Journal of Clinical Medicine最新文献

{"title":"The Importance of Comorbidities at Baseline and 5-Year Follow-Up in a Lung Cancer Biomarker Screening Trial.","authors":"Nimue Lilith Romeikat, Frank Sullivan, Fergus Daly, Wenyan Kong","doi":"10.3390/jcm14062116","DOIUrl":"10.3390/jcm14062116","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Despite recent lung cancer screening (LCS) studies proving significant mortality reduction, comorbidities are a prominent issue affecting cost effectiveness, which is holding back national implementation. Incidental findings (IFs) of comorbidities make a significant contribution to delayed diagnoses and raise discussions about optimal management plans. This is particularly relevant to national lung cancer screening (NLCS), as the high-risk population qualifying for the screening often have increased likelihood for comorbidities due to their smoking history. <b>Methods</b>: The Early Detection of Cancer of the Lung Scotland (ECLS) (ClinicalTrials.gov identifier NCT01925625) study showcases a targeted approach to NLCS by implementing the blood-based biomarker EarlyCDT-Lung test. Firstly, this paper explored the ECLS dataset for comorbidities present within the screening population at baseline A chi-square analysis was then undertaken to investigate the relationship of cohort allocation and incidence of new comorbidities over the five-year follow-up period. <b>Results</b>: High prevalence conditions were cardiovascular (38.5%), neurological/psychiatric (33.9%), gastrointestinal (29.8%), and respiratory (19.2%). While 20.3% of the total patient cohort showed a newly discovered comorbidity, there was no significant variation in new incidences between the intervention and control cohort. <b>Conclusions</b>: When considering these results alongside the all-cause mortality reduction shown in previous analyses, they indicate that this targeted approach to LCS might help improve the benefit-harm ratio through the introduction of biomarkers. Further refining selection criteria for low-dose CT screening might contribute to minimising the risk of overdiagnosis and overtreatment.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719686","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":"Lumbar Muscle Fatty Infiltration and Atrophy in Patients with Low Back Pain and Degenerative Spinal Pathologies: A CT Imaging Study.","authors":"Tess Mardulyn, Arnaud Delafontaine, Patrice Jissendi, Laurent Fabeck","doi":"10.3390/jcm14062125","DOIUrl":"10.3390/jcm14062125","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Low back pain (LBP) may be related to intramuscular fatty infiltration (FI), the topography of which has been the subject of only a few studies. Our goal is therefore to determine the importance and topography of FI at the lumbar level and evaluate its correlation with LBP. <b>Methods:</b> We conducted a retrospective study and compared 254 LBP patients who underwent a lumbosacral CT scan with a sample of 115 healthy subjects, all classified into three age groups (≤35, 36-55, and >55 years old). In CT scan images from L2 to S1, muscle density (Hounsfield unit values ranging from -29 to +150), reflecting intramuscular FI, was measured. LBP was further divided into five subgroups of pathologies. <b>Results:</b> There was a significant difference in muscle density between the small and large circles at the L4/L5 and L5/S1 levels in LBP patients, which was not observed in the healthy subjects. In both LBP patients and healthy subjects, a decreasing density gradient was observed from L2 to S1, with a significant difference in density across age groups. LBP patients exhibit lower muscle densities compared to healthy subjects. <b>Conclusions:</b> In LBP patients, fatty infiltration (FI) of the paraspinal muscles is most pronounced in the lower lumbar region and appears to be localized at the level of muscle insertion. This localized muscle deficit differs from the age-related process of FI and may contribute to the development of LBP and discopathies.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719095","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":"Cognitive and Psychomotor Performance of Patients After Ischemic Stroke Undergoing Early and Late Rehabilitation.","authors":"Aleksander Korchut, Danuta Sternal, Sylwia Krzemińska, Ewa Marcisz-Dyla, Ewelina Bąk","doi":"10.3390/jcm14062122","DOIUrl":"10.3390/jcm14062122","url":null,"abstract":"<p><p><b>Objectives:</b> The aim of this study was to determine the performance of cognitive and psychomotor functions in patients after ischemic stroke, taking into account the effectiveness of early and late rehabilitation. <b>Methods:</b> The study included 86 patients with ischemic stroke hospitalized in the Neurological Rehabilitation Unit. The patients were divided into two groups according to the timing of rehabilitation, considering early rehabilitation which started within 30 days of hospital discharge (56 patients), and late rehabilitation which started after 30 days of hospital discharge (30 patients). Cognitive and psychomotor functions were measured in all the study patients using the Integrated System for the Measurement of Psychophysiological Variables called Polypsychograph, including tests assessing memory, attention, eye-hand coordination, and reaction speed. The measurements were repeated after 21 days of post-stroke rehabilitation. <b>Results:</b> Early rehabilitation led to significant improvements in most of the parameters studied, including memory, attention, speed of thinking, and precision of movement. Late rehabilitation was followed by an improvement in the results of the indicators studied to a lesser extent than the early rehabilitation. Improvements in temporal and qualitative parameters were observed in both groups of patients undergoing early and late rehabilitation. <b>Conclusions:</b> In patients after ischemic stroke, early rehabilitation improved cognitive and psychomotor performance to a greater extent than late rehabilitation.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719407","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":"Temperature Dynamics of Porcine and Human Lungs During Static Ice Storage: Ice Is Not 4 °C.","authors":"Ismail Cenik, Jan Van Slambrouck, Annalisa Barbarossa, Xin Jin, An-Lies Provoost, Pratik Patel, Lucas Churchill, Ben Bulka, John Haney, Laurens J Ceulemans","doi":"10.3390/jcm14062127","DOIUrl":"10.3390/jcm14062127","url":null,"abstract":"<p><p><b>Background</b>: Static ice storage (SIS) has long been accepted as the conventional lung preservation method, assuming to maintain 4 °C temperature. Although never directly confirmed by temperature measurements, this assumption has been widely accepted. We aimed to measure lung and preservation temperature with SIS in porcine experiments and clinical observations. <b>Methods</b>: Porcine lungs were preserved with SIS for 8 h (group I, <i>n</i> = 3) and 3 h followed by 10 °C storage (group II, <i>n</i> = 3). Tissue (tissueT°), first bag preservation solution (psT°) and second bag saline (salineT°) temperature were monitored. In clinical lungs (<i>n</i> = 4), psT° was monitored during SIS. Surface (surfaceT°) and core (coreT°) temperature were assessed before and after SIS (<i>n</i> = 62). <b>Results</b>: After 4 h in porcine lung group I, average tissueT° was 0.66 °C, psT° was 0.12 °C and salineT° was -0.02 °C. After 3 h in group II, average tissueT° was 1.90 °C, psT° was 0.57 °C and salineT° was 2.33 °C. In clinical observations, psT° was below 4 °C after 9-13 min and 0 °C after 78-267 min. After SIS, median surfaceT° was 1.25 °C (min-max; -3.2-9.2 °C) and coreT° was 1.45 °C (-0.4-4.8 °C). <b>Conclusions</b>: SIS leads to rapid temperature drops below 4 °C, approaching 0 °C within 2-4 h. The post-SIS lung temperature shows considerable variability and does not consistently remain at the commonly assumed 4 °C, posing potential freezing injury to donor lungs.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719787","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":"Evaluating Vaporized Cannabinoid Therapy in Multiple Sclerosis: Findings from a Prospective Single-Center Clinical Study.","authors":"Konstantina Stavrogianni, Dimitrios K Kitsos, Vasileios Giannopapas, Vassiliki Smyrni, Athanasios K Chasiotis, Alexandra Akrivaki, Evangelia-Makrina Dimitriadou, Christina Zompola, John S Tzartos, Georgios Tsivgoulis, Sotirios Giannopoulos","doi":"10.3390/jcm14062121","DOIUrl":"10.3390/jcm14062121","url":null,"abstract":"<p><p><b>Introduction:</b> Multiple Sclerosis (MS) is associated with a wide range of debilitating symptoms, and conventional therapies often fail to adequately address the disease's multifaceted challenges. Cannabidiol (CBD) 13.0% + Delta9-tetrahydrocannabinol (THC) 9.0% (CBD13/THC9), a vaporized cannabis-based medicinal product, presents a novel therapeutic option for managing MS symptoms. <b>Methods:</b> This single-center longitudinal study followed 69 MS patients over a six-month period. Participants were assessed at treatment initiation and at three- and six-month intervals. Key measures included muscle spasticity, urine bladder dysfunction, and the evaluation of disability progression rate. The evaluation included the Modified Ashworth Scale (MAS), the Post Void Residual (PVR) volume, and the Expanded Disability Status Scale (EDSS). <b>Results:</b> Significant improvement was observed across all outcome assessments. The EDSS score was decreased over time (<i>p</i> = 0.009), indicating a slight reduction in disability progression rate, while MAS scores showed substantial improvement in muscle spasticity (<i>p</i> < 0.001). Urine bladder function improved significantly, with PVR volume showing notable improvement between baseline and the six-month assessment (<i>p</i> < 0.001). Correlation analyses revealed that a gradual increase in vaporized CBD13/THC9 dose was correlated with slightly lower EDSS scores, while the adverse effects were negatively associated with the frequency of cannabinoid use. Finally, patients who were smokers used CBD13/THC9 more frequently. <b>Conclusions:</b> The vaporized CBD13/THC9 formulation demonstrated notable efficacy in slightly improving disability progression rate via reduction in muscle spasticity and urine bladder dysfunction in MS patients. This highlights its addon therapeutic value during rehabilitation in MS patients with debilitating disability symptoms.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719536","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":"An Atypical Presentation of Reticular Erythematous Mucinosis: A Case Report and Comprehensive Literature Review.","authors":"Beatrice Bălăceanu-Gurău, Cristina Violeta Tutunaru, Olguța Anca Orzan","doi":"10.3390/jcm14062131","DOIUrl":"10.3390/jcm14062131","url":null,"abstract":"<p><p>Reticular erythematous mucinosis (REM) is a rare form of primary cutaneous mucinosis, often linked to viral infections, inflammatory conditions, ultraviolet radiation, radiotherapy, malignant disorders, or an underlying immune dysfunction. It typically affects middle-aged women and manifests as symmetrical erythematous macules, papules, or plaques that exhibit a reticular and annular configuration, mainly on the midline of the thorax or dorsum. Although these regions represent the most prevalent sites, atypical occurrences have been noted. We report an unusual case of REM in a pediatric female patient with an ongoing history of B-cell acute lymphoblastic leukemia. The physical examination revealed an atypical distribution of REM lesions, symmetrically affecting the gluteal region and proximal thighs. Establishing a definitive diagnosis required a meticulous correlation between clinical, dermoscopic, and histopathologic findings. To our knowledge, this is the first documented case of REM in a patient with acute lymphoblastic leukemia. Our study underlines the importance of including REM in the differential diagnosis of persistent erythematous lesions, particularly in immunocompromised patients or those with a history of malignancy. Furthermore, we provide a comprehensive literature review, emphasizing the etiology, risk factors, pathogenetic mechanisms, diagnostic challenges, and different therapeutic options for REM.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719399","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":"Combined Surgically Induced Macular Detachment and Autologous Internal Limiting Membrane Transplantation for Refractory Full Thickness Macular Hole.","authors":"Rino Frisina, Laura Di Leo, Ilenia Gallo Afflitto, Andrea Vulpetti, Lorenzo Motta, Gabriella De Salvo","doi":"10.3390/jcm14062123","DOIUrl":"10.3390/jcm14062123","url":null,"abstract":"<p><p><b>Background/Objectives</b>: To propose a combined surgery of surgically induced macular detachment (MD) and autologous internal limiting membrane (ILM) transplantation to treat refractory full thickness macular holes (FTMHs). <b>Methods</b>: A series of patients affected by refractory FTMHs underwent a combined surgery. The following demographic and clinical data were collected: age, gender, eye, lens status, and best corrected visual acuity (BCVA). The tomographic pre- and post-operative parameters were the following: pre-operative FTMH diameter, refractory FTMH morphology (flat/with cuff), FTMH closure, foveal profile (regular/flat/inverted), flap displacement, and outer retinal layers restoration. <b>Results:</b> The study included a total of 14 pseudophakic eyes (14 patients). In all of the patients, surgical FTMH closure was reached. The mean BCVA improved after surgery from 1.1 ± 0.14 to 0.48 ± 03 logMAR (<i>p</i> < 0.0001). Statistical analysis demonstrated that the larger the FTMH, the poorer the post-operative gain in BCVA (<i>p</i> -0.5). The post-operative regular foveal profile was obtained in 50% of the eyes with a mean post-operative BCVA of 0.3 logMAR. A negative correlation between the time interval from diagnosis to surgery and post-operative BCVA gain was highlighted (<i>p</i> -0.8). <b>Conclusions</b>: The proposed combined surgical technique led to encouraging anatomical and functional results. Surgically induced MD increased the elasticity of the retina, and the free flap isolated the macular hole from the vitreous chamber favoring its closure.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719409","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":"Safety and Efficacy of Stem Cell Therapy in Ischemic Stroke: A Comprehensive Systematic Review and Meta-Analysis.","authors":"Abdulrahim Saleh Alrasheed, Tala Abdullah Aljahdali, Israa Aqeel Alghafli, Ghadeer Aqeel Alghafli, Majd Fouad Almuslim, Noor Mohammad AlMohish, Majed Mohammad Alabdali","doi":"10.3390/jcm14062118","DOIUrl":"10.3390/jcm14062118","url":null,"abstract":"<p><p><b>Background:</b> Although recent advancements in ischemic stroke management have reduced associated mortality rates, there remains a pressing need for more reliable, efficacious, and well-tolerated therapeutic approaches due to the narrow therapeutic window of current treatment approaches. The current meta-analysis sought to evaluate the safety and efficacy of stem cell-based therapeutic options for patients with ischemic stroke. <b>Methods:</b> PubMed, Web of Science, and Cochrane library databases were searched to retrieve randomized controlled trials (RCTs) evaluating the efficacy and safety of stem cell therapy (SCT) in ischemic stroke patients. Key outcomes included the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Barthel Index (BI), Fugl-Meyer Assessment (FMA), infarct size, and safety profile. The random effects model with the continuous method was used to calculate the pooled effect size in Review Manager 5.4.1, and subgroup analyses were performed based on demographics, stroke duration, and SCT delivery protocols. <b>Results:</b> A total of 18 RCTs involving 1026 patients were analyzed, with 538 in the treatment group and 488 in the control group. The mean change in NIHSS score was comparable between groups [MD = -0.80; 95% CI: -2.25, 0.65, <i>p</i> < 0.0001]. However, SCT showed better outcomes in mRS [MD = -0.56; 95% CI: -0.76, -0.35, <i>p</i> = 0.30] and BI scores [MD = 12.00; 95% CI: 4.00, 20.00, <i>p</i> = 0.007]. Additionally, the mean change in FMA score was significantly greater with SCT [MD = 18.16; 95% CI: 6.58, 29.75, <i>p</i> = 0.03]. The mean change in infarct volume also favored stem cell therapy [MD = 8.89; 95% CI: -5.34, 23.12, <i>p</i> = 0.08]. The safety profile was favorable, with adverse event rates comparable to or lower than controls. <b>Conclusions:</b> SCT offers a safe and effective approach to improving functional outcomes in stroke patients, particularly with early intervention. These findings highlight the potential of SCT in ischemic stroke rehabilitation while underscoring the need for standardized protocols and long-term safety evaluation.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719691","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":"Sleep Health and Psychological Wellbeing in Adult Women: A Specific Focus on Endometriosis-A Survey Study.","authors":"Elisabetta Baldi, Debora Meneo, Silvia Cerolini, Francesca Gelfo, Chiara Baglioni","doi":"10.3390/jcm14062103","DOIUrl":"10.3390/jcm14062103","url":null,"abstract":"<p><p><b>Background</b>: Endometriosis is a chronic, oestrogen-sensitive inflammatory disease, which can have a significant impact on women's wellbeing. Nevertheless, the sleep health of this population has been poorly investigated. This exploratory study aimed at describing sleep health, psychological wellbeing, and prevalence of endometriosis among a sample of female students and at evaluating the impact of endometriosis on sleep health and psychological wellbeing in women suffering from the disease. <b>Methods</b>: Women were recruited with a two-stage procedure in a cross-sectional study using online questionnaires: Insomnia Severity Index, Hospital Anxiety and Depression Scale, and Difficulties in Emotion Regulation Scale-Short form. Furthermore, specific questions were used to measure the five dimensions of sleep health: satisfaction, vigilance, efficiency, duration, and timing. <b>Results</b>: In the first stage of the enrolment procedure, 1068 students (18-45 years old) responded to the questionnaire, and 8.7% reported a physician diagnosis of endometriosis. Additionally, in the second stage of the enrolment procedure, 75 women were recruited through social media and reported a diagnosis of endometriosis. Then, all women with endometriosis (169) were age-matched with 169 women without the disease. Multivariate regression analyses showed a bidirectional association between sleep health and psychological wellbeing in the matched sample. Independent samples t-test showed that women with endometriosis reported more severe insomnia symptoms and lower psychological wellbeing than controls. Statistically significant differences were also found in global sleep health and satisfaction, vigilance, and efficiency. Among women with endometriosis, pain and anxiety symptoms were bidirectionally associated, while sleep health was significantly associated with disease stage and psychological difficulties. <b>Conclusions</b>: Considering and treating sleep difficulties in this population may contribute to an improvement in psychological wellbeing and quality of life.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719757","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":"Improving Perioperative Care in Gastric Surgery: Insights from the EUropean PErioperative MEdical Networking (EUPEMEN) Project.","authors":"Orestis Ioannidis, Elissavet Anestiadou, Jose M Ramirez, Nicolò Fabbri, Javier Martínez Ubieto, Carlo Vittorio Feo, Antonio Pesce, Kristyna Rosetzka, Antonio Arroyo, Petr Kocián, Luis Sánchez-Guillén, Ana Pascual Bellosta, Adam Whitley, Alejandro Bona Enguita, Marta Teresa-Fernandéz, Stefanos Bitsianis, Savvas Symeonidis","doi":"10.3390/jcm14062108","DOIUrl":"10.3390/jcm14062108","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Gastric cancer remains a leading cause of cancer-related deaths worldwide and surgical resection represents the mainstay of treatment procedures. However, despite the advancements noted in the field of surgical oncology, perioperative complications and variability in the perioperative care provided persist. To address the challenges caused by non-standardized perioperative care for gastric surgery across European healthcare systems, the EUropean PErioperative MEdical Networking (EUPEMEN) protocol has been developed. The present study concisely provides the EUPEMEN protocol's development, implementation, and impact on perioperative management in gastric resections. <b>Methods:</b> The EUPEMEN protocol was developed through a multidisciplinary collaboration involving five academic healthcare professionals from four European countries. The main activities of the collaborative group included a literature review, consensus development, the creation of multimodal rehabilitation manuals, and the development of an online learning platform. The EUPEMEN project aims for the uniform adoption of evidence-based practices across preoperative, intraoperative, and postoperative phases, leading in nutritional, psychological, and physiological optimization. <b>Results:</b> The implementation of the EUPEMEN protocol aims to optimize perioperative outcomes, including reduced postoperative complications, a shorter length of hospitalization, and improved recovery trajectories. The above have been achieved through structured guidelines that ensure consistent care delivery across diverse healthcare settings and tools such as rehabilitation manuals and a free-access online educational platform. <b>Conclusions:</b> The EUPEMEN protocol represents a new standard for perioperative care in the field of gastric surgery that is based on multidisciplinary collaboration and evidence-based practices. While challenges such as resource constraints and variability in adherence remain, the protocol demonstrates significant potential to improve patient outcomes and streamline perioperative management. Future research should focus on long-term effects and adaptation challenges in the setting of non-European healthcare systems.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719551","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}