Tag: nevin manimala

Arthritis Res Ther. 2025 Jan 15;27(1):9. doi: 10.1186/s13075-024-03470-y.

ABSTRACT

OBJECTIVES: To explore the role of newly emerging autoantibodies (AAbs) – peptidyl-arginine deiminase 4 (aPAD4), carbamylated proteins (aCarP), and anti-RA33 (aRA33) – alongside the traditionally assessed rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA), in predicting the response to abatacept (ABT) and its retention rate in rheumatoid arthritis (RA) patients.

METHODS: Data from 121 consecutive ABT-treated RA patients were recorded. The RF and ACPA status were retrospectively assessed by reviewing the patients’ clinical records. Positivity for aPAD4, aCarP and aRA33 were determined by Enzyme-Linked Immunosorbent Assay (ELISA). The achievement of a moderate or good EULAR response at 6 months and the 3-years retention were analyzed as treatment outcomes. Multiple logistic regression models and Cox regression hazard analysis models were built to identify the association between such outcomes and the different AAbs, after adjustment for different confounders. The AAbs were assessed both individually and in different combinations to identify the most robust predictive model.

RESULTS: In the studied cohort, RF, ACPA, aPAD4, aCarP and aRA33-Ab tested positive in 74.4%, 69.4%, 43.8%, 23.9%, 14.9% patients, respectively. A moderate or good EULAR response at 6 months was achieved by 64.5% of subjects and the cumulative 3-years retention rate was 56.6%. A higher EULAR response rate was recorded in patient with positivity for RF (67% in subjects tested positive vs. 58% in negative), ACPA (68% vs. 57%), aPAD4 (68% vs. 62%), and aCarP (72% vs. 62%), although statistical significance was not reached likely due to sample size limitations. Similarly, ACPA, aPAD4, aCarP were associated with higher 3-year retention rates, though not statistically significant individually. The combined analysis revealed that positivity for ACPA and/or aPAD4 predicted a significantly higher EULAR response rate at 6 months compared with double negativity (adjusted OR 2.7, p 0.026). Furthermore, positivity for at least one of ACPA, aPAD4, or aCarP predicted a significantly higher 3-year ABT retention rate compared to triple negativity (62.1% single or double positive vs. 33.5% triple negative, adjusted HR 0.48, p 0.022).

CONCLUSION: This study highlights the potential benefits of using a combined assessment of ACPA aPAD4 and aCarP in predicting effectiveness of ABT in RA.

PMID:39815378 | DOI:10.1186/s13075-024-03470-y

Breast Cancer Res. 2025 Jan 15;27(1):7. doi: 10.1186/s13058-024-01957-9.

ABSTRACT

BACKGROUND: Hereditary predisposition to breast and ovarian cancer syndrome (HBOC) is a pathological condition with increased cancer risk, including breast (BC), ovarian cancer (OC), and others. HBOC pathogenesis is caused mainly by germline pathogenic variants (GPV) in BRCA1 and BRCA2 genes. However, other relevant genes are related to this syndrome diagnosis, prognosis, and treatment, including TP53, PALB2, CHEK2, ATM, etc. This study aimed to identify the prevalence of non-BRCA genes in HBOC patients of Northeast Mexico.

METHODS: This multicentric study included 1285 patients with HBOC diagnosis from four oncologic centers in northeast Mexico from 2016 to 2023. Genomic and clinical data were analyzed based on multi-gene panel results and electronic records of the medical geneticist consultation. For the data analysis of qualitative and quantitative variants, JASP statistical software (version 0.18.1) was used, taking p < 0.05 as a significant result.

RESULTS: We found that 32.7% of the patients had at least one GPV in non-BRCA genes. The five most frequent non-BRCA genes were CHEK2, PALB2, MUTYH, CDKN2A, and ATM. Among the group of non-BRCA genes, six are involved in the homologous repair pathway (HR), and three are related to DNA damage repair (DDR) pathways. In analyzing GPVs in molecular pathways, both have similar frequencies with no statistical difference for BC.

CONCLUSION: Multi-gene testing implementation improves the detection of often overlooked genes related to HBOC pathogenesis and treatment. Non-BRCA GPVs in Northern Mexico correspond to one-third of the HBOC cases, including HR and DDR pathways genes that would be misdiagnosed if not tested. HR patient carriers are potential targets of iPARP therapies. The optimal approach to cancer treatment for non-BRCA mutation carriers warrants further investigation to develop newer therapies.

PMID:39815370 | DOI:10.1186/s13058-024-01957-9

Reprod Health. 2025 Jan 15;22(1):3. doi: 10.1186/s12978-024-01925-8.

ABSTRACT

BACKGROUND: Today, the screening of fetal abnormalities during pregnancy is used as one of the components of the prenatal care worldwide, and many abnormalities are detected by ultrasound during pregnancy. On the other hand, the possibility of an abnormality in the fetus causes worry and anxiety in pregnant women. Therefore, the present study was conducted with the aim of determining the relationship between worry and anxiety with the general health status of pregnant women at risk of diagnosing fetal abnormalities.

METHODS: This descriptive-analytical cross-sectional study was conducted on 275 pregnant women with a gestational age of 16 to 18 weeks. They were referred by health centers, midwives, or gynecologists to determine fetal abnormalities according to the national guidelines of Iran for ultrasound scan anomalies. Pregnancy imaging was performed in Bojnurd city between April and December 2023. The data collection tools included a pregnancy-personal characteristics questionnaire, Goldberg general health standard questionnaire, Cambridge anxiety, and Spielberger anxiety scales. Data were analyzed using descriptive statistics tests, Pearson’s correlation coefficient, and generalized linear models (GLM). A significance level of p < 0.05 was considered statistically.

RESULTS: The average age of the participants was 28.13 ± 6.17 years. The average total score of general health was 15.49 ± 7.14, while the average total worry and anxiety scores were 16.81 ± 11.74 and 45.12 ± 6.06, respectively. A positive and significant correlation was observed between general health and worry (r = 0.374), as well as between general health and anxiety (r = 0.160). Additionally, based on the test of generalized linear models, education (beta coefficient = – 3.208 and p = 0.008) and type of pregnancy (beta coefficient = – 2.323 and p = 0.029) were related to general health.

CONCLUSION: The present findings demonstrate a relationship between the general health and worry and anxiety levels of pregnant women at risk of abnormality diagnosis. Pregnant women who are anxious and worried tend to have lower general health levels. Understanding this relationship between worry, anxiety, and the general health of pregnant women can provide useful information to policymakers and health planners to improve the health of expectant mothers.

PMID:39815352 | DOI:10.1186/s12978-024-01925-8

J Orthop Surg Res. 2025 Jan 15;20(1):49. doi: 10.1186/s13018-025-05457-0.

ABSTRACT

OBJECTIVES: To systematically evaluate the efficacy of lateral unicompartmental knee arthroplasty (LUKA) and total knee arthroplasty (TKA) in the treatment of isolated lateral compartment knee osteoarthritis (LCKO), and to provide guidance and a basis for selecting surgery in clinical practice.

METHODS: Inclusion and exclusion criteria for literature were established, appropriate effect indicators were selected, and PubMed, Web of Science, Embase, Medline, Cochrane Library, and CNKI databases were searched using a computer. The Newcastle Ottawa scale (NOS) was used to evaluate the quality of the literature. After data extraction, Meta-analysis was performed using Revman5.4 software.

RESULTS: A total of 8 studies were included in this meta-analysis, involving 490 patients, with 204 in the TKA group and 286 in the LUKA group. Meta-analysis found that, there was no significant statistical difference in operation time between the LUKA group and the TKA group. Nevertheless, LUKA offers advantages such as reduced intraoperative blood loss and shorter hospitalization time. At the same time, the LUKA group also had advantages over the TKA group in postoperative visual analogue scale (VAS) score, knee joint range of motion, Oxford Knee Score (OKS)score and Hospital for Special Surgery (HSS) score.

CONCLUSION: When LUKA and TKA are used to treat isolated LCKO, LUKA has the advantages of less intraoperative blood loss, shorter hospital stay, lower postoperative VAS score, and better knee function score and range of motion.

PMID:39815335 | DOI:10.1186/s13018-025-05457-0

Cardiooncology. 2025 Jan 15;11(1):3. doi: 10.1186/s40959-024-00294-2.

ABSTRACT

BACKGROUND: Fluoropyrimidines, including 5-fluorouracil and capecitabine, are the most common chemotherapeutic agents for colorectal carcinoma. Although previous studies have suggested varying degrees of cardiotoxicity with these drugs, there is a notable lack of large-scale investigations with appropriate control groups. This study aimed to evaluate cardiovascular outcome among colorectal carcinoma patients treated with fluoropyrimidines.

METHODS: A retrospective propensity score- matched cohort study was conducted in patients diagnosed with colorectal carcinoma between January 1, 1993 and December 31, 2021 at public hospitals in Hong Kong. Cardiovascular outcomes in patients prescribed fluoropyrimidines were compared with controls. Further analyses to compare 5-fluroracil and capecitabine were performed.

RESULTS: A total of 51,888 colorectal carcinoma patients were identified. After 1:1 propensity score matching, 21,216 patients were included in the final analysis, with 10,608 patients in each group. 1.06% patients experienced a major adverse cardiovascular event (MACE) at 1 year. There was no significant difference in MACE risk between the two groups (HR 0.91, 95% confidence interval (95%CI): 0.70-1.18, p = 0.46). Risk of cardiovascular death was similar between the two groups (HR 1.05, 95%CI: 0.69-1.60, p = 0.82). Subgroup analysis did not demonstrate a statistically significant elevated risk of MACE during fluoropyrimidine use in high-risk patient groups. Further comparison of 5-fluorouracil and capecitabine did not reveal a difference in MACE (0.80% vs. 0.98%; HR 1.09, 95%CI: 0.64-1.85, p < 0.75).

CONCLUSION: Fluoropyrimidine use in patients with colorectal carcinoma did not increase the risk of MACE, cardiovascular death, or other specific cardiovascular conditions. There was no significant difference in cardiovascular risk between 5-fluorouracil and capecitabine.

PMID:39815329 | DOI:10.1186/s40959-024-00294-2

BMC Med Inform Decis Mak. 2025 Jan 15;25(1):28. doi: 10.1186/s12911-025-02855-6.

ABSTRACT

BACKGROUND: Despite the adverse health outcomes associated with longer duration diarrhea (LDD), there are currently no clinical decision tools for timely identification and better management of children with increased risk. This study utilizes machine learning (ML) to derive and validate a predictive model for LDD among children presenting with diarrhea to health facilities.

METHODS: LDD was defined as a diarrhea episode lasting ≥ 7 days. We used 7 ML algorithms to build prognostic models for the prediction of LDD among children < 5 years using de-identified data from Vaccine Impact on Diarrhea in Africa study (N = 1,482) in model development and data from Enterics for Global Health Shigella study (N = 682) in temporal validation of the champion model. Features included demographic, medical history and clinical examination data collected at enrolment in both studies. We conducted split-sampling and employed K-fold cross-validation with over-sampling technique in the model development. Moreover, critical predictors of LDD and their impact on prediction were obtained using an explainable model agnostic approach. The champion model was determined based on the area under the curve (AUC) metric. Model calibrations were assessed using Brier, Spiegelhalter’s z-test and its accompanying p-value.

RESULTS: There was a significant difference in prevalence of LDD between the development and temporal validation cohorts (478 [32.3%] vs 69 [10.1%]; p < 0.001). The following variables were associated with LDD in decreasing order: pre-enrolment diarrhea days (55.1%), modified Vesikari score(18.2%), age group (10.7%), vomit days (8.8%), respiratory rate (6.5%), vomiting (6.4%), vomit frequency (6.2%), rotavirus vaccination (6.1%), skin pinch (2.4%) and stool frequency (2.4%). While all models showed good prediction capability, the random forest model achieved the best performance (AUC [95% Confidence Interval]: 83.0 [78.6-87.5] and 71.0 [62.5-79.4]) on the development and temporal validation datasets, respectively. While the random forest model showed slight deviations from perfect calibration, these deviations were not statistically significant (Brier score = 0.17, Spiegelhalter p-value = 0.219).

CONCLUSIONS: Our study suggests ML derived algorithms could be used to rapidly identify children at increased risk of LDD. Integrating ML derived models into clinical decision-making may allow clinicians to target these children with closer observation and enhanced management.

PMID:39815316 | DOI:10.1186/s12911-025-02855-6

BMC Nurs. 2025 Jan 15;24(1):51. doi: 10.1186/s12912-025-02710-z.

ABSTRACT

BACKGROUND: Nursing care is important and necessary for Acute Coronary Syndrome patients who have undergone angiography and stenting, to minimize complications. The purpose of this study was to assess the effects of High-Quality Nursing Interventions on the quality of life and cardiac index of Acute Coronary Syndrome patients, treated with drug-eluting stents.

METHODS: In this randomized trial, 70 patients of the cardiac intensive care units in one of Jahrom university of medical sciences hospitals (Iran) were selected from July 2023 to October 2023 by the available method, and randomly allocated (stochastic assignment) to two intervention (High-Quality Nursing Interventions) and control groups (routine nursing care). Quality of life and Cardiac Index were measured by cardiac index calculation formula and the McNew Cardiac Quality Questionnaire, respectively. Data were analysed using SPSS version 19 software, Mann‒Whitney, chi‒square and Wilcoxon tests, with a significance level at a p < .05.

RESULTS: A statistically significant difference demonstrated between the mean of the quality of life and cardiac index in the intervention group(p < .05).

CONCLUSIONS: High-Quality Nursing Interventions improved quality of life and cardiac index of Acute Coronary Syndrome patients, treated with drug-eluting stents. Therefore, it is recommended to use this nursing approach in special cardiac care units.

TRIAL REGISTRATION: IRCT79432(2024.10.08), “Retrospectively registered”.

PMID:39815311 | DOI:10.1186/s12912-025-02710-z

J Orthop Surg Res. 2025 Jan 15;20(1):48. doi: 10.1186/s13018-025-05453-4.

ABSTRACT

BACKGROUND: The location and size of necrotic lesions are important factors for collapse, The preserved angles (PAs) are divided into anterior preserved angle (APA) and lateral preserved angle (LPA), which could accurately measure the location of necrosis lesion. We used them to evaluate the effect of the location and size of necrotic lesions on collapse by finite element analysis, to offer a framework for evaluating the prognosis of osteonecrosis of the femoral head (ONFH) in clinical settings.

METHODS: 3 left hip models were constructed based on CT data. Within each hip model, three necrosis lesion models were modeled, with necrotic tissue volumes of 30%, 50%, and 70% repectively. The ONFH models with LPA of 45.5°, 50.5°, 55.5°, 60.5°, 65.5°, 70.5°, and 75.5° when APA was 60.5°, and ONFH models with APAs of 45.5°, 50.5°, 55.5°, 60.5°, 65.5°, 70.5°, and 75.5° when LPA was 60.5° were Constructed. The maximum von Mises stess of the femoral head and necrotic lesion, as well as the femoral head displacement, were calculated to evaluate the biomechanical effects of these models.

RESULTS: (1) In models with the same necrotic volume, when APA was 60.5°, the indexes of the LPA < 60.5° models were significantly higher than those of the LPA ≥ 60.5° models (P < 0.05); the differences of the indexes among the LPA ≥ 60.5° models were not statistically significant (P > 0.05). (2) When LPA was 60.5°, the indexes of models with APA < 60.5 ° and APA ≥ 60.5 ° show the same trend as the former. (3) In the models with the same PAs, there was no statistically significant difference in the indexes (P > 0.05).

CONCLUSION: The location of the necrotic lesion exerts a greater impact on femoral head collapse compared with the size of the lesion. The location of the necrosis may deserve more consideration when assessing the risk of collapse in patients with early onset ONFH.

PMID:39815308 | DOI:10.1186/s13018-025-05453-4

Eur J Med Res. 2025 Jan 16;30(1):32. doi: 10.1186/s40001-025-02276-1.

ABSTRACT

BACKGROUND: Dementia is a growing public health concern with limited effective treatments. Diet may be a modifiable factor that significantly impacts brain health. Mediterranean diet (MeDi) has been suggested to be associated with brain Magnetic Resonance Imaging (MRI) markers related to dementia, but the existing evidence is inconsistent.

OBJECTIVES: This systematic review and meta-analysis aimed to quantify the association between MeDi and dementia-related MRI markers.

METHODS: A systematic search was conducted on PubMed, Embase, and Web of Science up to September 2024. Two reviewers worked in parallel to select studies and extract data. We considered epidemiologic studies that reported beta coefficients (β) with 95% confidence intervals (CIs) for MRI markers related to MeDi. Separate meta-analyses were performed for cross-sectional and longitudinal studies.

RESULTS: A total of 20 relevant studies involving 44,893 individuals were included in the analysis. Thirteen cross-sectional studies included a total of 42,955 participants. A meta-analysis of cross-sectional studies revealed significant associations between MeDi and white matter hyperintensity (WMH) (β = – 0.03, 95% CI = – 0.05- – 0.01, P = 0.02). However, there were no significant associations found between MeDi and total brain volume (TBV) (β = – 0.03, 95% CI = – 0.20-0.13, P = 0.71), gray matter volume (GMV) (β = 0.26, 95% CI = – 0.19-0.71, P = 0.26), white matter volume (WMV) (β = – 0.09, 95% CI = – 0.40-0.22, P = 0.58), or hippocampal volume (HCV) (β = – 1.02, 95% CI = – 7.74-9.79, P = 0.82). In the longitudinal analysis, seven prospective studies with an average follow-up period ranging from 1.5 to 9 years and involving 1,938 participants. The combined effect size of MeDi showed no significant association with TBV or GMV.

CONCLUSION: Adherence to MeDi may be associated with reduced WMH in older adults. This suggests that MeDi may affect brain health and highlights the need for further research into its role as a modifiable lifestyle factor that might potentially modify the risk of dementia.

PMID:39815306 | DOI:10.1186/s40001-025-02276-1

BMC Public Health. 2025 Jan 14;25(1):156. doi: 10.1186/s12889-025-21398-z.

ABSTRACT

BACKGROUND: Lebanon has experienced a series of devastating crises that continue to have significant adverse effects on the mental health of parents and their children, especially those who are unemployed, burdened with debt or financial difficulties, and have pre-existing mental health conditions. Accordingly, this study aimed to assess the effect of financial insecurities on parents in Lebanon amid the multiple crises, and the impact of parents’ mental health on their children’s emotional and behavioral wellbeing.

METHODS: A cross-sectional study including 589 parents in Lebanon was performed using convenience sampling of parents of any gender with children aged 4 to 18 from the five Lebanese governorates. The study collected the sociodemographic data of the participants and incorporated supplementary measures such as the Parental Stress Scale (PSS), Pediatric Symptom Checklist (PSC), and the InCharge Financial Distress/Financial Well-Being (IFDFW) scale. Statistical tests included bivariate analysis, ANOVA test, linear regression, and mediation analyses.

RESULTS: A total of 589 parents, primarily mothers, participated in this study. Most children were males in elementary school. Bivariate analyses revealed that parents with non-Lebanese nationality, primary education, employment, or children in technical schools reported significantly higher PSS and PSC scores. Negative correlations were observed between the IFDFW scale and both PSS (r=-0.200, p < 0.001) and PSC scores (r=-0.086, p = 0.038), indicating lower stress and symptoms with improved financial well-being. Multivariable analysis showed that higher PSC scores, age, complementary education, and Lebanese nationality were associated with increased parental stress, while unemployment, lower age, and higher IFDFW were associated with reduced stress. Similarly, higher PSC scores were linked to increased parental stress, age, non-Lebanese nationality, and IFDFW, whereas university education, higher GPA, and residence outside Beirut/Mount Lebanon were associated with reduced PSC scores. Mediation analysis indicated that parental stress fully mediated the relationship between IFDFW and PSC scores, underscoring the impact of financial well-being on a child’s psychological symptoms via parental stress.

CONCLUSIONS: The study revealed significant financial distress and low financial well-being among participants amid Lebanon’s economic crisis, with a notable mediated association between financial well-being, parental stress, and child mental health symptoms. Parental stress was heightened among those with lower education levels, non-Lebanese nationality, and employment in low-wage jobs, with children from these families exhibiting elevated mental health symptoms. Additionally, regional factors and socioeconomic status played a role, as children in urbanized areas and technical schools reported higher distress. Targeted interventions are urgently recommended to alleviate financial and emotional burdens on families and ensure improved mental well-being for both parents and children.

PMID:39815287 | DOI:10.1186/s12889-025-21398-z