Tag: nevin manimala

Updates Surg. 2025 Apr 23. doi: 10.1007/s13304-025-02207-z. Online ahead of print.

ABSTRACT

The donor-site wound from deep inferior epigastric perforator flap breast reconstruction differs from abdominoplasty due to higher positioning and tension, potentially affecting healing. Closed-incision negative-pressure therapy has been proposed to improve wound healing and reduce complications. This study aimed to evaluate the impact of this tool on donor-site wound’s complications and scar-related patient outcomes. This retrospective cohort study included 140 patients who underwent delayed deep inferior epigastric perforator flap breast reconstruction between September 2020 and March 2023. Patients were assigned to Group A (closed-incision negative-pressure therapy) or group B (micropore tape dressings). Both groups received standardized perioperative care. Complications were analyzed, and scar were assessed 1 year postoperatively using SCAR-Q. Statistical significance was set at p ≤ 0.05. There were no significant differences between the two groups in baseline characteristics. Wound dehiscence was significantly lower in Group A compared to Group B (p = 0.0003). The mean time to wound healing after dehiscence was similar between groups (p = 0.270). No significant differences were found in other complications, such as infection or hematoma. Concerning SCAR-Q, patients in Group A reported significantly better outcomes on the symptom scale (p = 0.03), whereas no significant differences were observed for appearance or psychosocial impact. Closed-incision negative-pressure therapy reduced the rate of wound dehiscence but did not significantly improve scar quality or other complications. Given the limited benefits and lack of cost-effectiveness data, this tool should be considered for further study rather than routine clinical use in low-risk deep inferior epigastric perforator flap patients.

PMID:40268808 | DOI:10.1007/s13304-025-02207-z

Behav Res Methods. 2025 Apr 23;57(5):154. doi: 10.3758/s13428-025-02637-y.

ABSTRACT

Response times (RTs) are a ubiquitous variable for assessing cognitive and motor processes. However, variability introduced by keyboards, especially in online experiments, has raised concerns among behavioral researchers. Here, we evaluate the impact of keyboard delays on RT measurements using linear mixed-effects models and grouped data t-tests through a series of simulations. The results showed that the impact of keyboard delays on statistical power is minimal in most cases. Keyboard-induced variability does not inflate type I error rates and has a negligible impact on power, except in rare scenarios of RT distribution shifts or in studies focused on individual differences with low signal-to-noise ratios. Thus, commercially available keyboards remain suitable for most RT experiments, including those conducted online.

PMID:40268807 | DOI:10.3758/s13428-025-02637-y

Strahlenther Onkol. 2025 Apr 23. doi: 10.1007/s00066-025-02404-0. Online ahead of print.

ABSTRACT

INTRODUCTION: Primary orbital lymphomas are predominantly low-grade subtypes, such as extranodal marginal zone lymphomas (MALT) and follicular lymphomas, which are highly radiosensitive. Mantle cell lymphoma (MCL), although less common, is an aggressive high-grade subtype with an intermediate-to-poor prognosis. While systemic therapies are standard for MCL, data on the efficacy of radiotherapy in localized orbital MCL are limited. This study evaluates the long-term outcomes of radiotherapy for localized orbital MCL using the Surveillance, Epidemiology, and End Results (SEER) database.

MATERIALS AND METHODS: This retrospective study analyzed cases of localized orbital MCL treated with radiotherapy between 2000 and 2021 identified in the SEER database. Demographic, clinical, and survival data were extracted. The primary endpoints were overall (OS) and cancer-specific survival (CSS), estimated using the Kapla-Meier method and Cox proportional hazards models. Statistical analyses were conducted using R software (R Foundation, Vienna, Austria), with a significance threshold set at p < 0.05.

RESULTS: Among 13,662 patients with localized primary orbital lymphomas, 63 (0.5%) cases were histologically confirmed as MCL. Of these, 35 patients (55.6%) received radiotherapy. The age-adjusted incidence rate of orbital MCL was 0.033 per 1,000,000 person-years (95% CI: 0.025-0.042). Patients were predominantly elderly (42.9% were over 80 years old) and male (male-to-female ratio of 2.18 : 1; p = 0.012). With a median follow-up of 91 months (range: 4-237 months), the median OS was 113 months. The 5‑, 10-, and 15-year OS rates were 76.5% (95% CI: 62.7-93.4%), 48.2% (32.9%-70.6%), and 42.8% (27.4%-66.9%), respectively. Median CSS was not reached, with 5‑, 10-, and 15-year CSS rates of 98.0% (95% CI: 78.0-100.0%), 83.4% (69.5%-100.0%), and 83.4% (69.5%-100.0%), respectively. Chemotherapy did not show a significant impact on survival.

CONCLUSION: Radiotherapy achieves excellent long-term survival outcomes for localized orbital MCL, particularly in elderly and frail patients who may not tolerate systemic therapies. These findings support radiotherapy as an effective therapeutic option for this rare lymphoma subtype. Future multicenter studies are warranted to optimize radiotherapy protocols and improve patient outcomes.

PMID:40268802 | DOI:10.1007/s00066-025-02404-0

Eur Radiol. 2025 Apr 23. doi: 10.1007/s00330-025-11616-y. Online ahead of print.

NO ABSTRACT

PMID:40268798 | DOI:10.1007/s00330-025-11616-y

Eur Radiol. 2025 Apr 23. doi: 10.1007/s00330-025-11599-w. Online ahead of print.

NO ABSTRACT

PMID:40268797 | DOI:10.1007/s00330-025-11599-w

Eur Radiol. 2025 Apr 23. doi: 10.1007/s00330-025-11600-6. Online ahead of print.

NO ABSTRACT

PMID:40268796 | DOI:10.1007/s00330-025-11600-6

Skeletal Radiol. 2025 Apr 23. doi: 10.1007/s00256-025-04916-3. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim was to study the association between specific radiographic findings and patient reported shoulder pain and disability in patients suspected of subacromial impingement syndrome (SIS).

MATERIALS AND METHODS: This cross-sectional study used baseline data from a prospective study. Study population included patients age 18 to 63 years, referred to orthopaedic clinic on suspicion of SIS. Radiographic findings before first visit to a department of orthopaedic surgery comprised subacromial calcifications, acromial morphological characteristics (i.e. acromial type and spur), acromioclavicular osteoarthritis, signs of previous glenohumeral dislocation (Bankart/Hill-Sachs lesions), and architectural measures (i.e. acromial tilt, acromion index, and lateral acromial angle). Shoulder pain and disability were evaluated using the Oxford Shoulder Score (OSS) from patient’s response to a questionnaire at first visit to the public department of orthopaedic surgery or before surgery for SIS. A low OSS was defined as having a score < 25. Associations between the radiographic findings and low OSS were analysed using logistic regression.

RESULTS: The population comprised 825 patients. Median time between radiographic examination and completion of the questionnaire was 9 days (SD = 27.1). In adjusted analysis, we found a statistically significant association for lateral spur especially birdbeak type (OR = 2.24 (95% CI 1.36-3.71)), Bankart/Hill-Sachs lesion (OR = 2.49 (95% CI 1.38-4.48)), and acromial tilt > 35° (OR = 0.62 (95% CI 0.41-0.94)). Female sex (OR = 2.25 (95% CI 1.59-3.18)) was also associated with low OSS.

CONCLUSION: In terms of associations with patient-reported shoulder pain and disability, lateral spurs, with emphasis on birdbeak type, Bankart/Hill-Sachs lesions, and acromial tilt > 35°, seemed clinically important.

PMID:40268775 | DOI:10.1007/s00256-025-04916-3

Neuroimage Clin. 2025 Apr 12;46:103782. doi: 10.1016/j.nicl.2025.103782. Online ahead of print.

ABSTRACT

Between 22 and 45 % of children born preterm experience difficulties with expressive and receptive language when they reach school age. Little is currently known about the neural mechanisms behind their linguistic performance. This study investigates the brain areas and white matter connections that form the structural language network in extremely preterm-born children who have reached school age. Structural brain connectivity was quantified using diffusion-weighted imaging (DWI) and tractography in n = 58 (62 % female) extremely preterm-born children aged 8-12 years. Language outcomes were assessed using the CELF-4-NL Recalling Sentences subtest. Language scores were below average in n = 13 (22 %) children. Language outcomes related significantly to a subnetwork of 16 brain regions (p = 0.012). The network comprised brain regions from the left hemisphere including the pars orbitalis, middle and superior frontal gyrus, frontal pole, pre- and postcentral gyrus, superior temporal gyrus, insula, caudate nucleus, thalamus, and putamen. In the right hemisphere, the anterior cingulate was part of the network. These findings suggest that extremely preterm children rely mostly on their left hemisphere during language processing, which is similar to typically developing children. However, they seem to use compensatory neural pathways that include brain areas right next to the areas typically involved in language processing. These areas include the pars orbitalis (adjacent to Broca’s area) and the putamen and caudate nucleus (adjacent to the limbic system). It is important to note that language difficulties were not necessarily related to brain injury around birth.

PMID:40267537 | DOI:10.1016/j.nicl.2025.103782

Shock. 2025 Apr 4. doi: 10.1097/SHK.0000000000002599. Online ahead of print.

ABSTRACT

OBJECTIVE: Sepsis represents a leading cause of global mortality, defined by a dysregulated inflammatory response. This study aims to investigate the potential causal associations between circulating inflammatory proteins and sepsis risk using a two-sample Mendelian randomization (MR) approach.

METHODS: Publicly available summary statistics from genome-wide association studies (GWAS) were used in this study. Genetic instruments for circulating inflammatory protein were derived from a GWAS meta-analysis of 11 cohorts encompassing 14,824 European participants. The relationship between genetically predicted protein levels and sepsis-related outcomes was evaluated using aggregated data from the UK Biobank-a multicenter prospective cohort study comprising over 500,000 European participants. Analyses were stratified by age, 28-day mortality, and ICU admission. Multiple MR methods, including inverse-variance weighted (IVW), MR-Egger, and weighted median, were applied to ensure the robustness of our findings.

RESULTS: The MR analysis identified significant causal associations between inflammatory proteins and sepsis outcomes. Genetically predicted elevated levels of β-NGF and a reduced risk of sepsis (odds ratio [OR] 0.77, 95% confidence interval [CI] = 0.60-0.99, P = 0.039). Among sepsis patients aged below 75 years, the risk was reduced by 30% (OR 0.70, 95% CI = 0.52-0.93, P = 0.013). Genetically predicted increases in TRAIL (OR 1.11, 95% CI = 1.02-1.20, P = 0.020) and VEGF-A (OR 1.18, 95%CI = 1.02-1.37, P = 0.031) were positively associated with sepsis incidence, while genetically predicted levels of CST5 (OR 0.81, 95%CI = 0.69-0.94, P = 0.006) and MCP-1 (OR 0.64, 95%CI = 0.45-0.92, P = 0.015) were inversely associated with sepsis-induced mortality.

CONCLUSION: This study provides evidence from a Mendelian randomization framework supporting the causal role for specific circulating inflammatory proteins (e.g., β-NGF, VEGF-A, and TRAIL) in influencing sepsis risk and mortality. These findings underscore the potential for therapeutic interventions targeting these proteins to mitigate sepsis risk and improve patient outcomes, along with further investigation into the underlying mechanisms and clinical implications.

PMID:40267509 | DOI:10.1097/SHK.0000000000002599

JMIR Aging. 2025 Apr 23;8:e65183. doi: 10.2196/65183.

ABSTRACT

BACKGROUND: Disturbed sleep patterns are common among older adults and may contribute to cognitive and physical declines. However, evidence for the relationship between sleep duration and cognitive frailty, a concept combining physical frailty and cognitive impairment in older adults, is lacking.

OBJECTIVE: This study aimed to examine the associations of sleep duration and its changes with cognitive frailty.

METHODS: We analyzed data from the 2008-2018 waves of the Chinese Longitudinal Healthy Longevity Survey. Cognitive frailty was rendered based on the modified Fried frailty phenotype and Mini-Mental State Examination. Sleep duration was categorized as short (<6 h), moderate (6-9 h), and long (>9 h). We examined the association of sleep duration with cognitive frailty status at baseline using logistic regressions and with the future incidence of cognitive frailty using Cox proportional hazards models. Restricted cubic splines were used to explore potential nonlinear associations.

RESULTS: Among 11,303 participants, 1298 (11.5%) had cognitive frailty at baseline. Compared to participants who had moderate sleep duration, the odds of having cognitive frailty were higher in those with long sleep duration (odds ratio 1.71, 95% CI 1.48-1.97; P<.001). A J-shaped association between sleep duration and cognitive frailty was also observed (P<.001). Additionally, during a mean follow-up of 6.7 (SD 2.6) years among 5201 participants who were not cognitively frail at baseline, 521 (10%) participants developed cognitive frailty. A higher risk of cognitive frailty was observed in participants with long sleep duration (hazard ratio 1.32, 95% CI 1.07-1.62; P=.008).

CONCLUSIONS: Long sleep duration was associated with cognitive frailly in older Chinese adults. These findings provide insights into the relationship between sleep duration and cognitive frailty, with potential implications for public health policies and clinical practice.

PMID:40267503 | DOI:10.2196/65183