Journal of Clinical Medicine最新文献

{"title":"Deterioration of Myocardial Global Longitudinal Strain and Its Relationship with Arterial Stiffness in Patients with Cardiac Amyloidosis: A Six-Month Follow-Up.","authors":"Dafni Korela, Emmanouil Foukarakis, Anthοula Plevritaki, Spyros Maragkoudakis, Ioannis Anastasiou, Alexandros Patrianakos, Nikolaos Kapsoritakis, Sophia Koukouraki, Olga Bourogianni, Charalampos Pontikoglou, Maria Psillaki, Helen A Padadaki, Ioannis Zaganas, Dimitris Samonakis, Eustathios Detorakis, Ioannis Petrakis, Kostas Stylianou, Gregory Chlouverakis, Emmanouil Giannakoudakis, Emmanouil Simantirakis, George Kochiadakis, Maria Marketou","doi":"10.3390/jcm14062078","DOIUrl":"10.3390/jcm14062078","url":null,"abstract":"<p><p><b>Background:</b> Cardiac amyloidosis (CA) is a progressive disorder characterized by amyloid fibril deposition in the heart, leading to heart failure and arrhythmias. Arterial stiffness, assessed by pulse wave velocity (PWV), is recognized as an adverse consequence of amyloidosis, yet its progression and relationship with myocardial dysfunction remain inadequately explored. This study examines the progression of PWV and its potential association with the deterioration of global longitudinal strain (GLS) in CA patients over a 6-month follow-up period. <b>Methods:</b> This prospective study enrolled 31 patients who were diagnosed with CA, including both the immunoglobulin light chain (AL) and transthyretin (ATTR) forms. All participants underwent a full echocardiographic study and PWV measurements (carotid-femoral [c-f] and carotid-radial [c-r] PWV) at baseline and 6-month follow-up. Age- and sex-matched individuals with similar cardiovascular risk factors were included as a control group. <b>Results:</b> In the CA group, the left ventricular mass index (LVMI) increased significantly from 119.4 ± 52.1 to 124 ± 53.2 g/m² (<i>p</i> = 0.002). Both c-f and c-r PWV showed significant increases at the 6-month follow-up (<i>p</i> < 0.001 and <i>p</i> = 0.005, respectively). The GLS deteriorated significantly from -14 ± 4.4% to -12.8 ± 4.9% (<i>p</i> = 0.018). No significant changes were observed in the control group. A weak correlation (r = 0.3; <i>p</i> = 0.095) was found between increases in PWV and GLS deterioration. <b>Conclusions:</b> Both arterial stiffness and myocardial dysfunction worsen rapidly in CA patients. However, the weak correlation between PWV and GLS suggests that they may evolve through independent mechanisms, necessitating further research to understand their complex interplay in CA.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719491","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":"Thoracic Ultrasound for Pre-Procedural Dynamic Assessment of Non-Expandable Lung: A Non-Invasive, Real-Time and Multifaceted Diagnostic Tool.","authors":"Guido Marchi, Federico Cucchiara, Alessio Gregori, Giulia Biondi, Giacomo Guglielmi, Massimiliano Serradori, Marco Gherardi, Luciano Gabbrielli, Francesco Pistelli, Laura Carrozzi","doi":"10.3390/jcm14062062","DOIUrl":"10.3390/jcm14062062","url":null,"abstract":"<p><p>Non-expandable lung (NEL) occurs when the lung fails to fully re-expand after pleural fluid drainage, complicating management and limiting therapeutic options. Diagnosis, based on clinical symptoms, pleural manometry, and traditional imaging, is often delayed to the peri- or post-procedural stages, leading to improper management, complications, and higher healthcare costs. Therefore, early, pre-procedural diagnostic methods are needed. Thoracic ultrasound (TUS) has emerged as a non-invasive tool with the potential to enhance diagnostic accuracy and guide clinical decisions, yet, it remains inadequately studied within the context of NEL. We conducted a non-systematic narrative review using a structured methodology, including a comprehensive database search, predefined inclusion criteria, and QUADAS-2 quality assessment. This approach ensured a rigorous synthesis of evidence on TUS in NEL, with the aim of identifying knowledge gaps and guiding future studies. Non-invasive, real-time, bedside M-mode TUS has demonstrated efficacy in predicting NEL prior to thoracentesis by detecting an absent sinusoidal sign and reduced atelectatic lung movement. Emerging experimental techniques, including 2D shear wave elastography (SWE), speckle tracking imaging (STI) strain analysis, the lung/liver echogenicity (LLE) ratio, TUS assessment of dynamic air bronchograms, and pleural thickening evaluation, show additional potential to enhance pre-procedural NEL detection. However, all these methods have significant limitations that require further comprehensive investigation. Despite their significant promise, TUS modalities for early NEL detection still require rigorous validation and standardization before broad clinical use. A multimodal diagnostic approach, combining clinical manifestations, pleural manometry, radiologic and ultrasonographic findings, along with emerging techniques (once fully validated), may provide the most extensive framework for NEL. Regardless of advancements, patient-centered care and shared decision-making remain essential. Further research is needed to improve outcomes, reduce healthcare costs, and enhance long-term treatment strategies.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719701","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":"Optical Imaging of Cilia in the Head and Neck.","authors":"Elizabeth Lee, Lidek Chou, Zhongping Chen, Brian J F Wong","doi":"10.3390/jcm14062059","DOIUrl":"10.3390/jcm14062059","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Cilia are hair-like organelles with various mechanosensory and chemosensory functions. In particular, motile cilia generate directional fluid flow important for multiple processes. Motile ciliopathies have serious clinical implications, including developmental and respiratory disorders. Evaluating the most suitable imaging methods for studying ciliary structure and function has great clinical significance. <b>Methods</b>: Here, we provide an overview of ciliary function, imaging modalities, and applications in ciliopathic diseases. <b>Results</b>: Optical imaging has become a crucial tool for studying ciliary structure and function, providing high-resolution, non-invasive imaging capabilities that are valuable for in vivo applications. Optical coherence tomography (OCT) is well suited for the visualization of ciliary anatomy and quantitative studies of microfluidic flow. <b>Conclusions</b>: A deeper understanding of ciliary biology can lead to novel approaches in diagnosing, treating, and monitoring ciliopathies, contributing to more effective and individualized care.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719613","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":"Circulating Tumor Cells from Surgical Manipulation Predict Recurrence and Poor Prognosis in Non-Small Cell Lung Cancer.","authors":"Akikazu Kawase, Keigo Sekihara, Noriyuki Matsutani, Masafumi Yamaguchi, Yujin Kudo, Makoto Endo, Tetsukan Woo, Yuichi Saito, Noriyoshi Sawabata","doi":"10.3390/jcm14062070","DOIUrl":"10.3390/jcm14062070","url":null,"abstract":"<p><p><b>Background/Objectives:</b> In our previous multicenter prospective controlled study (UMIN000018602), we investigated the impact of surgical manipulation on circulating tumor cells (CTCs) in patients with non-small cell lung cancer (NSCLC). CTCs were detected after surgery in four patients (4/29, 13.8%), although CTCs were not present before surgery. These four patients had tumor cells leaked into their bloodstream by surgeons' manipulation. We aimed to clarify long-term outcomes according to the presence of CTCs. <b>Methods:</b> Patients with cT1b-2N0M0 NSCLC scheduled for lobectomy were enrolled, based on the selection criteria of a consolidation-to-ground-glass opacity ratio (over 50%). Peripheral blood samples (≥3 mL) were collected before surgery (for pre-CTCs), during surgery, and immediately after pulmonary vein dissection (for post-CTCs). CTCs were isolated from these samples using ScreenCell^®'s size-selective method. <b>Results:</b> From July 2015 to January 2016, 29 patients were enrolled, yielding paired pre- and post-CTC samples for all patients. Thirteen patients were pre-CTC positive, and post-CTCs were detected in 17 patients. Survival analysis revealed a statistically significant difference in recurrence-free survival between patients with and without post-CTCs (<i>p</i> = 0.043), while pre-CTCs status had no significant impact on recurrence (<i>p</i> = 0.226). Patients with post-CTCs had a significantly higher recurrence rate than those without (<i>p</i> = 0.043). Half of patients with post-CTCs but without pre-CTCs had recurrence within 5 years after surgery. <b>Conclusions:</b> Post-CTCs emerged as a significant predictor of recurrence following lobectomy; however, it could be possible for thoracic surgeons to prevent recurrence by improving surgical techniques for NSCLC patients with post-CTCs but without pre-CTCs.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719446","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":"Advancements in Regenerative Therapies for Orthopedics: A Comprehensive Review of Platelet-Rich Plasma, Mesenchymal Stem Cells, Peptide Therapies, and Biomimetic Applications.","authors":"Andrew J Goulian, Brielle Goldstein, Maarouf A Saad","doi":"10.3390/jcm14062061","DOIUrl":"10.3390/jcm14062061","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Regenerative therapies have gained interest in orthopedic applications for their potential to enhance tissue regeneration, functional recovery, and pain modification. This review evaluates the clinical efficacy of platelet-rich plasma (PRP), mesenchymal stem cells (MSCs), peptide-based treatments, and biomimetic materials in orthopedic care, with a focus on pain reduction and functional outcomes. <b>Methods</b>: A structured literature search in PubMed (January 2009-January 2025) identified 160 studies. After applying inclusion criteria prioritizing randomized controlled trials (RCTs) and clinical trials, 59 studies were included: 20 on PRP, 20 on MSCs, 10 on peptide therapies, and 7 on biomimetics. Data extraction focused on pain reduction and functional recovery, with risk of bias assessed using the Cochrane Risk of Bias (RoB) tool and ROBINS-I tool. A random-effects meta-regression analysis was conducted to evaluate the impact of therapy type, sample size, and risk of bias on reported pain reduction outcomes. <b>Results</b>: Meta-regression analysis identified MSC therapy as the most effective intervention for pain reduction (β = 8.45, <i>p</i> < 0.05), with PRP and peptide-based therapies showing moderate improvements, and biomimetic therapies demonstrating the lowest effect. PRP provided short-term pain relief, particularly in acute injuries and tendon repair, though inconsistencies in preparation methods limited success in chronic conditions. MSC therapies demonstrated cartilage regeneration and early osteoarthritis improvement, but high costs and ethical concerns remain barriers to widespread adoption. Peptide-based therapies and biomimetic materials, including engineered scaffolds and autologous protein solutions, showed promise for infection control and wound healing, though further research is needed to optimize dosing, delivery methods, and long-term safety. <b>Conclusions</b>: Regenerative therapies offer significant potential in orthopedic care, with MSC therapies demonstrating the most reliable regenerative effects, PRP providing short-term symptomatic relief, and peptide-based and biomimetic treatments emerging as promising adjuncts. However, standardized protocols and large-scale clinical trials are needed to establish long-term efficacy and improve clinical translation for broader adoption.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719353","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":"Preliminary Results of a Multicenter Randomized Clinical Trial for Laparoscopic Repair of Pelvic Organ Prolapse: Sacropexy vs. Laparoscopic Lateral Suspension.","authors":"Isabel Ñíguez-Sevilla, María Luisa Sánchez-Ferrer, Vicente Luis Ruiz-Cotorruelo, Maciej Wilczak, Karolina Chmaj-Wierzchowska, Juan Antonio Solano-Calvo, María Elena Pérez-Muñuzuri, Juan Raúl Salinas-Peña, Julián Jesús Arense-Gonzalo","doi":"10.3390/jcm14062069","DOIUrl":"10.3390/jcm14062069","url":null,"abstract":"<p><p><b>Background:</b> Laparoscopic sacropexy (SCL) is the gold standard technique for the correction of apical pelvic organ prolapse (POP). However, other easier laparoscopic techniques, such as laparoscopic lateral suspension (LLS), have become popular. <b>Methods:</b> We conducted a multicenter randomized study of patients undergoing laparoscopic repair of apical and anterior prolapse. Patients were randomized into two groups: LLS vs. SCL. A non-inferiority study was proposed, in which the null hypothesis was that the difference in the proportion of therapeutic failures among women who undergo LLS compared to SCL is ≥15%. It was necessary to include 182 participants to detect a risk difference of 15% after one year with a statistical power of 0.80. <b>Results:</b> We recruited 176 women, of whom 106 patients underwent surgery with a follow-up between 1 and 12 months. There were no differences in basal characteristics. Regarding physical examination, there were no differences at stages III-IV in the POP-Q or the symptom scales in both groups. Concerning the post-surgical results, there were no failures detected in the physical examination in any group. There were no differences in the points of the POP-Q, the symptom scales, or the body image scale. We only found significant differences in the operative time, which was shorter for the LLS. <b>Conclusions:</b> Although these are preliminary results, since the sample includes 106 patients and the follow-up time is a limited period at the moment, we did not find any post-surgical differences between the two techniques. However, it will be necessary to complete the trial to draw relevant conclusions.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719475","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":"MicroRNAs in the Diagnosis of Digestive Diseases: A Comprehensive Review.","authors":"Mirela Livia Popa, Cristian Ichim, Paula Anderco, Samuel Bogdan Todor, Diana Pop-Lodromanean","doi":"10.3390/jcm14062054","DOIUrl":"10.3390/jcm14062054","url":null,"abstract":"<p><p>MicroRNAs (miRNAs) have emerged as crucial regulators in digestive pathologies, including inflammatory bowel disease (miR-31, miR-155, and miR-21), colorectal cancer (miR-21, miR-598, and miR-494), and non-alcoholic fatty liver disease (miR-21, miR-192, and miR-122). Their capacity to modulate gene expression at the post-transcriptional level makes them highly promising candidates for biomarkers and therapeutic interventions. However, despite considerable progress, their clinical application remains challenging. Research has shown that miRNA expression is highly dynamic, varying across patients, disease stages, and different intestinal regions. Their dual function as both oncogenes and tumor suppressors further complicates their therapeutic use, as targeting miRNAs may yield unpredictable effects. Additionally, while miRNA-based therapies hold great potential, significant hurdles persist, including off-target effects, immune activation, and inefficiencies in delivery methods. The intricate interplay between miRNAs and gut microbiota adds another layer of complexity, influencing disease mechanisms and treatment responses. This review examined the role of miRNAs in digestive pathologies, emphasizing their diagnostic and therapeutic potential. While they offer new avenues for disease management, unresolved challenges underscore the need for further research to refine their clinical application.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719528","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":"Mortality in Critically Ill Patients with Liberal Versus Restrictive Transfusion Thresholds: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with Trial Sequential Analysis.","authors":"Daniel Arturo Jiménez Franco, Camilo Andrés Pérez Velásquez, David Rene Rodríguez Lima","doi":"10.3390/jcm14062049","DOIUrl":"10.3390/jcm14062049","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Anemia is common in critically ill patients, yet red blood cell (RBC) transfusion without active bleeding does not consistently improve outcomes and carries risks such as pulmonary injury, fluid overload, and increased costs. Optimal transfusion thresholds remain debated, with some guidelines recommending a restrictive target of 7 g/dL instead of a more liberal target of 9 g/dL. <b>Methods</b>: We conducted a systematic review and meta-analysis following PRISMA guidelines, searching PubMed, EMBASE, and LILACS from January 1995 to October 2024. Thirteen randomized controlled trials involving 13,705 critically ill adults were included, with 6855 assigned to liberal and 6850 to restrictive transfusion strategies. The risk of bias was assessed using the Cochrane Risk of Bias Tool 2, and the pooled effect sizes were estimated with a random-effects model. We registered the protocol in PROSPERO International Prospective Register of Systematic Reviews (CDR42024589225). <b>Results</b>: No statistically significant difference was observed in 30-day mortality between restrictive and liberal strategies (odds ratio [OR] 1.02; 95% confidence interval [CI], 0.83-1.25; I² = 49%). Similarly, no significant differences emerged for the 90-day or 180-day mortality, hospital or intensive care unit (ICU) length of stay, dialysis requirement, or incidence of acute respiratory distress syndrome (ARDS). However, patients in the restrictive group received significantly fewer RBC units. The trial sequential analysis (TSA) indicated that the evidence accrued was insufficient to definitively confirm or exclude an effect on the 30-day mortality, as the required sample size was not reached. <b>Conclusions</b>: In conclusion, while our meta-analysis found no statistically significant difference in the short-term mortality between restrictive and liberal transfusion strategies, larger trials are needed to fully determine whether any clinically meaningful difference exists in critically ill populations.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719564","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 Role of Neutrophil-to-Lymphocyte Ratio and Right Ventricular Dysfunction in Indonesian Patients with COVID-19: A Retrospective Cohort Study.","authors":"Raksheeth Agarwal, Stanislaus Ivanovich Krishnanda, Oliver Emmanuel Yausep, Raka Aldy Nugraha, Gatut Priyonugroho, Siti Hertine, Sony Hilal Wicaksono, Prima Almazini, Dian Zamroni, Hary Sakti Muliawan","doi":"10.3390/jcm14062051","DOIUrl":"10.3390/jcm14062051","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The clinical impact of neutrophil-to-lymphocyte ratio (NLR) and right ventricular (RV) dysfunction on clinical outcomes in COVID-19 remains understudied in the Indonesian population. This study aims to investigate their prognostic value in hospitalized Indonesian adults with COVID-19. <b>Methods</b>: A retrospective cohort study was conducted at a COVID-19 referral hospital in Indonesia. We included all consecutive adults hospitalized between April 2020 and April 2021 who underwent transthoracic echocardiography (TTE) during admission. Clinical information was extracted from electronic medical records. TTE variables were defined according to the American Society of Echocardiography criteria. Statistical analyses were performed using SPSS. Ethical approval was obtained from the Institutional Review Board of Universitas Indonesia (#2022-01-135). <b>Results</b>: A total of 488 patients were included in this study-29 with and 459 without RV dysfunction. The mean age of the population was 54.8, with 42% being female. An NLR >4.793 was considered elevated. Elevated NLR was independently associated with RV dysfunction (OR: 3.38, <i>p</i> = 0.02). Older age (HR: 1.02, <i>p</i> = 0.01), obesity (HR: 1.85, <i>p</i> < 0.01), chronic kidney disease (HR: 1.69, <i>p</i> = 0.01), high NLR (HR: 2.75, <i>p</i> < 0.001), and RV dysfunction (HR: 2.07, <i>p</i> = 0.02) independently increased the risk of 30-day mortality by multivariate Cox regression analysis. <b>Conclusions</b>: In adult Indonesian patients hospitalized with COVID-19, an elevated NLR was associated with RV dysfunction, and both of these parameters increased the risk of 30-day mortality. This retrospective cohort study highlights the prognostic importance of NLR and RV dysfunction in hospitalized COVID-19 patients, providing physicians with tools to identify high-risk patients.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719660","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":"Screening of Neurodevelopmental and Psychiatric Disorders in School-Aged Children from Sahrawi Refugee Camp: A Cross-Sectional Observational Study.","authors":"Ilaria Accorinti, Linda Bonezzi, Gianluca Sesso, Simona Pipino, Francesca Pignatelli, Alessandra De Angelis, Annarita Milone, Roberta Battini","doi":"10.3390/jcm14062080","DOIUrl":"10.3390/jcm14062080","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The prevalence of neurodevelopmental and psychiatric disorders in children is a growing concern in developed countries. However, data from low- and middle-income countries (LMICs) remain scarce. The objective of this study was to ascertain the prevalence of such conditions in the school-aged children residing in Sahrawi refugee camps. In particular, the objective was to develop a bespoke screening instrument for the collection of epidemiological data and the examination of the impact of these disorders on academic performance and school life. <b>Methods</b>: A cross-sectional observational study was conducted in 13 primary schools within Sahrawi refugee camps, with a target sample size of 3425 children aged 7-14. The Strengths and Difficulties Questionnaire (SDQ) was administered to teachers to identify any neurodevelopmental issues. <b>Results</b>: A total of 74 (2.2% [95% CI: 1.7-2.7%]) of the 3425 children displayed positive SDQ results for neurodevelopmental or psychiatric difficulties. The most frequently identified issues were emotional and conduct problems, which often co-occurred. Boys exhibited higher hyperactivity rates than girls. <b>Conclusions</b>: This study's findings revealed significant neurodevelopmental and psychiatric challenges in Sahrawi children, with implications for their academic and social development. The results emphasize the necessity of enhancing teacher training and mental health interventions to facilitate early identification and support.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719664","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}