Tag: pubmed

JMIR Form Res. 2025 Feb 11. doi: 10.2196/67637. Online ahead of print.

ABSTRACT

BACKGROUND: As alcohol misuse remains pervasive within the military, evidence-based prevention programs that are feasible to implement and appropriately tailored to meet the needs and norms of military personnel are critically needed. Further, programs that target future military leaders, such as trainees, recruits, and cadets, may be especially impactful. eCHECKUP TO GO is an online, evidence-based brief alcohol intervention designed to reduce alcohol misuse through education and personalized feedback that may be suitable for military trainees. However, because it was developed for civilian students, efforts to adapt the content for military settings are needed.

OBJECTIVE: The objective of this study was to evaluate the acceptability of a military version of eCHECKUP TO GO, tailored to include military-specific terminology and alcohol use statistics.

METHODS: US Air Force Academy cadets were recruited to participate in a single-arm, mixed methods study. Following completion of eCHECKUP TO GO, participants completed a survey that assessed satisfaction with specific aspects of the user experience, including ease of use, design, and relevance of the information and personalized feedback (range: 1 [strongly disagree] to 7 [strongly agree]). A subset of cadets also participated in a focus group to expound on the survey responses.

RESULTS: Survey participants included 22 cadets (54.5% male; mean [M] age 19.6 years, SD 1.8). Six cadets (27.2%) also participated in the focus group. Participants were satisfied with the program overall (M 5.8, SD 0.9) and gave the highest ratings to ease of use (M 6.6, SD 0.7), site design (M 6.5, SD 0.6), and site interactivity (M 6.4, SD 1.0). Items pertaining to tailoring, relevance, and amount of content specific to cadets scored lowest (M 5.8, SD 1.4; M 5.6, SD 1.4; M 5.5, SD 1.5, respectively). Most (68.2%) said they would act upon the information they were provided. Focus group participants made suggestions for improved tailoring, such as increasing content on social aspects of drinking and military-specific risks of alcohol misuse (eg, Uniform Code of Military Justice violations).

CONCLUSIONS: Although acceptability of eCHECKUP TO GO was high, continued efforts are needed to ensure the content accurately reflects the experiences of cadets. Researchers who design military health promotion interventions need to consider the varied contexts within the force and rigorously evaluate the acceptability of all content before implementation.

PMID:40014874 | DOI:10.2196/67637

Perfusion. 2025 Feb 27:2676591251324648. doi: 10.1177/02676591251324648. Online ahead of print.

ABSTRACT

BACKGROUND: A gap in knowledge exists related to optimal bivalirudin dosing in children. The purpose of our analysis is to use quantitative methods and baseline data to quickly predict the optimal therapeutic bivalirudin dose for children.

METHODS: We developed an internal database of pediatric patients on ECMO or VAD, including baseline patient information, bivalirudin doses, and partial thromboplastin time (PTT) measurements throughout the treatment period. We fit an analysis of covariance (ANCOVA) model to the baseline data to determine the best predictors of therapeutic bivalirudin dose. We used five-fold cross-validation to ensure the model was not overfitting to any specific data subset.

RESULTS: The most notable variables that were statistically significant (p < .05) were: the primary use of bivalirudin for heart failure prophylaxis, no complications before bivalirudin administration, other reasons for bivalirudin use, other race (including Asian, pacific islander, and native American), Hispanic or Latinx ethnicity, primary diagnosis of heart failure, and primary diagnosis of myocarditis. To compare our model-predicted dose and the actual starting dose administered to the patients, we looked at how far off each of those was from the therapeutic dose. The mean of absolute differences was 0.28 mg/kg/hr for the administered starting dose and 0.23 mg/kg/hr for the model-predicted dose; therefore, the model results in an improvement of 18% in the difference from the therapeutic dose.

CONCLUSION: Our model provides an initial framework for determining a starting bivalirudin dose that takes into account patient demographic information and baseline admission data.

PMID:40014868 | DOI:10.1177/02676591251324648

JCO Glob Oncol. 2025 Feb;11:e2400530. doi: 10.1200/GO-24-00530. Epub 2025 Feb 27.

ABSTRACT

PURPOSE: The aim of this study was to evaluate the current availability and distribution of radiotherapy (RT) and nuclear medicine equipment in Vietnam, focusing on the shortage of linear accelerators (LINACs), positron emission tomography/computed tomography (PET/CT) scanners, and brachytherapy units. The study seeks to quantify these shortages and highlight the implications for cancer treatment access and outcomes.

METHODS: Data were collected from 50 hospitals across Vietnam that provide RT services or nuclear medicine imaging. The availability of LINACs, PET/CT devices, brachytherapy units, and other essential equipment was assessed, alongside patient loads and machine utilization rates. National data were compared with the standard in developed countries, with a particular focus on the International Atomic Energy Agency’s (IAEA) recommendations for RT infrastructure.

RESULTS: Vietnam has a total of 82 LINACs, resulting in a LINAC density of 0.82 per million people, which is far below the standard in developed countries of 4-8 per million. Of the existing LINACs, 43% are outdated and unable to deliver advanced RT techniques such as volumetric modulated arc therapy. Additionally, the country has only 12 PET/CT scanners and three cyclotrons, which limits access to early cancer diagnosis and treatment planning. The central region of Vietnam is particularly underserved, with only 1 PET/CT device and limited access to brachytherapy services. Long wait times for RT-often up to 2 weeks-are common, leading to delayed treatments and reduced treatment efficacy. Patients, particularly those with conditions requiring timely RT after chemotherapy, face increased risks because of these delays.

CONCLUSION: The shortage of modern RT and nuclear medicine equipment in Vietnam critically limits timely access to cancer treatment, affecting patient outcomes and placing a heavy burden on health care providers. Expanding access to advanced RT technology through government investment, public-private partnerships, and international collaborations with organizations such as the IAEA could alleviate these challenges. Increasing Vietnam’s RT capacity is essential for improving cancer care outcomes and managing the rising burden of cancer across the country.

PMID:40014841 | DOI:10.1200/GO-24-00530

JCO Glob Oncol. 2025 Feb;11:e2400312. doi: 10.1200/GO-24-00312. Epub 2025 Feb 27.

ABSTRACT

PURPOSE: Patients receiving immune checkpoint inhibitors (ICIs) may induce immune-related adverse events (irAEs). This study aimed to evaluate the toxicity induced by ICIs and explore the correlation between efficacy and toxicity in a Moroccan population.

METHODS: We conducted a prospective study of patients with solid tumors who received pembrolizumab or atezolizumab at the National Institute of Oncology, Rabat from July 2018 to December 2023. We identified irAEs according to ASCO 2021 guidelines and graded them according to the Common Terminology Criteria for Adverse Events Version 4.0. Efficacy with respect to progression-free survival (PFS) and overall survival (OS) was determined. A Cox regression model was used to determine the association between irAEs and survival.

RESULTS: Eighty-six patients with solid tumors who received ICIs were included. The primary tumor types were lung (40.7%), skin (29.1%), and GI cancer (14%). The ICIs most commonly used included pembrolizumab (67.4%) and atezolizumab (32.6%). ICIs were used as monotherapy (77.9%) or in combination (22.1%). A total of 58 (67.4%) patients presented any kind of irAEs. The most common toxicities in both the monotherapy and combination groups were GI, with rates of 25.3% and 31.5%, respectively. Patients with irAEs showed significantly longer median PFS compared with those without irAEs (9 v 3.6 months; hazard ratio [HR], 0.5 [95% CI, 0.32 to 0.99]; P = .04). The median OS was longer in patients with irAEs than in those without irAEs but was not statistically significant (19 v 10.3 months; HR, 0.8 [95% CI, 0.39 to 1.7]; P = .5).

CONCLUSION: Our results indicated that ICIs have the potential to induce irAEs in patients with solid tumors. These adverse effects were commonly GI. The development of irAEs was associated with improved effectiveness of ICI treatment across different malignancies.

PMID:40014840 | DOI:10.1200/GO-24-00312

Acta Odontol Latinoam. 2024 Dec;37(3):262-269. doi: 10.54589/aol.37/3/262.

ABSTRACT

Rehabilitating teeth after root canal treatment often requires the use of glass fiber posts (GFPs) to retain the final restorations, so the choice of resin cement is critical for bond strength (BS) and treatment success.

AIM: The aim of this study was to evaluate the effect of different GFP systems on BS to intraradicular dentin using two dual-curing resin cement types.

MATERIALS AND METHOD: Thirty bovine incisors with wide canals were filled endodontically with gutta-percha and epoxy resin sealer. Initially, the canal filling was removed, and 4 mm of the apical seal was left intact. The teeth were divided into three groups according to the GFPs used: AP (anatomical posts – prefabricated GFP (Reforpost #2, Angelus®) relined with composite resin (Filtek Z350, 3M ESPE); SPLENDOR (Splendor SAP, Angelus®), and milled CAD/CAM (FiberCAD, Angelus®). Posts were fixed with conventional (RelyX Ultimate, 3M ESPE) or self-adhesive resin cement (RC) (RelyX U200, 3M ESPE), following the manufacturer’s instructions. After 48 h, the roots were sectioned into thirds and subjected to pushout BS testing using a universal testing machine. BS data were analyzed using Wilcoxon and Mann- Whitney U tests. Failure modes were assessed with Fisher’s Exact test (α=0.05).

RESULTS: In the apical and middle root sections, BS was similar in the AP and Splendor groups, both of which performed better than the milled CAD/CAM group (p≤0.05). In the cervical section, BS was significantly higher for the anatomical posts than for Splendor and milled CAD/CAM posts. Self-adhesive RC promoted statistically lower BS compared to conventional RC for the milled CAD/CAM post in the cervical and middle thirds (p≤0.05). Self-adhesive RC provided statistically higher bond strength than conventional RC for the anatomical post in the apical third (p≤0.05). No significant difference in failure modes was observed between resin cements and different root sections (p>0.05).

CONCLUSION: The BS of the GFP system was affected by resin cement type and root section, with composite resin-relined anatomically shaped posts generally performing better.

PMID:40014824 | DOI:10.54589/aol.37/3/262

Acta Odontol Latinoam. 2024 Dec;37(3):227-236. doi: 10.54589/aol.37/3/227.

ABSTRACT

The risk of losing a tooth with furcation involvement is twice as high as that of losing a multirooted tooth with good periodontal status. Early diagnosis of furcation involvement increases the likelihood of retaining the tooth in the oral cavity.

AIM: To explore the behavior and limitations of general dentists in the southern region of Santa Fe Province in the detection and clinical management of furcation lesions.

MATERIALS AND METHOD: A cross-sectional study was conducted using an anonymous online questionnaire consisting of 32 questions to assess general dentists’ experience in diagnosis and management of furcation lesions (instrumental, classification and treatment), how likely they were to refer patients, and their self-perception regarding certain topics. Invitations to participate were extended twice between November 2022 and March 2023 via email sent by the Dental Association of the 2nd District of Santa Fe Province. The invitation emails contained a link to the questionnaire on the Google Forms platform, which participants accessed after reading the information sheet and providing informed consent to participate. Once the survey was completed, the responses were exported as a matrix from the Google Forms platform and anonymized.

RESULTS: Most of the 121 surveyed dental professionals reported difficulties with diagnosis, limitations in handling instruments, and challenges in selecting appropriate treatments.

CONCLUSIONS: As reported by similar studies in other countries, there is a clear need for further training and development of continuous education programs for general dentists in the region.

PMID:40014820 | DOI:10.54589/aol.37/3/227

Acta Odontol Latinoam. 2024 Dec;37(3):217-226. doi: 10.54589/aol.37/3/217.

ABSTRACT

The Decayed, Missing and Filled Teeth (DMFT) index is widely used for detecting carious lesions, primarily focusing on established cavities, while the International Caries Detection and Assessment System (ICDA-S-II) is designed to identify incipient lesions.

AIM: The aim of this cross-sectional study was to assess the diagnostic effectiveness of the DMFT index compared to the ICDA-S-II criteria designed for early-stage carious lesion diagnosis in schoolchildren from Belém (Brazil).

MATERIALS AND METHOD: A cohort of 107 twelve-year-old schoolchildren from Belém (Brazil) underwent dental examinations by three calibrated examiners using the DMFT and ICDA-S-II indices. The ICDA-SII assessment involved prophylaxis, relative isolation, and a standardized drying period. Statistical analyses included ANOVA, chi-squared and G tests.

RESULTS: No statistically significant differences were observed among examiners for either the DMFT (p = 0.699) or the ICDA-S-II (p = 1.000) indices. Gender did not influence results (DMFT: p = 0.697; ICDA-S-II: p = 0.310). Caries-free prevalence differed significantly, at 32% according to DMFT and 2.8% according to ICDA-S-II (p<0.001).

CONCLUSIONS: The DMFT index consistently underestimated carious lesions, whereas the ICDA-SII index enhanced the identification of incipient potentially reversible lesions. DMFT and ICDAS-II indices have demonstrated their efficacy in cavity detection, with the most significant distinction arising in ICDAS-II in the identification of early-stage carious lesions.

PMID:40014819 | DOI:10.54589/aol.37/3/217

Anesth Analg. 2025 Feb 27. doi: 10.1213/ANE.0000000000007435. Online ahead of print.

ABSTRACT

BACKGROUND: Preoperative anemia is common and associated with adverse outcomes in surgical patients. There is limited information to guide the design and implementation of preoperative anemia clinics (PAC), which represents a critical barrier to entry for many practices.

METHODS: This is a descriptive observational study highlighting the design and implementation of a multidisciplinary PAC, including key steps in planning, stakeholder engagement, organizational structure, identification of target populations, establishing anemia treatments, information technology and electronic health record integration, provider training, and data infrastructure. Demographic and clinical characteristics, laboratory results, and anemia treatments for individuals evaluated in the PAC from November 4, 2019 through September 15, 2023 are enumerated. Patient-reported outcomes (PROs) assessing changes in anemia symptoms and well-being after surgery are evaluated for 2 subsets of patients (one before PAC implementation [pre-PAC], another after PAC implementation [post-PAC]), without formal statistical comparison given limited sample sizes.

RESULTS: The PAC was initiated as a multidisciplinary effort under support from a Mayo Clinic Practice Transformation Award in 2019, including broad representation from anesthesiology, surgery, and medical practices, along with institutional project management support (eg, project manager, information technologists, systems engineers). While initially limited to cardiac surgery patients, the PAC underwent planned incremental expansion to include other surgical services. Over the study period, 1188 PAC consultations across 1159 unique patients met eligibility criteria, with a median age of 66 (57-73) years and 58.1% women. The most common etiology of anemia was iron deficiency (69.1%) followed by anemia related to cancer (17.3%). Anemia-directed therapies were recommended in 1038 (87.4%) encounters, with 730 (70.3%) of those receiving recommended treatment preoperatively. Seven hundred nine (97.1%) treatments included intravenous iron and 146 (20.0%) included erythropoiesis-stimulating agents. Fifteen pre-PAC and 38 post-PAC implementation patients completed PROs. PAC implementation was accompanied by earlier resolution of anemia symptoms and less pronounced declines in postoperative well-being scores.

CONCLUSIONS: This report highlights the key steps for successful PAC implementation. Treatment is possible for most patients and may be accompanied by improvements in patient-important outcomes.

PMID:40014801 | DOI:10.1213/ANE.0000000000007435

SICOT J. 2025;11:11. doi: 10.1051/sicotj/2025008. Epub 2025 Feb 27.

ABSTRACT

INTRODUCTION: This biomechanical study evaluated the effect of screw reinsertion with a locking plate on fixation strength and the stability of osteosynthesis in medial tibial plateau fractures using porcine bone.

MATERIALS AND METHODS: Thirty porcine tibiae were divided into three groups: group A (underwent biomechanical testing after medial tibial fixation with a large fragment T-shaped locking plate), group B (underwent plate fixation, followed by the removal of all screws and plates and refixation with the same screws and plates using the same holes before biomechanical testing), and group C (underwent biomechanical testing once after plate fixation, followed by the removal of all screws and plates, refixation with the same screws and plates using the same holes, and then biomechanical testing). The translation pattern of the constructs in each group was examined using cyclic loading tests. The changes in the joint gap and step-off after 2000 cycles were compared among the three groups.

RESULTS: Significant differences in displacement were observed at 10-100 cycles (group A: -0.01 ± 0.04 mm, group B: -0.02 ± 0.04 mm, group C: -0.13 ± 0.15 mm, P = 0.021). However, no significant differences were found in other displacement and translation measurements among the groups. Regarding the gap and step-off among groups, significant differences were observed in anterior and posterior gap changes. Despite the statistical significance, the absolute displacement values were small, suggesting minimal clinical relevance. These findings indicate that reinserting screws and plates into the same hole may not substantially compromise overall fixation strength.

CONCLUSION: Screw reinsertion in the same holes after removal did not significantly compromise the stability of osteosynthesis in this biomechanical model. These findings suggest that reinsertion may be a viable option in revision surgery.

PMID:40014800 | DOI:10.1051/sicotj/2025008

MMWR Morb Mortal Wkly Rep. 2025 Feb 27;74(6):83-90. doi: 10.15585/mmwr.mm7406a2.

ABSTRACT

Annual influenza vaccination is recommended for all persons aged ≥6 months in the United States. Interim influenza vaccine effectiveness (VE) was calculated among patients with acute respiratory illness-associated outpatient visits and hospitalizations from four VE networks during the 2024-25 influenza season (October 2024-February 2025). Among children and adolescents aged <18 years, VE against any influenza was 32%, 59%, and 60% in the outpatient setting in three networks, and against influenza-associated hospitalization was 63% and 78% in two networks. Among adults aged ≥18 years, VE in the outpatient setting was 36% and 54% in two networks and was 41% and 55% against hospitalization in two networks. Preliminary estimates indicate that receipt of the 2024-2025 influenza vaccine reduced the likelihood of medically attended influenza and influenza-associated hospitalization. CDC recommends annual receipt of an age-appropriate influenza vaccine by all eligible persons aged ≥6 months as long as influenza viruses continue to circulate locally.

PMID:40014791 | DOI:10.15585/mmwr.mm7406a2