Nevin Manimala

Eur J Pediatr. 2025 Jan 11;184(2):130. doi: 10.1007/s00431-024-05945-1.

ABSTRACT

Most of the available tools to assess adherence to Mediterranean diet (MedDiet) were constructed for adults, having limited applicability to children and adolescents. The aim of this study is to validate a specific questionnaire to assess adherence to MedDiet in children aged 3 to 6 years (MED4CHILD questionnaire). The validation was performed in a baseline examination of a cohort of children who were recruited in schools in seven cities. Of the total sample of 1509 children, we included 858 children aged 3 to 6 years with complete information on adherence to the MedDiet, food consumption, anthropometry and cardiometabolic characteristics. Adherence to the MedDiet was assessed using an 18-item questionnaire, adapted from validated questionnaire for adults using the Delphi method. Food and beverage consumption was assessed using a validated COME-Kids Food and Beverage Frequency Questionnaire. Anthropometric measurements and cardiometabolic risk factors were assessed using standard methods. Statistical analyses included kappa agreement, ANOVA and linear regression models. Higher MED4CHILD scores were associated with higher intakes of food characteristic of the MedDiet. The MED4CHILD questionnaire showed moderate validity, especially for key items of the Mediterranean diet (kappa ranging from 0.333 to 0.665). Direct significant associations were found between MED4CHILD scores and cardiometabolic profile, including waist circumference (p), triglycerides and HOMA-IR (p < 0.05).

CONCLUSION: The 18-item MED4CHILD questionnaire showed moderate validity for assessing adherence to the MedDiet in children aged 3 to 6 years, in terms of agreement with food and beverage consumption and favourable cardiometabolic profile.

WHAT IS KNOWN: • The Mediterranean diet has been linked to a number of health benefits and the assessment of children’s adherence to this diet is important for public health and research. • The tools available to assess MedDiet compliance are mainly for adults.

WHAT IS NEW: • The MED4CHILD questionnaire is a simple, inexpensive and rapid tool for assessing MedDiet compliance in children. • This tool showed moderate relative validity and a high score was associated with a favourable cardiometabolic profile.

PMID:39798013 | DOI:10.1007/s00431-024-05945-1

Eur J Orthop Surg Traumatol. 2025 Jan 11;35(1):53. doi: 10.1007/s00590-024-04148-6.

ABSTRACT

PURPOSE: While treatment modalities for Maisonneuve fractures involving the proximal third of the fibula are established, no studies to date have reported outcomes associated with syndesmotic-only fixation of middle third fibular shaft fractures. The purpose of this study was to evaluate outcomes associated with syndesmotic-only fixation in the treatment of Maisonneuve fractures involving the middle third of the fibula.

METHODS: A retrospective review was conducted on 257 cases of syndesmotic ankle instability with associated fibular fractures at a level 1 trauma center between 2013 and 2023. Patients were divided into cohorts based on fibular fracture location in the proximal, middle, or distal third of the fibula. The Chi-square test of independence, two-sample t-test, and analysis of variance were used to compare outcome measures between cohorts.

RESULTS: Sixty-six patients were identified including 48% (n = 32) with proximal third fibular fractures, 20% (n = 13) with middle third fibular fractures, and 32% (n = 21) with distal third fibular fractures. Rates of infection, loss of reduction, wound healing complications, and reoperation did not vary significantly between cohorts. Functional outcome measures including range of motion, time to weight-bearing, and tibiofibular/medial clear space measurements at final follow-up were similar across cohorts.

CONCLUSION: Patients with Maisonneuve fractures involving the middle third of the fibula demonstrated positive outcomes with syndesmotic fixation alone, with no documented cases of infection, loss of reduction, or wound healing issues. By demonstrating maintenance of anatomic reduction and low rates of complications, our results support the use of syndesmotic-only fixation in the treatment of middle third Maisonneuve fractures.

PMID:39798008 | DOI:10.1007/s00590-024-04148-6

Eur Radiol. 2025 Jan 11. doi: 10.1007/s00330-024-11335-w. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim is to assess the feasibility and accuracy of a novel quantitative ultrasound (US) method based on global speed-of-sound (g-SoS) measurement using conventional US machines, for breast density assessment in comparison to mammographic ACR (m-ACR) categories.

MATERIALS AND METHODS: In a prospective study, g-SoS was assessed in the upper-outer breast quadrant of 100 women, with 92 of them also having m-ACR assessed by two radiologists across the entire breast. For g-SoS, ultrasonic waves were transmitted from varying transducer locations and the image misalignments between these were then related analytically to breast SoS. To test reproducibility, two consecutive g-SoS acquisitions each were taken at two similar breast locations by the same operator.

RESULTS: Measurements were found highly repeatable, with a mean absolute difference ± standard deviation of 3.16 ± 3.79 m/s. Multiple measurements were combined yielding a single g-SoS estimate per each patient, which strongly correlated to m-ACR categories (Spearman’s = 0.773). The g-SoS values for categories A-D were 1459.6 ± 0.74, 1475.6 ± 15.92, 1515.6 ± 27.10, and 1545.7 ± 20.62, with all groups (except A-B) being significantly different from each other. Dense breasts (m-ACR C&D) were classified with 100% specificity at 78% sensitivity, with an area under the curve (AUC) of 0.931. Extremely dense breasts (m-ACR D) were classified with 100% sensitivity at 77.5% specificity (AUC = 0.906).

CONCLUSION: Quantitative g-SoS measurement of the breast was shown feasible and repeatable using conventional US machines, with values correlating strongly with m-ACR assessments.

KEY POINTS: Question Breast density is a strong predictor of risk for breast cancer, which frequently develops in dense tissue regions. Therefore, density assessment calls for refined non-ionizing methods. Findings Quantitative global speed-of-sound (g-SoS) measurement of the breast is shown to be feasible using conventional US machines, repeatable, and able to classify breast density with high accuracy. Clinical relevance Being effective in classifying dense breasts, where mammography has reduced sensitivity, g-SoS can help stratify patients for alternative modalities. Ideal day for mammography or MRI can be determined by monitoring g-SoS. Furthermore, g-SoS can be integrated into personalized risk assessment.

PMID:39798006 | DOI:10.1007/s00330-024-11335-w

Eur Radiol. 2025 Jan 11. doi: 10.1007/s00330-024-11300-7. Online ahead of print.

ABSTRACT

OBJECTIVE: To provide up-to-date European Society of Urogenital Radiology (ESUR) guidelines for staging and follow-up of patients with ovarian cancer (OC).

METHODS: Twenty-one experts, members of the female pelvis imaging ESUR subcommittee from 19 institutions, replied to 2 rounds of questionnaires regarding imaging techniques and structured reporting used for pre-treatment evaluation of OC patients. The results of the survey were presented to the other authors during the group’s annual meeting. The lexicon was aligned with the Society of American Radiology (SAR)-ESUR lexicon; a first draft was circulated, and then comments and suggestions from the other authors were incorporated.

RESULTS: Evaluation of disease extent at diagnosis should be performed by chest, abdominal, and pelvic CT. The radiological report should map the disease with specific mention of sites that may preclude optimal cytoreductive surgery. For suspected recurrence, CT and [¹⁸F]FDG PET-CT are both valid options. MRI can be considered in experienced centres, as an alternative to CT, considering the high costs and the need for higher expertise in reporting.

CONCLUSIONS: CT is the imaging modality of choice for preoperative evaluation and follow-up in OC patients. A structured radiological report, including specific mention of sites that may preclude optimal debulking, is of value for patient management.

KEY POINTS: Question Guidelines were last published for ovarian cancer (OC) imaging in 2010; here, guidance on imaging techniques and reporting, incorporating advances in the field, are provided. Findings Structured reports should map out sites of disease, highlighting sites that limit cytoreduction. For suspected recurrence, CT and 18FDG PET-CT are options, and MRI can be considered. Clinical relevance Imaging evaluation of OC patients at initial diagnosis (mainly based on CT), using a structured report that considers surgical needs is valuable in treatment selection and planning.

PMID:39798005 | DOI:10.1007/s00330-024-11300-7

Naunyn Schmiedebergs Arch Pharmacol. 2025 Jan 11. doi: 10.1007/s00210-024-03754-9. Online ahead of print.

ABSTRACT

Limited treatment options are available for bladder cancer (BCa) resulting in extremely high mortality rates. Cyclovirobuxine D (CVB-D), a naturally alkaloid, reportedly exhibits notable antitumor activity against diverse tumor types. However, its impact on CVB-D on BCa and its precise molecular targets remain unexplored. This study conducts CCK8 assay, colony formation assay, and flow cytometry experiments to demonstrate that CVB-D inhibits long-term proliferation and viability of BCa cell lines, thereby inducing apoptosis in vitro. It employs PPI networks and the CytoHubba algorithm to identify COL1A1, COL6A1, COL6A2, COL5A2, COL5A1, COL12A1, COL18A1, ITGA5, VCL, FLNA, and GSN as crucial therapeutic targets for CVB-D that can halt the malignant progression of BCa. GO and KEGG analyses indicate that the PI3K/AKT signaling pathway potentially may play a pivotal role in mediating the anti-BCa growth effects of CVB-D. The ROC curve and K-M survival analyses reveal the significant clinical value of all the 11 identified therapeutic targets, with GSN as the most effective target of CVB-D in combating BCa. This study also uncovers a potential interaction between GSN and CVB-D through molecular docking and molecular dynamics simulations. RT-qPCR and Western blotting experiments provide further evidence that CVB-D effectively suppresses GSN mRNA and protein expression in a concentration-dependent fashion. Our comprehensive study is the first report on the molecular mechanism of CVB-D against BCa, identifying GSN as a pivotal target in CVB-D-based anti-BCa therapy. We believe that our study results may help establish a theoretical basis for the possible utilization of CVB-D in cancer therapeutics.

PMID:39797986 | DOI:10.1007/s00210-024-03754-9

Curr Microbiol. 2025 Jan 11;82(2):80. doi: 10.1007/s00284-025-04063-x.

ABSTRACT

Brucella spp. is the bacterium responsible for brucellosis, a zoonotic infection that affects humans. This disease poses significant health challenges and contributes to poverty, particularly in developing countries. This study aimed to assess the seroprevalence, risk factors, and clinical symptoms of human brucellosis within the general population of Multan and Muzaffargarh, Pakistan. A total of 307 blood samples were collected from patients visiting local hospitals in Multan and Muzaffargarh between August 2015 and January 2016. Demographic information, risk factors, and clinical outcomes were documented. Serum samples were initially screened for anti-Brucella antibodies using the Rose Bengal Plate Test, and positive cases were subsequently confirmed through RT-PCR. The chi-square test assessed the link between Brucella positivity and the identified risk factors. The study recorded an overall seroprevalence of 6.8%, with 8.9% in Multan and 4.3% in Muzaffargarh. Genus-specific Brucella detection through RT-PCR confirmed that 20 out of 21 samples were positive. Significant associations with human brucellosis were found for contact with aborted animals (p = 0.032) and consumption of raw milk (p = 0.031), while factors such as age, gender, occupation, urbanicity, and geographical region did not show a significant impact on seropositivity (p > 0.05). Non-specific clinical symptoms were commonly observed among seropositive patients. The findings highlight the significance of close human interaction with infected animals, especially concerning livestock practices and dairy product consumption. The results also emphasize the importance of focusing efforts on raising awareness in risky occupations and developing control programs by healthcare authorities.

PMID:39797980 | DOI:10.1007/s00284-025-04063-x

Arch Orthop Trauma Surg. 2025 Jan 11;145(1):117. doi: 10.1007/s00402-024-05643-5.

ABSTRACT

INTRODUCTION: Ankle fractures represent a significant portion of orthopedic injuries, with fracture dislocations tending to have worse outcomes. Logsplitter fractures represent a subset of fracture dislocations in which the talus is axially wedged in the tibiofibular joint. We aim to comprehensively investigate and report on the complications and functional outcomes associated with ankle fracture-dislocations.

MATERIALS AND METHODS: Following PRISMA guidelines, a medical librarian conducted a literature search in Embase, Ovid Medline, Scopus, Cochrane Central Register of Controlled Trials, and The Cochrane Database of Systematic Reviews. Studies examining ankle fracture-dislocations and reporting on functional or employment outcomes were included. Excluded were non-English studies, abstracts, conference proceedings, letters, perspective pieces, reviews, editorials, and case reports or series with fewer than five patients. Data on functional outcomes were extracted and reported using descriptive statistics. A comparative analysis of AOFAS scores between Logsplitter and ankle fracture-dislocations was conducted using pooled means and independent t-tests.

RESULTS: A total of 21 studies involving 810 cases of ankle fracture-dislocations were included. The pooled mean AOFAS score across 13 studies was 81.5, indicating “good” outcomes, while Logsplitter injuries had a significantly lower mean score of 75.8 compared to 82.9 for other ankle fracture-dislocations (p = 0.016). Complications included wound infection (7.3%), posttraumatic osteoarthritis (29.2%), nonunion/malunion (12.6%), and malunion. No studies reported on employment outcomes.

CONCLUSIONS: Ankle fracture-dislocations are high-energy injuries that affect a younger population compared to non-dislocated ankle fractures. Their functional outcomes resemble those of pilon fractures more than common ankle fractures. Logsplitter injuries are a subset of fracture dislocations that occur in even younger patients, with worse functional outcomes. This information can guide perioperative discussion and expectations for functional recovery. Additional studies are needed to evaluate the impact of these injuries on return to employment.

PMID:39797975 | DOI:10.1007/s00402-024-05643-5

Clin Transl Oncol. 2025 Jan 11. doi: 10.1007/s12094-024-03843-4. Online ahead of print.

ABSTRACT

BACKGROUND: The benefit of treatment with tyrosine kinase inhibitors targeting the epidermal growth factor receptor (EGFR-TKI) for lung adenocarcinoma (ADC), stratified by ethnicity, has not yet been fully elucidated.

METHODS: We searched PubMed, Embase, and Cochrane databases for studies that investigated EGFR-TKI for lung ADC. We computed hazard ratios (HRs) or risk ratios (RRs) for binary endpoints, with 95% confidence intervals (CIs). We used DerSimonian and Laird random-effect models for all endpoints. Heterogeneity was assessed using I² statistics. R, version 4.2.3, was used for statistical analyses.

RESULTS: A total of 18 studies, comprising 4,497 patients with lung ADC randomized to TKIs or chemotherapy alone. TKIs significantly improved OS (HR 0.91; 95% CI 0.88-0.95), PFS (HR 0.60; 95% CI 0.38-0.97), and ORR (HR 0.34; 95% CI 0.25-0.48) in Asian patients, compared with the chemotherapy alone. In Caucasian patients, TKIs significantly improved PFS compared with chemotherapy alone (HR 0.34; 95% CI 0.25-0.48) and ORR(RR 2.35; 95% CI: 1.05-5.28). TKIs significantly reduced any adverse events of any grade in patients with mixed ethnicity (RR 0.86; 95% CI 0.76-0.98) and any adverse events of grade ≥ 3 in Caucasian patients (RR 0.67; 95% CI 0.51-0.89).

CONCLUSIONS: This is the first meta-analysis to reveal the ethnic influence on the outcomes of oncologic treatments for patients with lung ADC. In collaboration with in-depth molecular characterization, these data will allow the creation of a clinical-pathological predictive model to increase the magnitude of the expected benefit for patients from different ethnic groups.

PMID:39797945 | DOI:10.1007/s12094-024-03843-4

Eur J Orthop Surg Traumatol. 2025 Jan 11;35(1):54. doi: 10.1007/s00590-024-04155-7.

ABSTRACT

BACKGROUND: The aim was to assess whether the postoperative Oxford Hip Score (OHS) demonstrated a ceiling effect at 1 or 2 years after total hip arthroplasty (THA) and to identify which patients are more likely to achieve a ceiling score and whether this limits assessment of their outcome.

METHODS: A retrospective cohort of 7871 patients undergoing primary THA was identified from an established arthroplasty database. Patient demographics, ASA grade, socioeconomic status, OHS and EuroQol questionnaire were collected preoperatively and at 1 and 2 years postoperatively. Regression analysis was used to identify independent preoperative factors associated with achieving a ceiling score. Receiver operating characteristic curves were used to identify preoperative OHS’s that predicted a postoperative ceiling score.

RESULTS: The ceiling effect (proportion achieving the maximal score) at 1 year was 21.8% (n = 1372) which increased significantly (p < 0.001) to 26.6% (n = 1569) at 2 years. Female gender (p ≤ 0.028), younger age (p < 0.001), decreasing socioeconomic deprivation (only for 2-year OHS), a better preoperative OHS (p < 0.001) or EQ-VAS (p < 0.001) were independently associated with a ceiling OHS postoperatively. The preoperative OHS was demonstrated to be a poor discriminator of achieving postoperative ceiling score at 1 year (AUC 62.4%, 95% CI 60.7 to 64.1, p < 0.001) and 2 years (AUC 61.5%, 95% CI 60.0 to 63.2). Those achieving a postoperative ceiling OHS at 1 and 2 years had statistically significant (p < 0.001) greater improvements in their OHS, EQ-5D and EQ-VAS and were more likely to have achieved a minimal important change in their OHS relative to their preoperative baseline and a postoperative patient acceptable symptom state.

CONCLUSION: The OHS demonstrated moderate ceiling effects at both 1 and 2 years following THA, and the preoperative score was a predictor of achieving a ceiling score. However, it would seem the ceiling effect did not limit the potential for improvements relative to baseline and achieving clinically meaningful values in the OHS.

PMID:39797938 | DOI:10.1007/s00590-024-04155-7

Geroscience. 2025 Jan 11. doi: 10.1007/s11357-024-01488-3. Online ahead of print.

ABSTRACT

Age-related cognitive impairment and dementia pose a significant global health, social, and economic challenge. While Alzheimer’s disease (AD) has historically been viewed as the leading cause of dementia, recent evidence reveals the considerable impact of vascular cognitive impairment and dementia (VCID), which now accounts for nearly half of all dementia cases. The Mediterranean diet-characterized by high consumption of fruits, vegetables, whole grains, fish, and olive oil-has been widely recognized for its cardiovascular benefits and may also reduce the risk of cognitive decline and dementia. To investigate the protective effects of the Mediterranean diet on cognitive health, we conducted a systematic literature review using PubMed, Web of Science, and Google Scholar, focusing on studies published between 2000 and 2024. The studies included in the meta-nalysis examined the adherence to the Mediterranean diet and the incidence of dementia and AD. We applied a random-effects model to calculate pooled hazard ratios (HRs) with 95% confidence intervals (CIs) and assessed heterogeneity through I-square statistics. Forest plots, funnel plots, and Z-score plots were used to visualize study outcomes. Of the 324 full-text records reviewed, 23 studies met the inclusion criteria. The combined HR for cognitive impairment among those adhering to the Mediterranean diet was 0.82 (95% CI 0.75-0.89); for dementia, the HR was 0.89 (95% CI 0.83-0.95); and for AD, the HR was 0.70 (95% CI 0.60-0.82), indicating substantial protective effects. Significant heterogeneity was observed across studies, though Z-score plots suggested sufficient sample sizes to support reliable conclusions for each condition. In conclusion, this meta-analysis confirms that adherence to the Mediterranean diet is associated with an 11-30% reduction in the risk of age-related cognitive disorders, including cognitive impairment, dementia, and AD. These findings underscore the Mediterranean diet’s potential as a central element in neuroprotective public health strategies to mitigate the global impact of cognitive decline and dementia and to promote healthier cognitive aging.

PMID:39797935 | DOI:10.1007/s11357-024-01488-3