Nevin Manimala

Dermatol Surg. 2026 Jan 14. doi: 10.1097/DSS.0000000000004987. Online ahead of print.

ABSTRACT

BACKGROUND: Patient satisfaction with Mohs micrographic surgery is dependent on multiple clinical and surgical factors. This study implements a novel survey to assess patient satisfaction in multiple domains.

OBJECTIVE: (1) To assess whether satisfaction changes over time and (2) to evaluate predictors of patient satisfaction in multiple satisfaction domains.

MATERIALS AND METHODS: The Oxford Skin Cancer Treatment Scale (OxSCanTr) assesses patient satisfaction with scar aesthetics, treatment choice, surgical experience, and postoperative concerns. Surveys were completed immediately after surgery and at 1 week and 4 weeks postoperatively. Clinical and demographic data were collected. Statistical analysis included repeated-measures analysis of variance, univariate, and multivariate repeated-measures linear regression.

RESULTS: Satisfaction does not vary significantly over time. Diabetes, immunosuppression, and linear closure methods are associated with higher total satisfaction. Linear closure method predicts higher total, aesthetic outcome, and treatment experience satisfaction. Patient age, number of Mohs stages, noncutaneous cancer history, tumor location, skin cancer history, postoperative defect size, and absorbable top sutures predict patient satisfaction in at least one domain.

CONCLUSION: This study increases awareness of the clinical and surgical factors that contribute to patient satisfaction with Mohs procedures, which can help to advance patient-centered care.

PMID:41538767 | DOI:10.1097/DSS.0000000000004987

JCO Glob Oncol. 2026 Jan;12:e2500182. doi: 10.1200/GO-25-00182. Epub 2026 Jan 15.

ABSTRACT

PURPOSE: Treatment completion (TC), defined by completing the recommended treatment regimen, and treatment adherence (TA), defined by completing the prescribed treatment in the expected time frame, are critical for improving breast cancer (BC) mortality. Therefore, we conducted this study to measure TC and TA in Tanzania.

METHODS: BC treatment data from 2019 to 2020 at Ocean Road Cancer Institute (ORCI) were collected. Demographic, socioeconomic, and clinical profiles were identified. TC and TA were measured by comparing chemotherapy and radiotherapy prescribed regimens to received treatment.

RESULTS: Overall, 813 patients were seen at ORCI between 2019 and 2020. Mean age of patients was 51 ± 12.5 years; 97.9% identified as female; and 67.6% resided outside of Dar es Salaam. Stage III/IV disease was identified in 43.8% patients, with 24.1% showing clinical evidence of metastasis on arrival. TC across treatments ranged between 46.8% and 47.4%, while overall TA was 21.2%. TC was associated with not having metastasis on arrival (P = .01) and residing in proximity to ORCI (P = .04). TA was associated with having insurance (P < .0001) and attending a follow-up appointment after treatment (P < .0001).

CONCLUSION: Poor TC and TA rates in Tanzania pose a significant risk to treatment efficacy. Interventions are needed to specifically target patients with advanced-stage disease and greater geographic distance to treatment to increase treatment compliance.

PMID:41538753 | DOI:10.1200/GO-25-00182

J Clin Oncol. 2026 Jan 15:JCO2500826. doi: 10.1200/JCO-25-00826. Online ahead of print.

ABSTRACT

PURPOSE: First-line treatment options for cisplatin-ineligible patients with metastatic urothelial cancer (mUC) are limited. We conducted a phase II study of erdafitinib, alone or with cetrelimab, in FGFR-altered mUC.

METHODS: Adults with mUC and select FGFR alterations who are ineligible for cisplatin were randomly assigned 1:1 in a noncomparative design to once-daily erdafitinib 8 mg (with pharmacodynamically guided uptitration to 9 mg) or erdafitinib 8 mg plus intravenous cetrelimab 240 mg once every 2 weeks at cycles 1-4 and 480 mg once every 4 weeks thereafter. Primary end points were investigator-assessed confirmed overall response rate (ORR) and safety; secondary end points included duration of response (DOR), progression-free survival, and overall survival (OS). No statistical hypotheses were tested.

RESULTS: At data cutoff, 87 patients were randomly assigned and treated (erdafitinib, n = 43; erdafitinib plus cetrelimab, n = 44). Of 64 patients with PD-L1 expression data, 56 (87.5%) had low levels of PD-L1 expression (combined positive score <10). Median survival follow-up was 14.2 months. Investigator-assessed confirmed ORR for erdafitinib was 44.2% (95% CI, 29.1 to 60.1) with one complete response (CR); median DOR and median OS were 9.7 months (95% CI, 4.6 to not estimable [NE]) and 16.2 months (95% CI, 8.3 to NE), respectively. Investigator-assessed confirmed ORR for erdafitinib plus cetrelimab was 54.5% (95% CI, 38.8 to 69.6), with six (13.6%) CRs; median DOR and median OS were 11.1 months (95% CI, 8.8 to NE) and 20.8 months (95% CI, 12.0 to NE), respectively. The most frequent treatment-related adverse events (TRAEs) were hyperphosphatemia (83.7% and 68.2% in erdafitinib and erdafitinib plus cetrelimab groups, respectively), stomatitis (69.8% and 56.8%), and dry mouth (37.2% and 56.8%). Grade ≥3 TRAEs occurred in 46.5% and 45.5% of patients receiving erdafitinib and erdafitinib plus cetrelimab, respectively.

CONCLUSION: First-line erdafitinib monotherapy and erdafitinib plus cetrelimab demonstrated antitumor activity and a manageable safety profile in cisplatin-ineligible patients with mUC.

PMID:41538748 | DOI:10.1200/JCO-25-00826

J Clin Oncol. 2026 Jan 15:JCO2501660. doi: 10.1200/JCO-25-01660. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the clinical benefit of extended endocrine therapy (eET) after 5 years of adjuvant treatment with luteinizing hormone-releasing hormone agonists (LHRHa) in premenopausal women with node-positive, hormone receptor-positive early breast cancer (eBC).

METHODS: We conducted a cohort study analysis on two prospectively collected data sets (the Young Women’s Breast Cancer Study and IEO Breast Cancer Cohort). Eligible patients were diagnosed with eBC at age ≤40 years (between 2005 and 2016), had node-positive, hormone receptor-positive disease, and remained premenopausal after 5 years of adjuvant LHRHa with no evidence of recurrence. The primary end point was invasive breast cancer-free survival (IBCFS), calculated from the sixth year after the initiation of adjuvant endocrine therapy (ET; study baseline), and adjusted through the propensity score (PS) weighting analysis.

RESULTS: A total of 501 patients were included in the analysis: 287 received eET for a median duration of 3.7 years (IQR, 2.3-5.0), including 48% tamoxifen monotherapy and 52% LHRHa plus tamoxifen or aromatase inhibitor. After a median follow-up of 7.3 years from the study baseline, the PS weighted IBCFS rates at 5 years were 85% in the eET group and 78% in the non-eET group (hazard ratio [HR], 0.63 [95% CI, 0.44 to 0.89]; P = .0135). The PS weighted distant recurrence-free survival rates at 5 years were 91% and 83% in the eET and non-eET group, respectively (cause-specific HR, 0.49 [95% CI, 0.31 to 0.79]). In both groups, bone fractures and major cardiovascular events were reported in 1% of patients.

CONCLUSION: In this cohort study analysis, extending ET in premenopausal patients with node-positive eBC after 5 years of LHRHa treatment was associated with a clinically meaningful reduction in both invasive and distant breast cancer recurrences.

PMID:41538747 | DOI:10.1200/JCO-25-01660

Cad Saude Publica. 2026 Jan 9;41(12):e00012225. doi: 10.1590/0102-311XPT012225. eCollection 2026.

ABSTRACT

The aim of the present study was to assess generational differences in food consumption among Brazilian adults born between 1928 and 1988. Data from the 2008-2009 (n = 25,324) and 2017-2018 (n = 36,480) Brazilian National Dietary Surveys were analyzed. Foods were classified according to the degree of processing using the NOVA classification. Differences in consumption between generations were assessed by comparing individuals in the same age group in each survey. To assess the effect of income on the consumption of ultra-processed foods, a linear regression model was developed for each income quartile. A reduction in total calorie intake was found in younger generations in both sexes and all age groups. In 2017-2018, younger generations (20 to 39 years of age) with lower income levels consumed a greater frequency of ultra-processed foods compared to older generations. The percentage contribution of each NOVA classification group to total caloric intake was similar across generations. The analyses demonstrated generational differences in food consumption among Brazilian adults born between 1928 and 1988. Among individuals 20 to 39 years of age, those belonging to younger generations had a greater consumption of ultra-processed foods compared to older generations, but only among lower income groups.

PMID:41538696 | DOI:10.1590/0102-311XPT012225

Cad Saude Publica. 2026 Jan 9;41(12):e00098324. doi: 10.1590/0102-311XEN098324. eCollection 2026.

ABSTRACT

This study examined the health-disease process among women agriculturalists in traditional communities of the Central Amazon, focusing on the intersections between labor, environmental conditions, and social factors. Fieldwork was conducted in the Rio Negro Sustainable Development Reserve, using semistructured interviews and participant observation across five communities. Content analysis was validated by rarefaction and word co-occurrence techniques, confirming the adequacy of the sample and the obtained thematic categories. Results indicate that agricultural work contributes to women’s health, autonomy, and dignity, while also exposing them to physical risks such as accidents and bodily strain. Care practices centered around traditional remedies and limited access to primary healthcare, which is hampered by long distances and resource shortages. Land conflicts, illegal land grabbing, and the impacts of major infrastructure projects, such as the Rio Negro Bridge and the proposed roads, further undermine healthcare provision. This study concludes that the multifactorial health-disease process is deeply tied to living and working conditions within a broader socioenvironmental context. Strengthening primary care and safeguarding traditional territories are essential to ensuring comprehensive health for these populations.

PMID:41538692 | DOI:10.1590/0102-311XEN098324

Cad Saude Publica. 2026 Jan 9;41(12):e00076025. doi: 10.1590/0102-311XEN076025. eCollection 2026.

ABSTRACT

Brazil is the third country that most receives Venezuelan migrants, with approximately 626,000 people. This migratory flow has increased demand on the Brazilian Unified National Health System, especially for care related to pregnancy and childbirth. The aim of the present study was to investigate access to healthcare on the part of Venezuelan migrant women and their perceptions of the care received in Brazil during their prenatal and childbirth care journey. A quantitative-qualitative study was conducted between 2021 and 2023 involving Venezuelan women who reside in the city of Manaus, Amazonas State. In the quantitative component, participant-driven sampling was used (n = 118), with calculation of absolute frequencies and prevalence rates with 95% confidence intervals. The qualitative component involved intentional sampling (n = 39) and Thematic Analysis. In the quantitative results, most participants received prenatal care (95%) mainly at public healthcare services beginning in the first trimester (83%) and with an adequate number of appointments (77%). The majority of births (58%) were natural and 95% of the women had an accompanier. Maternal and neonatal complications were reported in 14% and 21% of cases, respectively. The qualitative component identified difficulties in obtaining exams through the healthcare system and in forming a bond with the maternity ward during prenatal care, travelling from maternity to maternity, and cultural differences that influenced the perceptions of the care received. Language was also a factor that impacted the quality of care. In conclusion, care during pregnancy and childbirth was ensured in the Brazilian universal healthcare system, although challenges persist that require improvement based on the experiences of the migrant women.

PMID:41538690 | DOI:10.1590/0102-311XEN076025

Cad Saude Publica. 2026 Jan 9;41(12):e00074025. doi: 10.1590/0102-311XEN074025. eCollection 2026.

ABSTRACT

This study evaluated individual factors associated with the use of oral health services by Brazilian adults according to sex. This cross-sectional analysis used secondary data from the 2019 Brazilian National Health Survey. Data from 65,803 adults aged 18-59 years were included. The outcome was “the use of oral health services”. Independent variables were grouped into three constructs: sociodemographic data as predisposing factors, economic and access-related characteristics as capacity factors, and data on oral health conditions as need factors. Data were analyzed in Stata 15.0, using the structural equation modeling. Structural models were estimated for males and females. Analysis stratified by sex presented adequate adjustment indicators: comparative fit index > 0.90, Tucker-Lewis index > 0.90, and standardized root mean square residual < 0.05. The final models showed that predisposing factors effected capacity factors (β = 0.61 for men; β = 0.54 for women), which, in turn, directly affected need factors (β = -0.24 for men; β = -0.26 for women) and the outcome (β = 0.23 for men; β = 1.15 for women). The final structural model demonstrated a good fit, with need factors also directly affecting the outcome (β = 0.10 for men; β = 0.09 for women). All coefficients were statistically significant (p < 0.001). The use of oral health services was indirectly influenced by sociodemographic factors, and directly and indirectly influenced by economic and access-related factors. Oral health conditions had a direct effect on service use, with no variation between sexes. However, men were more affected by predisposing and capacity factors than women.

PMID:41538689 | DOI:10.1590/0102-311XEN074025

Rev Bras Enferm. 2026 Jan 9;78(suppl 3):e20250290. doi: 10.1590/0034-7167-2025-0290. eCollection 2026.

ABSTRACT

OBJECTIVES: to interpret young university students’ experiences regarding elder abuse and develop a theoretical model.

METHODS: a qualitative study, based on Strauss’ approach of Grounded Theory and Bauman’s theoretical framework, with theoretical saturation sampling, in which 34 university students from different areas were interviewed. Data processing used NVivo software. The study was approved by the Research Ethics Committee.

RESULTS: participants highlighted different types of elder abuse as well as their invisibility and trivialization in society. Older adults’ frailty and vulnerability were identified as risk factors, suggesting preventive strategies, including the inclusion of the topic in academic curricula, the promotion of healthy aging, and the strengthening of public policies.

FINAL CONSIDERATIONS: the theoretical model developed highlights the urgent need for educational interventions based on a critical understanding of this problem, with an emphasis on human sensitivity and the morality of social interactions.

PMID:41538683 | DOI:10.1590/0034-7167-2025-0290

Rev Saude Publica. 2026 Jan 12;59:e54. doi: 10.11606/s1518-8787.2025059006956. eCollection 2026.

ABSTRACT

OBJECTIVE: To describe all stages of developing strategies and quality control in the Aging and Brain Working Study linked to the Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil – Brazilian Longitudinal Study of Adult Health), a prospective cohort of 15,105 civil servants (aged 35-74) followed up since 2008.

METHODS: Based on the sample of participants alive at the beginning of the sample selection in September 2022 (n = 4,566) from ELSA-Brasil (Centro Investigação São Paulo), a representative sample of 2,165 individuals was calculated according to the following criteria and divided into two subsamples: (1) Sample of participants < 70 years old in Wave 3 (2017-2019) randomized according to cognitive trajectory from Wave 1 to 3, n = 1,670; (2) SuperAgers case-control sample, individuals aged ≥ 70 years in Wave 3, based on episodic memory in Wave 3, n = 495 participants (171 cases, 324 controls). The processes implemented to ensure quality control of information prior to data collection were selection of data collection instruments, training and certification of teams, preparation of a manual of definitions and standardized operating procedures, pilot studies, data collection logistics, harmonization of imaging protocols, and creation of an anti-noise device. Given the scope of the study, its multicenter nature, and the diversity of measures involved, this project required the implementation of effective quality assurance and control protocols, ensuring standardization, methodological consistency, and data integrity at all stages.

RESULTS: After implementing the quality assurance and control processes, the final stages related to clinical and imaging data collection, management, and continuous monitoring of field activities were conducted, with weekly reports and statistical monitoring of the sample.

CONCLUSIONS: The adoption of systematic stages of development and quality control was fundamental to ensure the production and reliability of information from brain neuroimaging studies.

PMID:41538678 | DOI:10.11606/s1518-8787.2025059006956