Temporomandibular disorders (TMDs) in patients with rheumatoid arthritis (RA) can lead to orofacial pain and dysfunction of the temporomandibular joint (TMJ). Self-care is a recognized primary intervention for controlling TMDs, offering a simple reversible treatment, since there is no specific treatment protocol for TMDs in RA patients. This study aims to investigate the effectiveness of self-management in improving TMD symptoms in RA patients under drug control.
This prospective Phase II clinical trial included 64 drug-controlled RA patients presenting with signs or symptoms of TMDs. All participants underwent baseline assessment using the RDC/TMD questionnaire, Numerical Analog Scale (NAS), and Helkimo Index, followed by a standardized clinical evaluation of jaw function and muscle/joint tenderness. Patients received structured self-care education, including bilateral chewing exercises, mouth-opening limitation within pain threshold, dietary modification, thermal modalities, parafunctional habit control, and therapeutic massage. Reminder messages and follow-up phone calls were provided to reinforce adherence. Clinical examinations were repeated after 2 months to evaluate changes in pain intensity, jaw mobility, joint sounds, and TMD severity.
Ultimately, reductions in TMD severity based on the Helkimo criteria and patient self-report using the NAS, as well as reductions in the number of painful muscles and joints, improvement in maximum mouth opening, lateral and protrusive movements, and decreased jaw sounds were observed in patients.
Adherence to self-management as the main component of treatment can be a highly effective, sustainable, and side-effect-free approach for managing symptomatic TMD in patients with RA.
Self-care significantly reduced TMD pain, improved mouth movements, and decreased jaw sounds in RA patients with TMJ involvement.
Trial Registration: Iranian Registry of Clinical Trials: IRCT N120221113056489
To evaluate the therapeutic efficacy and safety of pyrazinamide compared with pasiniazid in elderly patients with pulmonary tuberculosis (PTB) and to investigate their effects on serum inflammatory markers, including interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α).
Clinical data of 82 elderly PTB patients admitted between December 2022 and December 2023 were retrospectively analyzed. According to their documented treatment regimens, patients were divided into a control group (n = 41, treated with pasiniazid) and a study group (n = 41, treated with pyrazinamide). Sputum conversion rate, radiological lesion improvement, incidence of adverse drug reactions, and serum IFN-γ and TNF-α levels were compared between the two groups.
After 3 and 6 months of therapy, sputum conversion rates in the pyrazinamide group were 85.37% and 95.12%, respectively, significantly higher than those in the pasiniazid group (63.41% and 80.49%, P < 0.05). The total improvement efficiency was 90.24% in the study group versus 70.73% in the control group (P < 0.05). The incidence of adverse reactions was lower in the pyrazinamide group (14.63%) compared with the control group (36.59%, P < 0.05). After 3 months of treatment, both TNF-α and IFN-γ levels were markedly reduced in both groups (P < 0.05), with greater decreases observed in the pyrazinamide group (P < 0.001), suggesting enhanced immunomodulatory effects and better inflammatory resolution.
Pyrazinamide demonstrates superior therapeutic efficacy and lower adverse reaction rates compared with pasiniazid in elderly PTB patients. Its use is associated with significant reductions in systemic inflammatory cytokines (TNF-α and IFN-γ), indicating potential immunomodulatory benefits and clinical value as an adjunctive agent in tuberculosis management.
Understanding the morphology of the root canal is important for successful endodontic treatment. Studies have revealed the role of geographical and racial diversity in root canal anatomical variations. Considering the lack of enough study on the prevalence of C-shaped canals in maxillary molars in Iran, the present study aimed to investigate their prevalence in an Iranian population.
This cross-sectional study was performed on 313 maxillary cone-beam computed tomography (CBCT) scans of the Radiology Department of Tabriz Faculty of Dentistry. CBCT data were entered in NNT Viewer Version 2.21. The Martins classification system was used to identify and classify the C-shaped canals.
The C-shaped canal was found in 1.5% and 2.7% of maxillary first and second molars, respectively. Also, the prevalence of C-shaped canals was higher on the left side of the maxilla than on the right side without significant sex predilection.
The prevalence of C-shaped canals in the maxillary first and second molars in an Iranian population was 1.5% and 2.7%, respectively.
Colorectal cancer (CRC) is often diagnosed at advanced stages due to the lack of early symptoms. Conventional screening methods have limitations in sensitivity and patient compliance. Tumor biomarkers may provide a less invasive and more accurate diagnostic approach.
This retrospective study analyzed serum levels of serum amyloid A (SAA), macrophage inhibitory cytokine-1 (MIC-1), carcinoembryonic antigen (CEA), and carbohydrate antigen 125 (CA125) in 186 patients with CRC and 180 healthy controls recruited between December 2022 and June 2024. Differences in biomarker levels between groups were assessed using the Mann–Whitney U test. Associations with TNM stage, pathological grade, and lymph node metastasis were evaluated using Spearman’s correlation analysis. Diagnostic performance was determined by constructing receiver operating characteristic (ROC) curves.
CRC patients showed significantly higher serum levels of SAA, MIC-1, CEA, and CA125 compared with controls (all p < 0.001). Biomarker levels were positively correlated with each other and significantly associated with TNM stage, pathological grade, and lymph node metastasis. ROC analysis revealed AUC values of 0.76 (SAA), 0.74 (MIC-1), 0.81 (CEA), and 0.78 (CA125). The combined biomarker panel achieved an AUC of 0.96 (95% CI: 0.94–0.98; p < 0.001), with 90.9% sensitivity and 90.6% specificity, significantly outperforming individual markers.
Serum SAA, MIC-1, CEA, and CA125 are significantly elevated in CRC and correlate with tumor stage and metastasis. Their combined assessment provides superior diagnostic accuracy and may serve as a valuable noninvasive tool for CRC screening.
Mycoplasma pneumoniae pneumonia, primarily caused by Mycoplasma pneumoniae, poses a significant burden on pediatric respiratory health, with macrolide-resistant strains complicating treatment. With macrolide resistance on the rise, alternative treatment options are imperative. Doxycycline has emerged as a promising alternative due to its broad-spectrum efficacy and favorable safety profile. However, the clinical scenarios for its administration, particularly in macrolide-resistant Mycoplasma pneumoniae pneumonia in children, have not been extensively explored.
Clinical data of 129 pediatric patients with macrolide-resistant Mycoplasma pneumoniae pneumonia were retrospectively analyzed. Drug sensitivity testing was performed for one group to confirm the absence of doxycycline resistance, while the other group switched to doxycycline after unsatisfactory effects of macrolide therapy. Clinical response, laboratory parameters, treatment-emergent adverse events, and cytokine levels were compared between the groups.
The group that switched to doxycycline after drug sensitivity testing had notably shorter fever resolution time (3.65 ± 1.24 vs. 3.06 ± 1.15 days), cough relief time (4.82 ± 1.45 vs. 4.13 ± 1.36 days), and a higher chest X-ray improvement percentage (80.15 ± 5.48% vs. 81.95 ± 4.52%) compared to the unsatisfactory curative effect group. Baseline laboratory parameters, treatment-emergent adverse events, and baseline cytokine levels showed no significant differences. However, posttreatment, significant differences were observed in IL-8 (42.16 ± 7.89 vs. 38.83 ± 7.61 pg/mL), IL-10 (19.35 ± 3.21 vs. 18.14 ± 3.37 pg/mL), and SAA (31.14 ± 5.67 vs. 29.26 ± 3.22 mg/L) between the two groups.
Early doxycycline use, particularly after drug sensitivity testing, demonstrated potential clinical efficacy in the treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children.
Lumbar disc herniation (LDH) is a prevalent degenerative condition of the spine. This study aimed to explore the relationship between LDH and circadian rhythm (CR) disorders.
This single-center retrospective study included all patients presenting with LDH between April 2023 and April 2025. CR disorders were evaluated using the Chinese version of the Biological Rhythms Interview of Assessment in Neuropsychiatry (C-BRIAN) scale. The severity of intervertebral disc degeneration was graded according to the Pfirrmann classification system based on magnetic resonance imaging. Serum concentrations of interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) were quantified as inflammatory biomarkers. Low back pain intensity was assessed with the Visual Analog Scale (VAS), while the resultant functional disability was determined using the Oswestry Disability Index (ODI).
A total of 140 patients were included in the final analysis. The analysis revealed that higher Pfirrmann grades were strongly associated with elevated C-BRIAN scores (p < 0.001), indicating concurrent disruptions across sleep, activity, social, and dietary domains. This relationship was quantified by a significant positive correlation (r = 0.663, p < 0.01), and linear regression confirmed Pfirrmann grade as a significant predictor of C-BRIAN scores (b = 4.120, p < 0.01). Furthermore, C-BRIAN scores showed significant positive correlations with serum levels of IL-6 (r = 0.593, p < 0.01) and hs-CRP (r = 0.631, p < 0.01).
CR disorders are prevalent among patients with LDH and are positively correlated with the severity of disc degeneration. CR disorders are linked to elevated levels of the inflammatory markers IL-6 and hs-CRP.
Pulmonary fibrosis is a significant lung injury caused by multiple factors that profoundly affect the human quality of life. Currently, various animal models are used to understand the aetiology of pulmonary fibrosis and develop treatments. However, only pharmacogenetic models of pulmonary fibrosis have been discussed, and there have been no reviews of drug treatments. This study reviewed research articles as of August 2023 in major literature databases outlining different techniques for animal modelling of pulmonary fibrosis, including pharmacogenetic and nonpharmacogenetic approaches. Additionally, treatment approaches from both Western and traditional Chinese medicine are discussed. Study results show that along with commonly recognised medications such as pirfenidone and nintedanib, many traditional Chinese remedies and natural products, such as resveratrol and Qingfei Paidu, also offer preventative and therapeutic effects against pulmonary fibrosis.
More evidence is required to determine the physical therapists’ perception and knowledge about clinical practice guidelines (CPGs).
The main purpose of this study is to explore the physical therapists’ knowledge, attitude, and practice toward CPGs in Saudi Arabia.
A cross-sectional study was conducted among 115 physical therapists in Saudi Arabia. Data were collected through a self-administered electronic survey to assess the association between participants’ demographic and work data with CPG familiarity and evidence-based practice (EBP) understanding. Data were analyzed using descriptive statistics and multivariable ordinal logistic regression.
The study revealed that 81.7% of the participants indicated familiarity with CPG, with 94% having received prior education on the topic, mostly through 29% of postgraduate studies. About 50% of the participants reported that they always use CPGs when relevant. Participants who had a higher educational level showed more positive attitudes and greater levels of familiarity with CPG and EBP. Regarding the barriers of applying CPG recommendations, the highest two barriers were lack of time (63.5%) and work-limited resources (57.5%).
Despite familiarity and positive attitudes toward CPGs, adherence among physical therapists in Saudi Arabia was limited due to barriers such as lack of time, resources, and insufficient training.
Although several algorithms have been proposed to predict individual warfarin doses, the relationships between the international normalized ratio (INR) and cumulative warfarin dose remain to be determined.
The aim of this study was to explore the correlation between the INR and the cumulative dosage of warfarin within a week in patients who have undergone mechanical heart valve replacement.
A retrospective study was conducted at the First Affiliated Hospital of Shantou University Medical College in southern China. Fifty-two patients who underwent mechanical heart valve replacement between January 2016 and December 2022 were included. The daily warfarin dose, cumulative dosage of warfarin within a week, and INR value were recorded. A simple linear regression model was used to analyze the correlation between the INR and cumulative warfarin dosage within a week.
Of the 52 patients who underwent mechanical heart valve replacement, 19 were male, and 33 were female. Twenty-three and 18 patients had undergone mitral valve replacement and aortic valve replacement, respectively. Eleven patients underwent both mitral and aortic valve replacement. There was a strong linear correlation in 35 patients (67.31%), with a correlation coefficient (adjusted R2 ≥ 0.7) identified between the INR and the cumulative dosage of warfarin within a week. The patients with weak correlations (adjusted R2 < 0.7) were more likely to be female and have lower left ventricular ejection fractions, fewer days and lower cumulative warfarin doses at the first time of therapeutic INR. Multivariate logistic regression analysis revealed that none of these factors significantly affected the relationship between the INR and cumulative warfarin dose.
Our study revealed a strong linear correlation between the INR and the cumulative dosage of warfarin within a week in most patients with mechanical prosthetic heart valves.
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