Tag: nevin manimala

J Cardiovasc Pharmacol. 2026 Jun 4. doi: 10.1097/FJC.0000000000001840. Online ahead of print.

ABSTRACT

Sinus tachycardia is common after heart transplantation (HTx) and may worsen graft function via increased oxygen demand and remodeling. Ivabradine, a selective If channel inhibitor, lowers heart rate independently of sympathetic activity. This meta-analysis evaluates its efficacy and safety versus standard care in HTx recipients. A comprehensive search of PubMed, Embase, WoS, Scopus, and Cochrane was conducted through September 2025. Eligible studies included randomized and non-randomized comparative trials. Data were pooled with a random-effects model to estimate mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes. Six studies, including 852 adult HTx recipients, were included. Ivabradine consistently reduced HR across all time points. Statistical significance was reached at 24 months (MD -16.82 bpm; P=0.04) and 36 months (MD -12.94 bpm; P=0.04). A significant reduction was observed in LVMI (MD -11.10 g/m2; 95% CI -17.15 to -5.06; P<0.05; I^2=0%). While LVM and LVEF showed trends toward improvement at final follow-up (MD = -11.23 for LVM and +2.94% for LVEF), neither reached statistical significance (P = 0.06 and P = 0.48, respectively). No significant differences were found between the ivabradine and control groups regarding all-cause mortality (RR 1.16 at final follow-up; P=0.90), graft rejection (RR 1.14; P=0.87), or systolic blood pressure (MD 0.50 mmHg; P=0.83). Ivabradine lowers heart rate after heart transplantation but shows no clear benefit on mortality, rejection, or ejection fraction. It does not significantly affect blood pressure, supporting its tolerability, particularly when beta-blockers are not tolerated.

PMID:42359616 | DOI:10.1097/FJC.0000000000001840

Afr J Reprod Health. 2026 Jun 26;(12):(Afr J Reprod Health 2026; 30 [12]9-14:).. doi: 10.29063/ajrh2026/v30i12.1.

ABSTRACT

The advancement of sexual and reproductive health and rights (SRHR) in sub-Saharan Africa is fundamentally hindered by “health data poverty”.1 While many high-income countries have made significant progress in strengthening their health data systems, sub-Saharan Africa continues to face significant gaps.1-3 Despite the critical need for evidence-based practice, the regional data landscape is characterized by a pervasive ignorance regarding the intrinsic value of accurate data. Many countries in the region lack regular population censuses, reliable health records, and functional civil registration and vital statistics systems.

PMID:42359608 | DOI:10.29063/ajrh2026/v30i12.1

Asia Pac J Clin Oncol. 2026 Jun 26. doi: 10.1111/ajco.70134. Online ahead of print.

ABSTRACT

BACKGROUND: Neoadjuvant chemotherapy (NAC) exerts selective pressure on tumor biology, frequently altering the expression of ER, PR, and HER2 in residual disease. While guidelines mandate re-biopsy to guide adjuvant therapy, whether these biomarker conversions represent a true prognostic deterioration or a manageable adaptation remains controversial. This study investigates the relative prognostic weight of biomarker conversion and proliferative dynamics (Ki-67) in determining patient survival.

METHODS: We retrospectively analyzed 338 patients with invasive breast cancer who had residual disease following standard NAC and curative surgery. Paired biomarker status (pre-NAC vs. post-NAC) for ER, PR, HER2, and Ki-67 was evaluated. Adjuvant therapy was adapted according to the residual tumor profile, including targeted therapy for patients acquiring HER2 positivity. Survival outcomes were analyzed using Cox regression models.

RESULTS: Biomarker conversion was substantial, with conversion rates of 13.9% for ER, 18% for PR, and 27% for HER2. However, despite this high frequency of receptor conversion, changes in receptor status (loss or gain) did not translate into statistically significant differences in disease-free survival (DFS) or overall survival (OS) (all p > 0.05). In sharp contrast, Ki-67 dynamics emerged as the significant independent prognostic factor. Patients who converted from high-to-low proliferation (Ki-67 < 18%) achieved significantly superior DFS (HR: 0.45, 95% CI: 0.24-0.84, p = 0.011) and OS (HR: 0.36, 95% CI: 0.15-0.85, p = 0.020) compared to those with persistent high expression.

CONCLUSION: While biomarker conversion is a frequent event in residual breast cancer, it does not compromise survival outcomes when adjuvant treatment is adjusted according to the post-NAC immunohistochemical (IHC) profile. Instead, prognosis is predominantly driven by the tumor’s proliferative response. These findings suggest that persistent high Ki-67, rather than biomarker conversion, should be the primary marker for escalating adjuvant therapy and risk stratification.

PMID:42359564 | DOI:10.1111/ajco.70134

Neurourol Urodyn. 2026 Jun 26. doi: 10.1002/nau.70357. Online ahead of print.

ABSTRACT

BACKGROUND: Achieving continence in patients with neurogenic bladder is a difficult goal especially when stress urinary incontinence (SUI) due to intrinsic sphincter deficiency is involved. Two techniques are commonly used in that setting, but they have never been directly compared: the artificial urinary sphincter (AUS) and the fascial pubovaginal sling (PVS). The present study aims to compare the outcomes of AUS and PVS in female neuropathic patients.

METHODS: This retrospective international multicenter study was conducted from 2014 to 2023. We included all women with a past medical history of neurogenic bladder who underwent AUS or a PVS insertion (cadaveric or fascia lata) at three centers. The primary endpoint was the outcomes as assessed by the patient global impression of improvement (PGII) at 3 months and at the last follow-up.

RESULTS: Thirty-five patients were included: 16 with AUS and 19 with PVS. The PVS patients had fewer previous anti-incontinence procedures (10.5% vs. 43.8%; p = 0.02). The maximum cystometric capacity was significantly higher in the AUS group (364.1 vs. 252.8 mL; p = 0.03). All perioperative outcomes were similar in both groups with only two major postoperative complications in each group (12.5% vs. 10.5%; p = 0.99). Many functional outcomes favored AUS, but with no statistically significant difference, except for PGII = very much improved at 3 months (68.8% vs. 31.6%; p = 0.04).

CONCLUSION: AUS and PVS are two procedures yielding satisfactory outcomes in the female neurogenic SUI population, with similar morbidity. The functional outcomes may be more favorable with AUS.

PMID:42359558 | DOI:10.1002/nau.70357

J Craniofac Surg. 2026 Jun 26. doi: 10.1097/SCS.0000000000013053. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to comprehensively analyze changes in condylar volume and position before and after bilateral sagittal split ramus osteotomy (BSSRO) in mandibular prognathism patients with and without asymmetry in the Surgery-First Approach (SFA).

METHODS: A retrospective study included 10 patients in the asymmetry group and 13 in the symmetry group who underwent BSSRO in SFA. Computed tomography scans were collected at preoperative (T0) and 6 months postoperative (T1) to measure the 3D condylar volume (CV) and condylar displacement and rotation. Measurements on the deviated side (DS) and nondeviated side (NDS) were performed at each time point. Three-dimensional changes of condylar volume, displacement distance, and rotation angle were analyzed over time and compared between sides and groups using appropriate statistical methods.

RESULTS: Significant CV reduction was observed on both sides in the symmetry group after surgery. The center of the condylar head moved anteriorly in the symmetry group postoperatively. Meanwhile, it moved significantly forward and laterally on DS and anteriorly on NDS in the asymmetry group after surgery. The long axis of the condylar head rotated anteriorly and inferiorly on both sides and in both groups in the sagittal and coronal planes. In the horizontal plane, outward rotation on the DS and inward rotation on the NDS were identified in the asymmetry group.

CONCLUSIONS: In patients with severe facial asymmetry undergoing BSSRO, baseline condylar dysplasia is associated with greater postoperative condylar resorption. The pattern of condylar head displacement and rotation in our study resembled OFA results rather than those of other SFA studies. These findings suggest that SFA in our center may produce a similar impact on condylar remodeling as OFA.

PMID:42359509 | DOI:10.1097/SCS.0000000000013053

J Craniofac Surg. 2026 Jun 26. doi: 10.1097/SCS.0000000000013116. Online ahead of print.

ABSTRACT

OBJECTIVES: The possible cytotoxic effect of Centella asiatica extract on human dermal fibroblast cells was examined in this cell culture experiment. The main objective was to determine its basic safety for potential use in oral tissue regeneration applications and to assess its biocompatibility in vitro.

METHODS: Dulbecco’s Modified Eagle Medium with fetal bovine serum was used to cultivate human dermal fibroblasts. Using the conventional MTT experiment, cell viability was quantitatively evaluated. At concentrations of 5, 10, 50, 100, 150, and 200 g/mL, Centella asiatica extract was applied to cell cultures. A positive cytotoxicity control was Triton X-100, while untreated cells were used as the negative control. To determine dose-response associations (P<0.05), statistical analyses used one-way ANOVA and nonlinear regression.

RESULTS: When compared directly to the untreated control group, treatment with Centella asiatica extract did not result in a statistically significant decrease in human fibroblast vitality at any evaluated concentration. In addition, there was no concentration-dependent cytotoxic effect, as validated by nonlinear regression analysis. Up to the highest experimental dose of 200 g/mL, cellular viability remained surprisingly stable and was absolutely noncytotoxic. On the other hand, Triton X-100 significantly reduced overall cell survival.

CONCLUSION: At concentrations as high as 200 g/mL, the Centella asiatica extract is completely biocompatible and does not harm healthy human dermal fibroblasts. Its prospective applicability for additional experimental and clinical studies aimed at improving oral soft tissue regeneration and wound healing is strongly supported by the absence of dose-dependent toxicity, confirming its outstanding safety profile.

PMID:42359507 | DOI:10.1097/SCS.0000000000013116

J Environ Sci Health A Tox Hazard Subst Environ Eng. 2026 Jun 26:1-13. doi: 10.1080/10934529.2026.2692818. Online ahead of print.

ABSTRACT

Exposure to organochlorine pesticides (OCPs) may disrupt adolescent development; however, their precise impacts remain unclear. Using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2016, we examined associations between OCPs and adolescent body composition indicators, including body mass index (BMI) z_score, appendicular lean mass (ALM), trunk fat (TRF), total fat (TOF), total lean mass (TLM), and total percent fat (TPF). We fitted several statistical models including linear regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR). Mediation analysis evaluated the effect of serum albumin, while network toxicology and molecular docking identified key targets and pathways. Linear regression showed that OCPs were negatively correlated with BMI z_score, ALM, TRF, TOF, TLM, and TPF in adolescents, particularly in males. The WQS and BKMR revealed a negative relationship between OCPs mixtures and BMI z_score, TRF, TOF, and TPF, with hexachlorobenzene (HCB) as the major contributor. Albumin mediated the negative effects of HCB on all body composition indicators. Preliminary bioinformatics analyses suggested that HCB may influence body composition through inflammation, metabolic regulation, and apoptosis involving the MAPK, PI3K-Akt, and Ras signaling pathways. These findings suggest that HCB exposure may adversely affect adolescent growth and nutritional health, particularly among males.

PMID:42359500 | DOI:10.1080/10934529.2026.2692818

Biom J. 2026 Aug;68(4):e70145. doi: 10.1002/bimj.70145.

NO ABSTRACT

PMID:42359457 | DOI:10.1002/bimj.70145

Front Digit Health. 2026 Jun 10;8:1811259. doi: 10.3389/fdgth.2026.1811259. eCollection 2026.

NO ABSTRACT

PMID:42359447 | PMC:PMC13291121 | DOI:10.3389/fdgth.2026.1811259

Cureus. 2026 Jun 24;18(6):e111438. doi: 10.7759/cureus.111438. eCollection 2026 Jun.

ABSTRACT

Extramedullary disease (EMD) in multiple myeloma refers to soft-tissue plasmacytomas that spread hematogenously and grow independently of bone, an aggressive phenotype that has been associated with poorer responses and shorter survival across successive treatment eras. Bispecific antibodies are highly active in relapsed or refractory multiple myeloma (RRMM), but their efficacy in patients with baseline EMD has not been quantitatively synthesized. We performed a systematic review and meta-analysis, reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidance, of prospective trials of B-cell maturation antigen (BCMA)- or G protein-coupled receptor class C group 5 member D (GPRC5D)-directed CD3 bispecific antibodies in RRMM that reported the objective response rate (ORR) in patients with baseline EMD. One estimate per trial was included; proportions were pooled using a random-effects model on the logit scale with restricted maximum-likelihood estimation of between-study variance, and heterogeneity was assessed with the Cochran Q test and the I-squared statistic; fixed-effect and leave-one-out sensitivity analyses were performed, and risk of bias was appraised for each EMD subgroup. Four prospective studies comprising 144 patients with baseline EMD were included. Study-level ORRs were 58.3% for teclistamab, 38.5% for elranatamab, 52.6% for linvoseltamab, and 44.6% for talquetamab when recommended phase 2 dose cohorts were combined. The random-effects pooled ORR was 45.2% (95% CI, 37.2-53.4), with no observed between-study heterogeneity (I-squared = 0%); estimates were identical under a fixed-effect model, and leave-one-out pooled ORRs ranged narrowly from 44.0% to 47.6%. BCMA- and GPRC5D-directed bispecific antibodies produce objective responses in approximately half of patients with RRMM and baseline EMD, with broadly similar activity across agents despite high-risk biology, although the small number of trials and their differing, sometimes paramedullary-inclusive, definitions of EMD warrant caution in interpreting this estimate. These pooled estimates provide a benchmark for patient counseling and trial design and support combination strategies to improve outcomes in this population.

PMID:42359424 | PMC:PMC13293460 | DOI:10.7759/cureus.111438