Tag: nevin manimala

Int J Cardiol Heart Vasc. 2025 May 6;59:101689. doi: 10.1016/j.ijcha.2025.101689. eCollection 2025 Aug.

ABSTRACT

BACKGROUND: QFR, a non-invasive tool using 3D coronary artery imaging and fluid dynamics, helps assess revascularization benefits in patients with coronary chronic total occlusion (CTO).

METHODS AND RESULTS: A retrospective study of 616 CTO patients who underwent PCI for CTO, with QFR assessed post-procedure. In a 5-year follow-up study involving 616 patients, the study used three tertiles (first tertile: QFR ≥ 0.88, second tertile: 0.85 ≤ QFR < 0.88, third tertile: QFR < 0.85) to determine the “cut-off” value. QFR showed strong predictive power with an area under the curve (AUC) of 0.80 (95 % confidence interval: 0.77-0.83, P < 0.001). The occurrence of MACCEs among all participants in the study was 28.4 %. This rate varied across different groups, with 63.9 % in the low QFR tertile, 14.8 % in the middle tertile, and 12.6 % in the high QFR group. During the follow-up period, a variation in the occurrence of MACCEs was observed among the three groups (P < 0.05). Analysis using Kaplan-Meier curves indicated a statistically major difference in the cumulative rates of MACCEs across the groups. Competing risk regression analysis indicated that QFR is negatively associated with all-cause mortality, cardiovascular mortality, and composite MACCEs.

CONCLUSION: The study found a high prognostic value of physiological assessment using QFR after successful CTO intervention.

PMID:40476177 | PMC:PMC12138560 | DOI:10.1016/j.ijcha.2025.101689

Med J Islam Repub Iran. 2024 Dec 3;38:141. doi: 10.47176/mjiri.38.141. eCollection 2024.

ABSTRACT

BACKGROUND: Intussusception is one of the most frequent reasons for intestinal obstruction in young children, which needs to be treated immediately. When it comes to non-operative reduction, there is no gold standard. Our goal was to look into how general anesthesia affected the success rate of pneumatically reduced intussusception guided by fluoroscopy.

METHODS: This prospective study was done throughout the time between January 2023 and January 2024 by collaboration between the Pediatric Surgery Unit and Diagnostic Radiology Departments, Al-Azhar University Hospital, New Damietta, Egypt. Under general anesthesia, pneumatic reduction guided by fluoroscopy was performed on all intussusception patients. Children with pathologic lead points discovered by ultrasonography, those with symptoms of intestinal perforation or peritonitis, and those who were hemodynamically unstable were excluded. Statistical analysis of the obtained data was done using the SPSS program (version 20).

RESULTS: In all, 34 children between the ages of 3-28 months, pneumatic reduction under general anesthesia was successful in 32 individuals (94.1% overall). On the first trial, the intussusception was succeeded in 26 patients; on the second try, it was reduced in 5 patients, and in the third, in 1 patient. In two cases, the intussusception failed after three successive trials. One of them was diagnosed as an extended intussusception mass, which was later surgically confirmed, and the other was an appendico-cecal intussusception. During the reduction efforts, there was no bowel perforation or death reported.

CONCLUSION: As a first-line therapy for pediatric intussusception, fluoroscopy-guided PR under GA is straightforward, risk-free, and successful, with no complications or mortalities.

PMID:40476172 | PMC:PMC12138778 | DOI:10.47176/mjiri.38.141

Med J Islam Repub Iran. 2024 Dec 18;38:149. doi: 10.47176/mjiri.38.149. eCollection 2024.

ABSTRACT

BACKGROUND: There is no consensus on the role of oligohydramnios on the increased risk of fetal malpresentation. Therefore, we decided, for the first time, to collect all published studies on this topic to synthesize all available data through a systematic review and meta-analysis to evaluate the effect of oligohydramnios on the increased risk of fetal malpresentation.

METHODS: A search was done in the following international electronic bibliographic databases: PubMed, Web of Science, and Scopus to April 2021. Heterogeneity among studies was determined by the Q-test and I2 statistic. Publication bias was assessed by Begg and Egger tests. The results were reported using odds ratio (OR) estimates with 95% confidence intervals (CI) using a random-effects model. Data were analyzed using Stata software Version 14 (StataCorp).

RESULTS: The meta-analysis identified 431 articles, comprising 227,351 participants, exploring the link between oligohydramnios and malpresentation. A significant association was found (OR, 1.79 [95% CI, 1.42-2.15]), indicating that oligohydramnios increases the risk of malpresentation. The analysis also revealed substantial heterogeneity among the included studies (I² = 80.2%; P < 0.001).

CONCLUSION: This meta-analysis provides robust evidence that oligohydramnios is a significant risk factor for fetal malpresentation. These findings underscore the critical importance of monitoring amniotic fluid levels during pregnancy. The results suggest that healthcare providers should prioritize the assessment of amniotic fluid volume in pregnant patients, especially those presenting with risk factors for oligohydramnios.

PMID:40476169 | PMC:PMC12138669 | DOI:10.47176/mjiri.38.149

Patient Prefer Adherence. 2025 May 31;19:1625-1638. doi: 10.2147/PPA.S511332. eCollection 2025.

ABSTRACT

PURPOSE: This analysis aimed to document suboptimal insulin dosing (missed or skipped and mistimed basal and/or bolus) in people with diabetes (PwD), including type 1 diabetes (T1D) and type 2 diabetes (T2D). Additionally, barriers and solutions for optimal insulin dosing were explored.

PATIENTS AND METHODS: This multinational, cross-sectional, online survey was conducted in the United States, the United Kingdom, and Germany. Eligible PwD with T1D or T2D used an analog insulin pen. Data were analyzed using descriptive statistics.

RESULTS: A total of 1150 PwD (T1D: 300; T2D: 850) were included. Overall, a proportion of PwD reported missing 1 or more basal (48.2%) or bolus dose (59.6%) in the past 30 days. Among those who reported missing doses, the average number [standard deviation] was 3.6 [3.6] basal doses and 4.6 [7.4] bolus doses. PwD reported forgetting, being too busy/distracted, and finding it too complicated or burdensome as key reasons for missed doses. A proportion of PwD reported mistiming 1 or more basal (45.7%) dose or bolus (53.6%) dose in the past 30 days. Among those who reported mistiming doses, the average was 3.9 [4.0] basal and 5.1 [8.1] bolus doses. Key reasons reported for mistiming doses included being too busy or distracted, being out of routine, or having an unexpected or earlier/later-than-expected meal.

CONCLUSION: Suboptimal insulin use is prevalent among PwD, with nearly half of participants reporting missed or mistimed doses in the past 30 days. Results indicate the need for support to help PwD self-manage the complexity of insulin treatment and to improve outcomes due to suboptimal insulin dosing. Such support might include devices that record measurements and dosing and provide feedback.

PMID:40476160 | PMC:PMC12139093 | DOI:10.2147/PPA.S511332

J Psoriasis Psoriatic Arthritis. 2025 Jun 2:24755303251345804. doi: 10.1177/24755303251345804. Online ahead of print.

ABSTRACT

Biologic dosing frequency is a key concern among psoriasis (PsO) patients and physicians, yet dosing optimization remains a challenge. This study evaluates patient dosing preferences for IL-17 and IL-23 inhibitors, risankizumab (RZB) every 12 weeks, guselkumab (GUS) every 8 weeks, and ixekizumab (IXE) every 4 weeks, in managing PsO. This phone survey study evaluated 87 adults on RZB (n = 29), GUS (n = 35), or IXE (n = 23) from 2019 onward at two clinical sites. Patients were assessed for baseline PsO bothersome severity, current dosing frequency satisfaction, frequency of PsO flares, and preferred dosing frequency. Most patients were males (57.5%) with an average age of 54.1 years and an average treatment duration of 19.0 months. At baseline before treatment, 87% were ‘very bothered’ by their PsO. After treatment, 86% were either ‘3-somewhat’ or ‘4-very satisfied’ with their current dosing schedule, with no significant differences between each drug (P = 0.7). Across all biologics the majority of participants (62% with RZB, 57% with GUS, and 48% with IXE) preferred maintaining their current dosing frequency. No statistically significant differences were observed in dosing frequency preference between treatment groups, suggesting dosing schedule is not a primary concern for most patients. This aligns with previous research demonstrating effective disease control is the most important factor for patient satisfaction; however, tailoring dosing regimens to individual patient needs can also strengthen long-term adherence, as demonstrated in recent studies.

PMID:40476147 | PMC:PMC12133784 | DOI:10.1177/24755303251345804

Cureus. 2025 May 6;17(5):e83583. doi: 10.7759/cureus.83583. eCollection 2025 May.

ABSTRACT

BACKGROUND: Atrial fibrillation (AF) is a common complication following coronary artery bypass grafting (CABG) and is associated with increased morbidity and prolonged hospital stay. This study aimed to determine the frequency of new-onset atrial fibrillation (NOAF) in post-CABG patients and assess its association with demographic and clinical variables, including comorbidities.

METHODS: This descriptive observational study was conducted in the Cardiac ICU of Rehman Medical Institute (RMI) over six months. A total of 101 post-CABG patients admitted to the ICU were included and monitored for the development of AF. Patients with congenital anomalies, a prior history of arrhythmias, or those who did not provide consent were excluded. Data were collected prospectively, including patient demographics, comorbidities, and antiarrhythmic management. Statistical analysis was performed using SPSS version 26 (Armonk, NY: IBM Corp.), with quantitative variables presented as means±standard deviations and qualitative variables as frequencies and percentages.

RESULTS: The frequency of NOAF in post-CABG patients was found to be 13.86% (n=14). The mean age of the study population was 59.62 years (SD=9.81), with a male predominance (69 males, 32 females). Hypertension (HTN) and coronary artery disease (CAD) were the most common comorbidities, affecting 29.7% (n=30) and 20.8% (n=21) of patients, respectively. A trend was observed suggesting that patients with multiple comorbidities had an increased likelihood of developing AF, although this finding was descriptive and not statistically significant. Antiarrhythmic medications were administered in all AF cases, with a variable response.

CONCLUSION: The incidence of NOAF in post-CABG patients remains significant based on previous researches. Age and pre-existing comorbidities, particularly hypertension and CAD, appear to contribute to AF development. Developing preoperative and intraoperative risk assessment tools may help identify patients at higher risk for post-CABG atrial fibrillation. Future interventional studies can evaluate strategies such as fluid management, early beta-blockers, or anti-inflammatory therapies to reduce the incidence of AF.

PMID:40476136 | PMC:PMC12140130 | DOI:10.7759/cureus.83583

Cureus. 2025 May 6;17(5):e83569. doi: 10.7759/cureus.83569. eCollection 2025 May.

ABSTRACT

BACKGROUND: Circulatory system diseases are leading causes of emergency department (ED) visits in the United States. Understanding trends in these visits is crucial for healthcare planning.

OBJECTIVE: This study aimed to identify the most frequent primary circulatory system diagnoses presenting to EDs, examine temporal trends in ED visit rates from 2016 to 2022, and assess disparities by patient age, sex, race/ethnicity, insurance status, and geographic region.

MATERIALS AND METHODS: A cross-sectional analysis of the National Hospital Ambulatory Medical Care Survey (NHAMCS) data (2016-2022) identified ED visits with a primary circulatory disease diagnosis using International Classification of Diseases (ICD) codes. Weighted estimates ensured national representativeness. Descriptive statistics and inferential statistics were used to assess trends. Analyses were performed in STATA 17 (StataCorp., College Station, TX, USA) (p<0.05).

RESULTS: Overall ED visit rates for circulatory diseases rose from 15 per 1,000 in 2016 to 17 per 1,000 in 2019 (p<0.01), declined to 16 per 1,000 in 2020 (p<0.05 vs. 2019), and stabilized at 17 per 1,000 in 2021-2022 (no significant change, p=0.12). Essential hypertension (14%), hypertensive heart or kidney disease (13%), acute myocardial infarction (11%), atrial fibrillation/flutter (10%), and ischemic stroke (8%) represented the five most common primary diagnoses, accounting for over 56% of circulatory presentations. Older adults (65+) exhibited the highest visit rates (peaking at 55 per 1,000 in 2022), males had slightly higher rates than females (18 vs. 16 per 1,000 in 2022), and non-Hispanic Black individuals had persistently elevated rates (28 per 1,000 in 2022) compared to non-Hispanic White individuals (17 per 1,000) and Hispanic individuals (12 per 1,000) (all p<0.05). The Midwest and Northeast regions reported the highest rates, whereas the West had the lowest, underscoring geographic variation in circulatory disease burden. Medicare beneficiaries had the highest utilization (44 per 1,000 in 2022), highlighting insurance-related disparities.

CONCLUSIONS: In this nationally representative analysis, primary ED presentations for circulatory diseases were dominated by hypertension-related conditions and acute ischemic events. Stabilization of rates post-2020, particularly among older and Medicare-insured patients, indicates potential targets for intervention. Strengthening primary care access and preventive programs, especially for older adults and non-Hispanic Black individuals, may reduce ED reliance and improve equity in cardiovascular care.

PMID:40476134 | PMC:PMC12139463 | DOI:10.7759/cureus.83569

Cureus. 2025 May 6;17(5):e83560. doi: 10.7759/cureus.83560. eCollection 2025 May.

ABSTRACT

Context Hip range of motion plays a crucial role in the functional health of runners. Osteopathic manipulative treatment has historically been used to maintain or restore a joint’s range of motion; therefore, this study investigates how the Spencer technique impacts femoroacetabular active range of motion in runners. Objective This study investigated the impact that the bilateral Spencer technique has on all planes of hip motion. Methods Forty participants were randomly divided into treatment and control groups, with the treatment group receiving twice-weekly bilateral Spencer technique for four weeks and the control group receiving no treatment. Both groups were instructed to train as they normally would for the four weeks leading up to a five-kilometer (5K) race. Measurements of hip flexion, extension, internal rotation, external rotation, abduction, and adduction were taken to assess the percent change in range of motion over the course of training, as well as before and after the race, for all planes of motion in treatment vs control groups. Results The only significant difference in average percent change in range of motion for control (n=19) vs treatment groups (n=20) across both treatment and race periods was found for abduction wherein the control group experienced an average change of +7.09% (standard deviation of 17.38%) and the treatment group experienced an average change of -5.58% (standard deviation of 17.48%) for a difference of 12.67% (p=0.03). All other findings for all other motions across both training and race periods showed no statistically significant difference (p>0.05). Conclusion This study found that four weeks of twice-weekly treatment with the Spencer technique of the hip had no statistically significant impact on change in hip flexion, extension, internal rotation, external rotation, abduction, and adduction across the four weeks when compared to control. When analyzing the impact of this treatment on the change of these motions across a 5K race occurring at the end of the four weeks, this study found that the Spencer technique of the hip had a statistically significant negative impact on abduction, compared to the control. These findings bring into question the role that the Spencer technique of the hip may have for healthy individuals training for athletic competition and open the door for future research to analyze the effect that this osteopathic technique has on motion in a setting that better controls for differences in training habits.

PMID:40476131 | PMC:PMC12140400 | DOI:10.7759/cureus.83560

J Physiol Anthropol. 2025 Jun 5;44(1):16. doi: 10.1186/s40101-025-00396-5.

ABSTRACT

BACKGROUND: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that increase the risk of cardiovascular disease and type 2 diabetes. High-sensitivity C-reactive protein (hs-CRP) is a biomarker of systemic inflammation, but its relationship with MetS and its components remains unclear. This study investigates the association between hs-CRP and MetS in a representative Korean population.

METHODS: Using data from the 2022 Korea National Health and Nutrition Examination Survey (KNHANES), we analyzed 4,823 adults. MetS was defined according to revised NCEP-ATP III criteria. Multivariate analyses were conducted, adjusting for confounders such as sex, age, income, education, smoking, alcohol consumption, physical activity, and waist circumference.

RESULTS: Among the study population, 1,784 participants (37.0%) were diagnosed with MetS. hs-CRP levels were significantly higher in individuals with MetS (1.06 mg/L vs. 0.79 mg/L, p < 0.001) and increased with the number of MetS components (p for trend < 0.001). Significant associations were observed between hs-CRP and all MetS components. However, after adjusting for waist circumference, these associations lost statistical significance.

CONCLUSION: This study confirms a strong association between hs-CRP and MetS, primarily influenced by central obesity. The findings highlight abdominal obesity as a key contributor to systemic inflammation in MetS. Further longitudinal studies are needed to explore the causal relationship and underlying mechanisms.

PMID:40474309 | DOI:10.1186/s40101-025-00396-5

BMC Nutr. 2025 Jun 5;11(1):112. doi: 10.1186/s40795-025-01099-x.

NO ABSTRACT

PMID:40474304 | DOI:10.1186/s40795-025-01099-x