Tag: pubmed

Khirurgiia (Mosk). 2026;(2):93-99. doi: 10.17116/hirurgia202602193.

ABSTRACT

OBJECTIVE: The aim of the study is to compare between the use of buccal mucosal graft and lingual mucosal graft in management of anterior urethral stricture with evaluation of surgical outcome and donor site morbidity.

METHODS: This is a case control comparative study, was carried out at Ain Shams university hospital. All cases were selected from those attending the urology outpatient clinic presenting with lower urinary tract symptoms secondary to stricture anterior urethra and prepared for surgical management by urethroplasty with dorsal onlay technique.

RESULTS: There was no statistically significant difference between the studied groups regarding age, smoking, comorbidities, associated urinary condition and having urinary catheter. There was no statistically significant difference between the studied groups regarding stricture, graft and operation characteristics. There was no statistically significant difference between the studied groups regarding general and urethral outcomes. Problems with drinking (day-3), problems with eating soft food (day-3), problems with eating solid food (day-3 and week-2), dysgeusia (day-3 and week-2) and speaking problems (day-3, week-2 and month-6) were significantly less frequent in BMG group. Oral tightness (day-3, week-2 and month-6) was significantly more frequent in BMG group.

CONCLUSION: As evident from the current study, the study concluded that both buccal mucosal graft (BMG) and lingual mucosal graft (LMG) are effective options for the surgical management of anterior urethral strictures. The surgical outcomes, including graft success, stricture recurrence, and urethral function, were similar between the two groups. However, significant differences were observed in donor site morbidity. Patients in the LMG group experienced more early postoperative complications related to oral functions, such as difficulties with drinking, eating, and speaking. On the other hand, BMG patients reported more long-term issues with oral tightness. These findings suggest that both grafts are suitable for urethral stricture repair, but the choice of graft may depend on individual patient circumstances, particularly regarding their tolerance for specific oral complications.

PMID:41717750 | DOI:10.17116/hirurgia202602193

Khirurgiia (Mosk). 2026;(2):55-62. doi: 10.17116/hirurgia202602155.

ABSTRACT

BACKGROUND: Colorectal cancer is one of the most prevalent oncological diseases, with rectal cancer accounting for a substantial proportion of cases. Surgical intervention remains the cornerstone of treatment, with its success significantly influenced by individual pelvic anatomy. Nevertheless, there is a notable scarcity of studies specifically focused on evaluating surgical complexity based on pelvic MRI pelvimetry.

OBJECTIVE: To identify the prognostic factors of pelvic MRI pelviometry that affect the complexity of surgical treatment of rectal tumors.

MATERIAL AND METHODS: A retrospective analysis was conducted on 28 patients with tumors of the rectum and rectosigmoid junction who underwent surgery at the University Clinic of the MNOI of Lomonosov Moscow State University between 2022 and 2024. Surgical complexity was assessed based on operative time, blood loss, conversion rate, ureteral injury, and anastomotic leakage. Correlations between these parameters and MRI pelvimetry data were analyzed.

RESULTS: The mean operative time was 262±85 minutes, with a mean blood loss of 161±240 mL. Ureteral injuries and conversions were observed in 7.1% of cases (2 each), and anastomotic leakage occurred in 10.7% (3 cases). Significant correlations were found between operative time and intertuberous (r=-0.55; p<0.05) and interspinous distances (r=-0.46; p<0.05), as well as sacrococcygeal distance (r=0.48; p<0.05), anorectal angle (r=0.46; p<0.05), and tumor size (r=0.39; p<0.05).

CONCLUSION: Several MRI pelvimetry parameters of the pelvis were significantly correlated with surgical complexity in rectal cancer. Preoperative evaluation of these parameters may improve surgical planning and outcomes.

PMID:41717746 | DOI:10.17116/hirurgia202602155

Khirurgiia (Mosk). 2026;(2):51-54. doi: 10.17116/hirurgia202602151.

ABSTRACT

OBJECTIVE: To improve surgical treatment of abdominal trauma using endoscopic surgical methods.

MATERIAL AND METHODS: The study enrolled 87 patients with abdominal organ injuries. All patients were divided into two groups depending on surgical approach: group 1 – traditional surgical treatment, group 2 – advanced strategy based on endoscopic surgical methods.

CONCLUSION: Endoscopic technologies for abdominal trauma reduce the incidence of open diagnostic surgeries, postoperative morbidity and length of hospital-stay.

PMID:41717745 | DOI:10.17116/hirurgia202602151

Khirurgiia (Mosk). 2026;(2):29-35. doi: 10.17116/hirurgia202602129.

ABSTRACT

OBJECTIVE: To improve treatment outcomes in patients with acute severe pancreatitis by using of complex staged surgical treatment based on minimally invasive techniques in multi-field emergency hospital.

MATERIAL AND METHODS: The study enrolled 343 patients with acute pancreatitis (mild – 123 (35.9%) patients, moderate – 119 (34.7%) patients, severe – 101 (29.4%) patients). Seventy-one (70.3%) patients had severe alimentary pancreatitis, 29 (28.7%) – biliary pancreatitis, 1 (1.0%) – traumatic pancreatitis. Mean hospital-stay in patients with severe acute pancreatitis was 23.0 [1; 115] days.

RESULTS: Organizational measures, reorganization of hospital management structure, changes in methodological principles and personnel of surgical department are described. Minimally invasive percutaneous, transluminal, laparoscopic and traditional surgical interventions were performed in 52 (51.5%) patients with severe pancreatitis. Sequestrectomy was performed in 19 (36.5%) patients (percutaneous – 14 (26.9%), transluminal – 5 (9.6%)). Mortality rate without surgery was 18.4% (n=9), after minimally invasive sequestrectomy- 31.1% (n=5).

CONCLUSION: There were better postoperative outcomes in patients with acute severe pancreatitis in multi-field emergency hospital after organizational restructuring of hospital, changes in medical personnel training and equipment. Optimized interdisciplinary interaction in multidisciplinary approach to acute severe pancreatitis was effectively achieved through higher versatility of all surgeons to multifunctional specialists.

PMID:41717742 | DOI:10.17116/hirurgia202602129

Int J Soc Psychiatry. 2026 Feb 20:207640251411971. doi: 10.1177/00207640251411971. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to assess the prevalence and predictors of depression, anxiety, and stress among medical residents in Tehran, Iran.

METHODS: This cross-sectional study was conducted from January 1 to February 28, 2022, as part of a broader investigation into mental health among medical residents A total of 353 medical residents from various universities in Tehran participated. Data were collected via an online questionnaire, including the Depression, Anxiety, Stress Scale-21 (DASS-21) and demographic variables. Statistical analyses, including Pearson’s Chi-square test and linear regression, were used to identify significant mental health predictors.

RESULTS: The prevalence of depression, anxiety, and stress was 69.3%, 63.2%, and 64.6%, respectively. Significant predictors included marital status, gender, number of children, housing situation, specialty type, and workload. First-year residents reported higher psychological distress than senior residents. Surgical residents exhibited the highest levels of depression, anxiety, and stress, followed by medical and paramedical specialties.

CONCLUSION: Our findings highlight the urgent need for targeted mental health interventions for medical residents in Tehran, addressing specific risk factors across specialties and residency years to enhance well-being and healthcare quality.

PMID:41717738 | DOI:10.1177/00207640251411971

Inorg Chem. 2026 Feb 20. doi: 10.1021/acs.inorgchem.5c05447. Online ahead of print.

ABSTRACT

The Ga-rich region of the Fe-Ni-Ga ternary system was investigated, by exploring a line of compositions Fe_xNi_3-xGa₄, with 0.5 ≤ x ≤ 2.5. The single-phase cubic material was found only at the composition Fe_1.5Ni_1.5Ga₄ and its immediate vicinity, representing a new phase in the Fe-Ni-Ga diagram. The homogeneity range of this phase was estimated by additionally exploring a set of compositions Fe_xNi_yGa_z around the central composition Fe_1.5Ni_1.5Ga₄. The structural model was constructed based on the structure of the binary Ni₃Ga₄ parent phase, which crystallizes in the cubic Ia 3̅ d space group. We have considered that by substituting Fe for Ni, the Ia 3̅ d structure is preserved, with the Fe and Ni being statistically distributed at their 48g Wyckoff site. The possibility of a symmetry-reduced chiral structural model I4₁32 driven by chemical ordering of Fe and Ni cannot be entirely ruled out on the basis of the crystallographic study. The magnetic study of the Fe_1.5Ni_1.5Ga₄ phase has revealed that the material forms a spin glass phase below the spin freezing temperature T_f ≈ 9 K. Since the spin glass ordering of the Fe and Ni magnetic moments is compatible with their random distribution, the magnetic study supports the disordered cubic Ia 3̅ d model.

PMID:41717735 | DOI:10.1021/acs.inorgchem.5c05447

Head Neck. 2026 Feb 20. doi: 10.1002/hed.70206. Online ahead of print.

ABSTRACT

BACKGROUND: Expiratory muscle strength training (EMST) is a non-invasive, evidence-based treatment that is used to improve swallowing in head and neck cancer (HNC) survivors. This prospective, pilot implementation study evaluated the feasibility, acceptability, and potential clinical effectiveness of a novel student-led tele-EMST program for HNC survivors.

METHODOLOGY: HNC survivors (n = 13) completed an eight-week tele-EMST program. Acceptability was measured using the Theoretical Framework of Acceptability Questionnaire (TFAQ) and the Telehealth Usability Questionnaire (TUQ). Feasibility was tracked weekly. Swallowing performance, airway clearance, and quality of life were evaluated using the Timed Water Swallow Test (TWST), peak expiratory flow rate (PEFR), and SWAL-QoL, respectively. Data were collected with REDCap. Descriptive and non-parametric statistics were performed.

RESULTS: Acceptability of the tele-EMST program was high, as evidenced by high ratings on the TUQ (mean: 88.1/100%, SD: 16.3) and significant improvement on the TFAQ (p < 0.05). Technical issues occurred in 24% of sessions but were all resolved. Swallowing performance (TWST, p < 0.05), self-reported dysphagia symptoms, and mental health scores (SWAL-QoL, p = 0.03; p = 0.02) significantly improved. No significant changes in PEFR were observed (p = 0.59).

CONCLUSION: The findings of this small pilot feasibility suggest that a student-led, tele-EMST program is a promising, scalable approach to reduce treatment inequities and support survivorship care for HNC survivors with dysphagia.

PMID:41717720 | DOI:10.1002/hed.70206

Circ Popul Health Outcomes. 2026 Feb 20:e013261. doi: 10.1161/CIRCOUTCOMES.125.013261. Online ahead of print.

ABSTRACT

BACKGROUND: Lp(a) (lipoprotein[a]) is a known cardiovascular risk factor; however, its role in cardiac remodeling and functional changes over time across diverse racial and ethnic groups remains underexplored.

METHODS: MESA is a prospective multi-ethnic cohort study of individuals without a history of cardiovascular disease on enrollment (2000-2002), conducted across 6 sites in the United States. Participants with baseline Lp(a) measurements and cardiac magnetic resonance imaging at both baseline and 10-year follow-up exam were included. Lp(a) was treated as both a log-transformed continuous variable (per SD log) and a categorical variable based on data-driven Lp(a) terciles. Multivariable regression models adjusted for sociodemographic, and cardiovascular risk factors, including coronary artery calcium and interim myocardial infarction, were used to assess associations between Lp(a) and longitudinal changes in left ventricular and atrial structure and function over a decade across different racial/ethnic groups.

RESULTS: A total of 2366 participants were included. The average age at baseline was 60±9 with 53% women, 43% White, 24% Black, 21% Hispanic, and 12% Chinese. Each 1-SD increase in log-transformed Lp(a) was associated with an increase in left ventricular end-systolic volume index (β, 0.60 [95% CI, 0.02-1.18]), and left atrial minimum volume index (β, 0.81 [95% CI, 0.09-1.52]), and a decline in left ventricular ejection fraction (β, -0.75 [95% CI, -1.34 to -0.17]), and total left atrial emptying fraction (β, -1.17 [95% CI, -2.09 to -0.24]) in Hispanic subjects over a decade. No significant associations were seen in White, Black, or Chinese participants. The observed findings persisted after adjusting for coronary artery calcium, interim myocardial infarction, and atrioventricular decoupling, and when Lp(a) was treated as a categorical variable with race-specific terciles.

CONCLUSIONS: Elevated Lp(a) levels were independently associated with maladaptive left ventricular and left atrial remodeling in Hispanic adults over a decade, while no statistically significant relationships were observed in White, Black, and Chinese participants. This suggests a unique susceptibility of Hispanic individuals to Lp(a)-mediated cardiovascular remodeling, independent of ischemic pathways.

PMID:41717692 | DOI:10.1161/CIRCOUTCOMES.125.013261

J Obstet Gynaecol Res. 2026 Feb;52(2):e70214. doi: 10.1111/jog.70214.

ABSTRACT

AIM: To evaluate the educational outcomes of a nationwide faculty development initiative tailored to obstetrician-gynecologists in Japan, addressing the gap in systematic faculty development implementation and assessment within the specialty.

METHODS: This observational study evaluated three online faculty development seminars conducted by the Japan Society of Obstetrics and Gynecology between December 2023 and August 2024. Using Kirkpatrick’s four-level model, we assessed participant satisfaction (Level 1), self-assessed knowledge gain (Level 2), and behavioral implementation in clinical practice (Level 3). Data were collected using post-seminar and longitudinal follow-up questionnaires.

RESULTS: Level 1 (Reaction): Among the 195 participants, 85.1% completed the post-seminar surveys, with satisfaction rates ranging from 87.9% to 93.0%. Level 2 (Learning): Self-assessed knowledge scores significantly improved across all three seminars (e.g., Seminar 1: from 4.0 to 7.0 on a 9-point scale, p < 0.05). Level 3 (Behavior): Among participants who attended multiple sessions, 74.1% reported implementing learned skills, such as feedback techniques and leadership strategies, with the majority noting positive educational outcomes.

CONCLUSIONS: Nationwide faculty development programs tailored to obstetrics and gynecology can enhance educational competence and promote behavioral change. Our findings highlight the feasibility and effectiveness of specialty-specific faculty development and indicate the need for long-term objective assessments to ensure a sustainable impact. These findings have significant implications for the field of obstetrics and gynecology, suggesting that targeted faculty development initiatives can play a crucial role in improving the quality of medical education and addressing workforce shortages.

PMID:41717673 | DOI:10.1111/jog.70214

Trop Med Int Health. 2026 Feb 20. doi: 10.1111/tmi.70094. Online ahead of print.

ABSTRACT

INTRODUCTION: Gonorrhoea remains a leading sexually transmitted infection worldwide, with an estimated 82 million new cases being reported annually. In Kenya, epidemiological and antimicrobial resistance data are fragmented and under-represent high-risk populations, hampering targeted interventions.

OBJECTIVE: To estimate the pooled prevalence of Neisseria gonorrhoeae and assess patterns of antimicrobial resistance in Kenya between 2019 and 2024.

METHODOLOGY: We searched PubMed, Google Scholar, OpenAlex and Research4Life following PRISMA guidelines, yielding 1116 records. Two reviewers independently screened studies against predefined inclusion criteria. Prevalence and resistance data were extracted, and a random-effects meta-analysis was performed to compute pooled estimates with 95% confidence intervals. Heterogeneity among studies was assessed using the I² statistic.

RESULTS: Eleven studies comprising 5170 participants met inclusion criteria. The pooled prevalence of N. gonorrhoeae was 22.5% (95% CI: 17.2-27.8). Key risk factors included sex work, low educational attainment and multiple sexual partners. Resistance rates were highest for tetracycline (98.0%), ciprofloxacin (96.7%) and penicillin (94.7%) and lowest for azithromycin (2.0%), cefixime (2.6%) and ceftriaxone (1.3%).

CONCLUSION: N. gonorrhoeae poses an urgent public health threat in Kenya. Strengthening surveillance, expanding access to reliable diagnostics and enforcing antibiotic stewardship are critical. Exploration of alternative therapies including phage therapy, alongside accelerated vaccine research, will be essential for sustainable disease control.

PMID:41717668 | DOI:10.1111/tmi.70094