Nevin Manimala

Urol J. 2026 Jan 11. doi: 10.22037/uj.v23i00.8586. Online ahead of print.

ABSTRACT

PURPOSE: To compare outcomes of super mını percutaneous nephrolıthotomy (smPCNL) with extracorporeal shock wave lithotripsy (ESWL) for stones 1- 2 cm. Material and Methods: After receiving the ethics committee approval for this study (Date: 10/09/2021 Decision No: 2021/10-01), the files of patients who underwent smPCNL and ESWL for kidney stones between January 2017 and June 2021 by the Urology Department of Van YYU Dursun Odabaşı Medical Center were retrospectively scanned. A total of 300 patients’ data were scanned retrospectively. After exclusion criteria and ESWL patients whose sessions were not completed were excluded, a total of 159 patients, 82 ESWL and 77 smPCNL, were included in our study.

RESULTS: The mean age in the ESWL group was 6.72±3.71, and the mean age in the smPCNL group was 6.63±3.59 (1-18). There was no significant difference in age profile between the groups (p=.87). Regarding the direction of the stone procedure in the smPCNL group, the procedure was performed on the right side in 42 patients (54.54%) and on the left side in 35 patients (45.46%). In the ESWL group, the procedure was performed on the right side in 38 patients (46.35%) and on the left side in 44 patients (53.65%). No statistically significant difference was found between the groups in terms of side direction (p=.38). The mean BMI(Body Mass Index) in the ESWL group was 20.10±2.01, while it was 20.23±2.05 in the smPCNL group.No statistically significant difference was observed between two groups in terms of BMI (p=.68). The mean stone size in the ESWL group was calculated as 13.74±1.91 mm (10-20 mm) and 149.75±45.46 mm², which would provide more accurate results. The mean value in the smPCNL group was 14.064±2.6 mm (10-20 mm) and 150.879±50.34 mm². No statistically significant difference was found between the groups in terms of stone size (p=(mm)=.37, p=(mm²)=.88). Among 82 patients treated with ESWL, 21 (25.6%) were stone-free after the first session, increasing to 40 (48.8%) by the end of the second session and to 50 (61.0%) at the end of the third session. In terms of sedo-analgesia, 19 (23.20%) were exposed to 1 session, 16 (19.5%)ere exposed to 2 sessions, and 31 (37.80%) were exposed to 3 sessions. 16 (19.5%) patients did not receive anesthesia. When evaluated in terms of the need for re-intervention, it was observed as 22 patients (26.8%) in the ESWL group and 4 patients (5.2%) in the smPCNL group (p=.0003). In the comparison of stone-free rate of smPCNL and ESWL groups, a statistically significant difference was observed in both early and late periods (p=,001). When comparing the early and late periods of smPCNL (p=.79) and ESWL(p=.19) within their own groups, no statistical difference was observed. When smPCNL and ESWL were classified according to the Clavien-Dindo classification in terms of complications, no statistically significant difference was observed (p=,51).

CONCLUSION: ESWL remains the preferred first-line option for many pediatric patients due to its safety and non-invasive nature. However, smPCNL provides higher single-session stone-free rates for 10-20 mm renal stones and may reduce repeated anesthesia exposure. SmPCNL should be considered a viable first-line alternative to achieve higher stone-free rates without increasing complication risk. Prospective, multicenter randomized trials are warranted.

PMID:41618667 | DOI:10.22037/uj.v23i00.8586

Eur J Pain. 2026 Feb;30(2):e70213. doi: 10.1002/ejp.70213.

ABSTRACT

BACKGROUND: To evaluate whether sponsorship influences the reporting of positive results and the occurrence of selective outcome reporting (SOR) in randomised controlled trials (RCTs) investigating pharmacologic interventions for postoperative pain management following third molar extraction.

METHODS: This meta-research included RCTs comparing at least one active drug with placebo, two active drugs, or combination thereof, and reporting outcomes related to pain reduction after third molar extraction. Searches were conducted in PubMed, Scopus and Web of Science without date restrictions and last search was performed on 2024 August. Study selection was performed in Rayyan QCRI, with two independent reviewers screening titles, abstracts and full texts. Data extraction was also conducted independently by two reviewers, collecting information on year of publication, trial design, number of groups, placebo comparisons, sample size (number of patients/teeth), follow-up losses, statistical significance of results, protocol registration and funding disclosures. Selective outcome reporting was assessed by comparing registered protocols with published outcomes. Associations between sponsorship status and both SOR and positive result reporting were analysed using chi-square test (α = 0.05).

RESULTS: A total of 430 RCTs were included. No association was found between sponsorship status and SOR (p = 0.861), nor between sponsorship status and the reporting of positive results (p = 0.241).

CONCLUSIONS: In this sample, sponsorship was not associated with either selective outcome reporting or the likelihood of reporting positive results in RCTs on postoperative pain management after third molar extraction.

SIGNIFICANCE STATEMENT: The absence of sponsorship bias in RCTs on third molar extraction suggests that industry-funded and non-sponsored studies provide comparably reliable evidence, supporting clinicians in making unbiased, evidence-based decisions for postoperative pain management in third molar surgery.

PMID:41618646 | DOI:10.1002/ejp.70213

Am J Hosp Palliat Care. 2026 Jan 30:10499091261422382. doi: 10.1177/10499091261422382. Online ahead of print.

ABSTRACT

BackgroundChemotherapy at the end of life may not extend survival and can diminish quality of life. Understanding patterns of use is critical to ensuring equitable, patient-centered care.ObjectiveTo examine racial and ethnic disparities in chemotherapy receipt within 30 days of death among patients with colon cancer, and whether these disparities changed over time.DesignWe conducted a retrospective cohort study using the National Cancer Database, identifying patients with colon cancer who died within 30 days between 2004 and 2021. The final sample included 43 490 patients. The primary outcome was chemotherapy receipt within 30 days of death. Multivariable logistic regression adjusted for demographics, insurance, comorbidities, facility characteristics, and socioeconomic factors. A difference-in-differences approach compared 2 periods: 2004-2012 and 2013-2021.ResultsAmong 43 490 patients (mean age, 75.6 years; 51.1% female), 1275 (2.9%) received chemotherapy near death. Adjusted analyses found no statistically significant racial or ethnic differences in use. However, Asian American patients had a marginally increased likelihood of receiving chemotherapy over time compared with non-Hispanic White patients (interaction OR, 2.25; 95% CI, 0.95-5.32; P = .065). Older age (≥80 years: OR, 0.12), higher comorbidity burden (Charlson-Deyo score ≥2: OR, 0.61), and uninsured status were associated with lower odds of treatment. Private insurance (OR, 1.67) and treatment at comprehensive cancer centers were associated with higher odds.ConclusionWhile overt racial disparities were not observed, disparities by insurance and facility type point to structural inequities that should be addressed in future quality improvement efforts.

PMID:41618641 | DOI:10.1177/10499091261422382

Glob Public Health. 2026 Dec 31;21(1):2624148. doi: 10.1080/17441692.2026.2624148. Epub 2026 Jan 30.

ABSTRACT

The United States is experiencing a resurgence of measles, a highly contagious disease previously declared eliminated in 2000. This article examines the current trends of this resurgence, focusing on the increasing number of cases and outbreaks, the factors contributing to low vaccination rates, and the critical role of vaccine hesitancy. Data from the Centers for Disease Control and Prevention (CDC) as of May 15, 2025, are presented, highlighting the significant increase in measles activity and the concentration of cases within outbreaks. The analysis explores the epidemiological characteristics of these outbreaks, including severity and transmission dynamics, and examines the decline in national MMR vaccine coverage. Finally, the article discusses evidence-based strategies to enhance vaccine accessibility, combat misinformation, and improve outbreak response, emphasizing the urgent need for a coordinated public health approach to mitigate future outbreaks and protect vulnerable populations.

PMID:41618620 | DOI:10.1080/17441692.2026.2624148

Paediatr Anaesth. 2026 Jan 30. doi: 10.1002/pan.70139. Online ahead of print.

NO ABSTRACT

PMID:41618612 | DOI:10.1002/pan.70139

J Geriatr Oncol. 2026 Jan 29;17(2):102895. doi: 10.1016/j.jgo.2026.102895. Online ahead of print.

ABSTRACT

INTRODUCTION: Older adults represent a growing proportion of patients with cancer. However, confirmatory randomized controlled trials (RCTs) continue to rely primarily on tumor-based endpoints such as overall survival (OS), which may overlook outcomes particularly important to older adults, including quality of life (QOL), functional status, and treatment tolerance. This review aimed to systematically characterize the primary endpoints used in confirmatory RCTs enrolling adults aged ≥65 years and to evaluate how novel endpoints reflecting patient priorities were defined and analyzed.

MATERIALS AND METHODS: PubMed, CINAHL, and the Cochrane Library were searched for English-language confirmatory RCTs exclusively enrolling adults aged ≥65 years with cancer and reporting a primary endpoint (up to January 19, 2024). Endpoints were classified as conventional (tumor-based) or novel (non-tumor-based). Data were extracted on endpoint definitions, measurement tools, and statistical approaches.

RESULTS: Of 822 records identified, 66 RCTs met the eligibility criteria, yielding 71 primary endpoints. Conventional outcomes predominated (n = 53; 74.6%), with OS being the most frequent, followed by progression-free survival and disease-free survival. Novel endpoints (n = 18; 25.3%) included health-related QOL (HR-QOL), toxicity, geriatric assessment-based measures, composite endpoints, and patient satisfaction. HR-QOL was most commonly assessed using the European Organization for Research and Treatment of Cancer QLQ-C30. Definitions of toxicity and functional decline varied across studies. Variance assumptions were rarely reported, and minimal clinically important differences were inconsistently applied. Additional endpoints, such as quality-adjusted survival, overall treatment utility, and disability-free survival, were infrequently reported.

DISCUSSION: Survival remains the predominant endpoint in confirmatory RCTs involving older adults with cancer, while patient-relevant outcomes are inconsistently incorporated. Addressing these gaps may facilitate more patient-centered trial designs and improve the real-world applicability of research findings for the aging cancer population.

PMID:41616435 | DOI:10.1016/j.jgo.2026.102895

J Electrocardiol. 2026 Jan 24;95:154198. doi: 10.1016/j.jelectrocard.2026.154198. Online ahead of print.

ABSTRACT

BACKGROUND: Duchenne muscular dystrophy (DMD) is an inherited neuromuscular disorder causing progressive degeneration of skeletal and cardiac muscles due to dystrophin deficiency. Cardiac involvement ranges from mild to severe, including heart failure, arrhythmias, conduction defects, and sudden cardiac death.

OBJECTIVE: This study aimed to evaluate early markers of cardiac repolarization abnormalities in DMD patients by analyzing standard 12‑lead ECG parameters-QT interval, corrected QT (QTc), T peak to T end (Tp-e), Tp-e/QT, and Tp-e/QTc ratios-and microvolt T-wave alternans (MTWA) from 24-h Holter monitoring.

METHODS: Seventy-four individuals participated: 39 DMD patients and 35 age- and sex-matched healthy controls. Data on demographics, ambulation status, ECG, and Holter recordings were collected and compared. All participants underwent standard 12‑lead electrocardiography and 24-h Holter electrocardiogram monitoring. ECG measurements were performed manually by a blinded operator using standardized techniques. Holter recordings were collected and compared (analyzable data obtained from 33 patients and 34 controls). The QTc interval was calculated using Bazett’s formula. Correlation analyses and statistical comparisons between groups were performed using appropriate parametric and non-parametric tests.

RESULTS: DMD patients exhibited significantly higher resting heart rates. The Tp-e interval was similar between groups, while the QT interval was significantly shorter in the patient group, the QTc interval showed no significant difference between groups. Tp-e/QT ratio was higher in the patient group; Tp-e/QTc ratios showed no difference. The QTc interval was significantly prolonged in the non-ambulatory DMD group. MTWA values did not differ significantly between groups. Due to the limited sample size and absence of established pediatric reference values, MTWA findings must be considered inconclusive.

CONCLUSION: In conclusion, our study reveals subtle repolarization alterations in DMD patients, including elevated resting heart rate and a trend toward increased Tp-e/QT ratio. While these findings do not yet establish a definitive arrhythmic phenotype, they suggest the presence of early electrophysiological changes that may warrant longitudinal cardiac evaluation. Prospective follow-up studies are essential to determine the prognostic significance of these parameters and their relationship to clinical arrhythmic outcomes in the pediatric DMD population.

PMID:41616430 | DOI:10.1016/j.jelectrocard.2026.154198

J Pediatr Nurs. 2026 Jan 29;87:306-313. doi: 10.1016/j.pedn.2026.01.031. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to examine the relationships among marital satisfaction, maternal attachment, and maternal burnout, and to evaluate the mediating role of maternal burnout in the relationship between marital satisfaction and maternal attachment.

METHOD: Data were collected from 301 mothers with infants aged 0-12 months. Information was obtained using a Mother and Infant Descriptive Information Form, the Maternal Burnout Scale, the Marital Satisfaction Scale, and the Maternal Attachment Inventory. Data were analyzed using SPSS software. Scale reliability was assessed with Cronbach’s alpha, relationships between variables were examined using Pearson correlation analysis, and path analysis was conducted for model testing. Statistical significance was set at p ≤ 0.05.

RESULTS: Maternal burnout and marital satisfaction were at moderate levels, while maternal attachment was high. The path model showed good fit indices, and maternal burnout played a significant mediating role in the relationship between marital satisfaction and maternal attachment. Marital duration, child’s gender, number of children, and child’s age were variables influencing the model. Marital satisfaction was negatively correlated with maternal burnout and positively correlated with maternal attachment. Maternal burnout and maternal attachment were also significantly negatively correlated.

CONCLUSION: Increased marital satisfaction was associated with lower maternal burnout, which in turn positively affected the mother-infant bond. Supporting couple relationships and addressing mothers’ psychosocial needs may improve maternal and infant health during early parenting.

IMPLICATIONS TO PRACTICE: Integrating psychosocial and relational screening into postpartum care and involving partners in interventions may help reduce maternal burnout and strengthen mother-infant attachment.

PMID:41616417 | DOI:10.1016/j.pedn.2026.01.031

J Trace Elem Med Biol. 2026 Jan 27;94:127826. doi: 10.1016/j.jtemb.2026.127826. Online ahead of print.

ABSTRACT

Trace elements such as iron (Fe), copper (Cu), and zinc (Zn) are essential dietary components that support a broad range of biochemical and physiological functions. Despite being required in trace amounts, disturbances in their homeostasis can lead to a wide range of health issues. Their assessment in biological matrices, including hair, in companion animals continues to be explored as a means of understanding nutritional status, environmental exposure, and pathological conditions. However, data for companion animals remain limited. This study evaluated the influence of selected individual (sex, age) and environmental (diet type, living environment) factors on Fe, Zn, and Cu concentrations in the hair of clinically healthy dogs and cats living in Bucharest, Romania. Elemental quantification was performed using ICP-MS following acid digestion. Median concentrations were compared using Mann-Whitney U and Kruskal-Wallis tests, and associations among elements were evaluated using Spearman’s rank correlation with Benjamini-Hochberg correction (FDR 0.05) to control for false discoveries. Dogs exhibited significantly higher hair Fe (168.29 µg/g) and Cu (6.99 µg/g) concentrations than cats (57.67 µg/g Fe; 5.86 µg/g Cu), whereas Zn levels were similar between species (93.12 µg/g in dogs; 101.20 µg/g in cats). Sex, age, and diet type showed no significant influence on Fe, Zn, or Cu in either species. In contrast, the living environment significantly affected Fe levels: dogs kept outdoors had markedly higher Fe concentrations (312.21 µg/g) than indoor dogs (78.31 µg/g), and the same pattern was observed in cats (111.05 µg/g in outdoor cats; 40.52 µg/g in indoor cats), while Zn and Cu remained unaffected. All pairwise correlations among Fe, Zn, and Cu were positive and remained statistically significant after FDR correction. Zn-Cu demonstrated the strongest association in both species (ρ = 0.773 in dogs; ρ = 0.883 in cats), with cats showing overall stronger inter-element correlations than dogs. These findings contribute to the limited reference data on companion animal hair mineral profiles and highlight the potential value of hair analysis for exploring environmental influences and trace element interactions in dogs and cats.

PMID:41616405 | DOI:10.1016/j.jtemb.2026.127826

Semin Arthritis Rheum. 2026 Jan 23;77:152925. doi: 10.1016/j.semarthrit.2026.152925. Online ahead of print.

ABSTRACT

OBJECTIVES: Immunoglobulin (Ig)G4-related disease (IgG4-RD) can affect any organ, but coronary artery involvement (CAI) is a potentially life-threatening manifestation of this disease. In this scoping review, we critically appraised the literature on IgG4-related CAI, aiming to explore clinical, radiological and histopathological characteristics as well as treatment strategies and prognosis.

METHODS: A comprehensive search was performed on January 02, 2025 in PubMed® to identify studies describing individuals with IgG4-related CAI, including both coronaritis (true arteritis of the coronary vessel wall) and periarteritis (peri-coronary involvement), and considering case reports, case series, retrospective cohort studies and observational studies. Two reviewers independently conducted the revision of literature under the guidance of the methodologist to identify eligible studies. Data extraction included clinical presentation, imaging findings, histopathology, treatment, and outcomes. Given the heterogeneity of the studies, descriptive statistical analysis was used whenever possible to summarise the data.

RESULTS: Out of 964 screened references, 143 articles met the above-mentioned inclusion criteria. Most CAI cases were included in case reports (90.2 %), 7 % in case series and 2.8 % in retrospective cohort studies or observational studies. CAI predominantly affected males in the sixth decade of life and frequently coexisted with aortic and large vessel involvement. All segments of the coronary arterial tree could be involved, even the smallest branches. Images detected by various methods revealed several types of lesions: stenosis, wall-thickening, aneurysm, ectasia, pseudotumor, pseudoaneurysm, dissection, and soft tissue masses. Increase serum IgG4 levels and increased inflammatory markers were reported. Histopathology was consistent with IgG4-RD in all coronary samples obtained. Glucocorticoid therapy, alone or combined with immunosuppressants and/or surgical interventions, was the most commonly reported treatment. Rituximab seemed to be an effective therapy for IgG4-related CAI even without associated glucocorticoids. Despite treatment, relapse and progression of coronary lesions were noted in some cases.

CONCLUSIONS: Early identification and multidisciplinary management og IgG4-related CAI are crucial to reduce morbidity and mortality. Available data on the response to various treatments are limited, as dedicated coronary artery imaging was not consistently obtained soon enough after treatment to assess response. In addition, long-term follow-up was not available for all patients. Further studies are required to understand the real prevalence, natural history, optimal diagnostic strategies, and therapeutic approaches for this serious condition.

PMID:41616384 | DOI:10.1016/j.semarthrit.2026.152925