Tag: nevin manimala

Global Spine J. 2025 Dec 20:21925682251409696. doi: 10.1177/21925682251409696. Online ahead of print.

ABSTRACT

Study DesignRetrospective cohort study.ObjectivesPrior studies have shown that adult spinal deformity (ASD) patients undergoing revision surgery due to mechanical complications had less radiographic improvement and worsening patient-reported outcomes scores. The combination of customized 3D planning and personalized implants has been shown to contribute to improved achievement of alignment goals. This study aimed to determine whether such improved correction also results in a correspondingly lower revision surgery rate due to mechanical complications.MethodsPre- and postoperative radiographic alignment measures, including lumbar lordosis (LL), distal lumbar lordosis (DLL), pelvic incidence (PI) – LL mismatch, and L1 pelvic angle (L1PA), as well as data on mechanical complications leading to reoperation were collected on 115 ASD patients with personalized interbody implants and minimum 2-year follow-up. This cohort was statistically compared to a multicenter dataset (ISSG) of 997 ASD patients treated using stock devices and using the same reoperation classifications.ResultsPostoperatively achieved alignment measures correlated significantly with their respective preoperative alignment goals, with the following average offsets from plan: 2.4° LL, -0.2° DLL, -2.4° PI-LL, 0.3° L1PA. Compared to the ISSG cohort that utilized stock interbody implants, the cohort utilizing 3D preoperative planning and personalized interbody implants resulted in significantly fewer revisions for mechanical complications up to 2 years postoperatively: 5/115 (4.3%) vs 166/997 (16.6%), P < 0.001.ConclusionsThese findings suggest that achieving planned alignment targets with personalized interbody devices is associated with reduced revision surgery for mechanical complications, a result which may have positive implications for improved patient outcomes and reduced cost.

PMID:41420413 | DOI:10.1177/21925682251409696

Clin Otolaryngol. 2025 Dec 20. doi: 10.1111/coa.70076. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the effects and morbidities associated with perioperatively administered analgesics in paediatric patients undergoing tonsillectomy.

DESIGN AND SETTING: Systematic review and network meta-analysis (NMA) of randomised controlled trials.

PARTICIPANTS: Paediatric patients undergoing tonsillectomy.

MAIN OUTCOME MEASURES: The treatment networks included five interventions (paracetamol, paracetamol with opioids, ibuprofen, ketorolac or opioids) and a control group (placebo or saline). The outcomes measured were the incidence of postoperative bleeding (any event and those requiring surgical intervention), postoperative nausea and vomiting (PONV) and the frequency of analgesic intake. Both pairwise analysis and NMA were utilised to assess the data.

RESULTS: No treatments induced significant postoperative bleeding compared with the control. Paracetamol, ibuprofen and ketorolac tended to decrease the incidence of PONV. Only ibuprofen significantly reduced the need for analgesics (odds ratio = 0.32, 95% confidence interval = 0.11-0.91, p < 0.05). All other comparisons showed trends but lacked statistical significance, as their confidence intervals included 1.0. The ranking hierarchy revealed that ketorolac ranked the lowest in postoperative bleeding but first in the incidence of PONV. Paracetamol ranked second in postoperative bleeding, PONV, and need for analgesics.

CONCLUSION: While ibuprofen appeared to be the most effective in managing postoperative pain, paracetamol showed favourable trends in reducing postoperative bleeding, PONV, and the need for additional analgesics. Ketorolac tended to be associated with a lower incidence of PONV but showed a tendency toward a higher incidence of postoperative bleeding. However, further well-designed, standardised studies would be needed to confirm these conclusions.

PMID:41420409 | DOI:10.1111/coa.70076

Int J Gynaecol Obstet. 2025 Dec 20. doi: 10.1002/ijgo.70750. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the rate of pharmacological treatment failure in early pregnancy loss, assess post-treatment residua thickness as a predictor of retained products of conception (RPOC), identify a clinically relevant cutoff, and evaluate additional clinical and sonographic predictors.

METHODS: This retrospective cohort study was conducted at a tertiary medical center and included patients treated with mifepristone-misoprostol for first-trimester pregnancy loss between January 2019 and January 2022. Treatment success was assessed via transvaginal ultrasound, with residua thickness measured 14 days post-treatment. The primary outcome was failure, defined as histologically confirmed RPOC following hysteroscopy. Secondary analyses evaluated clinical and sonographic predictors, focusing on post-treatment residual thickness. Statistical analysis included receiver operating characteristic (ROC) curve assessment and multivariable logistic regression.

RESULTS: Of the 717 patients included, 537 (74.9%) achieved successful medical management without further intervention, while 180 (25.1%) required intervention. Treatment failure was associated with greater post-treatment residua thickness (mean 19.1 ± 9.1 mm vs. 10.4 ± 6.7 mm, P < 0.001). Residua thickness was an independent predictor of failure (adjusted odds ratio [aOR] 1.17, 95% confidence interval [CI]: 1.13-1.21, P < 0.001). ROC analysis identified an optimal cutoff of 14.9 mm, yielding 70% sensitivity and 81% specificity (area under the curve [AUC]: 0.835, 95% CI: 0.80-0.87) for predicting the need for surgical intervention.

CONCLUSION: Post-treatment residual thickness is a significant predictor of pharmacological treatment failure in early pregnancy loss, with a clinically relevant cutoff of approximately 15 mm. Histologic validation provides a promising framework for refining management protocols, emphasizing the need for further studies to establish robust predictive criteria.

PMID:41420407 | DOI:10.1002/ijgo.70750

Physiol Rep. 2025 Dec;13(24):e70704. doi: 10.14814/phy2.70704.

ABSTRACT

The microcirculation comprises small vessel networks that regulate blood perfusion within tissues. The relationship between tissue shape or size and its microvascular properties is not yet clear. This study develops an algorithm for computationally simulating branching arteriolar networks within ellipsoidal tissue volumes, including user-adjustable parameters (e.g., tissue width-length-height dimensions and microvessel density) for application within different rodent skeletal muscles. The algorithm is developed using principles from constrained constructive optimization, an iterative network generation framework based on proposed mechanisms of vascular growth. Networks generated within muscles of varying shapes and sizes were analyzed over a range of geometric (e.g., mean diameter, length, and number of bifurcations per Strahler’s and centrifugal order, fractal dimension) and hemodynamic (e.g., Murray’s law exponent, hematocrit) properties. Statistical similarity was observed across different skeletal muscle tissues, with differences due to tissue shape being observed only above a vessel diameter threshold of ~25 μm (varying at large or small tissue volumes at the scale m³ or mm³). The algorithm was comprehensively validated against in vivo data using different modeling approaches (whole tissue vs. subsection simulations). The algorithm’s accuracy and adaptability support a wide range of research objectives and contributes to advancing current understanding of perfusion distribution in healthy tissue.

PMID:41420392 | DOI:10.14814/phy2.70704

J Pharm Pract. 2025 Dec 19:8971900251408312. doi: 10.1177/08971900251408312. Online ahead of print.

ABSTRACT

Introduction: Heart failure is a leading cause of morbidity and mortality worldwide. Literature suggests that the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors can be beneficial to decrease hospitalizations and cardiac mortality in patients with heart failure with an ejection fraction >40%. Research Question: This study assessed the impact of a pharmacist monitoring program on the use of SGLT2 inhibitors for patients hospitalized with heart failure with an ejection fraction >40%, accounting for documented reasons for not prescribing. Study Design: This was a single-center, retrospective, pre/post interventional study. The pre-intervention cohort was assessed for usage prior to initiation of the pharmacist monitoring program, whereas the post-intervention group was assessed after initiation. Methods: Hospitalized patients were identified retrospectively through a report of intravenous diuretic use on the cardiology floor in conjunction with a documented diagnosis of heart failure and ejection fraction >40%. Data Analysis: Data was assessed via Chi-squared or student’s t-test for comparison between the pre-intervention and post-intervention groups. Results: There was a statistically significant increase in documented appropriate use of SGLT2 inhibitors after implementation of pharmacist monitoring program (40.9% pre-intervention vs 62.7% post-intervention, P = <0.001). The most common reasons they were held was due to risk of infection and renal dysfunction. Conclusion: Implementation of a pharmacist monitoring program was associated with an increase in utilization of SGLT2 inhibitors in eligible patients, driven by an increase in documentation. There was an increase in prescribing in patients that were eligible for the medication.

PMID:41420391 | DOI:10.1177/08971900251408312

J Cosmet Dermatol. 2025 Dec;24(12):e70623. doi: 10.1111/jocd.70623.

ABSTRACT

BACKGROUND: Oxidative stress on the skin can exacerbate undesirable skin conditions and promote skin aging. It is unclear how consumers of skincare products recognize, perceive, and describe oxidation effects in skin. It is also unclear what they perceive to be the solution for oxidation in the skin.

AIMS: To determine which facial skin qualities consumers associate with oxidation, and to determine skincare product qualities that consumers associate with anti-oxidation.

METHODS: Focus group discussions (FGDs) with 24 female volunteers (aged 25-50 years), and an online survey with 800 female volunteers (aged 20-50 years), were conducted across four Chinese cities (Shanghai, Beijing, Chengdu, and Xi’an) in September 2024. Females of all skin types who regularly used skincare products were eligible to participate. Total unduplicated reach and frequency (TURF) and principal component analyses (PCA) were performed on data collected from the online surveys.

RESULTS: Consumers mainly associated oxidation-related skin effects with the skincare descriptive categories “repair,” “firming,” and “skin and spot lightening.” Consumers who had skin oxidation concerns made a stronger association with “skin and spot lightening” than those who did not have oxidation concerns. TURF analysis found skincare products with the descriptive categories “repair” and “skin and spot lightening” can reach 73% of the surveyed female skincare consumer population.

CONCLUSION: Participants associated antioxidant effects with facial skin repair and spot lightening. These associations are stronger for participants who have skin aging concerns. Skincare products that can promote skin repair and lightening are estimated to reach 73% of the female skincare consumers similar to the study participants.

PMID:41420387 | DOI:10.1111/jocd.70623

Physiol Rep. 2025 Dec;13(24):e70683. doi: 10.14814/phy2.70683.

ABSTRACT

To compile and statistically summarize quantitative evidence on the acute effects of resistance training sessions on muscle glycogen concentration, a systematic search was conducted on Pubmed, Web of Science, and Scopus databases up to 28th July 2024. Twenty studies including 168 male and 12 female participants were eligible. A multilevel, random-effects meta-analysis was used to calculate the overall mean difference (MD) with a 95% confidence interval (CI) and prediction interval (PI). The model (28 effect sizes across 20 clusters) revealed a significant glycogen decrease (MD = -104.3; 95% CI: -137.6 to -71.0; PI: -244.4 to 35.7; p < 0.001). Meta-regression showed greater depletion with more sets (Estimate = -11.2; 95% CI: -18.0 to -4.3; p = 0.001) and longer session duration (Estimate = -1.3; 95% CI: -2.3 to -0.3; p = 0.009), but less with higher intensity (Estimate = 2.88; 95% CI: 1.2 to 4.5; p = 0.0006). Subgroup analysis showed greater depletion with varied intensity (MD = -162.9) versus fixed (MD = -82.5), and in untrained (MD = -113.0) versus trained participants (MD = -101.3). A single resistance training session depletes glycogen in the vastus lateralis muscle, with depletion influenced by training intensity, session duration, number of sets within session and training status.

PMID:41420384 | DOI:10.14814/phy2.70683

Rural Remote Health. 2025 Dec;25(4):9867. doi: 10.22605/RRH9867. Epub 2025 Dec 17.

ABSTRACT

INTRODUCTION: Sexually transmissible infection (STI) rates continue to rise across Australian rural and regional areas. Reported STI rates are often misleadingly low due to barriers in accessing testing, lack of service accessibility and affordability. Utilising innovative solutions such as vending machines can improve access by providing an alternative testing option that increases privacy and convenience.

METHODS: Community reference groups were assembled to support an STI test vending machine pilot (STI-X) for 12 months across six planned and two temporary regional locations in northern Victoria, Australia. The vending machines were generally situated in publicly accessible areas where consumers could obtain a test kit for chlamydia, gonorrhoea and HIV, complete the specimen collection in a private setting and then post the kit to a laboratory.

RESULTS: STI-X was deemed an acceptable solution for increasing access to specialist sexual health testing. Professionals were supportive of the additional option for individuals who may not use standard healthcare pathways. They identified that the vending machines were easy to use; however, better communication was needed to enhance uptake. Therefore, utilising community-driven promotional approaches, such as word of mouth, are necessary to ensure that information on novel health initiatives reaches the intended audiences.

CONCLUSION: STI testing vending machines have proved feasible and acceptable to professionals and users in rural and regional Australian communities. This technology would benefit from future research specifically in rural communities to determine whether priority populations will increase their STI testing. Policymakers should encourage innovative solutions in rural communities to combat growing workforce concerns.

PMID:41420381 | DOI:10.22605/RRH9867

OTJR (Thorofare N J). 2025 Dec 19:15394492251395673. doi: 10.1177/15394492251395673. Online ahead of print.

ABSTRACT

The Raising Families Project delivered three, 12-week cohorts of interprofessional services alongside graduate student training, where weekly evaluation surveys provided formative data. This article examines quality improvement via ongoing formative program evaluation. The purpose of the current study was to gather and analyze Raising Families Project participant feedback relating to program delivery logistics, to improve ongoing and future program delivery and quality. A total of 347 weekly evaluation surveys were collected from caregivers (n = 37), students (n = 35), and clinicians (n = 7). Descriptive statistics and reflexive thematic analysis were utilized to analyze survey data. Five themes were developed related to quality improvement, namely immediate vs. sustained adjustments, logistical enhancements, challenging flexibility, collaborative benefits/varied meaning, revealing complexity of participants’ preferences, alongside iterative improvements resulting from feedback. Findings suggest the need to include formative evaluation, to embed the caregiver/family in interprofessional approaches, and to consider individuals’ needs in practice.

PMID:41420367 | DOI:10.1177/15394492251395673

Iran Biomed J. 2025 Nov 1;29(6). doi: 10.61882/ibj.5018.

ABSTRACT

BACKGROUND: Accurate detection of actionable EGFR mutations is essential for guiding targeted therapy in NSCLC. Liquid biopsy approaches using ctDNA and exoDNA offer noninvasive alternatives for molecular profiling. This study evaluated the diagnostic performance of nested PCR combined with sanger sequencing for detecting common EGFR mutations (exon 19 deletions and the L858R point mutation) in plasma samples from Iranian NSCLC patients.

METHODS: In this retrospective observational study, blood samples were collected from 30 NSCLC patients with confirmed EGFR mutations. ctDNA was extracted from plasma and analyzed using nested PCR followed by sanger sequencing. Specificity was assessed in 20 EGFR-wild type NSCLC patients serving as controls. Diagnostic performance was further evaluated in relation to clinicopathological factors.

RESULTS: EGFR mutations were detected in plasma ctDNA in 63.3% of patients. Detection sensitivity was significantly associated with tumor stage but was independent of mutation subtype, age, sex, or smoking status. The assay showed high specificity, with no false positive results in control samples (95% CI: 83.9-100.0%). Although exoDNA analysis demonstrated a higher sensitivity than ctDNA (76.6% vs. 63.3%), this difference was not statistically significant. Notably, combined analysis of ctDNA and exoDNA increased overall detection sensitivity to 80%.

CONCLUSIONS: Nested PCR with sanger sequencing represents a reliable rule in strategy for EGFR mutation detection in plasma. Integrating ctDNA and exoDNA analyses substantially improves sensitivity and may enhance noninvasive molecular diagnostics in NSCLC.

PMID:41420326 | DOI:10.61882/ibj.5018