Tag: nevin manimala

J Foot Ankle Res. 2025 Mar;18(1):e70038. doi: 10.1002/jfa2.70038.

ABSTRACT

AIM: To prospectively evaluate the association of various markers of sarcopenia and frailty with clinical outcomes in diabetes-related foot disease (DRFD), namely wound healing, amputation-free survival, and death over 3 years.

METHODS: This was an observational study of patients with DRFD at a quaternary multidisciplinary diabetic foot service. Initial assessment includes classification of DRFDs using WIfI classification, assessment of frailty using the FRAIL scale, and measurement of handgrip strength (HGS) using a dynamometer. Muscle mass was ascertained by measuring the psoas muscle area at the level of L3 vertebrae on computed tomography. Patients were followed up for 3 years and primary outcomes were wound healing, amputation-free survival, and death.

RESULTS: One hundred patients with a median age of 71 were included in the analysis. The majority of the patients were male (75%). Forty-seven percent of patients were considered as frail, with 37 patients recorded to have low HGS. Patients with high HGS had significantly higher odds of wound healing by 3.83 times when compared to those with low HGS (odds ratio = 3.83. 95% CI 1.35-10.92). Patients with low psoas muscle index (PMI) and low HGS were observed to have a higher risk of death based on the following hazard ratios: HGS (high vs. low), HR = 0.46, 95% CI: 0.22-0.997; PMI (low vs. high), HR = 2.15, 95% CI: 1.17-3.96.

CONCLUSION: There was a significant prevalence of frailty and reduced HGS among our patients with DRFD. Low HGS was associated with poor wound healing and increased mortality in patients with DRFD. Additionally, low muscle mass was associated with increased mortality in this population. This research highlights the need for more precise tests and future studies of the links between sarcopenia, frailty, and outcomes in DRFD.

PMID:40119820 | DOI:10.1002/jfa2.70038

Laryngoscope. 2025 Mar 22. doi: 10.1002/lary.32149. Online ahead of print.

ABSTRACT

BACKGROUND: Understanding the trajectory of complications following total pharyngolaryngectomy (TPL) with free jejunal transfer (FJT) is crucial for enhancing patient management and improving surgical outcomes. However, the traditional Clavien-Dindo classification captures only the highest grade of complication and is unable to capture the progression of complications, limiting its utility for longitudinal assessments. This study utilized the comprehensive complication index (CCI) to provide a continuous evaluation of complications over time.

METHODS: This retrospective observational study included patients who underwent TPL with FJT between 2018 and 2023. Daily postoperative complications were tracked using the CCI, calculated from postoperative day 1 to day 30. A group-based trajectory model was employed to classify patterns of change in daily CCI. The predictive power of early CCI for a subsequent serious complication course was evaluated using receiver operating characteristic curve analysis.

RESULTS: The trajectory modeling for a total of 161 eligible patients identified three distinct complication trajectories: no complication (n = 80), moderate (n = 66), and severe (n = 15). Initial CCI values were predictive of the severe complication course: a cutoff value of 8.7 for the CCI on postoperative day 2 provided an area under the curve of 0.926 with 86.7% sensitivity and 93.8% specificity.

CONCLUSIONS: Complication trajectories after TPL with FJT can be effectively categorized using the CCI, providing insights beyond the traditional grading systems. Early identification of the severe complication course allows for targeted interventions that may improve patient outcomes.

PMID:40119752 | DOI:10.1002/lary.32149

Evolution. 2025 Mar 22:qpaf062. doi: 10.1093/evolut/qpaf062. Online ahead of print.

ABSTRACT

Reproductive accessory glands are organs involved in reproduction that do not directly produce or release gametes but can play crucial roles in securing reproductive success. In fishes, the two leading hypotheses about why accessory glands evolved are 1) in response to sperm competition, or 2) to facilitate parental care activities. Here, we investigate the evolutionary history of accessory glands and test these hypotheses by estimating quantitative differences in evolutionary rates. We found that accessory glands are present in 116 of the 607 sampled species of ray-finned fishes, representing 26/267 families. We estimated that accessory glands have arisen independently ~20 times and that these glands were gained 5.8 times faster in lineages with male parental care, compared to those without male care, supporting the hypothesis that they evolved to facilitate care. In contrast, group spawning, used as a proxy for sperm competition risk, seemed to select against the evolution of accessory glands, as lineages exhibiting group spawning gained accessory glands 3.9 times slower than those with pair spawning (though this failed to reach statistical significance). This study provides new insights into the evolutionary history of accessory glands in fishes and highlights the importance of parental care in shaping reproductive anatomy.

PMID:40119739 | DOI:10.1093/evolut/qpaf062

J Feline Med Surg. 2025 Mar;27(3):1098612X241309829. doi: 10.1177/1098612X241309829. Epub 2025 Mar 22.

ABSTRACT

ObjectivesThe aim of the study was to determine differences, agreements and correlations of acid-base variables between arterial and venous blood gas in anaesthetised cats in a euvolaemic or hypovolaemic state.MethodsA group of six cats was used in a prospective randomised crossover haemorrhage-resuscitation study. Anaesthetised cats underwent three treatments at intervals of 2 months. Each treatment had a controlled haemorrhage phase and a resuscitation phase. The haemorrhage phase is the focus of this study. Arterial (carotid artery) and central venous blood were drawn simultaneously from preplaced catheters before haemorrhage (euvolaemic state; mean ± SD blood loss 1.3 ± 0.3 ml/kg for pre-haemorrhage data collection) and soon after controlled haemorrhage (hypovolaemic state; mean ± SD blood loss 15.8 ± 9.9 ml/kg). Acid-base variables from arterial and venous blood were compared under euvolaemic and hypovolaemic states as follows: (1) a paired t-test to determine the differences between the two samples; (2) a Bland-Altman plot to evaluate agreement and establish maximum clinically acceptable differences (defined a priori); and (3) Pearson’s correlation with least squares linear regression to determine the strength of correlation between the variables.ResultsThe differences in pH and partial pressure of carbon dioxide were statistically significant under euvolaemic and hypovolaemic states but would not alter clinical decision-making. Agreements were clinically acceptable for all acid-base variables, except for the bias observed in the partial pressure of carbon dioxide under a hypovolaemic state. Correlations for all variables were strong under a euvolaemic state but weakened under a hypovolaemic state.Conclusions and relevanceUsing central venous blood sampling for acid-base analysis was clinically acceptable compared with arterial blood in our haemorrhage-resuscitation cat model during early compensated hypovolaemia. However, the partial pressure of carbon dioxide should be interpreted with caution, especially during hypovolaemia. Further investigation is necessary to determine whether these findings can be translated to critically ill cats.

PMID:40119721 | DOI:10.1177/1098612X241309829

Knee Surg Sports Traumatol Arthrosc. 2025 Mar 22. doi: 10.1002/ksa.12650. Online ahead of print.

ABSTRACT

PURPOSE: While both iliotibial band graft augmented by gracilis tendon (ITB + G) and hamstring autograft with modified Lemaire lateral extra-articular tenodesis (STG + LET) are established techniques for addressing rotatory instability in anterior cruciate ligament reconstruction, no direct comparison exists between these approaches. The purpose of this study was to provide the first direct comparison between these two surgical techniques regarding graft survival, functional outcomes and return to sport.

METHODS: This single-centre, single-surgeon retrospective study analyzed 56 patients (28 per group) after 1:1 propensity score matching based on age, gender and Tegner activity scale. Primary end point was failure (graft retear or secondary meniscal lesion). Secondary outcomes included the International Knee Documentation Committee (IKDC), anterior cruciate ligament-return to sport after surgery (ACL-RSI) scores, and return to sport rate. Kaplan-Meier survival analysis and between-group comparisons were performed using appropriate statistical tests.

RESULTS: At mean follow-up of 53.3 ± 6.4 months, failure-free survival rates at 24 months were 85.7% (95% confidence interval [CI]: 66.3-94.4) for STG + LET and 89.3% (95% CI: 70.4-96.4) for ITB + G (p = 0.664). Graft retear rate was 7.1% (STG + LET: 3.6%, ITB + G: 10.7%). Secondary meniscal injuries occurred equally (14.3%) in both groups. Return-to-sport rate was 89.3% at mean of 9.6 ± 3.9 months. Mean IKDC scores were 87.5 ± 11.4 for STG + LET and 83.6 ± 16.3 for ITB + G, with 73.7% achieving Patient Acceptable Symptom State criteria. ACL-RSI scores were similar between groups (STG + LET: 74.2 ± 24.3 and ITB + G: 73.5 ± 26.8).

CONCLUSION: No significant differences were found between ITB + G and STG + LET techniques regarding failure rates, return to sport and functional outcomes. Both techniques achieved satisfactory results in this cohort, with similar complication profiles. This comparison provides valuable clinical guidance, supporting surgical decision-making based on surgeon experience.

LEVEL OF EVIDENCE: Level III, retrospective cohort study.

PMID:40119696 | DOI:10.1002/ksa.12650

Clin Transl Med. 2025 Apr;15(4):e70283. doi: 10.1002/ctm2.70283.

NO ABSTRACT

PMID:40119678 | DOI:10.1002/ctm2.70283

Am J Hum Biol. 2025 Mar;37(3):e70030. doi: 10.1002/ajhb.70030.

ABSTRACT

OBJECTIVE: Bone remodeling relies on a dynamic process of concurrent deposition and resorption of bone material, which regulates bone mineral density (BMD), a critical component of overall bone health. Chronic dysregulation of the remodeling process during an individual’s life can result in low BMD, osteoporosis, reduced mineral reserves and/or increased fracture risk. Prior studies have investigated the link between parity and BMD, positing that one cost of reproduction is increased bone resorption above deposition, resulting in net BMD loss. Further, bone remodeling is sensitive to repetitive mechanical loading, suggesting that differences in bone loading could modify associations between parity and BMD. We seek to understand how reproductive investment (using parity as a proxy) challenges bone remodeling.

METHODS: We examined associations between parity and regional BMD using anthropometric, dual-energy x-ray absorptiometry, and questionnaire data from the National Health and Nutrition Examination Survey (2007-2018 cohorts; n = 5144).

RESULTS: In unadjusted linear regressions, higher parity was associated with lower BMD in all regions except the thoracic spine, arms, and total BMD (p < 0.004). In regressions adjusting for BMI and age, parity was positively associated with BMD in the pelvis, arms, and total BMD (p < 0.004). The maximally controlled models, which adjust for race/ethnicity, sedentary time, poverty income ratio, and lifetime estrogen exposure, among other health and lifestyle variables, yielded similar results.

DISCUSSION: Our results suggest that more rigorous statistical modeling and selection of reproductive cost variables may help explicate the biological mechanisms underlying conflicting parity-BMD associations and their impact on bone health and aging.

PMID:40119659 | DOI:10.1002/ajhb.70030

Int J Nurs Pract. 2025 Apr;31(2):e70011. doi: 10.1111/ijn.70011.

ABSTRACT

BACKGROUND: Incentive spirometry is used in addition to care, especially in reducing pulmonary complications after surgery. Complications in the cardiovascular and pulmonary systems can basically be determined by blood values and vital signs, which are important objective data of haemodynamics.

AIM: This study aimed to test the hypothesis that the use of incentive spirometry in conjunction with postoperative pulmonary rehabilitation care has a notable impact on arterial blood gas, oxygen saturation (SpO2) and vital signs.

METHODS: This randomised, controlled trial used repeated-measures design. It was conducted between 2021 and 2022, and data from 58 patients who underwent coronary artery bypass graft surgery at the cardiovascular surgery clinic of a university hospital were analysed. All patients received pulmonary rehabilitation, and incentive spirometry was added for the experimental group.

RESULTS: In the experimental group, on post-op day 3, the arterial partial pressure of oxygen (PaO2) (p = 0.01), arterial oxygen saturation (SaO2) (p = 0.002) and oxygen saturation (SpO2) (p < 0.001) values were statistically significantly higher. Additionally, on post-op day 3 the experimental group had significantly lower systolic blood pressure (p = 0.03), diastolic blood pressure (p = 0.004) and respiratory rate (p < 0.001).

CONCLUSION: Incentive spirometry after coronary artery bypass graft surgery improves oxygen levels and vital signs.

PMID:40119648 | DOI:10.1111/ijn.70011

Am J Epidemiol. 2025 Mar 21:kwaf063. doi: 10.1093/aje/kwaf063. Online ahead of print.

ABSTRACT

Earlier pubertal timing and faster pubertal tempo (pace of progression through puberty) might be associated with increased body mass index (BMI) later in life. In a follow-up study of 13 219 boys and girls from the Danish National Birth Cohort (DNBC), we investigated the association between pubertal timing and tempo and BMI trajectories from puberty to adulthood and explored the potential confounding role of childhood BMI. Based on half-yearly information on self-reported current Tanner stages, pubertal timing and tempo were estimated using non-linear mixed effect growth models. In total, 136 457 height and weight measurements from 7 to 18 years were included. BMI trajectories from 11 to 18 years were fitted according to pubertal timing and tempo while adjusting for potential confounders, including childhood BMI at age 7 years. Children with earlier pubertal timing had higher, and children with later pubertal timing had lower BMI trajectories from 11 to 18 years than children with average pubertal timing. After adjustment for childhood BMI, the difference disappeared in boys but persisted in girls, suggesting that earlier pubertal timing may be independently associated with later BMI in girls only. Faster pubertal tempo was associated with slightly higher BMI in young women only.

PMID:40119643 | DOI:10.1093/aje/kwaf063

Am J Epidemiol. 2025 Mar 21:kwaf064. doi: 10.1093/aje/kwaf064. Online ahead of print.

NO ABSTRACT

PMID:40119642 | DOI:10.1093/aje/kwaf064