Nevin Manimala

Eur Arch Paediatr Dent. 2026 Jan 21. doi: 10.1007/s40368-026-01168-0. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the effect of socio-economic background on oral health knowledge and cultural beliefs of parents and associate knowledge to proactive behaviours.

METHODS: This is a cross-sectional study with a convenient sample consisting of parents seeking dental care for their children at two different dental centres. Data were collected via a structured, interview-based questionnaire, covering demographic characteristics and parental oral health knowledge and behaviours. Analysis was performed based on parental socioeconomic background determined by monthly family income (< 1400€ low, 1400-2500€ medium). Differences within and between groups were assessed using chi-square and Fisher’s exact tests and associations with demographic or behavioural characteristics using multivariate regression analysis (statistical significance p < 0.05).

RESULTS: Of the participants, 111 were from low and 105 from medium socio-economic backgrounds, with the latter demonstrating significantly better oral health knowledge and more proactive behaviours, such as regular preventive dental visits and lower consumption of sugary snacks (p < 0.05). Parents from low socio-economic backgrounds showed poor knowledge regarding aetiopathogenesis of common dental diseases, with significant differences for the effect of microbes in dental plaque accumulation formation (p = 0.03) and for brushing (p = 0.02) and sugary snack consumption (p = 0.04) in caries development. Multivariate regression analysis showed that area of residency and mother’s occupation were significantly associated with decreased knowledge, that was associated with infrequent brushing and frequent sugary snack consumption.

CONCLUSION: Significant associations highlighted the need for targeted educational interventions and public health policies to reduce oral health disparities and improve awareness.

PMID:41563691 | DOI:10.1007/s40368-026-01168-0

Eur Arch Paediatr Dent. 2026 Jan 21. doi: 10.1007/s40368-026-01169-z. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of the study was to evaluate and compare the effects of custom-made camouflaged caterpillar, camouflaged alligator and conventional syringes on anxiety and behaviour in children during local anaesthesia administration.

METHODS: This was a randomised controlled study in which 150 children aged between 7 and 9 years were randomly assigned to receive local anaesthesia using a custom-made camouflaged caterpillar, a camouflaged alligator or a conventional syringe. A pulse oximeter was used to measure pulse rate. Children were scored using the Venham’s Clinical Anxiety Scale (VCAS) and the Faces, Legs, Activity, Cry, Consolability (FLACC) scale. Data were analysed using repeated measures ANOVA, one-way ANOVA followed by Tukey’s honestly significant difference (HSD) post-hoc test, and chi-square tests. After the treatment, the child was asked to fill out the Venham’s Picture Test (VPT). In addition, parents were asked to fill out the Parental Emotional Stress Questionnaire (PESQ) and recall questionnaire.

RESULTS: The mean increase in the pulse rate was lowest in the custom-made caterpillar camouflaged syringe group, with a statistically significant difference. The mean scores of VCAS (0.66 ± 0.69), FLACC (1.38 ± 1.05), and VPT (0.62 ± 0.75) were lowest in the custom-made caterpillar camouflaged syringe group, which signified better behaviour of a child than the other two groups. The parental emotional stress quotient in the custom-made caterpillar camouflaged group revealed satisfactory outcomes with the procedure.

CONCLUSION: Custom-made caterpillar camouflaged syringes for local anaesthesia effectively decreased the anxiety of children.

PMID:41563690 | DOI:10.1007/s40368-026-01169-z

Braz J Microbiol. 2026 Jan 21;57(1):40. doi: 10.1007/s42770-025-01851-2.

ABSTRACT

Dental caries is a highly prevalent multifactorial oral disease that can cause both local and systemic lesions. The aim of this study was to evaluate the in vitro antiseptic effect of a topical solution containing polyhexamethylene guanidine hydrochloride (PHMGH) and its possible toxic effects in vivo. PHMGH was tested (0.31-625.0 ppm) against Streptococcus mutans, Streptococcus sanguinis, Streptococcus salivarius, Streptococcus mitis, Streptococcus sobrinus, Lactobacillus casei, and Enterococcus faecalis by determining the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), minimum biofilm inhibitory concentration (MBIC₇₅), fractional inhibitory concentration index (FICI), and bactericidal kinetics. The polymer was effective against all microorganisms, with MIC and MBC ranging from 0.31 to 1.24 ppm; lower values were observed especially against S. mitis and E. faecalis when compared to commercial chlorhexidine digluconate. PHMGH inhibited 75% of the microbial biofilms, including S. mutans, with the MBIC₇₅ of PHMGH and CLX being similar for this microorganism. The combination of the polymer with CLX exerted indifferent effects against the cariogenic microorganisms. Regarding bactericidal kinetics, the polymer caused higher percent reductions in the microorganisms than CLX; at concentrations of 3.000 and 1.000 ppm, with 2 and 4 min of exposure, respectively, inducing 100% bacterial death. Given the promising results, rats received daily oral instillations of four drops of PHMGH at a concentration of 625 ppm for 90 days, mimicking a mouthwash. None exhibited alterations in mucosae or tongue, as well as no body weight and histological changes were observed in the oral mucosa, tongue, esophagus, stomach, and intestine. The toxicological evaluation showed that the treated animals did not present significant alterations in the parameters of hepatotoxicity and nephrotoxicity and DNA damage. Regarding the histopathological analyses of the digestive organs, there were no statistics differences, except for the mononuclear inflammatory infiltrate in the intestinal mucosa, which was significantly higher in treated animals. Under the present experimental conditions, PHMGH exerted in vitro antimicrobial activity against dental caries microorganisms, with no evidence of in vivo toxicity; thus, it becomes a promising and less costly option for the development of oral antiseptic products.

PMID:41563683 | DOI:10.1007/s42770-025-01851-2

Curr Hypertens Rep. 2026 Jan 21;28(1):9. doi: 10.1007/s11906-025-01359-y.

ABSTRACT

PURPOSE OF REVIEW: To discuss available data on renal denervation (RDN) for treating hypertension and how expanding access to RDN may improve rates of controlled hypertension while helping address hypertension treatment disparities.

RECENT FINDINGS: RDN is an FDA-approved procedure for the treatment of patients with confirmed uncontrolled hypertension, with proven efficacy and safety in randomized sham-controlled trials. Centers for Medicare & Medicaid Services completed a national coverage analysis for RDN coverage for the treatment of uncontrolled hypertension. By summarizing the available data on RDN and hypertension statistics among different race and ethnicities in the United States, our review highlights the potential for RDN to improve treatment control rates, without increasing medication burden. By expanding coverage for the procedure, RDN may be an important tool to reduce significant treatment disparities in hypertension.

PMID:41563652 | DOI:10.1007/s11906-025-01359-y

Endocrine. 2026 Jan 21;91(1):45. doi: 10.1007/s12020-025-04537-9.

NO ABSTRACT

PMID:41563647 | DOI:10.1007/s12020-025-04537-9

Int Ophthalmol. 2026 Jan 21;46(1):65. doi: 10.1007/s10792-025-03924-5.

ABSTRACT

PURPOSE: To compare the functional and anatomical outcomes of pars plana vitrectomy (PPV) with or without internal limiting membrane (ILM) peeling in patients suffering with non-resolving vitreous hemorrhage and tractional retinal detachment.

METHODS: Fifty-seven patients (57 eyes) suffering from PDR were randomly assigned to undergo PPV with ILM peeling (n = 26) or without ILM peeling (n = 31). Outcomes assessed over a 6-month follow-up included best-corrected visual acuity (BCVA), need for additional anti-VEGF injections, frequency of reoperations, central macular thickness (CMT), development of epiretinal membrane (ERM), macular traction, and vascular parameters derived from OCT imaging.

RESULTS: Both groups showed statistically significant improvements in BCVA postoperatively (p < 0.001), with no significant difference between them (p = 0.846). The ILM peeling group required fewer repeat anti-VEGF injections (7.7% vs. 35.5%, p = 0.030) and exhibited a significantly lower incidence of secondary ERM (11.5% vs. 51.6%, p = 0.004). ERM formation correlated with iatrogenic retinal tears (p = 0.007) and tractional retinal detachment (TRD) (p < 0.001). Reoperations for ERM removal occurred exclusively in the non-ILM peeling group. No significant intergroup differences were found in CMT, foveal avascular zone (FAZ) area, or vessel density.

CONCLUSION: ILM peeling during diabetic vitrectomy effectively minimizes the risk of postoperative ERM formation and reduces the need for further Anti-VEGF injections for DME. However, it does not confer a significant advantage in terms of visual acuity improvements.

PMID:41563617 | DOI:10.1007/s10792-025-03924-5

Cancer Causes Control. 2026 Jan 21;37(2):36. doi: 10.1007/s10552-025-02121-0.

ABSTRACT

PURPOSE: In 2020, health care systems worldwide were challenged by the COVID-19 pandemic, disrupting the medical care trajectory of cancer patients. The observed diagnostic delays requested further monitoring including an assessment of survival probabilities.

METHODS: The 1-, 2- and 3-years relative survival (RS; Ederer II; follow-up until 1st May 2025) was calculated for invasive tumours diagnosed between 2017 and 2021 in Belgium (overall and per cancer type) and compared with asymptotic two-sided Z-tests on the log-transformed scale.

RESULTS: Following a decrease of the 1- and 2-years RS for 2020 (82.0% and 75.5%) compared to 2019 (82.5% and 76.1%), the 3-years RS for 2020 (72.0%) aligned again with the 3-years RS for 2019 (72.2%). The 2021 (1-, 2- and 3-years) RS and 2022 (1- and 2-years) RS estimates are in line with the increasing pre-pandemic survival rates for all cancers. The RS results showed a wide heterogeneity across cancer types. In addition, we observed small shifts in the characteristics of the cancer patient populations with contrasting impact on survival.

CONCLUSION: Since the start of the COVID-19 pandemic, the importance of timeliness in the monitoring of cancer incidence and survival emerged for many cancer registries worldwide. Based on our RS results, we advocate for tailored survival analyses per subpopulation (age group, cancer type, stage, etc.) to reveal mid- and long-term survival effects of the pandemic.

PMID:41563602 | DOI:10.1007/s10552-025-02121-0

Cancer Causes Control. 2026 Jan 21;37(2):33. doi: 10.1007/s10552-025-02099-9.

ABSTRACT

PURPOSE: To examine the relationship between guideline-concordant breast cancer care and hazard of cancer death by patient race and ethnicity.

METHODS: We used SEER-Medicare data to identify 212,555 older women diagnosed with invasive breast cancer between 2000 and 2017. Guideline-concordant diagnostic workup, locoregional treatment, and initiation of systemic therapy were defined using NCCN guidelines. Hazards of breast cancer death 2 and 5 years from diagnosis by each guideline-concordance outcome overall and stratified by race and ethnicity were estimated using Cox proportional hazards models.

RESULTS: Non-concordant diagnostic workup, locoregional treatment, and systemic therapy initiation were each associated with increased hazards of 2- and 5-year breast cancer mortality (diagnostics HR_2-year (95% CI) 1.33 (1.25-1.41), HR_5-year 1.29 (1.23-1.35); locoregional HR_2-year 2.10 (1.98-2.23), HR_5-year 1.83 (1.76-1.90); systemics HR_2-year 1.67 (1.51-1.84), HR_5-year 1.56 (1.45-1.68)). Non-concordant diagnostic workup and systemic therapy initiation were associated with greater hazard of 2- and 5-year breast cancer death among Black, Asian/Pacific Islander, Hispanic White, and non-Hispanic White patients; there was no consistent association among American Indian/Alaska Native patients for either outcome. Locoregional treatment was strongly associated with hazards of cancer death for all groups.

CONCLUSION: Equitable delivery of guideline-recommended breast cancer care from diagnosis through treatment across racial and ethnic groups may mitigate survival disparities. Efforts to improve access to high-quality care must be informed by and responsive to the social and structural root causes of health inequities.

PMID:41563590 | DOI:10.1007/s10552-025-02099-9

Support Care Cancer. 2026 Jan 21;34(2):112. doi: 10.1007/s00520-026-10343-4.

ABSTRACT

BACKGROUND: Early phase clinical trials (EP-CTs) investigate novel therapeutic approaches for patients with cancer, but little is known about patterns of supportive care service utilization and advance care planning (ACP) in this population. We sought to characterize these features in an EP-CT population and evaluate associations among receipt of supportive care services and ACP documentation.

METHODS: We retrospectively reviewed the electronic health record (EHR) of consecutive patients enrolled in EP-CTs at Massachusetts General Hospital from 01/01/17-12/30/19. We abstracted sociodemographics, performance status (Eastern Cooperative Oncology Group [ECOG] score), oncology history, trial details, as well as receipt and timing of six supportive care services (palliative care [PC], social work [SW], spiritual services [SS], parental support [PS], physical therapy [PT], and nutrition). We additionally abstracted receipt and timing of ACP documentation (defined as any EHR-documented conversation addressing illness understanding or values, preferences, or goals for future medical care, as identified using a structured keyword search). We then separately examined associations between receipt of any supportive care service and ACP documentation, number of supportive care services received and ACP documentation, and subtype of supportive care received and ACP documentation. These analyses used logistic regression models adjusted for age, sex, cancer type, and performance status.

RESULTS: During our study period, 376 patients participated in EP-CTs (median age 63.0 years, 55.9% female, 97.3% stage 4, median ECOG 1, median follow-up: 223 days, median time from diagnosis to EP-CT: 844 days). Nearly all received at least one type of supportive care across their illness trajectory (88.0%), with varied rates by service type (PC: 54.8%, SW: 64.1%, SS: 39.1%, PS: 8.0%, PT: 54.0%, nutrition: 61.2%). Most also had some form of ACP (73.9%) documented between diagnosis and death. Multivariable regression models demonstrated that receipt of any of the six forms of supportive care was associated with higher likelihood of ACP documentation (odds ratio [OR]: 9.18, 95% confidence interval (CI): 4.49-18.78, p < 0.001). Similarly, we observed associations between number of supportive care services received when considered as a continuous covariate and ACP documentation (OR_{1 service}:1.89, 95%CI:0.90-4.03, p = 0.090; OR_{2 services}: 15.36, 95%CI 5.78-40.78, p < 0.001, OR_{3+ services}: 35.78, 95%CI: 14.35-89.24, p < 0.001). These associations also persisted when considering PC independently (OR_PC = 11.17, 95%CI_PC = 5.76-21.67, p < 0.001) from other supportive care services (OR_other = 5.41, 95%CI_other: 2.64-11.09, p < 0.001).

CONCLUSIONS: In this large cohort of EP-CT participants, most patients received supportive care services and had documented ACP, suggesting trial-related engagement does not impede care delivery. Notably, receipt of supportive care services correlated with ACP documentation. These findings underscore the importance of addressing individual supportive care needs among EP-CT participants.

PMID:41563588 | DOI:10.1007/s00520-026-10343-4

Infect Dis Ther. 2026 Jan 21. doi: 10.1007/s40121-026-01302-x. Online ahead of print.

ABSTRACT

INTRODUCTION: Aging in people with HIV (PWH) is accompanied by an increased burden of multimorbidity and persistent inflammation. Identifying biomarkers that reflect comorbidity risk can help improve long-term care. This study evaluated the association of multimorbidity with GDF-15, sICAM-1, sVCAM-1, and sP-selectin in PWH.

METHODS: A cross-sectional study was performed in two cohorts of adults receiving antiretroviral therapy: a discovery cohort (n = 74) and a validation cohort (Spanish CoRIS network) (n = 150). Median age was 53 years in both cohorts (IQR 44-60 and 45-58), and women represented 19 (25.7%) and 75 (50.0%), respectively. Multimorbidity was defined as ≥ 2 comorbidities, including but not limited to cardiovascular, metabolic, renal, and non-AIDS-defining cancers. Plasma GDF-15, sICAM-1, sVCAM-1, and sP-selectin were quantified by multiplex immunoassay. Associations with log-transformed GDF-15 were assessed using multivariable linear regression including age-multimorbidity ordinal categories, tobacco smoking, and CD4+ nadir.

RESULTS: Multimorbidity prevalence was 48.6% (36) in the hospital cohort and 54.7% (82) in CoRIS. In both cohorts, participants with multimorbidity had significantly higher GDF-15 levels (hospital: 771.5 vs. 390.0 pg/ml; CoRIS: 485.2 vs. 360.1 pg/ml; both p < 0.001). In the hospital cohort, smoking and age-multimorbidity were independently associated with elevated GDF-15, with 26.1% and 16.0% increases per category, respectively (p < 0.05). These associations were confirmed in CoRIS, with 5.44% and 19.0% increases (p < 0.01). CD4+ nadir showed no significant association with GDF-15. No significant associations were observed between multimorbidity and sICAM-1, sVCAM-1, or sP-selectin (all p > 0.05).

CONCLUSIONS: Elevated GDF-15 was consistently associated with multimorbidity in PWH, primarily driven by aging and tobacco smoking. GDF-15 appears to reflect a broader state of multisystem physiological stress than traditional endothelial activation markers, supporting its utility as a biomarker to identify PWH at higher risk of age-related comorbidities and to monitor the impact of modifiable risk factors in clinical care.

PMID:41563586 | DOI:10.1007/s40121-026-01302-x