Nevin Manimala

Medicine (Baltimore). 2025 May 16;104(20):e42510. doi: 10.1097/MD.0000000000042510.

ABSTRACT

The aim of this study was to investigate the safety and efficacy of the double mini-incision approach, and to clarify its surgical details. We retrospectively enrolled 82 patients with primary carpal tunnel syndrome. Among them, 30 patients with conventional approach were enrolled in group A, and the other 52 patients with double mini-incision approach were enrolled in group B. Objective tests were performed on patients, and basic information and subjective evaluation of patients were collected. The surgical effects and complications of the 2 approaches were compared. In addition, the surgical details of double mini-incision were further explored. The incision length of group B (26.1 ± 6.1 mm) was significantly shorter than that of group A (45.7 ± 5.9 mm, P ＜ .001). Patients in group B (93.7 ± 5.4) had significantly higher satisfaction with incision appearance than those in group A (84.3 ± 6.1, P ＜ .001). At the 12-month follow-up, no statistically significant difference in clinical outcomes were observed between the 2 groups (P > .05). However, there were 2 cases with wound pain and 1 case with pillar pain in group A, but none in group B. Two patients in group B who underwent the distal incision 1st were transferred to the conventional approach because of the epineurium and perineurium injury. The double mini-incision approach offers a sufficient range of release and surgical field, resulting in favorable surgical outcomes. The proximal incision made 1st helps to reduce the risk of nerve injury.

PMID:40388748 | DOI:10.1097/MD.0000000000042510

Medicine (Baltimore). 2025 May 16;104(20):e42473. doi: 10.1097/MD.0000000000042473.

ABSTRACT

Patients with coronary heart disease may have a higher risk of medication discrepancy during hospital-family transition period because of the complexity of their diseases, the diversity of medicines brought out of hospital and the sensitivity of medicine taking time. This study aims to analyze the influencing factors of medication discrepancy in patients with coronary heart disease during hospital-family transition period. Patients admitted to the department of cardiovascular medicine from July 1, 2023 to June 30, 2024 in a hospital in Ningbo City, Zhejiang Province, China. Electronic medical record system and patients themselves before discharge collected the baseline data of patients with coronary heart disease. Within 2 weeks after discharge, the patients were investigated by telephone follow-up with the medication discrepancy tool. Logistic regression was used to determine the influencing factors of patients’ medication discrepancy. The incidence of medication discrepancy in 107 patients within 2 weeks after discharge was 23.4%. The main discrepancy type is “medication omission.” The causes of patient-induced medication discrepancy are relatively high, and the most common reason is “forgetting to take medicine.” Logistic regression analysis showed that aspirin medication history and family APGAR index were the influencing factors of medication discrepancy. The incidence of medication discrepancy in patients with coronary heart disease in hospital-family transition period is high, among which omission is the most common. Aspirin medication history and family function are the key to identify patients’ medication discrepancy. Medical staff should pay attention to the management of medication discrepancy in patients with coronary heart disease.

PMID:40388747 | DOI:10.1097/MD.0000000000042473

Medicine (Baltimore). 2025 May 16;104(20):e42501. doi: 10.1097/MD.0000000000042501.

ABSTRACT

To clarify the patterns, reasons, and patient characteristics associated with emergency visits in the final 30 days of life for patients receiving home care in Japan. We conducted a retrospective analysis of emergency visits made by home care physicians to patients who died while receiving home care in 2018. Data on patient characteristics and emergency visits during the final 30 days of life were extracted from medical records. Poisson regression analysis was used to identify factors associated with emergency visit frequency. Among 83 end-of-life patients (median age 84 years, 49.4% male), a total of 86 emergency visits were recorded. These visits occurred most frequently in the days immediately preceding death, with 40.7% occurring within 5 days before death. Visits were more common during afternoons (37.2%) and weekends (39.6%). The primary reasons for visits included respiratory distress (20.9%), clinical assessment (14.0%), and neurological symptoms (12.8%). While some visits resulted in medication prescriptions (26.7%) or laboratory tests (22.1%), 36.1% involved observation only. Multivariable analysis revealed that longer duration of home care was associated with increased emergency visit frequency (31-365 days: relative risk [RR] 2.30, 95% confidence interval [CI]: 1.16-4.54; >365 days: RR 3.00, 95% CI: 1.56-5.78), while younger age was associated with increased visits (≤79 years: RR 2.04, 95% CI: 1.19-3.47). Emergency home visits in the terminal phase often clustered near death and frequently resulted in observation only, suggesting that some visits may be driven more by caregiver anxiety than medical urgency. Additionally, care level appeared to play a limited role during this period. These findings highlight the need for proactive symptom management, caregiver support, and scalable approaches such as telehealth to optimize end-of-life care.

PMID:40388741 | DOI:10.1097/MD.0000000000042501

Medicine (Baltimore). 2025 May 16;104(20):e42522. doi: 10.1097/MD.0000000000042522.

ABSTRACT

May measurement month (MMM) is a global blood pressure (BP) screening campaign that aims to emphasize the importance of BP measurement and identify those who require intervention/follow-up for elevated BP. The objective of this regional analysis in Newfoundland and Labrador (NL), Canada, was to examine the proportion of individuals screened with elevated BP, including those with and without a history of hypertension (HTN). This cross-sectional study was completed in accordance with the global MMM protocol. All consenting adults ≥18 years old were eligible to take part. Data collection took place in 28 community pharmacies across the province of NL. Descriptive statistics were analyzed and associations between elevated BP and covariates of interest were determined using logistic regression. A total of 384 participants took part in this study, with a mean age of 54.4 years (standard deviation 18.2); 66.1% (n = 254) of participants were female and 41.4% (n = 159) had known HTN. A complete set of 3 BP readings were recorded for a total of 375 participants and therefore, these participants were included in the analysis. Elevated BP was observed in 21.9% (n = 82) of participants, including 13.5% of those who had no history of HTN (i.e., 30 of 222). Known HTN and diabetes were statistically significant predictors of elevated BP in the multivariate regression model. Regional implementation of the MMM campaign in NL helped to identify a relatively large proportion of individuals with elevated BP, including those with no history of HTN. Targeted measures are needed to achieve BP targets among individuals with hypertension and diabetes in the province.

PMID:40388740 | DOI:10.1097/MD.0000000000042522

Medicine (Baltimore). 2025 May 16;104(20):e42423. doi: 10.1097/MD.0000000000042423.

ABSTRACT

Post-traumatic stress disorder (PTSD) and Attention deficit and hyperactivity disorder (ADHD) are common mental illnesses. Observational studies have indicated that these conditions often co-occur with gastrointestinal diseases. However, the causal relationship between PTSD and ADHD with gastrointestinal diseases remain unclear. We conducted Mendelian randomization (MR) analysis to investigate these associations. We selected genetic instrument data with genome-wide significance levels for PTSD and ADHD from the psychiatric genomics consortium open genome-wide association study platform. Summary statistics for the 24 gastrointestinal diseases were obtained from the FinnGen study. We used the “TwoSampleMR” package in R to perform a 2-sample MR analysis and conducted sensitivity analysis of the results. We found that genetic susceptibility to PTSD was associated with 1 gastrointestinal disease, specifically pancreatic cancer (P = .003; odds ratios [OR] = 1.295; 95% CI, 1.094-1.531). Genetic susceptibility to ADHD was associated with 4 gastrointestinal diseases: gastroesophageal reflux (P = .014; OR = 1.100; 95% CI, 1.020-1.186), gastric ulcer (P = .004; OR = 1.208; 95% CI, 1.061-1.376), duodenal ulcer (P = .020; OR = 1.206; 95% CI, 1.029-1.413), and chronic gastritis (P = .021; OR = 1.122; 95% CI, 1.018-1.237). This study provides MR evidence supporting causal relationship between PTSD and ADHD with specific gastrointestinal diseases.

PMID:40388735 | DOI:10.1097/MD.0000000000042423

Medicine (Baltimore). 2025 May 16;104(20):e42484. doi: 10.1097/MD.0000000000042484.

ABSTRACT

Previous studies have confirmed that hyperthyroidism is one of the common causes of secondary osteoporosis and can aggravate the disease severity in patients with osteoporosis. This study is mainly based on the Taiwan National Health Insurance Database and through big data analysis shows that combining traditional Chinese medicine (TCM) treatment can help the health of patients with hyperthyroidism and osteoporosis. There were 4980 patients who received TCM treatment and 19,920 controls who did not receive TCM treatment selected from Taiwan National Health Insurance Database in a 4:1 ratio of gender, age, and index year. Cox proportional hazards analyzes were performed to compare fracture, inpatient, and all-cause mortality over an average follow-up period of 15 years. A total of 4745/5823/3487 enrolled subjects (19.06%/23.39%/14.00%) suffered fractures/hospitalization/all-cause death which TCM group was 452/987/511 (15.10%/19.82%/10.26%); control group was 3993/4836/2976 (20.05%/24.28%/14.94%). Cox proportional hazards regression analysis showed that subjects in the TCM group had lower fractures, hospital mortality, and all-cause mortality (adjusted HR = 0.563; 95% confidence intervals [CI] = 0.392-0.680, P < .001; adjusted HR = 0.614; 95% CI = 0.474-0.714, P < .001; adjusted HR = 0.691; 95% CI = 0.569-0.792, P < .001). Kaplan-Meier analysis showed that the cumulative risk of fracture, hospitalization and death were lower in TCM group with significant differences (all log-rank P < .001). The analysis of this study shows that patients with hyperthyroidism and osteoporosis even with comorbidity of atrial fibrillation, atrial flutter, or heart failure combined with TCM treatment are associated with a lower risk of fractures, hospitalization, or all-cause death, providing clinicians with a treatment option.

PMID:40388732 | DOI:10.1097/MD.0000000000042484

Medicine (Baltimore). 2025 May 16;104(20):e42508. doi: 10.1097/MD.0000000000042508.

ABSTRACT

Chronic kidney disease is a progressive condition, and serum creatinine (CR) levels are closely associated with the glomerular filtration rate, serving as a key indicator of renal function and disease progression. This study aimed to develop a smartphone-based colorimetric analysis system for the efficient and rapid quantification of serum CR and validate its performance to determine whether the method meets clinical testing standards. The CR standard solution was analyzed using a smartphone, and the R, G, and B values were plotted against the concentration. The precision, accuracy, detection limit, linear range, and clinically reportable range of the smartphone detection system were evaluated according to the National Committee for Clinical Laboratory Standards guidelines. Subsequently, 65 serum samples from healthy individuals and 26 serum samples from nephropathy patients were collected and tested using the smartphone system and an automated biochemical analyzer, respectively, to further validate the feasibility of the method. Among all the color channels, the G value showed the strongest correlation with CR concentration, and therefore was used to establish the standard curve. The validation of the assay system demonstrated that its precision and accuracy met clinical standards. The limit of blank, limit of detection, and limit of quantification were 29.95 μmol/L, 32.39 μmol/L, and 36.61 μmol/L, respectively. The linear range was 36.75 to 200.46 μmol/L, whereas the clinical reporting range spanned from 36.61 to 801.84 μmol/L. Furthermore, the results obtained from the 2 methods were statistically analyzed, revealing a strong correlation between the 2 sets of data. Smartphone-based serum CR testing meets clinical standards, and its portability and efficiency position it as a valuable tool for screening and monitoring chronic kidney disease.

PMID:40388728 | DOI:10.1097/MD.0000000000042508

Bioinformatics. 2025 May 19:btaf273. doi: 10.1093/bioinformatics/btaf273. Online ahead of print.

ABSTRACT

MOTIVATION: Genomic data sharing beacon protocol, developed by the Global Alliance for Genomics and Health (GA4GH), offers a privacy-preserving mechanism for querying genomic datasets while restricting direct data access. Despite their design, beacons remain vulnerable to privacy attacks. This study introduces a novel privacy vulnerability of the protocol: One can reconstruct large portions of the genomes of all beacon participants by only using the summary statistics reported by the protocol.

RESULTS: We introduce a novel optimization-based algorithm that leverages beacon responses and single nucleotide polymorphism (SNP) correlations for reconstruction. By optimizing for the SNP correlations and allele frequencies, the proposed approach achieves genome reconstruction with a substantially higher F1-score (70%) compared to baseline methods (45%) on beacons generated using individuals from the HapMap and OpenSNP datasets. We show that reconstructed genomes can be used by downstream applications such as in membership inference attacks against other beacons. Our findings reveal that beacons releasing allele frequencies substantially increases the reconstruction risk, underscoring the need for enhanced privacy-preserving mechanisms to protect genomic data.

AVAILABILITY AND IMPLEMENTATION: Our implementation is available at https://github.com/ASAP-Bilkent/Beacon-Reconstruction-Attack.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:40388204 | DOI:10.1093/bioinformatics/btaf273

Clin Transl Sci. 2025 May;18(5):e70222. doi: 10.1111/cts.70222.

ABSTRACT

Rational prescribing in geriatrics represents an important ethical as well as socio-economic issue. The aim of this project was to analyze the drug-related problems (DRPs) among the Czech nursing home residents and increase public awareness of further possible employment of clinical pharmacists in social care. The project was designed as a multicenter observational study. A total of 16 nursing homes and 800 participants with an average age of 84.6 ± 7.3 years were included in the study. Of them, a DRP was noted in 93.3% of people. The total amount of DRPs identified was 2215, which means an average of 2.8 ± 1.6 DRPs per patient. The most common DRPs identified were ‘overtreatment’ (19.5%), ‘undertreatment’ (12.8%), inappropriate dose (10.6%), recommendations for laboratory monitoring (10.4%) and adverse effects (10.3%). Of different drug classes, BZDs (OR 16.6, 95% CI 1.0-270.2), PPIs (OR 2.5, 95% CI 1.1-5.6) and NSAIDs (OR 4.4, 95% CI 1.1-18.3) were identified to be most commonly associated with DRPs. The risk of DRP identification clearly increased with the number of drugs used, with seven drugs demonstrated as the best cut-off for predicting DRP identification (AUC 0.842, sensitivity 0.602; specificity 0.796). ‘SENIOR’ project has confirmed a high rate of excessive polypharmacy among nursing home residents in the Czech republic resulting in high risk of potential and manifested DRPs. The project emphasized the role of clinical pharmacists in optimizing safety and effectiveness of treatment among older nursing home residents.

PMID:40388195 | DOI:10.1111/cts.70222

Reproduction. 2025 May 1:REP-25-0087. doi: 10.1530/REP-25-0087. Online ahead of print.

ABSTRACT

Superovulation is widely used to maximise oocyte/embryo yield in animal models. However, it has been implicated in disrupting normal follicular development, potentially affecting perifollicular angiogenesis. This study investigated the impact of superovulation on ovarian perifollicular neoangiogenesis using Light Sheet Fluorescence Microscopy (LSFM), and by quantitatively profiling the three-dimensional (3D) perifollicular capillary bed in murine antral follicles. Dioestrus CD1 mice received 2.5, 5.0, or 7.5 IU pregnant mare serum gonadotrophin (PMSG) intraperitoneally, and ovaries were collected 24 and 48 hours later, with those from normal cycling females (dioestrus, proestrus, oestrus) as controls. Ovaries were fixed and labelled with fluorescently tagged Wheat Germ Agglutinin lectin and CD34 to visualise the oocyte zona pellucida and thecal vasculature, respectively. Optically cleared samples were imaged using LSFM, and 3D volume rendering, vessel segmentation, and image analysis were performed using Arivis Vision 4D and Fiji. Quantitative metrics including vessel volume, length, branching, density, spatial arrangement and oocyte characteristics were profiled. Statistical analysis was based on Kruskal-Wallis tests. PMSG-induced superovulation showed dose-dependent effects on perifollicular vasculature, causing premature (24h) neoangiogenesis at 7.5 IU and reduced final (48h) vessel density at 2.5 IU compared to naturally cycling animals. Whereas the former may be a compensatory mechanism for reduced blood flow to individual follicles, the latter suggests an insufficient response to ovarian stimulation. By contrast, intrafollicular metrics were largely unaffected. This study provides the first comprehensive quantitative 3D analysis of thecal vasculature and oocytes in murine ovaries and highlights its potential applications in other areas of reproductive biology.

PMID:40388193 | DOI:10.1530/REP-25-0087