Tag: pubmed

Clin Exp Dent Res. 2025 Dec;11(6):e70167. doi: 10.1002/cre2.70167.

ABSTRACT

OBJECTIVES: This retrospective cohort study aimed to assess the survival rate of implants placed in grafted edentulous maxillary arches following a delayed loading protocol versus a graftless approach with an immediate loading protocol.

MATERIALS AND METHODS: Eighty seven patients with atrophic edentulous maxillae were included in two groups: Group-1 (GG group, n = 155 implants): 26 patients that underwent maxillary bone grafting before treatment with axially placed delayed loading implants and provided with a fixed full-arch prostheses; Group-2 (GL group; n = 244 implants): 61 patients who received axial and tilted implants without bone augmentation followed by an immediately loaded fixed full-arch prostheses. Patients were followed up for up to 10 years. Kaplan-Meier and Mantel-Cox analyses were performed to determine implant survival rates, and a Cox hazards model was run to assess the influence of patient, implant, and prosthesis-based covariates.

RESULTS: There were no significant differences in implant failure rates between the two treatment groups (p = 0.298). Five implant failures were observed in Group-1 (GG group) and four failures were observed in Group-2 (GL group) (N = 9). Survival rate was 96.8% and 98.4% in the GG and GL groups, respectively. No significant association between patient and implant-based covariates and implant failure was observed in both groups; however, a significant association was observed regarding the nature of the opposing arch (p = 0.019).

CONCLUSION: Immediately loaded implants placed in maxillary native bone show statistically similar survival rates compared to implants placed in grafted bone following a delayed loading. The nature of the opposing arch may negatively influence the survival rate of dental implants.

CLINICAL SIGNIFICANCE: For atrophic edentulous maxillae, both grafted and graftless approach may represent a viable treatment modality in the long term.

PMID:41252708 | DOI:10.1002/cre2.70167

Clin Exp Dent Res. 2025 Dec;11(6):e70221. doi: 10.1002/cre2.70221.

ABSTRACT

OBJECTIVE: Evidence on biological, technical, and esthetic outcomes following dental implant treatment in the anterior maxilla after traumatic tooth loss is limited. Therefore, this study aimed to evaluate the survival, esthetic, and patient-reported outcome measures of implant treatment in the anterior maxilla after up to 9 years of functional loading.

MATERIAL AND METHODS: The study was conducted at Copenhagen University Hospital, Denmark. Patients who underwent implant treatment for anterior maxillary tooth loss due to trauma between 2007 and 2019, with at least 1 year of functional loading, were recalled for clinical and radiographic follow-up.

RESULTS: In total, 56 implants in 49 patients were included. The mean follow-up period was 4.2 years (range 1-9.5 years). Implant and superstructure survival rates were 100%. Between baseline and the latest follow-up, there was no statistically significant change in radiographic crestal bone level, but a statistically significant improvement in papilla index. Although not significant, soft tissue texture appeared to improve, while slight soft tissue discoloration was observed in most patients, but remained unchanged from baseline to follow-up. Crown esthetics generally declined from baseline to follow-up, although not significantly. Correlation analysis indicated an association between esthetic outcomes and several variables, such as age, gender, number of lost teeth, type of bone defect, and complications before loading. In total, 14% of implants exhibited crown infraposition at follow-up. No predictive factors for crown infraposition could be identified. Patient-reported outcome measures generally revealed satisfaction with the treatment results.

CONCLUSIONS: The present study found that the biological, technical, and esthetic outcomes of dental implant treatment in the anterior maxilla following traumatic tooth loss are, in general, stable and satisfactory to both clinician and patient. To achieve optimal results in these complex cases, interdisciplinary treatment planning is essential.

PMID:41252690 | DOI:10.1002/cre2.70221

West Afr J Med. 2025 Jun 30;42(6):466-473.

ABSTRACT

BACKGROUND: Serum biomarkers, such as glial fibrillary acidic protein (GFAP), have been proposed to accurately assess stroke severity and prognosis. However, there is limited published data on their potential role in resource-limited settings where the stroke burden is highest.

OBJECTIVE: The study aims to determine the predictive value of the serum level of GFAP in assessing the severity and functional outcome of acute stroke.

METHOD: This prospective cohort study recruited forty consecutively presenting stroke subjects each for both ischaemic stroke and intracerebral haemorrhage at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife with forty apparently healthy controls. Serum concentrations of GFAP were measured using Enzyme-Linked Immunoassays, and the data were analyzed using Statistical Package for the Social Sciences software with significance at p<0.05.

RESULT: The median serum GFAP levels among apparently healthy controls, ischaemic stroke group and the ICH group at admission were 18.04 pg/ml, 24.10 pg/ml, and 33.33 pg/ml respectively. At admission, there was a significant difference in the median serum GFAP level in the ICH and apparently healthy control group as well as in the ischaemic stroke group and apparently healthy control group (p = 0.001). The study found no significant correlation between admission NIHSS and serum GFAP levels in both the ischaemic stroke group and the ICH group. In the ICH group, there was an inverse correlation between median serum GFAP level at day 7 and Barthel index at day 7 (p = 0.021) and day 30 (p = 0.001), but a positive correlation with modified Rankin score at day 30 (p = 0.001).

CONCLUSION: The study found that routine screening for serum GFAP level at admission in ischaemic stroke and ICH does not predict acute stroke severity and does not correlate with functional outcomes. However, Serum GFAP level at day 7 correlated with 30-day functional outcomes for ICH and its usefulness may be explored further in larger studies.

PMID:41252688

West Afr J Med. 2025 Jun 30;42(6):457-465.

ABSTRACT

BACKGROUND: Chronic diseases contribute the highest to disease burden and deaths worldwide and require long-term access to health care. This study identified the payment methods and coping strategies for healthcare costs by patients with chronic diseases using public health facilities in Yenagoa, Bayelsa State, Nigeria.

METHODS: Three hundred and thirty-nine (339) adult patients, being managed for chronic conditions (Hypertension, Diabetes mellitus, Tuberculosis & HIV), were randomly selected from three specialist hospitals that are the major providers of specialized care for patients with chronic diseases in the State. Data on sociodemographic characteristics, morbidity patterns, household financing and coping with health expenditure were collected. Chi-squared test was used to identify significant associations. A p-value 0.05 was considered significant.

RESULTS: Majority were females 211(62%) and about a third were not working 113(33.3%). To pay for their chronic disease healthcare expenses, 268 (79.1%) paid out-of-pocket while 71 (20.9%) used social health insurance. Among the 120 (35.4%) patients who subscribed to a health insurance program, about 2 in 5 still paid out-of-pocket. Missing a clinic visit 145(42.8%) was the common coping strategy followed by patients having to forfeit necessities 113(33.3%) to cope with their healthcare costs. The type of chronic disease was statistically associated with payment methods adopted by patients (p<0.01).

CONCLUSIONS: Most patients with chronic diseases rely on out-of-pocket payments for healthcare expenditures including patients with health insurance coverage. This has necessitated households to adopt coping strategies, found to be economically distressing, to source funds for healthcare needs. Targeted programmes are needed for patients with chronic diseases to enhance financial risk protection.

PMID:41252669

J Anim Physiol Anim Nutr (Berl). 2025 Nov 18. doi: 10.1111/jpn.70031. Online ahead of print.

ABSTRACT

Chronic kidney disease (CKD) is a known risk factor for hypercalcemia in cats. Phosphate-restricted diets have also been implicated in causing hypercalcemia, in part because phosphate restriction increases the Ca:P ratio. The primary objective of this study was to evaluate the impact of two different therapeutic renal foods on ionized (iCa) and total (tCa) calcium concentrations in cats with early-stage CKD. Twenty colony-housed cats with stage 1 or 2 CKD were enrolled, and 18 cats completed the study. Cats were randomly assigned to receive one of two diets formulated for renal disease for 140 days: a moderately phosphate restricted food (M-PR; n = 10 cats; 1.8 g/Mcal calcium; 1.5 g/Mcal phosphorus; Ca:P ratio, 1.2:1) or a more highly phosphate restricted food (H-PR; n = 8 cats; 2.3 g/Mcal calcium; 1.1 g/Mcal phosphorus; Ca:P ratio, 2.0:1). Blood and urine samples were collected on Days 0, 28, 84, and 140. Data were analyzed using a linear mixed model with fixed effects of diet, day, and diet by day interaction. At baseline, all cats had iCa within the normal reference interval (1.10─1.30 mmol/L). On d28 and thereafter, cats fed H-PR food had higher iCa compared with cats fed M-PR food (day 140 means: 1.42 mmol/L vs. 1.24 mmol/L, respectively; p < 0.001). Results were similar for tCa (day 140 means: 11.49 mg/dL vs. 9.51 mg/dL, respectively; p < 0.001; normal reference interval 8.80-10.00 mg/dL). This corresponded to higher fractional excretion of calcium in urine in cats fed H-PR food (Day 140 means 1.18% vs. 0.19%; p < 0.001), and increased calcium oxalate (CaOx) stone formation risk metrics (Day 140 means for CaOx RSS 4.54 vs. 3.13; Day 140 means for CaOx CORI risk index 563 vs. 30/L, respectively; all p < 0.020). Cats fed H-PR food also had higher FGF-23 concentrations compared with cats fed M-PR food (Day 140 means: 2329 vs. 204 pg/mL, respectively; p = 0.003; normal reference interval ≤ 299 pg/mL), and lower calcitriol concentrations (Day 140 means: 94 vs. 186 pmol/L, respectively; p = 0.021; normal reference interval 90-342 pmol/L). PTH concentrations in cats consuming H-PR food were significantly decreased from their baseline means and from cats consuming M-PR food at all timepoints (Day 140 means: < 0.05 vs. 3.1 pmol/L, respectively; p < 0.050; normal reference interval 0.7-3.4 pmol/L). Therapeutic renal diets impact calcium status in cats with early-stage CKD, but the effect is formulation dependent. Cats fed a M-PR food maintained normal iCa and tCa, which suggests this food is a safe and well-accepted option for cats with early-stage renal disease.

PMID:41252663 | DOI:10.1111/jpn.70031

JCO Oncol Pract. 2025 Nov 18:OP2500505. doi: 10.1200/OP-25-00505. Online ahead of print.

ABSTRACT

PURPOSE: This study assesses the accuracy of radiographic clinical staging by computed tomography (CT) of mismatch repair-deficient (dMMR) colon cancer, given emerging data for neoadjuvant immune checkpoint inhibitors (ICIs).

METHODS: Patients with stage I-III colon cancer treated with upfront surgical resection were retrospectively reviewed using the electronic medical record from a single institution from 2012 to 2023. We performed a cohort study of dMMR tumors with a stage-matched control cohort of mismatch repair-proficient (pMMR) tumors. The primary end point was the accuracy of clinical stage using preoperative CT compared with pathologic stage for dMMR colon cancer. Statistical analysis was performed using R.

RESULTS: We identified 78 patients with dMMR colon cancer. For dMMR tumors, T-stage clinical radiologic staging matched pathologic stage in 51% of cases and the nodal stage was accurately matched in 55% of cases. For stage I and IIA (low-risk) tumors, the overstaging rate on CT was 41% and for T4 or N+ (high-risk), the understaging rate was 25%. When comparing the dMMR and pMMR cohorts, pMMR nodal status was more likely to be understaged (P < .001). There was moderate to substantial interrater reliability for overall stage, T stage, and N staging between radiologists (kappa = 0.64, 0.60, and 0.63, respectively).

CONCLUSION: Radiographic tumor and nodal staging for dMMR colon tumors is unreliable with high rates of overstaging low-risk tumors where neoadjuvant treatment may not be indicated. The low accuracy of clinical staging demonstrates clear limitations to make systemic therapy decisions. Additional diagnostic modalities for lymph node status may be necessary to accurately clinically stage patients before neoadjuvant ICIs in patients with locally advanced disease.

PMID:41252662 | DOI:10.1200/OP-25-00505

J Craniofac Surg. 2025 Nov 14. doi: 10.1097/SCS.0000000000012129. Online ahead of print.

ABSTRACT

The review was performed to evaluate effect of maxillo-mandibular advancements (MMA) on patients with obstructive sleep apnea (OSA) for long term and subjective outcomes. Review was adhered to PRISMA guidelines 2020. Articles screening was done independently by two authors. Quality assessment was done through Newcastle Ottawa scale (NOS) and Cochrane risk of bias (ROB)-2 tool. Standardized mean difference (SMD) was used as summary statistic measure employing random effect model through Review manager (RevMan) version 5.3. Twelve studies (5 retrospective studies, 4 prospective studies and 3 clinical studies) were included for qualitative synthesis and ten studies for meta-analysis. Included studies evaluated subjective parameters like apnea index (AI), Apnea-Hypopnea Index (AHI), Desaturation Index (DI), Epworth Sleepiness Scale (ESS), Hypopnea index (HI), Respiratory Disturbance Index (RDI), Total Sleep Time (TST) and airway morphological parameters like Posterior Airway Space (PAS). Meta-analysis was conducted on AHI, mean SpO2, RDI, TST, ESS and airway morphological parameters like Al and PAS which indicated that post treatment witgh MMA had improved the overall quality of life (P<0.05). Included studies had presence of low to moderate risk of bias. No asymmetry was seen on funnel plot signifying absence of publication bias in meta-analysis. It was found that MMA is an ideal, reliable and most effective treatment modality for patients with OSA improving their overall quality of life with minimal complications with high success and cure rate.

PMID:41252649 | DOI:10.1097/SCS.0000000000012129

West Afr J Med. 2025 Jun 30;42(6):452-456.

ABSTRACT

BACKGROUND: Stroke remains one of the leading causes of disability worldwide. Arm function recovery is essential for stroke survivors’ ability to perform activities associated with daily living. Consequently, impairment in arm function is a significant target for stroke survivors’ physical or robotic rehabilitation. This study aims to explore the barriers and facilitators to the implementation of a robotic rehabilitation programme for stroke survivors in a resource-poor setting.

METHODS: A cross-sectional design with a qualitative approach was chosen. A semi-structured, interview-based questionnaire was administered and data were collected from stroke survivors presenting at the adult neurology clinic of two tertiary institutions in Nigeria. Data from the interview-based questionnaire were analyzed using descriptive statistics.

RESULTS: A total of 52 stroke survivors participated and were interviewed. More than half (55.8%) of the respondents were elderly, with a male-to-female ratio of 1.6:1. Majority of respondents (58%) had no idea about the use of robotics for stroke rehabilitation. About 44% of the respondents believe that the major determinant of interest in robotics will be favourable outcome after trials on other participants. Lack of financial support and transportation aid constitute barriers, while creation of awareness and the availability of transportation aid from home to hospital were the major facilitators to participation.

CONCLUSION: These findings highlight the fact that most stroke survivors in the resource-poor setting were not aware of the usefulness of robotics in stroke rehabilitation. Hence, increasing knowledge and creating awareness about robotic rehabilitation will make it more readily acceptable for stroke survivors. KEYWORDS: Barrier, Facilitator, Robotic rehabilitation, Stroke survivors, Implementation.

PMID:41252638

AIDS Educ Prev. 2025 Jul;6(1):1-11. doi: 10.1521/aeap.1994.6.1.1.

ABSTRACT

Heterosexual transmission of the human immunodeficiency virus (HIV) has become a significant health issue for women. The present study describes the extent to which a sample of women from an urban area report making efforts to protect themselves from becoming infected with HIV through several protective sexual behaviors. Secondly, we assess the extent to which adoption of these protective behaviors can be explained by health beliefs and previous HIV testing. Forty-nine percent of the sample reported having used a condom in the past year because of fear of AIDS and 48% reported having carried condoms. Women in this sample perceived themselves to be moderately susceptible to AIDS and they were well aware of the severity of the disease. Women tended to think that protecting themselves from AIDS would not be overly burdensome and that the recommended sexual protective behaviors were highly effective for preventing AIDS. Messages about the severity of AIDS and the effectiveness of protective sexual behaviors seem to be reaching women. Beliefs about personal susceptibility were consistently associated with the adoption of multiple protective behaviors, suggesting that messages emphasizing the ubiquity of risk, especially in demographically high-risk populations, may be particularly appropriate and effective.

PMID:41252637 | DOI:10.1521/aeap.1994.6.1.1

AIDS Educ Prev. 2025 Jul;6(1):12-26. doi: 10.1521/aeap.1994.6.1.12.

ABSTRACT

We examined correlates of condom use among heterosexual whites, blacks, and Hispanics (ages 20-45 years) with an human immunodeficiency virus (HIV) risk factor in a community-based longitudinal sample (San Francisco; n = 716). Lag models were used to examine hypothesized antecedents of condom use at wave 2. High levels of condom use were associated with labeling one’s sexual behavior as risky for HIV infection, high levels of condom enjoyment and commitment to use condoms, good sexual communication practices, gender (trend), and marital status. The results support the need for wide-ranging intervention programs that stimulate people to make personal risk assessments, teach basic sexual skills, and direct those in need of intensive help to appropriate agencies.

PMID:41252630 | DOI:10.1521/aeap.1994.6.1.12