Frontiers in Medicine最新文献

{"title":"Characteristic of clinical trials related to traumatic brain injury registered on ClinicalTrials.gov over the past two decades (2004-2023).","authors":"Ruili Guo, Qingya Yang, Xuan Zhou, Shining Li, Yao Liu","doi":"10.3389/fmed.2024.1435762","DOIUrl":"10.3389/fmed.2024.1435762","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this report is to provide a comprehensive overview of clinical trials and protocols related to traumatic brain injury over the past two decades.</p><p><strong>Methods: </strong>We collected information on clinical trials related to traumatic brain injury (TBI) from the ClinicalTrials.gov database, identified key categorical variables, and assessed their characteristics.</p><p><strong>Results: </strong>A total of 367 TBI-related trials were identified for analysis. All identified trials were interventional clinical trials. Most trials were small-scale, with 75.2% enrolling 1-100 participants, and only about 20% were funded by industry or the National Institutes of Health (NIH). In most trials, participants were gender-neutral (96.5%), and the primary age group was adults and older adults (56.9%). Of all identified TBI trials, 78.2% were randomized, and 69.4% were blinded. Additionally, the primary purpose of 297 trials (80.9%) was treatment, with drug therapy as the most common intervention. A total of 153 trials (41.7%) were completed; however, only 58 trials submitted results to the registry. Furthermore, 81 trials (22.1%) were discontinued early, primarily due to recruitment problems. Clinical trials started between 2004 and 2013 reported a higher proportion of results compared with those started between 2014 and 2023 (35.1% vs. 11.1%, <i>p</i> < 0.001). In addition, between 2014 and 2023, there was an increase in trials for diagnostic purposes (2.4% vs. 6.5%, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Based on the data collected from the ClinicalTrials.gov, our study reveals that most clinical trials related to TBI focus on drug-related treatments, underreporting remains a significant concern, and greater emphasis should be placed on improving the publication and dissemination of clinical trial results.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344685","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 composition of the stent microbiome is associated with morbidity and adverse events during endoscopic drainage therapy of pancreatic necroses and pseudocysts.","authors":"Fabian Frost, Valeria Khaimov, Volkmar Senz, Stefan Weiss, Bastian Klußmann-Fricke, Malte Rühlemann, Corinna Bang, Andre Franke, Tilman Pickartz, Christoph Budde, Ali A Aghdassi, Stefan Siewert, Frank U Weiss, Niels Grabow, Markus M Lerch, Matthias Sendler","doi":"10.3389/fmed.2024.1462122","DOIUrl":"10.3389/fmed.2024.1462122","url":null,"abstract":"<p><strong>Background: </strong>Development of pancreatic necroses or pseudocysts are typical complications of pancreatitis and may require endoscopic drainage therapy using metal or plastic stents. Microbial infection of these lesions poses a major challenge. So far, the composition and significance of the microbial colonization on drainage stents are largely unknown although it may impact outcomes during endoscopic drainage therapy.</p><p><strong>Methods: </strong>A total of 26 stents used for drainage of pancreatic lesions were retrieved and the stent microbiome was determined by 16S rRNA gene sequencing. Additional analysis included comparison of the stent microbiome to the intracavitary necrosis microbiome as well as scanning electron microscopy (SEM) and micro-computed tomography (μCT) imaging of selected metal or plastic stents.</p><p><strong>Results: </strong>The stent microbiome comprises a large proportion of opportunistic enteric pathogens such as <i>Enterococcus</i> (14.4%) or <i>Escherichia</i> (6.1%) as well as oral bacteria like <i>Streptococcus</i> (13.1%). Increased levels of opportunistic enteric pathogens were associated with a prolonged hospital stay (<i>r</i> = 0.77, <i>p</i> = 3e-06) and the occurrence of adverse events during drainage therapy (<i>p</i> = 0.011). Higher levels of oral bacteria were associated (<i>r</i> = -0.62, <i>p</i> = 8e-04) with shorter durations of inpatient treatment. SEM and μCT investigations revealed complex biofilm networks on the stent surface.</p><p><strong>Conclusion: </strong>The composition of the stent microbiome is associated with prolonged hospital stays and adverse events during endoscopic drainage therapy, highlighting the need for effective infection control to improve patient outcomes. In addition to systemic antibiotic therapy, antimicrobial stent coatings could be a conceivable option to influence the stent microbiome and possibly enhance control of the necrotic microflora.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344690","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":"Paediatric formulations-part of the repurposing concept?","authors":"Siri Wang, Viviana Giannuzzi","doi":"10.3389/fmed.2024.1456247","DOIUrl":"10.3389/fmed.2024.1456247","url":null,"abstract":"<p><p>The lack of available appropriate paediatric formulations is a significant challenge for optimal treatment in children. The resulting manipulation of adult medicines implies risk of medication errors, inaccurate dosing, and unacceptable dosage forms resulting in non-compliance. This represents significant unmet needs for a large and vulnerable patient group. Currently, the repurposing discussions seems only to a limited degree to cover the aspects of paediatric off-label use of adult medicines, including reformulation strategies to cover unmet needs for suitable formulations in the youngest age groups. Similarly, limited focus seems to be put on incentives in this specific area of repurposing. This paper will discuss the role of reformulation for paediatric needs as part of the repurposing concept, and potential factors contributing to barriers to incentivise the development of new formulations for children.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371535","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":"Corrigendum: Frailty index and risk of delirium in hospitalized patients: a two-sample Mendelian randomization study.","authors":"Yu Chen, Fang Feng, Qun Li, Hong Guo, Lu Zhang, Jian Liu","doi":"10.3389/fmed.2024.1485061","DOIUrl":"https://doi.org/10.3389/fmed.2024.1485061","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fmed.2024.1361437.].</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336369","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":"Applications of leech therapy in medicine: a systematic review.","authors":"Mahsa Hosseini, Ali Jadidi, Mohammad Moein Derakhshan Barjoei, Mehdi Salehi","doi":"10.3389/fmed.2024.1417041","DOIUrl":"10.3389/fmed.2024.1417041","url":null,"abstract":"<p><strong>Background: </strong>Leech therapy (LT) is one of the most widely used treatment methods in traditional medicine. The present study aimed to systematically review clinical trials regarding the effects of LT on the prevention and healing of different diseases.</p><p><strong>Methods: </strong>To identify all relevant published studies, we conducted a comprehensive search of PubMed, Scopus, and Web of Science databases without any temporal or geographical constraints until April 2023. To categorize the articles, five stages were considered. The PRISMA checklist and Cochran's bias analysis tool were used.</p><p><strong>Results: </strong>In total, 12 trials that met the inclusion criteria were studied. The results of the studies showed that LT has had successful outcomes in treating different conditions. These included hormonal and metabolic complications, cardiovascular problems, and inflammatory-based diseases.</p><p><strong>Conclusion: </strong>\"Leech therapy\" is a traditional medical treatment used successfully to control and treat various conditions. Although this method can have complications, it is possible to benefit from this low-cost and low-complication treatment by taking preventive measures.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344683","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":"Prospective case-control study on pain intensity after the use of promethazine in patients undergoing videothoracoscopy.","authors":"Xiangwei Zhou, Benhui He, Xia Zheng, Chao Li, Zeyu Mi, Mingqing Peng, Min Li","doi":"10.3389/fmed.2024.1453694","DOIUrl":"10.3389/fmed.2024.1453694","url":null,"abstract":"<p><strong>Objective: </strong>Effective and secure pain management following video-assisted thoracoscopic surgery (VATS) is crucial for rapid postoperative recovery. This study evaluated analgesic and sedative effects of sufentanil and promethazine in patient-controlled intravenous analgesia (PCIA) post-thoracic surgery, along with potential adverse reactions.</p><p><strong>Methods: </strong>In this prospective, randomized, controlled, double-blind, clinical study, 60 patients (American Society of Anesthesiologists status I-III) undergoing VATS were enrolled. The patients were randomized into experimental (Group P) or control (Group C) groups. PCIA was administered post-general anesthesia using a double-blind method. Group P received sufentanil (3 μg/kg) + promethazine (1 mg/kg) + 0.9% sodium chloride solution (100 mL total), while Group C received sufentanil (3 μg/kg) + 0.9% sodium chloride solution (100 mL total). PCIA settings included a 1-mL bolus and 15-min locking time. The primary outcomes were the visual analog scale (VAS) at rest and during coughing and sedation (Ramsay) scores at 6, 12, 24, and 48 h. The secondary outcomes were rescue drug use rate, hemodynamic parameters (mean arterial pressure and heart rate), percutaneous oxygen saturation, respiratory rate, and occurrence of adverse reactions.</p><p><strong>Results: </strong>Group P exhibited lower resting and coughing VAS scores at 6, 12, 24, and 48 h, plus decreased incidence of nausea and vomiting within 48 h post-surgery compared with Group C (<i>p</i> < 0.05). No significant differences were observed in pruritus, sedation (Ramsay) scores, mean arterial pressure, heart rate, oxygen saturation, or respiratory rate between the two groups (<i>p</i> > 0.05).</p><p><strong>Discussion: </strong>The combination of sufentanil and promethazine for postoperative intravenous analgesia could effectively reduce adverse effects such as nausea and vomiting, contributing to postoperative pain relief.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344689","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":"Aetiologies of bacterial tick-borne febrile illnesses in humans in Africa: diagnostic limitations and the need for improvement.","authors":"Abdulrahman Adamu, Flavia Reyer, Nafiú Lawal, Abdurrahman Jibril Hassan, Mustapha Umar Imam, Muhammad Bashir Bello, Peter Kraiczy","doi":"10.3389/fmed.2024.1419575","DOIUrl":"10.3389/fmed.2024.1419575","url":null,"abstract":"<p><p>Tick-borne febrile illnesses caused by pathogens like <i>Anaplasma</i> spp., <i>Bartonella</i> spp., <i>Borrelia</i> spp., <i>Ehrlichia</i> spp., <i>Coxiella burnetii</i>, <i>Francisella tularensis</i>, and <i>Rickettsia</i> spp., are significant health concerns in Africa. The epidemiological occurrence of these pathogens is closely linked to the habitats of their vectors, prevalent in rural and semi-urban areas where humans and livestock coexist. The overlapping clinical presentations, non-specific symptoms, and limited access to commercially available <i>in vitro</i> diagnostics in resource-limited settings exacerbate the complexity of accurate diagnoses. This review aimed to systematically extract and analyze existing literature on tick-borne febrile illnesses in Africa, highlighting the diagnostic challenges and presenting an up-to-date overview of the most relevant pathogens affecting human populations. A comprehensive literature search from January 1990 to June 2024 using databases like PubMed, Cochrane Library, Science Direct, EMBASE, and Google Scholar yielded 13,420 articles, of which 70 met the inclusion criteria. <i>Anaplasma</i> spp. were reported in Morocco, Egypt, and South Africa; <i>Francisella</i> spp. in Kenya and Ethiopia; <i>Ehrlichia</i> spp. in Cameroon; <i>Bartonella</i> spp. in Senegal, Namibia, South Africa, and Ethiopia; <i>Borrelia</i> spp. in Senegal, Gabon, Tanzania, and Ethiopia; <i>Coxiella burnetii</i> in 10 countries including Senegal, Mali, and South Africa; and <i>Rickettsia</i> spp. in 14 countries including Senegal, Algeria, and Uganda. Data were analyzed using a fixed-effect model in R version 4.0.1 and visualized on an African map using Tableau version 2022.2. This review highlights the urgent need for improved diagnostics to better manage and control tick-borne febrile illnesses in Africa.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344682","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":"Oral propranolol for the treatment of hemangiomas in high-risk infants: safety and cost analysis of outpatient-initiated therapy","authors":"Rina Su, Hua Qian, Cui Hu, Wei Li, JiBin Li, Bo Wu, Yang Gu, Ting Zhang, YaFen Wu, YingYing Qian, Hui Lu","doi":"10.3389/fmed.2024.1439449","DOIUrl":"https://doi.org/10.3389/fmed.2024.1439449","url":null,"abstract":"ObjectivesTo investigate the safety and cost analysis of oral propranolol treatment for high-risk infantile hemangiomas starting from the outpatient setting.MethodsA total of 41 high-risk infantile hemangioma patients from outpatient settings and 43 from inpatient settings were selected for the study. After routine pre-treatment examinations, patients were administered propranolol in a stepwise incremental dosing regimen over three consecutive days in the outpatient clinic. Changes in heart rate, blood pressure and PR interval before and after medication were compared. On the 10th day post-medication, liver and kidney functions, fasting blood glucose, tumor ultrasonography, and electrocardiogram were re-evaluated. The costs of treatment starting from the outpatient clinic (including pre-treatment examinations and the first three days of treatment) were calculated and compared with those of similarly managed inpatient cases.ResultsThe majority of patients exhibited a reduction in heart rate and blood pressure, as well as an extended PR interval after treatment of medication (<jats:italic>P</jats:italic> &amp;lt; 0.05), which remained within normal limits without clinical symptoms. On the 10th day post-medication, statistical differences in blood biochemistry and electrocardiograms were observed when compared to pre-treatment values (<jats:italic>P</jats:italic> &amp;lt; 0.05), but all values remained within normal ranges. No severe adverse reactions such as hypoglycemia occurred. Additionally, the cost of treatment from the outpatient clinic was significantly lower than that of inpatient care.ConclusionOral propranolol treatment for high-risk infantile hemangiomas starting from the outpatient setting is associated with few adverse reactions and significantly reduced treatment costs. It is worthy of broader application in hospitals without dermatology wards.","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Spotlight on the traditional medicine in prevention and treatment of diabetes in the aging population.","authors":"Lai Jiang, Hao Chi, Xuancheng Zhou, Jingyi Tang, Jieying Zhang, Qinhong Zhang, Shenbin Liu, Jiangang Shen, Guanhu Yang","doi":"10.3389/fmed.2024.1478185","DOIUrl":"https://doi.org/10.3389/fmed.2024.1478185","url":null,"abstract":"","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11427392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344687","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":"Autologous serum eye drops for patients with dry eye disease: a systematic review and meta-analysis of randomized controlled trials","authors":"Chang-Zhu He, Zhao-Jun Zeng, Jun Qiao Liu, Qin Qiu, Yu He","doi":"10.3389/fmed.2024.1430785","DOIUrl":"https://doi.org/10.3389/fmed.2024.1430785","url":null,"abstract":"BackgroundDry eye disease (DED) is highly prevalent worldwide, leading to increased medical costs, economic burdens on families and society, and a diminished quality of life for patients. The utilization of autologous serum eye drops (ASEDs) for the treatment of DED is progressively rising.ObjectiveTo further evaluate the efficacy and safety of ASEDs in the treatment of DED.MethodsA thorough search for randomized controlled trials (RCTs) was conducted across eight databases, including PubMed, EMBASE, the Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang, SinoMed, and VIP. This search encompassed the inception of each database up to April 1, 2024, with a specific focus on identifying RCTs evaluating the efficacy and safety of ASEDs for the treatment of DED. Data analysis was conducted utilizing Stata 15.0 software and the Cochrane Risk of Bias Assessment Tool was utilized to appraise the literature’s quality.ResultsThe study encompassed 12 RCTs. In comparison to the use of artificial tears (AT), patients diagnosed with DED who utilized ASEDs displayed elevated the Schirmer test (ST) scores [WMD = 2.35, 95% CI (1.45, 3.24), <jats:italic>p</jats:italic> &amp;lt; 0.001] and tear-film breakup time (TBUT) scores [WMD = 2.83, 95% CI (2.27, 3.39), <jats:italic>p</jats:italic> &amp;lt; 0.001], decreased Corneal fluorescence staining (CFS) scores [SMD = −2.11, 95% CI (−3.07, −1.15), <jats:italic>p</jats:italic> &amp;lt; 0.001] and the Ocular Surface Disease Index (OSDI) scores [WMD = −10.54, 95% CI (−13.31, −7.77), p &amp;lt; 0.001], and experienced a reduced frequency of adverse events [RR = 0.36, 95% CI (0.13, 0.99), <jats:italic>p</jats:italic> = 0.048].ConclusionIn this study, ASEDs had been shown to enhance tear secretion, extend tear film break-up time, mitigate corneal epithelial damage, ameliorate OSDI scores, and exhibit greater safety compared to AT.","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}