Medicine最新文献

{"title":"Addressing health issues and accessibility in Elttondoub village, Sudan: Perspectives from community leaders.","authors":"Ammar Elgadi, Reem Mustafa, Sara Muddathir, Sara Altraifi, Amar Shikhidris, Omar Abusalih, Omer Algali, Omer Hamid, Omer Omer, Alzhraa Hyder, Zahra Dafaalla, Zeinab Eltayeb, Zainab Mohammed, Sara Abdellateef, Sara Ali, Saria Tageldein, Sujood Fathi, Saeed Khalifa","doi":"10.1097/MD.0000000000043640","DOIUrl":"10.1097/MD.0000000000043640","url":null,"abstract":"<p><p>Sudan faces significant healthcare challenges in providing adequate healthcare, particularly in rural areas, due to a lack of infrastructure, trained medical professionals, and low health awareness. Elttondoub village faces various health problems related to endemic and chronic diseases, contaminated water sources, and poor healthcare accessibility. The present study aims to assess health issues and accessibility in Elttondoub village, reported by community leaders, and to draw effective strategies to improve healthcare accessibility and promote community involvement in healthcare. This community-based qualitative study involved 5 focus group discussions with community leaders and residents in Elttondoub villages, Sudan. The sample was purposive and volunteer-based, and consisted of teachers, medical workers, religious leaders, and the local people's committee. Data was collected through voice recordings and field notes, which were transcribed and analyzed thematically using Atlas.ti9. The interviews were based on the World Health Organization community health needs assessment and were translated into Arabic. A total of 23 community leaders were interviewed. There were several health problems in Elttondoub village, including malaria, chronic diseases, and water contamination. Healthcare accessibility was limited due to transportation, financial, and political issues. Also, there is a shortage of medical professionals. Residents showed good levels of health knowledge regarding their common endemic diseases. The main health challenges were the use of a first aid kit and when to seek medical advice. Medical professionals and religious leaders were the most trusted sources of health education, as the residents headed to them when they sought medical advice. Community solutions suggested included preventive measures, improving healthcare infrastructure, and organizing health education programs. The construction of roads and bridges over creeks and the completion of the landfill project were suggested as feasible ways to improve healthcare accessibility. The study emphasizes the need for health education programs by organizing health training sessions and workshops for the community. Community involvement and engaging with the government to address health issues and establish an appropriate environment for medical personnel to solve the shortage, and assist in educating residents about their health. Healthcare accessibility improvement by constructing roads and bridges will facilitate transportation.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43640"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appetite loss in patients with dyspepsia: A retrospective study of clinical characteristics and effectiveness of Korean medicine treatment.","authors":"Dahee Jeong, Na-Yeon Ha, Hae-In Jeong, Seok-Jae Ko, Jae-Woo Park, Jinsung Kim","doi":"10.1097/MD.0000000000043454","DOIUrl":"10.1097/MD.0000000000043454","url":null,"abstract":"<p><p>Loss of appetite is commonly observed in patients with dyspepsia in clinical practice. This study aimed to investigate the clinical characteristics and effectiveness of Korean medical treatment for patients with dyspepsia and appetite loss. Clinical records of 225 patients with dyspepsia who visited the Digestive Diseases Clinic of Kyung Hee University Korean Medicine Hospital between January 1, 2022, and July 31, 2024, were reviewed. Patients were classified into the anorexia with dyspepsia (AD) group (101) and non-anorexia with dyspepsia group (124), based on the presence of appetite loss. Clinical characteristics were analyzed accordingly. The AD group had a higher tendency to experience various gastrointestinal symptoms, including upper abdominal discomfort, early satiety, and upper abdominal bloating compared to the non-anorexia with dyspepsia group. Anorexia was positively linked to various aspects of quality of life, such as eating habits, energy levels, psychological, and role-functioning capacity. In electrogastrography analysis, the AD group exhibited a significantly higher preprandial dominant frequency. However, no significant differences were found in other electrogastrography parameters or heart rate variability results, indicating a limited impact of anorexia on physical function. Following 4 weeks of Korean medicine treatment, the AD group showed substantial improvements in overall quality of life. Dyspepsia accompanied by anorexia was more strongly linked to psychosocial and physical health challenges than dyspepsia with good appetite, highlighting Korean medical treatment as a potential therapeutic option for patients with anorexia.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43454"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nomogram model for poor surgical wound healing after the removal of thoracic and abdominal cavity drainage tube.","authors":"Fang Yang, Long Hu, Wenzhuo Liu, Qingmei Wang, Weizun Chang, Kaihong Ren, Qian Chen, Jiaxing Wang, Jing Chou","doi":"10.1097/MD.0000000000043379","DOIUrl":"10.1097/MD.0000000000043379","url":null,"abstract":"<p><p>Exploring the risk factors for poor surgical wound healing after the removal of thoracic and abdominal cavity drainage tube and constructing a nomogram model. We recruited 420 patients who underwent after the removal of thoracic and abdominal cavity drainage tube at Joint Logistic Support Force 921th Hospital from March 2021 to May 2024. A random number table method was utilized to allocate these patients into 2 cohorts for training (n = 294) and validation (n = 126), following a 7:3 ratio. Least absolute shrinkage and selection operator regression was applied to optimize the screening variables. Predictive models were developed using multifactorial logistic regression analysis with column line plots. Receiver operating characteristic curves, calibration curves, and Hosmer-Lemeshow goodness-of-fit tests were used to verify and evaluate the discrimination and calibration of the prediction models. Decision curve analysis was used to assess the clinical validity of the prediction models. Seven risk factors for predicting poor wound healing have been identified. This includes abnormal serum albumin, catheterization time, the volume of exudation during catheterization, duration of exudation, unplanned extubation, the volume of exudation after extubation, and incision infection. The Nomogram model demonstrated sufficient predictive accuracy, with area under the curve values of 0.930 (95% confidence interval: 0.890-0.970) and 0.948 (95% confidence interval: 0.888-1.000) in the training cohort and validation cohort, respectively. The calibration curve shows good consistency between the predicted risk of the model and the actual risk. The nomogram model established in this study for predicting poor surgical wound healing after the removal of thoracic and abdominal cavity drainage tube has good predictive value.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43379"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of ibuprofen and low-level laser therapy on pain intensity after elastomeric separator placement: A systematic review and network meta-analysis.","authors":"Shasha Gao, Peipei Wu, Yang Cheng","doi":"10.1097/MD.0000000000043559","DOIUrl":"10.1097/MD.0000000000043559","url":null,"abstract":"<p><strong>Background: </strong>This research aimed to assess the efficacy of ibuprofen and low-level laser therapy (LLLT) in pain reduction following the placement of elastomeric separators, utilizing a network meta-analysis (NMA) to synthesize data from relevant randomized controlled trials (RCTs). Our objective was to determine the most effective method for pain management in orthodontic patients.</p><p><strong>Methods: </strong>This study was registered with International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42025640519). A comprehensive literature search was conducted across various databases up to January 19, 2025, to identify RCTs evaluating the impact of ibuprofen and LLLT on pain intensity following orthodontic separator placement. The quality of the included studies was assessed using the Cochrane risk-of-bias tool. A NMA was performed to combine direct and indirect comparisons, ranking the interventions based on their effectiveness in alleviating pain at 6 hours and 24 hours after orthodontic separator placement.</p><p><strong>Results: </strong>Twenty-three studies with 1007 participants were included in the NMA. Both ibuprofen and LLLT demonstrated significantly greater reductions in pain intensity compared to control or placebo groups at all assessed time points. For ibuprofen, pain reduction was observed at 6-hour with a mean difference (MD) of -1.93 and a 95% confidence interval (CI) of -2.93 to -0.93, and at 24-hour with an MD of -1.63 (95% CI: -2.58 to -0.68). For LLLT, the MD at 6-hour was -1.46 (95% CI: -2.28 to -0.64), and at 24-hour, the MD was -1.84 (95% CI: -2.52 to -1.16). Ibuprofen showed greater effectiveness in reducing pain intensity at 6-hour, with a surface under the cumulative ranking curve (SUCRA) of 88.4, whereas LLLT demonstrated more sustained reduction at 24-hour, with a SUCRA of 81.8.</p><p><strong>Conclusion: </strong>This NMA provides evidence that both ibuprofen and LLLT are effective in reducing pain following elastomeric separator placement. Ibuprofen offers more immediate pain reduction, whereas LLLT offers more sustained effects over 24-hour. These findings suggest that a time-dependent, multimodal approach may be beneficial for optimizing orthodontic pain management. To further validate these findings and establish standardized clinical protocols, more high-quality randomized clinical trials are needed, particularly those involving direct, head-to-head comparisons between ibuprofen and LLLT.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43559"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous renal replacement therapy in a neonate with methylmalonic acidemia and severe hyperammonemia: A case report.","authors":"Bingchun Lin, Yichu Huang, Yanliang Yu, Xiaoyun Xiong, Chuanzhong Yang","doi":"10.1097/MD.0000000000042046","DOIUrl":"10.1097/MD.0000000000042046","url":null,"abstract":"<p><strong>Background: </strong>Methylmalonic acidemia (MMA) is a rare disease that is often misdiagnosed and overlooked. Metabolic acidosis and severe hyperammonemia are severe morbidities of MMA that demand immediate treatment.</p><p><strong>Casediagnosis: </strong>Here, we describe an MMA neonate with severe hyperammonemia and acidosis that was successfully rescued by continuous renal replacement therapy. A 6-day-old male neonate, with a gestational age of 39 + 3 weeks and a birth weight of 2880 g, was admitted to the emergency with the symptoms of \"cyanosis of the face and coma for 2 hours.\" The infant was suffering from hypoglycemia, hypocalcemia, severe hyperammonemia, and severe metabolic acidosis. After admission, the blood ammonia continued to rise, and continuous renal replacement therapy was promptly administered until the patient gradually regained consciousness. Blood tandem mass spectrometry and profiles revealed that methylmalonic acid and methyl citrate levels were significantly enhanced. Two heterozygous mutations were detected in the MUT gene, confirming the diagnosis of methylmalonic acidemia mut.</p><p><strong>Conclusions: </strong>The patient's symptoms gradually improved after receiving vitamin B12, l-carnitine, and specialized milk feeding. The patient was successfully discharged from the hospital after 41 days.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e42046"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deubiquitinase-associated mRNA signature model predicts prognosis and influences the immune microenvironment in patients with hepatocellular carcinoma: An observational study.","authors":"Haodong Liu, Yinan Liu, Shijie Liang, Zheng Yang, Wuning Mo","doi":"10.1097/MD.0000000000043442","DOIUrl":"10.1097/MD.0000000000043442","url":null,"abstract":"<p><p>Liver hepatocellular carcinoma (LIHC) represents a category of malignant neoplasms that present a considerable risk to public health. Recent studies have increasingly focused on the biological roles of messenger RNAs (mRNAs) linked to deubiquitinating enzymes in the context of LIHC. These deubiquitinating enzyme-associated mRNAs have been utilized to construct a prognostic model for this type of cancer. Prognostic mRNAs associated with LIHC were identified through univariate Cox regression and co-expression analysis. A clinical risk prediction model was established utilizing multivariate Cox regression and least absolute shrinkage and selection operator analysis, resulting in the stratification of patients into high-risk and low-risk categories. The model's accuracy and clinical significance were assessed through various methodologies, including receiver operating characteristic curves, area under the curve calculations, univariate and multivariate Cox regression analyses, principal component analysis, t-distributed stochastic neighbor embedding, Kaplan-Meier Plotter, gene set enrichment analysis, tumor mutation burden analysis, immune infiltration analysis, and drug sensitivity prediction. The UALCAN database was employed to validate the aberrant expression of the identified characteristic genes, and consistency clustering analysis was conducted to delineate and compare the molecular subtypes of LIHC. The risk model we developed exhibited robust predictive capabilities, with the high-risk cohort demonstrating reduced survival rates across various clinical contexts. This group also presented a more pronounced tumor mutation burden, exhibited stronger correlations with immune cell populations, and displayed heightened activation of numerous immune checkpoints. Notably, the characteristic genes (CBX2, ERGIC3, GNL2) were found to be aberrantly overexpressed in the cancer genome atlas cohort, correlating with unfavorable prognostic outcomes, and may play a role in tumor invasion and metastasis. Consistency clustering analysis revealed 3 distinct subtypes (C1, C2, C3), with subtype C3 showing elevated activation levels at the majority of immune checkpoints in comparison to subtypes C2 and C1, as well as increased sensitivity to pharmacological agents such as 5-fluorouracil and afatinib. The prognostic assessment model developed in this research offers an innovative approach for the identification of novel prognostic markers in patients diagnosed with (LIHC).</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43442"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of prolonged PCR positivity in COVID-19 patients.","authors":"Aytaj Allahverdiyeva, Sevim Mese, Naci Senkal, Alpay Medetalibeyoglu, Mustafa Onel, Hayriye Kirkoyun Uysal, Elvin Alaskarov, Ali Agacfidan","doi":"10.1097/MD.0000000000043581","DOIUrl":"10.1097/MD.0000000000043581","url":null,"abstract":"<p><p>This study aimed to investigate prolonged severe acute respiratory syndrome coronavirus-2 polymerase chain reaction (PCR) positivity in hospitalized COVID-19 patients and evaluate the diagnostic performance of rapid antigen tests (RAgT) compared to real-time reverse transcription-PCR (RT-PCR). A prospective single-center study included 82 patients with prolonged PCR positivity (≥28 days). Serial RT-PCR and RAgT were performed at days 7 to 10, 14 to 20, and 28 to 30 post-diagnosis. Clinical data, comorbidities, and laboratory parameters (inflammatory markers, hematological, and biochemical profiles) were analyzed. Statistical analyses included sensitivity, specificity, Cohen Kappa, and receiver operating characteristic curve assessment. RAgT demonstrated 100% sensitivity and 74% specificity relative to RT-PCR, with strong agreement (Cohen κ = 0.803, P* < .001). Inflammatory markers were elevated: C-reactive protein (median 3.55 mg/L), ferritin (510 µg/L), and D-dimer (1400 ng/mL). Comorbidities were present in 62% of patients, primarily hypertension (17%) and diabetes mellitus (15%). Female patients exhibited higher inflammatory markers (C-reactive protein, fibrinogen, and lactate dehydrogenase) and anemia prevalence. Receiver operating characteristic analysis revealed excellent discriminative performance (area under the curve = 0.99). RAgT showed high sensitivity in detecting severe acute respiratory syndrome coronavirus-2 among patients with prolonged PCR positivity, suggesting potential utility in differentiating active infection from residual viral RNA. Persistent PCR positivity may correlate with noninfectious viral shedding, and RAgT could complement RT-PCR in clinical decision-making, particularly in resource-limited settings. Further multicenter studies are needed to validate these findings and assess the impact of viral variants.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43581"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of anthropometric measurements of the hand on the development of carpal tunnel syndrome in female patients.","authors":"Memet Aslanyavrusu, Fahrettin Ege, Gülhan Sariçam","doi":"10.1097/MD.0000000000042981","DOIUrl":"10.1097/MD.0000000000042981","url":null,"abstract":"<p><p>This study aimed to evaluate whether anthropometric measurements and body mass index (BMI) are associated with the occurrence of carpal tunnel syndrome (CTS) in female patients. This cross-sectional, observational, case-control study included 100 women with symptoms of CTS and electrophysiological evidence of median nerve entrapment at the level of the carpal tunnel. 100 volunteers without symptoms of CTS and with normal electrophysiological results were included in the study as a control group. The external dimensions of the extended hand were measured in both groups. Hand ratio (HR), wrist ratio (WR), BMI, and electrophysiological results were compared between the 2 groups. The mean age of patients with CTS was 45.5 ± 10.38 years, compared to 39.0 ± 9.96 years in the control group (P < .003). The BMI was higher in the CTS group (31.2 ± 4.83 kg/m²) than in the controls (25.61 ± 3.60 kg/m²; t = 8.646, P < .001). HR was lower in CTS patients (2.27 ± 0.11) compared to controls (2.50 ± 0.11; t = -13.881, P < .001), while WR was higher in the CTS group (0.74 ± 0.03 vs 0.68 ± 0.02; t = 15.905, P < .001). These findings suggest that women with CTS tend to have lower HRs, higher WRs, and increased BMI compared to healthy individuals. Logistic regression showed that age was not a predictor of CTS, BMI had borderline significance, and smaller HRs along with thicker wrists significantly increased CTS risk.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e42981"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of virtual reality intervention on motor function in community-dwelling older adults: A systematic review and meta-analysis.","authors":"Yonggu Han, Seonggil Kim, Sunwook Park","doi":"10.1097/MD.0000000000043488","DOIUrl":"10.1097/MD.0000000000043488","url":null,"abstract":"<p><strong>Background: </strong>This systematic literature review analyzed the effects of virtual reality (VR) on physical function among community-dwelling older adults.</p><p><strong>Methods: </strong>Relevant studies published in CINAHL, Embase, PEDro, and PubMed databases were reviewed. Study quality was assessed using the Cochrane Risk of Bias 2 (RoB2) tool. A funnel plot supplemented with Egger regression test was used to analyze publication bias. Data analysis was performed using R Studio 4.2.2.</p><p><strong>Results: </strong>We included 20 out of 1240 studies. The overall effect size was 0.212 (95% confidence interval = 0.078-0.347). Control groups of 0.273 and 0.184 were observed for the general/conventional intervention and no intervention groups, respectively. During treatment periods, 0.290 and 0.065 were observed in the 1 to 8 and 9 to 12 week groups. Times per week values were 0.256 and 0.097 for the 2 to 3 and 1 times groups, respectively. RoB results showed that 0.315 and 0.066 indicated studies with low risk/some concern and high risk, respectively, confirming that VR improved the physical functions of older adults.</p><p><strong>Conclusions: </strong>The higher the number of treatments per week, the higher the quality of the included studies, and the higher the effect size. However, longer treatment periods were associated with reduced effect sizes. The results of this review will help to guide the development of effective VR interventions for community-dwelling older adults.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43488"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative research of epileptogenicity biomarkers and early prognosis after stereoscopic electroencephalography guided radiofrequency thermocoagulation in drug-resistant epilepsy patients.","authors":"Jingtao Yan, Yuhao Wang, Le Wang, Weipeng Jin, Deqiu Cui, Shaoya Yin","doi":"10.1097/MD.0000000000043334","DOIUrl":"10.1097/MD.0000000000043334","url":null,"abstract":"<p><p>Stereotactic electroencephalography (SEEG) is an important invasive assessment method in epilepsy surgery. After electrode implantation, SEEG-guided radiofrequency thermocoagulation (RF-TC) is performed on the discharge initiation and rapid propagation areas by monitoring intracranial electroencephalography. High-frequency oscillations (HFOs) and spikes are quantifiable epileptogenic biomarkers before and after RF-TC. This study aimed to quantitatively assess the changes in electrophysiological biomarkers - spikes and HFOs - before and after SEEG-guided RF-TC in drug-resistant epilepsy patients. We also sought to determine whether these changes, along with clinical characteristics, could serve as predictive factors for postoperative seizure outcomes. Three-minute segments of SEEG signals were analyzed in 44 patients before and after RF-TC. We used Anywave software to quantify the rate of spikes, rate of HFOs (80-512 Hz), rate of HFOs (80-250 Hz), and rate of HFOs (250-512 Hz). We analyzed the differences both at an individual level (paired t test and percentage) and at a group level (Fisher exact test). Logistic regression was used to analyze the possible influencing factors. After SEEG-guided RF-TC, 44 patients were included in the study; 25 patients showed clinical improvement, on the contrary 19 patients did not show clinical improvement. At an individual level of 44 patients, in the epileptic zone (EZ), 23 patients (52.3%) showed a significant intra-individual reduction of spikes. In the EZ, an intra-individual decrease in spikes was significantly more frequent in clinically improved patients than in not clinically improved patients (17 [68%] vs 6 [31.6%], P = .017). Duration of epileptic seizures (t = -2.052 P = .046 95% CI [-131.19--1.10]), frequency of seizure (χ = 8.636 P = .012), performance of magnetic resonance imaging (MRI) (χ = 3.889 P = .049) and spike of EZ (χ = 5.740 P = .017) had statistically significant effects on prognosis. Both faster frequency of seizure (OR = 0.025, 95% CI [0.001-0.469], P = .014) and positive performance of MRI (OR = 29.29, 95% CI [1.656-518.065], P = .021) presented a significant effect on clinically improved patients. Only both faster frequency of seizure (area under the curve = 0.739, 95% CI [0.588-0.890, P = .007) and spike ruduced of EZ (area under the curve = 0.682, 95% CI [0.520-0.844], P = .040) was predictive of clinical improvement. There may be difference in spikes in the EZ between clinically improved patients and clinically non-improved patients. Duration of seizure, frequency of seizure, positive MRI, and decreased spike rate in EZ after RF-TC were significantly associated with clinical improvement of seizures. More frequency of seizure and decreased spikes rate in EZ after RF-TC are significant in predicting the improvement of epileptic seizures.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43334"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}