Journal of Clinical Medicine最新文献

{"title":"The Paradox of Physical Activity and Coronary Artery Calcification: Implications for Cardiovascular Risk.","authors":"Da-Eun Sung, Ki-Chul Sung","doi":"10.3390/jcm13216523","DOIUrl":"10.3390/jcm13216523","url":null,"abstract":"<p><p>The introduction of CT scans and the subsequent Agatston score in the 1990s drastically improved our ability to detect coronary artery calcification (CAC). This led to its incorporation into cardiovascular risk assessment guidelines set forth by organizations such as the American Heart Association (AHA) and the American College of Cardiology (ACC). Over time, these guidelines have evolved significantly, reflecting an increasing understanding of CAC. Physical activity has become a key factor in the management of cardiovascular disease. However, the relationship between physical activity and CAC remains complex. Although physical activity is generally beneficial for cardiovascular health, paradoxically, high levels of physical activity have been associated with elevated CAC scores. However, these higher CAC levels may indicate the presence of more stable, calcified plaques that provide protection against plaque rupture. These contradictory findings call for balanced interpretations that acknowledge the cardiovascular benefits of physical activity. This review examines the historical development of clinical guidelines for CAC, the paradoxical relationship between physical activity and CAC, and potential underlying mechanisms. It emphasizes the need for future research to utilize objective measures and consistent methodologies to better understand the relationship between physical activity and CAC.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 21","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11547064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621762","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":"Effectiveness and Safety of GLP-1 Receptor Agonists in Patients with Type 1 Diabetes.","authors":"Sumaya N Almohareb, Osamah M Alfayez, Shoroq S Aljuaid, Walaa A Alshahrani, Ghalia Bakhsh, Mohammed K Alshammari, Majed S Al Yami, Omar A Alshaya, Abdullah S Alomran, Ghazwa B Korayem, Omar A Almohammed","doi":"10.3390/jcm13216532","DOIUrl":"10.3390/jcm13216532","url":null,"abstract":"<p><p><b>Background</b>: GLP-1 receptor agonists (GLP-1RA) are used in the management of type II diabetes mellitus or obesity, although its role in patients with type I diabetes mellitus (T1DM) has been debated. This study aimed to investigate the efficacy and safety of GLP-1RA in patients with T1DM using real-world data. <b>Methods</b>: This multicenter, retrospective study was conducted at three tertiary medical centers in Riyadh, Saudi Arabia. The study followed up patients (>16 years old) with T1DM treated with insulin followed by GLP-1RA add-on therapy. The efficacy outcomes included changes in HbA1c, body weight, and insulin requirements from baseline to each follow-up visit. The main safety outcomes assessed included hypoglycemic events and gastrointestinal (GI) adverse events. <b>Results</b>: The study included 144 patients with a mean age of 33.0 ± 10.1 years. Semaglutide was the most used GLP-1RA (63.9%) followed by liraglutide (34.0%). From baseline to 3-month follow-up, HbA1c (mean difference (MD) = -0.8%; <i>p</i> = 0.0053), weight (MD = -2.4 kg; <i>p</i> = 0.0253), and daily basal insulin dose (MD = -2.1 units; <i>p</i> = 0.0349) were significantly reduced. Likewise, HbA1c (MD = -0.5%; <i>p</i> = 0.0004), weight (MD = -3.6 kg; <i>p</i> < 0.0001), and daily basal insulin (MD = -2.4 units; <i>p</i> = 0.0282) were significantly reduced at the 4-6-month follow-up. The significant reductions in HbA1c, weight, and daily basal insulin levels were consistent for up to 18-month follow-up. Only one patient had a major hypoglycemic event, whereas 8.3% of the patients had GI adverse events. <b>Conclusions</b>: Overall, significant improvements in glycemic control, weight loss, and insulin requirements were observed with the use of GLP-1RA in patients with T1DM, with a limited number of GI adverse events.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 21","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621559","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":"Changing Epidemiology and Outcomes of Hemolytic Uremic Syndrome in Children: A Prospective National Cohort Study from the Polish Pediatric HUS Registry and the Polish Registry of Renal Replacement Therapy in Children.","authors":"Ilona Zagożdżon, Maria Szczepańska, Beata Leszczyńska, Wioleta Jarmużek, Monika Miklaszewska, Marcin Tkaczyk, Anna Medyńska, Anna Wieczorkiewicz-Płaza, Jacek Zachwieja, Piotr Protas, Paulina Rosińska, Urszula Jacher, Elżbieta Trembecka-Dubel, Danuta Zwolińska, Aleksandra Żurowska","doi":"10.3390/jcm13216499","DOIUrl":"10.3390/jcm13216499","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Hemolytic uremic syndrome (HUS) is a known cause of acute kidney injury in children, but there are few recent reports on its epidemiology and outcome. We aimed to investigate trends in the incidence and the long-term outcomes of both Shiga toxin-producing <i>Escherichia coli</i> -HUS (STEC-HUS) and atypical HUS (aHUS) in Poland over the last 12 years (2012-2023), based on the Polish Pediatric HUS and Pediatric Renal Replacement Therapy (RRT) Registries. <b>Methods</b>: A total of 436 patients (301 with STEC-HUS and 135 with aHUS) were included. <b>Results</b>: The incidence of STEC-HUS increased during the observation period, with a mean of 3.9 cases per million age-related population (marp). The incidence of aHUS was relatively constant with a mean of 1.8/marp. The majority of patients fully recovered, although kidney sequelae were observed at 5-year follow-ups in 31% of children with STEC-HUS, 57% of aHUS subjects in the pre-eculizumab era, and 37% of aHUS subjects who had received eculizumab. The overall mortality rate was 2% for STEC-HUS and 3.7% for aHUS, with no deaths reported in children on eculizumab and mortality mainly attributed to neurological damage. A decreasing incidence of chronic kidney disease stage 5 (CKD5) due to HUS was observed. <b>Conclusions</b>: Despite an unchanging incidence of aHUS and an increasing incidence of STEC-HUS, the kidney outcomes of both diseases have improved significantly over the last 12 years. Mortality from HUS has dropped due to improved symptomatic treatment and the introduction of anti-C5 therapy. The development of CKD5 in childhood as a consequence of HUS has become exceptional.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 21","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621578","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 Comparative Effectiveness of Potent P2Y12 Inhibitors Versus Clopidogrel in Patients with Acute Myocardial Infarction Undergoing PCI: National Registry Data.","authors":"Réka Aliz Lukács, Dániel Tornyos, Péter Kupó, András Jánosi, András Komócsi","doi":"10.3390/jcm13216536","DOIUrl":"10.3390/jcm13216536","url":null,"abstract":"<p><p>Dual antiplatelet therapy (DAPT), which is essential in AMI management, combines aspirin with a P2Y12 receptor antagonist. This study compared the effectiveness of potent P2Y12 inhibitors versus clopidogrel in AMI patients treated with percutaneous coronary intervention (PCI). <b>Methods:</b> 65,986 AMI patients included in a nationwide prospective registry who underwent PCI and received DAPT were studied. In total, 9,014 patients received potent P2Y12 inhibitors, and 56,074 received clopidogrel. This study focused on mortality, recurrent myocardial infarction, stroke, repeat revascularization, and major adverse cardiovascular events (MACE) over seven years. The analysis utilized unadjusted models and inverse probability of treatment weighting (IPTW) to compare prognosis, and decision curve analyses were constructed to aid clinical decision making. <b>Results:</b> Potent P2Y12 inhibitors significantly reduced mortality risk (unadjusted hazard ratio (HR): 0.58; IPTW HR: 0.68) and MACE (unadjusted HR: 0.66; IPTW HR: 0.78). Diabetic patients showed greater benefits (HR:0.45). In patients at high bleeding risk, the mortality rate was 13% (HR: 0.87, <i>p</i> = 0.08). For patients aged 75-79, the HR for mortality was 0.82, whereas for those aged >80 years, it was 0.79, indicating significant mortality risk reduction. Similar trends were observed for MACE. <b>Conclusion:</b> This study demonstrated that potent P2Y12 inhibitors are more effective than clopidogrel in reducing mortality and MACE in patients with AMI and underscored their potential role in improving outcomes across diverse patient subgroups. The trend was consistent even during the COVID-19 pandemic. These findings highlight the need for personalized DAPT strategies, particularly for high-bleeding-risk patients, and challenge current guidelines favoring clopidogrel use in older patients.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 21","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621585","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":"From Data Integration to Precision Medicine: A Value-Based Healthcare Approach for Sarcoma Care.","authors":"Bruno Fuchs, Philip Heesen","doi":"10.3390/jcm13216500","DOIUrl":"10.3390/jcm13216500","url":null,"abstract":"<p><p>The transformation of healthcare from a fee-for-service model to value-based care is particularly crucial in managing complex and rare diseases like sarcoma, where data fragmentation and variability present significant challenges. This manuscript reviews strategies for structured and harmonized data integration-a critical precursor to precision medicine in sarcoma care. We demonstrate how standardizing data formats, ontologies, and coding systems enable seamless integration of clinical, economic, and patient-reported outcomes across institutions, paving the way for comprehensive predictive analytics. By establishing robust value-based healthcare (VBHC) frameworks through digital transformation and predictive models, including digital twins, we create the foundation for personalized sarcoma treatment and real-world-time clinical decision-making. The manuscript also addresses practical challenges, including the need for system standardization, overcoming regulatory and privacy concerns, and managing high costs. We propose actionable strategies to overcome these barriers and discuss the role of advanced analytics and future research directions that further enhance VBHC and precision medicine. This work outlines the necessary steps to build a cohesive, data-driven approach that supports the transition to precision medicine, fundamentally improving outcomes for sarcoma patients.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 21","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621617","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":"Staging Accuracy and Prognostic Value of Prostate-Specific Membrane Antigen PET/CT Strongly Depends on Lymph Node Tumor Burden.","authors":"Oktay Özman, Hans Veerman, Roberto Contieri, Matteo Droghetti, Maarten L Donswijk, Marinus J Hagens, Pim J Van Leeuwen, André N Vis, Henk G van der Poel","doi":"10.3390/jcm13216534","DOIUrl":"10.3390/jcm13216534","url":null,"abstract":"<p><p><b>Objectives</b>: To explore the factors affecting the lymph node metastasis (LNM) detection performance of prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) and to evaluate its prognostic value for biochemical recurrence after radical prostatectomy (RP). <b>Methods</b>: Patients who had intermediate- or high-risk prostate cancer and underwent robot-assisted (RA)RP between 2017 and 2021 were included. Initial lymph node staging was carried out using PSMA PET/CT. Sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values were calculated. A cut-off value for LNM tumor deposit size that maximizes specificity was investigated and a post hoc specificity analysis was carried out. In survival analysis for biochemical progression-free survival (bPFS) after RP, Kaplan-Meier curves of molecular imaging (mi)N0 and miN1 patients were compared using the log-rank test and separate Cox regression models were developed to reveal the significance of PSMA PET/CT staging in pre- and post-surgery settings. <b>Results</b>: In 583 patients with a prevalence of pathology-proven LNM of 27.4%, overall sensitivity, specificity, PPV, and NPV of PSMA PET/CT per patient were 26.3% [95%CI 18.9-35.5], 93.9% [95%CI 84.9-100], 61.8% [95%CI 44.5-83.5], and 77.1% [95%CI 69.7-85.1], respectively. PSMA PET/CT showed a better sensitivity as LNM tumor deposit size increased (<i>p</i> = 0.003 OR 2.4 [95%CI 1.3-4.4]) and a better specificity in pT3-4 tumors (96.1%) versus pT2 (91.1%, <i>p</i> = 0.024 OR 2.7 [95%CI 1.1-6.3]). After adjustment according to 5.5 mm LNM tumor deposit size, which showed the best discriminative performance (AUC: 0.905 [95%CI 0.804-1.000, <i>p</i> < 0.001]), overall sensitivity tripled (90.2%, <i>p</i> < 0.001). The 1-year bPFS was 56.0% and 83.3% for miN1 and miN0 patients, respectively (<i>p</i> < 0.001). Whereas miN0pN1 was not, miN1pN1 disease was independently associated with decreased bPFS (HR:2.1 95%CI 1.3-3.4, <i>p</i> < 0.001). <b>Conclusions</b>: PSMA PET/CT has a lymph node tumor burden-dependent and cohort-driven diagnostic ability but consequently a strong independent prognostic value for predicting biochemical recurrence after RARP.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 21","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11547063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621632","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 Characteristics and Treatment Courses of Trauma-Induced Thrombotic Microangiopathy: A Retrospective Study.","authors":"Suyeong Hwang, Gun Woo Kim, Sung Hoon Cho, Kyoung Hoon Lim","doi":"10.3390/jcm13216527","DOIUrl":"10.3390/jcm13216527","url":null,"abstract":"<p><p><b>Introduction:</b> Thrombotic microangiopathy (TMA), defined by thrombocytopenia, microangiopathic hemolytic anemia, and organ injury, is not widely recognized as being trauma-related. This study aimed to describe the clinical features and outcomes of trauma-induced TMA (t-TMA) to assist in early diagnosis and management. <b>Methods:</b> A retrospective review was conducted on 30 trauma patients diagnosed with t-TMA between 2014 and 2019. Demographic, clinical, and laboratory data, as well as treatment methods, were analyzed. <b>Results:</b> Thrombocytopenia (<50,000/µL) occurred, on average, 2.9 days post-trauma, with diagnosis following 3.6 days later. Patients had a mean age of 67.6 years, and 63.3% were male. Clinical presentations included acute kidney injury (AKI) requiring renal replacement therapy (86.7%), altered mental status (53.3%), non-infectious fever (50%), and digital necrosis (43.3%). Eighteen patients were treated with therapeutic plasma exchange (TPE) alone, nine with TPE and methylprednisolone, and three with methylprednisolone alone. Remission was achieved in 96.7% of all cases. The mean TPE duration was 6.1 days, prolonged by prior platelet transfusions. The mortality rate was 26.7% (8/30), with sepsis being the most common cause of death (five patients), particularly for those treated with TPE and methylprednisolone. <b>Conclusions:</b> Trauma-induced TMA should be suspected in trauma patients presenting with unexplained thrombocytopenia, AKI, and elevated LDH. Early diagnosis and prompt treatment are crucial, while unnecessary platelet transfusions should be avoided. Careful infection management is critical to improving patient outcomes, particularly if patients are treated with TPE and methylprednisolone.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 21","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11547120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621633","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":"Transcatheter Repair of Tricuspid Valve Regurgitation: A Systematic Review.","authors":"Aswin Srinivasan, Jonathan Brown, Alexander Rhodes, Sobia Khan, Viswanath Chinta, Pranav Loyalka, Arnav Kumar","doi":"10.3390/jcm13216531","DOIUrl":"10.3390/jcm13216531","url":null,"abstract":"<p><p><b>Introduction:</b> Clinically significant severe tricuspid regurgitation (TR) is a common untreated pathology associated with increased mortality. Even though surgical valve replacement has been the mainstay option, transcatheter intervention is a novel and potentially effective tool. To the best of our knowledge, this is the first systematic review that assessed and compared clinical and echocardiographic outcomes of coaptation and annuloplasty devices in patients with clinically significant TR. <b>Methods:</b> PubMed, the Cochrane Central Register of Controlled Trials, and EMBASE were searched for articles published from August 2016 until February 2023. Primary endpoints were technical and procedural successes. Secondary endpoints were TR grade, NYHA, change in 6 min walk distance (6MWD), and echocardiographic parameters at 30-day follow-up. <b>Results:</b> We included thirty-eight studies consisting of 2273 patients with severe symptomatic TR (NYHA III-IV 77% and severe/massive/torrential TR 83.3%) and high surgical risk (mean EUROSCORE of 7.54). The technical success for the annuloplasty devices was 96.7% and for the coaptation device was 94.8%. The procedural success for the annuloplasty devices was 64.6% and for the coaptation device was 81.4%. The 6MWD increased by 17 m for the coaptation devices and increased by 44 m after 30 days for the annuloplasty devices. A reduction in TR grade to <2 was seen in 70% of patients with coaptation and 59% of patients with annuloplasty devices. <b>Conclusions:</b> Transcatheter tricuspid valve intervention appears to be feasible and is associated with favorable outcomes.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 21","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635741","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":"Aortic Stent Graft Treatment in a Medium-Size Aortic Center Performed by a Cardiac Surgeon Only-The 9 Years Experience in Poland.","authors":"Marian Burysz, Jakub Batko, Krzysztof Greberski, Artur Słomka, Radosław Litwinowicz","doi":"10.3390/jcm13216517","DOIUrl":"10.3390/jcm13216517","url":null,"abstract":"<p><p><b>Background</b>: The incidence of thoracic aortic aneurysms is estimated at 3.0-8.3/100,000 persons per year. There is a lack of reports in the literature on the outcomes of small- and medium-sized thoracic endovascular aortic repairs. The aim of this study is to present the results of thoracic endovascular aortic repairs at a single medium-sized center performed exclusively by a cardiac surgeon. <b>Methods</b>: Ninety patients who had undergone aortic stent graft implantations for the treatment of thoracic aortic anomalies were comprehensively, retrospectively evaluated. The detailed preoperative, surgical, and postoperative parameters of the patients, including the survival rate up to five years, were recorded and further analyzed. <b>Results</b>: The patients' Euroscores were four (2.1-9). The 30-day mortality rate was 8.9%, the 1-year mortality rate was 15.6%, and the 5-year mortality rate was 38.9% for all causes. Postoperative complications were observed in 10% of the patients. Statistically significant differences were observed between the urgency of surgery at 30 days and survival at one year, but not at five years. The most common complications were related to respiratory (4.4%), renal (3.3%), and neurological (3.3%) dysfunction. <b>Conclusions</b>: Thoracic endovascular aortic repair can be safely performed in small- and medium-sized centers with optimal long-term results.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 21","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621205","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":"A Retrospective Analysis of Emergency Versus Elective Surgical Outcomes in Colon Cancer Patients: A Single-Center Study.","authors":"Roxana Loriana Negruț, Adrian Coțe, Adrian Marius Maghiar","doi":"10.3390/jcm13216533","DOIUrl":"10.3390/jcm13216533","url":null,"abstract":"<p><p><b>Introduction:</b> Emergency surgical interventions for colon cancer are often associated with poorer outcomes compared to elective surgeries due to the advanced state of the disease and the urgency of intervention. This retrospective study aimed to evaluate the management of emergency management of colon cancer and to evaluate differences in patient outcomes. Conducted at a single surgical emergency center, the study analyzed 182 cases, focusing on demographics, tumor characteristics, surgical methods and patient outcomes. <b>Material and Methods:</b> A retrospective observational study was conducted, involving 182 cases who underwent surgery for colon cancer in a single surgical emergency center. Data was collected from hospital records, encompassing demographic details, tumor characteristics, surgical intervention detail and outcomes, alongside with inflammatory profiles. Statistical analyses included descriptive statistics and <i>t</i>-tests with standard significance at <i>p</i> < 0.05. <b>Results:</b> The study showed that emergency cases had significantly poorer in-hospital survival rates (75.42%) compared to elective surgeries. Inflammatory markers such as Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio were higher in emergency cases, suggesting heightened systemic stress. Emergency surgery was also associated with a higher incidence of ostomy and postoperative complications. <b>Conclusions:</b> Emergency surgery for colon cancer is linked to more advanced tumors, increased physiological stress and lesser clinical outcomes. Early detection strategies and active targeted screening could reduce the need for emergency interventions. Future research should focus on early diagnosis protocols and enhancing public health strategies to minimize emergency presentations, thereby leading to better outcomes for colon cancer patients.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"13 21","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620635","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}