Clinics and Practice最新文献

{"title":"Cariogenic Risk Modifies the Effect of Marginal Adaptation on Caries Adjacent to Posterior Composite Restorations: A Stratified Multivariate Analysis.","authors":"Andrei Georgescu, Sorin Andrian, Cristina-Angela Ghiorghe, Galina Pancu, Claudiu Topoliceanu, Ionuţ Tărăboanţă, Irina Nica, Răzvan Brânzan, Cristina Dascălu, Maria-Alexandra Mârţu, Mihaela Sălceanu","doi":"10.3390/clinpract16090163","DOIUrl":"10.3390/clinpract16090163","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Caries adjacent to restorations or sealants (CARS) is among the most frequent biological causes of composite restoration failure, resulting from the interplay between the patient's cariogenic risk and restoration-related factors such as marginal adaptation. The study aimed to investigate whether cariogenic risk modifies the effect of marginal adaptation on the occurrence of caries adjacent to posterior composite restorations (CARS), using risk-stratified univariate analysis and a clustering-adjusted approach, to identify associated clinical, socio-demographic, and local risk factors. <b>Methods:</b> This retrospective cross-sectional study evaluated 453 posterior direct composite resin restorations (Class I, Class II) in 88 patients at the Faculty of Dental Medicine, \"Grigore T. Popa\" University, Iași, Romania. CARS and marginal adaptation were assessed using FDI Criteria. Patients were classified as high or low cariogenic risk using a multifactorial institutional protocol. Univariate analysis and Generalized Estimating Equations (GEE) accounting for within-patient clustering were performed. <b>Results:</b> CARS prevalence was 27.9% in high cariogenic risk patients versus 3.15% in low cariogenic risk patients. Univariate analysis identified high cariogenic risk (OR = 11.904), deficient marginal adaptation (OR = 25.929-69.475), restoration age of 3-5 years (OR = 3.045), and Class II configuration (OR = 2.597) as significant risk factors. GEE analysis, adjusted for clustering of restorations within patients, confirmed high cariogenic risk (OR = 12.597) and deficient marginal adaptation (OR = 121.320) as independent correlates of CARS. A significant interaction between the two (<i>p</i> < 0.001) showed that marginal adaptation remained the dominant local risk factor in low cariogenic risk patients, while its association with CARS was largely attenuated in high-risk patients. <b>Conclusions:</b> GEE analysis confirmed high cariogenic risk and deficient marginal adaptation as independent correlates of CARS, with marginal adaptation acting as the dominant local risk factor only in low-risk patients.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 9","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041374","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":"Stable-Phase Peyronie's Disease: Have Perilesional Injections of Hyaluronic Acid Come of Age?","authors":"Tommaso Cai, Daniele Tiscione, Marco Puglisi, Daniele Mattevi, Simone Botti, Tommaso Ceccato, Truls Erik Bjerklund Johansen","doi":"10.3390/clinpract16090162","DOIUrl":"10.3390/clinpract16090162","url":null,"abstract":"<p><p><b>Background</b>: Peyronie's Disease (PD) is a complex andrological condition that severely compromises patients' quality of life. While a novel formulation of hyaluronic acid (HA) has recently gained traction for treating the acute inflammatory phase, clinical evidence regarding its role in stable-phase (chronic) PD is lacking. We aimed to assess the therapeutic outcomes and safety profile of Perovial^®, a specialized HA formulation, in patients with stable disease. <b>Methods</b>: A cohort of 47 patients with stable-phase PD was treated at a single andrological center between June and December 2025. The treatment protocol consisted of eight weekly injections targeted around the tunica albuginea plaque. Clinical efficacy was assessed 3 months post-treatment by comparing baseline data with the following outcome measures: change in penile curvature (Δ°), the international index of erectile function (IIEF-5) score, Peyronie's Disease Questionnaire (PDQ) and Global Assessment of Peyronie's Disease (GAPD). <b>Results</b>: At the 3-month follow-up visit, a statistically significant improvement in penile curvature was registered in 35 out of 47 patients (Δ° - 16) (<i>p</i> < 0.001). All patients had a significant improvement from baseline in terms of IIEF (20 vs. 24; <i>p</i> < 0.001) and in all PDQ domains. No major adverse events or complications were observed during the study period. At the GAPD questionnaire, 43 patients (91.2%) reported subjective improvement of penile curvature. <b>Conclusions</b>: Perilesional injection of Perovial^® seems a promising intervention in patients with stable-phase PD in terms of penile curvature reduction and patient-reported quality of life improvement.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 9","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041174","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":"Clinical Relevance of Calcifications in Osteosarcoma Lung Metastases: Correlations Among Radiological Patterns, Histological Subtypes, and Chemotherapy Responses.","authors":"Paolo Spinnato, Mario Simonetti, Maria Carpenzano, Gabriele Bilancia, Nicola Marrone, Annamaria Chiesa, Maddalena Di Carlo, Emanuela Palmerini, Luca Cevolani, Marco Colangeli, Marco Gambarotti, Alberto Righi, Alessandra Longhi","doi":"10.3390/clinpract16090161","DOIUrl":"10.3390/clinpract16090161","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Osteosarcoma is a rare malignancy and the most common primary malignant bone tumor. Metastases commonly affect the lungs and are associated with reduced life expectancy. Calcifications can be present within a metastatic nodule at baseline or can appear during follow-up. We aimed to assess the clinical significance of calcifications in lung metastases, particularly in relation to radiological pattern, histopathological subtype, and treatment response. <b>Methods:</b> A retrospective cohort of patients with osteosarcoma and lung metastases at diagnosis was evaluated for the period 2000-2018. The presence of calcifications inside pulmonary lesions on baseline lung CT and/or follow-up was assessed and recorded. Radiological data were then checked against histopathological data (i.e., osteosarcoma subtypes and chemotherapy response with necrosis percentage) and the radiological pattern of the primary tumor (i.e., osteolytic, sclerotic, or mixed pattern). <b>Results:</b> Of a cohort of 92 patients, 14 were excluded due to having no baseline or follow-up chest CT. Of the 78 patients with an osteosarcoma diagnosis, lung metastases at diagnosis, and chest CT who were enrolled (42 men and 36 women; mean age: 23.8 years [range, 6-73 years]), 70 (89.7%) had a baseline imaging study of the primary tumor (osteosarcoma). The presence of calcifications in lung metastases at both baseline and follow-up was significantly associated with the radiological pattern of the primary lesion (<i>p</i> < 0.0001). Calcifications were not present in the lung metastases of any of the 18 patients (0%) with a lytic radiological pattern at any stage, whereas all 32 patients (100%) with a purely sclerotic pattern had calcifications within lung metastases at baseline or during follow-up; of the 20 patients with a mixed radiological pattern, 11 (55%) had no calcifications and 9 (45.0%) had detectable calcifications. No statistically significant association was found between histopathological subtype and calcification. Osteoblastic osteosarcoma was more frequently associated with calcification (66.0%). During induction chemotherapy, five poor responders and three good responders (necrosis > 90%) developed calcifications (<i>p</i> = 0.72; OR = 0.67; 95% CI, 0.10-3.86). <b>Conclusions:</b> In patients with osteosarcoma, calcifications within pulmonary metastases are strongly associated with the radiological pattern of the primary tumor, and this association is greatest for a pure sclerotic pattern, followed by the mixed one. We found no statistically significant association between the occurrence of calcifications during follow-up and chemotherapy response measured by necrosis percentage of the surgical specimen in our limited cohort; further research is needed.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 9","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041095","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":"Scientific Clinical Trial Publication Productivity in Medical Oncology: A Comparative Analysis and Data Review of Northern and Southern Italy.","authors":"Vittorio Gebbia, Sergio Rizzo, Dario Piazza, Daniela Sambataro, Giuseppa Scandurra, Maria Rosaria Valerio","doi":"10.3390/clinpract16090159","DOIUrl":"10.3390/clinpract16090159","url":null,"abstract":"<p><p><b>Background:</b> Italy exhibits a socioeconomic divide between its northern and southern regions, which extends into healthcare delivery and biomedical research. Medical oncology is particularly affected by this structural imbalance. This paper examines geographic disparities in clinical trial scientific publication output, citation impact, research funding, and collaboration networks in medical oncology between northern and southern Italy. <b>Methods:</b> A narrative bibliometric analysis was conducted using data from PubMed and other institutional databases of Italian Scientific Institutes for Hospitalization and Care. Data from the Italian National Agency for the Evaluation of Universities and Research Institutes, the Alliance Against Cancer, and the Italian Association for Cancer Research were also reviewed. Regional output was compared across two macro-areas, namely north and south Italy. <b>Results:</b> Northern Italian institutions account for a disproportionate share of publications, high-impact citations, and funded research projects. Northern Italy produces an estimated four to six times more medical oncology papers than southern Italy, driven by a higher concentration of cancer institutes, better-funded university hospitals, and stronger multidisciplinary infrastructure than in the south. Clinical trial density is highest in the north compared to the south (0.53 versus 0.02 per 100,000 inhabitants). <b>Conclusions:</b> The north-south divide in Italian oncology research productivity is real, multi-factorial, and persistent. The analysis reveals a substantial gap in research productivity, institutional capacity, and access to clinical trials between the two macro-regions. Targeted policy interventions, including decentralized trial models, dedicated funding streams for southern institutions, and stronger infrastructure for inter-regional collaboration, are urgently needed to ensure representativeness in oncology evidence generation and equitable scientific progress.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 9","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041222","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":"Neurobiological Effects of Non-Invasive Behavioural Management Strategies in Paediatric Dentistry: A Scoping Review.","authors":"Love Bukola Ayamolowo, Idayat Adetoun Raji, Bukola Abimbola Adesoji, Dorcas Oluwatola Adelakun, Moréniké Oluwátóyìn Foláyan","doi":"10.3390/clinpract16090160","DOIUrl":"10.3390/clinpract16090160","url":null,"abstract":"<p><p>Behavioural management strategies used in paediatric dentistry have neurobiological effects. This scoping review aimed to map the existing literature on the neurobiological effects of non-invasive behavioural management strategies used in paediatric dentistry. The study protocol was registered on the Open Science Framework (registration number: OSF.IO/9EZVT). A search was conducted on PubMed, Web of Science, Scopus, Google Scholar, and African Journals Online (AJOL) for studies published up to May 2025. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Studies were included if they assessed non-invasive behavioural strategies in children aged 0-17 years undergoing dental procedures and reported at least one neurobiological or physiological outcome. The data were summarised descriptively, and key findings were thematically synthesised to identify trends in behavioural strategy types and neurobiological outcomes measured. Out of 1720 records retrieved, 35 studies met the inclusion criteria. These included randomised and non-randomised controlled trials and observational studies conducted in 13 countries on five continents involving 2919 children. The behaviour management strategies identified were 18 in number, with distraction (<i>n</i> = 19) and tell-show-do (<i>n</i> = 17) being the most frequently applied. The neurobiological outcomes assessed included anxiety (<i>n</i> = 36), pain perception (<i>n</i> = 8), fear (<i>n</i> = 7), and stress response (<i>n</i> = 1). Their physiological regulation was assessed using heart rate (<i>n</i> = 26), oxygen saturation (<i>n</i> = 10), blood pressure (<i>n</i> = 8), pulse rate (<i>n</i> = 6), cortisol (<i>n</i> = 4), respiratory rate (<i>n</i> = 1), and oxytocin (<i>n</i> = 1). Behavioural assessment tools used were classified into Child-Reported Anxiety and Fear Instruments (<i>n</i> = 23), Pain Perception Instruments (<i>n</i> = 9), Clinician/Observer-Rated Behavioural and Anxiety Scales (<i>n</i> = 18), and Parental and Proxy Reports (<i>n</i> = 2). This review underscores the emerging evidence that non-invasive behavioural strategies may be linked to neurobiology in paediatric dentistry. More studies are needed in new countries to be able to map the possible impact of context and culture on study findings.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 9","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041112","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":"Clinical Characteristics, Treatment Patterns, and Survival Outcomes of Right-Sided RAS/RAF Wild-Type Metastatic Colorectal Cancer: A Real-World Multicenter Cohort Study.","authors":"Nur Deniz Yildiz, Çağatay Arslan, İlker Nihat Okten, Umut Kefeli, Mahmut Emre Yildirim, Nuri Karadurmus, Tuba Baydas, Bülent Karabulut, Irfan Cicin, Cemil Bilir, Melike Ozcelik, Timucin Cil, Sinemis Celik, Oktay Bozkurt, Hakan Harputluoglu, Bala Başak Oven, Mehmet Artaç, Hacı Mehmet Türk, Ahmet Alacacıoğlu, Mahmut Gumus, Şuayib Yalcin","doi":"10.3390/clinpract16090158","DOIUrl":"10.3390/clinpract16090158","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background&lt;/b&gt;: Right-sided metastatic colon cancer represents a clinically distinct subgroup with inferior outcomes and uncertain optimal biologic treatment selection, even among patients with RAS wild-type disease. Real-world data focusing specifically on right-sided RAS wild-type metastatic colon cancer remain limited. This study aimed to describe clinicopathologic characteristics, metastatic patterns, treatment approaches, and survival outcomes in this population using a national multicenter registry. &lt;b&gt;Methods&lt;/b&gt;: This retrospective multicenter cohort study was conducted using data from the ONKO-KOLON Türkiye registry. Patients with pathologically confirmed KRAS/NRAS wild-type metastatic colorectal cancer and available primary tumor localization were evaluated. The main analytic cohort included patients with right-sided metastatic colon cancer, defined as right colon or transverse colon tumors. Left-sided colon cancer patients were used as a contextual comparator, while rectal cancer patients were excluded from sidedness-based colon comparisons. Survival outcomes were estimated using the Kaplan-Meier method, and prognostic factors were evaluated using Cox regression analyses. &lt;b&gt;Results&lt;/b&gt;: Among 1079 patients in the source cohort, primary tumor localization was available in 1065 patients. Of these, 213 had right-sided colon cancer, 464 had left-sided colon cancer, and 388 had rectal cancer. In the right-sided cohort, median age was 61.5 years, 64.3% were male, and 66.7% had synchronous/de novo metastatic disease. Liver metastasis was the most common metastatic site (63.4%), followed by lymph node (31.0%), lung (21.1%), and peritoneal metastases (15.5%). First-line anti-VEGF-based treatment was used in 46.0% of patients, while anti-EGFR-based treatment was used in 40.8%. Among evaluable patients, the objective response rate was 46.8% and the disease control rate was 79.2%. Median progression-free survival was 10.0 months, and median overall survival was 24.0 months. In unadjusted exploratory analysis, median OS was 27.0 months with anti-EGFR-based treatment and 17.0 months with anti-VEGF-based treatment (log-rank &lt;i&gt;p&lt;/i&gt; = 0.022), whereas median PFS was 10.0 months in both groups. In an extended covariate-adjusted multiple-imputation sensitivity model, the anti-EGFR OS estimate did not meet statistical significance (adjusted HR 0.66, 95% CI 0.43-1.00; &lt;i&gt;p&lt;/i&gt; = 0.051). In a secondary contextual comparison, median overall survival was shorter in the right-sided than in the left-sided colon cancer group (24.0 vs. 28.0 months; HR 1.47, 95% CI 1.19-1.82; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), whereas progression-free survival did not differ significantly. &lt;b&gt;Conclusions&lt;/b&gt;: This study provides a descriptive account of metastatic patterns, treatment approaches, and outcomes in a dedicated right-sided RAS wild-type metastatic colon cancer cohort. The unadjusted OS difference between biological treatment groups was not confirmed after measured covariate","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 9","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040669","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":"Exploring the Role of Resistance Training in the Prevention and Management of Chronic Conditions: A Narrative Review.","authors":"Anu M Räisänen","doi":"10.3390/clinpract16080157","DOIUrl":"10.3390/clinpract16080157","url":null,"abstract":"<p><p>Physical activity is widely recognized as a fundamental component of health promotion and chronic disease prevention. Historically the focus has primarily been on aerobic exercise, while resistance training has received comparatively less attention. This imbalance underestimates the critical role of muscular performance in supporting physical health, functional capacity, long-term mobility, and overall quality of life. Current physical activity guidelines for Americans recommend that adults engage regularly in both aerobic and muscle-strengthening activities. However, only approximately one-quarter of adults in the United States meet these recommendations, despite nearly half achieving recommended levels of aerobic activity alone. Although any form of physical activity can confer health benefits, participation in both aerobic exercise and muscle-strengthening, such as resistance training, produces more comprehensive and substantial health outcomes. As research on resistance training has evolved beyond its traditional focus on athletic performance, a growing body of evidence has demonstrated its effectiveness in the prevention and management of numerous chronic conditions. This narrative review summarizes the role of resistance training in the prevention and management of several prevalent lifestyle-related chronic conditions, including type 2 diabetes, obesity, hypertension, cardiovascular disease, dyslipidemia, and osteoporosis.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 8","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13510394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833276","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":"Threshold Validity of N3 Criteria in Nasopharyngeal Carcinoma: A Narrative Methodological Review of Pragmatic Cutoffs and Biologically Defensible Risk Boundaries.","authors":"Erkan Topkan, Efsun Somay, Melis Selek, Ugur Selek","doi":"10.3390/clinpract16080156","DOIUrl":"10.3390/clinpract16080156","url":null,"abstract":"<p><p>This narrative methodological review aims to critically assess whether current AJCC/UICC N3-defining criteria for nasopharyngeal carcinoma (NPC) represent validated biological and statistical thresholds or pragmatic staging boundaries. Specifically, it examines the evidential basis of the >6 cm nodal-size threshold, extension below the caudal border of the cricoid cartilage, and advanced radiologic extranodal extension (rENE), with emphasis on the distinction between prognostic-variable validity and threshold validity. The >6 cm criterion is a historically inherited threshold that predates contemporary MRI-based staging and may insufficiently capture the three-dimensional complexity of nodal tumor burden. Similarly, defining inferior nodal extension by the caudal border of the cricoid cartilage improves anatomical reproducibility compared with earlier lower-neck definitions, yet it remains a pragmatic imaging landmark rather than a validated biological boundary for lymphatic dissemination. By contrast, advanced rENE is more biologically informative because it reflects invasive tumor behavior; nonetheless, its staging utility depends on standardized imaging definitions, interobserver reliability, external validation, and incremental clinical utility. Emerging imaging-derived descriptors-including MRI-based nodal diameter, nodal volume, middle-neck involvement, total tumor volume, and integrated imaging-biological models-underscore the limitations of relying exclusively on single categorical thresholds. Future N3 refinement should move beyond substituting one cutoff for another by characterizing nodal descriptors in continuous, ordinal, volumetric, or severity-graded forms before adopting simplified categories. Future refinement of NPC nodal staging will likely require approaches that move beyond isolated anatomical thresholds and better account for the multidimensional nature of nodal disease, including tumor burden, spatial distribution, invasive characteristics, and biological risk.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 8","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833546","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":"Interventional Endoscopic Ultrasound in Gastroenterology: A Comprehensive Bibliometric Analysis (2001-2024).","authors":"Koji Takahashi, Noa Minami, Kohei Horie, Taiga Sudo, Nana Yamada, Terunao Iwanaga, Takafumi Sakuma, Hidehiro Kamezaki","doi":"10.3390/clinpract16080153","DOIUrl":"10.3390/clinpract16080153","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Interventional endoscopic ultrasound (I-EUS) has evolved from a diagnostic imaging modality into a transformative therapeutic platform encompassing biliary drainage, pancreatic interventions, luminal bypass, pain management, and ablative therapies. Despite the rapid proliferation of I-EUS research, a comprehensive bibliometric analysis characterizing the global intellectual architecture of this field is lacking. <b>Methods</b>: A Web of Science Core Collection search identified 4340 records, of which 2237 were included (2001-2024), analyzed with R bibliometrix (version 5.0) and VOSviewer (version 1.6.20). <b>Results</b>: Publication output demonstrated three distinct phases with pronounced acceleration from 2017. The United States led global output (<i>n</i> = 625, 27.9%), followed by Japan (<i>n</i> = 435, 19.4%) and Italy (<i>n</i> = 166, 7.42%). At the continental level, Asia collectively produced the largest share of output (<i>n</i> = 884, 39.5% of the total corpus), exceeding the Americas (<i>n</i> = 687, 30.7%) and Europe (<i>n</i> = 492, 22.0%). <i>Gastrointestinal Endoscopy</i> was the most productive journal (<i>n</i> = 173). Tokyo Medical University was the most productive institution (<i>n</i> = 93, 4.16%). Four thematic clusters were identified: EUS-guided biliary and pancreatic ductal drainage; diagnostic, ablative, and injection EUS for pancreatic tumors; LAMS-enabled luminal bypass and gallbladder drainage; and pancreatic fluid collections and necrotizing pancreatitis. Temporal overlay confirmed EUS-guided gastroenterostomy, EUS-guided gallbladder drainage, and EUS-guided radiofrequency ablation as the leading research frontiers. Annual output showed no discernible contraction during the COVID-19 pandemic period (2020-2021). <b>Conclusions</b>: The United States led global I-EUS research output with higher rates of international collaboration compared with East Asian nations, although Asia as a continent generated the largest aggregate volume of publications. EUS-guided biliary drainage and pancreatic fluid collection management constitute the established, high-volume core of the field, while EUS-guided gastroenterostomy and novel ablative technologies represent the most dynamic investigative frontiers.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 8","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833408","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":"Gross Total Resection and Recurrence-Free Survival in Diffuse Gliomas: A Single-Center Cohort Study from Eastern Europe.","authors":"Teodor Cristian Blidaru, Marius Cristian Zaharia, Dan Mitrea, Raluca Maria Marin, Natalia Blidaru, Manuela Ghica, Maria Sinziana Matei, Raluca Papacocea, Stefan Strilciuc, Dragos Nicolae Garofil","doi":"10.3390/clinpract16080155","DOIUrl":"10.3390/clinpract16080155","url":null,"abstract":"<p><p><b>Background/Objectives:</b> The independent contribution of extent of resection (EOR) to early recurrence in diffuse gliomas remains debated, as crude analyses are confounded by tumor biology, and real-world data from Eastern European centers are scarce. <b>Methods:</b> We retrospectively studied 283 consecutive adults with surgically treated diffuse gliomas (2021-2024) at a Romanian tertiary center. Primary endpoints were recurrence-free survival (RFS) at 1 and 2 years, evaluated as landmark endpoints; secondary endpoints were overall recurrence, reoperation, and reirradiation. Clinical, histopathological, surgical, imaging, and treatment variables were analyzed with complete-case Firth-penalized logistic regression. <b>Results:</b> Among evaluable patients, 70.6% (132/187) were recurrence-free at 1 year and 64.2% (120/187) at 2 years; overall recurrence occurred in 53.7% (139/259). After adjustment, gross total resection (GTR) was independently associated with higher odds of remaining recurrence-free at 1 year (OR 12.37, 95% CI 3.23-52.58; <i>p</i> < 0.001) and 2 years (OR 10.56; <i>p</i> < 0.001), as was subtotal resection (STR) at both time points (OR 4.15, 95% CI 1.17-16.16, <i>p</i> = 0.027; and OR 3.93, <i>p</i> = 0.027), versus partial resection/biopsy. <b>Conclusions:</b> EOR was independently associated with early RFS, supporting maximal safe resection as a primary surgical objective. The landmark endpoints were not evaluable in 96 of 283 patients, almost all of whom underwent biopsy or partial resection, so the odds ratios indicate the direction of the effect and not its precise magnitude. Overall recurrence, evaluable in 91.5% of the cohort, showed a concordant gradient. External validation is needed.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"16 8","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13510490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833365","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}