and women in healthy aging are different.

METHODS: The data of the cross-sectional study were collected between April-July 2024 with the participation of 381 elderly individuals through a questionnaire form. The questionnaire included a socio-demographic data form and the Engagement in Healthy Ageing Scale. The data of the study were analyzed using Standard Package of Statistical System package program 23. Descriptive statistics, t-test, Anova test and Forward Linear Regression analysis were used to evaluate the data.

RESULTS: Being female decreases the level of engagement in healthy ageing (OR = 3.220; CI:, -2.904/-0.702). Education status affects the level of engagement in healthy ageing in both men and women. In addition to educational level, income status, presence of COPD, musculoskeletal diseases and previous MI were found to be factors affecting engagement in healthy ageing in women.

CONCLUSIONS: Gender affects engagement in healthy ageing in individuals over 65 years of age. Gender differences should be taken into consideration in studies to be carried out for the promotion of healthy ageing. Public Health Programs should be carried out to increase physical activity in women and to rehabilitate chronic diseases.

PMID:40474265 | DOI:10.1186/s41043-025-00785-7