Nevin Manimala

Glob Health Action. 2026 Dec;19(1):2698916. doi: 10.1080/16549716.2026.2698916. Epub 2026 Jul 13.

ABSTRACT

BACKGROUND: The psychological impact of disasters extends beyond directly exposed populations to those indirectly affected through close social networks. Sex is a critical factor of post-trauma outcomes, yet its role in shaping the mental health of indirectly exposed individuals remains underexplored.

OBJECTIVE: This study investigates sex-based disparities in psychosocial distress among a cohort remotely exposed to a major earthquake.

METHODS: Approximately 3 months after the 2023 Kahramanmaras earthquakes, 129 Turkish medical students with indirect exposure (e.g. via affected relatives or close social circles) took part in this cross-sectional study, completing a structured anxiety survey and a self-report form. The self-report form assessed academic stress, health behaviors (smoking, alcohol use, exercise, and nutrition status), and lifestyle factors.

RESULTS: After Bonferroni correction, no variable remained statistically significant. However, using the Benjamini-Hochberg false discovery rate procedure, peer bullying was associated with sex (χ²(3) = 13.581, p_FDR = .046, Cramer’s V = 0.324). All other chi-square tests were nonsignificant under both correction methods.

CONCLUSION: After rigorous correction, sex differences were largely attenuated. Peer bullying showed a possible association under FDR, but not under Bonferroni, suggesting the need for larger confirmatory studies.

PMID:42438926 | DOI:10.1080/16549716.2026.2698916

Pediatr Int. 2026 Jan-Dec;68(1):e70482. doi: 10.1111/ped.70482.

ABSTRACT

BACKGROUND: Weight changes following gluten-free diet (GFD) initiation in children with celiac disease remain debated. The diet corrects malabsorption in underweight children but may promote excessive weight gain in those diagnosed at normal weight. We examined whether weight gain on the GFD represents physiological recovery or emerging obesity risk in a Turkish pediatric cohort.

METHODS: We retrospectively analyzed 117 children diagnosed with celiac disease between 2015 and 2025. Patients were stratified by dietary adherence: strict (n = 56), partial (n = 44), and non-adherent (n = 17). Adherence was assessed via clinical symptoms, tissue transglutaminase serology, and patient interviews. Body mass index (BMI) and height-for-age z-scores were calculated at diagnosis and follow-up (minimum 12 months) per WHO 2007 Growth Reference standards.

RESULTS: BMI z-scores increased significantly only in the strict adherence group (median Δ +0.27, p = 0.036), while partial adherence (p = 0.451) and non-adherence (p = 0.579) groups showed no significant change. Between-group comparison was not significant (p = 0.326). Height-for-age z-scores showed no significant change in the strict adherence group (p = 0.247); BMI gains reflected disproportionate weight gain rather than proportional growth recovery. Six patients (5.1%) exceeded the obesity threshold (z-score > +2) during follow-up.

CONCLUSION: Weight gain occurred primarily with strict GFD adherence. Without corresponding linear growth improvement, BMI increases in strictly adherent children may not represent catch-up growth alone. Low obesity frequency may reflect traditional Turkish dietary patterns. Dietary counseling for celiac patients should extend beyond gluten avoidance to address overall nutritional balance.

PMID:42438923 | DOI:10.1111/ped.70482

Pediatr Int. 2026 Jan-Dec;68(1):e70477. doi: 10.1111/ped.70477.

ABSTRACT

BACKGROUND: This study aimed to validate our therapeutic strategy for the nonselective conservative treatment of pediatric acute appendicitis.

METHODS: This single-center retrospective comparative study was conducted using the data of 368 patients with acute appendicitis. Two therapeutic strategies were compared: emergent open appendectomy (early group, n = 138 patients; 2007-2011) and conservative antibiotic treatment (late group, n = 230; 2012-2023). Both strategies were nonselectively applied, regardless of the degree of disease progression.

RESULTS: None of the patients in the late group required admission to the intensive care unit or experienced mortality. Compared with the early group, the late group had a significantly longer duration of hospitalization (5 vs. 7 days; p = 0.0017) and a higher rate of non-planned readmission after initial admission (2% vs. 13%; p = 0.0004). Surgery was performed on a nonworking day for 26% of patients and at night for 59% of patients in the early group. However, subsequent interval appendectomy for patients in the late group was not performed on a nonworking day or at night.

CONCLUSIONS: Nonselective conservative treatment with antibiotics was safe for managing acute appendicitis in children and eliminated the need for surgery at night and during nonworking days, despite longer duration of the initial hospitalization and the higher rate of readmission.

PMID:42438921 | DOI:10.1111/ped.70477

Korean J Intern Med. 2026 Jul;41(4):734-747. doi: 10.3904/kjim.2025.375. Epub 2026 Jul 1.

ABSTRACT

BACKGROUND/AIMS: The optimal adjuvant chemotherapy and anti-human epidermal growth factor receptor 2 (HER2) therapy regimen following surgery for T1a/b HER2-positive breast cancer remains debatable.

METHODS: In this single-center retrospective analysis, we examined the postoperative treatment strategies for patients diagnosed with T1a/b node-negative HER2-positive breast cancer. Invasive breast cancer-free survival (IBCFS), invasive disease-free survival, and overall survival (OS) were compared between patients who received chemotherapy only, chemotherapy plus anti-HER2 therapy, and neither adjuvant treatment.

RESULTS: The analysis included 165 patients, with a median follow-up duration of 98.4 (25.8-238.5) months. Patients who did not receive any adjuvant therapy had a 15-year IBCFS rate of 86.9%, and those who received only chemotherapy exhibited a rate of 77.6%. Conversely, those who received both trastuzumab and chemotherapy had the highest 15-year IBCFS rate of 97.4%, although the difference between the treatment groups was not statistically significant (p = 0.492). Among patients with T1a tumors, chemotherapy plus anti-HER2 therapy showed the most favorable long-term IBCFS, with a 15-year rate of 100%, compared with 57.5% in the chemotherapy-only group and 79.8% in the no-treatment group (p = 0.363). The 15-year OS rate was 100% in both chemotherapy-containing treatment groups, compared with 90.4% in the no-treatment group (p = 0.068).

CONCLUSION: In this retrospective cohort of patients with HER2-positive T1a/bN0 breast cancer, anti-HER2-containing adjuvant treatment was associated with numerically favorable long-term outcomes, particularly among those with T1a tumors. Given the retrospective study design and limited number of events, these findings should be interpreted cautiously.

PMID:42438913 | DOI:10.3904/kjim.2025.375

Korean J Intern Med. 2026 Jul;41(4):597-619. doi: 10.3904/kjim.2025.301. Epub 2026 Jul 1.

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has highlighted a complex, bidirectional relationship between SARSCoV-2 infection and autoimmune diseases. This review examines how SARS-CoV-2 infection influences the incidence, progression, and outcomes of five major autoimmune conditions: systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease, and Guillain-Barré syndrome. Patients with autoimmune diseases are at increased risk of severe COVID-19 due to intrinsic immune dysregulation and the use of immunosuppressive therapies, both of which impair antiviral host defenses. Conversely, COVID-19 has been implicated in the initiation and exacerbation of autoimmune responses through mechanisms such as molecular mimicry and bystander activation. Concerns have also arisen regarding the safety and efficacy of COVID-19 vaccines in immunocompromised populations. Although vaccines are generally tolerated in these individuals, certain immunosuppressive therapies may attenuate humoral and cellular immune responses. Strategies such as adjusting immunosuppressive regimens and optimizing the timing of vaccination have been proposed to improve vaccine efficacy. Disease-specific considerations are essential to balance infection risk with adequate control of autoimmune activity. Overall, this review underscores the importance of individualized treatment strategies, close clinical monitoring, and interdisciplinary care in managing patients with autoimmune diseases during the COVID-19 pandemic. A deeper understanding of these interactions will be critical for improving patient outcomes and preparing for future pandemics involving immune-mediated diseases.

PMID:42438903 | DOI:10.3904/kjim.2025.301

Intern Med. 2026 Jul 11. doi: 10.2169/internalmedicine.7638-26. Online ahead of print.

ABSTRACT

Objective To evaluate the needle selection process for endoscopic ultrasound-guided tissue acquisition (EUS-TA) using 22-gauge needles in pancreatic solid lesions ≤20 mm. Methods Consecutive patients with pancreatic solid lesions ≤20 mm who underwent EUS-TA were retrospectively reviewed at a referral center. Only procedures that used 22-gauge needles were included. The overall diagnostic accuracy was compared between the fine-needle aspiration (FNA) and fine-needle biopsy (FNB) groups. Multivariable logistic regression and propensity score-matched analyses were performed. Patients or Materials A total of 348 patients with pancreatic solid lesions ≤20 mm were included (FNA, n=193; FNB, n=155). Results No statistically significant difference in the overall diagnostic accuracy was observed between the FNA and FNB groups (92.7% vs. 95.5%, p=0.27). The median number of needle passes was lower in the FNB group (2 vs. 3, p<0.001), and the histological yield was higher (92.9% vs. 84.5%, p=0.019). The needle type was not independently associated with diagnostic accuracy (OR 1.76, 95% CI 0.69-4.52; p=0.24). In lesions measuring ≤10 mm, subgroup analysis was limited by the small sample size of the study. The rarly adverse event rates were low in both groups. Conclusion In pancreatic solid lesions ≤20 mm, FNB showed a higher histological yield and required fewer needle passes, whereas no significant difference in the diagnostic accuracy was observed between FNA and FNB. Therefore, the routine replacement of FNA with FNB may not be justified when benign-malignant differentiation is sufficient. FNB may be preferable when histological architecture or immunohistochemical evaluation is required and is considered technically feasible.

PMID:42438026 | DOI:10.2169/internalmedicine.7638-26

J Prosthodont Res. 2026 Jul 11. doi: 10.2186/jpr.JPR_D_25_00384. Online ahead of print.

ABSTRACT

PURPOSE: Registration accuracy is vital for digital workflows because misalignment increases errors. This study explores the effects of registration methods, cone-beam computed tomography (CBCT) image quality, and number of registration points (NRP).

METHODS: All participants underwent intraoral and CBCT scanning. In Section 1, registration included four groups: three points, two points and one surface, one point and two surfaces, and three surfaces. In Section 2, after grouping the registrations on the basis of image quality (high, medium, or low), clinicians performed calibration trials. In Section 3, the NRP was increased from two to seven points. Deviations were measured by evaluating the anatomical landmarks (including the cusp tips, central fossae, and ends of the developmental grooves).

RESULTS: Significant differences were observed in the registration methodologies (P < 0.001), with deviations increasing from 257.0 μm (group 3 points) to 479.3 μm (group 3 surfaces). Calibration precision improved proportionally with enhanced CBCT image quality. Deviations significantly decreased from 314.4 μm (low quality) to 237.6 μm (high quality; P < 0.001). Increasing the NRP from two to four points reduced the deviations from 375.4 to 228.2 μm; however, further increasing the NRP beyond four points yielded no significant improvement (P > 0.999, P > 0.999, P = 0.152).

CONCLUSIONS: Clinicians should prioritize point-based registration to improve accuracy. High CBCT image quality significantly improves accuracy. Increasing the NRP beyond four points demonstrates no statistically significant reduction in deviation.

PMID:42438012 | DOI:10.2186/jpr.JPR_D_25_00384

J Vet Med Sci. 2026 Jul 13. doi: 10.1292/jvms.26-0179. Online ahead of print.

ABSTRACT

Mastitis is one of the most common diseases in dairy cows, causing significant economic losses due to reduced productivity and the need for treatment. In recent years, MRSA (methicillin-resistant Staphylococcus aureus) has emerged as an important cause of chronic and recurrent mastitis, posing additional challenges for herd health management. The aim of this study was to conduct a comparative analysis of recurrent mastitis in Holstein-Friesian cows caused by MRSA and non-MRSA Staphylococcus aureus, with a particular focus on the number of recurrences, somatic cell count (SCC), milk production, and risk factors. The study included 120 cows, divided into two groups of 60, raised under identical conditions on a single farm. Milk samples were collected under sterile conditions, cultured on Blood agar and Mannitol Salt agar, and analyzed for the presence of MRSA using PCR for the mecA gene. Cows were monitored for the number of recurrences, SCC, daily milk yield, and response to therapy. Statistical analyses included t-tests, ANOVA, correlation analysis, and logistic regression. The results showed that MRSA-infected cows had significantly higher recurrence rates, along with elevated SCC and reduced milk yield compared to the non-MRSA group. MRSA was identified as the strongest independent risk factor for mastitis recurrence. These findings highlight the importance of regular bacteriological monitoring, appropriate therapy, and preventive measures to reduce economic losses and protect herd health.

PMID:42437984 | DOI:10.1292/jvms.26-0179

Dent Mater J. 2026 Jul 11. doi: 10.4012/dmj.2025-344. Online ahead of print.

ABSTRACT

The aim of this study was to investigate the bond strength of resin composites to the dentin surface after the removal of amalgam restorations. The dentin surfaces of amalgam-removed molars were subjected to different surface treatments (n=45). Following ortho-phosphoric acid, sandblasting, and Er:YAG laser the samples were divided into 3 subgroups, and samples were formed using different universal adhesives (Solare Universal Bond, Gluma Bond Universal, Scotchbond Universal Plus) and nanohybrid composites (G-aenial A’CHORD, Charisma Topaz, Filtek Z550). The microshear bond strength (µSBS) was measured in each group, and the data were statistically analysed via one-way analysis of variance (ANOVA) and Tukey’s post-hoc test. The 3M subgroup (39.91 MPa) had the highest bond strength on the laser-treated dentin surfaces, whereas the lowest value was measured in the Kulzer subgroup (3.61 MPa) on the sandblasted dentin surfaces. Composite resin adhesion to amalgam-contaminated dentin surfaces with surface modifications, especially laser treatment, yielded successful results.

PMID:42437979 | DOI:10.4012/dmj.2025-344

Int J Dent Hyg. 2026 Jul 12. doi: 10.1111/idh.70133. Online ahead of print.

ABSTRACT

BACKGROUND: Oral health is a multi-factorial condition influenced by diet, hygiene and sociocultural habits and its historical evolution can be traced through the bioarchaeological analysis of dento-skeletal remains, offering unique insights into past lifestyles and public health trends.

AIM: This observational study aimed to explore diachronic trends in oral health and hygiene over the last 2000 years in Milan, Italy, through the bioarchaeological analysis of skeletal remains from four historical periods (Roman Era, Early and Late Middle Ages, Modern Era).

METHODS: Forty individuals (equally represented by biological sex and age-at-death) were examined for dental calculus, wear, caries, and bone resorption. Data were collected using standardised clinical indices (OHI, BEWE, ICDAS, Black’s classification and bone resorption) and statistically analysed to identify sex-based and diachronic differences.

RESULTS: A progressive decline in dental calculus and wear was shown, reflecting dietary transitions and improved hygiene practices. Caries prevalence varied across periods, peaking in the Modern Era, while bone resorption varied little across periods. Notable sex-based disparities were observed in the earlier periods, especially regarding calculus, but diminished over time.

CONCLUSIONS: Skeletal remains provide valuable insight into long-term oral health evolution and emphasise the relevance of archaeological evidence for contemporary public health perspectives.

PMID:42437968 | DOI:10.1111/idh.70133