Tag: nevin manimala

Eur J Orthop Surg Traumatol. 2025 Aug 12;35(1):347. doi: 10.1007/s00590-025-04458-3.

ABSTRACT

INTRODUCTION: Paediatric pelvic fractures are rare injuries. In such cases, the measurement of spinopelvic parameters is important in objectively evaluating pelvic asymmetry. This study investigated functional outcomes after the treatment of paediatric pelvic fractures.

MATERIALS AND METHODS: Patients aged 10-18 years who were admitted to our level 1 trauma centre were included in this retrospective study. Spinopelvic parameters were used to evaluate functional outcomes, and the changes of spinopelvic parameters in patients treated surgically and conservatively were compared. The Injury Severity Score (ISS) and Pelvic Abbreviated Injury Scale (AIS) score were calculated. Haemoglobin decreases in the first 24 h, and blood transfusion amounts were evaluated.

RESULTS: A total of 60 patients were treated during the study period, 28 (47%) surgically and 32 (53%) conservatively. No statistically significant differences in spinopelvic parameter measurements were observed between the groups (p > 0.05). There were also statistically significant differences between the groups in terms of haemoglobin decrease (p = 0.026) and transfusion amounts (p = 0.049) in the first 24 h; ISS and Pelvic AIS scores (p = 0.003), with values being higher in the surgery group.

CONCLUSIONS: This study aimed to evaluate the appropriate treatment of paediatric pelvic trauma and present quantitative data on functional outcomes for the first time in the literature. Surgery is the main treatment approach for displaced paediatric pelvic fractures to prevent deformity and complications. In this study, there was no statistically significant difference between the spinopelvic parameter measurements of patients who underwent surgical treatment and those who received conservative treatment (p > 0.05). This indicates that when unstable paediatric pelvic fractures are treated surgically, the outcomes are comparable to those achieved through conservative treatment. Studies with longer follow-up are needed to better demonstrate functional outcomes.

PMID:40794290 | DOI:10.1007/s00590-025-04458-3

J Am Chem Soc. 2025 Aug 12. doi: 10.1021/jacs.5c10754. Online ahead of print.

ABSTRACT

Array-based differential sensing is inspired by a mammal’s sense of taste and smell. The human sense of touch is also array-based; using mechanosensors in the skin that differentiate surfaces by their surface chemistry. Inspired by this, we aimed to develop a rationally biased and randomized oligomer sensor array which differentiates bulk solids by their surface chemistry. Column chromatography mimics this aspect of the sense of touch, as it is traditionally used to physically separate molecules in solution by the strength of their noncovalent interactions with the stationary phase. In this report, we differentiated column chromatography stationary phases (the analyte) by the retention time (the sensor’s analytical response) of a vast library of oligomers with statistically biased but random monomer compositions (the sensor array). The use of unsupervised principal component analysis (PCA) validated our sensor array design by differentiating five surfaces with tight replicate clustering and a high degree of cross-reactivity.

PMID:40794286 | DOI:10.1021/jacs.5c10754

Acta Anaesthesiol Scand. 2025 Sep;69(8):e70111. doi: 10.1111/aas.70111.

ABSTRACT

BACKGROUND: Concerns about the delayed diagnosis of acute compartment syndrome have led to recommendations favouring general anaesthesia over spinal anaesthesia in surgeries for diaphyseal tibia fractures. However, there is a lack of supporting clinical evidence. This study compared spinal anaesthesia and general anaesthesia in terms of compartment pressures, risk of acute compartment syndrome, and postoperative outcomes in tibia shaft fractures treated with intramedullary nailing.

METHODS: A randomized controlled study was carried out at a tertiary hospital from 2011 to 2021. Fifty patients with unilateral tibia shaft fractures were randomly assigned to receive either spinal or general anaesthesia. The primary outcome was compartment and delta pressures in the anterior tibial muscle compartment for 24 h after surgery. Secondary outcomes included near-infrared spectroscopy values, pain scores, and opioid consumption.

RESULTS: Delta pressures were higher in the spinal anaesthesia group (estimated average effect over 24 h: 6.4 mmHg [CI 0.2-12.6]; p = 0.042). However, absolute compartment pressures were comparable between groups (effect estimate: -0.9 mmHg [CI -6.7 to 5.0]; p = 0.77). No cases of acute compartment syndrome occurred in the spinal anaesthesia group, while three patients treated with general anaesthesia required fasciotomy. There was no statistical difference in compartment surface oxygenation measured with near-infrared spectroscopy, pain scores, or median total opioid consumption between the study groups during the 24-h postoperative follow-up.

CONCLUSION: Spinal anaesthesia was not associated with higher compartment pressures compared to general anaesthesia. These findings suggest that prevailing concerns and recommendations about spinal anaesthesia for tibia shaft fracture surgery may need reconsideration and challenge recommendations favouring general anaesthesia as the primary method.

EDITORIAL COMMENT: This study addresses whether or not spinal anaesthesia might affect acute compartment syndrome and outcomes in tibial shaft fractures. Despite small sample sizes, the findings suggest that spinal anaesthesia does not increase compartment pressures or delay diagnosis of acute compartment syndrome when patients are appropriately monitored. These results support spinal anaesthesia as a safe alternative in selected trauma patients in this context.

TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT01795287.

PMID:40792424 | DOI:10.1111/aas.70111

ESC Heart Fail. 2025 Aug 12. doi: 10.1002/ehf2.15391. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Heart failure (HF) is a multifactorial disease for which peak oxygen uptake (VO₂peak) may potentially be a prognostic marker of adverse clinical outcomes. This systematic review and meta-analysis aimed to assess published data on the prognostic impact of VO₂peak in HF.

METHODS: A literature search of observational studies was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until January 2025. A meta-analysis was conducted using the random-effects inverse-variance model through hazard ratios (HRs). Increased heterogeneity among studies was evaluated through meta-regressions and publication bias via Egger’s test.

RESULTS: Sixty-four studies were included in this systematic review and meta-analysis. Per 1 mL/kg/min increase in VO₂peak, all-cause mortality [HR: 0.86, 95% confidence interval (CI) 0.82-0.90, I² = 85%, P < 0.01] and incident ventricular assist device, transplant and all-cause mortality (HR: 0.84, 95% CI 0.79-0.89, I² = 33%, P < 0.01) were significantly reduced, but statistical significance of VO₂peak with cardiovascular mortality was not observed (HR: 0.92, 95% CI 0.82-1.02, I² = 0%, P = 0.12) using adjusted models. Variance among studies was detected based on age, sex, body mass index, left ventricular ejection fraction, atrial fibrillation, hypertension, chronic kidney disease, diabetes and treatment. A significant risk of publication bias was evident.

CONCLUSIONS: VO₂peak is a prognostic marker for multiple causes of mortality and hospitalization in patients with HF, which may promote further insights into patient risk stratification for adverse events and targeted management.

PMID:40792415 | DOI:10.1002/ehf2.15391

Healthc Q. 2025 May;28(1):85-92. doi: 10.12927/hcq.2025.27626.

ABSTRACT

Little is known about domiciliary hostels (known as residential care facilities [RCFs] in Hamilton, Ontario) for those needing affordable housing and minimal supports. Our multiple-methods study examined the characteristics and health needs of 36 RCF tenants across four RCFs. We found that 64.4% of participants were 50+ years old, 22.2% had ever been unhoused, 77.4% had comorbid physical and mental illness and 83.3% had been hospitalized. Financial resources, capacity for work and physical pain were key quality-of-life concerns. A whole-systems approach involving healthcare, social care and housing is needed to serve this marginalized and aging population.

PMID:40792411 | DOI:10.12927/hcq.2025.27626

Healthc Q. 2025 May;28(1):12-15. doi: 10.12927/hcq.2025.27637.

ABSTRACT

The health workforce is the lifeblood of the Canadian health system. Comprehensive data is essential to inform policy and resources allocation and to address care gaps. While data collection challenges exist, Canadian Institute for Health Information’s (CIHI’s) new health workforce data standards and the establishment of Health Workforce Canada strive to improve data quality. Using findings from The State of the Health Workforce in Canada, 2023 report, this article provides insights into Canada’s health workforce and underscores the value of enhancing Canada’s data collection and reporting. Strengthening health workforce data will drive improvements, fostering a healthier population and a sustainable health workforce.

PMID:40792400 | DOI:10.12927/hcq.2025.27637

Healthc Q. 2025 May;28(1):7-11. doi: 10.12927/hcq.2025.27638.

ABSTRACT

People living with dementia require care from a variety of health professionals and in different settings to optimize their quality of life. A phase-based approach to costing health system use supports our understanding of the longitudinal costs of care through disease progression at a population level. This report estimates five-year and phase-based net health system costs of dementia.

PMID:40792399 | DOI:10.12927/hcq.2025.27638

Subst Use Addctn J. 2025 Aug 12:29767342251351751. doi: 10.1177/29767342251351751. Online ahead of print.

ABSTRACT

BACKGROUND: Stigma continues to be a barrier to accessing quality care for many patients with mental health conditions and/or substance use disorder (SUD), commonly referred to as addiction. This paper aims to evaluate the impact that undergraduate medical education (UME) has in reducing stigmatizing language use and potentially mitigating this barrier to care.

METHODS: A systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines identified 2017 articles across 7 databases. Search terms related to stigma surrounding mental health, addiction, and suicide were incorporated into medical education. Blinded, double-reviewed papers meeting the inclusion criteria were further evaluated at full length to obtain information including sample size, variables, and outcomes.

RESULTS: Three studies met the review’s selection criteria: 1 pretest/posttest case series, 1 survey evaluating language stigma, and 1 qualitative essay review to discover common themes in medical students’ experience with patients with SUD. Statistically significant results included changes in characteristic association, attitudes based on language, and the effects of an educational intervention.

CONCLUSIONS: These results reinforce the importance of language and educational exposure in addressing stigma toward patients with mental health diagnoses. Although the results of all studies indicated some level of stigma associated with patients with a mental health diagnosis, there was limited consensus surrounding methods to reduce it in UME. Additional research on the implementation of medical school-focused mental health awareness programs is needed, preferably using rigorous randomized controlled trial study designs, longitudinal follow-up, and critical appraisal of texts to better understand effective interventions on persistent mental health stigma among medical students.

PMID:40792396 | DOI:10.1177/29767342251351751

Eur J Psychotraumatol. 2025 Dec;16(1):2536973. doi: 10.1080/20008066.2025.2536973. Epub 2025 Aug 12.

ABSTRACT

Background: Eye movement desensitisation and reprocessing (EMDR) therapy primarily aims to reduce the emotional intensity or subjective disturbance associated with traumatic memories. However, to date, only one study has investigated whether a reduction in emotional intensity is related to a reduction in post-traumatic stress disorder (PTSD) symptoms.Objective: Therefore, the purpose of the present study was to determine the relationship between changes in emotional intensity of traumatic memories during EMDR therapy and treatment outcomes.Method: One hundred twenty-five patients (88.8% female, M age = 36.4 years, SD = 11.40) with PTSD due to multiple traumatisation participated in a six-day intensive treatment programme consisting of a combination of six 90 min EMDR therapy sessions, six 90 min prolonged exposure sessions, six 60 min sessions of physical activity, and six 60 min psychoeducation sessions delivered at an academic outpatient mental healthcare clinic.Results: The results showed that a greater reduction in the emotional intensity of traumatic memory during EMDR therapy was associated with a larger decrease in PTSD symptoms at four weeks post-treatment.Conclusions: Clinicians should monitor changes in emotional intensity during treatment to assess treatment progress. Furthermore, the findings justify the use of memory disturbance as an outcome measure in experimental studies on EMDR therapy. Future research should focus on EMDR therapy processes and their relationship to treatment outcome, whereas replication of the present findings in other trauma populations is warranted.

PMID:40792392 | DOI:10.1080/20008066.2025.2536973

Phys Occup Ther Pediatr. 2025 Aug 12:1-17. doi: 10.1080/01942638.2025.2543271. Online ahead of print.

ABSTRACT

AIMS: Sensory differences are associated with disruption to daily occupations for both children and families. A one-to-one coaching approach with mothers is effective in increasing performance and satisfaction in children’s daily occupations, and in reducing maternal stress. The study aimed to pilot a brief online group coaching intervention for mothers of children with sensory differences.

METHODS: Eleven mothers participated in a brief online group coaching intervention of four x 90-minute sessions, based on Occupational Performance Coaching (OPC). Mothers gave both quantitative and qualitative feedback on their experience in the group. Mothers reported child occupational goals, maternal stress, and maternal sense of competence pre and post intervention.

RESULTS: Statistically significant improvement in child occupations and aspects of maternal stress were observed. Maternal sense of competence showed improvement but did not reach statistical significance. They valued the sensory focus and found the group safe and supportive; they also gave feedback on how groups could be improved.

CONCLUSIONS: For mothers of children with sensory differences and associated occupational concerns, a brief online group coaching intervention, based on OPC, has the potential to support child occupational performance and reduce maternal stress.

PMID:40792388 | DOI:10.1080/01942638.2025.2543271