Nevin Manimala

Int J Gynaecol Obstet. 2025 Jan 4. doi: 10.1002/ijgo.16115. Online ahead of print.

ABSTRACT

OBJECTIVE: The study was conducted to determine the effect of emotional freedom techniques (EFT) on the severity of premenstrual syndrome (PMS).

METHODS: The study was conducted as a randomized controlled trial, with a premenstrual syndrome sample comprising 78 single female students of reproductive age presenting with PMS complaints (40 in the experimental group and 38 in the control group). Students in the experimental group were interviewed individually in the week before their menstrual cycle and received two EFT sessions with a 3-day interval.

RESULTS: The participants in the experimental group had higher post-test subjective units of experience (SUE) mean scores (experimental group mean 7.8 ± 1.7; control group mean 0.5 ± 5.7) and lower post-test PMS total (experimental group mean 76.8 ± 30.1; control group mean 127.4 ± 34.6) and subscale mean scores than the students in the control group, and the difference between the groups was statistically significant (P < 0.05). In repeated measures analysis, time-dependent change showed statistical significance between the groups (P < 0.05).

CONCLUSION: The EFT was found to be an effective non-pharmacologic intervention for coping with PMS.

PMID:39754454 | DOI:10.1002/ijgo.16115

Ther Apher Dial. 2025 Jan 4. doi: 10.1111/1744-9987.14243. Online ahead of print.

ABSTRACT

INTRODUCTION: Transcutaneous auricular vagus nerve stimulation (tVNS) has shown potential in neurological, autoimmune, and cardiovascular disorders, but its effects on HD patients remain unclear. This study aimed to evaluate the efficacy and safety of tVNS in HD patients.

METHODS: We conducted a randomized controlled clinical trial on patients receiving HD ≥6 months. The tVNS group received stimulation for 1 h during the first 2 h of HD sessions, three times weekly for 8 weeks, while the control group received standard care. The primary outcomes were dialysis efficiency (Single-pool Kt/V, Sp Kt/V) and dialysis-related symptoms (Dialysis Symptom Index, DSI), assessed every 4 weeks. Secondary outcomes included pain and fatigue scores, physical performance, Hemodialysis Comfort Scale, hemoglobin levels, Mini-Mental State Examination, and anxiety and depression scores, measured at baseline and 8 weeks after intervention.

RESULTS: A total of 63 patients were enrolled in the study, with 32 patients assigned to the tVNS group and 31 patients to the control group. At 8 weeks, the tVNS group showed significant improvements in Sp Kt/V (1.31 ± 0.11 vs. 1.25 ± 0.10, p = 0.02), and DSI (12.09 ± 5.84 vs. 16.26 ± 5.27, p = 0.004), as well as reductions in pain and fatigue, and increases in physical function, comfort, and hemoglobin. However, there were no statistically significant changes observed in cognitive function, anxiety, or depression.

CONCLUSIONS: tVNS could improve dialysis efficiency, symptoms, and physical function in HD patients, indicating it may have a role as a complementary therapy.

PMID:39754453 | DOI:10.1111/1744-9987.14243

Am Surg. 2025 Jan 4:31348241312120. doi: 10.1177/00031348241312120. Online ahead of print.

ABSTRACT

The goal of our study is to evaluate the safest, efficient, and most cost-effective way to manage suspected choledocholithiasis. This retrospective study evaluated adult patients with suspected choledocholithiasis based on labs and imaging at a single institution between 2017 and 2022 and characterized them into 1 of 3 groups based on their management pathway: (1) ERCP-first, (2) MRCP-first, or (3) surgery-first with possible intraoperative cholangiogram pending laboratory trend. Our primary outcome was hospital length of stay. 34 patients (25%) had MRCP-first, 60 patients (45%) had ERCP-first, and 39 patients (30%) received surgery first. There was no statistically significant difference in the length of stay with respect to the management pathway utilized (P > .05); however, those admitted to a surgical service were discharged on average one day before those admitted to the medicine service (P = .01).

PMID:39754441 | DOI:10.1177/00031348241312120

J Orthop Surg Res. 2025 Jan 4;20(1):12. doi: 10.1186/s13018-024-05404-5.

ABSTRACT

OBJECTIVE: This meta-analysis evaluates the comparative efficacy of lateral unicompartmental arthroplasty (UKA) versus medial UKA in treating unicompartmental knee osteoarthritis (KOA).

METHODS: We systematically searched Cochrane, PubMed, Embase, and Web of Science databases from January 2000 to September 2024. Literature screening, quality assessment, and data extraction were conducted based on predefined inclusion and exclusion criteria. Review Manager 5.4 software was used to analyze postoperative functional scores, pain scores, aseptic loosening, progression of contralateral arthritis, and prosthesis survival.

RESULTS: Fifteen cohort studies, encompassing 2,592 knees with medial UKA and 614 knees with lateral UKA, were included. The analysis showed no statistically significant differences in functional scores [SMD = 0.11, 95% CI (- 0.10, 0.33), I² = 64%, P = 0.31], pain scores [SMD = 0.23, 95% CI: (- 0.22, 0.67), I² = 91%, P = 0.32], aseptic loosening [OR = 1.33, 95% CI: (0.31, 5.78), I² = 0%, P = 0.70], progression of contralateral arthritis [OR = 0.37, 95% CI: (0.07, 1.91), I² = 0%, P = 0.23], short- to intermediate-term survival [OR = 1.40, 95% CI: (0.84, 2.35), I² = 0%, P = 0.20], and long-term survival [OR = 1.12, 95% CI: (0.61, 2.05), I² = 0%, P = 0.70].

CONCLUSION: Our findings indicate no significant differences in functional outcomes, pain relief, aseptic loosening, progression of contralateral arthritis, or prosthesis survival between lateral and medial UKA. Thus, both approaches are reliable options for patients with unicompartmental KOA.

PMID:39754240 | DOI:10.1186/s13018-024-05404-5

BMC Health Serv Res. 2025 Jan 3;25(1):13. doi: 10.1186/s12913-024-12123-4.

ABSTRACT

BACKGROUND: Cancer requires interdisciplinary intersectoral care. The Care Coordination Instrument (CCI) captures patients’ perspectives on cancer care coordination. We aimed to translate, adapt, and validate the CCI for Germany (CCI German version).

METHODS: The original English version contains 29 items in three domains, measured on a 4-point Likert scale (strongly disagree to strongly agree). Validation was conducted in three phases (mixed methods): (I) translation; (II) adaptation: pilot testing and revision in an iterative process using semi-structured, cognitive interviews with patients and professionals (physicians specializing in cancer), with interviews transcribed and qualitatively analyzed by inductive coding; and (III) validation: quantitative validation performed online (LimeSurvey), of at least 80 German patients, each with common cancer (breast, prostate) and rare cancer (different entities), with examination of factor structure (factor analysis) and determination of internal consistency (Cronbach’s α) as well as potential influencing factors such as gender, education, or migration background (multivariable regression).

RESULTS: Six patients and six professionals tested the translated instrument for comprehensibility, readability, and acceptability. Two items were consistently problematic for interviewees. A 31-item version (29 items + 2 alternative items) was validated in 192 patients. The alternative items had a higher variance in response behavior and were better understood; therefore, they replaced the two problematic items. However, the three original domains could not be confirmed statistically. Exploratively, a two-factorial structure (with cross-loadings) emerged, which can be interpreted as “communication/information” (16 items) and “need-based navigation” (17 items). Overall, the instrument had a high internal consistency (total score α = 0.931, M = 47.16, SD = 14.25; communication/information α = 0.924, M = 30.14, SD = 8.93; need-based navigation α = 0.868, M = 23.99, SD = 8.37). Significant factors on the care coordination score are treatment location (hospital vs. private practice oncologist M = -9.83 score points, p = 0.011) and gender (women vs. men M = 8.92 score points, p = 0.002).

CONCLUSION: The CCI German version is a valid instrument for measuring patients’ perceptions of cancer care coordination. Both domains reflect important aspects of care. The sensitivity of the CCI should be examined in future studies involving different cancer entities.

PMID:39754236 | DOI:10.1186/s12913-024-12123-4

Chin Med. 2025 Jan 3;20(1):1. doi: 10.1186/s13020-024-01053-2.

ABSTRACT

BACKGROUND: This research aims to explore the anti-obesity potential of Wu-Mei-Wan (WMW), particularly its effects on adipose tissue regulation in obese mice induced by a high-fat diet (HFD). The study focuses on understanding the role of heat shock factor 1 (HSF1) in mediating these effects.

METHODS: HFD-induced obese mice were treated with WMW. Body weight, food intake, and histopathological analysis of adipose tissue were conducted. Brown adipose tissue (BAT) activity was evaluated using Positron Emission Tomography, and ultrastructural changes were examined via transmission electron microscopy. Proteomic analysis identified targets of WMW in obesity treatment. HSF1 expression was inhibited to confirm its role. Molecular docking studied interactions between WMW and HSF1. Short-chain fatty acids (SCFAs) in the intestines were measured to determine if WMW’s effects on HSF1 are mediated through SCFAs. Protein expression was assessed using western blot, immunohistochemistry, immunofluorescence and RT-qPCR were employed to detect the mRNA levels. Statistical analyses included t-tests, ANOVA, and non-parametric tests like the Mann-Whitney U test or Kruskal-Wallis test.

RESULTS: WMW significantly mitigates the adverse effects of a HFD on body weight and glucose metabolism in obese mice. Both low-dose WMW and high-dose WMW treatments led to reduced weight gain and improved glucose tolerance, with low-dose WMW showing more pronounced effects. WMW also reversed structural damage in BAT, enhancing mitochondrial integrity and thermogenic function, particularly at the low dose. Additionally, WMW treatment promoted the browning of WAT, evidenced by increased expression of key thermogenic proteins such as UCP1 and PGC-1α. The increase in HSF1 expression in both BAT and WAT, observed with WMW treatment, was crucial for these beneficial effects, as inhibition of HSF1 negated the positive outcomes. Furthermore, WMW treatment led to elevated levels of short-chain fatty acids SCFAs in the intestines, which are associated with increased HSF1 expression.

CONCLUSIONS: WMW represents a potent therapeutic strategy for obesity, promoting metabolic health and beneficial modulation of adipose tissue through an HSF1-dependent pathway.

PMID:39754217 | DOI:10.1186/s13020-024-01053-2

J Orthop Surg Res. 2025 Jan 3;20(1):5. doi: 10.1186/s13018-024-05434-z.

ABSTRACT

OBJECTIVE: To investigate the application value of arthroscopic channel modification in meniscal injury repair.

METHODS: We retrospectively analyzed the data of 100 patients with meniscus injuries treated with knee arthroscopy from December 2022 to December 2023 and divided them into a control group and a modified group according to the application of “arthroscopic access modification technology”. We compared the operation time, postoperative hospitalization time, VAS score, Lysholm knee function score, postoperative complications, and postoperative images of the patients in these two groups. We compared the operation time, postoperative hospitalization time, pre- and postoperative VAS scores, Lysholm knee function scores, postoperative complications and postoperative imaging indices of the patients in the two groups.

RESULTS: All patients successfully underwent surgery and were followed up without intraoperative vascular or nerve injury or postoperative complications such as infection, wound necrosis or thrombosis. The average follow-up time was 16.03 ± 3.69 months; the average operation time and postoperative hospitalization time of the modified group were significantly better than those of the control group were (P < 0.05); the pain and knee function of the two groups significantly improved over time (P < 0.05); and, compared with those of the control group, the modified group could obtain a more satisfactory score at an early stage of the postoperative period (P < 0.05), and the comparison of the intermediate and long-term scores of the two groups was not statistically significant (P > 0.05). There was no statistically significant difference (P > 0.05).

CONCLUSION: The improved arthroscopic access technique can make the entry and exit of instruments into and out of the joint cavity smoother, improve the surgical field of view, significantly shorten the operation time, reduce the occurrence of intraoperative complications, improve the function of patients’ knee joints earlier, and increase their satisfaction with the operation.

PMID:39754209 | DOI:10.1186/s13018-024-05434-z

Diabetol Metab Syndr. 2025 Jan 3;17(1):1. doi: 10.1186/s13098-024-01543-1.

ABSTRACT

BACKGROUND: To identify the relationship between BMI or lipid metabolism and diabetic neuropathy using a Mendelian randomization (MR) study.

METHODS: Body constitution-related phenotypes, namely BMI (kg/m²), total cholesterol (TC), and triglyceride (TG), were investigated in this study. Despite the disparate origins of these data, all were accessible through the IEU OPEN GWAS database ( https://gwas.mrcieu.ac.uk/ ). Instrumental variables and F-statistics for each exposure-outcome pair were determined in weighted mode, weighted median, MR-Egger and Inverse-Variance Weighted (IVW) MR analyses. The p-value threshold was consistently set at 5.00E-08, following established methodology. The preliminary analysis utilized the IVW method to explore potential causal relationships between body constitution-related phenotypes and diabetic neuropathy. Inverse variance weighting, a technique amalgamating random variables, assigns weights inversely proportional to each variable’s variance, commonly used for merging findings from independent studies. The weighted median method provides a causal estimate even when up to 50% of the instruments are invalid, enhancing robustness. The weighted mode method identifies the most common causal effect, reducing bias when some instruments exhibit horizontal pleiotropy. The Wald ratio method was utilized to calculate exposure-outcome effects, employing a range of methodologies to ensure result accuracy across different scenarios. This study addresses the critical gap in understanding the causal relationship between BMI, lipid metabolism, and diabetic neuropathy (DN). Employing a MR approach, it highlights BMI as a predictive factor for DN progression, providing insights into potential risk management strategies.

RESULTS: IVW analysis showed that BMI (P = 0.033, OR = 2.53, 95% CI 1.08-5.96) and triglycerides level (P = 0.593, OR = 1.11, 95% CI 0.77-1.60) were positively associated with the initiation of DN, indicating that the values of BMI and triglycerides are potentially the risk factors in DN development. Additionally, TC was negatively associated with the DN (P = 0.069, OR = 0.72, 95% CI = 0.50-1.03).The forest plot of advanced analysis between BMI and DN relationship indicated a positive correlation between increasing BMI and the risk of DN. In addition, it is evident that with the increase in BMI, the risk of diabetic polyneuropathy also rises. This research demonstrates a positive association between BMI and DN risk (P = 0.033, OR = 2.53, 95% CI = 1.08-5.96). However, no significant correlation was observed between triglycerides (P = 0.593) or total cholesterol (P = 0.069) and DN development, underscoring the complex interplay between lipid metabolism and DN.

CONCLUSION: This research demonstrates a positive association between the risk of DN and BMI, while no significant correlation exists between TG or TC and the development of DN. These results imply that BMI may serve as a predictive factor for the progression of DN.

PMID:39754202 | DOI:10.1186/s13098-024-01543-1

Trials. 2025 Jan 3;26(1):5. doi: 10.1186/s13063-024-08626-4.

ABSTRACT

BACKGROUND: Breast cancer is the most diagnosed cancer in women worldwide and carries a considerable psychosocial burden. Interventions based on Acceptance and Commitment Therapy (ACT) and compassion-based approaches show promise in improving adjustment and quality of life in people with cancer. The Mind programme is an integrative ACT and compassion-based intervention tailored for women with breast cancer, which aims to prepare women for survivorship by promoting psychological flexibility and self-compassion. A pilot study of the Mind programme has shown acceptability and preliminary efficacy in improving quality of life and psychological health. This paper presents the study protocol of two randomised controlled trials that aim to test the efficacy and cost-effectiveness of an optimised version of the Mind programme in women with breast cancer.

METHODS: Participants will be women diagnosed with breast cancer randomly assigned to the Mind programme or a support group intervention (active control) in a 1:1 ratio for study 1, while study 2 includes one more arm (treatment as usual; inactive control) and a 2:2:1 ratio. Both interventions will be delivered weekly via an 8-session face-to-face or online group format. Data will be collected at baseline, post-treatment and 6-month follow-up. The efficacy and cost-effectiveness of the two interventions will be assessed. Treatment outcomes will comprise cancer-specific quality of life (primary outcome), anxiety and depressive symptoms, psychological flexibility, self-compassion, health-related quality of life, resource use, and intervention’s acceptability and feasibility. Study 1 will also include immunological and epigenetic markers associated with breast cancer prognosis and mental health. Outcome assessors will be blind to group allocation. Statistical analyses will be conducted using an intention-to-treat approach. Analyses of moderators and mediators of change will also be performed.

DISCUSSION: These trials examine the efficacy and cost-effectiveness of an integrative ACT and compassion-based intervention tailored for women with breast cancer. Greater improvements in psychosocial, biological and resource use are expected in the Mind group, when compared to the control group(s). Results will likely support the potential benefits of the Mind programme for breast cancer patients and highlight the clinical relevance of integrative and holistic interventions in oncology. TRIALS REGISTRATION {2A, 2B}: ClinicalTrials.gov NCT05642897 and NCT06212414. Registered on December 8, 2022, and January 18, 2024.

PMID:39754194 | DOI:10.1186/s13063-024-08626-4

J Transl Med. 2025 Jan 4;23(1):8. doi: 10.1186/s12967-024-06035-4.

ABSTRACT

BACKGROUND: Anti-CD19 chimeric antigen receptor (CAR) T cell therapy is a common, yet highly efficient, cellular immunotherapy for lymphoma. However, many recent studies have reported on its cardiovascular (CV) toxicity. This study analyzes the cardiotoxicity of CD19 CAR T cell therapy in the treatment of lymphoma for providing a more valuable reference for clinicians.

METHODS: The PubMed, Embase, Cochrane library, and Web of Science databases were comprehensively searched from the time of their establishment to May 2024. The ClinicalTrials.gov English database is a comprehensive repository of the original studies of CD19 CAR T cell therapy and associated adverse outcomes, such as arrhythmia, CV events, and hypotension, in patients with lymphoma. The Cochrane Collaboration tool and the Newcastle-Ottawa Scale (NOS) were used to assess the quality of the included original studies. For RCTs, the Cochrane Collaboration tool was used to assess the risk of bias. For non-randomized studies, the risk of bias was assessed using the NOS quality assessment scale.

RESULTS: A risk analysis of two randomized controlled trials and nine cohort studies, totaling 1379 patients with lymphoma receiving CD19 CAR-T, is conducted. The incidences for all-cause mortality, CV events, and hypotension were found to be 17.8%, 17.8%, and 52.8%, respectively. Additionally, the incidences of heart failure (HF), cardiomyopathy, cardiac arrest, and other CV events are 3%, 0.6%, 1.3%, and 2.5%, respectively. In addition to cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) as adverse events, patients treated with CD19 CAR T cells are also at risk of CV events. The most common CV events are arrhythmia and HF. Our further analysis showed that the incidence of CV events was 28.7% in the elderly and 13.5% in adults. The incidence of CV events in the elderly was higher than that in adults, and it was statistically significant. Furthermore, the incidence of CV events and hypotension is strongly associated with patients with CRS.

CONCLUSION: Therefore, clinicians should pay close attention to the occurrence of such CV events and take timely prevention and intervention measures to further improve the safety of CD19 CAR T cell therapy.

PMID:39754193 | DOI:10.1186/s12967-024-06035-4