Tag: nevin manimala

World J Urol. 2025 Jun 3;43(1):351. doi: 10.1007/s00345-025-05659-5.

ABSTRACT

PURPOSE: To investigate the diagnostic and prognostic value of netrin-1 in Bladder Pain Syndrome /Interstitial Cystitis (BPS/IC).

METHODS: A total of 40 BPS/IC patients, 20 patients with overactive bladder (OAB), and 20 healthy controls were included. Baseline data of all participants were collected. Plasma netrin-1 expression levels were measured before treatment and two months after treatment. Statistical significance of differences among the three groups was analyzed. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic and prognostic value of netrin-1.

RESULTS: The netrin-1 expression level in the BPS/IC group was 777.37 ± 268.02 pg/ml, which was significantly higher than in the other two groups (P < 0.001). No significant difference in netrin-1 expression was observed between the OAB group and the healthy control group. Netrin-1 expression was positively correlated with ICSI, ICPI, and VAS scores. The netrin-1 expression level two months after treatment in the BPS/IC group was 485.06 ± 135.99 pg/ml, which was significantly lower than before treatment CONCLUSION: Netrin-1 can serve as a diagnostic and prognostic biomarker for BPS/IC. However, the underlying mechanisms of netrin-1 in BPS/IC remain unclear and require further investigation.

PMID:40459754 | DOI:10.1007/s00345-025-05659-5

World J Urol. 2025 Jun 3;43(1):350. doi: 10.1007/s00345-025-05721-2.

ABSTRACT

BACKGROUND AND OBJECTIVES: Residual stone fragments (RFs) following ureteroscopy increase the risk of reintervention. This study assesses stone-free rates (SFR) using non-contrast computed tomography (NCCT), identifies factors influencing SFR, and investigates the relationship between RFs and retreatment rates (RTR).

METHODS: Patients who underwent ureteroscopy for urolithiasis between September 2017 and March 2024 were included if they had postoperative NCCT. Exclusion criteria include nephrocalcinosis and combined intrarenal surgery. Clinical data, procedural details, and postoperative outcomes were analyzed. Univariate and multivariate Cox regression models assessed factors affecting SFR and RTR. A Kaplan Meier curve analyzed time to retreatment after surgery.

KEY FINDINGS AND LIMITATION: Among 457 patients (519 renal units) the true SFR was 42.8%, increasing to 58.4% and 78.6% when RFs < 3 mm and < 4 mm were included. Factors negatively associated with SFR included prior urolithiasis treatment, percutaneous nephrolithotomy, positive urine culture, prior stenting, larger stone size, and mid- or lower-pole stone location. Conversely, exclusively ureteric stones and single stones were associated with higher SFR. On multivariate analysis, positive urine culture, prior urolithiasis treatment, increasing stone size, and mid-pole stone location remained significant predictors of reduced SFR. Logistic regression revealed the odds ratio for RTR with RF > 3 mm versus RF < 3 mm was 7.14 (95% CI: 1.96-24.39). Limitations included the risk of missing some stone-related outcomes during follow-up.

CONCLUSIONS AND CLINICAL IMPLICATIONS: The NCCT determined true SFR was 42.8%, with the size of RFs strongly correlating with the RTR. Patients with residual calculi should be counselled about increased risk of retreatment rate.

PMID:40459750 | DOI:10.1007/s00345-025-05721-2

Hernia. 2025 Jun 3;29(1):195. doi: 10.1007/s10029-025-03376-x.

ABSTRACT

INTRODUCTION: Recurrent hiatal hernia (HH) is a significant challenge in surgical practice, with recurrence rates reported to range between 25% and 42%. This condition often requires redo surgeries, which are technically demanding and complex. While advancements in surgical techniques have improved outcomes, the optimal strategy for the surgical management of HH recurrence remains unclear. While mesh reinforcement is proposed to reduce recurrence, its use remains controversial due to potential complications. This systematic review and meta-analysis aim to evaluate whether redo-surgery for HH with cruroplasty using mesh reinforcement was superior to suture cruroplasty in terms of postoperative complications and mortality. To our knowledge, there is no existing review on the topic using a systematic approach.

METHODS AND PROCEDURES: A comprehensive literature search of PubMed, Scopus, and Web of Science was conducted according to PRISMA 2020 guidelines. Studies evaluating postoperative outcomes of redo surgery for recurrent HH with and without mesh reinforcement were included. A random-based model was used in the meta-analysis to explore potential between-study heterogeneity. Odds ratios (OR) with 95% confidence intervals (CI) were calculated. The risk of bias was assessed with the Risk Of Bias In Non-randomized Studies – of Interventions (Version 2) ROBINS-I.

RESULTS: A total of 14 studies with 1011 patients were included. No statistically significant difference was observed in postoperative complications (OR = 0.58, 95% CI = 0.32-1.04, p = 0.07) or mortality (OR = 0.41, 95% CI = 0.08-1.98, p = 0.27) between mesh-reinforced and non-reinforced cruroplasty. However, the results suggest a numerical tendency toward lower rates in the mesh group, which did not reach statistical significance. The funnel plots were symmetrical, suggesting no significant publication bias. The overall quality of evidence was moderate, with considerable heterogeneity among studies.

CONCLUSION: This review highlights the sheer lack of robust data on the benefit of mesh placement in HH repair and the significant heterogeneity in the available literature. Although mesh reinforcement shows a potential trend toward better outcomes, it does not achieve statistical significance in reducing complications or mortality. New prospective, RCTs are necessary to better evaluate the benefits and risks of mesh placement.

PMID:40459749 | DOI:10.1007/s10029-025-03376-x

J Sleep Res. 2025 Jun 3:e70107. doi: 10.1111/jsr.70107. Online ahead of print.

ABSTRACT

Our purpose was to evaluate how cannabis smoking influenced multiple sleep latency test (MSLT) outcomes. This was a retrospective study of all adults that had undergone a MSLT at St. Michael’s Hospital (Toronto, Ontario, Canada) from 1 January 2008 until 31 December 2018. Three groups of persons were considered: active cannabis-only smokers, active tobacco-only smokers and non-active cannabis and tobacco smokers. A range of outcomes from the MSLT and preceding overnight polysomnogram were evaluated. Descriptive statistics at the univariate level were used. We identified a total of 139 individuals undergoing MSLT, of whom 9 (6.5%) were active cannabis-only smokers, 14 (10.0%) were active tobacco-only smokers and 116 (83.4%) were non-smokers. There were non-significant trends among cannabis-only smokers versus non-smokers and tobacco-only smokers towards lower mean sleep onset latency on MSLT (8.1 min vs. 9.2 min and 10.5 min, respectively) and there was a greater proportion of severe sleepiness (33.3% vs. 22.4% and 14.3%, respectively), having at least one REM sleep onset period (55.6% vs. 28.4% and 42.9%, respectively), narcolepsy diagnosis (22.2% vs. 8.6% and 7.1%, respectively), and idiopathic hypersomnia diagnosis (33.3% vs. 30.2% and 14.3%). Although we found no significant differences among the groups we evaluated, there were non-significant trends in multiple outcomes indicative of hypersomnia among active cannabis-only smokers, most notable of which were more frequent (and potentially incorrect) diagnoses of narcolepsy and idiopathic hypersomnia.

PMID:40458917 | DOI:10.1111/jsr.70107

Oper Dent. 2025 Jun 3. doi: 10.2341/23-073-LIT. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the bond strength of self-adhesive (no need for bonding procedures) and conventional (with total-etch or self-etch primers) cementation strategies and the qualitative variables that interfere with the adhesion of fiberglass posts through a systematic review and meta-analysis of in vitro studies.

METHODS: This systematic review and meta-analysis was performed according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) and registered under the International Prospective Register of Systematic Reviews (PROSPERO). The research question was “What resin cement provides better bond strength between the fiberglass posts and the root dentin: conventional or self-adhesive?” The PubMed/MEDLINE, Web of Science, Scopus, and Cochrane databases were searched by two independent researchers.

RESULTS: There were statistically significant differences between self-adhesive and conventional resin cements (p<0.00001), favoring conventional cements.

CONCLUSION: Conventional cements presented the best results regarding the bond strength of the fiberglass post cementation. However, variations in methodology and the risk of bias in analyzed studies may have decreased the reliability of the present study. More studies on this subject using a leveled methodology are recommended.

PMID:40458915 | DOI:10.2341/23-073-LIT

J Infect Dis. 2025 Jun 3:jiaf219. doi: 10.1093/infdis/jiaf219. Online ahead of print.

ABSTRACT

BACKGROUND: Invasive mold infections (IMI) can lead to severe morbidity and mortality, but routine public health surveillance is lacking. Although extensive evaluation is needed for clinical diagnosis, case classification prediction models may inform surveillance efforts, which are essential to better characterize epidemiologic trends and assess the value of a more inclusive IMI case definition.

METHODS: We modeled medical record data of potential IMI cases from 4 medical centers in Houston, Texas, during September 2016 to August 2018. We used least absolute shrinkage and selection operator and random forest machine learning methods to identify key host and clinical factors, mycological evidence, diagnostics, and health care exposures predictive of IMI case versus noncase status using both conventional and novel definitions. We assessed feature importance by measuring each variable’s impact on prediction error using leave-one-covariate-out and permutation feature importance approaches.

RESULTS: Receipt of systemic antifungal medication, hospital billing codes related to IMI, and positive pulmonary histopathology results were identified as the most important predictors of IMI case status across all measures. Removal of these features from the models resulted in reductions to prediction accuracy ranging from 3.6% (95% confidence interval [CI], 3.2%-3.2%) to 7.6% (95% CI, 7.2%-8.0%). Some IMI risk factors, including cancer diagnosis and prolonged receipt of corticosteroid medications, worsened prediction in several assessments of feature importance.

CONCLUSIONS: Features identified as important predictors of IMI case status using machine learning methods deviated from classic IMI risk factors. Our results will inform robust and feasible IMI case prediction models for public health surveillance.

PMID:40458914 | DOI:10.1093/infdis/jiaf219

Oper Dent. 2025 Jun 3. doi: 10.2341/24-007-LIT. Online ahead of print.

ABSTRACT

OBJECTIVE: The use of resin composites (RC) for complex restorations, including those involving cusp coverage, has increased dramatically in recent years. However, reports in the literature regarding the performance of posterior multisurface RC and amalgam (AM) restorations. show conflicting results. This systematic review and meta-analysis aims to assess the clinical performance of complex (involving two or more surfaces) direct posterior resin composite and amalgam restorations in permanent teeth.

METHODS: Inclusion criteria were for prospective randomized controlled trials (RCTs) of multisurface direct RC and AM restorations of permanent posterior teeth with a follow-up period of three years or more. The trials needed to include a minimum of 20 restored teeth for each evaluated material. Retrospective studies, studies lacking survival rates or clearly reported reasons for failure, and those with unclear randomization methods were excluded.Five bibliographic databases (Medline-OVID, Embase, Cochrane Library, Web of Science, and LILACS [Latin American and Caribbean Health Sciences Literature Database]) and manual searches were screened. The Cochrane Risk of Bias Tool was used to assess the included studies. Random-effects meta-analyses were conducted using the Freeman-Tukey double arcsine transformation and the DerSimonianLaird random-effects model to evaluate restorative failures and compare the survival of AM and RC restorations.

RESULTS: From the 6303 identified studies, 198 underwent meticulous examination, and 15 RCTs met the inclusion criteria. Only two studies compared AM and RC restorations. Although the combined data from these studies showed a trend toward higher failure rates in multisurface RC restorations, the difference was not statistically significant (p=0.06). The most common reasons for the failure of RC restorations were secondary caries, restoration fracture, and tooth fracture. For AM, the most common reasons for failure were secondary caries and tooth fracture.

CONCLUSIONS: The quality of the evidence was low. The scarcity of studies comparing RC and AM in complex restorations has resulted in insufficient evidence to substantiate superior performance by either material.

PMID:40458903 | DOI:10.2341/24-007-LIT

MAbs. 2025 Dec;17(1):2511220. doi: 10.1080/19420862.2025.2511220. Epub 2025 Jun 3.

ABSTRACT

Developing therapeutic antibodies is a challenging endeavor, often requiring large-scale screening to produce initial binders, that still often require optimization for developability. We present a computational pipeline for the discovery and design of therapeutic antibody candidates, which incorporates physics- and AI-based methods for the generation, assessment, and validation of candidate antibodies with improved developability against diverse epitopes, via efficient few-shot experimental screens. We demonstrate that these orthogonal methods can lead to promising designs. We evaluated our approach by experimentally testing a small number of candidates against multiple SARS-CoV-2 variants in three different tasks: (i) traversing sequence landscapes of binders, we identify highly sequence dissimilar antibodies that retain binding to the Wuhan strain, (ii) rescuing binding from escape mutations, we show up to 54% of designs gain binding affinity to a new subvariant and (iii) improving developability characteristics of antibodies while retaining binding properties. These results together demonstrate an end-to-end antibody design pipeline with applicability across a wide range of antibody design tasks. We experimentally characterized binding against different antigen targets, developability profiles, and cryo-EM structures of designed antibodies. Our work demonstrates how combined AI and physics computational methods improve productivity and viability of antibody designs.

PMID:40458889 | DOI:10.1080/19420862.2025.2511220

J Surg Oncol. 2025 May;131(6):994-995. doi: 10.1002/jso.28069. Epub 2024 Dec 29.

ABSTRACT

Mujtaba Khalil and colleagues published their study “Impact of Spousal Mental Illness on Healthcare Utilization Among Patients With Gastrointestinal Cancer” in the Journal of Surgical Oncology provides important insights into the impact of spousal mental illness on healthcare utilization and expenditure for patients with gastrointestinal cancer. Although the study is innovative, there are limitations such as sample representativeness and underestimation of mental health diagnosis. It is recommended that future studies expand the sample size, combine clinical and administrative data to improve diagnostic accuracy, conduct long-term follow-up studies, conduct intervention studies, and explore solutions at the policy level to more fully understand and address the impact of spousal mental illness on patients’ medical utilization and expenditure.

PMID:40458886 | DOI:10.1002/jso.28069

Acta Cardiol. 2025 Jun 3:1-8. doi: 10.1080/00015385.2025.2511519. Online ahead of print.

ABSTRACT

INTRODUCTION: Infective endocarditis is defined as an infection of the endothelial surfaces in the heart (valves and endocardium), prosthetic heart valves, and intracardiac devices (such as pacemaker leads and ventricular assist devices). Due to diagnostic challenges, determining the true incidence of infective endocarditis is difficult. Despite advancements in diagnosis and treatment, incidence and mortality rates have not decreased. In this study, we evaluated the clinical and laboratory parameters of patients with infective endocarditis followed in our hospital between 2005 and 2018 and assessed their relationship with in-hospital and one-year mortality.

METHODS: This study retrospectively analysed 145 patients aged ≥18 years who were diagnosed with infective endocarditis and followed in our hospital between 2005 and 2018. Data were analysed using IBM SPSS V23. Statistical analyses included the Shapiro-Wilk test, T-test, Mann-Whitney U test, and Chi-square test.

RESULTS: The average age of the patients was 53 (18-86), and 52.4% (n = 76) were male. In 34% (n = 37) of our patients, the predisposing factor for infective endocarditis was rheumatic valve disease. In-hospital mortality was 31.7%, and one-year mortality was 40.6%. A statistically significant difference in in-hospital mortality was found between combination therapy (23%) and medical therapy (40.8%). Mitral valve involvement was the most common, occurring in 48.3% of patients. Staphylococci were the most frequently isolated microorganisms in blood cultures (41.4%). Heart failure was the most common complication and was associated with the highest mortality rate (23.4%). NYHA was an independent predictor of in-hospital mortality.

CONCLUSION: In our study, surgical intervention, i.e. combination therapy, applied after two weeks of antibiotic treatment, was found to be more effective. Early combination therapy may be life-saving.

PMID:40458879 | DOI:10.1080/00015385.2025.2511519