Journal of Clinical Trials and Experimental Investigations

Rehabilitation of a lost immature permanent central incisor due to avulsion injury with a modified essix retainer: A case report

Elif Bilgin — 2024-12-26

The type of injury in which a tooth is completely displaced from its alveolar socket following trauma is called avulsion. Traumatic injuries to permanent incisors are quite common during childhood, with 0.5–16% of children aged 7 to 10 experiencing permanent incisor avulsion. Tooth avulsion usually occurs due to road traffic accidents, falls, and other physical impacts. It can also happen during sports in schools or as a result of physical violence. Permanent incisors are important not only for aesthetics but also for phonetics, mastication, and the psychological health of young patients. Traumatic dental injuries should be thoroughly evaluated and managed by clinicians. An appropriate emergency intervention and treatment plan are crucial for a good prognosis. However, due to various reasons, this condition can result in tooth loss. It is essential to preserve the spaces of avulsed teeth with space maintainers until the patient reaches the appropriate age for permanent treatment. The aim of this study is to improve the quality of life of an 8 year old pediatric patient in the mixed dentition period, whose upper right central permanent incisor was avulsed, by providing temporary oral rehabilitation with a modified essix appliance and to offer a qualified treatment alternative to the patient.

Catastrophic abdomen after appendicular peritonitis, multidisciplinary experience: A case report

Jorge Oswaldo Mier Araujo — 2024-12-30

The term 'catastrophic abdomen' describes a series of complex and severe medical situations that combine significant inflammation, severe infections and a history of multiple abdominal surgeries that alter the normal anatomy. In these conditions, the internal organs become especially vulnerable, presenting fragility and an edematous state, i.e. swelling due to fluid accumulation. In addition, in certain cases, there may be the presence of fistulas or intestinal leaks that are difficult to control, further complicating the patient's clinical situation. When this situation is combined with the presence of extensive adhesions or significant scarring, it is referred to by the term 'hostile abdomen'. Finally, in the case of intestinal fistulas connecting directly with the granulation tissue overlying the viscera, a phenomenon known as enteroatmospheric fistulation is generated. 13-year-old male patient diagnosed with catastrophic abdomen. He underwent laparotomy due to generalized peritonitis and intestinal perforation. During the procedure, the Bogota bag, the Bates system and a fistula were used, and abdominal wall closure through “component separation” with fasciotomy of the rectus abdominis, in addition to parenteral nutritional support. The incidence of 'catastrophic abdomen' is extremely low, with an estimated prevalence of approximately one case per-100,000 population, according to the World Health Organization (WHO). By presenting our case, we aimed to highlight the multidisciplinary approach and surgical management strategies in addressing catastrophic abdomen resulting from appendicular peritonitis, emphasizing complex interventions and patient outcomes.

Determination of the risk of liver fibrosis with the FIB-4 scale in 290,353 spanish workers: Associated variables

María Teresa García-González — 2024-12-30

Objective: Liver fibrosis is a progressive disease characterised by the accumulation of excessive scar tissue in the liver. It occurs in response to chronic viral hepatitis, alcohol abuse or non-alcoholic fatty liver disease (NAFLD). There are different ways to diagnose it, including FIB-4. The aim of this study is to assess which variables are associated with increased liver fibrosis as determined by FIB-4.

Material and methods: A cross-sectional descriptive study of 290,353 Spanish workers, evaluating the influence of age, sex, social class, tobacco consumption, and BMI on the prevalence of hepatic fibrosis determined by FIB-4.

Results: The prevalence of moderate and high FIB-4 values is 12.8% in women and 4% in women. These prevalence increase with age, as socioeconomic status decreases, in smokers and as BMI increases.

Conclusion: The profile of a person with elevated FIB-4 values will be a male, older, with a low socioeconomic status, smoker and overweight.

Evaluation of the effectiveness of intraoperative fluoroscopy and postoperative computed tomography in thoracolumbar fusion surgeries

Haluk Cem Cakaloglu — 2024-12-30

Objective: This study aims to evaluate the accuracy and safety of pedicle screw placement in thoracolumbar spinal fusion surgeries. comparing intraoperative two-way fluoroscopy and postoperative computed tomography (CT), and to analyze the influence of spinal anatomy and biomechanics.

Materials and methods: A retrospective cohort study was conducted on 94 patients who underwent thoracolumbar spinal fusion surgery. Demographic data including age, gender, and surgical indications were collected. Intraoperative fluoroscopy and postoperative CT images were analyzed to assess pedicle screw placement accuracy.

Results: Among the 519 pedicle screws placed, 496 (95.6%) were graded as A or B in the intraoperative fluoroscopy, whereas 23 (4.4%) were C, D, or E. Postoperative CT findings demonstrated a significant difference (p<0.001) in screw placement accuracy, with 483 (93.1%) screws rated as A or B. Moreover, the postoperative CT showed a higher precision in determining the screws’ alignment with vertebral bodies, stability, and potential complications. The correlation between intraoperative and postoperative imaging modalities indicated substantial sensitivity (93.8%), specificity (95.6%), positive predictive value (98.8%), and negative predictive value (83.3%).

Conclusion: Postoperative CT emerges as a crucial imaging method in enhancing the success and safety of pedicle screw placement in spinal fusion surgeries.

The relationship between hematological parameters and infectious mononucleosis in children

Hakan Onur — 2024-12-30

Objective: To evaluate the association between hematological parameters and (EBV) in infants and to help with early warning, identification, and intervention in the development of infection.

Material and methods: This is a prospective and observational study of all infants admitted to the pediatric emergency department with cervical lymphadenopathy and fever from January 2021 to December 2022. Multivariate analysis was conducted to evaluate the independence of the association between the hematological parameters and the risk of EBV infection.

Results: A total of 89 children with fever and lymphadenopathy were enrolled during the study period. While EBV-VCA IgG value was negative in 52 children, EBV-VCA IgM was negative in 47 children. The optimal cut-off value for NLR was ≤ 0.9, with 54.76% sensitivity and 76.6% specificity. The area under the ROC curve for NLR was 0.66. The optimal cut-off value for ALT was 30 mg/dL, with 47.6% sensitivity and 89.3% specificity. The area under the ROC curve for ALT was 0.54. The optimal cut-off value for AST was greater than 31 mg/dL, with 57.1% sensitivity and 68.0% specificity. The area under the ROC curve for AST was 0.64. The optimal cut-off value for lymphocyte was >5.16, with 50% sensitivity and 87.2% specificity. The area under the ROC curve for lymphocyte was 0.67.

Conclusion: New inflammatory markers, NLR, MPV, and PDW, have the advantages of being simple, economical, and rapid. They also have a certain sensitivity and specificity for predicting the occurrence of EBV, and have important clinical application value.

Risk of insulin resistance applying 3 different scales in 703,472 spanish workers: Associated variables

Astrid Camero — 2024-12-30

Objective: Insulin resistance (IR) is a highly prevalent condition that causes significant morbidity and has a multifactorial etiology. The objective of this study is to assess the risk of developing IR by applying three different criteria, and to determine how IR is associated with various sociodemographic variables, tobacco consumption, and obesity using the Body Mass Index (BMI) and the Clínica Universidad de Navarra Body Adiposity Estimator (CUN BAE) criteria.

Materials and methods: A cross-sectional descriptive study of 703,472 Spanish workers, evaluating the influence of age, sex, social class, tobacco consumption, and obesity (based on BMI and CUN BAE criteria) on the prevalence of IR by applying the Triglycerides Glucose Index (TyG index), Metabolic Score for Insulin Resistance (METS-IR), and Triglycerides/HDL-cholesterol scales.

Results: The prevalence of high IR risk varies with the different criteria applied. The variables that most increase the risk of high IR across all three criteria are obesity (both BMI and CUN BAE) and age.

Conclusion: The high IR risk profile according to all three scales is an older male from social class III, a smoker, and obese.

The relationship between social media addiction, inflammation, Dopamine, and awareness in adult patients with acne vulgaris

Mehmet Semih Celik — 2024-12-30

Objective: The aim of this study is to explore the relationship between social media addiction, inflammation, dopamine levels, and awareness in adult patients with acne vulgaris, considering psychological and physiological aspects.

Material and methods: A total of 98 participants were included in the study: 53 acne patients (23 male, 30 female) and 45 control group members (20 male, 25 female). Both the case and control groups consisted of non-smokers and individuals who were not addicted to alcohol or gambling. The patient group was divided into three subgroups (mild, moderate, and severe) based on the International Global Acne Grading System (IGA). All participants were administered the 6-item Bergen Social Media Addiction Scale (BSMAS), and according to the results, they were classified into four groups: mild, moderate, high, and very high addiction.

Results: The addiction level of the case group was observed as moderate with a score of 14.0±4.45, while the addiction level of the control group was observed as high with a score of 21.0±5.20. A significant difference was found between the two groups (p<0.001).

Conclusion: We attribute the lower level of addiction in acne patients compared to the healthy control group to a decrease in dopamine activation secondary to inflammation and to the state of awareness. However, it is clear that this issue requires further detailed research.

Artificial intelligence in Otorhinolaryngology practice: Comparative performance of ChatGPT and Gemini AI

Ahmet Celik — 2024-12-30

Objective: This study aims to evaluate the accuracy of ChatGPT and Gemini AI in the field of otorhinolaryngology.

Materials and methods: This study evaluated the performance of ChatGPT 4.0 and Gemini AI in answering 150 multiple-choice questions evenly distributed across otorhinolaryngology domains: ear, nose, and throat. Both models were tested under standardized conditions, with their responses compared to an answer key. The true and false answers were evaluated.

Results: For ear-related questions, ChatGPT correctly answered 34 (68%), while Gemini AI correctly answered 33 (66%) (p=0.832). For nose-related questions, both models achieved identical results: 34 correct answers (68%) and 16 incorrect answers (32%) (p=1.000). For throat-related questions, ChatGPT provided 34 correct answers (68%) compared to Gemini AI's 38 correct answers (76%) (p=0.373). Overall, ChatGPT achieved 102 correct answers (68%) and Gemini AI achieved 105 (70%), with no statistically significant difference between the models (p=0.708). The total correct answers across all topics were 207 (69%), and incorrect answers were 91 (31%). Binary logistic regression showed no significant differences in performance between the AI models or topics, confirming their comparable accuracy in otorhinolaryngology question sets.

Conclusion: ChatGPT 4.0 and Gemini AI demonstrated comparable performance in answering otorhinolaryngology questions, with no statistically significant differences observed across ear, nose, and throat topics. Both models achieved high accuracy rates (ChatGPT: 68%, Gemini AI: 70%), suggesting their potential applicability in clinical decision-making and supporting otorhinolaryngology-related diagnostics.

The role of digital pathology and artificial intelligence-assisted analysis in breast cancer diagnosis

Havva Hande Keser Sahin — 2024-12-30