Nevin Manimala

Clin Oral Implants Res. 2025 Oct 4. doi: 10.1111/clr.70053. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the impact of the marginal fit of implant-supported prostheses (ISP) on peri-implant bone levels. Additionally, the study aimed to determine a clinically relevant threshold for the radiographic vertical misfit gap at the ISP, when present, and to identify potential risk factors associated with changes in bone levels.

METHODS: This study involved subjects who received ISPs for tooth replacement therapy. Standardized intraoral periapical radiographs were taken 10 years after loading to assess the radiographic distance between the implant shoulder and the most coronal point of crestal bone (DIB). ISP marginal gaps were categorized as no gap or gap, with vertical dimensions categorized as 0 mm, > 0- < 0.1 mm, and ≥ 0.1 mm. A multivariable linear mixed-effect model was applied to control for potential confounders.

RESULTS: A total of 301 patients and 505 implants with a 10.6 ± 0.7 years follow-up were analyzed. ISPs without gaps exhibited statistically significantly lower DIB values (3.22 ± 0.8 mm) than those with gaps (3.43 ± 0.6 mm; p = 0.001). Gaps ≥ 0.1 mm were associated with statistically significantly higher DIB values (3.45 ± 0.7 mm; p = 0.001) compared with gaps between > 0 and < 0.1 mm (3.36 ± 0.5 mm; p = 0.001), or no gaps (3.22 ± 0.7 mm; p = 0.001). Each increment of 0.1 mm in the vertical crestal gap corresponded to a significant increase in DIB values (0.08 mm; p = 0.03). Finally, smoking and a history of periodontitis were independent risk factors for increased DIB.

CONCLUSIONS: Marginal misfit of ISP affects peri-implant bone stability, with gaps ≥ 0.1 mm linked to higher DIB. Smoking and periodontitis are independent risk factors for increased DIB.

PMID:41046331 | DOI:10.1111/clr.70053

BMC Oral Health. 2025 Oct 4;25(1):1527. doi: 10.1186/s12903-025-06884-5.

ABSTRACT

OBJECTIVE: Oral health is a neglected aspect of healthcare, especially among prison inmates who face barriers in accessing dental services. Dental caries is a prevalent and preventable disease that affects inmates’ general health and quality of life. This study evaluated dental caries and its predictors among inmates in the Eastern Province of Saudi Arabia.

METHODS: This cross-sectional study was conducted as part of an ongoing oral health program by the College of Dentistry, Imam Abdulrahman Bin Faisal University(IAU), Dammam, targeting inmates in prisons across Dammam, Khobar, Dhahran, Jubail, and AlHasa in the Eastern Province of Saudi Arabia. This prison outreach program is conducted annually from January to April. Male and female inmates who voluntarily consented were included without exclusion criteria. Data collection involved oral examinations using the DMFT index and Simplified Oral Hygiene Index (OHI-S), following World Health Organization’s (WHO) criteria, and structured interviews based on the WHO Oral Health Questionnaire for Adults. Calibrated examiners performed the examinations using portable dental units. Statistical analysis included t-tests, ANOVA, Pearson correlation, and multiple linear regression analysis.

RESULTS: The sample consisted of 230 participants with 86.1% males and 13.9% females. In the study, 98.3% of the sample had untreated decay and 99.1% of participants had DMFT score ranging from 1 to 28, with a mean score of 14.41 ± 7.89. About 25.2% of participants never cleaned their teeth using any tool, 23.5% did not use toothpaste, and 23.5% consumed soft drinks several times a day. Dental attendance, defined as being seen by a dentist at prison, within the last year was reported by 37% of participants and 15.2% never received dental care. Most participants (85.2%) reported dental pain during the last year. The study showed a statistically significant correlation between the simplified oral hygiene index and the mean decayed score (r = 0.456, P < 0.001). The mean DMFT of the sample significantly increased with advancing age (P = 0.023). Male participants (15.12 ± 7.94) demonstrated significantly higher mean DMFT score than females (10.03 ± 6.05) (P = 0.001). Similarly, significantly higher DMFT was found in Saudi (15.74 ± 7.91) versus non-Saudi participants (10.45 ± 6.41) (P < 0.001). Those who used toothpaste (12.82 ± 6.95) had significantly lower mean DMFT score than those who did not use toothpaste (19.59 ± 8.58) (P = 0.006). A statistically significant relationship was observed between soft drink consumption and caries experience (P = 0.043).

CONCLUSION: Untreated decay was highly prevalent among inmates in this study. A statistically significant correlation was found between oral hygiene and caries experience, with advancing age, male gender, Saudi nationality, and frequent soft drink consumption being significantly associated with higher caries levels. These findings highlight the urgent need for targeted oral health promotion strategies and improved access to dental care within correctional facilities. Policy implications include the integration of oral health education into prison health programs and the establishment of routine dental screenings. Future research should explore the effectiveness of mobile dental services and behavioral interventions tailored to this high-risk population.

PMID:41046304 | DOI:10.1186/s12903-025-06884-5

Eur Radiol. 2025 Oct 4. doi: 10.1007/s00330-025-12040-y. Online ahead of print.

ABSTRACT

OBJECTIVES: To develop a predictive model incorporating both clinical and imaging findings to predict early progression in patients with advanced hepatocellular carcinoma (HCC) undergoing atezolizumab plus bevacizumab (Atezo-Bev) therapy.

MATERIALS AND METHODS: A total of 140 consecutive patients with HCC who initiated Atezo-Bev therapy between January 2020 and May 2022 at two tertiary care centres were retrospectively enrolled. Early progression was defined as progressive disease in the first response evaluation conducted at 4 weeks and 12 weeks after treatment initiation using dynamic CT or MRI. Images were reviewed by two radiologists. Logistic regression analysis was performed to determine the early progression scores.

RESULTS: The first response evaluation of Atezo-Bev therapy was conducted at a median of 56 days (interquartile range, 42-64 days) after treatment initiation. Approximately 40% (56/140) of patients with HCC showed early progression. The early progression score was defined as follows: (age < 60 years; 1 point) + (serum alpha-fetoprotein level ≥ 300 ng/mL; 3 points) + (neutrophil-to-lymphocyte ratio ≥ 2.8; 1 point) + (infiltrative appearance; 2 points). At a score of 3 or higher, the early progression score showed sensitivity of 91.1% (95% confidence interval [CI]: 83.6-98.5%) and a specificity of 53.6% (95% CI: 42.9-64.2%). At a score of 6 or higher, the score demonstrated a sensitivity of 55.4% (95% CI: 42.3-68.4%) and a specificity of 91.7% (95% CI: 85.8-97.6%).

CONCLUSION: We developed an early progression score that integrates clinical and imaging factors with high specificity to accurately predict early progression in patients with advanced HCC undergoing Atezo-Bev therapy.

KEY POINTS: Question No validated imaging-based tool currently exists to predict early progression to Atezo-Bev therapy in advanced HCC. Findings Infiltrative tumour appearance, high AFP, high neutrophil-to-lymphocyte ratio, and younger age were significantly associated with early progression. Clinical relevance A composite early progression score integrating clinical and imaging features showed high diagnostic accuracy for predicting treatment failure.

PMID:41046297 | DOI:10.1007/s00330-025-12040-y

Ann Surg Oncol. 2025 Oct 4. doi: 10.1245/s10434-025-18423-1. Online ahead of print.

ABSTRACT

BACKGROUND: Complete cytoreductive surgery is crucial in advanced ovarian cancer (OC) treatment. Diaphragmatic surgery, including stripping (DS) and resection (DR), is often necessary for optimal cytoreduction. However, postoperative complications and the timing of adjuvant chemotherapy initiation remain critical concerns. This study evaluates the impact of DR and DS on surgical outcomes, chemotherapy timing, and survival.

PATIENTS AND METHODS: This retrospective, monocentric study analyzed 215 patients with International Federation of Gynecology and Obstetrics (FIGO) stage III-IV OC undergoing DS or DR between 2011 and 2023. Clinical, surgical, and survival data were collected; complications were graded using the Clavien-Dindo system. Statistical analysis included contingency and survival tests.

RESULTS: A total of 215 patients underwent diaphragmatic surgery: 122 patients (56.7%) underwent DR and 93 (43.3%) DS. No significant differences existed between groups regarding age, body mass index (BMI), histological subtype, American Society of Anesthesiologists (ASA) score, or primary/interval debulking surgery distribution (p = 0.122). DR was more common in patients with greater peritoneal disease (p = 0.003), higher pleural involvement (p = 0.002), and longer operative times (p = 0.018). Postoperatively, DR was associated with increased thoracic complications (87.7% versus 52.7%, p < 0.001), greater oxygen supplementation needs (55.7% versus 35.5%, p = 0.003), and elevated liver enzymes. However, no significant differences emerged in severe complications (p = 0.077), reoperation rates (p = 0.227), or time to chemotherapy initiation (p = 0.742). A decreasing trend in thoracostomy tube placement was observed since 2018. Progression-free and overall survival were similar between groups.

CONCLUSIONS: Despite requiring greater intraoperative effort and resulting in higher postoperative morbidity, DR is not associated with an increased incidence of severe complications (grade 3+) or delayed chemotherapy initiation compared with DS. These findings support the feasibility of DR for achieving complete cytoreduction in advanced OC.

PMID:41046296 | DOI:10.1245/s10434-025-18423-1

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