Tag: nevin manimala

Int J Gen Med. 2025 Mar 17;18:1529-1542. doi: 10.2147/IJGM.S496799. eCollection 2025.

ABSTRACT

INTRODUCTION: Foodborne disease outbreaks (FBDOs) pose a significant threat to public health globally, leading to substantial morbidity, mortality, and economic losses. However, the underlying causes and impacts of FBDOs often remain underexplored in specific regions, limiting the effectiveness of targeted prevention strategies.

METHODS: This study aimed to investigate the epidemiological characteristics, causes, and economic burden of FBDOs in Jinhua city, Zhejiang province, China, between 2018 and 2022. Data were collected from the national surveillance system, encompassing 63 FBDOs with 305 cases. FBD cases were defined as patients with diarrhea, vomiting, or toxic symptoms suspected to be caused by food consumption, with outbreaks referring to incidents where two or more individuals presented similar symptoms after consuming the same food. Descriptive statistics were used to analyze numerical and categorical variables, focusing on outbreak sources, pathogenic factors, and economic consequences.

RESULTS: Data analysis revealed that catering services were the most common source of FBDOs, likely due to the widespread consumption of prepared meals and potential lapses in hygiene. Approximately 50% of the outbreaks were linked to unidentified pathogens. The reported microorganisms, including Norovirus, Nontyphoidal Salmonella, and Vibrio parahaemolyticus, were among the target pathogens of the national surveillance system and are also recognized as common causes of FBDOs globally. Among the identified causes, Mushroom toxin (19.05%) was the leading factor, followed by Norovirus (12.70%) and Nontyphoidal Salmonella (6.35%). Norovirus caused the highest number of cases (52). The total economic burden of FBDOs was estimated at 228,078.74 yuan, with a median cost of 648.29 yuan per case. Two fatalities were attributed to wood ear and nitrite consumption.

DISCUSSION: The findings highlight high-risk foods and vulnerable populations, underscoring the significant public health and economic impacts of FBDOs. To address these challenges, enhanced surveillance systems, the establishment of regional laboratory centers, and the application of new diagnostic technologies are crucial. Collaborative efforts among governments, the food industry, and consumers are essential to strengthening food safety and reducing the burden of foodborne diseases.

PMID:40123815 | PMC:PMC11928438 | DOI:10.2147/IJGM.S496799

Int J Gen Med. 2025 Mar 17;18:1497-1507. doi: 10.2147/IJGM.S506941. eCollection 2025.

ABSTRACT

BACKGROUND: Coronary microvascular dysfunction (CMD) after percutaneous coronary intervention (PCI) is a critical prognostic factor in acute coronary syndrome (ACS). This study aimed to evaluate the combined predictive value of the triglyceride-glucose index (TyG) and non-HDL-C/HDL-C ratio (NHHR) for CMD in ACS patients post-PCI.

METHODS: A retrospective analysis of 542 ACS patients undergoing PCI (2021-2023) was conducted. Patients were classified into CMD (n=273) and non-CMD (n=269) groups based on CMD presence post-PCI. Baseline characteristics and biochemical markers were analyzed. TyG index and NHHR were calculated, and univariate and multivariate analyses were performed to identify predictors of CMD. ROC curves evaluated the predictive value of TyG combined with NHHR, while net reclassification index (NRI) and integrated discrimination improvement (IDI) assessed incremental predictive value.

RESULTS: CMD patients exhibited significantly higher levels of TyG and NHHR compared to non-CMD patients. Multivariate logistic regression indicated that TyG (OR = 1.89, 95% CI: 1.24-2.88, P = 0.003) and NHHR (OR = 1.34, 95% CI: 1.11-1.62, P = 0.011) were independent predictors of CMD. The combined model showed significant improvement in discrimination (C-statistic increased from 0.750 to 0.782, P < 0.001) and reclassification (NRI = 0.458, IDI = 0.051, both P < 0.001).

CONCLUSION: TyG and NHHR are novel predictors of CMD post-PCI, with combined use improving risk stratification. Given the retrospective nature of the study, further multicenter prospective research is required to validate these findings.

PMID:40123809 | PMC:PMC11928440 | DOI:10.2147/IJGM.S506941

Prenat Diagn. 2025 Mar 23. doi: 10.1002/pd.6776. Online ahead of print.

ABSTRACT

OBJECTIVE: Outcomes in pregnancies with rare autosomal aneuploidies (RAAs) are poorly characterized, with most studies having small sample sizes. Here, we describe outcomes and management in a large cohort of pregnancies that screened positive for an RAA (RAA+).

METHODS: Results of prenatal cell-free DNA screening were linked to de-identified insurance claims data. Diagnosis and procedure codes were used to estimate pregnancy outcomes and management. Relevant covariates in comparative analyses were adjusted using propensity-score matching. Outcomes were statistically compared using Mantel-Haenszel and McNemar’s tests.

RESULTS: Among 682 RAA+ pregnancies, the rate of live birth was significantly lower (56.7% vs. 78.7%; p < 0.001), and the rates of miscarriage and preterm birth were significantly higher (14.8% vs. 3.2%, p < 0.001; 18.5% vs. 8.9%, p < 0.001; respectively), compared to pregnancies with RAA- results. In pregnancies that screened positive for a rare autosomal trisomy (RAT+) and in which the RAT+ results were known, ultrasounds (mean: 3.7 vs. 2.5, p = 0.002), and pregnancy-specific visits (mean: 6.6 vs. 5.1; p = 0.007) were more frequent compared with pregnancies in which the RAT+ result was unknown.

CONCLUSION: Pregnancies with RAA+ results had higher rates of adverse outcomes compared with those with RAA- results, and awareness of RAA+ results was associated with more intensive monitoring.

PMID:40122782 | DOI:10.1002/pd.6776

Psychooncology. 2025 Mar;34(3):e70135. doi: 10.1002/pon.70135.

ABSTRACT

OBJECTIVE: Pancreatic cancer (PaCa) patients face a 5-year survival rate of just 13%. Most patients present with unresectable disease and endure aggressive treatments with significant chronic and debilitating side effects. PaCa patients also experience significant unmet supportive care needs (e.g., physical, psychological, informational/educational); however, limited qualitative studies have explored the specific needs of racially and ethnically diverse PaCa populations.

AIMS: This study identified supportive care needs in a racially and ethnically diverse sample of PaCa survivors.

METHODS: As part of a larger project to develop a psychosocial symptom management intervention, semi-structured qualitative interviews were conducted with PaCa survivors to explore the supportive care needs at diagnosis and after treatment. Qualitative data were analyzed using Rapid Qualitative Analysis, and personal/medical characteristics were analyzed using descriptive statistics.

RESULTS: PaCa survivors (n = 18; M_age = 64) participated, with the majority identifying as female (66.7%), White (88.9%), and Hispanic (55.6%). Over one-third completed interviews in Spanish. Four themes emerged: (1) information/health system needs, including difficulty understanding complex medical concepts, limited holistic care, post-treatment symptom management, and health behaviors; (2) psychosocial needs related to quality of life and relationships with family and healthcare providers; (3) physical and functional needs, including persistent side effects and lifestyle changes; and (4) positivity and gratitude.

CONCLUSIONS: We emphasize the themes of unmet supportive care needs in a racially and ethnically diverse sample of PaCa survivors. These findings underscore the importance of developing interventions to address these gaps and improve the overall quality of life for diverse PaCa patients.

PMID:40122779 | DOI:10.1002/pon.70135

Am Surg. 2025 Mar 23:31348251329478. doi: 10.1177/00031348251329478. Online ahead of print.

ABSTRACT

Background: Advice regarding application preparation is often anecdotal; there is limited information about how programs evaluate applicants. It is unclear if holistic review is being properly used in an increasingly competitive field. This study aims to describe desirable applicant characteristics and the application review process of CRS programs. Methods: A survey was distributed to all United States CRS Program Directors (PD) during the 2022 application cycle. The survey had questions regarding number of applicants received and the review process including which screening parameters were used and which criteria were valued when evaluating applications. Descriptive statistics are reported. Results: Thirty-six responses from the 67 CRS residency PD (54%) were received. Most (72%) characterized their review process as “holistic.” The majority (58%) of PD classified their hospital setting as academic. The median number of applications reviewed per program was 100, with a median of 26% (IQR 20-31%) of applicants invited to interview. When deciding who to interview, in-training examination (ABSITE) score (92%), letter of recommendation (LOR) content (89%), LOR writer (83%), and research productivity (83%) were the most commonly considered criteria. The “Top 3 Criteria” cited by PD in choosing applicants to interview were LOR, ABSITE and Publications/Research. Discussion: CRS residencies continue to value traditional metrics such as ABSITE scores, publications, and LOR with both the content and identity writer appearing to be important. Despite many PDs claiming they use a holistic review process, our results indicate otherwise. Increased education providing the rationale behind holistic review should be provided.

PMID:40122773 | DOI:10.1177/00031348251329478

Int J Geriatr Psychiatry. 2025 Mar;40(3):e70071. doi: 10.1002/gps.70071.

ABSTRACT

OBJECTIVES: Suicide rates are driven by availability of lethal means, increase with age, and are often higher in rural versus urban areas. This study examines temporal and geographic variations in suicides among elderly with a focus on rural-urban differences in method-specific suicide rates among people aged 65 and older in Spain, a rapidly aging country.

METHODS: Population-based study including all suicides among people over 65 in Spain between 2010 and 2022. We examined overall and method-specific suicide rates and their temporal and geographical variation, stratifying results by sex and urbanicity level. Time trends were estimated via joinpoint regression. Maps were created to analyze the geographical distribution of suicide rates.

RESULTS: While 2010-2022 suicide rates in people aged 65 and older remained largely stable overall, they increased by an annual 2.6% for women living in urban areas. The most common suicide methods were hanging for men living in rural and urban areas (68.5% and 47.3%, respectively) and for women living in rural areas (42.1%); for women living in urban areas jumping was the modal suicide method (46.9%). Method-specific trend analyses revealed recent increases in male suicide by poisoning and hanging in rural areas, decreases in male suicide by hanging and increases in male suicide by jumping in urban areas, and increases in female suicide by poisoning and jumping in urban areas. We identified and mapped remarkable geographic variation in overall and sex-specific suicide rates across Spain’s regions.

CONCLUSIONS: These results, highlighting recent increases in female suicides in urban areas and in specific method-specific male suicides both in rural and urban areas, and demonstrating geographical variation across regions, should help guide targeted suicide prevention efforts.

PMID:40122772 | DOI:10.1002/gps.70071

HPB (Oxford). 2025 Mar 10:S1365-182X(25)00076-0. doi: 10.1016/j.hpb.2025.03.001. Online ahead of print.

ABSTRACT

INTRODUCTION: Enhanced recovery after surgery (ERAS) protocols facilitate patient recovery without increasing complication rates. An ERAS protocol designed for our liver transplant (LT) patients obtained a median hospital length of stay (LOS) of 4 days. However, a proportion of patients do not achieve early discharge. This study aimed to identify factors that predict an LOS≤ 4 days.

METHODS: Identifying factors associated with LOS <4 days in our LT patients.

RESULTS: We performed 293 LTs (2012-2021), LOS≤4 days in 171 (58.4 %). The following factors emerged as statistically predictors of LOS≤4 days in the univariate analysis: male sex, HCC or HCV patients, lower MELD score, lower BAR score, no DCD patients, shorter operative time, no intraoperative transfusion, shorter ICU stay, no Clavien-Dindo complications grade ≥ III, no primary graft dysfunction, no acute rejection, no readmission at 30 days and no retransplantation were associated to LOS≤4 days. However, in the multivariate analysis, the only independent risk factor that predicted LOS≤4 days was the presence of hepatocarcinoma. DCD donors and higher MELD score were negative factors.

CONCLUSIONS: Applying ERAS programs in LT patients is beneficial, safe and extensible to all patients, but those with hepatocarcinoma obtain higher rates of LOS≤4 days.

PMID:40122765 | DOI:10.1016/j.hpb.2025.03.001

Pharmacol Res. 2025 Mar 22:107689. doi: 10.1016/j.phrs.2025.107689. Online ahead of print.

NO ABSTRACT

PMID:40122723 | DOI:10.1016/j.phrs.2025.107689

Clin Ther. 2025 Mar 22:S0149-2918(25)00074-8. doi: 10.1016/j.clinthera.2025.03.001. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to evaluate the efficacy and safety of triple combination of ezetimibe (Eze)/atorvastatin (Ato) 10/40 mg + amlodipine (Aml) 10 mg therapy for lowering the low-density lipoprotein cholesterol (LDL-C) and blood pressure compared with either Eze/Ato 10/40 mg or Aml 10 mg therapies in patients with comorbid primary hypercholesterolemia and essential hypertension.

METHODS: This was a randomized, multicenter, double-blind, active-controlled, Phase III clinical trial. Participants underwent a wash-out period (2 weeks for nonfibrate medications, 6 weeks for fibrates) followed by 4 weeks of therapeutic lifestyle changes. Subsequently, 109 participants were randomly assigned to 3 groups: (1) Eze/Ato 10/40 mg + Aml 10 mg, (2) Eze/Ato 10/40 mg, and (3) Aml 10 mg. The coprimary end points were percentage change in LDL-C and change in mean sitting systolic blood pressure (SBP) compared with baseline at week 8.

FINDINGS: A total of 109 participants were enrolled in the study, and there were no statistically significant differences in the baseline characteristics of participants across the 3 groups. After 8 weeks of treatment, the least-square (LS) mean (SE) of percent change from baseline in LDL-C was -57.95% (3.52%) for the Eze/Ato 10/40 mg + Aml 10 mg group and 8.93% (3.54%) for the Aml 10 mg group. The LS mean difference (SE) between these 2 groups was statistically significant at -66.88 (4.95) (95% CI, -76.77% to -56.99%) (P < 0.0001). Furthermore, at week 8, the LS mean (SE) change in mean sitting SBP between the Eze/Ato 10/40 mg + Aml 10 mg group and the Eze/Ato 10/40 mg group was -19.24 (2.42) mm Hg and -4.43 (2.56) mm Hg, respectively. The LS mean difference (SE) between the 2 groups was statistically significant -14.81 (3.53) (95% CI, -21.87 to -7.74) mm Hg (P < 0.0001). No serious adverse drug reactions occurred in any of the study groups.

IMPLICATIONS: Triple combination therapy with Eze/Ato + Aml has effectively reduced the LDL-C and SBP independently, compared with either Eze/Ato or Aml therapies over 8 weeks of treatment period. In terms of safety, there were no significant differences among the 3 treatment groups. This research lays the groundwork for the development of a triple fixed-dose combination in the future, which could improve patient convenience and adherence by reducing pill burden. Clinical Research Information Service (CRIS), Republic of Korea: KCT0006283.

PMID:40122716 | DOI:10.1016/j.clinthera.2025.03.001

Musculoskeletal Care. 2025 Mar;23(1):e70089. doi: 10.1002/msc.70089.

ABSTRACT

OBJECTIVE: This study aimed to determine the number and proportion of exercise interventions within preexisting clinical trials for people with knee osteoarthritis (KOA) that satisfied the World Health Organisation’s (WHO) guidelines for physical activity.

METHODS: A descriptive analysis of studies included in an umbrella review was undertaken. Data from each exercise intervention relating to the type, dose and intensity of exercise was extracted, and the number and proportion of interventions that satisfied the WHO guidelines (aerobic, muscle strengthening, balance [for studies where the average age was more than 65 years old], a combination or all) was recorded at the study and intervention level.

RESULTS: Data were extracted from 199 studies containing 266 exercise interventions. Overall, only one study (0.5%) satisfied all components of the WHO guidelines. Of the 122 interventions that had an average participant age over 65, none fulfiled all aspects of the WHO guidelines, which included balance. There were 16 (6.0%) and 12 (4.5%) other interventions that satisfied the aerobic or muscle strengthening components of the guidelines, respectively.

CONCLUSION: This descriptive analysis highlighted the lack of exercise interventions in clinical trials for people with KOA that satisfied the WHO guidelines. Thus, they may not be dosed appropriately to achieve broader health outcomes associated with following the physical activity guidelines.

PMID:40122701 | DOI:10.1002/msc.70089