Background: The study aimed to evaluate the effectiveness of an experimental primer (EP) based on the 10-MDP monomer when used with the fifth-generation adhesive system. Methods and Results: Tests were performed on tooth samples from wisdom teeth and premolars extracted for orthodontic purposes. The EP consisted of 10-MDP monomer (10%), ethanol (40%), propanol-2 (30%), water (18%), and a camphorquinone-based photoinitiator system (2%). The pH of the EP was 2.4. The adhesive resin of the fifth-generation OptiBond Solo Plus (OSP) and the universal composite Herculite XRV were the materials of choice. Two adhesive techniques were tested: the traditional total-etch technique with OSP application, and the optional technique with sequential EP and OSP applications using a selective-etch approach. Adhesive bond strength was assessed in two groups using the ultra-test technique (Ultradent Products, Inc., USA). All samples in each group underwent two sequential shear bond strength (SBS) tests. The quality of the resin composite adhesion was assessed on four specimens using an FE-SEM (Thermo Fisher Scientific Apreo 2S LoVac). Microleakage assessment was made on 10 teeth. In each tooth, two artificial cavities of similar size were prepared. Fillings were placed using two techniques in each tooth. Depth of dye penetration at tooth-composite interface was assessed using nonparametric scores. The phase composition of the dentin surface was assessed on six tooth samples divided into three groups of two using thin-film X-ray diffraction (TF-XRD). Samples from the control group were used for XRD of the dentin surface. Samples of Group 1 were used to apply EP to the dentin surface; samples of Group 2 were used for sequential application of EP and OSB to the dentin surface. A significant difference of more than three times (P=0.000) was observed between the SBS values of the first and second tests in samples from Group 1 compared with those from Group 2. SEM of the filling-to-dentin interface in samples with sequential application of EP and OSP using a selective etch approach showed a more uniform hybrid layer than with OSP application with the total-etch technique. Microleakage analysis of the dentin-composite interface revealed a significantly higher dye penetration rate in samples with the traditional OSP application. The presence of the 10-MDP calcium salt peak at diffraction angle of 2 theta=2.540 after sequential application of EP and OSP corresponded to the longest d-spacing (3.48 nm) of the nanolayered structure on the surface of tooth dentin.(International Journal of Biomedicine. 2026;16(1):101-106.)
Nasopharyngeal carcinoma is a rare malignancy in children, representing less than one percent of pediatric cancers, with incidence varying across regions. A fourteen-year-old boy presented with one month of right nasal obstruction, ear fullness, hearing loss, and progressive headache. Physical examination revealed a 20 & times;20 mm mass at the level II of the neck. Anterior rhinoscopy revealed mucosal discharge and a friable mass occupying the right nasal cavity. The left nasal cavity showed inferior turbinate hypertrophy, livid mucosa, and mucous secretion, with a mass appearance suggestive of contralateral compression. Contrast-enhanced MSCT angiography of the head and neck revealed a bilateral solid nasopharyngeal mass (3.75 & times;3.71 & times;4.27 cm) with post-contrast enhancement, extending into the sphenoid sinus and associated with destruction of the right sphenoid and temporal bones. Because early symptoms are nonspecific, the diagnosis of nasopharyngeal carcinoma in children is often delayed. Early recognition and evaluation are essential to reduce morbidity and improve clinical outcomes.(International Journal of Biomedicine. 2026;16(1):111-115.)
Magnetic foreign bodies of the gastrointestinal tract (GIT) in children represent a rare but hazardous type of foreign body, capable of causing severe complications such as multiple perforations and inter-intestinal fistulas. In recent years, their incidence has increased due to the widespread use of magnetic toys and construction sets. Diagnosis is particularly challenging, as parents are not always aware of the ingestion, and the clinical presentation may mimic other acute surgical conditions. The article presents a clinical case of a 1.5-year-old boy who ingested 5 magnetic beads, complicated by fistula formation and perforation, as well as an analysis of data from the Republican Scientific Center of Emergency Medical Care (RSCEMC), in the Department of Pediatric Emergency Surgery for the period 2014-2019, describing the features of diagnosis, treatment strategies, and outcomes. (International Journal of Biomedicine. 2026;16(1):116-119.)
Background: Systemic lupus erythematosus (SLE) is a chronic, potentially life-threatening autoimmune disorder that damages various tissues and organs. It is more prevalent in women than in men. Real-world medical practice provides comprehensive clinical and laboratory information. A variety of factors complicate processes in patients with SLE. Two important risk factors, serum interleukin-6 (IL-6) and vitamin D, are to be investigated to determine their precise role in SLE. Methods and Results: We analyzed variation in serum IL-6 and vitamin D, their association, and other characteristics in normal-weight SLE (NW-SLE) and overweight SLE (OW-SLE), compared with NW controls (NW-C) and OW controls (OW-C). The enzyme-linked immunosorbent assay (ELISA) kit methods were used for diagnostic purposes and to determine vitamin D and IL-6 levels. Conventional methods were used to record the other variables, including hemoglobin (Hb), hepcidin (Hp), body mass index (BMI), menstrual cycle length (MCL), and menstrual phase duration (MPD). Serum levels of IL-6 presented significant variations for NW-SLE compared to NW-C (P<0.02), and OW-SLE compared to OW-C, and OW-SLE compared to NW-SLE (P<0.01). The serum levels of vitamin D indicated a significant difference between OW-SLE compared to NW-SLE (P<0.03) and NW-SLE compared to NW-C, OW-SLE compared to OW-C, and OW-C compared to NW-C (P<0.01). Furthermore, vitamin D and IL-6 showed a significant negative correlation in OW-SLE and NW-SLE patients (P<0.01). Conclusion: The results of this study highlight the importance of measuring serum IL-6 and vitamin D levels in conjunction with BMI assessment in patients with SLE. This study revealed an inverse relationship between vitamin D and IL-6 in patients with SLE. Since vitamin D is an important modifiable factor in SLE, and its deficiency is associated with disease activity and the risk of complications, correction of vitamin D deficiency can complement standard therapy and improve the prognosis of SLE.
Background: This meta-analysis aimed to assess the clinical efficacy and safety of PD-1 inhibitor-based treatment in advanced cervical cancer patients. Methods and Results: PubMed and Web of Science were systematically searched for relevant studies. This meta-analysis comprises 14 studies involving 1504 patients. The pooled results of ORR (objective response rate) and DCR (disease control rate) are as follows, respectively: 1) 16% and 53% in patients who were treated with a PD-1 inhibitor; 2) 26% and 56% in patients who were treated with a PD-1 plus a CTLA-4 inhibitor; 3) 68% and 92% in patients who were treated with a PD-1 inhibitor plus an antiangiogenic agent. Patients treated with a PD-1 inhibitor, a PD-1 inhibitor plus an antiangiogenic agent, or single-agent pembrolizumab experienced >= grade 3 adverse events at rates of 21%, 50%, and 10%, respectively. Conclusion: Although the therapeutic efficacy of a PD-1 inhibitor plus an antiangiogenic agent is superior to PD-1 inhibitor monotherapy or the combination of a PD-1 and CTLA-4 inhibitor, this combination is more toxic than other treatment strategies. Further evidence from large-scale randomized controlled trials is needed to validate the current results.(International Journal of Biomedicine. 2026;16(1):46-52.)
Negative pressure wound therapy (NPWT) has been widely used in wound repair and tissue regeneration, and its mechanistic role in fracture healing is gaining increasing attention. Bone morphogenetic protein-9 (BMP-9), a recognized and highly effective osteoinductive factor, plays a crucial role in bone repair. However, the regulatory mechanism of its expression under negative pressure remains unclear. This study aimed to investigate whether negative pressure wound therapy (NPWT) accelerates fracture healing by upregulating BMP-9 and osteocalcin (OCN) expression through activation of the MAPK/ERK5 signaling pathway. A tibial fracture model was established in Sprague-Dawley (SD) rats. The rats were randomly divided into the control group, the Model+Gauze group, the Model+Gauze+BIX group, the Model+NPWT group, and the Model+NPWT+BIX group. Fracture tissue was obtained 14 days after surgery for molecular and histological analysis. Real-time fluorescence quantitative PCR results showed that mRNA expression of BMP-9, OCN, MEK5, and ERK5 in the Model+NPWT group was significantly higher than that in the other groups (P<0.05). Western blot analysis was consistent with this finding, demonstrating a significant increase in protein expression. Further immunohistochemistry revealed that OCN expression in the fracture area of the Model+NPWT group was significantly increased, suggesting a stimulatory effect on osteoblastic activity. This study demonstrates that NPWT may upregulate BMP-9 and OCN expression by activating the MAPK/ERK5 signaling pathway, thereby enhancing the osteogenic response at the fracture site and ultimately promoting fracture repair. This study provides a new perspective on the molecular mechanisms by which NPWT promotes fracture healing and provides a theoretical basis for its clinical application in fracture treatment.(International Journal of Biomedicine. 2026;16(1):33-40.)
Background: The gamma-glutamyl transferase to high-density lipoprotein cholesterol (GGT/HDL-C) ratio has been reported to be associated with various metabolic diseases, but its relationship with cognitive dysfunction remains limited. This study aimed to investigate the relationship between the GGT/HDL-C ratio and cognitive dysfunction in older adults. Methods and Results: This cross-sectional study included 2,769 participants and used data from the National Health and Nutrition Examination Survey (NHANES) database (2011 similar to 2014). Natural logarithmic (ln) transformation was performed on GGT/HDL-C before analysis. After adjusting for various covariates, logistic regression models showed that the association between ln(GGT/ HDL-C) and cognitive dysfunction assessed by total-CF and AFT remained significant [OR (95% CI): 1.374 (1.126 similar to 1.676), 1.220 (1.030 similar to 1.444)], whereas no significant correlation was found with CERAD W-L or DSST (P>0.05). Then, restricted cubic spline (RCS) regression and threshold effect analyses were conducted, and we observed nonlinear associations between ln(GGT/HDL-C) and cognitive dysfunction measured by total-CF, CERAD W-L and DSST (all P-nonlinear<0.05). Subgroup analyses were performed based on multiple variables, including age, gender, BMI, race, education level, DM, sleep problems, hypertension, drinking, and smoking status. The results suggested that the association between ln(GGT/HDL-C) and cognitive dysfunction was comparable across most subgroups. Conclusion: Our study suggested that higher levels of ln(GGT/HDL-C) might be associated with an increased risk of cognitive dysfunction in older adults.
Background: Total gastrectomy remains a key component of gastric cancer treatment, and the method used to construct the esophagojejunostomy may influence long-term functional outcomes and quality of life. Evidence comparing hand-sewn and mechanical anastomoses in this context remains inconsistent. This retrospective study aimed to evaluate and compare longterm functional outcomes and quality of life in patients undergoing total gastrectomy with either hand-sewn or mechanical esophagojejunostomy. Methods and Results: The study included 153 patients who underwent total gastrectomy for histologically confirmed gastric adenocarcinoma. Patients were divided into two groups based on the anastomotic technique: mechanical circular stapler or hand-sewn anastomosis (according to a patented method). Long-term outcomes were evaluated 12 months postoperatively using EORTC QLQ-C30 and QLQ-STO22 questionnaires, along with endoscopic assessment of reflux esophagitis using the Los Angeles classification. Postoperative complications were graded according to the Clavien-Dindo classification. Both groups demonstrated comparable short-term postoperative outcomes and similar complication rates according to the Clavien-Dindo classification. However, patients with a hand-sewn anastomosis showed significantly better long-term quality-of-life scores (EORTC QLQ-C30, QLQ-STO22), including higher functional domain scores and lower scores for reflux, pain, nausea, and dietary restriction. Endoscopic assessment revealed no significant differences in esophagitis prevalence or severity between groups. Conclusion: While mechanical anastomosis offers advantages in operative duration and blood loss, the hand-sewn technique provides superior long-term functional outcomes and quality-of-life benefits. These findings support the consideration of hand-sewn esophagojejunostomy in clinical settings where long-term recovery and patient-reported outcomes are prioritized.(International Journal of Biomedicine. 2026;16(1):41-45.)
Background. Triple-negative breast cancer (TNBC) is characterized by pronounced biological heterogeneity and variable sensitivity to neoadjuvant chemotherapy, underscoring the need for additional diagnostic and predictive biomarkers. TRPS1, a GATA family transcription factor, has been identified as a highly sensitive marker of mammary differentiation; however, its clinical relevance in TNBC remains insufficiently explored. Methods and Results. The aim of this study was to evaluate TRPS1 expression in TNBC and to assess its association with clinicopathological features, stromal tumor-infiltrating lymphocytes, and the efficacy of neoadjuvant chemotherapy. This single-center retrospective study included 54 patients with invasive TNBC treated with neoadjuvant chemotherapy. TRPS1 expression was assessed by immunohistochemistry using an H-score-based approach. Stromal tumor-infiltrating lymphocytes were evaluated on hematoxylin and eosin-stained tumor slides. Response to neoadjuvant chemotherapy was assessed by the rate of pathological complete response and the Residual Cancer Burden classification. High TRPS1 expression was detected in 53.7% of cases and was associated with a significantly higher pathological complete response rate (51.7% vs. 20.0%, P=0.016), a more favorable distribution of Residual Cancer Burden categories, and higher levels of stromal tumor-infiltrating lymphocytes. Overall, TRPS1 expression in TNBC was associated with improved response to neoadjuvant chemotherapy. Conclusions. TRPS1 expression in TNBC is associated with enhanced sensitivity to neoadjuvant chemotherapy and may be considered not only a diagnostic marker of mammary differentiation but also a potential predictive marker of treatment response. (International Journal of Biomedicine. 2026;16(1):53-58.)
Background: Clinical and radiographic criteria are used to diagnose nasal polyps, but histopathologic examination is necessary for a definitive diagnosis. There are numerous categories for the histological classification of nasal polyps. The aim of this study was to identify the histological subtypes of nasal polyps in adult patients in Al Kharj city. Material and Methods: Fifty-one individuals who had surgery to remove nasal polyps between January 2024 and June 2025, and whose diagnoses were verified by histological analysis, were the subject of a retrospective study based on hospital information. Males made up more than half (58.8%) of the patients. Inflammatory or allergic polyps were found in most cases (52.9%). Inverted papilloma was found in 21 cases (41.2%). Of the 51 cases, only 3 were malignant. Conclusion: Uupon histological inspection, the nasal polyps primarily exhibit an inflammatory or allergic pattern. Histopathological examination of a resected nasal polyp is often necessary to establish the definitive diagnosis, as it is challenging to detect the pathology of a nasal mass clinically.(International Journal of Biomedicine. 2026;16(1):59-63.)
Background: Both increased body mass index (BMI) and urinary tract infections (UTI) are common pediatric problems. Being overweight or obese is a risk factor for pediatric UTI, but it has not been extensively studied. This study aimed to investigate the clinical and microbiological associations between overweight and obesity and UTI among hospitalized children. Methods and Results: This cross-sectional analytical study involved hospitalized children at Al-Khansaa Pediatric Hospital in Mosul, northern Iraq. Atotal of 74 patients aged <= 15 years of both sexes were included in the study from October 2023 to September 2024. Upper UTI was documented by urine culture and ultrasonography. The mean age of patients was 6.88 +/- 4.49 years. Males accounted for 37.8%, females for 62.2%, and 77% of patients were from urban areas. Patients were divided into three groups based on BMI: normal weight, overweight, and obese. Most patients (43.2%) had a normal weight, 18.9% were overweight, and 37.8% were obese. Overweight and obesity were more prevalent among UTI children than among normal children, according to the current data (P=0.03 and P=0.000, respectively). E. coli was the main causative organism among the normal weight group (31%), while Candida species dominated among the overweight and obese groups (38% and 35%). There was increasing resistance to antibiotics with the increase in BMI among the obese group, with a significant Spearman correlation (R2 =0.14, P=0.045). Conclusion: According to this study, overweight and obesity are possible risk factors for pediatric UTI. Increases in BMI beyond the normal range shift the causative microorganisms of UTI from E. coli to Candida species and increase antibiotic resistance. (International Journal of Biomedicine. 2026;16(1):90-94.)
Background: Transfusion-transmitted infection (TTI) poses significant risks to blood transfusion safety and represents a major public health challenge in Sudan. However, current data on TTI prevalence among blood donors is limited. This study aimed to assess the prevalence of TTI among male blood donors at the Blood Bank of Nao Teaching Hospital, Omdurman, Sudan, from January 2019 to December 2022. Methods and Results: A retrospective 4-year descriptive cross-sectional study was conducted using blood donation records to examine the prevalence of TTI, including human immunodeficiency virus (HIV), hepatitis B (HBV), hepatitis C (HCV), and syphilis. Data were analyzed for trends over the four-year period. The study identified a total TTI prevalence of 8.8% (302 of 3401 donors). Among TTI, HBV had the highest prevalence at 4.29%, followed by syphilis at 3.91%. HIV prevalence was 0.56%, and HCV prevalence was 0.12%. No cases of co-infection were reported. The overall TTI prevalence declined from 10.2% in 2019 to 6.9% in 2022. Conclusion: The findings emphasize the importance of ongoing monitoring and improved screening measures to enhance blood safety in Sudan. The high prevalence of HBV and syphilis underscores the need for targeted public health campaigns to raise awareness and promote safe blood donation practices.(International Journal of Biomedicine. 2026;16(1):95-100.)
Background: Diabetic nephropathy (DN) is a major cause of chronic kidney disease (CKD) and end-stage renal disease worldwide. While biochemical markers such as blood urea nitrogen, serum creatinine, estimated glomerular filtration rate (eGFR), and albuminuria are routinely used, early and subclinical renal dysfunction may be missed. Renal Doppler ultrasound, particularly the resistive index (RI) and pulsatility index (PI), provides a noninvasive tool for assessing intrarenal hemodynamics. This study aimed to explore the association between common biochemical markers and renal Doppler ultrasound parameters in diabetic patients and to evaluate how factors such as glycemic control and disease duration influence these measures. Methods and Results: A cross-sectional study was conducted on type 2 diabetes (T2D). Biochemical markers and Doppler indices were measured. Appropriate statistical tests were performed to examine relationships between biochemical and Doppler ultrasound findings. Of the 150 patients (mean age of 51.2 +/- 8.4 years), 41.3% had poor glycemic control (HbA1c > 8%). Both RI and PI exhibited significant negative correlations with eGFR (P<0.001) and significant positive correlations with blood urea and serum creatinine. RI and PI values were noticeably higher in patients with poorer glycemic control and longer duration of diabetes. Peak systolic velocity (PSV) and end-diastolic velocity (EDV) had no significant correlation with biochemical markers (P>0.05). Conclusion: In patients with T2D, there is a strong correlation between biochemical markers of renal dysfunction and renal Doppler ultrasound parameters, particularly RI and PI. These parameters worsen with poor glycemic control and longer disease duration. (International Journal of Biomedicine.
Background: Ultrasound is widely used to evaluate liver morphology in nonalcoholic fatty liver disease (NAFLD), yet the relationships between ultrasound-derived liver size and patient characteristics remain incompletely described in Saudi populations. This study assessed the association between right-lobe liver size and demographic/anthropometric variables among adults with ultrasound-confirmed NAFLD in Jeddah, Saudi Arabia. Methods and Results: This retrospective, cross-sectional, two-center study included 212 adults (>= 18 years) with NAFLD documented on ultrasound reports from 2 tertiary hospitals in Jeddah between 2020 and 2025. The primary outcome was right-lobe liver size (cm) extracted from ultrasound reports and/or PACS measurements. Predictors included sex, age, BMI, and hospital site. Of 212 participants, 114 (53.8%) were female; mean age was 49.5 years, and mean BMI was 31.6 kg/m2, with most participants classified as overweight or obese. Mean right-lobe liver size was similar between Hospital A and Hospital B (15.98 +/- 2.02 vs 16.07 +/- 2.03 cm; P=0.763). Females had numerically larger right-lobe measurements than males in both hospitals, but differences were not statistically significant overall (16.18 +/- 2.07 vs 15.84 +/- 1.94 cm; P=0.218). Liver size correlated inversely and weakly with age (r=-0.160, P=0.019) and weakly and positively with weight (r=0.221, P=0.001) and BMI (r=0.180, P=0.009). In multivariable regression adjusting for sex, BMI, and hospital, age remained independently associated with liver size (beta=-0.023 cm/year; P=0.026), while BMI did not retain significance (beta=0.043 cm per kg/m2; P=0.110); sex and hospital were not significant predictors. Conclusion: In adults with ultrasound-reported NAFLD in Jeddah, right-lobe liver size showed modest associations with age and adiposity, with age remaining an independent predictor after adjustment. Sex-based differences were small and non-significant, and measurements were consistent across two hospitals. Standardized acquisition and inclusion of objective NAFLD severity measures (e.g., elastography and laboratory markers) are needed to refine the interpretation of routine ultrasound liver size metrics in regional NAFLD populations.(International Journal of Biomedicine. 2026;16(1):64-70.)
Background: Childhood overweight and obesity are major public health concerns, yet evidence on key sociodemographic and familial risk factors in Albania is limited. This study examined associations between overweight (including obesity) and sex, residence, parental education, and parental chronic health conditions among children aged 8-9 years. Methods: Data were drawn from the nationally representative Assessment of Childhood Obesity and Impact of the COVID-19 Pandemic on the Daily Routine and Behaviors of School-Aged Children in Albania, conducted within WHO COSI Round 6. A one-stage stratified cluster sampling of primary schools was applied. Anthropometric measurements were collected, and parents reported chronic health conditions. Logistic regression analyses assessed associations between overweight/obesity and sociodemographic and parental health factors, adjusting for confounders. Results: Among 3,058 children (50.3% boys; 62.6% urban), overweight prevalence was higher in boys, urban residents, and children of parents with medium or higher education. Parental chronic conditions, including hypertension, diabetes, and high cholesterol, were associated with increased odds of child overweight. Adjusted analyses confirmed male sex (OR=1.40), urban residence (OR=1.34), and parental multimorbidity (OR up to 1.47) as significant predictors. Conclusion: Childhood overweight in Albania is shaped by sex, urbanization, parental education, and parental chronic health conditions, reflecting combined lifestyle, environmental, and intergenerational influences.(International Journal of Biomedicine. 2026;16(1):83-89.)
Background: Stunting is a nutritional problem that often affects children worldwide. Leptin and adiponectin are essential in modulating bone metabolism and, consequently, skeletal growth and height. This study aims to analyse leptin and adiponectin levels in stunted children and normal children and to determine the threshold values of leptin and adiponectin as early biomarkers of stunting. Methods and Results: A case-control study was conducted in the working area of Kota Ruteng Primary Health Center Care, in Manggarai Regency, East Nusa Tenggara, Indonesia, from September to December 2024. The subjects were randomly selected from children aged 24-60 months. A total of 80 children, including 38 boys and 42 girls, were enrolled and divided into a stunting group (n=40) and a non-stunting group (n=40). Multivariate analysis demonstrated that age 2-3 years, premature birth, low birth weight, and height were significant determinants of stunting, while leptin and adiponectin were independently associated with increased risk. ROC analysis showed that leptin had moderate discriminatory ability (AUC = 0.630; cut-off <2.18 ng/mL), whereas adiponectin yielded an AUC of 0.266 with a cut-off <29.5 ng/mL Conclusion: Stunted children have higher leptin levels, and their height and adiponectin levels are lower than those of non-stunted children. Leptin and adiponectin levels can be used as early biomarkers of stunting.
Objective: This review examines the interrelation between diabetes mellitus (DM) and apical periodontitis (AP), explaining key biological mechanisms and summarizing the main findings from animal and human studies. Methods and Results: A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science, focusing on peer-reviewed studies published over the last two decades. Several studies have shown that hyperglycemia impairs VEGFregulated angiogenesis, reduces osteoblast activity, and maintains elevated levels of inflammatory cytokines such as TNF-alpha and IL-6, thereby increasing periradicular lesion size and delaying tissue healing. Diabetic animal models showed reduced bone density, increased vascular calcification, and accelerated progression from caries to pulp necrosis. Clinically, T2DM (type 2 diabetes mellitus) was associated with higher AP prevalence, greater bacterial endotoxin load, and lower root-canal success rates. These effects were magnified by poor glycemic control. Conclusion: Diabetes mellitus exacerbates AP through impaired angiogenesis, dysregulated immune response, and impaired bone metabolism. To reduce these risks, strategies such as strict blood glucose control, enhanced antimicrobial disinfection, minimally invasive interventions, and the use of bioactive materials are recommended. Future research should explore how controlling oral infections impacts systemic metabolic health. Investigating the role of bioactive materials and anti-inflammatory treatments in improving AP outcomes is also essential.(International Journal of Biomedicine. 2026;16(1):6-13.)
Introduction: Kidney tumors, predominantly renal cell carcinoma (RCC), continue to pose a clinical challenge due to their asymptomatic nature in early stages and variable biological behavior. Methods and Results: Our retrospective study included 200 patients who underwent surgical treatment for RCC between 2015 and 2024. Patients were followed at 3, 12, and 24 months using the Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scale. Cox regression compared open radical nephrectomy (ORN) and open nephron-sparing surgery (NSS). ECOG-PS score increased gradually: baseline (0.07±0.252), 3 months (0.02±0.149), 12 months (0.20±0.505), 24 months (0.24±0.570), and 36 months (0.44±0.990) (P<0.01). Kaplan-Meier curves showed better survival for tumors <4 cm. Cox regression analysis indicated a lower mortality rate with open NSS (HR = 0.148, 95% CI; 0.019–1.126), although the difference was not statistically significant. No significant difference in creatinine levels was observed between groups. Conclusion: Patients with smaller renal tumors typically exhibit more favorable survival outcomes than those with larger masses. Current trends in kidney tumor management emphasize the use of less invasive surgical techniques, which aim to achieve comparable oncologic control while preserving overall renal function.
Background: Experimental methods for evaluating composite filling materials and their use are essential for achieving reliable, predictable clinical results in tooth restoration. This study aimed to evaluate the impact of bottom increment thickness, preheating, and light exposure duration on microhardness and depth of cure of bulk-fill resin composite after polymerization in a covered slot. Methods and Results: A total of 32 filling samples were made using Tetric® N-PowerFill 2 bulk-fill resin composite material (Ivoclar Vivadent AG). Composite filling samples were made in opaque plastic molds with isosceles trapezoidal slots. The slot was 1.5 mm wide. The lower and upper bases of the trapezoid were 3 and 6 mm, respectively. The height of the trapezoidal slot was 5 mm. Filling samples were divided into 8 groups of 4 each. All trapezoidal slots were filled with 2 successive layers of different thicknesses. In Groups 1, 3, 5, and 7, the height of the bottom horizontal layer was ~1mm, the top horizontal layer ~ 4 mm. In Groups 2, 4, 6, and 8, the height of the bottom horizontal layer was ~ 4mm, the top horizontal layer ~ 1 mm. Every layer was cured individually. In Groups 1, 2, 5, and 6, the light exposure for each layer was 20 sec, while in Groups 3, 4, 7, and 8, it was 40 sec. Filling samples in Groups 1, 2, 3, and 4 were made from a room-temperature composite (22-24°C). In Groups 5, 6, 7, and 8, the material was polymerized after heating in the slot up to 55-60°C. Photoactivation was performed with the Valo X LED lamp (Ultradent, USA) in standard mode. The surface microhardness of composite filling samples was assessed using the Vickers hardness tester after exposure to light and storage in a dark container for 24 hours. Measurements were performed using a “ПMT-3” tester with an indenter at a 50g load for a 15-second dwell time. Indentations were made in a linear order at levels of 0.5, 1.5, 2.5, 3.5, and 4.5 mm from the top surface. Doubling the photoactivation time of the room-temperature composite from 20 seconds to 40 seconds increased the VHN of composite fillings at depths of 1.5, 2.5, 3.5, and 4.5 mm by 55%, but mostly insignificantly. The only difference of ~1.6 times was noted in VHN at a depth of 4.5 mm between the filling samples from Group 3 and Group 2 (p=0.0071), indicating the importance of both low increment thickness and prolonged irradiance. The surface hardness of fillings at 0.5 mm in samples from Groups 1, 2, 3, and 4 was relatively high and did not show significant statistical differences among them. It was another confirmation of the crucial importance of close light source adjustment to the surface of light-cured material. Photoactivation of a heated composite material in a covered slot had certain advantages over using a room-temperature composite, as demonstrated by the VHN of filling samples at different depths. For example, at all depths, the VHN of composite fillings in Group 8 was statistically greater than in Group 2, regardless of the thickness of the bottom increment. Moreover, the difference increased with depth, from 1.4 (P=0.0431) [at 0.5 mm] to 1.8 (P=0.0001) [at 4.5 mm]. However, it was noteworthy that prolonged irradiance of a 4 mm-thick layer of resin composite is beneficial and may offset the low polymerization kinetics of a room-temperature filling material. Conclusion: Lowering the thickness of the bottom layer of bulk-fill composite, along with its preheating and prolonged photoactivation, cumulatively contributed to a significant increase in depth of cure and microhardness of filling samples made in a covered slot.
Background: The use of narcotic substances among minors represents an increasing public health concern in Albania and globally, carrying significant physical and mental health consequences. The goal of this study was to provide clinical and epidemiological evidence of psychoactive substance use among minors to inform national policy, optimize preventive strategies, and enhance therapeutic frameworks tailored to youth at risk in Albania. Methods and Results: This study employed a retrospective observational design and was conducted at the Clinical Toxicology Service of the University Hospital Centre “Mother Teresa” in Tirana. The study included all patients who were treated for confirmed or suspected of intoxication by psychoactive substances from January 1, 2020, to December 31, 2024. Data were collected from clinical records and included types of substances used, treatment provided, and demographic factors. A total of 1,032 patients were treated for psychoactive substance intoxication. Among them, 27(2.6%) were minors (<18 years), while 1,005 (97.4%) were adults. Among minors, 25(92.6%) were male and 26(96.3%) resided in urban areas. The majority of minors, 18(66.7%), lived in Tirana prefecture. Among minors, cannabis was the most prevalent substance used (37.0%), followed by opioids (22.2%), polysubstances (22.2%), and cocaine (18.5%). No alcohol-only intoxications were recorded among minors. A significantly higher proportion of minors had cannabis-related intoxication than did adults (37.0% vs. 5.7%), while cocaine use was more common among adults (39.1% vs. 18.5%). These differences were statistically significant (P<0.001). Conclusion: This study highlights the urgent need to address narcotic substance use among minors in Albania. Strengthening national surveillance systems and integrating mental health services into prevention efforts will be key to protecting vulnerable populations and shaping effective policy responses.
