Frontiers in Medicine最新文献

{"title":"Hypertensive disorders of pregnancy in Hunan Province, China, 2012-2022.","authors":"Xu Zhou, Yinglan Wu, Xiaoying Chen, Yurong Jiang","doi":"10.3389/fmed.2024.1415696","DOIUrl":"https://doi.org/10.3389/fmed.2024.1415696","url":null,"abstract":"<p><strong>Objective: </strong>To explore the relationship between hypertensive disorders of pregnancy (HDP) and adverse pregnancy outcomes and explore the risk factors for HDP.</p><p><strong>Methods: </strong>Data were obtained from the Maternal Near-Miss Surveillance System in Hunan Province, China, 2012-2022. Chi-square trend tests (<i>χ²</i> _trend) were used to determine trends in prevalence by year. Unadjusted odds ratios (uORs) were used to examine the association between HDP and adverse pregnancy outcomes. Multivariate logistic regression analysis (method: Forward, Wald, <i>α</i> = 0.05) and adjusted odds ratios (aORs) were used to identify risk factors for HDP.</p><p><strong>Results: </strong>Our study included 780,359 pregnant women, and 38,397 women with HDP were identified, with a prevalence of 4.92% (95% CI 4.87-4.97). The prevalence of preeclampsia-eclampsia, gestational hypertension, chronic hypertension, and chronic hypertension with superimposed preeclampsia was 2.28% (95% CI 2.25-2.31), 2.04% (95% CI 2.00-2.07), 0.43% (95% CI 0.41-0.44), and 0.18% (95% CI 0.17-0.19), respectively. From 2012 to 2022, the prevalence of HDP increased from 3.11 to 7.39%, showing an upward trend (<i>χ</i> ² _trend = 2220.88, <i>p</i> < 0.01). HDP was associated with the following adverse pregnancy outcomes: maternal deaths (uOR =4.05), maternal near-miss (uOR =6.37), preterm birth (uOR =2.51), stillbirth and neonatal death (uOR =1.45), low birthweight (uOR =4.37), abruptio placentae (uOR =4.45), uterine atony (uOR =1.49), retained placenta (uOR =1.54), puerperal infections (uOR =2.14), abdominal surgical site infections (uOR =2.50), urinary tract infections (uOR =1.60), upper respiratory tract infections (uOR =1.75), heart disease (uOR =2.76), embolism (uOR =2.66), liver disease (uOR =1.25), anemia (uOR =1.38), diabetes mellitus (uOR =2.35), renal disease (uOR =4.66), and pulmonary disease (uOR =4.70, <i>p</i> < 0.05). Results of multivariate logistic regression analysis showed risk factors for HDP: maternal age > 30 years (aOR > 1, <i>p</i> < 0.05), gravidity > = 4 (aOR =1.10, 95% CI 1.05-1.14), primipara (aOR > 1, <i>p</i> < 0.05), and previous cesarean sections (aOR =1.27, 95% CI 1.24-1.31).</p><p><strong>Conclusion: </strong>The prevalence of HDP was relatively high in Hunan Province. HDP was associated with many adverse pregnancy outcomes. Advanced maternal age, high gravidity, primipara, and previous cesarean section were risk factors for HDP.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1415696"},"PeriodicalIF":3.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931204","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":"Bridging the gap in AI integration: enhancing clinician education and establishing pharmaceutical-level regulation for ethical healthcare.","authors":"Alessandro Perrella, Francesca F Bernardi, Massimo Bisogno, Ugo Trama","doi":"10.3389/fmed.2024.1514741","DOIUrl":"10.3389/fmed.2024.1514741","url":null,"abstract":"","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1514741"},"PeriodicalIF":3.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921374","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":"Efficacy and safety of wet cupping in the treatment of neurodermatitis: a systematic review and meta-analysis.","authors":"Yan Zhai, You-Yi Hui, Ze-Fei Jiang, Lin Ding, Jie Cheng, Tang Xing, Han Zhai, Hong Zhang","doi":"10.3389/fmed.2024.1478073","DOIUrl":"10.3389/fmed.2024.1478073","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Neurodermatitis is a chronic skin condition characterized by intense itching and skin thickening due to neurological dysfunction. Its persistent nature poses a challenge to effective treatment, significantly impacting patients' quality of life. Wet cupping therapy is increasingly being used in clinics to manage neurodermatitis, so it is imperative to assess the evidence regarding its effectiveness and safety.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This review aimed to evaluate the efficacy and safety of wet cupping therapy in patients with neurodermatitis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods and analysis: &lt;/strong&gt;Randomized controlled trials (RCTs) investigating wet cupping for neurodermatitis were identified through searches of eight electronic databases and three clinical trial registration platforms from inception to March 2024, using predefined search terms. Included studies underwent quality appraisal using the Cochrane Collaboration's Risk of Bias Assessment tool. The quality of evidence was assessed independently by two reviewers using the Grading of Recommendations Assessment, Development, and Evaluation System (GRADE). Meta-analysis and publication bias assessment were conducted using ReviewManager 5.4 and STATA 17.0 software, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This review encompassed 19 studies, comprising 6 types of comparisons and involving 1,505 participants. The findings revealed no significant difference in the total effective rate between wet cupping alone and high-potency steroids (&lt;i&gt;n&lt;/i&gt; = 269, RR = 1.13, 95% CI [0.90, 1.41], &lt;i&gt;p&lt;/i&gt; = 0.29, I&lt;sup&gt;2&lt;/sup&gt; = 83%). However, wet cupping combined with medication or moxibustion exhibited superior efficacy compared to medication alone (&lt;i&gt;n&lt;/i&gt; = 272, RR = 1.28, 95% CI [1.16, 1.41], &lt;i&gt;p&lt;/i&gt; &lt; 0.00001, I&lt;sup&gt;2&lt;/sup&gt; = 43%) and (&lt;i&gt;n&lt;/i&gt; = 534, RR = 1.22, 95% CI [1.14, 1.30], &lt;i&gt;p&lt;/i&gt; &lt; 0.00001, I&lt;sup&gt;2&lt;/sup&gt; = 0%). Wet cupping groups demonstrated lower recurrence rates (&lt;i&gt;n&lt;/i&gt; = 266, RR = 0.31, 95% CI [0.16, 0.60], &lt;i&gt;p&lt;/i&gt; = 0.0005, I&lt;sup&gt;2&lt;/sup&gt; = 0%) and a reduced incidence of adverse events (&lt;i&gt;n&lt;/i&gt; = 673, RR = 0.44, 95% CI [0.21, 0.90], &lt;i&gt;p&lt;/i&gt; = 0.02, I&lt;sup&gt;2&lt;/sup&gt; = 36%). Furthermore, wet cupping alone or combined with moxibustion effectively lowered the levels of inflammatory factors compared to medication: TNF-&lt;i&gt;α&lt;/i&gt; (&lt;i&gt;n&lt;/i&gt; = 120, MD = -6.99, 95% CI [-8.13, -5.85], &lt;i&gt;p&lt;/i&gt; &lt; 0.00001, I&lt;sup&gt;2&lt;/sup&gt; = 0%), IL-1β (&lt;i&gt;n&lt;/i&gt; = 120, MD = -5.28, 95% CI [-6.91, -3.65], &lt;i&gt;p&lt;/i&gt; &lt; 0.00001, I&lt;sup&gt;2&lt;/sup&gt; = 48%), and IL-6 (&lt;i&gt;n&lt;/i&gt; = 180, MD = -8.61, 95% CI [-13.24, -3.99], &lt;i&gt;p&lt;/i&gt; = 0.0003, I&lt;sup&gt;2&lt;/sup&gt; = 81%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The efficacy of wet cupping therapy is comparable to that of high-potency steroids. Its combined use with medication or moxibustion appears to enhance effectiveness, reduce recurrence rates, and improve safety. However, due to the overall low grade of evidence for the identified outcomes and poor methodol","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1478073"},"PeriodicalIF":3.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921378","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":"Nurses' professional quality of life and job satisfaction in Jordan.","authors":"Khaldoun M Hamdan, Rabia S Allari, Nadiah A Baghdadi, Shaherah Yousef Andargeery, Abdullah M Haymour, Evan Sabrah, Abeer M Shaheen","doi":"10.3389/fmed.2024.1478316","DOIUrl":"10.3389/fmed.2024.1478316","url":null,"abstract":"<p><strong>Background: </strong>Professional quality of life has received widespread concern in nursing over the last few years. Nurses with a high professional quality of life enthusiastically approach their work and provide excellent patient care. On the other hand, poor professional quality of life may affect nurses' quality of care, resulting in job dissatisfaction and jeopardizing patient outcomes.</p><p><strong>Aim: </strong>To examine the relationship between the professional quality of life and job satisfaction among registered nurses.</p><p><strong>Method: </strong>A cross-sectional correlational design and convenience sampling were used. Data were collected using the Professional Quality of Life Scale-Health and the Job Satisfaction Survey.</p><p><strong>Results: </strong>The mean total score for the nurses' job satisfaction survey was high 117.47 (SD = 27.26). The nature of work subscale had the highest mean, while the fringe benefits subscale had the lowest. The mean total score for the Professional Quality of Life Scale for Health Workers was moderate 98.41 (SD = 12.15). The Compassion Satisfaction subscale had the highest mean score, while the moral distress subscale had the lowest. There was a statistically significant positive relationship between nurses' job satisfaction and professional quality of life for health workers.</p><p><strong>Conclusion: </strong>Nursing supervisors need to be more aware of the variables influencing nurses' professional quality of life and job to assess the degree of moral distress and satisfaction. Although nurses offer their patients physical, psychological, and spiritual care, their duties and interactions with patients can have a negative impact on them. As a result, nurses will be better equipped to care for patients if they have the assistance and support they need.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1478316"},"PeriodicalIF":3.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921405","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":"Photobiomodulation therapy for congenital color vision deficiency: results of a preliminary randomized clinical trial.","authors":"Yidi Liu, Qinghua Yang, Jun Yu, Liang Jia","doi":"10.3389/fmed.2024.1497501","DOIUrl":"10.3389/fmed.2024.1497501","url":null,"abstract":"<p><strong>Purpose: </strong>This study presents a novel randomized controlled trial investigating photobiomodulation (PBM) therapy as an intervention method for color vision deficiency (CVD).</p><p><strong>Methods: </strong>A total of 74 participants with CVD were assigned to either the PBM group or the control group. In the PBM group, participants wore virtual reality (VR) goggles twice daily, with a 12-h interval, over a four-week period. The VR video consisted of alternating red and green images, each presented for 5 s, totaling 6 min and 20 s. No treatment was administered to the control group. Color vision improvement was assessed using Yu's, Ishihara's pseudoachromatic plates, Color Blindness Check (CBC), and FM-100 Hue total error score (TES).</p><p><strong>Results: </strong>After 4 weeks, in terms of Yu's and Ishihara's Plates, the patients in PBM group could identify increasing pieces (before: 1.6 ± 1.6, 2.3 ± 2.2; 4 weeks: 6.5 ± 4.4, 5.4 ± 2.9), while in control group, the number was before: 2.6 ± 3.4, 2.6 ± 2.5; 4 weeks: 3.3 ± 3.6, 2.9 ± 2.2. As for CBC scores, the patients in PBM also showed improved high scores (before: 2353.3 ± 700.0; 4 weeks: 2693.6 ± 642.5). Moreover, PBM treatment resulted in a significant reduction of FM-100 scores (before: 298.0 ± 211.3; 4 weeks: 202.1 ± 114.4).</p><p><strong>Conclusion: </strong>These findings suggest that PBM therapy holds promise as a potential treatment option for individuals with CVD.</p><p><strong>Clinical trial registration: </strong>The study received approval from the Ethics Committee of PLA General Hospital, China (KY2021-017). Additionally, it was registered as a Chinese domestic clinical trial (ChiCTR2200056761) at \"http://Chictr.org.cn/index.aspx\".</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1497501"},"PeriodicalIF":3.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921411","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":"Gamma delta T cells in cancer therapy: from tumor recognition to novel treatments.","authors":"Xinyu Luo, Yufan Lv, Jinsai Yang, Rou Long, Jieya Qiu, Yuqi Deng, Guiyang Tang, Chaohui Zhang, Jiale Li, Jianhong Zuo","doi":"10.3389/fmed.2024.1480191","DOIUrl":"10.3389/fmed.2024.1480191","url":null,"abstract":"<p><p>Traditional immunotherapies mainly focus on αβ T cell-based strategies, which depend on MHC-mediated antigen recognition. However, this approach poses significant challenges in treating recurrent tumors, as immune escape mechanisms are widespread. γδ T cells, with their ability for MHC-independent antigen presentation, offer a promising alternative that could potentially overcome limitations observed in traditional immunotherapies. These cells play a role in tumor immune surveillance through a unique mechanism of antigen recognition and synergistic interactions with other immune effector cells. In this review, we will discuss the biological properties of the Vδ1 and Vδ2 T subsets of γδ T cells, their immunomodulatory role within the tumor microenvironment, and the most recent clinical advances in γδ T cell-based related immunotherapies, including cell engaging strategies and adoptive cell therapy.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1480191"},"PeriodicalIF":3.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921397","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":"High-frequency laser therapy: a new alternative to physiotherapy in the treatment of cervical disk hernia.","authors":"Ozlem Kuculmez, Emine Dündar Ahi, Sacide Nur Cosar, Sukran Guzel","doi":"10.3389/fmed.2024.1429660","DOIUrl":"10.3389/fmed.2024.1429660","url":null,"abstract":"<p><strong>Introduction: </strong>High-frequency laser therapy has been increasingly used in several musculoskeletal disorders, but there is still a lack of evidence for the usage of the device in neck pain. This study aimed to compare the effectiveness of physiotherapy, high-frequency laser, and exercise therapy methods in the treatment of pain in cervical disk herniation.</p><p><strong>Methods: </strong>It was a multicenter, randomized, controlled clinical trial. Patients aged between 18 and 65 with neck pain and a diagnosis of cervical disk hernia were included in the study. Patients with a history of cervical surgery, rheumatism, cancer, or pacemaker were excluded from the study. The patients were randomized into 15 sessions of physiotherapy, high-frequency laser, or exercise therapy groups and evaluated with a range of motion, visual analog score, Neck Disability Index, and Short Form Health Survey-36 before treatment, after treatment, and in 1st and 3rd months. <i>p</i> < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>In total, 150 patients were analyzed. There was a significant improvement in range of motion, visual analog score, Neck Disability Index, and Short Form Health Survey-36 scores in three groups after 3-month follow-up (<i>p</i> < 0.05). The improvement was statistically greater in the physiotherapy and high-frequency laser therapy groups (<i>p</i> < 0.05), but there was no significant difference between these two groups (<i>p</i> > 0.05).</p><p><strong>Discussion: </strong>The results in the physiotherapy and high-frequency laser therapy groups were better than the exercise group. They may be alternatives to each other in cervical disk hernia treatment.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1429660"},"PeriodicalIF":3.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921401","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":"Evaluating the effect of chronic and continuous use of methadone on the glomerular filtration rate of patients receiving oral methadone (syrup).","authors":"Valiollah Goudarzvand Chegini, Amir Mohammad Kazemifar, Amir Ershad Tavakolian, Arian Ghannadi Karimi, Arsalan Jamali Pour Sofi, Darya Ipchian, Sahand Kamali, Mehran Ebrahimi Varkiani, Zohreh Yazdi","doi":"10.3389/fmed.2024.1496505","DOIUrl":"10.3389/fmed.2024.1496505","url":null,"abstract":"<p><strong>Introduction: </strong>This study systematically examines the effects of chronic oral methadone use on the glomerular filtration rate (GFR) in patients participating in methadone maintenance therapy (MMT) in Qazvin City, Iran. Methadone, a synthetic <i>μ</i>-opioid receptor agonist, is predominantly utilized for the management of opioid dependence and pain relief; however, there is growing concern regarding its potential nephrotoxic effects.</p><p><strong>Methods: </strong>An observational cross-sectional study was executed involving 150 participants who had been on methadone syrup for a minimum duration of 2 years. Comprehensive data pertaining to demographic variables, methadone dosage, and serum creatinine levels were meticulously gathered at baseline, as well as at 3 and 6 months. GFR was calculated utilizing the Cockcroft-Gault formula.</p><p><strong>Results: </strong>The results demonstrate that, while the mean GFR values remained within the normal range, a significant correlation was observed between methadone dosage and a reduction in GFR; specifically, higher dosages were associated with lower GFR values. In contrast, the duration of methadone use did not significantly affect GFR.</p><p><strong>Conclusion: </strong>These findings indicate that, although methadone dosage may influence renal function, long-term methadone therapy does not inherently exacerbate the risk of chronic kidney disease (CKD) in this population. This underscores the critical need for diligent monitoring of methadone dosages to mitigate the risk of potential renal impairment and highlights the importance of further research into the long-term implications of methadone on renal health.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1496505"},"PeriodicalIF":3.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921382","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 between red cell distribution width and 30-day mortality in patients with sepsis-associated liver injury: a retrospective cohort study.","authors":"Ting Ao, Yingxiu Huang, Peng Zhen, Ming Hu","doi":"10.3389/fmed.2024.1510997","DOIUrl":"10.3389/fmed.2024.1510997","url":null,"abstract":"<p><strong>Background: </strong>Sepsis-associated liver injury (SALI) is a critical component of sepsis-induced multiple organ dysfunction with high mortality. Identifying biomarkers for risk stratification is essential. Red cell distribution width (RDW), indicating variation in red blood cell volume, has been linked to adverse outcomes in various diseases. This study aimed to evaluate the association between RDW and 30-day mortality in SALI patients.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from the Medical Information Mart for Intensive Care-IV database. Patients admitted to the intensive care unit (ICU) with SALI were included. RDW was recorded within the initial 24 h. The primary outcome was 30-day mortality. A multivariable Cox regression analysis was performed to examine the relationship between RDW and mortality.</p><p><strong>Results: </strong>Among 529 SALI patients (mean age 68.7 years, 61.8% male), 46.1% had RDW > 15.5%. The 30-day mortality rate was 35.5%. RDW was significantly higher in non-survivors compared to survivors (17.2 ± 3.0 vs. 15.4 ± 2.3, <i>P</i> < 0.001). Cox regression identified RDW as an independent risk factor for 30-day mortality (HR 1.14, 95% CI 1.09 to 1.19, <i>P</i> < 0.001). Subgroup analyses demonstrated that the findings were consistent across the various groups.</p><p><strong>Conclusion: </strong>Elevated RDW is independently associated with higher 30-day mortality in patients with SALI, suggesting its potential role in risk stratification and clinical management.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1510997"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914185","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":"3D-printed porous titanium versus polyetheretherketone cages in lateral lumbar interbody fusion: a systematic review and meta-analysis of subsidence.","authors":"Shu-Xin Liu, Teng-Hui Zeng, Chien-Min Chen, Li-Ru He, An-Ping Feng, Shang-Wun Jhang, Guang-Xun Lin","doi":"10.3389/fmed.2024.1389533","DOIUrl":"10.3389/fmed.2024.1389533","url":null,"abstract":"<p><strong>Background: </strong>Cage subsidence frequently complicates lumbar fusion procedures, including lateral lumbar interbody fusion (LLIF), potentially leading to recurrent pain, impaired fusion, and accelerated degeneration of adjacent segments. A critical factor influencing cage subsidence is the selection of material. Polyetheretherketone (PEEK) and three-dimensional printed titanium (3D-Ti) cages are commonly used in LLIF procedures, each offering distinct advantages. However, these materials possess inherent property differences that may translate into divergent settling rates. To contribute to this discourse and offer insights, this systematic review and meta-analysis aims to compare the rates of cage subsidence between 3D-Ti and PEEK cages in LLIF.</p><p><strong>Methods: </strong>A meticulous systematic search that employs distinct MeSH terms was conducted in major electronic databases (MEDLINE, PubMed, Embase, Scopus, Web of Science, and Cochrane) up to December 20, 2023. The quality of inclusion was measured using the Newcastle-Ottawa Scale (NOS) for non-randomized trials. The primary outcome measure was cage subsidence, while the secondary outcome involved evaluating subsidence within each treatment segment using the Marchi classification.</p><p><strong>Results: </strong>The review included 265 patients (441 segments) from three studies. All with NOS ratings exceeding 5 stars. In the analysis, 189 segments (42.9%) underwent LLIF with 3D-Ti cages, while 252 segments (57.1%) participated in LLIF with PEEK cages. Overall, the cage subsidence rate was significantly lower with 3D-Ti compared to PEEK (<i>p</i> < 0.00001, OR = 0.25; 95% CI 0.14 to 0.44). Specifically, the 3D-Ti group exhibited a markedly lower subsidence rate, categorized by grade I, II, and III, compared to the PEEK group (<i>p</i> < 0.05). Furthermore, the incidence of severe subsidence was significantly reduced in the 3D-Ti group compared to the PEEK group (<i>p</i> = 0.0004, OR = 0.17; 95% CI 0.07 to 0.46).</p><p><strong>Conclusion: </strong>The study concludes that the subsidence rate associated with 3D-Ti cages in LLIF is notably lower than that observed with PEEK cages, underscoring the potential advantages of 3D-Ti cages in mitigating cage subsidence.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1389533"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914102","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}