Journal of Clinical Medicine最新文献

{"title":"Evaluating Sepsis Management and Patient Outcomes: A Comprehensive Retrospective Study of Clinical and Treatment Data.","authors":"Sahbanathul Missiriya Jalal, Suhail Hassan Jalal, Abeer Abbas Alabdullatif, Kamilah Essa Alasmakh, Zahraa Hussain Alnasser, Wadiah Yousef Alhamdan","doi":"10.3390/jcm14103555","DOIUrl":"10.3390/jcm14103555","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Sepsis, as a major cause of mortality worldwide, requires timely diagnosis and prompt treatment to improve patient outcomes. In this study, we evaluated sepsis management strategies and their impact on clinical outcomes in hospitalized patients. <b>Methods:</b> A retrospective study was conducted by analyzing clinical and treatment data from the electronic records of sepsis patients who had been admitted to tertiary care hospitals in eastern Saudi Arabia. Using systematic sampling, the details of eligible patients were obtained. Data were collected on patient demographics, vital signs, Sequential Organ Failure Assessment (SOFA) and laboratory parameters, treatment (antibiotic therapy, vasopressor use, or fluid resuscitation), and outcomes (survival in hospital). Statistical analyses were performed to assess the association between clinical and treatment strategies and patient outcomes. <b>Results:</b> A total of 234 sepsis cases were analyzed, of which 70.9% were survivors and 29.1% were non-survivors. Patients aged 60 years and above were the most affected. Statistically significant differences were observed across all of the measured vital sign variables and outcomes (<i>p</i> < 0.0001). Based on SOFA scores, 56.41% of patients were assessed as having a moderate risk. Through our comparison of clinical and laboratory parameters between survivors and non-survivors, significant differences were found in all of the measured variables (<i>p</i> < 0.0001). The odds of survival were significantly higher in those who received early administration of broad-spectrum antibiotics (OR = 4.9449, <i>p</i> = 0.0001), vasopressor therapy (OR = 1.9408, <i>p</i> = 0.0262), and fluid resuscitation OR = 11.035, <i>p</i> = 0.0001). <b>Conclusions:</b> The results of this study highlight the importance of early sepsis recognition, prompt antibiotic therapy, and standardized protocol adherence in improving patient outcomes and reducing mortality and morbidity.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159332","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":"Efficacy and Safety of Open-Conjunctiva Ab Externo 63 µm vs. 45 µm XEN^® Gel Stent in Glaucoma Surgery: One-Year Follow-Up.","authors":"Yann Bertolani, Jaume Rigo-Quera, Laura Sánchez-Vela, Olivia Pujol-Carreras, Manuel Amilburu, Antonio Dou, Marta Castany","doi":"10.3390/jcm14103545","DOIUrl":"10.3390/jcm14103545","url":null,"abstract":"<p><p><b>Background</b>: To compare the efficacy and safety of the XEN^® 63 µm and 45 µm devices with the ab externo open conjunctiva with a 30G needle approach. <b>Methods</b>: A retrospective, non-randomized and single-center study was conducted. Consecutive eyes undergoing a XEN^® 63 µm implant were compared with a matched cohort of cases with a XEN^® 45 µm implant. Standalone and combined procedures with phacoemulsification were included. <b>Results</b>: A total of 28 XEN^® 45 µm and 28 XEN^® 63 µm were included. Complete surgical success was achieved in 17 cases (60.7%) in the 45 µm group and in 20 cases (71.4%) in the 63 µm group, with no statistical differences. One year after the surgery, the mean IOP was 13.8 ± 3.3 mmHg for the 45 µm group and 12.4 ± 4.2 mmHg for the 63 µm group (<i>p</i>-value > 0.05). Likewise, the use of glaucoma medication was lowered in the 63 µm device (0.32 ± 0.87) compared to the 45 µm device (0.39 ± 0.86), with no statistical significance. Postoperative hypotony was more frequent in the 63 µm device (39.3%) than in the 45 µm group (28.6%), with no statistical differences. However, hypotony-associated complications (including choroidal detachment, hypotony keratopathy, and hypotony maculopathy) were significantly higher in the 63 µm group (<i>p</i> = 0.011). <b>Conclusions:</b> Although the XEN^® 63 µm may offer a greater IOP-lowering effect with better complete surgical success, no significant differences were detected compared to the 45 µm device. Hypotony-related complications were higher in the XEN 63 µm, although most of them resolved with conservative management.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159192","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 Hepatic Axis Fructose-Methylglyoxal-AMPK: Starring or Secondary Role in Chronic Metabolic Disease?","authors":"Alejandro Gugliucci","doi":"10.3390/jcm14103559","DOIUrl":"10.3390/jcm14103559","url":null,"abstract":"<p><p>Biochemical alterations linked to metabolic syndrome (MetS), type 2 diabetes (T2DM), and metabolic dysfunction-associated steatotic liver disease (MASLD) may be brought on by the Western diet. Based on research conducted over the past decade, fructose is one of the main culprits. Over 80% of ingested fructose is metabolized by the liver at first pass, where it stimulates de novo lipogenesis (DNL) to drive hepatic triglyceride (TG) synthesis, which contributes to MASLD, hepatic insulin resistance (IR), and dyslipidemia. Fructose reduction produces quick and significant amelioration in these metabolic disturbances. We hereby propose potential overarching processes that can link these pathways to signaling disruption by the critical metabolic sensor AMP-activated protein kinase (AMPK). We proffer that when large amounts of fructose and glucose enter the liver, triose fluxes may be sufficient to produce transient increases in methylglyoxal (MG), allowing steady-state concentrations between its production and catabolism by glyoxalases to be high enough to modify AMPK-sensitive functional amino acid residues. These reactions would transiently interfere with AMPK activation by both AMP and aldolase. Such a sequence of events would boost the well-documented lipogenic impact of fructose. Given that MG adducts are irreversible, modified AMPK molecules would be less effective in metabolite sensing until they were replaced by synthesis. If proven, this mechanism provides another avenue of possibilities to tackle the problem of fructose in our diet. We additionally discuss potential multimodal treatments and future research avenues for this apparent hepatic AMPK malfunction.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Halitosis in Adolescents and Young Adults with Removable Retainers, Fixed Retainers, or No Orthodontic Treatment: A Cross-Sectional Study with Salivary pH Subgroup Analyses.","authors":"Magda Mihaela Luca, Roxana Buzatu, Bogdan Andrei Bumbu","doi":"10.3390/jcm14103560","DOIUrl":"10.3390/jcm14103560","url":null,"abstract":"<p><p><b>Background and Objectives</b>: Halitosis is a persistent oral health issue that can undermine self-esteem and social interactions, particularly in younger populations who may be more vulnerable to peer judgment. Orthodontic retainers-both removable and fixed-can alter oral microbiota and salivary parameters, potentially influencing malodor development. This study aimed to compare halitosis severity and oral-health-related quality of life (OHRQoL) in adolescents and young adults (aged 12-25) wearing removable retainers, fixed retainers, or no orthodontic appliances, with an additional focus on salivary pH as a possible modifying factor. <b>Methods</b>: A total of 88 participants were allocated into three groups: removable retainer (n = 28), fixed retainer (n = 30), and no orthodontic treatment (n = 30). Halitosis severity was measured via organoleptic evaluation (0-5 scale) and the Halitosis Associated Life-Quality Test (HALT, 0-100). Salivary pH was determined using a digital pH meter. OHRQoL was assessed through the Oral Health Impact Profile-14 (OHIP-14, 0-56). One-way ANOVA with Tukey's post hoc test and chi-square analyses were employed to compare outcomes among groups. Spearman's correlation explored relationships among HALT, organoleptic scores, OHIP-14, and salivary pH. <b>Results</b>: Fixed retainer wearers exhibited higher mean organoleptic scores (2.2 ± 0.6) compared to removable retainer users (1.7 ± 0.5, <i>p</i> = 0.003). HALT results similarly showed that the fixed retainer group (35.6 ± 6.4) reported more halitosis-related burdens than the removable group (31.4 ± 5.9, <i>p</i> = 0.015). Low salivary pH (<6.8) was linked to greater malodor indices in all cohorts (<i>p</i> < 0.05). Correlations revealed moderate positive associations between HALT and OHIP-14 (r = +0.52, <i>p</i> < 0.001). <b>Conclusions</b>: Adolescents and young adults wearing fixed orthodontic retainers reported more severe halitosis and a correspondingly lower oral-health-related quality of life than those with removable retainers or no orthodontic appliances. Salivary pH emerged as an influential factor, indicating that maintaining a neutral oral environment could mitigate malodor. Targeted interventions emphasizing hygiene and saliva management may improve overall well-being in this vulnerable age group.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158791","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":"Automated Stuttering Detection Using Deep Learning Techniques.","authors":"Noura Alhakbani, Raghad Alnashwan, Abeer Al-Nafjan, Abdulaziz Almudhi","doi":"10.3390/jcm14103552","DOIUrl":"10.3390/jcm14103552","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Disfluencies such as repetitions, prolongations, interjections, and blocks in sounds, syllables, or words can sometimes hinder communication. Currently, disfluencies are manually measured, which has inherent limitations, such as being time-consuming and subjective, which can lead to inconsistencies in measurement. <b>Methods:</b> To address these challenges, this study presents an innovative automated system for detecting disfluencies utilizing advanced artificial intelligence technologies; specifically, deep learning models such as convolutional neural networks (CNN) and convolutional long short-term memory (ConvLSTM). The system was evaluated using two benchmark datasets: FluencyBank and SEP-28K. <b>Results:</b> Our proposed system demonstrates remarkable performance, achieving detection accuracies of 0.97 and 0.96, respectively, for CNNs and ConvLSTM models. These results not only exceed those of prior studies but also highlight the effectiveness of our approach in enhancing stuttering evaluation. <b>Conclusions</b>: By providing a reliable and efficient tool for professionals in therapeutic settings, our system represents a significant advancement in the field, offering improved outcomes for individuals affected by stuttering.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12111818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159088","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":"Renal Denervation After USA FDA Approval: An Update from an Interventional Cardiologist's Perspective.","authors":"Jiandong Zhang, Peter M Belford, George A Stouffer","doi":"10.3390/jcm14103554","DOIUrl":"10.3390/jcm14103554","url":null,"abstract":"<p><p>In late 2023, the U.S. Food and Drug Administration (FDA) approved two renal denervation (RDN) systems for the treatment of hypertension. Several professional societies, including the Society of Cardiovascular Angiography and Intervention (SCAI), the American Heart Association (AHA), and numerous European associations, have recognized the potential role of RDN in managing hypertension. Despite widespread enthusiasm from clinicians, patients, and the industry, the American Medical Association's Current Procedural Terminology (CPT) panel rejected the introduction of new codes for renal denervation at its September 2024 meeting. This article analyzes the latest evidence from clinical trials and registries, reviews current challenges in clinical practice, and explores the role of contemporary hypertension treatment from the perspective of interventional cardiologists.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159108","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 Efficacy of Platelet-Rich Plasma and Hyaluronic Acid Versus Hyaluronic Acid for Knee Osteoarthritis with MRI Analysis: A Randomized Controlled Trial.","authors":"Mandy Zhang, Kelvin Chew, Patrick Goh, Mon Hnin Tun, Kenneth Sheah, Victor Tan, Baoying Lim, Chung Sien Ng, Benedict Tan","doi":"10.3390/jcm14103553","DOIUrl":"10.3390/jcm14103553","url":null,"abstract":"<p><p><b>Background:</b> Some evidence suggests that combining hyaluronic acid (HA) with platelet-rich-plasma (PRP) may offer synergistic benefits by enhancing the biological and mechanical properties of joints. However, data on the combination of HA+PRP vs. HA alone in the management of knee osteoarthritis (OA) remain limited. <b>Methods:</b> A double-blinded randomized controlled trial was conducted at an outpatient clinic and enrolled 58 patients with Kellgren-Lawrence grade 2-3 knee OA. They were randomly allocated to receive either intra-articular PRP combined with HA (<i>n</i> = 29 knees) or HA alone (<i>n</i> = 29 knees). The primary outcome was pain, assessed using a visual analog scale (VAS). Secondary outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), health-related quality of life (EQ-5D-5L), and structural changes on MRI, measured by the Whole-Organ MRI Score (WORMS). The VAS, WOMAC, and EQ-5D-5L were evaluated at baseline and at months 1, 3, 6, and 12. MRI WORMS was assessed at baseline and 12 months. <b>Results</b>: The baseline characteristics were comparable between the HA+PRP and HA groups. Both interventions showed improvements in pain and function at 12 months. However, the between-group difference in VAS at 12 months-the primary outcome-was not statistically significant (<i>p</i> = 0.102) and did not exceed the minimal clinically important difference (MCID) of 20 mm. The HA group demonstrated significantly greater VAS score reductions at 1 month (-31.1 [95% CI: -38.9 to -23.2] vs. -14.3 [95% CI: -22.2 to -6.4], <i>p</i> = 0.003) and at 6 months (-32.1 [95% CI: -40.1 to -24.1] vs. -19.2 [95% CI: -27.1 to -11.3], <i>p</i> = 0.024), compared to the HA+PRP group, although these differences did not reach clinical significance. No significant between-group differences were observed in the WOMAC scores, EQ-5D-5L, or total WORMS scores at all time points (<i>p</i> > 0.05). At 12 months, MRI assessment revealed a significant decrease in bone marrow edema in the HA+PRP group (-0.7 [95% CI: -1.6 to 0.2]) compared to the HA group (0.7 [95% CI: -0.2 to 1.6], <i>p</i> = 0.030). <b>Conclusions</b>: Both HA+PRP and HA treatments were effective in reducing pain and improving function in patients with knee OA over 12 months. While HA demonstrated greater early pain relief, the addition of PRP was associated with a significant reduction in bone marrow edema at 12 months. These findings suggest potential structural benefits of HA+PRP, although clinical superiority over HA alone was not established.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12111974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159330","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":"Ridge Recontouring with Simultaneous Implant Placement Using Autogenous Bone Core Grafts.","authors":"Horia Mihail Barbu, Andreea Sorina Petris, Stefania Andrada Iancu, Alexandru Burcea, Andreea Mariana Banateanu, Ana Caruntu","doi":"10.3390/jcm14103541","DOIUrl":"10.3390/jcm14103541","url":null,"abstract":"<p><p><b>Background:</b> The autogenous bone core block (BCB) is a viable, biologically advantageous, and minimally invasive alternative to other augmentation procedures for small bone defects around dental implants. This study focused specifically on horizontal vestibular defects in the mandible, a frequently encountered yet underrepresented clinical situation, to evaluate the effectiveness and predictability of bone core grafting. <b>Methods:</b> Cylindrical autogenous bone cores, harvested from the implant-site osteotomy using trephine drills with a 2.5 internal diameter, were stabilized with osteosynthesis screws, and implants were placed simultaneously. Initial preoperative measurements of the edentulous ridge width were performed based on cone beam computer tomography (CBCT). At 4 months postoperatively, a subsequent CBCT measurement was performed for each implant site. <b>Results:</b> A total of 38 augmentation procedures were analyzed with a mean horizontal bone gain of 1.8 mm (<i>p</i> = 0.000). Improved outcomes were observed in V-shaped defects with remaining vertical bony walls, which contributed to better graft stability and volume preservation. While Khoury et al. previously validated the general applicability of this technique across various defect types, our study refines its indication by offering a clear protocol tailored to a common clinical niche. <b>Conclusions:</b> The proposed BCB method proved to be a safe, efficient, and with reduced morbidity procedure, providing clinicians with a practical and evidence-based tool for predictable horizontal bone augmentation.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159489","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":"Association Between Tobacco and Periodontal Disease in Latin America from 2000 to 2024: Cross-Sectional Analysis of Global Burden of Disease Study.","authors":"Brenda Herrera-Serna, Olga López-Soto, Héctor Fuentes-Barría, Raúl Aguilera-Eguía, Lissé Angarita-Davila, Diana Rojas-Gómez","doi":"10.3390/jcm14103549","DOIUrl":"10.3390/jcm14103549","url":null,"abstract":"<p><p><b>Objectives:</b> This study aims to examine the ecological-level association between active and passive tobacco use and periodontal disease in Latin America from 2000 to 2024. <b>Methods:</b> A cross-sectional ecological study was conducted using secondary data from the Global Burden of Disease Study. Data from 20 Latin American countries were analyzed, stratified by country, sex, and age group. Multiple regression models were used to assess the relationship between tobacco consumption and periodontal disease prevalence, adjusted for age and sex. <b>Results:</b> The prevalence of periodontal disease was high in both sexes, particularly among individuals older than 55 years. The countries with the highest age-standardized rates were Colombia, Panama, and Costa Rica, with nearly 35,000 cases per 100,000 population. Regression models indicated that passive tobacco exposure explained 90.4% of the variability in women (R² = 0.9041) and 92.5% in men (R² = 0.9253). Active tobacco use showed weaker associations, with R² values of 0.3721 in women and 0.4601 in men. Passive exposure demonstrated better predictive accuracy, with lower Root MSE values (3192.8 and 3261.7). <b>Conclusions:</b> There is a significant ecological-level association between tobacco use and periodontal disease in Latin America, particularly for passive exposure. These findings highlight the need to strengthen tobacco control policies and preventive strategies targeting environmental exposure. However, due to the ecological nature of the study, these associations do not imply causality at the individual level. Longitudinal studies with individual-level data are needed to explore the underlying biological and contextual factors.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158720","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":"Multimodality Imaging Leading the Way to a Prompt Diagnosis and Management of Transthyretin Amyloidosis.","authors":"Anca Bălinișteanu, Roxana Cristina Rimbaș, Alina Ioana Nicula, Diana Piroiu, Adrian Dumitru, Amalia Ene, Dragoș Vinereanu","doi":"10.3390/jcm14103547","DOIUrl":"10.3390/jcm14103547","url":null,"abstract":"<p><p><b>Background/Objectives:</b> A 43-year-old male presented with neurological symptoms and asymptomatic cardiac dysfunction, left ventricular hypertrophy, and impaired global longitudinal strain with apical sparing, associated with elevated NT-proBNP. <b>Methods:</b> Multimodality imaging (bone scintigraphy and cardiac magnetic resonance) revealed cardiac amyloid deposition. Genetic testing confirmed variant transthyretin amyloidosis (ATTR) with mixed phenotype. <b>Results:</b> Treatment with tafamidis 20 mg for stage I polyneuropathy, available at that moment, was initiated with good neurological outcome. Three years later, cardiac function deteriorated, following a moderate COVID-19 infection, with heart failure symptoms and reduced ventricular and atrial functions. For progressive ATTR cardiomyopathy, we intensified therapy to tafamidis free acid 61 mg, associated with SGLT2 inhibitor, spironolactone, and furosemide with subsequent improvements of symptoms and stabilization of imaging findings. <b>Conclusions:</b> This case emphasizes the importance of multimodal imaging in early detection, monitoring, and guiding individualized management in ATTR cardiomyopathy.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159485","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}