Category: Statistics

Maedica (Bucur). 2026 Mar;21(1):12-20. doi: 10.26574/maedica.2026.21.1.12.

ABSTRACT

OBJECTIVES: Postoperative pain following breast surgery remains a significant clinical challenge and may delay recovery while increasing the need for systemic analgesics. Dexmedetomidine, a selective α-2 adrenergic receptor agonist, has been shown to enhance the analgesic effects of local anesthetics. This randomized comparative study aimed to evaluate the analgesic efficacy of dexmedetomidine administered alone or in combination with ropivacaine in patients undergoing modified radical mastectomy.

MATERIALS AND METHODS: This prospective randomized trial was conducted in Hippokrateio Hospital of Athens, Greece, between October 2021 and September 2022, in the first Propaedeutic Surgical Clinic, National and Kapodistrian University of Athens. Ninety female patients (Angle Side Angle – ASA I-II) aged 25-65 years old, who had been scheduled for modified radical mastectomy, were randomized into three groups (n = 30 each). Group R received 0.375% ropivacaine, Group D, dexmedetomidine (1 μg/kg) and Group RD, a combination of both agents. A standardized volume of 10 mL was infiltrated using a landmark-guided technique along the anatomical course of the long thoracic nerve and the adjacent peri-incisional fascial plane before wound closure. Postoperative pain was evaluated using the visual analog scale (VAS) at 0, 4, 8, 16, and 24 hours and only at rest measured in our study. Rescue analgesia with intravenous paracetamol and tramadol was recorded. Statistical analysis included one-way and repeated-measures ANOVA, with significance set at p < 0.05.

RESULTS: The RD group demonstrated clinically meaningful threshold VAS scores at all-time points (p < 0.001) and required substantially less rescue analgesia than Groups R and D, confirming the additive analgesic effect of dexmedetomidine when combined with ropivacaine.

CONCLUSIONS: The combination of dexmedetomidine and ropivacaine significantly improves postoperative analgesia following modified radical mastectomy without increasing adverse effects. Dexmedetomidine appears to be a safe and effective adjuvant within multimodal analgesia strategies.

PMID:41978866 | PMC:PMC13061461 | DOI:10.26574/maedica.2026.21.1.12

Maedica (Bucur). 2026 Mar;21(1):21-26. doi: 10.26574/maedica.2026.21.1.21.

ABSTRACT

Introduction: Continuous positive airway pressure (CPAP) therapy is the main therapeutic method for obstructive sleep apnea syndrome (OSAS). The way of accommodating the patient with the CPAP mask is very important for adherence to therapy. In this study, we tried to determine the patient-reported causes for suboptimal use of CPAP therapy and to draw up some recommendations for their management, with the aim to improve adherence to CPAP therapy. Materials and methods: The present study investigated 86 patients diagnosed with OSAS who were divided into two categories by CPAP adherence (at least four hours per night therapy in at least 70% of the recommended days): CPAP adherent patients (n = 50) and non-adherent patients (n = 36). All participants completed a questionnaire to report the side effects of therapy and the main reasons for suboptimal use of CPAP therapy. Results: The reported causes for the inappropriate use of therapy with statistical significance included side effects of the mask and device, misperception of disease severity and lack of confidence that CPAP therapy is useful for treating OSAS. Dry mouth, the main side effect reported by both adherent and non-adherent patients, was not a predictor of statistical significance for adherence to therapy. Suboptimal use of therapy, a statistically significant factor for adherence to treatment, occurred in some of the OSAS patients who developed anxiety related to CPAP device. Many non-adherent participants used an air humidifier attached to CPAP to treat dry mouth as a side effect, which did not help increase adherence in this group of patients. Conclusion: Multiple factors may be involved in OSAS patients’ adherence to CPAP therapy. Of these, side effects in therapy can play an important role and resolving them can be an essential factor for patient adherence.

PMID:41978863 | PMC:PMC13061430 | DOI:10.26574/maedica.2026.21.1.21

Maedica (Bucur). 2026 Mar;21(1):107-114. doi: 10.26574/maedica.2026.21.1.107.

ABSTRACT

OBJECTIVES: Cutaneous melanoma (CMM) is an aggressive malignancy whose incidence continues to rise worldwide. Ultraviolet (UV) radiation from natural and artificial sources is a major environmental risk factor and is classified as a Group 1 carcinogen by the International Agency for Research on Cancer. The present study aimed to evaluate the association between sun exposure patterns and the clinicopathological characteristics of patients with cutaneous melanoma, focusing on tumor thickness and markers of tumor aggressiveness.

MATERIALS AND METHODS: This retrospective cohort study included 115 patients with histologically confirmed primary cutaneous melanoma treated in our Plastic Surgery Department between January 2018 and December 2022. Demographic, clinical and histopathological data were collected from medical records and Breslow thickness was categorized as thin (≤2 mm) or thick (>2 mm). Statistical analysis included chi-square and Mann-Whitney U tests, followed by multivariate logistic regression to identify predictors of increased tumor thickness. A p-value < 0.05 was considered statistically significant.

RESULTS: Statistically significant associations were identified between several clinicopathological variables and melanoma characteristics. Sun exposure pattern was significantly associated with tumor anatomical location [χ²(6) = 85.11, p < 0.001], with chronic exposure predominantly linked to melanomas of the posterior trunk, while intermittent exposure was more frequently observed in melanomas of the lower limbs. Patients with thick melanoma were significantly older than those with thin tumors (p = 0.032). Melanoma thickness was also significantly associated with histological subtype (p = 0.002), ulceration (p < 0.001), and mitotic activity (p = 0.002), with nodular melanoma, ulcerated tumors, and lesions with increased mitotic activity more frequently presenting greater Breslow thickness. Metastatic disease occurred more often in patients with thick melanomas (p = 0.046). In multivariate analysis, mitotic activity remained an independent predictor of thick melanoma [OR = 1.75, p < 0.001], while ulceration showed borderline significance (odds ratio [OR) = 4.14, p = 0.050]. Overall, sun exposure pattern was associated with melanoma location but not with markers of tumor aggressiveness.

CONCLUSION: Sun exposure pattern was associated with melanoma anatomical location but not with tumor aggressiveness. Increased mitotic activity was the strongest independent predictor of thick melanoma, while ulceration showed borderline significance. These findings suggest that intrinsic tumor characteristics play a greater role in melanoma progression than sun exposure patterns.

PMID:41978861 | PMC:PMC13061449 | DOI:10.26574/maedica.2026.21.1.107

Maedica (Bucur). 2026 Mar;21(1):57-63. doi: 10.26574/maedica.2026.21.1.57.

ABSTRACT

OBJECTIVES: Bruxism is an oral habit that sums symptoms like tooth clenching, grinding and jaw contractions. This study aimed to evaluate self-assessment bruxism among dental students.

MATERIAL AND METHODS: A questionnaire assessing the perception of bruxism symptoms was administered to a cohort of students (n=301) from “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania. Data regarding demographics, lifestyle and current symptoms were collected.

RESULTS: Statistically significant associations between sedentary behavior (lack of sport participation) and bruxism symptoms were found. Participants who did not practice a sport were more likely to report sleep grinding (36.1% vs. 24.5%, p=0.041), increased tooth wear (21.5% vs. 10.9%, p=0.027) and clenching upon waking (31.4% vs. 20.9%, p=0.049). Conversely, those who reported never clenching during stressful situations were more likely to be physically active (43.6% vs. 25.1%, p=0.009). Similarly, absence of clenching during tense moments was associated with sports participation (47.3% vs. 27.7%, p=0.005).

CONCLUSION: Psychosocial factors and lifestyle significantly impact the presence of bruxism symptoms. The results of the present study suggest that physical activity may reduce the risk of bruxism-associated symptoms. However, correlating perceived symptoms with objective clinical assessment remains necessary.

PMID:41978857 | PMC:PMC13061466 | DOI:10.26574/maedica.2026.21.1.57

Maedica (Bucur). 2026 Mar;21(1):81-88. doi: 10.26574/maedica.2026.21.1.81.

ABSTRACT

INTRODUCTION: This study sought to assess the effectiveness of intraoral hyaluronic acid (HA) gel in alleviating postoperative pain, oedema and trismus after mandibular third molar surgery, and its capacity to reduce the need for non-steroidal anti-inflammatory drugs (NSAIDs).

MATERIALS AND METHODS: This split-mouth study included 33 healthy patients aged 18 to 45 years with bilaterally impacted mandibular third molars who came to the Department of Oral and Maxillofacial Surgery, MES Dental College, Perinthalmanna, India, between November 2023 and March 2025. In the experimental procedure, 0.2% HA gel was applied to the extraction socket, while the control side did not receive any HA gel after surgical extraction. Postoperative evaluations of pain, oedema and trismus were documented on days 3 and 7 for both groups.

RESULTS: The use of HA markedly decreased pain perception during the initial postoperative period. However, trismus and the degree of oedema did not differ statistically significantly between the experimental and control groups.

CONCLUSION: The intraoral application of HA gel after mandibular third molar surgery demonstrated analgesic effects and reduced the need for NSAID use.

PMID:41978844 | PMC:PMC13061434 | DOI:10.26574/maedica.2026.21.1.81

BMC Med. 2026 Apr 14. doi: 10.1186/s12916-026-04826-8. Online ahead of print.

ABSTRACT

BACKGROUND: It is unclear why women more frequently experience post-COVID symptoms than men. Sex and age-dependent immune dysregulation triggered by SARS-CoV-2 infection might be involved in this association. We assessed whether age modified the association between sex and post-COVID symptoms, and whether this effect modification might be attributable to SARS-CoV-2 infection.

METHODS: From the French population-based prospective cohort study with random sampling EpiCov (Spring 2020-Autumn 2022), we included two groups of participants aged ≥ 17: those with a first SARS-CoV-2 confirmed infection during the Omicron wave in 2022 (infected participants, N = 10,618), and those with no SARS-CoV-2 infection history (uninfected participants, N = 28,716). In both groups, we assessed effect modification by age on the association between sex and any self-reported persistent symptom in Autumn 2022 using modified Poisson regressions.

RESULTS: Respectively, 10.0% (95% CI: 9.2%, 10.8%) infected participants and 3.1% (95% CI: 2.8%, 3.4%) uninfected participants reported persistent symptoms. In both groups, women more frequently reported persistent symptoms than men (adjusted prevalence ratios (aPRs) [95% CI]: 2.06 [1.70, 2.49] and 1.55 [1.25, 1.92], respectively). However, in infected participants, this association was stronger before than after 35 years (aPRs [95% CI]: 3.54 [2.12, 5.91], 1.77 [1.32, 2.37]; 1.65 [1.20, 2.26]; 1.74 [1.15, 2.63] for 17-34, 35-49, 50-64 and ≥ 65-year-olds, respectively, interaction P = 0.041). We found no effect modification by age in uninfected participants.

CONCLUSIONS: Women are a target population in post-COVID symptoms management, especially among younger adults. Sex and age-dependent mechanisms attributable to SARS-CoV-2 infection may be involved in post-COVID symptoms.

PMID:41975411 | DOI:10.1186/s12916-026-04826-8

BMC Oral Health. 2026 Apr 13. doi: 10.1186/s12903-026-08298-3. Online ahead of print.

NO ABSTRACT

PMID:41975404 | DOI:10.1186/s12903-026-08298-3

BMC Oral Health. 2026 Apr 13. doi: 10.1186/s12903-026-08317-3. Online ahead of print.

NO ABSTRACT

PMID:41975402 | DOI:10.1186/s12903-026-08317-3

BMC Psychiatry. 2026 Apr 13. doi: 10.1186/s12888-026-08070-5. Online ahead of print.

NO ABSTRACT

PMID:41975379 | DOI:10.1186/s12888-026-08070-5

BMC Oral Health. 2026 Apr 13. doi: 10.1186/s12903-026-08214-9. Online ahead of print.

NO ABSTRACT

PMID:41975375 | DOI:10.1186/s12903-026-08214-9