Tag: statistics

J Pediatr Gastroenterol Nutr. 2025 Dec 9. doi: 10.1002/jpn3.70298. Online ahead of print.

ABSTRACT

OBJECTIVES: We aim to categorize the mechanical properties of the esophagus in children with eosinophilic esophagitis (EoE) in different disease stages and based on different management modalities, using endoscopic functional luminal imaging probe (EndoFLIP) which has been established to objectively evaluate mechanical properties of the esophagus in patients with EoE.

METHODS: We performed a retrospective analysis of children who completed EndoFLIP during sedated endoscopy over 2 years. Patients with EoE were categorized into EoE remission or active EoE based on published guidelines. Control subjects were those with normal endoscopy, esophageal biopsies, and EndoFLIP parameters. EndoFLIP studies were analyzed for distensibility index (DI) and maximum diameter (MD) at the esophagogastric junction (EGJ), as well as contractile response (CR).

RESULTS: We included 130 subjects, 60 controls, and 70 with EoE (34 [49%] had active EoE and 36 [51%] were in remission). DI and MD were significantly lower in active EoE compared to controls (p < 0.001). DI and MD were significantly lower in initial (baseline) EoE compared to active EoE on therapy (p < 0.05) and EoE remission (p < 0.001). There was no statistically significant difference in DI and MD between EoE subgroups on different therapies.

CONCLUSION: Assessment of esophageal mechanical properties using EndoFLIP provides valuable information on disease severity in pediatric EoE. In our cohort, histological remission achieved with therapies such as proton pump inhibitors, topical steroids, and dupilumab was associated with improved distensibility and diameter at the EGJ. However, a subset of patients continued to demonstrate abnormal EndoFLIP findings despite histologic improvement.

PMID:41363038 | DOI:10.1002/jpn3.70298

Pulmonology. 2025 Dec 31;31(1):2598693. doi: 10.1080/25310429.2025.2598693. Epub 2025 Dec 9.

ABSTRACT

INTRODUCTION AND OBJECTIVES: Risk factors of poor outcomes associated with COVID-19 are not well identified in patients with interstitial lung disease (ILD).

PATIENTS OR MATERIALS AND METHODS: We analysed a multicentre prospective cohort of patients with ILD and COVID-19 from January 2020 to December 2022. Risk factor analysis for death at 90 days and hospitalisation was conducted using logistic regression, adjusted for age and sex.

RESULTS: A total of 603 patients were included (66 years [54-74], 62% male). ILD diagnoses were autoimmune ILD (n = 147 [24%]), idiopathic pulmonary fibrosis (IPF, n = 124 [21%]), non-IPF fibrosing ILD (n = 118 [20%]), granulomatosis (n = 115 [19%]), exposure-related/secondary ILD (n = 68 [11%]), and other rare lung diseases (n = 31 [5%]). Hospitalisation due to COVID-19 was associated with cardiovascular disease, cancer or haematological disease, background glucocorticoid therapy, DL_CO < 40%pred and FVC < 70%pred. Death due to COVID-19 at day 90 was associated with the underlying ILD diagnosis, background glucocorticoid therapy, cardiovascular disease, cancer or haematological disease, and DL_CO < 40%pred, whereas vaccination against SARS-CoV-2 was protective. COVID-19-related mortality occurred mainly in the first 90 days after SARS-CoV-2 infection.

CONCLUSIONS: Poor outcomes related to COVID-19 are associated with ILD subtype and severity, background glucocorticoid therapy and absence of vaccination. There is no evidence of late mortality.

PMID:41363029 | DOI:10.1080/25310429.2025.2598693

J Pediatr Gastroenterol Nutr. 2025 Dec 9. doi: 10.1002/jpn3.70307. Online ahead of print.

ABSTRACT

OBJECTIVE: Data on the relationship between body composition and strength in children with intestinal failure (IF) is lacking. The objectives were to (1) assess strength in children with IF compared to published norms; (2) examine the relationship between body composition and strength.

METHODS: Children aged 4-18 years with IF, excluding those with significant developmental delay or mobility challenges, were included. Functional strength was assessed using the Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2) and muscle strength was measured with a dynamometer for handgrip strength (HGS) and knee flexion/extension. Body composition was assessed using dual-energy X-ray absorptiometry. Two-sample t-test compared strength in IF patients to published norms, and the relationship between body composition and strength was analyzed using linear regression.

RESULTS: Thirty-one children (71% male, mean age 9.9 years) were included. Twelve (39%) received parenteral nutrition (PN). Children with IF had significantly lower HGS (p = 0.004), knee flexion (p = 0.002), and extension (p < 0.001) compared to published norms. Specifically, 80.6% scored below the mean for HGS, 71.0% for knee flexion, and 74.2% for extension. BOT-2 revealed 26.9% had scores less than -1 SD. No significant differences in strength were found between those on enteral nutrition or PN. A significant positive relationship between functional strength and increased fat-free mass, and decreased fat mass was found (r² = 0.36, p = 0.002), with male sex strengthening the relationship (r² = 0.62, p < 0.001).

CONCLUSION: Children with IF, both on enteral nutrition and PN, are weaker than healthy literature controls. Decreased strength was associated with lower fat-free mass. This relationship was stronger in males than in females, highlighting the need to further investigate the mechanisms behind body composition and strength in this population.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04610918.

PMID:41363022 | DOI:10.1002/jpn3.70307

J Pediatr Gastroenterol Nutr. 2025 Dec 9. doi: 10.1002/jpn3.70308. Online ahead of print.

ABSTRACT

OBJECTIVES: Hepatitis-associated aplastic anemia (HAAA) is described as acute severe hepatitis of unknown origin followed by bone marrow failure (BMF). We aimed to provide a comprehensive picture of pediatric HAAA.

METHODS: Two-center retrospective analysis was performed using data from children diagnosed with acquired BMF, including severe aplastic anemia (SAA) and myelodysplastic syndrome type refractory cytopenia of childhood (RCC). The assessment of the subcohort of HAAA included clinical features indicative of diagnosis and disease progression, with additional data from previously published case series.

RESULTS: Cohort comprised 62 children with acquired BMF and 22 children with HAAA. Median age of HAAA patients was 13.5 years. Potentially triggering viral infections were detected in 45%. The median interval from hepatitis onset to cytopenia was 3 weeks. All cases presented with severe hepatitis (median alanine transaminase 2127 U/L) and all but one with hyperbilirubinemia (median bilirubin 15.3 mg/dL). Coagulopathy was variable (median international normalized ratio 1.5). Four patients (18%) developed acute liver failure, two (9%) required liver transplantation. Hepatic parameters normalized within a median of 8.5 weeks. There was no statistically significant difference in the course of hepatitis between patients with SAA and RCC. Early lymphopenia was a key finding in patients with HAAA, progressing from a median of 905/µL at hepatitis onset to 530/µL within 4 weeks.

CONCLUSIONS: HAAA occurs in both SAA and RCC. Most cases present with severe acute cholestatic hepatitis and variable coagulopathy. Hepatic recovery is common. Lymphopenia at disease onset is frequent and may serve as a diagnostic marker.

PMID:41363020 | DOI:10.1002/jpn3.70308

Zh Nevrol Psikhiatr Im S S Korsakova. 2025;125(11):111-116. doi: 10.17116/jnevro2025125111111.

ABSTRACT

OBJECTIVE: To study the risk factors for a slowed intra-atrial conduction in patients with schizophrenia.

MATERIAL AND METHODS: One hundred twenty-two electrocardiograms of patients with schizophrenia who took antipsychotics were analyzed. The components of the metabolic syndrome, as well as anthropometric parameters, were identified as potential risk factors.

RESULTS: Slowed intra-atrial conduction (P >0.10 s) was found in 21 (17.2%) patients. Therefore, the patients were divided into two groups depending on the presence or absence of slowed intra-atrial conduction. Male sex (p=0.031), the duration of basic therapy (p<0.001), hypertriglyceridemia (p=0.043), the presence of metabolic syndrome (p=0.015), and hypersthenic body type (p<0.001) were statistically significant risk factors for slowed intra-atrial conduction in patients with schizophrenia.

CONCLUSION: If these risk factors are identified in patients with schizophrenia, continuous monitoring of the electrocardiogram and pharmacological interventions are recommended for the identified indications.

PMID:41362983 | DOI:10.17116/jnevro2025125111111

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