European Journal of Medical Research最新文献

{"title":"Hydrogel-based nanoparticles: revolutionizing brain tumor treatment and paving the way for future innovations.","authors":"Alireza Shadab, Simin Farokhi, Arshia Fakouri, Neda Mohagheghzadeh, Ali Noroozi, Zahra Sadat Razavi, Arian Karimi Rouzbahani, Hamidreza Zalpoor, Mohamad Mahjoor","doi":"10.1186/s40001-025-02310-2","DOIUrl":"10.1186/s40001-025-02310-2","url":null,"abstract":"<p><p>Brain tumor treatment remains a significant challenge due to their high mortality and resistance to current therapies. This paper discusses the promising potential of hydrogel-based nanoparticles as innovative drug delivery systems for brain tumor therapy. Extensive characterization techniques reveal the ability of these Nano-systems to demonstrate prolonged blood circulation and targeted delivery, leading to improved survival rates. Designed with optimized physicochemical characteristics, these nanoparticles effectively cross the blood-brain barrier, circumventing a major impediment to drug delivery to the brain. By delivering drugs directly to the tumor bed, these nanoparticles enhance therapeutic outcomes and minimize adverse effects. In addition, this review investigates the techniques for characterizing, visualizing, and modifying these nanoparticles, as well as the standing challenges and promising research avenues for their clinical application. Further investigations are encouraged by this review to investigate potential advancements in hydrogel-based nanoparticle therapeutic approaches for brain tumors. This includes investigating tailored hydrogels, hybrid systems, computational modeling, and the integration of gene therapy and immunotherapy techniques. The study also addresses the need for enhanced synthesis techniques, stability, scalability, and cost-cutting measures to overcome obstacles and advance the clinical use of hydrogel-based nanoparticles in treating brain tumors.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"71"},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor-associated macrophage-derived exosome miR-194 confers cisplatin resistance in GC cells.","authors":"Yi Zhou, Yang-Cheng Sun, Qiong-Yan Zhang, Jing Wang, Xian-Ya Zhu, Xiang-Yu Su","doi":"10.1186/s40001-025-02329-5","DOIUrl":"10.1186/s40001-025-02329-5","url":null,"abstract":"<p><strong>Objective: </strong>At all stages of gastric cancer (GC), cisplatin is the first-line chemotherapeutic agent, but its efficacy remains limited, with a response rate of less than 20%, largely because of resistance to the drug. It aims to determine whether macrophage-derived exosomes are involved in the mechanism of cisplatin resistance, in order to identify potential methods for reversing resistance and improving patient outcomes.</p><p><strong>Methods: </strong>Macrophages induced by IL-13 and IL-4 were characterized using flow cytometry, then co-cultured with GC cells and cisplatin. Cell viability and apoptosis were subsequently evaluated through CCK-8 assays and flow cytometry. Exosome miR-194, derived from M2 macrophages, was characterized and co-cultured with gastric cancer cells and cisplatin to assess cell survival. Furthermore, a mouse GC model was established, and miR-194 was injected to observe tumor growth.</p><p><strong>Results: </strong>Results indicate that M2 macrophages enhance cisplatin resistance in gastric cancer cells mainly through miR-194, as demonstrated by CCK-8 and apoptosis assays. Cellular uptake experiments demonstrated that miR-194 can transfer from macrophages to GC cells and exert functional effects. Western blotting and PCR analysis further confirmed that macrophage-derived miR-194 inhibits apoptosis in GC cells and enhances cisplatin resistance by downregulating PTEN.</p><p><strong>Conclusion: </strong>Macrophage-derived miR-194 promotes cisplatin resistance in GC cells by inhibiting apoptosis through PTEN downregulation. These findings provide new insights and theoretical backing for clinical treatment strategies in GC.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"75"},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individualized drug therapy and survival prediction in ICU patients with acute kidney injury: construction and validation of a nomogram.","authors":"Rui Yang, Xiaozhe Su, Ziqi Liu, Shuai Shao, Yinhuai Wang, Hao Su, Haiqing He","doi":"10.1186/s40001-025-02300-4","DOIUrl":"10.1186/s40001-025-02300-4","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is defined by a sharp decrease in the estimated glomerular filtration rate (eGFR). However, the impact of medication history on the survival of AKI patients has received little attention. Hence, it is necessary to investigate the potential of medication history as a predictor of survival outcomes among AKI patients in the intensive care unit (ICU).</p><p><strong>Methods: </strong>Critically ill AKI patients were sourced from the MIMIC-IV database. To ascertain significant, drug-related, independent predictors of survival, univariate Cox analysis and stepwise Cox regression were performed. Based on the identified predictor, a nomogram was developed to estimate the individualized survival probability for AKI patients. Additionally, to address potential confounders among patients with medications referenced in the nomogram, a propensity score matching procedure was applied. Ultimately, a comparative analysis was performed to elucidate the prognostic disparities among these patient subgroups.</p><p><strong>Results: </strong>This study enrolled 1,208 patients and developed a nomogram incorporating oxygen flow rate, respiratory frequency, continuous venovenous hemodiafiltration status, age, and medication use (including ibuprofen, epinephrine, cefazolin, warfarin, and vasopressin). The predictive model demonstrated diagnostic accuracy, with AUC values for 1-year, 3-year, and 5-year survival among AKI patients of 0.827, 0.799, and 0.777 in the training dataset, and 0.760, 0.743, and 0.740 in the internal validation dataset, respectively. Kaplan-Meier survival analyses revealed significant differences in survival outcomes among AKI patients based on their exposure to different medications.</p><p><strong>Conclusions: </strong>In summary, the developed prediction model demonstrated accuracy for AKI patients in the ICU and helped clinical decision-making. However, future studies will require external validation to confirm these findings.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"65"},"PeriodicalIF":2.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of ocular biometrics using spectral domain optical coherence tomography with Purkinje image and optic nerve head alignments in mice.","authors":"Ying Hon Sze, Bing Zuo, Da Qian Lu, King Kit Li, Dennis Yan Yin Tse, Qian Zhao, Thomas Chuen Lam","doi":"10.1186/s40001-025-02305-z","DOIUrl":"10.1186/s40001-025-02305-z","url":null,"abstract":"<p><strong>Background: </strong>Mice are an emerging model for experimental myopia. Due to their small eye size, non-invasive optical coherence tomography is essential for evaluating ocular biometrics. There is currently no universally accepted protocol for those measurements. This study aims to compare ocular biometric measurements using two methods: Purkinje image-based alignment and optic nerve head alignment, utilizing spectral domain optical coherence tomography. Gaining an understanding of the implications of these methods in determining axial elongation in the normal growing eyes of wild-type C57BL/6J mice would offer valuable insight into their relevance for the experimental myopia model.</p><p><strong>Methods: </strong>Ocular dimensions and refractive development were measured on postnatal days P21 (n = 10), P28 (n = 15), and P35 (n = 8). The Purkinje image-based alignment (P1) was determined using a photorefractor and aligned perpendicular to the corneal apex using SD-OCT. In comparison, due to the absence of a fovea in the mouse retina, the optic nerve head (ONH) alignment was used. Variance analysis, regression analysis, and Bland-Altman analysis were performed to compare the differences between alignment methods as well as the replication by another operator.</p><p><strong>Results: </strong>Mice developed hyperopic ametropia under normal visual conditions. The photorefractor measured a technical variation of 3.9 D (95% CI, n = 170, triplicates). Bland-Altman analysis revealed a shorter (mean ± SD) axial length (- 26.4 ± 18.1 μm) and vitreous chamber depth (- 39.9 ± 25.4 μm) in the Purkinje image-based alignment. There was a significant difference in the relative growth trend in VCD (linear regression, p = 0.02), which was relatively stable and showed shortening when measured with ONH alignment from postnatal age 21 to 35 days.</p><p><strong>Conclusions: </strong>SD-OCT allowed precise in-vivo measurement and segmentation of ocular dimensions, regardless of the methods adopted. P1 alignment consistently resulted in significantly shorter VCD and AL compared to ONH alignment at most time points. When considering temporal changes from P21 to P35, both methods showed similar results, with significant elongation of ACD, LT, and AL as expected. However, our findings revealed a significant shortening of VCD over time with the adoption of ONH alignment, while the change in P1 alignment was relatively stable. Therefore, AL provides a better measure for evaluating ocular growth in mice using optical coherence tomography than VCD for myopia research.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"67"},"PeriodicalIF":2.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing a radiomics model using contrast-enhanced ultrasound for preoperative prediction of neoplastic gallbladder polyps exceeding 10 mm.","authors":"Dong Jiang, Yi Qian, Yijun Gu, Ru Wang, Hua Yu, Zhenmeng Wang, Hui Dong, Dongyu Chen, Yan Chen, Haozheng Jiang, Yiran Li","doi":"10.1186/s40001-025-02292-1","DOIUrl":"10.1186/s40001-025-02292-1","url":null,"abstract":"<p><strong>Background: </strong>A key challenge in the medical field is managing gallbladder polyps (GBP) > 10 mm, especially when their nature is uncertain. GBP with a diameter exceeding 10 mm are associated with an increased risk of gallbladder cancer, making the key to their management the differentiation between benign and malignant types. The current practice, due to the inability to predict accurately, leads to excessive surgeries and ineffective follow-ups, increasing patient risks and medical burdens.</p><p><strong>Purpose: </strong>This study aims to establish an imaging radiomics model using clinical data and contrast-enhanced ultrasound (CEUS) to predict neoplastic GBP exceeding 10 mm in diameter preoperatively.</p><p><strong>Materials and methods: </strong>Data from 119 patients with GBP > 10 mm of unknown origin were analyzed. A total of 1197 features were extracted from the GBP area using conventional ultrasound (US) and CEUS. Significant features were identified using the Mann-Whitney U test and further refined with a least absolute shrinkage and selection operator (LASSO) regression model to construct radiomic features. By integrating clinical characteristics, a radiomics nomogram was developed. The diagnostic efficacy of the preoperative logistic regression (LR) model was validated using receiver operating characteristic (ROC) curves, calibration plots, and the Hosmer-Lemeshow test. CEUS is an examination based on conventional ultrasound, and conventional two-dimensional ultrasound still poses significant challenges in differential diagnosis. CEUS has a high accuracy rate in diagnosing the benign or malignant nature of gallbladder space-occupying lesions, which can significantly reduce the preoperative waiting time for related examinations and provide more reliable diagnostic information for clinical practice.</p><p><strong>Results: </strong>Feature selection via Lasso led to a final LR model incorporating high-density lipoprotein, smoking status, basal width, and Rad_Signature. This model, derived from machine learning frameworks including Support Vector Machine (SVM), Logistic Regression (LR), Multilayer Perceptron (MLP), k-Nearest Neighbors (KNN), and eXtreme Gradient Boosting (XGBoost) with fivefold cross-validation, showed AUCs of 0.95 (95% CI: 0.90-0.99) and 0.87 (95% CI: 0.72-1.0) in internal validation. The model exhibited excellent calibration, confirmed by calibration graphs and the Hosmer-Lemeshow test (P = 0.551 and 0.544).</p><p><strong>Conclusion: </strong>The LR model accurately predicts neoplastic GBP > 10 mm preoperatively. Radiomics with CEUS is a powerful tool for analysis of GBP > 10 mm. The model not only improves diagnostic accuracy and reduces healthcare costs but also optimizes patient management through personalized treatment plans, enhancing clinical outcomes and ensuring resources are more precisely allocated to patients who need surgery.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"66"},"PeriodicalIF":2.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting survival in malignant glioma using artificial intelligence.","authors":"Wireko Andrew Awuah, Adam Ben-Jaafar, Subham Roy, Princess Afia Nkrumah-Boateng, Joecelyn Kirani Tan, Toufik Abdul-Rahman, Oday Atallah","doi":"10.1186/s40001-025-02339-3","DOIUrl":"10.1186/s40001-025-02339-3","url":null,"abstract":"<p><p>Malignant gliomas, including glioblastoma, are amongst the most aggressive primary brain tumours, characterised by rapid progression and a poor prognosis. Survival analysis is an essential aspect of glioma management and research, as most studies use time-to-event outcomes to assess overall survival (OS) and progression-free survival (PFS) as key measures to evaluate patients. However, predicting survival using traditional methods such as the Kaplan-Meier estimator and the Cox Proportional Hazards (CPH) model has faced many challenges and inaccuracies. Recently, advances in artificial intelligence (AI), including machine learning (ML) and deep learning (DL), have enabled significant improvements in survival prediction for glioma patients by integrating multimodal data such as imaging, clinical parameters and molecular biomarkers. This study highlights the comparative effectiveness of imaging-based, non-imaging and combined AI models. Imaging models excel at identifying tumour-specific features through radiomics, achieving high predictive accuracy. Non-imaging approaches also excel in utilising clinical and genetic data to provide complementary insights, whilst combined methods integrate multiple data modalities and have the greatest potential for accurate survival prediction. Limitations include data heterogeneity, interpretability challenges and computational demands, particularly in resource-limited settings. Solutions such as federated learning, lightweight AI models and explainable AI frameworks are proposed to overcome these barriers. Ultimately, the integration of advanced AI techniques promises to transform glioma management by enabling personalised treatment strategies and improved prognostic accuracy.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"61"},"PeriodicalIF":2.8,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of dietary inflammatory index with ocular diseases: a population-based cross-sectional study.","authors":"Xue Wang, Can Zhang, Haitao Jiang","doi":"10.1186/s40001-025-02294-z","DOIUrl":"10.1186/s40001-025-02294-z","url":null,"abstract":"<p><strong>Background: </strong>Our research was designed to investigate the relationship between dietary inflammatory index (DII) and risk of ocular diseases, including glaucoma, cataract, age-related macular degeneration (ARMD), and diabetic retinopathy.</p><p><strong>Methods: </strong>We used the National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2008 to conduct this study. The correlation between DII and risk of ocular diseases was examined using weighted multivariable logistic regression analysis, restricted cubic spline (RCS) plots, and subgroup analysis.</p><p><strong>Results: </strong>In total, 2885 participants from the NHANES database were included. The DII scores were divided into four group: Q1 (- 4.438-0.386), Q2 (0.387-1.848), Q3 (1.849-3.073), and Q4 (3.074-4.970). RCS shown that there was a U-shaped correlation between DII and prevalence of glaucoma, cataract, ARMD, and diabetic retinopathy. After adjusting for underlying confounding variables, compared to Q1 group, the odd ratios (ORs) with 95 percent confidence intervals (CIs) for glaucoma, cataract, ARMD, and diabetic retinopathy across the quartiles were [0.97 (0.54, 1.75), 1.20 (0.68, 2.11), and 1.29 (0.73, 2.30)], [0.87 (0.56, 1.35), 1.12 (0.73, 1.73), and 1.16 (0.75, 1.80)], [0.85 (0.53, 1.36), 0.66 (0.40, 1.09), and 0.97 (0.61, 1.56)] and [0.86 (0.63, 1.18), 0.89 (0.65, 1.22), and 1.04 (0.75, 1.45)] for DII, respectively.</p><p><strong>Conclusions: </strong>Reducing the intake of pro-inflammatory foods may be an effective measure to prevent the onset of ocular disease, including glaucoma, cataract, ARMD, and diabetic retinopathy. However, eating only anti-inflammatory foods is not the best choice.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"62"},"PeriodicalIF":2.8,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of systemic immune-inflammation index for acute appendicitis in the geriatric population.","authors":"Ömerul Faruk Aydın, Ali Cankut Tatlıparmak","doi":"10.1186/s40001-025-02336-6","DOIUrl":"10.1186/s40001-025-02336-6","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to evaluate the diagnostic accuracy of the systemic immune-inflammation index (SII) in distinguishing acute appendicitis from non-appendicitis cases in geriatric patients who underwent surgery with a preliminary diagnosis of appendicitis.</p><p><strong>Methods: </strong>A retrospective study was conducted on geriatric patients with suspected acute appendicitis at a tertiary healthcare center. Demographic data, clinical features, and laboratory values were obtained from medical records. The SII was calculated based on neutrophil, platelet, and lymphocyte counts, and the patients were classified according to histopathological outcomes. The primary outcome was the diagnostic accuracy of SII in identifying appendicitis in the elderly population.</p><p><strong>Results: </strong>The study included 64 geriatric patients with suspected appendicitis, comprising 45 patients with confirmed appendicitis (70.3%) and 19 patients without appendicitis (29.7%). The mean age of the patients was 71 years (interquartile range: 67-76), with no significant difference between the appendicitis and non-appendicitis groups (p = 0.590). Females constituted 50% of the total cohort. The SII was significantly higher in the appendicitis group (median: 3687, interquartile range: 2420-5930) compared to the non-appendicitis group (median: 1589, interquartile range: 1134-2248, p < 0.001). The area under the receiver operating characteristic curve for the index was 0.81 (95% confidence interval: 0.68-0.93, p < 0.001), indicating good diagnostic accuracy. A threshold of greater than 2289 yielded a sensitivity of 0.78 and specificity of 0.79. The positive predictive value was 0.90, while the negative predictive value was 0.60.</p><p><strong>Conclusions: </strong>The SII demonstrated high diagnostic accuracy in differentiating between acute appendicitis and non-appendicitis cases in geriatric patients. SII may be a valuable diagnostic tool in elderly patients with suspected appendicitis, aiding timely and accurate clinical decision-making.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"63"},"PeriodicalIF":2.8,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience in setting up non-robotic minimally invasive direct coronary artery bypass grafting in a non-routine off-pump coronary artery bypass center.","authors":"Yukiharu Sugimura, Tomoyuki Suzuki, Sebastian Johannes Bauer, Friederike Irmgard Schoettler, Moritz Benjamin Immohr, Michael André Maliwa, Arash Mehdiani, Lachmandath Tewarie, Gereon Schaelte, Ajay Moza, Payam Akhyari","doi":"10.1186/s40001-025-02320-0","DOIUrl":"10.1186/s40001-025-02320-0","url":null,"abstract":"<p><strong>Background: </strong>The safety of minimally invasive direct coronary artery bypass (MIDCAB) has been proven. Nevertheless, reports on clinical outcomes in MIDCAB and the learning curve of this challenging technique in a non-routine off-pump coronary artery bypass (OPCAB) center are still limited. Here, we introduce our clinical outcomes of non-robotic MIDCAB.</p><p><strong>Methods: </strong>Between August 2022 and March 2024, 72 consecutive patients with a mean age of 67.4 ± 9.5 years underwent non-robotic MIDCAB (defined as off-pump bypass grafting of the left internal mammary artery to the left anterior descending artery through left-sided mini-thoracotomy). We analyzed operation time and incidence of major adverse cardiac and cerebrovascular events (MACCE). Further, subgroup analyses included body mass index (BMI) with a cut-off of 30 kg/m² [BMI ≧ 30: n = 18 (25.0%)] and body surface area (BSA) with a cut-off of 2.0 m² [BSA ≧ 2.0: n = 34 (47.2%)].</p><p><strong>Results: </strong>All patients survived, whereas MACCE occurred in 4 patients (5.6%). By correlation analyses, no learning curve for operation time was observed in all cases analysis (p = 0.79), but MACCE (n = 4, 5.6%) exclusively observed in the first 34 patients. Furthermore, BMI ≧ 30 or BSA ≧ 2.0 was not significantly related to longer operation time (p = 0.42 and p = 0.52, respectively) and MACCE (p = 0.26 and p = 0.35, respectively). In addition, body size had no effect on operation time according to multiple regression analysis (p = 0.36).</p><p><strong>Conclusions: </strong>Our study suggested that implementing non-robotic MIDCAB can be safely accomplished at a center with no previous routine in OPCAB surgery, even for patients with bigger body sizes. MACCE occurs more frequently in the early stages when adopting this surgical technique.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"64"},"PeriodicalIF":2.8,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agreement of zero-heat-flux thermometry compared with infrared tympanic temperature monitoring in adults undergoing major surgery.","authors":"Jingyan Wang, Hao Liang, Congzhe Tian, Guiyuan Rong, Xinfeng Shao, Cheng Ran","doi":"10.1186/s40001-025-02317-9","DOIUrl":"10.1186/s40001-025-02317-9","url":null,"abstract":"<p><p>The patient's body temperature significantly fluctuates, affected by factors, including anesthesia. The ideal temperature monitoring method that is suitable for perioperative application is of great significance for identifying hypothermia and malignant hyperthermia early, as well as for guiding intraoperative temperature protection. This study aims to compare the cutaneous zero-heat-flux (ZHF) thermometer application in general anesthesia using the infrared tympanic measurement as a reference. We conducted a prospective observational study and enrolled 130 patients scheduled for major surgery with general anesthesia. A forehead ZHF sensor (T_zhf) and an infrared tympanic thermometer (T_tym) were used to continuously measure core temperature. We assessed the agreement using Bland-Altman analysis and concordance correlation coefficient, comparing the paired measurement of T_zhf and T_tym. We further calculated the percentage of difference within 0.5 ℃ between the two devices. Sensitivity, specificity, and predictive values were estimated to interpret the performance of the ZHF thermometer in detecting hypothermia and hyperthermia. The analysis involved 1626 pairs of measurements for the comparison. The mean difference between the ZHF and the tympanic measurements was 0.11 ℃ ± 0.27 ℃, 93.5% of the measurements differences fell within ± 0.5 ℃. T_zhf was significantly correlated with T_tym (r = 0.90). The ZHF thermometry detected the presence of T_tym hypothermia with sensitivity and specificity of 0.89 and 0.88, respectively. Temperature monitoring with the ZHF thermometer indicates a good agreement with the infrared tympanic measurement and a high performance for detecting intraoperative hypothermia.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"60"},"PeriodicalIF":2.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}