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Ogura T, Uba Y, Kanadani T, Bessho K, Nishikawa H. Stent-in-stent deployment for malignant hilar obstruction using multi-hole stent can prevent tumor ingrowth during 6-month cholangioscopic follow-up. Endoscopy 2025; 57:E99-E100. [PMID: 39909411 PMCID: PMC11798663 DOI: 10.1055/a-2518-5430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2025]
Affiliation(s)
- Takeshi Ogura
- Endoscopy Center, Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Japan
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Yuki Uba
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Takafumi Kanadani
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Kimi Bessho
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Hiroki Nishikawa
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
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Fan R, Chen Q, Gao S, Wang L, Mao S, Yan Z. A real-world study on the influence of unplanned reoperations on hospitalized patients using the diagnosis-related group. Ann Med 2025; 57:2473633. [PMID: 40038862 PMCID: PMC11884101 DOI: 10.1080/07853890.2025.2473633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2024] [Revised: 01/27/2025] [Accepted: 01/28/2025] [Indexed: 03/06/2025] Open
Abstract
OBJECTIVE The issue of unplanned reoperations poses significant challenges within healthcare systems, with assessing their impact being particularly difficult. The current study aimed to assess the influence of unplanned reoperations on hospitalized patients by employing the diagnosis-related group (DRG) to comprehensively consider the intensity and complexity of different medical services. METHODS A retrospective cohort study of surgical patients was conducted at a large tertiary hospital with two hospital districts employing data sourced from a DRG database. Hospital length of stay (LOS) and hospitalization costs were measured as the primary outcomes. Discharge to home was measured as the secondary outcome. Frequency matching based on DRG, regression modeling, subgroup comparison and sensitivity analysis were applied to evaluate the influence of unplanned reoperations. RESULTS We identified 20820 surgical patients distributed across 79 DRGs, including 188 individuals who underwent unplanned reoperations and 20632 normal surgical patients in the same DRGs. After DRG-based frequency matching, 564 patients (188 with unplanned reoperations, 376 normal surgical patients) were included. Unplanned reoperations led to prolonged LOS (before matching: adjusted difference, 12.05 days, 95% confidence interval [CI] 10.36-13.90 days; after matching: adjusted difference, 14.22 days, 95% CI 11.36-17.39 days), and excess hospitalization costs (before matching: adjusted difference, $4354.29, 95% CI: $3,817.70-$4928.67; after matching: adjusted difference, $5810.07, 95% CI $4481.10-$7333.09). Furthermore, patients who underwent unplanned reoperations had a reduced likelihood of being discharged to home (before matching: hazard ratio [HR] 0.27, 95% CI 0.23-0.32; after matching: HR 0.31, 95% CI 0.25-0.39). Subgroup analyses indicated that the outcomes across the various subgroups were mostly uniform. In high-level surgery subgroups (levels 3-4) and in relation to complex diseases (relative weight ≥ 2), the increase in hospitalization costs and LOS was more pronounce after unplanned reoperations. Similar results were observed with sensitivity analysis by propensity score matching and excluding short LOS. CONCLUSIONS Incorporating the DRG allows for a more effective assessment of the influence of unplanned reoperations. In managing such reoperations, mitigating their influence, especially in the context of high-level surgeries and complex diseases, remains a significant challenge that requires special consideration.
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Affiliation(s)
- Rui Fan
- Medical Quality Management Office, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
| | - Qifeng Chen
- Medical Administration Division, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
| | - Shang Gao
- Medical Quality Management Office, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
| | - Lili Wang
- Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
- Nursing Department, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
| | - Shuqi Mao
- Department of Hepatopancreatobiliary Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
| | - Zhiyu Yan
- Medical Quality Management Office, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
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Yue X, Wang Y, Zheng R, Li L. The coping experiences in patients with hepatocellular carcinoma and their spouses following postoperative recurrence: A dyadic qualitative study. Asia Pac J Oncol Nurs 2025; 12:100665. [PMID: 40104041 PMCID: PMC11919323 DOI: 10.1016/j.apjon.2025.100665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Accepted: 02/05/2025] [Indexed: 03/20/2025] Open
Abstract
Objective Dyadic coping practices can vary depending on cultural contexts, socioeconomic factors, and the stages of the cancer journey. This study aimed to explore the dyadic coping experiences of hepatocellular carcinoma (HCC) patients and their spouses following postoperative recurrence in the Chinese cultural context, where cancer recurrence is frequently seen as a death sentence, and family-centered care is prioritized. Methods A descriptive qualitative research design was used, involving face-to-face, in-depth semi-structured interviews with 13 pairs of hepatocellular carcinoma patients and their spouses at a tertiary cancer hospital from July to October 2023. The interview guide was designed based on the Actor-Partner Interdependence Model (APIM) framework. Data were analyzed using thematic analysis, and the study adhered to the COnsolidated criteria for REporting Qualitative research (COREQ) checklist. Results Three themes were identified: (1) active coping strategies, (2) negative coping tendencies, and (3) the need for systematic coping support. The majority of couples perceived hepatocellular carcinoma recurrence as a death sentence, which prompted them-especially the spouses-to adopt proactive strategies, such as striving to seek advanced treatments and concealing unfavorable information. In contrast, patients, particularly those with a hereditary hepatocellular carcinoma background, often exhibited passivity, withdrawal, and contemplation of treatment abandonment. Spouses frequently felt overwhelmed and unable to alleviate their partners' anxiety about recurrence and death, particularly in the absence of support from health care professionals. They expressed a strong need for professional guidance and targeted interventions to address end-of-life concerns, emphasizing the need for increased financial support, empowerment through knowledge, and access to peer support networks. Conclusions This research emphasizes the importance of recognizing the interdependent coping experiences of recurrent HCC patients and their spouses. Health care professionals are encouraged to implement culturally sensitive, dyadic interventions that foster collaborative coping, address death-related anxiety, and empower couples in managing recurrence together, thereby enhancing their coping strategies and confidence.
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Affiliation(s)
- Xian Yue
- Department of Nursing, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- Department of Hepatobiliary, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Yanhui Wang
- Department of Hepatobiliary, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Ruishuang Zheng
- Department of Hepatobiliary, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Laiyou Li
- Department of Nursing, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Sun Y, Chen X, Ni J, Yu J. Peritoneal dialysis peritonitis due to Neisseria: clinicopathological features of 10 patients with a review of the literature. Ren Fail 2025; 47:2466820. [PMID: 40012242 PMCID: PMC11869343 DOI: 10.1080/0886022x.2025.2466820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Revised: 01/27/2025] [Accepted: 02/08/2025] [Indexed: 02/28/2025] Open
Abstract
BACKGROUND Peritoneal dialysis-associated peritonitis (PDAP) frequently arises as a complication in patients undergoing peritoneal dialysis. However, the understanding of the role of Neisseria, a gram-negative coccus, in PDAP is limited. METHODS This study retrospectively analyzed data for patients with Neisseria-associated PDAP who were treated at our center from January 2010 to June 2022. These patients were classified into the Neisseria group (Group N) and matched 1:2 by sex, age, dialysis duration, and residual kidney Kt/V with a coagulase-negative staphylococci group (Group CNS) and a Staphylococcus aureus group (Group S) as controls. Statistical analysis was conducted via SPSS 25.0 and was supplemented with a review of the relevant literature, to investigate clinical features, pathways of infection, and patient outcomes. RESULTS This study included 10 cases of Neisseria-associated PDAP, comprising 6 male and 4 female patients. The patients had an average age of 58.10 ± 14.52 years, and the average duration of peritoneal dialysis was 72.00 ± 46.99 months. Among these patients, 3 had first-time infections, while 7 had a prior history of PDAP. After treatment, 9 patients achieved medical cure, and 1 patient was transferred to hemodialysis (HD). Baseline comparisons across the 3 groups indicated notable differences in body temperature upon admission, which were statistically significant (p < 0.05), with patients in Group S having higher body temperatures compared to Group N and Group CNS. Compared with Group N, Group S presented a markedly elevated high-sensitivity C-reactive protein (hs-CRP) level, decreased serum albumin levels, reduced serum potassium levels, whereas Group CNS presented a significantly lower neutrophil percentage (N%) than did Group N (p < 0.05). Although survival analysis did not reveal statistically significant differences due to the limited sample size, Kaplan-Meier curves indicated a trend toward lower cure rates and slightly worse long-term outcomes in Group S than in Group N and Group CNS, with the latter 2 groups showing similar results. CONCLUSION Neisseria-associated PDAP generally has favorable outcomes, similar to those of CNS-related PDAP and better than those of S-related PDAP. Hypoalbuminemia, hypokalemia and elevated hs-CRP are key risk factors affecting outcomes, emphasizing the need to address them during treatment.
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Affiliation(s)
- Yue Sun
- Department of Nephrology (Key Laboratory of Kidney Disease Prevention and Control Technology), Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Xinyu Chen
- Department of Nephrology (Key Laboratory of Kidney Disease Prevention and Control Technology), Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Jun Ni
- Department of Nephrology (Key Laboratory of Kidney Disease Prevention and Control Technology), Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Jin Yu
- Department of Nephrology (Key Laboratory of Kidney Disease Prevention and Control Technology), Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
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Warang P, Singh G, Moshir M, Binazon O, Laghlali G, Chang LA, Wouters H, Vanhoenacker P, Notebaert M, Elhemdaoui N, Augustynková K, Steeland S, Ulrichts P, Baumeister J, Schotsaert M. Impact of FcRn antagonism on vaccine-induced protective immune responses against viral challenge in COVID-19 and influenza mouse vaccination models. Hum Vaccin Immunother 2025; 21:2470542. [PMID: 40028815 PMCID: PMC11881870 DOI: 10.1080/21645515.2025.2470542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 02/03/2025] [Accepted: 02/19/2025] [Indexed: 03/05/2025] Open
Abstract
Antagonism of the neonatal Fc receptor through an engineered antibody Fc fragment, such as efgartigimod, results in a decrease in immunoglobulin G levels. This approach is being evaluated as a therapeutic strategy for the treatment of IgG-mediated autoimmune diseases. Our goal was to evaluate the impact of mFc-ABDEG, a mouse-adapted antibody Fc fragment with a mode of action highly similar to efgartigimod, on vaccine-induced protective immune responses against viral infections. Therefore, mouse vaccination models for COVID-19 and influenza were employed, utilizing an mRNA COVID-19 vaccine (COMIRNATY) and an adjuvanted, inactivated quadrivalent influenza vaccine (Seqirus+AddaVax), respectively. In both models, vaccination induced robust humoral responses. As expected, animals treated with mFc-ABDEG had lower levels of virus-specific IgG, while virus-specific IgM responses remained unaffected. The COVID-19 vaccine induced a strong Th1-type T cell response irrespective of mFc-ABDEG treatment. Influenza vaccination resulted in a poor T cell induction, regardless of mFc-ABDEG treatment, due to the Th2-biased response that inactivated influenza vaccines typically induce. Importantly, mFc-ABDEG treatment had no effect on protective immunity against live viral challenges in both models. Vaccinated animals treated with mFc-ABDEG were equally protected as the non-treated vaccinated controls. These non-clinical data demonstrate that FcRn antagonism with mFc-ABDEG did not affect the generation of vaccine-induced protective humoral and cellular responses, or protection against viral challenges. These data substantiate the clinical observations that, although IgG titers were reduced, FcRn antagonism with efgartigimod did not impair the ability to generate new specific IgG responses, regardless of the timing of vaccination.
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Affiliation(s)
- Prajakta Warang
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gagandeep Singh
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mahan Moshir
- Department of Translational & Clinical Sciences, Argenx, Ghent, Belgium
| | - Ornella Binazon
- Department of Non-Clinical Pharmacology & Toxicology, Argenx, Ghent, Belgium
| | - Gabriel Laghlali
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lauren A. Chang
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | | | | | - Sophie Steeland
- Department of Translational & Clinical Sciences, Argenx, Ghent, Belgium
| | - Peter Ulrichts
- Department of Translational & Clinical Sciences, Argenx, Ghent, Belgium
| | - Judith Baumeister
- Department of Non-Clinical Pharmacology & Toxicology, Argenx, Ghent, Belgium
| | - Michael Schotsaert
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Genomics Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Sun Z, Chen Y, Su Q. Prenatal ultrasound for the diagnosis of the cerebellar abnormalities: a meta-analysis. J Matern Fetal Neonatal Med 2025; 38:2453997. [PMID: 39864828 DOI: 10.1080/14767058.2025.2453997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Revised: 01/02/2025] [Accepted: 01/09/2025] [Indexed: 01/28/2025]
Abstract
OBJECTIVE Fetal cerebellar abnormalities are associated with neurodevelopmental disorders and structural brain malformations. Accurate and early diagnosis is crucial for prenatal counseling and planning postnatal interventions. While prenatal ultrasound is a key tool for detecting fetal brain abnormalities, variations in diagnostic accuracy across studies necessitate a systematic evaluation of its effectiveness in diagnosing cerebellar abnormalities. METHODS A comprehensive literature search was conducted across major databases to identify relevant studies on prenatal ultrasound for diagnosing cerebellar anomalies. Inclusion criteria included studies with clear diagnostic outcomes, diverse patient populations, and standardized ultrasound protocols. Meta-analytic techniques were employed to assess overall diagnostic accuracy, sensitivity, specificity, and heterogeneity using Meta Disk. The quality of the included studies was evaluated using the QUADAS-2 tool. RESULTS The meta-analysis included fifteen studies involving 1,902 fetuses with suspected cerebellar abnormalities. The pooled sensitivity and specificity of prenatal ultrasound were 0.83 (95% CI: 0.80-0.86) and 0.97 (95% CI: 0.96-0.98), respectively. The positive likelihood ratio was 7.96 (95% CI: 3.23-19.64), the negative likelihood ratio was 0.18 (95% CI: 0.09-0.36), and the odds ratio was 46.76 (95% CI: 14.06-155.53). The combined area under the curve (AUC) reached 0.93, indicating robust diagnostic performance. Heterogeneity was observed, influenced by factors such as gestational age at screening, operator expertise, and ultrasound equipment quality. CONCLUSIONS Prenatal ultrasound is a reliable tool for detecting cerebellar abnormalities with high sensitivity and specificity. However, variability in diagnostic performance suggests the need for standardized protocols and advanced imaging techniques to enhance accuracy. Future research should focus on integrating multiple imaging modalities to optimize prenatal screening outcomes.
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Affiliation(s)
- Zhen Sun
- Department of Clinical Medicine, Quanzhou Medical College, Quanzhou, China
| | - Yanqiu Chen
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Qichen Su
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
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Cai P, Zheng Y, Chen L, Fang Q, Lei Y, She Z. Association of serum N,N,N-trimethyl-5-aminovaleric acid, trimethylamine N-oxide, and trimethyllysine levels with gestational diabetes mellitus. J Matern Fetal Neonatal Med 2025; 38:2467999. [PMID: 39972978 DOI: 10.1080/14767058.2025.2467999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2024] [Revised: 01/27/2025] [Accepted: 02/10/2025] [Indexed: 02/21/2025]
Abstract
OBJECTIVE To investigate the association of serum N,N,N-trimethyl-5-aminovaleric acid (TMAVA), trimethylamine N-oxide (TMAO), and trimethyllysine (TML) levels with gestational diabetes mellitus (GDM). METHODS Seventy pregnant women from the Hunan Provincial Maternal and Child Health Care Hospital (March 2021 to October 2023) were enrolled in this study. Forty GDM patients with GDM were included in the GDM group (GDM), and 30 healthy controls were included (Con). Participants were further categorized into adverse and good outcome groups based on pregnancy outcomes. Serum TMAVA, TMAO, and TML levels were quantified using ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Correlations between biomarker levels and clinical indicators were assessed using Pearson and Spearman analyses. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to evaluate risk factors and predictive value. RESULTS Serum TMAVA, TMAO, and TML levels were significantly higher in the GDM group. TMAVA levels were positively correlated with fasting plasma glucose (FPG), fasting insulin (FINS), creatinine (Cr), TMAO, and TML. TMAO and TML positively correlated with FPG, 2-h postprandial glucose (2h PG), FINS, Cr, and uric acid (UA) levels, while TMAO negatively correlated with triglyceride (TG). Combined TMAVA, TMAO, and TML predicted GDM with an area under the curve (AUC) of 0.940 (95% CI: 0.883-0.997). Elevated TMAVA levels were associated with adverse pregnancy outcomes in GDM, with an AUC of 0.757 (95% CI: 0.612-0.902). CONCLUSIONS Elevated serum levels of TMAVA, TMAO, and TML were significantly associated with the occurrence of GDM and adverse pregnancy outcomes. The combined detection of these three biomarkers demonstrated superior accuracy in predicting GDM. Among them, TMAVA demonstrated the highest predictive efficiency for adverse pregnancy outcomes in women with GDM. These findings provide new biomarkers for early screening and risk assessment of GDM, offering promising applications in clinical practice.
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Affiliation(s)
- Pei Cai
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Yi Zheng
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Lulu Chen
- Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha, China
- Changsha Duxact Biotech Co., Ltd., Changsha, China
| | - Qing Fang
- Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha, China
- Changsha Duxact Biotech Co., Ltd., Changsha, China
| | - Yingjuan Lei
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Zhihua She
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
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Zhang Y, Bi Q, Zhang L, Zhu D. Preoperative Simulation and Three-Dimensional Model for the Operative Treatment of Tibiofibular Diaphyseal Fracture: A Randomized Controlled Clinical Trial. J INVEST SURG 2025; 38:2463351. [PMID: 39956543 DOI: 10.1080/08941939.2025.2463351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Accepted: 02/01/2025] [Indexed: 02/18/2025]
Abstract
BACKGROUND In order to ascertain the safety and therapeutic efficacy of preoperative simulation in conjunction with three-dimensional (3D) printing modalities for the surgical management of tibiofibular diaphyseal fractures. We postulate that preoperative simulation and three-dimensional (3D) printing techniques have a significant impact on reducing the mean operative time, diminishing intraoperative blood loss, and decreasing the frequency of fluoroscopic. MATERIAL AND METHODS Sixty patients with tibiofibular diaphyseal fracture were divided into the conventional surgery group (n = 30) and the 3D printing group (n = 30). In the 3D printing group, preoperative equal-ratio fracture models prepared using the 3D printing technique were used to perform preoperative simulation, guide the real surgical operation, examine implant reduction and placement as well as preoperative plate/screw size. The operation time, intraoperative bleeding, frequency of fluoroscopies, Visual Analog Scale (VAS), and Johner-Wruhs Scale were recorded. RESULTS The operation time, blood loss, and the frequency of fluoroscopy during operation in the group with preoperative simulation and 3D printing were less than that in the conventional surgery group (p < 0.001). Meanwhile, the Visual Analog Scale (VAS) and Johner-Wruhs Scale were also improved in both groups. CONCLUSION The findings indicated that preoperative simulation and three-dimensional (3D) printing may facilitate the treatment of tibiofibular diaphyseal fractures, potentially enhancing preoperative planning and contributing to the precision and personalization of the surgical procedure. Thus, the application of this technology possesses considerable promise for future utilization in clinical practice. TRIAL REGISTRY Name of the registry: This study was registered in the Chinese Clinical Trial Registry; Trial registration number: ChiCTR2100052379.
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Affiliation(s)
- Yin Zhang
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Qing Bi
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Li Zhang
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Danjie Zhu
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
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Ozarslan N, Mong C, Ategeka J, Li L, Buarpung S, Robinson JF, Kizza J, Kakuru A, Kamya MR, Dorsey G, Rosenthal PJ, Gaw SL. Placental malaria induces a unique methylation profile associated with fetal growth restriction. Epigenetics 2025; 20:2475276. [PMID: 40051167 PMCID: PMC11901535 DOI: 10.1080/15592294.2025.2475276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2024] [Revised: 02/21/2025] [Accepted: 02/24/2025] [Indexed: 03/12/2025] Open
Abstract
Fetal growth restriction (FGR) is associated with perinatal death and adverse birth outcomes, as well as long-term complications, including increased childhood morbidity, abnormal neurodevelopment, and cardio-metabolic diseases in adulthood. Placental epigenetic reprogramming associated with FGR may mediate these long-term outcomes. Placental malaria (PM), characterized by sequestration of Plasmodium falciparum-infected erythrocytes in placental intervillous space, is the leading global cause of FGR, but its impact on placental epigenetics is unknown. We hypothesized that placental methylomic profiling would reveal common and distinct mechanistic pathways of non-malarial and PM-associated FGR. We analyzed placentas from a US cohort with no malaria exposure (n = 12) and a cohort from eastern Uganda, a region with a high prevalence of malaria (n = 12). From each site, 8 cases of FGR and 4 healthy controls were analyzed. PM was diagnosed by placental histopathology. We compared the methylation levels of over 850K CpGs of the placentas using Infinium MethylationEPIC v1 microarray. Non-malarial FGR was associated with 65 differentially methylated CpGs (DMCs), whereas PM-FGR was associated with 133 DMCs, compared to their corresponding controls without FGR. One DMC (cg16389901, located in the promoter region of BMP4) was commonly hypomethylated in both groups. We identified 522 DMCs between non-malarial FGR vs. PM-FGR placentas, independent of differing geographic location or cellular composition. Placentas with PM-associated FGR have distinct methylation profiles compared to placentas with non-malarial FGR, suggesting novel epigenetic reprogramming in response to malaria. Larger cohort studies are needed to determine the distinct long-term health outcomes in PM-associated FGR pregnancies.
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Affiliation(s)
- Nida Ozarslan
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Corina Mong
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - John Ategeka
- Infectious Diseases Research Collaboration, Uganda
| | - Lin Li
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Sirirak Buarpung
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Joshua F. Robinson
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Jimmy Kizza
- Infectious Diseases Research Collaboration, Uganda
| | - Abel Kakuru
- Infectious Diseases Research Collaboration, Uganda
| | - Moses R. Kamya
- Infectious Diseases Research Collaboration, Uganda
- Department of Medicine, Makerere University, Kampala, Uganda
| | - Grant Dorsey
- Division of HIV, Global Medicine, and Infectious Diseases, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Philip J. Rosenthal
- Division of HIV, Global Medicine, and Infectious Diseases, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Stephanie L. Gaw
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Center for Reproductive Sciences and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
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Shin S, Chen S, Xie K, Duhun SA, Ortiz-Cerda T. Evaluating the anti-inflammatory and antioxidant efficacy of complementary and alternative medicines (CAM) used for management of inflammatory bowel disease: a comprehensive review. Redox Rep 2025; 30:2471737. [PMID: 40056427 DOI: 10.1080/13510002.2025.2471737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2025] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic autoimmune condition whose pathogenesis has not been fully elucidated, and current treatments are not definitive and often carry several side effects. The Complementary and Alternative Medicine (CAM) offers a new approach to conventional medicine. However, their clinical application and mechanisms remain limited.Objective: The aim of this review is to evaluate the anti-inflammatory, impact on microbiota and antioxidant efficacy of currently available CAM for IBD.Methods: The literature collection was obtained from Google Scholar, MEDLINE, PubMed and Web of Science (WOS). Studies in both human and animal models, published in English language between 2018 and 2024, were selected. Sixty-seven studies were included in the current review after inclusion and exclusion screening processes.Results: Mostly, studies showed significant anti-inflammatory, gut microbiota restoring, antioxidant effects of polyphenols, polysaccharides, emodin, short-chain fatty acids (SCFA; including butyrate, propionate and acetate), and probiotics although some contrasting results were noted. Current evidence shows that polyphenols exhibit the most consistent result in alleviating IBD pathophysiology, primarily due to their significant SCFA-elevating effect.Discussion: Future studies may focus on human studies, narrowing down on individual factors which may change natural product's metabolism. Further research studies are also essential to obtain therapeutic recommendations.
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Affiliation(s)
- Sia Shin
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Siqi Chen
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Kangzhe Xie
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Suehad Abou Duhun
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Tamara Ortiz-Cerda
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Departamento de Citología e Histología Normal y Patológica, Facultad de medicina, Universidad de Sevilla, Seville, Spain
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11
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Sheng J, Yang Y, Qiu Y, Lu C, Fu X. Solid and cystic intrapancreatic accessory spleen: report of 10 cases in a single institution. Ann Med 2025; 57:2463564. [PMID: 39927469 PMCID: PMC11812107 DOI: 10.1080/07853890.2025.2463564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2024] [Revised: 10/21/2024] [Accepted: 01/07/2025] [Indexed: 02/11/2025] Open
Abstract
BACKGROUND Precise diagnosis of intrapancreatic accessory spleen (IPAS) remains challenging due to its rarity and diverse presentations. Despite comprehensive examinations, including radiography and other diagnostic methods, the potential for malignancy cannot be excluded, often leading to unnecessary pancreatic surgeries. We review our institutional experience to provide insights for accurately distinguishing IPAS. METHODS We retrospectively reviewed 10 patients who underwent distal pancreatectomy for the lesion in the pancreas tail which was determined to be IPAS on final pathology at our institution between January 2020 and April 2024. The presenting symptoms, medical history, preoperative imaging, operative therapy, final pathology and postoperative course were evaluated. RESULTS Patient ages ranged from 30 to 72 (median 55.5), including six women and four men. Most patients were asymptomatic. One patient had the medical history of splenectomy. Lesions ranged from 1.4 to 7.3 cm (mean 2.9 cm). All lesions were located in the pancreatic tail. On radiologic evaluation, these lesions had both solid and cystic presentations. The most common operative approach was laparoscopic distal pancreatectomy and splenectomy. Four patients were diagnosed with epidermoid cysts arising in intrapancreatic accessory spleen (ECIPAS) on final pathologic evaluation. CONCLUSIONS IPAS are predominantly benign lesions which have solid and cystic presentations commonly mistaken for pancreatic neoplasms. Combining CT, MRI, EUS-FNA and nuclear medicine may enhance IPAS detection, though no definitive diagnostic method exists. Increased awareness of IPAS in the differential diagnosis of pancreatic tail tumors, coupled with advancements in imaging techniques could improve diagnostic accuracy and exclude malignancy, preventing unnecessary surgeries.
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Affiliation(s)
- Jianjie Sheng
- Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yifei Yang
- Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yudong Qiu
- Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
- Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Chenglin Lu
- Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
- Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Xu Fu
- Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
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12
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Lin X, Li H. Diverse processes in rotavirus vaccine development. Hum Vaccin Immunother 2025; 21:2475609. [PMID: 40126359 PMCID: PMC11934161 DOI: 10.1080/21645515.2025.2475609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2024] [Revised: 02/27/2025] [Accepted: 03/03/2025] [Indexed: 03/25/2025] Open
Abstract
Rotavirus is a major cause of severe diarrhea and mortality in children under five years of age, leading to approximately 128,500 deaths annually.1-3 Vaccination is the most effective strategy for preventing rotavirus infection. While two widely used vaccines, Rotarix and RotaTeq, have shown good efficacy in high-income countries, their effectiveness is lower in low- and middle-income countries due to factors such as malnutrition and poor sanitation.4-6 These challenges include complex vaccination schedules and high production costs. Researchers are working on novel vaccines, including inactivated virus and viral protein-based options, as well as virus-like particles and recombinant proteins.7-9 Improving vaccine stability and applicability is crucial for resource-limited settings, and global vaccination strategies are expected to significantly reduce infection burdens, improve child health, and contribute to the achievement of global health goals.10-14.
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Affiliation(s)
- Xiaochen Lin
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Yunnan Provincial Key Laboratory of Vaccine R&D for Major Infectious Diseases, Kunming, China
| | - Hongjun Li
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Yunnan Provincial Key Laboratory of Vaccine R&D for Major Infectious Diseases, Kunming, China
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13
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Huang FJ, Fang YY, Wen JY, Li JJ, Lin Q, Su QY, Chen YY, Wang L, Zeng JJ, Chi BT, He RQ, Qin DY, Yang LH, Chen G. From PD-1/PD-L1 to tertiary lymphoid structures: Paving the way for precision immunotherapy in cholangiocarcinoma treatment. Hum Vaccin Immunother 2025; 21:2444697. [PMID: 39757910 DOI: 10.1080/21645515.2024.2444697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Revised: 12/07/2024] [Accepted: 12/16/2024] [Indexed: 01/07/2025] Open
Abstract
Cholangiocarcinoma (CCA) is a highly malignant hepatobiliary tumor characterized by limited treatment options and poor prognosis. The recent rise of immunotherapy has significantly influenced research in this field. This study presents a bibliometric analysis of 416 articles retrieved from the WOSCC, Wan fang Data, CNKI and VIP databases, spanning contributions from 32 countries, 589 institutions and 3,200 authors. The analysis identified "PD-L1," "PD-1" and "pembrolizumab" as central research foci, while "immune checkpoint inhibitors," "tumor immune microenvironment," "tertiary lymphoid structures" and "durvalumab" emerged as key areas of interest. These findings emphasize the pivotal role of immunotherapy in improving survival outcomes for CCA, and they highlight the significance of tertiary lymphoid structures within the tumor microenvironment as a promising target for future research. This study offers a strategic overview of the evolving landscape of CCA immunotherapy, providing valuable insights to guide future scientific endeavors in this domain.
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Affiliation(s)
- Fang-Ju Huang
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Ye-Ying Fang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Jia-Ying Wen
- Department of Radiotherapy, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Jian-Jun Li
- Department of General Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Qian Lin
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Qin-Yan Su
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Yi-Yang Chen
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Lei Wang
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Jian-Jia Zeng
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Bang-Teng Chi
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Rong-Quan He
- Department of Medical Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Di-Yuan Qin
- Department of Computer Science and Technology, School of Computer and Electronic Information, Guangxi University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Li-Hua Yang
- Department of Medical Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Gang Chen
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
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Ogura T, Uba Y, Kanadani T, Bessho K, Nishikawa H. Multi-hole metal stent can prevent cystic and pancreatic duct obstruction during endoscopic ultrasound-guided antegrade stenting combined with hepaticogastrostomy. Endoscopy 2025; 57:E163-E164. [PMID: 39961365 PMCID: PMC11832272 DOI: 10.1055/a-2528-0340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2025]
Affiliation(s)
- Takeshi Ogura
- Endoscopy Center, Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Yuki Uba
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Takafumi Kanadani
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Kimi Bessho
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Hiroki Nishikawa
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
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15
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Ogura T, Uba Y, Kanadani T, Hattori N, Nishikawa H. Reintervention for recurrent biliary obstruction after stent-in-stent deployment of multi-hole self-expandable metal stents. Endoscopy 2025; 57:E181-E182. [PMID: 39978392 PMCID: PMC11842147 DOI: 10.1055/a-2534-3143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2025]
Affiliation(s)
- Takeshi Ogura
- Endoscopy Center, Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Japan
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Yuki Uba
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Takafumi Kanadani
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Nobuhiro Hattori
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Hiroki Nishikawa
- 2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
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16
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Han X, Zhang B. Comparison of the value of transvaginal ultrasonography and MRI in the diagnosis of cesarean scar pregnancy: a meta-analysis. J Matern Fetal Neonatal Med 2025; 38:2445661. [PMID: 39762030 DOI: 10.1080/14767058.2024.2445661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 12/13/2024] [Accepted: 12/16/2024] [Indexed: 01/11/2025]
Abstract
OBJECTIVE To compare the diagnostic value of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) in cesarean scar pregnancy (CSP) by a method of meta-analysis. METHODS Studies on TVS and MRI for CSP were collected from PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang data, and Chinese Scientific Journal Database (VIP database) until April 1, 2024. Stata 15.0 software was used for data analysis. Mann-Whitney U-test was applied to compare the diagnostic efficiency of the TVS and MRI groups. RESULTS Nine articles with 713 subjects were involved in this review. The pooled sensitivity (0.96, 95%CI: 0.94-0.97), specificity (0.90, 95%CI: 0.84-0.94), and DOR (197.28, 95%CI: 99.71-390.31) in the MRI group were higher than those (Sensitivity = 0.83, 95%CI: 0.77-0.87; Specificity= 0.74, 95%CI: 0.63-0.83; DOR = 13.66, 95%CI: 7.84-23.79) in the TVS group. The positive likelihood ratio and negative likelihood ratio of the MRI group were 9.56 (95%CI: 8.82-15.72) and 0.05 (95%CI: 0.03-0.07), while those of the TVS group were 3.21 (95%CI:2.18-4.74) and 0.24 (95%CI: 0.18-0.31), respectively. In the MRI and TVS groups, the area under the curve (AUC) of the summary receiver operating characteristic was 0.9497 and 0.86, respectively. The results of Mann-Whitney U-tests of the two groups showed significant differences in the pooled sensitivity (Z= -3.311, p < 0.001), specificity (Z= -2.123, p = 0.034), and DOR (Z= -3.272, p = 0.001). CONCLUSION Both MRI and TVS can effectively diagnose CSP. However, compared with TVS, MRI has better diagnostic accuracy for CSP, with higher sensitivity and specificity. Considering the good diagnostic accuracy of ultrasound, patients with ultrasound suspicion of CSP should be sent to a reference center where MRI can express its full diagnostic potential regarding depth, topography of invasion and myometral residue, which is useful for subsequent management.
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Affiliation(s)
- Xiao Han
- Department of Ultrasound, the First Affiliated Hospital of Hainan Medical College, Haikou, Hainan, China
| | - Boyang Zhang
- Department of Ultrasound, the First Affiliated Hospital of Hainan Medical College, Haikou, Hainan, China
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17
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Darbà J, Ascanio M. Hepatocellular carcinoma: what are the differential costs compared to the general population? J Med Econ 2025; 28:471-478. [PMID: 40126406 DOI: 10.1080/13696998.2025.2484073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2025] [Revised: 03/20/2025] [Accepted: 03/21/2025] [Indexed: 03/25/2025]
Abstract
INTRODUCTION Hepatocellular carcinoma (HCC), which accounts for about 90% of all primary liver cancer cases, is the fifth most common malignancy and the second leading cause of cancer-related mortality worldwide. This study aims to analyse the differential costs of HCC-related hospital admissions compared to the general population in Spain. METHODS A retrospective multicenter study analyzed inpatient admissions from a Spanish national discharge database, covering 90% of hospitals between 2010 and 2022. HCC-related admissions were identified using ICD-9 and ICD-10 codes, while control admissions were selected from the general population in the same database without an HCC diagnosis. The direct hospitalization cost was included, covering medical examinations, procedures, medications, surgeries, personnel and equipment. Statistical methods, including nearest-neighbor matching, propensity score matching, and a generalized linear model, were used to estimate differential costs and to ensure comparability based on age, gender, and Charlson Comorbidity Index (CCI). RESULTS A total of 199,670 HCC-related hospital admissions and 200,000 control admissions were analyzed. Most HCC-related admissions involved male patients (78%) aged 66-85 years, with an average CCI of 5.18. HCC-related admissions incurred significantly higher costs, with an estimated differential cost of €1,303.68 using GLM, €1,804.25 via propensity score matching, and €1,767.77 using nearest-neighbor matching. Total costs per HCC admission ranged between €1,000 and €31,000. CONCLUSIONS HCC-related hospital admissions impose a significantly higher economic burden due to the complexity of care. Given the high mortality and resource utilization, advancements in early detection, treatment, and cost-effective interventions are needed to improve patient outcomes and reduce healthcare costs.
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Affiliation(s)
- Josep Darbà
- Department of Economics, Universitat de Barcelona, Barcelona, Spain
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18
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Aldali F, Deng C, Nie M, Chen H. Advances in therapies using mesenchymal stem cells and their exosomes for treatment of peripheral nerve injury: state of the art and future perspectives. Neural Regen Res 2025; 20:3151-3171. [PMID: 39435603 PMCID: PMC11881730 DOI: 10.4103/nrr.nrr-d-24-00235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 07/26/2024] [Accepted: 08/26/2024] [Indexed: 10/23/2024] Open
Abstract
"Peripheral nerve injury" refers to damage or trauma affecting nerves outside the brain and spinal cord. Peripheral nerve injury results in movements or sensation impairments, and represents a serious public health problem. Although severed peripheral nerves have been effectively joined and various therapies have been offered, recovery of sensory or motor functions remains limited, and efficacious therapies for complete repair of a nerve injury remain elusive. The emerging field of mesenchymal stem cells and their exosome-based therapies hold promise for enhancing nerve regeneration and function. Mesenchymal stem cells, as large living cells responsive to the environment, secrete various factors and exosomes. The latter are nano-sized extracellular vesicles containing bioactive molecules such as proteins, microRNA, and messenger RNA derived from parent mesenchymal stem cells. Exosomes have pivotal roles in cell-to-cell communication and nervous tissue function, offering solutions to changes associated with cell-based therapies. Despite ongoing investigations, mesenchymal stem cells and mesenchymal stem cell-derived exosome-based therapies are in the exploratory stage. A comprehensive review of the latest preclinical experiments and clinical trials is essential for deep understanding of therapeutic strategies and for facilitating clinical translation. This review initially explores current investigations of mesenchymal stem cells and mesenchymal stem cell-derived exosomes in peripheral nerve injury, exploring the underlying mechanisms. Subsequently, it provides an overview of the current status of mesenchymal stem cell and exosome-based therapies in clinical trials, followed by a comparative analysis of therapies utilizing mesenchymal stem cells and exosomes. Finally, the review addresses the limitations and challenges associated with use of mesenchymal stem cell-derived exosomes, offering potential solutions and guiding future directions.
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Affiliation(s)
- Fatima Aldali
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Chunchu Deng
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Mingbo Nie
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Hong Chen
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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Aluyi-Osa G, Suleman A, Salati C, Spadea L, Gagliano C, Musa M, Zeppieri M. Multidisciplinary management of pituitary macroadenoma. World J Methodol 2025; 15:97694. [DOI: 10.5662/wjm.v15.i3.97694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 11/18/2024] [Accepted: 12/03/2024] [Indexed: 03/06/2025] Open
Abstract
BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations. This manuscript explores the multidisciplinary approach to understanding and managing pituitary macroadenomas, integrating neurosurgery, endocrinology, radiology, and pathology perspectives.
AIM To summarize the literature on pituitary macroadenoma and outline the possible multidisciplinary approach in the diagnosis, management, and rehabilitation of individuals with pituitary adenomas, to add to already preexisting knowledge, in managing these cases enhancing better ocular and systemic outcomes.
METHODS A search was conducted on an online publication database (PubMed) using the term “pituitary adenoma” including all results published over twenty years (2004-2024). Results were sorted for relevance, language, and completeness.
RESULTS A total of 176 records were returned. The guidelines of the PRISMA 2020 statement were followed in this study. A total of 23 records were excluded due to being out of scope while a further 13 records were duplicates. Another 17 records were not available as full-length articles and were also excluded. The references of each included record was further searched for relevant publications. A total of 141 records were therefore used in this minireview.
CONCLUSION Pituitary macroadenomas pose substantial clinical challenges due to their size and potential for significant hormonal and neurological impact, modern therapeutic strategies offer effective management options. Early detection and comprehensive treatment are essential for optimizing patient outcomes and maintaining quality of life. Continued research and advancements in medical technology are likely to further enhance the management and prognosis of this condition in the future
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Affiliation(s)
- Gladness Aluyi-Osa
- Department of Ophthalmology, Africa Eye Laser Center, Km 7, Benin 300105, Nigeria
| | - Ayuba Suleman
- Department of Ophthalmology, Africa Eye Laser Center, Km 7, Benin 300105, Nigeria
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
| | - Leopoldo Spadea
- Eye Clinic, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00142, Italy
| | - Caterina Gagliano
- Department of Medicine and Surgery, University of Enna "Kore", Enna 94100, Italy
- Mediterranean Foundation "G.B. Morgagni", 95125 Catania, Italy
| | - Mutali Musa
- Department of Ophthalmology, Africa Eye Laser Center, Km 7, Benin 300105, Nigeria
- Department of Optometry, University of Benin, Benin 300283, Nigeria
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
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20
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Yin L, Xu Y, Mu J, Leng Y, Ma L, Zheng Y, Li R, Wang Y, Li P, Zhu H, Wang D, Li J. CNKSR2 interactome analysis indicates its association with the centrosome/microtubule system. Neural Regen Res 2025; 20:2420-2432. [PMID: 39359098 PMCID: PMC11759008 DOI: 10.4103/nrr.nrr-d-23-01725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/27/2024] [Accepted: 03/04/2024] [Indexed: 10/04/2024] Open
Abstract
JOURNAL/nrgr/04.03/01300535-202508000-00031/figure1/v/2024-09-30T120553Z/r/image-tiff The protein connector enhancer of kinase suppressor of Ras 2 (CNKSR2), present in both the postsynaptic density and cytoplasm of neurons, is a scaffolding protein with several protein-binding domains. Variants of the CNKSR2 gene have been implicated in neurodevelopmental disorders, particularly intellectual disability, although the precise mechanism involved has not yet been fully understood. Research has demonstrated that CNKSR2 plays a role in facilitating the localization of postsynaptic density protein complexes to the membrane, thereby influencing synaptic signaling and the morphogenesis of dendritic spines. However, the function of CNKSR2 in the cytoplasm remains to be elucidated. In this study, we used immunoprecipitation and high-resolution liquid chromatography-mass spectrometry to identify the interactors of CNKSR2. Through a combination of bioinformatic analysis and cytological experiments, we found that the CNKSR2 interactors were significantly enriched in the proteome of the centrosome. We also showed that CNKSR2 interacted with the microtubule protein DYNC1H1 and with the centrosome marker CEP290. Subsequent colocalization analysis confirmed the centrosomal localization of CNKSR2. When we downregulated CNKSR2 expression in mouse neuroblastoma cells (Neuro 2A), we observed significant changes in the expression of numerous centrosomal genes. This manipulation also affected centrosome-related functions, including cell size and shape, cell proliferation, and motility. Furthermore, we found that CNKSR2 interactors were highly enriched in de novo variants associated with intellectual disability and autism spectrum disorder. Our findings establish a connection between CNKSR2 and the centrosome, and offer new insights into the underlying mechanisms of neurodevelopmental disorders.
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Affiliation(s)
- Lin Yin
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
| | - Yalan Xu
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
| | - Jie Mu
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- College of Life Sciences, and School of Pharmacy, Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Yu Leng
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
| | - Lei Ma
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
| | - Yu Zheng
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
- Department of Urology, Qingdao Municipal Hospital Affiliated to Qingdao University, Qingdao, Shandong Province, China
| | - Ruizhi Li
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
| | - Yin Wang
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Peifeng Li
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Hai Zhu
- Department of Urology, Qingdao Municipal Hospital Affiliated to Qingdao University, Qingdao, Shandong Province, China
| | - Dong Wang
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Jing Li
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Medical College, Qingdao University, Qingdao, Shandong Province, China
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Byeon H. Innovative approaches to managing chronic multimorbidity: A multidisciplinary perspective. World J Clin Cases 2025; 13:102484. [DOI: 10.12998/wjcc.v13.i19.102484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2024] [Revised: 02/13/2025] [Accepted: 02/25/2025] [Indexed: 03/19/2025] Open
Abstract
The rising prevalence of chronic multimorbidity poses substantial challenges to healthcare systems, necessitating the development of innovative management strategies to optimize patient care and system efficiency. The study by Fontalba-Navas et al investigates the implementation of a novel high complexity unit (HCU) specifically designed to improve the management of patients with chronic complex conditions. By adopting a multidisciplinary approach, the HCU aims to provide comprehensive, patient-centered care that enhances health outcomes and alleviates the strain on traditional hospital services. Utilizing a longitudinal analysis of data from the Basic Minimum Data Set, this study compares hospitalization metrics among the HCU, Internal Medicine, and other departments within a regional hospital throughout 2022. The findings reveal that the HCU's integrated care model significantly reduces readmission rates and boosts patient satisfaction compared to conventional care practices. The study highlights the HCU's potential as a replicable model for managing chronic multimorbidity, emphasizing its effectiveness in minimizing unnecessary hospitalizations and enhancing the overall quality of patient care. This innovative approach not only addresses the complexities associated with chronic multimorbid conditions but also offers a sustainable framework for healthcare systems confronting similar challenges.
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Affiliation(s)
- Haewon Byeon
- Worker's Care and Digital Health Lab, Department of Future Technology, Korea University of Technology and Education, Cheonan 31253, South Korea
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22
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Mishra R, Patel H, Jamal A, Singh S. Potential role of large language models and personalized medicine to innovate cardiac rehabilitation. World J Clin Cases 2025; 13:98095. [DOI: 10.12998/wjcc.v13.i19.98095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 11/20/2024] [Accepted: 02/20/2025] [Indexed: 03/19/2025] Open
Abstract
Cardiac rehabilitation is a crucial multidisciplinary approach to improve patient outcomes. There is a growing body of evidence that suggests that these programs contribute towards reducing cardiovascular mortality and recurrence. Despite this, cardiac rehabilitation is underutilized and adherence to these programs has been a demonstrated barrier in achieving these outcomes. As a result, there is a growing focus on innovating these programs, especially from the standpoint of digital health and personalized medicine. This editorial discusses the possible roles of large language models, such as their role in ChatGPT, in further personalizing cardiac rehabilitation programs through simplifying medical jargon and employing motivational interviewing techniques, thus boosting patient engagement and adherence. However, these possibilities must be further investigated in the clinical literature. Likewise, the integration of large language models in cardiac rehabilitation will be challenging in its nascent stages to ensure accurate and ethical information delivery.
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Affiliation(s)
- Rishith Mishra
- School of Medicine, University of Missouri Kansas City, Kansas City, MO 64106, United States
| | - Hersh Patel
- School of Medicine, University of Missouri Kansas City, Kansas City, MO 64106, United States
| | - Aleena Jamal
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, United States
| | - Som Singh
- School of Medicine, University of Missouri Kansas City, Kansas City, MO 64106, United States
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23
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Jiang J, Shi HT, Wu J, Sha SM, Cai SX, Liu X. Successful treatment of depressed esophageal squamous papilloma with interferon- alpha 2a: A case report. World J Clin Cases 2025; 13:99311. [DOI: 10.12998/wjcc.v13.i19.99311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2024] [Revised: 01/27/2025] [Accepted: 02/26/2025] [Indexed: 03/19/2025] Open
Abstract
BACKGROUND Esophageal squamous papilloma (ESP) is a rare benign tumor of the esophagus, typically characterized by an exophytic and warty appearance, with a diameter of less than 5 mm. Endoscopic resection is considered the most effective treatment for these tumors.
CASE SUMMARY In this paper, we discussed the pathogenesis, clinical characteristics, and therapeutic options of ESP based on our experience with a case presenting a depressed appearance and treated with interferon-alpha 2a (IFNα2a) injection.
CONCLUSION This paper reports the first successful clinical case of using the human IFNα2a for the treatment of ESP with a depressed endoscopic appearance. However, the efficacy of interferon treatment requires to validation in a large number of subsequent cases.
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Affiliation(s)
- Jiong Jiang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Hai-Tao Shi
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Jie Wu
- Department of Pathology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Su-Mei Sha
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Shang-Xuan Cai
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Xin Liu
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
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24
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Yi JB, Chang MC. Necessity of collaboration between pain physicians and orthotists in pain medicine. World J Clin Cases 2025; 13:104976. [DOI: 10.12998/wjcc.v13.i19.104976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2025] [Revised: 02/19/2025] [Accepted: 02/27/2025] [Indexed: 03/19/2025] Open
Abstract
In this editorial, we comment on the article by Nagamine et al, published in the World Journal of Clinical Cases. The authors suggest that virtual reality technology has potential in alleviating pain by enhancing brain network functionality. Alongside virtual reality, various treatment methods are used to effectively manage musculoskeletal pain. One such method is the use of orthoses, which are applied in clinical settings. We emphasize the need for collaboration between pain physicians and orthotists when applying orthoses for pain management. The efficacy of orthoses is maximized when customized to the physical characteristics of each patient, type of disease, and location of pain. Orthoses are designed to restore anatomical alignment and biomechanical function; however, their success depends on the expertise of trained orthotists, who should effectively communicate with physicians and understand the mechanical principles of musculoskeletal alignment. The professional knowledge of orthotists is critical in ensuring that orthoses are appropriately designed and applied to achieve therapeutic efficacy. Since no single treatment modality typically offers sufficient relief for musculoskeletal pain, effective collaboration between pain physicians and orthotists is crucial to optimize the use of orthoses in the management of pain.
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Affiliation(s)
- Jin-Bok Yi
- Department of Rehabilitation Technology, Hanseo University, Seosan 31962, South Korea
| | - Min Cheol Chang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu 705-717, South Korea
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25
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Maranhão BHF, Junior CTDS, Barillo JL, Souza JBS, Silva PS, Stirbulov R. Total adenosine deaminase cases as an inflammatory biomarker of pleural effusion syndrome. World J Clin Cases 2025; 13:101850. [DOI: 10.12998/wjcc.v13.i19.101850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2024] [Revised: 11/04/2024] [Accepted: 03/04/2025] [Indexed: 03/19/2025] Open
Abstract
BACKGROUND Although inflammatory diseases commonly affect the pleura and pleural space, their mechanisms of action remain unclear. The presence of several mediators emphasizes the concept of pleural inflammation. Adenosine deaminase (ADA) is an inflammatory mediator detected at increased levels in the pleural fluid.
AIM To determine the role of total pleural ADA (P-ADA) levels in the diagnosis of pleural inflammatory diseases.
METHODS 157 patients with inflammatory pleural effusion (exudates, n = 124, 79%) and non-inflammatory pleural effusion (transudates, n = 33, 21%) were included in this observational retrospective cohort study. The P-ADA assay was tested using a kinetic technique. The performance of the model was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC). The ideal cutoff value for P-ADA in pleural inflammation was determined using the Youden index in the ROC curve.
RESULTS The transudates included congestive heart failure (n = 26), cirrhosis of the liver with ascites (n = 3), chronic renal failure (n = 3), and low total protein levels (n = 1). The exudate cases included tuberculosis (n = 44), adenocarcinoma (n = 37), simple parapneumonic effusions (n = 15), complicated parapneumonic effusions/empyema (n = 8), lymphoma (n = 7), and other diseases (n = 13). The optimal cutoff value of P-ADA was ≥ 9.00 U/L. The diagnostic parameters as sensitivity, specificity, positive and negative predictive values, positive and negative likelihood values, odds ratio, and accuracy were 77.69 (95%CI: 69.22-84.75); 68.75 (95%CI: 49.99-83.88); 90.38 and 44.90 (95%CI: 83.03-95.29; 30.67-59.77); 2.48 and 0.32 (95%CI: 2.21-11.2; 0.27-0.51); 7.65 (95%CI: 0.78-18.34), and 75.82 (95%CI: 68.24-82.37), respectively (χ² = 29.51, P = 0.00001). An AUC value of 0.8107 (95%CI: 0.7174-0.8754; P = 0.0000) was clinically useful. The Hosmer-Lemeshow test showed excellent discrimination.
CONCLUSION P-ADA biomarker has high diagnostic performance for pleural inflammatory exudates.
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Affiliation(s)
- Bernardo Henrique Ferraz Maranhão
- Department of Specialized Medicine, Federal University of the State of Rio de Janeiro, Rio de Janeiro 20270004, State of Rio de Janeiro, Brazil
| | | | - Jorge Luiz Barillo
- Department of Thoracic Surgery, General Hospital Santa Teresa, Petropolis 25680-003, Rio de Janeiro, Brazil
| | | | - Patricia Siqueira Silva
- Professor Mazzini Bueno Tuberculosis Research and Assistance Center, Federal Fluminense University, Niteroi 24020-080, Rio de Janeiro, Brazil
| | - Roberto Stirbulov
- Department of Clinics, Rua Baronesa de Itu, São Paulo 1231001, São Paulo, Brazil
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26
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Iwamuro M, Yoshikawa T, Kamio T, Hirata S, Matsueda K, Kametaka D, Otsuka M. Temporal changes in computed tomography findings of a persimmon bezoar: A case report. World J Clin Cases 2025; 13:103426. [DOI: 10.12998/wjcc.v13.i18.103426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2024] [Revised: 01/18/2025] [Accepted: 02/06/2025] [Indexed: 02/27/2025] Open
Abstract
BACKGROUND Gastric bezoars are masses of indigestible material that accumulate in the stomach, causing nausea, abdominal pain, and vomiting. Persimmon bezoars (diospyrobezoars), which comprise tannins and fibers from persimmons, are relatively rare but may cause significant gastric complications, including gastric outlet obstruction or ileus. Although computed tomography (CT) is a useful imaging tool, diagnosing bezoars can be challenging because their density is similar to that of food debris and gastric content.
CASE SUMMARY Here, we report the case of a 72-year-old woman with a persimmon bezoar that was diagnosed using serial CT imaging and confirmed by endoscopy. CT performed over several months revealed changes in the internal structure and density of the bezoar, suggesting progressive hardening. The patient had a history of a partial gastrectomy and excessive persimmon consumption, both of which are risk factors for bezoar formation. Endoscopic fragmentation of the bezoar successfully resolved symptoms.
CONCLUSION Gastric bezoars, particularly persimmon bezoars, present diagnostic challenges because of their variable imaging characteristics. Serial CT can document temporal changes in bezoar density, potentially reflecting changes in hardness. Early diagnosis and endoscopic treatment are essential for effective management, particularly in patients with predisposing factors. This case underscores the importance of considering bezoars in the differential diagnosis of gastric masses, and highlights the value of CT for monitoring changes in bezoar characteristics over time.
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Affiliation(s)
- Masaya Iwamuro
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Tomoki Yoshikawa
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Tomohiro Kamio
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Shoichiro Hirata
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Katsunori Matsueda
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Daisuke Kametaka
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Motoyuki Otsuka
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
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27
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Song YL, Wang CF. Temporary bilateral uterine artery occlusion in the control of hemorrhage: A case report and review of literature. World J Clin Cases 2025; 13:101309. [DOI: 10.12998/wjcc.v13.i18.101309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Revised: 11/01/2024] [Accepted: 12/05/2024] [Indexed: 02/27/2025] Open
Abstract
BACKGROUND Intramural pregnancy is rare, with an unclear etiology and pathophysiology. Surgical, medical, and expectant management options are available for this condition. However, most reported cases are managed surgically. Despite the risks of massive intraoperative bleeding and acute and long-term complications, uterine artery embolization is often selected. Temporary occlusion of the bilateral uterine arteries during surgery is associated with fewer complications.
CASE SUMMARY We reported the case of a patient who was diagnosed with intramural pregnancy approximately one month after medical abortion. We performed laparoscopic resection with hysteroscopy. Since the lesion had abundant blood flow, we temporarily blocked the bilateral uterine arteries to prevent massive intraoperative bleeding. The surgical process went smoothly. The postoperative course was uneventful.
CONCLUSION Temporary occlusion of the bilateral uterine arteries in the treatment of intramural pregnancy may prevent excessive uterine bleeding during surgery.
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Affiliation(s)
- Yu-Liang Song
- Department of Gynecology, Zhejiang Hospital, Hangzhou 310030, Zhejiang Province, China
| | - Chun-Feng Wang
- Department of Gynecology, Zhejiang Hospital, Hangzhou 310030, Zhejiang Province, China
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28
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Li MZ, Deng J. Birt-Hogg-Dubé syndrome - a rare genetic disorder complicated by pneumothorax: A case report. World J Clin Cases 2025; 13:100610. [DOI: 10.12998/wjcc.v13.i18.100610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Revised: 10/10/2024] [Accepted: 01/24/2025] [Indexed: 02/27/2025] Open
Abstract
BACKGROUND Birt-Hogg-Dubé (BHD) syndrome is a rare genetic disorder associated with mutations in the BHD gene, which can manifest symptoms at any age, including dermatological and pulmonary complications, as well as renal tumors. This study presents a case of a BHD patient who experienced spontaneous pneumothorax, aiming to enhance the understanding of this syndrome.
CASE SUMMARY A 42-year-old female patient presented with left-sided chest pain and tightness lasting three days. Chest computed tomography scans revealed left-sided pneumothorax and multiple pulmonary bullae. Physical examination indicated decreased vocal fremitus and tympanic percussion on the left side. A thorough family history revealed a pattern of pulmonary disorders, including emphysema, spontaneous pneumothorax, and lung cancer among relatives. Genetic testing identified a heterozygous frameshift mutation in the FLCN gene at the 17p11.2 locus. Based on the clinical presentation, imaging findings, family history, and genetic results, the patient was suspected to have BHD syndrome.
CONCLUSION We present a case of a heterozygous mutation in the FLCN gene in a patient with BHD syndrome, aiming to review the associated clinical characteristics and genetic mechanisms of this condition. This case serves as a reference point to offer insights into the diagnosis of multiple pulmonary cysts and spontaneous pneumothorax of unknown etiology in clinical practice.
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Affiliation(s)
- Meng-Zhen Li
- Department of Orthopedics, The First People's Hospital of Kunshan, Jiangsu University, Kunshan 215300, Jiangsu Province, China
| | - Jun Deng
- Department of Emergency Surgery, The First People's Hospital of Kunshan, Jiangsu University, Kunshan 215300, Jiangsu Province, China
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29
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Martínez-Hincapie CI, González-Arroyave D, Ardila CM. Rectal abscess secondary to foreign body insertion: A case report. World J Clin Cases 2025; 13:103438. [DOI: 10.12998/wjcc.v13.i18.103438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2024] [Revised: 01/16/2025] [Accepted: 02/12/2025] [Indexed: 02/27/2025] Open
Abstract
BACKGROUND Rectal foreign bodies, though uncommon, present diagnostic and therapeutic challenges, particularly when they result from accidental ingestion. The nonspecific symptoms and the potential for serious complications necessitate a thorough and methodical approach to diagnosis and treatment. This case report aims to highlight the diagnostic complexities and management strategies involved in treating a patient with a rectal foreign body, focusing on the use of advanced imaging techniques and the importance of a multidisciplinary approach.
CASE SUMMARY A 48-year-old male with a history of hypertension presented with a one-year history of post-defecation anorectal pain and mild post-defecation rectorrhagia. Initial evaluation revealed hemodynamic stability and a tender, non-mucosal lesion in the anterior left rectal region. Imaging studies, including colonoscopy, magnetic resonance imaging, and endosonography, identified an erythematous, exophytic lesion and a perirectal abscess containing a foreign body. Surgical intervention revealed necrotic tissue and purulent material, along with two solid foreign body fragments (bone or plant matter). Postoperative follow-up showed the patient in good condition, and pathology confirmed the fragments as mature bone.
CONCLUSION This case underscores the diagnostic challenges posed by rectal foreign bodies with nonspecific symptoms and no clear history of ingestion.
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Affiliation(s)
| | | | - Carlos M Ardila
- Department of Basic Sciences, Faculty of Dentistry Universidad de Antioquia, Medellin 0057, Antioquia, Colombia
- Department of Periodontics, Saveetha Dental College, and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Saveetha, Saveetha 600077, India
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30
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Ait Addi R. Rates of p16 and p53 expression in head and neck cutaneous squamous cell carcinoma vary according to human papillomavirus status. World J Clin Cases 2025; 13:104313. [DOI: 10.12998/wjcc.v13.i18.104313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2024] [Revised: 01/27/2025] [Accepted: 02/08/2025] [Indexed: 02/27/2025] Open
Abstract
The strong association between human papillomavirus (HPV) infection and oropharyngeal squamous cell carcinoma (SCC) is well-documented, with p16 expression serving as a reliable predictor of HPV involvement. HPV-related tumors are characterized by distinct mechanisms affecting p16 and p53 protein pathways. However, the prevalence of HPV and the combined predictive utility of p16 and p53 expression in head and neck cutaneous SCC remain less explored, necessitating further research to understand their role in this subset of SCC. HPV, p16, and p53 statuses were determined using immunohistochemistry staining methods rather than more sensitive techniques such as polymerase chain reaction or HPV genotyping, limiting the ability to assess specific area HPV types potentially associated with prognosis. Further studies assessing multiple molecular markers in head and neck cutaneous patients will better predict the diverse outcomes and potentially the type of treatment targeted to those markers.
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Affiliation(s)
- Rachid Ait Addi
- Department of Biology, Independent Senior Researcher, Marrakesh 41020, Morocco
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31
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Anand R, Nag DS, Patel R, Sharma P, Uppalapati VK, Singh UK. Comparative efficacy of hyperbaric bupivacaine vs hyperbaric ropivacaine in spinal anesthesia for cesarean section: A meta-analysis. World J Methodol 2025; 15:99300. [DOI: 10.5662/wjm.v15.i2.99300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 10/11/2024] [Accepted: 11/15/2024] [Indexed: 11/27/2024] Open
Abstract
BACKGROUND Intrathecal bupivacaine is the traditional anesthetic drug used in spinal anesthesia for caesarean sections (CSs), but ropivacaine has emerged as a potential alternative. This meta-analysis compares the efficacy and safety of intrathecal hyperbaric bupivacaine vs hyperbaric ropivacaine for cesarean sections.
AIM To systematically evaluate and compare the efficacy and safety of intrathecal hyperbaric bupivacaine and hyperbaric ropivacaine for spinal anesthesia in CSs.
METHODS A thorough search of electronic databases was carried out to find pertinent randomized controlled trials (RCTs) comparing intrathecal hyperbaric ropivacaine and hyperbaric bupivacaine during CSs. PubMed, Cochrane database, Google Scholar, and Scopus were searched, and papers from January 2000 to January 2024 were deemed eligible and filtered using predetermined inclusion and exclusion criteria. Studies were assessed for methodological quality, and data were extracted for time to adequate anesthesia (sensory and motor blockade), duration of sensory and motor block, hemodynamic changes and side effect profile. The standardized mean difference with 95%CI was used for continuous data. Dichotomous variables were assessed using the Mantel-Haenszel test and the random effect model to compute the odds ratio.
RESULTS Total 8 RCTs were selected from a pool of 119 search results for meta-analysis. The meta-analysis evaluated pooled effect sizes and assessed heterogeneity among the studies. The primary objective was to compare key outcomes to identify any significant variances in efficacy and safety profiles between two local anesthetics. The analysis revealed that the difference in the onset of sensory blockade between the two local anesthetics was statistically insignificant (P = 0.1586). However, the onset of motor blockade appeared to be faster with bupivacaine (P = 0.03589). Additionally, the regression of sensory and motor blockade occurred earlier in the ropivacaine group. Furthermore, the duration of the first analgesic effect was shorter with a significance level of P < 0.05. Regarding side effects profile, including hypotension, nausea, and shivering, the study did not observe any significant differences between the two groups.
CONCLUSION This meta-analysis offers insights into the effectiveness and safety of hyperbaric bupivacaine vs ropivacaine for cesarean sections. Hyperbaric ropivacaine had a comparable safety profile and faster regression of sensory and motor blockade than hyperbaric bupivacaine, perhaps aiding early mobilization of parturient and facilitating mother-child bonding. Choosing ropivacaine may offer benefits beyond efficacy for cesarean section patients and short surgical procedures.
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Affiliation(s)
- Rishi Anand
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jhārkhand, India
| | - Deb Sanjay Nag
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jhārkhand, India
| | - Roushan Patel
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jhārkhand, India
| | - Prashant Sharma
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jhārkhand, India
| | | | - Umesh Kumar Singh
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jhārkhand, India
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Grewal H, Dhillon G, Buddhavarapu V, Verma RK, Munjal RS, Sharma P, Sidhu G, Kashyap R, Surani S. Strategic insights of telehealth platforms and strengths, weaknesses, opportunities, and threats analysis of Amazon's clinical endeavors. World J Methodol 2025; 15:98513. [DOI: 10.5662/wjm.v15.i2.98513] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 07/23/2024] [Accepted: 07/31/2024] [Indexed: 11/27/2024] Open
Abstract
BACKGROUND The adoption of telehealth services surged after the coronavirus disease 2019 pandemic, revolutionizing traditional healthcare delivery models. Amazon Clinic's recent nationwide launch marks a significant milestone in this trend. This study aims to offer a strengths, weaknesses, opportunities, and threats (SWOT) analysis of Amazon Clinic and compare its features with leading virtual healthcare platforms.
AIM To evaluate Amazon Clinic's telehealth services through a SWOT analysis and compare its features with other leading virtual healthcare platforms.
METHODS The initial search terms included were, amazon clinic odds ratio (OR) amwell OR Teladoc OR Walmart virtual health service OR CVS minute clinic OR CirrusMD OR brightside health, from 2000 to 2023. This search yielded 111 articles, from which duplicates were removed, and unrelated titles were filtered out. Eight articles were retained for a final review, including comparative studies, usability research, retrospective analyses, observational studies, and review articles. The data was organized and analyzed using Rayyan software and summarized in a table and PRISMA flowcharts.
RESULTS The review included eight articles focusing on various aspects of telehealth. Comparative studies highlighted differences between Teladoc and traditional physician offices, noting lower diagnostic imaging orders and antibiotic prescriptions for Teladoc. User demographics for Teladoc showed younger, less engaged patients. Usability studies emphasized the importance of website design for telemedicine adoption. Tele-mental health platforms like Brightside showed superior outcomes in treating depression compared to traditional methods. Telemedicine for specialized fields like skin reconstruction demonstrated cost efficiency and reduced waiting times. The SWOT analysis identified Amazon Clinic's strengths, such as its vast consumer base and transparent pricing, and weaknesses like the lack of pediatric care. Opportunities included potential partnerships and service expansions, while threats involved competition and regulatory challenges.
CONCLUSION Amazon Clinic's entry into the telehealth sector represents a significant development with various strengths and opportunities. However, it faces challenges from established healthcare providers and regulatory landscapes. The future success of Amazon Clinic will depend on strategic collaborations, addressing service gaps, and navigating competition and regulations. Telemedicine's impact will hinge on its ability to effectively leverage these opportunities and overcome inherent challenges in the ever-evolving healthcare landscape.
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Affiliation(s)
- Harpreet Grewal
- Department of Radiology, Ascension Sacred Heart Hospital, Pensacola, FL 32503, United States
| | - Gagandeep Dhillon
- Department of Medicine, UM Baltimore Washington Medical Center, Glen Burnie, MD 21061, United States
| | - Venkata Buddhavarapu
- Department of Medicine, Banner Baywood Medical Center, Banner Health, Mesa, AZ 85206, United States
| | - Ram Kishun Verma
- Department of Sleep Medicine, Parkview Health System, Fort Wayne, IN 46845, United States
| | - Ripudaman Singh Munjal
- Department of Medicine, Touro university College of Osteopathic Medicine, Vallejo, CA 94592, United States
| | - Pranjal Sharma
- Department of Nephrology, Northeast Ohio Medical Center, Rootstown, OH 44272, United States
| | - Gurmanpreet Sidhu
- Department of Pathology, Government Medical College Patiala, Patiala 147001, Punjab, India
| | - Rahul Kashyap
- Department of Research, Wellspan Health, York, PA 17403, United States
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, United States
| | - Salim Surani
- Department of Medicine & Pharmacology, Texas A&M University, College Station, TX 77843, United States
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33
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Zhao NB, Luo Z, Li Y, Xia R, Zhang Y, Li YJ, Zhao D. Diagnostic value of ultrasonography for post-liver transplant hepatic vein complications. World J Transplant 2025; 15:100373. [DOI: 10.5500/wjt.v15.i2.100373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Revised: 01/09/2025] [Accepted: 01/18/2025] [Indexed: 02/21/2025] Open
Abstract
Liver transplantation (LT) is the most effective treatment for patients with end-stage liver disease, and maintaining vascular patency of the transplanted liver is one of the crucial prerequisites for surgical success. Despite hepatic vein complications following LT occurring at a relatively low frequency, ranging between 2% to 11%, delayed diagnosis and treatment may lead to graft dysfunction and even patient mortality. Clinical manifestations of hepatic vein complications are often subtle and nonspecific, posing challenges for early diagnosis. Signs may initially present as mild abnormalities in liver function, delayed recovery of liver function, unexplained ascites, lower limb edema, and perineal edema. Prolonged duration of these complications can lead to hepatic sinusoidal dilatation and eventual liver failure due to prolonged hepatic congestion. Ultrasonography has become the preferred imaging modality for post-liver transplant evaluation due to its convenience and non-invasiveness. Although hepatic vein complications may manifest as disappearance or flattening of the hepatic vein spectrum on routine ultrasound imaging, these findings lack specificity. Contrast-enhanced ultrasound that visualizes the filling of contrast agent in the hepatic veins and dynamically displays blood flow perfusion information in the drainage area can, however, significantly improve diagnostic confidence and provide additional information beyond routine ultrasound examination.
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Affiliation(s)
- Ning-Bo Zhao
- Department of Ultrasound, National Clinical Research Centre for Infectious Disease, Shenzhen Third People’s Hospital, The Second Hospital Affiliated With The Southern University of Science and Technology, Shenzhen 518112, Guangdong Province, China
| | - Zi Luo
- Department of Ultrasound, National Clinical Research Centre for Infectious Disease, Shenzhen Third People’s Hospital, The Second Hospital Affiliated With The Southern University of Science and Technology, Shenzhen 518112, Guangdong Province, China
| | - Ying Li
- Department of Ultrasound, National Clinical Research Centre for Infectious Disease, Shenzhen Third People’s Hospital, The Second Hospital Affiliated With The Southern University of Science and Technology, Shenzhen 518112, Guangdong Province, China
| | - Rui Xia
- Department of Thyroid and Hernia Surgery, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
| | - Yu Zhang
- Department of Ultrasound, National Clinical Research Centre for Infectious Disease, Shenzhen Third People’s Hospital, The Second Hospital Affiliated With The Southern University of Science and Technology, Shenzhen 518112, Guangdong Province, China
| | - Yi-Jun Li
- Department of Ultrasound, National Clinical Research Centre for Infectious Disease, Shenzhen Third People’s Hospital, The Second Hospital Affiliated With The Southern University of Science and Technology, Shenzhen 518112, Guangdong Province, China
| | - Dong Zhao
- Department of Liver Surgery and Organ Transplantation Center, Shenzhen Third People’s Hospital, The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen 518112, Guangdong Province, China
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Lackovic MM, Joksimovic BD, Babovic JC, Isenovic ER, Gluvic ZM. Recurrent acute pancreatitis as an initial presentation of primary hyperparathyroidism in juvenile patient. World J Clin Cases 2025; 13:100439. [DOI: 10.12998/wjcc.v13.i17.100439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2024] [Revised: 01/13/2025] [Accepted: 01/21/2025] [Indexed: 02/18/2025] Open
Abstract
Acute pancreatitis recurrence should always alert clinicians to primary hyperparathyroidism, especially in younger patients and those with a hereditary condition. When parathyroid abnormalities are adequately recognized and addressed, more recurrent attacks of acute pancreatitis are unlikely to occur.
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Affiliation(s)
- Milena M Lackovic
- Department of Endocrinology, University Clinical-Hospital Centre Zemun-Belgrade, Faculty of Medicine, University of Belgrade, Belgrade 11080, Serbia
| | - Bojan D Joksimovic
- Department of Endocrinology, University Clinical-Hospital Centre Zemun-Belgrade, Faculty of Medicine, University of Belgrade, Belgrade 11080, Serbia
| | - Jelena C Babovic
- Department of Geriatrics, University Clinical-Hospital Centre Zemun-Belgrade, Faculty of Medicine, University of Belgrade, Belgrade 11080, Serbia
| | - Esma R Isenovic
- Department of Radiobiology and Molecular Genetics, Vinča Institute of Nuclear Sciences - National Institute of the Republic of Serbia, University of Belgrade, Belgrade 11000, Serbia
| | - Zoran M Gluvic
- Department of Endocrinology, University Clinical-Hospital Centre Zemun-Belgrade, Faculty of Medicine, University of Belgrade, Belgrade 11080, Serbia
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35
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Danış F, Kudu E. Recurrent acute pancreatitis and primary hyperparathyroidism in patients presenting to the emergency department: Diagnostic challenges. World J Clin Cases 2025; 13:100741. [DOI: 10.12998/wjcc.v13.i17.100741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2024] [Revised: 01/19/2025] [Accepted: 01/21/2025] [Indexed: 02/18/2025] Open
Abstract
We read the article by Karim MM et al discusses the presentation of primary hyperparathyroidism as recurrent acute pancreatitis, a rare clinical condition in pediatric patients presenting to the emergency department. As emergency medicine clinicians, we frequently encounter diverse and complex cases, and such rare conditions pose significant challenges in the diagnostic process. This article will discuss the management and diagnostic approach of such cases encountered in the emergency department.
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Affiliation(s)
- Faruk Danış
- Department of Emergency Medicine, Bolu Abant İzzet Baysal University Medical School, Bolu 14000, Türkiye
| | - Emre Kudu
- Department of Emergency Medicine, Marmara University Pendik Training and Research Hospital, İstanbul 34899, Türkiye
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36
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Wang ZY, Zhang Y, Pei H, Wang C, He BJ. Electroacupuncture combined with rehabilitation techniques for patients with rotator cuff injury. World J Clin Cases 2025; 13:98692. [DOI: 10.12998/wjcc.v13.i17.98692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 12/18/2024] [Accepted: 01/23/2025] [Indexed: 02/18/2025] Open
Abstract
Recently, we read a retrospective study by Chen et al, which demonstrated that electroacupuncture is highly effective in relieving pain due to rotator cuff injuries and accelerating the recovery of shoulder function, promoting repair of rotator cuff injuries. This study provides a new way to the conservative treatment of early rotator cuff injuries. In the present letter, we review the current treatment of rotator cuff injury with electroacupuncture combined with rehabilitation techniques and propose our views.
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Affiliation(s)
- Zi-Yue Wang
- Department of Orthopedic Surgery, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Yi Zhang
- Department of Orthopedic Surgery, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Hang Pei
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Chao Wang
- Department of Orthopedics, Anji County Hospital of Chinese Medicine, Huzhou 313399, Zhejiang Province, China
| | - Bang-Jian He
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
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37
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Halawa ARR, Farooq S, Amjad MA, Jani PP, Cherian SV. Role of interventional pulmonology in intensive care units: A scoping review. World J Crit Care Med 2025; 14:99654. [DOI: 10.5492/wjccm.v14.i2.99654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Revised: 10/31/2024] [Accepted: 12/23/2024] [Indexed: 02/27/2025] Open
Abstract
Interventional pulmonology (IP) represents a rapidly growing and developing subspecialty within pulmonary medicine. To the intensivist, given the elaborate undertakings with respect to airway, lung and pleural disease management-IP has shown an increasing presence and remain a major ally in the care of these patients. Thus, an understanding of the different roles that IP could offer to the intensivist is of prime importance in the multi-disciplinary care of the complex patients within the intensive care units, particularly in relation to lung, airway and pleural diseases. This review article will explore the different intersections of IP in critical care and discuss the applications of this discipline within the highly complex critical care environment.
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Affiliation(s)
- Abdul Rahman R Halawa
- Department of Critical Care, Pulmonary and Sleep Medicine, University of Texas Health-McGovern Medical School, Houston, TX 77030, United States
| | - Saad Farooq
- Department of Critical Care, Pulmonary and Sleep Medicine, University of Texas Health-McGovern Medical School, Houston, TX 77030, United States
| | - Mohammad Asim Amjad
- Department of Critical Care, Pulmonary and Sleep Medicine, University of Texas Health-McGovern Medical School, Houston, TX 77030, United States
| | - Pushan P Jani
- Department of Critical Care, Pulmonary and Sleep Medicine, University of Texas Health-McGovern Medical School, Houston, TX 77030, United States
| | - Sujith V Cherian
- Department of Critical Care, Pulmonary and Sleep Medicine, University of Texas Health-McGovern Medical School, Houston, TX 77030, United States
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38
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Nagamine T. Challenges in using virtual reality technology for pain relief. World J Clin Cases 2025; 13:103372. [DOI: 10.12998/wjcc.v13.i16.103372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2024] [Revised: 01/04/2025] [Accepted: 01/14/2025] [Indexed: 02/10/2025] Open
Abstract
The present paper addresses two issues pertaining to the use of virtual reality (VR). One issue pertains to the equipment utilized. VR technology can be classified into two main categories: Immersive and non-immersive. The immersive type of technology necessitates the use of substantial equipment, yet it is demonstrably efficacious. Furthermore, the efficacy of this approach is enhanced when combined with relaxation and biofeedback techniques. The other issue is that the efficacy of this approach is diminished when applied to chronic pain, in comparison to acute pain. The relief of chronic pain is a challenging endeavor due to the diminished functionality of the medial prefrontal cortex (mPFC) within the default mode network. Given the close relationship between the mPFC and the reward system dopamine, it is essential to develop a program that activates the reward system dopamine through the use of VR technology.
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Affiliation(s)
- Takahiko Nagamine
- Psychiatric Internal Medicine, Sunlight Brain Research Center, Hofu 7470066, Yamaguchi, Japan
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39
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Marano G, Mazza M. Territories of mourning: Addressing submerged problems of grief through multidisciplinary care. World J Clin Cases 2025; 13:98271. [DOI: 10.12998/wjcc.v13.i16.98271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Revised: 12/20/2024] [Accepted: 01/07/2025] [Indexed: 02/10/2025] Open
Abstract
Mourning and grief are natural responses to loss and can be especially complex and prolonged in the context of end-of-life care. Caregivers play a crucial role in supporting individuals through this difficult journey, often balancing their own grief with the need to provide care. This paper explores the experiences of mourning and grief in hospice settings, with a focus on the emotional challenges faced by both patients and caregivers during the grieving process. Psychological support plays a crucial role at the end of life in a multidisciplinary care approach. By addressing the complex interplay between biological disease and psychological well-being, healthcare professionals can provide more comprehensive and compassionate care. A deep understanding of mourning and elaboration of grief would improve the implementation of suitable support interventions and facilitate collaboration among family members and healthcare teams, ultimately improving the quality of end-of-life care and promoting the well-being of both patients and their families.
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Affiliation(s)
- Giuseppe Marano
- Department of Neurosciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Marianna Mazza
- Department of Neurosciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
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40
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Li H, Zhang X, Zhaxi Y, Pan C, Zhang Z, Pan J, Shahzad K, Sun F, Zhen Y, Jinmei J, Zhao W, Song T. Integrative multi-omics analysis reveals liver-gut axis adaptation in high-altitude goats. COMPARATIVE BIOCHEMISTRY AND PHYSIOLOGY. PART D, GENOMICS & PROTEOMICS 2025; 54:101422. [PMID: 39842302 DOI: 10.1016/j.cbd.2025.101422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2024] [Revised: 01/02/2025] [Accepted: 01/16/2025] [Indexed: 01/24/2025]
Abstract
The liver-gut axis is an important regulatory axis for the host's metabolic functions. The study of liver gene expression, changes in metabolic products and the regulation of gut microbial communities in plateau animals under harsh environments can reveal the mechanisms by which Tibetan goats adapt to the plateau environment. This study employs transcriptome, metabolome and metagenomic analyses to reveal the differences in genes, metabolism, and gut microbiota between Jianzhou big-eared goats (JBG) and Xizang cashmere goats (TCG), which is of significant importance for improving survival models of high-altitude ruminants. The results showed that there were 553 DEGs in the liver of JBG and TCG. Hepatic metabolomic analysis revealed significant differences in metabolic activity between the JBG and TCG groups, with notable increases in glycerophospholipid and retinol metabolic pathways. The gut microbiota, including Andreesenia, Dielma, Oscillibacter, Agrobacterium, Hyella and Thermosinus, interact with liver metabolites and can regulate the high-altitude adaptability of goats. This study reveals that TCG enhance immune regulation and energy utilization efficiency by regulating liver gene expression, modulating metabolic pathways, and improving gut microbiota, thereby helping TCG maintain healthy survival capabilities in hypoxic and high-radiation environments.
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Affiliation(s)
- Haiyan Li
- College of Life Sciences and Engineering, Southwest University of Science and Technology, Mianyang, Sichuan 621000, China; Institute of Animal Science, Xizang Academy of Agricultural and Animal Husbandry Science, Lhasa, Xizang 850009, China
| | - Xin Zhang
- College of Life Sciences and Engineering, Southwest University of Science and Technology, Mianyang, Sichuan 621000, China
| | - Yangzong Zhaxi
- Institute of Animal Science, Xizang Academy of Agricultural and Animal Husbandry Science, Lhasa, Xizang 850009, China; Key Laboratory of Animal Genetics and Breeding on Xizang Plateau, Ministry of Agriculture and Rural Affairs, Lhasa, Xizang 850009, China
| | - Cheng Pan
- College of Life Sciences and Engineering, Southwest University of Science and Technology, Mianyang, Sichuan 621000, China
| | - Zhenzhen Zhang
- College of Life Sciences and Engineering, Southwest University of Science and Technology, Mianyang, Sichuan 621000, China
| | - Junru Pan
- College of Life Sciences and Engineering, Southwest University of Science and Technology, Mianyang, Sichuan 621000, China
| | - Khuram Shahzad
- Department of Biosciences, COMSATS University Islamabad, Park Road, Islamabad 45550, Pakistan
| | - Fengbo Sun
- Xizang Animal Husbandry Station, Lhasa, Xizang 850000, China
| | - Yang Zhen
- Xizang Animal Husbandry Station, Lhasa, Xizang 850000, China
| | - Jiacuo Jinmei
- Xizang Animal Husbandry Station, Lhasa, Xizang 850000, China
| | - Wangsheng Zhao
- College of Life Sciences and Engineering, Southwest University of Science and Technology, Mianyang, Sichuan 621000, China.
| | - Tianzeng Song
- Institute of Animal Science, Xizang Academy of Agricultural and Animal Husbandry Science, Lhasa, Xizang 850009, China; Key Laboratory of Animal Genetics and Breeding on Xizang Plateau, Ministry of Agriculture and Rural Affairs, Lhasa, Xizang 850009, China.
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41
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Wise PM, Vander Voort WD, Priester J, Saiz AM. Preoperative planning technique for anterior pelvis percutaneous intramedullary screw fixation. OTA Int 2025; 8:e386. [PMID: 40070579 PMCID: PMC11896102 DOI: 10.1097/oi9.0000000000000386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 01/21/2025] [Accepted: 01/23/2025] [Indexed: 03/14/2025]
Abstract
Useful techniques have been previously described for the planning of safe transsacral-transiliac screws, but to our knowledge, no straightforward technique has been described for anterior pelvic percutaneous fixation. As this method of anterior ring fixation has demonstrated biomechanical and clinical benefits, we propose a preoperative planning technique for determining the corridor characteristics of the patient's superior pubic ramus/anterior column for fracture fixation with percutaneous intramedullary screws. This technique helps the surgeon assess what diameter of solid or cannulated screw the corridor allows and predict the length of screw needed.
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Affiliation(s)
- Patrick M. Wise
- Department of Orthopaedic Surgery, UC Davis Medical Center, Sacramento, CA
- Department of Orthopaedic Surgery, 60th Surgical Operations Squadron, David Grant Medical Center, Travis AFB, CA
| | - Wyatt D. Vander Voort
- Department of Orthopaedic Surgery, UC Davis Medical Center, Sacramento, CA
- Department of Orthopaedic Surgery, 60th Surgical Operations Squadron, David Grant Medical Center, Travis AFB, CA
| | - Jacob Priester
- Department of Orthopaedic Surgery, UC Davis Medical Center, Sacramento, CA
- Department of Orthopaedic Surgery, 60th Surgical Operations Squadron, David Grant Medical Center, Travis AFB, CA
| | - Augustine M. Saiz
- Department of Orthopaedic Surgery, UC Davis Medical Center, Sacramento, CA
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42
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Kim E, Tanzi RE, Choi SH. Therapeutic potential of exercise-hormone irisin in Alzheimer's disease. Neural Regen Res 2025; 20:1555-1564. [PMID: 38993140 PMCID: PMC11688551 DOI: 10.4103/nrr.nrr-d-24-00098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/20/2024] [Accepted: 06/04/2024] [Indexed: 07/13/2024] Open
Abstract
Irisin is a myokine that is generated by cleavage of the membrane protein fibronectin type III domain-containing protein 5 (FNDC5) in response to physical exercise. Studies reveal that irisin/FNDC5 has neuroprotective functions against Alzheimer's disease, the most common form of dementia in the elderly, by improving cognitive function and reducing amyloid-β and tau pathologies as well as neuroinflammation in cell culture or animal models of Alzheimer's disease. Although current and ongoing studies on irisin/FNDC5 show promising results, further mechanistic studies are required to clarify its potential as a meaningful therapeutic target for alleviating Alzheimer's disease. We recently found that irisin treatment reduces amyloid-β pathology by increasing the activity/levels of amyloid-β-degrading enzyme neprilysin secreted from astrocytes. Herein, we present an overview of irisin/FNDC5's protective roles and mechanisms against Alzheimer's disease.
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Affiliation(s)
- Eunhee Kim
- Genetics and Aging Research Unit, MassGeneral Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
| | - Rudolph E. Tanzi
- Genetics and Aging Research Unit, MassGeneral Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
| | - Se Hoon Choi
- Genetics and Aging Research Unit, MassGeneral Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
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43
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Afandi B, Hassanein M, Suliman M, Hafidh K. Personalized risk reduction strategies utilizing the diabetes and ramadan risk calculator: a narrative review. J Diabetes Metab Disord 2025; 24:30. [PMID: 39735174 PMCID: PMC11680539 DOI: 10.1007/s40200-024-01506-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Accepted: 11/26/2024] [Indexed: 12/31/2024]
Abstract
The Diabetes and Ramadan Risk Calculator, developed in 2021, is a pivotal tool for assessing fasting-related risks among patients with diabetes. This ground-breaking innovation offers a quantitative assessment of risk scores during fasting, revolutionizing the landscape of diabetes management during Ramadan. Many components assessed by the calculator are amenable to modification, presenting an opportunity for year-round intervention to mitigate risk scores and subsequent fasting risks. By targeting modifiable risk factors and adapting strategies over time, individuals with diabetes can proactively diminish their fasting-related risks, safeguarding their physical well-being and spiritual engagement and potentially improving their overall diabetes control. This review aims to elucidate the evolution of the strategies for addressing modifiable risk factors, reducing risk scores and levels, and ensuring safe fasting practices.
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Affiliation(s)
- Bachar Afandi
- Endocrine Division, Tawam Hospital & UAE University, AlAin, UAE
| | - Mohammed Hassanein
- Endocrine Department, Dubai Hospital, Mohammed Bin Rashid University, Dubai, UAE
| | | | - Khadija Hafidh
- Diabetes Unit, Rashid Hospital, Mohammed Bin Rashid University, Dubai, UAE
- Diabetes Unit, Medical Department, Rashid Hospital, Dubai Academic Health Corporation, Oud Metha Street, PO Box 4545, Dubai, UAE
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44
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He YC, Wang NX, Zhong T. Reference diagnosis and treatment process of juvenile hemochromatosis patients. World J Clin Cases 2025; 13:99198. [DOI: 10.12998/wjcc.v13.i15.99198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 12/18/2024] [Accepted: 01/11/2025] [Indexed: 01/21/2025] Open
Abstract
The compelling case report by Xie et al, published in a renowned medical journal, is an excellent example of meticulous clinical evaluation, comprehensive laboratory testing, advanced imaging, and genetic analysis. The authors identified novel compound heterozygous mutations in the hemojuvelin gene of a patient diagnosed with juvenile hemochromatosis. They suggested that long-term, strategic phlebotomy might offer a novel therapeutic strategy for severe juvenile hemochromatosis, challenging the traditional treatment paradigms.
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Affiliation(s)
- Yan-Chun He
- College of Medicine, Jining Medical University, Jining 272067, Shandong Province, China
| | - Nan-Xue Wang
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining 272029, Shandong Province, China
| | - Tao Zhong
- College of Medicine, Jining Medical University, Jining 272067, Shandong Province, China
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45
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Xu R, Sun LX, Chen Y, Ding C, Zhang M, Chen TF, Kong LY. Stoma occlusion caused by abdominal cocoon after abdominal abscess surgery: A case report. World J Clin Cases 2025; 13:98608. [DOI: 10.12998/wjcc.v13.i15.98608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 11/27/2024] [Accepted: 01/02/2025] [Indexed: 01/21/2025] Open
Abstract
BACKGROUND Abdominal cocoons (ACs) lack characteristic clinical manifestations and are mainly intestinal obstructions that are difficult to distinguish from intestinal obstruction caused by other causes, resulting in difficult preoperative diagnosis and misdiagnosis and mistreatment. There are no reports of enterostomy occlusion caused by ACs in the literature at home and abroad.
CASE SUMMARY Here, we report a 16-year-old female patient with intestinal obstruction due to AC. She was treated with abdominal surgery three times. First, she underwent a laparotomy for peritonitis after trauma from a traffic accident. During the procedure, pelvic empyema, severe intestinal adhesions, and damage to the serous layer of the rectum were found, but no significant intestinal rupture and perforation were found. As a precaution, she underwent a prophylactic ileostomy after a flush in her abdomen. The second and third surgeries were for treatment of recurrent stoma obstruction. The patient’s condition was complicated for a long period, but after comprehensive treatment by our department, the patient was successfully discharged from the hospital and is currently recovering well.
CONCLUSION Currently, abdominal contrast-enhanced computed tomography is the best imaging modality for preoperative evaluation of AC, but most patients are diagnosed only after intraoperative exploration. For the treatment of typical or severe ACs, the primary method of removal and healing of ACs is complete removal of the abdominal fibrous membrane. Finding a breakthrough in the anatomy is the key to the success of the surgery.
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Affiliation(s)
- Rui Xu
- Department of General Surgery, The People’s Hospital of Suqian City, Suqian 223800, Jiangsu Province, China
| | - Li-Xin Sun
- Department of General Surgery, The People’s Hospital of Suqian City, Suqian 223800, Jiangsu Province, China
| | - Yan Chen
- Department of General Surgery, The People’s Hospital of Suqian City, Suqian 223800, Jiangsu Province, China
| | - Chuang Ding
- Department of General Surgery, The People’s Hospital of Suqian City, Suqian 223800, Jiangsu Province, China
| | - Ming Zhang
- Department of General Surgery, The People’s Hospital of Suqian City, Suqian 223800, Jiangsu Province, China
| | - Teng-Fei Chen
- Department of General Surgery, The People’s Hospital of Suqian City, Suqian 223800, Jiangsu Province, China
| | - Ling-Yong Kong
- Department of General Surgery, The People’s Hospital of Suqian City, Suqian 223800, Jiangsu Province, China
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46
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Boini A, Grasso V, Taher H, Gumbs AA. Artificial intelligence and the impact of multiomics on the reporting of case reports. World J Clin Cases 2025; 13:101188. [DOI: 10.12998/wjcc.v13.i15.101188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2024] [Revised: 12/31/2024] [Accepted: 01/11/2025] [Indexed: 01/21/2025] Open
Abstract
The integration of artificial intelligence (AI) and multiomics has transformed clinical and life sciences, enabling precision medicine and redefining disease understanding. Scientific publications grew significantly from 2.1 million in 2012 to 3.3 million in 2022, with AI research tripling during this period. Multiomics fields, including genomics and proteomics, also advanced, exemplified by the Human Proteome Project achieving a 90% complete blueprint by 2021. This growth highlights opportunities and challenges in integrating AI and multiomics into clinical reporting. A review of studies and case reports was conducted to evaluate AI and multiomics integration. Key areas analyzed included diagnostic accuracy, predictive modeling, and personalized treatment approaches driven by AI tools. Case examples were studied to assess impacts on clinical decision-making. AI and multiomics enhanced data integration, predictive insights, and treatment personalization. Fields like radiomics, genomics, and proteomics improved diagnostics and guided therapy. For instance, the “AI radiomics, genomics, oncopathomics, and surgomics project” combined radiomics and genomics for surgical decision-making, enabling preoperative, intraoperative, and postoperative interventions. AI applications in case reports predicted conditions like postoperative delirium and monitored cancer progression using genomic and imaging data. AI and multiomics enable standardized data analysis, dynamic updates, and predictive modeling in case reports. Traditional reports often lack objectivity, but AI enhances reproducibility and decision-making by processing large datasets. Challenges include data standardization, biases, and ethical concerns. Overcoming these barriers is vital for optimizing AI applications and advancing personalized medicine. AI and multiomics integration is revolutionizing clinical research and practice. Standardizing data reporting and addressing challenges in ethics and data quality will unlock their full potential. Emphasizing collaboration and transparency is essential for leveraging these tools to improve patient care and scientific communication.
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Affiliation(s)
- Aishwarya Boini
- Davao Medical School Foundation, Davao Medical School Foundation, Davao 8000, Philippines
| | - Vincent Grasso
- Department of Computer Engineering, Department of Electrical and Computer Engineering University of New Mexico, Albuquerque, NM 87106, United States
| | - Heba Taher
- Department of Pediatric Surgery, Cairo University Hospital, Cairo 11441, Egypt
| | - Andrew A Gumbs
- Department of Minimally Invasive Digestive Surgery, Hospital Antoine Beclère, Assistance Publique-Hospitals of Paris, Clamart 92140, France
- Department of Surgery, University of Magdeburg, Magdeburg 39130, Saxony-Anhalt, Germany
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47
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Farsakoury R, Nashwan AJ. Revitalizing upper blepharoplasty: Preserving volume. World J Clin Cases 2025; 13:100563. [DOI: 10.12998/wjcc.v13.i15.100563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 12/27/2024] [Accepted: 01/09/2025] [Indexed: 01/21/2025] Open
Abstract
Blepharoplasty is a frequently performed aesthetic surgery today aimed at enhancing eyelid appearance and correcting age-related changes. The traditional method of subtraction blepharoplasty, which involved removing fat and excess skin, is now considered outdated. This letter explores Gorgy et al's commentary on Miotti et al's study, highlighting a shift in upper eyelid blepharoplasty towards a more conservative, volume-preserving approach. The study systematically reviewed 10 publications, including three retrospective studies, five comparative studies, and two clinical trials. It emphasizes the trend towards preserving the patient's natural anatomy and focusing on enhancement rather than alteration. However, the study's limitations, such as the lack of long-term comparative research, a relatively small sample size, and a single-center design, indicate that further research with extended follow-up is necessary to validate the safety and effectiveness of these techniques. The focus is increasingly on preserving and augmenting volume in upper blepharoplasty rather than removing tissue.
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Affiliation(s)
- Rana Farsakoury
- Department of Plastic and Reconstructive Surgery, Hamad Medical Corporation, Doha 3050, Qatar
| | - Abdulqadir J Nashwan
- Department of Nursing and Midwifery Research, Hamad Medical Corporation, Doha 3050, Qatar
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48
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Fu XP. Dual benefits of sodium-glucose cotransporter 2 inhibitors in metabolic diseases: Diabetes control and gout management. World J Clin Cases 2025; 13:100262. [DOI: 10.12998/wjcc.v13.i14.100262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Revised: 12/22/2024] [Accepted: 12/30/2024] [Indexed: 01/15/2025] Open
Abstract
The study by Lin et al delves into the clinical impact of dapagliflozin, a representative sodium-glucose cotransporter 2 (SGLT2) inhibitor, on chronic heart failure complicated by hyperuricemia. This investigation highlights dapagliflozin’s efficacy in lowering serum uric acid levels, enhancing cardiac function, and reducing cardiovascular events. This work not only provides a comprehensive analysis of dapagliflozin’s sustained benefits in these patients but also introduces novel insights for managing chronic heart failure exacerbated by elevated uric acid. Furthermore, this review examines the potential role of SGLT2 inhibitor in the context of gout, evaluating its mechanisms and clinical application prospects in the management of hyperuricemia, thereby further enriching the medical community’s understanding of SGLT2 inhibitor.
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Affiliation(s)
- Xiao-Peng Fu
- College of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, Fujian Province, China
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49
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Finsterer J, Mehri S. Electromyography biofeedback training for post-stroke dysphagia. World J Clin Cases 2025; 13:97380. [DOI: 10.12998/wjcc.v13.i14.97380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 10/08/2024] [Accepted: 01/07/2025] [Indexed: 01/15/2025] Open
Abstract
Dysphagia is a common complication of ischemic stroke and is usually difficult to treat. The mainstay of standard therapy of post-stroke dysphagia (PSD) is effortful swallowing. Since its introduction in 2004, there is increasing evidence that surface electromyography-guided biofeedback training (EMGBT) can enhance the therapeutic effect of standard LE. In this editorial, we comment on the article by Meng et al published in the recent issue of the World Journal of Clinical Cases, which provided evidence that particularly extensive EMGBT with an increased number of sessions is definitively more effective than the standard speech therapy or ordinary EMGBT. Among the 90 PSD patients with ischemic stroke or intracerebral bleeding, those who underwent EMGBT in more sessions than usual particularly benefited from the approach. It was concluded that EMGBT is more effective than traditional swallowing training in improving dysphagia and swallowing disorders as well as hyoid-laryngeal complex movement speed in PSD patients.
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Affiliation(s)
- Josef Finsterer
- Department of Neurology, Neurology and Neurophysiology Center, Vienna 1180, Austria
| | - Sounira Mehri
- Laboratory of Nutrition and Vascular Health, Faculty of Medicine, Monastir 5000, Tunisia
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50
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Xu LY, Yu Y, Cen LS. Insight into the efficacy and safety of pirfenidone: The treatment of idiopathic pulmonary fibrosis. World J Clin Cases 2025; 13:98769. [DOI: 10.12998/wjcc.v13.i14.98769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 12/09/2024] [Accepted: 01/02/2025] [Indexed: 01/15/2025] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) has a poor prognosis if left untreated; therefore, early treatment with pirfenidone is crucial. Lei et al conducted a retrospective analysis to evaluate the effectiveness of early pirfenidone treatment on lung function in 113 patients with IPF. In addition to other research, pirfenidone has demonstrated efficacy in patients at all stages of IPF once correct diagnosis has been made. In advanced IPF, we include the requirement for pirfenidone. Therefore, it is essential to choose an appropriate method of administration method, such as inhalation. This may circumvent the drawbacks of the high cost and possible adverse effects of this drug.
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Affiliation(s)
- Li-Ying Xu
- Department of Medical Administration, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou 310006, Zhejiang Province, China
| | - Yi Yu
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310051, Zhejiang Province, China
| | - Lu-Sha Cen
- Department of Ophthalmology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou 310006, Zhejiang Province, China
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