Nevin Manimala

Can J Urol. 2025 Aug 29;32(4):271-282. doi: 10.32604/cju.2025.066395.

ABSTRACT

BACKGROUND: Accurate complication reporting in endourology remains challenging, with the Clavien-Dindo Classification and Comprehensive Complication Index being the most commonly used systems. This study aimed to compare surgical outcomes and complication reporting in ureterolithotripsy (URL), percutaneous nephrolithotomy (PCNL), and extracorporeal shock wave lithotripsy (ESWL) using both systems.

METHODS: This prospective, single-center, non-interventional study included 473 patients undergoing URL, PCNL, or ESWL from October 2022 to October 2024. Demographic, stone-related, and procedural variables were recorded. Complications were classified using the CDC, and cumulative morbidity was assessed using CCI. Statistical analyses, including univariate and multivariate regression, were performed to identify predictors of higher CCI scores.

RESULTS: PCNL was associated with the highest complication rates, including an 11% transfusion rate. ESWL had the lowest complication burden, while URL demonstrated intermediate risk. CCI scores correlated positively with length of stay (LOS; r = 0.47), highlighting its ability to capture overall morbidity. Multivariate analysis identified stone size, operating time, and positive urine culture as significant predictors of higher CCI scores. The CCI provided a more comprehensive representation of morbidity compared to the CDC.

CONCLUSIONS: CCI demonstrates superior sensitivity in evaluating postoperative morbidity compared to CDC, particularly in more invasive procedures such as PCNL. Standardized reporting frameworks incorporating CCI may enhance surgical outcome assessment in endourology.

PMID:40910324 | DOI:10.32604/cju.2025.066395

Can J Urol. 2025 Aug 29;32(4):243-254. doi: 10.32604/cju.2025.066700.

ABSTRACT

BACKGROUND: Intermediate-risk prostate cancer (IR-PC) represents a heterogeneous group requiring nuanced treatment approaches, and recent advancements in radiotherapy (RT), androgen deprivation therapy (ADT), and prostate-specific membrane antigen positron emission tomography (PSMA-PET/CT) imaging have prompted growing interest in personalized, risk-adapted management strategies. This study by the Turkish Society for Radiation Oncology aims to examine radiation oncologists’ practices in managing IR-PC, focusing on RT and imaging modalities to identify trends for personalized treatments.

METHODS: A cross-sectional survey was conducted among Turkish radiation oncologists treating at least 50 prostate cancer (PC) cases annually. The 22-item questionnaire covered IR-PC management aspects such as risk stratification, imaging preferences, androgen deprivation therapy (ADT) use and duration, RT techniques, and treatment combinations. Anonymous responses were analyzed using descriptive statistics.

RESULTS: Thirty radiation oncologists participated, 57% with over 20 years of experience. The median annual number of PC cases treated was 130. For risk stratification, 43% followed the National Comprehensive Cancer Network (NCCN) guidelines, while 30% used the D’Amico classification. Imaging preferences revealed 47% favored PSMA-PET/CT. External beam RT was universally preferred, with 60% adopting ultra-hypofractionation. ADT was used by 97%, with 73% recommending it for unfavorable IR-PC cases. Short-term ADT (4-6 months) was the standard, administered concurrently with RT by 57%. Cardiovascular status influenced decisions for 97% of respondents, while 37% also considered patient age, preferences, and sexual health.

CONCLUSIONS: This national survey demonstrates a shift toward personalized care in intermediate-risk prostate cancer in Turkey, marked by selective PSMA-PET/CT use, tailored ADT, and evolving radiotherapy practices. The findings underscore the importance of multidisciplinary collaboration-particularly between urologists and radiation oncologists-to optimize imaging integration and treatment outcomes.

PMID:40910322 | DOI:10.32604/cju.2025.066700

Infect Control Hosp Epidemiol. 2025 Sep 5:1-8. doi: 10.1017/ice.2025.10251. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Enhanced environmental disinfection is linked to reduced hospital-acquired infection rates. In this study, we aimed to evaluate the efficacy of an emerging disinfection technology, a filtered far-UV-C handheld (FFUHH) device, for reducing bacterial loads on high-touch surfaces in shared clinical workrooms, and to isolate, identify and characterize clinically significant environmental pathogens.

METHODS: We compared samples from high-touch items (dictation device, mouse, armchair, desk, and keyboard) before and after FFUHH treatment. Samples were collected weekly: contact plates for colony counts and swabs before and after intervention on standardized adjacent areas for each surface, respectively. The swabs were enriched and cultured on selective media to isolate pathogens. Environmental samples, as well as clinical samples collected from patients during the study period, were validated using MALDI-TOF and whole genome sequencing.

RESULTS: Among the 440 collected plates (220 before and 220 after treatment), the highest mean colony count pre-treatment was detected from armchairs, and the lowest from keyboards. The mean reduction of colony-forming units ranged 53% and 83% and was statistically significant (P < 0.05) across all surfaces except for the keyboard. We characterized multidrug-resistant Staphylococcus epidermidis ST5 and ST16 strains, a carbapenem-resistant Acinetobacter baumannii, and a Klebsiella pneumoniae genetically related to a clinical isolate with a rare sequence type not previously detected in our institution.

CONCLUSION: The FFUHH effectively reduced the microbial burden on high-touch surfaces. It can offer an advantage for surface disinfection and an alternative to routinely used biocides.

PMID:40910299 | DOI:10.1017/ice.2025.10251

Curr Med Imaging. 2025 Aug 29. doi: 10.2174/0115734056389602250826081355. Online ahead of print.

ABSTRACT

INTRODUCTION: Anemia is a common blood disorder caused by a low red blood cell count, reducing blood hemoglobin. It affects children, adolescents, and adults of all genders. Anemia diagnosis typically involves invasive procedures like peripheral blood smears and complete blood count (CBC) analysis. This study aims to develop a cost-effective, non-invasive tool for anemia detection using eye conjunctiva images.

METHOD: Eye conjunctiva images were captured from 54 subjects using three imaging modalities such as a DSLR camera, a smartphone camera, and a smartphone camera fitted with a 3D-printed spacer macro lens. Image processing techniques, including You Only Look Once (YOLOv8) and the Segment Anything Model (SAM), and K-means clustering were used to analyze the image. By using an MLP classifier, the images were classified as anemic, moderately anemic, and normal. The trained model was embedded into an Android application with geotagging capabilities to map the prevalence of anemia in different regions.

RESULTS: Features extracted using SAM segmentation showed higher statistical significance (p < 0.05) compared to K-Means. Comparing high resolution(DSLR modality) and the proposed 3D-printed spacer macrolens shows statistically significant differences (p < 0.05). The classification accuracy was 98.3% for images from a 3D spacer-equipped smartphone camera, on par with the 98.8% accuracy obtained from DSLR camerabased images.

CONCLUSION: The mobile application, developed using images captured with a 3D spacer-equipped modality, provides portable, cost-effective, and user-friendly non-invasive anemia screening. By identifying anemic clusters, it assists healthcare workers in targeted interventions and supports global health initiatives like Sustainable Development Goal (SDG) 3.

PMID:40910296 | DOI:10.2174/0115734056389602250826081355

Endocr Metab Immune Disord Drug Targets. 2025 Aug 29. doi: 10.2174/0118715303410531250815124524. Online ahead of print.

ABSTRACT

INTRODUCTION: Celiac Disease (CeD) is a serious, lifelong autoimmune condition. There remains a significant unmet medical need for effective pharmacological treatments for CeD.

METHODS: We utilized summary statistics for 2,888 druggable genes from the eQTLGen Consortium and the FinnGen Consortium for CeD. In our Mendelian Randomization (MR) analysis, we identified genes associated with CeD that had a false discovery rate (FDR) < 0.05 using the Inverse Variance Weighted (IVW) method. To enhance the reliability of the results, we validated them through colocalization analysis and Summary-data-based Mendelian Randomization (SMR) analyses.

RESULTS: Through our analysis, we identified 18 druggable genes with a causal relationship to CeD under an FDR < 0.05. Subsequent colocalization and SMR analyses highlighted the PRKCD gene as a potential therapeutic target for CeD (IVW method: Odds Ratio 1.319, 95% Confidence Interval 1.182-1.471, P = 6.85E-07, FDR = 0.002). Additionally, these results have passed horizontal pleiotropy tests, heterogeneity analysis, and leave-one-out sensitivity analysis.

DISCUSSION: The identification of PRKCD as a therapeutic target represents a significant advancement in addressing the unmet medical need for CeD treatment. However, the hypothesis that PRKCD contributes to CeD pathogenesis by regulating tight junction proteins and altering intestinal barrier function requires further experimental validation in future studies.

CONCLUSION: Our study is the first to identify the PRKCD gene as a potential therapeutic target for treating CeD, providing new insights into the treatment of CeD and guiding the development of corresponding therapeutic drugs.

PMID:40910294 | DOI:10.2174/0118715303410531250815124524

Curr Neurovasc Res. 2025 Aug 29. doi: 10.2174/0115672026383185250825114834. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aims to investigate the effect of the serum Total Cholesterol (TC) to High-Density Lipoprotein cholesterol (HDL) ratio (T/H ratio) on Hemorrhagic Transformation (HT) after Intravenous Thrombolysis (IVT) in patients with Acute Cerebral Infarction (ACI).

METHODS: Patients with ACI who received alteplase were enrolled. Subgroups were classified based on the occurrence of hemorrhagic transformation (HT) after intravenous thrombolysis (IVT), whether tirofiban was coadministered, and their 90-day prognosis. The primary observation indicators were HT and the 90-day prognosis. Single-factor and multi-factor analyses were performed to identify independent predictors of HT and prognosis.

RESULTS: Age, TC, and HDL were identified as risk factors for ACI. The T/H ratio and HDL were statistically significant in relation to HT (p < 0.05). A correlation was observed between the T/H ratio and HT, with HT more likely to occur when the T/H ratio was greater than or equal to 3.25. The use of tirofiban after IVT did not increase the risk of HT. Significant differences were observed in HT, type of HT, age, hypertension, baseline National Institutes of Health Stroke Scale (NIHSS) score, platelet volume distribution width, TC, D-dimer, and fibrinogen degradation products between groups with different prognoses.

DISCUSSION: The T/H ratio was statistically associated with HT-ACI and predicted HT-ACI to some extent. However, the study had two limitations: the small sample size and the assessment of prognosis through follow-up phone calls, which affected the final results.

CONCLUSION: Patients with ACI undergoing IVT who had higher baseline NIHSS scores, lower TC, higher HDL, and a higher T/H ratio were at increased risk of HT, which was also associated with long-term outcomes. The T/H ratio may be a valuable predictor of HT following IVT.

PMID:40910292 | DOI:10.2174/0115672026383185250825114834

Pharmacotherapy. 2025 Sep 5. doi: 10.1002/phar.70056. Online ahead of print.

ABSTRACT

INTRODUCTION: Pediatric plastic bronchitis (PB) is a rare complication of surgically palliated congenital heart disease (CHD). Fibrin casts obstruct airways and can cause respiratory distress. There are no therapeutics approved by the United States Food and Drug Administration to treat PB, but inhaled tissue plasminogen activator (tPA) has been anecdotally used to relieve symptoms. We conducted a phase II open-label clinical trial to test the safety of inhaled tPA in pediatric PB.

METHODS: Patients with an acute exacerbation of PB requiring hospitalization were enrolled to test the safety of an inhaled tPA regimen (5 mg every 6 h). The primary end point was to assess the safety and tolerability of repeated doses of nebulized, inhaled tPA in pediatric patients with acute PB. Safety parameters consisted of clinical laboratories to assess bleeding, which were measured prior to, during, and after tPA treatment. To benchmark efficacy using spirometry and oxygen saturation, children with Fontan-palliated CHD without a history of PB, with and without protein losing enteropathy (PLE), and healthy children were enrolled in a control arm that did not receive tPA.

RESULTS: Of the 10 patients with PB screened for enrollment, eight qualified for immediate treatment with inhaled tPA. A total of 29 non-PB participants (PLE, n = 8 [10-18 yo]; CHD, n = 9 [8-17 yo]; and healthy, n = 12 [7-16 yo]) were enrolled. There were no differences in pretreatment clinical blood laboratory values of hemostasis and those during and after treatment with the study drug (primary safety outcome). However, there were four episodes of self-limiting epistaxis related to the study drug. Inhaled tPA statistically improved oxygen saturation although this was moderate and likely not clinically significant; inhaled tPA did not alter spirometry values.

CONCLUSION: In this small, phase II study, repeated doses of inhaled tPA in patients with an acute exacerbation of PB did not result in disrupted systemic coagulation or hematological homeostasis or serious bleeding. However, patients should be monitored for localized bleeding. Larger, randomized trials are needed to provide more comprehensive assessments of bleeding risk and to further assess efficacy.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02315898.

PMID:40910281 | DOI:10.1002/phar.70056

Curr Stem Cell Res Ther. 2025 Aug 28. doi: 10.2174/011574888X382647250728115724. Online ahead of print.

ABSTRACT

OBJECTIVE: Bronchopulmonary dysplasia (BPD), a prevalent chronic pulmonary disorder predominantly affecting preterm infants, is characterized by impaired lung development and persistent inflammatory-mediated lung injury. Dermal fibroblast-derived exosomes (DF-Exos) have been demonstrated to alleviate inflammation and promote epithelial tissue repair; however, their role in lung injury remains to be elucidated. This study aimed to evaluate the effects of DF-Exos on BPD and explore their relationship with autophagy.

METHODS: DF-Exos were isolated using the ultracentrifugation method. Neonatal Sprague-Dawley (SD) rats were exposed to hyperoxic conditions (90% O₂) for 7 days to establish a BPD model. Lung morphology, pulmonary vasculature, and the expression of inflammatory mediators were assessed. The expressions of autophagy-related proteins Beclin1, LC3B, and p62 were detected to evaluate autophagy.

RESULTS: Neonatal rats exposed to hyperoxic conditions showed alveolar simplification, reduced microvascular density, and a significant upregulation of pro-inflammatory mediators, including IL-1β, IL-6, and TNF-α. In contrast, the levels of the anti-inflammatory cytokine IL-10 showed no statistically significant alteration. The expression of autophagy-related protein Beclin1 and LC3B conversion decreased, and p62 accumulated. DF-Exos administration improved alveolar development, increased microvascular density, alleviated inflammation, facilitated the expression of Beclin1 and the conversion of LC3B, and reduced the expression of p62.

DISCUSSION: Our study showed that in the BPD model, DF-Exos can promote alveolar repair and vascular regeneration, modulate inflammatory responses, and enhance autophagic activity. However, they may also cause transient lung injury in the early stages of development. This effect may be influenced by mild immune rejection. Further studies are needed to elucidate the underlying mechanisms and determine a safe therapeutic dose.

CONCLUSION: DF-Exos partly ameliorated lung injury in the hyperoxia-induced BPD model, prospectively by enhancing autophagy.

PMID:40910249 | DOI:10.2174/011574888X382647250728115724

Curr Drug Deliv. 2025 Aug 28. doi: 10.2174/0115672018373037250821092024. Online ahead of print.

ABSTRACT

BACKGROUND: Head and neck squamous cell carcinomas (HNSCCs) require precise treatments. Cetuximab (Ceb) targets EGFR, and copper (Cu) compounds show promise in cancer therapy. This study investigates Ceb-Cu-p-NC, a nanoengineered drug delivery system, designed for enhanced HNSCC treatment. The objective of this study is to evaluate the potential of Ceb-Cu-p-NC in HNSCC treatment.

METHODS: Cu precursor, Ceb, poloxamer-407, and hyaluronic acid were used to synthesize Ceb-Cu-p- NC. Fluorescence microscopy and UV spectrophotometry were utilized to determine Ceb integration efficiency, cellular interactions, and drug concentration. Drug release was assessed via in-vitro studies at pH 5.4 and 7.4. Studies using A-253 cell lines were conducted to analyze cytotoxicity, viability, apoptosis, and cell cycle arrest.

RESULTS: In this study, Ceb-Cu-p-NC showed size reduction (85-120 nm) and zeta potential shift. The Ceb integration was 34.92% with 82.5% entrapment efficiency. Cytotoxicity studies revealed enhanced efficacy (IC50: 27.55 mg/mL – 51.47 mg/mL). Flow cytometry showed significant apoptosis and S-phase cell cycle arrest, with statistically significant results (p < 0.05).

DISCUSSION: Ceb conjugation to Cu-p-NC enhanced nanoparticle stability, reduced surface charge, and enabled targeted, controlled drug release. The formulation showed superior cytotoxicity, apoptosis induction, and S-phase arrest in A-253 cells compared to free Ceb, highlighting its potential as an effective targeted therapy for head and neck cancer.

CONCLUSION: Ceb-Cu-p-NC demonstrates targeted efficacy against HNSCCs, with controlled release, increased cytotoxicity, and apoptosis.

PMID:40910245 | DOI:10.2174/0115672018373037250821092024

Curr Pediatr Rev. 2025 Aug 28. doi: 10.2174/0115733963380997250823060812. Online ahead of print.

ABSTRACT

INTRODUCTION: To study internet health information-seeking behavior and its determinants among caregivers in a tertiary Pediatric Outpatient Department (OPD) in Eastern India.

METHODS: A cross-sectional study was conducted between September and December 2022 at the Pediatric Outpatient Department of the All India Institute of Medical Sciences (AIIMS), Deoghar, India. A 13-item validated questionnaire was administered through face-to-face interviews, capturing demographic information and internet health information-seeking behavior. Statistical analyses, including multivariable logistic regression, identified significant determinants.

RESULTS: Outpatient visits were primarily for acute diseases (39.3%), followed by chronic disease monitoring (19.5%) and acute follow-ups (19.3%). Approximately 34.4% of caregivers sought health information online. Internet health information-seeking behavior was significantly associated with higher educational attainment and visit reasons. Caregivers with higher secondary education or graduate degrees were 7.5 and 7.6 times more likely, respectively, to seek health information online. Those attending for acute or acute follow-up visits had 2.2- and 3.5-times higher odds, respectively. The multivariable model explained 32.4% variability and had a predictive accuracy of 74.1%.

DISCUSSION: The relatively low prevalence of online health information-seeking highlights regional gaps in digital health literacy. Education level and visit type were key predictors, underscoring the need for targeted guidance. Findings are limited by self-reporting and single-center design but offer direction for integrating digital support into pediatric care.

CONCLUSION: One-third of caregivers utilized the internet for children’s health information, with higher education and acute visit reasons as key determinants.

PMID:40910239 | DOI:10.2174/0115733963380997250823060812