Tag: nevin manimala

Environ Toxicol Chem. 2025 Jan 9:vgaf007. doi: 10.1093/etojnl/vgaf007. Online ahead of print.

ABSTRACT

Water reservoirs and lakes are gaining popularity for recreation activities as populations increase and green spaces become in high demand. However, these activities may cause contamination to critical water resources. This study investigates the impact of recreational activities on the presence and concentration of polycyclic aromatic hydrocarbons (PAHs) and ultraviolet (UV) filters in drinking water reservoirs in Southeast Queensland, Australia. Polydimethylsiloxane passive samplers were used to monitor 14 lakes over a 3-year period, focusing on seasonal variations and the influence of recreational activities such as petrol-powered boating and swimming. A total of 15 PAHs and six UV filters were detected, with chrysene (97%) and octyl salicylate (34%) being the most prevalent PAH and UV filter, respectively. Polycyclic aromatic hydrocarbon levels were statistically significantly higher in lakes permitting petrol-powered boating, especially during summer (p = 0.005 to 0.05). Lake Maroon and Lake Moogerah were the only sites that showed significantly higher PAH levels in summer (3.9 ± 1.1 and 4.0 ± 1.2 ng L-1, respectively) than winter (1.6 ± 0.61 and 1.5 ± 0.84, respectively). Ultraviolet filters were generally detected in higher levels in lakes allowing swimming, with Lake Moogerah and Lake Sommerset measuring UV filter concentrations of 20 ± 4.1 and 20 ± 11 ng L-1 in summer, respectively. Other lakes that do not permit swimming, such as Lake Maroon and Lake Samsonvale, also exhibited elevated UV filter levels, suggesting illegal swimming. These findings highlight the complexity of PAH and UV filter presence, influenced by multiple factors including lake size, recreational activity type, and seasonal variations. The levels of individual PAHs and UV filters in this study were below established freshwater guidelines. However, when considering their bioaccumulation potential and mixture toxicity, mitigating the impact of these substances on our environment and the organisms within it should be of priority.

PMID:39953706 | DOI:10.1093/etojnl/vgaf007

J Pharm Pract. 2025 Feb 14:8971900251320740. doi: 10.1177/08971900251320740. Online ahead of print.

ABSTRACT

Background: Asthma is one of the most common pediatric disease states. However, current literature about outpatient pharmacy appointment effectiveness on pediatric asthma control is not widely available. Objective: To determine whether outpatient pharmacist visits in pediatric patients with asthma result in a measurable difference in asthma control, utilizing the validated asthma control test (ACT) and childhood asthma control test (C-ACT) scoring tools. Methods: This study enrolled 16 children ages 6-17 years old at an outpatient primary care clinic (November 2023-April 2024). The patients visited the outpatient pharmacist 2 to 3 times over a 12-week period. The primary outcome was the change in the patient’s ACT or C-ACT from the baseline to the final study visit. Additional outcomes of interest included improvement in inhaler technique using a Vitalograph AIM® device, medication adherence rates, and change in emergent interventions from 6 months before enrollment compared to 3 months after the final visit. Results: The median improvement in asthma control test was 3 at the final study visit (4 or 12 weeks after counseling), which was statistically significant (P = 0.0348). This was an improvement from 50% of patients controlled at baseline to 100% at the final visit (P = 0.0053). Emergent interventions including oral steroid courses, emergency department visits, and hospitalization for asthma were less common after pharmacist intervention than before enrollment (P = 0.0464). Improvements in technique were seen at the initial visit using Vitalograph AIM® to visualize counseling points. Conclusion: Our study supports that outpatient pharmacist visits can have a measurable impact on pediatric asthma control.

PMID:39953701 | DOI:10.1177/08971900251320740

Ann Surg. 2025 Jan 28. doi: 10.1097/SLA.0000000000006639. Online ahead of print.

ABSTRACT

OBJECTIVES: To define the evolving role of serial transverse enteroplasty(STEP) in the surgical management of intestinal failure(IF) in patients with short bowel syndrome(SBS) especially among the adult population.

BACKGROUND: The current literature is lacking the rationale and long-term efficacy of STEP as a part of the multidisciplinary management of SBS-IF adult population.

METHODS: The study included a total of 64 total parenteral nutrition (TPN) dependent patients. The causes of SBS were wide-ranging with residual bowel length of 79+47 cm and plasma citrulline level of 22+12 umol/L. Partial or full colon was preserved in 56(88%) patients. STEP was primary in 32 patients and integrated with autologous gut reconstruction(AGR) in the remaining 32. Integrated STEP was technically feasible in 44% of the preoperative candidates. To assess the therapeutic benefits of integrated STEP, 32 of the contemporaneous AGR-only patients were statistically identified by propensity-score matching as control group.

RESULTS: With a mean follow-up of 35+24 months, the 64 study patients received a total of 81 STEP procedures. The 5-year disease-specific survival was 91% with a respective restored enteral autonomy (EA) rate of 80%. Compared to the matched control, integrated STEP significantly(P=0.02) enhanced the cumulative restoration of EA. The ASA comorbidity class IV was the only significant(P=0.05) survival risk factor. Preoperative TPN caloric requirements and total increment in bowel length were independent predictors of STEP-associated EA. Consequently, STEP was a significant predictor of restored EA among the overall SBS-IF patients.

CONCLUSIONS: This study underscores the wide-applicability and long-term therapeutic efficacy of STEP among the SBS-patients including adults. Accordingly, the procedure should be increasingly utilized for all ages and promptly considered as an integral part of the SBS-IF management armamentarium.

PMID:39953696 | DOI:10.1097/SLA.0000000000006639

Pediatr Blood Cancer. 2025 Feb 14:e31606. doi: 10.1002/pbc.31606. Online ahead of print.

ABSTRACT

A better understanding of positron emission tomography (PET) response in nodular lymphocyte-predominant Hodgkin lymphoma (nLPHL) is critical for incorporating PET into prospective trials. PET scans from Children’s Oncology Group study AHOD03P1 for patients less than 22 years with low-risk nLPHL, treated with three cycles of doxorubicin, vincristine, prednisone, and cyclophosphamide chemotherapy, were retrospectively reviewed and assigned Deauville 5-point scale (5PS) scores. Five-year post-PET event-free survival was 90.1% (80% CI: 85.2%-93.4%) for PET-negative (5PS 1-3) and 66.7% (80% CI: 36.4%-85.0%) for PET-positive (5PS 4-5) patients. PET response after three cycles of low-dose chemotherapy is predictive of relapse risk for low-risk nLPHL.

PMID:39953678 | DOI:10.1002/pbc.31606

Asia Pac J Clin Oncol. 2025 Feb 14. doi: 10.1111/ajco.14156. Online ahead of print.

ABSTRACT

BACKGROUND: Pneumocystis jirovecii pneumonia (PCP) is an unrecognized infection in non-HIV patients, particularly those with solid and hematologic malignancies. These patients experience higher mortality rates. This study aims to describe the incidence, initial characteristics, management, and outcomes of PCP at a tertiary cancer care center.

METHODS: This retrospective observational study included all patients who underwent P. jirovecii PCR testing at our center from January 2019 to January 2022. PCP was diagnosed in PCR-positive patients. Data on demographics, treatment, and outcomes were extracted from medical records. The primary outcomes were ICU admission and 21-day mortality. Statistical analysis compared PCR-positive and PCR-negative patients, with a specific focus on lung cancer patients, and analyzed determinants of 21-day mortality in PCP patients.

RESULTS: Of the 345 patients suspected of PCP, 54 (15.7%) were diagnosed with PCP. PCP patients were generally older. None of the PCP patients were on prophylaxis, compared to 14.8% of PCR-negative patients. In lung cancer patients, age and radiotherapy within the past year were significantly associated with a PCP diagnosis. The 21-day mortality rate among PCP patients was 35.4%. Independent risk factors for mortality included age and hematologic malignancy, while recent chemotherapy and higher neutrophil counts were associated with lower mortality.

CONCLUSION: PCP is associated with the highest mortality in patients with hematologic malignancies and lung cancer. The findings underscore the importance and efficacy of prophylaxis in at-risk groups and should raise awareness for the diagnosis of PCP in overlooked populations, such as older cancer patients and those undergoing radiotherapy.

PMID:39953677 | DOI:10.1111/ajco.14156

Clin Transl Sci. 2025 Feb;18(2):e70080. doi: 10.1111/cts.70080.

ABSTRACT

Selection of rational antagonists of P2Y₁₂ receptor for CAD patients who inherit CYP2C19 LoF alleles remains still conflicting. This study compared the clinical outcomes in CAD patients inheriting CYP2C19 LoF alleles undergoing PCI and treated with clopidogrel against alternative antagonists of P2Y₁₂ receptor. A thorough literature search was performed across multiple scientific databases following the PRISMA guidelines and PICO model. Setting the statistical significance at p < 0.05 and RevMan software was used to calculate the risk ratios (RRs). Estimation of the pooled analysis revealed a significant 62% increased risk of major adverse cardiovascular events (MACE) in CAD patients inheriting CYP2C19 LoF alleles and treated with clopidogrel against those treated with alternative P2Y₁₂ receptor antagonists such as prasugrel or ticagrelor (RR 1.62; 95% CI 1.42-1.86; p < 0.00001). In addition, Asian CAD patients were found at a significantly higher risk of MACE (RR 1.93; 95% CI: 1.49-2.49; p < 0.00001) juxtaposed to CAD patients of other ethnicities (RR 1.51; 95% CI: 1.29-1.78; p < 0.00001). Conversely, between these two treatment groups, taking clopidogrel against prasugrel/ticagrelor, who possess CYP2C19 LoF alleles, no significant differences in bleeding events were observed (RR 0.94; 95% CI 0.79-1.11; p = 0.47). CAD patients undergoing PCI who inherited CYP2C19 LoF alleles and treated with clopidogrel were associated with significantly higher risk of MACE against those treated with alternative antagonists of P2Y₁₂ receptor, that is, prasugrel or ticagrelor.

PMID:39953666 | DOI:10.1111/cts.70080

Immun Inflamm Dis. 2025 Feb;13(2):e70152. doi: 10.1002/iid3.70152.

ABSTRACT

PURPOSE: Multiple organ dysfunction syndrome (MODS), defined as two or more organ dysfunction during infection or following shock or trauma, correlates with poor outcomes. Clinical data, including MODS in the renal intensive care unit (ICU), are scarce. Therefore, we investigate the clinical characteristics and prognosis of patients with MODS in the renal ICU.

METHODS: A single-center, retrospective cohort study of 99 adult patients with MODS admitted to the renal ICU of the National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing, China, from October 1, 2011 to October 1, 2021.

RESULTS: 99 patients had a mean age of 49.7 ± 16.5 years old, and 51 (51.5%) patients died within 28 days after being admitted to the renal ICU. Infection (80 patients, 80.8%) was the most common reason for admission, with 47 cases being pulmonary infections. Of all of the 99 patients, 73 (73.7%) presented with persistent lymphocytopenia (lymphocyte count < 1.1 × 10⁹/L from the day of ICU admission through to day 7), with 33 and 40 presenting moderate (lymphocyte count 0.6-1.1 × 10⁹/L) and severe persistent lymphopenia (lymphocyte count ≤ 0.6 × 10⁹/L), respectively. These patients had higher illness severity and chronic kidney disease (CKD) prevalence. Patients with severe persistent lymphopenia were associated with higher 28-day ICU mortality (87.5% vs. 42.4% vs. 7.7%, p < 0.001) versus those with moderate and without persistent lymphopenia. Multivariable logistic regression analysis revealed that the number of organs involved, APACHE-II score, and persistent lymphopenia were independent risk factors for 28-day mortality in patients with MODS. The value of lymphocyte count on day 7 of admission in predicting poor prognosis of patients was higher than on other days (Area Under Curve, AUC = 0.831).

CONCLUSIONS: Patients with MODS are critically ill with high mortality. Persistent lymphopenia is frequent in patients with MODS and is independently associated with 28-day mortality. Lymphocyte counts on day 7 of admission were shown to be highly predictive of prognosis.

PMID:39953665 | DOI:10.1002/iid3.70152

J Forensic Leg Med. 2025 Feb 10;110:102826. doi: 10.1016/j.jflm.2025.102826. Online ahead of print.

ABSTRACT

BACKGROUND: Non-fatal strangulation (NFS) is a major risk factor for female homicide. Victims may present in a variety of clinical settings. In this study, we analysed reported signs, symptoms and injuries following NFS.

METHODS: This is a clinical audit of 170 NFS victims who underwent a documented clinical examination, including forensic photography.

RESULTS: Patients reported neck pain (77.6 %), an inability to breathe (60 %), headache (55.9 %), sore throat (52.9 %) and voice changes (47.1 %). In 76.5 % neck injuries were detected comprising non-petechial bruising (59.2 %), linear abrasions (scratch marks) (25.4 %), neck swelling (12.3 %), petechial haemorrhage (7.7 %) and ligature marks (1.5 %) with no detectable neck injury in 23.5 % of cases. There was no typical patient profile of NFS signs, symptoms or injuries or correlation of any signs, despite extensive interrogation by statistical analyses.

CONCLUSIONS: To assist with therapeutic care and forensic evidence collection following NFS, signs, symptoms and injuries should be documented. A lack of detectable injury to the neck following NFS does not exclude NFS. In addition, detectable injury may indicate a defensive response by the patient and/or multiple applications of force.

PMID:39951846 | DOI:10.1016/j.jflm.2025.102826

Pregnancy Hypertens. 2025 Feb 13;39:101200. doi: 10.1016/j.preghy.2025.101200. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the relationship between blood pressure (BP) variability and perinatal outcomes.

STUDY DESIGN: This was a retrospective study of 996 pregnant women with hypertension/risk factors for hypertension in pregnancy. BP variability was calculated by visit-to-visit standard deviation (SD) and mean difference (MD). Logistic regression explored the relationship between BP variability and perinatal outcome, adjusting for confounders.

MAIN OUTCOME MEASURES: Correlation between BP variability and i) fetal growth restriction (FGR) and ii) preterm birth (PTB).

RESULTS: FGR and PTB complicated 128/996 (13 %) and 233/996 (23 %) pregnancies. At visit 1, 61 (6 %) women were taking labetalol, 125 (13 %) were taking calcium channel blockers and 780 (78 %) were not taking antihypertensives. Increased BP variability was associated with FGR and PTB. These relationships persisted after adjustment for number of antihypertensives, pre-pregnancy BP, BMI, ethnicity and previous FGR for systolic but not diastolic BP variability (adjusted OR for FGR: 1.16 [95 % C.I. 1.03-1.30]; PTB: 1.16 [1.05-1.29]). However, statistical significance was lost after adjustment for maximum BP. Nifedipine was associated with increased BP variability, compared with labetalol, despite adjustment for ethnicity and pre-existing hypertension (adjusted difference: 1.93 mmHg [0.13-3.73], p = 0.04).

CONCLUSIONS: Increased visit-to-visit systolic but not diastolic BP variability is associated with adverse perinatal outcomes. Nevertheless, it is unclear whether BP lability directly influences perinatal outcome, or merely reflects peak BP. The difference in BP variability between antihypertensives may reflect varying effectiveness or factors influencing antihypertensive choice. Prospective research is needed to investigate any potential link between antihypertensive medications, BP variability and perinatal outcome.

PMID:39951841 | DOI:10.1016/j.preghy.2025.101200

Opt Lett. 2025 Feb 15;50(4):1393-1396. doi: 10.1364/OL.541372.

ABSTRACT

In this paper, we propose a novel, to the best of our knowledge, and efficient parameter estimator based on the k-nearest neighbor (kNN) and data generation method for the lognormal-Rician turbulence channel, which is of vital importance to the free-space optical/quantum communications. The Kolmogorov-Smirnov (KS) goodness-of-fit statistical tools are employed to investigate the validity of the kNN approximation under different channel conditions, and it is shown that the choice of k plays a significant role in the approximation accuracy. We present several numerical results to illustrate that solving the constructed objective function can provide a reasonable estimate of the actual values. The mean square error simulation results show that increasing the number of generated samples by two orders of magnitude does not lead to a significant improvement in estimation performance when solving the optimization problem by the gradient descent algorithm. However, the estimation performance under the genetic algorithm (GA) approximates to that of the saddlepoint approximation and expectation-maximization (EM) estimators. Therefore, combined with the GA, we demonstrate that the proposed estimator achieves the best trade-off between the computation complexity and the accuracy.

PMID:39951812 | DOI:10.1364/OL.541372