Tag: nevin manimala

Acta Neuropathol Commun. 2025 May 3;13(1):90. doi: 10.1186/s40478-025-01998-x.

ABSTRACT

Traumatic brain injury (TBI) occurs in 2-3 million Americans each year and is a leading cause of death and disability. Among the many physiological consequences of TBI, the hypothalamic pituitary axis (HPA) is particularly vulnerable, including a reduction in growth hormone (GH) and insulin-like growth factor (IGF-1). Clinical and preclinical supplementation of IGF-1 after TBI has exhibited beneficial effects. IGF-1 receptors are prominently observed in many tissues, including in the brain and in the gastrointestinal (GI) system. In addition to causing damage in the brain, TBI also induces GI system damage, including inflammation and alterations to intestinal permeability and the gut microbiome. The goal of this study was to assess the effects of systemic IGF-1 treatment in a rat model of TBI on GI outcomes. Because GI dysfunction has been linked to hippocampal dysfunction, we also examined proliferation and immature granule cells in the hippocampal dentate gyrus. 10-week-old male rats were treated with an intraperitoneal (i.p.) dose of IGF-1 at 4 and 24 h after lateral fluid percussion injury (FPI). At 3- and 35-days post-injury (DPI), gut permeability, gut dysmorphia, the fecal microbiome, and the hippocampus were assessed. FPI-induced permeability of the blood-gut-barrier, as measured by elevated gut metabolites in the blood, and this was prevented by the IGF-1 treatment. Gut dysmorphia and alterations to the microbiome were also observed after FPI and these effects were ameliorated by IGF-1, as was the increase in immature granule cells in the hippocampus. These findings suggest that IGF-1 can target gut dysfunction and damage after TBI, in addition to its role in influencing adult hippocampal neurogenesis.

PMID:40319295 | DOI:10.1186/s40478-025-01998-x

J Orthop Surg Res. 2025 May 3;20(1):442. doi: 10.1186/s13018-025-05858-1.

ABSTRACT

BACKGROUND: Patellar component design in total knee arthroplasty (TKA) can influence patellofemoral kinematics and clinical outcomes. The medialized dome design (MDD) aligns the patella apex more medially, while the anatomic patella design (APD) aims to replicate the native patella’s shape and tracking. Although biomechanical studies suggest potential benefits of APD, clinical evidence remains inconclusive.

METHODS: A systematic review and meta-analysis following PRISMA guidelines was conducted to compare the clinical outcomes of MDD and APD in a modern posterior-stabilized TKA (ATTUNE system). We searched PubMed, Scopus, Embase, and Web of Science on January 10, 2025, without language or date restrictions. Eligible studies included randomized controlled trials (RCTs) and comparative cohort designs evaluating patient-reported outcome measures (PROMs), revisions, complications, range of motion (ROM), and radiologic measures of patellar stability. Risk of bias was assessed using RoB-2 for RCTs and ROBINS-I for cohort studies. Pooled effect sizes were calculated using Hedges’s g and random-effects modeling.

RESULTS: Seven studies, including three RCTs and four cohort studies, with a total of 1,069 patients and 1,113 knees (507 APD vs. 606 MDD), were included. The meta-analysis demonstrated no significant difference in PROMs (Hedges’s g = 0.09; 95% CI [-0.04 to 0.22]; P = 0.17) or ROM (Hedges’s g = 0.02; 95% CI [-0.21 to 0.26]; P = 0.83) between APD and MDD. While revision rates and complications were higher for APD, the differences were not statistically significant compared to MDD (14 vs 9). Radiographic measures showed inconsistencies and did not definitively favor either design.

CONCLUSIONS: Current evidence suggests that APD offers no clear clinical advantage over MDD in the ATTUNE posterior-stabilized TKA. Both designs yield broadly comparable PROMs and knee function outcomes. Larger RCTs with extended follow-up are warranted to clarify the safety of APD.

LEVEL OF EVIDENCE: III.

PMID:40319293 | DOI:10.1186/s13018-025-05858-1

BMC Public Health. 2025 May 3;25(1):1643. doi: 10.1186/s12889-025-22538-1.

ABSTRACT

Worldwide, home care in the form of home healthcare and home help, has become increasingly more available. This systematic review aims to provide a deeper understanding of factors that are of particular importance for infection control in the home care setting for older adults. Five databases were searched (MEDLINE, Embase, ProQuest, Web of Science, CINAHL) for eligible studies using any research design reporting on individual, medical, behavioral and environmental factors. Retrieved studies were screened and assessed for quality. The Joanna Briggs Institute manual guided the research process and the work of generating a synthesis. Qualitative findings were compiled using meta-aggregation. For quantitative evidence, meta-analyses were conducted when possible. Of 19,484 unique records, 27 studies (7 cohort studies, 9 cross-sectional and 11 qualitative) were included in the review. Risk factors for infection reported in the quantitative studies referred to individual, medical, social, behavioral, environmental, and organisational aspects. Meta-analyses showed associations between urinary catheter use (OR 3.97, 95%CI 2.56-6.15) and limited mobility (OR 1.49, 95%CI 1.31-1.68), respectively, and risk of infection. Pooled ORs of urinary incontinence and risk of infection were not statistically significant. Findings from the qualitative studies covered perceived and observed risk factors to infection control and prevention. The evidence resulted in five synthesised findings covering attitudes, behaviors, home environment, personal interactions, lack of equipment, unsafe disposal of material, pets, unsafe practices and procedures, and lack of training. The combined quantitative and qualitative evidence sheds light on separate yet interconnected elements of risks for infection that may reinforce each other, potentially exposing vulnerable older adults to amplified risks.

PMID:40319285 | DOI:10.1186/s12889-025-22538-1

BMC Infect Dis. 2025 May 3;25(1):650. doi: 10.1186/s12879-025-10983-7.

ABSTRACT

OBJECTIVES: Viral respiratory infections can be complicated by bacterial superinfections. SARS-CoV-2 patients may suffer from superinfections, and negative effects of additional infections have been identified. When analysing hospital data, patients typically leave the facility of observation, due to discharge or death, which leads to changes in the study cohort over time. This may distort the estimate of the impact of superinfection. Therefore, it is essential for the statistical analysis of hospital data to acknowledge this change of the risk set over time. We analysed superinfections in a retrospective cohort study with 268 critically ill patients, taking into account discharge and death as competing risks in the statistical analysis.

METHODS: We evaluated bacterial respiratory infections and bloodstream infections and used multi-state statistical modelling to account for the different patient states. We calculated risks of superinfection, probability of discharge or death over time and analysed subgroups according to age and sex.

RESULTS: The observed pathogen spectrum was mainly composed of Enterobacterales, Nonfermenters but also Staphylococcus aureus. We identified an elevated mortality due to bacterial infection of the respiratory tract or bloodstream infection (adj. cause-specific HR 1.7, CI 1.15-2.52) as well as a reduced discharge rate (adj. cause-specific HR 0.51, CI 0.36-0.73). Female patients showed a tendency to have a reduced risk of acquiring a superinfection (adj. subdistribution HR 0.71, CI 0.48-1.04), and in case of infection a higher mortality compared to male patients (interaction effect HR 1.49, CI 0.67-3.30).

CONCLUSIONS: The study accounts for competing risks and quantifies the risk of death associated with bacterial superinfection in critically ill COVID-19 patients. We observed an increased risk of death for patients who developed a superinfection, with Enterobacterales being the predominant agent. The results emphasize the need for microbiological sampling in SARS-CoV-2-infected patients.

CLINICAL TRIAL NUMBER: German Clinical Trials Register number: DRKS00031367, registration date: 01.03.2023 ( https://drks.de/search/de/trial/DRKS00031367 ).

PMID:40319280 | DOI:10.1186/s12879-025-10983-7

BMC Sports Sci Med Rehabil. 2025 May 3;17(1):113. doi: 10.1186/s13102-025-01167-6.

ABSTRACT

BACKGROUND: Efficient methods to reduce erector spinae stiffness are important for solving lumbar spine problems, however, the trunk training positions effective for reducing erector spinae stiffness are unclear. Furthermore, it unclear whether whole-body vibration and trunk training are synergistic. Therefore, this study aimed to clarify the differences in the immediate effects on reducing erector spinae stiffness among three types of training: simple spinal flexion training, spinal neutral position training, and spinal flexion training combined with whole-body vibration.

METHODS: This single-blind randomized controlled trial included 36 healthy university students who were assigned to either the spinal neutral position training group, spinal flexion training group, or whole-body vibration (vibration conditions: 35 Hz, 4 mm) + spinal flexion training group. Training consisted of only one session of the assigned exercise in each group (20 s × 8 sets, rest 15 s). The outcomes measured were erector spinae stiffness, tenderness threshold of the erector spinae, lumbar proprioception, and maximum lumbar forward bending angle. All statistical analyses were performed using a split-plot design analysis of variance.

RESULTS: There were no significant group × period interactions for erector spinae stiffness; however, a significant main effect of time was observed (p < 0.01). Comparison of pre- and post-intervention stiffness indicated no significant differences in the spinal flexion training group. In contrast, both the spinal neutral position (p < 0.01, pre-intervention: 49.0 [10.6], post-intervention: 47.1 [6.4]) and whole-body vibration + spinal flexion training groups (p = 0.02, pre-intervention: 49.8 [12.6], post-intervention: 47.9 [9.4]) showed significantly less stiffness post-intervention compared to pre-intervention.

CONCLUSIONS: Trunk training performed in the spinal neutral position or spinal flexion position combined with whole-body vibration reduces erector spinae stiffness more effectively than simple spinal flexion training.

TRIAL REGISTRATION: This study was registered in the Japan Registry of Clinical Trials as a clinical trial (ID: jRCT1042240153; registration date: 20/12/2024).

PMID:40319275 | DOI:10.1186/s13102-025-01167-6

BMC Pregnancy Childbirth. 2025 May 3;25(1):526. doi: 10.1186/s12884-025-07613-0.

ABSTRACT

BACKGROUND: It is ambiguous whether the multiple COS with supraphysiologic hormonal doses impact ovarian reserve functions or pregnancy outcomes. The aim is to explore the effect of multiple COS during ART on ovarian reserve function and clinical pregnancy outcomes in infertile women.

METHODS: The retrospective study included 45,555 IVF/ICSI fresh cycles enrolled between January 2015 and March 2021 and were segregated into 5 different cycle cohorts. The participants were retrospectively grouped according to the number of repeated cycles. The primary observables symbolizing ovarian reserve function were antral follicle count (AFC) and anti-Müllerian hormone (AMH). We analyzed clinical pregnancy rate (CPR), live birth rates (LBR), and early miscarriage rate (EMR) to explore clinical pregnancy outcomes.

RESULTS: Among populations with different numbers of COS cycles, regression analyses found that the number of COS cycles had no significant impact on pregnancy outcomes (p > 0.05) after adjusting for confounding factors. However, factors such as age, BMI, and embryo transfer parameters showed significant associations with pregnancy outcomes. Intra-group analysis within same population revealed that, basal FSH, basal LH, AMH, and AFC exhibit no significant distinction (P > 0.05). Cycle 2 in Group B (aOR = 8.29; 95% CI, 6.80-10.12; P = 0.000), Cycle 3 in Group C (aOR = 6.05; 95% CI, 3.28-11.15; P = 0.000) and Cycle 4 in Group D (aOR = 20.46; 95% CI, 3.05-137.24; P = 0.002) had the highest CPR within each group; Cycle 2 in Group B and Cycle 3 in Group C had the highest LBR and lowest EMR within each group, and the differences did not reached statistical significance in the remaining groups.

CONCLUSION(S): The number of COS cycles did not significantly adversely affect pregnancy outcomes across different populations. In self-controlled comparisons within the same population, repeated COS (≤ 5 cycles) may not impair ovarian reserve function, while repeated COS (≤ 4 cycles) positively influenced clinical pregnancy outcomes, suggesting a potential cumulative effect.

PMID:40319269 | DOI:10.1186/s12884-025-07613-0

BMC Neurol. 2025 May 3;25(1):194. doi: 10.1186/s12883-025-04209-1.

ABSTRACT

BACKGROUND: Seeking medical attention promptly after an acute stroke is essential for effective treatment and improved patient outcomes. However, delayed medical intervention after acute stroke contributes to increased mortality and morbidity. This study explored factors that contribute to the delayed appearance of stroke patients at the emergency department.

METHODS: A prospective cross-sectional study was conducted for 9 months at a referral hospital in Addis Ababa. Data was collected using questionnaires administered to stroke patients or their caregivers upon their arrival at the emergency department. Electronic medical records were further reviewed, and the treating physicians described the subsequent management of the patient after their arrival at the emergency department. Data was analyzed using descriptive and analytic parameters.

RESULTS: Only 33.3% (n = 30) arrived at the emergency department within 4.5 h. Hemorrhagic stroke was a statistically significant predictor of early presentation to the emergency department (OR = 3.182; 95% CI (1.258-8.046); p = 0.036). The absence of any substance was another marginally significant predictor for early appearance (OR = 2.555; 95% (0.936-6.970); p = 0.067). One of the marginally significant predictors for late presentation was low drug adherence (OR = 0.224; 95% CI (0.48-1.044); p = 0.057). The other factors attributed to the time of arrival, though not statistically significant, were level of education, perception of stroke as a serious illness, and prior number of health visits before arrival to the emergency department.

CONCLUSION: The study found that many of the factors that cause delays in getting to the hospital can be changed, except for the type of stroke. Time spent in the hospital could also be positively impacted by the intervention from the appropriate authorities.

PMID:40319255 | DOI:10.1186/s12883-025-04209-1

BMC Public Health. 2025 May 3;25(1):1644. doi: 10.1186/s12889-025-22841-x.

ABSTRACT

BACKGROUND: Despite global efforts to mitigate COVID-19 infection through vaccination and therapeutic interventions, morbidity and mortality rates continued at variable rates. Although mortality risk and clinical features of COVID-19 are well-documented, recovery patterns and prognostic factors post-admission remain inconclusive, particularly in resource-limited settings like Ethiopia. This systematic review and meta-analysis (SRM) aimed to estimate the pooled incidence rate of recovery and predictors among hospitalized COVID-19 patients in Ethiopia.

METHODS: We searched (N = 1,191) articles using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline from PubMed/MEDLINE (N = 755), Scopus (N = 137), Web of Science (N = 84), Science Direct (N = 148), Cochran (N = 25), and Google Scholar searching (N = 42) from December 2019 to February 2024. The data were extracted using a Microsoft Excel spreadsheet and exported to Stata TM version 17.0 for further analysis. The Article quality was assessed using the Joanna Briggs Institute checklist. The pooled incidence rate of recovery was estimated using a weighted inverse variance random-effects meta-regression. Heterogeneity among studies was evaluated using the I² statistic. Subgroup analyses and sensitivity tests were also conducted to explore publication bias. This file is registered in international Prospero with ID (CRD42024518569).

RESULT: Sixteen (N = 16) published studies with 7,676 hospitalized COVID-19 patients were included in the final report. The mean age of participants ranged from 29 (± 17) to 57.5 (± 3) years, with male patients constituting the largest proportion of participants, 4,491(58.5%). During recovery screening, 6,304(82.21%) cases were discharged as improved, 159 (2.1%) attriters, and 818 (10.6%) died during inpatient treatment. The pooled incidence of recovery, mortality, and attrition rates were found to be 82.32% (95% CI: 78.81-85.83; I² = 94.8%), 14.3% (I² = 98.45%), and 2.7% (I² = 81.34%), respectively. Incidence of recovery rate varied across regions and epidemic phases, with the highest rate observed in Addis Ababa (89.94%, I² = 78.33%) and the lowest reported in the Tigray region (59.7%, I² = 0.0%). Across epidemic phases, the recovery rate was 88.05% (I² = 29.56%) in Phase II, 84.09% (I² = 97.57%) in Phase I, and 78.92% (I² = 96.9%) in Phase III, respectively. Factors included being aged 15-30 years (pooled OR = 2.01), male sex (pooled OR = 1.46), no dyspnea (pooled OR = 2.4; I² = 79%), and no baseline comorbidities (pooled OR = 1.15; I² = 89.3%) were predictors for recovery. CONCLUSION AND RECOMMENDATION: In Ethiopia, more than eight out of ten hospitalized COVID-19 patients recovered after inpatient treatment. However, the incidence of recovery rates varied significantly across epidemic phases, study settings, and regions. Factors including younger age, male sex, no dyspnea (shortness of breathing), and no underlying comorbidity heightened recovery. It is highly recommended those inpatients cares should focus on high-risk groups (older adults) and implement standardized treatment protocols in each study setting. Regions with lower recovery rates need aid in logistical support and training for healthcare providers.

PMID:40319254 | DOI:10.1186/s12889-025-22841-x

BMC Geriatr. 2025 May 3;25(1):307. doi: 10.1186/s12877-025-05978-7.

ABSTRACT

BACKGROUND: Oxidative damage is the principal cellular disturbance in the skin aging. Missense polymorphisms strengthen or weaken detoxification enzyme activity. Determination of deleterious functional effects of polymorphisms in detoxification genes (NQO1 and EPHX1) in skin aging was the overall purpose of conducting this hospital-based research.

METHODS: Cases recruitment on dermatological examination-based evidence performed sequentially between November 2022, and April 2023 at the Motahari Hospital Dermatology Outpatient Clinic. Genotype analysis was performed using PCR-RFLP and T-ARMS -PCR. All statistical analyses were performed using SPSS software, and differences were taken as significant at P < 0.05.

RESULTS: This study results implicate that skin aging obtains on a genetic level and in particular the results suggest that His139Arg, Tyr113His and P187S represent true genetic susceptible loci for cutaneous aging related traits. We found that these new susceptibility loci exhibit sex- and age-specific effect on aging skin risk as well as implicated in interactions with modifiable risk factors including water intake, micronutrient care, sleeping habits, sun exposure and application of sunscreen cream, in the development of an increased risk of aging skin.

CONCLUSIONS: Molecular defects associated with the His139Arg, Tyr113His and P187S polymorphisms manifest as an observable change in the external appearance of the skin. This study underscores the need to move toward scrutinizing the ageing skin changes at molecular levels.

PMID:40319243 | DOI:10.1186/s12877-025-05978-7

BMC Gastroenterol. 2025 May 3;25(1):333. doi: 10.1186/s12876-025-03801-6.

ABSTRACT

OBJECTIVES: This study aimed to investigate the factors affecting effect of extracorporeal shock wave lithotripsy (ESWL) for pancreatic duct stones.

MATERIALS AND METHODS: The data of 160 patients who underwent ESWL for pancreatic duct stones in Department of Gastroenterology, First People’s Hospital of Hangzhou, Westlake University School of Medicine, from July 2017 to June 2023, were retrospectively analyzed. The age and sex of the patients were recorded. All patients underwent spiral computed tomography (CT) abdominal plain scan. The placement of the pancreatic duct stent was recorded. The maximum CT value of stones was manually measured. The regions of interest (ROI) was delineated using ITK-SNAP software, and the stone volume was recorded. According to the size of residual stones after lithotripsy, 99 patients were included in the complete lithotripsy group (CL Group) and 61 patients in the incomplete lithotripsy group (ICL Group). SPSS 26.0 software was used for processing and analysis. A P value < 0.05 was considered statistically significant.

RESULTS: The Sex, maximum CT value, and volume of pancreatic duct stones were statistically significant in both groups. Binary logistic regression analysis showed that female sex, maximum CT value, and volume of pancreatic duct stones were independent risk factors affecting incomplete ESWL fragmentation in pancreatic duct stones. ICL group had a higher mean number of treatments and mean number of impacts than CL group.

CONCLUSION: The Sex, maximum CT value, and volume of stones were related to the therapeutic effect of ESWL. Female sex, maximum CT value, and volume of stones were independent risk factors affecting incomplete stone fragmentation.

PMID:40319240 | DOI:10.1186/s12876-025-03801-6