Clinics最新文献

{"title":"Simultaneous 18F-labeled AlF-FAPI PET/MR images targeting the myocardial fibrosis in coronary artery disease and degenerative mitral valve regurgitant participants with left ventricular mechanical dyssynchrony","authors":"YuFeng Chen ,&nbsp;Jia Guo ,&nbsp;YuJi Zhang ,&nbsp;DengShun Tao ,&nbsp;KeYan Zhao ,&nbsp;QingXue Shi ,&nbsp;GuoXu Zhang ,&nbsp;HuiShan Wang","doi":"10.1016/j.clinsp.2025.100624","DOIUrl":"10.1016/j.clinsp.2025.100624","url":null,"abstract":"<div><h3>Background</h3><div>Myocardial fibrosis contributes to LV mechanical dyssynchrony and fibroblast activation protein is considered as a specific biomarker related to tissue remodeling. The authors aimed to explore the relationship between LVMD and myocardial fibrosis, and patterns of LV fibrosis distribution in CAD and Degenerative Mitral Valve Regurgitant (DMVR) participants by the technique of ¹⁸F-AlF-FAPI PET/MR.</div></div><div><h3>Methods</h3><div>37 CAD and DMVR participants with LVMD and normal ones underwent cardiac PET/MR imaging, the correlations between SUV_mean of FAPI-uptakes and score/percentage of LV wall thickening, peak myocardial strains, and displacements were analyzed in PET/MR images, and ejection fractions and function parameters of mitral valve were compared.</div></div><div><h3>Results</h3><div>There was inverse correlation between SUV_mean and score/percentage of LV wall thickening, peak circumferential and short-axial radial myocardial strains, and global peak myocardial strains and ejection fractions showed a decrease significantly in participants with heart diseases. In CAD participants, FAPI was distributed in the ischemic coronary arteries regions. Functions of myocardium in LAD and RCA regions were sensitive to fibrosis, however, those in LCX regions were resistant to fibrosis. In DMVR participants, high uptakes of FAPI were the locations of the valve annulus and papillary muscles, and SUV_mean in the basal inferospetal/basal inferior segments were a positive correlation with function parameters of the mitral valve.</div></div><div><h3>Conclusion</h3><div>Uptake of ¹⁸F-AlF-FAPI in the myocardium could detect fibrosis and predict LVMD in CAD and DMVR participants. Moreover, there were different distributions of FAPI-uptake in those participants. In DMVR participants, SUV_mean in the basal inferospetal/basal inferior segments could assess dysfunction of the mitral valve.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100624"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CircRBM33 competitively binds miR-15a-5p to mediate EZH1 expression to ameliorate sepsis-induced acute lung injury","authors":"Jinquan Lin ,&nbsp;Qiongying Wei ,&nbsp;Zhipeng Fang","doi":"10.1016/j.clinsp.2024.100550","DOIUrl":"10.1016/j.clinsp.2024.100550","url":null,"abstract":"<div><h3>Background</h3><div>The study was to investigate circRBM33 in septic acute lung injury (ALI).</div></div><div><h3>Methods</h3><div>Treatment of Murine Lung Epithelial-12 cells (MLE-12) cells was performed using 10 ng/mL Lipopolysaccharide (LPS). circRBM33, miR-15a-5p, and Enhancer of zeste homolog 1 (EZH1) were ascertained through RT-qPCR or Western blot analysis. The viability of MLE-12 cells was measured using the MTT assay, and their rate of apoptosis was ascertained through flow cytometry. B-cell lymphoma-2 (Bcl-2), and Bcl-2-associated X (Bax) were determined using Western blot analysis. Oxidative stress levels were assessed with ELISA kits, and levels of malondialdehyde(MDA) content, Superoxide Dismutase (SOD) activity, and glutathione (GSH) were detected. Dual luciferase reporter gene and RIP assays verified the targeting link between miR-15a-5p and circRBM33 or EZH1. The role of circRBM33 in ALI <em>in vivo</em> was determined by performing cecum ligation-perforation (CLP) surgery. HE staining, W/D pulmonary edema, and histological damage scores were taken to assess the extent of lung tissue damage. ELISA was performed to determine proinflammatory factors in lung tissue and cells.</div></div><div><h3>Results</h3><div>CircRBM33 downregulation ameliorated ALI-induced edema, apoptotic, and inflammatory reactions in mouse lung tissues. In addition, apoptosis and inflammation mediated by LPS in MLE-12 cells were ameliorated by circRBM33 downregulation, whereas miR-15a-5p knockdown or EZH1 elevation eliminated the action of silencing circRBM33. circRBM33 mediated EZH1 expression by competitive adsorption of miR-15a-5p.</div></div><div><h3>Conclusion</h3><div>CircRBM33 improves ALI in septic mice by targeting the miR-15a-5p/EZH1 axis.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100550"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New, late-onset relapsing-remitting multiple sclerosis in a woman in her 60s after SARS-CoV-2 vaccination","authors":"Carla Alexandra Scorza ,&nbsp;Fulvio Alexandre Scorza ,&nbsp;Josef Finsterer","doi":"10.1016/j.clinsp.2024.100556","DOIUrl":"10.1016/j.clinsp.2024.100556","url":null,"abstract":"","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100556"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gyosaponin ameliorates sevoflurane anesthesia-induced cognitive dysfunction and neuronal apoptosis in rats through modulation of the PI3K/AKT/mTOR pathway","authors":"Lijuan Lin ,&nbsp;Chenhui Zhu ,&nbsp;Bing Yan ,&nbsp;Pinxian Yu ,&nbsp;Liu Yang ,&nbsp;Wei Huang ,&nbsp;Junren Chen","doi":"10.1016/j.clinsp.2024.100560","DOIUrl":"10.1016/j.clinsp.2024.100560","url":null,"abstract":"<div><h3>Background</h3><div>Sevoflurane (Sev) is an inhalational anesthetic for surgical procedures where it can trigger cognitive dysfunction and neuronal apoptosis. Gyosaponin (GpS) was studied for its effects on brain morphology and cognitive behaviors in Sev-anesthetized rats.</div></div><div><h3>Methods</h3><div>Male Sprague-Dawley rats were induced by 3 % Sev anesthesia, and 25 mg/kg and 100 mg/kg GpS were injected into the rats by tail vein. The in vitro model of Sev anesthesia was constructed by treating primary rat hippocampal neurons with 4.1 % Sev in the presence of GpS (5, 10, and 20 μM). The neuroprotective effects of GpS against Sev-induced cognitive deficits in rats were evaluated using the open field and Morris water maze tests. The apoptosis of hippocampal neurons was observed using HE staining and TUNEL assay. Apoptosis-related proteins and proteins related to the PI3K/Akt/mTOR pathway were determined via Western blot. Also, pro-inflammatory factors were measured via ELISA.</div></div><div><h3>Results</h3><div>GpS diminished the Sev-triggered apoptosis in neurons and Cleaved caspase-3, BAX, TNF-α, IL-6, lessened oxidative stress damage, and stimulated the PI3K/Akt/mTOR pathway. GpS therapy markedly enhanced learning and memory abilities in rats suffering from Sev-related cognitive impairments.</div></div><div><h3>Conclusion</h3><div>GpS ameliorates Sev-induced neurotoxicity and cognitive dysfunction by modulating the PI3K/Akt/mTOR pathway and alleviating neuronal apoptosis and oxidative stress.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100560"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of adipose-derived mesenchymal stem cells on the viability of the transverse rectus abdominis myocutaneous flap in rats","authors":"André Luiz Pires de Freitas ,&nbsp;Sang Won Han ,&nbsp;Priscila Keiko Matsumoto Martin ,&nbsp;Lydia Masako Ferreira","doi":"10.1016/j.clinsp.2025.100590","DOIUrl":"10.1016/j.clinsp.2025.100590","url":null,"abstract":"<div><h3>Introduction</h3><div>The Transverse Rectus Abdominis Myocutaneous (TRAM) flap is used for breast reconstruction, but involves the risk of necrosis. Adipose tissue-derived mesenchymal Stem Cells (ADSCs) can be used to stimulate neovascularization and reduce the risk of TRAM flap necrosis.</div></div><div><h3>Aim</h3><div>Determine the effect of ADSCs on TRAM flap viability in rats.</div></div><div><h3>Methods</h3><div>Twenty-four Wistar-EPM rats were distributed into three groups (<em>n</em> = 8). A right caudal pedicled TRAM flap was performed in all the animals and was the only procedure performed in Group TRAM. The additional procedures of intradermal injection of α-MEM culture medium and intradermal injection of α-MEM containing ADSCs labeled with a fluorescent marker were performed in Groups α-MEM and α-MEM-SC, respectively. The percentage of flap necrosis was determined, and the level of neovascularization and distribution of stem cells in the TRAM flap was assessed using immunohistochemical analysis and fluorescence microscopy, respectively.</div></div><div><h3>Results</h3><div>The percentage of necrosis observed in Group α-MEM-SC was lower than that observed in Groups TRAM and α-MEM, namely 23.36 % vs. 50.42 % and 53.57 %, respectively (<em>p</em> &lt; 0.05). In Zone IV of the flap, the number of vessels was greater in Group α-MEM-SC than in the other groups (<em>p</em> &lt; 0.05). Multiple stem cells were observed in the four zones of the flap in Group α-MEM-SC. No stem cells were observed in Groups TRAM or α-MEM.</div></div><div><h3>Conclusion</h3><div>ADSCs increased TRAM flap viability and the number of vessels in Zone IV of the flap in rats.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100590"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual reality and traditional training in surgical instrumentation: A non-inferiority comparative study","authors":"Cristina Pires Camargo ,&nbsp;Sergio Henrique Bastos Damous ,&nbsp;Jocielle Santos de Miranda ,&nbsp;Patricia Zen Tempski ,&nbsp;Francisco de Salles Collet e Silva ,&nbsp;José Maria Soares Jr. ,&nbsp;Edivaldo Massazo Utiyama ,&nbsp;Rolf Gemperli","doi":"10.1016/j.clinsp.2025.100609","DOIUrl":"10.1016/j.clinsp.2025.100609","url":null,"abstract":"<div><h3>Objective</h3><div>Medical education is undergoing a profound transformation due to technological advancements. Integrating cutting-edge tools like virtual environments and computer-based simulators heralds a new era in teaching methodologies. The objective of the study is to analyze the performance and satisfaction levels of residents undergoing basic surgical skills training using virtual reality.</div></div><div><h3>Methods</h3><div>The authors recruited residents from the first year in general surgery and allocated them randomly into three groups: a) Text; b) Practice and c) Virtual reality. Initially, the residents completed a pretest for an evaluation and then they were trained according to the group they were assigned to. All the residents performed a 30-minute training session. After that, they took a posttest. Both tests were composed of multiple-choice ten questions. At the end of this study, the authors determined the score by calculating the delta of the performance (Δ = posttest –pretest). After the training, all the participants filled in a five-question satisfaction questionnaire.</div></div><div><h3>Results</h3><div>Regarding the difference between the pretest and post-test, there was no difference between groups. Only one participant (1/8) showed nausea in the virtual groups. The recommendation and satisfaction after the task were higher in the Virtual reality group compared to the Text group. There was an association between satisfaction after the exercises (VR) and recommendation score.</div></div><div><h3>Conclusions</h3><div>Virtual reality is safe and non-inferior to traditional surgical instrumentation training. This tool might be a practical and attractive alternative to the traditional instrumentation classes.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100609"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phyllodes tumors of the breast: A comprehensive review of diagnosis, treatment, and follow-up","authors":"Aline Rocha Donato ,&nbsp;Rodrigo Goncalves ,&nbsp;Jonathan Yugo Maesaka ,&nbsp;Fernando Nalesso Aguiar ,&nbsp;José Maria Soares Jr. ,&nbsp;Carlos Alberto Ruiz ,&nbsp;José Roberto Filassi ,&nbsp;Edmund Chada Baracat","doi":"10.1016/j.clinsp.2025.100617","DOIUrl":"10.1016/j.clinsp.2025.100617","url":null,"abstract":"<div><div>Phyllodes Tumor (PT) of the breast is a rare type of fibroepithelial neoplasm, classified into benign, borderline, and malignant subtypes. These tumors are known to be locally aggressive and have an inherent potential for Local Recurrence (LR), even after adequate surgical treatment. Establishing strategies to reduce LR has become increasingly important, as 21 % to 36 % of patients experience disease recurrence despite achieving negative surgical margins. Although surgical resection of the lesion is the gold standard treatment for all subtypes of phyllodes tumors, the ideal extent of the surgical margin remains a topic of debate with no consensus in the literature. Adjuvant radiotherapy is suggested as a tool to improve local control of the disease and reduce the recurrence rate; however, published data on this approach are currently conflicting. In this review paper, the authors will provide a detailed analysis of the current evidence on the diagnosis, treatment, follow-up, outcomes, and future perspectives of phyllodes tumors.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100617"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Routinely available inflammation biomarkers to predict stroke and mortality in atrial fibrillation","authors":"Long Wu ,&nbsp;Zhiquan Yuan ,&nbsp;Yuhong Zeng ,&nbsp;Lanqing Yang ,&nbsp;Qin Hu ,&nbsp;Huan Zhang ,&nbsp;Chengying Li ,&nbsp;Yanxiu Chen ,&nbsp;Zhihui Zhang ,&nbsp;Li Zhong ,&nbsp;Yafei Li ,&nbsp;Na Wu","doi":"10.1016/j.clinsp.2025.100610","DOIUrl":"10.1016/j.clinsp.2025.100610","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to assess the predictive value of 7 routinely available inflammation biomarkers for stroke and all-cause mortality in 229 non-valvular AF patients.</div></div><div><h3>Methods and results</h3><div>C-reactive protein, Albumin (ALB), d-dimer, fibrinogen, the number of platelets, lymphocytes, monocyte and neutrophils were measured. The Multivariable Cox proportional hazard model was used to assess the predictive value of the inflammation biomarkers for stroke and all-cause mortality, the c-statistic, Net Reclassification Improvement (NRI), and Integrated Discrimination Improvement (IDI) were calculated. Lymphocyte Monocyte Ratio (LMR) was the most informative biomarker for predicting stroke, and adding LMR to the CHA₂DS₂-VASc score did not improve its predictive ability for stroke, but it did improve its reclassification ability. Similar results were observed when comparing LMR+ CHA₂DS₂-VASc score with the ABC stroke score. For all-cause mortality, a Systemic Inflammation Score (SIS) score was calculated using ALB, fibrinogen and LMR, and adding SIS to the CHA₂DS₂-VASc score showed a significant improvement in its predictive ability and reclassification ability. There were no significant differences in predictive and reclassification ability for all-cause mortality between SIS+CHA₂DS₂-VASc score and ABC death score.</div></div><div><h3>Conclusions</h3><div>Adding routinely available inflammatory biomarkers to the CHA₂DS₂-VASc score increased its ability to predict all-cause mortality, suggesting this cost-effective biomarker strategy may help to improve decision support in AF.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100610"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of the leukoreduction filtration moment on the clinical outcome of transfused patients: A retrospective cohort study","authors":"Natasha Dejigov Monteiro da Silva ,&nbsp;Lilia de Souza Nogueira ,&nbsp;Youko Nukui ,&nbsp;Cesar de Almeida-Neto","doi":"10.1016/j.clinsp.2025.100633","DOIUrl":"10.1016/j.clinsp.2025.100633","url":null,"abstract":"<div><h3>Introduction</h3><div>Leukoreduction is performed to decrease the occurrence of adverse effects of transfusion, and can be performed by pre-storage (bench or in-line) or post-storage filtration (bedside) moment. The authors verified the effect of the leukoreduction filtration moment of Red Blood Cell (RBC) and Platelet Concentrate (PC) on the occurrence of Adverse Transfusion Reactions (ATRs), the presence of Healthcare-Associated Infections (HAIs), Length of Hospital Stay (LOS), and hospital death.</div></div><div><h3>Methods</h3><div>Retrospective cohort conducted at the <em>Hospital das Clínicas</em> of the Medicine Faculty of the University of São Paulo, and at the <em>Fundação Pró-Sangue Hemocentro</em> in São Paulo, Brazil. Adult patients, hospitalized for &gt;24 hours, who received leukoreduced RBC and/or PC transfusion between 2017‒2020 were included. The generalized mixed effects model and the Wald test were applied in the analysis with a significance level of 5 %.</div></div><div><h3>Results</h3><div>The authors evaluated 3668 patients who received 23,782 transfusions and we found no evidence of a leukoreduction filtration moment effect for ATR (<em>p</em> = 0.991) or HAI (<em>p</em> = 0.982), regardless of the transfused blood component. Meanwhile, the leukoreduction filtration moment had an effect (<em>p</em> &lt; 0.001) on LOS, depending on the blood component transfused (<em>p</em> = 0.023), with pre-storage RBC filtration showing better performance, while in-line filtration stood out for PC. Both the leukoreduction filtration moment and the blood component (<em>p</em> = 0.041) influenced hospital death, with emphasis on the protective effect of bench RBC filtration and pre-storage PC filtration.</div></div><div><h3>Conclusion</h3><div>The leukoreduction filtration moment associated with the blood component had an effect on the LOS and hospital death of patients undergoing transfusion.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and swallowing characteristics of tracheostomized patients with post-intubation acquired tracheal or laryngotracheal stenosis","authors":"Carina Escudero ,&nbsp;Fernanda Chiarion Sassi ,&nbsp;Ana Paula Ritto ,&nbsp;Paulo Francisco Guerreiro Cardoso ,&nbsp;Claudia Regina Furquim de Andrade","doi":"10.1016/j.clinsp.2024.100552","DOIUrl":"10.1016/j.clinsp.2024.100552","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the clinical and swallowing profiles of patients with post-intubation tracheal or laryngotracheal stenosis requiring tracheostomy prior to surgical or corrective airway interventions.</div></div><div><h3>Methods</h3><div>A retrospective cohort clinical study. Patients who met the inclusion criteria underwent a swallowing evaluation, as well as imaging studies of the neck and chest. At 6 and 12-months after the initial assessment, all patients participated in follow-up speech pathology consultations to evaluate the current state of swallowing and the progress of airway stenosis treatment.</div></div><div><h3>Results</h3><div>Twenty-five patients with a median tracheostomy duration of 30.52 months were assessed. The study found a female predominance (68%) and a high prevalence of subglottic stenosis (44%). Most patients required intubation due to severe acute respiratory failure and airway protection due to a decreased level of consciousness. Imaging revealed additional airway abnormalities, including laryngotracheobronchitis and laryngeal edema. Swallowing assessments showed that 20% had significant dysphagia. After one year, only two patients were successfully decannulated, while others remained tracheostomy dependent.</div></div><div><h3>Conclusion</h3><div>The study underscores the need for personalized, multidisciplinary care for these patients. It finds that while treatments like reconstructive surgeries and the Montgomery T-tube can be effective, complications such as clinical instability and dysphagia can worsen outcomes and extend the need for tracheostomy.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100552"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}