Category: Nevin Manimala

Lung. 2025 Oct 4;203(1):97. doi: 10.1007/s00408-025-00853-z.

ABSTRACT

BACKGROUND: Refractory chronic cough (RCC) significantly impairs patient quality of life and poses a major challenge in clinical management. However, little is known about the healthcare resource utilization (HRU) of patients with RCC.

OBJECTIVE: The goal of our study is to describe the HRU and associated costs of RCC patients and those with non-refractory chronic cough (non-RCC).

METHODS: Patients with chronic cough were prospectively recruited from 6 centers in France. At 6 months, the patients were classified as having RCC or no RCC. A retrospective analysis was made using the French National Health Insurance Database (SNDS) in order to determine healthcare utilization for the one-year period preceding inclusion at the site and for the one-year period thereafter.

RESULTS: Sixty-eight patients were included. Among them, 32 (47%) patients had RCC. There was no difference between groups regarding clinical data apart from cough duration (56.8 ± 59.5 months in the no RCC group vs. 139.3 ± 123.8 months in the RCC group, p = 0.002). Within 1 year prior to inclusion, there was no difference in terms of drug dispensations between the 2 groups. During the 1-year post-inclusion period, a significantly higher proportion of patients with RCC received at least one dispensation of opioids and amitriptyline compared to those with no RCC (8 (25%) vs. 2 (6%) for opioids, p = 0.038 and 14 (44%) vs. 3 (8%) for amitriptyline, p = 0.0015, respectively). Within 1 year after inclusion, more patients with RCC had attended speech pathologist visits in comparison to patients with no RCC (14 (44%) patients vs. 10 (28%) patients, p = 0.21, respectively). Total costs within 12 months prior to inclusion were 3,878€ [2,498 – 5,755€] for patients with no RCC and 5,159€ [3,426 – 7,138€] with RCC, but the difference was not significant. No change occurred in the 1-year period following inclusion.

CONCLUSION: RCC has a high healthcare utilization with substantial costs.

PMID:41046288 | DOI:10.1007/s00408-025-00853-z

Pediatr Surg Int. 2025 Oct 4;41(1):310. doi: 10.1007/s00383-025-06216-2.

ABSTRACT

PURPOSE: To evaluate the relationship between nutritional status and surgical outcomes in patients with esophageal atresia (EA) from the Turkish Esophageal Atresia Registry (TEAR).

METHODS: Between 2015 and 2024, 713 patients with the complete data of neonatal period and first year of life were included. According to FENTON, growth charts and patients were grouped as small for gestational age (SGA, < 10 percentiles), medium SGA (percentiles = 10-20), appropriate for gestational age (AGA, percentiles = 20-90) and large for gestational age (LGA, percentiles > 90) at birth. The z scores for height-for-weight were reevaluated at 6th and 12th months of age.

RESULTS: Among 713 patients, 56% were boys. 23.7% of patients were SGA. There was no difference among groups for demographic features, outcomes, and mortality (p > 0.05). Patients with SGA had a higher rate of karyotype anomalies (23.1%, p < 0.05). At the 6th month, 20% of patients had improved nutritional status, 46.2% unchanged, and 33.5% worsened. At the 12th month, it was 31.6%, 50.2%, and 18.3%, respectively. 32.8% of the SGA patients had severe malnutrition at the 6th month, while this rate decreased to 10.2% at the end of the first year of life. Patients with worsened nutritional status had a significantly higher rate of mortality (10.2%) than patients with unchanged and improved nutritional status (3.7%, 2%, respectively, p < 0.05). There was no statistical difference between nutritional status and surgical outcomes at the 6th and 12th months (p > 0.05).

CONCLUSIONS: The incidence of SGA was significantly higher in EA patients with karyotype anomalies. While 20% of patients improved nutritional status at the 6th month, only one-third of patients improved nutritional status at the end of the first year. Closer follow-up is needed in patients with EA to avoid malnutrition, which can lead to poor growth, developmental delay, and impaired immune function.

PMID:41046286 | DOI:10.1007/s00383-025-06216-2

BMC Oral Health. 2025 Oct 4;25(1):1526. doi: 10.1186/s12903-025-06530-0.

ABSTRACT

BACKGROUND: This study aimed to investigate the association between taurodontism and maternal-child characteristics, as well as its relationship with other dental anomalies including hypodontia, hyperdontia, and pyramidal molars.

METHODS: Panoramic radiographs were obtained from 815 patients aged 9 to 15 years. A total of 62 children with taurodontism and their mothers agreed to participate. Other dental anomalies and taurodontism types were also recorded. Mothers completed a questionnaire that included the mother and child’s demographic characteristics and potential etiological factors. The collected data were subjected to statistical analysis.

RESULTS: The most common form of taurodontism was hypotaurodontism, most frequently affecting the right maxillary first molar (43.5%). Heart disease (n = 5) was the most frequently observed systemic condition among children with taurodontism. A statistically significant association was observed between the number of taurodontic teeth and the presence of pyramidal molars (p < 0.05). Regression analysis revealed significant associations (p < 0.05) between the presence of more than two taurodontic teeth and several factors, including maternal smoking during pregnancy, a higher number of siblings, female sex, and consanguineous marriage. These findings may assist in identifying at-risk pediatric populations and underscore the importance of considering these variables in the clinical assessment of dental anomalies.

CONCLUSIONS: Evaluating taurodontism in children with heart disease or pyramidal molars may contribute to early diagnosis and more effective management. The findings of this study highlight the need for increased clinician awareness and further research with larger sample sizes and healthy control groups to better understand the risk factors associated with taurodontism.

PMID:41046282 | DOI:10.1186/s12903-025-06530-0

Insights Imaging. 2025 Oct 4;16(1):214. doi: 10.1186/s13244-025-02101-7.

ABSTRACT

OBJECTIVES: We investigated whether body composition parameters assessed on baseline computed tomography enterography (CTE) could predict transmural healing (TH) in patients with Crohn’s disease (CD) receiving Ustekinumab (UST).

MATERIALS AND METHODS: Adult patients with active CD treated with standard UST from August 2020 to August 2022 were enrolled. Body composition, including creeping fat (CF, mesenteric creeping fat index (MCFI) and fibrofatty proliferation score), skeletal muscle, visceral adipose, and subcutaneous adipose-related parameters were assessed on baseline CTE. Cox regression analysis was performed to identify independent predictors of TH.

RESULTS: This study included 113 patients, and TH occurred in 26 (23. 0%) patients. The results of the univariable analysis indicated a statistically significant association of the presence of sarcopenia, higher MCFI score, and higher fibrofatty proliferation score with an increased failure rate of TH. We found no evidence that skeletal muscle index, subcutaneous adipose index, visceral adipose index, and visceral adipose/subcutaneous adipose area ratio were associated with TH. Multivariable analysis revealed that sarcopenia (Hazard ratio (HR): 0.35, 95% CI: 0.14-0.87, p = 0.023), MCFI score (HR: 0.67, 95% CI: 0.49-0.91, p = 0.010) and fibrofatty proliferation score (HR: 0.50, 95% CI: 0.29-0.85, p = 0.011) remained significant. MCFI score (χ²-df = 5.58) was the most critical factor for TH prediction, followed by fibrofatty proliferation score (χ²-df = 5.43) and sarcopenia (χ²-df = 4.12).

CONCLUSIONS: Among all the body composition parameters, MCFI and fibrofatty proliferation score assessed on baseline CTE were independently associated with TH, and they demonstrated greater predictive efficacy compared to sarcopenia.

CRITICAL RELEVANCE STATEMENT: Creeping fat on baseline CTE was an important predictive factor for transmural healing in patients with Crohn’s disease receiving Ustekinumab, which enables early risk stratification of patients and has potential implications for decision-making.

KEY POINTS: Identifying predictors of transmural healing may provide insight into earlier dose optimization to improve the rate of transmural healing. Higher creeping fat scores (mesenteric creeping fat index and fibrofatty proliferation) were independently associated with a lower rate of transmural healing. Mesenteric creeping fat index and fibrofatty proliferation score demonstrated greater predictive efficacy compared to sarcopenia.

PMID:41046272 | DOI:10.1186/s13244-025-02101-7

BMC Cancer. 2025 Oct 4;25(1):1510. doi: 10.1186/s12885-025-14915-1.

ABSTRACT

BACKGROUND: High prevalence of EGFRm lung cancer was found in the Asian population. Preclinical data suggest that inflammatory cytokines activated by PM2.5 affected EGFRm clone expansion. Here, we explored the correlation between inflammatory markers and EGFRm NSCLC.

METHODS: Resected NSCLC patients (2016-2023) were enrolled. Tumor tissues and blood serum were retrieved from Ramathibodi tumor biobank. EGFR 19del and L858R mutations were performed by rt-PCR in cancerous tissue and dPCR in normal tissue in the same patient. NF-Kb and STAT3 protein signaling were measured by ELISA in both cancerous and normal tissue. Cytokines (IL-1ß, IL-6, IL-8, IL-10, IL-12 and TNF-α) were explored in serum by flow cytometry.

RESULTS: Among 140 patients, EGFRm prevalence was 58% in cancerous tissue but only 5% in normal tissue. NF-kB and STAT3 were statistically higher in cancerous tissue than normal tissue [NF-kB median O.D.=0.82 (IQR; 0.07-2.82) vs. 0.32 (IQR; 0.05-2.48), P < 0.001; STAT3 median O.D.=0.32 (IQR; 0.10-1.58) vs. 0.17 (IQR; 0.06-1.29, P < 0.001]. STAT3 was significantly increased in EGFRm compared to EGFRwt [median O.D.=0.36 (IQR; 0.234-0.592) vs. 0.23 (IQR; 0.158-0.409), OR = 11.09 (95% CI; 2.17-56.58), P = 0.004]. TNF-α, IL-10, and STAT3 in cancer cells were higher in EGFRm than EGFRwt (P = 0.003, 0.008, and < 0.001, respectively). None of cytokines was statistically different between EGFRm and EGFRwt patients. However, only STAT3 in cancer cells and non-smoker were associated with EGFRm NSCLC in multivariable analysis.

CONCLUSION: Inflammation could be one of the pathogenesis of both NSCLC and EGFRm lung cancer as we demonstrated in our pilot study. STAT3 is a potentially inflammatory-predictive biomarkers. Larger cohort is needed.

PMID:41046266 | DOI:10.1186/s12885-025-14915-1

Confl Health. 2025 Oct 4;19(1):67. doi: 10.1186/s13031-025-00710-z.

ABSTRACT

OBJECTIVE: This study investigates the impact of childhood maltreatment on treatment outcomes among male ex-combatants in a randomized controlled trial (RCT) of Narrative Exposure Therapy for Forensic Offender Rehabilitation (FORNET), a specialized psychotherapy used to treat trauma sequelae including symptoms of posttraumatic stress disorder (PTSD), compared with treatment as usual (TAU). Specifically, we aim to compare former child and adult male soldiers who experienced childhood sexual abuse (CSA) with those who did not.

METHODS: We conducted a sub-analysis of data from Koebach et al. [J Consult Clin Psychol. 2021], focusing on a sample of male former soldiers in the eastern Democratic Republic of Congo (DRC). Participants were categorized into two groups based on their history of CSA. Outcome measures included the prevalence of lifetime sexual assaults, perpetration of sexual violence against others, appetitive aggression, current violent behavior, symptoms of PTSD and depression and responses to two treatment modalities: TAU and FORNET.

RESULTS: The group with a history of CSA had significantly higher rates of re-experiencing sexually assaults, especially by superiors, and of perpetrating sexual assaults against others. In addition, this group presented elevated baseline scores in all outcomes (appetitive aggression, current violent behavior, symptoms of PTSD and depression). Regarding effectiveness of treatment arms, the FORNET group demonstrated significantly greater reductions in appetitive aggression levels, PTSD symptoms and depressive symptoms compared to the TAU group, with no difference in treatment effectiveness between participants with and without a history of CSA. However, individuals with CSA showed statistically superior improvements in current violent behavior, with similar score levels to those without CSA after 6-9 months.

CONCLUSION: CSA among former soldiers was significantly associated with a higher prevalence of PTSD and increased risk of both sexual revictimization and the perpetration of sexual and other violent acts. FORNET demonstrates effectiveness in reducing appetitive aggression, PTSD symptoms, and violent behavior even in the subgroup highly affected by CSA – showing an even greater impact on current violent behavior. The ability of NET to address trauma and perpetration in a chronological sequence and adapt to the specific challenges of CSA likely account for its effectiveness in treating this complexly traumatized population, ultimately contributing to a reduction of violence in post-conflict communities. Special attention should be paid to revictimization during the rehabilitation process of ex-combatants.

PMID:41046251 | DOI:10.1186/s13031-025-00710-z

Br J Cancer. 2025 Oct 4. doi: 10.1038/s41416-025-03224-w. Online ahead of print.

ABSTRACT

BACKGROUND: Survival differences between socioeconomic groups in colorectal cancer have been studied for patients diagnosed in the 90s and 00s, but research on recent patients using individual measures of socioeconomic position is limited.

METHODS: CRCBaSe, a database of linked national registry data, was used to analyse stage I-III colorectal cancer patients diagnosed in Sweden between 2008 and 2021. The exposures of interest were income and education. Flexible parametric survival models were fitted and standardised survival probabilities and hazard ratios (HR) were calculated for cancer-specific survival, recurrence, and overall survival.

RESULTS: Analysis of 59,995 patients showed better 5-year standardised cancer-specific survival in the least deprived income group, 77.8% (95%CI 76.9-78.6) vs. 73.2% (95%CI 72.6-73.9) in the most deprived income group, HR 0.93 (95%CI 0.87-0.99). Time to recurrence was not statistically different between socioeconomic groups. Overall survival was better in the least deprived income group, with a 5-year standardised overall survival of 70.0% (95%CI 69.1-70.8) vs. 63.5% (95%CI 62.9-64.1) in the most deprived income group, HR 0.82 (95%CI 0.79-0.86).

CONCLUSION: We found large disparities in cancer-specific and overall survival between the highest and most deprived income and education groups, despite improvements in care and the introduction of guidelines.

PMID:41046246 | DOI:10.1038/s41416-025-03224-w

J Prosthet Dent. 2025 Oct 3:S0022-3913(25)00750-4. doi: 10.1016/j.prosdent.2025.09.019. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Grinding is often required for the clinical adjustments of zirconia restorations; nevertheless, the effects of following regeneration firing processes on additively manufactured zirconia are still unclear.

PURPOSE: The purpose of this in vitro study was to evaluate the effects of grinding and regeneration firing (RF) on the phase transformation and biaxial flexural strength (BFS) of additively or subtractively manufactured 3 mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP).

MATERIAL AND METHODS: A total of 108 disk-shaped (Ø15×1.5 mm) 3Y-TZP specimens (n=54) were fabricated using either subtractive manufacturing (SM) or additive manufacturing (AM) techniques. Grinding was performed using a 150-μm-grit diamond rotary instrument with a high-speed handpiece, and RF was carried out at 1000 °C for 15 minutes in a sintering furnace. The crystalline phases were analyzed using X-ray powder diffraction (XRD). All specimens were loaded until fracture using a universal testing machine for a biaxial flexural strength test at a crosshead speed of 1 mm/minute. Microstructure and fracture surfaces were examined using scanning electron microscopy. BFS data were statistically analyzed using 1-way ANOVA, followed by the Tukey post hoc test for pairwise comparisons. (α=.05). The Weibull modulus and characteristic strength were calculated to assess the reliability of strength data.

RESULTS: Tetragonal-to-monoclinic phase transformation was detected in ground specimens of both AM and SM groups, whereas only the tetragonal phase was observed in their corresponding RF groups. The highest BFS (1427.2 MPa) was observed in ground AM specimens (P<.001). Grinding and RF did not significantly affect the BFS of SM zirconia (P=.927 and P=.999, respectively) but significantly increased the BFS of AM zirconia (P<.001). RF increased the Weibull modulus in both AM (from m=6.98 to 12.25) and SM (from m=5.91 to 8.35) zirconia.

CONCLUSIONS: The implementation of RF after grinding is crucial, particularly for AM zirconia, to improve mechanical strength and structural reliability.

PMID:41046229 | DOI:10.1016/j.prosdent.2025.09.019

J Prosthet Dent. 2025 Oct 3:S0022-3913(25)00751-6. doi: 10.1016/j.prosdent.2025.09.022. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: An efficient protocol for removing stains from 3-dimensionally (3D) printed artificial teeth must also preserve their surface properties.

PURPOSE: The purpose of this in vitro study was to evaluate methods of removing stains from a 3D printed resin (Bio Crown) for artificial teeth submitted to immersion in coffee by using spectrophotometric analysis (CIEDE2000) and analyzing surface roughness with a profilometer and topography with a scanning electron microscope (SEM).

MATERIAL AND METHODS: Disks (Ø10×1.2 mm) were 3D printed and stained in instant coffee simulating 1 year of consumption. Color data (L*, a*, b*) and roughness (Ra, µm) were obtained at T0 (baseline, before staining), T1 (after staining), and T2 (after each stain removal protocol, n=12). The stain removal groups used sodium perborate (SP), 0.25% sodium hypochlorite (SH), conventional polishing with brush and pumice stone + felt wheels and universal paste (CP), and polishing with 3-abrasive tip kit (AP); the control was storage in distilled water (DW). Mixed 2-way ANOVA followed by the Bonferroni test was performed to statistically analyzing data with α=.05.

RESULTS: Roughness increased in all groups between T1 and T2 (P<.05), except for SH. The AP (0.64 ±0.12 µm) and CP (0.52 ±0.17 µm) groups showed similar roughness and higher roughness compared with the other groups (SP 0.40 ±0.22 µm, SH 0.31 ±0.12 µm, and DW 0.34 ±0.11 µm). A significant color difference (ΔE₀₀) was observed between T0 (1.03 ±0.49) and T1 (1.36 ±0.77), (P<.001), and the color remained statistically similar between T1 and T2 (1.48 ±1.02).

CONCLUSIONS: No method was effective in removing coffee stains. The polishing methods resulted in greater roughness, followed by sodium perborate. The only protocol that did not increase the roughness of the 3D printed resin for artificial teeth was 0.25% sodium hypochlorite. Longer application periods of the staining removal protocols are suggested for future studies.

PMID:41046228 | DOI:10.1016/j.prosdent.2025.09.022

Clin Genitourin Cancer. 2025 Aug 28:102423. doi: 10.1016/j.clgc.2025.102423. Online ahead of print.

ABSTRACT

INTRODUCTION: The EV-302 trial demonstrated a very significant overall survival (OS) benefit for Enfortumab Vedotin plus Pembrolizumab (EVP) relative to standard chemotherapy (CHT) for patients with metastatic urothelial carcinoma. However, questions have been raised regarding the high rate of treatment discontinuation in the CHT arm for reasons unrelated to adverse events or progression (33% vs. 10% with EVP, P < .01), potentially resulting in loss of unaccounted information, or informative censoring, and affecting survival results interpretation.

MATERIALS AND METHODS: We performed a multistep analysis to assess the impact of differential dropout on trial outcomes. First, Kaplan-Meier (KM) curves were reconstructed from published data to estimate time-to-event outcomes. Second, a reverse KM analysis was conducted to evaluate censoring patterns in the overall population and key subgroups (PD-L1 expression; cisplatin eligibility). Third, simulation models were employed to test whether informative censoring could negatively impact survival benefit by EVP. Finally, we compared the CHT arm of EV-302 to those of other contemporary RCTs through reconstructed survival analyses and risk-of-bias assessments.

RESULTS: Overall, no significant imbalance in censoring between the treatment arms of EV-302 was found on reverse KM analysis when assessing OS (P = .73); however, a significant difference was noted for progression-free survival (PFS) (P = .002). Simulation analysis revealed that even under extreme assumptions of informative censoring, the OS benefit of EVP remained statistically significant. Comparison with historical RCTs confirmed that the CHT outcomes in EV-302 were not anomalously poor. Risk of bias was low overall, although deviations from intervention and outcome measurement were flagged for EV-302.

CONCLUSIONS: Despite the high discontinuation rate in the CHT arm, OS benefit with EVP remains robust. These findings support the reliability of EV-302 results and mitigate concerns about informative censoring, thus encouraging the use of EVP in clinical practice.

PMID:41046201 | DOI:10.1016/j.clgc.2025.102423