Nevin Manimala

J Gastrointest Cancer. 2025 Jun 27;56(1):141. doi: 10.1007/s12029-025-01260-6.

ABSTRACT

BACKGROUND: The combination of FOLFOX/FOLFIRI with an EGFR-antibody (cetuximab/panitumumab) is a first-line standard for RAS wild-type metastatic colorectal cancer (mCRC). The OPTIMOX stop-and-go regimen, which reduces oxaliplatin-induced neuropathy, and fluorouracil/folinic acid (FU/FA) were standard maintenance-therapies in the pre-antibody era. Whether an EGFR-antibody adds value to the OPTIMOX strategy in the RAS wild-type setting remains unknown.

METHODS: In the open-label, randomized, multicenter phase II ERBIMOX trial, patients with KRAS wild-type mCRC received either first-line induction-therapy with 8 cycles of mFOLFOX7 followed by maintenance-therapy with FU/FA (OPTIMOX arm) or mFOLFOX7 + cetuximab followed by FU/FA + cetuximab (ERBIMOX arm). Primary objective was to demonstrate superiority of additional cetuximab to mFOLFOX7 during induction/maintenance-therapy. Primary endpoint was objective response rate (ORR). Secondary endpoints included progression-free survival (PFS), overall survival (OS) and safety. The trial is registered at EudraCT (No.2006-002744-28).

RESULTS: From 2006-2011, 138 patients with KRAS wild-type mCRC from 23 German sites were randomly assigned to either OPTIMOX (N = 63) or ERBIMOX (N = 75). ORR numerically favored the ERBIMOX arm (64.0% vs. 54.0%, P = 0.3071). Median PFS (ERBIMOX vs. OPTIMOX) was 9.6 vs. 8.8 months (P = 0.7612), median OS 25.6 vs. 30.9 months (P = 0.5821). Most common grade 3/4 adverse events (AEs) were skin reactions (21.9% vs. 2.1%) and gastrointestinal disorders (13.5% vs. 9.5%). No cetuximab-related deaths occurred.

CONCLUSION: In treatment-naïve KRAS wild-type mCRC, adding cetuximab to mFOLFOX7 resulted in numerically higher ORR than mFOLFOX alone, but no statistically significant differences in ORR, PFS or OS; probably because of the premature stop due to poor recruitment. The safety profile was as expected, with few discontinuations.

PMID:40571867 | DOI:10.1007/s12029-025-01260-6

AAPS J. 2025 Jun 27;27(5):113. doi: 10.1208/s12248-025-01096-9.

ABSTRACT

Herein, we report a new modified nanoprecipitation method for the fabrication of water-dispersible Poly(lactic-co-glycolic acid) (PLGA) nanoparticles encapsulating three poorly water-soluble anticancer agents as model drugs: paclitaxel (PTX), docetaxel (DTX) or curcumin (Cur). These nanoparticles were water dispersible with favourable size for anticancer applications (below 200 nm) and relatively high drug loading (6.3-8.9%). These nanoparticles were stable for four weeks in solid state and up to 48 h when dispersed in water. PTX and Cur nanoparticles showed a very minimal release of the payload during a 72-h in vitro release study. The new method also yielded reproducible results across three different batches of each type of nanoparticles and following three times upscaling of PTX nanoparticles. PTX and Cur nanoparticles were more effective than the free drugs against MDA-MB-231 cells (p < 0.05). In addition, PTX nanoparticles showed a significant enhanced induction of early apoptosis in MDA-MB-231 cells (42.3%) in comparison to free PTX (23.7%, p < 0.05). Both flow cytometry and confocal microscopy confirmed the uptake of the nanoparticles by MDA-MB-231 cells. In conclusion, our modified nanoprecipitation method produces PLGA nanoparticles loaded with different anticancer agents and suitable for cancer therapy.

PMID:40571866 | DOI:10.1208/s12248-025-01096-9

Eur J Orthop Surg Traumatol. 2025 Jun 26;35(1):281. doi: 10.1007/s00590-025-04404-3.

ABSTRACT

PURPOSE: The aim of this study was to analyze the functional and radiological outcomes of delay arthroscopic repair of traumatic massive rotator cuff tears (mRCTs).

METHODS: This is a prospective study of patients with traumatic mRCTs treated by arthroscopic repair within the first 12 months after trauma. Degenerative tears, single tendon tears, associated fractures, severe arthropathy, irreparable tears, patients older than 75, and those with less than 1 year of follow-up were excluded. Range of motion, pain, and the ASES score were analyzed. MRI was performed preoperatively to assess the rotator cuff tear and 6 months after surgery to evaluate tendon healing. The average follow-up was 22 (± 6.3) months. A p value of < 0.05 was considered statistically significant.

RESULTS: A total of 20 patients were included, with a mean age of 61.7 (± 8) years, 60% male, 65% dominant side affected, and 65% manual workers. The mean time to diagnosis was 4.5 (± 2.7) months, and the mean time to surgery was 7.6 (± 3) months. The mean ASES score was 80.6 ± 15 95% of patients achieved satisfactory results. Elevation improved by a mean difference of – 38 degrees (p < 0.001), external rotation – 29 degrees (p < 0.001), pain decreased by 6 points (p < 0.001), and the ASES score improved by 41 points (p < 0.001). The rate of retear was 60% and patients in whom surgery was performed more than 6 months after the trauma had a 4.7-fold increased risk of retear (p = 0.018). Patients without a retear demonstrated better postoperative external rotation (p = 0.013) and ASES scores (p = 0.033).

CONCLUSIONS: Delayed arthroscopic repair of massive traumatic rotator cuff tears led to good functional outcomes in 95% of patients, despite a rate of retear of 60%. Patients operated on more than 6 months after trauma had a relative risk of 4.7 for presenting a retear.

PMID:40571862 | DOI:10.1007/s00590-025-04404-3

Eur J Orthop Surg Traumatol. 2025 Jun 26;35(1):280. doi: 10.1007/s00590-025-04380-8.

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the short-term postoperative outcomes of patients undergoing patella open reduction internal fixation procedures based on the type of anesthesia administered.

METHODS: A retrospective review was conducted of patients who were surgically treated for displaced patella fractures from 2012 to 2024 at a single multi-site academic institution. Patients were included if they were > 18 years of age, sustained an isolated patella fracture, and had a minimum of 6-month follow-up. Patients were divided into groups based on the anesthetic modality used during their surgery: regional anesthesia only (RA), general/neuraxial anesthesia (NR), and a combination of these methods (CA). Comparisons of statistics were performed using Pearson chi-squared tests, one-way ANOVA tests, and linear regression tests as appropriate.

RESULTS: There were no complications associated with the administration of anesthesia within each cohort. There was no significant difference in fracture healing rates (p = .210) nor complication rates between the anesthesia groups (p = .088). The RA and CA groups had significantly shorter operating room (wheels in to wheels out) times than the NR group (p < .001), significantly greater 3-month (p = .001) and 6-month knee ROM (p = .016) than the NR group when controlling for age, fracture pattern, and repair method.

CONCLUSION: This study demonstrates the efficacy of the use of regional anesthesia only for repair of a patella fracture. This technique is associated with greater early range of knee motion in patients after surgery and a shorter surgical time with no increase in intra or postoperative complications.

PMID:40571850 | DOI:10.1007/s00590-025-04380-8

J Perinatol. 2025 Jun 26. doi: 10.1038/s41372-025-02343-9. Online ahead of print.

ABSTRACT

Small for gestational age (SGA) infants face increased morbidity, mortality, and long-term health risks, yet causes of SGA remain unclear. While placental insufficiency and environmental factors contribute, genetic disorders play a significant role. Syndromes like Silver-Russell and Noonan are linked to SGA, but the overall genetic contribution remains uncertain. We reviewed literature on genomic sequencing in SGA and fetal growth restriction (which often precedes SGA) and identified 161 single-gene disorders. The top ten genes explained one-third of cases, but half were attributable to unique genes. Genetic disorders were frequently accompanied by congenital anomalies (often skeletal dysplasia) and developmental delays. Current guidelines for genetic evaluation of SGA are limited. Our findings support consideration of exome or genome sequencing, particularly in the setting of congenital anomalies or developmental delays. Early identification of genetic disorders can enable tailored therapy. Given the complexity of the SGA genetic landscape, prospective genomic studies are urgently needed.

PMID:40571843 | DOI:10.1038/s41372-025-02343-9

Support Care Cancer. 2025 Jun 26;33(7):631. doi: 10.1007/s00520-025-09690-5.

ABSTRACT

OBJECTIVE: This study aims to explore the effects and safety of Baduanjin on lung cancer patients post-surgery.

METHODS: We conducted a comprehensive search of ten databases for relevant studies up to November 1, 2024. Studies included RCTs where Baduanjin was compared with respiratory training, routine care or no treatment. Statistical analyses and forest plots were generated using Review Manager 5.4.1. Results were expressed as mean difference with 95% confidence interval. The GRADE tool was used to assess the level of evidence for all outcomes.

RESULTS: Nine RCTs involving 795 lung cancer patients who underwent lung resection surgery were included in meta-analysis. Baduanjin showed significant improvements compared to comparison group in 6-min walk distance (MD = 22.93, 95% CI [10.60, 35.26], P = 0.0003), FEV₁ (MD = 0.27, 95% CI [0.11, 0.44], P = 0.001), FVC (MD = 0.34, 95% CI [0.14, 0.54], P = 0.0008), and FACT-L (MD = 20.46, 95% CI [9.48, 31.44], P = 0.0003). Additionally, Baduanjin significantly reduced the self-rating anxiety scale (MD = – 6.68, 95% CI [- 10.05, – 3.32], P = 0.0001) and self-rating depression scale scores (MD = – 6.15, 95% CI [- 7.83, – 4.46], P < 0.0001). No adverse events were reported in the included studies.

CONCLUSION: Baduanjin is a safe and effective home-based feasible rehabilitation measure for enhancing postoperative activity tolerance, lung function, and quality of life while reducing negative emotions in patients after lung cancer surgery. However, due to the limitations, including low-quality evidence, high heterogeneity, and insufficient safety data in this review, the results should be interpreted cautiously. More rigorously designed, high-quality RCTs should be conducted in the future while emphasizing patient compliance and the safety of the interventions.

PMID:40571840 | DOI:10.1007/s00520-025-09690-5

J Pediatr Nurs. 2025 Jun 25;84:319-327. doi: 10.1016/j.pedn.2025.06.042. Online ahead of print.

ABSTRACT

PURPOSE: To identify the physical activity levels and influencing factors of children with epilepsy in China.

METHODS: This study was designed as a sequential explanatory mixed-method study. The quantitative phase included a sample of 195 children with epilepsy and their caregivers from November 2023 to April 2024. Data were analyzed using descriptive statistics, the independent t-tests, and one-way analysis of variance. The qualitative data were collected through semi-structured interviews, and a total of 8 children and 15 caregivers were interviewed from May 2024 to June 2024. The content analysis was conducted using the MaxQda software. Interpretative thematic analysis was used to explore the multidimensions of physical activity. The following joint display analysis was used to integrate quantitative and qualitative data.

RESULTS: Children with epilepsy tend to have limited physical activity and engage in a limited variety of activities, influenced by the multidimensional factors. Through joint display, five meta-themes and thirteen meta-subthemes were identified, including limited physical activity (insufficient physical activity and preference for simple activity types), misconceptions (excessive limitations, few concerns, and fear of seizure-related injury), personal factors (disease burden, personal characteristic, and the stigma), family and school factors (influenced by caregivers knowledge, parental and family support, and school support), and healthcare factors (the advice and attitudes of healthcare staff).

CONCLUSION: The research highlights the importance of supporting the physical activity of children with epilepsy. Epilepsy nurses should incorporate physical activity education and counseling into their routine clinical care, and develop targeted interventions to encourage regular physical activity.

IMPLICATIONS FOR PRACTICE: Epilepsy nurses should prioritize correcting misconceptions about physical activity in children with epilepsy. During clinical consultations, epilepsy nurses should implement tailored activity programs and provide individualized education and counseling.

PMID:40570474 | DOI:10.1016/j.pedn.2025.06.042

Prev Vet Med. 2025 Jun 24;243:106607. doi: 10.1016/j.prevetmed.2025.106607. Online ahead of print.

ABSTRACT

Smallholder dairy farming plays a crucial role in Kenya’s economy, with many farmers relying on dairy cattle for their livelihoods. However, milk production is affected by factors such as breed selection, nutrition, and endemic diseases. This cross-sectional study determined factors associated with daily milk yield in lactating smallholder dairy cows in Kabete Sub-County, Kiambu County, Kenya. We hypothesized that milk production is significantly associated with nutrition, management practices, and cow-level factors. On-farm questionnaires were administered to farmers in 62 randomly selected farms to collect animal- and farm-level information. A total of 196 lactating cows (1-6 per farm, averaging 3) were assessed, with measurements taken on daily milk yield, California Mastitis Test score, egg/oocyst count, days in milk, and body condition score (BCS). Descriptive statistics and multilevel mixed-effects linear regression were used for analysis, with daily milk yield as the outcome variable. The mean daily milk yield per cow was 10.8 ± 4.8 liters (range 1-24 liters). Feeding practices were significantly associated with daily milk yield. Cows supplemented with yeast products were associated with a 7.56 L/day higher milk yield compared to those without (β=7.56, 95 % CI 3.66-11.45). Feeding napier grass, hay, and dairy meal was associated with increased milk yield by 3.68 L/day (β=3.68, 95 % CI 0.89-6.46), 2.73 L/day (β=2.73, 95 % CI 1.32-4.12), and 2.16 L/day (β=2.16, 95 % CI 0.88-3.44), respectively. The association between BCS and daily milk yield depended on wheat bran supplementation; when fed, higher BCS (≥3) was associated to significantly increased yield. Each additional cow in the herd was associated with a 0.25 L/day increase in milk yield. Negative associations with daily milk yield included breed (β=-2.66, 95 % CI -4.59 to -0.08) and days in milk (β=-0.01, 95 % CI -0.008 to -0.004). Ayrshires produced 2.66 L/day less milk than Friesians. Mastitis also had a significant association, with daily milk yield decreasing by 2.52 L/day, 2.58 L/day, and 3.85 L/day when two, three, and four quarters were infected, respectively. In conclusion, feeding practices, particularly supplementation with yeast and specific forages, along with cow-level factors such as breed, days in milk, BCS, and mastitis status, significantly influenced milk yield in smallholder dairy farms.

PMID:40570469 | DOI:10.1016/j.prevetmed.2025.106607

J Emerg Med. 2025 Mar 19;75:14-23. doi: 10.1016/j.jemermed.2025.03.009. Online ahead of print.

ABSTRACT

BACKGROUND: Fever avoidance after cardiac arrest is recommended but cooling devices may not be used even if targeting normothermia.

OBJECTIVES: We sought to establish the incidence of postarrest fever and association with clinical outcomes depending on whether a cooling device was used.

METHODS: We conducted a retrospective study of adult cardiac arrest survivors admitted to intensive care units (ICUs) in our health system in 2021. Our primary outcome was discharged alive. Univariate and multivariable statistics were computed, and additional outcomes included cooling device use, Tmax of ≥38°C within 48 h of admission, and Glasgow Coma Scale (GCS) ≥8 at discharge.

RESULTS: 364 patients were screened and 194 ultimately analyzed. Seventy-eight (40.2%) were female, median (IQR) age was 63 (54.0-72.8) years old, 96 (49.7%) were provided a cooling device, and 49 (25.3%) reached a temperature ≥38°C within 48 h of admission. Patients without a cooling device more often reached Tmax ≥38°C (37.1% vs. 13.5%, p < 0.001). Greater GCS on day 3 was a consistent independent predictor of being discharged alive and of GCS ≥8 at discharge while failure to use a cooling device was the strongest independent predictor of postarrest fever.

CONCLUSIONS: Cooling devices were associated with fever prevention but used in patients who ultimately did poorly. Moreso than use of a cooling device, achieving fever avoidance may be more important for prognosis.

PMID:40570447 | DOI:10.1016/j.jemermed.2025.03.009

Talanta. 2025 Jun 25;296:128451. doi: 10.1016/j.talanta.2025.128451. Online ahead of print.

ABSTRACT

According to statistical data from the World Health Organization, in 2040, there will be an estimated 28.4 million new cancer cases. Gastric cancer (GC) is one of the most significantly deadly neoplasms: one out of every thirteen deaths worldwide. This situation happens due to two main factors: the clinical manifestations of the disease and the low efficacy of current detection techniques. The biosensors have gained attention as promising tools for early diagnosis, considering their easy integration into point-of-care technology. These devices enable the development of minimally invasive, highly sensitive, cost-effective, and user-friendly tests suitable for accurately screening large population groups. This review will explore applying nanomaterial-based electrochemical biosensor technology for screening, early detection, and prognostic assessment of stomach cancer. It comprehensively explains biosensor development engineering factors such as shelf life, scalability, reproducibility, and assay time. It compares Electroanalytical Techniques and biorecognition probes for successful biosensor manufacturing, instilling confidence in the review’s findings. The role of GC biomarkers and their diagnostic value and biological functions will be covered, highlighting emerging blood biomarkers. It emphasises electrochemical detection in clinical samples and the role of nanomaterials in these outcomes. Finally, translating nanobiosensors into mHealth applications by integration with Internet of Medical Things frameworks is critically reviewed, filling a critical knowledge gap. Therefore, the proposal aims to guide researchers in this interdisciplinary field of Biosensor PoC technologies development for the critical selection of biosensor components from a manufacturing and materials engineering point of view that guarantees a suitable integration and translation to the healthcare system.

PMID:40570441 | DOI:10.1016/j.talanta.2025.128451