Nevin Manimala

J Wound Care. 2025 Jun 1;34(Sup6):S6-S14. doi: 10.12968/jowc.2025.0172. Epub 2025 Jun 3.

ABSTRACT

OBJECTIVE: This study examines a large dataset of near infrared spectroscopy (NIRS) usage from a multistate mobile wound care practice. The goal was to quantify: wounds imaged with NIRS; why providers used the technology; and how NIRS imaging impacted clinical decision-making. Healing rates were also compared to published data.

METHOD: Deidentified electronic medical record (EMR) data were extracted from Wound Care Plus, LLC, US between 1 April 2024 and 10 March 2025. The dataset was analysed for the total number of patients and wounds treated. NIRS was assessed for reason and impact of use. Healing rates were calculated for NIRS-imaged wounds.

RESULTS: The dataset identified 19,192 wounds from 6147 patients treated by numerous practitioners in 22 US states, with NIRS imaging used in 2165 patients (35%) and 4060 wounds (21%). The rationale for NIRS use included: microcirculation assessment and vascular referral (8.89%); debridement necessity and effectiveness (29.16%); tissue oxygenation trending (66.65%); and care plan evaluation (92.98%). The NIRS group included patients with skin changes, no improvement for >2 weeks, temperature variation, diabetes, peripheral arterial disease, venous disease, stroke, heart attack or vascular intervention. NIRS impacted medical decision-making and plan of care (PoC) changes including: palliative (5.22%); maintenance (20.76%); healable (17.39%); hospice (0.64%); additional studies (11.6%); vascular consultation or surgical referral (5.44%); and/or vascular studies (10%). The healing rate was 36.5% for pressure ulcers, 38.15% for lower extremity wounds and 39.68% for all wounds, compared to the published healing rate of 22.5%; this represents an improvement of 62%-76% in healing rates compared with the previously published rate.

CONCLUSION: This analysis demonstrated that providers used NIRS selectively, in cases of greatest clinical complexity or worsening, and that NIRS was beneficial to: monitoring tissue oxygenation (StO₂; oxy- and deoxyhaemoglobin ratios); appropriate vascular referrals; and effective and efficient debridement. Modifications to the PoC based on NIRS imaging can provide improved healing rates while gaining efficiency and efficacy.

PMID:40504489 | DOI:10.12968/jowc.2025.0172

J Cancer Surviv. 2025 Jun 12. doi: 10.1007/s11764-025-01841-1. Online ahead of print.

ABSTRACT

PURPOSE: The MELACARE intervention aimed to evaluate a nurse-led follow-up program incorporating skin self-examination (SSE) education and psychosocial support to address fear of cancer recurrence (FCR) in early-stage melanoma survivors. This study assessed the MELACARE intervention’s impact on FCR, psychological well-being, SSE performance, and healthcare usage compared to standard physician-led follow-up.

METHODS: A two-group randomised controlled trial was conducted at Herlev and Gentofte Hospital, Denmark. Participants included 153 patients with surgically treated melanoma (stages IA-IIA). Patients were randomised to either the MELACARE intervention (n = 78) or a control group provided treatment as usual (n = 75). The intervention involved nurse-led sessions focusing on SSE techniques and metacognitive strategies. Outcomes included FCR (primary), distress, anxiety, depression, health-related quality of life (HRQoL), patient activation, and SSE frequency and confidence (secondary) at 6 months.

TRIAL REGISTRATION: ClinicalTrials.gov (NCT05253872).

RESULTS: At 6 months, the mean of the primary outcome FCR was lower in the intervention compared to the control groups, but the difference was not statistically significant (- 0.86 [- 3.34;1.62]). Intervention patients reported higher HRQoL (18% [3;32]) and patient activation (0.43 [0.15;0.71]) as the only significant secondary outcomes. Confidence in SSE was higher in the intervention group, with most performing SSE at recommended intervals.

CONCLUSIONS: The MELACARE intervention may improve HRQoL and patient activation but did not reduce FCR. High fidelity of delivery and patient adherence highlight its potential utility.

IMPLICATIONS FOR CANCER SURVIVORS: The MELACARE approach empowers melanoma survivors through structured SSE education and psychosocial support. Future analyses will investigate long-term safety and efficacy.

PMID:40504479 | DOI:10.1007/s11764-025-01841-1

J Robot Surg. 2025 Jun 12;19(1):284. doi: 10.1007/s11701-025-02457-4.

ABSTRACT

This study aims to comprehensively assess the clinical performance of the Versius robotic platform in the context of robot-assisted radical prostatectomy (RARP), focusing on its safety profile, practicality, and postoperative functional recovery, in order to support its integration into urologic cancer management. An extensive literature search was performed using databases including PubMed, Embase, Web of Science, the Cochrane Library, and ClinicalTrials.gov, covering publications up to December 2024. The eligible studies were those reporting on perioperative metrics or functional outcomes associated with Versius-assisted RARP. Data extraction and synthesis were carried out under a single-arm meta-analytic framework. The aggregated measures such as operative duration, intraoperative blood loss, length of hospitalization, complication frequency, positive surgical margin (PSM) rate, and continence outcomes were calculated using Stata 18 SE. The study heterogeneity was quantified via the I² statistic and sensitivity tests were performed to explore heterogeneity sources. A total of four studies comprising 145 patients were included. The pooled average duration of surgery was 190.63 min, with a mean blood loss of 320.35 mL. The rate of high-grade complications (Clavien-Dindo > II) was 7%, while the PSM rate stood at 32%. Continence recovery rates at 1, 2 and 3 months post-surgery were 43%, 65%, and 73%, respectively. Considerable inter-study heterogeneity was identified, possibly influenced by differences in surgical proficiency and Versius system configurations. The sensitivity analysis highlighted operative console time as a stable parameter, with reduced heterogeneity after removal of an outlier study. The study demonstrates that the Versius robotic platform achieves comparable oncological and functional results to conventional prostatectomy techniques, with the added advantage of potential cost savings, positioning it as a viable surgical option. Its modular structure and ergonomic enhancements present distinct benefits, although procedural variability persists. Additional high-quality, multi-institutional prospective studies are necessary to substantiate these preliminary findings and inform standardized surgical practices.

PMID:40504465 | DOI:10.1007/s11701-025-02457-4

Emerg Radiol. 2025 Jun 12. doi: 10.1007/s10140-025-02352-3. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the predictive value of two radiological markers, the spot sign and leakage sign, for spontaneous intracranial hematoma expansion and their association with clinical outcomes, including neurological deterioration and in-hospital mortality.

MATERIALS & METHODS: This prospective single-center study included 94 adult patients with spontaneous intraparenchymal hemorrhagic stroke, confirmed by non-enhanced CT (NECT) and contrast-enhanced CT (CECT) in the arterial phase. Hematoma volumes and spot/leakage signs were assessed using standardized imaging protocols and analyzed by two blinded neuroradiologists. Clinical and radiological data were evaluated using multivariate analyses, with survival outcomes compared via Kaplan-Meier curves. Statistical significance was set at p ≤ 0.05.

RESULTS: Among 94 patients, hematoma expansion occurred in 42%, neurological deterioration in 15.5%, and mortality in 39.4%. The leakage sign was the strongest independent predictor of hematoma expansion (OR: 9.27, 95% CI: 2.95-29.20), neurological deterioration (OR: 26.67, 95% CI: 1.62-47.39), and mortality (OR: 7.56, 95% CI: 2.97-19.25). The spot and leakage signs demonstrated high specificity for predicting outcomes, with the leakage sign showing greater sensitivity for hematoma expansion. Patients with a positive leakage sign had significantly lower median survival (6 days) compared to those with a positive spot sign alone (54 days) or no signs (110 days, p < 0.001).

CONCLUSION: The leakage sign demonstrated greater sensitivity and comparable specificity to the spot sign for predicting hematoma expansion. Both signs were associated with neurological deterioration and in-hospital mortality, with the leakage sign showing a stronger predictive value.

PMID:40504437 | DOI:10.1007/s10140-025-02352-3

Discov Oncol. 2025 Jun 12;16(1):1068. doi: 10.1007/s12672-025-02898-1.

ABSTRACT

BACKGROUND: Laryngeal squamous cell carcinoma (LSCC) is the second most common malignancy of the respiratory tract after lung cancer, presents symptoms like hoarseness, sore throat, and dysphagia, and about 150,000 new cases are diagnosed worldwide annually. Risk factors such as tobacco smoking, alcohol consumption, and genetic variations, including TAS2R16 polymorphisms, significantly influence LSCC development. Recent research suggests TAS2R16, a bitter taste receptor, may play a role in inflammation regulation and could be linked to cancer susceptibility, particularly in individuals with alcohol and nicotine dependency.

METHODS: A total of 312 LSCC patients and 320 healthy controls participated in the study. Deoxyribonucleic acid (DNA) was extracted using salting-out technology. Real time polymerase chain reaction was used for genotyping. Using the ELISA technique, serum levels were measured.

RESULTS: The distribution of TT, CT, and CC genotypes of TAS2R16 rs860170 is statistically significantly different in groups: LSCC patients, both early-stage and late-stage LSCC patients, patients without metastasis and control group. Results showed that TAS2R16 rs1357949 GG and AG genotypes together are associated with decreased odds of developing LSCC in non-smoking patients under the dominant model. Also, each rs1357949 G allele was found to decrease the odds of LSCC occurrence in non-smokers under the additive model. TAS2R16 serum levels in the LSCC were greater in TAS2R16 rs978739 CT genotype carriers than in the control group.

CONCLUSIONS: The distribution of TAS2R16 rs860170 genotypes varies notably between LSCC patients, including those at early and late stages, as well as those without metastasis. Additionally, rs1357949 GG and AG genotypes show a protective effect against LSCC development in non-smokers, with the G allele reducing the odds of occurrence. Higher serum levels of TAS2R16 were observed in LSCC patients with the rs978739 CT genotype, suggesting a potential link between these genetic variations and LSCC pathophysiology.

PMID:40504435 | DOI:10.1007/s12672-025-02898-1

Int Ophthalmol. 2025 Jun 12;45(1):241. doi: 10.1007/s10792-025-03614-2.

ABSTRACT

BACKGROUND: The repair of Lower eyelid defect is a medical challenge for plastic surgeons. Objective to investigate the clinical effect of repairing inferomedial eyelid defects with temporal island flaps pedicled with the orbicularis oculi muscle.

METHODS: A retrospective analysis was conducted on 12 cases of inferomedial eyelid defects caused by tumors, scars or other reasons, in The First Affiliated Hospital of Anhui Medical University from January 2021 to October 2022. Temporal island flaps pedicled with the orbicularis oculi muscle or traditional nasolabial fold flaps were used to repair the inferomedial eyelid defects, and the patients were followed up for 2 to 13 months to observe postoperative tumor residue, scar release degree, flap survival, lower eyelid ectropion. Descriptive statistical methods were used to evaluate the treatment effect.

RESULTS: In 11 out of 12 patients, the tumors were completely resected with no residual at the margins and bases. In 1 patient with lower eyelid ectropion, it was completely corrected, which the scar was completely released and the lower eyelid was restored. The flaps in all 12 patients survived completely, and in one case, there was partial epidermal necrosis, which healed after dressing change and delayed healing. One patient designed the nasolabial V-Y advancement flap developed eyelid ectropion and retraction. During the follow-up period of 2 to 13 months, no lower eyelid ectropion or epiphora occurred.

CONCLUSION: The orbicularis oculi muscle-pedicled temporal island flap demonstrates significant clinical efficacy in reconstructing inferomedial eyelid defects, particularly due to its combination of surgical practicality and favorable tissue characteristics. This technique offers three distinct advantages: (1) straightforward surgical preparation with minimal donor site morbidity, (2) optimal tissue compatibility through preserved eyelid texture and robust vascular supply, and (3) enhanced rotational capacity and generous flap dimensions.

LEVEL OF EVIDENCE: Level IV, therapeutic study.

PMID:40504433 | DOI:10.1007/s10792-025-03614-2

J Med Syst. 2025 Jun 12;49(1):80. doi: 10.1007/s10916-025-02212-0.

ABSTRACT

In the context of Evidence-Based Practice (EBP), Systematic Reviews (SRs), Meta-Analyses (MAs) and overview of reviews have become cornerstones for the synthesis of research findings. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and Preferred Reporting Items for Overviews of Reviews (PRIOR) statements have become major reporting guidelines for SRs/MAs and for overviews of reviews, respectively. In recent years, advances in Generative Artificial Intelligence (genAI) have been proposed as a potential major paradigm shift in scientific research. The main aim of this research was to examine the performance of four LLMs for the analysis of adherence to PRISMA 2020 and PRIOR, in a sample of 20 SRs and 20 overviews of reviews. We tested the free versions of four commonly used LLMs: ChatGPT (GPT-4o), DeepSeek (V3), Gemini (2.0 Flash) and Qwen (2.5 Max). Adherence to PRISMA 2020 and PRIOR was compared with scores defined previously by human experts, using several statistical tests. In our results, all the four LLMs showed a low performance for the analysis of adherence to PRISMA 2020, overestimating the percentage of adherence (from 23 to 30%). For PRIOR, the LLMs presented lower differences in the estimation of adherence (from 6 to 14%) and ChatGPT showed a performance similar to human experts. This is the first report of the performance of four commonly used LLMs for the analysis of adherence to PRISMA 2020 and PRIOR. Future studies of adherence to other reporting guidelines will be helpful in health sciences research.

PMID:40504403 | DOI:10.1007/s10916-025-02212-0

J Wound Care. 2025 Jun 2;34(6):444-454. doi: 10.12968/jowc.2022.0088.

ABSTRACT

OBJECTIVE: The antibacterial properties of amniotic membranes are the reason for their wide clinical use. Amniotic membrane soaked in antibiotics can be used in local antibiotic therapy, creating new options for the treatment of infections. The aim of this study was to analyse the inhibiting effect of both human and porcine amniotic membranes soaked in antibiotics on the growth of microorganisms.

METHOD: Human and porcine placentas were collected during natural births, under aseptic conditions. Each amnion was divided into three parts: intravital; cryopreserved; and radio-sterilised. Discs of 8mm in diameter were cut from the amniotic membrane. The discs were incubated in antibiotics (gentamicin, neomycin sulfate and colistin) for three hours and then subjected to microbiological tests to assess the inhibition of bacterial growth. The inhibiting effect on microorganisms-Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae– were examined.

RESULTS: The findings of the study showed that porcine amniotic membrane was as effective in carrying antibiotics as human amnion. The ability of cryopreserved or radio-sterilised amniotic membrane to inhibit the growth of microorganisms was not reduced compared to that of fresh amnion. There was a statistically significant difference in the studied groups. The highest growth inhibition efficacy was noted for Escherichia coli, meticilin-sensitive Staphylococcus aureus, Acinetobacter baumannii-sensitive extended-spectrum beta-lactamase. The highest mean zones of growth inhibition were obtained for gentamicin and neomycin sulfate.

CONCLUSION: This study revealed that both human and porcine amniotic membranes can be used in carrying antibiotics. Differently prepared amniotic membrane can be successfully used in microorganism inhibition.

PMID:40504401 | DOI:10.12968/jowc.2022.0088

Abdom Radiol (NY). 2025 Jun 12. doi: 10.1007/s00261-025-05048-x. Online ahead of print.

ABSTRACT

PURPOSE: Organizing pneumonia is an inflammatory disorder that may co-exist with malignancy in the lung or elsewhere in the body. We aimed to assess patients with a lung biopsy diagnosis of organizing pneumonia for subsequent pathology confirmation of co-existing malignancy.

METHODS: In this retrospective IRB-approved, HIPAA-compliant study, 1314 consecutive patients who underwent CT-guided lung biopsy for suspected lung cancer or metastatic disease from 02/2014 to 04/2022 at a single tertiary referral hospital were identified. In 98/1314 (7.5%) patients, biopsies showed organizing pneumonia, which represented our study cohort. Clinical outcomes, including follow-up imaging and repeat tissue sampling if performed, were evaluated through chart review. Descriptive statistics were calculated.

RESULTS: There were 43/98 (44%) females, mean age was 66 ± 14 years, mean lesion size 2.9 ± 2.1 cm, and 11/98 (11.2%) had prior history of malignancy. Of 98 patients initially diagnosed with organizing pneumonia on lung biopsy, 11 (11.2%) were subsequently found to have malignancy. Among these, 6 (54.5%) had pulmonary metastases and 5 (45.5%) had primary lung cancer. Malignancies were confirmed through percutaneous re-biopsy in 3/11 (27%) and bronchoscopic, endoscopic, or surgical procedures in 8/11 (73%).

CONCLUSION: Malignancy can co-exist with organizing pneumonia in a substantial percentage of initial lung biopsies. Therefore, repeat tissue sampling should be considered when there is high clinical suspicion of malignancy despite an initial histopathological diagnosis of organizing pneumonia. This is especially relevant in lesions that demonstrate FDG avidity on PET/CT or an increase in size on interval imaging, or in instances where the biopsy core sizes are small or where the biopsies have intraprocedural complications.

PMID:40504392 | DOI:10.1007/s00261-025-05048-x