Nevin Manimala

Ir J Med Sci. 2026 May 6. doi: 10.1007/s11845-026-04418-8. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the relationship between cervical area (CA) measured by two-dimensional (2D) transvaginal ultrasonography (TVUS) and the latency period in pregnancies complicated by preterm premature rupture of membranes (PPROM), and to compare its predictive performance with that of cervical length (CL).

METHODS: This retrospective cohort study included 164 singleton pregnancies with PPROM (24 + 0-32 + 3 weeks). Archived TVUS images obtained within 24 h of admission were reanalyzed in a blinded manner. CA (cm²), CL (mm), and cervical funneling were recorded. The latency period was defined as the time from membrane rupture to delivery and categorized as short (≤ 10 days) or long (> 10 days). Group comparisons, correlation analyses, receiver operating characteristic (ROC) curves, and multivariable logistic regression were performed to identify independent predictors.

RESULTS: Seventy-eight pregnancies had a short latency period. Both CL and CA were significantly lower in the short-latency group. Although the area under the curve (AUC) for CA was higher than that for CL (0.763 vs. 0.678), pairwise comparison using the DeLong test did not show a statistically significant difference (p = 0.064). In the multivariable analysis, cervical funneling (adjusted OR 10.777, 95% CI 4.456-26.063; p < 0.001) and CA (adjusted OR 0.701, 95% CI 0.598-0.822; p < 0.001) remained independent predictors of a short latency, whereas CL lost significance (p = 0.383). CA and CL showed a positive correlation with the latency period (p < 0.001).

CONCLUSIONS: CA measured by 2D-TVUS is an independent predictor of the latency period in PPROM and shows comparable discriminative ability to CL. Incorporating CA assessment may improve risk stratification and aid in timely perinatal management decisions in PPROM pregnancies.

PMID:42090061 | DOI:10.1007/s11845-026-04418-8

Ir J Med Sci. 2026 May 6. doi: 10.1007/s11845-026-04427-7. Online ahead of print.

ABSTRACT

BACKGROUND: Ischemic cardiomyopathy (ICM) and idiopathic dilated cardiomyopathy (DCM) shared common structural alterations with a high mortality from sudden cardiac death (SCD) and pump failure. Implantable cardioverter-defibrillator (ICD) has been confirmed both beneficial and cost-effective for primary prevention of SCD in patients with ischemic or non-ischemic heart diseases. The management of heart failure has improved due to the of implantation of ICD and cardiac resynchronization therapy-defibrillator (CRT-D). It remains unclear whether there is a difference in clinical effectiveness of primary prophylactic ICD implantation between patients with ICM and DCM.

METHODS: We conducted a retrospective, single-center study, which enrolled 53 DCM patients and 25 ICM patients with guideline indications for primary prophylactic ICD or CRT-D treatment. Primary endpoint was all-cause mortality and secondary outcomes included cardiovascular death.

RESULTS: During a median follow-up of 38.5 months, all-cause death occurred in 8 patients (32%) in the ICM group and 5 patients (9.43%) in the DCM group (P = 0.012). Cardiovascular death occurred in 5 patients (20%) in the ICM group and 3 patients (5.66%) in the DCM group (P = 0.052). Multivariable Cox regression analysis showed that cardiogenic mortality in the ICM group is higher than that in the DCM group (hazard ratio [HR] 0.119, 95% confidence interval (CI) 0.016 to 0.860, P = 0.035).

CONCLUSIONS: Among patients who received ICD implantation for the primary prevention of SCD, there is no statistical difference in benefits between DCM and ICM patients. However, compared with DCM patients, ICM patients have a higher cardiovascular mortality, due to more exposure to risk factors.

PMID:42090060 | DOI:10.1007/s11845-026-04427-7

Eur J Nutr. 2026 May 6;65(4):129. doi: 10.1007/s00394-026-03979-9.

ABSTRACT

PURPOSE: Evidence indicates that early-life nutrition may influence later cardiometabolic health, but most studies examine individual outcomes rather than multiple markers. This study assessed the relationship between macronutrient intake at 12 months and cardiometabolic health at ages 5-6 years in preschool children from the EDEN mother-child cohort.

METHODS: Macronutrient intake was derived from 3-day food records, standardized as SD. Body mass index z-scores (z-BMI) were calculated using International Obesity Task Force (IOTF) references. Four sex-specific cardiometabolic phenotypes, based on anthropometric and biological data, were previously identified: “Higher adiposity, blood pressure (BP) and insulin resistance (IR)”, “Higher IR and lower adiposity”, “Higher triglycerides, low-density lipoprotein cholesterol (LDL-c) and lower high-density lipoprotein cholesterol (HDL-c)”, and “Higher BP and lower adiposity”. Multivariable linear regressions examined associations between macronutrients and z-BMI (for 426 boys, 387 girls) and cardiometabolic phenotypes (256 boys, 221 girls).

RESULTS: In girls, higher fat intake at 12 months was linked to higher z-BMI at 5-6 years (β = 0.07 [95%CI 0.00; 0.15]). In boys, greater mono- and disaccharide intake was associated with a higher score on the “Higher triglycerides, LDL-c, and lower HDL-c” pattern (β = 0.22 [0.04; 0.41]), while in girls, it was associated with the “Higher BP and lower adiposity” pattern (β = 0.18 [0.01; 0.35]). Other macronutrients showed no significant associations.

CONCLUSION: In infancy, higher fat intake may contribute to a higher z-BMI in girls in early childhood, and higher sugar intake to less favourable cardiometabolic health.

PMID:42090019 | DOI:10.1007/s00394-026-03979-9

Eur J Orthop Surg Traumatol. 2026 May 6;36(1):186. doi: 10.1007/s00590-026-04765-3.

ABSTRACT

BACKGROUND: This study aims to describe a cohort of patients who underwent conversion to total hip arthroplasty (THA), comparing surgical approach and robotic assistance.

METHODS: Patients ≥ 18 years who underwent conversion to THA between January 1, 2015 and May 6, 2024, were retrospectively reviewed, and additionally contacted via telephone for updated patient reported outcome measures (PROMs), including the Hip Disability and Osteoarthritis Outcome Score, Joint Replacement (HOOS, JR) questionnaire. Surgical approach and robotic assistance were per surgeon preference, with consideration for the approach of the previous hip surgery. Descriptive statistics were calculated, and continuous variables analyzed using the Student’s T-Test, the Wilcoxon Ranked Sum Test. Categorical variables were compared using Chi-Squared Tests and Fisher’s Exact Tests, and outcomes analyzed with logistic regression in R statistical software.

RESULTS: 83 patients met inclusion (53% anterior approach; 26.5% robotic assistance). Conversion via anterior approach demonstrated shorter operative times than posterior (by 45.9 min; p < 0.001), in addition to fewer postoperative transfusions (22.7% vs. 53.8%; p = 0.006). Length of stay (LOS), and fluoroscopy time were not significant. When stratified by previous surgery 37 patients were converted from prior intramedullary nail, 16 via the anterior approach. Mean operative time remained shorter (p = 0.003) and transfusion remained less (p = 0.015) compared to posterior conversion in this subset. Robotic assistance was associated with shorter operative times (by 44.9 min p < 0.001), and shorter LOS (p < 0.001). Zero robotic-assisted patients required transfusion within 24 h postoperatively compared to 50.8% of non-robotic cases (p < 0.001), although transfusion risk was not significant considering approach or robotic assistance after multivariable regression controlling for preoperative hemoglobin. PROMs were equivocal between compared groups (mean HOOS Jr 11.0 ± 5.1, response rate 42.2%).

CONCLUSION: Conversion THA demonstrates acceptable outcomes, with documented overall improvements in postoperative function. The anterior approach and robotic assistance were associated with significantly shorter surgical times, and less risk of transfusion, potentially demonstrating some advantage in this conversion scenario, although patient selection may have also influenced outcomes.

PMID:42090018 | DOI:10.1007/s00590-026-04765-3

World J Urol. 2026 May 6;44(1):343. doi: 10.1007/s00345-026-06428-8.

ABSTRACT

INTRODUCTION: Laser enucleation of the prostate (LEP) has become a standard treatment for benign prostatic obstruction, yet its adoption is limited by a steep learning curve and a lack of validated training models. This study aimed to evaluate the face and content validity of a bench-top simulator specifically developed for LEP training within the framework of the European School of Urology (ESU) Lower Urinary Tract Endoscopy Working Group.

METHODS: Fourteen expert endourologists assessed the simulator during the European Urology Residents Education Programme (EUREP) 2025. Face and content validity were evaluated using 4-point Likert questionnaires, structured using the ESU validation framework. Descriptive statistics and content validity indices (I-CVI, S-CVI/Ave, S-CVI/UA) were calculated to assess agreement across anatomical, procedural, and educational domains.

RESULTS: Face validity scores were high across all items (mean 3.57-3.86; ≥90% agreement). The overall S-CVI/Ave was 0.85 and S-CVI/UA 0.47. Domain-specific analysis showed strong content validity for procedural steps (S-CVI/Ave = 0.89) and educational/global domains (0.95), moderate validity for essential anatomy (0.81), and lower ratings for intraoperative conditions (0.69), primarily due to the absence of bleeding simulation. When restricted to core domains (procedural + educational), S-CVI/Ave improved to 0.91.

CONCLUSION: The simulator demonstrated strong face and content validity. Expert ratings indicated favorable perceptions of its realism, procedural similarity, and educational utility. These findings suggest that the simulator may be a useful component of a structured transurethral procedural training curriculum, although further construct validation is needed.

PMID:42090017 | DOI:10.1007/s00345-026-06428-8

Int Ophthalmol. 2026 May 6;46(1):226. doi: 10.1007/s10792-026-04094-8.

ABSTRACT

PURPOSE: To compare the intraoperative complication rates and incidence of postoperative day 1 (POD1) intraocular pressure (IOP) elevation in primary phacoemulsification cataract surgery performed by residents and staff surgeons in a teaching hospital and determine the risk factors associated with posterior capsule tear (PCT) and POD1 IOP elevation.

METHODS: This retrospective study included all cases of primary phacoemulsification in patients aged 18 years or older, performed by residents and staff surgeons from May 27, 2022, to May 31, 2023 in a tertiary eyecare center in Turkey. There were no exclusion criteria. Data collected included primary surgeon, level of experience, preoperative status of cases, intraoperative complications, other operative details and POD1 IOP measurements.

RESULTS: A total of 1500 surgeries were included; 68.8% were performed by residents. Overall intraoperative complication rates were similar in groups in simple and complex cases. There was no statistically significant difference in PCT rates between groups in simple (2.4% and 1.9%, p = 0.800) and complex cases (3.7% and 5.1%, p = 0.455). Rate of POD1 IOP elevation above 25 mm Hg was also similar in groups (22.7% and 22.6%, p = 0.903). Pseudoexfoliation + small pupil and special cataracts were significant risk factors for PCT among residents (p = 0.048 and p = 0.033, respectively). Pseudoexfoliation + small pupil, glaucoma or ocular hypertension and uveitis were significant risk factors for POD1 IOP elevation.

CONCLUSION: Overall intraoperative complication and PCT rates were comparable between residents and staff surgeons in both simple and complex cases. Resident involvement was not a risk factor for POD1 IOP elevation.

PMID:42090014 | DOI:10.1007/s10792-026-04094-8

Eur J Trauma Emerg Surg. 2026 May 6;52(1):159. doi: 10.1007/s00068-026-03207-3.

ABSTRACT

PURPOSE: Tibial plateau fractures (TPF) are often associated with non-bony injuries that may impair knee stability and long-term outcomes. However, it remains unclear in which patients preoperative MRI is indicated to detect these injuries, and clear recommendations for surgical decision making are lacking. This study aimed to develop a CT-based predictor of surgically relevant non-bony injuries.

METHODS: This retrospective single-center study included all intra-articular TPF treated between January 2022 and May 2025 at a Level I trauma center. Fractures were classified according to the 10-segment and three-column classifications. Operative reports were reviewed to identify non-bony injuries requiring surgical treatment. Descriptive statistics and multivariate logistic regression were performed to determine predictors of surgically relevant non-bony injuries.

RESULTS: Among 243 patients (mean age 49,3 ± 14,9 years), 34,6% had at least one surgically treated non-bony injury. Posterior column involvement was significantly associated with a higher injury rate (41,4%), particularly affecting meniscus (20,7%), Anterior cruciate ligament (ACL) (17,2%), and medial collateral ligament (MCL) (12,3%). The posterolateral-central (PLC) segment showed the highest segment-specific injury rate (37,6%) and was an independent predictor of ACL injury. Increasing fracture complexity was associated with a higher incidence of soft tissue injuries.

CONCLUSION: TPF should be regarded as complex intra-articular injuries rather than simple bone fractures. This study provides a CT-based tool to identify fracture patterns associated with surgically relevant non-bony injuries. These findings may support indications for preoperative MRI, guide treatment strategies, and help prevent poor outcomes and post-traumatic osteoarthritis.

PMID:42090008 | DOI:10.1007/s00068-026-03207-3

Child Neuropsychol. 2026 May 6:1-15. doi: 10.1080/09297049.2026.2659058. Online ahead of print.

ABSTRACT

This study aimed to provide a comprehensive comparison of inhibitory control performance among children with Attention-Deficit/Hyperactivity Disorder (ADHD), Specific Learning Disorder (SLD), and comorbid ADHD+SLD, relative to typically developing peers. It sought to clarify whether inhibitory control deficits are generalized across tasks or specific to distinct types of inhibition. A total of 120 children (30 per group; aged 9-11 years) participated. Three tasks assessed different facets of inhibitory control: the Stroop Color-Word Test (interference suppression), the Cued Go/No-Go Task (prepotent response inhibition), and the Stop-Signal Task (cancellation of ongoing responses). Analyses controlled for baseline processing speed. Findings revealed distinct inhibitory profiles. Children with ADHD showed broad deficits across all tasks, most pronounced in the Cued Go/No-Go Task, indicating a core weakness in prepotent response inhibition. The SLD group demonstrated slower reaction times, particularly in the Cued Go/No-Go Task in the initial analysis. Slower responses reflect both processing-speed deficits and potential differences in motor planning and execution. However, after statistically controlling for these general speed effects, the SLD group’s profile revealed a specific and significant deficit only in interference suppression, with no core impairment in prepotent response inhibition or action cancellation. The comorbid ADHD+SLD group exhibited the most severe and pervasive deficits across all measures, exceeding single-diagnosis groups, suggesting a synergistic impairment. These results support the multidimensional nature of inhibitory control and highlight disorder-specific neurocognitive signatures. The findings underscore the need for differentiated assessment and intervention approaches targeting distinct inhibitory processes and processing-speed deficits, particularly in children with comorbid conditions.

PMID:42089258 | DOI:10.1080/09297049.2026.2659058

J Prosthodont. 2026 May 6. doi: 10.1111/jopr.70154. Online ahead of print.

ABSTRACT

PURPOSE: To assess current utilization of the Prosthodontic Diagnostic Index (PDI), identify perceived benefits and limitations, and evaluate support for future updates.

MATERIALS AND METHODS: A survey regarding the use of the PDI was made available through email invitations to 68 US dental school prosthodontic/restorative department chairs (PD), 48 graduate prosthodontic program directors (GP), and 1834 private practice prosthodontists (PP) from the American College of Prosthodontists (ACP) member database. The results of this initial survey were inconclusive due to low response rates. The survey was also administered during the 2024 ACP Annual Session with an improved response rate for educators. Descriptive statistics were used to analyze responses from predoctoral education programs and graduate prosthodontic programs.

RESULTS: Responses were received from 43.8% (n = 21) graduate prosthodontic programs (GP) and 35.3% (n = 24) predoctoral programs (PD). The PDI was taught to graduate prosthodontic residents at 100% (n = 21) of the responding programs and at 58% (n = 14) of responding predoctoral programs. In contrast, the response rate for private practice prosthodontists, 2% (n = 43), was too low for statistical analysis. The PDI was used for new patient screening in 76.2% (n = 16) of GP and 41.7% (n = 10) of PD programs. The PDI was valued for enhancing diagnostic consistency (81.0%, n = 17 GP and 83.3%, n = 21 PD) and objective patient screening (90.5%, n = 19 GP and 87.5%, n = 21 PD). Common themes were observed in open-ended questions regarding the limitations of the PDI, including that the system was cumbersome, complicated, time-consuming to use, issues with calibration across all cohorts, and lacked recognition by general dentists and other dental specialists. The majority of respondents agreed that the PDI needs an update (76.2%, n = 16 GP and 66.7%, n = 16 PD), including the development of an ACP-endorsed classification system for implant-based treatment (81.0%, n = 17 GP and 91.7%, n = 22 PD).

CONCLUSIONS: The PDI is viewed as a beneficial diagnostic and educational tool in academic settings. However, it is complex and has limited alignment with contemporary prosthodontic practice. A revision of the classification system could address current limitations and better support clinical decision-making.

PMID:42089246 | DOI:10.1111/jopr.70154

J Am Heart Assoc. 2026 May 6:e047074. doi: 10.1161/JAHA.125.047074. Online ahead of print.

ABSTRACT

BACKGROUND: Stroke remains a leading cause of mortality and disability worldwide, requiring modifiable risk factors for prevention. Oral health, particularly posterior occlusal contact that supports mastication, may influence systemic vascular outcomes; however, its role in stroke remains unclear. This study investigated whether reduced posterior occlusal contact independently predicts stroke in Japanese adults.

METHODS: We conducted a retrospective cohort study using data collected from April 2016 to March 2022 from a nationwide health insurance database in Japan. Adults aged 40 to 74 years without a history of stroke were included. Posterior occlusal status was categorized as Eichner A (full posterior occlusal contact), B (partial contact), or C (no contact). The primary outcome was stroke incidence, identified using validated insurance claims. Cox proportional hazards models were used to estimate hazard ratios (HRs), adjusting for demographics, health behaviors, comorbidities, and tooth counts.

RESULTS: Among 981 543 participants (mean age 49.6±7.0 years; 57.5% male) followed for 2 712 815 person-years, 7086 strokes occurred. In adjusted Cox models, Eichner B was significantly associated with higher stroke risk than Eichner A (HR, 1.26 [95% CI, 1.10-1.44], P<0.001). Eichner C showed elevated risk, although not statistically significant (HR, 1.17 [95% CI, 0.91-1.50], P=0.229). Associations were observed in both sexes and across age groups.

CONCLUSIONS: Reduced posterior occlusal support was associated with higher stroke risk independent of tooth count and conventional vascular risk. These findings highlight that posterior occlusal support may represent a potential marker of cerebrovascular risk and warrant further investigation into its clinical relevance.

PMID:42089190 | DOI:10.1161/JAHA.125.047074