Tag: nevin manimala

J Card Fail. 2025 Jan;31(1):178-179. doi: 10.1016/j.cardfail.2024.12.005.

ABSTRACT

Cardiology providers and healthcare clinicians tackling heart failure (HF) face an escalating challenge: rising prevalence rates and widening disparities among populations. In this context, leveraging up-to-date and specialized data becomes paramount. Although the American Heart Association’s (AHA) Heart and Stroke Statistics provides a sweeping overview of cardiovascular health with a few pages dedicated to HF and cardiomyopathy, the Heart Failure Society of America’s (HFSA) HF Stats annual publication offers an up-to-date and in-depth look at multiple themes related to HF epidemiology, global trends, outcomes and much more. This article highlights the unique benefits of HF Stats, why providers and clinicians should want to utilize the report and its dedicated website, HFStats.org, and how the report contents can enhance clinical practice, research, and patient care.

PMID:39818425 | DOI:10.1016/j.cardfail.2024.12.005

Vet J. 2025 Jan 14:106301. doi: 10.1016/j.tvjl.2025.106301. Online ahead of print.

ABSTRACT

Canine mammary tumors (CMTs) are common tumors in female dogs (FDs), and at least nearly half of these lesions of malignant. We examined the epidemiology of CMTs in Japan using excisional biopsy cases (n = 7,802) collected from 2005 to 2023 in the Kyushu-Okinawa region. We investigated the prevalence, effects of breed, neutering, and age on CMT and malignant CMT (mCMT) risk through general statistics and multivariate analyses. The distribution of CMT histological types was also compared among different breeds and mixed breeds. In the Cohort (n = 6,197) consisting of cases from primary veterinary hospitals, the numbers of CMT and mCMT cases (2,928 and 822 cases, respectively) and the adjusted prevalence is ranged 4.76-8.09 per 1,000 dogs and increasing over time (P < 0.001). A multivariate model identified breeds with high or low risks of CMT or mCMT. Neutered FDs had lower risk of CMT than intact FDs (risk ratio = 0.57, 95%CI: 0.53-0.61). Compared to the age with the highest incidence, those aged ≥8 and ≥14 years had comparable rates of CMT and mCMT, respectively. Certain breeds exhibited biases regarding CMT histological types compared to mixed breeds. This first epidemiological analysis of CMT in Japan will be a valuable resource for CMT control.

PMID:39818359 | DOI:10.1016/j.tvjl.2025.106301

Environ Res. 2025 Jan 14:120860. doi: 10.1016/j.envres.2025.120860. Online ahead of print.

ABSTRACT

The growing impact of climate change and escalating wildfire seasons has led to heightened ambient air pollution, potentially affecting children’s sleep health. However, current epidemiological research often relies on outdoor weather data to model the environmental impacts on sleep health, potentially mischaracterizing the actual bedroom environment. To address these challenges, we conducted experiments to investigate the relationships among ambient, indoor, and personal exposure to PM_2.5 concentrations and obstructive sleep apnea (OSA) in children. We employed computational fluid dynamics (CFD) simulations to assess how personal exposures are influenced by factors such as air distribution design, supply air temperature (T_sa), body shape, and sleep position. Our statistical analysis revealed notable associations between OSA severity as measured by obstructive apnea-hypopnea index (OAHI) and indoor PM_2.5 concentrations (β: 11.52; 95% CI: 5.07 to 17.96; p < 0.01) and personal PM_2.5 exposures (β: 18.92; 95% CI: 9.80 to 28.04; p < 0.001), with personal exposure demonstrating a stronger relationship. Our findings highlighted the critical role of T_sa and body shape in exacerbating personal exposure, as they could modify the bedding microenvironment around children’s breathing zone during sleep. We assessed the effect of air filtration interventions on mitigating personal PM_2.5 exposure and modulating OSA severity in children. Higher air filter efficiencies such as MERV14 or above can modulate severe OSA for more than 80% of the year. However, during wildfire episodes, because air filtration interventions alone may be insufficient, comprehensive strategies, including the potential use of air cleaners and personal protective equipment (PPE), are necessary to ensure children’s health. Our research demonstrated that quantifying personal exposure is a more informative predictor than solely relying on ambient or indoor measures for estimating OSA in children.

PMID:39818351 | DOI:10.1016/j.envres.2025.120860

J Steroid Biochem Mol Biol. 2025 Jan 14:106677. doi: 10.1016/j.jsbmb.2025.106677. Online ahead of print.

ABSTRACT

Vitiligo is a common chronic skin depigmentation disorder that seriously decreases the patients’ overall quality of life. Human blood metabolites could contribute to unraveling the underlying biological mechanisms of vitiligo. We used GWAS summary statistics to assess the causal association between genetically predicted 1,400 serum metabolites and vitiligo risk by Mendelian randomization (MR). Then, after constructing the mouse model of vitiligo, we did non-targeted metabolomics analysis on the mouse serum and validated MR’s pathway enrichment results ulteriorly. In the initial phase, MR analysis revealed causative associations between 36 metabolites and vitiligo risk, including 8 metabolite ratios and 28 individual metabolites (19 known and 9 unknown metabolites). In the validation stage, 7 metabolites were successfully validated. Of the 28 individual metabolites, most are related to lipid metabolism. Genetically predicted higher 4-oxo-retinoic acid showed the strongest protective effect on vitiligo, while the most potent risk effect was the increase in quinate. The metabolites associated with vitiligo risk are mainly enriched in alpha-linolenic acid metabolism, linoleic acid metabolism, arginine biosynthesis and metabolism pathways, validated through the serum metabolomics of vitiligo mouse. By integrating genomics and metabolomics, this study provides new insights into the association between metabolites and vitiligo, highlighting the potential roles of specific metabolites in the pathogenesis of vitiligo. These metabolites associated with vitiligo could serve as new biomarkers, further research could help to reveal how these metabolites influence specific pathways in the development of vitiligo.

PMID:39818343 | DOI:10.1016/j.jsbmb.2025.106677

J Affect Disord. 2025 Jan 14:S0165-0327(25)00082-5. doi: 10.1016/j.jad.2025.01.065. Online ahead of print.

ABSTRACT

BACKGROUND: A knowledge gap exists in understanding the role of social isolation as a determinant of mental health among hybrid employees during the COVID-19 era.

METHODS: Using 2024 Household Pulse Survey data, we investigated the relationship between social isolation and mental health among US hybrid employees. We assessed depression symptoms using the Patient Health Questionnaire-2 and anxiety symptoms using the Generalized Anxiety Disorder-2. Social isolation was assessed using five items adapted from the Berkman-Syme Social Network Index. Covariates included age, race/ethnicity, gender identity, educational attainment, employment sector, household income, marital status, number of children, number of remote workdays, and region. Weighted multivariable logistic regression models estimated the adjusted associations between social isolation and mental health.

RESULTS: Compared to those in the less than once a week group, those who had a phone call with family, friends, or neighbors at frequencies of 1-2, 3-4, or 5+ times per week were significantly less likely to experience depression and anxiety symptoms. We observed similar statistically significant patterns when modeling each mental health outcome with weekly frequencies of social gatherings with friends or relatives, annual frequencies of church or religious service attendance, and annual frequencies of club or organization meeting attendance.

LIMITATIONS: Observed associations do not establish causality.

CONCLUSIONS: More frequent interpersonal communication, social gatherings, and attendance at organization meetings were significantly associated with better mental health. This empirical evidence provides meaningful insights for stakeholders, such as employers, human resources departments, psychiatrists, and hybrid employees.

PMID:39818332 | DOI:10.1016/j.jad.2025.01.065

J Vasc Surg Venous Lymphat Disord. 2025 Jan 14:102167. doi: 10.1016/j.jvsv.2025.102167. Online ahead of print.

ABSTRACT

OBJECTIVE: This study sought to investigate the changes in plasma D-dimer levels during catheter-directed thrombolysis (CDT) in patients with acute lower extremity deep venous thrombosis (DVT), analyze imaging results, and assess their clinical implications.

METHODS: We retrospectively analyzed 62 patients diagnosed with acute lower extremity DVT who underwent CDT between March 2019 and December 2022. Plasma D-dimer levels were measured before CDT, at regular intervals after CDT, and at the end of CDT. Lower limb venography was performed every two days during CDT to assess the thrombus clearance rate and level of thrombus dissolution. Statistical analysis was conducted to observe the D-dimer concentration changes and analyze the correlation between D-dimer concentration and thrombus clearance rate. Additionally, a receiver operating characteristic (ROC) curve was constructed to determine the diagnostic performance of D-dimer in assessing the efficacy of thrombolysis, including the calculation of the area under the curve (AUC), sensitivity, specificity, and optimal cut-off value.

RESULTS: During CDT for acute lower extremity DVT, plasma D-dimer levels rapidly increased, peaking on CDT day 1, and then gradually decreased, followed by a rapid decline but remained slightly elevated compared to normal levels. There was a positive correlation between D-dimer levels and thrombolysis efficacy (r = 0.809, P = 0.00). The linear regression equation for this correlation was Y = 0.161 + 0.028X. The AUC of D-dimer was 0.95, with a cut-off value of 9.935 mg/L (sensitivity 93.2% and specificity 95.4%).

CONCLUSION: Plasma D-dimer concentration can serve as an indicator for evaluating the efficacy of thrombolysis during CDT in acute lower extremity DVT.

PMID:39818303 | DOI:10.1016/j.jvsv.2025.102167

Spine J. 2025 Jan 14:S1529-9430(25)00020-8. doi: 10.1016/j.spinee.2024.12.029. Online ahead of print.

ABSTRACT

BACKGROUND CONTEXT: There are a number of risk factors- from biological, psychological, and social domains- for non-specific chronic low back pain (cLBP). Many cLBP treatments target risk factors on the assumption that the targeted factor is not just associated with cLBP but is also a cause (i.e, a causal risk factor). In most cases this is a strong assumption, primarily due to the possibility of confounding variables. False assumptions about the causal relationships between risk factors and cLBP likely contribute to the generally marginal results from cLBP treatments.

PURPOSE: The objectives of this study were to a) using rigorous confounding control compare associations between modifiable causal risk factors identified by Mendelian randomization (MR) studies with associations in a cLBP population and b) estimate the association of these risk factors with cLBP outcomes.

STUDY DESIGN/SETTING: Cross sectional analysis of a longitudinal, online, observational study.

PATIENT SAMPLE: 1,376 participants in BACKHOME, a longitudinal observational e-Cohort of U.S. adults with cLBP that is part of the NIH Back Pain Consortium (BACPAC) Research Program.

OUTCOME MEASURES: Pain, Enjoyment of Life, and General Activity (PEG) Scale.

METHODS: Five risk factors were selected based on evidence from MR randomization studies: sleep disturbance, depression, BMI, alcohol use, and smoking status. Confounders were identified using the ESC-DAG approach, a rigorous method for building directed acyclic graphs based on causal criteria. Strong evidence for confounding was found for age, female sex, education, relationship status, financial strain, anxiety, fear avoidance and catastrophizing. These variables were used to determine the adjustment sets for the primary analysis. Potential confounders with weaker evidence were used for a sensitivity analysis.

RESULTS: Participants had the following characteristics: age 54.9 ± 14.4 years, 67.4% female, 60% never smokers, 29.9% overweight, 39.5% obese, PROMIS sleep disturbance T-score 54.8 ± 8.0, PROMIS depression T-score 52.6 ± 10.1, Fear-avoidance Beliefs Questionnaire 11.6 ± 5.9, Patient Catastrophizing Scale 4.5 ± 2.6, PEG 4.4 ± 2.2. In the adjusted models, alcohol use, sleep disturbance, depression, and obesity were associated with PEG, after adjusting for confounding variables identified via a DAG constructed using a rigorous protocol. The adjusted effect estimates- the expected change in the PEG outcome for every standard deviation increase or decrease in the exposure (or category shift for categorical exposures) were the largest for sleep disturbance and obesity. Each SD increase in the PROMIS sleep disturbance T-score resulted in a mean 0.77 (95% CI: 0.66, 0.88) point increase in baseline PEG score. Compared to participants with normal BMI, adjusted mean PEG score was slightly higher by 0.37 points (95% CI: 0.09, 0.65) for overweight participants, about 0.8 to 0.9 points higher for those in obesity classes I and II, and 1.39 (95% CI: 0.98, 1.80) points higher for the most obese participants. Each SD increase in the PROMIS depression T-score was associated with a mean 0.28 (95% CI: 0.17, 0.40) point increase in baseline PEG score, while each SD decrease in number of alcoholic drinks per week resulted in a mean 0.12 (95% CI: 0.01, 0.23) increase in baseline PEG score in the adjusted model.

CONCLUSIONS: Several modifiable causal risk factors for cLBP – alcohol use, sleep disturbance, depression, and obesity- are associated with PEG, after adjusting for confounding variables identified via a DAG constructed using a rigorous protocol. Convergence of our findings for sleep disturbance, depression, and obesity with the results from MR studies, which have different designs and biases, strengthens the evidence for causal relationships between these risk factors and cLBP. The estimated effect of change in a risk factors on change in PEG were the largest for sleep disturbance and obesity. Future analyses will evaluate these relationships with longitudinal data.

PMID:39818276 | DOI:10.1016/j.spinee.2024.12.029

Ann Epidemiol. 2025 Jan 14:S1047-2797(25)00011-0. doi: 10.1016/j.annepidem.2025.01.005. Online ahead of print.

ABSTRACT

PURPOSE: To compare the overall survival and the risk of all-cause and heart failure-specific hospitalization in nonagenarian patients hospitalized for symptomatic severe aortic stenosis (AS) who underwent transcatheter aortic valve implantation (TAVI) or conservative treatment.

METHODS: Population-based retrospective cohort study based on healthcare utilization databases of the Italian region of Lombardy. The cohort included all nonagenarians hospitalized for AS between 2017 and 2021, who underwent TAVI within 90 days from first diagnosis or conservative treatment. The association between TAVI and clinical outcomes was assessed through Cox or Fine&Grey regression models. High-dimensional propensity score matching was used to reduce the heterogeneity between groups.

RESULTS: Overall, 16,848 nonagenarians hospitalized for AS were identified. Among these, 320 patients underwent TAVI, of which 193 were matched to as many control patients. The 2-year survival rates were 76.0% and 37.7%, respectively, in TAVI and control patients, corresponding to an HR of 0.24 (95% CI 0.15-0.37). The 2-year cumulative incidence of rehospitalization for heart failure was 11.1% and 26.5%, respectively, corresponding to an HR of 0.64 (95% CI 0.40-0.99).

CONCLUSIONS: This study further supports the usefulness of TAVI in nonagenarians, as it showed to improve their survival rate, reduce their risk of rehospitalization, and likely increase their quality of life.

PMID:39818241 | DOI:10.1016/j.annepidem.2025.01.005

Ann Anat. 2025 Jan 14:152378. doi: 10.1016/j.aanat.2025.152378. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the impact of the temporal bone styloid process (SP) angulation on the carotid arteries (CA), both internal and external carotid arteries (ICA and ECA). The SP topographical variability and the clinical significance will be further discussed.

MATERIALS: One hundred computed tomography angiographies (CTAs) (200 sides of 50 male and 50 female patients) were retrospectively studied. The sample’s mean age was 62.72 ± 14.77 (range: 20-89 years). The SP length and angle were measured on CTA sagittal and coronal sections, and the relationship with the ICA and ECA was measured in axial sections. The SP elongation was considered when the SP length > 33mm in accordance with prior studies in the same population.

RESULTS: Patients with elongated SPs had an average SP sagittal angle of 59.97 ± 7.75 degrees, while those without elongation had an average sagittal angle of 67.12 ± 9.43 degrees (p<0.001). The correlation between SP length and sagittal angle was statistically significant (R=-0.433, p<0.001), as well as between SP length and coronal angle (R=-0.361, p<0.001). Patients with elongated SPs had an average SP coronal angle of 69.20 ± 5.35 degrees, while those without elongation had an average angle of 76.89 ± 4.02 degrees (p=0.002). After excluding patients with elongated SP, the remaining patients (n=57) had an average SP sagittal angle of 67.77 ± 9.51 degrees, and a mean SP coronal angle was 75.83 ± 5.19 degrees. The SP sagittal and coronal angles influenced none of the measured ICA and ECA parameters after excluding patients with elongated SPs.

CONCLUSION: The current imaging study has enhanced our understanding of the SP’s topographical variability in relation to the CA. Our findings indicate that the length of the SP influences this relationship, whereas the angle (coronal and sagittal) of the SP does not-particularly when excluding patients with elongated SPs. Therefore, clinicians must recognize the variability in the position of the ICA and ECA within the neck.

PMID:39818238 | DOI:10.1016/j.aanat.2025.152378

Value Health Reg Issues. 2025 Jan 15;46:101070. doi: 10.1016/j.vhri.2024.101070. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to analyze the direct healthcare costs and early complications associated with pretransplant portal vein thrombosis (PVT) in cirrhotic patients undergoing their first orthotopic liver transplant (LT) at a hospital in Colombia from 2013 to 2021.

METHODS: A registry-based retrospective follow-up study was conducted on cirrhotic patients aged 14 years or older who underwent their first LT at the San Vicente Fundación Rionegro Hospital between January 2013 and April 2021. The primary outcomes were early (30-day) vascular and biliary complications and direct healthcare costs. The generalized linear model was used to estimate observed and adjusted mean differences in costs and risk ratios for complications based on pretransplant PVT. Costs were expressed in 2020 international dollars.

RESULTS: The medical records of 161 patients were analyzed, with 15.5% having pretransplant PVT. Patients with pretransplant PVT exhibited a statistically significant higher risk of early vascular complications (adjusted risk ratio 2.17; 95% CI 1.04-4.51; P = .039). However, there was no statistically significant difference in the risk of early biliary complications (P = .225). Patients with grade I PVT did not show a significant difference in costs compared with patients without PVT (P = .661). For patients with grade II-IV PVT, the adjusted mean difference in the healthcare cost was 33 175 international dollars (95% CI 730-65 620).

CONCLUSIONS: Patients with pretransplant grade II-IV PVT have a higher risk of early vascular complications and require more medical resources, leading to increased costs associated with LT.

PMID:39818171 | DOI:10.1016/j.vhri.2024.101070