Journal of Clinical Medicine最新文献

{"title":"Modern Biomarkers in IgA Nephropathy and Their Potential in Paediatric Research.","authors":"Agnieszka Such-Gruchot, Małgorzata Mizerska-Wasiak, Emilia Płatos, Małgorzata Pańczyk-Tomaszewska","doi":"10.3390/jcm14093263","DOIUrl":"10.3390/jcm14093263","url":null,"abstract":"<p><p>Immunoglobulin A nephropathy (IgAN) is one of the most common forms of glomerulonephritis and one of the main causes of end-stage renal disease (ESRD), affecting up to 40% of patients after 20 years of the disease. Over the past few years, several studies have been conducted to search for biomarkers that can diagnose IgAN in a non-invasive way, select patients in the asymptomatic phase, assess the progression of the disease process and monitor its efficacy, and assess the risk of IgA nephropathy progression. Non-invasive investigations using molecules as an alternative to renal biopsy have potential relevance for diagnosis, the determination of treatment efficacy and the assessment of disease activity. For the early screening of IgAN with isolated haematuria, these factors may be useful for early intervention and result in a reduction in the risk of impaired renal function. The clinical studies discussed in this review underline that featured molecules show potential as biomarkers for the diagnosis and assessment of disease progress in IgAN.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12072798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiological Evaluation of Retained Primary Molars in Adolescents with Mandibular Second Premolar Agenesis.","authors":"Dita Meistere, Aleksandra Karkle, Sindija Mengele, Liga Kronina, Laura Neimane","doi":"10.3390/jcm14093241","DOIUrl":"10.3390/jcm14093241","url":null,"abstract":"<p><p><b>Objectives</b>: We aimed to evaluate the condition of retained primary molars in case of mandibular second premolar agenesis. <b>Materials and Methods</b>: In total, 2692 panoramic radiographs of adolescent patients were analyzed to determine the prevalence of tooth agenesis. Patients (N = 156) with at least one mandibular second premolar agenesis were further explored to determine the presence and condition of retained primary teeth. Teeth were classified as good or poor based on root resorption, infraocclusion, caries, and restorations. <b>Results</b>: The prevalence of mandibular second premolar agenesis was 5.8% (N = 156). For the set period for this study, 138 (58.5%) primary molars were present. Out of these retained teeth, N = 83 were in good condition. There was a statistically significant positive weak correlation between age and the level of root resorption (rs = 0.348, <i>n</i> = 138, <i>p</i> < 0.001). There was no association between infraocclusion and the level of root resorption (<i>p</i> = 0.747). Signs of infraocclusion were noted in 32 out of 138 teeth. There was no association between gender and the presence of infraocclusion (<i>p</i> = 0.067) and the presence or lack of infraocclusion and the therapeutic status of a tooth (<i>p</i> = 0.450). Only 28 out of 138 (20.3%) were intact. There was a significant difference in the level of root resorption between restored and/or carious (median = 3, IQR 2-4) and intact teeth (median = 2, IQR 1.75-3), U = 1168, <i>p</i> = 0.044, r = 0.242. <b>Conclusions</b>: Overall, 35.2% of corresponding primary molars were present in oral cavity, and were in good condition, and could potentially be preserved in the long term.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12072898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Dydrogesterone Versus Vaginal Progesterone for Luteal Phase Support in Frozen-Thawed Embryo Transfer Cycles: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Konstantinos Stavridis, Dimitrios Balafoutas, Theodoros Kalampokas, Vassiliki Benetou, Evangelia Samoli, Nikolaos Vlahos, Maria-Iosifina Kasdagli","doi":"10.3390/jcm14093238","DOIUrl":"10.3390/jcm14093238","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Until recently, oral dydrogesterone has only been established in fresh in vitro fertilization (IVF) cycles, whereas its role in luteal phase support (LPS) for frozen embryo transfer (FET) cycles remains unclear. The aim of this study is to determine whether oral dydrogesterone as LPS in FET cycles results in pregnancy rates comparable to vaginal progesterone, focusing primarily on ongoing pregnancy rates, but also on clinical pregnancy, miscarriage, and live birth rates. <b>Methods</b>: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five databases (Embase, MEDLINE^®, APA PsycInfo, Global Health, and HMIC) and two additional sources were searched from inception to November 28, 2024. Only randomized controlled trials (RCTs) were included. A common effects model combined risk estimates, and heterogeneity was assessed using I². Study quality was evaluated with Risk of Bias 2 (RoB2), and evidence certainty was graded using GRADE. <b>Results</b>: Overall, five RCTs with a total of 636 women were included in the meta-analysis. The comparison between oral dydrogesterone and vaginal progesterone for LPS did not yield significant differences for any of the outcomes studied. For ongoing pregnancies, the pooled odds ratio (OR) was 0.90 (95% CI: 0.59-1.35), with no heterogeneity (I² = 8.7%). For miscarriage events, the OR was 1.41 (95% CI: 0.63-3.13, I² = 0). For clinical pregnancies, the OR was 0.94 (95% CI: 0.62-1.42, I² = 49.2%), with heterogeneity attributed to dosage. For live births, the pooled OR was 1.08 (95% CI: 0.67-1.75, I² = 0%). Two studies were assessed as high risk of bias, two as low risk, and one as moderate. The GRADE assessment indicated low to moderate certainty of evidence. <b>Conclusions</b>: Oral dydrogesterone and vaginal progesterone yield comparable reproductive outcomes for LPS in FET cycles. Given its ease of administration, dydrogesterone may serve as a viable alternative in future FET protocols. However, further RCTs are needed to assess its efficacy against other progesterone administration routes.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12072605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Prophylactic Device Against Head Deformity to Prevent Severe Positional Plagiocephaly.","authors":"Yukari Tanaka, Hiroshi Miyabayashi, Takanori Noto, Risa Kato, Nobuhiko Nagano, Ichiro Morioka","doi":"10.3390/jcm14093261","DOIUrl":"10.3390/jcm14093261","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Preventing head deformity in the early postnatal period could avert positional plagiocephaly (PP). Accordingly, we developed a novel prophylactic device to prevent head deformity and examined its impact on the incidence of PP and prevention of severe PP at 3 months of age. <b>Methods</b>: The newly developed prophylactic device was used immediately after birth or at the 1-month checkup, and cranial shape was measured before device application and at 3 months of age. The diagnostic threshold for PP was >5% for cranial vault asymmetry index (CVAI); cranial asymmetry (CA) of ≥13 mm was deemed severe. A database comprising cranial geometry of 3-month-old healthy Japanese infants (<i>n</i> = 110) served as the control. <b>Results</b>: This study included 42 infants who started using the novel prophylactic device immediately after birth or at the 1-month checkup. Measurements at 3 months of age revealed that the prophylactic device group had significantly lower CA and CVAI than the control group (CA [median]: 5.5 vs. 8.0, respectively, <i>p</i> = 0.007; CVAI: 4.3 vs. 5.8, respectively, <i>p</i> = 0.048). However, the PP prevalence did not differ significantly between the two groups (41% vs. 57%, respectively, <i>p</i> = 0.094). The number of infants with severe PP was significantly lower in the prophylactic device group than in the control group (0% vs. 14%, respectively; <i>p</i> = 0.012). At 3 months of age, no significant differences in CA or CVAI were observed between the immediate postnatal and 1-month groups. <b>Conclusions</b>: The novel prophylactic device against head deformity could prevent severe PP.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12072440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of the Abdominal Perforator Exchange (APEX) Technique in the Perforator Selection Algorithm for Delayed Deep Inferior Epigastric Perforator (DIEP) Flap Breast Reconstruction.","authors":"Dmitry V Melnikov, Elina I Abdeeva, Semyon I Ivanov, Victor A Gombolevskiy","doi":"10.3390/jcm14093256","DOIUrl":"10.3390/jcm14093256","url":null,"abstract":"<p><p><b>Background</b>: The deep inferior epigastric artery perforator (DIEP) flap is currently the most widely used method for autologous breast reconstruction. Its primary advantage over the transverse rectus abdominis muscle (TRAM) flap is the reduction in donor-site morbidity, as it preserves the integrity of the abdominal muscles and motor nerves. Importantly, each patient's unique vascular anatomy requires an individualized approach to perforator selection and the surgical technique. <b>Objective</b>: We aimed to minimize donor-site morbidity and refine the perforator selection strategy in delayed DIEP flap breast reconstruction using the abdominal perforator exchange (APEX) technique. <b>Materials and Methods</b>: In this study, we prospectively and retrospectively analyzed the use of the APEX technique in patients undergoing delayed DIEP flap breast reconstruction between April 2020 and October 2024. All patients underwent preoperative non-contrast magnetic resonance angiography of the donor area. A total of 106 patients were enrolled and divided into two groups: 34 patients underwent reconstruction using the APEX technique, and 72 patients received standard DIEP flap breast reconstruction. <b>Results</b>: Our study demonstrated a statistically significant increase in operative time, averaging 30.5 min in the APEX group (<i>p</i> < 0.05). There was also a significant difference in the incidence of marginal flap necrosis between the two groups. No cases of myotomy were observed, and motor nerve transection was required in one case. <b>Conclusions</b>: The APEX technique has been shown to be reliable when standard dissection would compromise the neuromuscular anatomy of the abdominal wall without compromising perfusion in the flap.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12072376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Bronchoscopy in the Diagnosis of Interstitial Lung Disease: A State-of-the-Art Review.","authors":"A Rolando Peralta, Al Muthanna Shadid","doi":"10.3390/jcm14093255","DOIUrl":"10.3390/jcm14093255","url":null,"abstract":"<p><p>The diagnostic evaluation of interstitial lung diseases (ILDs) remains challenging due to their heterogeneous etiologies and overlapping clinical and radiographic patterns. A confident diagnosis often necessitates histopathological sampling, particularly when high-resolution computed tomography and serologic assessments are inconclusive. While surgical lung biopsy (SLB) has long been considered the diagnostic gold standard, its invasiveness, associated morbidity, and limited feasibility in high-risk patients have driven the pursuit of less invasive alternatives. Here, we review the current applications, diagnostic yield, procedural techniques, and complications of several bronchoscopic modalities. Bronchoalveolar lavage (BAL) aids in characterizing inflammatory profiles and differentiating among conditions such as hypersensitivity pneumonitis, sarcoidosis, and eosinophilic pneumonia. Endobronchial biopsies (EBBs) and endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) are valuable in diagnosing granulomatous diseases with lymphadenopathy. Transbronchial lung biopsy (TBLB) is effective for peribronchial and centrilobular diseases but is limited by small sample size and tissue distortion. Transbronchial lung cryobiopsy (TBC) enables acquisition of larger, well-preserved parenchymal tissue samples from the peripheral lung. Over recent years, studies have demonstrated that TBC, when interpreted within a multidisciplinary discussion (MDD), achieves diagnostic concordance rates with SLB exceeding 75%, and up to 95% in cases where high diagnostic confidence is reached. When performed in experienced centers using standardized protocols, TBC is considered a viable first-line histopathologic tool in the diagnostic evaluation of ILD. Adequate training and standardization of the TBC procedure are needed to ensure low complication rates and a high yield.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12072706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter-Relationships Between the Deep Learning-Based Pachychoroid Index and Clinical Features Associated with Neovascular Age-Related Macular Degeneration.","authors":"Michiyuki Saito, Mizuho Mitamura, Yuki Ito, Hiroaki Endo, Satoshi Katsuta, Susumu Ishida","doi":"10.3390/jcm14093245","DOIUrl":"10.3390/jcm14093245","url":null,"abstract":"<p><p><b>Background/Objectives</b>: To investigate the impact of pachychoroid on the clinical features of neovascular age-related macular degeneration (nAMD) in Japan using the deep learning-based Hokkaido University pachychoroid index (HUPI), which has a high discriminative ability for pachychoroid. <b>Methods</b>: This retrospective observational study examined 124 eyes of 111 treatment-naïve nAMD patients, including 44 eyes with type 1 macular neovascularization (MNV), 26 eyes with type 2 MNV, and 54 eyes with polypoidal choroidal vasculopathy (PCV). HUPI was calculated for each eye from EDI-OCT choroidal images using our modified LeNet that had learned the image patterns of pachychoroid. Differences in HUPI between nAMD types and inter-relationships between nAMD parameters, including HUPI, were evaluated. <b>Results</b>: The mean HUPI was 0.53 ± 0.30 for type 1 MNV, 0.33 ± 0.23 for type 2 MNV, and 0.61 ± 0.3 for PCV, with significant differences between any two of the three groups (<i>p</i> < 0.05, for each). Round-robin multiple regression analysis for nAMD parameters showed the close associations of the HUPI with choroidal vascular hyperpermeability (CVH) and subretinal fluid (SRF) (<i>p</i> = 0.017 and <i>p</i> < 0.001 for each) and the clear division of nAMD parameters into the following two groups: one including intraretinal fluid and type 1 and type 2 MNV and the other including SRF, CVH, polypoidal lesions, and HUPI. <b>Conclusions</b>: HUPI revealed that eyes with type 1 MNV and PCV had more pachychoroid-like features than eyes with type 2 MNV. HUPI was tightly associated with CVH and SRF but not MNV per se in nAMD parameters, reinforcing the pathoetiological concept of differentiating pachychoroid from typical nAMD.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12072645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Frailty and Other Factors as Estimated by HU to Predict Response to Anabolic Bone Medications.","authors":"Abdelrahman M Hamouda, Zach Pennington, Rahul Kumar, Michael L Martini, Derrick Obiri-Yeboah, Maria Astudillo Potes, Nicholas Kendall, Anthony L Mikula, Michelle J Clarke, William E Krauss, Ahmad N Nassr, Brett A Freedman, Arjun S Sebastian, Melvin D Helgeson, Kurt A Kennel, Jeremy L Fogelson, Benjamin D Elder","doi":"10.3390/jcm14093247","DOIUrl":"10.3390/jcm14093247","url":null,"abstract":"<p><p><b>Introduction:</b> Bone health optimization is a key component of the preoperative management of spine surgery patients, as poor bone quality increases the odds of mechanical complications. The present study aimed to achieve the following: (1) compare the relative efficacy of current osteoporosis medications in improving bone quality; (2) identify factors influencing treatment response in preoperative spine surgery patients. <b>Methods:</b> Patients treated at a single, multisite institution who received osteoporosis treatment were identified. Data were gathered on pre- and post-treatment lumbar spine Hounsfield Unit (HU) measurements, patient demographics, frailty scores (modified Frailty Index/mFI, risk analysis index/RAI), and pharmacologic treatment details. The primary outcome was a ≥7 point improvement in lumbar HU, and baseline and logistic regression models were utilized to identify factors associated with this improvement. Medications were grouped as anabolic (teriparatide, romosozumab) and antiresorptive (denosumab, alendronate) therapies. <b>Results:</b> A total of 267 patients were included (median age: 74 years; IQR [66-81]; 67.3% female), with 127 (47.6%) improving by ≥7 HU. The treatment agents used were alendronate (95), denosumab (113), romosozumab (31), and teriparatide (28). Univariable comparisons revealed significant differences across medication groups in age (<i>p</i> < 0.001), sex (<i>p</i> < 0.001), mFI (<i>p</i> < 0.001), RAI (<i>p</i> = 0.004), BMI (<i>p</i> < 0.001), pre-treatment HU (<i>p</i> = 0.022), and treatment duration (<i>p</i> < 0.001). The highest HU improvement rates (ΔHU ≥ 7) were observed in patients receiving the anabolic medications romosozumab (67.7%) and teriparatide (60.7%). Univariable logistic regression identified male sex (OR 0.54, <i>p</i> = 0.019), higher pre-treatment HU (OR 0.99, <i>p</i> = 0.006), and longer treatment duration (OR 0.97, <i>p</i> = 0.003) as factors associated with lower odds of HU improvement. Only romosozumab was associated with significantly higher odds of HU improvement relative to alendronate (OR 3.02, <i>p</i> = 0.012). In our multivariable analysis, male sex (OR 0.53, <i>p</i> = 0.028) and higher pre-treatment HU (OR 0.99, <i>p</i> = 0.002) remained significant predictors of HU improvement. However, medication type was not significant in the multivariable analysis. <b>Conclusions:</b> Our study highlights that male sex and higher pre-treatment HU were independently associated with lower odds of HU improvement, while medication type was not a significant predictor. Additionally, anabolic agents offered superior improvement relative to antiresorptive therapies.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12072346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Risk Factors of Metabolic-Associated Fatty Liver Disease in Children with Down Syndrome at a Tertiary Care Center.","authors":"Maria D Karaceper, Maria-Jose Villegas, Sanathan Sadh, Sierra Kawesa, Jamie Strain, Asha Nair, Alissa Dupuis, Mary Pothos, Ming-Hua Zheng, Mohit Kehar","doi":"10.3390/jcm14093239","DOIUrl":"10.3390/jcm14093239","url":null,"abstract":"<p><p><b>Background:</b> The global rise of metabolic-associated fatty liver disease (MAFLD) in children is particularly concerning in high-risk groups such as those with Down Syndrome (DS), who have an elevated risk of obesity and insulin resistance. Despite increasing recognition of MAFLD in pediatric populations, data on its prevalence and risk factors among children with DS in Canada remain limited. <b>Method:</b> This retrospective study reviewed medical records of children with DS at the CHEO Down Syndrome Clinic (2013-2023). A diagnosis of MAFLD required evidence of hepatic steatosis on imaging, lab markers, or biopsy, along with the presence of metabolic risk features. Demographic, laboratory, and diagnostic data were analyzed. <b>Results:</b> Among 503 children with DS (231 females, 271 males; median age: 172 months), 54 (10.7%) had MAFLD. The MAFLD group was older (median age: 205 vs. 163 months, <i>p</i> = 0.0002) and had higher BMI (31.39 vs. 20.5, <i>p</i> < 0.0001). Most cases (47/54) were diagnosed via ultrasound, and 49/54 met MAFLD criteria due to excessive adiposity. Lab results showed a median ALT of 35 U/L, triglycerides of 4.4 mmol/L, and LDL cholesterol of 2.59 mmol/L. FibroScan in 13 children revealed a median transient elastography of 5.3 kPa. BMI was the strongest predictor of MAFLD (OR: 1.2, 95% CI: 1.1-1.2). <b>Conclusions:</b> The DS clinic-based prevalence of MAFLD underscores the need for proactive screening and early intervention. BMI was the strongest predictor, emphasizing targeted management strategies. Further research is needed to refine diagnostic approaches and improve outcomes.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12072516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence Methods in the Detection of Oral Diseases on Pantomographic Images-A Systematic Narrative Review.","authors":"Katarzyna Zaborowicz, Maciej Zaborowicz, Katarzyna Cieślińska, Agata Daktera-Micker, Marcel Firlej, Barbara Biedziak","doi":"10.3390/jcm14093262","DOIUrl":"10.3390/jcm14093262","url":null,"abstract":"<p><p><b>Background:</b> Artificial intelligence (AI) is playing an increasingly important role in everyday dental practice and diagnosis, especially in the area of analysing digital pantomographic images. Through the use of innovative and modern algorithms, clinicians can more quickly and accurately identify pathological changes contained in digital pantomographic images, such as caries, periapical lesions, cysts, and tumours. It should be noted that pantomographic images are one of the most commonly used imaging modalities in dentistry, and their digital analysis enables the construction of AI models to support diagnosis. <b>Objectives:</b> This paper presents a systematic narrative review of studies included in scientific articles from 2020 to 2025, focusing on three main diagnostic areas: detection of caries, periapical lesions, and cysts and tumours. The results show that neural network models, such as U-Net, Swin Transformer, and CNN, are most commonly used in caries diagnosis and have achieved high performance in lesion identification. In the case of periapical lesions, AI models such as U-Net and Decision Tree also showed high performance, surpassing the performance of young dentists in assessing radiographs in some cases. <b>Results:</b> The studies cited in this review show that the diagnosis of cysts and tumours, on the other hand, relies on more advanced models such as YOLO v8, DCNN, and EfficientDet, which in many cases achieved more than 95% accuracy in the detection of this pathology. The cited studies were conducted at various universities and institutions around the world, and the databases (case databases) analysed in this work ranged from tens to thousands of images. <b>Conclusions:</b> The main conclusion of the literature analysis is that, thanks to its accessibility, speed, and accuracy, AI can significantly assist the work of physicians by reducing the time needed to analyse images. However, despite the promising results, AI should only be considered as an enabling tool and not as a replacement for the knowledge of doctors and their long experience. There is still a need for further improvement of algorithms and further training of the network, especially in identifying more complex clinical cases.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 9","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12072333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}