Tag: pubmed

Zh Nevrol Psikhiatr Im S S Korsakova. 2025;125(11):86-99. doi: 10.17116/jnevro202512511186.

ABSTRACT

OBJECTIVE: To search for evidence-based data on the efficacy of Gliatilin (choline alfoscerate) in patients with cognitive impairments.

MATERIAL AND METHODS: The study focused on sources covering the efficacy of drug therapy for vascular and post-traumatic cognitive impairments not reaching the level of dementia (mild cognitive impairment, MCI) using Gliatilin. A systematic literature review, paired meta-analysis, metaregression, and subgroup analyses were conducted. A total of 10 studies strictly meeting the objective were selected.

RESULTS: The study demonstrated a statistically significant effect of Gliatilin in treating patients with vascular or post-traumatic MCI. It also showed statistically significant superiority of its parenteral (or parenteral followed by oral) administration (for at least 28 days) compared to basic therapy in patients with vascular MCI.

CONCLUSION: The main challenge during the analysis was methodological, population, and statistical heterogeneity, which required not only the use of a random effects model but also active search and exclusion of some sources. However, despite several limitations, the internal consistency and absence of contradictions in the analysis results demonstrated the robustness of the evidence obtained. The inclusion of a highly effective drug in the specialized medical care system will ensure the availability of cognitive impairment treatment programs and improve patients’ quality of life.

PMID:41362980 | DOI:10.17116/jnevro202512511186

Zh Nevrol Psikhiatr Im S S Korsakova. 2025;125(11):52-56. doi: 10.17116/jnevro202512511152.

ABSTRACT

OBJECTIVE: To determine the contribution of constitutional and morphological characteristics of patients with schizophrenia to suicidal behavior.

MATERIAL AND METHODS: The study included 200 patients with schizophrenia. The anthropometric assessment was conducted using the V.V. Bunak method modified by V.P. Chtetsov, and the Rees-Eysenk and Tanner indices were calculated. Through a clinical interview and analysis of medical records, the history of suicidal attempts was collected. The Beck Hopelessness Scale was used as an additional tool to assess the suicidal risk. Statistical processing was performed using the χ² test and the Kruskal-Wallis test with the multiple post hoc pairwise comparison procedure (Dunn test).

RESULTS: The prevalence of external forms of suicidal behavior in patients was 34%. Internal forms of suicidal behavior based on the factor of hopelessness were found in 41% of patients. In the group of patients with a history of suicidal attempts, the asthenic type was significantly more common (p=0.019). In patients with the andromorphic type of somatic sexual differentiation, internal forms of suicidal behavior prevailed (47.1%, p=0.011), and persons with the gynecomorphic type generally had a high percentage of both external (41.2%) and internal (43.1%) forms of suicidal behavior (p=0.004). In patients with an asthenic somatotype, external forms of suicidal behavior were more common (47%, p=0.011), while in those with a mesosthenic somatotype, internal forms prevailed (49.5%, p<0.001).

CONCLUSION: The patterns found in this study indicate that a shift in somatic sexual differentiation to gynecomorphy and a morphophenotypic shift towards asthenia are associated with an increased risk of suicidal behavior in patients with schizophrenia.

PMID:41362975 | DOI:10.17116/jnevro202512511152

J Prosthodont. 2025 Dec 9. doi: 10.1111/jopr.70070. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the accuracy of guided surgery in a healed ridge and various maxillary anterior extraction sockets.

MATERIALS AND METHODS: Forty radiopaque urethane resin bone models simulating the maxillary right central incisor were fabricated and divided into four groups (n = 10 each). Group H (healed ridge), Group L (socket adjacent to labial cortex), Group C (centralized socket), and Group P (socket adjacent to palatal cortex). Models were scanned using a TRIOS 4 intraoral scanner, and CBCT scans were acquired. Implant planning was performed using software (Codiagnostix), and implants were placed with a fully guided static computer-aided implant surgery (s-CAIS) protocol. Deviations between planned and actual implant positions were measured in global, bucco-lingual, and mesio-distal deviations at the crest and apex.

RESULTS: Group C showed the greatest global deviation at both the crest (0.83 ± 0.34 mm) and apex (0.98 ± 0.29 mm), whereas Group L showed the lowest global deviations at the crest (0.38 ± 0.17 mm) and apex (0.49 ± 0.26 mm). Angular deviation was highest in Group H (2.91° ± 1.37°) and lowest in Group C (1.87° ± 1.11°). Depth deviations were not statistically different. One-way ANOVA revealed socket morphology significantly influenced global, labial-palatal, and mesial-distal deviations at both crest and apex levels (p < 0.05), with Group L showing superior apical accuracy (p < 0.001).

CONCLUSIONS: Socket morphology significantly affects s-CAIS accuracy. Centralized sockets showed greater positional deviations, particularly at the crest. Socket morphology should be carefully considered during virtual treatment planning for immediate implant placement.

PMID:41362959 | DOI:10.1111/jopr.70070

Hong Kong Med J. 2025 Dec 9. doi: 10.12809/hkmj2412577. Online ahead of print.

ABSTRACT

INTRODUCTION: Faculty development for trainers and nurturing feedback literacy in trainees is crucial for effective workplace-based assessments (WBAs) to support trainee competency development. Separate training sessions for trainers and trainees can be challenging when resources are limited. Combined training can optimise resources and foster mutual understanding, although such approaches face challenges related to power dynamics. This study aimed to evaluate the effectiveness of a conjoint WBA workshop in enhancing trainer engagement, improving trainee feedback literacy, and exploring the benefits and challenges of integrating trainers and trainees in a shared learning environment.

METHODS: A mixed-methods study was conducted with 13 trainers and five trainees from the Hong Kong College of Otorhinolaryngologists. Quantitative data were collected using the Feedback Literacy Behaviour Scale for trainees and the Continuing Professional Development-Reaction Questionnaire for trainers. Pre- and post-intervention comparisons were analysed using paired t tests. Qualitative data from focus group interviews were thematically analysed.

RESULTS: Quantitative analysis showed statistically significant increases in trainee feedback literacy (P<0.001) and improvements in trainers’ beliefs about capabilities and engagement intentions (P<0.05). The qualitative analysis supported these findings and identified three key factors: mutual understanding, clarification of the WBA purpose, and effective instructional design. Participants valued the mutual understanding fostered in the conjoint setting, which aligned expectations and created a supportive learning environment.

CONCLUSION: Conjoint WBA workshops may effectively promote trainer engagement and trainee feedback literacy, aligning expectations and fostering a positive feedback culture. Further research is needed to explore the longitudinal impact and applicability to other specialties.

PMID:41362934 | DOI:10.12809/hkmj2412577

Iran Endod J. 2025;20(1):e41. doi: 10.22037/iej.v20i1.49169. Epub 2025 Oct 29.

ABSTRACT

INTRODUCTION: The dental pulp is a specialized connective tissue responsible for maintaining tooth vitality through a complex interplay of cellular, vascular, and immunological components. Despite the clinical use of conventional capping materials, their limited regenerative potential often results in pulp devitalization and compromised structural integrity. Recent advances in tissue engineering, particularly the application of three-dimensional scaffolds, have demonstrated promising outcomes in promoting dentin-pulp complex regeneration and biomimetic tissue repair. This systematic review and meta-analysis evaluated the efficacy of three-dimensional matrices, with or without bioactive materials, as direct pulp capping agents in animal models. Outcomes included cellularity, dentin thickness, dentin bridge formation, dystrophic calcification, inflammation control, and pulp organization compared to commercial materials.

MATERIALS AND METHODS: A comprehensive search was conducted in indexed databases and gray literature. A random-effects meta-analysis used standardized mean differences and the inverse variance method. Heterogeneity (I²), publication bias (Egger’s and Begg’s tests), and risk of bias (SYRCLE’s RoB tool) were assessed. Statistical analyses were conducted using RevMan (P<0.05).

RESULTS: Seventeen studies met the inclusion criteria, with 13 included in the meta-analysis. The risk of bias was predominantly low, yet the certainty of evidence was very low. Scaffolds significantly enhanced cellularity (P=0.02; I²=91%), dentin thickness (P<0.00001; I²=87%), and inflammation control (P=0.03; I²=20%) compared to controls. No significant differences were observed for dentin bridge formation (P=0.30; I²=63%), dystrophic calcification (P=0.14; I²=32%), or pulp organization (P=0.10; I²=0%).

CONCLUSION: Three-dimensional scaffolds demonstrated potential in promoting cellular activity, dentin formation, and inflammation control. However, their impact on dentin bridge formation, pulp organization, and dystrophic calcification remains inconclusive. Further high-quality studies are required to validate their clinical applicability.

PMID:41362914 | PMC:PMC12682324 | DOI:10.22037/iej.v20i1.49169

J Public Health Res. 2025 Dec 4;14(4):22799036251401951. doi: 10.1177/22799036251401951. eCollection 2025 Oct.

ABSTRACT

OBJECTIVES: To investigate and highlight the factors associated with smoking relapse and to demonstrate the withdrawal symptoms related to smoking cessation.

METHODS: This study is part of a larger historical cohort involved 490 participants who attended smoking cessation clinics in primary health care settings. A total of 143 relapsed after they initially quit smoking and included in this study. The participants were interviewed by phone using a structured questionnaire after obtaining informed consent. Frequency distribution tables and proportions were used to describe the study results.

RESULTS: More than half (55.9%) of participants who initially quit smoking by attending the smoking cessation clinics reported that relationships with smokers were the main reason for smoking relapse. Emotional or social problems led to relapse among 38.5% of the participants. Withdrawal symptoms were relatively low (14.7%). An increase in appetite was prevalent among 74.8% of smoking quitters as the main withdrawal symptom. This was followed by weight gain in 72%, craving for cigarettes/smoking in 71.3%, and feelings of anger in 53.1%. All the tested sociodemographic variables, namely: age, sex, nationality, income, education, and marital status, failed to show a statistically significant association with early timing of relapse (1-6 months).

CONCLUSION: The study identified various factors linked to smoking relapse among individuals using smoking cessation services. Relationships with smokers and emotional or social problems were the most common reasons. Additional research is needed to investigate strategies and interventions specifically targeting early smoking relapse to attain the desired health outcomes from smoking cessation services.

PMID:41362898 | PMC:PMC12681661 | DOI:10.1177/22799036251401951

Cardiovasc Ther. 2025 Nov 30;2025:4097327. doi: 10.1155/cdr/4097327. eCollection 2025.

ABSTRACT

BACKGROUND AND AIMS: Arrhythmias and major adverse cardiac events remain significant complications following ST-segment elevation myocardial infarction (STEMI). Shenfu injection, a traditional Chinese medicine formulation, has shown cardioprotective effects in preclinical studies. This trial is aimed at investigating whether Shenfu injection as an adjunctive therapy to standard treatment could reduce arrhythmias and improve clinical outcomes in patients with STEMI undergoing percutaneous coronary intervention (PCI).

METHODS: A single-center, prospective, randomized, controlled trial was conducted at Shanghai Ninth People’s Hospital among 245 patients with STEMI undergoing PCI. Participants were randomized to receive either standard therapy plus Shenfu injection (50 mL, administered intravenously twice daily for five consecutive days) (n = 123) or standard therapy alone (n = 122). The primary endpoint was the incidence of in-hospital arrhythmias. Secondary endpoints included major adverse cardiac events (MACEs) during the 12-month follow-up period and cardiac magnetic resonance imaging parameters.

RESULTS: A total of 245 patients underwent randomization (123 assigned to Shenfu injection group and 122 assigned to control group). During hospitalization, patients assigned to Shenfu injection had a significantly lower incidence of arrhythmias compared with the control group (24.4% vs. 38.5%, p = 0.017), with the most pronounced effect on frequent ventricular premature contractions (7.3% vs. 15.5%, p = 0.042). After adjustment for key baseline covariates including age, coronary artery disease extent, myocardial injury markers (CK-MB max and TNI max), left ventricular ejection fraction, B-type natriuretic peptide, door-to-balloon time, hypertension, and diabetes mellitus, Shenfu injection remained independently associated with reduced risk of in-hospital arrhythmias (adjusted OR 0.454, 95% CI: 0.249-0.827, p = 0.010). Cardiac magnetic resonance imaging performed in 174 patients revealed significantly smaller infarct size (16.1 ± 9.1 vs. 20.8 ± 13.1 g, p = 0.007) and lower incidence of microvascular obstruction (45.0% vs. 65.0%, p = 0.008) in the Shenfu group, with both parameters showing significant positive correlations with arrhythmia occurrence. During the 12-month follow-up, patients receiving Shenfu injection had a higher event-free rate from MACEs compared with the control group (12-month Kaplan-Meier event-free rate estimates, 84.6% vs. 73.0%, respectively; p = 0.028).

CONCLUSIONS: Treatment with Shenfu injection as an adjunctive therapy to standard treatment in patients with STEMI undergoing PCI significantly reduced in-hospital arrhythmias, infarct size, microvascular obstruction, and major adverse cardiac events during a 12-month follow-up period. The independent effect on arrhythmias after comprehensive statistical adjustment and the demonstrated correlation between reduced myocardial damage and arrhythmia prevention suggest the potential therapeutic value of Shenfu injection in improving both short-term and long-term outcomes in STEMI patients.

TRIAL REGISTRATION: Chinese Clinical Trial Registry Identifier: ChiCTR2200066918.

PMID:41362880 | PMC:PMC12682446 | DOI:10.1155/cdr/4097327

Genet Med Open. 2025 Oct 13;3:103464. doi: 10.1016/j.gimo.2025.103464. eCollection 2025.

ABSTRACT

PURPOSE: The long-term developmental outcomes of children with a prenatal diagnosis of a copy-number variant of uncertain significance (VUS) remain unclear. This study compared the developmental, social-emotional, and health outcomes of children with and without a prenatal VUS, assessed maternal perceptions of their child’s health and development, and examined the reclassification rate of VUS after more than 2 years.

METHODS: Women who underwent prenatal chromosomal microarray testing in Victoria, Australia (2013-2019), were recruited retrospectively (2021-2023). Children with a VUS (cases) were compared with controls without a VUS. We assessed a range of cognitive, developmental, and health outcomes in the children, who were on average 6 years old. Statistical analyses compared group outcomes and adjusted for maternal sociodemographic factors.

RESULTS: The study included 134 mother-child pairs (46 with a VUS and 88 controls). No significant differences were found between groups in intellectual functioning, adaptive behavior, or social-emotional measures. Maternal perceptions of their child and family well-being were also similar. Reanalysis reclassified 66.0% of VUS as benign and 8.5% as pathogenic.

CONCLUSION: Children with a prenatal VUS diagnosis have developmental outcomes and family well-being comparable to those without. These findings contribute valuable evidence to support prenatal genetic counseling and clinical laboratory reporting practices.

PMID:41362834 | PMC:PMC12681968 | DOI:10.1016/j.gimo.2025.103464

Anesthesiol Res Pract. 2025 Dec 7;2025:7816719. doi: 10.1155/anrp/7816719. eCollection 2025.

ABSTRACT

OBJECTIVE: The purpose of this study was to investigate the effects of acupuncture on pain, prostaglandin E2 (PGE2), and interleukin-6 (IL-6) levels during septorhinoplasty surgeries.

MATERIALS AND METHODS: This randomized, controlled study included 70 patients. The patients were divided into two groups: an acupuncture group (n = 35) and a control group (n = 35). The acupuncture group received bilateral press needle acupuncture at the PC 6 and ST 36 points 24 h before surgery. Blood samples were collected for analysis and comparison of preoperative and postoperative levels of IL-6 and PGE2. The primary outcomes were the postoperative visual analog scale (VAS) scores.

RESULTS: In terms of evaluating postoperative pain, no statistically significant differences were observed between the study groups with regard to VAS scores. At 30 min after surgery, fewer patients in the acupuncture group needed analgesics than in the control group (p = 0.044). Postoperative IL-6 levels were lower in the acupuncture group than in the control group (p = 0.014). There was no significant difference in postoperative PGE2 levels between the groups (p = 0.568). The acupuncture group had lower diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) at 30 min intraoperatively and lower DBP at 60 min (p = 0.012, p = 0.026, and p = 0.012, respectively). At 15 min into the operation, the heart rate was higher in the acupuncture group than in the control group (p = 0.039). After surgery, the acupuncture group had lower blood pressure at 5 min and 6 h after surgery than the control group (p = 0.034 and p = 0.041, respectively).

CONCLUSIONS: The evidence from this study suggests that acupuncture can reduce the need for pain medication after septorhinoplasty surgery, and by decreasing IL-6 levels, it may contribute to the inflammatory process.

TRIAL REGISTRATION: ClinicalTrials.gov: NCT04009070.

PMID:41362812 | PMC:PMC12682433 | DOI:10.1155/anrp/7816719

J Med Educ Curric Dev. 2025 Dec 5;12:23821205251405327. doi: 10.1177/23821205251405327. eCollection 2025 Jan-Dec.

ABSTRACT

BACKGROUND: Pathophysiology bridges basic and clinical sciences, offering essential insights into disease mechanisms, diagnosis, and treatment. However, lecture-based learning remains predominant in China, often lacking dynamic evaluation systems. In alignment with the “Healthy China 2030” initiative, innovative methods such as problem-based learning (PBL), case-based learning (CBL), team-based learning (TBL), and seminar are increasingly explored to enhance integrated and competency-based medical education.

METHODS: Sixty third-year clinical medicine students were randomly assigned to either a traditional instruction group or a Combi-Method group following a standardized preclass exam. The Combi-Method integrated PBL, CBL, TBL, and seminars. Instruction was based on real-world clinical cases. Knowledge acquisition was assessed through a postclass quiz, including multiple-choice, short-answer, and case study questions on renal, pulmonary, and hepatic insufficiency.

RESULTS: The 2 groups exhibited comparable baseline characteristics in age, gender, and preclass scores. The Combi-Method group achieved significantly higher scores in several domains, particularly in renal and pulmonary insufficiency, and demonstrated superior clinical reasoning and knowledge application. Although some areas showed no statistical difference, the overall performance favored the Combi-Method.

CONCLUSIONS: The Combi-Method proves to be an effective instructional model for pathophysiology, promoting deeper understanding, enhanced clinical reasoning, and knowledge integration. This approach aligns with the goals of competency-based medical education and supports its broader adoption in undergraduate medical curricula.

PMID:41362786 | PMC:PMC12681592 | DOI:10.1177/23821205251405327