Tag: pubmed

Int Endod J. 2026 Jan 9. doi: 10.1111/iej.70095. Online ahead of print.

ABSTRACT

OBJECTIVE: Photon-counting computed tomography (PCCT) represents a major innovation in X-ray detection technology, offering improved signal efficiency and reduced electronic noise compared with cone-beam computed tomography (CBCT), which can enhance image quality. This study aimed to evaluate the diagnostic performance of PCCT in detecting vertical root fractures (VRF), in comparison with four CBCT devices.

METHODOLOGY: Eighteen single-rooted teeth were endodontically treated, and VRF was induced in eight of them. Each tooth was individually placed into the mandibular first premolar empty socket of an anthropomorphic phantom and scanned under three conditions: without a metal post, with a nickel-chromium metal post (Ni-Cr), and with a cobalt-chromium metal post (Co-Cr) in five CT devices: the NAEOTOM Alpha PCCT (Siemens Healthineers) device and four CBCT devices (3D Accuitomo 170-Morita, Veraview X800-Morita, NewTom VGi evo-NewTom, and Carestream 9600-Carestream). The highest-resolution protocol available on each device was used, resulting in a total of 270 scans. Five experienced dentomaxillofacial radiologists independently and blindly evaluated the scans using a five-point confidence scale. Diagnostic accuracy was assessed by calculating the area under the ROC curve (AUC), sensitivity, and specificity, with results compared by two-way ANOVA with post hoc Tukey’s test (α = 0.05).

RESULTS: NewTom VGi and PCCT devices showed significantly higher AUC values than the Veraview X800, regardless of the metal post material (p < 0.05). CS9600 and PCCT devices exhibited significantly higher sensitivity values in diagnosing with Ni-Cr posts than the Accuitomo 3D and Veraview X800 devices (p < 0.05). With the Co-Cr metal post, the NewTom VGi, CS9600, and PCCT devices showed significantly higher sensitivity values compared to the Veraview X800 device (p < 0.05). There were no statistically significant differences in specificity, regardless of the CT device or metal post material (p > 0.05).

CONCLUSIONS: The NEAOTOM Alpha PCCT showed high diagnostic accuracy for VRF detection in an ex vivo model, comparable to high-resolution CBCT devices, highlighting its diagnostic performance under controlled ex vivo conditions.

PMID:41510664 | DOI:10.1111/iej.70095

Int J Gynaecol Obstet. 2026 Jan 9. doi: 10.1002/ijgo.70789. Online ahead of print.

ABSTRACT

BACKGROUND: The WHO recommends that all pregnant women receive an ultrasound (US) scan prior to 24 weeks gestation to encourage early identification of various conditions, such as fetal anomalies, multiple gestation, and placental abnormalities; however, global access to US remains limited. This has prompted many research groups to develop artificial intelligence (AI) approaches for obstetric US.

OBJECTIVE: The aim of this study was to update and synthesize current literature regarding the development of AI algorithms for obstetric US.

SEARCH STRATEGY: Methods were modified from Horgan et al. scoping review on the progress of AI algorithms for obstetric US. Our search, which encompassed papers published between 1991 and May 2022, adapted Horgan’s search strategy by replicating the search strings across PubMed, Cochrane Library, and clinicaltrials.gov databases, while also snowballing additional references.

SELECTION CRITERIA: Studies included both AI and obstetric US with a focus on one or more maternal and/or fetal conditions between January 2022 and January 2024. After removing duplicates, publications were screened for inclusion criteria based on their mention of both AI and obstetric US and a main objective assessing maternal and/or fetal conditions. Studies were excluded if they failed to mention the use of AI or obstetric ultrasound, discussed AI algorithm development, or consisted of expert opinions, reviews, and abstracts.

DATA COLLECTION AND ANALYSIS: We used Zotero to manage references and extracted data onto an Excel template. The remaining publications were reviewed for data extraction including-authors, dates, objectives, settings, and funding sources. Publications were categorized into seven main areas based on Horgan’s framework, with additional subcategories for emerging topics. Descriptive statistics summarized the data, with graphical visualizations depicting the geographic distribution of studies.

MAIN RESULTS: A total of 96 articles were included in the final results, revealing the rapid increase in the number of publications related to AI in obstetrics. The greatest proportion of studies were categorized as fetal biometry (25%) and anatomical evaluation of the fetus (20%). Studies took place across multiple regions with the greatest number in Asia (41%) and Europe (27%). A total of 22% were conducted in low- or middle-income countries (LMICs).

CONCLUSION: This scoping review demonstrates the growth and development of AI-enabled obstetric US applications. There is a wide variety of innovative applications on the horizon and implementation approaches and implications should be explored as these technologies become clinically available. We encourage development of algorithms that focus on parameters that identify conditions linked to the global burden of maternal and neonatal mortality and morbidity, such as gestational age and placental location.

PMID:41510613 | DOI:10.1002/ijgo.70789

Asia Pac J Clin Oncol. 2026 Jan 9. doi: 10.1111/ajco.70062. Online ahead of print.

ABSTRACT

BACKGROUND: Sentinel lymph node biopsy (SLNB) reduces morbidity in breast cancer (BC) surgery compared to axillary lymph node dissection. Standard tracers such as vital blue dye (VBD), methylene blue (MB), and radioisotopes (RIs) are effective but costly and logistically challenging. Gentian violet (GV), a low-cost alternative, offers a potential solution for resource-constrained settings.

METHODS: We conducted a single-center retrospective study at Cancer Foundation Hospital, analyzing 40 BC patients who underwent SLNB using GV and RI (January-December 2024). Sentinel lymph node (SLN) detection rates, concordance between GV and RI, and safety profiles were assessed. Detection was compared across tumor grade, histopathology, receptors, and chemotherapy status.

RESULTS: The median patient age was 52 years, with most patients having a BMI between 21 and 30 (72.5%). T2 tumors were the most common (60%), followed by T3 (17.5%). Stage II disease predominated (75%), and invasive ductal carcinoma (IDC) was the most frequent histological subtype (70%). Among the cohort, 60% were estrogen/progesterone receptor-positive, 22.5% were triple-positive, and 10% were triple-negative. GV dye successfully identified SLNs in 97.5% of cases, with GV detecting more nodes than RI in 32.5% of patients, while both methods identified the same number in 50% of cases. The false-negative rate for GV was 2.5%. Detection rates were consistent across tumor subtypes, grades, and receptor statuses, with no statistically significant differences (p > 0.05). Neoadjuvant chemotherapy (NACT) did not impact SLN detection (p = 0.803). GV dye exhibited a favorable safety profile, with no intraoperative or postoperative complications reported at Days 0, 3-7, and 30. No cases of staining-related reactions, dermatitis, tattooing, or skin necrosis were observed.

CONCLUSIONS: Gentian violet is a safe, effective, and affordable alternative to MB for SLNB in BC. It demonstrates high detection rates and excellent safety, particularly suitable for resource-limited settings. Larger studies are warranted to validate these findings and support broader clinical adoption.

PMID:41510595 | DOI:10.1111/ajco.70062

Nurs Crit Care. 2026 Jan;31(1):e70313. doi: 10.1111/nicc.70313.

ABSTRACT

BACKGROUND: Excessive noise exposure in intensive care units (ICUs) remains a critical issue that adversely affects both healthcare professionals and patients. Prolonged and unnecessary noise contributes to psychological stress, sleep disturbance and physiological alterations, ultimately delaying patient recovery and increasing staff fatigue.

AIM: This Study Aimed to Assess the Effect of Implementing a Structured Noise Reduction Bundle on Critical Care Nurses’ Knowledge and Practice in an Adult ICU in Egypt.

STUDY DESIGN: A quasi-experimental pre-post research design was employed in a single adult ICU characterised by an open-unit layout, which may influence ambient noise levels. Data were collected using four instruments: (1) a questionnaire assessing nurses’ socio-demographic characteristics and knowledge regarding the noise reduction bundle; (2) an observational checklist evaluating adherence to noise reduction bundle practices; and (3) objective noise level measurements within the ICU before and after intervention.

RESULTS: Implementation of the noise reduction bundle significantly improved ICU noise outcomes and enhanced nursing competencies. Post-intervention, mean knowledge scores increased from 20.3 to 25.6 (p < 0.001), with satisfactory knowledge rates rising from 15.6% to 81.3%. Practice scores improved from 42.9 to 60.3 (p < 0.001), with satisfactory practice rates increasing from 14.1% to 82.8%. These improvements were strongly correlated with a statistically significant reduction in average noise levels across all ICU shifts (p < 0.001), reflecting tangible environmental improvements.

CONCLUSION: Effective noise reduction in ICUs requires integrated bundle interventions, workflow modifications and behavioural changes in staff communication, which collectively foster a sustainable and quiet clinical environment conducive to patient recovery and staff well-being.

RECOMMENDATIONS: Future research should involve larger and more diverse populations to validate these findings, develop standardised noise control protocols and assess the long-term impact of continuous staff education programmes and integrate noise management strategies within institutional quality improvement frameworks.

RELEVANCE TO CLINICAL PRACTICE: Noise in intensive care units (ICUs) is a critical environmental stressor that affects both patients and healthcare professionals. Excessive noise disrupts patient sleep, delays recovery, increases stress and contributes to staff fatigue and communication errors. Implementing a structured noise reduction bundle provides a practical and evidence-based approach to minimise unnecessary sound exposure, enhance patient comfort and promote safer, more focused clinical environments. Strengthening ICU nurses’ knowledge and adherence to noise reduction practices fosters a culture of awareness and accountability that supports high-quality, patient-centred care.

PMID:41510571 | DOI:10.1111/nicc.70313

Rev Med Virol. 2026 Jan;36(1):e70104. doi: 10.1002/rmv.70104.

NO ABSTRACT

PMID:41510570 | DOI:10.1002/rmv.70104

Kidney Med. 2025 Nov 7;8(2):101175. doi: 10.1016/j.xkme.2025.101175. eCollection 2026 Feb.

ABSTRACT

RATIONALE & OBJECTIVE: There are substantial racial/ethnic disparities in access to kidney replacement therapies (KRT). Although existing work often focuses on discrete treatment outcomes, a holistic depiction of racial/ethnic groups’ differential experiences requires a longitudinal approach.

STUDY DESIGN: A sequence analysis in national registry data.

SETTING & PARTICIPANTS: Adults aged 18-64 years with incident kidney failure in 2009 in the United States Renal Data System database.

EXPOSURE: Race/ethnicity (non-Hispanic Asian American [Asian-NH], non-Hispanic African American or Black [Black-NH], Hispanic, and non-Hispanic White [White-NH]) and age group (18-44 years and 45-64 years).

OUTCOME: Ten-year KRT modality sequences (in-center dialysis, home dialysis, deceased donor kidney transplant [DDKT], living donor kidney transplant, stopped dialysis, and mortality).

ANALYTICAL APPROACH: Using sequence analysis, longitudinal KRT modalities were characterized using descriptive statistics and visualized with state distribution plots, stratified by race/ethnicity and age.

RESULTS: The study included 50,776 adults with kidney failure (24% 18-44 years old and 76% 45-64 years old; 3.6% Asian-NH, 35.8% Black-NH, 17.7% Hispanic, and 42.9% White-NH). Among those aged 18-44, Hispanic and Asian-NH patients more frequently survived 10 years compared with Black-NH and White-NH patients. Among non-White patients, receipt of DDKT increased in years 4-6. Asian-NH patients had the highest DDKT receipt frequency. Asian-NH and White-NH patients more frequently experienced treatment sequences with 3 or more KRT modalities, and these sequences more commonly included transplant. Among patients initially receiving home dialysis, Asian-NH and White-NH patients more commonly transitioned to transplant compared with Black-NH and Hispanic patients. Compared with patients aged 18-44 years, racial/ethnic differences in KRT treatment sequences were attenuated among those aged 45-64 years.

LIMITATIONS: Descriptive analyses cannot identify causal mechanisms. Excluding patients missing KRT modality may limit generalizability.

CONCLUSIONS: Patterns in the KRT modality sequences offer a more nuanced view of racial/ethnic disparities in access to treatments for incident kidney failure.

PMID:41510562 | PMC:PMC12775809 | DOI:10.1016/j.xkme.2025.101175

Turk Gogus Kalp Damar Cerrahisi Derg. 2025 Oct 20;33(4):517-527. doi: 10.5606/tgkdc.dergisi.2025.27712. eCollection 2025 Oct.

ABSTRACT

BACKGROUND: This study aims to evaluate the diagnosis, surgical outcomes, and prognosis of patients with traumatic diaphragmatic rupture and discuss recent advancements in diagnostic technologies.

METHODS: Between January 2014 and January 2024, a total of 35 patients (27 males, 8 females; mean age: 45.3±14.2 years; range, 13 to 68 years) who underwent diaphragmatic repair for traumatic diaphragmatic rupture in three centers were retrospectively analyzed. Data including demographic characteristics of the patients, medical history, type of trauma, clinical findings, diagnostic methods used preoperatively, preoperative interventions, the establishment of an intraoperative diagnosis, associated organ injuries, side of the diaphragmatic rupture, type of surgical procedure, postoperative complications, and length of hospital stay were recorded.

RESULTS: Among the cases, penetrating trauma was the most common mechanism (62.9%). Among the 25 patients who underwent computed tomography, a preoperative diagnosis of diaphragmatic rupture was established in 14 (56%). The median defect size in the diaphragm was 5.7 cm in blunt trauma cases and 4.04 cm in penetrating trauma cases. The morbidity rate was 40%, and the mortality rate was 5.7%. The length of hospital stays for the surgically treated patients ranged from 4 to 16 days. Comparing the laparotomy and thoracotomy groups, the laparotomy group had a longer hospital stay (p=0.017) and had statistically significant data in terms of participation in multidisciplinary surgery (p=0.001).

CONCLUSION: Diaphragmatic rupture should be considered in cases involving high-energy blunt trauma, particularly when multiple lower rib fractures, liver lacerations, or splenic lacerations are present, or in patients with a history of penetrating trauma to the thoracoabdominal region. As delays in diagnosis and treatment may increase morbidity and mortality, early recognition and prompt management are essential. The choice of surgical procedure should be guided by the presence or absence of concomitant injuries.

PMID:41510551 | PMC:PMC12728965 | DOI:10.5606/tgkdc.dergisi.2025.27712

Turk Gogus Kalp Damar Cerrahisi Derg. 2025 Oct 20;33(4):546-554. doi: 10.5606/tgkdc.dergisi.2025.27813. eCollection 2025 Oct.

ABSTRACT

BACKGROUND: This study aims to emphasize the features that should be considered in the follow-up of patients with solitary fibrous tumors by analyzing the clinical and pathological parameters that are effective in the prognosis.

METHODS: In this study, 53 patients (28 males, 25 females; mean age: 56.2±5 years; range, 24 to 76 years) diagnosed with solitary fibrous tumor and operated on between 2009 and 2023 were retrospectively examined. The patients included in the study were followed for at least one year. Patients with complete clinical and pathological data records were included in the study. Survival and recurrence rates were analyzed in relation to clinical and pathological parameters.

RESULTS: The median follow-up was 44.9 months. Eight (15%) patients underwent anatomic resection, 23 (35.8%) patients underwent wedge resection, five (5.6%) patients underwent total pleurectomy, 26 (41.5%) patients underwent mass excision, and three (1.8%) underwent mass excision and chest wall resection. Survival analyses were conducted using the Kaplan-Meier method. Overall survival and disease-free survival were calculated in months from the date of surgery until the date of death or recurrence, respectively. Low mitotic rate was found to be a significant independent predictor of reduced mortality (odds ratio [OR]=0.46, 95% confidence interval [CI]: 0.243-0.877, p=0.018), indicating better survival outcomes in patients with low mitotic activity. In contrast, low Ki-67 expression was not a statistically significant predictor (OR=0.9, 95% CI: 0.880-1.116, p=0.885). Pleomorphism was strongly associated with increased mortality (OR=10.0, 95% CI: 1.316-76.081, p=0.026), highlighting the importance of pleomorphism as an important prognostic marker. Necrosis, although not statistically significant (OR=6.3, 95% CI: 0.497-79,123, p=0.156), showed a trend indicating worse outcomes. Similarly, CD34 negativity showed a trend in favor of mortality (OR=3.5, 95% CI: 0.429-28.990, p=0.241.

CONCLUSION: Solitary fibrous tumors are generally benign and have low recurrence and high survival rates. However, the recurrence rate is higher in malignant solitary fibrous tumors. According to the results of our study, high mitosis rate and pleomorphism are important independent predictors of increased mortality in solitary fibrous tumors. These findings emphasize the importance of detailed histopathological examination in prognostic evaluation.

PMID:41510546 | PMC:PMC12728960 | DOI:10.5606/tgkdc.dergisi.2025.27813

Turk Gogus Kalp Damar Cerrahisi Derg. 2025 Oct 20;33(4):470-478. doi: 10.5606/tgkdc.dergisi.2025.28290. eCollection 2025 Oct.

ABSTRACT

BACKGROUND: This study aims to evaluate our experience with magnetic resonance lymphangiography in single-ventricle congenital heart disease patients and to examine the association between imaging findings and clinical outcomes and postoperative outcomes.

METHODS: Between November 2022 and May 2025, a total of 33 patients (22 males, 11 females; median age: 44 months; range, 37 to 57.5 months) with single-ventricle congenital heart disease who underwent T2-weighted magnetic resonance lymphangiography at our center were retrospectively analyzed. The T2-weighted sequences were chosen for their high-resolution depiction of lymphatic structures without the need for contrast agents. The imaging findings were analyzed for preoperative risk evaluation or suspected postoperative lymphatic complications.

RESULTS: Lymphatic abnormalities were categorized into types 1 to 3 based on the extent and distribution of T2-hyperintense signals. No patients in this cohort exhibited type 4 abnormalities. Among 33 patients, 11 (33%) were classified as type 1, 18 (55%) as type 2, and four (12%) as type 3. Although not statistically significant, patients with type 3 patterns had the longest median pleural effusion duration (27.5 days) and length of hospital stay (61 days). One patient showed early postoperative progression from type 2 to type 3, which resolved clinically and radiologically after fenestration ballooning. In the late period, two patients developed protein-losing enteropathy, and one had Fontan failure.

CONCLUSION: Magnetic resonance lymphangiography provides critical information about structural lymphatic abnormalities. It also aids risk stratification prior to the Fontan procedure and guides individualized management of postoperative complications, ultimately guiding treatment and improving outcomes.

PMID:41510542 | PMC:PMC12728969 | DOI:10.5606/tgkdc.dergisi.2025.28290

Turk Gogus Kalp Damar Cerrahisi Derg. 2025 Oct 20;33(4):451-459. doi: 10.5606/tgkdc.dergisi.2025.27992. eCollection 2025 Oct.

ABSTRACT

BACKGROUND: This study aims to investigate the effects of deep parasternal intercostal plane block on left internal thoracic artery vasospasm in coronary artery bypass grafting patients.

METHODS: Between March 2024 and August 2024, a total of 29 patients (24 males, 5 females; mean age: 60.1±8.3 years; range, 56 to 66 years) who were scheduled for elective coronary artery bypass grafting were included in this prospective study. An ultrasound-guided bilateral deep parasternal intercostal plane block was performed with 15 mL of 0.25% bupivacaine per side after anesthesia induction. Left internal thoracic artery peak systolic velocity, end-diastolic velocity, and resistive index, along with heart rate and mean arterial pressure, were recorded immediately before the block (T0) and 30 min after (T1). Demographics, body mass index, and comorbidities of the patients were noted.

RESULTS: After deep parasternal intercostal plane block administration, the left internal thoracic artery resistivity index decreased significantly (p=0.041), and the left internal thoracic artery diameter increased significantly (p=0.004). Although the peak systolic velocity increased and the end-diastolic velocity decreased following the block, these changes were not statistically significant (p=0.145 and p=0.135, respectively).

CONCLUSION: Our study findings suggest that deep parasternal intercostal plane block administration may prevent left internal thoracic artery vasospasm by increasing arterial conduit diameter and reducing the resistivity index. Based on these findings, we believe that this method can be safely applied under ultrasound guidance without complications.

PMID:41510541 | PMC:PMC12728966 | DOI:10.5606/tgkdc.dergisi.2025.27992