Tag: pubmed

Ann Chir Plast Esthet. 2025 Mar 19:S0294-1260(25)00029-9. doi: 10.1016/j.anplas.2025.02.005. Online ahead of print.

ABSTRACT

INTRODUCTION: The advent of artificial intelligence technologies, such as ChatGPT and Gemini, presents new opportunities to enhance physician-patient communication through tailored patient-facing medical information (PFI). Effective postoperative care is critical to successful patient outcomes in hand surgery, making it essential to deliver information in a clear, comprehensible, and accurate manner. This study aims to evaluate the ability of ChatGPT to generate accessible PFI to enhance patient understanding in hand surgery.

METHODS: A cross-sectional study was conducted involving five French hand surgeons and 28 non-medical individuals. Participants blindly evaluated PFI containing text and images generated by ChatGPT and Gemini compared to those provided by established organizations (EOs). The evaluations focused on three common hand surgeries: carpal tunnel syndrome, Dupuytren’s disease, and synovial cyst. Hand surgeons evaluated PFI based on accuracy, clarity, comprehensiveness, and overall preference. Non-medical participants evaluated PFI based on clarity and overall preference. Surveys were used to capture these evaluations, allowing for a systematic and effective comparison between both sources. Readability was analyzed using six readability formulas, and Likert scale responses were statistically analyzed using paired t-tests.

RESULTS: No significant difference was found in terms of accuracy between ChatGPT-generated text responses and EO-provided text responses. However, text responses provided by EOs were rated significantly higher in terms of comprehensiveness and clarity by hand surgeons. Interestingly, non-medical participants rated the clarity and overall preference of ChatGPT-generated text responses higher than those from EOs. EO-provided images were also significantly favored in terms of comprehensiveness and clarity by hand surgeons. Notably, 65% of non-medical participants preferred EO-provided images over AI-generated ones. Both sources, however, produced information that exceeded the recommended readability levels for patient comprehension.

CONCLUSION: This study underscores the potential of AI-generated medical information to enhance patient understanding, particularly through the comprehensive nature of materials created by tools like ChatGPT. The divergence in preferences between hand surgeons and patients highlights the need to refine the accuracy, clarity, and relevance of AI-generated content to align with the standards upheld by healthcare professionals. Continued exploration in this area is crucial for optimizing patient education and communication, particularly in the context of postoperative care.

PMID:40113462 | DOI:10.1016/j.anplas.2025.02.005

Orthop Surg. 2025 Mar 20. doi: 10.1111/os.70029. Online ahead of print.

ABSTRACT

OBJECTIVE: The degeneration characteristics of adjacent segment disease are complex. Improper surgical planning has caused unnecessary surgical trauma and costs. The purpose of this study was to establish a staging system for adjacent segment disease and evaluate its guiding significance for surgical decisions in adjacent segment disease.

METHODS: A retrospective study was performed on 103 patients with adjacent segment disease who underwent treatment between January 2017 and January 2023. Based on radiological findings, adjacent segment disease was categorized into four stages, with no cases identified in Stage IV. Patients were divided into four intervention groups: Group A (control group, traditional posterior lumbar fusion with rod-screw revision), Group B (Stage I, percutaneous endoscopic decompression), Group C (Stage II, oblique lumbar interbody fusion), and Group D (Stage III, cortical bone trajectory screws with posterior lumbar interbody fusion). Clinical and radiological outcomes were evaluated postoperatively, at 3 months, and at 12 months. Statistical analysis was conducted using t-tests, Mann-Whitney U tests, chi-square tests, and Spearman’s correlation.

RESULTS: Surgical expenses, duration, estimated blood loss, postoperative hospital stays, disc height index, and Pfirrmann grading all demonstrated significant correlations with the established grading system (p < 0.05). Patients achieved favorable clinical outcomes. Specifically, Groups B, C, and D showed earlier functional recovery compared to Group A, with Groups B and C experiencing more rapid relief from low back pain. Furthermore, Groups B, C, and D had shorter surgical times and reduced blood loss, while Groups B and C also incurred lower surgical costs and shorter hospital stays (p < 0.05).

CONCLUSION: The new grading system, developed based on the characteristics of adjacent segment degeneration, showed excellent surgical adaptability, despite varying degrees of correlation across different factors. This system was closely linked to the degree of intervertebral disc degeneration and the intervertebral disc height index. All patients achieved favorable surgical outcomes, suggesting that this grading system could provide valuable guidance in making surgical treatment decisions.

PMID:40113451 | DOI:10.1111/os.70029

Zhonghua Zhong Liu Za Zhi. 2025 Mar 23;47(3):275-282. doi: 10.3760/cma.j.cn112152-20240810-00336.

ABSTRACT

Objective: The 5th edition of the WHO classification of central nervous system (CNS) tumors in 2021 made significant revisions to the nomenclature and grading system of solitary fibrous tumors (SFT). This study aimed to explore the changes in the grading of CNS SFT and its relationship with clinical pathological features and prognosis. Methods: This study retrospectively reviewed the clinical and pathological data of 82 patients with CNS SFT diagnosed at the First Affiliated Hospital of Fujian Medical University from March 2006 to June 2021, reassessed their grading according to the WHO 5th edition CNS tumor classification, and conducted a comprehensive analysis of their histological morphology, immunohistochemical characteristics, and clinical imaging data. Results: The age of the patients ranged from 21 to 83 years, with a median age of 48 years. Follow-up was completed for 82 patients, during which 10 patients died, 24 recurred, and 5 metastasized. MRI imaging showed that SFT exhibited isointense signals on T1-weighted imaging (T1WI) and complex signals on T2-weighted imaging (T2WI), with signal intensity decreasing as the content of collagen fibers increased. According to the 2021 grading criteria, there was a significant change in the grading of SFT, with the number of grade 1 SFT increasing from 10 cases under the 2016 standard to 39 cases, while the number of grade 2 and 3 SFT decreased accordingly. The 2016 grading system was significantly correlated with the overall survival (OS) of patients (P=0.009), while the 2021 grading system did not reach statistical significance. Both grading systems were correlated with histological phenotype, Ki-67 index, mitotic figures, and necrosis (P＜0.05). All cases expressed STAT6, and showed varying degrees of expression of vimentin, CD99, BCL-2, and CD34. The staining intensity of type Ⅳ collagen fibers, as analyzed semi-quantitatively, was correlated with the OS of the patients (P=0.017). Conclusions: The new grading system for CNS SFT has undergone significant changes, and its association with OS requires further validation. In-depth study of the content and fine structure of collagen fibers in SFT may have important clinical significance for the prognosis assessment and the formulation of treatment plans for patients. Moreover, quantitative analysis of T2WI signal intensity may provide a new method for preoperative preliminary assessment of the collagen fiber content in SFT.

PMID:40113429 | DOI:10.3760/cma.j.cn112152-20240810-00336

Zhonghua Zhong Liu Za Zhi. 2025 Mar 23;47(3):237-243. doi: 10.3760/cma.j.cn112152-20240529-00224.

ABSTRACT

Objective: To analysis the prevalence characteristics of cancer mortality among the elderly in Qidong City, Jiangsu Province, from 1972 to 2021, and to provide scientific basis for the development of precise prevention and control strategies for cancer in the elderly. Methods: Data of cancers were obtained from Qidong Cancer Registry, a descriptive study method was used to calculate the crude mortality rate (CMR) of cancer among the elderly (≥60 years old). The China age-standardized rate (ASR-C) was calculated using the age structure of the Chinese population in 2000, and world age-standardized rate (ASR-W) was calculated using Segi’s world standard population. Joinpoint regression analysis was performed using Joinpoint 4.9.1.0 software to calculate the annual percentage change (APC) and average annual percentage change (AAPC) of mortality. Results: From 1972 to 2021, there were 74 723 cancer deaths in the elderly in Qidong, with CMR of 752.08/10⁵, ASR-C of 666.03/10⁵ (994.22/10⁵ for males and 470.29/10⁵ for females) and ASR-W of 681.11/10⁵. The ASR-C showed little fluctuation before 2000, increased rapidly from 2001 to 2011, and then decreased from 2011 to 2021. From 2017 to 2021, the CMR was 791.01/10⁵, the ASR-C was 689.80/10⁵ (956.77/10⁵ for males and 469.98/10⁵ for females), and the ASR-W was 657.53 /10⁵. The CMR for the 60-64, 65-69, 70-74, 75-79, and 80+ age groups from 2012 to 2021 were 385.42/10⁵ 505.51/10⁵, 721.64/10⁵, 1 213.28/10⁵, and 1 705.32/10⁵, respectively. The CMR of elderly under 75 years old were lower from 2012 to 2021 than in other periods, while those of elderly people aged more than 75 years were higher from 2012 to 2021 than in other periods. The AAPC for ASR-C of all cancers over the 50 years was 0.22%, with APC of -1.59% in 2008-2021 (both P＜0.05). Over the 50 years, the top five cancers in terms of mortality were lung cancer, gastric cancer, liver cancer, colorectal cancer, and esophageal cancer. Their AAPCs of ASR-C were 1.61%, -2.36%, -0.10%, 1.44%, and -2.03%, respectively. The increasing trends of mortality rates for lung cancer and colorectal cancer and the decreasing trends for gastric cancer and esophageal cancer were statistically significant (P＜0.05). Conclusions: The mortality of cancers among elderly is at a high level in Qidong. The overall mortality since 2008 have shown a decreasing trend, and the prevention and control of some cancers have been effective.

PMID:40113424 | DOI:10.3760/cma.j.cn112152-20240529-00224

Zhonghua Zhong Liu Za Zhi. 2025 Mar 23;47(3):228-236. doi: 10.3760/cma.j.cn112152-20240110-00019.

ABSTRACT

Objective: With the aggravation of population aging, the burden of malignant tumors in the elderly population is becoming more and more heavy. This study aims to analyze the incidence and mortality of malignant tumors in the elderly population in Hebei Province in the past decade. Methods: The incidence and mortality data of malignant tumors in people aged ≥60 years old in 38 cancer registration areas in Hebei Province from 2011 to 2020 were collected, and the incidence and mortality were analyzed by gender, urban and rural areas, and age groups. The age standardized rates were calculated using the 2000 Chinese population census and Segi’s world population. The trend of incidence and mortality was analyzed using the Joinpoint model and the average annual percent change (AAPC). Results: From 2011 to 2020, 216 200 new cases of malignant tumors were reported in the elderly population in the cancer registration areas of Hebei Province, and 170 700 deaths were reported. The peak ages of incident cases number for males and females were 65-69 years old and 60-64 years old, respectively. The crude incidence rate of malignant tumors in the elderly was 905.42/10⁵, and the crude mortality rate was 714.96/10⁵. In general, the incidence and mortality in rural areas were higher than those in urban areas, and the incidence and mortality in males were higher than those in females. The peak ages of incidence and mortality were 80-84 years old and 85+ years old, respectively. From 2011 to 2020, lung cancer, gastric cancer, esophageal cancer, female breast cancer, and colorectal cancer were the main malignant tumors of incidence rate in the elderly population in Hebei Province, and lung cancer, gastric cancer, liver cancer, esophageal cancer, and colorectal cancer were the main malignant tumors in the mortality rate. From 2011 to 2020, the incidence and mortality of malignant tumors in the elderly population in Hebei Province showed a decreasing trend, and AAPC for the age-standardized incidence and mortality were -4.69% and -5.53%, respectively. The rank of incidence and mortality rate of each cancer had changed, but the top two were still lung cancer and stomach cancer. Conclusions: The incidence and mortality of cancer in the elderly population in Hebei province have decreased, but the burden is still heavy. Lung cancer and stomach cancer are still the focus of prevention and treatment in the elderly population in Hebei province.

PMID:40113423 | DOI:10.3760/cma.j.cn112152-20240110-00019

Zhonghua Yi Xue Za Zhi. 2025 Mar 25;105(12):935-938. doi: 10.3760/cma.j.cn112137-20241128-02670.

ABSTRACT

This retrospective study collected the clinical data of patients with benign prostatic hyperplasia (BPH) treated with Rezūm water vapor thermal therapy system between July 2022 and August 2024 in the Department of Urology at the Second Affiliated Hospital of Soochow University. All patients were over 80 years old with comorbid high-risk diseases. The international prostate symptom score (IPSS), quality of life (QOL) score, maximum urinary flow rate (Q_max), and post-void residual urine volume (PVR) were recorded and compared preoperatively and postoperatively at 3 and 6 months. A total of 34 patients were included, with a mean age of (85.4±5.1) years. All patients had at least two chronic diseases, including hypertension, diabetes, cardiovascular and cerebrovascular disease, and chronic obstructive pulmonary disease. Among them, 10 patients required long-term anticoagulation with aspirin and (or) clopidogrel. The differences in IPSS[(13.5±3.2) scores vs (12.6±2.2) scores], QOL score[(2.3±0.6) scores vs (2.2±0.7) scores], Q_max[(14.7±1.8) ml/s vs (15.0±1.2) ml/s], and PVR[50.0(19.0, 81.0) ml vs 45.2(17.5, 63.5) ml] at both 3 and 6 months postoperatively were not statistically significant (all P>0.05). However, statistically significant differences were observed when compared with the preoperative data (all P<0.05). The results suggest that the Rezūm water vapor thermal therapy is safe and feasible for elderly, high-risk patients with BPH, improving lower urinary tract obstruction symptoms with good short-term efficacy.

PMID:40113420 | DOI:10.3760/cma.j.cn112137-20241128-02670

Zhonghua Yi Xue Za Zhi. 2025 Mar 25;105(12):912-918. doi: 10.3760/cma.j.cn112137-20241115-02564.

ABSTRACT

Objective: To explore the construction and clinical value of a predictive model for malignant ventricular arrhythmias (MVA) in children with viral myocarditis (VMC) based on parameters of ventricular repolarization heterogeneity. Methods: We retrospectively analyzed 99 children with VMC admitted to Henan Provincial People’s Hospital from January 2019 to February 2023 as the training set, and 38 children with VMC admitted from March 2023 to May 2024 as the external validation set in a cross-sectional study. Patients were divided into MVA and non-MVA groups based on the occurrence of MVA. We measured QT interval (QT), corrected QT interval (QTc), T-wave peak-end interval (TpTe), and heart rate-corrected TpTe (TpTec) in all children using conventional electrocardiography and Holter monitoring. Multi-variate logistic regression analysis was used to identify factors influencing the occurrence of MVA in children with VMC and the efficacy of models predicting MVA with cardiac troponin I (cTnI) and different electrocardiographic parameters was evaluated using the receiver operating characteristic (ROC) curve. The predictive power of the models was internally and externally validated through C-index, Hosmer-Lemeshow goodness-of-fit test, ROC curves, and decision curve analysis. Results: There were 99 children in the training set and 38 in the external validation set, with no significant differences in age [(6.9±3.7) vs (6.9±3.4) years] and gender (boys: 46.5% vs 50.0%) between the two groups (all P>0.05). In the training set, there were 47 cases (47.5%) in the MVA group, and there were 20 cases (52.6%) in the MVA group in the external validation set. In both the training and external validation sets, there were statistically significant differences in cTnI, QTc, TpTec, and TpTe/QT between the MVA and non-MVA groups (P<0.01). TpTec [OR (95%CI): 1.123 (1.067-1.183)] and TpTe/QT [OR (95%CI): 1.026 (1.008-1.045)] were both associated with the occurrence of MVA in children with VMC. The Hosmer-Lemeshow goodness-of-fit test showed that there was no statistically significant difference between the predicted and observed values (P=0.294). The area under the ROC curve (AUC) (95%CI) for cTnI to predict MVA in VMC children was 0.651 (0.540-0.763), with a sensitivity of 0.617 and a specificity of 0.865 when the Youden’s index was maximized (2 475.000). For TpTec, the AUC (95%CI) was 0.917 (0.859-0.975), with a sensitivity of 0.723 and a specificity of 0.981 when the Youden’s index was maximized (110.500). For TpTe/QT, the AUC (95%CI) was 0.825 (0.746-0.905), with a sensitivity of 0.745 and a specificity of 0.750 when the Youden’s index was maximized (0.265). The AUC (95%CI) for the combination of TpTec and TpTe/QT was 0.939 (0.892-0.987), with a sensitivity of 0.894 and a specificity of 0.865 when the Youden’s index was maximized (0.472), which was higher than that of TpTe/QT (P<0.01). In the validation set, the accuracy and fit of the TpTec combined with TpTe/QT model were also good (P=0.800), and the AUC (95%CI) for predicting MVA was 0.992 (0.972-1.000), with a sensitivity of 0.936 and a specificity of 0.904 when the Youden’s index was maximized (0.557). Conclusions: TpTec≥110.50 ms and TpTe/QT≥0.265 indicate a potential risk of MVA in children with VMC, requiring close clinical attention. The predictive value of the combined TpTec and TpTe/QT for MVA in children with VMC is higher than that of TpTe/QT alone.

PMID:40113416 | DOI:10.3760/cma.j.cn112137-20241115-02564

Zhonghua Yi Xue Za Zhi. 2025 Mar 25;105(12):907-911. doi: 10.3760/cma.j.cn112137-20240825-01959.

ABSTRACT

Objective: To explore the application value of the single-channel contrast agent/tracer injection mode in positron emission tomography/magnetic resonance imaging (PET/MRI) examination. Methods: A total of 65 patients who underwent PET/MRI examination in the Department of Radiology of General Hospital of Eastern Theater from June 2021 to March 2022 were prospectively enrolled as the control group (double-channel contrast/tracer injection mode), and 78 patients examined from April to May 2022 as the test group (single-channel contrast/tracer injection mode).The nursing operation time, the puncture success rate of indwelling needle, the incidence of blood extravasation, and the image quality were analyzed and compared between two groups. Results: The age of 143 patients was (53.7±16.3) years, and 90 (63.0%) were male. The control group was (54.7±17.0) years, with 43 males (66.2%). The test group was (50.8±18.5) years, with 47 males (60.3%). The nursing operation time of patients in the test group was shorter than that in the control group [3.2 (3.0, 3.3) vs 6.2 (5.4, 6.5) min]. The success rate of indwelling needle puncture in the test group was higher than that in the control group [100.0 (78/78) vs 92.3% (60/65)], and the rate of blood extravasation was lower than that in the control group [0 (0/78) vs 6.2% (4/65)] (all P<0.05). There was no statistically difference in the pass rate of PET/MRI images between two groups [94.9% (74/78) vs 98.5% (64/65), P=0.374]. Conclusion: Compared with the traditional double-channel contrast agent/tracer injection mode, the single-channel contrast agent/tracer injection mode reduces the nursing operation time and the incidence of blood extravasation, increases the success rate of indwelling needle puncture, and does not affect the image quality of PET/MRI.

PMID:40113415 | DOI:10.3760/cma.j.cn112137-20240825-01959

Nutr Health. 2025 Mar 20:2601060251329429. doi: 10.1177/02601060251329429. Online ahead of print.

ABSTRACT

BackgroundMany Americans look to primary care physicians (PCPs) for education on how to lead healthier lives. Understanding the duration of nutrition education necessary for PCPs to produce a behavioral impact may inform physician appointment recommendations.AimTo assess whether the duration of nutrition education given by PCPs correlates with changes in dietary behavior, or secondarily, health status, among patients without complex chronic disease.MethodsPRISMA-ScR guidelines were followed for this scoping review. Inclusion criteria of our review included: PCPs providing nutrition/dietary education, dietary intervention, adult participants, original research, manuscript published in English, study conducted in the U.S., and published 2011-present. Databases searched: PubMed, Cumulative Index to Nursing and Allied Health Literature, and Scopus. Exclusion criteria included: patients experiencing complex chronic health conditions. Data extracted included: study design, description of PCP dietary intervention, length of nutrition education, and general directions of health/behavioral outcomes.ResultsThree reviewed papers studying behavioral interventions that included PCP nutrition education yielded a positive impact on patient outcomes such as dietary behavior and/or weight loss, though only two of the three studies yielded results that achieved statistical significance.ConclusionThere appears to be an important role for nutrition education in the primary care setting. However, our review exposed great need for further research on the specific association between duration of nutrition counseling and resulting changes in dietary and health outcomes.

PMID:40112329 | DOI:10.1177/02601060251329429

Work. 2025 Mar 20:10519815251320260. doi: 10.1177/10519815251320260. Online ahead of print.

ABSTRACT

BackgroundWork-related Musculoskeletal Disorders (WMSDs) are a significant concern in occupational health. However, in South Korea, the implementation of effective ergonomic assessment methods remains limited owing to procedural complexities and a lack of understanding. This highlights the critical need for a comprehensive approach to assess musculoskeletal workload and mitigate WMSDs.ObjectiveThe purpose of this study is to compare the reliability of four work posture assessment methods and to propose a new Musculoskeletal Disorder Assessment Index (MDAI) that is easy to use and can evaluate local work load.MethodsThis study introduced a novel Musculoskeletal Disorder Assessment Index (MDAI) that incorporates posture, force, and repeatability as primary risk factors. The MDAI was compared with established assessment methods using empirical data gathered from a manufacturing facility. Thirty-two tasks encompassing diverse physical activities were evaluated using these methods, and their respective action levels were analyzed.ResultsThe MDAI offered a more comprehensive assessment, effectively capturing local workload variations across different body regions. Statistical analysis revealed significant disparities between the MDAI and the other methods, underscoring the distinct advantages of the MDAI approach in accurately assessing local workload. The MDAI excelled in evaluating tasks involving intricate and diverse local workload factors.ConclusionsThis study contributes to the field of ergonomics by introducing a novel musculoskeletal disorder assessment index that enhances the detailed evaluation of local body region workload. Considering posture, force, and repeatability, the MDAI provides a reliable framework for identifying and addressing the risks associated with musculoskeletal disorders.

PMID:40112327 | DOI:10.1177/10519815251320260