Nevin Manimala

Rhinology. 2025 Nov 14. doi: 10.4193/Rhin24.049. Online ahead of print.

ABSTRACT

BACKGROUND: A healthy olfactory cleft is critical to normal olfactory function. The aim of this study was to explore the differential orthonasal and retronasal olfactory functions in patients with olfactory cleft (OC) obstructions including a combination of OC syndrome, chronic rhinosinusitis with or without nasal polyps (CRSwNP or CRSsNP), and respiratory adenomatoid epithelial hamartoma (REAH).

METHODS: Patients (n = 93) presenting to an ENT clinic with OC obstruction underwent nasal endoscopy, chemosensory event-related potential (ERP) recordings, and radiologic assessment, and were subsequently diagnosed with OC syndrome, CRSsNP with OC syndrome, CRSwNP in the OC, REAH, and CRSwNP with REAH. Orthonasal and retronasal function were assessed using the complete Sniffin’ Sticks test and a set of 30 powders, respectively.

RESULTS: Orthonasal function was lower in patients with REAH and CRSwNP+REAH compared to CRSwNP in OC patients. Retronasal function was similarly diminished in REAH compared to CRSwNP in OC. Patients with OC syndrome alone had higher orthonasal scores than those with CRSsNP plus OC syndrome and CRSwNP in OC but not statistically different retronasal function. There was no significant difference in orthonasal or retronasal scores in REAH patients based on concurrent CRSwNP.

CONCLUSIONS: REAH corresponded with greater orthonasal and retronasal olfactory loss compared to other olfactory cleft obstructions, indicating a greater effect on the olfactory mucosa beyond disrupting airflow. The difference between CRS and OC syndrome is more pronounced orthonasally than retronasally.

PMID:41235453 | DOI:10.4193/Rhin24.049

Knee Surg Sports Traumatol Arthrosc. 2025 Nov 14. doi: 10.1002/ksa.70188. Online ahead of print.

ABSTRACT

PURPOSE: The primary objective was to assess the clinical efficacy and patient satisfaction following arthrolysis for Cyclops syndrome postanterior cruciate ligament reconstruction (ACLr). The secondary objective was to compare clinical and functional outcomes in patients who underwent early and late arthroscopic debridement. We hypothesised that arthroscopic anterior arthrolysis for Cyclops syndrome post-ACLr leads to significant improvement in functional outcomes and patient satisfaction.

METHODS: One hundred ninety-seven patients underwent arthroscopic anterior arthrolysis for Cyclops syndrome after primary ACLr between 1 January 2018 and 1 July 2024. The simple knee value (SKV), International Knee Documentation Committee (IKDC), return to sports after injury (RSI) score, Tegner score and time to return to sports (RTS) were assessed. Subgroup analyses were performed to compare early (≤6 months) versus late debridement (>6 months) and evaluate the impact of age and symptoms, using a linear and logistic regression analyses.

RESULTS: 4.3% (n = 197) of our primary ACLr underwent an arthroscopic arthrolysis for Cyclops syndrome. One hundred eighty-two patients (92%) would repeat the anterior debridement. The mean SKV was 79.6 ± 16.4%, the mean IKDC score was 80.1 ± 13.3 and the mean RSI score was 62.7 ± 26.6. Younger age than 24.5 at ACLr was significantly associated with RTS to preinjury level following arthroscopic debridement of the Cyclops lesion (p = 0.039), and age younger than 29.5 years was significantly linked to resumption of running (p = 0.001). No statistically significant difference was found between early and late debridement when it came to RTS (6.9 ± 5.5 vs. 5.3 ± 4.4; p = 0.10) and functional scores (SKV 82.1 ± 10.6 vs. 79.0 ± 17.5; p = 0.19, IKDC 83.3 ± 11.1 vs. 79.3 ± 13.7; p = 0.12, RSI 67.4 ± 22.9 vs. 61.4 ± 27.4, p = 0.23).

CONCLUSION: Arthroscopic anterior arthrolysis for Cyclops syndrome post-ACLr is an effective and satisfactory procedure regardless of timing. Young population achieve superior functional recovery and RTS to preinjury level.

LEVEL OF EVIDENCE: Level IV.

PMID:41235440 | DOI:10.1002/ksa.70188

AIDS Patient Care STDS. 2025 Nov;39(11):462-472. doi: 10.1177/10872914251395736.

ABSTRACT

Young Black sexual minority men living with HIV (YBSMM+) consistently report reduced engagement in the HIV care continuum. YBSMM+ are also highly burdened by depressive symptoms, which are strongly associated with suboptimal HIV care outcomes. Yet, little is known about the processes that drive depression-related disparities among YBSMM+. Informed by Minority Stress Theory, we examined three indirect effects, assessing whether the associations between experiences of racism, heterosexism, and HIV-related discrimination and depressive symptoms were mediated by three corresponding forms of internalized stigma. Participants included 216 YBSMM+ from the Southern United States who were assessed at three consecutive time points (longitudinal analyses), as well as 172 YBSMM+ who completed a fourth assessment (cross-sectional analysis). Data were collected from November 2016 to October 2022. Multiple regression analyses revealed that more frequent HIV-related discrimination at baseline significantly predicted greater internalized HIV stigma at the subsequent assessment, and that greater internalized racism at the fourth visit was significantly associated with more frequent depressive symptoms. No indirect effects achieved statistical significance, although recall bias due to long follow-up intervals may have affected the findings. These results suggest that, compared with internalized heterosexism and HIV stigma, internalized racism may be uniquely related to depressive symptoms, emphasizing the importance of exploring the impact of distinct forms of stigma on mental health. Future research may benefit from employing shorter time intervals to capture more nuance, assessing how ingrained internalized stigma has become, and considering the salience of internalized negative attitudes to core self-conceptions in similar longitudinal models.

PMID:41235433 | DOI:10.1177/10872914251395736

Afr J Emerg Med. 2025 Dec;15(4):100913. doi: 10.1016/j.afjem.2025.100913. Epub 2025 Oct 29.

ABSTRACT

The overwhelming flow of non-emergent cases burdens Emergency Medical Services (EMS), reducing their capacity to respond to life-threatening emergencies and compromising care for patients with emergent clinical needs. This study evaluated the appropriateness of the EMS deployment in a district of the North West Province in South Africa.

METHODS: A retrospective quantitative descriptive analysis was conducted on cases completed by the district EMS service between 1 and 12 January 2022. Patient report forms and control room assessment forms, containing demographic and clinical data, were analysed to assess the EMS deployment accuracy. Descriptive statistics were used to analyse the continuous and categorical variables, while Pearson’s chi-square test and ANOVA tests examined associations between call prioritisation decisions, on-scene resource allocation, and the qualifications of call takers and dispatchers.

RESULTS: Of the 535 records meeting the inclusion criteria, 71.1% revealed mismatches between call prioritisation and on-scene triage. The over-prioritisation rate was 90.9%, while the under-prioritisation rate was 17.1%. Additionally, 35.0% of patients were transported to a medical facility without receiving any medical interventions.

CONCLUSION: Significant disparities exist between call prioritisation and actual patient clinical needs, exacerbating the strain on an already resource-constrained EMS system. Standardised call prioritisation protocols and improved training for call takers and dispatchers are necessary to enhance EMS efficiency.

PMID:41235402 | PMC:PMC12607023 | DOI:10.1016/j.afjem.2025.100913

Europace. 2025 Nov 14:euaf289. doi: 10.1093/europace/euaf289. Online ahead of print.

ABSTRACT

BACKGROUND: Antiarrhythmic drugs are used during cardiopulmonary resuscitation (CPR) to improve the chances of return of spontaneous circulation (ROSC) in shockable rhythms. To date, their impact on clinical outcomes remains uncertain. This review aimed to provide an evaluation of respective up-to-date evidence.

METHODS: We searched Embase, MEDLINE(R), and Cochrane Central Register of Controlled Trials. Data on study design, population characteristics, antiarrhythmic drugs used, and predefined outcomes were extracted. A meta-analysis was conducted in groups with at least three studies reporting the same outcome. Additionally, we performed subgroup analysis according to the study design.

RESULTS: Initially, 5,080 studies were identified, and 29 were included, with, in total, 60,205 patients. A statistically significant difference in achieving ROSC was found comparing 1) lidocaine and no lidocaine, favouring lidocaine (OR = 1.61, 95% CI: 1.11 – 2.32, p=0.01), 2) nifekalant and lidocaine, favouring nifekalant (OR = 4.18, 95% CI: 2.23 – 7.83, p<0.00001), and 3) esmolol and no esmolol, favouring esmolol (OR = 3.0, 95% CI: 1.40 – 6.40, p=0.005). For the effect on survival to hospital discharge, a significant difference between lidocaine and no lidocaine, favouring lidocaine (OR = 1.66, 95% CI: 1.02 – 2.7, p=0.04), was found.

CONCLUSION: Evidence supporting the use of any antiarrhythmic drugs during CPR remains limited and is partly inconclusive. For the effect on survival to hospital discharge, a statistically significant difference was only found favouring the administration of lidocaine compared to no lidocaine. Further research with improved trial design and into novel drug options should be conducted.

PMID:41233941 | DOI:10.1093/europace/euaf289

Alzheimer Dis Assoc Disord. 2025 Nov 14. doi: 10.1097/WAD.0000000000000704. Online ahead of print.

ABSTRACT

Dementia is a global health issue and its effects on family caregivers are substantial. This study investigated the relationship between cohabitation with patients and the mental health of families in South Korea. On the basis of the nationwide data, 24,874 individuals with dementia within their families were included in the analysis. Multivariate logistic models were used to compare the 3 mental health issues (stress, depression, and suicidal ideation) between the cohabiting and noncohabiting groups. Approximately 15% of participants cohabited with patients with dementia. Members of the cohabiting group had a more stressful status and a higher rate of suicidal ideation than those in the noncohabiting group; however, this association remained significant only for older caregivers (≥65 y). In conclusion, the mental health of family members living with patients with dementia, particularly older caregivers, should be carefully assessed.

PMID:41233930 | DOI:10.1097/WAD.0000000000000704

Perioper Med (Lond). 2025 Nov 13;14(1):125. doi: 10.1186/s13741-025-00578-w.

ABSTRACT

BACKGROUND: Preoperative anemia is a major clinical problem that increases perioperative patient morbidity and mortality. Additionally, preoperative anemia causes hemodynamic instability, delayed recovery after anaesthesia and surgery, prolong length of hospital stay and increases risk of postoperative infection. However, the prevalence of preoperative anemia remains unexplored in conflict affected areas.

OBJECTIVE: To assess prevalence and severity of preoperative anemia and associated factors among orthopedic patients in Bahir Dar city Comprehensive Referral Hospitals, Northwest Ethiopia, 2024.

METHODS: Multi-center cross-sectional study was conducted. Data was collected using questionnaire and checklist. All consecutive scheduled emergency and elective patients were included in the study. Data was transformed from Epi data to SPSS and logistic regression analysis was done. Both crude and adjusted odds ratio were used to assess the strength of association. Hosmer -Lemeshow test and multi collinearity were checked. Variables with a p-value of less than 0.05 were considered as statistically significant.

RESULTS: A total of 820 patients were included in this study with a response rate of 99.9%. Prevalence of preoperative anemia was 46.7% (n = 383/820) with (95%, CI = 0.33353- 0.5987) in this study. Emergency orthopedic cases (AOR = 3.014, CI = 2.480-5.717), traumatic related orthopedic cases (AOR = 2.01, CI = 1.480- 3.21), repeated history of anesthesia and orthopedic surgery (AOR = 3.11, CI = 1.480- 3.54), presence of coexisting diseases (AOR = 1.501, CI = 1.002- 3.74) and preoperative blood loss greater than 500 ml (AOR = 3.001, CI = 2.012- 5.104) were associated with preoperative anemia. CONCLUSION AND RECOMMENDATION: The prevalence of preoperative anemia among orthopedic patients was high in the study area. Orthopedic patients should be screened for preoperative anemia routinely. Additionally, nutritional and iron therapy should be given for mild to moderate anemia. Moreover, blood transfusion should be considered for patients with severe anemia.

PMID:41233925 | DOI:10.1186/s13741-025-00578-w

J Eat Disord. 2025 Nov 13;13(1):262. doi: 10.1186/s40337-025-01341-8.

ABSTRACT

BACKGROUND: This study aims to investigate whether individuals with Avoidant/Restrictive Food Intake Disorder (ARFID) experience unhelpful cognitions that overlap with Anorexia Nervosa (AN). It also examines whether these cognitions play a role in driving problematic eating behaviours that are typically associated with AN because they are designed to prevent weight gain.

METHODS: There were 184 participants (68 individuals with AN, 61 individuals with ARFID, and 55 people with no eating disorder) who were screened using Diagnostic Statistical Manual (DSM-5) criteria. Participants were an adult community sample who completed an anonymous online survey. Questionnaires measured core beliefs, assumptions and automatic thoughts that are associated with AN, and an assessment of concerns about weight and shape was completed. An observational design was used to compare how responses varied according to diagnosis.

RESULTS: Individuals with ARFID were found to have significantly higher levels of disordered core beliefs, assumptions, automatic thoughts, and weight/shape concerns than people with no eating disorder. They showed lower levels of these cognitions relative to individuals with AN. Disordered assumptions and automatic thoughts explained a large proportion of variance in behaviours intended to prevent weight gain in this group.

CONCLUSIONS: The findings have implications for the diagnosis and treatment of ARFID. They challenge diagnostic conceptualisations of ARFID as entirely separable from other eating disorders and any associated weight/shape concerns. They also highlight the need for clinicians to assess and treat unhelpful cognitions that may be maintaining disordered patterns of eating. Future research directions are discussed.

PMID:41233924 | DOI:10.1186/s40337-025-01341-8

Nutr Metab (Lond). 2025 Nov 13;22(1):140. doi: 10.1186/s12986-025-01037-5.

ABSTRACT

BACKGROUND: The prevalence of metabolic disorders such as obesity, type 2 diabetes, and dyslipidemia has increased globally. Postbiotics as non-viable microbial products or metabolites, have recently emerged as potential modulators of metabolic health due to their anti-inflammatory and insulin-sensitizing properties. In order to obtain a better viewpoint from them, this study aimed to comprehensively investigate the effects of postbiotics on metabolic health.

METHODS: This systematic review and meta-analysis, adhering to PRISMA 2020 guidelines, synthesized data from 25 RCTs assessing the effects of postbiotic supplementation on metabolic parameters. Databases including PubMed, Embase, Web of Science, and Scopus were searched up to June 2025. Outcomes included glycemic indices, anthropometric measures, lipid profiles, inflammatory markers, and blood pressure.

RESULTS: Postbiotic supplementation significantly reduced serum insulin levels (WMD: – 2.76 µU/mL), triglycerides (TG) (-8.46 mg/dL), waist circumference (WC) (-1.47 cm), and C-reactive protein (CRP) (-0.99 mg/L). However, changes in fasting blood glucose (FBG), homeostatic model assessment for insulin resistance (HOMA-IR), HbA1c, other profile lipids, blood pressure as well as weight and body mass index (BMI) were not statistically significant. Subgroup analyses revealed more pronounced benefits in younger participants, bacterial-based formulations, and interventions longer than 8 weeks. Risk of bias was low to moderate, and no major publication bias was detected.

CONCLUSION: Postbiotic supplementation demonstrates modest but clinically relevant benefits on insulin sensitivity, central adiposity, TG, and systemic inflammation. These effects suggest a promising adjunctive role for postbiotics in metabolic health interventions, though further trials with standardized formulations and longer durations are warranted.

PMID:41233893 | DOI:10.1186/s12986-025-01037-5

Cancer Cell Int. 2025 Nov 14;25(1):400. doi: 10.1186/s12935-025-04014-3.

ABSTRACT

Endometrial cancer (EC) is the fourth most abundant gynecological cancer. There is an increase in the incidence of mortality from uterine cancers in the past few decades. A comprehensive systematic study to provide an overview on the relationship between autophagy, metabolomics and the risk of oestradiol valerate (OV) induced endometrial cancer was conducted correlated with the use of liposomal loaded-resvida as an innovate drug delivery system. This article explores how metabolomic technology can offer valuable insights on autophagy molecular aspects in EC by identifying new possible metabolite biomarkers that has the potential to improve the accuracy of diagnosis, prognosis and disease monitoring. Metabolomics approach, included orthogonal partial least squares discriminant analysis (OPLS-DA), thus revolutionizes the management of endometrial cancer. Autophagy described in endometrial cancer, includes the role of HSP-70/C-fos/PTEN/mTOR/ERDj-4/p53 signaling pathways that trigger/inhibit the process and consequently represent a potential molecular targets in therapeutic approaches. Endometrial cancer exhibits a molecular complexity and heterogeneity coherent with histopathologic and metabolomic variability. Multivariate statistical analyses pointed out a noteworthy deviation in serum chemical profiles among control, oestradiol valerate, and Resvida and liposomal-Resvida treated groups. Loading plot guided the selection of differential metabolites, elucidating significant variation in metabolite concentration. Improved characterization of molecular alterations of each histological type provides relevant information about the prognosis and potential response to new liposomal therapies. CA125 as EC biomarker was ameliorated post Resvida (108.7 IU/mL) and liposomal Resvida (82.2 IU/Ml) treatment at P ≤ 0.05 in addition to up regulating autophagy biomarkers including mTOR/Cfos/ERDj-4/ PTEN by 20, 25, 14, and 17 fold change respectively and down regulating p53 protein expression by 0.4 ng/ml at P ≤ 0.05 post OV intoxication with liposomal regimen reflecting the most significant impact in modulating these altered genes. The current metabolomics study is the integration of histopathologic and autophagy molecular factors to improve the diagnosis, prognosis, and treatment of endometrial cancer in coherent with liposomal drug delivery system as a targeted therapy.

PMID:41233892 | DOI:10.1186/s12935-025-04014-3