Tag: nevin manimala

Pol Przegl Chir. 2026 Jan 21;98(1):33-36. doi: 10.5604/01.3001.0055.5840.

ABSTRACT

<b>Introduction:</b> Trauma remains the leading cause of death in the pediatric population under 18 years of age. Non-operative management (NOM) has become the standard of care for hemodynamically stable pediatric patients with nonpenetrating abdominal injuries. <br><br><b>Aim:</b> This study evaluates the application of the American Pediatric Surgery Association (APSA) guidelines in a pediatric trauma center in Krakow, Poland, between 2017 and 2024. <br><br><b>Methods:</b> A retrospective analysis was conducted on 295 pediatric patients hospitalized with multi-organ injuries, including the intra-abdominal ones. The data were analyzed with respect to injury severity, hospitalization duration, and outcomes. Statistical methods included Shapiro-Wilk tests, Mann-Whitney U tests, Spearman's rho correlation, and chi-square tests. P-value of less than 0.5 was considered significant. <br><br><b>Results:</b> Conservative treatment was effective in all implemented cases, with no complications or rehospitalizations. Hospitalization duration correlated with age and presence of central nervous system (CNS) or thoracic injuries in multi-organ injuries, but not with sex or radiological American Association for the Surgery of Trauma (AAST) organ injury scales. Within abdominal organs, liver injury had the greatest impact on hospital stay length. Surgical intervention was required only in hemodynamically unstable patients or selected high-grade pancreatic injuries. Conservative management following APSA guidelines proved to be safe and effective, though concurrent injuries often prolonged hospitalization. Hospital stay length appeared to better reflect overall trauma severity than organ-specific injury grading. Imaging included eFAST (Extended Focused Assessment with Sonography in Trauma) and contrast-enhanced computed tomography (CEST); follow-up was typically conducted with standard ultrasound. No long-term complications were reported on. <br><br><b>Conclusions:</b> The application of APSA guidelines in diagnostic and therapeutic management in pediatric patients with blunt abdominal trauma is safe and effective. Nonoperative management remains the gold standard for stable pediatric abdominal trauma patients. <br><br><b>Significance for the field:</b> Conservative treatment of blunt abdominal injuries in children is a safe way of patient management and needs a raised awareness, especially among non-pediatric surgeons.

PMID:41810499 | DOI:10.5604/01.3001.0055.5840

Pol Przegl Chir. 2026 Feb 16;98(1):37-44. doi: 10.5604/01.3001.0055.6392.

ABSTRACT

<b>Introduction:</b> Adolescent gynecomastia is a common benign enlargement of male breast tissue that may cause significant psychosocial distress. Persistent cases often necessitate surgical intervention. This study aimed to evaluate clinical features, surgical techniques, outcomes, complications, and patient satisfaction in adolescents undergoing gynecomastia surgery at a single center. <br><br><b>Aim:</b> The present study was undertaken to retrospectively analyze the clinical characteristics, surgical techniques utilized, treatment outcomes, complications, and patient satisfaction following surgical management of gynecomastia in adolescent boys treated at a single surgical center for the macro-region of western Poland between 2000 and 2025. The study also aimed to identify factors associated with treatment results to improve and individualize patient care in this population. <br><br><b>Methods:</b> A retrospective observational study analyzed data from 26 boys aged 10-17 years who underwent surgical treatment for unilateral or bilateral gynecomastia between 2000 and 2025 at the Clinic of Pediatric Surgery, Traumatology, and Urology, Karol Jonscher Clinical Hospital, Poznan University of Medical Sciences. Surgical management primarily involved periareolar excision of glandular tissue, with selective liposuction or skin resection based on severity. Collected data included demographics, gynecomastia laterality, operative times, histopathology, complications, and patient satisfaction (5-point Likert scale). Statistical analyses included descriptive statistics, t-tests, Mann-Whitney U tests, chi-square tests, and Spearman correlation. <br><br><b>Results:</b> Bilateral gynecomastia was predominant (77%), with a median age at surgery of 16 years. Mean operative time was longer for bilateral procedures (58.5 min) than for unilateral ones (38.3 min). Histopathology confirmed benign glandular tissue in most cases. Postoperative complications were rare (11.5% hematomas; one transfusion), and no reoperations were required. Overall satisfaction was high (median 4/5), though older adolescents reported slightly lower satisfaction (Rs = -0.395, p = 0.046). <br><br><b>Conclusions:</b> Surgical management of adolescent gynecomastia is safe, effective, and associated with high patient satisfaction. Bilateral cases require longer operative times, but complication rates remain low. Individualized preoperative planning, including weight optimization and age-appropriate counseling, enhances cosmetic and psychosocial outcomes. These results support timely surgical intervention in adolescents with persistent gynecomastia causing aesthetic or psychological concerns.

PMID:41810498 | DOI:10.5604/01.3001.0055.6392

Sports Med Arthrosc Rev. 2026 Mar 11. doi: 10.1097/JSA.0000000000000457. Online ahead of print.

ABSTRACT

Anterior cruciate ligament (ACL) rupture in young athletes is a common and devastating injury. The gold standard for treatment in young athlete population remains reconstruction using autografts especially bone-patellar tendon-bone (BTB) graft and hamstring tendons (HT) graft. A systematic review was conducted to compare the rates of overall return to sport (RTS), return to preinjury levels, and re-ruptures between young athletes who have undergone primary ACL reconstruction using a BTB versus HT autograft. 30 studies were included in the final analysis. A total of 5871 patient-athletes who underwent ACL reconstruction were included. Among them, 1684 patients received BTB and 4187 patients received HT. The overall RTS rate was 73.8%. The overall re-rupture rate was 4.2%. Higher rates of RTS and return to preinjury level, as well as a lower re-rupture rate, were observed in the BTB autograft. However, these differences did not reach statistical significance.

PMID:41810492 | DOI:10.1097/JSA.0000000000000457

Front Sports Act Living. 2026 Feb 23;8:1686129. doi: 10.3389/fspor.2026.1686129. eCollection 2026.

ABSTRACT

INTRODUCTION: A high peak knee abduction moment (pKAM) during change-of-direction (COD) movements is considered a risk factor for non-contact injury to the anterior cruciate ligament during multidirectional team sports. COD technique training aimed at avoiding injury-prone movement patterns can lead to reductions in the pKAM but may limit COD performance. In this study we investigated a novel constraints-led training approach based on a 1-on-1 laser tag game, which may optimize COD movement patterns simply through the game’s constraints rather than technique instructions. Specifically, we investigated whether the constraints-led training approach reduces the pKAM but with COD performance maintained or even improved.

METHODS: Twelve highly active individuals (75% female) with experience in COD sports completed an eight-week laser tag training (LASG) intervention while COD biomechanics and performance were obtained from 3D motion capture and full-body musculoskeletal modeling of a maximum-speed 135° COD. Training effects in the LASG group were compared to training effects of traditional COD technique training (CODG) and linear sprint training (CG) obtained from a previous study.

RESULTS: After the training, the LASG showed a statistically significant reduction in the pKAM compared to pre-training (p = 0.038, Cohen’s d = 0.63) with magnitudes comparable to the CODG (p = 0.056, d = 0.58). Further, the LASG showed improvements in COD performance, quantified through statistically significant reductions in COD completion times (p < 0.001, d = 2.47), which was not observed for CODG (p = 0.898, d = 0.04).

DISCUSSION: In conclusion, an eight-week laser tag training intervention can reduce the pKAM and improve performance during a maximum-speed COD and thus may be a useful tool in ACL injury prevention training.

PMID:41810460 | PMC:PMC12968199 | DOI:10.3389/fspor.2026.1686129

World J Gastroenterol. 2026 Mar 7;32(9):114200. doi: 10.3748/wjg.v32.i9.114200.

ABSTRACT

BACKGROUND: Assessment of the prognosis, follow-up monitoring, and adjuvant treatment decision-making for patients with stage II and III colorectal cancer (CRC) are controversial, as CRC harbors tremendous heterogeneity. Carcinoembryonic antigen (CEA) is an important tumor marker; however, the use of this marker in the management of CRC has not garnered adequate attention.

AIM: To determine the significance of perioperative CEA levels in prognostic stratification and treatment decision making to provide personalized diagnosis and treatment for patients with stage II and III CRC.

METHODS: Patients in the training and validation cohorts were diagnosed with primary stage II or III CRC. Preoperative CEA (pre-CEA) and postoperative CEA (post-CEA) were collectively defined as perioperative CEA. Kaplan-Meier (K-M) survival analyses were used to describe patient survival. Cox stepwise regression analysis based on Akaike information criterion was used to determine the prognostic value of clinicopathological characteristics. Nomograms were developed to predict the probability of overall survival (OS) and disease-free survival (DFS). Annual hazard curves and pie charts were used to demonstrate the features of recurrence or metastasis. Differences were considered statistically significant at P < 0.05.

RESULTS: A total of 2496 and 1293 patients were included in the training and validation cohorts, respectively. K-M analysis indicated that patients with elevated perioperative CEA had poorer OS and DFS, with post-CEA being an independent prognostic factor for OS and DFS. Nomograms based on factors associated with prognosis were constructed, which showed good predictive ability for 3-, 5-, and 7-year OS and DFS. Patients with elevated perioperative CEA were more likely to have recurrence or metastasis, and the period of the second year after surgery was the peak time of recurrence or metastasis. OS and DFS were significantly worse in patients without adjuvant chemotherapy when they had elevated perioperative CEA. Adjuvant chemotherapy could significantly improve the OS of patients with elevated perioperative CEA. Patients with elevated post-CEA who received XELOX could achieve better OS and DFS.

CONCLUSION: Perioperative CEA demonstrate sufficient sensitivity in the prognosis prediction and follow-up of patients with stage II and III CRC. Furthermore, perioperative CEA, especially post-CEA, show promise in guiding adjuvant chemotherapy, suggesting potential for further study.

PMID:41810442 | PMC:PMC12968575 | DOI:10.3748/wjg.v32.i9.114200

Curr Res Food Sci. 2026 Mar 2;12:101371. doi: 10.1016/j.crfs.2026.101371. eCollection 2026.

ABSTRACT

The brewing process is a crucial step in determining the flavor profile of green tea infusions. However, the flavor differences arising from top-brewing and bottom-brewing methods remain poorly understood, and the underlying mechanisms are largely unexplored. In this study, GC-MS and sensory analysis were employed to investigate the flavor differences in Shucheng Little Cymbidium tea infusions under varying water temperatures and brewing methods. Subsequently, the variations in major polyphenolic compounds were analyzed, and the potential causes of flavor differences were explained from the perspective of the interactions between EGCG and key aroma compounds. Multivariate statistical analysis revealed that compounds such as geraniol, nonanal, and methyl salicylate serve as important markers for discriminating between different brewing conditions. Moreover, EGCG exhibited a significant binding effect with compounds such as geraniol and nonanal, driven by hydrogen bonding and hydrophobic interactions. This binding may regulate the transfer of aroma compounds from tea leaves to the infusion during brewing, thereby shaping distinct sensory characteristics. These findings provide a molecular-level rationale for empirical techniques in traditional tea art. More importantly, it inspires researchers to pay attention to the crucial role of the tea infusion matrix in determining flavor.

PMID:41810421 | PMC:PMC12969635 | DOI:10.1016/j.crfs.2026.101371

Trauma Surg Acute Care Open. 2026 Mar 6;11(1):e001924. doi: 10.1136/tsaco-2025-001924. eCollection 2026.

ABSTRACT

INTRODUCTION: Globally, trauma patients suffer from high rates of preventable deaths, in part driven by low rates of access to and application of resource-relevant evidence-informed clinical guidance. This mixed-methods study assessed the accessibility (barriers to attempting to use guidance), clarity (ease of comprehension), utility (based on resources and time), and implementation of trauma guidance for Peruvian injury providers.

METHODS: Semistructured qualitative interviews were conducted in Spanish at three hospitals in Lima, Peru. Interviews were analyzed in Dedoose V.9.1.12 using an iteratively developed codebook; quantitative self-administered surveys were then developed and distributed at the Pan American Trauma Society Conference. Surveys were analyzed using descriptive statistics and frequencies.

RESULTS: 38 interviews and 83 surveys were conducted with surgical attendings, emergency physicians, and surgical and emergency residents across all years of training. Access barriers included paywalls, language barriers, low user-friendliness, and technology limits (poor internet, few computers). A mobile app and portable physical guidance are preferred potential solutions. Utility barriers included low equipment maintenance and high patient volumes. Resource-based guidance, conciseness (eg, flowcharts), and standardization are perceived to potentially increase utility. Implementation barriers included limited training time, reliance on more experienced colleagues rather than guidance, low enforcement, and low funding. Potential facilitators are increased administrative support and staff willingness to use guidance improving patient mortality, clinical errors, and length of stay. No barriers to clarity were reported.

CONCLUSION: Barriers to using clinical guidance included low user-friendliness, low local applicability, and an unsupportive culture. Mobile apps, resource stratification, and administrative involvement are priorities to address these needs. Trauma guidance adapted to local realities may reduce preventable deaths in acute care. Further work is needed to identify how to create and distribute updated clinical guidance to better serve trauma providers worldwide.

LEVEL OF EVIDENCE: Economic and Value-based Evaluations Level 2.

PMID:41810415 | PMC:PMC12970114 | DOI:10.1136/tsaco-2025-001924

Front Vet Sci. 2026 Feb 23;13:1751034. doi: 10.3389/fvets.2026.1751034. eCollection 2026.

ABSTRACT

INTRODUCTION: Endothelial glycocalyx damage contributes to morbidity and mortality in critical illness. In this exploratory study in cats with trauma and non-traumatic illness, the endothelial glycocalyx thickness was estimated using sidestream dark field videomicroscopy and the Glycocheck™ software, with the primary aims of assessing feasibility, describing of Glycocheck™ microcirculatory parameters and exploring potential effects of illness severity and IV fluid administration.

METHODS: This was a prospective, single center, observational study. Recorded variables included age, weight, diagnosis, length of hospitalization (LOH), packed cell volume (PCV) and IV fluid administration. Each patient was assigned a fast Acute Patient Physiologic and Laboratory Evaluation score (APPLE_fast) and for cats with trauma – Animal Trauma Triage score (ATT). Within 24 h from admission, cats were anesthetized, and images from the sublingual mucosal vessels obtained for Glycocheck™ analysis. The perfused boundary region (PBR), an inverse estimate for endothelial glycocalyx thickness, was calculated for vessels with diameter of 5-25, 5-9, 10-19 and 20-25 μm, respectively. Normality was assessed using Shapiro-Wilk test and histograms. The effects of APPLE_fast, LOH, ATT, PCV, IV fluid administration, and illness group on PBR were analysed using generalised linear models. Distribution of vascular segment counts was assessed using Friedman’s test and Wilcoxon rank-signed test.

RESULTS: Nineteen cats were included, 11 with trauma. Success rate for measurements was 95%. Survival to discharge was 95%. Mean ± standard deviation for PBR 5-25 was 2.60 ± 0.22 μm, PBR 5-9: 1.38 ± 0.15 μm, PBR 10-19: 3.02 ± 0.22 μm and PBR 20-25: 3.03 ± 0.38 μm, within previously established tolerance intervals. There were no statistically significant effects of group, LOH, ATT, APPLE_fast, PCV and IV fluids on any PBR measurements. Vascular segment counts across the 5-25 μm range were not equally distributed (p < 0.001).

CONCLUSION: This exploratory study demonstrates the feasibility of assessing endothelial glycocalyx thickness in hospitalized sick cats. While no effects of clinical variables on PBR were identified, the study highlights important methodological considerations and provides valuable insights to guide future, larger-scale investigations.

PMID:41810410 | PMC:PMC12967996 | DOI:10.3389/fvets.2026.1751034

Gastro Hep Adv. 2025 Oct 12;5(4):100835. doi: 10.1016/j.gastha.2025.100835. eCollection 2026.

ABSTRACT

BACKGROUND AND AIMS: Crohn’s disease (CD) patients may experience anastomotic bleeding after lower gastrointestinal surgery, but its endoscopic management remains underexplored. We aimed to analyze the risk factors for anastomotic bleeding and the efficacy of endoscopic treatment.

METHODS: We retrospectively analyzed clinical characteristics, endoscopic treatments, and outcomes of CD patients with postoperative anastomotic bleeding from January 2021 to May 2025 at multiple centers. Anastomotic bleeding was defined as (i) direct bleeding (melena/hematochezia) or (ii) hemoglobin decrease ≥2 g/dL. Patients were followed up for 1 year, with rebleeding requiring endoscopic reintervention.

RESULTS: We included a total of 21 patients with 100% of patients having onsite bleeding controlled with initial endoscopic treatment and 9 patients (42.9%) having rebleeding. There was no statistical difference between the rebleeding group and nonrebleeding group in terms of age, gender, comorbidity, anticoagulation or antiplatelet therapy, clotting disorder, hemoglobin before or after procedure, bleeding type, the Rutgeert’s score, and endoscopic treatment. However, a greater number of patients in the rebleeding group required blood transfusion (88.9% vs 33.3%, P value = .011), and a greater volume of blood transfusion 2.0 (2.0-3.5 units) vs 0.0 (0.0-1.8 units) than those in nonrebleeding group (P value = .013). None of the 21 patients had no endoscopy-associated complications.

CONCLUSION: Endoscopic therapy appears to be safe and effective for the majority of CD patients with anastomotic bleeding following bowel surgery. The requirement for blood transfusion at the inception, in conjunction with a high volume of blood transfusion appear to be high risk factors for rebleeding.

PMID:41810383 | PMC:PMC12969671 | DOI:10.1016/j.gastha.2025.100835

medRxiv [Preprint]. 2026 Feb 24:2026.02.23.26346831. doi: 10.64898/2026.02.23.26346831.

ABSTRACT

The daily cortisol cycle is a critical indicator of hypothalamic-pituitary-adrenal (HPA) axis function. The current analytical approaches produce several outputs difficult to integrate into simple statistical models, clinical workflows, and ML/AI pipelines requiring single-value inputs. We developed the Cortisol Sine Score (CSS), a model-free scalar metric that quantifies daily cortisol exposure by computing a weighted sum of cortisol measurements across the day, using sine-transformed time-of-day weights. The CSS produces positive values for morning-dominant patterns, negative values for evening-shifted profiles, and near-zero values for flattened rhythms characteristic of chronic stress and circadian disruption. We validated the CSS performance in 3,006 samples from 501 pregnant women enrolled in the March of Dimes program, with cortisol values measured at 6 time points per day collected during the second trimester of pregnancy. The CSS showed strong correlations with observed and model-estimated amplitude and acrophase from Cosinor regression and JTK_CYCLE approaches, with excellent classifying performance (AUC=0.89, high versus low). The CSS successfully captured established associations between social disadvantage and cortisol dysregulation, and demonstrated utility in predicting gut microbiome composition in metagenomic analyses. Importantly, the CSS maintains excellent fidelity to the full 6-sample protocol with as few as 3-4 daily measurements. The 4-sample protocol achieves great performance (r = 0.952, MAE = 0.087) while reducing participant burden. The 06:00 time point was identified as essential for accurate CSS quantification. The CSS bridges the gap between circadian analysis and practical implementation by providing a simple, interpretable, and robust assessment of cortisol daily cycle in large-scale epidemiological studies, clinical screening, and biomedical sensors.

HIGHLIGHTS: Current state-of-the-art approaches estimating the daily cortisol exposures produce multi-output information difficult to implement in simple statistical analyses or ML/AI multi-omics approachesCortisol Sine Score is a novel model-free scalar metric expressing cortisol daily exposure and rhythmicity (morning vs evening exposure)Cortisol Sine Score was validated using 3006 salivary samples from clinical data and golden standards in circadian analyses such as Cosinor and JTK_CYCLECortisol Sine Score was the top performer in our benchmarking approach predicting association with social disadvantage and gut microbiome compositionReliable with 3-4 daily samples, reducing participant burdenOpen-source R package CortSineScore democratizes cortisol cycle analysis.

PMID:41810379 | PMC:PMC12970380 | DOI:10.64898/2026.02.23.26346831