Nevin Manimala

J Orthop Surg Res. 2025 May 31;20(1):555. doi: 10.1186/s13018-025-05788-y.

ABSTRACT

BACKGROUND: Humeral capitellum osteochondritis dissecans (OCD) is a common condition among overhead throwing athletes and is typically treated surgically. While stable lesions can be treated nonoperatively, untreated unstable lesions can lead to significant elbow discomfort and impaired quality of life. This study reviews the revision rate and interval in athletes with elbow OCD following primary surgery.

METHODS: Data was extracted from PubMed, Embase, and Medline between 1990 and 2022, and two reviewers independently screened the duplicate reports of complications and revision surgeries. The Methodological Index for Nonrandomized Research score was used for risk of bias assessment. Inclusion criteria were as follows: studies in the English language, those involving humans, those reporting complications, and those performing revision surgeries following capitellar OCD surgery. Logit transformation and random effects were calculated using the Der Simonian Laired estimator, and the Shapiro-Wilk test was first performed to determine whether revision interval data followed a normal distribution. The Wilcoxon rank sum test was used for nonparametric data comparison, while Spearman’s rank correlation assessed whether shorter follow-up periods underestimated the revision rate.

RESULTS: A total of 6,457 studies were identified through the initial literature search (PubMed: 1,924; Embase: 2,532; Medline: 2,001), with 4,147 duplicates removed, leaving 2,310 unique studies for screening. After applying the inclusion criteria, 20 full-text articles were selected, all of which were level IV case series with MINORS scores ranging from 7 to 14 (mean: 10.65), demonstrating moderate heterogeneity (I² = 41%) and strong inter-reviewer agreement across screening phases (κ = 0.78-0.98). Twenty studies involving 477 elbows (474 athletes) were included, 55 of which underwent revision surgery. The athletes were divided into debridement, microfracture, and osteochondral grafting groups. The overall revision rate was 11.53%, and the revision rate of the three groups were 11.2%, 14.2%, and 9.19%, respectively. Eleven of the 20 studies (24 of 175 athletes underwent revision surgery) with complete data were included in interval analysis of revision surgery. The mean intervals of all participants and three groups were 25, 41.8, 10.4, and 24.2 months, respectively. Spearman’s rank correlation showed no significant association between the follow-up duration and the revision rate (rho = -0.31, p = 0.18) or the revision interval (rho = 0.02, p = 0.95) in the overall cohort. Correlation coefficients across surgical subgroups also varied in direction and were not statistically significant.

CONCLUSION: Approximately 11% of patients required revision surgery following primary treatment for elbow OCD, with an average interval of 25 months. No significant association between follow-up duration and either revision rate or revision interval. Thus, further investigations, rehabilitation programs may be required to decrease this revision rate.

PMID:40450334 | DOI:10.1186/s13018-025-05788-y

BMC Public Health. 2025 May 31;25(1):2009. doi: 10.1186/s12889-025-23306-x.

ABSTRACT

BACKGROUND: Recent developments suggest a strong association between cardiometabolic multimorbidity, depression, and hospitalization. The aim of this study was to investigate the association of cardiometabolic multimorbidity with depression and the length of hospitalization among individuals aged 40 and older.

METHODS: This study is based on the secondary analysis of data obtained from the 2022 Turkey Health Survey conducted by the Turkish Statistical Institute (TUIK). A weighted sample of 31,425,252 individuals aged 40 and over was analyzed. The dependent variables of the study are depression and hospitalization, while the independent variable is cardiometabolic multimorbidity. Other covariates include gender, age, education level, physical activity, body mass index, tobacco use, and alcohol use. The weights from the database provided by TUIK were used in the data analysis. The relationship between cardiometabolic multimorbidity and depression was investigated using univariate and multivariate logistic regression analysis.

RESULT: Of the included participants, 51.2% were female and 35.5% were between the ages of 40-49. In Model 1, individuals with five cardiometabolic diseases had a 10-fold higher risk of developing depression compared to those with no diseases (OR: 10.0; 95% CI: 9.82-10.23). In Model 2, the risk of depression was 5.1 times higher in individuals with three diseases (OR: 5.1; 95% CI: 5.08-5.14), 5.83 times higher in those with four diseases (OR: 5.3; 95% CI: 5.78-5.88), and 14.6 times higher in individuals with five diseases (OR: 14.6; 95% CI: 14.36-14.99). Furthermore, as the number of cardiometabolic diseases increases, a significant increase in the length of hospitalization was observed (p < 0.001).

CONCLUSIONS: The findings of this study revealed that cardiometabolic multimorbidity may increase the risk of depression and the length of hospitalization in adults. These results may provide guidance for developing disease prevention and control strategies regarding cardiometabolic multimorbidity and associated factors in adults.

PMID:40450317 | DOI:10.1186/s12889-025-23306-x

BMC Public Health. 2025 May 31;25(1):2022. doi: 10.1186/s12889-025-23155-8.

ABSTRACT

BACKGROUND: Although there is consistent evidence of unhealthy changes in the 24-h movement behaviours when comparing pre-COVID-19 periods to the early stages of the pandemic, there is limited research on long-term changes among adolescents. This study aimed to analyze both between- and within-participant differences in accelerometer-assessed 24-h movement behaviours by comparing cross-sectional and prospective data from the pre-COVID-19 period (August to December 2019) to the period following the reopening of schools for in-person classes in southern Brazil (August to December 2022).

METHODS: This is a repeated cross-sectional design with a nested cohort. The 24-h movement behaviours (i.e., light physical activity [LIPA] and moderate-to-vigorous physical activity [MVPA], sedentary behaviour [SB], and sleep time [SPT]) were assessed by processing raw accelerometer data derived from a 24-h/7-day wrist-worn protocol. Compositional multilevel models were applied to compare the 24-h movement behaviour composition between time points for both cross-sectional and prospective data. Self-reported sociodemographic characteristics were examined as potential moderators.

RESULTS: The cross-sectional and prospective samples comprised, respectively, 1276 (53% female, average age of 16.4 ± 1.1) and 249 (53% female, average age of 15.6 ± 0.8) participants. The 24-h movement behaviour composition differed between time-points in the cross-sectional (p < 0.001) and prospective samples (p < 0.001). Differences from 2019 to 2022 were explained by lower MVPA (-3.3 and -5.4 min/day in cross-sectional and prospective analysis, respectively) and a higher SB (4.7 and 34 min/day in cross-sectional and prospective analysis, respectively). No significant differences were observed for LIPA and SPT.

CONCLUSIONS: Differences in the 24-h movement behaviour composition comparing the cross-sectional samples, although statistically significant, were considered trivial and unlikely to have a substantial practical impact. However, considerable differences were observed in the prospective analysis. The results suggest that most of the observed changes over time were expected as a natural consequence of aging during high school, with only a small portion attributable to the residual impact of the pandemic.

PMID:40450307 | DOI:10.1186/s12889-025-23155-8

BMC Oral Health. 2025 May 31;25(1):868. doi: 10.1186/s12903-025-06252-3.

ABSTRACT

BACKGROUND: Early childhood caries (ECC) is a widespread pediatric dental condition that is influenced by a combination of biological, behavioral, and demographic factors. Salivary biomarkers, including beta-defensin-2 (BD-2) and statherin (STATH), offer potential as non-invasive tools for detecting and assessing the risk of ECC. This study aims to compare the levels of salivary statherin and beta-defensin-2, alongside oral health behaviors and demographic factors, in children both with and without early childhood caries.

METHODS: This case-control study involved 75 children diagnosed with ECC and 75 age- and gender-matched caries-free controls. Unstimulated saliva samples were obtained and analyzed via ELISA to quantify the levels of beta-defensin-2 and statherin. Demographic and behavioral data were gathered through structured interviews with parents. Statistical analyses included t-tests, logistic regression, and machine learning models to predict the risk of ECC.

RESULTS: Salivary beta-defensin-2 levels were significantly higher in children with ECC (9.25 ± 2.89 ng/mL) compared to caries-free controls (6.41 ± 2.45 ng/mL, p = 0.003), indicating its potential as a diagnostic biomarker. Statherin levels, although lower in the ECC group, did not differ significantly between groups (p = 0.08). Behavioral factors such as regular dental visits and parental education levels were strongly associated with ECC prevalence. Machine learning models demonstrated high accuracy in predicting ECC, with the Gradient Boosting and CatBoost achieving the highest performance.

CONCLUSIONS: Salivary beta-defensin-2 is a promising ECC risk assessment biomarker, while statherin is less effective as an independent predictor. Behavioral and demographic factors significantly influence ECC prevalence. Machine learning models integrating clinical, demographic, and salivary data provide a robust tool for detection and targeted prevention strategies. Comprehensive approaches combining salivary biomarkers and behavioral interventions are critical to managing ECC, particularly in resource-limited settings.

PMID:40450305 | DOI:10.1186/s12903-025-06252-3

BMC Oral Health. 2025 May 31;25(1):870. doi: 10.1186/s12903-025-06188-8.

ABSTRACT

BACKGROUND: This study aimed to determine normative values for mesiodistal and buccolingual crown diameters of permanent teeth in the Turkish population and compare them with values reported in previous studies for other populations and the Turkish population.

MATERIALS AND METHODS: The mesiodistal and buccolingual diameters of permanent teeth were measured using digital calipers from dental cast models of 200 patients. The data analysis was conducted employing the SPSS 21 package software. The descriptive statistics were obtained for all parameters. Student t-test was utilized to compare the measurements between male and female patients. A paired t-test was used to compare the right and left side teeth. The significance level was set at 0.05.

RESULTS: A total of 4800 teeth were measured. Men’s tooth sizes were larger than women’s tooth sizes. A stronger sexual dimorphism was observed in the buccolingual diameter in comparison to the mesiodistal diameter. No clinically significant differences were observed between antimeric teeth. In the maxilla and mandible, the first molars were found to have the largest mesiodistal and buccolingual diameters, whereas mandibular central teeth had the smallest diameters.

CONCLUSIONS: Current norm values of mesiodistal and buccolingual diameters of permanent teeth in the Turkish population were established. The norm values presented are close to the tooth dimensions in studies carried out on other populations. Compared to previous studies, there is an increase in mesiodistal diameters in the Turkish population, with this increase being more pronounced in males. The mean mesiodistal and buccolingual diameters of permanent teeth can be useful for orthodontists, prosthodontists, anatomists, anthropologists, and forensic dentistry specialists.

PMID:40450299 | DOI:10.1186/s12903-025-06188-8

BMC Oral Health. 2025 May 31;25(1):866. doi: 10.1186/s12903-025-06258-x.

ABSTRACT

OBJECTIVE: The commonly used lateral cephalometric radiographs, including traditional lateral cephalometric radiographs and CBCT-synthesized lateral cephalometric radiographs, have the problem of overlapping anatomical structures, which interferes with the identification of landmarks. Therefore, we proposed a new method called CBCT-based locally reconstructed lateral cephalometric radiographs and evaluated its precision and reproducibility.

MATERIALS AND METHODS: CBCT and lateral cephalometric radiographs were obtained from five orthodontic patients. Twenty-six cephalometric landmarks were identified using three methods by ten orthodontists. The landmarks on each image were recorded as (X, Y), and the absolute values of the differences between each measurement and the average values of the X and Y coordinates were calculated (ΔX and ΔY). Additionally, the distance between each located point and the centroid was calculated (ΔD). The differences in ΔX, ΔY, and ΔD among the groups were compared through analysis of variance (ANOVA). Bonferroni post hoc correction was used for pairwise comparisons. p < 0.05 was considered statistically significant.

RESULTS: The reproducibility of 14 landmarks in the CBCT-based locally reconstructed lateral cephalometric radiographs was better than that of the other methods in at least one direction (p < 0.05). Among these landmarks, the precision of the CBCT local reconstruction group was greater in all directions for five landmarks than that of the other two groups (p < 0.05).

CONCLUSION: The CBCT locally reconstructed lateral cephalometric radiographs proposed in this study enhanced the precision and reproducibility of cephalometric landmark identification.

PMID:40450295 | DOI:10.1186/s12903-025-06258-x

Orphanet J Rare Dis. 2025 May 31;20(1):263. doi: 10.1186/s13023-025-03834-w.

ABSTRACT

BACKGROUND: Lymphangioleiomyomatosis (LAM) is a rare, low-grade neoplasm. Abnormal activation of the mammalian target of rapamycin (mTOR) pathway plays a critical role in LAM pathogenesis by promoting cell proliferation, which may increase susceptibility to malignancies in these patients. However, owing to the rarity of LAM, comprehensive data on the risk of malignancy in this population are limited.

METHODS: We retrospectively analyzed 849 LAM patients who participated in the LAM-China Registry Study at Peking Union Medical College Hospital. We collected medical records of patients with malignant tumors and estimated the incidence of malignancy in the LAM-China cohort.

RESULTS: A total of 849 patients were included in our research, of whom 760 were sporadic LAM and 89 had tuberous sclerosis complex-associated LAM. Thirty-one patients (3.65%) had a history of malignancy. More than 80% of LAM and malignant tumors developed successively within 5 years, with a median time interval of 1.5 years. Eighteen patients who were diagnosed with malignancy after diagnosis of LAM were included in the incidence calculation. The three most prevalent cancers were thyroid cancer (n = 5), breast cancer (n = 4) and ovarian cancer (n = 3). Except for lung cancer, the SIRs for all other cancers mentioned in the present study were significantly increased: thyroid cancer (SIR = 10.87, 95% CI 3.53-25.37), breast cancer (SIR = 5.95, 95% CI 1.62-15.24), and ovarian cancer (SIR = 24.54, 95% CI 5.07-71.86). After standardization by age, the SIR for malignancy in our cohort was 3.20 (95% CI 1.89-5.05, p = 0.00003). However, this elevated risk of malignancy appeared to be confined to younger age groups. Among individuals aged over 50 years, there was no statistically significant difference in the incidence of malignancy between LAM patients and the reference population.

CONCLUSION: The risk of malignant tumors is significantly increased in LAM patients than that in the reference population. Thyroid cancer, breast cancer, and ovarian cancer were the three most prevalent malignancies in our cohort. Each type of cancer that appeared in the cohort presented a relatively high incidence, except for lung cancer.

PMID:40450294 | DOI:10.1186/s13023-025-03834-w

BMC Oral Health. 2025 May 31;25(1):869. doi: 10.1186/s12903-025-06238-1.

ABSTRACT

BACKGROUND: Tooth loss is often followed by potential complications, including restricted mouth opening, edema, regional pain, and alveolar osteitis (AO), all of which can impair socket healing and quality of life, compromising the ability to socialize and speak post-extraction. One of the approaches currently used to minimize adverse effects is to use platelet-rich fibrin (PRF) immediately following tooth extraction to reduce these complications. This study aims to evaluate the effectiveness of platelet-rich fibrin in promoting soft and hard tissue healing, and its effects on post-extraction complications.

METHOD: A systematic review and meta-analysis were conducted, following an electronic and manual search of PubMed, EMBASE, Web of Science, and Scopus databases. A total of 455 articles were screened, of which 41 articles underwent systematic review, and 21 studies (701 patients) were included for meta-analysis. Statistical analyses were performed using Comprehensive Meta-Analysis software. The risk of bias was evaluated by three assessors based on five domains. To evaluate PRF effectiveness, the focus was on split-mouth designs to minimize inter-patient variability.

RESULT: PRF significantly improved soft tissue healing (eight studies, p < 0.05), reduced AO incidence (four studies, p < 0.05), and lowered post-operative pain (eleven studies, p < 0.05). However, PRF did not demonstrate statistically significant improvement in bone healing (three studies, p > 0.05).

CONCLUSION: The analysis showed that PRF significantly improved soft tissue healing and reduced the incidence of AO. While PRF helped reduce pain, the results were inconsistent and influenced by the timing of post-operative assessments. The impact on hard tissue healing was controversial, and future research should explore alternative methods to evaluate PRF’s effects on bone regeneration.

PMID:40450285 | DOI:10.1186/s12903-025-06238-1

BMC Oral Health. 2025 May 31;25(1):857. doi: 10.1186/s12903-025-06203-y.

ABSTRACT

BACKGROUND: Achieving optimal dentofacial aesthetics requires an understanding of tooth morphology and its impact on dental harmony. Variations in tooth size can significantly influence the occurrence of different malocclusions, affecting aesthetics and functional occlusion. This systematic review aims to analyse and summarise the existing literature on tooth size variations in different malocclusion categories, focusing on the morphological dimensions of permanent dentition.

METHODS: Systematic literature search was conducted in six electronic databases (PubMed/Medline, Cochrane, Web of science, Scopus, LILAC, OVID) until February 2025 for original articles assessing the morphological dimension of the permanent dentition in various malocclusions. The risk of bias and quality assessment was done using the modified Downs and Black quality index for retrospective and cross sectional study. The review was registered on Prospero (CRD42024526671).

RESULTS: Nine studies (4 retrospective, 5 cross sectional) met the eligibility criteria. A total of 2044 pre-treatment dental casts of patients with various malocclusions were included. In mandibular first molars, the mean difference (MD) of the mesiodistal width was higher in Class III malocclusion than Class II div 1 malocclusion (3 studies; MD [95%CI]: 0.45[, -0.66, -0.24]), Class II division 2 malocclusion (3 studies; MD [95%CI]: 0.29[, -0.55, -0.24]) and Class I malocclusion (7 studies; MD [95%CI]: 0.20[ -0.35 to -0.05]). These findings were statistically significant. For mandibular canines, MD of the mesiodistal width was higher in Class III malocclusion than in Class II division 1 malocclusion (3 studies; MD [95%CI]:0.28 [ -0.45 to -0.10]), which was statistically significant. With the maxillary canines, the MD of the mesiodistal width was higher in Class II division 1 malocclusion (3 studies; MD [95%CI]: 0.30[0.12, 0.47]), which was statistically significant.

CONCLUSION: In Class III malocclusion, the mandibular dentition was found to be significantly larger compared to other malocclusions. The Maxillary dentition was significantly larger in Class II malocclusion compared to other malocclusions. Within the limitations of the study, Class III and Class II malocclusions were found to have larger mesio-distal width as compared to Class I malocclusion. These findings may aid clinicians in treatment planning, particularly in space analysis, arch coordination, and appliance selection during orthodontic interventions.

PMID:40450279 | DOI:10.1186/s12903-025-06203-y

BMC Complement Med Ther. 2025 May 31;25(1):195. doi: 10.1186/s12906-025-04938-3.

ABSTRACT

BACKGROUND: Herbal products have been used for gas pains in children for many years. However, the quality of herbal products used in children and the presence of contamination in the products are controversial. This study was conducted to evaluate the frequency of use of herbal products for gas pain in pediatric patients, the attitudes of parents towards the use of herbal products, and the pyrrolizidine alkaloid content of herbal products used for gas pain.

METHODS: The survey part of the study was conducted between 15.06.2020-15.09.2020 at Gazi University Hospital Pediatrics Clinics. The surveys were conducted face to face with the parents. The Statistical Package for Social Sciences (SPSS) 23 program was used in the analysis of the data. In the other part of the study, 28 herbal products frequently used in gas pain were purchased from spice shops, markets and internet sites and their pyrrolizidine alkaloid content was evaluated by LC-QTOF-MS analysis.

RESULTS: 31.5% of the participants had their children use herbal products for gas pains. When the plants used for gas pains in children were examined, fennel came first with a usage rate of 51.3%. The plants used in gas pains were purchased from spice shops by most of the participants (59%). The presence of pyrrolizidine alkaloids above 10 µg/kg concentration was detected in 75% of herbal products used in gas pains.

CONCLUSION: In all segments of society, children are given herbal products for gas pains. Parents mostly buy herbal products from spice shops. Products sold for gas pains may cause hepatotoxic effects in children when consumed for a long time and in high doses due to the pyrrolizidine alkaloids they contain. Herbal products to be used in gas pain should be used under the consultancy of a physician/pharmacist and should be obtained from pharmacies.

PMID:40450273 | DOI:10.1186/s12906-025-04938-3