Nevin Manimala

Medicine (Baltimore). 2025 Feb 14;104(7):e41510. doi: 10.1097/MD.0000000000041510.

ABSTRACT

BACKGROUND: As the survival rate of breast cancer patients increases, breast cancer-related lymphedema (BCRL) has gradually received attention from researchers. This study aims to sort out and summarize the relevant studies on BCRL using bibliometric analysis and to explore future research trends.

METHODS: In this study, we searched the Web of Science Core Collection for publications related to BCRL, analyzed the publication trends by applying Microsoft Excel 2019, and analyzed authors, cited journals, journal mapping overlays, cited references, and keywords by applying CiteSpace (v.6.1.R3 Advanced). SCImago Graphica (v.1.0.39) was applied to analyze countries/regions, institutions, and published journals.

RESULTS: We finally included 1000 publications published between 2003 and July 4, 2024. Publications showed an upward trend, with the largest number of publications in 2023. USA is the most published country, Harvard University is the most published institution, Taghian AG is the most published author, and DiSipio T is the most cited author. Lymphatic Research and Biology is the most published journal, and Cancer-American Cancer Society is the most cited journal. “Breast cancer,” “arm lymphedema,” and “quality of life” were the most frequent keywords. Current research focuses on risk factors, treatment strategies, and patients’ quality of life with BCRL. Future research will mainly focus on establishing BCRL evaluation protocols, improving treatment techniques, and early prevention and detection of BCRL.

CONCLUSION: Our study sorts out the current knowledge structure in the field and highlights the current state of research and future research directions. These findings inform researchers and clinicians.

PMID:39960934 | DOI:10.1097/MD.0000000000041510

Medicine (Baltimore). 2025 Feb 14;104(7):e41579. doi: 10.1097/MD.0000000000041579.

ABSTRACT

Recently, a variational canal starting from the sigmoid notch and extending in the ramus has been reported. The aim of this study was not only to investigate the presence and localization of the sigmoid canal (SC) between the sexes, which has not been studied before, but also to define the morphometric characteristics of the SC. The possible complications that this anatomical variation may cause are also being discussed. Between 2022 and 2024, a total of 546 cone beam computed tomography images obtained in sagittal, coronal, and horizontal planes were retrospectively analyzed. The presence, localization, and morphometric characteristics of the SCs were recorded and evaluated using statistical analysis software. The presence of SC was observed in 5.5% of the images and it was determined that 4.0% of these canals were unilateral and 1.5% were bilateral. The rate of right SC was 3.3% and the rate of left SC was 3.7%. When morphometric evaluation is made, the average value of the length of the SC is 8.0 mm, with a minimum value of 3.1 mm and a maximum value of 13.9 mm. Knowledge of the SC will prevent possible complications in surgical procedures, provide a more accurate diagnosis at the diagnostic stage and ensure that the treatment plan is created appropriately. More studies are needed on this subject.

PMID:39960932 | DOI:10.1097/MD.0000000000041579

Medicine (Baltimore). 2025 Feb 14;104(7):e41567. doi: 10.1097/MD.0000000000041567.

ABSTRACT

This study aimed to identify the factors influencing multiple admissions within 1 year for patients with heart failure (HF) and to examine the impact of early readmission on subsequent admissions. A retrospective questionnaire survey was conducted on 498 patients with HF admitted to our hospital’s Cardiology department between January 1, 2020, and December 31, 2022. Multivariate regression analysis identified factors influencing multiple admissions, and propensity score matching (PSM) assessed the impact of readmissions within 30 days and 31 to 90 days post-discharge on unplanned admissions within a year. The incidence of multiple admissions was 22.09% (110/498), with first readmissions within 30 days post-discharge at 13.25% (66/498) and within 31 to 90 days at 15.86% (79/498). Influential factors for multiple unplanned hospital admissions included age, history of atrial fibrillation, chronic kidney disease, chronic obstructive pulmonary disease, New York Heart Association grade ≥ III, hemoglobin (Hb) < 110g/L, taking 7 or more medications, and readmission within 31 to 90 days (P < .05). Post-PSM analysis showed that the first admission within 30 days (odds ratio [OR] = 6.400, 95% confidence interval [Cl] = 2.638-15.527, P = .001), and the first admission within 31 to 90 days significantly increased the risk of multiple admissions (OR = 5.694, 95% Cl = 2.615-12.402, P = .001). Patients with HF exhibit a high rate of numerous readmissions within 1 year. Clinical medical staff should focus more on patients with early readmissions, enhance self-management, and improve management of comorbidities and medications through a multidisciplinary team approach. Enhancing continuous nursing and improving access to medical services may reduce patient readmission rates.

PMID:39960925 | DOI:10.1097/MD.0000000000041567

Medicine (Baltimore). 2025 Feb 14;104(7):e41582. doi: 10.1097/MD.0000000000041582.

ABSTRACT

This study shares our 5-year experience with chorionic villus sampling (CVS) and analyzes the indications, results, and complications of this procedure. We conducted a retrospective analysis of data from singleton pregnancies that underwent CVS between 2015 and 2020 at the Maternal-Fetal Medicine Unit of Health Science University, Izmir Tepecik Research, and Training Hospital. Maternal demographics, indications, karyotype results, and pregnancy outcomes were recorded. We retrospectively analyzed data from 468 CVS procedures, conducted between 2015 and 2020. The most common indications for CVS were positive screening test results in the first trimester, fetal structural abnormalities, and increased nuchal translucency (NT) observed during ultrasound. Fetal structural abnormalities had the highest detection rate, at 34.5% for chromosomal abnormalities, followed by increased NT and first-trimester screen-positive test results (26.9% and 11.3%), respectively. The culture success rate was 96.3% (451 out of 468). The most prevalent chromosomal abnormalities were numerical, including Trisomy 21 (10.9%), Trisomy 18 (4.2%), and Trisomy 13 (1.9%). Results could not be obtained in 17 patients (3.6%); 12 (2.5%) were due to insufficient samples and culture failure, while 5 (1.06%) were due to maternal contamination. Amniocentesis was required as a secondary sampling in 24 cases (5.1%) and performed in 17 cases (3.6%). This study emphasizes the significance of CVS in prenatal diagnosis and the management of high-risk pregnancies. However, we must be aware of the associated risks and limitations, which include culture success rates, inconclusive results, and the occasional need for secondary sampling.

PMID:39960922 | DOI:10.1097/MD.0000000000041582

Medicine (Baltimore). 2025 Feb 14;104(7):e41498. doi: 10.1097/MD.0000000000041498.

ABSTRACT

BACKGROUND: Breast cancer as the malignant tumor with the highest incidence and mortality rate among the global female population. Insomnia is a common complaint in breast cancer patients, more than one-third (38-47%) of breast cancer patients suffer it. Auricular acupressure (AA), a non-pharmacological therapy, has been used in the studies to intervene in insomnia in breast cancer patients. The objective of this systematic review and meta-analysis is to investigate the efficacy and safety of AA therapy in intervening with insomnia in breast cancer.

METHODS: A systematic literature search was performed for 10 databases up to January of 2024 to identify randomized control trials (RCTs). The methodological quality of RCTs was assessed independently using the Cochrane Handbook for Systematic Reviews of Interventions. The quality of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation approach. Data were screened and extracted independently using predesigned forms. The meta-analysis was conducted using RevMan 5.3 software, P-value < .05 means statistically significant.

RESULTS: This review included 15 studies from 3 different countries with a total of 1125 adult participants. The pooled results showed that AA significantly in improving sleep quality (mean difference [MD] = -3.36, 95% confidence interval [CI]: [-4.65, -2.07], P < .001) and life quality (MD = -7.82, 95% CI: [-14.76, -0.88], P = .03). Based on data from sleep monitoring devices, AA was valuable for improving sleep efficiency (MD = -3.63, 95% CI: [-4.19,-3.07], P = .03) in breast cancer patients. Adverse events were reported in 5 RCTs. Common adverse reactions include auricular skin allergic reaction (10/259, 3.9%), bruising (7/259, 2.7%), pain (3/259, 1.2%), and local pressure ulcers on the auricular points (2/259, 0.8%). The evidence grade was moderate because of the substantial heterogeneity among studies. Heart, Shenmen, and Subcortex were the 3 most numerous auricular points, with a total share of up to 71.70%.

CONCLUSION: This systematic review and meta-analysis demonstrates the efficacy and safety of AA in intervening insomnia in breast cancer patients, providing a basis for the selection of clinical auricular points. However, the high-quality RCTs in existence are not enough, and more rigorous trials are needed to identify the efficacy of AA and insomnia.

PMID:39960920 | DOI:10.1097/MD.0000000000041498

Medicine (Baltimore). 2025 Feb 14;104(7):e41439. doi: 10.1097/MD.0000000000041439.

ABSTRACT

So far, there is no clear pathogenesis and no cure for systemic lupus erythematosus (SLE). The therapeutic benefits of existing drug therapies are far from ideal. The proteome is a major source of therapeutic targets. Therefore, new drug targets for SLE need to be discovered. Based on the STROBE-Mendelian randomization (MR) checklist, we performed MR to explore potential drug targets for SLE, using genome-wide association study summary statistics of plasma and cerebrospinal fluid (CSF) and further replicated in the external validation. Bidirectional MR, reverse causality testing by Steiger filtering, Bayesian co-localization were used. In addition, protein-protein interaction networks (PPI) were performed to reveal potential associations between proteins and current SLE drugs. At false discovery rate (FDR) significance (PFDR < .05), MR analysis revealed 8 proteins. Five proteins decreased the SLE risks, whereas the other 3 proteins increased the SLE risks. None of the 8 proteins had reverse causality except sICAM-1. Bayesian co-localization suggested that 5 proteins shared the same variant with SLE. PPI network suggested that intercellular adhesion molecular 1 (ICAM-1), Fc-gamma-RIIb (FCG2B) and N-terminal pro-B-type natriuretic peptide (N-terminal pro-BNP) interacted with targets of current SLE medications. Our integrative analysis revealed that SLE risk is causally associated with ICAM-1, FCG2B, and N-terminal pro-BNP. These 3 proteins have the potential to become drug targets of SLE, especially for ICAM-1 and FCG2B. More further studies are also warranted to support this finding.

PMID:39960916 | DOI:10.1097/MD.0000000000041439

Medicine (Baltimore). 2025 Feb 14;104(7):e41539. doi: 10.1097/MD.0000000000041539.

ABSTRACT

BACKGROUND: Vocal cord leukoplakia is a precancerous lesion for which early surgical intervention following ineffective conservative treatment is the predominant approach. Carbon dioxide (CO2) laser treatment is a novel, minimally invasive therapy. However, there is insufficient evidence to suggest that CO2 laser treatment is superior to conventional surgical methods in terms of efficacy and safety. Therefore, this meta-analysis aimed to evaluate the efficacy and safety of CO2 laser treatment vs conventional surgical treatment for vocal cord leukoplakia.

METHODS: A literature search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across 8 databases. Studies on the use of carbon dioxide laser therapy for vocal cord leukoplakia were included in the review. Two researchers conducted a systematic search for randomized controlled trials in PubMed, Embase, Cochrane, Web of Science, China National Knowledge Infrastructure, Wanfang, Chinese Science and Technology Periodical Database, and Chinese Biomedical Literature databases. Meta-analysis was performed using Stata 18.0, and RevMan 5.2 software.

RESULTS: The findings indicated that Compared with conventional surgery, CO2 laser surgery significantly reduced the recurrence rate of vocal cord leukoplakia (odds ratio [OR] = 0.25, 95% confidence interval, CI [0.12, 0.51]). CO2 laser surgery significantly improved the cure rate of vocal cord leukoplakia (OR = 3.07, 95% CI [1.17, 8.09]). Voice quality following CO2 laser surgery was significantly superior to that following conventional surgery, particularly in terms of fundamental frequency disturbance (standardized mean difference [SMD] = -0.8, 95% CI [-1.25, -0.34]) and amplitude disturbance (SMD = -0.52, 95% CI [-0.95, -0.09]). The CO2 laser group exhibited a lower incidence of postoperative adverse reactions (OR = 0.32, 95% CI [0.03, 3.19]); however, this difference was not statistically significant.

CONCLUSION: The results of this meta-analysis suggest that CO2 laser surgery can reduce the recurrence rate of vocal cord leukoplakia, improve the cure rate, and enhance voice quality. Therefore, CO2 laser surgery is recommended as a minimally invasive surgical approach for vocal cord leukoplakia.

PMID:39960915 | DOI:10.1097/MD.0000000000041539

Medicine (Baltimore). 2025 Feb 14;104(7):e41388. doi: 10.1097/MD.0000000000041388.

ABSTRACT

Spondyloarthritis (SpA) encompasses a group of inflammatory joint disorders affecting the spine and joints, including ankylosing spondylitis and nonradiographic axial SpA, exhibiting diverse extra-articular manifestations. Genetic factors, beyond human leukocyte antigen B27, play a significant role in SpA development. Leveraging advanced statistical methods, this study explores bidirectional Mendelian randomization (MR) and Bayesian colocalization to unravel the genetic links between SpA and its extra-articular manifestations. Positive MR analysis indicates causal relationships between ankylosing spondylitis and various extra-articular conditions. Leave-one-out analysis suggests that these effects are not driven by individual single-nucleotide polymorphisms. In reverse MR, potential reverse causal relationships are explored, revealing uveitis, inflammatory bowel disease, and ulcerative colitis as candidates. Colocalization analysis, unfortunately, does not identify shared genetic foundations. In conclusion, seronegative spinal arthritis may lead to myocarditis, atrioventricular block, bronchiectasis, Crohn disease, and coccygeal plexus syndrome, while there is a 2-way causal relationship with uveitis, inflammatory bowel disease, and ulcerative colitis.

PMID:39960913 | DOI:10.1097/MD.0000000000041388

Anemia. 2025 Feb 7;2025:5695022. doi: 10.1155/anem/5695022. eCollection 2025.

ABSTRACT

Background and Objective: IDA and chronic headache disorders such as migraines and tension-type headaches are common conditions that significantly affect quality of life. Emerging evidence suggests a bidirectional relationship between these two conditions. This systematic review and meta-analysis aimed to explore and quantify the association between iron deficiency anemia (IDA) and chronic headache disorders, with a focus on understanding the bidirectional nature of this relationship. Methods: A comprehensive literature search was conducted across PubMed, Embase, and Web of Science to identify relevant studies published up until August 10, 2024. Observational studies examining the prevalence, incidence, or association between IDA and chronic headache disorders were included. Data were extracted and assessed for quality using the Newcastle-Ottawa Scale. Meta-analyses were performed using a random-effects model to calculate pooled prevalence rates and risk ratios (RRs), with heterogeneity assessed via the I ² statistic and meta-regression. A sensitivity analysis was conducted using the leave-one-out approach, and publication bias was evaluated through a funnel plot. Results: The meta-analysis included 13 studies: five studies examined chronic headaches among patients with IDA, and eight studies examined IDA among patients with chronic headaches. The pooled prevalence of chronic headaches among patients with IDA was 38% (95% CI: 15%-69%). In addition, 20% (95% CI: 10%-35%) of patients with chronic headaches were found to have IDA. Anemic patients were found to have a 76% higher risk of developing chronic headaches compared to nonanemic individuals (RR: 1.76; 95% CI: 1.22-2.52). Significant heterogeneity was observed across the studies. Conclusion: This meta-analysis demonstrates a significant association between IDA and chronic headache disorders, with a pooled prevalence of 38% for chronic headaches in IDA patients and 20% for IDA in chronic headache patients. IDA was associated with a 76% higher risk of chronic headaches. Routine screening for IDA in high-risk populations may improve headache outcomes, but further longitudinal studies are needed to establish causality and refine management strategies.

PMID:39959849 | PMC:PMC11828653 | DOI:10.1155/anem/5695022

MedEdPORTAL. 2025 Feb 14;21:11499. doi: 10.15766/mep_2374-8265.11499. eCollection 2025.

ABSTRACT

INTRODUCTION: With increasing rates of fatal opioid overdoses and substance use disorders, discussing harm reduction strategies in undergraduate medical education is imperative. Medical students learn opioid pharmacology but often lack adequate training in recognizing and responding to opioid overdoses. Incorporating naloxone training into preclinical undergraduate medical education can be lifesaving.

METHODS: This educational activity trained second-year medical students in opioid overdose recognition and response. The 2-hour interactive session included an informative presentation on opioid use statistics, harm reduction, and opioid overdose; a case-based learning session; and hands-on practice on task trainers using an OSCE-style checklist. Student confidence in four areas was assessed through pre- and posttraining surveys on 5-point Likert scales. Data analysis was conducted using R (programming language), with exploratory analyses for sample size, normality, and variable selection. The Wilcoxon signed rank test evaluated changes in attitudes from pre- to posttest.

RESULTS: Eighty-six students participated, with 60 completing pre- and posttest surveys. Significant improvements were observed in confidence across all areas: assessing an opioid overdose (p < .001), administering naloxone (p < .001), continuing management after naloxone (p < .001), and training others on naloxone administration (p < .001).

DISCUSSION: Early training in opioid overdose management increased second-year medical students’ confidence in key areas, potentially enabling them to better combat the crisis during their clinical years and educate at-risk patients. Future activities should incorporate objective skill assessments to evaluate competency and explore long-term knowledge retention during clinical rotations.

PMID:39959842 | PMC:PMC11825861 | DOI:10.15766/mep_2374-8265.11499