Tag: pubmed

J Pediatr Orthop. 2025 Feb 3. doi: 10.1097/BPO.0000000000002917. Online ahead of print.

ABSTRACT

BACKGROUND: Shoulder dislocation can be seen early in infancy and can be diagnosed by shoulder ultrasound. Botulinum toxin injection in the internal rotators of the shoulder can be used to as an adjunct to relieve the internal rotation contracture. The aim of this study was to evaluate the intermediate-term outcomes of shoulder dislocations treated with injection botulinum toxin and to identify the factors determining the outcomes of the procedure.

METHODS: Eighty-six children with ultrasound diagnosed shoulder dislocation underwent injection BTX-A between 2011 and 2022. Children who underwent nerve surgeries and the ones with inadequate follow-up were excluded. Sixty-two children were followed up for a mean duration of 36 months. Injection botulinum toxin A 2 U/kg body weight was injected each into the subscapularis and the pectoralis major. After manual stretching of contracted anterior soft tissue and shoulder capsule, a shoulder spica was applied for 3 weeks. Hospital for Sick Children Active Movement Scale (HSC-AMS) score and active and passive shoulder was recorded before and after the procedure and the requirement for further interventions was noted.

RESULTS: Outcomes were divided into 3 categories: group A-27 (44%) children who did not require any further surgery in our follow-up period; group B-27 (44%) needed further procedure for recurrence of IR contracture; and group C-8 (12%) developed external rotation contracture later. Children in group A had statistically significant higher preinjection HSC-AMS score for elbow flexion and shoulder abduction than the other groups. Children in group C had greater passive external rotation and weak elbow extension and wrist dorsiflexion as compared with the other 2 groups.

CONCLUSIONS: Injection botulinum toxin A is effective in treating shoulder dislocations in children with early recruitment of C5 to 6 muscles, while children with involvement of C7 muscles may develop an external rotation contracture subsequently, hence this procedure should be avoided.

LEVEL OF EVIDENCE: Level IV-therapeutic.

PMID:39894942 | DOI:10.1097/BPO.0000000000002917

Cleft Palate Craniofac J. 2025 Feb 2:10556656251314264. doi: 10.1177/10556656251314264. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the reliability of different digitizing methods not only among themselves but also with direct measurements from facial plaster models of unoperated cleft babies.

DESIGN: Single-center retrospective study.

SETTING: The study consisted facial models of babies with unilateral (UCLP, n = 65) and bilateral (BCLP, n = 65) cleft lip and palate from the archives of the Department of Orthodontics, Marmara University, Istanbul, Turkey. Those models were digitized using Medit i600, iTero Element 2 (Align Technology), and E3 3Shape scanning devices. A digital caliper with a 0.03 precision (INSIZE Digital Caliper) was used for manual measurements on plaster models. 3Shape Ortho Analyzer software was used for digital measurements.

RESULTS: All scanning methods were reliable and compatible with a rate of 90% or more compared to manual measurements. The E3 3Shape device showed the lowest deviations (UCLP, between 0.04 and 0.11 mm; BCLP, between 0.04 and 0.25 mm) from manual measurements. In the UCLP group, Medit i600 presented the highest deviation (0.15-0.58 mm) whereas Itero Element 2 showed the highest deviation in the BCLP group (0.16-0.46 mm). Although there were statistically significant differences in the deviations of digital measurements, the values were still within clinically acceptable limits.

CONCLUSION: Intraoral scanners were less reliable in topographic measurements, especially in cases with increased depth. Although the highest compatible results were found with E3 3Shape model scanner, iTero Element 2 and Medit i600 were promising and advisable for digitizing and archiving the plaster models of babies with cleft lip and palate.

PMID:39894926 | DOI:10.1177/10556656251314264

Ultrasound Obstet Gynecol. 2025 Feb;65(2):198-205. doi: 10.1002/uog.29169.

ABSTRACT

OBJECTIVE: To investigate the correlation between the number, location and size of uterine fibroids and the incidence of late miscarriage during pregnancy.

METHODS: This was a retrospective, multicenter cohort study of singleton pregnancies, with a live fetus at the first-trimester ultrasound examination, without known genetic anomalies or major fetal defects, from January 2012 to December 2022. We assessed the impact of fibroids and their characteristics, identified on ultrasound imaging at 11 + 0 to 13 + 6 weeks, on the risk of late miscarriage occurring at 11 + 0 to 21 + 6 weeks. Fibroid number, location and size were investigated, and adjusted odds ratios (aORs) with 95% CIs were calculated using multiple logistic regression and propensity score analysis via inverse probability of treatment weighting (IPTW) to minimize confounding. Singleton pregnancies without uterine fibroids comprised the control group. We further calculated the adjusted absolute risk (aAR) for the control group and the adjusted risk differences (aRD) for the study groups.

RESULTS: In total, 31 355 singleton pregnancies were analyzed, of which 942 (3.0%) had uterine fibroids. Multiple logistic regression analysis showed that pregnancies with a single fibroid did not have higher odds for late miscarriage compared to those without fibroids (aOR, 1.2 (95% CI, 0.6-2.4)), but women with multiple fibroids did have higher odds of late miscarriage (aOR, 2.5 (95% CI, 1.0-6.2)). Similarly, multiple logistic regression analysis after IPTW did not find higher odds of late miscarriage in pregnancies with a single fibroid (aOR, 1.7 (95% CI, 0.9-3.0) and aRD, 0.7% (95% CI, -0.2 to 2.1%)) but revealed increased odds of late miscarriage in women with multiple fibroids (aOR, 2.9 (95% CI, 1.1-7.3) and aRD, 2.0% (95% CI, -0.6 to 9.7%)). Analysis of the location of single fibroids revealed that submucosal fibroids significantly increased the odds of late miscarriage by 4.7 times, while the presence of fibroids in other locations did not have a statistically significant association with late miscarriage. When we limited our study population to cases with submucosal and intramural fibroids, logistic regression showed no significant increase in the odds of miscarriage for a single fibroid (aOR, 1.8 (95% CI, 0.9-3.5) and aRD, 1.2% (95% CI, -0.1 to 3.1%)), but revealed significantly higher odds for multiple fibroids (aOR, 3.8 (95% CI, 1.4-10.6) and aRD, 5.1% (95% CI, 0.6-22.0%)) compared with controls. IPTW analysis found a 2.3-fold increase in the odds of late miscarriage for a single fibroid (aOR, 2.3 (95% CI, 1.2-4.2)) and an even larger increase in the odds of late miscarriage for multiple fibroids (aOR, 5.7 (95% CI, 2.2-15.1)).

CONCLUSION: Uterine fibroids are associated with increased odds of late miscarriage, particularly when they are multiple and submucosal. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.

PMID:39894923 | DOI:10.1002/uog.29169

Ultrasound Obstet Gynecol. 2025 Feb;65(2):226-234. doi: 10.1002/uog.29155.

ABSTRACT

OBJECTIVES: Ultrasound is the first-line imaging modality of the pelvis in the pediatric and adolescent gynecology (PAG) population. Ultrasound findings in pre- and postpubertal PAG patients differ from those in adults. Diagnostic models for adnexal pathology have not been validated in this cohort. The primary aim of this study was to evaluate normative findings and the incidence of pathology in this cohort. The secondary aim was to assess the performance of expert opinion alone, as well as using retrospective application of the International Ovarian Tumor Analysis (IOTA) simple rules (SRs) and benign descriptors (BDs) in those found to have an adnexal mass.

METHODS: This was a retrospective review of pelvic ultrasound examinations performed in patients < 18 years of age from January 2017 to July 2021 in one expert center in the UK. Analysis was performed on three age groups: neonatal (aged < 1 year), premenarchal (aged ≥ 1 year) and postmenarchal. The study was locally approved as an audit (GRM_082). Expert review of images of ovarian masses was performed using retrospective application of the IOTA-SRs and IOTA-BDs.

RESULTS: In total, data on 1429 pelvic ultrasound examinations were retrieved, of which 116 were excluded, resulting in the inclusion of 1313 ultrasound images (1145 patients). The median age at the first ultrasound scan was 2 days after birth in the neonatal group (n = 20), 8.8 years in the premenarchal group (n = 124) and 16.1 years in the postmenarchal group (n = 961). The status of menarche was unknown in a further 40 patients. Normative ultrasound findings were in keeping with those in the existing literature. Uterine anomalies were seen in 14 (1.2%) patients. Endometrial pathology was rare, with five cases of gestational trophoblastic disease. The most frequent indication for ultrasound scan for each group were a known medical condition in neonates (n = 11 (55.0%)), suspected precocious puberty in premenarchal girls (n = 38 (30.6%)) and abnormal vaginal bleeding in postmenarchal girls (n = 504 (52.4%)). Polycystic ovarian appearances were described in 150 (15.6%) postmenarchal girls. Adnexal pathology was identified in 102 (8.9%) participants on initial ultrasound: four neonates, three premenarchal and 95 postmenarchal patients. Benign cystadenomas and hemorrhagic cysts were the most common adnexal mass type in all groups. Final outcomes were available for 79/95 masses in the postmenarchal group, none of which were malignant. The IOTA-SRs, IOTA-BDs, expert opinion and standard ultrasound reporting could characterize as benign 96.2%, 87.3%, 98.7% and 77.2% of the masses, respectively, all with a specificity of 100%. Eleven patients underwent 12 surgeries overall (three oophorectomies, six cystectomies and three cyst aspirations), with 11 out of 12 masses classified as benign based on retrospective expert assessment.

CONCLUSIONS: Ultrasound is effective for assessment of the female pelvis in the PAG population. Adnexal masses are common, but few require surgical intervention and most resolve expectantly. The IOTA-BDs and IOTA-SRs maintain their performance in this population. Larger studies are required for the prospective validation of diagnostic models which may aid a fertility-sparing approach to care. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

PMID:39894922 | DOI:10.1002/uog.29155

Rural Remote Health. 2025 Feb;25(1):9170. doi: 10.22605/RRH9170. Epub 2025 Feb 2.

ABSTRACT

INTRODUCTION: The third objective of the UN Sustainable Development Goals (SDGs), ‘ensure healthy lives and promote well-being for all at all ages’, is manifest in Indonesia’s commitment to health. One of the SDG3 targets is to reduce under-five mortality and infant mortality. In rural areas of Indonesia, there is a lack of access to medical facilities (healthcare services, anthropometry tools) and health workers, so low birth weight (LBW, <2500 g) in rural areas remains high. This study aimed to determine the profile of and test the factors that cause LBW in Indonesia.

METHODS: This study used secondary data from the National Socio-Economic Survey/Survei Sosial Ekonomi Nasional (SUSENAS) 2021 with a national sample of 4 711 455 women (weighted), which is analyzed descriptively and inferentially. The analysis was conducted descriptively to determine the profile and distribution of LBW at the national and provincial levels, while inferential analysis was performed using logistic regression to determine the variables that most influence LBW.

RESULTS: The prevalence of LBW in Indonesia was found to be 11.7%. North Maluku was the province with the highest LBW rate (20.1%), and West Java had the highest number of LBW infants in Indonesia, with 104 585 infants. This study found that smoking, rural areas, poor nutrition, age of childbirth, age and birth spacing significantly affected the incidence of LBW in Indonesia. In rural Indonesia, women tend to give birth to LBW babies (adjusted odds ratio: 1.249; 95%CI: 1.241-1.256). The incidence of LBW babies in rural areas was higher than in urban areas (12.9% v 10.8%) in Indonesia.

CONCLUSION: This study concluded that smoking behavior is the main variable that influences the incidence of LBW in Indonesia. Therefore, there should be assistance to families by prioritizing significant factors for LBW (living in a village/rural area, low education, smoking behavior, not or rarely consuming nutritious food, maternal age at first birth 35 years and birth spacing <33 months). Especially for rural areas, governments need to improve access to healthcare facilities including availability of anthropometry tools, health workers, and healthcare services.

PMID:39894906 | DOI:10.22605/RRH9170

Lasers Med Sci. 2025 Feb 3;40(1):60. doi: 10.1007/s10103-025-04326-w.

ABSTRACT

Verrucous venous malformation (VVM) is a rare vascular malformation with hyperkeratosis. Concomitant laser and surgery are first line treatments, but evidence establishing efficacy is limited. We assess the efficacy of laser alone for VVM. Retrospective analysis of patients receiving laser treatment for VVM between 1994-2023. Of 83 patients, 29 were excluded due to missing data, 7 due to concomitant surgical excision and 47 were evaluated. Pulse dye laser (PDL) and combined dual PDL-neodymium-doped yttrium aluminium garnet (PDL-Nd:YAG) lasers were used. Outcomes were difference in percentage surface area (SA) reduction and colour improvement after laser treatment. Two blinded healthcare professionals independently graded the VVMs. Tools used included a numerically graded colour chart, and a 10 × 10 surface area grid to assess pre/post photos printed to the same scale. Mean Joules delivered with PDL; 9.29 and PDL-Nd:YAG; 9.16. Spot size (mm) for PDL; 8.58 and PDL-Nd:YAG; 9.63. Mean number of treatments was 5.27 and 3.68 in red and purple lesions respectively. Mean SA reduction for red and purple lesions; PDL; 71.11% and 6.67%, and PDL-Nd:YAG; 54.30% and 32.35%. Mean colour improvement in red and purple; PDL; 53.13% and 8.59%, and PDL-Nd:YAG; 46.88% and 40.81%. Red responded better than purple (p = 0.0014 and p = 0.024), for SA and colour respectively. There was no statistical significance in better outcomes; age at first treatment or number of treatments. Laser alone is an effective non-invasive method for improvement of colour and SA. Red lesions responded better to laser. PDL-Nd:YAG laser is preferred in purple lesions.

PMID:39894904 | DOI:10.1007/s10103-025-04326-w

J Cancer Educ. 2025 Feb 3. doi: 10.1007/s13187-025-02570-w. Online ahead of print.

ABSTRACT

This study aims to explore disparities in cancer treatment decision-making and the factors associated with the decision to pursue treatment. We used Behavioral Risk Factor Surveillance System (BRFSS) data collected between 2017 and 2022. We employed the PRECEDE-PROCEED model to guide our analysis of factors associated with treatment decisions. Descriptive statistics and multivariable logistic regression analysis were conducted to assess the association between treatment decision-making and the predisposing, enabling, and reinforcing factors (following the PRECEDE-PROCEED model). All analyses were weighted and adjusted for the demographic characteristics of the participants. Our sample included N = 19,388 cancer patients, 20.98% of whom refused treatment. American Indians, younger adults, and breast cancer patients were more likely to decide to go for treatment. Patients who had private insurance (OR = 1.25, P = .037) and those who did not have problems affording care (OR = 1.22, P = .02) were more likely to decide to get treatment. The more patients had regular doctors, the more they decided to continue to pursue treatment for cancer (Only one doctor: OR = 1.20, P = .042; More than one: OR = 1.28, P = .007). Finally, the more days patients experienced a bad health situation, the more they decided to have cancer treatment (for 14 + days with bad health: OR = 1.20, P < .001). The results suggest the need for enhanced patient education to improve cancer treatment adherence and informed decision-making. It highlights the importance of culturally tailored educational programs, age-related concerns, addressing financial barriers, and emphasizing the importance of regular healthcare visits for cancer patients.

PMID:39894898 | DOI:10.1007/s13187-025-02570-w

BMC Public Health. 2025 Feb 2;25(1):422. doi: 10.1186/s12889-025-21535-8.

ABSTRACT

BACKGROUND: Type 2 diabetes (T2D) disproportionately affects individuals of South Asian descent. Additionally, diabetes distress (DD) may lead to complications with diabetes management. This study examines the prevalence of DD among foreign-born individuals of South Asian descent in New York City (NYC) and its association with sociodemographic and clinical factors.

METHODS: Baseline data was collected from the Diabetes Research, Education, and Action for Minorities (DREAM) Initiative, an intervention designed to reduce hemoglobin A1c (HbA1c) among South Asian individuals with uncontrolled T2D at primary care practices in NYC. The Diabetes Distress Scale (DDS) measured DD, and Core Healthy Days Measures assessed physical and mental healthy days. Sociodemographic variables were analyzed using descriptive statistics, Chi-square tests assessed categorical variables, and Wilcoxon Rank Sum tests evaluated continuous variables (Type I error rate = 0.05). Logistic regression models examined associations between HbA1c, mental health, and other covariates with dichotomized DD subscales.

RESULTS: Overall, 414 participants completed the DDS at baseline (median age = 55.2 years; SD = 9.8). All were born outside of the US; the majority were born in Bangladesh (69.8%) followed by India, Pakistan, and Nepal (24.7%) and Guyana and Trinidad and Tobago (5.5%). High emotional burden, regimen-related distress and physician-related distress were reported by 25.9%, 21.9%, and 6.2% of participants, respectively. In adjusted analyses, individuals with ≥ 1 day of poor mental health had higher odds of overall distress (OR:3.8, p = 0.013), emotional burden (OR:4.5, p < 0.001), and physician-related distress (OR:4.6, p = 0.007) compared to individuals with no days of poor mental health. Higher HbA1c (OR:1.45, p = < 0.001) was associated with regimen-related distress; and lower emotional support was associated with overall distress (OR:0.92, p < 0.001) and regimen-related distress (OR:0.95, p = 0.012). Individuals born in Bangladesh had significantly lower odds of overall distress, emotional burden, and regimen-related distress compared to individuals born in Guyana and Trinidad and Tobago.

CONCLUSIONS: Findings highlight the rate and risk factors of DD among individuals of South Asian descent living in NYC. Screening for DD in patients with prediabetes or diabetes should be integrated to address mental and physical health needs. Future research can benefit from a longitudinal analysis of the impact of DD on diabetes self-management and health outcomes.

TRIAL REGISTRATION: This study uses baseline data from “Diabetes Management Intervention for South Asians” (NCT03333044), which was registered with clinicaltrials.gov on 6/11/2017.

PMID:39894868 | DOI:10.1186/s12889-025-21535-8

Sci Rep. 2025 Feb 2;15(1):4026. doi: 10.1038/s41598-025-88651-8.

ABSTRACT

Duchenne muscular dystrophy (DMD) is a severe neuromuscular disease due to loss of dystrophin, leading to progressive muscle wasting and physical inactivity. In this pilot study, we studied the effect of daily supplementation of the anabolic substrate beta-hydroxy-beta-methylbutyrate (HMB) on whole body protein and amino acid kinetics using novel isotope methods and daily activity in a canine model of DMD. Six DMD dogs were administered 3 g daily of HMB or placebo for 28 days according to a randomized, placebo-controlled, double-blinded crossover design. We measured pre- and post-intervention daily activity, biochemistry markers, and whole-body amino acid kinetics. We tracked daily activity with an activity monitoring device and measured plasma creatine kinase and standard clinical biochemistry panels to monitor muscle and organ function. To calculate whole body and intracellular amino acid production, we administered in the postabsorptive state an IV stable isotope solution containing 20 amino acid tracers. We collected blood before and six times after until two hours post tracer pulse administration and measured amino acid enrichments and concentrations by LC-MS/MS, subsequently followed by (non) compartmental modeling of the decay enrichment curves. Results were expressed as mean with 95% CI. Whole body production, plasma concentrations, and intra-/extracellular compartmental analyses of various amino acids were attenuated in HMB-dosed DMD dogs. Specifically, the plasma concentration of hydroxyproline (marker of collagen breakdown) was significantly higher in the placebo group compared to the HMB group. The intra- and extracellular pool sizes and flux between the two compartments of hydroxyproline was reduced in HMB treated dogs. DMD dogs treated with HMB as compared to placebo had a respective 40% increase in exertional (play) (951 [827, 1075] versus 569 [491, 647]; p < 0.0001) and 10.5% increase in non-exertional (active) activity (15,366 [14742, 15990] versus 13,806 [13148,14466]; p = 0.0016). In addition, a 6% reduction was found in rest time after HMB supplementation compared to placebo (23,857 [23,130, 24,584], versus 25,363 [24500, 26225]; p = 0.0122). Creatine kinase was not statistically different between groups. We did not observe any adverse clinical or biochemical-related effects of HMB dosing. Daily HMB supplementation in DMD dogs can safely and positively influence protein and amino acid metabolism and improve overall daily activity.

PMID:39894866 | DOI:10.1038/s41598-025-88651-8

Breast Cancer Res Treat. 2025 Feb 2. doi: 10.1007/s10549-025-07624-7. Online ahead of print.

ABSTRACT

PURPOSE: This study explored changes in employment and financial hardship following breast cancer diagnosis.

METHODS: We used data from a single-institution, longitudinal study of women with newly diagnosed breast cancer who received curative intent chemotherapy. The primary outcomes of interest in this analysis were breaks in active employment, defined as being out of work for the four weeks prior, and patient-reported acute financial burden during chemotherapy and up to 24 months following chemotherapy completion. Mixed-effects logistic regression models were used to identify factors associated with breaks in employment and financial burden.

RESULTS: The cohort consisted of 104 women who were employed at time of breast cancer diagnosis. The mean age was 49.6 years and 86% were non-Hispanic White, 11% African American or Black, and 4% another race or ethnicity. In multivariable models, African-American women were 168% more likely to report a break from active employment than their non-Hispanic white counterparts (adjusted odds ration [aOR] 2.68; p = 0.026). A break from active employment was not statistically associated with greater self-reported acute financial burden, but patients from the lowest socioeconomic status tertile were 173% more likely to report financial burden than those in the highest tertile (aOR 2.73; p = 0.022).

CONCLUSION: African-American breast cancer survivors were more likely to report breaks from active employment than their White peers, even after adjusting for type of work and socioeconomic status.

IMPLICATION FOR CANCER SURVIVORS: African-American and Black breast cancer survivors may face greater challenges returning to work.

PMID:39894861 | DOI:10.1007/s10549-025-07624-7