Nevin Manimala

Naunyn Schmiedebergs Arch Pharmacol. 2025 Dec 17. doi: 10.1007/s00210-025-04889-z. Online ahead of print.

ABSTRACT

Changing lifestyles and the rising incidence of lifestyle diseases are causing people to increasingly turn to dietary supplements, often perceived as therapeutic measures aimed at maintaining or improving health. Although supplements cannot be marketed for the treatment or prevention of disease, many people assume they will improve health, alleviate the course of illness, or, for example, delay the aging process. Unfortunately, this is not true. Furthermore, people around the world often choose to treat illnesses with supplements instead of consulting with specialists and undergoing appropriate treatment. Information on supplement safety and some common interactions with drugs and food was gathered based on an analysis of numerous websites, databases, and publications. This analysis presents statistical data, current legal regulations, the advantages and disadvantages of supplementation, and highlights the importance of supplement control. It turns out that manufacturers are generally exempt from conducting costly and lengthy clinical trials by classifying their products as dietary supplements. This misinformation prevents consumers from making informed decisions about their use. Educating the public about the safety, benefits, and risks of dietary supplements is crucial. These topics should serve as a starting point for a broader discussion about the need for quality control and access to safe dietary supplements. Raising public awareness of healthcare in its broadest sense is crucial.

PMID:41405711 | DOI:10.1007/s00210-025-04889-z

Eur Radiol. 2025 Dec 17. doi: 10.1007/s00330-025-12201-z. Online ahead of print.

NO ABSTRACT

PMID:41405694 | DOI:10.1007/s00330-025-12201-z

Eur Radiol. 2025 Dec 17. doi: 10.1007/s00330-025-12171-2. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate deep-learning (DL) model accuracy in quantifying multifidus (MF) and erector spinae (ES) fat fraction (FF) compared to Dixon MRI, and to explore the indirect effect of muscle function between muscle degeneration and disability outcomes in chronic low back pain (CLBP).

MATERIALS AND METHODS: 96 CLBP and 86 healthy participants underwent 3 T MRI, muscle function assessment, Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), and Short Form 36-Health Survey (SF-36). A DL-Otsu thresholding model quantified muscle FF and functional muscle volume from 3D T2_WI images, validated against Dixon-FF. Lin’s concordance correlation coefficient (CCC), Bland-Altman, and Passing-Bablok analyses assessed the concordance between Otsu-FF and Dixon-FF. Partial correlations and mediation analysis examined associations among muscle degeneration, muscle function, and disability outcomes.

RESULTS: Otsu-FF showed agreement with Dixon-FF (MF: CCC = 0.96, 95% CI: 0.95, 0.97; ES: CCC = 0.95, 95% CI: 0.94, 0.96; bias: MF = 0.009; ES = 0.021). Partial correlations revealed MF and ES FF correlated with disability scores (ODI/RMDQ: r = 0.25 to 0.49; SF-36: r = -0.42, -0.28, p < 0.01). Muscle endurance negatively correlated with ODI (r = -0.57, 95% CI: -0.65, -0.45) and RMDQ (r = -0.49, 95% CI: -0.61, -0.35), positively with SF-36 (r = 0.51, 95% CI: 0.38, 0.63) (p < 0.01). Muscle endurance showed indirect effects on associations between muscle FF and disability outcomes (mediation proportion: 27.12% to 100%).

CONCLUSION: DL method accurately quantified muscle FF, closely matching Dixon results. Muscle FF correlated with disability outcomes in CLBP, with muscle endurance demonstrating a statistically indirect association within this relationship.

KEY POINTS: Question What are the associations between the deep learning-derived paraspinal muscle degeneration index, muscle function, and lumbar disability outcomes among patients with chronic low back pain? Findings In chronic low back pain, deep learning-quantified higher fat fraction of paraspinal muscles correlated with worse lumbar disability outcomes, with muscle endurance demonstrating an indirect effect in this association. Clinical relevance Incorporating the fat fraction of multifidus and erector spinae muscles and muscle endurance assessment is helpful for targeting rehabilitation training in chronic low back pain, improving disability outcomes.

PMID:41405693 | DOI:10.1007/s00330-025-12171-2

Pediatr Blood Cancer. 2025 Dec 17:e70067. doi: 10.1002/1545-5017.70067. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to explore the dynamic alterations of T helper 17 (Th17) cells, regulatory T (Treg) cells and regulatory B (Breg) cells in children with persistent immune thrombocytopenia (ITP).

METHODS: A prospective cohort study was conducted involving 34 children with persistent ITP and 30 age- and sex-matched healthy controls. Peripheral blood samples were collected at baseline and 3 months post-treatment. T helper 17 and Treg cells were quantified as percentages of CD3⁺CD4⁺ T lymphocytes, and Breg cells as a percentage of CD19⁺ B lymphocytes using BD FACSDx Flex flow cytometry. All patients received standard first-line treatment with intravenous immunoglobulin and prednisone, and response was evaluated after 3 months.

RESULTS: At baseline, children diagnosed with ITP exhibited a pronounced imbalance in immune cell subsets compared with age- and sex-matched healthy controls. Specifically, Th17 cell levels and the Th17/Treg ratio were significantly elevated (7.81% ± 3.13% vs. 3.30% ± 1.51% and 1.23 ± 0.72 vs. 0.44 ± 0.23, respectively; both p < 0.001), indicating a proinflammatory immune profile. In contrast, the frequencies of immunosuppressive Treg and Breg cells were notably decreased (6.80% ± 1.75% vs. 8.03% ± 1.14%, p = 0.026; 3.10% ± 2.00% vs. 6.61% ± 1.69%, p < 0.001). After 3 months of standardised treatment, no statistically significant changes were observed in the levels of these immune cell subsets or the Th17/Treg ratio compared with pre-treatment values. Clinically, 73.5% achieved a complete response, 20.6% achieved a partial response, and 5.9% showed no response.

CONCLUSION: Both Th17/Treg cell imbalance and Breg cell deficiency contribute to the pathogenesis of persistent ITP in children. Concurrent monitoring of these immune subsets may aid in immunophenotyping, and their potential role as biomarkers for treatment outcomes warrants further investigation.

PMID:41404740 | DOI:10.1002/1545-5017.70067

Pediatr Blood Cancer. 2025 Dec 17:e70065. doi: 10.1002/1545-5017.70065. Online ahead of print.

ABSTRACT

BACKGROUND: The prevalence and clinical correlates of symptoms of anxiety and depression in pediatric patients with brain tumors are not well described. We aimed to identify clinical characteristics that are correlated with elevated symptoms of anxiety and depression following initial diagnosis.

PROCEDURE: Pediatric patients diagnosed with a brain tumor at Texas Children’s Hospital from 2012 to 2019 were enrolled. Using the parent-proxy report form of the BASC-2, patients were assessed for symptoms of anxiety and depression within 6 months of diagnosis. Correspondence analysis was applied to determine the correlation values (r) for anxiety and depression; r ≥ 0.71 was considered statistically significant as it explained at least 50% of the shared variance.

RESULTS: All patients (n = 149, mean age = 9 years [range 3-18], 56% male) underwent a tumor-directed surgery or biopsy. Overall, 24% (n = 35) of patients had elevated symptoms of anxiety, and 15% (n = 22) had elevated symptoms of depression. There was a strong correlation between elevated anxiety symptoms and surgical resection alone (r = 0.96), surgery plus chemotherapy (r = 0.86), and infratentorial tumors (r = 1.00). Elevated depression symptoms correlated with a diagnosis of low-grade glioma (r = 1.00), infratentorial tumors (r = 0.76), and low global intellectual functioning (r = 0.81).

CONCLUSIONS: Treatment type, tumor histology, tumor location, and global intellectual functioning are significantly associated with anxiety and depression symptoms in children with brain tumors close to the time of diagnosis. These findings may inform the provision of screening and supportive services to these high-risk groups.

PMID:41404737 | DOI:10.1002/1545-5017.70065

Ecol Food Nutr. 2025 Dec 17:1-22. doi: 10.1080/03670244.2025.2602593. Online ahead of print.

ABSTRACT

In this systematic review and meta-analysis, we examined how gender inequality influences undernutrition among Indian children across varying social structures. Studies on rural and urban patrilineal and matrilineal communities reporting the prevalence of undernutrition in children were included, following PRISMA 2020 guidelines. We conducted three random-effects meta-analyses to estimate the relative risk (RR) of undernutrition, with boys as the control and girls as the intervention group. In total, 58 articles (73,910 children) were analyzed and classified into three categories, i.e., urban tribal and non-tribal (n = 11), rural non-tribal (n = 13), and rural tribal (n = 34). We found that gender disparity in undernutrition is locale- and population-specific, with girls from rural tribal communities experiencing a higher risk (RR 1.062) than their rural non-tribal and urban counterparts.

PMID:41404703 | DOI:10.1080/03670244.2025.2602593

J Nurs Scholarsh. 2025 Dec 17:e70059. doi: 10.1111/jnu.70059. Online ahead of print.

ABSTRACT

BACKGROUND: Stroke is a global health concern. A timely response to a stroke can help reduce morbidity and mortality. However, barriers to timely response include poor recognition of stroke symptoms. Stroke symptom messages are designed to increase stroke recognition and encourage individuals to seek urgent medical assistance. The Face, Arm, Speech, Time (FAST) and Balance, Eyes, Face, Arm, Speech, Time (BE FAST) are commonly used stroke symptom messages shown to improve stroke symptom recognition and response. However, cultural factors and language differences may limit the effectiveness of stroke symptom messages and their acceptability in different countries and contexts. There has not been a comprehensive examination of the stroke symptom messages used worldwide and how these messages have been adapted in various settings.

AIMS: We explored what stroke response messages are being used globally, and the contextual factors that influence the adoption of a stroke response mnemonic in different settings.

METHODS: A 14-item survey was disseminated by the World Stroke Organization to its networks. The survey contained open- and closed-ended questions and allowed uploading relevant stroke symptom campaign materials. The survey was analyzed using descriptive statistics and a content analysis.

RESULTS: All except one survey respondent used a stroke symptom message. Fifteen respondents (27%) reported they did not translate their stroke awareness messaging. Of these 15 respondents, they used the English versions of FAST (n = 8), BE FAST (n = 4), and both FAST and BE FAST (n = 3). Forty respondents (71%) reported that they/their organization used an acronym to raise public awareness of the signs/symptoms of stroke that was different from FAST or BE FAST (English), many of which were direct or indirect translations or influenced by FAST and BE FAST. Survey responses shared insights and recommendations related to the content, tailoring and dissemination of stroke symptom messages.

CONCLUSIONS: Study findings highlight the global use of stroke symptom messages and their contextual adaptations to fit diverse settings and contexts. The challenges in applying universal or commonly used stroke symptom messages to different contexts were highlighted.

CLINICAL RELEVANCE: Nurses could have a key role in raising awareness of stroke symptoms and the development of locally adapted stroke symptom messages.

PMID:41404701 | DOI:10.1111/jnu.70059

Folia Med Cracov. 2025 Sep 30;65(3):141-160. doi: 10.24425/fmc.2025.156690.

ABSTRACT

INTRODUCTION: The burden on caregivers of chronically ill patients is a subject of concern for many specialists. The course of multiple sclerosis and the associated change in the patient’s functional ability, as well as the resources available to the caregiver, are related to the burden felt by the caregiver. It is extremely important in relation to the care provided to assess the factors that may determine the burden on caregivers. The aim of this study was to identify selected determinants of burden on caregivers of multiple sclerosis patients.

MATERIAL AND METHODS: A diagnostic survey was conducted among 107 caregivers of multiple sclerosis patients using the CBS Caregiver Burden Scale, Guy’s Neurological Disability Scale (GNDS), Berlin Social Support Scale (BSSS), Antonovsky’s SOC-29 Life Orientation Questionnaire, and the author’s own questionnaire. The collected survey data were entered into a Microsoft Excel spreadsheet and then analyzed using Statistica 13 software. The level of statistical significance was adopted as α = 0.05.

RESULTS: The burden on caregivers was high in all subscales. Life orientation and social support were associated with the burden on caregivers. Low life orientation, decreasing perceived available support and currently provided support, as well as a shortage of currently received support and increased search for support resulted in a higher overall burden among caregivers. In addition, deteriorating functioning of patients exacerbated the caregivers’ feelings of social isolation, disappointment, and emotional involvement.

CONCLUSIONS: Caregivers experienced burdens in various dimensions related to the functional ability of patients and their own resources, such as social support and life orientation.

PMID:41404690 | DOI:10.24425/fmc.2025.156690

Folia Med Cracov. 2025 Sep 30;65(3):85-100. doi: 10.24425/fmc.2025.156686.

ABSTRACT

INTRODUCTION: Population aging is associated with increased problems of physical and functional fitness in geriatric patients. Fitness constitutes a key element of independence and quality of life in elderly individuals. The proprioceptive neuromuscular facilitation (PNF) method is widely used in orthopedic and neurological rehabilitation; however, there is a lack of research on its comprehensive application in elderly patients in hospital settings.

OBJECTIVE: To assess the impact of the PNF concept on independence in elderly individuals and to compare the effectiveness of the PNF method with general rehabilitation (GR) during a maximum 10-day hospital treatment.

MATERIAL AND METHODS: The study included 80 randomly selected patients over 64 years of age hospitalized in the Department of Internal Medicine and Geriatrics. Patients were randomly divided into two 40-person groups: GR and PNF. Functional fitness assessment was conducted at the beginning of rehabilitation and after a maximum of 10 days of therapy or on the day of discharge. The following were used: ADL assessment, IADL, Up & Go test, SPPB test, balance assessment, gait speed measurement, 5-times sit-to-stand test, and NRS scale.

RESULTS: Patients rehabilitated according to the PNF concept achieved statistically significantly greater improvement in functional and physical fitness compared to the GR group.

CONCLUSIONS: The PNF method in elderly individuals allows for more effective achievement of the main goal of rehabilitation, which is reaching maximum patient independence.

PMID:41404686 | DOI:10.24425/fmc.2025.156686

Folia Med Cracov. 2025 Sep 30;65(3):71-83. doi: 10.24425/fmc.2025.156685.

ABSTRACT

BACKGROUND: Core stability allows to control and properly perform movements of all body. Optimal core stability level depends on deep muscles capacity and neuromuscular control. Poor core stability is a risk factor for injury, especially during physical activity.

OBJECTIVE: The purpose of this study was to examine the differences in core stability between sport and recreational horse riders and people, who don’t do any sports. We hypothesized that horse riders demonstrate better core stability performance.

METHODS: 75 people aged 15-30 (20 recreational horse riders, 20 sport horse riders and 35 non-horse riders) was examined in 4 core stability tests. Individuals were assigned to each group based on authors questionnaire. Differences between groups were assessed by analysis of variance (ANOVA).

RESULTS: The study showed that sport horse riders have the best core stability. Recreational riders, who trained for shorter periods of time obtained much lower results in each test. The non-horse rider group demonstrated the worst results. There was no statistically significant relationship between the frequency of equestrian training and tests results.

CONCLUSIONS: Horse riding increases core stability and has a positive effect on all its parameters. The longer the equestrian training, the better core stability.

PMID:41404685 | DOI:10.24425/fmc.2025.156685