Tag: nevin manimala

Clin Oral Investig. 2025 Apr 5;29(4):223. doi: 10.1007/s00784-025-06293-6.

ABSTRACT

OBJECTIVE: This study investigates the frequency and characteristics of obsessive-compulsive (OC) symptoms and Obsessive-Compulsive Personality Disorder (OCPD) in patients with Burning Mouth Syndrome (BMS).

BACKGROUND: Obsessive-Compulsive Disorder (OCD) is a chronic condition involving intrusive thoughts (obsessions) and repetitive behaviors (compulsions), while Obsessive-Compulsive Personality Disorder (OCPD) is a personality disorder characterized by specific traits such as perfectionism, rigidity and need for control. Both conditions frequently overlap, but their prevalence in patients with BMS has never been explored.

MATERIALS AND METHODS: A total of 151 BMS patients were assessed using the Obsessive-Compulsive Inventory-Revised (OCI-R), Compulsive Personality Assessment Scale (CPAS), Visual Analog Scale (VAS), Short-Form McGill Pain Questionnaire (SF-MPQ), Hamilton Anxiety and Depression scales (HAM-A, HAM-D), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). Patients were grouped based on OCI and CPAS scores.

RESULTS: n = 123 (81.6%) of our sample were females, with a mean age of 63.19 ± 12.2 years. Clinically significant OC symptoms (OCI-R > 21) were observed in 41.7% of the sample, while 37% met OCPD criteria; both OC symptoms and OCPD were present in 24.5% of patients.

CONCLUSIONS: BMS patients show a high prevalence of OC symptoms and OCPD traits, which should be taken into account by clinicians and considered in the therapeutic approach, given that they could complicate symptom management.

CLINICAL RELEVANCE: By identifying these symptoms and traits through OCI-R and CPAS, clinicians may improve treatment strategies, in the perspective of a multidisciplinary tailored and personalized approach.

PMID:40186752 | DOI:10.1007/s00784-025-06293-6

Arch Orthop Trauma Surg. 2025 Apr 5;145(1):222. doi: 10.1007/s00402-025-05845-5.

ABSTRACT

OBJECTIVE: The aim of this study compare the effectiveness of the space between the popliteal artery and the posterior knee capsule (iPACK) and posterior capsule injection (PCI) in patients with primary end stage knee osteoarthritis treated with total knee arthroplasty (TKA).

METHODS: This was a double-blind, prospective, randomised trial. A total of 195 participants were randomly assigned to one of three groups: Group 1 with an adductor canal block (ACB) plus iPACK. Group 2 with ACB + PCI and a final control group with ACB only. All participants underwent primary total knee arthroplasty. Outcome measures comprised pain assessment using the Visual Analog Scale (VAS) and monitoring opioid analgesic consumption. VAS measurements were taken at the 1st, 6th, 12th, 24th, 48th, and 72nd hours, followed by the 10th day and the 12th week.

RESULTS: Age, sex, BMI and side of surgery were analyzed and no significant differences were found. Groups ACB + iPACK and ACB + PCI exhibited significantly lower VAS scores compared to the control group at 3, 6, and 12 h after surgery, with group ACB + iPACK showing the lowest VAS scores among all groups. No significant difference in VAS values between groups was detected after 24 h postoperatively and after that. Significant differences were observed between groups in opioid consumption. The values for the first hour, first day, second day, and total consumption exhibited statistically significant differences between the groups.

CONCLUSION: Our study has shown that PCI in combination with ACB is not inferior to the iPACK technique. It is our belief that these combination techniques can be used in accordance with the surgeon’s experience and preference. It is important to remember that PCI is quicker and easier to perform without using ultrasonography.

PMID:40186749 | DOI:10.1007/s00402-025-05845-5

MAGMA. 2025 Apr 5. doi: 10.1007/s10334-025-01226-6. Online ahead of print.

ABSTRACT

In quantitative susceptibility mapping (QSM), it is impossible to define an absolute reference for the reconstructed susceptibility values. Therefore, it has been suggested to use a relative reference, such as the mean susceptibility within an anatomical ROI. We investigated the theoretical basis of referencing, and what impact it may have on statistical ROI comparisons, particularly for clinical applications. We analysed a clinical epilepsy study and in-silico QSM reconstruction challenge data with various reference regions. The results are analysed as in a clinical study and resulting statistical variations are investigated from a theoretical point of view. We found that referencing has an impact on the significance of clinical findings. These effects may arise from a change in the precision of test statistics due to referencing. We also show potential biasing of results from referencing. Our findings suggest there may not be one “optimal” reference region, and care should always be taken with reference region selection depending on the specific pathology or cohort under investigation. Not explicitly referencing is less likely to lead to false positives than cherry picking a reference region to maximize statistically significant results. We encourage results to be published with their reference to facilitate future comparisons of datasets from different sources.

PMID:40186727 | DOI:10.1007/s10334-025-01226-6

Cogn Process. 2025 Apr 5. doi: 10.1007/s10339-025-01265-w. Online ahead of print.

ABSTRACT

Cognitive sex differences are shaped by hormone effects on brain development, organisation, structure, function, and ageing. In human speech and language, sex differences and hormone effects are typically studied in the form of performance-based differences (via measures of central tendency) with little attention given to underlying cognitive strategy. This study presents data from 126 healthy adults, aged 20-79 years, from three studies of letter based verbal fluency. Comparisons were conducted based on sex, menstrual cycle phase, and menopause stage to examine total words produced, plus switching and clustering strategy use. The investigation probed differences in performance, underlying cognitive strategies, and correlations between performance and strategy. For performance, there were no statistically significant sex or menopause group differences in total words, number of switches and cluster size. Menstrual cycle differences were significant for switches and cluster size, but not total words. However, there were large effect sizes for correlations between total word performance and strategy measures in some groups; these correlations formed patterns which differed as a function of sex, menstrual cycle phase, and menopausal stage. Words produced were highly correlated with switching in younger women at higher hormone menstrual cycle phases. Correlations between total words and both strategies were moderate and equivalent in older premenopausal and perimenopausal women. Postmenopausal women showed a pattern of higher correlation between total words and cluster size which was observed in younger women at the lower hormone cycle phase, and men. This study illustrates the impact of hormones and sex differences on strategy use in verbal fluency-underscoring the value of comparisons in strategy use between women at different reproductive life stages.

PMID:40186722 | DOI:10.1007/s10339-025-01265-w

Am J Speech Lang Pathol. 2025 Apr 4:1-37. doi: 10.1044/2025_AJSLP-24-00298. Online ahead of print.

ABSTRACT

PURPOSE: Although approximately 40% of school-based speech-language pathologists (SLPs) regularly serve Deaf and hard of hearing (DHH) students, at present, there are no agreed-upon standards specifying the minimum qualifications and best practices for working with this population, especially those who use signed language. The goal of the present study is to establish expert consensus on recommended clinical training and practice for SLPs working with signing DHH children.

METHOD: Experts in fields related to speech-language pathology and deaf education (N = 30, 16 DHH) participated in three rounds of a classical e-Delphi study. In Round 1, experts responded to open-ended questions about the role of SLPs working with DHH children who sign. In Rounds 2 and 3, experts rated their agreement with statements generated by fellow experts in Round 1.

RESULTS: A mixed-method design included qualitative content analysis (Round 1) and quantitative descriptive statistics (Rounds 2 and 3). Experts rated a total of 185 items in Round 2 and 186 items in Round 3. Consensus (at least 70% agreement) was met for 158 statements, with recommendations for SLPs’ knowledge, attitudes, and practices. Consensus was not achieved for 28 items, including the level of American Sign Language proficiency required for SLPs.

CONCLUSIONS: This study is the first to elicit input from a panel of experts seeking to establish professional standards for SLPs who work with signing DHH children. These findings contribute to the movement toward more inclusive and culturally responsive clinical practice and can inform educational standards and policy for SLPs. Future research is needed to determine whether practicing SLPs meet these recommended standards and how clinical training can support growth for standards that are not currently being met.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.28665218.

PMID:40184609 | DOI:10.1044/2025_AJSLP-24-00298

J Am Acad Orthop Surg Glob Res Rev. 2025 Mar 25;9(4). doi: 10.5435/JAAOSGlobal-D-25-00032. eCollection 2025 Apr 1.

ABSTRACT

INTRODUCTION: Surgical treatment of metacarpophalangeal (MCP) joint hyperextension in the treatment of thumb basal joint arthritis can be categorized as motion preserving and arthrodesis. We compared minimum 2-year results between nonsurgical thumbs and thumbs undergoing ligament reconstruction with tendon interposition (LRTI) alone, thumb MCP arthrodesis, and volar plate capsulodesis as adjunct procedures to LRTI.

METHODS: Single surgeon patients with thumb MCP hyperextension >30° underwent arthrodesis or volar plate capsulodesis with LRTI. Thirty-one LRTI thumbs were compared with 22 LRTI with arthrodesis (LRTI + A), 21 LRTI with MCP capsulodesis (LRTI + C), and 65 nonsurgical controls. Patient-reported outcome measures were recorded with grip strength, tip pinch, lateral pinch, opposition, and pre-/postoperative hyperextension measured by one of the authors.

RESULTS: No difference was found in Michigan Hand Questionnaire scores (P = 0.13), QuickDASH values (P = 0.38), or visual analog scale results (P = 0.86). No difference was observed in grip strength (P = 0.97) or tip pinch (P = 0.66). Lateral pinch was decreased between LRTI and nonsurgical thumbs but not when compared with groups with adjunct MCP procedures (P = 0.0064). LRTI + A had the least opposition (P < 0.001). In the LRTI + C group, MCP hyperextension worsened in two patients (9%) and 14 of 22 (63%) had postoperative values equal or greater than 30°.

DISCUSSION AND CONCLUSION: Our LRTI + C cohort experienced persistent MCP hyperextension, with mean postoperative hyperextension of >30°. Despite the literature suggesting that this portends inferior outcomes, our LRTI + C cohort demonstrated near-equal outcomes when compared with the LRTI, LRTI + A, and control groups. We no longer perform capsulodesis for MCP hyperextension and offer arthrodesis for MCP arthrosis or hyperextension not actively correctable by the patient.

PMID:40184604 | DOI:10.5435/JAAOSGlobal-D-25-00032

Neurology. 2025 May 13;104(9):e213560. doi: 10.1212/WNL.0000000000213560. Epub 2025 Apr 4.

ABSTRACT

BACKGROUND AND OBJECTIVES: Poor long-term blood pressure (BP) control due to undertreatment of hypertension is not uncommon after intracerebral hemorrhage (ICH). It heightens the risk of ICH recurrence and subsequent stroke, which is the highest within the first year. Promptly achieving BP targets would significantly reduce these risks. To accomplish this, upfront triple antihypertensive medications could be prescribed soon after ICH because many ICH survivors require ≥3 antihypertensives. However, not all would suit this approach, particularly those with cerebral amyloid angiopathy (CAA), where elevated admission BP may be due to acute hypertensive response rather than underlying hypertension. In addition, overtreatment and excessive BP lowering would cause more side effects and have been associated with increased mortality in older patients. Hence, to facilitate individualized treatment, we aimed to develop a score (TRICH) to predict the need for ≥3 antihypertensives at 3 months after ICH.

METHODS: We developed the score using data from the University of Hong Kong prospective ICH registry (2011-2022) and validated it in 3 hospitals (2020-2022) locally. Consecutive patients with spontaneous ICH who survived >90 days and had follow-up BP 3 months after ICH were included. Predictors for needing ≥3 antihypertensive medications at 3 months were identified using multivariate logistic regression, and the score was created using the β-coefficients.

RESULTS: The TRICH score was developed from 462 patients (mean age 66.6 ± 14.3 years, 60% male) and validated in 203 patients (mean age 66.3 ± 14.6 years, 62% male). The 9-point score (age younger than 60 years = 1, male = 1, ischemic heart disease = 1, admission estimated glomerular filtration rate <60 mL/min/1.73 m² = 2, admission systolic BP 190-230 mm Hg = 2 while >230 mm Hg = 4) has a c-statistic (95% CI) of 0.79 (0.75-0.83) in the development cohort and 0.76 (0.69-0.82) in validation. A dichotomized score (≥3 points) predicted the need for ≥3 antihypertensives with 0.73 (95% CI 0.67-0.80) sensitivity and 0.76 (95% CI 0.70-0.81) specificity. The score performed better in patients with untreated/uncontrolled hypertension before ICH than in controlled patients (c-statistic [95% CI] 0.81 [0.77-0.86] vs 0.74 [0.69-0.80], p = 0.037) but showed no difference between patients with CAA and non-CAA patients.

DISCUSSION: The TRICH score identifies patients with ICH who need ≥3 antihypertensive medications 3 months after ICH with good discrimination ability. It may guide upfront triple antihypertensive prescription, but further research is warranted, particularly in non-Han Chinese populations.

PMID:40184593 | DOI:10.1212/WNL.0000000000213560

Retina. 2025 Apr 2. doi: 10.1097/IAE.0000000000004477. Online ahead of print.

ABSTRACT

PURPOSE: To report the 5-year outcomes of intravitreal aflibercept in patients with macular edema due to central retinal vein occlusion(CRVO).

METHODS: Participants in this study were 51 treatment naïve patients with macular edema due to CRVO, who received intravitreal aflibercept 2.0mg using a treat-and-extend regimen after a loading dose of three-monthly injections. The primary outcomes were the mean change in best-corrected visual acuity(BCVA) and central subfield thickness(CST) at month 60 compared to baseline.

RESULTS: At month 60, there was a statistically significant improvement in BCVA with a mean change of 11.5 letters compared to baseline(p<0.001). 19.6% of patients gained ≥15 ETDRS letters compared to baseline. Accordingly, at month 60, there was a statistically significant reduction in CST of about 195 μm compared to baseline(p<0.001). The mean number of injections at month 60 was 23.7. At month 60, about 50% of patients were found to have “good” treatment response, which was associated with ellipsoid zone integrity and the absence of hyperreflective foci on optical coherence tomography. It is worthy to note that 60.8% of patients achieved treatment interval of ≥8 weeks, while 31.4% of patients ≥12 weeks. Factors associated with an extended treatment interval was intact ellipsoid zone, lower baseline CST and the absence of disorganization of inner retinal layers.

CONCLUSIONS: At the 5-year follow-up, intravitreal aflibercept showed a mean gain of 11.5 letters in BCVA with an average of 23.7 injections. 31.4% of patients achieved a treatment interval of ≥12 weeks, while about half of patients showed good treatment response.

PMID:40184581 | DOI:10.1097/IAE.0000000000004477

JCO Glob Oncol. 2025 Apr;11:e2400212. doi: 10.1200/GO.24.00212. Epub 2025 Apr 4.

ABSTRACT

PURPOSE: Although lung cancer is a major cause of cancer incidence and mortality worldwide, lung cancer studies in sub-Saharan Africa are scarce. Here, we present outputs from a designated lung cancer program in western Kenya, part of the Multi-National Lung Cancer Control Program, which focused on case finding, diagnosis, and treatment.

METHODS: We retrospectively reviewed patients with pathologically confirmed non-small cell lung cancer (NSCLC) enrolled in this program at Moi Teaching and Referral Hospital from January 2018 to December 2022. Clinical data were analyzed using descriptive statistics, Kaplan-Meier methods, and proportional hazards regression model.

RESULTS: Two hundred forty-nine patients diagnosed with NSCLC were included with a median age at diagnosis of 61 (IQR, 52-70) years. Most patients were married (n = 177; 71%) and nonsmokers (n = 177; 71%) with 58 (23%) having received tuberculosis treatment and 93 (37%) having Eastern Cooperative Oncology Group (ECOG) performance status (PS) of ≥2. At diagnosis, adenocarcinoma was the prominent histology (n = 187; 75%) along with clinical stage IV (n = 195; 78% stage IV) or unstaged (n = 40; 16%) disease. Most patients received chemotherapy and radiotherapy (n = 176; 71%) with few palliative care referrals (n = 2; 0.8%). The median overall survival (OS) was only 3.7 months (IQR, 2.7-5.4). ECOG PS (3 or 4) and being unstaged were predictors of poor 1-year OS.

CONCLUSION: Patients with NSCLC enrolled in this program presented with advanced disease and poor survival. Despite a designated case finding effort, late diagnosis remained common and highlights a need for locally relevant interventions targeting community and provider education as well as innovative diagnostics that can improve early recognition of lung cancer. These interventions must also be paired with access to proven treatments including molecular therapies and palliative care which can extend lung cancer survival.

PMID:40184569 | DOI:10.1200/GO.24.00212