Tag: pubmed

Eur J Orthop Surg Traumatol. 2025 Jul 31;35(1):332. doi: 10.1007/s00590-025-04456-5.

ABSTRACT

BACKGROUND: Rates of both total shoulder arthroplasty (TSA) and cervical spine surgery for degenerative cervical spine disease (DCSD) are increasing. However, it is still unknown if prior cervical spine surgery for DCSD impact outcomes following TSA. This study aims to compare the risk of complications and revisions in patients undergoing TSA with DCSD between patients with and without prior cervical spine surgery.

METHODS: This study is a retrospective review of the PearlDiver Mariner Database. Based on whether or not patients had prior cervical spine surgery, the patients with DCSD and undergoing TSA were divided into 2 groups: patients with DCSD and cervical spine surgery, and patients with DCSD and without cervical spine surgery. The two groups were matched based on age, gender, the Charlson comorbidity index (CCI), and obesity. Surgical complications and revisions with regards to their TSA at 1 through 5 years post-operatively were compared between the groups.

RESULTS: The TSA with DCSD and no cervical spine surgery cohort were older (63.7 ± 8.4 vs 61.2 ± 8.4 years, p < .001), had higher CCI (1.2 ± 1.7 vs 1.0 ± 1.6, p < .001), had a higher proportion of males (47.8% vs 41.8%, p = 0.01), and had a lower % of patients with obesity (50.9% vs 53.3%, p = 0.01). After matching, 2899 patients remained in each group. The group with prior cervical spine surgery had higher rates of mechanical loosening at 5 years post-operatively (1.2% vs 1.8%, p = 0.05), and lower rates of periprosthetic fractures at 3 and 4 years post-operatively (0.4% vs < 10, p = 0.01; 0.5% vs < 10, p = 0.02 respectively). No difference in the remaining surgical complications or revisions was seen between the two groups.

CONCLUSION: This study highlights an increase in risk of mechanical loosening after TSA in patients with prior cervical spine surgery. Additionally, patients with DCSD without prior cervical spine surgery had an increased risk of sustaining periprosthetic fractures after TSA, potentially due to untreated myelopathy and related falls.

PMID:40742568 | DOI:10.1007/s00590-025-04456-5

Support Care Cancer. 2025 Jul 31;33(8):734. doi: 10.1007/s00520-025-09797-9.

ABSTRACT

PURPOSE: This study aims to evaluate the association between receiving pre-radiotherapy multidisciplinary survivorship care and patient-reported outcomes measures (PROMs) pertaining to quality of life (QOL), symptom burden, and psychological distress at one-year post-radiotherapy among head and neck cancer (HNC) survivors.

METHODS: Survivors who underwent radiotherapy from 2017-2022 and completed PROMs during their one-year post-radiotherapy visit at a multidisciplinary HNC survivorship clinic were included. Survivors with recurrent disease, second primary tumor, and/or distant metastasis were excluded. Differences in PROMs between propensity score matched survivors who did and did not have a pre-radiotherapy visit were analyzed using multivariable regression models controlling for covariates.

RESULTS: 310 survivors were included (mean [SD] age, 61.09 [9.58] years; 238 [76.8%] male; 159 [51.3%] pre-radiotherapy visit; 163 [52.6%] oropharyngeal; 161 [54.9%] early T stage; 159 [51.5%] early N stage). Compared to survivors without a pre-radiotherapy visit, survivors with a pre-radiotherapy visit had higher physical (+ 7.26 points, 95% CI [3.35, 11.18], p < 0.001) and social-emotional (+ 5.93 points, 95% CI [1.58, 10.29], p = 0.008) QOL scores and lower depression (-1.31 points, 95% CI [-2.61, -0.01], p = 0.048), anxiety (-1.18 points, 95% CI [-2.23, -0.13], p = 0.027), dysphagia (-3.77 points, 95% CI [-6.36, -1.19], p = 0.004), insomnia (-2.76 points, 95% CI [-4.61, -0.92], p = 0.004), and neck disability (-2.28 points, 95% CI [-4.41, -0.16], p = 0.035) scores one-year post-radiotherapy.

CONCLUSIONS: Receiving pre-radiotherapy multidisciplinary survivorship care was associated with higher QOL and lower symptom burden and psychological distress among HNC survivors. These findings support implementing proactive survivorship care in clinical practice to improve health outcomes in HNC.

PMID:40742566 | DOI:10.1007/s00520-025-09797-9

Eur Child Adolesc Psychiatry. 2025 Jul 31. doi: 10.1007/s00787-025-02797-4. Online ahead of print.

ABSTRACT

Few randomized clinical trials (RCTs) have compared cognitive behavioral therapy (CBT) versus active control interventions for pediatric obsessive-compulsive disorder (OCD), and the range of investigated outcomes has been limited. We investigated benefits and harms of family-based CBT with exposure and response prevention (FCBT) versus family-based psychoeducation and relaxation training (FPRT) in pediatric OCD. This single-center RCT was investigator-initiated, independently funded, including participants with OCD aged 8-17 years with a Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) entry score ≥ 16. We randomized participants 1:1 to 14 sessions of FCBT versus FPRT. Allocation was masked to assessors and statisticians. The primary outcome was CY-BOCS end-of-treatment-score (week-16) analyzed by intention-to-treat. Adverse events were reported by the Negative Effects Questionnaire (NEQ-20). One-hundred-and-thirty participants were randomized, 52.3% females; mean age 13.3 (SD = 2.9) years; mean CY-BOCS total score 25.8 (SD = 4.9); n = 64 to FCBT versus n = 66 to FPRT. Sixteen participants dropped out (four from FCBT, 12 from FPRT). The mean CY-BOCS total score at end-of-treatment was significantly lower for FCBT (15.9, SD = 8.7) versus FPRT (19.9, SD = 8.1), estimate – 3.89, 95%CI [-6.83, – 0.96), p = 0.01, effect size = 0.47, 95% CI [0.09, 0.85]. This difference was below our predefined minimal clinically important difference of four points. The average weekly NEQ frequency score showed no significant group differences. FCBT was associated with significantly larger symptom reduction than FPRT, but with a modest effect. FCBT and FPRT appeared comparably tolerable. A rigorous methodology enabled the counteraction of several biases. Limitations included missing self-reported data and inability of masking participants and treatment providers.

PMID:40742552 | DOI:10.1007/s00787-025-02797-4

Langenbecks Arch Surg. 2025 Jul 31;410(1):236. doi: 10.1007/s00423-025-03808-3.

ABSTRACT

BACKGROUND: Postoperative ileus (POI) is a common consequence following abdominal surgeries; however, its incidence and risk factors in non-abdominal procedures remain unknown. Identifying clinical indicators of POI in this population is essential for early detection and treatment.

OBJECTIVE: This study aims to assess the incidence and determinants of postoperative ileus (POI) in patients undergoing non-abdominal surgeries at Debre Tabor Comprehensive Specialized Hospital.

METHODS: A prospective cohort study was conducted between September 1, 2024, and January 30, 2025. Demographic characteristics, comorbidities, surgical details, and perioperative parameters were recorded. Data were analyzed using SPSS version 27, with continuous and categorical variables summarized using descriptive statistics. Independent predictors of postoperative ileus (POI) were identified through bivariate and multivariate logistic regression analyses.

RESULTS: Among the 400 patients who underwent elective non-abdominal surgery, 31 (7.75%) developed postoperative ileus (POI). Significant predictors included opioid use (OR = 3.28 [95% CI, 2.25-7.12], P < 0.01), neuromuscular blockers (OR = 2.33 [95% CI, 2.01-5.12], P < 0.01), poor postoperative functional status (OR = 5.67 [95% CI, 3.41-8.91], P < 0.01), and delayed postoperative mobility (OR = 4.45 [95% CI, 2.05-8.17], P < 0.01).

RECOMMENDATION AND CONCLUSION: POI occurs in a significant proportion of patients undergoing non-abdominal surgery. Implementing targeted perioperative strategies may reduce the incidence of POI and enhance postoperative outcomes.

PMID:40742541 | DOI:10.1007/s00423-025-03808-3

Int Urogynecol J. 2025 Jul 31. doi: 10.1007/s00192-025-06253-4. Online ahead of print.

ABSTRACT

INTRODUCTION AND HYPOTHESIS: After the age of 80, the cumulative incidence of surgery of pelvic organ prolapse (POP) exceeds 15%. While concomitant supracervical hysterectomy (SCH) is very popular at the time of sacrocolpopexy in some parts of the world, it is rarely performed in many European countries. The aim of the present study was to compare the outcomes of robotic sarcrocolpopexy with or without SCH.

METHODS: The charts of all consecutive patients who underwent minimally invasive sacrocolpopexy for POP at a single center between 2013 and 2023 were included in a retrospective study. The remaining patients were included for analysis and divided in two groups: with (HYST) vs. without (no HYST) supracervical hysterectomy.

RESULTS: Out of 197 minimally invasive sacrocolpopexy, 88 were included in the present analysis: 39 in the HYST group and 49 in the no-HYST group. The only statistically significant difference at baseline between the two groups was the higher proportion of grade 3 or 4 uterine prolapse in the HYST group (35.1% vs. 10.2%; p = 0.01). The postoperative complications rates were similar in both groups (16.7% vs. 18.4%; p = 0.84). After a median follow-up of 12 months, the subjective success rate was similar (96.6% vs. 92.2%; p = 0.44). Most outcomes were not significantly different.

CONCLUSIONS: In the present study, we did not demonstrate a benefit for SCH at the time of sacrocolpopexy. However, we did not observe an increased morbidity in the HYST group, suggesting that it may not exist anymore beyond the learning curve in the robotic era.

PMID:40742532 | DOI:10.1007/s00192-025-06253-4

Eur J Drug Metab Pharmacokinet. 2025 Jul 31. doi: 10.1007/s13318-025-00959-y. Online ahead of print.

ABSTRACT

INTRODUCTION: An increasing number of patients in clinical practice are transitioning from intravenous (IV) to subcutaneous (SC) dosing of infliximab. In this simulation study, we evaluated hypothetical dosing scenarios both for typical adults and adults with obesity and for children switching from steady-state IV to SC infliximab, as well as those initiating SC infliximab therapy.

METHODS: By combining two previous published infliximab models, we were able to simulate both IV and SC dosing in adults and children. Various dosing regimens were simulated using a large virtual population. In each scenario, the distribution of trough concentrations and area under the plasma concentration-time curve (AUC) was calculated.

RESULTS: Peak levels were higher after IV dosing compared with SC dosing, while trough levels were higher after SC dosing, leading to more stable infliximab levels over time. Overall exposure remained largely similar when switching from a standard IV to SC dosing regimen. Patients with a high body mass index and those on high-frequency IV dosing regimens of infliximab demonstrated reduced exposure when transitioned to the fixed SC dose. Paediatric patients exhibited higher exposure on the fixed SC dose. Simulation of SC induction schemes demonstrated early achievement of steady-state plasma levels.

CONCLUSION: Infliximab exposure (AUC) remains largely similar when transitioning from standard IV to SC dosing. Current dosing regimens may not be optimal for patients with severe obesity, paediatric patients and patients on high-frequency infliximab regimens. These findings provide a foundation for future clinical research to refine SC infliximab dosing in these populations.

PMID:40742528 | DOI:10.1007/s13318-025-00959-y

Macromol Rapid Commun. 2025 Jul 31:e00251. doi: 10.1002/marc.202500251. Online ahead of print.

ABSTRACT

This study aimed to identify solvent characteristics that enhance drug loading in polymeric micelles. Polyethylene glycol-block-polystyrene (PEG-b-PS) and curcumin were used as model compounds to investigate the impact of 40 different solvent mixtures on drug loading during flow-based assembly. We tested five algorithms: Random Forest (RF), Gradient Boosting (GP), XGBoost, Support Vector Regression (SVR), and Multilayer Perceptron (MLP), with the MLP model proving to be the most effective among them. To explain the model’s predictions, we utilized SHapley Additive exPlanations (SHAP) values to identify solvent properties that contribute to high drug loading. Of the nine descriptors examined-curcumin solubility, polarity, Hildebrand solubility parameters, dipole moment, dielectric constants, viscosity, and Hansen solubility parameters (δD, δP, and δH)-solubility emerged as the most critical factor. Therefore, to achieve optimal drug loading, researchers should prioritize solvents with the highest solubility.

PMID:40742525 | DOI:10.1002/marc.202500251

Mol Diagn Ther. 2025 Jul 31. doi: 10.1007/s40291-025-00801-w. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Primary ciliary dyskinesia (PCD) is a rare genetic condition characterised by abnormal ciliary motility, primarily affecting the respiratory tract. Despite its clinical significance, there is currently no gold standard for PCD diagnosis. This study aims to address this diagnostic challenge by evaluating a comprehensive approach in a large cohort of patients with suspected PCD.

METHODS: We conducted a retrospective analysis of 128 patients with suspected PCD at a specialised clinical reference unit. A thorough anamnesis was performed, followed by a triad of diagnostic tests: (i) a high-speed video analysis of ciliary beat pattern; (ii) transmission electron microscopy for ciliary ultrastructure examination; and (iii) a genetic analysis, primarily through clinical exome sequencing. Correlations between the clinical, morphological and genetic findings were studied. Functional assays on RNA were performed to assess new splicing variants. Pearson’s chi-square test was used to compare categorical variables and comparisons of means were performed using the Student’s t-test.

RESULTS: A definitive PCD diagnosis was established in 72% of the studied patients. Notably, only 58% of the diagnosed cases showed positive results across all three diagnostic tests. Patients with immotile cilia have a higher frequency of neonatal respiratory distress and had a higher likelihood of receiving a genetic diagnosis. A high-speed video analysis was altered in 116 patients, 53 of them with immotile cilia. A transmission electron microscopy revealed ultrastructural alterations in 67 patients, with class 1 defects being more common. DNAH5, RSPH1 and DNAH11 were the most represented genes among the 18 causal genes found. Among the 71 causal genetic variants found, we highlight the overrepresentation of the c.85G>T in RSPH1 and describe the aberrant effect on RNA of the splicing variants DNAH11:c.11497-6T>G, DNAH9:c.2596-2dup, CCDC40:c.2597A>G and CCDC40:c.2832G>A. Finally, we describe a severe phenotype associated with the RSPH1 gene, contrary to previously reported data.

CONCLUSIONS: This comprehensive analysis of a large cohort of patients with PCD underscores the challenges in achieving a definitive diagnosis and emphasises the need for a multi-faceted diagnostic approach. This study enhances our understanding of this rare condition, including the identification of new splicing variants and an unexpected severe phenotype associated with RSPH1, challenging previous assumptions about genotype-phenotype correlations in PCD.

PMID:40742517 | DOI:10.1007/s40291-025-00801-w

J Epidemiol Glob Health. 2025 Jul 31;15(1):100. doi: 10.1007/s44197-025-00421-x.

ABSTRACT

BACKGROUND: In Ethiopia’s Sidama National Regional State, diarrhea remains the second most common cause of illness among children under five, despite a decrease in its mortality rate. However, limited research has been conducted in Ethiopia to identify the causes behind the continuing rise in the prevalence of diarrhea in children associated with exposure to domestic animals. Therefore, this study explores the relationship between domestic animal, environmental, and human behavioral factors and confirmed cases of diarrhea in children under five in the Sidama National Regional State of Ethiopia.

METHODS: We conducted a matched-pairs case-control study involving 306 cases and 306 controls in the Sidama region from September 2022 to February 2023. Cases and controls were identified at healthcare facilities, and interviews and observations were completed at residential homes with children under five. We collected data using the KoboCollect application and analyzed it through conditional logistic regressions. The random forest (RF) method with the classification RF model was used to compare its findings with those of the multivariate conditional regression analysis. The statistical analyses were conducted using R v.4.3.2 software.

RESULTS: The study indicated that having a caretaker who is a housewife [matched adjusted odds ratio (mAOR) = 3.09, 5% CI (1.09, 8.70)], a mean number of chickens ≥ 5 [mAOR = 5.18, 95% CI (2.70, 9.95)], the absence of soap at handwashing facilities [mAOR = 2.61, 95% CI (1.34, 5.10)], those who travel more than 30 min to fetch water [mAOR = 3.14, 95% CI (1.13, 8.78)], children who are in contact with animal feces [mAOR = 2.44, 95% CI (1.24, 4.82)], and households living with animals [mAOR = 3.28, 95% CI (1.71, 6.30)] showed significant associations with under-five diarrhea. The random forest analysis also identified the first five variables as the main risk factors for diarrhea occurrence among children under-five years of age.

CONCLUSIONS: Risk factors for diarrhea among children under-five include a high number of chickens, cohabitation with animals, prolonged water-fetching times, poor hand hygiene, and caretakers’ occupational status. Animal feces management, improved water access, and hygiene education are critical to reducing under-five diarrheal diseases.

PMID:40742515 | DOI:10.1007/s44197-025-00421-x

Ultrasound J. 2025 Jul 31;17(1):37. doi: 10.1186/s13089-025-00441-5.

ABSTRACT

BACKGROUND: The efficacy of bedside chest ultrasonography for the detection and diagnosis of pneumothorax is under debate. We aimed to compare Emergency Healthcare Workers performed chest ultrasonography with chest X-ray in the detection and diagnosis of pneumothorax in the emergency department.

METHODS: We queried PubMed, Cochrane, ScienceDirect, Web of Science and ClinicalTrials.gov databases from 2000 through January 2024. We included all studies (both retrospective and prospective) that compared the diagnostic performance of chest ultrasonography with chest radiography, using chest computed tomography as the gold standard. Participants are patients consulting in the emergency department and physician that performed the chest ultrasound was an Emergency Healthcare Workers. Studies reporting the sensitivity and specificity for both chest ultrasonography and chest X-ray met inclusion criteria. We applied a random effects meta-analysis methodology. We then performed a meta-regression analysis to search for influencing variables such as technical parameters of echograph, patients and pneumothorax.

MAIN RESULTS: 15 studies totaling 3,171 patients were analyzed. 71% of patients were male with a mean age of 40.2 years. The mean prevalence of pneumothorax was 27.6% (95 CI 20.9 to 34.3). Chest ultrasonography had higher sensitivity (79.4%, 68.2 to 90.7) compared to chest X-ray (48.1%, 36.8 to 59.4), and a greater negative predictive value (chest ultrasonography = 94.3%, 91.2 to 97.3, and chest X-ray = 87.9%, 84.1 to 91.6). There was no statistical difference in specificity between the two modalities: chest ultrasonography 99.5%, 99 to 100 and chest X-ray 99.8%, 99.4 to 100) or in positive predictive value (chest ultrasonography 94.2%, 90.5 to 97.9 vs chest X-ray 96.7%,92 to 100). Characteristics of echograph or pneumothorax and patients sociodemographic did not influence results.

CONCLUSION: In this systematic review and meta-analysis, chest ultrasonography performed by Emergency Healthcare Workers, had greater sensitivity and negative predictive value than chest radiography for the diagnosis of pneumothorax in emergency department patients.

PMID:40742513 | DOI:10.1186/s13089-025-00441-5