Clinics最新文献

{"title":"Prognostic impact of sarcomatous component in patients with localized and locally advanced uterine carcinosarcoma: a retrospective study in Latin America","authors":"Daniel Santos Rocha Sobral Filho ,&nbsp;Giulia Mazaro de Oliveira ,&nbsp;Letícia Vecchi Leis ,&nbsp;Mariana de Paiva Batista ,&nbsp;Vanessa da Costa Miranda ,&nbsp;Renata Colombo Bonadio ,&nbsp;Maria del Pilar Estevez Diz ,&nbsp;Samantha Cabral Severino da Costa","doi":"10.1016/j.clinsp.2025.100854","DOIUrl":"10.1016/j.clinsp.2025.100854","url":null,"abstract":"<div><h3>Objective</h3><div>Evaluate the prognostic of the sarcomatous component (homologous vs heterologous).</div></div><div><h3>Methods</h3><div>This retrospective study evaluated patients with FIGO I‒IVA Uterine Carcinosarcoma (UCS) treated at a single cancer center. The endpoints were Overall Survival (OS) and Disease-Free Survival (DFS) according to the sarcomatous component. The Kaplan-Meier was used for survival analyses. Hazard Ratio (HR) and 95% Confidence Interval (95% CI) were calculated using Cox regression.</div></div><div><h3>Results</h3><div>61 patients with localized/locally advanced disease (34 homologous vs. 27 heterologous) were included. The most common pathological subtype was Rhabdomyosarcoma (60%) in the heterologous and endometrial stromal sarcoma (95%) in the homologous group. All patients underwent surgery. Adjuvant Chemotherapy (CT) was indicated for approximately 70%. A difference was observed between patients who did not complete adjuvant CT: 32.0% vs. 57.9% in homologous and heterologous groups, respectively (p = 0.03). The main reason for this was recurrence during treatment. Comparing homologous vs. heterologous group, median DFS was 143.2 months vs. 18.0 months (HR = 3.72, 95% CI 1.73‒8.02; p = 0.001) and median OS was 143.2 months vs. 34.4 months (HR = 2.79, 95% CI 1.27‒6.13; p = 0.001), respectively. Heterologous subtype (HR = 4.34, 95% CI 1.59‒11.85, p = 0.004) and FIGO stage III (HR = 3.33, 95% CI 1.18–9.39, p = 0.023) were associated with inferior DFS and OS, while completing adjuvant CT (HR = 0.22, 95% CI 0.07‒0.69, p = 0.009) was associated with superior outcomes.</div></div><div><h3>Conclusions</h3><div>The sarcomatous component has a relevant prognostic impact in localized/locally advanced UCS. The heterologous component was associated with a worse DFS and OS. Other negative prognostic factors were FIGO stage III and not completing adjuvant CT.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100854"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145838382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limb remote ischemic preconditioning attenuates biomarkers of acute lung injury and inflammation during thoracoscopic lobectomy: a randomized controlled trial","authors":"Wenfu Zhang ,&nbsp;Mingwang Zeng ,&nbsp;Chao Yang ,&nbsp;Lijun Yang ,&nbsp;Juan Yang ,&nbsp;Yi Wang ,&nbsp;Haiyu Xie ,&nbsp;Lifeng Wang ,&nbsp;Maolin Zhong ,&nbsp;Fuzhou Hua ,&nbsp;Weidong Liang","doi":"10.1016/j.clinsp.2026.100883","DOIUrl":"10.1016/j.clinsp.2026.100883","url":null,"abstract":"<div><h3>Background</h3><div>One-Lung Ventilation (OLV), though essential for thoracic surgery, triggers inflammation and oxidative stress that may lead to Acute Lung Injury (ALI). Remote Ischemic Preconditioning (RIPC) is a simple, non-invasive intervention that may activate protective pathways and reduce ischemia-reperfusion injury. This randomized controlled trial assessed whether limb RIPC attenuates OLV-induced lung injury during thoracoscopic lobectomy.</div></div><div><h3>Methods</h3><div>Fifty-four patients undergoing thoracoscopic lobectomy with OLV were randomized to the RIPC (<em>n</em> = 27) or Control (NC, <em>n</em> = 27) group. RIPC consisted of five cycles of 5-min ischemia and 5-min reperfusion using a lower limb tourniquet before OLV. Blood samples were collected at T0 (post-induction), T1 (30-min after OLV), T2 (90-min after OLV), and T3 (30-min after resumption two-lung ventilation). The primary endpoint was plasma CC16. Secondary endpoints included IL-6, MDA, arterial blood gases, Intraoperative Oxygenation Indices (OI, RI, A-aDO₂, a/A), and hospital stay.</div></div><div><h3>Results</h3><div>Plasma CC16, IL-6, and MDA levels were significantly lower in the RIPC group from T1 to T3 (all <em>p</em> &lt; 0.001). In contrast, oxygenation indices, blood gas parameters, and hospital stay did not differ significantly between groups (all <em>p</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Limb RIPC effectively reduced systemic markers of lung injury (CC16), inflammation and oxidative stress during OLV but not in short-term improvements in oxygenation or clinical recovery. These findings suggest that RIPC confers molecular protection, with potential functional benefits requiring longer follow-up or evaluation in high-risk populations. Larger multicenter trials are warranted.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100883"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resveratrol protects against isoflurane-induced testicular injury: a stereological and molecular study in mice","authors":"Zahra Mohammadi ,&nbsp;Sanaz Alaee ,&nbsp;Majid Kamali-Dolat Abadi ,&nbsp;Somayyeh Karami-Mohajeri ,&nbsp;Zahra Khodabandeh ,&nbsp;Saeed Shokri ,&nbsp;Sulagna Dutta ,&nbsp;Pallav Sengupta ,&nbsp;Hesam Kamyab","doi":"10.1016/j.clinsp.2026.100878","DOIUrl":"10.1016/j.clinsp.2026.100878","url":null,"abstract":"<div><h3>Background</h3><div>This study examines the therapeutic effects of resveratrol, known for its antioxidant and anti-inflammatory properties, in mitigating the harmful effects of isoflurane, an inhalation anesthetic, on testicular tissues in mice.</div></div><div><h3>Methods</h3><div>Sixty adult male C57BL/6 mice were grouped into six categories: control (normal saline), isoflurane only (1.5% for 1-hour/day), low-dose Resveratrol (RSV, 50 mg/kg/day), high-dose RSV (100 mg/kg/day), isoflurane combined with low-dose RSV, and isoflurane combined with high-dose RSV. After 35-days, the mice were euthanized, and their testes were harvested for stereological analysis and the assessment of antioxidant and apoptotic markers.</div></div><div><h3>Results</h3><div>Exposure to isoflurane resulted in decreased seminiferous tubule volume and length, along with increased interstitial tissue volume of the testis. Co-treatment with resveratrol, especially at higher doses, mitigated these changes. Additionally, resveratrol modulated the expression of the apoptotic genes <em>Bcl2l1, Bax</em>, and <em>Caspase-3</em>, and enhanced the expression of antioxidant genes <em>GPX1, Sod1</em>, and <em>catalase</em> in mice that received isoflurane.</div></div><div><h3>Conclusions</h3><div>The findings suggest that resveratrol effectively counters isoflurane-induced damage in testicular structures and gene expression, enhancing tubular integrity and antioxidant defense. This indicates a potential therapeutic approach to protect against isoflurane-induced testicular toxicity.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100878"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146230470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term outcome of totally laparoscopic gastrectomy for gastric cancer: a comparative study","authors":"Liu Liu ,&nbsp;Shijie Feng ,&nbsp;Haiyan Wang ,&nbsp;Lin Liu","doi":"10.1016/j.clinsp.2026.100887","DOIUrl":"10.1016/j.clinsp.2026.100887","url":null,"abstract":"<div><h3>Objective</h3><div>Whether Totally Laparoscopic Gastrectomy (TLG) is beneficial for patients with gastric cancer remains not fully understood. This study was to evaluate the advantages of Totally Laparoscopic Gastrectomy (TLG) for treating Gastric Cancer (GC).</div></div><div><h3>Methods</h3><div>From January 2019 to December 2021, 380 patients with gastric cancer were included into this study (190 per group). The outcomes of interest, including postoperative recovery, inflammation, and oncological results, were compared between the two groups.</div></div><div><h3>Results</h3><div>The patient baselines between the two groups were comparable. The TLG group had lower risks of wound infection (<em>p</em> = 0.02) and total complications (<em>p</em> = 0.03) compared to LAG. The TLG group exhibited significantly shorter operative time (median: 215 vs. 240 min, <em>p</em> &lt; 0.001), less intraoperative blood loss (median: 50 vs. 100 mL, <em>p</em> &lt; 0.001), shorter time to first flatus (median: 3 vs. 4 days, <em>p</em> &lt; 0.001), and reduced length of postoperative hospital stay (<em>p</em> &lt; 0.001). Furthermore, patients in the TLG group exhibited lower White Blood Cell (WBC) counts on POD 1 compared to patients in the LAG group (mean 11.74 vs. 12.75 × 10^9/L; <em>p</em> = 0.003). Multivariate logistic regression analysis revealed that TLG was an independent predictor of shorter postoperative hospitalization (OR (95% CI): 0.54 (0.30‒0.95), <em>p</em> = 0.03). Interestingly, the TLG group had more lymph nodes harvested than the LAG group (median (range): 23 (2‒88) vs. 23 (2‒88), <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>This study demonstrates that TLG has a lower risk of complications and faster postoperative recovery, thus TLG is superior to LAG for the treatment of gastric cancer.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100887"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term effects of a 12-week Zumba program on thyroid and cardiometabolic markers in overweight/obese postmenopausal women: A randomized pilot study","authors":"Hanen Saadouni ,&nbsp;Okba Selmi ,&nbsp;Nejmeddine Ouerghi ,&nbsp;Hamza Marzouki ,&nbsp;Soukaina Hattabi ,&nbsp;Lamia Attig ,&nbsp;Katja Weiss ,&nbsp;Thomas Rosemann ,&nbsp;Beat Knechtle ,&nbsp;Anissa Bouassida","doi":"10.1016/j.clinsp.2026.100880","DOIUrl":"10.1016/j.clinsp.2026.100880","url":null,"abstract":"<div><h3>Objective</h3><div>This pilot study aimed to investigate the effects of a 12-week Zumba training program on Thyroid-Stimulating Hormone (TSH), Free Thyroxine (FT4), lipid profile, and anthropometric parameters in overweight and obese postmenopausal women.</div></div><div><h3>Methods</h3><div>Twenty-two women (aged 44‒60 years) were randomly assigned to a Zumba training group (ZG; <em>n</em> = 11) or a control group (CG; <em>n</em> = 11). The ZG participated in 60-min Zumba sessions three times per week for 12-weeks, while the CG maintained their usual lifestyle. Before and after the intervention, participants underwent assessments of body composition, blood pressure, and circulating levels of TSH, FT4, Total Cholesterol (TC), and Triglycerides (TG).</div></div><div><h3>Results</h3><div>Following the intervention, the ZG showed significant reductions in TSH (<em>p</em> = 0.001; Cohen’s d (<em>d)</em> = 0.90), TG levels (<em>p</em> = 0.043; <em>d</em> = 0.75), body fat percentage, body mass index, waist and hip circumference, and both systolic and diastolic blood pressure (all <em>p</em> &lt; 0.05). No significant changes were observed for FT4 and TC levels. No notable changes were recorded in the CG.</div></div><div><h3>Conclusions</h3><div>The 12-week Zumba program can serve as a feasible and enjoyable strategy for promoting physical activity in overweight and obese postmenopausal women, leading to improvements in thyroid function, TG levels, body composition, and blood pressure. These preliminary findings support the potential of Zumba for enhancing cardiometabolic health during menopause, though larger, long-term trials are needed to confirm these effects and investigate their durability.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100880"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"POEM for Zenker’s diverticulum (Z-POEM): Technical advances, challenges and complications – a narrative review","authors":"Ygor Rocha Fernandes ,&nbsp;Mateus Pereira Funari ,&nbsp;Christiano Makoto Sakai ,&nbsp;Fauze Maluf-Filho","doi":"10.1016/j.clinsp.2026.100897","DOIUrl":"10.1016/j.clinsp.2026.100897","url":null,"abstract":"<div><h3>Background/Aims</h3><div>Zenker's Diverticulum (ZD) is a pharyngoesophageal pulsion diverticulum traditionally managed with open surgical or endoscopic (rigid and flexible) techniques. Zenker’s Peroral Endoscopic Myotomy (Z-POEM) has recently emerged as a minimally invasive alternative demonstrating promising efficacy and safety. This narrative review aims to synthesize current evidence regarding the technical evolution of Z-POEM, its indications, procedural nuances, long-term outcomes, cost-effectiveness, and future directions.</div></div><div><h3>Methods</h3><div>A structured narrative review was conducted in accordance with SANRA guidelines to assess the technical modifications, clinical outcomes, and complications of Zenker’s Per-Oral Endoscopic Myotomy (Z-POEM). Relevant literature published between January 2016 and September 2025 was systematically searched across PubMed, Scopus, and EMBASE, supplemented by manual citation tracing. Eligible studies included clinical trials, cohorts, observational reports, and technical notes focusing on Z-POEM or its variants. Data extraction and synthesis were performed independently by two reviewers, with findings organized into thematic domains comprising procedural techniques, efficacy, safety, adverse events, recurrence, and follow-up.</div></div><div><h3>Results</h3><div>Proper patient selection is critical for technical success. Factors such as diverticulum size, symptom severity, and anatomical features guide the optimal technique. Long-term studies report sustained clinical success exceeding 85% over 30‒40 months. Repeat Z-POEM procedures have shown high efficacy in managing recurrence. Comparative data indicate Z-POEM achieves superior clinical outcomes compared with flexible endoscopic septotomy, with comparable safety and procedure times.</div></div><div><h3>Conclusions</h3><div>Z-POEM demonstrates high safety and efficacy, though long-term durability may favor Z-POEM in larger or fibrotic diverticula. Further research should focus on cost-effectiveness, technique standardization, and long-term comparative outcomes to refine patient selection criteria and consolidate Z-POEM as a first-line therapy for ZD.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100897"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Six IL-8 gene polymorphisms and the entire cancer susceptibility according to a comprehensive analysis especially in prostate cancer","authors":"Xiao Zhang ,&nbsp;Jian Sun ,&nbsp;Xiqi Ding","doi":"10.1016/j.clinsp.2026.100862","DOIUrl":"10.1016/j.clinsp.2026.100862","url":null,"abstract":"<div><h3>Objectives</h3><div>Interleukin-8 (IL-8) is a key cytokine regulating immunity and inflammation, and its genetic polymorphisms have been increasingly linked to cancer susceptibility. However, findings on the role of specific IL-8 polymorphisms across different cancers remain inconsistent, necessitating a comprehensive meta-analysis.</div></div><div><h3>Methods</h3><div>The authors systematically searched Embase, PubMed, Chinese databases, Google Scholar, and Web of Science up to June 25, 2023. A total of 104 case-control studies (26,029 cases and 31,577 controls) were included in a high-powered meta-analysis. Summary Odds Ratios (ORs) with 95% Confidence Intervals (95% CIs) were calculated using Stata. Additionally, the authors performed an ELISA-based validation study to measure serum IL-8 levels in Prostate Cancer (PCa) patients grouped by genotype.</div></div><div><h3>Results</h3><div>The +2767 polymorphism was associated with a significant reduction in overall cancer risk. The +781 polymorphism increased cancer risk specifically in Caucasian populations. In contrast, the -251 polymorphism demonstrated a strong pan-cancer risk association, particularly in Mixed/Asian ethnicities, gastric cancer, lung cancer, and hospital-based studies. Mechanistically, patients with the -251 AA/AC genotypes had elevated serum IL-8 levels, which were linked to more aggressive PCa pathogenesis.</div></div><div><h3>Conclusion</h3><div>This pioneering meta-analysis identifies the IL-8 -251 polymorphism as a high-risk biomarker and +2767 as a protective variant. By functionally validating that the -251 risk allele promotes PCa progression via IL-8 overexpression, the present study establishes IL-8 genotyping as a potential tool for ethnic-specific risk stratification and prognostic prediction, with broad implications for precision oncology.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100862"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nomogram prediction model for the clinical efficacy of flunarizine hydrochloride in patients with vertigo based on 5-HT and oxidative stress indicators✰","authors":"Hua Zhang,&nbsp;Xu Pan,&nbsp;Dan Lin,&nbsp;Xiaogang Yang,&nbsp;Puzhao Liu","doi":"10.1016/j.clinsp.2026.100936","DOIUrl":"10.1016/j.clinsp.2026.100936","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to develop and validate a nomogram model integrating 5-Hydroxytryptamine (5-HT) and oxidative stress markers to predict the efficacy of flunarizine hydrochloride in treating vertigo.</div></div><div><h3>Methods</h3><div>A retrospective study included 244 vertigo patients treated with flunarizine hydrochloride from September 2022 to December 2024. Patients were divided into training (70%) and validation (30%) sets. Clinical data, 5-HT levels, and oxidative stress indicators (Superoxide Dismutase [SOD], Malondialdehyde [MDA], Glutathione Peroxidase [GSH-Px]) were collected and analyzed. The influencing factors of treatment efficacy were screened using univariate and multivariate logistic regression. Least Absolute Shrinkage and Selection Operator (LASSO) regression was implemented using the R 'glmnet' package with 10-fold cross-validation. A nomogram model was constructed by integrating the independent influencing factors of treatment efficacy. Model performance was assessed via calibration curves, Consistency index (C-index), Decision Curve Analysis (DCA), and Receiver Operating Characteristic (ROC) curve.</div></div><div><h3>Results</h3><div>There were 176 cases in the effective group and 68 cases in the ineffective group. Age, 5-HT, SOD, MDA, and GSH-Px were identified as independent predictors of treatment efficacy (<em>p</em> &lt; 0.05). After variable selection via LASSO regression, the reduced nomogram demonstrated strong discriminative ability, with C-indexes of 0.862 (in the training set) and 0.874 (in the validation set), and average absolute errors of 0.144 and 0.138, respectively. Hosmer-Lemeshow tests confirmed good fit of the model (training: χ² = 9.061, <em>p</em> = 0.337; validation: χ² = 8.034, <em>p</em> = 0.430). ROC analysis yielded Area Under the Curve (AUC) values of 0.861 (95% CI: 0.797–0.925) and 0.870 (95% CI: 0.798–0.973) for training and validation sets, with sensitivity/specificity values of 0.892/0.711 and 1.000/0.650, respectively.</div></div><div><h3>Conclusion</h3><div>The simplified nomogram incorporating age and oxidative stress markers demonstrates robust predictive accuracy while enhancing clinical feasibility. Actionable thresholds were established, such that patients with a score &gt; 70-points should be considered for alternative therapies due to a high predicted risk of treatment non-response.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100936"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT grading combined with inflammatory markers for predicting the efficacy of conservative treatment in acute appendicitis","authors":"Zhizun Lin","doi":"10.1016/j.clinsp.2026.100929","DOIUrl":"10.1016/j.clinsp.2026.100929","url":null,"abstract":"<div><h3>Aims</h3><div>To investigate the clinical characteristics of patients with first-episode acute appendicitis and explore the value of CT imaging grading combined with inflammatory markers in evaluating the cure and relapse of conservative treatment.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted to collect the clinical data of 482 patients with acute appendicitis diagnosed in the Emergency Department of the Second Affiliated Hospital of Fujian Medical University from October 2021 to February 2024. The imaging features of these patients were evaluated using Computed Tomography (CT) scans. Descriptive analysis, chi-square test, ordinal logistic regression model, Kaplan-Meier curve, and COX regression analysis were used to analyze the data.</div></div><div><h3>Results</h3><div>Elevated levels of Procalcitonin (PCT) and C-Reactive Protein (CRP) were associated with higher CT grades. Acute appendicitis patients with higher CT grades had a poor prognosis with antibiotic treatment. CT grade was a predictor of the prognosis of antibiotic treatment, and a high CT grade was an independent risk factor for relapse.</div></div><div><h3>Conclusion</h3><div>CT grade combined with inflammatory markers (PCT and CRP) can effectively predict the prognosis of conservative treatment for acute appendicitis, and CT grade can be used to predict the risk of relapse.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100929"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective analysis of post-COVID-19 hospitalization: Impact on pulmonary function, physical performance and overall functionality","authors":"Danielle Brancolini de Oliveira,&nbsp;Gabriela Sayuri Ochiai,&nbsp;Elizabeth Mendes da Silva,&nbsp;Camila Machado de Campos,&nbsp;Caroline Gil de Godoy,&nbsp;Erika Christina Gouveia e Silva,&nbsp;Celso Ricardo Fernandes Carvalho,&nbsp;Jose Eduardo Pompeu","doi":"10.1016/j.clinsp.2026.100938","DOIUrl":"10.1016/j.clinsp.2026.100938","url":null,"abstract":"<div><h3>Background</h3><div>COVID-19 can lead to enduring long-term effects, particularly in severe cases requiring hospitalization. This study contrasts Normal lung Patterns (NP) with Restrictive lung Disease (RD) regarding the evolution of physical performance and functionality post-COVID-19 hospitalization.</div></div><div><h3>Methods</h3><div>This is a prospective cohort study. Individuals post-COVID-19 were evaluated at 1- and 12-months post-discharge. Data collection included analysis of lung function, physical performance, functionality, and clinical data.</div></div><div><h3>Results</h3><div>Of the 185 participants initially assessed, 62 attended the final evaluation. At 1 month post-discharge, 57 (92%) had been admitted to the ICU and 47 (76%) exhibited RD. After 12-months, RD decreased to 20 (32%). Both groups showed improved Sit-to-Stand repetitions (p = 0.002). A substantial percentage (28%) of participants with RD experienced functional impairments at one month, with a notable proportion maintaining these limitations after one year (15%).</div></div><div><h3>Conclusions</h3><div>Almost half of individuals with RD (43%) still exhibited this pulmonary alteration after one year (RD 20/47). Additionally, RD participants demonstrated decreased physical performance at one month (15%), with only a fraction (5%) showing improvement after one year. Finally, these results pointed out the necessity of long-term follow-up regarding the recovery trajectory of post-COVID patients. Furthermore, there is a clear need to offer specific rehabilitation focusing on pulmonary, physical performance and functionality.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100938"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147709412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}