Nevin Manimala

Acta Pharm Sin B. 2025 Jan;15(1):123-132. doi: 10.1016/j.apsb.2024.12.004. Epub 2024 Dec 12.

ABSTRACT

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

PMID:40041892 | PMC:PMC11873617 | DOI:10.1016/j.apsb.2024.12.004

Neuropsychiatr Dis Treat. 2025 Feb 28;21:421-436. doi: 10.2147/NDT.S501207. eCollection 2025.

ABSTRACT

PURPOSE: Brexpiprazole, when administered with antidepressant therapy, may provide additional benefits due to complementary actions on noradrenaline (norepinephrine), serotonin, and dopamine neurotransmitter systems. This review addressed the question: what information can preclinical studies provide on the use of brexpiprazole + antidepressant treatment?

METHODS: A systematic literature review was conducted to search for preclinical studies of brexpiprazole + antidepressant therapy that included a behavioral test relating to any psychiatric disorder. Ovid MEDLINE, Ovid Embase, and conference abstracts were searched (January 1, 2011-July 5, 2021). The statistically significant (p<0.05) findings for brexpiprazole + antidepressant were extracted.

RESULTS: Of 296 records screened, nine articles were eligible, describing seven unique studies. In rodent models, including three models of depression (unpredictable chronic mild stress, social defeat stress, and lipopolysaccharide-induced depression), brexpiprazole + selective serotonin reuptake inhibitor (SSRI) or serotonin-noradrenaline reuptake inhibitor (SNRI) consistently showed statistically significant benefits over vehicle on depression-like behaviors (forced swim test, tail suspension test, sucrose preference), whereas brexpiprazole and antidepressant monotherapies did not. In the predator scent stress model of post-traumatic stress disorder (PTSD), brexpiprazole + SSRI (escitalopram) showed a significant benefit over vehicle and/or monotherapy on anxiety-like behaviors (elevated plus-maze) and hyperalertness (acoustic startle response), whereas brexpiprazole and escitalopram monotherapies did not significantly differ from vehicle. In the fear conditioning model of PTSD, brexpiprazole showed significant improvements whether administered as monotherapy or in combination with escitalopram.

CONCLUSION: Based on a small number of studies, the administration of brexpiprazole with an antidepressant appears to have a greater treatment effect than either brexpiprazole or antidepressant monotherapies in preclinical studies of depression- and PTSD-like behaviors. Thus, preclinical studies support evidence from randomized clinical trials for the therapeutic effects of adjunctive brexpiprazole in the treatment of major depressive disorder, and brexpiprazole in combination with sertraline in the treatment of PTSD. Funding: Otsuka/Lundbeck.

PMID:40041884 | PMC:PMC11878111 | DOI:10.2147/NDT.S501207

Health Educ J. 2023 Nov;82(7):725-738. doi: 10.1177/00178969231185652. Epub 2023 Jul 13.

ABSTRACT

OBJECTIVE: African Americans in the USA experience a disproportionate burden of chronic disease. Healthy lifestyle promotion programmes can help decrease this disease risk. This study determined the feasibility of using dyadic peer support to augment an existing healthy lifestyle programme in African American churches.

DESIGN: A prospective pre-post design was used with 80 participants from three churches in the southeastern USA over an 18-week period.

METHODS: Participants attended 9 weeks of group nutrition classes followed by 9 weeks of a dyadic peer support programme. Feasibility was measured by recruitment, acceptability, ability to collect peer support data, ability to implement the peer support component and preliminary health outcomes. Descriptive statistics and multilevel models were used to analyse the data.

RESULTS: Seventy-eight percent of participants completed group classes and peer support activities. Over 95% of participants would work with a partner again. Lay leaders and educators felt they had the resources and participant support to implement a dyadic peer support intervention. Participants achieved small but significant average increases of 1.1 fruit servings per day (p = .001) and 1.2 days of physical activity per week (p = .01) post-intervention. Significant changes in weight (-2.6 pounds, 95% confidence interval [CI] = -4.18, -1.1; p = .001) and vegetable intake (0.681 servings, 95% CI = 0.122, 1.241; p = .017) achieved during the first 9 weeks of the programme were maintained during the second 9 weeks.

CONCLUSION: Dyadic peer support can successfully be used to augment existing healthy lifestyle promotion programmes within African American churches. Studies using control groups are needed to test the effectiveness of dyadic peer support on health outcomes more rigorously.

PMID:40041881 | PMC:PMC11879274 | DOI:10.1177/00178969231185652

Int J Public Health. 2025 Feb 18;70:1607953. doi: 10.3389/ijph.2025.1607953. eCollection 2025.

ABSTRACT

OBJECTIVES: To investigate the gender difference in Intimate partner violence (IPV) victimization and its association with mental health, examine social-demographic and health characteristics-specific relationships.

METHODS: This cross-sectional study evaluated lifetime prevalence of total, psychological, physical and sexual IPV victimization. Gender-stratified multiple logistic regressions were performed to examine associations between total and subtypes of IPV victimization and anxiety and depressive symptoms, suicide ideation and suicide attempt. Sensitivity analyses and stratification analyses were additionally conducted.

RESULTS: Among 21,824 participants (female: 44.7%), females reported higher total, psychological and physical but not sexual lifetime prevalence of IPV victimization than males. Specifically, male participants with psychological (OR = 3.62, 95% CI: 2.58-5.08 vs. OR = 1.87, 95% CI: 1.39-2.51) or sexual (OR = 4.02, 95% CI: 2.61-6.20 vs. OR = 1.46, 95% CI: 0.91-2.35) IPV victimization presented greater odds of presenting possible anxiety than females; males with physical IPV victimization showed greater likelihood of with suicide ideation than females (OR = 9.95, 95% CI: 6.68-14.82 vs. OR = 4.61, 95% CI: 3.02-6.15).

CONCLUSION: Prevention programs should be tailored to respond to IPV in various contexts to reduce the likelihood of and the detrimental effects of IPV.

PMID:40041880 | PMC:PMC11876969 | DOI:10.3389/ijph.2025.1607953

Arthrosc Sports Med Rehabil. 2024 Sep 19;7(1):101005. doi: 10.1016/j.asmr.2024.101005. eCollection 2025 Feb.

ABSTRACT

PURPOSE: To determine if there is a significant difference using femoral heads (FHs) as an anatomic horizon when measuring the lateral center-edge angle (LCEA) compared to floor, acetabular teardrops, and ischial tuberosities (ITs) and to determine their accuracy by comparing to a computed tomography (CT) scan with commercially available software.

METHODS: Between June 2019 and May 2020, patients with preoperative supine anteroposterior pelvis radiographs and CT scans were included and retrospectively analyzed. The LCEA was measured on all preoperative supine anteroposterior pelvis radiographs 4 times per hip, using the 4 methods. The 4 anatomic horizons used to measure LCEA were compared to each other to determine statistically significant difference. The LCEA measured in the CT scan at the 12-o’clock position was used to compare and determine radiographs’ LCEA accuracy.

RESULTS: Ninety-six patients (100 hips) met the inclusion criteria. Sixty-two were women (65%), and the mean age was 35.2 ± 15 years. The mean value for LCEA in CT was 32.2 and 31.1 for the 4 anatomic horizons on x-ray (P < .001). The lowest mean difference between CT scan and x-ray was obtained using the FHs (2.3 ± 2.4). Less mean difference was obtained between FHs and ITs (1.0 ± 0.8).

CONCLUSIONS: In this study, radiographic measurements underestimated LCEA compared with those from CT scans. Using the FHs as an anatomic horizon on radiographs was a more accurate method to measure LCEA than using acetabular teardrops, ITs, or floor. While this difference is statistically significant, it is not likely to be clinically significant.

CLINICAL RELEVANCE: Assessment of acetabular coverage is an essential aspect of diagnosing and managing hip pathologies. One of the methods used for this is the LCEA measurement, which is based on a radiographic analysis of the hip joint. It is important to compare the measurements using different horizons and increasingly sophisticated imaging modalities to provide the most accurate information to guide clinical decision making.

PMID:40041846 | PMC:PMC11873461 | DOI:10.1016/j.asmr.2024.101005

Arthrosc Sports Med Rehabil. 2024 Oct 9;7(1):101020. doi: 10.1016/j.asmr.2024.101020. eCollection 2025 Feb.

ABSTRACT

PURPOSE: To conduct a comprehensive analysis of public Instagram posts pertaining to the Latarjet procedure and Bankart repair with the aim of elucidating patients’ perspectives on the perioperative process, satisfaction, and expectations.

METHODS: We performed a descriptive social media-based investigation using relevant hashtags associated with surgical treatment of anterior shoulder instability, covering the period from January 2023 until January 2024. Posts were categorized by perspective, timing, content, tone, and satisfaction.

RESULTS: A total of 2,395 posts were retrieved, with 526 posts concerning surgical treatment of shoulder instability. Of the posts, 201 (37.9%) were authored by patients and 224 (42.3%) portrayed personal content and patient experience. Most were neutral (308; 58.1%) or positive (203; 38.3%) in tone. Rehabilitation was mentioned frequently by patients undergoing both procedures (49.2% of Bankart posts and 45.6% of Latarjet posts). Comparative analysis revealed no statistically significant differences regarding immobilization (P = .229), rehabilitation (P = .226), return to sport (P = .464), tone (P = .236), or expression of satisfaction (P = .826) between the 2 procedures. However, patients treated with the Latarjet procedure mentioned surgical site more frequently (P = .011). There were no differences in mentions of complications (P = .143). Complications were mentioned in 18 Bankart posts (9.6%), most commonly recurrence, and in 10 Latarjet posts (5.3%), in which the most mentioned complication was pain.

CONCLUSIONS: Social media posts reflect mostly a neutral or positive patient experience in the surgical treatment of anterior instability. Bankart and Latarjet posts exhibit no differences regarding satisfaction, tone, return to work, or return to activities of daily living. Mentions of complications are rare. The most frequent complication mentioned in Bankart posts is recurrence, whereas that in Latarjet posts is postoperative pain.

CLINICAL RELEVANCE: This analysis explores the relevance of social media as an instrument to gain insight into patients’ perceptions of surgical interventions for anterior shoulder instability.

PMID:40041843 | PMC:PMC11873532 | DOI:10.1016/j.asmr.2024.101020

Arthrosc Sports Med Rehabil. 2024 Jul 17;7(1):100979. doi: 10.1016/j.asmr.2024.100979. eCollection 2025 Feb.

ABSTRACT

PURPOSE: To use a publicly available Major League Baseball (MLB) game video to investigate whether pitch type and pitching elbow angle at peak valgus stress and at release point are associated with the odds of undergoing Tommy John surgery.

METHODS: This case-control study compared pitchers who had undergone ulnar collateral ligament reconstruction to a matched control group of pitchers who had not undergone the surgery. Pitchers were selected based on inclusion in online baseball player and injury databases, including the MLB Health and Injury Tracking System, with those pitching fewer than 10 innings in MLB excluded. The experimental group included measurements from all pitchers before their ulnar collateral ligament injury who eventually had undergone Tommy John surgery since 2010. Greedy matching algorithm was used to select a matched cohort of pitchers based on age, height, weight, years in the MLB, hand dominance, pitching role (starter vs reliever), and average pitching velocity. Conditional logistic regression models were used to measure the association between pitch angle and log odds of receiving a Tommy John surgery.

RESULTS: There were 249 paired cases and controls (N = 498) included in the conditional logistic regression analysis. There was no statistically significant association between average elbow angle at peak valgus stress and the odds of undergoing Tommy John surgery (odds ratio, 1.02; 95% confidence interval, 0.99-1.03; P = .14).

CONCLUSIONS: Peak valgus elbow angle, release point angles, and combinations of angles and specific pitches were not associated with an increased risk of undergoing Tommy John surgery.

LEVEL OF EVIDENCE: Level III, observational study, case-control design.

PMID:40041841 | PMC:PMC11873486 | DOI:10.1016/j.asmr.2024.100979

Arthrosc Sports Med Rehabil. 2024 Sep 10;7(1):100998. doi: 10.1016/j.asmr.2024.100998. eCollection 2025 Feb.

ABSTRACT

PURPOSE: To analyze a series of cases with and without medial meniscal posterior root tears (MMPRTs) to determine whether varus alignment and increased sagittal medial tibial slope (MTS) are risk factors for MMPRTs.

METHODS: The study evaluated 2 groups of patients: The tear group included patients with arthroscopically confirmed MMPRTs, and the no-tear group consisted of control patients matched to the tear group who underwent similar imaging but did not have meniscal root tears. Age, sex, side of injury, and body mass index were recorded for all cases. Preoperative joint space height and Kellgren-Lawrence grade were measured on radiographs. Group matching was performed based on demographic factors (age, sex, and body mass index), joint space height, and Kellgren-Lawrence grade. Mechanical axis measurements were determined from full-limb-length radiographs. MTS was analyzed on preoperative magnetic resonance imaging. Two observers performed the measurements on 2 separate occasions, and intraobserver reliability and interobserver reliability were analyzed using the intraclass correlation coefficient (ICC). Multivariate regression analysis was performed to identify potential risk factors associated with MMPRTs.

RESULTS: Of the 142 matched patients included, 76 had root tears (tear group) and 66 did not (no-tear group). Both mechanical axis (183.2° ± 3.2° vs 181.2° ± 2.3°) and MTS (4° ± 1.9° vs 2.4° ± 2.5°) measurements were significantly greater in the tear group (P < .01 for each). However, despite the statistical significance, the small degrees of difference between the groups raises questions about the clinical significance. The intraobserver ICCs were 0.98 and 0.99 for mechanical axis and 0.87 and 0.98 for MTS. The interobserver ICCs showed excellent reliability for mechanical axis (0.95) and good reliability for MTS (0.77). The lower intraobserver and interobserver reliabilities for MTS measurements also suggest a higher likelihood of error. The multivariate logistic regression model indicated that the risk of sustaining an MMPRT increased with varus alignment (odds ratio, 1.268; 95% confidence interval, 1.104-1.478; P = .001) and increased MTS (odds ratio, 1.364; 95% confidence interval, 1.137-1.677; P = .002).

CONCLUSIONS: In this study, MMPRTs were associated with varus alignment and steeper MTS. However, the clinical significance of these associations may be limited owing to the small differences between the groups.

LEVEL OF EVIDENCE: Level III, retrospective case-control study.

PMID:40041827 | PMC:PMC11873484 | DOI:10.1016/j.asmr.2024.100998

Arthrosc Sports Med Rehabil. 2024 Sep 26;7(1):101011. doi: 10.1016/j.asmr.2024.101011. eCollection 2025 Feb.

ABSTRACT

PURPOSE: To determine the safest screw length that will avoid penetrating the femoral physis for surgical fixation of juvenile osteochondritis dissecans lesions and to compare the safe screw lengths for different regions in the condyles.

METHODS: After institutional review board approval, we retrospectively reviewed T1-weighted magnetic resonance images of pediatric patients. Longitudinal axis reference lines were made on the femur. Lines were then placed at 45° anterior and posterior to this axis to simulate screw start points. From these points, we measured the shortest distance from the articular surface to the physis, noting the shortest distances. These measurements simulated screw lengths in the anterior, posterior, and central regions on both the medial and lateral condyle. Statistical analysis was performed to determine the 95% confidence interval for all measurements. Analysis of variance was performed to compare different regions.

RESULTS: A total of 97 knee magnetic resonance images from patients aged 6 to 17 years were reviewed. The safe screw lengths among all samples were 14.1 mm, 20.9 mm, 18.2 mm, 14.4 mm, 17.5 mm, and 14.1 mm for the anteromedial, central medial, posteromedial, anterolateral, central lateral, and posterolateral regions, respectively. There was a difference in simulated screw lengths among all 6 groups (P < .001). There was a moderate correlation between increasing age of the patient and increasing screw length (r = .397, P < .001).

CONCLUSIONS: While a screw length of 14 mm appears to be safe in all ages and regions of the distal femur, safe screw length varies based on age and location of the lesion. The posteromedial region has a safe length of 18 mm.

CLINICAL RELEVANCE: Surgeons must respect the physis when repairing knee osteochondritis dissecans lesions in pediatric patients. Fluoroscopic confirmation should be used to confirm safe screw lengths, and surgeons should use caution when using screws longer than 14 mm (or 18 mm posteromedially), particularly in younger patients.

PMID:40041824 | PMC:PMC11873472 | DOI:10.1016/j.asmr.2024.101011

Arthrosc Sports Med Rehabil. 2024 Sep 17;7(1):100997. doi: 10.1016/j.asmr.2024.100997. eCollection 2025 Feb.

ABSTRACT

PURPOSE: To compare the clinical outcomes of rotator cuff repair using a double-row modified Mason-Allen stitch (DR-MA) with those repaired with a double-row suture bridge (DR-SB).

METHODS: A retrospective case-control matching study was conducted to compare the results of patients who received complete supraspinatus tendon repair using a DR-MA configuration and a DR-SB pattern between 2009 and 2020. Exact matching was performed for patients with intact rotator cuff repair at postoperative magnetic resonance imaging. The matching criteria included sex, workers’ compensation, smoking status, hyperlipidemia, size and retraction of tear, and acromioplasty. Clinical outcomes, including visual analog scale (VAS), American Shoulder and Elbow Surgeon (ASES) score, and active shoulder forward flexion (FF), were documented at the 2-year follow-up. The percentage of patients who achieved minimum clinically important difference (MCID) was reported.

RESULTS: A total of 64 patients, including 28 men and 36 women, were matched, and the 2-year follow-up rate was 100%. All patients received postoperative magnetic resonance imaging at 19 ± 11 months. Significant improvement in all clinical outcomes was observed, regardless of the repair pattern (P < .001). The 2-year VAS was better in the DR-MA group compared to the DR-SB group (1.5 ± 2.0 and 2.9 ± 2.6, respectively; P = .009). At the 2-year follow-up, 91%, 90%, and 63% of patients in the DR-MA group achieved MCID in VAS, ASES, and FF, respectively. There was no difference in the proportion of patients achieving MCID between the 2 treatment arms. However, a more substantial improvement in VAS (P = .008), ASES (P = .014), and FF (P = .039) between preoperation and the 2-year follow-up was noted in the DR-MA group.

CONCLUSIONS: No clinical differences in pain or function were found between DR-MA and DR-SB despite small and statistically significant differences in favor of DR-MA.

LEVEL OF EVIDENCE: Level III, retrospective cohort study.

PMID:40041822 | PMC:PMC11873470 | DOI:10.1016/j.asmr.2024.100997