Frontiers in Medicine最新文献

{"title":"Successful endoscopic mechanical lithotripsy for post-ERCP gallstone ileus: a case report.","authors":"Jing Wang, Zhe Luan, Bin Yan, Gang Sun","doi":"10.3389/fmed.2025.1604835","DOIUrl":"10.3389/fmed.2025.1604835","url":null,"abstract":"<p><p>Gallstone ileus is a rare but severe complication of gallstone disease and is typically caused by the formation of a fistula between the biliary and gastrointestinal systems. The conventional treatment approach is enterolithotomy with stone removal. However, for elderly patients or those with underlying comorbidities, surgical intervention poses significant risks. Therefore, exploring minimally invasive, nonsurgical treatment strategies holds critical clinical value. A 63-year-old female was admitted to the hospital due to abdominal pain, chills, and high fever. She was diagnosed with a large common bile duct stone (diameter 3.9 cm). During endoscopic retrograde cholangiopancreatography (ERCP), as the stone was too large to be removed directly, endoscopic sphincterotomy (EST) combined with the placement of a biliary plastic stent was performed. On the 7th postoperative day, the patient developed nausea, vomiting, and constipation. Laboratory tests revealed elevated inflammatory marker, pancreatic enzyme, bile enzyme, and bilirubin levels. Imaging studies revealed intestinal dilatation and a high-density shadow within the intestinal lumen, leading to the diagnosis of gallstone ileus. On postoperative day 11, biliary and pancreatic stents were placed. On postoperative day 16, endoscopic stone extraction was attempted, successfully relieving the obstruction. The patient recovered well postoperatively and experienced no recurrence during the 2-month follow-up. This case report describes the successful treatment of post-ERCP gallstone ileus using endoscopic stone extraction and fragmentation techniques.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1604835"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649093","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":"Clinical and immunological biomarkers in hypereosinophilic syndrome: the second step after diagnostic algorithms.","authors":"David Longhino, Ilaria Baglivo, Maria Antonietta Zavarella, Stefania Colantuono, Chiara Laface, Gabriele Lucca, Laura Bruno, Fabio Romano Selvi, Vincenzo Patella, Aikaterini Detoraki, Rosa Buonagura, Caterina Tatarelli, Barbara Moscatelli, Serena D'Avelli, Elisabetta Abruzzese, Elisabetta Greco, Antonio Gasbarrini, Livio Pagano, Marianna Criscuolo, Sabrina Giammarco, Cristiano Caruso","doi":"10.3389/fmed.2025.1600728","DOIUrl":"10.3389/fmed.2025.1600728","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic hypereosinophilic syndrome currently represents a major unmet need for all medical specialties dealing with this disease. Markers capable of characterising the wide variability of its clinical presentation are currently lacking.</p><p><strong>Objective: </strong>This study aims to evaluate a panel of possible markers in idiopathic hypereosinophilic syndrome.</p><p><strong>Methods: </strong>In this pilot prospective single-centre cohort study, we analysed clinical (age, years of disease, steroid therapy) and laboratory (absolute eosinophil count, total IgE antibodies, IgE antibodies against Staphylococcus aureus enterotoxins, serum eosinophil cationic protein, serum immunoglobulin free light chains k and λ and their ratio) data obtained from 21 patients suffering from idiopathic hypereosinophilic syndrome from June 2023 to December 2024.</p><p><strong>Results: </strong>Mean absolute eosinophilic count was 3758.57 cells/μL. 17 patients were receiving treatment with > 7.5 mg of prednisone or equivalent at the time of the diagnosis. 13 patients had positive Staphylococcus aureus enterotoxins IgE, while the mean total serum IgE was 241.64 kU/L. We observed a high serum eosinophil cationic protein value as well as a high serum κ free light chain, while serum λ and κ/λ were normal. Patients with higher absolute eosinophilic count had higher eosinophil cationic protein levels (<i>p</i> < 0.05), such as higher steroid consumption (<i>p</i> < 0.05). In addition, we found a strong association between high κ free light chain levels and high previous steroid use and with Staphylococcus aureus enterotoxins IgE positivity.</p><p><strong>Conclusion: </strong>Our results could increase the number of possible biomarkers for risk stratification in idiopathic hypereosinophilic syndrome.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1600728"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649086","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":"Case Report: Surgical management and prognostic factors in primary anorectal melanoma: a retrospective analysis of nine cases.","authors":"Xiangxiang Ren, Xiaoshi Jin, Tianhao Xie, Litao Liu, Qiang Wang, Xingli Sun, Meng Zhang","doi":"10.3389/fmed.2025.1614614","DOIUrl":"10.3389/fmed.2025.1614614","url":null,"abstract":"<p><strong>Background: </strong>Primary Anorectal malignant melanoma (pARMM) is an exceedingly rare and aggressive malignancy, accounting for approximately 1% of anorectal cancers. It originates from melanocytes in the anorectal mucosa and lacks distinctive clinical features, leading to frequent misdiagnosis and advanced presentation.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 9 patients (1 male, 8 females; median age 59 years) with histopathologically and immunohistochemically confirmed ARMM who underwent surgical resection (Wide Local Excision, WLE = 4; Abdominoperineal Resection, APR = 5) and had complete follow-up data (median 19 months, up to May 2025). Diagnostic methods included clinical evaluation, digital rectal exam (DRE), colonoscopy, imaging (CT), histopathology, and immunohistochemistry (IHC). Treatment approaches and outcomes were analyzed.</p><p><strong>Results: </strong>Common presenting symptoms were hematochezia (44.4%), tenesmus (22.2%), altered bowel habits, anal mass protrusion, or were asymptomatic (11.1% each). DRE revealed exophytic (<i>n</i> = 6) or polypoid (<i>n</i> = 3) masses. Colonoscopy showed lesions near the dentate line; only 33.3% had obvious pigmentation. IHC positivity: HMB-45/Melan-A 66.7%, S-100 55.6%. Pathological R0 resection was achieved in all patients. During follow-up, 3 patients (33.3%) developed distant metastases (lung, liver), 2 of whom died. Six patients remained disease-free.</p><p><strong>Conclusion: </strong>Primary Anorectal malignant melanoma (pARMM) often presents with symptoms mimicking common benign anorectal conditions, leading to frequent diagnostic errors. Definitive diagnosis requires histopathological examination, with immunohistochemical markers (HMB-45 and Melan-A positivity) providing critical confirmation. While surgical resection remains the primary treatment, a growing expert consensus supports wide local excision with adequate margins (≥1 cm) as sufficient management. Emerging evidence indicates comparable survival outcomes to more radical procedures in appropriately selected patients.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1614614"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649085","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":"Clinical factors associated with developmental delay in placental abruption.","authors":"Eun Hui Joo, Nari Kim, Hyun Mee Ryu, Sang Hee Jung, Eun Hee Ahn, Ji Yeon Lee","doi":"10.3389/fmed.2025.1544679","DOIUrl":"10.3389/fmed.2025.1544679","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the association between clinical characteristics and neonatal developmental delay (DD) in women with placental abruption (PA).</p><p><strong>Methods: </strong>We retrospectively reviewed obstetric characteristics and perinatal outcomes of singleton pregnancies complicated by PA who were healthy before pregnancy between 2010 and 2021. Neuromotor development was evaluated using Bayley Scales of Infant and Toddler Development, Third Edition, and/or Gross Motor Function Measure. Clinical characteristics were compared between offspring with and without developmental delay to identify associated risk factors.</p><p><strong>Results: </strong>Among 9,374 deliveries, 188 cases (2.0%) were diagnosed with PA, and 33 infants exhibited developmental delay. Maternal demographics, including age, body mass index (BMI), nulliparity, and history of preterm birth, did not differ significantly between groups. Prenatal ultrasound suspected PA in 16.4% of cases in the developmental delay group and 18.2% in the no-delay group. However, a longer interval between diagnosis and delivery [adjusted OR (aOR) = 9.82; 95% CI, 1.25-77.24; <i>P</i> = 0.030] and delivery before 32 weeks' gestation (aOR = 19.65; 95% CI, 1.46-264.40; <i>P</i> = 0.025) were significantly associated with developmental delay.</p><p><strong>Conclusion: </strong>Ultrasound findings suggestive of PA were not associated with developmental delay in offspring. However, a prolonged diagnosis-to-delivery interval and extreme prematurity were significant risk factors. These findings underscore the limitations of ultrasound in detecting clinically significant PA and highlight the importance of timely clinical decision-making. Further research is warranted to improve diagnostic strategies for PA.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1544679"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649087","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 efficacy and safety of nitinol vs. novel fully biodegradable occluders for transcatheter patent foramen ovale closure in migraine treatment: a retrospective cohort study.","authors":"Rui-Lin Li, Jing-Juan Huang, Jie Ming, Ying Hao, Wei Wen, Yun-Li Shen, Li Lin, Lin-Xiang Lu","doi":"10.3389/fmed.2025.1613687","DOIUrl":"10.3389/fmed.2025.1613687","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter closure of patent foramen ovale (PFO) has shown potential therapeutic benefits for clinical symptoms in selected patients with migraine. Nevertheless, the comparative effectiveness and safety of traditional nitinol vs. fully biodegradable occluders remain to be fully elucidated and warrant further investigation.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included 158 migraine patients with a confirmed patent foramen ovale (PFO) and a grade II-III right-to-left shunt (RLS) as determined by contrast-enhanced transthoracic echocardiography (cTTE), who underwent transcatheter PFO closure at Shanghai East Hospital, Tongji University, between October 2023 and January 2024. Based on the occluder type, patients were categorized into a nitinol group (<i>n</i> = 77) or a biodegradable group (<i>n</i> = 81). Clinical baseline characteristics, echocardiographic parameters, procedural data, safety outcomes, residual right-to-left shunt (RLS) grades, and migraine severity assessed using the Migraine Disability Assessment Scale (MIDAS) were compared between groups. The primary outcome was migraine relief (≥50% reduction in MIDAS score) following the procedure. Secondary outcomes included the incidence of safety-related events and the rate of residual right-to-left shunt.</p><p><strong>Results: </strong>Both the nitinol group and biodegradable groups showed significant reductions in MIDAS scores post-procedure with no significant difference in migraine relief between groups (<i>P</i> = 0.644, Kaplan-Meier analysis). Both occluders showed a high procedural success rate (100%) and similar safety profiles, with low rates of perioperative complications. The biodegradable occluder exhibited progressive degradation, with a significant reduction in size by 12 months, while maintaining closure efficacy. Residual right-to-left shunting was minimal in both groups, with RLS grades 0 and 1 observed in 82.35% of patients in the nitinol group and 78.87% in the bioabsorbable group at the 12-month follow-up.</p><p><strong>Conclusion: </strong>Both biodegradable and nitinol PFO occluders were equally effective in alleviating migraine symptoms, with excellent procedural success and safety profiles. The biodegradable occluder demonstrated effective closure and gradual degradation, offering a promising alternative to nitinol occluders, especially for patients concerned about long-term foreign body implantation. These findings support the clinical utility of both occluder types in PFO-related migraine treatment, with individualized device selection based on patient preferences and clinical factors.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1613687"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649088","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":"Development and validation of a visual prediction model for severe acute pancreatitis: a retrospective study.","authors":"Xiaoli Huang, Jia Xu, Xiaogang Hu, Juntao Yang, Menggang Liu","doi":"10.3389/fmed.2025.1564742","DOIUrl":"10.3389/fmed.2025.1564742","url":null,"abstract":"<p><strong>Background: </strong>Acute pancreatitis (AP) is a common acute abdominal disease. The early identification of patients at risk of progression to severe AP (SAP) is crucial for developing effective therapeutic and nursing measures. Although many scoring systems exist for SAP risk assessment, none is widely accepted. Systemic inflammatory grade (SIG) is a novel systemic inflammation-based scoring system, but its relationship with AP, as well as the SAP risk prediction model involving SIG, has not been reported.</p><p><strong>Methodology: </strong>The demographic information, clinical data, and laboratory results of patients diagnosed with AP were collected. Baseline comparisons were made using the Wilcoxon rank-sum test, chi-square test and Fisher's exact test. Logistic regression analyses were used to identify independent predictors of SAP; these factors were then used to establish a nomogram model. The model's predictive efficacy and threshold values were evaluated using the receiver operating characteristic (ROC) curve and calibration curve. The decision curve analysis (DCA) and clinical impact curve (CIC) were used to further evaluate the benefit of the model.</p><p><strong>Results: </strong>Five hundred and ninety-two patients aged 18-92 years (median, 43 years) were included. In two stepwise regressions, SIG, C-reactive protein (CRP), prognostic nutritional index (PNI), and white blood cell (WBC) were all considered independent risk factors for SAP (<i>p</i> < 0.05). A nomogram prediction model was constructed using these four factors, with an area under the curve (AUC) of 0.940 (95% CI: 0.907-0.972, <i>p</i> < 0.01). The AUC-ROC for 10-fold cross-validation was 0.942 ± 0.065. The results of the Hosmer and Lemeshow goodness of fit (GoF) test (<i>p</i>-value = 0.596) and the Brier score (0.031, 95% CI 0.020-0.042), as well as the calibration curve, all demonstrated that the model exhibits good accuracy. DCA and CIC curves showed that the model provided good predictive value.</p><p><strong>Conclusion: </strong>SIG, CRP, PNI, and WBC represent promising early prognostic markers for severe acute pancreatitis (SAP). A nomogram prediction model utilizing these markers offers effective early prediction for SAP.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1564742"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649090","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 change of retinal microvascular in APAC eyes and fellow PACS eyes detected using wide-field swept-source optical coherence tomographic angiography.","authors":"Rumin Zhao, Wenhui Geng, Zijian Zhang, Yunlong Wu, Xiaotong Wang, Bojun Zhao","doi":"10.3389/fmed.2025.1618436","DOIUrl":"10.3389/fmed.2025.1618436","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to quantitatively evaluate changes in vascular parameters in a 12 mm × 12 mm region centered on the fovea with wide-field swept-source optical coherence tomographic angiography (WF SS-OCTA), and establish their correlations with structural parameters in acute primary angle closure (APAC) eyes, as well as in fellow primary angle-closure suspect (PACS) eyes.</p><p><strong>Methods: </strong>In this retrospective study, WF SS-OCTA was utilized to measure vascular parameters in a 12 mm × 12 mm region centered on the fovea in 31 patients (31 APAC eyes and 31 fellow PACS eyes). Vascular parameters included vessel density (VD) of the superficial vascular complex (SVC) and deep vascular complex (DVC). Structural parameters comprised macular ganglion cell complex (GCC) thickness and peripapillary retinal nerve fiber layer (pRNFL) thickness. Pre- and postoperative (3 month after APAC attack) differences between APAC and PACS eyes were statistically analyzed.</p><p><strong>Results: </strong>No significant differences were observed in vascular density or structural parameters in PACS eyes pre- and postoperatively (<i>p</i> > 0.05). In APAC eyes, postoperative SVC VD showed no significant change in the 0-6 mm region but decreased significantly in the 6-12 mm annular region centered on the fovea (<i>p</i> < 0.05). DVC VD increased across all scanned regions postoperatively (<i>p</i> < 0.05). The average pRNFL thickness, quadrant-specific pRNFL thickness, and GCC thickness were significantly reduced after operation (<i>p</i> < 0.05). Multivariate linear regression revealed positive correlations between GCC thickness, SVC VD (0-6 mm, 0-12 mm, 6-12 mm), and pRNFL thickness (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Wide-field SS-OCTA revealed spatially distinct vascular responses in APAC eyes: underlying axonal loss with concomitant SVC compromise in the 6-12 mm annular region centered on the fovea and partial DVC recovery at 3 months after APAC attack, highlighting WF SS-OCTA's utility in monitoring APAC progression.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1618436"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649094","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":"Acute gastric dilatation after excessive consumption of traditional Chinese medicine: a case report.","authors":"Tao Zeng, Zi-Liang Chen, Yao-Hui Zhou, Wei-Qi Liu, Jian Chen, Jian-Hui Lu, Jia-Hao Lin","doi":"10.3389/fmed.2025.1584032","DOIUrl":"10.3389/fmed.2025.1584032","url":null,"abstract":"<p><strong>Introduction: </strong>Acute gastric dilatation (AGD) is a rare but clinically significant condition characterized by abnormal enlargement of the stomach. It can lead to serious complications such as gastric necrosis, perforation, and respiratory failure if not promptly managed. AGD has been associated with mechanical obstructions, binge eating, and systemic conditions like diabetes mellitus. However, AGD induced by excessive consumption of traditional Chinese medicine (TCM) has not been previously reported.</p><p><strong>Patient concerns: </strong>A 40-year-old male with a history of chronic dyspepsia presented to the emergency department with recurrent vomiting. Over the 3 days prior to admission, he self-reported consuming approximately 3.5 liters of TCM liquid (about 1.1-1.3 liters per day). This attempt to alleviate his chronic dyspepsia symptoms failed to show the expected therapeutic effect. The patient denied experiencing headache, dizziness, chest pain, palpitations, abdominal pain, or diarrhea.</p><p><strong>Diagnosis: </strong>Abdominal CT revealed significant gastric distension, and subsequent endoscopy showed pyloric ulcer with stenosis, gastric retention, chronic atrophic gastritis, and a relaxed cardia. Laboratory investigations indicated metabolic alkalosis, electrolyte imbalances, and signs of tissue hypoxia.</p><p><strong>Interventions: </strong>The patient was immediately managed with nasogastric tube decompression, anti-infection therapy, gastric mucosal protection, fluid resuscitation, parenteral nutritional support, fasting, and gastrointestinal decompression.</p><p><strong>Outcomes: </strong>The patient's symptoms and signs notably improved after these interventions. A follow-up CT scan demonstrated improved gastric dilation. At a 4-week follow-up, the patient reported complete resolution of vomiting and resumed normal oral intake. Repeat endoscopy showed healed pyloric ulcers and improved gastric motility. No adverse events (e.g., rehospitalization or medication intolerance) were reported during a 3-month follow-up period.</p><p><strong>Conclusion: </strong>This case highlights the necessity of including AGD in the differential diagnosis for patients presenting with frequent vomiting after excessive consumption of TCM. It underscores the importance of thorough evaluation to prevent misdiagnosis and severe complications. The case also emphasizes the need for caution when using TCM, especially in patients with organic lesions or pyloric obstruction.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1584032"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649059","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":"Anatomical landmark-guided laparoscopy for migrant fishbone - induced pancreatic abscesses: a case series study and review of the literature.","authors":"Chuanbing Zhao, Hongzhen Wei, Long He, Canglong Deng, Yu Lu, Jingjie Wang, Tao Yin","doi":"10.3389/fmed.2025.1598619","DOIUrl":"10.3389/fmed.2025.1598619","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic abscesses resulting from gastrointestinal fishbone migration represent rare yet clinically challenging surgical emergencies, with standardized management protocols remaining undefined.</p><p><strong>Methods: </strong>We analyzed three consecutive cases (2024-2025) treated via anatomical landmark-guided laparoscopy alongside 11 PubMed-indexed cases (2004-2025). This study evaluates a novel surgical paradigm for complete foreign body retrieval and abscess resolution.</p><p><strong>Results: </strong>The laparoscopic strategy achieved technical precision with minimal operative duration (73 ± 6 min) and blood loss (6.67 ± 4.71 mL), eliminating pancreatic fistula or hemorrhagic complications. Postoperative hospitalization was reduced by 43% compared to conventional interventions (5.3 ± 1.5 vs. 9.3 ± 3.1 days; *<i>p</i>* < 0.01). Crucially, this strategy attained hemostatic efficacy equivalent to augmented reality navigation (ARN)-assisted techniques without preoperative conditioning.</p><p><strong>Conclusion: </strong>These findings establish a reproducible framework integrating anatomical landmark navigation for emergency pancreatic abscess management. The approach offers clinically validated advantages in procedural safety, visceral preservation, and accelerated recovery trajectories compared to existing strategies.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1598619"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649060","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":"Development and validation of a perioperative risk prediction model for pressure ulcers in neurosurgical procedures: a machine learning approach with protocol compliance metrics.","authors":"Yaping Wang, Weiguang Yu, Hui Zhi, Kun Shang, Hongmei Yin, Dandan Shan, Xiao Li, Wenxia Li, Xiuru Zhang, Baoli Zhang","doi":"10.3389/fmed.2025.1600481","DOIUrl":"10.3389/fmed.2025.1600481","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to develop and validate a nomogram for predicting pressure ulcer (PU) incidence in neurosurgical patients to enhance postoperative risk management.</p><p><strong>Methods: </strong>A retrospective analysis of 1,020 patients across four tertiary centers (2005-2025) evaluated 20 variables. Propensity score matching (PSM) addressed confounding, while LASSO regression and machine learning identified predictors. Model performance was assessed via AUC-ROC, C-index, and decision curve analysis.</p><p><strong>Results: </strong>Eight independent predictors of PU were identified: diabetes duration, BMI, albumin, prealbumin, age, hemoglobin, temperature difference, and urinary incontinence. The training set achieved an AUC-ROC of 0.825 (95% CI: 0.797-0.853) with 77% sensitivity and 92% specificity, while the validation set showed an AUC-ROC of 0.800 (95% CI: 0.753-0.847) with 76% sensitivity and 92% specificity. The nomogram demonstrated recalibrated C-indices of 0.833 (training) and 0.826 (validation). Decision curve analysis confirmed significant net benefit across clinical thresholds.</p><p><strong>Conclusion: </strong>This validated nomogram enables early PU risk stratification, facilitating personalized postoperative interventions. Given its high sensitivity and specificity, the model can be integrated into clinical practice to assist in early identification of high-risk patients, thereby improving patient outcomes through timely interventions.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1600481"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649089","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}