Nevin Manimala

Cancer Med. 2025 Feb;14(4):e70680. doi: 10.1002/cam4.70680.

ABSTRACT

BACKGROUND: Germline genomic sequencing (GS) is increasingly offered to children with cancer. To optimize integration into routine care, assessment of implementation barriers and a better understanding of healthcare professionals’ perspectives and experiences are needed.

METHODS: Healthcare professionals delivered trio germline GS to newly diagnosed pediatric and adolescent patients with cancer via the PREDICT completed questionnaires with qualitative and quantitative items. Each study site recorded reasons for eligible families’ nonenrolment in PREDICT to identify barriers to recruitment. Quantitative data were analyzed via descriptive statistics, whereas qualitative data underwent inductive content analysis, with results integrated for interpretation.

RESULTS: Thirty-three healthcare professionals participated, including 23 oncology professionals and 10 genetic professionals. Healthcare professionals perceived PREDICT as beneficial to participating and future families, and that perceptions of personal benefit and altruism were drivers of family uptake. Concerns included workforce capacity and potential family distress given the trio design and high-stress diagnosis setting. Barriers to recruitment related to clinical decision-making, family factors, and logistics. Although most rated their genetics/genomics knowledge as “good,” regarding germline results, few were “very confident” interpreting (29%), explaining (32%), making treatment recommendations (9.7%), and providing psychosocial support to families (29%). They acknowledged a need for further training in these areas for trainees; yet, fewer were interested in training for themselves.

CONCLUSION: Successful implementation of routine germline GS will require targeted strategies to address logistical issues and alleviate potential negative psychosocial impacts for families. Recognizing the escalating demand on genetics experts, upskilling of the current workforce and involvement of a broader spectrum of healthcare professionals are warranted.

PMID:39953756 | DOI:10.1002/cam4.70680

Aust Dent J. 2025 Feb 14. doi: 10.1111/adj.13059. Online ahead of print.

ABSTRACT

OBJECTIVE: This systematic review and meta-analysis study was carried out to compare the effectiveness of occlusal splint (OS) and Botox (BTX) injections in temporomandibular disorders (TMDs).

MATERIAL AND METHODS: Irrespective of the starting year, studies were searched for up to 2024 using PubMed, Web of Science, Scopus databases and the Google Scholar search engine. In the study, graded chronic pain scale and maximum mouth opening amount parameters were analysed with Comprehensive Meta-Analysis programme.

RESULTS: Out of 619 studies, only six were included in the meta-analysis. The effect size was 0.293 in favour of BTX in the studies evaluating the maximum mouth-opening (MMO) range. However, the amount of MMO did not show a statistically significant difference between the OS and BTX groups (95% CI – 0.383 to 0.969, P = 0.395, z = -0.850). In the subgroup analyses carried out based on the follow-up periods, it was found that the MMO was statistically significantly higher in the BTX group at the first week and in the OS group at the third month. However, there was no significant difference observed at the first, second, sixth and twelfth month follow-ups (P > 0.05). No significant difference was found between the groups (P > 0.05) in the publications that evaluated the graded chronic pain scale (GCPS), although an effect size of 0.673 was found in favour of OS (95% CI 0.331 to 1.365, P = 0.272, z = -1.098).

CONCLUSION: BTX injections and OS applications show significant differences in the MMO of individuals in the early period. In contrast, the MMO of individuals and the GCPS show similar findings in the sixth month and longer follow-up.

PMID:39953753 | DOI:10.1111/adj.13059

Acta Ophthalmol. 2025 Feb 14. doi: 10.1111/aos.17460. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the incidence and risk factors of retinal detachment (RD) and bacterial endophthalmitis in a cohort of children who underwent cataract surgery before the age of eight.

METHODS: Data was retrieved from the Swedish national paediatric cataract register. All eyes with congenital or infantile cataract that underwent surgery between January 1, 2007, and December 31, 2023 with at least one follow-up were included. Cases associated with trauma, uveitis or RD at surgery were excluded. Parameters that could be important for complications were analysed.

RESULTS: RD was found in seven of 1073 eyes reflecting an incidence of 0.65%. There were no statistically significant differences in age at surgery, presences of intellectual disability or general disease, cataract type, surgical technique, axial length, corneal diameter, previous glaucoma surgery or occurrence of persistent fetal vasculature (PFV), although the frequency of glaucoma surgery and PFV was higher in RD cases; 42.9% versus 13.2% and 57.1% versus 26.0%. Aphakia was significantly more common in RD patients; 71.4% versus 19.3% (p = 0.042), as well secondary glaucoma; 57.1% versus 19.5% (p = 0.032). No cases of endophthalmitis were observed.

CONCLUSION: The incidence of RD was low compared to previous studies and no endophthalmitis was found. This might be a result of centralized paediatric cataract care with few but experienced surgeons. Aphakia and secondary glaucoma were associated with higher RD risk and those cases should be followed carefully. PFV and glaucoma surgery were found at a higher frequency in RD cases prompting comprehensive postoperative care also for these children.

PMID:39953745 | DOI:10.1111/aos.17460

Int J Adolesc Med Health. 2025 Feb 12. doi: 10.1515/ijamh-2024-0100. Online ahead of print.

ABSTRACT

OBJECTIVES: The present study was done to study the knowledge change among Medical Officers (MO) and Community health officers (CHO) regarding menstrual hygiene, early marriages, and HIV/STI with emphasis on adolescents after online training.

METHODS: This is a retrospective record-based analysis conducted in the State Adolescent Health Centre, AIIMS Mangalagiri, Andhra Pradesh in 2023-2024 over 10 months. Participants were selected based on their attendance at online training sessions involving MOs and CHOs on menstrual cups, menstrual hygiene, early marriages, and HIV/STI. The data from Google Forms for pretests and post-tests, containing a total of 30 questions in English and Telugu, covering menstrual hygiene, early marriage, and HIV/STI topics was retrieved. The study covered all 26 districts of Andhra Pradesh, India, with online training sessions conducted via Zoom. The proportion of correct responses to individual questions is given with a 95 % confidence interval. Statistical comparisons of scores of individual questions were done using the McNemar test. Statistical comparisons of total scores of pre-test and post-test were done using the paired t-test. A p-value less than 0.05 was considered significant.

RESULTS: Of the total 13,432 MOs and CHOs, 9,897 participated in the training with a response rate of 73.6 %. Among those who participated the training 2,809 (28.38 %) completed both pretest and posttest. The majority were CHOs (85.3 %), females, and aged under 35 years. Statistically significant increases in knowledge were observed across various aspects of menstrual hygiene, early marriages, and HIV/STI. Increase in knowledge regarding menstruation 4.3 % (3.5-5.1 %), p-value:<0.001, first vaginal bleeding (first menstruation) 4.7 % (3.9-5.5 %), p-value:<0.001, complication seen in delivering babies in teen pregnancy 4.9 % (4.1-5.7 %), p-value:<0.001, the symptom of STI 7.0 % (6.1-7.9 %), p-value:<0.001, and others. The total pretest mean score was 16.73 ± 4.44 and the post-test mean score was 18.81 ± 4.39. There was a statistically significant difference between pretest and post-test mean scores p value<0.001.

CONCLUSIONS: The training program significantly improved knowledge regarding menstrual hygiene, early marriages, and HIV/STI among the participants indicating the effectiveness of educational intervention in addressing gaps towards adolescent Health.

PMID:39953713 | DOI:10.1515/ijamh-2024-0100

Environ Toxicol Chem. 2025 Jan 9:vgaf007. doi: 10.1093/etojnl/vgaf007. Online ahead of print.

ABSTRACT

Water reservoirs and lakes are gaining popularity for recreation activities as populations increase and green spaces become in high demand. However, these activities may cause contamination to critical water resources. This study investigates the impact of recreational activities on the presence and concentration of polycyclic aromatic hydrocarbons (PAHs) and ultraviolet (UV) filters in drinking water reservoirs in Southeast Queensland, Australia. Polydimethylsiloxane passive samplers were used to monitor 14 lakes over a 3-year period, focusing on seasonal variations and the influence of recreational activities such as petrol-powered boating and swimming. A total of 15 PAHs and six UV filters were detected, with chrysene (97%) and octyl salicylate (34%) being the most prevalent PAH and UV filter, respectively. Polycyclic aromatic hydrocarbon levels were statistically significantly higher in lakes permitting petrol-powered boating, especially during summer (p = 0.005 to 0.05). Lake Maroon and Lake Moogerah were the only sites that showed significantly higher PAH levels in summer (3.9 ± 1.1 and 4.0 ± 1.2 ng L-1, respectively) than winter (1.6 ± 0.61 and 1.5 ± 0.84, respectively). Ultraviolet filters were generally detected in higher levels in lakes allowing swimming, with Lake Moogerah and Lake Sommerset measuring UV filter concentrations of 20 ± 4.1 and 20 ± 11 ng L-1 in summer, respectively. Other lakes that do not permit swimming, such as Lake Maroon and Lake Samsonvale, also exhibited elevated UV filter levels, suggesting illegal swimming. These findings highlight the complexity of PAH and UV filter presence, influenced by multiple factors including lake size, recreational activity type, and seasonal variations. The levels of individual PAHs and UV filters in this study were below established freshwater guidelines. However, when considering their bioaccumulation potential and mixture toxicity, mitigating the impact of these substances on our environment and the organisms within it should be of priority.

PMID:39953706 | DOI:10.1093/etojnl/vgaf007

J Pharm Pract. 2025 Feb 14:8971900251320740. doi: 10.1177/08971900251320740. Online ahead of print.

ABSTRACT

Background: Asthma is one of the most common pediatric disease states. However, current literature about outpatient pharmacy appointment effectiveness on pediatric asthma control is not widely available. Objective: To determine whether outpatient pharmacist visits in pediatric patients with asthma result in a measurable difference in asthma control, utilizing the validated asthma control test (ACT) and childhood asthma control test (C-ACT) scoring tools. Methods: This study enrolled 16 children ages 6-17 years old at an outpatient primary care clinic (November 2023-April 2024). The patients visited the outpatient pharmacist 2 to 3 times over a 12-week period. The primary outcome was the change in the patient’s ACT or C-ACT from the baseline to the final study visit. Additional outcomes of interest included improvement in inhaler technique using a Vitalograph AIM® device, medication adherence rates, and change in emergent interventions from 6 months before enrollment compared to 3 months after the final visit. Results: The median improvement in asthma control test was 3 at the final study visit (4 or 12 weeks after counseling), which was statistically significant (P = 0.0348). This was an improvement from 50% of patients controlled at baseline to 100% at the final visit (P = 0.0053). Emergent interventions including oral steroid courses, emergency department visits, and hospitalization for asthma were less common after pharmacist intervention than before enrollment (P = 0.0464). Improvements in technique were seen at the initial visit using Vitalograph AIM® to visualize counseling points. Conclusion: Our study supports that outpatient pharmacist visits can have a measurable impact on pediatric asthma control.

PMID:39953701 | DOI:10.1177/08971900251320740

Ann Surg. 2025 Jan 28. doi: 10.1097/SLA.0000000000006639. Online ahead of print.

ABSTRACT

OBJECTIVES: To define the evolving role of serial transverse enteroplasty(STEP) in the surgical management of intestinal failure(IF) in patients with short bowel syndrome(SBS) especially among the adult population.

BACKGROUND: The current literature is lacking the rationale and long-term efficacy of STEP as a part of the multidisciplinary management of SBS-IF adult population.

METHODS: The study included a total of 64 total parenteral nutrition (TPN) dependent patients. The causes of SBS were wide-ranging with residual bowel length of 79+47 cm and plasma citrulline level of 22+12 umol/L. Partial or full colon was preserved in 56(88%) patients. STEP was primary in 32 patients and integrated with autologous gut reconstruction(AGR) in the remaining 32. Integrated STEP was technically feasible in 44% of the preoperative candidates. To assess the therapeutic benefits of integrated STEP, 32 of the contemporaneous AGR-only patients were statistically identified by propensity-score matching as control group.

RESULTS: With a mean follow-up of 35+24 months, the 64 study patients received a total of 81 STEP procedures. The 5-year disease-specific survival was 91% with a respective restored enteral autonomy (EA) rate of 80%. Compared to the matched control, integrated STEP significantly(P=0.02) enhanced the cumulative restoration of EA. The ASA comorbidity class IV was the only significant(P=0.05) survival risk factor. Preoperative TPN caloric requirements and total increment in bowel length were independent predictors of STEP-associated EA. Consequently, STEP was a significant predictor of restored EA among the overall SBS-IF patients.

CONCLUSIONS: This study underscores the wide-applicability and long-term therapeutic efficacy of STEP among the SBS-patients including adults. Accordingly, the procedure should be increasingly utilized for all ages and promptly considered as an integral part of the SBS-IF management armamentarium.

PMID:39953696 | DOI:10.1097/SLA.0000000000006639

Pediatr Blood Cancer. 2025 Feb 14:e31606. doi: 10.1002/pbc.31606. Online ahead of print.

ABSTRACT

A better understanding of positron emission tomography (PET) response in nodular lymphocyte-predominant Hodgkin lymphoma (nLPHL) is critical for incorporating PET into prospective trials. PET scans from Children’s Oncology Group study AHOD03P1 for patients less than 22 years with low-risk nLPHL, treated with three cycles of doxorubicin, vincristine, prednisone, and cyclophosphamide chemotherapy, were retrospectively reviewed and assigned Deauville 5-point scale (5PS) scores. Five-year post-PET event-free survival was 90.1% (80% CI: 85.2%-93.4%) for PET-negative (5PS 1-3) and 66.7% (80% CI: 36.4%-85.0%) for PET-positive (5PS 4-5) patients. PET response after three cycles of low-dose chemotherapy is predictive of relapse risk for low-risk nLPHL.

PMID:39953678 | DOI:10.1002/pbc.31606

Asia Pac J Clin Oncol. 2025 Feb 14. doi: 10.1111/ajco.14156. Online ahead of print.

ABSTRACT

BACKGROUND: Pneumocystis jirovecii pneumonia (PCP) is an unrecognized infection in non-HIV patients, particularly those with solid and hematologic malignancies. These patients experience higher mortality rates. This study aims to describe the incidence, initial characteristics, management, and outcomes of PCP at a tertiary cancer care center.

METHODS: This retrospective observational study included all patients who underwent P. jirovecii PCR testing at our center from January 2019 to January 2022. PCP was diagnosed in PCR-positive patients. Data on demographics, treatment, and outcomes were extracted from medical records. The primary outcomes were ICU admission and 21-day mortality. Statistical analysis compared PCR-positive and PCR-negative patients, with a specific focus on lung cancer patients, and analyzed determinants of 21-day mortality in PCP patients.

RESULTS: Of the 345 patients suspected of PCP, 54 (15.7%) were diagnosed with PCP. PCP patients were generally older. None of the PCP patients were on prophylaxis, compared to 14.8% of PCR-negative patients. In lung cancer patients, age and radiotherapy within the past year were significantly associated with a PCP diagnosis. The 21-day mortality rate among PCP patients was 35.4%. Independent risk factors for mortality included age and hematologic malignancy, while recent chemotherapy and higher neutrophil counts were associated with lower mortality.

CONCLUSION: PCP is associated with the highest mortality in patients with hematologic malignancies and lung cancer. The findings underscore the importance and efficacy of prophylaxis in at-risk groups and should raise awareness for the diagnosis of PCP in overlooked populations, such as older cancer patients and those undergoing radiotherapy.

PMID:39953677 | DOI:10.1111/ajco.14156

Clin Transl Sci. 2025 Feb;18(2):e70080. doi: 10.1111/cts.70080.

ABSTRACT

Selection of rational antagonists of P2Y₁₂ receptor for CAD patients who inherit CYP2C19 LoF alleles remains still conflicting. This study compared the clinical outcomes in CAD patients inheriting CYP2C19 LoF alleles undergoing PCI and treated with clopidogrel against alternative antagonists of P2Y₁₂ receptor. A thorough literature search was performed across multiple scientific databases following the PRISMA guidelines and PICO model. Setting the statistical significance at p < 0.05 and RevMan software was used to calculate the risk ratios (RRs). Estimation of the pooled analysis revealed a significant 62% increased risk of major adverse cardiovascular events (MACE) in CAD patients inheriting CYP2C19 LoF alleles and treated with clopidogrel against those treated with alternative P2Y₁₂ receptor antagonists such as prasugrel or ticagrelor (RR 1.62; 95% CI 1.42-1.86; p < 0.00001). In addition, Asian CAD patients were found at a significantly higher risk of MACE (RR 1.93; 95% CI: 1.49-2.49; p < 0.00001) juxtaposed to CAD patients of other ethnicities (RR 1.51; 95% CI: 1.29-1.78; p < 0.00001). Conversely, between these two treatment groups, taking clopidogrel against prasugrel/ticagrelor, who possess CYP2C19 LoF alleles, no significant differences in bleeding events were observed (RR 0.94; 95% CI 0.79-1.11; p = 0.47). CAD patients undergoing PCI who inherited CYP2C19 LoF alleles and treated with clopidogrel were associated with significantly higher risk of MACE against those treated with alternative antagonists of P2Y₁₂ receptor, that is, prasugrel or ticagrelor.

PMID:39953666 | DOI:10.1111/cts.70080