Nevin Manimala

J Orthop Traumatol. 2025 Jun 21;26(1):38. doi: 10.1186/s10195-025-00849-8.

ABSTRACT

PURPOSE: To investigate the effect of arthroscopic reduction combined with robot-guided screw placement on Hawkins type II fractures of the talus neck.

METHODS: Clinical data from 42 patients with talus neck Hawkins type II fracture treated in the institution from November 2019 to January 2021 were selected. According to the blind envelope method, 21 patients were enrolled in the study group, and 21 patients were enrolled in the control group. The patients in the study group underwent arthroscopy-assisted reduction combined with orthopedic robot navigation screw placement surgery, while those in the control group underwent open reduction surgery.

RESULTS: All 42 patients were followed up. The patients in the study group were followed up for a mean of 14.76 (range, 12-17) months. No talus avascular necrosis or fracture nonunion were observed. Subtalar arthritis was reported in two cases. Patients in the control group were followed up for an average of 14.52 (ranging from 12 to 17) months, and no talus avascular necrosis or fracture nonunion was found. Incisional infection occurred in one case and subtalar arthritis in three cases. The difference between the two groups was statistically significant (P < 0.05) in the duration from injury to surgery, operation time, blood loss, incision length, and number of guide pin insertions. There was no significant difference between the two groups in ankle joint range of motion, the American Orthopedic Foot and Ankle Society ankle-hindfoot score at the last follow-up, and visual analogue scale of pain before operation and at the last follow-up (P > 0.05).

CONCLUSIONS: The management of Hawkins type II fracture of the talus neck using arthroscopy-assisted reduction combined with robot navigation screw placement yields satisfactory results and represents a viable treatment alternative that warrants consideration.

PMID:40542971 | DOI:10.1186/s10195-025-00849-8

Int Urol Nephrol. 2025 Jun 21. doi: 10.1007/s11255-025-04604-0. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the feasibility and safety of robot-assisted partial nephrectomy (RAPN) to treat large (T2) cystic renal-cell carcinoma.

METHODS: A multinational study was conducted worldwide. Patients with renal tumors larger than 7cm who underwent partial nephrectomy between December 2007 and July 2017 were recruited retrospectively. The patients were divided into solid tumor group (143 cases) and cystic tumor group (28 cases). Baseline parameters, tumor characteristics, perioperative variables, and pathological outcomes were collected.

RESULTS: Between cystic and solid tumors, no statistically significant differences were detected in age, gender, BMI, ASA score, clinical tumor size, laterality, or R.E.N.A.L nephrometry score. Operating time, warm ischemic time, estimated blood loss, complications, histology outcomes, and margin status were comparable. Pathology of 6 cystic tumors came back benign (21.4%). In solid tumors, 6 intraoperative bleeding require transfusion, 1 ureteral damage, and 3 postoperative urinary fistulas were observed. In cystic tumors, conversion to radical nephrectomy happened in one case, because of sticky fat and the risk of cyst rupture. In two cases, postoperative bleeding was treated with embolism. The longest follow-up was 113 months. In cystic group, 1 recurrence or metastasis was observed, while in solid group, 14 cases were observed.

CONCLUSION: RAPN can be safely performed to treat large (T2) cystic renal-cell carcinoma. Patients with cystic renal-cell carcinoma exhibited favorable renal function recovery after robot-assisted partial nephrectomy (RAPN), which maximally preserved normal renal tissue and its function. Further studies are needed to better understand the role of RAPN for these challenging cases.

PMID:40542967 | DOI:10.1007/s11255-025-04604-0

Behav Genet. 2025 Jun 21. doi: 10.1007/s10519-025-10224-2. Online ahead of print.

ABSTRACT

Meta-analyses report small to moderate effect sizes or inconsistent associations (usually around r = -0.10) between wellbeing (WB) and social media use (SMU) and between anxious-depressive symptoms (ADS) and SMU (also around r = 0.10). This study employs the classical twin design, utilizing data from 6492 individuals from the Netherlands Twin Register, including 3369 MZ twins (893 complete twin pairs, 1583 incomplete twin pairs) and 3123 DZ twins (445 complete, 2233 incomplete) to provide insights into the sources of overlap between WB/ADS and SMU. Both hedonic and eudaimonic WB scales were used. SMU was measured by (1) the time spent on different social media platforms (SMU_t), (2) the frequency of posting on social media (SMU_f), and (3) the number of social media accounts individuals have (SMU_n). Our results confirmed the low phenotypic correlations between WB and SMU (between r = -0.09 and 0.04) as well as between ADS and SMU (between r = 0.07 and 0.10). For SMU, heritability estimates between 32 and 72% were obtained. The small but significant phenotypic correlations between WB/ADS and the SMU phenotypes were mainly determined by genetic factors (in the range of 80-90%). For WB and SMU, genetic correlations were between -0.10 and -0.0, and for ADS and SMU genetic correlations were between 0.10 and 0.23. Genetic correlations implied limited but statistically significant sets of genes that affect WB/ADS and SMU levels. Overall, the results indicate that there is evidence that the small associations between WB/ADS and SMU are partly driven by overlapping genetic influences. We encourage researchers and experts to consider more personalized approaches when considering the association between WB and SMU, as well as understanding the reasons for individuals’ observed SMU levels.

PMID:40542957 | DOI:10.1007/s10519-025-10224-2

J Neurooncol. 2025 Jun 21. doi: 10.1007/s11060-025-05105-x. Online ahead of print.

ABSTRACT

PURPOSE: In brain gliomas, non-invasive biomarkers reflecting tumor cellularity would be useful to guide supramarginal resections and to plan stereotactic biopsies. We aim to validate a previously-trained machine learning algorithm that generates cellularity prediction maps (CPM) from multiparametric MRI data to an independent, retrospective external cohort of gliomas undergoing image-guided biopsies, and to compare the performance of CPM and diffusion MRI apparent diffusion coefficient (ADC) in predicting cellularity.

METHODS: A cohort of patients with treatment-naïve or recurrent gliomas were prospectively studied. All patients underwent pre-surgical MRI according to the standardized brain tumor imaging protocol. The surgical sampling site was planned based on image-guided biopsy targets and tissue was stained with hematoxylin-eosin for cell density count. The correlation between MRI-derived CPM values and histological cellularity, and between ADC and histological cellularity, was evaluated both assuming independent observations and accounting for non-independent observations.

RESULTS: Sixty-six samples from twenty-seven patients were collected. Thirteen patients had treatment-naïve tumors and fourteen had recurrent lesions. CPM value accurately predicted histological cellularity in treatment-naïve patients (b = 1.4, R² = 0.2, p = 0.009, rho = 0.41, p = 0.016, RMSE = 1503 cell/mm²), but not in the recurrent sub-cohort. Similarly, ADC values showed a significant association with histological cellularity only in treatment-naive patients (b = 1.3, R² = 0.22, p = 0.007; rho = -0.37, p = 0.03), not statistically different from the CPM correlation. These findings were confirmed with statistical tests accounting for non-independent observations.

CONCLUSION: MRI-derived machine learning generated cellularity prediction maps (CPM) enabled a non-invasive evaluation of tumor cellularity in treatment-naïve glioma patients, although CPM did not clearly outperform ADC alone in this cohort.

PMID:40542949 | DOI:10.1007/s11060-025-05105-x

Anat Sci Int. 2025 Jun 21. doi: 10.1007/s12565-025-00855-0. Online ahead of print.

ABSTRACT

The vertebral artery (VA) supplies almost one-third of the blood flow to the brain, contributing mainly to its posterior circulation. This article provides a comprehensive overview of the different anatomical variations related to the origin, course, and termination of the VA and associated clinical implications. Data were compiled from numerous published studies accessed from the databases Medline, Scopus, Web of Science, Google Scholar, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Literature in Health Sciences (LILACS) as of January 2024. Methodological quality was evaluated with an assurance tool for anatomical studies (AQUA). Pooled prevalence was estimated using a random effects model, and differences in VA variant rates were assessed. VA variants were identified that could be separated into three categories: variation in origin, course, and terminal branches. A total of 16 studies met the established selection criteria for the current meta-analysis. VA variations were reported at an overall prevalence of 11% (CI: 7%-15%) and a heterogeneity of 77%. Statistically significantly higher rates were revealed in the following subgroups of the sample: imaging examinations versus cadavers (p = 0.032); right side of the body versus left (p = 0.034); and bilaterally versus unilaterally (p = 0.019). Concerns listed in included studies primarily focused on the possibility of iatrogenic damage during surgical procedures. A few studies also indicated higher rates of VA variants in patients who reported symptoms of recurrent headaches, vertigo, dizziness, and/or syncope. The presence of VA variants is high and can occur in various regions. However, the most important clinical consideration is that individuals with this variant must be constantly monitored since their posterior cerebral circulation could be affected. To avoid iatrogenic damage to the VA, clinicians should employ medical imaging to evaluate its course and branches prior to surgical interventions in the region.

PMID:40542940 | DOI:10.1007/s12565-025-00855-0

Neurosurg Rev. 2025 Jun 21;48(1):524. doi: 10.1007/s10143-025-03674-z.

ABSTRACT

The transpedicular screw placement has been the gold standard for over a decade in treating degenerative diseases of the lumbo-sacral spine related to vertebral instability. The evolution of neuronavigation and robotic surgery has mitigated many perioperative complications such as mispositioning, vascular damage, and nerve structure injuries, leading to enhanced postoperative outcomes, reduced blood loss, and decreased intraoperative radiation exposure. Our study proposes a multicenter comparison between robotic surgery and neuronavigation for treating degenerative diseases of the lumbo-sacral spine. We conducted a retrospective analysis at Papardo Hospital in Messina and Garibaldi Hospital in Catania, examining a consecutive series of 76 patients treated for degenerative diseases of the lumbo-sacral spine between March 2024 and December 2024 using the Excelsius GPS Robot and neuronavigation with the O-arm. We evaluated each procedure based on age, sex, body mass index, number of involved metameres, number of screws placed, operative times, estimated blood loss (EBL), radiation exposure, type of anesthesia, accuracy (using the Gertzbein and Robbins scale), and then compared various pre- and postoperative parameters through univariate statistical analysis. Patients were randomly assigned in a 1:1 ratio using a computer-generated sequence with permuted blocks of variable size (4-6). This ensured balanced allocation and minimized selection bias. A detailed statistical plan has been included: continuous variables were assessed using Student’s t-test or Mann-Whitney U test depending on distribution (Shapiro-Wilk test), while categorical variables were evaluated with Chi-square or Fisher’s exact test as appropriate. 48 out of 76 patients (average age 60.47 years) underwent pedicle screw placement via robotic surgery, and 28 patients (average age 65.92 years) via neuronavigation surgery. Robotic surgery showed comparable results to neuronavigation surgery in terms of blood loss. Additionally, functional outcomes, especially those evaluated with the ODI scale and VAS scale, were similar between the two patient groups. Despite a reported mispositioning rate of 2.2% in neuronavigation surgery, no clinical impact was observed in these specific cases. The surgical procedures included both decompression (laminectomy with partial facetectomy) and fusion in all patients. Operative time was recorded as skin-to-skin time, excluding anesthesia induction and positioning. Patients with prior surgeries at the index level, complex spinal deformities (Cobb angle > 30°), or revision surgeries were excluded from this study. The included diagnoses were degenerative disc disease (RS: 56%, NS: 52%), spinal stenosis (RS: 28%, NS: 31%), spondylolisthesis (RS: 12%, NS: 14%), and traumatic pathology (RS: 4%, NS: 3%). While there was a trend towards greater precision in screw placement with robotic technology, no significant difference was observed compared to neuronavigation with the O-arm. Both technological systems used in instrumented spinal surgery appear safe and effective. However, they present a steep learning curve, and various technical aspects of these systems are continuously reassessed to improve operational efficiency and achieve these objectives.

PMID:40542927 | DOI:10.1007/s10143-025-03674-z

Ir J Med Sci. 2025 Jun 21. doi: 10.1007/s11845-025-03988-3. Online ahead of print.

ABSTRACT

INTRODUCTION: ECG is a frequently used and easily accessible diagnostic tool used to evaluate cardiac involvement in hyperkalemia patients.

OBJECTIVE: The present study aimed to investigate the mortality prediction potential of the frontal QRS-T angle in hyperkalemia patients and the effects of the treatment process on this angle.

METHOD: The study was planned as a prospective study. A total of 121 hyperkalemia patients were included in the study. Conditions that caused high potassium were identified and the PR, QRS, QT, QTc, and frontal QRS-T angle were calculated and recorded from the 12-lead ECG recordings of the patients at the time of admission to the emergency room.

RESULTS: The mean age of the patients was 58.5 ± 9.2 years (median: 59), 63 (% 52.1) were female and 58 (% 47.9) were male. The second measurements of the ECG parameters PR, QTc, QRS, T-amplitude, T duration, and frontal QRS-T values were lower than the first measurements (p < 0.001; p = 0.007; p < 0.001; p < 0.001; p < 0.001; p = 0.006, respectively). The ability of the patient’s ECG parameters PR, QT, QTc, QRS, T-amplitude, frontal QRS-T angle, and frontal QRS-T (absolute value) to predict the development of mortality In the ROC Curve analysis, it was found that these parameters did not have a statistically significant effect in predicting mortality.

CONCLUSION: As well as known ECG findings, in cases of hyperkalemia, widening of the frontal QRS-T angle and correction of this widened angle in patients with normokalemia detected with treatment can be used as an important follow-up parameter.

PMID:40542911 | DOI:10.1007/s11845-025-03988-3

Neurosurg Rev. 2025 Jun 21;48(1):522. doi: 10.1007/s10143-025-03611-0.

ABSTRACT

Traumatic brain injury (TBI) is a significant public health issue, with 30% to 50% of patients developing post-traumatic hydrocephalus (PTH). This condition can elevate intracranial pressure, leading to headaches, vomiting, altered consciousness, and potentially coma or death, severely impacting quality of life. This study aims to systematically evaluate risk factors associated with PTH following TBI. The authors searched PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials for studies published from 2000 to 2024. Data extraction was standardized, and statistical analysis was performed using State 14.0 software. We assessed the risk of bias and compared patient characteristics, using fixed or random effects models to summarize PTH risk factors, calculating pooled odds ratios (OR) and 95% confidence intervals (CI). A total of 25 studies involving 1,383,328 TBI patients met the inclusion criteria. Significant factors associated with an increased risk of PTH included decompressive craniectomy (DC) (p < 0.001), intraventricular hemorrhage (IVH) (p = 0.016), lower Glasgow Coma Scale (GCS) scores (p < 0.001), subdural hematoma (p < 0.001), postoperative meningitis (p = 0.027), external ventricular drainage (EVD) (p < 0.001), traumatic subarachnoid hemorrhage (SAH) (p < 0.001), and epidural hematoma (p < 0.001). Age was not significantly correlated with PTH. Identifying these risk factors (DC, IVH, GCS, subdural hematoma, postoperative meningitis, external ventricular drainage, traumatic SAH, and epidural hematoma) highlights the importance of close monitoring in TBI patients. This approach aims to enable early identification of PTH and reduce its incidence, ultimately improving survival outcomes and long-term prognosis for TBI patients.

PMID:40542903 | DOI:10.1007/s10143-025-03611-0

Eur Phys J E Soft Matter. 2025 Jun 21;48(6-7):33. doi: 10.1140/epje/s10189-025-00498-z.

ABSTRACT

The most studies on the stability of foam bubbles investigated the mechanical stability of thin films between bubbles due to the drainage by gravity. In the current work, we take an alternative approach by assuming the rupture of bubbles as a series of random events and by investigating the time evolution of the size distribution of foam bubbles over a long time up to several hours. For this purpose, we first prepared layers of bubbles on Petri dishes by shaking soap solutions of a few different concentrations, and then we monitored the Petri dishes by using a time-lapse video imaging technique. We analyzed the captured images by custom software to count the bubble size distribution with respect to the initial concentration and elapsed time. From the statistics on our data, we find that the total bubble volume decreases exponentially in time, and the exponent, i.e., the mean lifetime, is a function of the bubble size. The mean lifetimes of larger bubbles are observed to be shorter than those of smaller bubbles, by approximately a factor of 2.

PMID:40542902 | DOI:10.1140/epje/s10189-025-00498-z

Vet Res Commun. 2025 Jun 21;49(4):232. doi: 10.1007/s11259-025-10801-0.

ABSTRACT

Avian colibacillosis, caused by avian pathogenic Escherichia coli (APEC), represents a major threat to the poultry industry, leading to significant economic losses. This study aimed to characterize selected biofilm-producing APEC strains isolated from diseased chickens in the Tizi-Ouzou region of Algeria and to explore potential associations between antimicrobial resistance and the presence of virulence factors. Twenty-four confirmed biofilm-producing E. coli isolates were analyzed for serotype distribution, antimicrobial resistance patterns and virulence gene profiles. While none belonged to the O157 serogroup, all isolates demonstrated concerning resistance profiles, with high rates observed for tetracycline (83.3%), ampicillin (75%), and ciprofloxacin (62.5%). Notably, 40% of the strains exhibited biofilm-forming capability, predominantly showing weak to moderate production levels.Virulence gene profiling revealed traT, bcsA, and csgA as nearly ubiquitous (95.8%), with fimH present in 83.3% of isolates. Intermediate prevalence was noted for iutA (62.5%), fliC (45.8%), and agn43 (33.3%), while fyuA (29.2%) and several other virulence markers (kpsMT II, papC, cnf1, ibeA) occurred at lower frequencies (< 10%). Statistical analysis identified significant correlations between virulence gene content and phenotypic characteristics, including a positive association between virulence gene number and biofilm intensity (p < 0.05). Moreover, the fimH gene showed a strong positive correlation with resistance to the antibiotic nalidixic acid. Resistance to β-lactam antibiotics (cefotaxime, cefepime, aztreonam) was positively correlated (p < 0.05) with papC and ibeA, but negatively correlated with csgA. These findings underscore the complex interplay between antimicrobial resistance and virulence in Algerian biofilm-producing APEC strains, highlighting the need for enhanced surveillance programs and tailored intervention strategies. This study provides critical baseline data for developing effective control measures against colibacillosis poultry production systems.

PMID:40542899 | DOI:10.1007/s11259-025-10801-0