Tag: nevin manimala

J Robot Surg. 2025 Sep 1;19(1):544. doi: 10.1007/s11701-025-02707-5.

ABSTRACT

Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the standard surgical approach for patients with ulcerative colitis (UC) or familial adenomatous polyposis (FAP) seeking bowel continuity. While laparoscopy improves recovery, robotic-assisted surgery may offer advantages in pelvic procedures. However, its comparative efficacy remains unclear. This systematic review followed PRISMA guidelines to compare short-term outcomes of robotic-assisted IPAA with laparoscopic and open techniques. Literature was searched across PubMed, Embase, Web of Science, and the Cochrane Library for studies from January 2000 to June 2025. Included studies compared adult patients (≥ 18 years) undergoing IPAA for malignancy, UC or FAP. Primary outcomes were operative time, blood loss, hospital stay, and complications; secondary outcomes included conversion to open surgery, readmission, and reoperation. Meta-analysis was performed using pooled odds ratios, mean difference and 95% confidence intervals. Ten studies including 3,166 patients met inclusion criteria. Robotic IPAA was associated with a shorter length of stay (WMD – 1.1 days, 95% CI – 1.8 to – 0.3) and a non-significant trend toward fewer conversions to open surgery (OR 0.33, 95% CI 0.10-1.13). However, robotic procedures had longer operative times. Estimated blood loss did not differ significantly, and no significant differences were found in postoperative complications, anastomotic leaks, readmissions, or reoperations. Robotic-assisted IPAA is a safe and viable alternative to laparoscopic and open surgery, offering benefits in shorter hospital stay and conversion rates. Although operative times are longer, morbidity is comparable. Further prospective studies are needed to confirm these findings and evaluate long-term functional outcomes.

PMID:40889021 | DOI:10.1007/s11701-025-02707-5

J Egypt Natl Canc Inst. 2025 Sep 1;37(1):63. doi: 10.1186/s43046-025-00313-y.

ABSTRACT

BACKGROUND: The potential involvement of JC polyomavirus (JCPyV) in prostate cancer (PCa) remains a subject of debate, as existing in vitro studies have produced conflicting results. Understanding the viral oncogenic mechanisms underlying prostate cancer could offer valuable insights into its etiology. This study aimed to explore the association between JCPyV infection and prostate cancer by detecting the viral large T-antigen gene in prostate tissue specimens.

METHODS: A case-control study was conducted from February 2022 to March 2023, including 100 participants: 50 diagnosed with prostate cancer (cases) and 50 with benign prostatic hyperplasia (BPH) as controls. Formalin-fixed paraffin-embedded (FFPE) prostate tissue samples were collected from all participants. Nested polymerase chain reaction (PCR) was employed to detect JCPyV large T-antigen DNA using specific primers. Demographic and clinical data were obtained via a structured questionnaire. Statistical analysis was carried out using SPSS version 20, and associations between JCPyV presence and prostate cancer were analyzed using logistic regression.

RESULTS: The mean age of the prostate cancer group was 67.5 ± 10.9 years, compared to 70.9 ± 8.9 years in the control group. JCPyV large T-antigen DNA was detected in 29 out of 50 (58%) prostate cancer cases, compared to 19 out of 50 (38%) controls (P = 0.045; odds ratio = 1.45; 95% confidence interval: 1.011 to 5.019). Within the prostate cancer group, patients testing positive for the JCPyV T-antigen had a mean age of 73.3 ± 8.7 years, significantly higher than T-antigen-negative patients, whose mean age was 67.0 ± 8.3 years (P = 0.029).

CONCLUSION: The prevalence of JCPyV large T-antigen gene was significantly higher in prostate cancer patients than in individuals with benign prostatic hyperplasia. These findings suggest that JCPyV infection may be linked to an increased risk of prostate cancer, reinforcing prior studies that imply a potential oncogenic role for the virus in prostate carcinogenesis. Further investigations are necessary to elucidate the molecular mechanisms driving this association and its potential clinical implications.

PMID:40888995 | DOI:10.1186/s43046-025-00313-y

Support Care Cancer. 2025 Sep 1;33(9):828. doi: 10.1007/s00520-025-09881-0.

ABSTRACT

PURPOSE: The impact of a cancer diagnosis on racial differences in financial well-being and treatment related financial toxicity has not been well characterized. The purpose of this study was to compare relative disparities in financial distress by race among respondents with and without a history of cancer.

METHODS: We performed a retrospective cohort study based on the National Health Interview Survey (2010 to 2018). Primary outcomes included financial hardship questions about medication adherence, worry about medical costs, and worry about monthly bills. Multivariable logistic regression analysis examined the association of a cancer diagnosis and racial disparities in financial hardship using an interaction term of race and history of cancer.

RESULTS: We included 204,754 participants without a history of cancer and 19,094 cancer survivors. Black participants with a history of cancer reported higher rates of medication modification due to financial constraints (9.2%), compared to Black participants without cancer (4.8%) and White participants with (5.1%) or without (3.8%) cancer. By multivariable analysis, a history of cancer significantly worsened Black-White disparities in financial-related medication adherence measures and problems with medical bills, with Black patients more likely to report that they took less medicine to save money (OR 1.48, 95% CI 1.17-1.88, P = 0.001), delayed filling prescriptions to save money (OR 1.42, 95% CI 1.13-1.77, P = 0.002), and asked for lower-cost medications to save money (OR 1.27, 95% CI 1.07-1.50, P = 0.005), had problems paying medical bills (OR 1.29, 95% CI 1.08-1.53, P = 0.003), paid off medical bills over time (OR 1.45, 95% CI 1.24-1.69, P < 0.001), and delayed medical care because of worry about cost (OR 1.31, 95% CI 1.03-1.66, P = 0.023).

CONCLUSIONS: Black-White disparities in self-reported medical financial hardship among insured adults are worsened by a diagnosis of cancer. Policy- and system-level interventions are required to improve long-term financial distress among Black cancer survivors.

PMID:40888994 | DOI:10.1007/s00520-025-09881-0

Cerebellum. 2025 Sep 1;24(5):146. doi: 10.1007/s12311-025-01896-x.

ABSTRACT

Spinocerebellar ataxia (SCA) composite score (SCACOMS) is a statistically-derived composite measure comprising weighted items that are sensitive to change during early-stage disease. SCACOMS items and weights include the functional Scale for the Assessment and Rating of Ataxia Gait (12%), Stance (17%), Sitting (8%), and Speech (10%) items, and the Clinician Global Impression of Change (CGI) (53%). The content validity of SCACOMS is yet to be established. Semi-structured qualitative interviews were conducted with individuals with SCA (N = 24) and healthcare professionals (HCPs) who treat SCA (N = 2) to evaluate the relevance and weighting of SCACOMS items for assessment of SCA progression. Interviews were audio recorded, transcribed, coded, and analyzed using ATLAS.Ti v23 software, following established methods. SCACOMS items measured all sign and symptom concepts reported by > 50.0% of individuals with SCA, including difficulties with speech (79.2%), balance (75.0%), and gait (66.7%). Of SCACOMS items, individuals with SCA ranked Gait as most important for assessing disease progression (45.8%) and CGI as least important (58.3%). When weighting SCACOMS items, individuals with SCA assigned the highest weight to Gait (mean [standard deviation], 32.8% [13.24]) and the lowest weight to Sitting (12.9% [7.98]). HCPs varied the item weights dependent on SCA severity. Agreement with the statistically-derived weighting of SCACOMS varied, with 41.6% of individuals with SCA indicating that CGI weighting was too high. Overall, all participants indicated that SCACOMS could detect meaningful changes and/or disease stabilization. This study supports the content validity of SCACOMS in SCA; however, SCACOMS item weights may warrant adjustment.

PMID:40888983 | DOI:10.1007/s12311-025-01896-x

Environ Monit Assess. 2025 Sep 1;197(9):1069. doi: 10.1007/s10661-025-14535-z.

ABSTRACT

Airborne microbial communities show marked seasonal variability, with implications for both environmental processes and public health. In this study, metagenomic sequencing was applied to characterize airborne microbiota across four distinct seasons in India-winter (Sw), summer (Ss), southwest monsoon (Ssw), and northeast monsoon (Sne). Distinct shifts in dominant bacterial taxa were observed. Sne was dominated by Pseudomonas (42.3%) alongside sulfur-oxidizing Thiobacillus and Stenotrophomonas, likely influenced by lower temperatures and anthropogenic inputs. In Ss, Thiobacillus (72.9%) prevailed, followed by Pseudomonas (8.06%) and Sphingosinicella (6.68%), reflecting adaptation to arid, UV-intense conditions. Ssw featured Thiobacillus (58%) and Pseudomonas (18.5%) with additional plant-associated Lactobacillus and Clostridium, suggesting enhanced biogenic emissions. Sw was distinct for Enterococcus (21.9%) dominance and reduced Thiobacillus (16.2%), associated with high humidity and precipitation. Species richness followed the order Ssw > Sw > Ss > Sne, with the highest diversity during Ssw and Sw as indicated by Chao1, Fisher, Shannon, and Simpson indices. Kruskal-Wallis tests revealed no statistically significant differences in alpha diversity across seasons. Canonical Correspondence Analysis (CCA) highlighted strong seasonal structuring linked to environmental parameters such as temperature, humidity, and UV exposure. Dendrogram clustering showed greatest dissimilarity between Sne and Sw, while Ss and Ssw formed a closely related group. Ordination analyses (PCA, PCoA, NMDS) further confirmed seasonal distinctions. Seasonal variations in dominant bacterial taxa indicate potential public health risks in semi-urban tropical environments. Thiobacillus, prevalent in summer and the southwest monsoon, is generally non-pathogenic. In contrast, Pseudomonas species, abundant during the northeast monsoon and winter, are metabolically versatile, encompassing environmental strains and opportunistic pathogens known to cause respiratory and wound infections, especially in immunocompromised individuals. Winter also saw the presence of Enterococcus faecalis, a gut commensal and opportunistic pathogen linked to hospital-acquired infections and notable for multi-drug resistance. These seasonal shifts highlight varying exposure risks, emphasizing the need for public health attention to airborne microbial dynamics across different seasons.

PMID:40888959 | DOI:10.1007/s10661-025-14535-z

Orthopadie (Heidelb). 2025 Sep 1. doi: 10.1007/s00132-025-04709-5. Online ahead of print.

ABSTRACT

BACKGROUND: The advent of navigation, followed by robotics in knee prosthetic surgery aims, among other things, to enhance the alignment of components and to improve the control of stress forces (i.e., weight, gravity, and static and dynamic stabilizers) on the bearing surface throughout the range of motion; however, the benefits of robotic-assisted total knee arthroplasty (TKA) are debated.

OBJECTIVE: This quasi-randomized controlled trial (RCT) compares robotic-assisted and conventional TKA, focusing on surgical duration, hospital stay and serum markers. It aims to address current gaps in the literature and clarify potential advantages.

MATERIAL AND METHODS: All patients who received a TKA at the Department of Orthopedic Surgery of the Eifelklinik St. Brigida in Simmerath, Germany, between 2021 and 2025 were prospectively invited to participate in the present clinical trial. All patients followed the same clinical, imaging, and anesthesiological presurgical and postsurgical pathways irrespective of their allocation. All surgeries were performed using a standard medial parapatellar approach and a functional alignment philosophy. Both groups received the same implants, and patients followed the same postoperative physiotherapy program. Deviation from the planned surgical procedure and rehabilitation protocol warranted exclusion from the study. For patients allocated to robotic-assisted TKA, the CORI system (Smith & Nephew plc, Watford, United Kingdom) was used.

RESULTS: A total of 1099 patients completed the study, 59% (649 of 1099) of the patients were women and 50% (547 of 1099) of TKAs were performed on the left side. The mean body mass index (BMI) was 30.2 ± 4.9 kg/m^2, and the mean age was 66.9 ± 8.2 years. Comparability was found between the two cohorts regarding the number of women, side of surgery, mean BMI, age, hemoglobin, hematocrit and leucocyte count at admission. Robotic-assisted TKA was associated with a longer surgical time of 1.6 min (p = 0.04) and a lower C‑reactive protein level at both the first (p = 0.0003) and fifth (p = 0.003) postoperative days. No other difference between groups was found.

CONCLUSION: Robotic-assisted TKA was associated with lower serum C‑reactive protein levels. No difference was found in the length of hospitalization and erythropoietic function in serum. Although the surgical execution of conventional TKA was statistically significantly faster, the clinical relevance of the endpoint surgical duration is negligible.

PMID:40888957 | DOI:10.1007/s00132-025-04709-5

World J Urol. 2025 Sep 1;43(1):523. doi: 10.1007/s00345-025-05901-0.

ABSTRACT

INTRODUCTION: Percutaneous nephrolithotomy (PCNL) has undergone numerous technological innovations recently that make it even less invasive, but global adoption of these innovations remains unclear. This study sought to compare the effect of region and education on the penetrance of recent advances in PCNL worldwide.

METHODS: An anonymous 32-item survey was developed and distributed via the Endourological Society’s Twitter/X account in November 2023. The survey collected data on participants’ geographic region, PCNL volume, fellowship training, and PCNL practices. Descriptive statistics were calculated, and chi-square or Fisher’s exact tests were used for comparisons.

RESULTS: Responses were received from 160 PCNL providers worldwide. Respondents were categorized by geography, fellowship training, and procedural volume. Spinal anesthesia was more commonly used by Asian providers (31%, p = 0.001), while supine positioning was notably more common in Europe (76%, p = 0.001). Asian providers favored pneumatic energy (63%), while North American and European providers more frequently used dual energy lithotripters (31-72%) and hemostatic tract agents (p < 0.001). High-volume providers and those with more post-fellowship experience tended to use smaller sheaths, including mini-PCNL. Postoperative imaging practices also varied by region and fellowship-training status.

CONCLUSION: PCNL practices vary significantly worldwide, influenced by regional, economic, and experiential factors. Our survey indicates a significant shift in practices with 41% of providers using supine position and over 50% doing tubeless PCNL. However, ultrasound access has been slow to gain widespread use with 73% still using predominantly fluoroscopy, similar to prior studies. Further randomized studies are needed to establish the clinical effectiveness of new technologies and to drive standardization of care across geographic and economic barriers.

PMID:40888955 | DOI:10.1007/s00345-025-05901-0

J Robot Surg. 2025 Sep 1;19(1):543. doi: 10.1007/s11701-025-02708-4.

ABSTRACT

The aim of our study is to compare and assess the correlation of preoperative factors, intraoperative events and post-operative outcomes of robot assisted transperitoneal (RATP) and robot assisted retroperitoneal (RARP) partial nephrectomy (PN) in T1 renal cancer. Data from 2609 patients during the period of 10 years who underwent either RATP or RARP partial nephrectomies was retrospectively analyzed. We compared preoperative factors (age, BMI, tumour size/stage, PADUA score, preoperative eGFR, history of previous abdominal and ipsilateral surgery), intraoperative events: operative time (OT), warm ischemia time (WIT), estimated blood loss (EBL), and post-operative outcomes: complications, eGFR, positive surgical margins (PSM), and death due to disease (DOD) or due to other causes (DOC) and survival rates. Patients in the RATP-PN group were younger, PADUA score was similar in both groups-9, tumour size was smaller in RARP-PN. OT (103 min. vs 86 min) and WIT (23 min vs 10 min) were longer in RATP-PN (p < 0.001). EBL was higher in RATP-PN and in T1b tumours (p = 0). At 40 months follow-up, eGFR was same in both groups. There were slightly more Clavien-Dindo ≥3a complications in RARP-PN cohort. T1b tumours showed higher EBL than T1a tumours (p = 0). At end of follow-up, in RP group, 79.86% were alive, 3.87% DOD and 16.86% DOC; in TP cohorts, at 40 months of follow-up, 82.68% were alive, 2.66% DOD and 14.66% DOC. There is no relation between preoperative demographic or tumour factors on post operative complications. Tumour size and PADUA score had no effect on EBL Advanced age is a strong predictor for DOC in both T1a and T1b tumours; high PADUA score is associated with DOD in T1a tumours but not in T1b tumours.

PMID:40888954 | DOI:10.1007/s11701-025-02708-4

Acta Neurochir (Wien). 2025 Sep 1;167(1):235. doi: 10.1007/s00701-025-06647-9.

ABSTRACT

PURPOSE: Anterior choroidal artery (AChoA) aneurysms are rare and pose a significant treatment challenge due to the artery’s small caliber and critical vascular territory. Endovascular treatment (EVT) has become a preferred approach, but optimal management strategies remain debated. This study compares the efficacy and safety of different EVT techniques, including primary coiling, stent-assisted coiling (SAC), and flow diversion (FD), in treating AChoA aneurysms.

METHODS: Patients were categorized by endovascular technique, aneurysm morphology, and rupture status. Angiographic occlusion rates were assessed using the Raymond-Roy Occlusion Scale (RROS), and clinical outcomes were measured via the Modified Rankin Scale (mRS) at discharge and follow-ups. Statistical analyses compared occlusion rates, procedural complications, and functional outcomes among treatment groups.

RESULTS: In this study, 60 patients with 80 anterior choroidal artery aneurysms were treated. Among these, 44 aneurysms (55%) were classified as dependent, meaning the choroidal branch arose from the aneurysm dome or neck, while 36 aneurysms (45%) were independent, originating from the carotid artery near the choroidal branch. Primary coiling was used in 29 cases, stent-assisted coiling (SAC) in 21, and flow diversion (FD), with or without additional coiling, in 30 cases. Complete occlusion rates were significantly higher with SAC (83.3%) and FD (76.1%) compared to primary coiling (31.8%) (p < 0.05). Flow diversion was associated with more technical complications (25%), and ischemic events were more common in dependent aneurysms (p < 0.05). Importantly, no cases of symptomatic AChoA occlusion occurred after FD treatment. The overall mortality rate was 5%, with all deaths occurring in the primary coiling group among patients with ruptured aneurysms.

CONCLUSION: EVT of AChoA aneurysms is effective, with SAC and FD demonstrating superior occlusion rates compared to primary coiling. FD carries a higher risk of technical complications but maintains AChoA patency. To optimize outcomes, treatment choice should be guided by aneurysm morphology and patient risk factors.

PMID:40888948 | DOI:10.1007/s00701-025-06647-9

Lasers Med Sci. 2025 Sep 1;40(1):347. doi: 10.1007/s10103-025-04590-w.

ABSTRACT

The present study aimed to compare photobiomodulation (PBMT) and the use of a non-steroidal anti-inflammatory drug (NSAID), after surgical removal of lower lip lesions with a high-power diode laser. This was a series of 13 cases, in which all subjects were treated with high-power diode laser (808 nm) in continuous mode, with a power between 2.0 and 2.5 W. In the experimental group (G1) (n = 7), the subjects underwent PBMT using a low-power laser (LPL) (660 nm, 1 J, 40 mW, spot area of ​​0.04 cm², punctual), on the first, third and seventh post-surgery day. In the control group (G2) (n = 6), a NSAID (nimesulide 100 mg, every 12 h, for five days) was prescribed, and the LPL device was positioned, without being activated, to mimic the PBMT. The visual analogue scale (VAS) was applied to assess postoperative pain. The size of the surgical wound was measured immediately after surgery, as well as after two, seven, 15 and 30 days. For statistical analysis, the significance level was set at p < 0.05. Most subjects were male (53.8%) with a mean age of 44.7 years. Subjects in G1 reported less pain during follow-ups than those in G2, but with no significant differences between groups in all experimental times (p > 0.05). In the analysis, after seven days, the G1 presented a smaller surgical wound (p = 0.017). PBMT can be an alternative in relation to the use of nimesulide, allowing for less painful symptoms and optimization of the healing process.

PMID:40888946 | DOI:10.1007/s10103-025-04590-w