Conventional suturing in periodontal flap surgery may increase postoperative discomfort and requires additional visits for suture removal. Cyanoacrylate tissue adhesives and low-level laser therapy (LLLT) have individually shown benefits in wound healing and postoperative symptom reduction. This pilot randomized controlled trial evaluated the feasibility and preliminary clinical outcomes of a sutureless periodontal flap closure technique using cyanoacrylate adhesive with adjunctive LLLT compared with conventional suturing. This prospective, parallel-group pilot randomized controlled trial was conducted over a 4-month period from October 2025 to January 2026, in the Department of Periodontics, Kothiwal Dental College and Research Centre, Moradabad, India. 20 systemically healthy adults (mean age 31.9 ± 3.6 years; 55% males) with Stage II or III, Grade B periodontitis requiring flap surgery were randomly allocated (1:1) to conventional silk sutures (control, n = 10) or cyanoacrylate adhesive with LLLT (intervention, n = 10). The primary outcome was postoperative pain measured using a 100-mm visual analog scale. Secondary outcomes included wound healing index, analgesic consumption, plaque index, probing pocket depth (PPD), clinical attachment level (CAL), and patient treatment preference. Statistical analysis was performed using mixed-effects models and generalized linear mixed models, with independent t-test or Mann-Whitney U test for between-group comparisons. Statistical significance was set at p < 0.05, and 95% confidence intervals were calculated. All participants completed the study with 100% follow-up and no adverse events. Baseline demographic characteristics were comparable between groups (p > 0.05). The intervention group demonstrated significantly lower analgesic consumption (mean difference 2.30 tablets; 95% confidence interval 1.18-3.42; p = 0.001) and higher patient preference scores (mean difference 1.50 points; 95% confidence interval 0.83-2.17; p = 0.001). Postoperative pain scores were consistently lower and early wound healing scores were higher in the intervention group across follow-up visits (p < 0.05). Both groups showed significant reductions in probing pocket depth and clinical attachment level at 6 weeks (p < 0.05), with no statistically significant between-group differences over time (p > 0.05). Cyanoacrylate adhesive with adjunctive low-level laser therapy appears feasible and may improve early postoperative outcomes following periodontal flap surgery. Larger randomized trials are required to confirm these findings. The study was prospectively registered with the Clinical Trials Registry-India (CTRI/2025/09/095379) on September 24, 2025.

Uncomplicated urinary tract infections (UTIs) affect ∼50%-60% of women. Treatment failure can have adverse effects on antibiotic resistance, healthcare utilization and quality of life. The lack of consistently applied definitions of treatment failure prevents comparisons between studies of UTI treatments. We conducted a systematic literature review to investigate definitions of treatment failure in UTI and the corresponding failure rates. MEDLINE, Embase and CENTRAL databases were searched from 2011 to 2024 and relevant conference proceedings from 2021 to 2024 for English language studies reporting rates of treatment failure in females aged ≥12 years with uncomplicated UTI. Publications included reported 14 clinical trials, 11 non-interventional observational studies with chart review and 10 healthcare database studies. Treatment failure definitions were classified as microbiological, clinical, antibiotic prescription based or a composite of these. Evaluation timepoints typically ranged from 1 to 30 days post-treatment. In clinical trials, failure rates varied from 0.8% to 83%, often with marked differences between microbiological, clinical and prescription definitions within the same trial. Rates of treatment failure using combined endpoints, including prescription failure with a healthcare encounter in database studies, were generally more consistent (6.87%-16.7%). Few studies assessed time to symptom resolution. Prescription failure or additional healthcare visits frequently occurred after a median 2-4 weeks. Treatment failure definitions have been variably defined in the literature. Symptom scores in clinical trials and the need for additional antibiotics or healthcare visits are meaningful outcomes that could underly treatment failure definitions in future studies. The optimal time for each outcome assessment needs further evaluation.

ObjectiveTo improve understanding of the postoperative care challenges of patients with head and neck cancer and to help address these care needs before surgery.Study DesignQualitative study with intervention development and process testing.SettingTertiary care academic medical center.MethodsTo examine perioperative patient experiences, we first performed interviews of 28 adult patients with head and neck cancer undergoing resection with microvascular free flap reconstruction. We then developed a unique preoperative virtual visit focused on socioeconomic and perioperative needs. 50 visits were then conducted by advanced practice providers, and visit content was analyzed.ResultsBefore the new preoperative visit, 73% of patients did not plan for postoperative care preoperatively and 73% did not feel comfortable with postoperative care needs. 55% reported unaddressed socioeconomic hardship. Themes included: limited understanding of surgery and limited understanding of postoperative care needs. After the new preoperative visit, 62% of visits addressed significant care‐related concerns not previously identified.ConclusionAn additional preoperative virtual visit by an advanced practice provider may help improve surgical expectations and better prepare patients and their caregivers for perioperative needs.

<sec><title>BACKGROUND</title>Rifamycin TB preventive treatment (TPT) is critical to TB elimination. However, clinicians may be reluctant to recommend it over concerns related to drug-drug interactions (DDI). In this secondary analysis of data from the 2R² randomised clinical trial (comparing standard dose rifampin to high-dose rifampin for TPT), we investigate if participants taking medications with potential rifampin DDI had similar TPT completion, safety, and follow-up visits compared to those without.</sec><sec><title>METHODS</title>Data on concomitant medications, adverse events, treatment completion, and follow-up visits were compared between participants with and without potential rifampin DDI. Analyses were conducted with R, reporting risk difference (RD) using g-computation with logistic regression.</sec><sec><title>RESULTS</title>282 of 1,368 participants (21%) were taking essential medications with potential rifampin DDI. There was no RD in TPT completion (RD 0.04 [95% confidence interval (CI): -0.02; 0.09]) or adverse events (RD 0.02 [95% CI: -0.01; 0.06]) between participants with and without these medications. Individuals talking medications with potential DDI had a higher percentage of two or more unscheduled visits (12%) compared to those not taking them (5%) (P = 0.0001).</sec><sec><title>CONCLUSION</title>In participants taking medications with potential rifampin DDI, rifampin TPT can be used safely without impacting completion rates. However, additional follow-up visits should be anticipated.</sec>.

BackgroundAdjuvant endocrine therapy is a cornerstone in managing estrogen receptor–positive early breast cancer but may adversely affect metabolic health, including weight gain, insulin resistance, and dyslipidemia. These changes increase the risk of cardiovascular disease and may influence breast cancer outcomes. However, the timing and magnitude of early metabolic changes following endocrine therapy initiation remain poorly characterized. Conventional definitions such as metabolic syndrome rely on dichotomous thresholds and may lack sensitivity to detect early treatment-related metabolic changes, highlighting the need for refined assessment approaches.ObjectiveThis prospective follow-up study aims to investigate early metabolic effects of initiating adjuvant endocrine therapy in women with estrogen receptor–positive early breast cancer and to compare conventional and expanded approaches to metabolic health classification.MethodsThis single-center, prospective observational study was conducted at Aarhus University Hospital, Denmark. Women aged≥18 years with early-stage estrogen receptor–positive breast cancer initiating adjuvant endocrine therapy and without pre-existing diabetes were eligible. Metabolic health was assessed at baseline and after 3 months using biometric measurements (weight, waist and hip circumference, waist-to-hip ratio, and blood pressure) and non-fasting blood samples (plasma glucose; hemoglobin A1c, (HbA1c); lipid profile; and estradiol). The 3-month follow-up was selected to capture early metabolic changes while aligning with routine clinical care to minimize additional visits and reduce selection bias. Metabolic health will be evaluated using two conventional measures and two extended, exploratory measures. Conventional measures are metabolic syndrome (MetS), defined as meeting ≥3 of 5 established criteria (blood pressure ≥130/85 mmHg, triglycerides >2 mmol/l, high-density lipoprotein cholesterol <1.295 mmol/l, waist circumference >88 cm, and plasma glucose >7.8 mmol/l), and the Metabolic Syndrome z score (MetS-Z), a continuous standardized composite of the MetS components. Additional extended measures are exploratory: the extended MetS, which expands the standard MetS definition by incorporating low-density lipoprotein cholesterol (>3 mmol/l), body mass index (≥30 kg/m²), waist-to-hip ratio (>0.85), and HbA1c (≥42 mmol/mol), and the EMETA score, a standardized composite of the extended MetS components calculated using the same approach as the MetS-z score.ResultsThe study was funded in July 2024. Recruitment occurred between November 2024 and April 2025, and follow-up was completed in September 2025. Statistical analyses are planned for February 2026, with results expected to be published in summer 2026.ConclusionsThis study is expected to provide insights into early metabolic changes following initiation of adjuvant endocrine therapy and evaluate different approaches to classifying metabolic health. The aim to inform future research by helping to identify patients at increased risk of cardiometabolic complications and adverse breast cancer outcomes, warranting confirmation and validation of expanded metabolic measures in longer-term, larger cohorts.

Metabolic syndrome (MetSyn) is associated with frailty in older adults, with few data among midlife women. We examined MetSyn, including duration, for associations with the development of prefrailty and frailty. The Study of Women's Health Across the Nation is a multiethnic, longitudinal cohort study of women aged 42-52 years at the time of enrollment (1996-1997). MetSyn was measured longitudinally, using ATP III criteria, starting at baseline. Pre-frailty and frailty were measured at two later visits (2012/13 and 2015/16) using Fried criteria. Associations of pre-frailty and frailty with prevalent MetSyn, the cumulative number of prior visits with MetSyn, and individual MetSyn criteria were examined using multivariable models. A total of 1769 women were included (mean age 59.7 years, SD 3.3). The adjusted odds ratios (aOR) for having pre-frailty or frailty in women with MetSyn compared to those without were 2.77 (95% CI, 2.19-3.50) and 8.73 (95% CI, 5.89-12.95), respectively. Each additional visit a woman met criteria for MetSyn was associated with a higher odds of pre-frailty and frailty (aOR 1.20; 95% CI: 1.14-1.26, and aOR: 1.41; 95% CI: 1.33-1.50, respectively). Individual MetSyn criteria were also associated with the risk of frailty. Among women in this multiethnic cohort, MetSyn was common during midlife and strongly associated with future development of pre-frailty and frailty while women were in their early 60s. Measurement of MetSyn during midlife can help identify women at high risk for developing frailty early in the aging process.

Renal cell carcinoma (RCC) primarily affects older adults who often present with frailty, increasing their risk of surgical complications and delayed recovery. Prehabilitation, incorporating exercise, nutrition, and psychological support, may improve postoperative outcomes. However, no studies have investigated prehabilitation prior to surgery for RCC. The aim is to assess whether a one-month multimodal prehabilitation program including geriatric interventions improves recovery in patients with frailty undergoing surgery for localized RCC≤7cm. 60 patients, aged ≥65, with a Clinical Frailty Scale (CFS) score of 3-6 are randomized 1:1 to standard care or prehabilitation involving home-based exercise, geriatric assessment with tailored interventions, and smoking cessation support. The primary outcome is change in Quality of Recovery-15 (QoR-15) 21days postoperatively. Secondary outcomes include changes in QoR-15, health-related quality of life (EQ-5D-5L) and physical performance (30-s chair-stand test, handgrip strength) assessed preoperatively, 1, 21 and 90days postoperatively. Postoperative complications will be evaluated using the Clavien-Dindo classification, alongside a cost-effectiveness analysis. Long-term outcomes include 1- and 5-year recurrence-free, cancer-specific, and overall survival. Pre-KiT explores if a pragmatic geriatric prehabilitation strategy is effective and feasible for older frail patients with RCC. The intervention is designed for easy implementation in clinical practice: administered by a single healthcare professional, requiring only one additional hospital visit, and consists of home-based exercises. This low-resource approach also aims to minimize financial costs, which is of importance for implementation possibilities. If successful, it could improve standard care and outcomes after surgery. ClinicalTrials.gov ID: NCT06745609. Prospectively registered December 12th, 2024.

Survival and well-being of patients on haemodialysis depend on the provision of regular and effective therapy. Interruptions that shorten a haemodialysis session have adverse effect on patient outcomes. With increasing demands for haemodialysis, machines nowadays are in constant use with usually two or three daily shifts throughout the week. Increased machine malfunction is therefore inevitable, resulting in inadequate treatment and considerable stress for patients and care staff. Unplanned service demands are increasingly a reality. Service technicians often need to be summoned at short notice, but without full knowledge of the nature of the failure, appropriate spare parts often are unavailable on site, meaning that additional visits to replace components need to be planned. To mitigate these problems, the ClinicsPredictive Maintenance tool was devised to monitor the 'technical health' of haemodialysis machines throughout their operational life. The tool enables continuous and remote assessment of haemodialysis machines to predict failures, thereby allowing technicians to proactively schedule onsite servicing to replace affected components. The Clinics Predictive Maintenance tool was assessed in a field study (1235 machines in 34 dialysis units of a provider network) in Portugal between 2019 and 2023. Compared to the pre-monitoring period, breakdown rates decreased while mean time between failures increased. Unplanned service actions were reduced by 27%. The study shows that pre-emptive and timely servicing of haemodialysis equipment prevents disruptions of treatments by machine failures. The Clinics Predictive Maintenance tool enables staff to manage multiple patients and shifts throughout the day more effectively, mitigating potential risks associated with ineffective or improperly maintained equipment.

In patients with insufficient posterior occlusal support, transfer of the interocclusal relationship to a mechanical articulator commonly requires record bases to stabilize gypsum casts. This short communication describes a digital-to-physical workflow that combines intraoral scanner-derived interocclusal registration with a patient-specific, 3D-printed gyroid-based mounting jig. Digital mounting was established intraorally and transferred to gypsum casts mounted on an articulator without an additional clinical visit. The workflow was demonstrated in a single clinical case as a proof of concept. This approach may reduce clinical steps and facilitate efficient articulator mounting in selected clinical situations.

The Osteoporotic Fractures in Men study (MrOS) is amongst the largest and longest running prospective cohort studies of older men. MrOS determined how fracture risk was related to bone mass, bone geometry, lifestyle, anthropometric and neuromuscular measures, comorbidity, biomarkers, and fall propensity. The cohort consisted of 5994 community-dwelling, ambulatory U.S. men aged 65 years or older recruited at 6 US academic clinical centers in 2000-2002 and followed through November 2024. After enrollment, men were contacted by mail/phone every 4 months to ascertain information on incident falls, fractures and deaths/loss to follow-up. All fractures were confirmed by imaging reports. Over the 25-year study, 95% of active surviving participants had complete follow-up. The MrOS study had 5 major clinic visits; while an ancillary sleep study had 2 additional clinic visits. MrOS has provided a comprehensive analysis of factors associated with areal (a) and volumetric (v) bone mineral density (BMD) and clinical risk factors for aBMD loss among men. Further analyses identified risk factors for hip, all non-spine, rib, wrist and vertebral fractures. MrOS was the largest single cohort to estimate associations of aBMD with incident fractures in men and results indicated stronger associations in men than women. MrOS also analyzed other structural features from dual x-ray absorptiometry (DXA) and both central and peripheral quantitative computed tomography in relationship to fractures in men. Serum, urine and DNA were collected at clinic visits and extensive analyses have been performed with respect to sex steroid and calciotropic hormones, bone turnover and other novel measures of bone health. Several analyses evaluated the performance of formal tools in estimating the absolute risk of fractures in older men; findings indicated that better fracture prediction tools are needed. MrOS encourages outside investigators to make use of the publicly available data and to access the biospecimen bank. https://mrosonline.ucsf.edu.

Mid-term results of a minimally invasive management of scaphoid non-union: Arthroscopy-assisted osteosynthesis and autologous bone grafting.

BackgroundEvery year, approximately 20,000 youths lose a parent to firearm injury in the United States. Many more youths have parents who sustain nonfatal firearm injuries. The effect of parents’ firearm injuries on their children’s health and health care is poorly understood.MethodsUsing U.S. commercial health insurance claims data from the 2007–2022 period, we identified youths, 1 to 19 years of age, whose parents had received treatment for firearm injury (exposure). Each youth with exposure was matched with up to five control youths on the basis of year, month, youth sex, metropolitan statistical area, state, insurance plan type, and prescription drug coverage; mean values of age and a risk score predicting future health care use (to provide a proxy for health status) were balanced. The primary outcome was a diagnosis of psychiatric disorder among youths, assessed as a rate, which was defined as the number of youths with at least one related insurance claim in a given month, divided by the total number of youths. Secondary outcomes included substance use disorder diagnosis, health care use, and medical spending. After matching, we estimated the difference in differences in outcomes between the exposure group and the control group 12 months before the parental injury through 12 months after the injury, using a least-squares regression model with adjustment for age and risk score.ResultsWe examined 3790 youths with exposure and 18,535 matched controls. The mean age of the youths was 10.7 years, and 51.5% were male. Parental firearm injury was associated with 8.4 additional psychiatric diagnoses (95% confidence interval [CI], 4.8 to 12.0) per 1000 youths and 23.1 additional mental health visits (95% CI, 8.2 to 38.1) per 1000 youths as compared with control, averaged over the year. This associated increase in the exposure group was largest for diagnoses of trauma-related disorders, including post-traumatic stress disorder, with an additional 8.5 diagnoses (95% CI, 6.0 to 10.9) per 1000 youths as compared with control, averaged over the year. No apparent changes relative to control were observed in rates of other diagnoses, medical encounters, procedures, and services or in medical spending.ConclusionsParents’ firearm injuries were associated with increases in rates of psychiatric disorders and mental health visits among their children. (Funded by the National Institute for Health Care Management and the National Institute of Mental Health.)

Frequent monitoring is essential for assessing the progression of adolescent idiopathic scoliosis (AIS), especially during years of growth. Standard practice involves radiographic measurement of Cobb angles every 4–6 months; however, this may not align with curve progression given unpredictable growth patterns. The emergence of clinical artificial intelligence (AI) tools, such as the Momentum SpineTM smartphone application, have been developed to address monitoring concerns. Video-imaging technology is used to measure extra-spinal, topographic markers that are correlated to the magnitude of spinal deformity. The purpose of the current study is 1) to validate the AI-generated Cobb angle produced via Momentum SpineTM and 2) to assess the AI's ability to track disease progression overtime. Eligible AIS patients (n=131) consented to partake in the study and underwent same-day radiographic imaging and AI scan at the baseline visit. Subsequent same-day AI scans were performed at any follow-up visits with radiographic imaging, with 17 patients having completed an additional follow-up visit thus far. Paired t-test was used to compare all same-day radiographic and AI-generated Cobb angles. Two-way ANOVA was used to assess the accuracy of AI-generated Cobb angle compared to radiographic Cobb angle overtime. Paired t-test results of all scans demonstrated that mean Momentum SpineTM main curve Cobb angle differed by an average of 6.72° compared to the radiographic measurement ((MAI = 26.8±12.7° vs. Mradiograph = 33.5±14.2°). Despite this difference being statistically significant, (−6.72°, 95% CI [−8.19°,−5.26°], t(127)=9.09, p &lt; 0 .0001), it falls within the accepted range for inter-rater variability of ~7° between clinicians. In the population with follow-up, post-hoc analysis showed the agreement between AI-predicted Cobb angle and radiographic measurement improved to an average difference of 4.05° (AI:24.24±13.4° vs radiograph:28.29±14.0°, p=0.6788). Momentum SpineTM can estimate Cobb angles within the accepted range of inter-rater variability between clinicians when compared to same-day radiographic Cobb angles. Therefore, it can be used to detect and monitor AIS. The next step in this study is to evaluate at-home AI scans performed on a monthly basis and determine potential practice change by scheduling clinic visits when progression is detected, as well as eliminating planned visits when the curve is reported to be stable.

and psychological changes they experience have important effects on both their own well-being and the development of their babies (Curren et al., 2022).The postpartum period is a psychologically fragile time for women (Liu et al., 2021).This period carries a high risk of developing depression due to psychosocial factors or hormonal changes (Oliveira et al., 2022).Postpartum depression is defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as "a major depressive episode with antenatal onset and the onset of mood symptoms occurring during pregnancy or within 4 weeks after delivery."(American Psychiatric Association, 2013).Postpartum depression can significantly impact a mother's ability to provide the best care for her baby, with potential negative consequences for both partners (Saharoy et al., 2023).For these reasons, by integrating postpartum depression screening into routine postpartum visits, healthcare providers can proactively identify at-risk mothers and provide timely intervention and support.This process can significantly improve outcomes for both mothers and babies by ensuring that mothers receive the support they need during this vulnerable time (Saharoy et al., 2023; Terrone et al., 2023).Online delivery of postnatal care has been shown to be effective in reducing symptoms of postpartum depression.In a meta-analysis, online care was found to significantly improve mothers' depression levels (Hanach et al., 2021).The World Health Organization (WHO) recommends that mothers and babies stay in a health facility for at least 24 h after birth.At least three additional postnatal visits are recommended within the first six weeks (for healthy women and newborns, between 48-72 h, between 7-14 days, and at the sixth week after birth) (World Health Organization, 2022b).American College of Obstetricians and Gynecologists (ACOG) recommends comprehensive monitoring of mother and baby up to 12 weeks postpartum (American Bra Karagl

BackgroundSince June 2024, the United States (US) Advisory Committee on Immunization Practices has recommended routine vaccination against respiratory syncytial virus (RSV) for all adults aged ≥ 75 years. Despite the recommendation, uptake of RSV vaccine among those aged ≥ 75 years remains low, especially compared with other countries that have similar recommendations. We therefore evaluated the potential public health and economic impact of improving vaccine coverage among US adults aged ≥ 75 years, based on observed uptake within the same age group in Scotland.Public health outcomes associated with alternative vaccination strategies for US adults aged ≥75 yearsMethodsWe developed a cohort model to depict public health and economic outcomes associated with RSV and the single-season impact of routine immunization with RSV vaccines available during the first season. Severe public health outcomes included RSV episodes requiring hospitalizations (RSV-H) or emergency department (ED; RSV-ED) care, respectively, and RSV hospitalization-associated deaths; economic outcomes included costs associated with medical care for RSV. Vaccine effectiveness (vs. RSV-H: 79%, vs. RSV-ED: 78%) was based on real-world observational data from the 2023-24 RSV season in the US. Two different uptake scenarios were considered: Scenario 1 (23.6%, based on US uptake) and Scenario 2 (68.6%, based on uptake in Scotland).ResultsWith Scenario 1 (23.6% uptake), there were 83,469 RSV-H episodes, 54,864 RSV-ED episodes, and 8,713 RSV-related deaths; associated medical care costs totaled $2.3 billion. With Scenario 2 (68.6% uptake), there were 46,326 RSV-H episodes, 30,823 RSV-ED episodes, and 4,836 RSV-related deaths; associated medical care costs totaled $1.3 billion, representing 44% reductions in all public health and economic outcomes in a single season.ConclusionFindings suggest that if uptake of RSV vaccine among US adults aged ≥ 75 years was comparable to uptake in Scotland, nearly 40,000 additional hospitalizations, 25,000 additional RSV-ED visits, and 4,000 additional RSV-related deaths could have been prevented in the first season following vaccine administration. The US should improve targeted efforts to reach remaining unvaccinated eligible adults to prevent severe outcomes.DisclosuresReiko Sato, PhD, Pfizer Inc: Stocks/Bonds (Public Company) Erica Chilson, PharmD, Pfizer Inc: Stocks/Bonds (Public Company) Erin Quinn, BS, Pfizer Inc: Advisor/Consultant Ahuva Averin, MPP, Pfizer Inc: Grant/Research Support

INTRODUCTIONSmoking impairs the outcome of surgery for many reasons. This study aimed to determine the effect of smoking, smoking cessation intervention, and other factors on the incidence of postoperative complications after elective orthopedic and hand surgery directed at bone or cartilage attached at the bone.METHODSAltogether 451 patients, aged 18 years, participated in this single-center interventional study in Finland between 2015 and 2019. Their smoking status was confirmed by laboratory tests. The study's outcome was the occurrence, number, and severity of complications. A complication was defined as a prolonged hospital stay or any additional treatment or visit to a healthcare unit within 12 months, and its severity was determined by a modified Clavien-Dindo-Sink (CDS) index.RESULTSNine out of 80 smokers stopped smoking with laboratory verification before surgery, and additionally, six smokers stopped smoking at or after surgery. In comparison to never smokers, continuing smokers had more often at least one complication (adjusted odds ratio, AOR=2.50; 95% confidence interval, CI: 1.23–5.09; p<0.05) and more complications (adjusted risk ratio, ARR=1.58; 95% CI: 1.08–2.30; p<0.05). Further, the odds of being in a higher CDS-index category compared to the lower category (AOR=2.19; 95% CI: 1.14–4.19; p<0.05) also increased. With decreasing age, the occurrence (AOR = 0.98; 95% CI: 0.96–1.00; p<0.05) and number of complications (ARR=0.98; 95% CI: 0.97–1.00; p<0.01) decreased. Additionally, the odds of being in a higher CDS-index category compared to a lower category increased (AOR=0.98; 95% CI: 0.96–1.00; p<0.05). In comparison to men, women were more likely to have at least one complication (AOR=1.68; 95% CI: 1.03–2.75; p<0.05). With increasing alcohol consumption, the occurrence of at least one complication increased (AOR=1.10; 95% CI: 1.02–1.19; p<0.05).CONCLUSIONSContinuing to smoke and decreasing age, the occurrence, number, and severity of complications increased. Alcohol consumption and female sex were linked to an elevated occurrence of complications. It is important to wean every smoking patient, especially young smokers, from smoking to reduce the occurrence and severity of complications.

Unplanned readmissions of patients with cancer increase healthcare costs and disrupt care. Although well-studied in surgical oncology, data on patients receiving active treatment for advanced cancer remain limited. This study examined the causes, clinical characteristics, and outcomes of unplanned readmissions. This retrospective, multicenter study included patients with advanced solid tumors from six South Korean university hospitals who had unplanned readmissions within 1 month of prior hospitalization in 2019. Patients with terminal cancer who did not receive active treatment were excluded. Readmissions were categorized as Cancer Progression (e.g., worsening symptoms), treatment-related (e.g., therapy complications), or other (e.g., non-cancer conditions). Additional unplanned hospital use within 1 month post-discharge was analyzed in survivors with 6-month follow-up data. Among the 542 patients, readmissions were classified as cancer progression (42.6%), treatment-related (37.3%), or other (20.1%). The cancer progression group had the longest hospital stay (median, 12 days) and the highest mortality (23.4%). The Treatment-Related group had shorter stays (8 days) and lower mortality (8.4%). Among the 445 survivors, 24.9% had unplanned hospital visits within 1 month post-discharge. Home discharge increased the likelihood of these events (adjusted odds ratio: 4.82 for readmissions, 2.65 for emergency department visits). Cancer progression was the leading cause of readmission and was associated with prolonged hospital stays and high mortality rates. Home discharge is a key predictor of early additional unplanned hospital visits, indicating the need for careful post-discharge monitoring in this population.

Chronic rotator cuff disease (RCD) is a growing cause of persistent shoulder pain and disability. Although acupuncture is commonly used, sustained benefits remain uncertain. Thread-embedding acupuncture (TEA) provides prolonged stimulation, but evidence for chronic RCD is limited; thus, we evaluated its effectiveness, safety, and cost-effectiveness versus sham TEA. Patients with chronic rotator cuff disease were included. The treatments were divided into 2 groups once a week for 8 weeks. The control group received sham TEA, which was different from that administered to the experimental group. In other words, a randomized, patient-assessor-blinded, controlled, clinical trial was conducted. The effects of TEA were evaluated based on indicators related to pain reduction (100-mm visual analog scale), shoulder function improvement (shoulder pain and disability index, range of motion [ROM] of the shoulder), and quality of life (rotator cuff quality of life score and EuroQol 5-dimension 5 levels). Additional follow-up visits were conducted via telephone at 12 and 16 weeks of age. The results showed pain relief and functional improvement within each group; however, no statistical significance was observed between each group. However, the ROM of the external rotation (ER) side was statistically significant in the experimental groups, as compared to the control group (P < .05). Adverse events that could be considered as safety issues have not been reported. In the cost-effectiveness evaluation, TEA treatment was found to be more economical, depending on the indices (i.e., some ROM indices and rotator cuff quality of life score) and the socially agreed willingness to pay based on those indices. The TEA treatment resulted in partial clinical improvements, including pain relief and shoulder function; however, these results were not statistically significant. Nevertheless, the TEA treatment was statistically significant in clinical improvement and cost-effectiveness for the range of external rotations.

Time efficiency of a digital workflow with immediate restoration for posterior single implants (SafetyCrown): A randomized clinical trial.

Abstract Background Pivotal clinical trials have shown the efficacy of the anti-interleukin-23 p19 antibody risankizumab (RZB) for treatment of moderate-to-severe Crohn’s disease (CD) in adults. Here, efficacy and safety in a real-world setting were evaluated. Methods APPRISE (NCT05841537) is an ongoing prospective, single arm, noninterventional, postmarketing, observational study. Adults (aged ≥15 years [y], if allowed per local label) with a confirmed diagnosis of CD initiated RZB at the investigator’s discretion in accordance with local marketing authorisation. The first 500 enrolled pts were included in this interim analysis. Study visits were prespecified, occurring monthly (± 7 days) for the first 3 mo, with an additional visit at 6 mo. The primary outcome of clinical remission per Harvey Bradshaw Index (HBI) at 12 months in patients with clinical response per HBI at mo 3 is not included here as it is not within the scope of this interim analysis. Secondary outcomes included clinical remission and corticosteroid (CS)-free clinical remission ([HBI]) (outcomes defined in Table 1 footnotes). A post hoc analysis of efficacy stratified by CS use, advanced therapy inadequate response (AT-IR), and ustekinumab (UST) failure at baseline (BL) was also performed. Data are as observed after handling of intercurrent events (Table 1 footnote). Results Of pts who received ≥1 dose of RZB (483 pts), 52% were male, 51% were AT-exposed, 17% used CS at BL, and 74 pts had UST failure at BL. Median (min, max) disease duration was 10.2 y (0.0, 54.0). Sustained clinical remission at 6 mo was achieved by 84.1% of pts who clinical remission at 3 mo (Table 1). CS-free clinical remission at 3 mo was achieved by 60.3% of pts. Sustained CS-free clinical remission at 6 mo was achieved by 82.5% of pts who achieved the outcome at 3 mo. A post hoc subgroup analysis found that, among pts who had failure of UST at BL, 95.5% achieved clinical remission at both 3 mo and 6 mo. At 3 mo, 36.7% of pts who used CS at BL achieved CS-free clinical remission (vs 65.4% of pts not using CS at BL); approximately 60% of pts achieved CS-free clinical remission at 3 mo regardless of BL AT-IR status or prior UST failure at BL. In 41.6% of pts, ≥ 1 treatment emergent adverse event (TEAE) was reported, 8.9% of pts reported serious TEAEs, and 2.9% discontinued RZB treatment (Table 2). A TEAE resulting in death, unrelated to RZB treatment, was reported in 1 pt after the 6-mo data cutoff. Conclusion In a real-world setting, most pts treated with RZB achieved and sustained clinical and steroid-free clinical remission, and the durability of effect was observed regardless of prior UST failure. RZB was well tolerated, and no new safety concerns were identified. Conflict of interest: Bossuyt, Peter: Grant support for research from AbbVie, EG Consulting fee from AbbVie, Bristol Meyers Squibb, CIRC, Galapagos, Janssen, Jeito capital, Lilly, Pentax, Pfizer, PSI-CRO, Roche, Takeda, Tetrameros Speakers fee from AbbVie, AMC ICP, Amgen, Bristol Myers Squibb, Celltrion, Dr Falk Benelux, EG, Galapagos, Globalport, Lilly, Medtalks, Materia Prima, Pentax, Springer Media Hisamatsu, Tadakazu: Grant support: Mitsubishi Tanabe Pharma Corporation, EA pharma Co. Ltd., AbbVie GK, JIMRO Co. Ltd., Zeria Pharmaceutical Co. Ltd., Kyorin Pharmaceutical Co. Ltd., Takeda Pharmaceutical Co. Ltd., Pfizer Inc., Mochida Pharmaceutical Co. Ltd., Boston Scientific Corporation, Kissei Pharmaceutical Co. Ltd. Consulting: Mitsubishi Tanabe Pharma Corporation, EA pharma Co. Ltd., AbbVie GK, Janssen Pharmaceutical K.K., Pfizer Inc., Eli Lilly, Gilead Sciences, Bristol Myers Squibb, Abivax, MSD, Chugai. Lecture fee: Mitsubishi Tanabe Pharma Corporation, AbbVie GK, EA pharma Co. Ltd., Kyorin Pharmaceutical Co. Ltd., JIMRO Co., Janssen Pharmaceutical K.K., Mochida Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co. Ltd., Pfizer Inc., Kissei Pharmaceutical Co. Ltd. Atreya, Raja: RA has served as a speaker, or consultant, or received research grants from AbbVie, Abivax, AlfaSigma, Arena Pharmaceuticals, Astra-Zeneca, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Celltrion Healthcare, Dr Falk Pharma, Galapagos, Gilead, GlaxoSmithKline, InDex Pharmaceuticals, Johnson &amp; Johnson, Lilly, Materia Prima, Merck Sharpe &amp; Dohme, Pfizer, Roche Pharma, Takeda Pharma, Viatris. Tinoco da Silva Torres, Joana: Grant: Abbvie, Janssen Personal Fees: Pfizer, Janssen, Abbvie, Sandoz, Lilly, Sanofi, Takeda Non-financial Support: Janssen, Abbvie Aponte, Fernando: AbbVie employee and may own AbbVie stock or options. Mallick, Madhuja: Full-time employee of AbbVie and may own AbbVie stock or options. Chen, Shirley H.: AbbVie contractor and may own AbbVie stock or options. Kligys, Kristina: Full-time employee of AbbVie and may own AbbVie stock or options. Juillerat, Pascal: Speaker and advisor Fees: AbbVie, Amgen, Aspen Pharmacare, Bristol Myers Squibb, CLS Vifor Pharma, Eli Lilly, Ferring Pharmaceuticals, Gilead Sciences, Johnson &amp; Johnson, Merck Sharp &amp; Dohme, Pfizer, Pierre Fabre, Sandoz, Takeda, Tillotts Pharma AG, UCB Pharma.