Tag: pubmed

Egypt Heart J. 2025 Sep 15;77(1):88. doi: 10.1186/s43044-025-00685-5.

ABSTRACT

BACKGROUND: Atrial fibrillation (AF) is the most common sustained cardiac rhythm disorder, significantly impacting global health and healthcare costs. Pulmonary vein isolation (PVI) is the preferred method for catheter-based AF ablation, reducing arrhythmia recurrence. However, vascular access complications remain a concern. This systematic review and meta-analysis aimed to compare the efficacy and safety of venous closure systems (VCSs), like Perclose™ ProGlide™, with traditional manual compression (MC) techniques, focusing on time to hemostasis (TTH), time to ambulation in hours (TTA), time to discharge (TTD), and complication rates.

METHOD: A comprehensive search was conducted in PubMed, Medline, Scopus, and Embase, adhering to PRISMA guidelines. Five studies met the inclusion criteria, comprising randomized controlled trials (RCTs) and observational studies. Data were analyzed using OpenMeta, applying a random-effects model to calculate standardized mean differences (SMDs) and odds ratios (ORs). Heterogeneity was assessed using the I² statistic, and funnel plots evaluated publication bias.

RESULT: The meta-analysis included 5 studies with a total of 240 patients. VCSs significantly reduced TTA (SMD – 2.029, 95% CI – 3.097 to – 0.962, p = 0.001) and TTD (SMD – 2.081, 95% CI – 3.870 to – 0.292, p = 0.023) compared to MC, but showed no significant reduction in TTH (SMD – 1.109, 95% CI – 2.524 to 0.307, p = 0.125). No significant differences were observed in bleeding complications (OR 1.35, 95% CI 0.413 to 4.125, p = 0.604) or hematoma rates (OR 4.665, 95% CI 0.768 to 28.345, p = 0.094).

CONCLUSION: VCSs demonstrated faster ambulation and discharge times compared to MC techniques, suggesting potential benefits in improving patient flow and satisfaction. However, the slight increase in hematoma risk warrants further investigation. These findings could guide clinical decision-making in vascular access management post-AF ablation.

PMID:40952576 | DOI:10.1186/s43044-025-00685-5

Curr Med Sci. 2025 Sep 15. doi: 10.1007/s11596-025-00111-6. Online ahead of print.

ABSTRACT

OBJECTIVE: Optimizing sedation to minimize respiratory depression during fiberoptic bronchoscopy (FOB) presents an ongoing challenge. This trial compared the safety and efficacy of remimazolam-remifentanil versus propofol-remifentanil for maintaining spontaneous ventilation in patients undergoing FOB.

METHODS: This pre-registered randomized controlled trial enrolled 103 consecutive candidates for FOB (April 2023 to April 2024). After excluding 10 ineligible participants, 93 were enrolled in a two-phase study. In the initial dose-determination phase, 21 participants underwent dose escalation to establish the induction dose of remimazolam (0.35 mg/kg) using the modified Dixon’s method. Subsequently, 72 participants were randomly assigned in a 1:1 ratio to remimazolam-remifentanil group (Group R-R) or propofol-remifentanil group (Group P-R) (n = 36 each). Remifentanil was administered by target-controlled infusion (3.0 ng/mL plasma concentration) in both groups. Group R-R received remimazolam 0.35 mg/kg, while Group P-R received propofol 2.0 mg/kg after remifentanil loading. Standardized supplemental doses were administered for inadequate sedation (Modified Observer’s Assessment of Alertness/Sedation score >1 or Bispectral index >75). The primary endpoint was the incidence of respiratory depression, defined as SpO₂ <95% or a respiratory rate <8 breaths/min. Secondary outcomes included procedure completion, movement or cough-related interruptions, hemodynamic stability, adverse events, procedural time, and satisfaction ratings from both bronchoscopists and participants.

RESULTS: Group R-R demonstrated a significantly lower incidence of respiratory depression (11.1% vs. 33.3%; P = 0.045) and of hypotension requiring vasopressors (16.7% vs. 41.7%; P = 0.020). However, transient involuntary movements (25.0% vs. 8.3%; P = 0.111) and cough (38.9% vs. 22.2%; P = 0.125) were numerically more frequent in Group R-R, though not statistically significant. All procedures were completed successfully without discontinuation. Hypertension, arrhythmias, procedural times, and satisfaction scores were comparable between groups (all P > 0.05).

CONCLUSIONS: Compared to propofol-remifentanil, remimazolam-remifentanil provides effective moderate sedation for FOB with superior respiratory safety and reduced hypotension requiring vasopressors, despite a numerically higher incidence of transient movement and cough. It thus represents a promising alternative for maintaining spontaneous ventilation during FOB.

PMID:40952556 | DOI:10.1007/s11596-025-00111-6

Environ Geochem Health. 2025 Sep 11;47(10):433. doi: 10.1007/s10653-025-02743-y.

ABSTRACT

Fluoride (F^–) and arsenic (As) are the two most conspicuous contaminants, in terms of distribution and menace, in aquifers cause health problems. These contaminants in the shallow aquifers of the eastern Henan Plain, posing serious health risks for the local residents. A total of 136 groundwater samples (74 from the dry season and 62 from the wet season) were analyzed to investigate the to assess the levels and mechanisms of high F^– and As enrichment in groundwater. Statistical and geostatistical methods, including charge balance calculations and health risk assessments, were employed to evaluate the spatial distribution and associated health risks of these contaminants. The results indicate the maximum concentrations of 2.82 mg/L for F^– and 51.4 μg/L for As, predominantly in the central, eastern, and southern regions of the study area, particularly at depths of 10-40 m. Elevated levels of these contaminants are associated with higher pH and increased Na⁺, HCO₃^–, SO₄^2- ions, while Ca²⁺ levels are depleted, attributed to fluorite and sulfide-bearing minerals and anthropogenic activities. The northern part shows a higher vulnerability to non-carcinogenic health risks, whereas the southeastern region exhibits greater carcinogenic risks. The hazard index (HI) values exceeding 1.0 suggest significant non-carcinogenic health risks. The study addresses a significant gap by comprehensively examining the co-occurrence and mechanisms of fluoride and arsenic in groundwater, providing critical data for policymakers to enhance and improve water quality management.

PMID:40952528 | DOI:10.1007/s10653-025-02743-y

J Diabetes. 2025 Sep;17(9):e70156. doi: 10.1111/1753-0407.70156.

ABSTRACT

BACKGROUND: This randomized controlled trial (RCT) was designed to evaluate the effects of sitagliptin on diabetic foot ulcers (DFUs).

METHODS: This was a randomized, open-label clinical trial. The participants were assigned to either the control group, which received standard conventional therapy alone, or the sitagliptin treatment group, which received an oral administration of sitagliptin (100 mg once daily) in conjunction with standard conventional therapy. The primary endpoints were the ulcer healing rate and adverse reactions. The secondary endpoints included the time to ulcer healing, peripheral blood CD34+ endothelial progenitor cells (EPCs) count, serum levels of stromal cell-derived factor-1α (SDF-1α), and glycosylated hemoglobin A1c (HbA1c).

RESULTS: A total of 62 subjects were enrolled in this trial, with 31 individuals assigned to each group. One participant from each group was lost to follow-up. Posttrial analysis revealed that, compared with the control group, the sitagliptin group demonstrated a significantly greater reduction in ulcer area and improved efficacy in terms of ulcer healing (p < 0.05). Although not statistically significant (p = 0.071), the sitagliptin group also tended to have a shorter ulcer healing time. Additionally, the sitagliptin group presented significantly greater numbers of CD34+ EPCs and higher SDF-1α levels compared to the control group (p < 0.05). No statistically significant difference in HbA1c levels was observed between the two groups (p > 0.05). No adverse events associated with sitagliptin treatment were reported.

CONCLUSIONS: The DPP-4 inhibitor sitagliptin may facilitate the healing of DFUs independent of its glucose-lowering effects, potentially by enhancing the mobilization of CD34 + EPCs in peripheral blood.

TRIAL REGISTRATION: Registration number: ChiCTR 2000029230, Approval date: 2020/01/19.

PMID:40948240 | DOI:10.1111/1753-0407.70156

Cardiol Young. 2025 Sep 15:1-7. doi: 10.1017/S1047951125109554. Online ahead of print.

ABSTRACT

BACKGROUND: Patients diagnosed with hypertension (HT) are at high risk for end-organ damage. With changing living conditions and access to healthcare facilities worldwide, the rate of diagnosis in childhood is increasing. In this study, healthy children were compared with a group of pediatric patients diagnosed with hypertension. Cardiac findings in the hypertensive group were compared at presentation and at six months. We aimed to determine the discriminatory value of epicardial adipose tissue (EAT) measurements as an early imaging marker for cardiac involvement in children with HT compared to healthy children and to determine its prognostic feature for HT treatment response.

METHODS: Fifty-nine primary hypertension patients and 76 control patients aged 0-18 years were compared. EAT values measured between the healthy group and the patient group and at the beginning of treatment and subsequent follow-ups in the patient group were evaluated with M-mode measurements.

RESULTS: There was no difference between the groups in terms of sex, and age. EAT was found to be significantly higher in the patient group than in the healthy group. There was a statistically significant difference between the EAT measurements evaluated before and after treatment in the patient group.

CONCLUSIONS: Hypertension is an important cause of morbidity and mortality. Using EAT measurements as a noninvasive parameter may provide information about early cardiac involvement due to HT. EAT is promising as an imaging marker that can be used in diagnosis and follow-up.

PMID:40948230 | DOI:10.1017/S1047951125109554

J Cosmet Dermatol. 2025 Sep;24(9):e70456. doi: 10.1111/jocd.70456.

NO ABSTRACT

PMID:40948229 | DOI:10.1111/jocd.70456

Microsurgery. 2025 Sep;45(6):e70111. doi: 10.1002/micr.70111.

ABSTRACT

BACKGROUND: The aim of this study is to compare the traditional triple innervation technique with a new version, designed to reduce eye-mouth synkinesis. To reduce unpleasant synkinesis, the authors proposed changing the connection between the masseteric nerve and the injured facial nerve, analyzing the outcome in terms of reduction of synkinesis and power of contraction of the mimic muscle. The traditional technique conveys the quantitative stimuli from the masseteric nerve to the temporofacial branch and from the hypoglossal nerve (30%) to the cervicofacial branch. Traditionally, the stimulus coming from the masseteric nerve is directed in that way to both the orbicularis oculi and the great zygomatic muscle, leading to eye-mouth synkinesis. The evolved technique connects the masseteric nerve more distally on the branch directed to the great zygomatic muscle and the hypoglossal nerve (30%) to the main trunk of the injured facial nerve. Long-term follow-up could be interesting to check what happens to the eye without the stimulus coming from the masseteric nerve.

METHODS: Exactly 32 patients were included, subdivided into two groups based on the type of surgical technique. Static symmetry, voluntary movements, and synkinesis were evaluated with eFACE software.

RESULTS: Both techniques allowed to obtain excellent outcomes: pre- and post-operative parameters showed a statistically significant improvement in both groups and no differences between the two groups, except in palpebral fissure width forced eye closure, in oculo and midfacial synkinesis: a significant reduction of synkinesis was evident in the evolved version group.

CONCLUSIONS: The new triple innervation offers significant improvements in reducing synkinesis, ocular and mid-facial muscle spasm, leading to a more relaxed tone at rest.

PMID:40948226 | DOI:10.1002/micr.70111

Anal Chem. 2025 Sep 15. doi: 10.1021/acs.analchem.5c03642. Online ahead of print.

ABSTRACT

This study refined the nontarget fingerprinting approach for accurate source apportionment by combining online solid-phase extraction with liquid chromatography-quadrupole time-of-flight mass spectrometry in data-independent acquisition mode, enabling both source concentration estimation and compound-level attribution. We established dilution curves (100 to 0% v/v) for three representative point sources and applied the nontarget source apportionment approach to five laboratory-prepared mixed samples. A total of 2489, 5750, and 6585 qualitative fingerprints (including both MS¹ and MS² features) were established for each source; their peak areas showed statistically significant and consistent associations across the dilution samples (r = 0.51-0.98, p < 7.2 × 10^-10) and mixed samples (r = 0.38-0.91, p < 3.1 × 10^-5). Linear and nonlinear regression models were applied across multiple dilution ranges to establish quantitative fingerprints, combined with a two-step approach for source apportionment. Incorporating MS² data alongside MS¹ increased the number of quantitative fingerprints by 29.1-39.6% across three representative sources and enabled accurate source concentration estimates (0.79-1.32-fold of actual values) in mixed samples. Analysis of compounds with peak areas >10⁴ in mixed samples showed that the majority compounds (63.9-81.5%) had estimated peak areas closely aligned with observed values (0.5-1.5-fold), indicating reliable and meaningful interpretation in compound-level source apportionment. This study enhances the efficiency and robustness of source estimation and deepens environmental insights, underscoring the potential of nontarget methodologies to enhance our understanding of contaminant distributions in environments.

PMID:40948219 | DOI:10.1021/acs.analchem.5c03642

J Coll Physicians Surg Pak. 2025 Sep;35(9):1180-1184. doi: 10.29271/jcpsp.2025.09.1180.

ABSTRACT

OBJECTIVE: To explore the challenges and opportunities associated with the implementation of formative assessment (FA) practices in medical colleges of Peshawar.

STUDY DESIGN: A cross-sectional study. Place and Duration of the Study: Four Medical colleges, two private (Rehman Medical College, Northwest School of Medicine) and two public (Khyber Medical College, Khyber Girls Medical College), in Peshawar, Pakistan, from November 2023 to April 2024.

METHODOLOGY: This study used a validated questionnaire to gather quantitative information about the challenges teachers face and the present use of formative assessment in the medical college. The sample included four medical colleges, two private and two public sectors, with a total sample size of 258 medical teachers. The data collected were analysed employing descriptive statistics, including frequencies and percentages, which were used to summarise the demographic characteristics and responses to the questionnaire items.

RESULTS: The quantitative study revealed that 88.4% (n = 228) of the medical teachers believed that they understood the concept of FA. Similarly, 86% (n = 222) felt they clearly understood the distinction between formative and summative assessments. Additionally, 81.4% (n = 210) considered feedback to be a crucial component of FA. In contrast, 62% (n = 160) believed that FA to be an approach primarily used for grading and certification. Only one-third of participants frequently conducted FA and provided feedback to students, whereas almost half stated they did so only occasionally. About the adding of FA scores in final course, semester, or overall grade, over half of the participants reported doing it occasionally, while 28.8% (n = 74) of participants revealed doing it routinely.

CONCLUSION: Despite most of the participants expressing confidence in their understanding of FA, a discrepancy was identified between teachers’ perceived understanding and their actual practice of FA. Although many participants acknowledged the significance of FA, the low proportion of teachers who practise it regularly raises concerns about the implementation of this valuable tool in medical education.

KEY WORDS: Formative assessment, Medical colleges, Challenges, Peshawar, Practice, Teacher.

PMID:40948167 | DOI:10.29271/jcpsp.2025.09.1180

J Coll Physicians Surg Pak. 2025 Sep;35(9):1159-1164. doi: 10.29271/jcpsp.2025.09.1159.

ABSTRACT

OBJECTIVE: To evaluate the predictive power of the ARISCAT (assess respiratory risk in surgical patients in Catalonia) score for postoperative pulmonary complications (PPCs) following major urological procedures.

STUDY DESIGN: A descriptive study. Place and Duration of the Study: Department of Anaesthesiology and Critical Care, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkiye, from January to December 2023.

METHODOLOGY: A total of 140 ASA I-IV patients aged 18-85 years who had elective major urological surgery were included. Records were kept including patient demographics, surgical technique, comorbidities, length of postoperative hospital stay, ASA scores, preoperative pulmonary risk scores (ARISCAT), and any PPCs occurring during hospitalisation. Appropriate statistical analyses were performed using Chi-square or Fisher’s exact tests for categorical variables, Mann-Whitney U and Student’s t-tests for numerical variables, and ROC analysis to evaluate the predictive power of the ARISCAT score for PPC incidence.

RESULTS: Of the 140 patients who had major urological surgery, 24 (17.1%) experienced postoperative pulmonary problems. The findings showed that the development of PPC was significantly correlated with the ASA and the ARISCAT scores, the amount of intraoperative fluids administered, the length of the operation, and a body mass index of 25 or above.

CONCLUSION: The ARISCAT risk score system was shown to be a simple, repeatable, economical, and effective method for forecasting the occurrence of PPC in major urological procedures. In terms of forecasting the growth of PPC, it was found that the ARISCAT score outperforms the ASA score. It was believed that implementing effective preventative measures, morbidity and mortality rates could be decreased when high-risk individuals were identified.

KEY WORDS: ASA score, ARISCAT score, Postoperative pulmonary complications, Major urological surgery.

PMID:40948164 | DOI:10.29271/jcpsp.2025.09.1159