Medical Principles and Practice最新文献

{"title":"Xenotransplantation of Solid Organs: Revolutionizing Transplantation through Innovation, Ethics, and Global Solutions.","authors":"Sami Alobaidi, Sami Alobaidi","doi":"10.1159/000546031","DOIUrl":"10.1159/000546031","url":null,"abstract":"<p><p><p>Xenotransplantation represents a transformative solution to the global organ shortage, leveraging advances in genetic engineering, immunosuppression, and biosecurity. This review explores groundbreaking innovations such as CRISPR-Cas9 and multigene editing, which have redefined immunogenicity reduction and significantly enhanced the graft survival. Key breakthroughs, including the incorporation of human complement-regulatory proteins and α-Gal knockout strategies, have propelled xenotransplantation closer to clinical application. Ethical considerations, such as zoonotic risks and patient selection criteria, are discussed alongside international regulatory efforts to standardize safety protocols. This manuscript uniquely highlights recent preclinical and clinical achievements, such as successful pig-to-human kidney and heart transplants, which underscore the field's potential for clinical translation. By addressing current challenges, such as long-term graft viability and societal acceptance, xenotransplantation is poised to bridge critical gaps in transplantation medicine. Future directions emphasize the integration of innovative technologies and collaborative frameworks to advance clinical applications responsibly. </p>.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"418-431"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021429","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 D-Dimer and Long-Term Major Adverse Cardiovascular Outcomes in Patients with Masked Hypertension.","authors":"Ugur Kokturk, Uğur Köktürk, Hamdi Püşüroğlu, İlyas Çetin, Mustafa Umut Somuncu, Mehmet Altunova, Ahmet Avcı, Mehmet Ertürk","doi":"10.1159/000546076","DOIUrl":"10.1159/000546076","url":null,"abstract":"<p><p><p>Objective: We investigated the relationship between D-dimer levels and long-term major adverse cardiovascular events (MACEs) in masked hypertension patients admitted to the cardiology outpatient clinic.</p><p><strong>Methods: </strong>A total of 512 masked hypertension patients with a median 6 years of follow-up data who underwent serum D-dimer measurement in the hypertension outpatient clinic between April 2014 and June 2016 were retrospectively enrolled. The patients were stratified according to their D-dimer levels and were then divided into tertiles. Clinical outcomes were assessed for MACEs, which were defined as all-cause mortality, cardiovascular mortality, nonfatal myocardial infarction, and nonfatal stroke.</p><p><strong>Results: </strong>The long-term incidence of MACE in masked hypertension patients was higher in the highest tertile of D-dimer. In multivariable analysis, D-dimer was an independent predictor of long-term MACE in masked hypertensive patients (OR: 1.006 [1.004-1.007]; p < 0.001). Compared to the lowest tertile, MACE was approximately 3 times higher in tertile 2 and approximately 10.5 times higher in the highest tertile. In addition, MACE was approximately 3.5 times more common in tertile 3 than in tertile 2. D-dimer was able to predict MACE in patients with masked hypertension (AUC for MACE 0.778; 95% CI: 0.724-0.832; p < 0.001) based on receiver operating characteristic curve analysis. In the Kaplan-Meier curve showing follow-up without MACE (MACE free) according to the D-dimer cutoff value, the long-term incidence of MACE was significantly higher in the high D-dimer group (p < 0.001).</p><p><strong>Conclusions: </strong>D-dimer levels in patients with masked hypertension showed a significant association with increased long-term risk of MACE in this study. </p>.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"491-499"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989682","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":"Comparison of Thyroid Uptake Values Measured from 131I Scintigraphy and Uptake Probe in Hyperthyroid Patients.","authors":"Nami Yeyin, Sinem Akyol, Lebriz Uslu-Beşli, Mustafa Demir","doi":"10.1159/000541147","DOIUrl":"10.1159/000541147","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Thyroid uptake test plays an important role in diagnosis, treatment planning and radioiodine dose determination in patients with hyperthyroidism. The aim of this study was to compare the % uptake values calculated with gamma camera and uptake probe after diagnostic 131I application in hyperthyroid patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;In this study, % uptake values were measured using a thyroid uptake probe and gamma camera in 32 patients who underwent thyroid radioiodine uptake measurement in our Nuclear Medicine center. Thyroid uptake measurements were prepared in the neck phantom with 0.74-0.925 MBq activity of 131I radionuclide. After counting the phantom with 131I separately in the uptake probe and gamma camera, 131I sample was orally administered to the patient. % uptake values were calculated by the uptake probe measurements and drawing regions of interest (ROI) from scintigraphic images at 2 and 24 h.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The 2-h mean % uptake values in the probe and gamma camera were calculated as 30.5 ± 20.4 and 27.1 ± 18.6, respectively. The 24-h mean % uptake values in the thyroid probe and gamma camera were calculated as 57.6 ± 21.9 and 55.3 ± 21.5, respectively. Linear regression analyses for the 2- and 24-h % uptake values calculated with the probe and gamma camera were found as R2 = 0.8412 and R2 = 0.7313, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The 2- and 24-h % uptake values with the probe and gamma camera were found to be consistent with each other, indicating that they can be safely used interchangeably in patients with hyperthyroidism.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Thyroid uptake test plays an important role in diagnosis, treatment planning and radioiodine dose determination in patients with hyperthyroidism. The aim of this study was to compare the % uptake values calculated with gamma camera and uptake probe after diagnostic 131I application in hyperthyroid patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;In this study, % uptake values were measured using a thyroid uptake probe and gamma camera in 32 patients who underwent thyroid radioiodine uptake measurement in our Nuclear Medicine center. Thyroid uptake measurements were prepared in the neck phantom with 0.74-0.925 MBq activity of 131I radionuclide. After counting the phantom with 131I separately in the uptake probe and gamma camera, 131I sample was orally administered to the patient. % uptake values were calculated by the uptake probe measurements and drawing regions of interest (ROI) from scintigraphic images at 2 and 24 h.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The 2-h mean % uptake values in the probe and gamma camera were calculated as 30.5 ± 20.4 and 27.1 ± 18.6, respectively. The 24-h mean % uptake values in the thyroid probe and gamma camera were calculated as 57.6 ± 21.9 and 55.3 ± 21.5, respectively. Linear regression analyses for the 2- and 24-h % uptake values calculated with the probe a","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"48-56"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120216","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":"Predictive Value of Age, Creatinine, and Ejection Fraction I and II Scores for Postoperative Atrial Fibrillation in Isolated On-Pump Coronary Artery Bypass Grafting Surgery: A Multicenter Retrospective Study.","authors":"Sameh Alagha, Serkan Mola, Mehmet Çeber, Alp Yıldırım","doi":"10.1159/000543188","DOIUrl":"10.1159/000543188","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study evaluated the predictive performance of age, creatinine, and ejection fraction (ACEF) I and II scores for the development of postoperative atrial fibrillation (PoAF) after isolated on-pump coronary artery bypass grafting (CABG) surgery and compared them with a novel nomogram model developed for PoAF prediction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Subjects and methods: &lt;/strong&gt;This retrospective multicenter study involved 511 patients who underwent isolated on-pump CABG. Their ACEF scores were calculated, and multivariate logistic regression analysis was performed to develop a nomogram model. The discriminative performance of the ACEF scores and the novel nomogram model was assessed using the area under the receiver operating characteristic curve (AUC).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 511 patients, 169 (33.1%) developed PoAF. The ACEF I and II scores showed moderate discriminative ability (AUC = 0.642 and 0.647, respectively), with no significant difference between them (p = 0.787). Logistic regression analyses identified age, preoperative hemoglobin levels, emergency procedure, chronic kidney disease or need for dialysis, preoperative β-blocker use, preoperative angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use, inotrope requirement, postoperative stroke, and postoperative potassium levels as independent predictors of PoAF. The novel nomogram model demonstrated greater predictive ability than the ACEF scores (AUC = 0.742, p &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;ACEF scores could be helpful risk stratification tools for PoAF after on-pump CABG procedures. Additional validation studies are required to confirm their clinical utility in diverse surgical procedures and patient populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study evaluated the predictive performance of age, creatinine, and ejection fraction (ACEF) I and II scores for the development of postoperative atrial fibrillation (PoAF) after isolated on-pump coronary artery bypass grafting (CABG) surgery and compared them with a novel nomogram model developed for PoAF prediction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Subjects and methods: &lt;/strong&gt;This retrospective multicenter study involved 511 patients who underwent isolated on-pump CABG. Their ACEF scores were calculated, and multivariate logistic regression analysis was performed to develop a nomogram model. The discriminative performance of the ACEF scores and the novel nomogram model was assessed using the area under the receiver operating characteristic curve (AUC).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 511 patients, 169 (33.1%) developed PoAF. The ACEF I and II scores showed moderate discriminative ability (AUC = 0.642 and 0.647, respectively), with no significant difference between them (p = 0.787). Logistic regression analyses identified age, preoperative hemoglobin levels, emergency procedure, chronic kidney disease or need for dialysis, preoperative β-blocker use, preoperative angiotensin","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"162-171"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007877","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 Valproate Therapy for Seizures, Migraines, and Bipolar Disorders.","authors":"Laxminarayana Kurady Bairy, Sampath Madhyastha","doi":"10.1159/000543555","DOIUrl":"10.1159/000543555","url":null,"abstract":"<p><p>Valproate, a widely utilized medication for epilepsy, mood disorders, and migraines, has attracted attention for its potential therapeutic benefits extending beyond its traditional uses. This review article compiles recent findings on the expanded utility of valproate outside of epilepsy, mood disorders, and migraines. The review acknowledges conflicting results, discusses opportunities for future research, and underlines both well-established and lesser-known adverse effects, along with possible interventions to mitigate these side effects. In addition to treating generalized and focal epilepsy, valproate has shown efficacy in managing status epilepticus, migraines, and manic episodes of bipolar disorder in conjunction with lithium. Anticipated as a valuable resource, this review aims to furnish researchers and clinicians with the most current and comprehensive information on the uses of valproate.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"301-315"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007874","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":"Risks of New-Onset Atrial Fibrillation after Coronary Artery Bypass Grafting.","authors":"Orhan Guvenc, Gamze Güvenç, Mesut Engin","doi":"10.1159/000545376","DOIUrl":"10.1159/000545376","url":null,"abstract":"","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"400-401"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710560","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":"Is Baricitinib Effective and Safe for Patients with Difficult-to-Treat Rheumatoid Arthritis? Comparative Data with the RA Group of Rheumatoid Arthritis not Difficult to Treat.","authors":"Ali Ekin,Salim Misirci,Ahmet Görünen,Belkis Nihan Coskun,Burcu Yagiz,Ediz Dalkilic,Yavuz Pehlivan","doi":"10.1159/000541488","DOIUrl":"https://doi.org/10.1159/000541488","url":null,"abstract":"OBJECTIVEThis study investigates the efficacy and safety of baricitinib, an oral targeted synthetic Disease Modifying Anti-Rheumatic Drugs (DMARD), in patients with difficult-to-treat rheumatoid arthritis (D2T RA) compared to those without, aiming to determine its potential as an alternative treatment for D2T RA.SUBJECT AND METHODSA total of 78 patients participated in this retrospective cohort study, with 33 meeting the D2T RA criteria and 45 were in the non-D2T RA group. Various clinical and laboratory parameters, adverse events, and disease activity indices were assessed, alongside drug efficacy and survival rates.RESULTSPatients with D2T RA exhibited higher seronegativity, prior use of bDMARDs and cDMARDs, and longer disease duration. Both groups experienced reductions in VAS and DAS28 scores, as well as SDAI, CDAI, HAQ, CRP, and ESR levels at baseline and 3, 6, and 12 months post-baricitinib initiation, with sustained efficacy observed over 12 months. The most prevalent adverse event was infection (28.21%). Although initial drug survival rates were similar between groups, the non-D2T RA group demonstrated higher rates at 24 months (46.70% vs. 59.40%). Subgroup analyses showed comparable survival rates between D2T RA and non-D2T RA groups, whether treated with baricitinib alone or in combination with methotrexate or leflunomide.CONCLUSIONDespite potential treatment resistance, patients meeting the D2T RA criteria shared similar safety and efficacy profiles with those non-D2T RA. Baricitinib emerges as a promising treatment option for D2T RA patients, offering effectiveness and safety comparable to the non-D2T RA group.","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":"75 1","pages":"1-19"},"PeriodicalIF":3.2,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Silver Dressings on Wound Healing Rate in Patients with Lower Extremity Ulcers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Qingling Yi,Zhongkui Huang,Bangli Tang","doi":"10.1159/000541331","DOIUrl":"https://doi.org/10.1159/000541331","url":null,"abstract":"OBJECTIVEThe ulcers of lower extremities, both venous and diabetic, impose a massive burden on sufferers globally. This meta-analysis evaluates the efficacy of silver dressings in improving healing rate of these ulcers.METHODSWe carried out comprehensive searches in PubMed, Embase, Web of Science, the Cochrane Library, and China National Knowledge Internet (CNKI) up to March 2024. Two reviewers independently screened the study and extracted data. While the primary outcome was wound healing rate, secondary outcomes included wound healing area and recurrence rate. Data were analyzed using Stata 16.0. software.RESULTSA total of 18 studies involving 1825 participants were included. Silver dressings demonstrated statistically significant effects in improving healing rates for diabetic foot ulcers (DFU) (OR 2.14, 95% CI: 1.52, 3.00, p = 0.00), whereas the effects were not statistically significant for venous leg ulcers (VLU) (OR 1.32, 95% CI: 0.97, 1.78, p = 0.07). Silver dressings also reduced ulcer area by 27.44 cm2 (95% CI 6.96 to 47.92) and recurrence rate of 45% (95% CI 0.11 to 1.79). Subgroup analysis revealed that the Asia-Pacific region and treatments of six weeks or less exhibited higher healing rates than their respective counterparts, although there was no statistical significance.CONCLUSIONSThis study indicated a statistically significant benefit of the treatment for DFU. However, the effect on VLU, though positive, did not reach statistical significance. This distinction should be considered in clinical application and further research.","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":"1 1","pages":"1-17"},"PeriodicalIF":3.2,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142205910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Significance of Nuclear Factor Kappa B (p65) among Breast Cancer Patients in Cape Coast Teaching Hospital.","authors":"Precious Barnes, Abraham Mensah, Leonard Derkyi-Kwarteng, Ernest Adankwa, Elvis Agbo, Ewura Seidu Yahaya, Benjamin Amoani, George Adjei, Samuel Mingyigilougu Apewe Ka-Chungu, Patrick Kafui Akakpo, Faustina Halm-Lai, Kwabena Dankwa, Daniel Amoako-Sakyi, Samuel Victor Nuvor, Dorcas Obiri-Yeboah, Roland Osei Saahene","doi":"10.1159/000539241","DOIUrl":"10.1159/000539241","url":null,"abstract":"<p><p>Breast cancer is the most prevalent cancer among African women, with high mortality rates in Ghana. Nuclear factor kappa B (NF-kB) has been associated with tumor progression in breast cancer. However, its clinical validation is controversial and understudied with no known published data on NF-kB (p65) among breast cancer patients in Ghana and other African countries. This study assessed the prognostic significance of NF-kB (p65) expression and its association with various clinicopathological features in breast cancer patients. Ninety formalin-fixed breast cancer tissues and 15 normal breast tissues were used to determine the expression of NF-kB (p65) using immunohistochemistry. We explored the correlation between expression of NF-kB (p65) and clinicopathological features. NF-kB (p65) was expressed in 86.7% of breast cancer tissues. There was a significant relationship between NF-kB (p65) expression and tumor grade, proliferation index (Ki67), and molecular subtype. High NF-kB (p65) expression in tumor grade 3 was about 10 times that of grade 1 (54.2% vs. 5.1%), and Ki67 &gt; 20 was 79.7% compared to 20.3% for Ki67 ≤ 20. Patients with triple-negative breast cancer (TNBC) had 49.1% overexpression of NF-kB (p65) compared to 17%, 25.4%, and 8.5% for luminal A, luminal B, and HER2 cases, respectively. This study demonstrates that NF-kB (p65) was highly expressed among breast cancer patients at Cape Coast Teaching Hospital, Ghana, especially in TNBC. NF-kB (p65) could serve as a biomarker for cancer stage, progression, prognosis and as a therapeutic target.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-11"},"PeriodicalIF":2.9,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898835","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":"Comparison of BAP65, DECAF, PEARL, and MEWS Scores in Predicting Respiratory Support Need in Hospitalized Exacerbation of Chronic Obstructive Lung Disease Patients.","authors":"Nilüfer Aylin Acet-Öztürk, Özge Aydin-Güçlü, Merve Nur Yildiz, Ezgi Demirdöğen, Aslı Görek Dilektaşli, Funda Coşkun, Esra Uzaslan, Ahmet Ursavaş, Mehmet Karadağ","doi":"10.1159/000538812","DOIUrl":"10.1159/000538812","url":null,"abstract":"<p><strong>Objective: </strong>Prognostic models aid clinical practice with decision-making on treatment and hospitalization in exacerbation of chronic obstructive lung disease (ECOPD). Although there are many studies with prognostic models, diagnostic accuracy is variable within and between models.</p><p><strong>Subjects and methods: </strong>We compared the prognostic performance of the BAP65 score, DECAF score, PEARL score, and modified early warning score (MEWS) in hospitalized patients with ECOPD, to estimate ventilatory support need.</p><p><strong>Results: </strong>This cross-sectional study consisted of 139 patients. Patients in need of noninvasive or invasive mechanical ventilation support are grouped as ventilatory support groups (n = 54). Comparison between receiver operating characteristic curves revealed that the DECAF score is significantly superior to the PEARL score (p = 0.04) in discriminating patients in need of ventilatory support. DECAF score with a cutoff value of 1 presented the highest sensitivity and BAP65 score with a cutoff value of 2 presented the highest specificity in predicting ventilatory support need. Multivariable analysis revealed that gender played a significant role in COPD exacerbation outcome, and arterial pCO2 and RDW measurements were also predictors of ventilatory support need. Within severity indexes, only the DECAF score was independently associated with the outcome. One-point increase in DECAF score created a 1.43 times higher risk of ventilatory support need. All severity indexes showed a correlation with age, comorbidity index, and dyspnea. BAP65 and DECAF scores also showed a correlation with length of stay.</p><p><strong>Conclusion: </strong>Objective and practical classifications are needed by clinicians to assess prognosis and initiate treatment accordingly. DECAF score is a strong candidate among severity indexes.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861958","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}