{"title":"Influence of prone, supine, and lateral positions during spine surgery on vascular, abdominal, and postural anatomy: a comprehensive review and Bayesian meta-analysis.","authors":"Samir Smajic, Markus Konieczny, Koroush Kabir, Raffaele Scrofani, Filippo Migliorini, Anel Dracic","doi":"10.1186/s40001-025-03239-2","DOIUrl":"10.1186/s40001-025-03239-2","url":null,"abstract":"<p><strong>Background: </strong>Patient positioning alters the three-dimensional relationship between the spine and surrounding neurovascular and visceral structures, thereby influencing both the technical feasibility and safety of lumbar procedures. Quantitative estimates of these positional shifts remain heterogeneous.</p><p><strong>Objective: </strong>To determine, across contemporary imaging studies, how prone, supine, and lateral decubitus positions alter the displacement of great vessels and retroperitoneal organs, the location of the psoas/lumbar plexus, and segmental lumbar lordosis.</p><p><strong>Methods: </strong>MEDLINE, Embase, and CENTRAL were searched from 2015 to 2025. Eligible studies compared at least two positions in adults and reported millimetre or degree differences for the outcomes of interest. Random‑effects (REML) subgroup meta‑analyses, a graph‑theoretical network meta‑analysis (netmeta), leave‑one‑out diagnostics, and Bayesian sensitivity models were performed. Risk of bias was assessed with ROBINS‑I.</p><p><strong>Results: </strong>Nine studies (41 independent comparisons; n = 1,248) met inclusion criteria. Retro‑peritoneal organs moved posteriorly by a pooled + 6.34 mm (95% CI 1.87-10.80; p = 0.007) when patients were turned from lateral decubitus to the prone position, narrowing the anterior working corridor at L2-L4. No significant pooled displacement was detected for major vessels (+ 1.26 mm, 95% CI -2.43-4.94), psoas/plexus (+ 0.94 mm, 95% CI -3.58-5.46) or segmental lordosis (+ 1.55°, 95% CI -4.62-7.73°). Direct contrasts showed that the supine-to-prone transition increased combined displacement/lordosis by + 3.64 mm / °(95% CI 0.53-6.76). Network ranking favoured the supine position for anatomical stability, but inconsistency was high (I<sup>2</sup> = 89%). Two studies were low, three moderate, three serious and one critical risk of bias; removing serious/critical studies did not change the effect direction.</p><p><strong>Conclusions: </strong>Turning a patient prone produces a reproducible posterior migration of the colon and kidney (6 mm) and a modest increase in lumbar lordosis (3-4°). Vascular and psoas positions are highly patient-specific and cannot be assumed based on supine imaging alone. Preoperative planning should therefore incorporate position-matched imaging or intraoperative navigation, especially for anterior or anterolateral approaches at L2-L4. Further high-quality, multi-positional imaging studies are warranted to clarify the sources of the marked heterogeneity observed.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"932"},"PeriodicalIF":3.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243982","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}
Yu Wang, Shu Zhou, JinJin Zhang, LiuRong Zhang, Qi Yang, YiDi He, GengYun Sun
{"title":"An early predictive model for acute respiratory distress-syndrome related to pancreatitis in pregnancy: an 8-year multicenter analysis.","authors":"Yu Wang, Shu Zhou, JinJin Zhang, LiuRong Zhang, Qi Yang, YiDi He, GengYun Sun","doi":"10.1186/s40001-025-03223-w","DOIUrl":"10.1186/s40001-025-03223-w","url":null,"abstract":"<p><strong>Background: </strong>Acute respiratory distress syndrome (ARDS) related to acute pancreatitis in pregnancy (APIP) is associated with a higher risk of maternal and fetal death. This study aimed to explore early predictors and develop a predictive model for ARDS associated with APIP aligned with the updated global ARDS definition.</p><p><strong>Methods: </strong>The APIP data of two hospitals over an 8-year period were retrospectively collected. The variables were analyzed using Least Absolute Shrinkage and Selection Operator regression, and binary logistic regression to build a predictive model, visualized with a nomogram. The performance of the predictive model was then evaluated.</p><p><strong>Results: </strong>Of 6597 patients with acute pancreatitis, 103 pregnant patients were included, and 24 pregnant patients had ARDS. Lower oxygen saturation as measured by pulse oximetry to fraction of inspired oxygen (SpO<sub>2</sub>/FiO<sub>2</sub>) ratio, elevated heart rate (HR), and total cholesterol (TCH) were identified as independent risk factors for ARDS in APIP. Compared to previous scoring systems, the predictive model was more discriminating between APIP and ARDS, with an area under the receiver operating characteristic curve of 0.926 (95% CI 0.864-0.988). Notably, the new model performed best when the prediction cutoff was set at 0.205 (sensitivity = 0.823, specificity = 0.958). Calibration and decision curve analyses confirmed the strong clinical utility and accurate risk prediction.</p><p><strong>Conclusion: </strong>A new accurate utility predictive model for ARDS related to APIP, including three simple variables (HR, TCH, and SpO<sub>2</sub>/FiO<sub>2</sub>), was constructed at admission. Elevated total cholesterol level was first identified as an independent risk factor for ARDS in patients with APIP.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"931"},"PeriodicalIF":3.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244013","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":"The expression of establishment of cohesion 1 homolog 2 (ESCO2) in tumor cells and its research progress as a therapeutic target.","authors":"Chunmei Lu, Hanchi Wu, Huiyu Wang","doi":"10.1186/s40001-025-03164-4","DOIUrl":"10.1186/s40001-025-03164-4","url":null,"abstract":"<p><p>The initiation and progression of tumors are closely linked to aberrant regulation of multiple genes. Among these genes, sister chromatid cohesion acetyltransferase 2 (ESCO2) has emerged as an important target in cancer research. ESCO2 exhibits complex and heterogeneous expression patterns across various types of malignancies and tumor progression stages. Extensive studies have shown that ESCO2 primarily functions in chromosomal cohesion, significantly contributing to genomic stability maintenance. Dysregulated expression of ESCO2 in tumor cells is often correlated with malignant behaviors. Given its essential role in tumorigenesis, ESCO2 has increasingly been explored as a promising therapeutic target in recent years. This review article summarizes recent research progress regarding ESCO2 in malignant tumors, aiming to identify a novel target for their treatment.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"930"},"PeriodicalIF":3.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238090","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":"Life's Essential 8, phenotypic age, and cardiovascular age in prediabetes: predictive value in the UK Biobank and protein mediation in cardiovascular-diabetes comorbidity.","authors":"Chaoping Chen, Chenhao Li, Qingru Zhu, Yang Yang, Sixiang Jia, Xiaojian Zhang, Shudong Xia","doi":"10.1186/s40001-025-03218-7","DOIUrl":"10.1186/s40001-025-03218-7","url":null,"abstract":"<p><strong>Background: </strong>Lifestyle improvement may help reverse prediabetes. Indicators such as Life's Essential 8 (LE8) and biological aging measures (phenotypic age, cardiovascular biological age) partially reflect metabolic status in prediabetes, but their predictive value for cardiovascular mortality and stroke in this population remains unclear.</p><p><strong>Methods: </strong>We analyzed data from 74,678 White participants with prediabetes in the UK Biobank, defined by either HbA1c (5.7-6.4%) or fasting glucose (6.1-6.9 mmol/L). Follow-up continued until October 10, 2023. Cox regression was used to examine associations between LE8, phenotypic age (PhenoAge), cardiovascular biological age (CBA), and outcomes of cardiovascular (CVD) mortality and stroke. Restricted cubic spline (RCS) models identified biological age risk thresholds. Mediation analysis assessed whether proteins such as CST3, EFEMP1, FES, IGFBP2, IGFBP6, LPA, PCSK9, and TIMP1 mediated these effects.</p><p><strong>Results: </strong>Over a median follow-up of 13.4 years, 2263 participants died from CVD causes. Each 1-year increase in CBA or PhenoAge was associated with a ~ 10% higher risk of CVD mortality (CBA aHR = 1.10; PhenoAge aHR = 1.09; both P < 0.001), while each 1-point increase in LE8 score was linked to a 3% lower risk (HR = 0.97, P < 0.001). The risk biological ages for these two indicators were also identified: PhenoAge ≥ 58.52 years and CBA ≥ 62.42 years. Similar trends were observed for stroke. Mediation analysis revealed that CST3, TIMP1, IGFBP2, and IGFBP6 contributed to the biological pathways between aging/lifestyle and CVD outcomes. The combined LE8 and PhenoAge model showed the strongest predictive performance for CVD mortality (AUC = 0.716) and stroke (AUC = 0.638) over 15 years.</p><p><strong>Conclusion: </strong>LE8 combined with phenotypic age provides prognostic value for CVD outcomes in prediabetes. These findings highlight the potential of lifestyle modification and delayed biological aging in reversing prediabetes and underscore comorbidity-related proteins as promising therapeutic targets.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"929"},"PeriodicalIF":3.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238082","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}
Mohammad Hadi Gerami, Roya Khorram, Soheil Rasoolzadegan, Saeid Mardpour, Pooria Nakhaei, Soheyla Hashemi, Bashar Zuhair Talib Al-Naqeeb, Amir Aminian, Sahar Samimi
{"title":"Retraction Note: Emerging role of mesenchymal stem/stromal cells (MSCs) and MSCs-derived exosomes in bone- and joint-associated musculoskeletal disorders: a new frontier.","authors":"Mohammad Hadi Gerami, Roya Khorram, Soheil Rasoolzadegan, Saeid Mardpour, Pooria Nakhaei, Soheyla Hashemi, Bashar Zuhair Talib Al-Naqeeb, Amir Aminian, Sahar Samimi","doi":"10.1186/s40001-025-03274-z","DOIUrl":"10.1186/s40001-025-03274-z","url":null,"abstract":"","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"927"},"PeriodicalIF":3.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225270","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}
Michael Paal, Katharina Habler, Alice Ewert, Michael Vogeser, Leonie Grosse, Victoria Lieftüchter, Simone C Tauber, Johannes Schiefer, Petra Allartz, Dennis Tappe, Kirsten Pörtner
{"title":"First therapeutic drug monitoring of experimental favipiravir in Borna disease virus 1 (BoDV-1) encephalitis patients reveals significant gaps in antiviral treatment: a pilot investigation.","authors":"Michael Paal, Katharina Habler, Alice Ewert, Michael Vogeser, Leonie Grosse, Victoria Lieftüchter, Simone C Tauber, Johannes Schiefer, Petra Allartz, Dennis Tappe, Kirsten Pörtner","doi":"10.1186/s40001-025-03117-x","DOIUrl":"10.1186/s40001-025-03117-x","url":null,"abstract":"<p><strong>Background: </strong>The Borna disease virus 1 (BoDV-1) causes a rare, but severe form of encephalitis in Germany, characterized by rapid progression, late diagnosis, and a high case fatality. Therapy is experimental and recommendations are lacking. Favipiravir (FPV) suppresses BoDV-1 replication in vitro and has been used in a handful of BoDV-1 patients within individual treatment attempts, but little is known about the drug´s pharmacokinetics in encephalitis.</p><p><strong>Methods: </strong>To monitor and therefore optimize experimental FPV treatment, we established a liquid chromatography tandem mass spectroscopy (LC-MS/MS) assay for serum and cerebrospinal fluid (CSF), and analyzed stored specimens of two patients with BoDV-1 encephalitis in the context of therapeutic drug monitoring as a pilot investigation.</p><p><strong>Results: </strong>We demonstrate for the first time that orally administered FPV reaches the CSF in BoDV-1 encephalitis. However, the half-maximal inhibitory concentration (IC50) for BoDV-1 was met only in one patient, raising questions on significantly higher dosing and/or alternative formulations for effective treatment.</p><p><strong>Conclusion: </strong>In conclusion, monitoring experimental FPV therapy in BoDV-1 encephalitis is feasible and should be performed continuously. Future prospective in-depth (multicenter) studies should include more patients and focus on dose-finding, dose-response relationships, and define a therapeutic index to improve outcomes of this so far nearly uniformly fatal disease.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"928"},"PeriodicalIF":3.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228560","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":"Investigation of adherence to immunosuppressive therapy and perceived social support in organ recipients.","authors":"Satı Doğan, Özkan Uğuz, Müjgan Solak","doi":"10.1186/s40001-025-03244-5","DOIUrl":"10.1186/s40001-025-03244-5","url":null,"abstract":"<p><strong>Background: </strong>Adherence to immunosuppressive therapy in organ transplant patients is an important factor for the patient's health and the success of the transplant. In this study, we investigated the relationship between the perceived level of social support and adherence to immunosuppressive therapy in post-transplant patients.</p><p><strong>Methods: </strong>This descriptive and cross-sectional study was conducted with 116 post-transplant liver and kidney transplant recipients. Data were collected using the Personal Information Form, the Multidimensional Perceived Social Support Scale, and the İmmunosuppressive Therapy Adherence Scale (ITAS). Statistical analyses were performed using IBM SPSS Statistics version 30.0, and the significance level was set at p < 0.05.</p><p><strong>Results: </strong>The mean age of the participants was 41.52 ± 12.23 years. Of the patients, 62.7% had undergone kidney transplantation and 37.3% had undergone liver transplantation, with the majority (83.9%) receiving organs from living donors. The overall adherence to immunosuppressive therapy was relatively high, with 51.7% of the patients achieving full adherence (ITAS = 12), with a mean ITAS score of 10.22 ± 1.30 (out of 12). A positive and significant relationship was found between adherence to immunosuppressive therapy and perceived level of social support (B = 0.052, p < 0.001).</p><p><strong>Conclusions: </strong>The importance of social support in the post-transplant period should not be overlooked; in particular, the involvement of family, friends, and other significant individuals should be systematically integrated into patient care. In this context, perceived social support is a practical and feasible strategy for improving adherence to immunosuppressive therapy. Healthcare professionals should routinely assess patients' levels of social support and implement targeted psychosocial interventions for individuals with inadequate support.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"926"},"PeriodicalIF":3.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225324","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}
Ani Zhao, Yanchun Peng, Lingyu Lin, Liangwan Chen, Yanjuan Lin
{"title":"The influencing factors of cognitive dysfunction in patients after cardiac surgery and the construction of a nomogram prediction model.","authors":"Ani Zhao, Yanchun Peng, Lingyu Lin, Liangwan Chen, Yanjuan Lin","doi":"10.1186/s40001-025-02949-x","DOIUrl":"10.1186/s40001-025-02949-x","url":null,"abstract":"<p><strong>Background: </strong>Early detection of cognitive dysfunction (POCD) in patients undergoing cardiac surgery may help improve the prognosis and quality of life. Identifying risk factors and clinically relevant factors is critical for prevention and treatment.</p><p><strong>Methods: </strong>This study retrospectively selected 305 patients admitted to the cardiac surgery Department of Union Hospital Affiliated with Fujian Medical University from January 2024 to July 2024 as the study objects. The cognitive function of the patients was assessed by the Montreal Cognitive Assessment Scale (MOCA) before and on the 6th day after surgery, and the patients were divided into a cognitive dysfunction group and a non-cognitive dysfunction group. Logistic regression was used to analyze the risk factors of POCD in patients undergoing cardiac surgery. R software was used to construct the nomogram model of POCD in heart patients.</p><p><strong>Results: </strong>Logistic regression model was used to screen the included variables, and the final results showed age (OR = 2.670, 95%CI 1.675-4.255, P < 0.001), white blood cell count (OR = 1.155, 95%CI 1.050-1.271, P = 0.009), lymphocytes (OR = 2.200, 95%CI 1.512-3.200, P < 0.001), and hemoglobin (OR = 1.020, 95%CI 1.009-1.032, P < 0.001) were independent risk factors for POCD on day 6 in patients undergoing cardiac surgery. The predicted value of the calibration curve of POCD on the 6th day of cardiac surgery was consistent with the actual value, and the Hosmer-Lemeshow goodness-of-fit test (χ<sup>2</sup> = 8.73, P = 0.36 > 0.05) showed good consistency. The area under the ROC curve is 0.80, with a good differentiation and decision curve.</p><p><strong>Conclusions: </strong>Age, white blood cell count, lymphocyte, and hemoglobin are independent risk factors for POCD on day 6 of cardiac surgery. The nomogram prediction model constructed in this study has good predictive ability.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"925"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205972","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}
Nai-Chen Shih, Chien-Han Tsao, Yu-Hsun Wang, James Cheng-Chung Wei
{"title":"Effects of surgery and CPAP on cardiovascular health in patients with obstructive sleep apnea.","authors":"Nai-Chen Shih, Chien-Han Tsao, Yu-Hsun Wang, James Cheng-Chung Wei","doi":"10.1186/s40001-025-03132-y","DOIUrl":"10.1186/s40001-025-03132-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess and compare the risks of cardiovascular disease and mortality in individuals with obstructive sleep apnea (OSA) undergoing treatment with either continuous positive airway pressure (CPAP) or upper airway surgery (UAS).</p><p><strong>Methods: </strong>Using the TriNetX database, we identified 1,477,746 OSA patients between 2014 and 2019. In total 3638 matched pairs of patients were selected, based on their propensity scores, with one group having received UAS and the other having received CPAP therapy. The Cox proportional hazards models were used to compare the risk of major adverse cardiovascular events (MACEs) between the two groups. Subgroup analyses based on age, sex, race, and BMI categories were conducted to validate the findings.</p><p><strong>Results: </strong>After propensity score matching, the UAS group had significantly lower risks of all-cause mortality (HR 0.45; 95% CI 0.33-0.59) and MACEs (HR 0.61; 95% CI 0.49-0.75) compared to the CPAP group. Subgroup analyses revealed that both male and female patients treated with UAS were associated with lower risks of all-cause mortality and MACEs. White individuals and those with BMI < 30 or ≥ 30, with age < 65 in the UAS group, consistently exhibited lower risks of all-cause mortality and MACEs.</p><p><strong>Conclusions: </strong>Patients with OSA receiving UAS were associated with lower risks of all-cause mortality and MACEs compared to those on CPAP. Subgroup analyses revealed variations in benefits, with lower risks of mortality and MACEs observed across different genders, age groups, racial backgrounds, and BMI categories within the UAS-treated population.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"923"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206018","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":"Advances in diagnostic techniques for eosinophilic esophagitis: a systematic review of emerging noninvasive methods.","authors":"Abdulrhman Khaled Al Abdulqader","doi":"10.1186/s40001-025-02989-3","DOIUrl":"10.1186/s40001-025-02989-3","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease characterized by esophageal dysfunction and eosinophilic inflammation. Traditional diagnostic methods rely on endoscopy with biopsy, which is invasive and resource-intensive. The recent advancements have focused on developing noninvasive and minimally invasive diagnostic tools to improve patient experience and facilitate disease monitoring.</p><p><strong>Objective: </strong>This systematic review aims to evaluate emerging noninvasive diagnostic techniques for EoE, including biomarkers, esophageal string tests (EST), and advanced imaging modalities, and their potential to complement or replace conventional diagnostic methods.</p><p><strong>Methods: </strong>A systematic search was conducted in major databases, including PubMed, Embase, and Cochrane Library, to identify studies investigating noninvasive diagnostic approaches for EoE. Inclusion criteria focused on original research and clinical trials evaluating diagnostic accuracy, patient acceptability, and clinical utility. Data on diagnostic methods, outcomes, and limitations were extracted and analyzed.</p><p><strong>Results: </strong>Emerging diagnostic methods, such as blood and urine biomarkers (e.g., EDN, ECP, eotaxin-3), EST, and advanced imaging (e.g., optical coherence tomography, EndoFLIP), demonstrated comparable sensitivity and specificity to endoscopic biopsy in detecting EoE. These tools offer advantages in reducing procedural burden, enabling dynamic disease monitoring, and enhancing patient adherence. However, challenges include variability in diagnostic thresholds and limited large-scale validation.</p><p><strong>Conclusion: </strong>Noninvasive diagnostic tools for EoE hold promise in transforming clinical practice by reducing reliance on invasive endoscopy. Further research is needed to standardize protocols and validate these methods for routine use.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"924"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205991","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}