Nevin Manimala

J Craniofac Surg. 2025 Mar 17. doi: 10.1097/SCS.0000000000011247. Online ahead of print.

ABSTRACT

In this study, the authors proposed to determine the superiority or inferiority of the 3D fixation method and 2 miniplate fixation methods in mandibular angle fractures. The purpose of this study was to evaluate the efficacy of a 3D curved angle strut plate and 2 miniplates in mandibular angle fracture fixation. The aim of this study was to evaluate the efficacy of 3-dimension curved angle strut plate versus 2 miniplates in mandibular angle fracture fixation. Sixteen patients requiring internal fixation of the mandibular angle fractures divided into 2 groups 8 in each group, group I was treated with using 3D curved angle strut plate. Group II was treated using two 2-mm miniplates. The results of this study suggested that there are statistically significant in time elapsed between plate adaptation and definitive fixation (min) between 2 groups. The 3D curved angle plate has relatively few or no postoperative complications compared with other techniques.

PMID:40096592 | DOI:10.1097/SCS.0000000000011247

J Am Acad Orthop Surg Glob Res Rev. 2025 Mar 14;9(3). doi: 10.5435/JAAOSGlobal-D-25-00028. eCollection 2025 Mar 1.

ABSTRACT

INTRODUCTION: Asynchronous telemedicine has emerged as a promising tool for increasing access to care and triaging patients for evaluation in clinic. However, the role of asynchronous telemedicine in the delivery of orthopaedic oncologic care has yet to be determined. The purpose of this study was to evaluate response time for these electronic consults and characterize their triage outcomes.

METHODS: Two hundred sixty-eight patients whose clinical data were reviewed using asynchronous telemedicine by an orthopaedic oncologist at a tertiary academic medical center from May 2020 to August 2023 were retrospectively identified. Demographic and clinical information, response time to consult, and triage outcome were collected and reported with descriptive statistics. Response time to asynchronous consults was compared with wait time for patients referred directly for a synchronous telehealth appointment using the Mann-Whitney U test.

RESULTS: Most patients (71.6%) live more than 100 miles from the clinic. After initial asynchronous review, 131 patients (48.9%) were invited to schedule an in-person appointment, 42 (15.7%) of whom eventually underwent biopsy or surgery. Nonsurgical follow-up with repeat imaging in the future was recommended for 72 patients (26.9%). As-needed follow-up was suggested for 65 patients (24.2%). The average response time to asynchronous consult was 6.9 days (median 4.0, SD 7.9 days) compared with wait time of 17.0 days (median 13.0, SD 17.9 days) for synchronous telehealth visit (P < 0.01).

CONCLUSION: Asynchronous telemedicine can expedite triage of orthopaedic oncology patients and reduce unnecessary in-person visits, which may be particularly beneficial for those seeking care from far distances. Additional studies are needed to assess clinical outcomes and patient satisfaction with this approach to care delivery.

PMID:40096577 | DOI:10.5435/JAAOSGlobal-D-25-00028

J Am Acad Orthop Surg Glob Res Rev. 2025 Mar 14;9(3). doi: 10.5435/JAAOSGlobal-D-24-00390. eCollection 2025 Mar 1.

ABSTRACT

BACKGROUND: Achilles tendon rupture treatment has changed substantially in the past decade, with an evolution toward less-invasive techniques and more convenient patient positioning. This review aims to report on the 1-year clinical outcomes of a medially based, mini-open, supine, Achilles tendon repair technique.

METHODS: In this retrospective review, all patients who underwent surgical management of an Achilles tendon rupture were included and analyzed based on approach, including (1) standard open prone technique, (2) mini-open repair, prone, and (3) medial mini-open repair, supine. Primary outcomes were the Patient-Reported Outcome Measures Information Systems (PROMIS) Physical Function, PROMIS Pain Interference, and PROMIS Depression scores. Secondary outcomes of interest were surgical time and complications.

RESULTS: Seventy-eight patients were included in this study who underwent Achilles tendon repair and were seen in follow-up at least 1-year postoperatively. Demographics are displayed in Table 1. No statistical difference was observed regarding sex, laterality, age, and mechanism between those with 1-year follow-up data and those who were lost to follow-up before the 1-year mark. Primary outcomes were notable for statistically significant difference in the PROMIS Depression score between the mini-open repair, prone group, and the mini-open repair, supine group. The remainder of the primary outcomes of interest were not statistically significant. Secondary outcomes were notable for markedly shorter surgical time for the mini-open repair, supine group compared with both the standard open prone and mini-open repair, prone groups, with times being 89, 72, and 58 minutes, respectively. Surgical time was defined as starting from the time the patient was anesthetized in the room and included positioning and time up until extubation.

CONCLUSION: The medial mini-open repair, supine technique shows promise as a noninferior surgical option for acute Achilles tendon rupture repair with markedly decreased operating room time and 1-year outcomes with comparable results to both open and mini-open prone techniques.

PMID:40096573 | DOI:10.5435/JAAOSGlobal-D-24-00390

Clin J Oncol Nurs. 2025 Mar 14;29(2):157-164. doi: 10.1188/25.CJON.157-164.

ABSTRACT

BACKGROUND: Given the potential positive and negative impacts of cannabis use during cancer care, more information is needed to understand how changes in cannabis legalization and social norms have affected cannabis use and clinical disclosure among cancer survivors.

OBJECTIVES: The purpose of this research was to explore cannabis behaviors, disclosure, and information needs among cancer survivors.

METHODS: The study team conducted cross- sectional analyses using descriptive statistics to assess data collected via an online survey distributed through online health communities.

FINDINGS: This analysis included 719 participants, and most reported currently undergoing treatment. About one-third reported current cannabis use. Cannabis use varied across the cancer care continuum, and most of those using cannabis discussed their use with a healthcare provider and reported interest in receiving more information about cannabis.

PMID:40096564 | DOI:10.1188/25.CJON.157-164

Clin J Oncol Nurs. 2025 Mar 14;29(2):180-183. doi: 10.1188/25.CJON.180-183.

ABSTRACT

Gender minority groups, comprising individuals whose gender identity and/or expression differ from their sex assigned at birth, experience significant health disparities in the United States and abroad. Members of this popula.

PMID:40096563 | DOI:10.1188/25.CJON.180-183

Clin J Oncol Nurs. 2025 Mar 14;29(2):135-143. doi: 10.1188/25.CJON.135-143.

ABSTRACT

BACKGROUND: Patient-provider cost-of-care conversations are one method to decrease the burden of financial distress. However, providers have identified a lack of confidence in initiating these conversations and time constraints as barriers.

OBJECTIVES: To improve provider confidence and patient satisfaction in four oncology clinics, a practice improvement initiative was conducted to evaluate a patient-provider cost-of-care conversation protocol.

METHODS: Two physicians and four advanced practice providers implemented the protocol in their clinics. Twenty-three patients participated in cost conversations with their providers during a routine clinic visit. Seventeen patients agreed to complete a follow-up interview.

FINDINGS: Provider confidence with initiating cost-of-care conversations improved post-protocol implementation. Provider feedback reflected support for the protocol and new insight into patients’ struggles with treatment-related financial toxicity. Patients reported being highly satisfied when discussing treatment costs with their providers. Comments from patients reflected their appreciation that providers took the time to discuss their financial concerns.

PMID:40096558 | DOI:10.1188/25.CJON.135-143

Clin J Oncol Nurs. 2025 Mar 14;29(2):E52-E59. doi: 10.1188/25.CJON.E52-E59.

ABSTRACT

BACKGROUND: Antineoplastic drug (AD) exposure presents severe risks to healthcare workers. Previous studies have demonstrated that patient bathrooms are highly contaminated and have led to concern for excreta as a source of environmental contamination with ADs.

OBJECTIVES: This study assessed AD contamination and current cleaning practices to remove AD surface contamination in patient bathrooms.

METHODS: Three surfaces in the bathrooms of patients who had received etoposide and/or cyclophosphamide were sampled and analyzed for contamination at three time points. Liquid chromatography-tandem mass spectrometry was used for analysis. Interviews and observations of daily and discharge cleaning were conducted to understand cleaning practices.

FINDINGS: A significant reduction in etoposide contamination on toilets and floors was observed following discharge cleaning; however, no significant reduction was observed on walls for either AD or on floors for cyclophosphamide.

PMID:40096556 | DOI:10.1188/25.CJON.E52-E59

Clin Infect Dis. 2025 Mar 17:ciaf114. doi: 10.1093/cid/ciaf114. Online ahead of print.

ABSTRACT

BACKGROUND: As syphilis rates have increased globally, chancroid has dramatically declined as a cause of genital ulcer disease (GUD).

METHODS: We recruited patients ≥18 years presenting to an STI clinic with GUD from Lilongwe, Malawi from November 2019 – April 2022. Lesion exudates were tested by darkfield microscopy (DFM) and polymerase chain reaction (PCR) for Treponema pallidum (TP), and by PCR for Haemophilus ducreyi (HD), herpes simplex virus (HSV) and Chlamydia trachomatis (CT). We evaluated the sensitivity and specificity of DFM relative to TP PCR, the distribution of GUD etiologies by PCR, and the performance of our HD PCR relative to Allplex Genital Ulcer assay (Seegene Inc) using the Cohen’s kappa statistic.

RESULTS: We enrolled 568 participants; the median age was 27 years (interquartile range: 23, 34), 61% (345/564) were men, and 13% (60/464) were living with HIV or newly diagnosed with HIV. DFM identified TP in 55 (10%) of participants, with a sensitivity and specificity of 12% and 94%, respectively. PCR identified TP in 367 (65%), HD in 128 (23%), HSV in 98 (17%), and CT in 36 (6%) of participants with only 1/36 (2.8%) with serovar L1, L2 or L3 consistent with lymphogranuloma venereum; no etiology was identified in 48 (8%). External validation confirmed the high HD prevalence (Cohen’s kappa 0.78, 89% agreement).

CONCLUSION: Syphilis and chancroid are common etiologies of GUD in Malawi. Our findings underscore the value of highly sensitive molecular diagnostic methods to periodically assess GUD causes among STI patients in countries using syndromic management.

PMID:40096547 | DOI:10.1093/cid/ciaf114

Int J Med Mushrooms. 2025;27(2):13-37. doi: 10.1615/IntJMedMushrooms.2024057053.

ABSTRACT

Current drug policy classifies psilocybin, a compound found in psychoactive mushrooms, as having high abuse potential while overlooking its therapeutic properties. We evaluated the risk of psilocybin mushrooms to Brazilian public health compared to other toxic agents and assessed the need for regulatory discussions. This retrospective cross-sectional study followed STROBE guidelines, using data from the Notifiable Diseases Information System (SINAN) on adverse events reported from 2007 to 2022. Participants were categorized into a general drug abuse group, which was further divided into psilocybin and unknown mushroom subgroups. Clinical outcomes included non-hospitalization, hospitalization, and death, with associations analyzed via the Chi-square test. Out of 112,451 individuals seeking medical attention for drug abuse-related events, men predominated (n = 79,514; 70.7%), with alcohol being the primary agent (n = 71,824; 49.2%). The psilocybin mushroom group included 13 participants, and the unknown mushroom group included 51. Hospitalization rates were 19.5% (n = 21,923) for drug abuse, 46.2% (n = 6) for psilocybin mushrooms (0.02% of all hospitalizations) (99% CI: 10.6%-81.6%), and 23.5% (n = 12) for unknown mushrooms (99% CI: 8.3%-38.7%). Mortality was 1.8% (n = 2035) for drug abuse group, with no fatal events in the psilocybin or unknown mushroom groups. Deaths were mainly linked to cocaine (33.3%). These findings suggest a low risk for psilocybin mushrooms, though underreporting may be a factor. This study underscores the need for evidence-based regulatory discussions to ensure safe access to psilocybin for clinical and ceremonial use.

PMID:40096533 | DOI:10.1615/IntJMedMushrooms.2024057053

Int J Oral Maxillofac Implants. 2025 Mar 17;0(0):1-31. doi: 10.11607/jomi.11079. Online ahead of print.

ABSTRACT

PURPOSE: The objective of this study is to evaluate the effects of gradually and non-gradually surface-roughened dental implants with identical macro-design and anodized surface topography on osteogenic differentiation in vitro in three-dimensional cell culture.

MATERIALS AND METHODS: The study compared two groups of implants, gradually (TiUltra) and non-gradually (TiUnite) anodized surfaces. Mouse-derived bone marrow stem cells (MSCs) were cultivated up to passage three. Subsequently, the GelXA BONE bioink, which had been homogeneously combined with the cells, was transferred into poly-lactic acid cages that had been previously rinsed in phosphate-buffered saline. To assess cell viability and proliferation, metabolic activity was measured. The adhesion of cells was evaluated through the use of a DNA-binding probe. The expression of osteogenic differantiation genes was analysed through quantitative polymerase chain reaction (qPCR) analysis on days 7, 14, and 21. The osteogenic gene expression markers were Type-I collagen, fibronectin, alkaline phosphatase (ALP), osteopontin (OSP), osteocalcin (OC), with ß-Actin serving as the housekeeping gene.

RESULTS: No statistically significant differences were observed in cell viability and proliferation values. Nevertheless, the qPCR values for osteogenic differentiation markers were notably elevated in the TiUltra group comparison to both theTiUnite and the control groups (p< 0.05). ALP values were significantly lower in the TiUltra group (p< 0.05).

CONCLUSIONS: It can be concluded that the TiUltra surface demonstrated higher osteogenic gene expression than the TiUnite surface. However, further experimental and clinical studies are required.

PMID:40096517 | DOI:10.11607/jomi.11079