Irish Journal of Medical Science最新文献

{"title":"Nintedanib and its combination with immunosuppressives in connective tissue disease-related interstitial lung diseases.","authors":"Emre Tekgoz, Seda Yurumez Colak, Ezgi Cimen Gunes, Nesrin Ocal, Muhammet Cinar, Sedat Yilmaz","doi":"10.1007/s11845-024-03848-6","DOIUrl":"https://doi.org/10.1007/s11845-024-03848-6","url":null,"abstract":"<p><strong>Background: </strong>Nintedanib reduces the decline of pulmonary function in patients with advancing lung fibrosis.</p><p><strong>Aim: </strong>To assess the characteristics of the patients with connective tissue diseases (CTDs) related to interstitial lung disease (ILD) under nintedanib treatment.</p><p><strong>Methods: </strong>The CTD-related ILD patients under nintedanib treatment who were followed up between 2020 and 2023 were included in the study. The clinical data of the patients before and after nintedanib were evaluated retrospectively.</p><p><strong>Results: </strong>There were 36 patients (19 female) with a mean age of 65.2 ± 8.5 years who were treated with nintedanib. The median duration for nintedanib treatment was 19 months. The most common CTD was Sjogren's syndrome (36.1%), followed by systemic sclerosis (27.8%), rheumatoid arthritis (25%), undifferentiated CTD (8.3%), and inflammatory myositis (2.8%). Fifteen (41.7%) patients had impaired pulmonary function tests (FVC < 70 ml and/or DLco < 80 ml), and 23 (63.9%) patients had ≥ 20% involvement of parenchyma in high-resolution computed tomography (HRCT) before nintedanib. According to HRCT findings, 25 (69.4%) patients had the usual interstitial pneumonia pattern. All patients had 300 mg/day of nintedanib and received at least one immunosuppressive treatment during the study period. The mean %predicted value of FVC was 82.8 ± 17.6, and DLco was 65.3 ± 19.2 before nintedanib treatment. Following the 6-month follow-up, FVC showed an increase to 92.3 ± 15.8 (with an R correlation coefficient of 0.54, p = 0.025), and 22 (61.1%) patients exhibited either stabilization or regression of findings on HRCT.</p><p><strong>Conclusions: </strong>Nintedanib emerges as a promising therapeutic agent compatible with immunosuppressives for treating progressive lung fibrosis in patients with CTD-related ILD.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications in interventional radiology: early detection and effective intervention strategies.","authors":"Hugo C Temperley, Annabel Hylands, Niall J O'Sullivan, Benjamin M Mac Curtain, Tatiana S Temperley, Caitlin Waters, Niall McEniff, Ian Brennan, Kevin Sheahan","doi":"10.1007/s11845-024-03845-9","DOIUrl":"https://doi.org/10.1007/s11845-024-03845-9","url":null,"abstract":"<p><p>This narrative review provides a comprehensive overview of complications in interventional radiology (IR), focusing on their aetiology, recognition, and management. As IR procedures continue to evolve and expand, understanding potential adverse events is crucial for improving patient safety and outcomes. The review will summarise various common complications associated with IR-based procedures, including their presentation, aetiology, and management. By consolidating current knowledge on these issues, the review offers valuable insights into minimising risks and enhancing procedural success. This synthesis will aid practitioners' knowledge and ultimately try and ensure safer IR practices and aftercare of patients.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute kidney injury and COVID-19: the predictive power of BUN/albumin ratio for renal replacement therapy requirement.","authors":"Selen Acehan","doi":"10.1007/s11845-024-03772-9","DOIUrl":"10.1007/s11845-024-03772-9","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the predictive power of the BUN/albumin ratio (BAR) measured in the emergency department (ED) for the requirement of renal replacement therapy (RRT) in patients admitted to the intensive care unit (ICU) with severe COVID-19 pneumonia and acute kidney injury (AKI).</p><p><strong>Materials and methods: </strong>The study included 117 patients with AKI who were admitted to the ICU and had COVID-19 pneumonia detected on chest computed tomography (CT) taken in the ED's pandemic area between November 1, 2020, and June 1, 2021. The predictive power of laboratory values measured at the time of ED admission for the requirement of RRT was analyzed.</p><p><strong>Results: </strong>Of the patients, 59.8% (n = 70) were male, with an average age of 71.7 ± 14.8 years. The mortality rate of the study was 35% (n = 41). During follow-up, 23.9% (n = 28) of the patients required RRT. Laboratory parameters measured at the time of ED admission showed that patients who required RRT had significantly higher BAR, BUN, and creatinine levels, and significantly lower albumin levels (all p < 0.001). ROC analysis to determine the predictive characteristics for RRT requirement revealed that the BAR had the highest AUC value (AUC, 0.885; 95% CI 0.825-0.945; p < 0.001). According to the study data, for BAR, a cut-off value of 1.7 resulted in a sensitivity of 96.4% and a specificity of 71.9%.</p><p><strong>Conclusion: </strong>In patients with severe pneumonia who develop acute kidney injury, the BUN/albumin ratio may guide clinicians early in predicting the need for renal replacement therapy.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"3015-3023"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and practice of foot self-care behaviours in Irish diabetes patients with high-risk feet.","authors":"Abdulmajeed Algethami, Mohamad Mustafa, Michael Lockhart, Lauren Reilly, Emma McKearney, Kelly Fortune, Najia Siddique, Tommy Kyaw-Tun, Seamus Sreenan, John Hubert McDermott","doi":"10.1007/s11845-024-03807-1","DOIUrl":"10.1007/s11845-024-03807-1","url":null,"abstract":"<p><strong>Background: </strong>Diabetic foot disease is associated with significant morbidity and mortality. Patients at high risk of developing diabetic foot disease can reduce their risk, however, by practicing appropriate foot self-care behaviours. Despite this fact, and often despite education regarding appropriate foot care, patients frequently engage in risky foot care practices which place them at risk of foot ulceration.</p><p><strong>Aim: </strong>We aimed to assess knowledge of appropriate foot care behaviours in a cohort of Irish patients at high risk of developing diabetic foot disease attending a multidisciplinary foot clinic, and to assess foot self-care practice. We also aimed to determine predictors for suboptimal self-care behaviour.</p><p><strong>Design: </strong>A questionnaire-based cohort study.</p><p><strong>Methods: </strong>A multi-aspect questionnaire was designed by the diabetes foot care team, based on the principles of good foot care and the education provided to patients attending the diabetes podiatry clinic.</p><p><strong>Results: </strong>One hundred forty-three participants with high-risk feet completed a questionnaire exploring foot care knowledge and practice. The responses revealed suboptimal foot care knowledge and practice. Participants frequently engaged in risky foot care practices, and were unable to consistently identify appropriate footwear for high-risk feet. Predictors of good foot care included a history of prior ulceration, podiatry attendance, microvascular complications of diabetes, and longer duration of diabetes.</p><p><strong>Conclusion: </strong>In this cohort of Irish patients with high-risk feet, foot care knowledge and practice varied widely. Participants frequently engaged in high-risk behaviours despite prior education. Improved strategies to impart diabetic foot care advice to patients with diabetes and high-risk feet are urgently required.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2791-2796"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and risk factors for chronic pain following primary total knee arthroplasty in an irish surgical population.","authors":"Aoife O'Brien-Horgan, Emma Woodhouse, Stephen Mannion","doi":"10.1007/s11845-024-03817-z","DOIUrl":"10.1007/s11845-024-03817-z","url":null,"abstract":"<p><strong>Objectives: </strong>To identify the incidence and characteristics of chronic post-surgical pain (CPSP) following total knee arthroplasty and determine peri-operative influencing factors.</p><p><strong>Methods: </strong>A representative, retrospective random sample was taken of patients who underwent total knee arthroplasty in the South Infirmary University Hospital Cork for an 18-month period. Two hundred fourteen patient charts were reviewed out of a total of 507 charts for that period to provide a 90% confidence interval.</p><p><strong>Results: </strong>The incidence of CPSP in an Irish population 6 months after total knee arthroplasty was found to be 36.5%. The following factors were found to be statistically significant with respect to the incidence of CPSP: female sex, lack of multimodal analgesia (consisting of paracetamol, NSAID, and opioids), general anaesthesia, and lower Oxford Knee Scores at 6 months post-surgery. Age, the knee operated on, ASA grade, or greatest acuity pain, were not found to be statistically significant factors in the development of CPSP.</p><p><strong>Conclusions: </strong>CPSP is common after total knee arthroplasty with an incidence of 36.5% at 6 months post procedure. Female sex, lack of multimodal analgesia, and lower Oxford Knee Scores were associated with increased CPSP.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2983-2988"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal weight-based epinephrine dosing for patients with a low likelihood of survival following out-of-hospital cardiac arrest.","authors":"Michael W Hubble, Stephen Taylor, Melisa Martin, Sara Houston, Ginny R Kaplan","doi":"10.1007/s11845-024-03797-0","DOIUrl":"10.1007/s11845-024-03797-0","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac arrest patients presenting with non-shockable rhythms have a low probability of survival, and epinephrine is one of the few pharmaceutical options for this group. The recommended 1.0 mg adult dose is extrapolated from early animal studies and lacks adjustment for patient weight. Although several prior studies have investigated \"low-\" and \"high-\" dose epinephrine, none have identified a benefit to either strategy.</p><p><strong>Aims: </strong>To identify an optimal weight-based epinephrine dose for return-of-spontaneous-circulation (ROSC) after a single bolus among patients with low likelihood of survival.</p><p><strong>Methods: </strong>Included were adult patients who experienced a witnessed, non-traumatic out-of-hospital cardiac arrest prior to EMS arrival. Patients with shockable presenting rhythms or receiving bystander CPR were excluded. The AUROC was used to assess the predictive value of epinephrine dose (mg/kg) for ROSC following a single bolus. From the ROC curve, the optimal threshold dosage (OTD) was determined using the Youden Index. A logistic regression model calculated the adjusted odds ratio of OTD on ROSC.</p><p><strong>Results: </strong>A total of 2,463 patients met inclusion criteria, of which 190 (7.7%) attained ROSC after the first epinephrine administration. The dosage AUROC for ROSC was 0.603 (p < 0.01). As calculated by the Youden index, the OTD was 0.013 mg/kg. Patients receiving ≥ OTD were more likely to attain ROSC after a single epinephrine bolus (OR = 2.25,p < 0.001).</p><p><strong>Conclusions: </strong>Among patients with a low likelihood of survival, the optimal dose of epinephrine for attaining ROSC with a single bolus of epinephrine was 0.013 mg/kg. These findings should inspire further investigation into optimal dosing strategies for epinephrine.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2713-2721"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular diagnosis of Alpha-sarcoglycanopathies by NGS in seven Moroccan families and report of two novel variants.","authors":"Yasmina Rahmuni, Youssef El Kadiri, Jaber Lyahyai, Abdelaziz Sefiani, Ilham Ratbi","doi":"10.1007/s11845-024-03792-5","DOIUrl":"10.1007/s11845-024-03792-5","url":null,"abstract":"<p><strong>Background: </strong>Limb-girdle muscular dystrophies constitute a heterogeneous group of neuromuscular diseases, both clinically and genetically. Limb-girdle muscular dystrophy by alpha-sarcoglycan deficiency or LGMD R3 α-sarcoglycan-related is a subtype of the autosomal recessive sarcoglycanopathies caused by variants in the alpha-sarcoglycan gene (SGCA) at 17q21.33. It appears in childhood by progressive weakness of pelvic and/or scapular girdle muscles and calf hypertrophy, with a wide range of clinical inter- and intra-familial clinical variability.</p><p><strong>Aims: </strong>Our report extends the molecular spectrum of SGCA gene with the identification of variant disease causing and will help for better management of patients and genetic counseling of families.</p><p><strong>Methods: </strong>In our study, seven unrelated families presented a clinical and paraclinical picture consistent with alpha-sarcoglycanopathy. A molecular study using Next-Generation Sequencing (NGS) was carried out on them.</p><p><strong>Results: </strong>Six different homozygous variants of the SGCA gene were identified in the patients analyzed, including four previously reported variants and two novel variants predicted to be deleterious by the prediction tools.</p><p><strong>Conclusions: </strong>Our results expand the spectrum of variants in Moroccan patients with sarcoglycanopathy, specifically LGMDR3, most importantly as this form is not common in the Moroccan population.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"3071-3076"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injury incidence in golf-a systematic review and meta-analysis.","authors":"Ilari Kuitunen, Ville T Ponkilainen","doi":"10.1007/s11845-024-03759-6","DOIUrl":"10.1007/s11845-024-03759-6","url":null,"abstract":"<p><strong>Objective: </strong>There is a lack of comprehensive analysis of injuries in golf per exposure time. Thus, the aim was to report the pooled incidence of injuries in golf.</p><p><strong>Methods: </strong>We searched PubMed, Scopus, SPORTDiscus, and Web of Science databases in March 2024 for this systematic review and meta-analysis. We included observational studies reporting the number of injuries per exposure time. A random-effects model was used to calculate the pooled injury incidence per 1000 athlete exposures (18 holes of golf) with 95% confidence intervals (CI). Incidences were separately analyzed for men, women, amateurs, professionals, and special athletes.</p><p><strong>Results: </strong>A total of 999 studies were screened, 29 full texts were assessed, and 7 studies with 269,754 athlete exposures were included. Seven studies assessed the overall incidence of injury, and the pooled estimate was 2.5 per 1000 athlete exposures (CI 0.9-7.5). The incidence was higher in special athletes (21.0, CI 7.7-45.1; one study) than among professionals (8.5, CI 7.6-9.4; one study), or in amateurs (1.3, CI 0.5-4.0; five studies). The injury incidence was 2.6 per 1000 athlete exposures (CI 0.7-9.6; four studies) in women and 1.4 per 1000 athlete exposures (CI 0.4-5.2; three studies) in men. A sensitivity analysis without special athletes had an incidence of 1.9 (CI 0.7-4.9; six studies).</p><p><strong>Conclusion: </strong>The injury incidence in golf is 2.5 injuries per 1000 athlete exposures (18 holes of golf). Reporting was limited as only one study reported injuries per exposure time in professionals, and in total, only seven studies were found. More research is needed in all levels and age groups to better estimate the injury incidence and associated risk factors in golf.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2803-2811"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of glenohumeral bone loss on range of motion in patients with anterior shoulder instability.","authors":"Mohamed Gaafar, Tom R Doyle, Julia K Frank, Eoghan T Hurley, Martin S Davey, Ailbhe White-Gibson, Sami Khan, Hannan Mullett","doi":"10.1007/s11845-024-03765-8","DOIUrl":"10.1007/s11845-024-03765-8","url":null,"abstract":"<p><strong>Background: </strong>Loss of shoulder range of motion (ROM) is common after surgical management of anterior shoulder instability; however, it remains unclear to what degree this is related to their injury.</p><p><strong>Aim: </strong>The purpose of this study was to compare passive shoulder ROM in patients with ASI to a normal contralateral shoulder.</p><p><strong>Methods: </strong>A total of 121 patients undergoing stabilization surgery were prospectively enrolled. Preoperative advanced imaging was used to assess for glenoid bone loss and the presence of off-track Hill-Sachs lesions. Passive ROM was measured in both shoulders while under anaesthesia prior to surgery.</p><p><strong>Results: </strong>In all directions, there was a significant loss of ROM in shoulders with instability. Regression analysis showed that neither a glenoid bone defect nor greater glenoid bone loss were associated with a loss of ROM in any plane. The presence of a Hill-Sachs lesion was significantly associated with a loss of external rotation, while off-track lesions were associated with a loss of ROM in all planes (p < 0.05).</p><p><strong>Conclusion: </strong>Patients with anterior shoulder instability lost motion in all directions, with a profound loss of external rotation. The presence of a glenoid bone defect nor greater bone loss did not reliably predict a loss of range of motion. A Hill-Sachs lesion was predictive of a loss of external rotation, while an off-track lesion was predictive of a loss of range in all directions.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2813-2818"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of patients with adrenal myelolipoma: experience from a tertiary referral centre.","authors":"Anant Paul, Conor Toale, Marie Egan, Maria Whelan, John Feeney, Stephen Crowther, James Gibney, Kevin Conlon","doi":"10.1007/s11845-024-03779-2","DOIUrl":"10.1007/s11845-024-03779-2","url":null,"abstract":"<p><strong>Background: </strong>Adrenal myelolipomas are rare, benign, tumours of the adrenal cortex.</p><p><strong>Aims: </strong>This study reports the experience of a tertiary adrenal surgery referral centre's approach to the management of patients with adrenal myelolipoma.</p><p><strong>Methods: </strong>A retrospective observational cohort study was conducted on all adult patients (> 18 years age) diagnosed with adrenal myelolipoma from January 1, 2014, to December 30, 2022. Demographics, imaging characteristics, histological diagnosis (where applicable) and follow-up data were compared between patients undergoing surgery and those referred to surveillance. Indications for operative intervention were recorded at the time of multidisciplinary team discussion, consisting of surgeons, endocrinology physicians, radiologists, pathologists and specialist nursing representatives.</p><p><strong>Results: </strong>Of the 522 patients with an adrenal lesion discussed in adrenal tumour meeting between 2014 and 2022, n = 15 (2.8%) were diagnosed with adrenal myelolipoma. Of the 15 patients, 4 underwent adrenalectomy at first presentation (27%), while 1 patient underwent adrenalectomy after interval follow-up. Indications for operative intervention were as follows: 'indeterminate lesion' (n = 3), 'abdominal pain and size (> 4 cm)' (n = 1) and 'mass effect on adjacent organs' (n = 1). The mean rate of lesion growth in patients referred for surveillance (n = 10) was 0.13 cm/year. Histology confirmed adrenal myelolipoma as the diagnosis in all resected tumours.</p><p><strong>Conclusions: </strong>For patients with adrenal myelolipoma, the presence of symptoms and/or indeterminate features on imaging may be more clinically useful indications for operative intervention over size alone. The surveillance of adrenal myelolipomas, even in patients with adrenal lesions > 4 cm, is a safe clinical strategy, provided the imaging characteristics are benign and patients remain asymptomatic.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2941-2947"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}