Clinics and Practice最新文献

{"title":"Clinical Characteristics and Mortality-Associated Factors in Trauma Patients Undergoing Permanent Versus Temporary Tracheostomy.","authors":"Ahmad K Alnemare","doi":"10.3390/clinpract15010012","DOIUrl":"10.3390/clinpract15010012","url":null,"abstract":"<p><p><b>Objective:</b> This study evaluated the characteristics, outcomes, and mortality-associated factors in patients who underwent tracheostomy after traumatic injury to optimize clinical decision-making and patient care in critical trauma settings. <b>Materials and Methods:</b> A retrospective cohort analysis was conducted using the National Trauma Data Bank (NTDB) records from 2013 to 2016. This study included 41,630 adult trauma patients who underwent tracheostomy procedures. Data analysis included descriptive statistics, univariate comparisons, and multivariate logistic regression analyses. The study protocol adhered to STROBE guidelines for observational studies. <b>Results:</b> Analysis of the total cohort revealed that patients with tracheostomy demonstrated high rates of severe injuries (75.2%) and a notable comorbidity burden, including cardiovascular disorders (4.0%) and blood disorders (5.8%). Multivariate analysis revealed that mortality risk was independently associated with advanced age (OR 1.018, 95% CI 1.016-1.021), higher injury severity scores (OR 1.004, CI 1.002-1.007), female sex (OR 1.187, CI 1.078-1.308), and cardiovascular surgical intervention (OR 1.487, CI 1.350-1.638). Among the study population, 7.6% underwent permanent tracheostomy procedures, with these patients showing some distinct clinical characteristics in terms of injury severity and comorbidity profiles. <b>Conclusions:</b> This comprehensive analysis demonstrates the complex clinical characteristics and mortality-associated factors in trauma patients requiring tracheostomy. Key factors influencing survival outcomes include age, injury severity, sex, and cardiovascular surgical intervention. These findings provide valuable insights for clinical decision-making and risk assessment in trauma patients requiring tracheostomy. The observed differences between permanent and temporary tracheostomy patients warrant further investigation with more detailed timing and indication data.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution of Major HLA-A, -B, -DR, and -DQ Loci Potentially Associated with Multiple Sclerosis in a Healthy Population from Southern Morocco.","authors":"Abir Fguirouche, Fatimazahra Ouahmani, Ikram Brahim, Raja Hazime, Nissrine Louhab, Najib Kissani, Mohamed Chraa, Brahim Admou","doi":"10.3390/clinpract15010010","DOIUrl":"10.3390/clinpract15010010","url":null,"abstract":"<p><p><b>Background:</b> Many factors contribute to the development and the progression of Multiple Sclerosis (MS), including Human Leukocyte Antigen (HLA) molecules. Some of them are considered as predisposing, like DRB1*15, DRB1*13, DRB1*03, DRB1*04, DQB1*06, DQB1*02, while HLA A2, HLA B44, DRB1*11, and DRB1*12 are rather considered as protective. Data about such associations in the Moroccan population remain unknown. The aim of this study was to determine the frequency of HLA class I (A and B) and II (DR and DQ) linked to Multiple Sclerosis (MS) in a healthy population from the South of Morocco. <b>Materials and Methods:</b> A cross-sectional study was carried out over the 2016-2023 period on 685 Moroccan healthy individuals, including 355 males and 330 females. Of the total sample tested, 685 underwent HLA class I typing, of which 305 also benefited from HLA class II typing. HLA class I typing was executed using the CDC (complement dependent cytotoxicity) technique (OneLambda™, Los Angeles CA, USA), and HLA class II typing was performed by either PCR-SSP (sequence-specific primer, OneLambda) or PCR-SSO (sequence-specific oligonucleotides) using the Luminex Xmap (Lifecodes, Immucor, Peachtree, Corners, GA, USA) system. <b>Results:</b> From different HLA molecules potentially predisposing to MS, our investigations showed that DRB1*03, DRB1*13, DRB1*15, DRB1*04, and DQB1*02 were observed in 19.2%, 15.8%, 13.31%, 12.7% and 31% respectively, while the frequency of those considered as protective, namely HLA-A2, HLA-B44, and HLA-DRB1*11 was 23.31%, 9.21% and 10.1% respectively. <b>Conclusions:</b> The findings of our study give evidence that among predisposing HLA class II molecules, DR allele groups were more prevalent, mostly DRB1*03, with also a high frequency of DQB1*06, while HLA-A2 marked the supposed protective specificities. These results need to be supported by complementary studies particularly in MS patients.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing International Guidelines for the Remission of Hypertension After Bariatric Surgery.","authors":"Carina Vieira Dias, Ana Lúcia Silva, Joana Dias, Paulo Cardoso, Rute Castanheira, Andreia Fernandes, Filipa Nunes, Tina Sanai, Mercedes Sanchez, João Maia-Teixeira, Ana Luísa De Sousa-Coelho","doi":"10.3390/clinpract15010011","DOIUrl":"10.3390/clinpract15010011","url":null,"abstract":"<p><strong>Background/objectives: </strong>Obesity remains a global health concern and is associated with increased risk of type 2 diabetes, hypertension, and cardiovascular disease overall. Dissimilar hypertension guidelines are available for clinicians, namely those prepared by the American Heart Association (AHA) and the European Society of Cardiology (ESC), which may lead to distinctive appreciation of health outcomes of patients with obesity after bariatric and metabolic surgery, such as hypertension remission. The main goal of this study was to compare the effects of applying stricter (AHA) versus looser (ESC) blood pressure criteria on hypertension diagnosis pre-bariatric surgery and remission assessment one year post-op.</p><p><strong>Methods: </strong>A retrospective analysis of clinical data from patients who underwent surgical treatment for obesity at a single university hospital was performed. To evaluate the hypertension improvement or remission, two different types of blood pressure (BP) categorization were considered (based on AHA and ESC guidelines), in which each patient would fit according to their BP values pre- (m0) and 12 months postoperative (m12).</p><p><strong>Results: </strong>From a sample of 153 patients submitted for surgical treatment of obesity, more patients were considered with hypertension based on the AHA guideline (130 vs. 102; <i>p</i> < 0.001), while a higher rate of hypertension remission at 12 months after bariatric surgery was observed when following the ESC guideline (58.82 vs. 53.08%). Baseline patients' clinical characteristics based on each hypertension outcome were mostly independent of the guideline used (<i>p</i> > 0.05), where only age and systolic blood pressure were relatively higher in \"ESC groups\".</p><p><strong>Conclusions: </strong>We conclude that only minor differences exist between the two guidelines used. If evaluated based on ESC guidelines, it is expected that less patients are considered with hypertension, and the remission rate may be, at least numerically, higher.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines for the Management of Complications of Diabetes in Saudi Arabia Using Delphi Technique for Consensus Among National Experts.","authors":"Raed Aldahash, Mohammed A Batais, Ashraf El-Metwally, Saja Alhosan, Mohammed Alharbi, Mohammed Almutairi, Abdulghani Alsaeed, Mohammed Alsofiani, Mohammed AlMehthel, Mohammed Aldubayee, Khaled Aldossari, Sulieman Alshehri","doi":"10.3390/clinpract15010009","DOIUrl":"10.3390/clinpract15010009","url":null,"abstract":"<p><p>(1) Background: Saudi Arabia has one of the leading cases of diabetes globally, with approximately 27.8% of adults suffering from the disease. Given the negative consequences of diabetes mellitus (DM), it is critical to develop guidelines for its management. (2) Methods: After a thorough review of the literature around diabetes management, a diverse panel of 14 clinical experts was identified to participate in the Delphi process. The Delphi process included three rounds to ensure all available evidence was accounted for. (3) Results: The Delphi method concluded with a total of 37 guidelines reviewed and approved by the panelists, followed by verification from a third party in Saudi Arabia. The Delphi and external evaluation confirmed that authentic, relevant, and applicable evidence for diabetes management in Saudi Arabia was accounted for. The process concluded with a list of 37 statements about the management of acute and chronic complications of diabetes in Saudi Arabia. (4) Conclusions: The preparation of contextual evidence for the management of diabetes in Saudi Arabia will be instrumental in addressing the burden of disease in the region. The guidelines offer useful insights into diabetes care, especially by prioritizing early detection and proactive management of complications. They highlight the importance of lifestyle changes and medical therapy. However, due to the ever-changing nature of diabetes, the document must be monitored and updated on a regular basis to ensure its continued relevance and effectiveness.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT, Google, or PINK? Who Provides the Most Reliable Information on Side Effects of Systemic Therapy for Early Breast Cancer?","authors":"Stefan Lukac, Sebastian Griewing, Elena Leinert, Davut Dayan, Benedikt Heitmeir, Markus Wallwiener, Wolfgang Janni, Visnja Fink, Florian Ebner","doi":"10.3390/clinpract15010008","DOIUrl":"10.3390/clinpract15010008","url":null,"abstract":"<p><p><b>Introduction:</b> The survival in early breast cancer (BC) has been significantly improved thanks to numerous new drugs. Nevertheless, the information about the need for systemic therapy, especially chemotherapy, represents an additional stress factor for patients. A common coping strategy is searching for further information, traditionally via search engines or websites, but artificial intelligence (AI) is also increasingly being used. Who provides the most reliable information is now unclear. <b>Material and Methods</b>: AI in the form of ChatGPT 3.5 and 4.0, Google, and the website of PINK, a provider of a prescription-based mobile health app for patients with BC, were compared to determine the validity of the statements on the five most common side effects of nineteen approved drugs and one drug with pending approval (Ribociclib) for the systemic treatment of BC. For this purpose, the drugs were divided into three groups: chemotherapy, targeted therapy, and endocrine therapy. The reference for the comparison was the prescribing information of the respective drug. A congruence score was calculated for the information on side effects: correct information (2 points), generally appropriate information (1 point), and otherwise no point. The information sources were then compared using a Friedmann test and a Bonferroni-corrected post-hoc test. <b>Results:</b> In the overall comparison, ChatGPT 3.5 received the best score with a congruence of 67.5%, followed by ChatGPT 4.0 with 67.0%, PINK with 59.5%, and with Google 40.0% (<i>p</i> < 0.001). There were also significant differences when comparing the individual subcategories, with the best congruence achieved by PINK (73.3%, <i>p</i> = 0.059) in the chemotherapy category, ChatGPT 4.0 (77.5%; <i>p</i> < 0.001) in the targeted therapy category, and ChatGPT 3.5 (<i>p</i> = 0.002) in the endocrine therapy category. <b>Conclusions:</b> Artificial intelligence and professional online information websites provide the most reliable information on the possible side effects of the systemic treatment of early breast cancer, but congruence with prescribing information is limited. The medical consultation should still be considered the best source of information.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11764162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pedicled Radial Forearm \"Free\" Flap for Intraoral Reconstruction Based on an Unexpectedly High Origin of the Radial Artery-Case Report.","authors":"Marino Lupi-Ferandin, Dinko Martinovic, Ante Pojatina, Ante Mihovilovic, Ema Puizina, Sasa Ercegovic, Ivana Stula, Josko Bozic, Slaven Lupi-Ferandin","doi":"10.3390/clinpract15010006","DOIUrl":"10.3390/clinpract15010006","url":null,"abstract":"<p><p><b>Background:</b> Radial forearm free flap (RFFF) is considered one of the workhorses in modern head and neck reconstruction surgery due to its technical simplicity, versatility and less time-consuming harvest. <b>Methods:</b> In this report, we present the case of a 56-year-old woman with sublingual squamous cell carcinoma (SCC) who underwent surgical resection and reconstruction of the defect with a RFFF. <b>Results:</b> The preoperative Allen test showed normal blood flow, and the ultrasound did not recognize any blood vessel abnormalities in the left arm. However, during the RFFF harvest, when the dissection of the pedicle came to the cubital fossa, there was no brachial artery bifurcation. While trying to find the bifurcation, the dissection almost came to the axillary region. Hence, the RFFF was converted to a pedicle flap and was pulled through to the intraoral defect where it was used for reconstruction. <b>Conclusions:</b> Hence, during the preoperative radiological ultrasound, besides the usual characteristics such as the radial artery diameter, flow and possible obstructions, it is also important to explore if there are any other anatomical abnormalities that could influence the operation.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11764455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Microvascular Complications in Sulfonylureas-Treated Diabetic Patients: Correlations with Glycemic Control, Risk Factors and Duration of the Disease.","authors":"Luminita-Georgeta Confederat, Roxana Stefan, Mihaela-Iustina Condurache, Oana-Maria Dragostin","doi":"10.3390/clinpract15010007","DOIUrl":"10.3390/clinpract15010007","url":null,"abstract":"<p><p><b>Background</b>: Diabetes has become one of the most challenging public health problems due to the alarming increase in prevalence and the morbidity and mortality attributed to its acute and chronic complications. <b>Objective:</b> This study aimed to investigate the development of chronic microvascular complications in sulfonylureas-treated diabetic patients and their correlations with glycemic control, risk factors and duration of the disease. <b>Methods</b>: This study included 200 patients that presented to \"Providența\" Medical Center, Iași. The information was obtained in a retrospective manner based on the observation sheets of the patients. A database was created, analyzed and statistically processed using the <i>Microsoft Excel software</i> (Version 15) and the <i>chi-square test of independence</i>. <b>Results</b>: The prevalence of diabetic polyneuropathy was 33.5%, while diabetic retinopathy was found in 27% of cases. For diabetic polyneuropathy, the results of the statistical analysis demonstrated a statistically significant dependence of the risk factors hyperlipidemia (significance level = 0.01) and overweight/obesity (significance level = 0.05). For diabetic retinopathy, the results demonstrated a statistically significant dependence of the risk factors hypertension (significance level = 0.05) and hyperlipidemia (significance level = 0.01). <b>Conclusions</b>: The present study reveals a strong correlation between the presence of risk factors and the development of microvascular complications of diabetes.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11764216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebrovascular Accidents After Orthotopic Liver Transplantation in Patients with Hepatopulmonary Syndrome: A Case Series.","authors":"Steffi K Chan, Manuel M Buitrago Blanco, Nicholas J Feduska, Vatche G Agopian, Samer S Ebaid, Tisha Wang, Ami Tamhaney, Igor Barjaktarevic","doi":"10.3390/clinpract15010005","DOIUrl":"10.3390/clinpract15010005","url":null,"abstract":"<p><p><b>Background:</b> Hepatopulmonary syndrome (HPS), defined by the presence of pulmonary vascular dilatations that cause right-to-left transpulmonary shunting of venous blood with a consequential increase in the alveolar-arterial oxygen gradient, is a relatively frequent complication of chronic liver disease. While orthotopic liver transplantation (OLT) is indicated and often curative in HPS patients with end-stage liver disease (ESLD), little is known about the peri- and post-operative-period risks of CVA in OLT recipients with HPS. <b>Case Presentation</b>: We report a case series of five non-consecutive OLT recipients with HPS who developed ischemic and/or hemorrhagic CVAs during or shortly after OLT, raising concern that the risks of neurological complications remain increased even after OLT. <b>Conclusions:</b> Our case series hopes to highlight the importance of close vigilance in this subset of patients, at a time when there may be multiple issues to be addressed in facilitating post-operative recovery.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11764223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic Resonance Imaging Techniques for Post-Treatment Evaluation After External Beam Radiation Therapy of Prostate Cancer: Narrative Review.","authors":"Eleni Bekou, Admir Mulita, Ioannis Seimenis, Athanasia Kotini, Nikolaos Courcoutsakis, Michael I Koukourakis, Francesk Mulita, Efstratios Karavasilis","doi":"10.3390/clinpract15010004","DOIUrl":"10.3390/clinpract15010004","url":null,"abstract":"<p><p><b>Background/Objectives</b>: This study aimed to investigate the prognostic value of advanced techniques of magnetic resonance imaging (MRI) biochemical recurrence (BCR) after radiotherapy in patients with prostate cancer (PCa). <b>Methods</b>: A comprehensive literature review was conducted to evaluate the role of MRI in detecting BCR of PCa patients after external beam radiation therapy. <b>Results</b>: National guidelines do not recommend imaging techniques in clinical follow-up PCa. However, in 2021, the European Association of Urogenital Radiology (ESUR), the European Association of Urological Imaging (ESUI), and the PI-RADS Steering Committee introduced the Prostate Imaging for Recurrence Reporting (PI-RR) system. PI-RR incorporates the MRI biomarkers in the post-treatment process. In the last decade, a growing number of clinical researchers have investigated the role of various MRI techniques in BCR. <b>Conclusions</b>: The integration of advanced MRI technologies into clinical routine marks the beginning of a new era of BCR with accuracy.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative Damage Assessment of Endodontic Instruments Based on Digital Image Stacking.","authors":"Raúl Argüello-Sánchez, Ivette Alejandra Calderón-Alday, Antonio Hernández-Morales, Benjamín Gonzalo Rodríguez-Méndez, Diego Medina-Castro, Régulo López-Callejas, Carlo Eduardo Medina-Solís","doi":"10.3390/clinpract15010003","DOIUrl":"10.3390/clinpract15010003","url":null,"abstract":"<p><strong>Background/objectives: </strong>The damage assessment of dental instruments, such as endodontic files, is crucial to ensure patient safety and treatment quality. Conventional scanning electron microscopy (SEM) has been the gold standard for this purpose; however, its limited accessibility and complex sample preparation protocols hinder its routine use in clinical settings. This study proposes a novel system that leverages digital photography and advanced image processing techniques as a viable alternative to SEM.</p><p><strong>Methods: </strong>Our system accurately detects early instrument damage by capitalizing on the high resolution of digital images. Its exceptionally user-friendly interface, portability, and key features make it highly suitable for daily clinical practice.</p><p><strong>Results: </strong>Our findings suggest that the proposed system provides image quality comparable to SEM.</p><p><strong>Conclusions: </strong>Image stacking provides a practical, efficient, and objective method for assessing endodontic instruments' morphology. By detecting early damage, this system significantly improves the safety and quality of endodontic procedures, especially for reusable NiTi files, instilling confidence and security in its use. It offers a cost-effective and user-friendly alternative to traditional methods such as visual inspection and SEM, making it a comfortable and confident choice for both research and clinical settings.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}