Tag: nevin manimala

Neurosurg Rev. 2025 Apr 26;48(1):390. doi: 10.1007/s10143-025-03536-8.

ABSTRACT

Gliomas account for 24.5% of all primary brain tumors and 80% of all malignant tumors in adults. Vascular endothelial growth factor receptors (VEGFR) tyrosine kinase inhibitors (TKIs) play an important role in disrupting angiogenesis, tumor growth, and invasion. This study evaluates the outcomes of VEGFR TKIs in patients with glioma, with a specific analysis on glioblastoma (GBM). Electronic databases of PubMed/Medline, Embase, Scopus, and Web of Science were conducted until 23 July 2024. Studies that evaluated the survival of patients with glioma treated with VEGFR TKI were included. All statistical analyses were conducted using the R program. A total of 24 studies, including 1,146 glioma patients with a median age range of 5.8 to 62 years were recruited. Regarding progression-free survival (PFS), the six-month PFS rate was reported with a pooled value of 21% [95% CI: 15% to 28%]. The 12-month PFS rate was evaluated in three studies, ranging from 5 to 38% with a pooled rate of 15% [95% CI: 8% to 27%]. Considering the radiological response, the pooled overall response rate (ORR) was 21% [95% CI: 15%-28%]. Evaluation of the subgroups based on drug type at the six-month follow-up showed no significant difference in overall survival (OS) rates among patients (p = 0.06). Our results revealed that VEGFR TKIs in patients with glioma, were associated with limited efficacy. The long-term effectiveness of these treatments remains controversial and requires longer follow-up, which is challenging in cancer cases.

PMID:40285944 | DOI:10.1007/s10143-025-03536-8

Support Care Cancer. 2025 Apr 26;33(5):425. doi: 10.1007/s00520-025-09491-w.

ABSTRACT

PURPOSE: Increasing patient enrollment and promoting equity in trial participation are essential to improving cancer care outcomes. Physicians play a crucial role in decision-making, making it important to understand communication strategies used by oncologists when discussing treatment options, including clinical trial participation.

METHODS: This observational qualitative study was conducted from 2022 to 2023. We recruited US medical oncologists who treat colon cancer and have access to clinical trials. Oncologists participated in simulated telehealth encounters with standardized patients with colon cancer who identified as Black or white and were referred to discuss treatment options, including a potential clinical trial.

RESULTS: Of 107 academic physicians contacted, 47 (44%) responded, and 21 (20%) participated. The median age was 41, 43% female, and 33% non-white. Average encounter length was 44:05 minutes. One to four treatment options were discussed. Clinical trials were discussed in nearly all conversations. Average duration of clinical trial-related talk was 08:30 minutes. Conversations with Black female patients were significantly shorter than with white female patients (mean difference: 7 minutes). Recommendations varied with 9/21 oncologists recommending a clinical trial, 9/21 deferring a decision, and 3/21 recommending standard of care. In the post-encounter survey, 86% of oncologists said they recommended a trial but only 43% actually did so.

CONCLUSION: Oncologists’ communication about treatment options may impact patients’ decisions and trial participation. In our study, fewer than half of oncologists recommended a trial with variability in how options were presented and the length of discussion. There was also a misperception with more oncologists thinking they recommended a trial, but they did not in the encounter. A more structured approach to these complex discussions may help oncologists communicate treatment options to patients in a more equitable and effective way.

PMID:40285937 | DOI:10.1007/s00520-025-09491-w

Urolithiasis. 2025 Apr 26;53(1):81. doi: 10.1007/s00240-025-01757-6.

ABSTRACT

Extracorporeal Shock Wave Lithotripsy (ESWL) is a widely used non-invasive treatment for kidney stones, but it can cause significant patient anxiety due to procedural unfamiliarity and discomfort. This study aimed to evaluate the effects of video-animated information on anxiety levels, procedural satisfaction, willingness to undergo ESWL again, and perceived pain during the procedure. A prospective randomized controlled trial was conducted with 80 patients scheduled for ESWL. Patients were randomized into two groups: the video group (n = 40) received video-animated information in addition to standard verbal and written information, while the non-video group (n = 40) received only standard information. Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI), and pain perception, satisfaction, and willingness to repeat the procedure were evaluated using the Visual Analog Scale (VAS). The video group showed a significant reduction in situational anxiety (STAI-S scores: 40.1 ± 3.7 to 35.3 ± 2.7, p < 0.001) compared to the non-video group (39.7 ± 4.2 to 38.5 ± 4.5, p = 0.106). The video group also reported higher satisfaction scores (8.8 ± 1.3 vs. 7.2 ± 2.0, p < 0.01) and greater willingness to repeat the procedure (5.6 ± 2.0 vs. 3.6 ± 1.9, p < 0.01). No significant difference was observed in VAS pain scores between the groups (4.9 ± 1.3 vs. 5.4 ± 1.6, p = 0.298). Video-animated information significantly reduces situational anxiety and improves patient satisfaction and willingness to undergo ESWL again, without significantly affecting perceived pain levels. These findings support the use of multimedia tools in patient education to enhance the ESWL experience.

PMID:40285924 | DOI:10.1007/s00240-025-01757-6

Support Care Cancer. 2025 Apr 26;33(5):424. doi: 10.1007/s00520-025-09481-y.

ABSTRACT

PURPOSE: Nonroutine discharge is associated with increased healthcare costs and higher readmission rates among surgical patients with spinal metastases. However, the factors influencing nonroutine discharge remain inadequately summarized, and related research is still in its early stages. This review aims to identify and analyze the risk factors associated with nonroutine discharge in these patients, with the goal of informing discharge planning.

METHODS: A scoping review was conducted following the framework established by Arksey and O’Malley. We systematically searched PubMed, Web of Science, and CINAHL for studies examining risk factors influencing nonroutine discharge in surgical patients with spinal metastases. Data extraction was performed independently by two researchers, with discrepancies resolved by a third reviewer.

RESULTS: Nine studies were included, which identified a range of factors influencing nonroutine discharge. These factors were categorized into three main domains: (1) sociodemographic factors (age, race, insurance status, marital status, and family member involvement), (2) disease-related factors (spinal cord injury grade, serum albumin level, body mass index, spinal surgery segment, type of surgery, preoperative functional dependency, ASA grade, emergency versus elective surgery, and activities of daily living at discharge), and (3) other factors (frailty index, comorbidity index, and the efficiency of the referral or discharge process).

CONCLUSION: The risk of nonroutine discharge in surgical patients with spinal metastases is influenced by sociodemographic, disease-related, and other factors. Early identification of patients at risk for nonroutine discharge is crucial for implementing a comprehensive, nurse-led discharge plan aimed at reducing hospital stay duration and minimizing related complications.

PMID:40285919 | DOI:10.1007/s00520-025-09481-y

Environ Monit Assess. 2025 Apr 26;197(5):600. doi: 10.1007/s10661-025-14049-8.

ABSTRACT

As an important crop in China, wheat serves as a crucial source of micronutrients and a potential vector for toxic elements in human diets. This study systematically collected wheat grains from 54 counties in Henan Province and conducted in vitro physiological extraction experiments to assess the bioavailability of Mn, Cu, Fe, and Cd in wheat samples. Results turned out that the bioavailability of Cd significantly decreased from the gastric to the intestinal stage. The bioavailability of Mn exhibited similar trends to Cd in the two phases, whereas Cu and Fe showed a higher bioaccessibility in the intestinal phase compared to the gastric phase. Correlation analysis revealed that higher total metal concentrations always resulted in a higher bioaccessible fraction, and the bioaccessibility of Cd was positively correlated with Mn and its bioaccessibility. Eventually, health risk to Cd from wheat consumption evaluated by Monte Carlo simulation indicated that children exhibited a heightened vulnerability to health risks in comparison to adults and risks could be decreased significantly by introducing bioaccessibility. Consequently, it is evident that refining the relationship between bioaccessibility and biotoxicity of elements could provide the methodology to accurately and efficiently assess human health risks.

PMID:40285907 | DOI:10.1007/s10661-025-14049-8

Ecotoxicology. 2025 Apr 26. doi: 10.1007/s10646-025-02889-6. Online ahead of print.

ABSTRACT

In Europe, the risk assessment of pesticides to soils organisms is based on standardized laboratory toxicity tests using artificial soil containing kaolin clay. However, kaolin is not the most representative clay type for European agricultural soils, and its use may affect the bioavailability and toxicity of pesticides, potentially leading to an underestimation of the actual risk to soil organisms. In this study, reproduction toxicity tests with the earthworm Eisenia andrei following OECD guideline 222 were performed in artificial soils prepared with kaolin or bentonite clay, using the pesticides carbendazim and imidacloprid. The results showed that the OECD guideline 222 quality criteria could be met in soils prepared with bentonite clay. EC₅₀ reproduction values (and 95% CIs) in soils prepared with kaolin and bentonite clay were 1.80 (1.02-2.57) and 4.19 (-10.4-18.8) mg kg^-1 for carbendazim, and 0.71 (0.06-1.36) and 2.27 (-0.26-4.80) mg kg^-1 for imidacloprid. For both pesticides, toxicity (LCx, ECx biomass, ECx reproduction) was higher in soils prepared with kaolin clay, although the differences were not always statistically significant. Differences in toxicity between the soils were likely due to a combination of the bentonite’s larger interlayer distance, providing space for the pesticides to enter in between the clay sheets, and the higher cation exchange capacity (7.30 and 22.8 cmol_c kg^-1 for kaolin and bentonite soil, respectively) leading to increased pesticide sorption. Overall, these findings suggest that kaolin is a suitable clay type for standardized artificial soil, as it exhibited the highest toxicity, and thus provided a “worst-case” scenario.

PMID:40285899 | DOI:10.1007/s10646-025-02889-6

Eur J Orthop Surg Traumatol. 2025 Apr 26;35(1):169. doi: 10.1007/s00590-025-04262-z.

ABSTRACT

BACKGROUND: The burden of orthopedic admissions has notably increased in recent years. Managing orthopedic conditions is challenging in clinical settings. Orthopedic complaints often necessitate urgent medical intervention to prevent complications and mortality. Despite advancements in medical care, some patients still experience severe complications, extended hospital stays, and death following orthopedic admission. In this study, we aimed to explore the distribution of potential risk factors and common patterns in orthopedic patients who died during their hospitalization.

MATERIALS AND METHODS: All the patients who were admitted to three tertiary trauma centers with orthopedic complaints from 2010 to 2023 and died during hospitalization were enrolled in this study. Demographic, injury-related, laboratory-related, intervention-related, complication-related, and healthcare-related data were extracted using the patient’s medical records. Descriptive analysis of the collected data was performed using the SPSS version 27 software.

RESULTS: 333 patients who died in the hospital with orthopedic complaints were included in the study and examined. The mean age of patients in this study was 67.89 years, comprising 68% males and 32% females. Trauma was patients’ most common clinical cause of admission (63.7%). The prevalence of death before surgery, death during the first 24 h after surgery, and death after 24 h postoperatively were 26.4%, 18.6%, and 55%, respectively.

CONCLUSIONS: Our findings suggest a high prevalence of trauma as a clinical complaint leading to death among patients, emphasizing the importance of developing an integrated protocol for trauma preventive strategies.

PMID:40285897 | DOI:10.1007/s00590-025-04262-z

Rheumatol Int. 2025 Apr 26;45(5):126. doi: 10.1007/s00296-025-05885-5.

ABSTRACT

Despite growing female participation in the workforce, gender disparities persist across sectors. Little is known about how these manifest in academic rheumatology in Argentina. To analyze recently published rheumatology research by Argentine authors from a gender perspective. A bibliometric analysis was conducted on rheumatology publications from 2018 to 2022 in the Argentine Journal of Rheumatology (AJR) and PubMed-indexed journals that included at least one Argentine author. Argentine authors were classified by gender, and authorship roles (overall, first, and corresponding authors) were assessed, along with pharmaceutical industry conflicts of interest (COIs). Of 130 AJR articles (1183 Argentine authors), 61.8% were women. In 440 PubMed-indexed articles (1957 Argentine authors), 55.2% were women. Women were more frequently first authors in both AJR and PubMed (67.7% vs. 58.4%; p = 0.13), but less often corresponding authors in PubMed (44%) than in AJR (60%; p = 0.02). In AJR, female authors had a higher median number per article (3, Interquartile range or IQR 2-6) than male authors (2, IQR 1-4; p = 0.002). In PubMed, male authors showed slightly greater median participation (1, IQR 1-2 vs. 1, IQR 0-2; p = 0.02). In industry-sponsored studies, only 28.1% of authors were women. In COI-declaring publications, 71.0% listed only male disclosures; of 153 total reports, just 26.8% were by women. Although women are the majority in Argentine rheumatology research, they remain underrepresented in leadership roles and industry-funded studies. Continued monitoring of gender and COI data is needed.

PMID:40285893 | DOI:10.1007/s00296-025-05885-5

Neurosurg Rev. 2025 Apr 26;48(1):389. doi: 10.1007/s10143-025-03509-x.

ABSTRACT

The number of spinal surgeries, including decompression and fusion procedures, has increased significantly. Despite the potential benefits, these surgeries can result in substantial blood loss, requiring perioperative blood transfusions. However, transfusions can pose risks, such as infections and thromboembolic events. This study aimed to compare the outcomes between transfusion and non-transfusion groups in spinal surgery patients, focusing on infection rates, DVT, mortality, and other complications. A systematic search was conducted across PubMed, Medline, Embase, and Scopus from inception to April 1, 2024, yielding 15 studies involving a total of 60,920 patients. These studies focused on adult patients undergoing spinal surgery for conditions such as tumors, trauma, infection, or congenital diseases, comparing those who received blood transfusions (PRBC, FFP, platelets, and allogeneic blood transfusions) to those who did not. Eligible studies reported outcomes such as mortality, ischemic events, surgery duration, pulmonary embolism, surgical site infections (SSI), and urinary tract infections (UTI). Statistical analysis was conducted using Comprehensive Meta-Analysis Version 3.3, applying a random-effects model. Outcomes were expressed as odds ratios (OR) for dichotomous variables and standard differences in means for continuous outcomes. The quality of studies was assessed using the Newcastle-Ottawa quality assessment scale. Heterogeneity was evaluated using I² statistics, and publication bias was assessed using funnel plots. Results indicated no significant difference in surgery duration between transfusion and non-transfusion groups. However, patients receiving transfusions experienced longer hospital stays (SMD: 1.462, p = 0.021) and higher odds of complications (OR: 3.11, p < 0.001). Moreover, the transfusion group exhibited elevated odds of mortality (OR: 3.96, p < 0.001), ischemic events (OR: 3.527, p < 0.001), respiratory complications (OR: 4.18, p < 0.001), renal complications (OR: 2.43, p < 0.001), pulmonary embolism (OR: 2.67, p = 0.012), deep vein thrombosis (OR: 2.737, p < 0.001), and thrombotic complications (OR: 5.232, p < 0.001). Additionally, the transfusion group had higher odds of surgical site infection (OR: 1.951, p < 0.001), while the non-transfusion group had decreased odds of urinary tract infection (OR: 2.960, p < 0.001). No significant difference was observed in respiratory tract infection (OR: 1.936, p = 0.09). Patients receiving blood transfusions had significantly higher odds of complications, including mortality, ischemic events, and thrombotic issues, as well as longer hospital stays. However, no significant difference was found in surgery duration between the transfusion and non-transfusion groups.

PMID:40285887 | DOI:10.1007/s10143-025-03509-x