Tag: nevin manimala

Acta Ortop Bras. 2025 Sep 22;33(5):e290072. doi: 10.1590/1413-785220253305e290072. eCollection 2025.

ABSTRACT

INTRODUCTION: Lower back disorders are prevalent and a significant reason for emergency care visits. In 2020, 619 million people experienced low back pain, expected to rise to 843 million by 2050. A common cause is the presence of a lumbosacral transitional vertebra (LSTV). Objectives: This study evaluates the prevalence of Bertolotti Syndrome in patients with low back pain in an emergency setting and assesses interobserver reliability of LSTV classifications.

METHODS: A retrospective analysis of 1023 lumbar spine radiographs from patients presenting with low back pain from 2018 to 2020 was conducted. After exclusions, 469 radiographs were analyzed. Two orthopedists classified LSTVs using Tini and Castellvi’s systems. Statistical analyses included the Kappa agreement index, two-proportion Z test, confidence interval for the mean, and p-value calculations.

RESULTS: The prevalence of Bertolotti Syndrome was 62.5% for observer A and 61.6% for observer B. Type I LSTV was the most common, with over 70% of cases, followed by type III at over 15%. The most frequent morphology was bilateral involvement of the transverse process, with more than 50% of cases exhibiting IB morphology according to both classifications.

CONCLUSION: This study found a high incidence of Bertolotti Syndrome (over 60%) in patients with low back pain seeking emergency care, suggesting that LSTV should be more frequently considered in differential diagnoses. Improved recognition of LSTV could lead to better management strategies for low back pain associated with this congenital anomaly. Level of Evidence III; Retrospective Cohort Study.

PMID:40995499 | PMC:PMC12456892 | DOI:10.1590/1413-785220253305e290072

Acta Ortop Bras. 2025 Sep 22;33(5):e287110. doi: 10.1590/1413-785220253305e287110. eCollection 2025.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate capsulolabral repair in athletes with traumatic anterior glenohumeral instability using magnetic resonance imaging (MRI) and correlate it with clinical and epidemiological data.

METHOD: A prospective therapeutic clinical study was conducted with 36 athletes undergoing surgical treatment. MRI was performed preoperatively and in the third month postoperatively. The morphology, height, angulation, integrity and density of the repaired capsulolabral tissue were evaluated. Linear and logistic regression models were applied.

RESULTS: A total of 36 athletes were evaluated (mean age 29.64 ± 9.08 years). For all numerical variables (morphology, integrity, angles and heights) the differences were statistically significant, except for the coronal angle and homogeneity. Longer time to surgery or multiple dislocations reduced the improvement in morphology. There were no new episodes of dislocation. In the 3-month radiological evaluation, the integrity of the labrum was present in 97% of the patients, however, all patients still had a heterogeneous labrum.

CONCLUSION: There are statistically significant differences between the morphology, height and angulation of the labrum between the pre- and postoperative periods of patients operated on for glenohumeral instability. Although the 3-month MRI showed integrity of the labrum in almost all athletes, this tissue still presented altered density even with satisfactory clinical results. Level of Evidence III; Prospective Study.

PMID:40995498 | PMC:PMC12456893 | DOI:10.1590/1413-785220253305e287110

BMC Sports Sci Med Rehabil. 2025 Sep 24;17(1):267. doi: 10.1186/s13102-025-01309-w.

ABSTRACT

BACKGROUND: Chronic ankle instability (CAI) is associated with impaired balance, proprioception, and limited dorsiflexion range of motion (ROM). Whole-body vibration (WBV) and blood flow restriction (BFR) may address these deficits. This study aimed to determine whether adding BFR to WBV would produce greater immediate improvements in these parameters compared to WBV alone.

METHODS: In this double-blind, randomized controlled trial, thirty-eight non-professional male athletes with CAI were randomly assigned to WBV (n = 19; age: 23.5 ± 4.7 years) or WBV + BFR group (n = 19; age: 24.1 ± 4.9 years). Both groups received a single session of WBV at 30 Hz and 2 mm amplitude; the WBV + BFR group additionally underwent BFR at 80% arterial occlusion pressure. Balance error scoring system (BESS), modified star excursion balance test (m-SEBT), ankle dorsiflexion proprioception, side hop test, dorsiflexion ROM, and perceived instability were measured before and after the intervention.

RESULTS: Statistical tests showed no significant changes in BESS scores (p > 0.05). The WBV + BFR group showed a significant improvement in anterior reach of the m-SEBT (p = 0.04), while the WBV-only group did not (p = 0.69). Statistical analysis indicated a significant reduction in dorsiflexion repositioning error in the WBV group (p = 0.004), with between-group differences favoring WBV. Perceived instability significantly improved in the combined group (p = 0.001). Both groups showed improved dorsiflexion ROM (p < 0.05), with no significant difference between them (p = 0.76).

CONCLUSION: Both WBV and WBV + BFR improved dorsiflexion ROM in athletes with CAI, but neither produced immediate gains in static or dynamic balance, except for anterior reach with the combined intervention. Adding one session of BFR to WBV appeared to impair proprioception and increase perceived instability. These methods may be better used as adjuncts in rehab, not standalone treatments. Clinically, they should be applied cautiously and not immediately before activities demanding high joint stability.

CLINICAL TRIAL REGISTRATION: Registered at IRCT (IRCT20230203057314N1; June 2, 2023).

PMID:40993815 | DOI:10.1186/s13102-025-01309-w

Infect Agent Cancer. 2025 Sep 24;20(1):64. doi: 10.1186/s13027-025-00694-8.

ABSTRACT

PURPOSE: To analyze outcomes and evaluate the survival benefits of metronomic chemotherapy (MC) with S-1 in locoregionally advanced nasopharyngeal carcinoma (LANPC) patients with residual EBV-DNA after induction chemotherapy (IC).

METHODS: We retrospectively included patients diagnosed with LANPC between October 2015 and August 2021. All patients were treated with IC and had residual EBV-DNA after IC. Chi-square test, Kaplan-Meier methods, and Cox proportional hazards model were used for statistical analyses.

RESULTS: A total of 103 patients were identified, including 20 (19.4%) who received MC using S-1 for one year. Among these patients, 40 experienced disease progression, including 12 with locoregional recurrence (30.0%), 24 with distant metastasis (60.0%), and 4 with both locoregional recurrence and distant metastasis (10.0%). The 5-year locoregional recurrence-free survival, distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates were 81.3%, 70.7%, 52.8%, and 72.1%, respectively. Multivariate prognostic analysis showed that post-IC residual EBV-DNA levels were independent prognostic factors for DMFS and PFS. Patients with EBV-DNA levels > 90 copies/mL had worse DMFS (hazard ratio [HR] 4.978, 95% confidence interval [CI] 1.413-17.535, P = 0.012) and PFS (HR 3.679, 95% CI 1.592-8.499, P = 0.002). Additionally, receiving MC was an independent prognostic factor for PFS and OS. Patients who received MC had better PFS (HR 0.310, 95% CI 0.120-0.802, P = 0.016) and OS (HR 0.100, 95% CI 0.013-0.745, P = 0.025).

CONCLUSIONS: Our study highlights the poorer survival outcomes observed in LANPC patients with residual EBV-DNA levels following IC, as well as the potential survival advantages of MC in this subgroup.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40993812 | DOI:10.1186/s13027-025-00694-8

Addict Sci Clin Pract. 2025 Sep 24;20(1):75. doi: 10.1186/s13722-025-00603-9.

ABSTRACT

BACKGROUND: Hepatitis C infection (HCV) and opioid use disorder (OUD) are syndemic in the U.S., thus primary care providers (PCPs) who treat OUD by prescribing buprenorphine can play key roles to advance HCV elimination targets. We compared HCV screening and treatment among PCPs who do and do not prescribe buprenorphine in Washington (WA) State.

METHODS: This study utilized a cross-sectional survey of PCPs in WA State, designed to characterize HCV care delivery practices and experiences/attitudes toward HCV. In this study, the independent variable was self-reported buprenorphine prescribing, and the main outcomes were (1) guideline-concordant HCV screening and (2) directly providing treatment for HCV. We used descriptive statistics to describe respondent characteristics. We used logistic regression to assess the association between buprenorphine prescribing status and HCV screening and treatment outcomes.

RESULTS: Our sample included 73 PCPs, of whom 55% prescribe buprenorphine. We found that 25% of buprenorphine prescribers directly treated HCV. There was over a 2x greater relative odds that buprenorphine prescribers would correctly screen for HCV relative to non-prescribers (OR = 2.24; 95% CI: 0.67-8.18, p = .20) and a nearly 2.5x greater relative odds that they would treat HCV relative to non-prescribers (OR = 2.42; 0.72-9.61; p = .17), although both findings were not statistically significant.

CONCLUSION: In a sample of PCPs in WA state, buprenorphine prescribers compared to non-prescribers appear more likely to screen for and directly treat HCV, yet only a minority treat HCV. Interventions are needed to enhance HCV guideline-concordant care among these and all PCPs on the frontlines of caring for persons with OUD.

PMID:40993801 | DOI:10.1186/s13722-025-00603-9

Trials. 2025 Sep 24;26(1):352. doi: 10.1186/s13063-025-09050-y.

ABSTRACT

BACKGROUND: The optimal duration of antibiotic treatment must strike a delicate balance: it must be long enough to achieve desirable efficacy yet short enough to prevent the development of toxicities, adverse events, and mitigate other arduous aspects related to patient burden. Historically, the approach used to determine duration of antibiotic treatment has been inefficient, severely impacting the refinement of therapeutics for tuberculosis (TB) where treatment duration, and its complications, can be extensive. Many of the challenges in duration-ranging have parallels and proposed solutions in the field of dose-ranging where the literature is substantially more established and where the traditions of qualitative, pairwise comparison studies have been replaced with model-based approaches. Such methods are more efficient and allow for interpolation between the doses observed.

METHODS: This work examines the utility of cutting-edge dose-finding methods (such as MCP-Mod) for duration-ranging of TB treatments. We compare the operating characteristics of the adapted model-based duration-ranging methodologies against standard qualitative methods for the purposes of estimating optimal duration and describing the duration-response relationship, using a simulation study motivated by a Multi-Arm Multi-Stage Response Over Continuous Intervention (MAMS-ROCI) clinical trial design. We explore three specific targets: (1) power to detect a duration-response relationship, (2) ability to accurately reproduce the duration-response curve, and (3) ability to estimate the optimal duration within an acceptable margin of error.

RESULTS: We find that model-based methods outperform standard qualitative comparisons on every target examined, particularly when the sample size is constrained to that of a typical Phase II trial.

CONCLUSIONS: We conclude that the success of the next era in TB therapeutics duration evaluation trials, and antibiotics duration-ranging more broadly, will meaningfully rely on the ability to simultaneously pair innovative model-based statistical methods with re-imagined study designs such as MAMS-ROCI.

PMID:40993799 | DOI:10.1186/s13063-025-09050-y

Cardiooncology. 2025 Sep 24;11(1):82. doi: 10.1186/s40959-025-00347-0.

ABSTRACT

BACKGROUND: Fruquintinib is a highly selective tyrosine kinase inhibitor that targets vascular endothelial growth factor receptors (VEGFR) 1, 2, and 3, which play a critical role in angiogenesis and tumor growth. As a novel anti-angiogenic agent, Fruquintinib has demonstrated promising efficacy in the treatment of various advanced malignancies, including metastatic colorectal cancer. However, concerns about its cardiovascular safety have emerged, given that VEGFR inhibition is often associated with cardiovascular adverse events.

METHODOLOGY: We conducted a systematic search through PubMed, Scopus, Embase, and Web of Science to identify randomized controlled trials and cohort studies that assessed the safety of Fruquintinib compared with placebo in patients with metastatic colorectal and other cancers. The evaluated outcomes included hypertension, coronary artery disease, cerebrovascular accidents, peripheral artery disease, heart failure, thromboembolism, arrhythmias, aortic dissection, and superior vena cava syndrome. Two independent reviewers screened the titles/abstracts based on predefined inclusion and exclusion criteria, followed by a full-text review of potentially relevant studies. Any disagreements between the reviewers were resolved through consultation with a third reviewer to ensure the accuracy and consistency of the study selection.

RESULTS: Fifteen reports were included in our study. Out of 3832 patients taking Fruquintinib monotherapy, a total of 997 developed hypertension with a pooled estimate incidence of 0.329 (95% CI: 0.248, 0.410; P < 0.001). In comparison to placebo, Fruquintinib was associated with significantly higher odds of developing hypertension (OR: 6.856; 95% CI: 5.071, 9.268; P < 0.001). Compared to Regorafenib, Fruquintinib demonstrated an OR of 1.549 (95% CI: 0.804, 2.983; P = 0.191) for the development of hypertension. Additionally, patients taking Fruquintinib had a pooled estimate incidence of 0.041 (95% CI: 0.021, 0.060, P < 0.001) for thromboembolism development with an OR of 2.092 (95% CI: 0.813, 5.385; P = 0.126) compared to placebo. Other reported cardiovascular side effects included sinus tachycardia, superior vena cava syndrome, peripheral edema, heart failure, myocardial enzymes elevation, and vascular access complications.

CONCLUSION: Our study found that Fruquintinib is associated with significant cardiovascular risks, with hypertension being the most common adverse event, while thromboembolism did not reach statistical significance. Therefore, close monitoring for treatment-related cardiovascular events should be considered in these patients.

PMID:40993794 | DOI:10.1186/s40959-025-00347-0

Parasit Vectors. 2025 Sep 24;18(1):378. doi: 10.1186/s13071-025-06938-1.

ABSTRACT

BACKGROUND: African animal trypanosomosis (AAT) and human African trypanosomosis (HAT) are transmitted and spread primarily by tsetse flies (Glossina spp.) in sub-Saharan Africa. The animal disease poses significant challenges to agropastoral systems, including in Kenya, where 38 out of 47 counties are infested with eight species of Glossina. Climate change and human activities can also aggravate these infestations, putting rural-scale farmers who rely on agropastoral systems at a greater risk. Geographical gaps in existing entomological datasets limit a comprehensive understanding of tsetse fly distribution across the country, especially amid rapid landscape dynamics.

METHODS: This study aimed to predict the spatial distribution of tsetse flies habitat in Kenya using recent entomological data (i.e., tsetse fly occurrence records), satellite-derived environmental variables, landscape structure, demographic indicators, and species-distribution modeling techniques. We applied four machine learning (ML) algorithms-random forest (RF), support vector machines (SVM), maximum entropy (MaxEnt), and generalized linear models (GLM)-to predict tsetse flies habitat suitability. Additionally, we developed ensemble models that combine the predictive power of the four algorithms. Predictions were made at the genus level (Glossina spp.) and the species level for one priority species (Glossina pallidipes).

RESULTS: The models performed well with true skill statistic (TSS) and area under the curve (AUC) metric measures of 0.67 and 0.88 for Glossina spp. and 0.85 and 0.96 for G. pallidipes, respectively. The predictions indicated an estimated potential suitable area of about 26% of Kenya for Glossina spp. and 9% for G. pallidipes. Tsetse fly habitat suitability was positively correlated with increased sheep density, normalized difference vegetation index, and soil moisture. However, suitability declined when the maximum land surface temperature (LST) exceeded 40 °C and elevation increased above 400 m.

CONCLUSIONS: These findings can help improve the targeting and, hence, the cost-effectiveness of surveillance and ultimately support an evidence-based progressive control of tsetse flies infestation in Kenya.

PMID:40993789 | DOI:10.1186/s13071-025-06938-1

Cancer Imaging. 2025 Sep 24;25(1):110. doi: 10.1186/s40644-025-00914-9.

ABSTRACT

BACKGROUND: In the era of therapeutic de-escalation, the opportunity to move from systematic axillary lymph node dissection (ALND) to sentinel lymph node biopsy in axillary node-positive breast cancer patients after neoadjuvant systemic therapy (NST) is currently considered. The purpose of this study was to identify FDG-PET parameters associated with axillary pathological complete response (pRAx) in the most proliferative tumor subtypes, eg Triple Negative (TN) and HER2-amplified.

METHODS: Patients with newly-diagnosed TN or HER2-amplified breast cancer, with pathologically-proven axillary node metastasis, no distant metastasis and indication of NST were prospectively included from September 2017 to December 2021. Sequential FDG-PET/CT scans were performed at baseline and after one cycle of NST. Metabolic parameters at baseline and their changes (Delta in %) of axillary nodes were assessed: SUVmax, SUVratio (SUVmax/SUVmax liver), SUVpeak, SUVmean, TLG and MTV. Logistic regressions with ROC curves were used to determine parameters associated with pRAx.

RESULTS: Sixty-one patients (24 TN, 19 ER-negative/HER2-amplified and 18 ER-positive/HER2-amplified) were recruited. Median value of Axillary SUVmax at baseline were 7.9, 7.0 and 5.2 and Delta Axillary SUVmax were -62%,-60% and -47% in these 3 subgroups, respectively. In univariate model, in the whole population, Delta Axillary SUVmax showed the greatest AUC for prediction of pRAx of 0.72 (95%CI: 0.59-0.85), whereas AUC of Axillary SUVmax at baseline was not statistically significant (AUC = 0.6 (95%CI: 0.46-0.74)). Specificity, sensitivity, PPV and NPV of Delta Axillary SUVmax were 96%, 49%, 94% and 58% respectively for predicting pRAx with a threshold of -68.7%. Odd Ratio associated with Delta Axillary SUVmax < -68.7% compared to ≥ -68.7% was 24.0 (95%CI: 2.9-194). In multivariate model, adjusted on tumor subtypes, Delta Axillary SUVmax was still significantly associated with pRAx (OR = 20.7 (95%IC: 2.5-172). AUCs adjusted on the tumor subtype were not significantly modified compared to univariate model (p = 0.45 compared to unadjusted AUC) suggesting that thresholds were not significantly different in each tumor subtype.

CONCLUSIONS: Delta Axillary SUVmax seems to be the most relevant metabolic parameter to predict an axillary pathological complete response and early metabolic response could be a valuable tool for selecting patients eligible for axillary surgical de-escalation after NST, regardless tumor subtypes.

PMID:40993786 | DOI:10.1186/s40644-025-00914-9

BMC Sports Sci Med Rehabil. 2025 Sep 24;17(1):269. doi: 10.1186/s13102-025-01285-1.

ABSTRACT

BACKGROUND: Physical preparation in basketball is essential but often limited by training time and prior focus on tactical and technical skills. While postural stability is known to assist injury prevention and performance, its specific impact on game-related performance remains unclear. With the development of motion analysis systems, the numerical values of external and internal loads measured during matches have become measurable. This study aimed to examine the relationship between postural stability and game-related performance and introduce a method for visualizing key competencies.

METHOD: Twenty-three U16 female basketball players (age = 15.22 ± 0.82 years, mass = 66.3 ± 8.85 kg, high = 174.0 ± 8.2 cm) participated from the Hungarian first league. Postural stability was assessed via plank test and one minute dynamic standing balance tests, while game-related performance was monitored through match-derived internal and external load values measured by WIMU PRO™ System, alongside statistical data derived from the official box scores. After the postural stability measurements, we monitored an official basketball match, which was conducted according to official International Basketball Association (FIBA) rules. For clear and comprehensive presentation, we combined the game-related performance indicators using Principal Component Analysis (PCA).

RESULTS: A moderate correlation (0.5 < r < 0.8, p < 0.05) was found between the game-related performance and postural stability variables. However, plank test indicators showed no significant correlations with game-related performance variables, except for bad throws (r = 0.56, p = 0.037), the postural error (PE), a variable reflecting compensatory movement during fatigue in the plank test, correlated with balance indicators (r = 0.63, p = 0.014). Mediolateral balance control correlated with explosive game-related performace metrics, including maximum acceleration (r = -0.65, p = 0.01), deceleration (r = 0.56, p = 0.035), and steals (r = -0.52, p = 0.05). PCA proved effective in creating game competency scores, enabling a graphical representation of game-related performance.

CONCLUSION: Findings suggest that trunk endurance alone was not directly related to game-related performance, while dynamic balance metrics showed moderate correlations. The PE values provide deeper insights into the balance-trunk stability relation. The dynamic balance test could support player monitoring, and the PCA based method facilitates player profiling.

PMID:40993779 | DOI:10.1186/s13102-025-01285-1