Nevin Manimala

Ann Nucl Med. 2025 Nov 7. doi: 10.1007/s12149-025-02127-3. Online ahead of print.

ABSTRACT

BACKGROUND: Lutetium-177 (¹⁷⁷Lu)-PSMA-617, a targeted radioligand therapy, has demonstrated significant survival benefits in patients with metastatic castration-resistant prostate cancer (mCRPC). Its application in patients with a superscan pattern, indicative of extensive skeletal metastases, is less studied due to concerns about hematologic toxicity from bone marrow involvement.

METHODS: This study analyzed 133 mCRPC patients treated with ¹⁷⁷Lu-PSMA-617, divided into Superscan and Non-superscan groups. PSA response (≥ 50% decline), PSA progression free survival (PFS), overall survival (OS), and treatment safety were assessed.

RESULTS: Among 133 patients, 17 (12.8%) exhibited a superscan pattern. The overall PSA response rate was 45.8%, (47.0% in the superscan group versus 45.6% in the non-superscan group; p = 0.485). Median PSA PFS was 8 months overall (95% CI: 5.5-10.4), with 4 months (95% CI: <1-10.5) in the superscan group and 8 months (95% CI: 5.6-10.3) in the non-superscan group (p = 0.311). Median OS was 13 months overall (95% CI: 8.6-17.3), with 6 months (95% CI: <1-18.7) in the superscan group and 14 months (95% CI: 9.3-18.6) in the non-superscan group (p = 0.052). Significant but manageable decreases were seen in platelet (PLT) and Alkaline phosphatase (ALP), and no significant changes in Hemoglobin (Hb), white blood cells (WBC), Lactate dehydrogenase (LDH), or creatinine, with no differences between superscan and non-superscan groups. Baseline hemoglobin was a significant predictor of OS (HR = 0.6, p = 0.001), while superscan pattern did not show statistical differences (HR = 1.0, p = 0.949).

CONCLUSION: This retrospective study suggests that ¹⁷⁷Lu-PSMA-617 is a feasible and safe radioligand therapy for mCRPC patients with a superscan pattern, showing comparable PSA response rates to non-superscan patients.

PMID:41201730 | DOI:10.1007/s12149-025-02127-3

Ir J Med Sci. 2025 Nov 7. doi: 10.1007/s11845-025-04154-5. Online ahead of print.

ABSTRACT

AIMS: To evaluate patient and clinician preferences for communicating dermatology test results (skin biopsies, swabs and blood results) with a focus on differences in preferred methods for normal and abnormal findings.

METHODS: A cross-sectional study was conducted involving two anonymised surveys. A structured questionnaire was distributed to 100 consecutive dermatology outpatients attending a dermatology centre over a four-week period from May to June 2025. Concurrently, an electronic survey was distributed nationally to dermatology clinicians, including consultants and registrars (n = 25). Descriptive statistics and chi-square testing were used to analyse differences.

RESULTS: For abnormal results, both patients (64%) and clinicians (60%) preferred face-to-face appointments, a further 33% of patients favoured mobile contact compared with 20% of clinicians. A statistically significant difference was observed in preferences for normal result communication between patients and clinicians (χ2 = 92.6, p < 0.001) with patients preferring mobile phone contact (53%) and text message (19%) and clinicians overwhelmingly preferring postal letters (72%). 59% reported that their preference would change depending on whether the result was normal or abnormal. Speed of communication was rated “very important” by 73% of patients. Concerns about digital confidentiality were moderate, with mean ratings of 2.33 for text and 2.32 for email on a 5-point scale.

CONCLUSIONS: Patients favour fast, digital methods for receiving normal results, while clinicians largely continue using traditional postal communication. Greater alignment exists for abnormal result delivery. These findings support a stratified approach to result communication that balances patient preferences, clinical context and confidentiality considerations.

PMID:41201726 | DOI:10.1007/s11845-025-04154-5

Ir J Med Sci. 2025 Nov 7. doi: 10.1007/s11845-025-04163-4. Online ahead of print.

ABSTRACT

BACKGROUND: Sport-related concussion is a significant concern in contact sports, yet research in amateur Gaelic games is limited.

AIMS: To examine the characteristics and mechanisms of suspected concussions in elite Gaelic football and hurling using video-based analysis.

METHODS: A retrospective video analysis was conducted on 96 suspected concussions (58 Gaelic football, 38 hurling) identified from broadcast footage during the 2018-2019 inter-county seasons. Events were coded for type of play, player role, object/body part striking the head, collision direction, legality, referee penalisation, and match quarter. Descriptive statistics, Chi-square Goodness-of-Fit test and standardised residuals assessed distributions.

RESULTS: In Gaelic football, suspected concussions were evenly distributed across quarters, χ²=6.23, p = 0.101. In hurling, incidents were overrepresented in the fourth quarter, χ²=14.00, p = 0.003, residual = + 3.08. Tackles were significantly more frequent in football (residual = + 8.63, χ²=95.79, p < 0.001) and hurling (residual = + 4.14, χ²=28.58, p < 0.001), while off-the-ball collisions and goalpost impacts were less frequent. Ball carriers were overrepresented in football (residual = + 5.99, χ²=48.38, p < 0.001) and hurling (residual = + 3.41, χ²=16.32, p = 0.001). Arms were the main impact source in football (residual = + 8.08, χ²=79.93, p < 0.001) with shoulders/torsos in hurling (residual = + 4.24/+2.87, χ²=36.53, p < 0.001). Front-on collisions predominated in both codes. Illegal play was significant in football (residual = + 2.6, χ²=13.52, p < 0.001), with illegal incidents penalised (residual = + 3.34, χ²=22.35, p < 0.001).

CONCLUSION: The findings underscore the need for targeted rule enforcement, player education, and management to reduce concussion risk in Gaelic football and hurling.

PMID:41201725 | DOI:10.1007/s11845-025-04163-4

Int J Cardiovasc Imaging. 2025 Nov 7. doi: 10.1007/s10554-025-03554-z. Online ahead of print.

ABSTRACT

Femoral artery pseudoaneurysms are a recognized complication of coronary angiography performed via femoral access, with incidence rates ranging from 0.2% to 8%. Identifying high-risk patients could guide procedural modifications to reduce this risk. This study evaluated whether computed tomography (CT)-derived measurements of adipose tissue and muscle mass predict femoral artery pseudoaneurysm development. In this retrospective cohort study, we included 148 patients who underwent coronary angiography via femoral access and had a thorax CT scan with 3 months of angiography at Health Sciences University Sultan 2. Abdülhamid Han Training and Research Hospital. CT images were analyzed at the 12th thoracic vertebra to measure adipose and muscle tissue areas, normalized by height squared to derive adiposity and muscularity indices. Patients were divided into those with pseudoaneurysms (n = 49) and controls (n = 99). Statistical analyses included t-tests, Mann-Whitney U tests, logistic regression, and receiver operating characteristic (ROC) curve analysis. Patients with pseudoaneurysms had significantly higher adipose tissue (median 241 cm² vs. 104 cm², p < 0.001) and adiposity index (median 14.11 vs. 7.29, p < 0.001) compared to controls. Multivariate logistic regression identified adipose tissue (OR 1.038, 95% CI 1.007-1.071, p = 0.017) and adiposity index (OR 1.294, 95% CI 1.065-1.572, p = 0.010) as independent predictors of pseudoaneurysm development. ROC analysis showed adipose tissue (AUC 0.801, threshold > 136 cm², specificity 75%, sensitivity 86%) and adiposity index (AUC 0.774, threshold > 10.03, specificity 71%, sensitivity 78%) had good predictive ability. CT-derived adipose tissue and adiposity index measurements are significant predictors of femoral artery pseudoaneurysm following coronary angiography. Pre-procedural CT assessment could identify high-risk patients, potentially guiding safer procedural strategies.

PMID:41201707 | DOI:10.1007/s10554-025-03554-z

Int J Cardiovasc Imaging. 2025 Nov 7. doi: 10.1007/s10554-025-03564-x. Online ahead of print.

ABSTRACT

The aim was to evaluate the differential effects of right-to-left shunts (RLS) linked to patent foramen ovale (PFO) on left atrial strain using two-dimensional speckle tracking imaging (2D-STI), and to investigate the prognostic value of left atrial strain in predicting the risk of cryptogenic stroke (CS) related to PFO-RLS. This study involved 81 PFO patients and 45 healthy controls (HCs), who were divided into three groups: the permanent RLS, the latent RLS, and the HC group. Clinical characteristics, conventional echocardiographic parameters, and left atrial strains, such as left atrial reservoir strain (LASr), left atrial conduit strain (LAScd), left atrial contraction strain (LASct), and left atrial stiffness index (LASI) were collected and compared among the three groups. The PFO patients with RLS were subsequently stratified into a CS group and a non-CS group. To identify the predictors of CS in PFO patients with RLS, logistic regression analysis and receiver operating characteristic (ROC) curves were performed. There were no significant differences in left atrial structural parameters among the three groups (all P > 0.05). Compared to the HC group, both the permanent and latent RLS groups demonstrated significantly higher rates of CS (63.4% vs. 35.0% vs. 8.9%, P < 0.001) and migraine (73.2% vs. 60.0% vs. 8.9%, P < 0.001). A graded impairment in left atrial functional parameters was observed across the three groups: LASr (35.40 ± 2.65 vs. 39.18 ± 2.57 vs. 40.19 ± 2.16, P < 0.001), LAScd (-21.55 ± 2.61 vs. -23.99 ± 3.02 vs. -24.86 ± 3.33, P < 0.001), and LASct (-13.86 ± 1.82 vs. -15.19 ± 2.13 vs. -15.33 ± 2.39, P = 0.003). Subgroup analyses revealed reduced LASr (35.29 ± 1.89 vs. 39.20 ± 3.07, P < 0.001) and LAScd (-21.18 ± 2.24 vs. -24.29 ± 2.99, P < 0.001) in the CS group compared to the non-CS group, while LASct showed no statistically significant intergroup difference (P > 0.05). LASr (OR (95%CI): 0.38(0.25-0.57), P < 0.001) and LAScd (OR(95%CI): 1.78(1.33-2.40), P < 0.001) were independent factors for predicting risk of CS related to PFO-RLS. ROC curves analysis demonstrated strong predictive performance of LASr and LAScd for the CS occurrence related to PFO-RLS (LASr: AUC = 0.85, 95%CI = 0.76-0.94, P < 0.001; LAScd: AUC = 0.80, 95%CI = 0.70-0.89, P < 0.001). PFO patients with RLS, especially those with permanent RLS, had impaired left atrial function and an increased risk of CS. The LASr and LAScd were strong predictors and effective indicators of CS in PFO patients with RLS.

PMID:41201706 | DOI:10.1007/s10554-025-03564-x

Eur J Orthop Surg Traumatol. 2025 Nov 7;36(1):7. doi: 10.1007/s00590-025-04575-z.

ABSTRACT

PURPOSE: This study, based on palpation, ultrasonography, casts, and dissection, aimed to identify the superficial transverse metacarpal ligament and further characterize the interdigital web, including skin gliding, slope’s angle and length, histology, and dynamic changes during finger abduction.

METHODS: The preferred hand of 10 healthy participants was studied by palpation and ultrasonography. Alginate casts of the webspace were obtained from seven healthy volunteers. Five cadaver hands were dissected for illustration and to histologically evaluate the dorsal and palmar web. Descriptive and non-parametric statistics were used.

RESULTS: The superficial transverse metacarpal ligament was detected through palpation in finger abduction at the webs, with an estimated width of about 7.1 mm. Ultrasonography was used to trace this ligament throughout its course and measure its thickness, with a median value of approximately 0.46 mm. Both palpation and ultrasonography revealed its proximal transverse and distal arciform fibres. The latter extended along the proximal phalanges. At the fleshy web, skin gliding was assessed by palpation. Both ultrasonography and dissection allowed for measuring the skin, which was thicker on the palmar side. Elastic fibres predominated on the dorsal side, and dense collagen on the palmar side. The alginate casts revealed that during finger abduction, the dorsal web opened as a curved triangle with the web’s edge, digital extensions, and dorsal skin as a checkrein.

CONCLUSIONS: Palpation, ultrasonography, and dissection detected complementary features of the natatory ligament and the interdigital space. The alginate casts revealed that the dorsal web opened as a curved triangle. Dissection provided detailed information about the involved structures.

PMID:41201689 | DOI:10.1007/s00590-025-04575-z

J Neurol. 2025 Nov 7;272(12):749. doi: 10.1007/s00415-025-13497-z.

ABSTRACT

BACKGROUND: Familial multiple sclerosis (MS), defined by the occurrence of MS in one or more relatives, is thought to represent a genetically influenced subtype of the disease.

OBJECTIVE: To compare clinical progression, cerebrospinal fluid (CSF) parameters, and treatment responses between familial and sporadic MS patients.

METHODS: We conducted a retrospective analysis of 1,035 patients diagnosed with MS according to the 2017 McDonald criteria (523 familial, 512 sporadic). Demographic variables, MS subtypes, expanded disability status scale (EDSS) scores, CSF oligoclonal band (OCB) status, IgG index, and treatment regimens were evaluated. Statistical tests included t tests, chi-square, and multivariable regression.

RESULTS: Familial MS patients showed a higher incidence of secondary progressive MS (10.9%) compared to sporadic cases (7.0%, p = 0.030). Disease duration was significantly longer in familial MS (14.5 vs. 12.3 years, p < 0.01) though time to diagnosis did not differ. OCB positivity rates were comparable, but the IgG index was significantly elevated in familial MS (p < 0.01). Treatment responses did not differ between groups.

CONCLUSION: Familial MS is associated with more rapid disease progression and enhanced humoral immune activation, suggesting a distinct phenotype. These findings support the need for genetic and immunologic investigations to guide personalized treatment strategies.

PMID:41201681 | DOI:10.1007/s00415-025-13497-z

Discov Oncol. 2025 Nov 7;16(1):2059. doi: 10.1007/s12672-025-03919-9.

ABSTRACT

OBJECTIVE: Elucidating the causal relationship between rheumatoid arthritis (RA) and pancreatic cancer (PC) remains methodologically challenging due to limitations inherent in observational studies. This study applied a bidirectional two-sample Mendelian randomization (MR) design to investigate the potential causal interplay between RA and PC, aiming to uncover shared pathogenic pathways and genetic predispositions through comprehensive instrumental variable analysis.

METHODS: Utilizing genome-wide association study (GWAS) meta-analysis data, we systematically screened and incorporated independent single nucleotide polymorphisms (SNPs) associated with RA and PC as instrumental variables. The primary analytical approach was the inverse-variance weighted fixed-effects model (IVW-FE). To ensure methodological rigor and validate causal inferences, we complemented this with several approaches: simple median, weighted median, and MR-Egger regression. Heterogeneity was assessed using Cochran’s Q test, and pleiotropy was evaluated using MR-Egger intercept analysis. Sensitivity analysis was conducted using the leave-one-out approach. All effect estimates are reported as odds ratios (ORs) with corresponding 95% confidence intervals (CIs).

RESULTS: Seventy-seven SNPs met the predefined inclusion criteria. MR analyses revealed that elevated genetic susceptibility to RA was causally associated with an increased risk of PC (OR = 1.187, 95% CI = 1.355-1.039, P = 0.011). MR-Egger regression analysis indicated no significant pleiotropic effects (intercept p = 0.434). Cochran’s Q statistics indicated no substantial heterogeneity in the causal estimates for RA (P = 0.064). Consistent with these findings, leave-one-out sensitivity analyses confirmed the absence of influential outlier variants in the instrumental variable sets. However, there was no significant causal association between PC and the risk of RA (OR = 0.991, 95% CI = 0.957-1.027, P = 0.620).

CONCLUSIONS: Our results support a unidirectional causal relationship, identifying RA as a potential risk factor for the development of pancreatic cancer, with no evidence for a reverse causal effect.

PMID:41201680 | DOI:10.1007/s12672-025-03919-9

Fish Physiol Biochem. 2025 Nov 7;51(6):189. doi: 10.1007/s10695-025-01590-z.

ABSTRACT

Totoaba (Totoaba macdonaldi) aquaculture offers economic and ecological advantages. However, its culture still relies on fishmeal in diets because alternative protein sources show reduced productive performance. The current study assessed the impact of low concentrations of methionine and taurine together with alternative proteins, on the productive performance of T. macdonaldi over a 60-day experimental period. Four diets were formulated for this purpose, a basal diet (D-BD), the basal diet with methionine (D-MET), the basal diet with taurine (D-TAU), and the basal diet with methionine and taurine (D-MET + TAU). The present experiment used a randomized design. One hundred forty-four juveniles (41.0 ± 0.5 g in weight) were randomly distributed in 12 tanks (500 L) in triplicate groups to assess biological indices, cholesterol content, hepatic gene expression, and the synthesis and transport of taurine. The statistical analysis revealed that the dietary treatments D-MET and D-TAU positively affected the growth rate, whereas their interaction resulted in a significantly higher growth (p < 0.05). The expression of the igf-1 gene in the liver increased and showed a positive interaction. When TAU and MET were limited, there was an observed overexpression of csad in hepatic tissue. Diets supplemented with TAU showed a decrease in total cholesterol level, whereas cholesterol level in the liver increased with MET supplemented alone. Total TAU content in fish tissues was significantly higher when both TAU and MET were supplemented. In conclusion, T. macdonaldi exhibits a limited capacity, for TAU synthesis, and MET limitation appears to restrict growth potential.

PMID:41201678 | DOI:10.1007/s10695-025-01590-z

J Child Adolesc Psychiatr Nurs. 2025 Nov;38(4):e70044. doi: 10.1111/jcap.70044.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has led to an increase in adolescent gaming due to lockdowns and the shift to online learning. Although factors linked to game addiction in adolescents before and during the pandemic have been explored, research on patterns following the easing of restrictions is limited.

PURPOSE: This study examined the relationship between perceived stress, loneliness, resilience, and game addiction among adolescents in Bangkok during the COVID-19 pandemic transition period.

METHODOLOGY: This correlational study included 346 high school students from two schools in Bangkok, Thailand, selected using a proportional stratified random sampling method. Data were collected from November to December 2022 during Thailand’s reclassification of COVID-19 as a communicable disease under a surveillance system. Descriptive statistics and Spearman’s correlation were used for the analysis.

RESULTS: The findings showed that 15.0% of adolescents were at risk of game addiction, with 4.4% being addicted. Most (87.3%) engaged in gaming, and 38.7% played games daily. Perceived stress (r_(s) = 0.14, p = 0.01) and loneliness (r_(s) = 0.25, p < 0.001) were positively correlated with game addiction, while resilience was negatively correlated (r_(s)= -0.26, p < 0.001). All resilience components-“I have” (external support) (r_(s) = -0.21), “I am” (inner strength) (r_(s) = -0.28), and “I can” (interpersonal and problem-solving skills) (r_(s)= -0.24)-were negatively correlated with game addiction (p < 0.001).

CONCLUSIONS: This study identified perceived stress and loneliness as risk factors for game addiction, and resilience as a protective factor. These findings offer valuable insights for professionals, including nurses, to develop targeted prevention programs for adolescents during the pandemic transition period and in the event of future crises.

PMID:41200867 | DOI:10.1111/jcap.70044