Maedica最新文献

{"title":"Medication Adherence and Its Determinants in Patients with Type 2 Diabetes Mellitus Attending an Internal Medicine Outpatient Department.","authors":"Olawale Omotayo Olatunji, Prashanth Kumar Patnaik, Vaishnavi Sathiya, Joshua Baidoo Otu-Ansah, Blessy Niharika Mede","doi":"10.26574/maedica.2026.21.1.42","DOIUrl":"https://doi.org/10.26574/maedica.2026.21.1.42","url":null,"abstract":"<p><strong>Background: </strong>Medication adherence remains a central element in achieving optimal glycemic control in type 2 diabetes mellitus. Many patients struggle to follow prescribed therapy, leading to early metabolic deterioration and a higher burden of complications. Understanding the factors that shape adherence in routine clinical settings can help guide targeted interventions.</p><p><strong>Materials and methods: </strong>A hospital-based observational study was conducted in the Internal Medicine Outpatient Department of the Dominica China Friendship Hospital, Dominica, between August 2024 and January 2025. Adults diagnosed with type 2 diabetes mellitus and on treatment for at least six months were eligible. A total of 420 patients were enrolled. Medication adherence was measured using the eight-item Morisky medication adherence scale (MMAS-8). Sociodemographic, clinical and behavioral characteristics were documented through structured interviews and medical records. Data were analyzed using chi-square tests to assess associations and multivariate logistic regression was applied to identify independent predictors of adherence.</p><p><strong>Results: </strong>Participants had a mean age of 54.6 ± 10.8 years, with males comprising 58.3% of the cohort. According to MMAS-8 scoring, 29.3% demonstrated high adherence, 41.9% moderate adherence and 28.8% low adherence (mean score 6.21 ± 1.54). Forgetfulness, discontinuation of therapy after symptomatic improvement and financial constraints were the most commonly reported barriers. On multivariable analysis, higher education, simplified drug regimen, regular follow-up and good glycemic control emerged as independent predictors of good adherence. Participants with high adherence exhibited significantly lower mean HbA1c levels compared with poorly adherent individuals (6.8 ± 0.9% vs 8.3 ± 1.1%, p < 0.001).</p><p><strong>Conclusion: </strong>Medication adherence was suboptimal in a substantial proportion of adults with type 2 diabetes mellitus. Interventions that strengthen diabetes education, reduce regimen complexity and promote structured follow-up may improve adherence and support better glycemic control.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"21 1","pages":"42-47"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679080","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":"Hearing Loss in Systemic Lupus Erythematosus: a Systematic Review.","authors":"Yara Hanna, Mohamad Tlais, Dania Natour, Yara Mazraani, Nazih Obeid, Georges Sarraf, Issa Zalzali, Yaghi Moghnie, Thea Harouny, Hussein Chebbo, Hadi Farhat","doi":"10.26574/maedica.2026.21.1.190","DOIUrl":"https://doi.org/10.26574/maedica.2026.21.1.190","url":null,"abstract":"<p><strong>Background: </strong>Hearing loss is an underrecognized manifestation of systemic lupus erythematosus (SLE). Proposed mechanisms include autoimmune inner ear injury, vascular occlusion related to antiphospholipid syndrome (APS) and ototoxicity from medications such as hydroxychloroquine (HCQ). Although multiple case reports and observational studies have described this complication, the overall burden and clinical significance remain unclear.</p><p><strong>Methods: </strong>A systematic review of PubMed, Embase, Web of Science, Scopus and the Cochrane Library was conducted up to September 2025, following PRISMA guidelines. Eligible studies included cohort, case-control, cross-sectional studies, case series, case reports and temporal bone analyses reporting auditory outcomes in SLE patients. Data on prevalence, clinical presentation, pathophysiology and management were extracted. Risk of bias was assessed using validated tools appropriate to each study design.</p><p><strong>Results: </strong>The search identified 236 records; after removal of duplicates and screening, 10 studies were included. These comprised case reports, small series, histopathology and larger observational studies. Reported prevalence of sensorineural hearing loss in SLE ranged from ~27% in pooled analyses to ~55-56% when extended high-frequency audiometry was used. Pathological studies demonstrated vasculitis, stria vascularis atrophy and hair cell loss in SLE patients. Case-based evidence consistently linked sudden hearing loss to antiphospholipid antibodies, supporting a vascular occlusive mechanism. Hydroxychloroquine ototoxicity was described in isolated cases, often reversible after discontinuation, but not consistently supported in larger studies.</p><p><strong>Conclusion: </strong>Hearing loss in SLE is more prevalent than in the general population and arises through multifactorial mechanisms. Early recognition and tailored management, including corticosteroids for autoimmune-mediated cases, anticoagulation for APS and discontinuation of suspected ototoxic drugs, may improve outcomes. Routine audiological monitoring should be considered to reduce the risk of irreversible disability in this patient population.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"21 1","pages":"190-197"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679134","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":"Therapeutic Implication of Hyaluronic Acid Gel Following Impacted Mandibular Third Molar Surgery: an Observational Study.","authors":"Varsha Achuthan, Roshni Abidha, Sachin Aslam A, Jhancy Rani Tv, Sruthy P S, Vaishnav Vidhyadahran","doi":"10.26574/maedica.2026.21.1.81","DOIUrl":"https://doi.org/10.26574/maedica.2026.21.1.81","url":null,"abstract":"<p><strong>Introduction: </strong>This study sought to assess the effectiveness of intraoral hyaluronic acid (HA) gel in alleviating postoperative pain, oedema and trismus after mandibular third molar surgery, and its capacity to reduce the need for non-steroidal anti-inflammatory drugs (NSAIDs).</p><p><strong>Materials and methods: </strong>This split-mouth study included 33 healthy patients aged 18 to 45 years with bilaterally impacted mandibular third molars who came to the Department of Oral and Maxillofacial Surgery, MES Dental College, Perinthalmanna, India, between November 2023 and March 2025. In the experimental procedure, 0.2% HA gel was applied to the extraction socket, while the control side did not receive any HA gel after surgical extraction. Postoperative evaluations of pain, oedema and trismus were documented on days 3 and 7 for both groups.</p><p><strong>Results: </strong>The use of HA markedly decreased pain perception during the initial postoperative period. However, trismus and the degree of oedema did not differ statistically significantly between the experimental and control groups.</p><p><strong>Conclusion: </strong>The intraoral application of HA gel after mandibular third molar surgery demonstrated analgesic effects and reduced the need for NSAID use.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"21 1","pages":"81-88"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679215","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":"Complex Features of Tumor-Infiltrating Lymphocytes (TILs) and Stromal Response After Neoadjuvant Breast Chemotherapy.","authors":"Dana Tapoi, Bogdan Adrian Carabas, Mariana Costache","doi":"10.26574/maedica.2026.21.1.97","DOIUrl":"https://doi.org/10.26574/maedica.2026.21.1.97","url":null,"abstract":"<p><p>Neoadjuvant chemotherapy (NAC) has become a cornerstone in the management of early-stage breast cancer, offering the dual benefits of downstaging tumors to facilitate surgical resection and providing an in vivo assessment of treatment sensitivity (1-3). The tumor microenvironment (TME), comprising a complex network of stromal cells, immune cells and extracellular matrix, plays a pivotal role in modulating therapeutic response (4-6). Within this ecosystem, tumor-infiltrating lymphocytes (TILs) have emerged as a robust biomarker, while stromal response to therapy - characterized by fibrosis, hyalinization and elastosis - reflects host tissue remodeling and may modulate immune function (1, 7-9) along the stromal response to therapy, characterized by features such as fibrosis, hyalinization and elastosis, reflects the host's tissue remodeling processes and may influence immune cell function and tumor behavior (10-13). This study investigates the dynamic interplay between TILs and stromal features in breast cancer following NAC, aiming to elucidate their combined prognostic and predictive significance (9, 14, 15).</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"21 1","pages":"97-106"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679276","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":"Validity of a Questionnaire Assessing Preparedness and Self-Reported Confidence of Lebanese Emergency Department Personnel in Managing Ophthalmic Emergencies and Mass Ocular Trauma.","authors":"Anthony Daher, Nour Jabbour, Maamoun Abdul Fattah, Yehya Tlaiss, Rayan Itaoui, Bachir Abiad","doi":"10.26574/maedica.2026.21.1.129","DOIUrl":"https://doi.org/10.26574/maedica.2026.21.1.129","url":null,"abstract":"<p><strong>Background: </strong>Ophthalmic emergencies constitute a significant portion of emergency department (ED) visits; yet, many non-ophthalmologists report feeling underprepared for their management. In Lebanon, mass-casualty events like the 2020 Beirut Port Blast have further highlighted the critical need for structured assessment of personnel preparedness in managing ocular trauma. This study aimed to evaluate the validity and reliability of a novel questionnaire designed to measure the self-reported preparedness and confidence of ED personnel and first responders in managing acute ocular emergencies.</p><p><strong>Methods: </strong>A cross-sectional validation study was conducted among 431 Lebanese ED healthcare providers and first-line responders, primarily paramedics (69.6%). The 10-item Likert scale instrument underwent expert review for content validity. Psychometric evaluation included internal consistency reliability (Cronbach's α and McDonald's ω) and construct validity via exploratory factor analysis (EFA).</p><p><strong>Results: </strong>The instrument demonstrated high internal consistency (Cronbach's α = 0.922; McDonald's = 0.924) and strong sampling adequacy (KMO = 0.910). EFA supported a clinically interpretable two-factor structure: \"Trauma-Specific Stabilization and Escalation Confidence\" and \"General Emergency Preparedness in Ophthalmology\". Participants reported the lowest confidence in medication indications (mean = 2.53) and training adequacy (mean = 2.62).</p><p><strong>Conclusion: </strong>The questionnaire is a valid and reliable tool for assessing self-reported preparedness in ophthalmic emergency management. It can serve as a standardized benchmarking instrument to identify educational gaps and guide training interventions in high-throughput, resource-constrained acute care settings.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"21 1","pages":"129-136"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679318","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":"The Dual Burden: Long-Term Impact of COVID-19 on Tuberculosis Incidence - Presentation and Outcomes.","authors":"Vidya Ganji, Bhushan Kamble, Farzana Mustafa, Naveen Ravi, U Madhusudhan, G Archana, M Kalpana, Madhuri Taranikanti, Nitin Ashok John","doi":"10.26574/maedica.2026.21.1.198","DOIUrl":"10.26574/maedica.2026.21.1.198","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains a major public health concern globally ranking as the second leading infectious disease and the 13th leading cause of death worldwide. The global healthcare systems have experienced unprecedented challenges in recent years due to COVID-19 pandemic causing widespread disruptions. Delaying TB diagnosis and treatment led to lower reported incidence but could increase mortality, hindering efforts to eradicate TB. Although a few studies have focused on COVID-19 and TB cases to date, most of them are case reports. Since it is unclear whether patients with COVID-TB co-infection have a worse prognosis or more likely to develop severe disease, we believed that doing this study was a necessity. The present systematic review investigates the long-term effects of COVID-19 on TB incidence, reporting follow-up and treatment outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The present study aimed to explore the long-term impact of COVID-19 on TB incidence, presentation and outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted our systematic review following PRISMA (Preferred reporting in systematic reviews and meta-analysis) guidelines. We performed a comprehensive literature search of EMBASE, PubMed, Scopus, The Lancet, Web of Science and Cochrane Central Register of Controlled Trials. The search items included \"Corona virus disease 19\", \"impact of COVID-19\", \"SARS-CoV-2\", \"Tuberculosis\", \"TB and COVID-19 co-infection\", \"comorbidities\", \"prognosis\", \"incidence\", \"outcomes\" and \"risk factors\" for articles published between the 1st of January 2020 and the 31st of June 2024. Searches were limited to English language only. We included articles with primary outcomes including studies which reported TB incidence or notification rates, clinical presentation, treatment interruption or outcomes of TB due to COVID-19 and TB-COVID-19 co-infection. Cohort studies, case-control studies, cross-sectional studies and surveillance or registry-based studies were included.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Information regarding COVID-19 and TB was collected from the databases, and out of 1973 articles, 41 articles were included. COVID-19 has had a negative impact on TB control programs leading to decrease in reporting of TB cases. As per the global tuberculosis report by WHO 2025, there has been approximately one-third reduction in incidence rates with TB case notifications declining by 21% of TB cases notification in 2020 compared to 2019. The reports indicated that the number of people diagnosed with TB was 7.5 million in 2022 above the baseline of 7.1 million in 2019 and 5.8 million in 2020.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;COVID-19 has affected TB diagnosis and control, with a significant decline in TB case notifications leaving many undiagnosed cases, thereby reversing years of progress in TB control. The high-TB burden countries like India should tackle the havoc caused by the CO","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"21 1","pages":"198-206"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679210","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":"Patterns and Determinants of Maxillofacial Trauma in Manipur: Prevalence of Protective Gear Use and Influence of Alcohol Consumption.","authors":"Wahengbam Tulsidas Singh, Deepak Ningombam Singh, Khwairakpam Chaoton Singh, Sanasam Gulshan Singh, Potsangbam Aparna Devi, Wahengbam Malvika","doi":"10.26574/maedica.2026.21.1.89","DOIUrl":"https://doi.org/10.26574/maedica.2026.21.1.89","url":null,"abstract":"<p><p><b>Introduction:</b> Motor vehicle collisions, violence between individuals, falls, sports-related accidents and firearm injuries are frequent causes of maxillofacial trauma, which is a significant public health concern. Alcohol intoxication and a lack of use of protective gear are two factors that are known to raise the risk and complexity of these injuries. Despite its clinical and societal impact, region-specific data on the distribution of maxillofacial trauma by anatomical site and etiology in Manipur, India, remain limited. This observational investigation was conducted to determine the patterns of maxillofacial fractures in terms of anatomical location and causative factors, identify the prevalence of protective equipment usage and explore the relationship between alcohol consumption and the etiology, anatomical site and severity of facial injuries. <b>Methods:</b> A prospective observational study was conducted over a two-month period at tertiary care hospitals in Manipur, enrolling 44 patients with radiographically confirmed maxillofacial trauma. Data on demographic characteristics, clinical presentation and imaging findings were systematically collected. The severity of facial injuries was assessed using the AIS-90 facial injury scale. Association between alcohol intoxication and various injury parameters were analyzed using the Chi-square test (p value < 0.05). <b>Results:</b> Males constituted the predominant proportion of patients (84.1%), with a mean age of 31.1 years. Fractures of the mandible were most common (50%), followed by dentoalveolar (15.9%) and midfacial fractures (11.4%). Road traffic accidents (RTAs) were the predominant cause (61.4%), followed by assault (13.6%) and accidental falls (9.1%). Only 2.3% of patients reported using protective gear at the time of injury. Alcohol intoxication was observed in 40.9% of cases and was significantly associated with RTAs (p value <0.05), fracture site (p value < 0.005) and severity (p value < 0.05). <b>Conclusion:</b> Motor vehicle collisions were identified as the leading cause of maxillofacial injuries, with alcohol intoxication and inadequate use of protective equipment markedly increasing both the risk and severity of trauma. Enforcement of helmet and seatbelt regulations, public awareness on alcohol-related risks and promotion of protective gear use are essential to reduce maxillofacial injuries in the region.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"21 1","pages":"89-96"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679115","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":"The Impact of Lifestyle and Physical Activity on Self-Reported Bruxism Symptoms in Young Adults.","authors":"Iulia-Karla Nica, Alexandru-Titus Farcasiu, Marina Imre","doi":"10.26574/maedica.2026.21.1.57","DOIUrl":"https://doi.org/10.26574/maedica.2026.21.1.57","url":null,"abstract":"<p><strong>Objectives: </strong>Bruxism is an oral habit that sums symptoms like tooth clenching, grinding and jaw contractions. This study aimed to evaluate self-assessment bruxism among dental students.</p><p><strong>Material and methods: </strong>A questionnaire assessing the perception of bruxism symptoms was administered to a cohort of students (n=301) from \"Carol Davila\" University of Medicine and Pharmacy, Bucharest, Romania. Data regarding demographics, lifestyle and current symptoms were collected.</p><p><strong>Results: </strong>Statistically significant associations between sedentary behavior (lack of sport participation) and bruxism symptoms were found. Participants who did not practice a sport were more likely to report sleep grinding (36.1% vs. 24.5%, p=0.041), increased tooth wear (21.5% vs. 10.9%, p=0.027) and clenching upon waking (31.4% vs. 20.9%, p=0.049). Conversely, those who reported never clenching during stressful situations were more likely to be physically active (43.6% vs. 25.1%, p=0.009). Similarly, absence of clenching during tense moments was associated with sports participation (47.3% vs. 27.7%, p=0.005).</p><p><strong>Conclusion: </strong>Psychosocial factors and lifestyle significantly impact the presence of bruxism symptoms. The results of the present study suggest that physical activity may reduce the risk of bruxism-associated symptoms. However, correlating perceived symptoms with objective clinical assessment remains necessary.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"21 1","pages":"57-63"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679235","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":"AI-Based Detection of Periapical Lesions in Endodontic Radiographs: a Diagnostic Accuracy Study.","authors":"Jasmine Marwaha, Ataul Hafeez Imran, Ronak N Patel, Mohammed Mustafa, Ashtha Arya, Arindam Banik","doi":"10.26574/maedica.2026.21.1.64","DOIUrl":"https://doi.org/10.26574/maedica.2026.21.1.64","url":null,"abstract":"<p><strong>Background: </strong>Periapical lesions pose a serious diagnosis problem in endodontics and there is high inter-observer variability in the conventional interpretation of radiographs. It has a solution in artificial intelligence (AI) technologies, which will improve the accuracy and consistency of diagnosis. This paper set out to determine the diagnostic accuracy of an AI system based on deep learning in identifying periapical lesions in endodontic radiographs as compared to clinical assessment and histopathological confirmation by an expert.</p><p><strong>Methods: </strong>A retrospective diagnostic accuracy study on 1,247 periapical radiographs of patients who had endodontic treatment or periapical surgery with histopathological verification was done. The architecture of a convolutional neural network (CNN) with EfficientNetB4 was trained using 80% of the dataset, where 10% was to be used as a validation and 10% as a test set. The diagnostic performance was assessed against the histopathological findings as the reference standard. The same radiographs were independently evaluated by three experienced endodontists. Sensitivity and specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) as well as area under the receiver operating characteristic curve (AUC-ROC) were determined.</p><p><strong>Results: </strong>The AI model had a total accuracy of 91.2 [standard deviation (SD) 1.7], a sensitivity of 93.4 (SD 1.5) and a specificity of 88.6 (SD 2.1). Endodontists had an average of 78.6 ± 4.3, which was highly lesser than the AI model (p <0.001). Agreement among clinicians (between different observers) was moderate (0.612). The AI model was superior in all categories of lesion sizes, showing significant improvement in cases of small lesions (less than 3 mm), with an accuracy of 87.8 compared to that of clinicians (64.2) (p<0.001).</p><p><strong>Conclusion: </strong>The model of AI built has shown better accuracy in detection of periapical lesions when compared with expert clinical assessment, especially when small lesions were involved. Such AI-based diagnostic tools may be important in facilitating endodontic diagnosis and treatment planning.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"21 1","pages":"64-72"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679350","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":"Parallel Configuration of the Cystic and Common Hepatic Ducts: a Surgical Odyssey.","authors":"Gerasimia D Kyrochristou, Dimitrios Kyrochristos, Michail Siokas, Vasileios Gkouvas, Konstantinos Vlachos, Georgios D Lianos","doi":"10.26574/maedica.2026.21.1.218","DOIUrl":"https://doi.org/10.26574/maedica.2026.21.1.218","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic cholecystectomy is among the most frequently performed surgical procedures worldwide; however, it carries a persistent risk of iatrogenic bile duct injury, particularly in the presence of anatomical variations. Misinterpretation of biliary anatomy remains a leading cause of serious complications, underscoring the importance of recognizing rare variants and adopting safe surgical strategies.</p><p><strong>Case report: </strong>We report the case of a 78-year-old patient undergoing elective laparoscopic cholecystectomy for recurrent cholecystitis and cholangitis. Given the history of repeated inflammatory episodes, dense adhesions and intraoperative technical difficulties were anticipated. Intraoperatively, dense adhesions and a contracted gallbladder were encountered. Indocyanine green fluorescence imaging revealed uncertain anatomical landmarks, demonstrating a rare parallel configuration of the cystic duct and common hepatic duct. Due to unsafe conditions, conversion to open surgery was performed, allowing safe ligation of the cystic duct. The postoperative course was uneventful.</p><p><strong>Conclusion: </strong>This case highlights the critical role of anatomical awareness, intraoperative vigilance and timely adoption of bailout strategies to ensure a safe cholecystectomy and prevent biliary injuries.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"21 1","pages":"218-221"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679100","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}