Tag: nevin manimala

Medicine (Baltimore). 2025 Feb 14;104(7):e41529. doi: 10.1097/MD.0000000000041529.

ABSTRACT

At present, there is a lack of research on the correlation between cumFPG and digestive malignancies, and previous cohort studies have not considered the competitive risk between death and digestive malignancies, which may overestimate the impact of related risk factors. To explore the correlation between cumFPG and malignant tumors of the digestive system. In this study, 53,747 participants who had undergone 3 consecutive physical examinations since 2006 were collected. Finally, a total of 53,747 participants were included in this study. According to the grouping method of previous studies, cumFPG was divided into 4 groups according to the quartile. Cox regression model and competitive risk model were used to assess the risk of new digestive system malignancy. In sensitivity analyses, participants with cancer within 5 years of follow-up were excluded to eliminate the possibility of reverse causation. Subjects taking hypoglycemic drugs were excluded to eliminate the effect of the drug on blood glucose. Restricted cubic splineregresion (RCS) was then used to calculate the relationship between cumFPG and GI cancers. The mean age of participants was 49.02 ± 11.78 years. During a mean follow-up of 10.58 years, 817 new Gastrointestinal cases were identified, and the Cox proportional hazards model suggested that the risk of incidence in the Q2 to Q4 group increased sequentially compared with the lowest Q1 group, even after excluding the diagnosis of digestive malignancy within 5 years, the participants taking hypoglycemic drugs, and the death competition risk model analysis. In site-specific analysis, we observed that this risk was more pronounced in colorectal cancer, liver cancer, and pancreatic cancer, while gastric cancer, small bowel cancer, and bile duct cancer all had a similar trend to the main model but were not statistically significant, while esophageal cancer was U-shaped but not statistically significant. RCS results showed that cumFPG was associated with a similar risk of digestive system tumors, showing an inverted “√” type relationship. High levels of cumFPG are an independent factor in malignancy of the digestive system. cumFPG can provide a new idea for the prevention of Gastrointestinal cancers.

PMID:39960953 | DOI:10.1097/MD.0000000000041529

Medicine (Baltimore). 2025 Feb 14;104(7):e41554. doi: 10.1097/MD.0000000000041554.

ABSTRACT

High-flow nasal cannula (HFNC) therapy has emerged as an important method of respiratory support in the pediatric emergency department (ED), but its optimal use and factors affecting success require further investigation. The aim of this study was to evaluate the diagnosis and treatment response of patients receiving HFNC therapy in the pediatric ED and to investigate the factors affecting the success of HFNC therapy. This retrospective, cross-sectional study analyzed the data of 415 patients admitted to the Pediatric ED of the Istanbul Medical Faculty from 2021 to 2022 who received HFNC therapy. Treatment failure was defined as the required noninvasive ventilation (NIV) or intubation. Diagnoses were confirmed by examination findings, radiological imaging, laboratory tests and other hospital admissions. Respiratory disease was diagnosed in 88.2% of patients. The most common diagnoses were bronchiolitis (48%), pneumonia (23.6%), asthma (9.6%), reactive airway disease (5.8%), and heart failure (4.8%). Among the patients, 55.4% were admitted to the pediatric service, 28% were admitted to the intensive care unit, 8.7% were discharged, and 7.7% left the ED with a referral to an external center. HFNC therapy ended with symptom regression in 63.9% of patients, transition to NIV in 25.8%, and intubation in 4.3%. Although patients did not respond to HFNC therapy at 0 to 1 hour, a HFNC response was observed in almost half of the patients in the following periods. The presence of chronic disease and abnormal chest radiography findings were found to be independent risk factors for treatment failure, whereas the presence of allergic disease and the duration of HFNC therapy were found to be protective factors. HFNC therapy was effective in most pediatric patients with respiratory distress. Clinicians should consider extending HFNC therapy beyond the first hour in initial nonresponders, as significant improvement may occur in the following hours. Chronic disease and abnormal chest radiography findings were independent risk factors for failure of HFNC therapy. Conversely, allergic disease and longer HFNC duration were protective. Clinical and laboratory parameters should be considered when evaluating the efficacy of HFNC therapy. Therefore, patients should be evaluated individually, and treatment should be planned.

PMID:39960951 | DOI:10.1097/MD.0000000000041554

Medicine (Baltimore). 2025 Feb 14;104(7):e41517. doi: 10.1097/MD.0000000000041517.

ABSTRACT

BACKGROUND: This study investigated the link between arterial tortuosity and cervical artery dissection, focusing on carotid and vertebral tortuosity indices, as well as carotid tortuosity classifications (kinking, looping, and coiling).

METHODS: We searched PubMed, SCOPUS, Web of Science, and Google Scholar from database inception to January 2024. The inclusion criteria encompassed human studies on tortuosity and cervical, carotid, or vertebral artery dissection. Exclusion criteria included case reports, non-English studies, and studies solely on connective tissue disorders and diseases. Quality and risk of bias were assessed using the Newcastle-Ottawa Scale. Random-effects model was employed for mean differences and odds ratios. When meta-analysis was not feasible, we summarized and integrated the results narratively.

RESULTS: Seven studies, involving 507 dissected patients and 582 non-dissected patients, were included. In a meta-analysis of 3 studies, vertebral tortuosity favored the dissection cases [MD = 3.58, 95% CI: 2.21-4.95]. The mean carotid tortuosity difference was not statistically significant in a meta-analysis of 2 studies [MD = 2.27, 95% CI: -0.16-4.70]. In the classification analysis, 2 studies indicated no conclusive association between kinking, coiling, and cervical arteries dissection. Regarding carotid classification and internal carotid artery dissection, meta-analyses only showed a significant association with kinking, but the result was inconclusive.

CONCLUSION: Tortuosity index screenings may help prevent cervical artery dissection among at-risk individuals. However, the association with specific tortuosity classifications remains inconclusive, and further research is needed to validate these findings. Standardized measurement criteria are crucial for future studies.

PMID:39960948 | DOI:10.1097/MD.0000000000041517

Medicine (Baltimore). 2025 Feb 14;104(7):e41540. doi: 10.1097/MD.0000000000041540.

ABSTRACT

This retrospective study aimed to examine hospitalization costs and associated factors for Parkinson disease (PD) patients. A total of 848 PD patients were extracted from the National Neurological and Brain Center in Xinjiang, and basic demographic information, medical insurance payment, and hospital expenses were collected. SPSS 26.0 was used and univariate analysis was performed on the number of days of hospitalization, times of hospitalizations, gender, payment method, and total hospitalization costs. Correlation analysis was performed using multiple linear regression to explore the influencing factors of hospitalization expenses. The average hospitalization cost of PD patients was 15,515.78 ± 29,667.49 yuan. Diagnosis fees accounted for the highest proportion (29.50%), followed by material costs (25.50%) and drug costs (21.20%). PD patients with less than 5 hospitalizations were the main source of disease, but 2.83% of them had more than 10 hospitalizations (P = .025). Female patients were significantly more than male patients, but the total hospitalization costs of male patients were much higher than those of female patients (P < .001). The number of PD patients increased significantly when they were over 60 years old, but the hospitalization costs were much lower than those of patients under 60 years old (P = .007). The effect of the payment method on total hospitalization cost did not show a statistical difference (P = .213). There was a positive correlation between hospitalization days and total hospitalization cost (P < .001). In conclusion, the results of the regression model suggested that age, length of hospital stay, gender, and number of hospitalizations could be used as predictive variables for hospitalization costs in PD patients.

PMID:39960945 | DOI:10.1097/MD.0000000000041540

Medicine (Baltimore). 2025 Feb 14;104(7):e41568. doi: 10.1097/MD.0000000000041568.

ABSTRACT

This study aimed to investigate the predictive effect of static lung compliance (SLC) and airway resistance (AR) in patients undergoing minimally invasive cardiac surgery (MICS) with unilateral pulmonary edema (UPE). A total of 245 patients who underwent MICS via cardiopulmonary bypass and minimal right lateral thoracic incision port access were enrolled, with immediate postoperative SLC and AR data collected upon intensive care unit (ICU) admission. Cutoff values for grouping patients into high (H-) and low (L-) compliance/resistance categories were determined using receiver-operating characteristic curves and Youden indexes. The primary outcome was the incidence of radiographically and clinically defined UPE within the first 24 hours postoperatively, while the secondary outcomes included duration of mechanical ventilation, length of ICU stay, total hospitalization days, in-hospital mortality, and the highest sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation II (APACHE-II) scores within the first 24 hours post-surgery. Results showed that patients in the L-compliance group (SLC < 40 mL/cmH2O) had longer durations of mechanical ventilation, length of ICU stay, and total hospitalization days, along with higher SOFA and APACHE-II scores compared to those in the H-compliance group (SLC ≥ 40 mL/cmH2O) (P < .05), although there was no significant difference in in-hospital mortality. Conversely, patients in the H-resistance group (AR ≥ 11 cm H2O/[L·s]) exhibited longer durations of mechanical ventilation, length of ICU stay, and total hospitalization days, as well as significantly higher SOFA, APACHE-II scores, but lower in-hospital mortality rates than those in the L-resistance group (AR < 11 cm H2O/[L·s]) (P < .05). In summary, immediate postoperative SLC < 40 mL/cm H2O and AR > 11 cm H2O/(L·s) are potentially valuable indicators for predicting postoperative UPE in patients undergoing MICS.

PMID:39960940 | DOI:10.1097/MD.0000000000041568

Medicine (Baltimore). 2025 Feb 14;104(7):e41510. doi: 10.1097/MD.0000000000041510.

ABSTRACT

BACKGROUND: As the survival rate of breast cancer patients increases, breast cancer-related lymphedema (BCRL) has gradually received attention from researchers. This study aims to sort out and summarize the relevant studies on BCRL using bibliometric analysis and to explore future research trends.

METHODS: In this study, we searched the Web of Science Core Collection for publications related to BCRL, analyzed the publication trends by applying Microsoft Excel 2019, and analyzed authors, cited journals, journal mapping overlays, cited references, and keywords by applying CiteSpace (v.6.1.R3 Advanced). SCImago Graphica (v.1.0.39) was applied to analyze countries/regions, institutions, and published journals.

RESULTS: We finally included 1000 publications published between 2003 and July 4, 2024. Publications showed an upward trend, with the largest number of publications in 2023. USA is the most published country, Harvard University is the most published institution, Taghian AG is the most published author, and DiSipio T is the most cited author. Lymphatic Research and Biology is the most published journal, and Cancer-American Cancer Society is the most cited journal. “Breast cancer,” “arm lymphedema,” and “quality of life” were the most frequent keywords. Current research focuses on risk factors, treatment strategies, and patients’ quality of life with BCRL. Future research will mainly focus on establishing BCRL evaluation protocols, improving treatment techniques, and early prevention and detection of BCRL.

CONCLUSION: Our study sorts out the current knowledge structure in the field and highlights the current state of research and future research directions. These findings inform researchers and clinicians.

PMID:39960934 | DOI:10.1097/MD.0000000000041510

Medicine (Baltimore). 2025 Feb 14;104(7):e41579. doi: 10.1097/MD.0000000000041579.

ABSTRACT

Recently, a variational canal starting from the sigmoid notch and extending in the ramus has been reported. The aim of this study was not only to investigate the presence and localization of the sigmoid canal (SC) between the sexes, which has not been studied before, but also to define the morphometric characteristics of the SC. The possible complications that this anatomical variation may cause are also being discussed. Between 2022 and 2024, a total of 546 cone beam computed tomography images obtained in sagittal, coronal, and horizontal planes were retrospectively analyzed. The presence, localization, and morphometric characteristics of the SCs were recorded and evaluated using statistical analysis software. The presence of SC was observed in 5.5% of the images and it was determined that 4.0% of these canals were unilateral and 1.5% were bilateral. The rate of right SC was 3.3% and the rate of left SC was 3.7%. When morphometric evaluation is made, the average value of the length of the SC is 8.0 mm, with a minimum value of 3.1 mm and a maximum value of 13.9 mm. Knowledge of the SC will prevent possible complications in surgical procedures, provide a more accurate diagnosis at the diagnostic stage and ensure that the treatment plan is created appropriately. More studies are needed on this subject.

PMID:39960932 | DOI:10.1097/MD.0000000000041579

Medicine (Baltimore). 2025 Feb 14;104(7):e41567. doi: 10.1097/MD.0000000000041567.

ABSTRACT

This study aimed to identify the factors influencing multiple admissions within 1 year for patients with heart failure (HF) and to examine the impact of early readmission on subsequent admissions. A retrospective questionnaire survey was conducted on 498 patients with HF admitted to our hospital’s Cardiology department between January 1, 2020, and December 31, 2022. Multivariate regression analysis identified factors influencing multiple admissions, and propensity score matching (PSM) assessed the impact of readmissions within 30 days and 31 to 90 days post-discharge on unplanned admissions within a year. The incidence of multiple admissions was 22.09% (110/498), with first readmissions within 30 days post-discharge at 13.25% (66/498) and within 31 to 90 days at 15.86% (79/498). Influential factors for multiple unplanned hospital admissions included age, history of atrial fibrillation, chronic kidney disease, chronic obstructive pulmonary disease, New York Heart Association grade ≥ III, hemoglobin (Hb) < 110g/L, taking 7 or more medications, and readmission within 31 to 90 days (P < .05). Post-PSM analysis showed that the first admission within 30 days (odds ratio [OR] = 6.400, 95% confidence interval [Cl] = 2.638-15.527, P = .001), and the first admission within 31 to 90 days significantly increased the risk of multiple admissions (OR = 5.694, 95% Cl = 2.615-12.402, P = .001). Patients with HF exhibit a high rate of numerous readmissions within 1 year. Clinical medical staff should focus more on patients with early readmissions, enhance self-management, and improve management of comorbidities and medications through a multidisciplinary team approach. Enhancing continuous nursing and improving access to medical services may reduce patient readmission rates.

PMID:39960925 | DOI:10.1097/MD.0000000000041567

Medicine (Baltimore). 2025 Feb 14;104(7):e41582. doi: 10.1097/MD.0000000000041582.

ABSTRACT

This study shares our 5-year experience with chorionic villus sampling (CVS) and analyzes the indications, results, and complications of this procedure. We conducted a retrospective analysis of data from singleton pregnancies that underwent CVS between 2015 and 2020 at the Maternal-Fetal Medicine Unit of Health Science University, Izmir Tepecik Research, and Training Hospital. Maternal demographics, indications, karyotype results, and pregnancy outcomes were recorded. We retrospectively analyzed data from 468 CVS procedures, conducted between 2015 and 2020. The most common indications for CVS were positive screening test results in the first trimester, fetal structural abnormalities, and increased nuchal translucency (NT) observed during ultrasound. Fetal structural abnormalities had the highest detection rate, at 34.5% for chromosomal abnormalities, followed by increased NT and first-trimester screen-positive test results (26.9% and 11.3%), respectively. The culture success rate was 96.3% (451 out of 468). The most prevalent chromosomal abnormalities were numerical, including Trisomy 21 (10.9%), Trisomy 18 (4.2%), and Trisomy 13 (1.9%). Results could not be obtained in 17 patients (3.6%); 12 (2.5%) were due to insufficient samples and culture failure, while 5 (1.06%) were due to maternal contamination. Amniocentesis was required as a secondary sampling in 24 cases (5.1%) and performed in 17 cases (3.6%). This study emphasizes the significance of CVS in prenatal diagnosis and the management of high-risk pregnancies. However, we must be aware of the associated risks and limitations, which include culture success rates, inconclusive results, and the occasional need for secondary sampling.

PMID:39960922 | DOI:10.1097/MD.0000000000041582

Medicine (Baltimore). 2025 Feb 14;104(7):e41498. doi: 10.1097/MD.0000000000041498.

ABSTRACT

BACKGROUND: Breast cancer as the malignant tumor with the highest incidence and mortality rate among the global female population. Insomnia is a common complaint in breast cancer patients, more than one-third (38-47%) of breast cancer patients suffer it. Auricular acupressure (AA), a non-pharmacological therapy, has been used in the studies to intervene in insomnia in breast cancer patients. The objective of this systematic review and meta-analysis is to investigate the efficacy and safety of AA therapy in intervening with insomnia in breast cancer.

METHODS: A systematic literature search was performed for 10 databases up to January of 2024 to identify randomized control trials (RCTs). The methodological quality of RCTs was assessed independently using the Cochrane Handbook for Systematic Reviews of Interventions. The quality of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation approach. Data were screened and extracted independently using predesigned forms. The meta-analysis was conducted using RevMan 5.3 software, P-value < .05 means statistically significant.

RESULTS: This review included 15 studies from 3 different countries with a total of 1125 adult participants. The pooled results showed that AA significantly in improving sleep quality (mean difference [MD] = -3.36, 95% confidence interval [CI]: [-4.65, -2.07], P < .001) and life quality (MD = -7.82, 95% CI: [-14.76, -0.88], P = .03). Based on data from sleep monitoring devices, AA was valuable for improving sleep efficiency (MD = -3.63, 95% CI: [-4.19,-3.07], P = .03) in breast cancer patients. Adverse events were reported in 5 RCTs. Common adverse reactions include auricular skin allergic reaction (10/259, 3.9%), bruising (7/259, 2.7%), pain (3/259, 1.2%), and local pressure ulcers on the auricular points (2/259, 0.8%). The evidence grade was moderate because of the substantial heterogeneity among studies. Heart, Shenmen, and Subcortex were the 3 most numerous auricular points, with a total share of up to 71.70%.

CONCLUSION: This systematic review and meta-analysis demonstrates the efficacy and safety of AA in intervening insomnia in breast cancer patients, providing a basis for the selection of clinical auricular points. However, the high-quality RCTs in existence are not enough, and more rigorous trials are needed to identify the efficacy of AA and insomnia.

PMID:39960920 | DOI:10.1097/MD.0000000000041498