International journal of surgery最新文献

{"title":"Potential of SPHK1 as a prognostic marker and therapeutic target in colorectal cancer: insights from bioinformatics and experimental analysis.","authors":"Yandong Miao, Jian Gan, Yan-Jing Ni, Zhao-Nan Zhang, Ling-Xia Yu, Wu-Xia Quan, Zheng-Chao Zhang, Hui-Min Wang, Shuang Han, Fan-Yong Qu, Qian-Qian Lu, Rui Ma, Jiang-Tao Wang, Wen-Yu Luan, Si-Xiang Lin, Deng-Hai Mi, Wen-Hua Huang","doi":"10.1097/JS9.0000000000002506","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002506","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) remains a major cause of cancer-related mortality globally, primarily due to its aggressive progression and poor prognosis in many patients. Despite treatment advances, new therapeutic targets are critically needed to enhance patient outcomes. Although sphingosine kinase 1 (SPHK1) has been linked to various cancers, its role in CRC progression, prognosis, and as a therapeutic target is not well understood.</p><p><strong>Objective: </strong>This study aimed to investigate the role and molecular mechanisms through which SPHK1 contributes to CRC progression, with a focus on its potential as a prognostic marker and therapeutic target by bioinformatics and experimental analysis.</p><p><strong>Methods: </strong>Multi-omics analysis was conducted using data from TCGA, GEPIA2, and other publicly available databases, as well as single-cell RNA sequencing data, to assess SPHK1 expression and its correlation with immune infiltration in CRC tissues. A Mendelian Randomization (MR) approach was employed to investigate the causal relationship between sphingomyelin levels and CRC risk. Multiplex Fluorescence Immunohistochemistry was used to analyze the expression levels of SPHK1, E-cadherin, and Vimentin in 90 CRC and corresponding normal tissues. Migration, invasion, and apoptosis assays were performed in CRC cell lines to examine the functional impact of SPHK1 modulation.</p><p><strong>Results: </strong>SPHK1 expression was significantly elevated in CRC tissues and correlated with poor prognosis. MR analysis confirmed a causal relationship between sphingomyelin levels and increased CRC risk. SPHK1 gene expression was significantly positively related to methylation levels at sites cg11001059 and cg26442874 and significantly negatively associated with methylation levels at cg02028751. SPHK1 expression was associated with immune cell infiltration and sphingolipid metabolism pathways. SPHK1 was found to modulate the expression of E-cadherin, promoting CRC cell migration and invasion, while inhibiting apoptosis.</p><p><strong>Conclusion: </strong>SPHK1 plays a key role in facilitating the epithelial-to-mesenchymal transition of CRC cells, enhancing their migratory and invasive abilities, and influencing the tumor microenvironment. The findings suggest that SPHK1 could be a potential biomarker and therapeutic target for CRC, with implications for the development of targeted therapies to improve patient outcomes.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative membranous urethra length and urinary continence following radical prostatectomy: a systematic review and meta-analysis.","authors":"Yunfei Yu, Shiyu Zhang, Xingyu Xiong, Yuanjun Wu, Shengzhuo Liu, Luchen Yang, Qiang Wei, Qiang Dong","doi":"10.1097/JS9.0000000000002600","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002600","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer is the second most common cancer and the fifth leading cause of cancer-related deaths in men globally. Radical prostatectomy (RP) is the primary treatment for localized prostate cancer but often leads to functional impairments, such as urinary incontinence (UI). Membranous urethra length (MUL) may predict postoperative continence recovery, though study results are inconsistent.</p><p><strong>Objective: </strong>To systematically review and meta-analyze the association between preoperative MUL and urinary continence recovery following RP.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted, including 34 studies with a total of 12 899 patients. Data were extracted on the relationship between MUL and urinary continence recovery at 1, 3, 6, and 12 months post-surgery. Hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the association between MUL and continence recovery. A random-effects model was used to account for heterogeneity.</p><p><strong>Results: </strong>Longer MUL was consistently associated with improved urinary recovery across all time points (1, 3, 6, and 12 months). Robot-Assisted Radical Prostatectomy (RARP) showed the strongest and most significant association with early recovery, especially within the first month. For patients with shorter MUL seeking the fastest recovery, RARP was the preferred surgical option. The pooled HR for all surgical approaches at 1 month was 1.80 (95% CI: [1.13, 2.87]), indicating a significant benefit of longer MUL on recovery.</p><p><strong>Conclusion: </strong>Preoperative MUL is a significant predictor of urinary continence recovery after RP. RARP, with its precision in preserving anatomical structures, is the optimal surgical approach for patients seeking the fastest recovery, particularly within the first month post-surgery. These findings highlight the importance of MUL in preoperative planning and patient counseling, as it can guide surgical decisions and help set realistic recovery expectations.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of semaglutide on fusion rates following posterior lumbar fusion surgery in patients with type 2 diabetes.","authors":"Yu Chang, Hong-Min Lin, Kuan-Yu Chi, Junmin Song, Hany Atwan","doi":"10.1097/JS9.0000000000002492","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002492","url":null,"abstract":"<p><strong>Background: </strong>Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist used in managing type 2 diabetes mellitus (T2DM), has demonstrated cardiovascular and glycemic benefits. However, its influence on surgical outcomes, particularly spinal fusion, remains unclear. This study aims to evaluate the association between semaglutide use and pseudarthrosis rates following posterior lumbar fusion surgery in patients with T2DM.</p><p><strong>Methods: </strong>Data were retrieved from the TriNetX Global Collaborative Network, which includes de-identified records from 117 healthcare systems. T2DM patients who underwent posterior lumbar fusion were identified using CPT codes, and semaglutide exposure was determined preoperatively. Patients were divided into semaglutide and non-semaglutide groups, with 1:1 propensity score matching applied. Pseudarthrosis was identified using ICD-10 code M96.0.</p><p><strong>Results: </strong>After matching, baseline characteristics were well-balanced between groups with 884 patients in each group. Semaglutide users had significantly lower rates of pseudarthrosis at 6 months (8.0% vs. 13.1%, OR: 0.58; 95% CI: 0.42-0.79), 1 year (8.9% vs. 14.0%, OR: 0.60; 95% CI: 0.45-0.81), and two years (10.1% vs. 15.7%, OR: 0.60; 95% CI: 0.45-0.80) compared to non-users.</p><p><strong>Conclusions: </strong>Semaglutide use is associated with a reduced risk of pseudarthrosis following posterior lumbar fusion in patients with T2DM. Further studies are warranted to elucidate the mechanisms underlying this potential benefit and to assess its implications in broader patient populations.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A commentary on \"Effect of parecoxib on postoperative delirium in patients with hyperlipidemia: a randomized, double-blind, single-center, superiority trial\".","authors":"Ying Zhou, Juntong Liu, Yufeng Yang","doi":"10.1097/JS9.0000000000002581","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002581","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating generative AI models for explainable pathological feature extraction in lung adenocarcinoma grading assessment and prognostic model construction.","authors":"Junyi Shen, Suyin Feng, Pengpeng Zhang, Chang Qi, Zaoqu Liu, Yuying Feng, Chunrong Dong, Zhenyu Xie, Wenyi Gan, Lingxuan Zhu, Weiming Mou, Dongqiang Zeng, Bufu Tang, Mingjia Xiao, Guangdi Chu, Quan Cheng, Jian Zhang, Shengkun Peng, Yifeng Bai, Hank Z H Wong, Aimin Jiang, Peng Luo, Anqi Lin","doi":"10.1097/JS9.0000000000002507","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002507","url":null,"abstract":"<p><strong>Background: </strong>Given the increasing prevalence of generative AI (GenAI) models, a systematically evaluation of their performance in lung adenocarcinoma histopathological assessment is crucial. This study aimed to evaluate and compare three visual-capable GenAI models (GPT-4o, Claude-3.5-Sonnet, and Gemini-1.5-Pro) for lung adenocarcinoma histological pattern recognition and grading, as well as to explore prognostic prediction models based on GenAI feature extraction.</p><p><strong>Materials and methods: </strong>In this retrospective study, we analyzed 310 diagnostic slides from The Cancer Genome Atlas Lung Adenocarcinoma (TCGA-LUAD) database to evaluate GenAI models and to develop and internally validate machine learning-based prognostic models. For independent external validation, we utilized 95 and 87 slides from obtained different institutions. The primary endpoints comprised GenAI grading accuracy (area under the receiver operating characteristic curve, AUC) and stability (intraclass correlation coefficient, ICC). Secondary endpoints included developing and assessing machine learning-based prognostic models using GenAI-extracted features from the TCGA-LUAD dataset, evaluated by Concordance index (C-index).</p><p><strong>Results: </strong>Among the evaluated models, claude-3.5-Sonnet demonstrated the best overall performance, achieving high grading accuracy (average AUC = 0.823) with moderate stability (ICC = 0.585) The optimal machine learning-based prognostic model, developed using features extracted by Claude-3.5-Sonnet and integrating clinical variables, demonstrated good performance in both internal and external validations, yielding an average C-index of 0.715. Meta-analysis demonstrated that this prognostic model effectively stratified patients into risk groups, with the high-risk group showing significantly worse outcomes (Hazard ratio = 5.16, 95% confidence interval = 3.09-8.62).</p><p><strong>Conclusion: </strong>GenAI models demonstrated significant potential in lung adenocarcinoma pathology, with Claude-3.5-Sonnet exhibiting superior performance in grading prediction and robust prognostic capabilities. These findings indicate promising applications of AI in lung adenocarcinoma diagnosis and clinical management.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of endovascular embolization and stereotactic radiosurgery as the first-line treatment for ruptured arteriovenous malformations: a propensity score matched analysis using nationwide multicenter prospective registry data.","authors":"Yu Chen, Chengzhuo Wang, Heze Han, Li Ma, Ruinan Li, Zhipeng Li, Haibin Zhang, Kexin Yuan, Anqi Li, Qinghui Zhu, Yongenbo Su, Dezhi Gao, Hengwei Jin, Youxiang Li, Shibin Sun, Yuanli Zhao, Xiaolin Chen, Jizong Zhao","doi":"10.1097/JS9.0000000000002546","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002546","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate and compare the risk-benefit profiles of endovascular embolization (EM) and stereotactic radiosurgery (SRS) as first-line therapeutic strategies for the management of ruptured arteriovenous malformations (AVMs).</p><p><strong>Materials and methods: </strong>We included patients with ruptured AVMs who underwent EM or SRS as the first-line treatments from a nationwide prospective multicenter registry (the *BLINDED* study) in China. Propensity score matching was employed to balance baseline characteristics between the EM and SRS groups. The primary outcomes were long-term hemorrhagic stroke or death, while secondary outcomes included long-term obliteration rates and neurological status. Subgroup analyses and sensitivity analyses using alternative study designs were conducted to ensure the robustness and consistency of the findings.</p><p><strong>Result: </strong>Of 3909 consecutive AVMs in the registry from 2011.08 to 2021.12, 1067 patients were eligible. After matching, 640 AVMs remained for the final analysis. The mean follow-up duration was 5.27 years. In terms of primary outcomes, SRS was associated with a lower risk of hemorrhagic stroke or death (hazard ratio [HR] 0.36, 95%confidence interval [CI] 0.23 to 0.58). Regarding the secondary outcomes, SRS was observed to have a significant advantage in long-term obliteration (odds ratio [OR] 7.89, 95%CI 5.15 to 12.11), and the incidence was significantly lower in the SRS group than in the EM group for the disabling neurological deficits (OR, 0.42, 95%CI, 0.25 to 0.70). Results of subgroup analyses and sensitivity analyses were consistent in trend but with slightly varied powers.</p><p><strong>Conclusion: </strong>This study suggests that SRS may more effective than EM in preventing future hemorrhagic stroke or death, achieving complete obliteration, and reducing long-term neurological disability.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-exploration of the optimal threshold for restrictive transfusion after hip fracture: a multicenter prospective Cohort.","authors":"Dajun Jiang, Mao Wei, Sen Lin, Jiaqing Cao, Yuquan Bian, Shizan He, Xiaolin Li, Jinshan Zhang, Limin Zhao, Changqing Zhang, Weitao Jia, Hongyi Zhu","doi":"10.1097/JS9.0000000000002599","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002599","url":null,"abstract":"<p><strong>Background: </strong>Restrictive transfusion is recommended in patients undergoing hip fracture surgery. However, the evidence regarding the optimal threshold for transfusion remained uncertain.</p><p><strong>Methods: </strong>In this multicenter prospective cohort, we enrolled participants who received surgical treatment of a hip fracture and were aged 65 years or older from 2017 to 2023. The restrictive transfusion of red blood cells (RBCs) with a threshold at hemoglobin level <8 g/dl was the standard of care during the study period. When periodic shortage of blood existed, the threshold was adjusted to <7 g/dl as a priori-defined coping strategy. The primary outcome was all-cause mortality within one year after surgery.</p><p><strong>Results: </strong>In this study, 3516 and 732 patients received standard care (threshold at hemoglobin level <8 g/dl) and alternative care (threshold at hemoglobin level <7 g/dl), respectively. Patients in alternative care group had a similar incidence of death within one year compared with patients in standard care group (157 [17.6%] patients versus 575 [17.1%] patients), with an adjusted hazard ratio (HR) of 1.01 (95% confidence interval [CI] 0.85 to 1.21, P = 0 · 885). For subgroup analysis of patients with cardiovascular disease (CVD) at baseline, death occurred in 53 (27.5%) patients of alternative care group and 182 (19.9%) of standard care group, with an adjusted HR of 1.45 (95% CI 1.05 to 1.99, P = 0.023).</p><p><strong>Conclusion: </strong>In patients without baseline CVD, adjusting the threshold for transfusion from the standard level (hemoglobin level <8 g/dl) to an alternative level (<7 g/dl) might be a safe practice in coping periodic blood shortage. In patients with baseline CVD, standard threshold remained recommended. Future randomized clinical trials were warranted by the current study.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness for early-stage NSCLC without lymph node involvement based on prospective studies.","authors":"Xue Yang, Zherui Xing, Sirui Long, Xiaoxi Yu, Nanhao Yin, Kailin Deng, Deying Kang, Fengming Spring Kong, You Lu, Ren Luo, Jianxin Xue","doi":"10.1097/JS9.0000000000002594","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002594","url":null,"abstract":"<p><strong>Background: </strong>There is ongoing uncertainty in comparing surgical and nonsurgical therapies, with or without systemic options, in heterogeneous early-stage non-small cell lung cancer without lymph node involvement (eNSCLC-N0).</p><p><strong>Materials and methods: </strong>We conducted an integrated evidence synthesis of prospective randomized controlled trials (RCTs) and non-RCTs, covering four databases through 1 September 2024. Treatment effects were evaluated using single-arm, pair-wise, and Bayesian random-effects network meta-analyses. Primary outcomes were overall survival (OS) and disease-free survival (DFS); secondary outcomes included recurrence and grade ≥3 adverse events.</p><p><strong>Results: </strong>This report included 31 clinical trials (24 RCTs) with 12,049 patients. In the network-analyses, adjuvant targeted therapy (ATKI) (rank 1) significantly improved DFS compared with mixed radical resection (RR) (hazard ratio [HR], 0.21; 95% confidence interval [CI], 0.05-0.90; rank 14; GRADE, very low) in the overall population. For patients with wild-type/unknown EGFR status, stereotactic body radiation therapy (SBRT) plus immune checkpoint inhibitors (I-SBRT) (rank 1) showed DFS benefit over SBRT alone (HR, 0.17; 95% CI, 0.03-0.83; rank 3; GRADE, high) and was non-inferior to adjuvant platinum-based chemotherapy (HR, 0.18; 95% CI, 0.02-1.65; rank 2; GRADE, very low).</p><p><strong>Conclusion: </strong>These findings suggest the combination of systemic therapies, such as surgery plus ATKI or SBRT plus immunotherapy, superior approaches for patients with eNSCLC-N0 depending on the genomic mutation status and patient tolerability.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of psychological and physiological factors in perioperative thirst discomfort trajectories in endonasal transsphenoidal surgery: a prospective cohort study.","authors":"Zhongmin Fu, Xian Luo, Lan Liu, Jing Shang, Min Chen, Xiaoju Miao","doi":"10.1097/JS9.0000000000002513","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002513","url":null,"abstract":"<p><strong>Background: </strong>Endonasal transsphenoidal surgery (ETSS) is a minimally invasive treatment for pituitary adenomas. Perioperative thirst discomfort is common and may signal complications like diabetes insipidus and the syndrome of inappropriate antidiuretic hormone secretion. Understanding the psychological and physiological factors influencing thirst is crucial for improving patient care.</p><p><strong>Materials and methods: </strong>This prospective cohort study enrolled 224 ETSS patients from July 2024 to December 2024 at a tertiary hospital in China. We measured thirst discomfort, the salivary pH, and serum thyroid thyroid-stimulating hormone (TSH) levels at multiple perioperative time points and collected data on demographics, anxiety, and depression. Latent growth mixture modeling identified thirst trajectories, principal component analysis determined key TSH and pH patterns, logistic regression assessed influencing factors, and structural equation modeling explored pathways among psychological and physiological variables.</p><p><strong>Results: </strong>Four distinct thirst discomfort trajectories were identified: low-level rapid relief, high-level unresolved, low-level slow relief, and low-level continuous deterioration. Principal component analysis revealed a stable decreasing trend in TSH, while salivary pH followed three trends, including stable decrease, postoperative recovery, and early fluctuations. Protective factors for the high-level unresolved group included stable decreasing TSH trends and higher anxiety, while diabetes and depression were risk factors. For the low-level slow relief group, stable decreasing TSH trends and higher anxiety were protective. The low-level continuous deterioration group was influenced by a decreasing pH trend as a risk factor, with stable decreasing TSH trends providing protection. Path analysis indicated that stable decreasing TSH trends were negatively correlated with anxiety and influenced pH stability, impacting thirst discomfort.</p><p><strong>Conclusion: </strong>Perioperative thirst discomfort in ETSS patients exhibits significant heterogeneity influenced by both psychological and physiological parameters (TSH levels and salivary pH). Identifying these factors can inform targeted perioperative management strategies, potentially mitigating thirst-related discomfort and improving overall patient outcomes.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality from alzheimer's disease and other dementias and its heterogeneity across states in india findings from GBD 2021 study.","authors":"Hongjuan Fang, Letong Li, Juntao Ai, Qiang Wang","doi":"10.1097/JS9.0000000000002460","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002460","url":null,"abstract":"<p><p>Dementia is a leading cause of death worldwide. This study examines trends and risk factors for dementia mortality in India and projects the future burden. Mortality and risk factors for Alzheimer's disease and other dementias (ADOD) in India between 1990 and 2021 were extracted from the Global Burden of Disease (GBD) 2021 database. Spatial autocorrelation analysis was calculated using ArcGIS 10.8. The age-period-cohort (APC) model was applied to analyze the independent effects of age, period and cohort. A bidirectional Mendelian randomization (MR) analysis assessed causality between risk factors and ADOD. The Bayesian APC model was conducted to predict future trends. From 1990 to 2021, deaths, crude mortality rates (CMRs) and age-standardized mortality rates (ASMRs) for ADOD increased gradually. Females had higher CMRs and ASMRs than males, and the burden persisted mainly in the elderly. In 2021, Uttar Pradesh, Maharashtra and Tamil Nadu were the top three states for deaths, but the top three states for ASMR were Meghalaya, Orissa and Telangana. Moreover, Meghalaya, Orissa and Telangana were also the three fastest growing states for ASMR. High fasting plasma glucose (FPG), high body mass index (BMI) and tobacco were the primary drivers of this increase. The MR analysis showed a statistically significant causal association of these three risk factors with ADOD. Projections showed that mortality in the elderly would continue to rise until 2050. Overall, the burden of dementia mortality in India has increased dramatically. There is an urgent need for targeted prevention and control strategies to reduce this burden.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}